Human Anatomy and Physiology with Pathophysiology

CHAPTER 6: SKELETAL SYSTEM: BONE AND JOINTS

OUTLINE I. FUNCTIONS OF THE SKELETAL SYSTEM
I. Functions of the Skeletal System
II. Extracellular Matrix 1. Support (provides framework; suited for bearing weight)
III. General Features of Bone 2. Protection (protects organs that it surrounds)
A. Structure of a Long Bone 3. Movement (contraction of skeletal muscle pulls the
B. Histology of Bone tendons)
C. Bone Ossification 4. Storage (minerals such as calcium and phosphorus)
D. Bone Growth 5. Blood cell production (red bone marrow produces RBC)
E. Bone Remodeling
F. Bone Repair
IV. Bone and Calcium Homeostasis
II. EXTRACELLULAR MATRIX
V. General Considerations of Bone Anatomy
VI. Axial Skeleton Components of Skeletal System
A. Skull
B. Auditory Ossicles • Bone
C. Hyoid
• Cartilage -reduce friction and model for bone formation
D. Vertebral Column
• Tendons -attach bone to muscle
E. Rib Cage
VII. Appendicular Skeleton • Ligaments -attach bone to bone
A. Pectoral Girdle All are connective tissues
B. Upper Limb
C. Pelvic Girdle Extracellular Matrix
D. Lower Limb
VIII. Joints Matrix contains collagen, ground substance, organic
IX. Effects of Aging on the Skeletal System and Joints molecules, water and minerals
X. Diseases
• Bone’s extracellular matrix -collagen and minerals flexible
and able to bear weight
Skeletal System
• Cartilage’s extracellular matrix -collagen and
proteoglycans (good shock absorber)
• Rigid framework to support the soft tissues of the body
• Tendons and ligaments’ extracellular matrix -collagen
and system of joints and levers to allow the body to move
(very tough)
• Consists of bones, as well as their associated connective
tissues including cartilage, tendons, ligaments Collagen -a tough ropelike protein
• Joint or articulation -place where two bones come
together Proteoglycans -large molecules that contains many
polysaccharides attached to proteins; store water between
polysaccharides

Hydroxyapatite -calcium phosphate crystal in the bone

Brittle bone disease -or osteogenesis imperfecta, imperfect

bone formation; a rare disorder caused by faulty genes
production that can result to little or poor-quality collagen
formation or poor-quality collagen

III. GENERAL FEATURES OF BONE

Based on shape:

• Long Bones -longer than wide and facilitate movement of

appendages (ex: humerus, femur, tibia, etc.)

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• Short Bones -approximately as wide as their long; helps Compact bone dense bone with few internal spaces
the transfer of force between the long bones (ex: carpals organized into osteons; forms the
and tarsals) diaphysis and covers the spongy bone of
• Flat Bones -relatively thin, flattened shape; well suited for the epiphyses
providing a strong barrier around soft organs (ex: cranial Medullary center of the diaphysis; red or yellow
bone, sternum, scapula, skull) cavity marrow
Yellow fat stored within the medullary cavity or in
• Irregular bones -complex in shape; bones that are not fit
marrow the spaces of spongy bone
into the other three categories; provides protection while
Red marrow blood forming cells; site of blood
allowing bending and flexing of certain body regions formation in adults
(vertebrae and facial)

Hematopoietic Tissue

‑ tissue that makes blood cells

• Red marrow -location of blood forming cells
• Yellow marrow -mostly fat
‑ Location:
• In newborns -most bones (red marrow)
• In adults -red is replaced with yellow marrow; red
marrow is mainly in epiphyses of femur and humerus

A. Structure of a Long Bone

B. Histology of Bone
Part Description Bone Cells
Diaphysis central shaft; compact bone tissue on the
outside part
• Osteocytes -maintain bone matrix; osteoblasts
Epiphysis two ends; spongy bone tissue; part of the
surrounded matrix
bone that develops from a center of
• Osteoblast -build bone; formation of the bones and repair
ossification distinct from the diaphysis
Periosteum membrane around bone’s outer surface; and remodeling of the bone; found in periosteum an
consist of dense connective tissue endosteum
Endosteum a thinner connective tissue that lines the • Osteoclast -carve bone; present and contribute to bone
medullary cavity repair and remodeling by removing existing bone called
Articular thin layer of hyaline cartilage that covers “bone reabsorption”
Cartilage the bone of the epiphyses where bone
articulates with other bones
Epiphyseal site of growth; between diaphysis and Bone tissue found throughout the skeleton is divided into two
plate epiphysis; only present when the long major types, based on the histological structure:
(growth plate) bone is still growing; when a bone stops
Compact Bone
growing it is replaced by the epiphyseal
line ‑ also known as cortical bone
Spongy bone bone having many small spaces; found ‑ Location: outer part of diaphysis (long bones) and thinner
mainly in the epiphysis; arranged into surfaces of other bones
trabeculae

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• Osteon/Haversian system -structural unit of compact
bone; includes lamella, lacunae, canaliculus, central canal,
osteocytes
• Lamella -rings of bone matrix; thin sheets
• Lacunae -spaces between lamella where osteocytes are
located
• Canaliculus -tiny canals where cells process extends from
the osteocytes; transport nutrients and remove waste
• Central canal -aka Haversian canal; center of osteon;
contains blood vessels
Steps:
1. Embryonic mesenchyme forms a collagen membrane
containing osteochondral progenitor cells.
2. Embryonic mesenchyme forms the periosteum, which
contains osteoblasts.
3. Osteochondral progenitor cells become osteoblasts at
centers of ossification; internally, the osteoblasts form
spongy bone; externally, the periosteal osteoblasts form
compact bone.
4. Intramembranous bone is remodeled and becomes
indistinguishable from endochondral bone.

Endochondral Ossification

‑ bone formation inside cartilage; cartilage models are

replaced by bone (ex: all bones except skull)

Steps:

Spongy Bone Tissue 1. Embryonic mesenchymal cells become chondroblasts,

which produce a cartilage model surrounded by the
‑ cancellous bone perichondrium.
‑ no osteons 2. Chondrocytes hypertrophy, the cartilage matrix becomes
‑ Location: calcified, and the chondrocytes die.
epiphyses of long 3. The perichondrium becomes the periosteum when
bones and center osteochondral progenitor cells within the periosteum
of other bones become osteoblasts.
4. Blood vessels and osteoblasts from the periosteum invade
• Trabeculae - the calcified cartilage template; internally, these
interconnecting osteoblasts form spongy bone at primary ossification
rods, spaces centers (and later at secondary ossification centers)
contain marrow externally, the periosteal osteoblasts form compact bone.
5. Endochondral bone is remodeled and becomes
indistinguishable from intramembranous bone.
C. Bone Ossification

• Ossification -process of bone formation (occurs in utero) Timetable of Human Ossification

• Osteoblast’s role: build bone; after an osteoblast
becomes surrounded by bone matrix it becomes an Time Period Bones Affected
Third month of Ossification in long bones
osteocyte
embryonic development beginning
• Ossification center -where bone formation begins
Fourth month Most primary ossification
o Primary ossification center -where bone first begins centers have appeared in the
to appear; forms diaphysis diaphysis of bone
o Secondary ossification center -forms epiphyses Birth to 5 years Secondary ossification centers
appear in the epiphyses
5-12 years in females, 5- Ossification is spreading rapidly
Intramembranous Ossification 14 years in males from the ossification centers
and various bones are becoming
‑ bone formation within connective tissue membranes; ossified
osteoblasts build bone (ex: skull bone) 17 to 20 years Bone of upper limbs and
‑ occurs in a 12-week-old fetus at ossification centers in the scapulae becoming completely
flat bones of the skull ossified

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 18 to 23 years Bones of the lower limbs and of 3. Cartilage model forms first then, osteoblasts enter the
coxas become completely callus and from cancellous bone this continues for 4-6
ossified weeks after injury.
23 to 25 years Bone of the sternum, clavicles 4. Cancellous bone is slowly remodeled to form compact and
and vertebrae become cancellous bone.
completely ossified
By 25 years Nearly all bones are completely
ossified

D. Bone Growth

Infancy and youth:

• Long bones lengthen and epiphyseal late

• Long bones widen by adding more lamella

Appositional growth -increase in bone width and diameter
End of bone growth (in length): epiphyseal plate is replaces by
an epiphyseal line
Classification of Bone Fracture
According to the severity of the injury to the soft tissues:
• Open fracture -formerly called a compound fracture;
wound extends to the site of the fractures or a fragment
of bone protrudes through the skin
• Closed fracture -formerly called a simple fracture; skin is
not perforated; damaged is only in the inside
• Complicated fracture -when soft tissues around a closed
fracture are damaged

Other types of bone fractures:

• Incomplete fracture -does not extend completely in the

bone; sliced
o green stick fracture -incomplete fracture on the
convex side of the curve of the bone; bends and
cracks
o hairline fracture -incomplete fractures which two
sections of the bone do not separate; common in
E. Bone Remodeling skull; small crack or severe bruise
• Complete fracture -broken into two pieces
‑ removal of existing bone by osteoclasts and deposition of
o communicated fracture -complete fracture in which
new bone by osteoblasts
the bone breaks into more than two pieces; usually
‑ occurs in all bones
two major and smaller fragments
‑ responsible for changes in bone shape, bone repair,
• Impacted fracture -a piece is driven into the spongy
adjustment of bone to stress, and calcium ion regulation
portion

According to the direction of the fracture:

F. Bone Repair
1. Broken bone causes bleeding and a blood clot forms.
2. Callus forms which is a fibrous network between 2
fragment.
• internal callus -forms between the ends of the broken
bone, as well as in the marrow cavity if the fracture
occurs in the diaphysis of a long bone
• external callus -forms a collar around the opposing
ends of the bone fragments
• Linear fractures -run parallel to the length of the bone
• Transverse fractures -right angles to the length of the
bone
• Spiral fractures -take a helical course around the bone
• Oblique fractures -run obliquely in the relation to the
length of the bone
• Dentate fractures -have rough, toothed, broken ends
• Stellate fractures -have breakage lines radiating from a
central point

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 Angle bend
Ramus branch off the body beyond the angle
Condyle smooth, rounded articular surface
Facet small, flattened articular surface
Ridges
Line, linea low ridge
Crest, crista prominent ridge
Spine very high ridge
Projections
Process prominent projection
Tubercle small, rounded bump
Tuberosity, knob; larger than a tubercle
IV. BONE AND CALCIUM HOMEOSTASIS tuber
• Bone is a major storage site for calcium Trochanter tuberosity on the proximal femur
Epicondyle enlargement near or above a condyle
• Movement of calcium in and out of bone helps determine
Lingula flat, tongue-shaped process
blood levels of calcium
Hamulus hook-shaped process
• Calcium moves into bone as osteoblasts build new bone
Cornu horn-shaped process
• Calcium moves out of bone as osteoclasts break down Openings
bone Foramen hole
Calcium homeostasis is maintained by three hormones: Canal, meatus tunnel
Fissure cleft
• parathyroid hormone (PTH) from parathyroid glands Sinus, cavity
• vitamin D from the skin or diet labyrinth
• calcitonin from the thyroid gland Depressions
Fossa general term for a depression
PTH and Vitamin D raise blood Ca2+ levels, whereas Notch depression in the margin of a bone
calcitonin lowers blood Ca2+ levels. Fovea little pit
Groove, ulcus deep, narrow depression
Calcium Homeostasis Process

1. Decreased blood Ca2+ stimulates PTH secretion from Axial Skeleton (80 Bones)
parathyroid glands.
2. PTH stimulates osteoclasts to break down bone and SKULL (CRANIUM) (22 BONES)
release Ca2+ into the blood. Braincase Parietal 2
3. In the kidneys, PTH increases Ca2+ reabsorption from the (neurocranium) Temporal 2
urine. PTH also stimulates active Vitamin D formation. Frontal 1
4. Vitamin D promotes Ca2+ absorption from the small Occipital 1
intestine into the blood. Sphenoid 1
5. Increased blood Ca2+ stimulates calcitonin secretion from Ethmoid 1
the thyroid gland. Face Maxilla 2
6. Calcitonin inhibits osteoclasts, which allows for enhanced (viscerocranium) Zygomatic 2
osteoblast uptake of Ca2+ from the blood to deposit into Palatine 2
bone. Nasal 2
Lacrimal 2
Inferior nasal concha 2
Mandible 1
V. GENERAL CONSIDERATIONS OF BONE ANATOMY
Vomer 1
Anatomical Terms for Features of Bones AUDITORY OSSICLES (6 BONES)
Term Description Malleus 2
Major Features Incus 2
Body, shaft main portion Stapes 2
Head enlarged (often rounded) end HYOID (1 BONE)
Neck constricted area between head and body VERTEBRAL COLUMN (26 BONES)
Margin, edge Cervical Vertebrae 7
border Thoracic Vertebrae 12

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 Lumbar Vertebrae 5 VI. AXIAL SKELETON
Sacrum 1
Coccyx 1 ‑ falls on the axis of the body
THORACIC CAGE (25 BONES) ‑ composed of the skull, auditory ossicles, hyoid bone,
Ribs 24 vertebral column, and thoracic cage
Sternum (3 parts, sometimes considered 3 1 ‑ protects the brain, the spinal cord, and the vital organs
bones) housed within the thorax

Appendicular Skeleton (126 Bones)

A. Skull
GIRDLE AND UPPER LIMB (64 BONES) ‑ superior portion of the axial skeleton
Pectoral Girdle Scapula 2 ‑ protects the brain and houses the eyes, ears, nose, and
Clavicle 2 mouth
Upper Limb Humerus 2 ‑ calvaria/skullcap -top of the skull
Ulna 2 ‑ composed of 22 bones divided into:
Radius 2
• Braincase/neurocranium (8)
Carpal bones 16
• Facial bones/viscerocranium (14)
Metacarpal bones 10
Phalanges 28
GIRDLE AND LOWER LIMB (62 BONES) Lateral View
Pelvic Girdle Coxal bone 2
Lower Limb Femur 2
Tibia 2
Fibula 2
Patella 2
Tarsal bones 14
Metatarsal bones 10
Phalanges 28
TOTAL BONES: 206

Frontal View

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PROCESSES AND OTHER FEATURES OF THE SKULL

Feature Location Description

External Features
Alveolar process Mandible, maxilla Ridges on the mandible and maxilla containing the teeth
Angle Mandible Posterior, inferior corner of the mandible
Coronoid process Mandible Attachment point for the temporalis muscle
Mental protuberance Mandible Chin (resembles a bent knee)
Horizontal plate Palatine Posterior third of the hard palate
Mandibular condyle Mandible Region where the mandible articulates with the skull
Mandibular fossa Temporal Depression where the mandible articulates with the skull
Mastoid process Temporal Enlargement posterior to the ear; attachment site for several muscles that move the
head
Nuchal lines Occipital Attachment points for several posterior neck muscles
Occipital condyle Occipital Point of articulation between the skull and the vertebral column
Palatine process Maxilla Anterior two-thirds of the hard palate
Pterygoid hamulus Sphenoid Hooked process on the inferior end of the medial pterygoid plate, around which the
tendon of one palatine muscle passes; an important dental landmark
Pterygoid plates Sphenoid Hooked process on the inferior end of the medial pterygoid plate, around which the
(medial and lateral) tendon of one palatine muscle passes; an important dental landmark
Ramus Mandible Portion of the mandible superior to the angle
Styloid process Temporal Attachment site for three muscles (to the tongue, pharynx, and hyoid bone) and
some ligaments
Temporal lines Parietal Attachment site for the temporalis muscle, which closes the jaw
Internal Features
Crista galli Ethmoid Process in the anterior part of the braincase to which one of the connective tissue
coverings of the brain (dura mater) connects
Petrous portion Temporal Thick, interior part of temporal bone containing the middle and inner ears and the
auditory ossicles
Sella turcica Sphenoid Bony structure, resembling a saddle, in which the pituitary gland is located

Braincase/Neurocranium o Foramen magnum -part of occipital bone; hole where

spinal cord joins brainstem
• Sphenoid bone -found a little deeper inside the skull;
butterfly shaped appearance; composed of two main
parts: greater wing and lesser wing
• Ethmoid bone -middle portion of the cranial floor

Sutures:

• sagittal suture -where two parietal bones meet

• coronal suture -where parietal and frontal bone connects
• lambdoidal suture -where parietal and occipital bone
connects
• Frontal bone -comprised anterior 1/3 of cranium; entire • squamous suture -connects parietal and temporal bone
forehead; frontal sinus is found
o Sinus -potential space which makes the skull light
weight
• Parietal bones -left and right; form the middle segment
• Temporal bone -forms the sides of the cranium; it extends
inward forming the floor of cranial canal
o external auditory canal -ear canal; a canal that
enables sound waves to reach the eardrum
• Occipital bone -posterior aspects of the cranium

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Facial Bones Inferior View

• Maxilla -upper jawbone; gives support to the face from

the eyes down to the mouth
• Palatine bones -hard palate (roof of the mouth)
• Zygomatic bones -cheek bones; forms the lower orbit;
floor of the eyes
o zygomatic arch -forms a bridge across the side of the
face and provides a major attachment site for a
muscle moving the mandible
• Lacrimal bones -medial wall of the orbit
• Nasal bones -upper third of nose
• Inferior nasal conchae -also called turbinate; thin curved
bones projecting medially
• Vomer -forms the lower portion of the nasal septum
• Mandible -lower jawbone; only movable bone in the face
o Temporomandibular joint (TMJ) -where mandible
connects with the temple to allow jaw movement

Bones Forming the Orbit

Superior View
• Frontal – roof
• Sphenoid – roof and posterolateral wall
• Zygomatic – lateral wall
• Maxilla – floor
• Lacrimal – medial wall
• Ethmoid – medial wall
• Palatine – medial wall

Bones Forming the Nasal Cavity

• Frontal – roof
• Nasal – roof
• Sphenoid – roof
• Ethmoid – roof, septum, lateral wall
• Inferior nasal concha – lateral wall
• Lacrimal – lateral wall
• Maxilla – floor
• Palatine – floor and lateral wall
• Vomer – septum

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SKULL FORAMINA, FISSURES, AND CANALS

Opening Location Structures Passing Through Openings

Carotid canal Temporal Carotid artery and carotid sympathetic nerve plexus
Ethmoidal foramina, Between frontal and ethmoid Anterior and posterior ethmoidal nerves
anterior and posterior
External auditory canal Temporal Sound waves en route to the eardrum
Foramen lacerum Between temporal, occipital, The foramen is filled with cartilage during life; the carotid canal
and sphenoid and pterygoid canal cross its superior part but do not actually pass
through it
Foramen magnum Occipital Spinal cord, accessory nerves, and vertebral arteries
Foramen ovale Sphenoid Mandibular division of trigeminal nerve
Foramen rotundum Sphenoid Maxillary division of trigeminal nerve
Foramen spinosum Sphenoid Middle meningeal artery
Hypoglossal canal Occipital Hypoglossal nerve
Incisive foramen (canal) Between maxillae Incisive nerve
Inferior orbital fissure Between sphenoid and maxilla Infraorbital nerve and blood vessels and zygomatic nerve
Infraorbital foramen Maxilla Infraorbital nerve
Internal auditory canal Temporal Facial nerve and vestibulocochlear nerve
Jugular foramen Between temporal and occipital Internal jugular vein, glossopharyngeal nerve, vagus nerve, and
accessory nerve
Mandibular foramen Mandible Inferior alveolar nerve to the mandibular teeth
Mental foramen Mandible Mental nerve
Nasolacrimal canal Between lacrimal and maxilla Nasolacrimal (tear) duct
Olfactory foramina Ethmoid Olfactory nerves
Optic canal Sphenoid Optic nerve and ophthalmic artery
Palatine foramina, Palatine Palatine nerves
anterior and posterior
Pterygoid canal Sphenoid Sympathetic and parasympathetic nerves to the face
Sphenopalatine foramen Between palatine and sphenoid Nasopalatine nerve and sphenopalatine blood vessels
Stylomastoid foramen Temporal Facial nerve
Superior orbital fissures Sphenoid Oculomotor nerve, trochlear nerve, ophthalmic division of
trigeminal nerve, abducens nerve, and ophthalmic veins
Supraorbital foramen or Frontal Supraorbital nerve and vessels
notch
Zygomaticofacial foramen Zygomatic Zygomaticofacial nerve
Zygomaticotemporal Zygomatic Zygomaticotemporal nerve
foramen

Paranasal Sinuses B. Auditory Ossicles

‑ smallest bones in the body

‑ amplifies sound and change the information from sound
to vibration
• malleus (hammer)
• incus (anvil)
• stapes (stirrup)

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C. Hyoid Four major curvatures:

‑ not part of skull and vertebral column • cervical curve (anteriorly)

‑ found near the throat
‑ u-shaped bone which functions as an attachment for
tongue muscle
‑ floating bone; not attached to other bone
• thoracic curve (posteriorly)
• lumbar curve (anteriorly)
• sacral curve (posteriorly)

CLIINICAL IMPACT

Abnormal Spinal Curvatures

• Lordosis -inward curvature of the spine; swayback;

abnormal anterior curvature
• Kyphosis -outward curvature of the spine; hunchback;
abnormal posterior curvature
• Scoliosis -sideways curvature; abnormal lateral curvature

D. Vertebral Column

‑ composed of 26 irregular bones called vertebrae

• 7 cervical vertebrae
• 12 thoracic vertebrae
• 5 lumbar vertebrae
• 1 sacral bone (5 fused)
• 1 coccyx bone (4 fused)
‑ functions:
• supports the weight of the head and trunk
• protects the spinal cord
• allows spinal nerves to exit the spinal cord
• provides a site for muscle attachment Typical Vertebra
• permits movement of the head and trunk
‑ appearance of all vertebrae except C1, C2, sacrum, and
coccyx

General Structure of a Vertebra

Feature Description
Body Disk-shaped; usually the largest part
with flat surfaces directed superiorly
and inferiorly; forms the anterior
wall of the vertebral foramen;
intervertebral disks are located
between the bodies
Vertebral foramen Hole in each vertebra through which
the spinal cord passes; adjacent
vertebral foramina form the
vertebral canal

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 Vertebral arch Forms the lateral and posterior walls Axis (C2)
of the vertebral foramen; possesses
several processes and articular ‑ 2nd cervical vertebra
surfaces ‑ rotates head
Pedicle Foot of the arch with one on each ‑ dens or odontoid process -pierces through the atlas to act
side; forms the lateral walls of the as pivot for the rotation of C1 and skull
vertebral foramen
Lamina Posterior part of the arch; forms the
posterior wall of the vertebral
foramen
Transverse process Process projecting laterally from the
junction of the lamina and pedicle; a
site of muscle attachment
Spinous process Process projecting posteriorly at the
point where the two laminae join; a
site of muscle attachment;
strengthens the vertebral column
and allows for movement
Articular processes Superior and inferior projections
containing articular facets where Thoracic Vertebrae
vertebrae articulate with each other;
strengthen the vertebral column and ‑ possess long, thin spinous processes that are directed
allow for movement inferiorly
Intervertebral Form intervertebral foramina ‑ have extra articular facets on their lateral surfaces that
notches between two adjacent vertebrae articulate with the ribs
through which spinal nerves exit the
vertebral canal

Cervical Vertebrae

‑ have small bodies, except for the atlas, which has no body
‑ dislocations and fractures are more common in this area
‑ C7 has the longest spinous process
‑ Whiplash -traumatic hyperextension of the cervical
vertebrae
Lumbar Vertebrae

‑ have large, thick bodies and heavy, rectangular transverse

and spinous processes
‑ low back pain and other medical ailments are more
common in this area

Atlas (C1)

‑ 1st cervical vertebra

ringlike vertebra that carries the skull/head
‑ has no body and no spinous process, but it has large
superior facets

Sacral Vertebrae

‑ five vertebrae fused into a single bone called the sacrum

• alae -wing-shaped areas in the superior surfaces of the
lateral parts

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• auricular surfaces -ear-shaped in the lateral surfaces E. Rib Cage
• median sacral crest -fusion of spinous processes of the
‑ protects vital organs within the thorax and prevents the
first four sacral vertebrae
collapse of the thorax during respiration
• sacral hiatus -usually the site of anesthetic injections
‑ made up of 25 bones:
• transverse lines -where the individual sacral vertebrae
• 12 pairs of ribs
fuse
• 1 sternum
• sacral promontory -bulges of the anterior edge of the
body of first sacral vertebra

Coccyx

‑ inferior portion
‑ also called as tail bone
‑ usually consists of three to five semi-fused vertebrae that
form a triangle, with the apex directed inferiorly

Ribs and Costal Cartilages

True ribs (1-7)

‑ aka vertebrosternal; superior 7 pairs

‑ attached directly to the sternum through costal cartilage

False ribs (8-12)

‑ inferior 5 pairs
Comparison of Vertebral Regions
‑ do not directly connect to the sternum
Feature Cervical Thoracic Lumbar • Vertebrochondral ribs (8-10) -upper 3 pairs; indirectly
Body Absent in C1, Medium-sized Large connected to the sternum
small in others with articular • Floating ribs (11-12) -aka vertebral ribs; lower 2 pairs; not
facets for ribs connected at all
Transverse Transverse Articular facets Square
process foramen for ribs, except
T11 and T12
Spinous Absent in C1, Long, angled Square Sternum
process bifid in others, inferiorly
except C7 ‑ breastbone
Articular Face superior/ Face obliquely Face medial/ ‑ divided into three parts:
facets inferior lateral
• Manubrium
• Sternal body/ Gladiolus
Intervertebral Discs • Xiphoid process

‑ pads of fibrocartilage that separates the vertebral bodies
‑ provide additional support and prevent the vertebral
bodies from rubbing against each other
‑ consist of:
• external annulus fibrosus
• internal, gelatinous nucleus pulposus
Sternal notch -separation of manubrium and gladiolus
Jugular notch -aka suprasternal notch; between the ends of
the clavicle which articulates with the sternum
Sternal angle -slight elevation in the sternum; important
landmark for locating the second ribs

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 VII. APPENDICULAR SKELETON Humerus

‑ consists of the bones of the upper and lower limbs, as well ‑ large, long bone of the arm
as the girdles, which attach the limbs to the axial skeleton
‑ upper extremity (64 bones) Anatomy of Humerus
‑ lower extremity (62 bones) Parts Description
head rounded proximal portion
anatomical neck around the edge of the humeral head
surgical neck located at the proximal end of the
A. Pectoral Girdle
humeral shaft
‑ consists of four bones (2 scapulae and 2 clavicles) greater tubercle bump; for muscle attachment
lesser tubercle for muscle attachment
Scapula intertubercular groove between the two tubercles
groove/bicipital that contains one tendon of the biceps
‑ or shoulder blade groove brachii muscle
‑ connects the upper extremity to the trunk only by the deltoid tuberosity muscle attachment for deltoid muscle;
clavicle protruded
‑ flat, triangular bone with three large fossae where capitulum lateral portion of the articular surface;
muscles extending to the arm are attached articulates with the radius
• glenoid cavity -fourth fossa where the head of the trochlea medial portion; articulates with the
humerus connects to the scapula ulna
• acromion process -form a protective cover for the lateral and medial points of attachment for the muscles
shoulder joint; form the attachment site for the clavicle; epicondyles of the forearm
provide attachment
• points for some of the shoulder muscles

Clavicle

‑ or collar bone
‑ attached to the sternum
‑ a long bone with a slight sigmoid (S-shaped) curve

Forearm

Radius

‑ lateral bone that articulates with capitulum

Ulna
B. Upper limb
‑ medial to the radius; longer bone than radius
‑ consists of the bones of the arm, forearm, wrist, and hand
• trochlear notch -fits over the trochlea of the humerus
• olecranon process -elbow
Arm
• coronoid process -helps complete the “grip” of the ulna
‑ region between the shoulder and the elbow • styloid process -where ligaments of the wrist are attached
• radial tuberosity -where biceps brachii attaches
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Wrist • Pelvis -includes pelvic girdle and coccyx
o False pelvis/Pelvis minor -part of pelvic girdle that is
Carpals
above the pelvic inlet
o True pelvis/Pelvis major -part of pelvic girdle that is
• Scaphoid (boat-shaped)
below the pelvic inlet
• Lunate (moon-shaped)
• iliac crest -can be seen along the superior margin of each
• Triquetrum (three-cornered)
ilium
• Pisiform (pea-shaped)
• acetabulum -socket of the hip joint
• Hamate (has a hooked process)
• obturator foramen -large hole in each hip bone
• Capitate (head-shaped)
• Trapezoid (similar to a four-sided geometric form with
two parallel sides) Differences Between the Male Pelvis and the Female Pelvis
• Trapezium (named after a four-sided geometric form with
no two sides parallel) Female pelvis -wider than male designed for childbearing

Area Description
General In females, somewhat lighter in weight
and wider laterally but shorter superiorly
to inferiorly and less funnel-shaped; less
obvious muscle attachment points in
females
Sacrum Broader in females, with the inferior part
directed more posteriorly; the sacral
promontory does not project as far
anteriorly in females
Pelvic inlet Heart-shaped in males; oval in females
Pelvic outlet Broader and more shallow in females
Subpubic Less than 90 degrees in males; 90 degrees
angle or more in females
So Long Top Part, Here Comes The Thumb Ilium More shallow and flared laterally in
females
Ischial spines Farther apart in females
Hand Ischial Turned laterally in females and medially in
tuberosities males
• Metacarpal (hands)
• Phalanges (fingers)
D. Lower Limb

‑ consists of the bones of the thigh, leg, ankle, and foot

C. Pelvic Girdle

‑ where lower limbs attach to body Thigh

‑ 3 bones fused as one
• ilium -most lateral and most superior part of pelvic
girdle; bowl like wall of pelvis
• ischium -inferior and posterior region
• pubis - hip socket (joint)
Femur
‑ longest bone; region between the hip and the knee
• head of femur -large spherical enlargement; attached to
pelvic bone
• greater trochanter and lesser trochanter -bump for
muscle attachment
• linea espera -ridge or depression running through the
shaft/body of the bone
• lateral epicondyle -for support

Patella

‑ knee cap; enables the tendon to bend over the knee;

sesamoid bone

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 VIII. JOINTS

Joints

‑ also called as articulations

‑ where 2 or more bones join together

Can be classified according to:

• Structure
o Fibrous
o Cartilaginous
o Synovial
• Function
o Synarthroses (non-movable)
o Amphiarthroses (slightly movable)
o Diarthroses (freely movable)

Leg Classification According to Structure:

• Tibia -larger and major weight-bearing bone of the leg Fibrous Joints
• Fibula -smaller; more lateral bone ‑ where 2 bones are united by fibrous connective tissue
‑ no joint cavity and has no movement
Ankle and Foot ‑ simply bind bones together

• Tarsals -ankle 3 Types:

• Metatarsals -foot
• Suture -joints between 2 flat bones, connects the cranial
• Phalanges -toes and fingers
bones
o Fontanels -soft spot in the skull of an infant; because
of immaturity; allows childbirth
• Syndesmosis -bands of fibrous tissue that binds 2 bones
separated by some distance and held together by distance
• Gomphosis -joint between tooth and socket; held
together by ligaments
Tarsals
Cartilaginous Joints
• Calcaneus
• Talus ‑ where 2 bones are united by cartilage
• Navicular ‑ provides slight movement
• Cuboid 2 Types:
• Cuneiforms
• Synchondrosis -hyaline cartilage, immovable (example:
costal cartilage)
• Symphysis -fibrocartilage, compressible fibrocartilaginous
pad that connects two bones; slight movement (example:
intervertebral disk, pubis symphysis)

Synovial Joints

‑ freely movable joints

‑ forms a cavity between 2 bones containing fluid called
synovial fluid
‑ usually found in appendicular bones

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Several Features of Synovial Joints:

• Articular cartilage -covers the articular surfaces of bones

within synovial joints
• Joint cavity -space in between
• Joint capsule -surrounds the cavity, which helps hold the
bones together while still allowing movement
• Synovial membrane -lines the joint cavity everywhere • Saddle -consist of two saddle-shaped articulating surfaces
except over the articular cartilage oriented at right angles to each other; movement in these
• Synovial fluid -forms a thin, lubricating film covering the joints can occur in two planes
surfaces of the joint Example: between the metacarpal bone and the carpal
• Bursa -lining of joint capsule bone (trapezium) of the thumb
o Bursitis -inflammation of bursa

6 Types:

• Gliding -plane joints; consist of two opposed fat surfaces

that glide over each other
Example: articular facets between vertebrae

• Ball and Socket -allows a wide range of movement in

almost any direction; consist of a ball (head) at the end of
one bone and a socket in an adjacent bone into which a
portion of the ball fits
Example: shoulder and hip joints

• Hinge -permit movement in one plane only; consist of a

convex cylinder of one bone applied to a corresponding
concavity of the other bone
Example: elbow and knee joint

Fetal Skull

• made up of partly ossified skull bones and largely of

fibrous and cartilaginous tissue
• Pivot -restrict movement to rotation around a single axis; • Sutures -lines of union
consists of a cylindrical bony process that rotates within a • Fontanels -fibrous spaces between bone which have not
ring composed partly of bone and partly of ligament completely united
Example: shaking the head “no”

• Ellipsoid -condyloid joints; elongated ball-and-socket

joints; shape of the joint limits its range of movement
nearly to that of a hinge motion, but in two planes
Example: joint between the occipital condyles of the skull
and the atlas

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 • Pronation -rotation of forearm so the palm is faced down
• Supination -palm face up

• Sphenoidal (2)
• Posterior
• Anterior
• Mastoid (2)
• Eversion -plantar surface turns laterally
• Inversion -plantar surface faces medially

Joint Movement

• Flexion -decreasing the angle of joints to bring articulating

bones closer or to bend
• Extension -straightening movement that increases angle
of joints to extend articulating bones (normal position)
• Hyperextension -extension beyond 180 degrees; can be
normal but can also result in injury • Rotation -turning of a structure around its long axis; as in
shaking the head to say “no”
• Circumduction -moving the distal end of an extremity in a
circle

• Dorsiflexion -movement of foot towards the shin

• Plantar flexion -pointing toes • Protraction -moving a part anteriorly
• Retraction -moving a part posteriorly

• Abduction -movement of away from mid-sagittal

line/midline
• Adduction -movement towards the midline

@medtech.files | by MAPB Chapter 6: Skeletal System: Bone and Joints

• Elevation -raising a part Gout Group of metabolic disorders that lead to
• Depression -lowering a part increased production and accumulation of
uric acid crystals in tissues, including joint
capsules; can lead to arthritis
Lyme disease Caused by a bacterial infection that affects
multiple organs, including the joints; can
lead to chronic arthritis
Bursitis Inflammation of a bursa, often due to
forceful contact or prolonged contact, such
as student’s elbow from leaning on a desk
Bunion Most bunions are deformations of the first
metatarsal (the great toe); bursitis may
accompany this deformity; irritated by
tight shoes
Tendinitis Inflammation of tendon sheaths, often
IX. EFFECTS OF AGING ON THE SKELETAL SYSTEM AND from overuse, such as tennis elbow
JOINTS Dislocation Movement of bones out of their correct
alignment at a joint; a partial dislocation is
1. Bone matrix becomes more brittle and decreases in total a subluxation
amount during aging. Sprain Stretching or tearing of ligaments
2. Joints lose articular cartilage and become less flexible with supporting a joint
age.
3. Prevention measures include exercise and calcium and
vitamin D supplements.

X. DISEASES

Condition Description
Tumors May be malignant or benign and cause a
range of bone defects
Gigantism Abnormally increased body size due to
excessive growth at the epiphyseal plates
Dwarfism Abnormally small body size due to
improper growth at the epiphyseal plates
Osteogenesis Brittle bones that fracture easily due to
imperfecta insufficient or abnormal collagen
Rickets Growth retardation due to nutritional
deficiencies in minerals (Ca2+) or vitamin
D; results in bones that are soft, weak, and
easily broken
Osteomyelitis Bone inflammation often due to a bacterial
infection that may lead to complete
destruction of the bone
Tuberculosis Typically, a lung bacterium that can also
affect bone
Osteomalacia Softening of adult bones due to calcium
depletion; often caused by vitamin D
deficiency
Osteoporosis Reduction in overall quantity of bone tissue
Arthritis Inflammation of a joint, leading to pain and
stiffness of the joint; over 100 causes,
including infectious agents, metabolic
disorders, trauma, and immune disorders
Degenerative joint Most common type of arthritis; affects 85%
disease of Americans over age 70; characterized by
(osteoarthritis) gradual degeneration of a joint with
advancing age; can be delayed with
exercise
Rheumatoid General connective tissue autoimmune
arthritis disorder that predominantly affects joints

@medtech.files | by MAPB Chapter 6: Skeletal System: Bone and Joints