APPENDICULAR

SKELETON

By: Dr. Mujahid Khan

 Composition
 The appendicular skeleton consists of Pectoral and
pelvic girdles and limb bones

 Mesenchymal bones form during the fifth week in the

limb buds

 Chondrification of mesenchymal bone models occurs in

the sixth week

 Clavicle initially develops from intramembranous

ossification

 Later forms growth cartilages at both ends

 Composition
 The models of pectoral girdle and upper limb
bones appear slightly before those of the pelvic
girdle and lower limbs

 The bone models appear in a proximodistal

sequence

 Ossification begins in the long bones by the

eighth week

 Initially occurs in the diaphysis

 Primary Ossification
 By 12 weeks primary ossification centers appear
in almost all bone of the limbs

 The clavicle begin to ossify before any other

bone in the body

 The femora are the next bones to show traces of

ossification

 First indication of ossification in cartilaginous

model appear in the center of the future shaft,
called primary center of ossification
 Primary Ossification
 Primary centers appear at different times in
different bones

 Most of them develop between 7th and 12 weeks

 Virtually all primary centers of ossification are

present at birth

 The part of the bone ossified from a primary

center is the diaphysis
 Secondary Ossification
 Secondary ossification centers of the bones at
knee are the first to appear

 The centers for the distal end of femur and

proximal end of tibia appear during 34 to 38
weeks

 Consequently they are present at birth

 Most secondary centers of ossification appear

after birth, called epiphysis
 Secondary Ossification

 The bone forms from the primary center in

the diaphysis do not fuse with that formed
from the secondary centers in the
epiphysis until the bone grows to its adult
length

 The delay enables lengthening of the bone

to continue until the final size is reached
 Secondary Ossification
 During bone growth, epiphysial plate
intervenes between the diaphysis and
epiphysis

 The epiphysial plate is eventually replaced

by bone development on each of its two
sides, diaphysial and epiphysial

 When this occurs, growth of the bone

ceases
 Limb Development
 The limb buds appear as elevations of the
ventrolateral body wall by end of 4th week

 The limb buds form deep to a thick band of

ectoderm

 The upper limb buds are visible by 26 to

27 days

 Lower limb buds appear 2 days later

 Limb Bud
 Each limb bud consists of a mass of
mesenchyme covered by ectoderm

 The mesenchyme is derived from the somatic

layer of lateral mesoderm

 The limb buds elongate by the proliferation of

the mesenchyme

 The upper limb buds appear low on the

embryo’s trunk
 Limb Bud
 The early stages of limb development are alike
for the upper and lower limbs

 Development of upper limb buds occurs 2 days

before that of lower limb buds

 The upper limb buds develop opposite the

caudal cervical segments

 Lower limb buds form opposite the lumbar and

upper sacral segments
 Limb Bud
 At the apex of each limb bud the ectoderm
thickens to form and apical ectodermal ridge
(AER)

 AER exerts an inductive influence on the limb

mesenchyme that initiates growth of limbs in
proximal-distal axis

 Mesenchymal cells aggregate at the posterior

margin of the limb bud to form the zone of
polarizing activity (ZPA)
 Digital Rays
 By the end of 6thweek, mesenchymal
tissue in the hand plates has condensed to
form digital rays

 These mesenchymal condensations or

finger buds outline the pattern of the digits

 During the 7th

week, similar condensations
of mesenchyme form digital rays and toe
buds in the foot plates
 Digital Rays
 AER induces development of the
mesenchyme into the mesenchymal
primordia of the bones in the digits

 The intervals between the digital rays are

occupied by loose mesenchyme

 Soon the intervening regions of

mesenchyme break down forming notches
between the digital rays
 Digital Rays
 As the tissue breakdown progresses, separate
digits are formed by the end of 8th week

 Programmed cell death (apoptosis) is

responsible for the tissue breakdown in the
interdigital regions

 Blocking these cellular and molecular events

could account for syndactyly, webbing or fusion
of the fingers or toes
 Final Stages of Limb
Development
 As the limbs elongate in the 5th week,
chondrification centers appear

 By the end of 6th week, the entire limb

skeleton is cartilaginous

 Osteogenesis of long bones begins in the

7th week from primary ossification centers
in the middle of the cartilaginous models of
long bones
 Final Stages of Limb
Development
 Primary ossification centers are present in all long
bones by the 12th week

 Ossification of the carpal (wrist) bones begins

during the first year after birth

 As the long bones form, myoblasts aggregate and

form a large muscle mass in each limb bud

 In general this muscle mass separates into dorsal

(extensor) and ventral (flexor) components
 Final Stages of Limb
Development
 The mesenchyme in the limb bud gives
rise to bones, ligaments, and blood
vessels

 From dermomyotome regions of somites,

myogenic precursor cells also migrate into
the limb bud

 Later they differentiate into myoblasts or

precursors of muscle cells
 Rotations of Limbs
 The cervical and lumbosacral myotomes
contribute to the muscles of the pectoral
and pelvic girdles, respectively

 Early in the seventh week the limbs extend

ventrally

 The developing upper limbs rotate in

opposite directions and to different
degrees
 Rotations of Limbs
 The upper limbs rotate laterally through 90 degrees on
their longitudinal axis

 Now the future elbows point dorsally

 Extensor muscles lie on the lateral and posterior aspects

of the limb

 The lower limbs rotate medially through 90 degrees

 Now the future knees face ventrally

 Extensor muscles lie on the anterior aspect of the lower

limb
 Cutaneous Innervation
of Limbs
 Motor axons arising from the spinal cord
enter the limb buds during the fifth week

 Grow into dorsal and ventral muscle

masses

 Sensory axons enter the limb buds after

the motor axons and use them for
guidance
 Cutaneous Innervation
of Limbs

 Neural crest cells, the precursors of

schwann cells, surround the motor and
sensory nerve fibers in the limbs

 Form the neurolemmal and myelin sheaths

 A dermatome in this area of skin supplied

by a single spinal nerve and its spinal
ganglion
 Cutaneous Innervation
of Limbs
 During the 5th week, the peripheral nerves grow
from the developing limb plexuses into
mesenchyme of limb buds

 The spinal nerves are distributed in segmental

bands, supplying both dorsal and ventral
surfaces of the limb buds

 As the limbs elongate, the cutaneous distribution

of the spinal nerves migrates along the limbs
 Cutaneous Innervation
of Limbs
 The original dermatomal pattern changes during
growth of the limbs

 An orderly sequence of distribution can still be

recognized in the adult

 When the limbs descend they carry their nerves

with them

 This explains the oblique course of the nerves

arising from the brachial and lumbosacral
plexuses
 Blood Supply to Limbs
 The limb buds are supplied by branches of the dorsal
intersegmental arteries

 They arise from the aorta and form a fine capillary

network in the mesenchyme

 The primordial vascular pattern consists of a primary

axial artery and its branches

 The vascular pattern changes as the limbs develop

 This occurs by vessels sprouting from existing vessels

 Blood Supply to Limbs
 The new vessels coalesce with other sprouts to
form new vessels

 The primary axial artery becomes the brachial

artery and common interosseous artery in the
forearm

 In the thigh the primary axial artery is

represented by the profonda femoris artery

 In the leg it is represented by the anterior and

posterior tibial arteries
 Anomalies of Limbs
 Minor limb anomalies are common and can be
corrected surgically

 The most critical period of limb development is

from 24 to 36 days after fertilization

 Exposure to teratogen before day 33 may cause

severe limb defects

 Major limb anomalies appear about twice in

1000 newborns