CHAPTER ONE: INTRODUCTION anteriorly MEDICAL TERMS:  Circumduction = circular limb movement;  Dermato – Skin ANATOMY combines flexion, extension,  Hydro – Sweat Glands = science of structure and function of the body adduction & abduction  Ichthyo – Scaly = has two fields:  Inversion = movement of the foot so that the  Kerato – overgrowth of keratin  Clinical Anatomy = macroscopic structure sole faces in a medial direction  Phyto/Onycho - Hair and function of the body referring to the Eversion = sole faces in a lateral direction  Lipo/Adipo – fat study of medicine and other health  Protraction & Retraction – move forward and  Melano – dark pigments backward sciences  Myco – fungus  Lateral Flexion – movement of trunk in coronal  Basic Anatomy = minimal amount of anatomy  Steato – Fat in Stool plane consistent with the understanding of the

OVERALL structure and function of the DERMATOLOGIC PROCEDURES: body Basic Structures:  For allergies  Skin o Scraping – for fongi DISCIPLINES OF ANATOMY * Epidermis (Superficial) o Patch – non-invasive a. Gross Anatomy – structures studied by the = stratified epithelial tissue o Scratch – Invasive naked eye = flattens as they mature vand rise to o Intradermal test – Non-invasive b. Systemic Anatomy – organized by systems surface  Mantu Test – for Tuberculosis exposure c. Regional Anatomy – study of all structures in * Dermis (Deep) a certain region of the body = also known as “CORIUM”  Schick – diphtheria d. Microscopic Anatomy (HISTOLOGY) – = dense connective tissue  SKIN GRAFTING cellular level = has blood, lympathic vessels & nerves o Split-Thickness Grafting = e. Cell Biology - Skin Appendages: great part of epidermis f. Developmental Anatomy (EMBRYOLOGY) 1. Nail involving tips of papillae g. Pathollogical Anatomy = dorsal, keratinized plates removed from donor and h. Radiological Anatomy = CLINICAL APPLICATION: placed to recipient Nail is used to pinch to asses the pain o Full-Thickness Skin = Body Positions: perception of the patient. For patients with epidermis, dermis and rapid - Anatomic Position = standing erect, upper limbs deeper stimuli, ballpen is used. establishment of circulation at side, face and palms of 2. Hair within recipient site and donor hands directed forward. > HAIR FOLLICLES: invagination of covered with split-thickness - Supine Position = lying on the back epidermis extending to dermis graft; MAY BE MADE FROM - Prone Position = lying face downwards > HAIR BULB: expanded extremeties oblique PEDICLE GRAFT to skin o Pedicle Graft = a flap of full- Planes of the Body: > HAIR PAPILLA: vascular connective tissue thickness skin is turned and  Median Sagittal Plane = vertical plane passing @ hair bulb stiched in positions to the through center of body; divides body > ARRECTOR PILLI: innervated by recipient site leaving the base into equal left & right halves sympathetic nerve fibers of the flap with blood supply * Paramedian = any plane on either sides of Parts of Body w/o Hair: and parallel to the Median Sagittal - LiPa SoSi Pe-Clit-La  Fascia Plane - Lips; Palm & Soles; Sides of Fingers, * Superficial Fascia/Campers * Medial (nearer) or Lateral (farther to Median) Toes & Feet; Glans Penis; Clitoris; Subcutaneous Tissue * Ipsilateral (same side) & Contralateral Labia Minora & Internal Surface of VARIES ACCORDING TO:  Coronal Plane = vertical planes at right angles Labia Majora  Thickness to Median Sagittal; divides body into SKIN CREASES: folds at the same place  Fat content equal anterior & posterior halves  Neighboring sheath  Horizontal or Transverse or Axial Plane = DSE: = mixture of loose areolar and adipose divides body into superior & inferior 1. PETICHIAE – pinpoint lesion = unites the dermis of the skin to the parts. 2. STAPH INFECTIONS underlying deep fascia a. Paronchia – nail and nail = contains bundles of collagen fibers: Terms Describing Location: ends - New Boy Scouts of Philippines  Anterior (Ventral) & Posterior (Dorsal) b. Carbuncle = at superficial - nape, back, soles, palms  Medial & Lateral fascia locally at the nape of = devoid of adipose:  Superior & Inferior the neck starting from the - SPACE  Proximal & Distal = closer or farther compared hair follicle - Scrotum, Penis, Auricles, to structure’s origin 3. ALOPECIA – hair baldness; can be Clitoris, Eyelids  Internal & External = distance of a structure affected by injury or heredity or * Deep Fascia / Scarpas from the center of an organ or cavity chemotherapy = membranous layer of connective tissue  Cranial & Caudal = sometimes used instead of 4. SHOCK – pale and goose flesh due to = Parts of the Body: Superior & Inferior overactivity of sympathetic system * Neck  well-defined layers;  Rostral = used particularly in the head; causing vasoconstriction of dermal determining the path taken by describe the position of a structure arterioles and contraction of arrector pili pathogens with reference to the nose. 3. Sebaceous Glands * Thorax & Abdomen  film of areolar  Superficial & Deep = relative positions of two = sloping undersurface of the follicles and tissue covering the muscles structures with respect to the surface lie within the dermis and aponeuroses  Supine & Prone – facing upward; downward = SEBUM: Secretion * Limbs  sheath around the muscles lying on back DSE: and other structures; Fibrous Sebaceous Cyst – obstruction of the mouth Septa may extend to deep of sebaceous gland usually at the scalp surface membranes and Terms Related to Movement: SUDORIFEROUS GLANDS divide muscle groups into  Flexion = movement along sagittal plane only; a. Sweat Glands compartments decreases joint angle = long spiral tubular * Joint Regions Extension = increases joint angle = extends to dermis & ends may lie in  as Retinacula;  Abduction = movement of a limb away from superficial fascia; deepest appendage thickened to form restraining bands Median Sagittal Plane but occurs Parts of Body w/o Sweat Glands: holding the underlying tendons in along Coronal Plane - CLiP position Adduction = movement towards midline - Lips (red margin); Glans Penis;  Rotation = movement of a body part around Clitoris  Muscles its long axis b. Apocrine Glands – sweat gland found in Belly = the fleshy part of the muscle * Medial Rotation = results in the anterior the axillary and pelvic regions A. Skeletal Muscles surface of the part facing medially c. Eccrine Glands – sweat gland found at the Voluntary Movement -- Pronation = medial rotation of the forearm; entire body ~ Origin = attachment that moves least palm of the hand faces posteriorly DSE: ~ Insertion = moves the most * Lateral Rotation = results in the anterior DIAPHORESIS – abnormal excretion of too (may be interchangeable) surface of the part facing laterally much sweat Ends of Muscles: -- Supination = lateral rotation of the forearm; - Tendon = cords of fibrous tissue, connects palm of the hand comes to face muscle to bones, cartilage or ligaments - Aponeuroses = attached to flattened -- Depth: Profundus (deep), Superficialis, capsule like the Cruciate Ligaments muscles; histologically similar to Externus (external) of the knees tendons but are sparingly -- Attachment: Sternocleidomastoid, supplied with blood Coracobrachialis vessels and nerves -- Action: Extensor, Flexor, Constrictor - Raphe = interdigitation of tendinous ends between two muscles serving as attachment B. Smooth Muscles =long, spindle-shaped cells; arranged in Muscle’s Internal Structure: bundles or sheets; Non-Striated 1. Endomysium =- wraps every muscle fiber 2. Perimysium = wraps fascicles Parts of the Body w/ Smooth Muscles: 3. Epimysium = wraps entire muscle 1. Digestive System ~ Circular = squeezes contents Muscle Fiber Configuration = muscle fibers can be ~ Longitudinal = pulls the wall of the tube arranged parallel or oblique to the long proximally over the contents axis; parallel ones can cause greater 2. Uterus & Urethra (storage organs) degree of movement. ~ Irregularly arranged fibers; Interlaced w/ * Ex. of Muscles w/ Parallel Fiber Arrangement one another; produces slow, sustained ~ Sternocleidomastoid movement; expels contents of organs ~ Rectus Abdominis 3. Blood Vessels Classification of Synovial Joints : ~ Sartorius ~ Circular = alters flow of blood by modifying Arrangement of Articular Surfaces & Types of * Pennate Muscles = fascicles attach obliquely volume of the lumen Movement to tendon; also called penniform; allow 1. Plane = apposed articular surfaces are flat or better stabilization, force production but C. Cardiac Muscles almost flat; allows bones to slide against compromises flexibility = branched, uninucleated striated muscles each other. see p.16, Fig. 1-14  Unipennate = fascicles on same side that unite with each other; Ex. sternoclavicular and acromioclavicular joints of tendon; on one side = arranged in whorls & spirals 2. Hinge = resembles door hinges, allows flexion, Ex. extensor digitorum longus = supplied by autonomic nerve fibers extension. Ex. knee, elbow, ankle  Bipennate = fascicles on both side of 3. Pivot = central bony pivot is surrounded by central tendon  Joints bony, ligamentous ring; see p.16, F.1-14 Ex. rectus femoris = site where two or more bones come together = rotation as only possible mov’t.  Multipennate = central tendon branches regardless of movement between them Ex. atlantoaxial (neck) and superior w/in a pinnate muscle = articulation of two cartiliges radioulnar (wrist) joints ~ arranged as a series of bipennate = facilitates the growth and avoid friction between 4. Condyloid = has 2 distinct convex surfaces muscles lying alongside one another bones articulating w/ 2 concave surfaces; Ex. acromial fibers of the deltoid flexion, extension, abduction, and ~ tendon lying within its center and the Classification According to Tissue Composition: adduction possible together w/ small muscle fibers passing to it from all 1. Fibrous Joints = “fixed joints” amount of rotation sides, converging as they go = fibrous tissue joins the articulating Ex. metacarpophalangeal joint (knuckles); Ex. tibialis anterior surfaces of the bones very little mov’t. temporomandibular joint = lack joint cavity 5. Ellipsoid = elliptical convex articular surface fits Muscle Action Ex. into an elliptical concave articular surface; 1. Prime Mover = it is the chief muscle or *sutures of the skull all mov’ts except rotation. member of a chief group of muscles (inferior tibiofibular joints) Ex. wrist joint; atlantooccipital joint responsible for a particular mov’t. * syndesmosis – fibrous connection 6. Saddle / Biaxial = articular surfaces are Ex. quadriceps femoris ~ knee extension between bones reciprocally concavoconvex and resemble a rhomboids ~ retracts scapula (posterior sacroiliac joint) saddle on horse's back; allows all mov’t 2. Antagonist = opposes the action of the p.m. 2. Cartilaginous Joints (e,f,ab,ad,r). Ex. biceps femoris ~ vs. knee joint extension  Primary Cartilaginous Joints Ex. carpometacarpal joint of thumb serratus anterior ~ vs. scapula retraction - bones are united by a plate or bar 7. Ball-and-Socket = ball-shaped head of one * Nerve Reflex Inhibition = PM & Antagonist of hyaline cartilage, NO mov’t. bone fits into a socket-like concavity of can’t contract together, action must Ex. Epiphysis & Diaphysis of a growing another; allows e, f, ad, ab, medial be opposed bone; First Rib & Manubrium Sterni rotation, lateral rotation, and circumduction 3. Fixator = contracts isometrically but only  Secondary Cartilaginous Joints Ex. shoulder and hip joints increases tone but not cause mov’t; - bones are united by a plate of stabilizes origin of PM for efficiency fibrocartilage and the articular Joint Stability: 3 Factors 4. Synergist = prevent unwanted movements in - surfaces of the bones are covered by Ω Articular Surfaces an intermediate joint a thin layer of hyaline cartilage - Shape **BUT: shape is not a factor in the ff: - only minimal mov’t. acromioclavicular joint, the calcaneocuboid Nerve Supply Skeletal Muscle Ex. symphisis pubis; intervertebral column joint, and the knee joint (60%) Motor 3. Synovial Joints - Arrangement (40%) Sensory = thin layer of hyaline cartilage covers articular - Size ~ With sympathetic autonomic nerve fibers surfaces of the bones & separated by a joint Ω Ligaments -- Motor Point cavity; * Fibrous Ligaments = prevent excess mov’t; = point of entry of nerve to muscle at ARTICULAR CARTILAGE smooth friction free stretches when stressed for midpoint of deep surface often near movement and decompression forces excessively long periods. Ex. flat feet margin; =has greatest degree of movement; freely * Elastic Ligaments = return to their original = minimal interference with nerve trunk movable length after stretching; Ex. bones of ** Muscle Tone Parts of Synovial Joint: inner ear = also tonus or residual muscle tension; * Synovial Membrane = lines joint cavity; = continuous and passive extends from and to margins of Ω Muscle Tone partial contraction of the muscles articular surfaces Ex. humerus-scapula joint = could easily maintained by unconscious nerve * Fibrous Capsule = external to synovial dislocate w/o muscle tone impulses membrane; its toughness offers knee joint = unstable w/o quadriceps  Flaccid – Reflex are interrupted protection but resist dislocation femoris muscle tonic activity  Hypotonic * Synovial Fluid = produced by Syno. Membrane Nerve Supply of Joints: Naming of Skeletal Muscles = pale yellow, slightly alkaline which Hilton’s Law = sensory nerve supplying a joint -- Shape: Ex. Deltoid (triangular), Teres (round), lubricates articular surfaces also supplies the muscles moving the joint Rectus (straight) * Articular Disks = discs or wedges of & the skin overlying the insertions of -- Size: Major (large), Latissimus (broadest), fibrocartilage interposed between these muscles Longissimus (longest) articular bone surfaces -- No. of Bellies: Biceps (2 heads), Quadriceps * Fatty Pads = lies between the synovial Clinical Notes: (4 heads), Digastrics (2 bellies) membrane and the fibrous capsule Syringomyelia = loss of sensation of pain in the Naming of Skeletal Muscles (continued) or bone. Ex. knee & hip joints joints, nervous system disease -- Position: Pectoralis (chest), Supraspinatus * Ligaments = unites bones; most lie outside the Obturator Nerve = supplies both hip & knee joint (above spine), Brachii (arms) capsule but some are within the  Ligaments = band of connective tissue uniting ** Portal Vein = convergence of all veins leaving Central Nervous System two structures; may be of two types: the gastrointestinal tract;  Neuroglia – special nerve tissues 1. Dense Collagen Fibers = unstretchable proceeds to liver  Neuron – nerve cell and its processes Ex. iliofemoral (hip) & collateral (elbow) lig. ** Sinusoids = capillary-like vessels in the liver;  Dendrites – short processes 2. Elastic Tissue = regain original length after blood comes from the Portal Vein  Axon – long processes stretching Parts of Body w/Sinusoids  Gray matter – with nerve cells embedded in Ex. ligamentum flavum (vertebrae) - Marrow, Spleen, Liver, other Endocrine neuroglia calcaneonavicular (foot) ligament Glands  White matter – with nerve fibers (axons)  Bursae = lubricating device consisting of a closed ** Arteriovenous Anastomosis = direct embedded in neuroglia fibrous sac lined with a delicate smooth connection of arterioles & venules w/o membrane passing through capillaries; fingers & toes TYPES OF NERVES: = walls are separated by a film of viscous a. Sensory Neurons fluid; commonly found close to joints Ω Capillaries = connects arterioles to venules -send message from parts of the body where the skin rubs against underlying  Sinusoids vs. Capillaries = both are thin- back to the spinal cord and the brain. bony structures walled, but sinusoids have irregular -information is then processed to let you cross-diameters and are wider. feel pain and other sensations  Synovial Sheath = tubular bursa that surrounds a -helps a person identify if its rough or tendon; tendon invaginates the bursa  Lymphatic System smooth, hot or cold from one side so that the tendon - LYMPH: Excess tissue fluid necessary for b. Motor Neurons becomes suspended w/in the bursa by a immunologic defenses --sends impulses or signals from CNS to mesotendon - NO Circulation occurs w/in Lymph System al parts of the body controlling muscle = sometimes mesotendon disappears or ○ Lymphatic Tissue = connective tissue with large contraction, allowing remains in the form of narrow threads, the no. of lymphocytes. Ex. Thymus, Lymph c. Autonomic vincula (long flexor tendons in fingers,toes) Nodes, Spleen, Lymphatic Nodules -controls involuntary or semi-voluntary ○ Lymphatic Vessels = drainage system, drains functions such as heart rate, BP, MESOTENDON: Enables blood vessels to enter the fluids from tissues bringing them back to digestion, temperature regulation and tendon; reduces friction between tendon and the blood; appears beaded due to sweating surrounding tissues/structure valves along the vessels d. Interneuron -link between sensory and motor neurons Parts of Body w/o Lymphatic Vessels: -for reflex actions - Nervous System, Eyeball, Internal Ear, Skin Epidermis, Bone & Cartilage A. Autonomic Nervous System -- acts as the “control system” Path of Lymph to Blood: -- promotes homeostasis Interstitial Fluid  Lymph in Lymph Capillaries -- governs involuntary functions  Small Lymph Vessels -- controlled by the hypothalamus  Large Lymph Vessels -- functional branches:  pass through Lymph Nodes ~ Sympathetic Nervous System (SNS)  Right Lymphatic Duct or Thoracic Duct ~ Parasympathetic Nervous System (PNS)  Blood Vessels ~ Enteric Nervous System (ENS) ~ Ex. Heart, smooth muscles, glands

 Nervous System  Sympathetic Nervous System Central NS = Brain & Spinal Cord ~ “Fight or Flight Mechanism” during emergency Peripheral NS  ~ Redistribution of blood from skin and intestine Ω 12 pairs of Cranial Nerves to skeletal muscle, heart and brain ~ Olfactory, Optic, Occulomotor, Trochlear, ~ Increase heart rate with constriction of Trigeminal, Abducens, Facial, Vestibulo- peripheral blood cochlear, Glossopharyngeal, Vagus, Spinal ~ Increase blood pressure Accessory, Hypoglossal ~ Prevents peristalsis of intestinal tracts and Ω 31 pairs of Spinal Nerves & Associated Ganglia close spinchter ~ 8C, 12T, 5L, 5S, 1C (Vertebrae=7,12,5,5,4-5) ~ Efferent Fibers ~ Spinal Cord terminates @ L1’s lower border - cell bodies (Sympathetic Connector ~ Cauda Equina (L2-5,S1-5,C1) Neurons) are at Lateral Gray Horn ~ Each SN has 2 Roots: - only from T1 to L2 of Spinal Cord * Anterior Root (Efferent) - have myelinated axons  impulses away from CNS fibers  cell bodies @ Anterior Gray Horn Ultimate Route:  Blood Vessels * Posterior Root (Afferent) 1.) Excitor Cells in Paravertebral Ganglion in Ω Artery = carry blood away from heart  carries impulses to CNS sensory fiber the Sympathetic Trunk ~ Arteriole = < 0.1mm, smallest arteries  cell bodies @ Posterior Root Ganglion * innervates smooth muscles of the blood ~ Anastomosis = artery-to-artery connection vessels, sweat glands, and arrector pili ~ Anatomic & Functional End Arteries * Figure A1 (T2-T4) see F.1-27 p.31 * Anatomic = terminal branches do not Preganglionic Mid-Thoracic  anastomose with branches of Postganglionic Mid-Thoracic arteries supplying adjacent areas Ex. arteries supplying the arms and legs  Collateral Circulation = detour of the Ultimate Route (continued): circulation especially among large * Figure A2 (T1) arteries that cross joints. see p.18 Preganglionic Upper Thoracic  * Functional = terminal branches do Postganglionic Cervical anastomose with those of adjacent Anterior Ramus  muscles, skin of antero- * Figure A3 (T12, L1-2) arteries; tissue dies if one of the lateral body wall & of all limbs; Preganglionic Lower Thoracic & Upper arteries is blocked. ~ also called Ventral Ramus Lumbar  Postganglionic Lower Ex. Coronary Arteries ~ generally larger than Posterior Ramus Lumbar & Sacral ~ forms Plexuses, a network of intersecting Ω Veins = carry blood to heart, some have valves nerves) from SN in the Cervica & Brachial ~ Venules = smallest veins (upper limb)l, Lumbar & Sacral region (lower SYNAPSE DO NOT SYNAPSE limb); Thoracic SN are independent of each ~ Tributaries = network of smaller veins that -Post Ganglionic -Preganglionic other and innervates the chest unite to form larger veins -Excitor Nerves -Splanchnic Posterior Ramus  muscles & skin of the back ~ Venous Plexuses = Larger veins that join with -Myelinated -Nonmyelinated one another Meningeal Branch  Vertebrae, Coverings of

~ Portal System = system of vessels interposed Meninges between two capillary beds. ** Rami Communicantes = arises from Thoracic ** Venae Comitantes = two veins that usually SN, part of Sympathetic NS of the accompany medium-sized, deep Autonomic NS arteries  Parasympathetic Nervous System - Conserve and restore energy - Lowers heart rate and promotes peristalsis of intestine thus opens spinchters ~ Efferent Fibers (2 sites = cranial & sacral) Cranial: - cells are called connector cells (CC) - CC-cell bodies are found in the brain in the same nuclei as the 3rd, 8th, 9th, 10th Cran.Nrvs. - the preganglionic fibers also leave the brain contained in these cranial nerves - these cranial preganglionic CCs synapse with excitor cells in peripheral ganglia: > ciliary, pterygopalatine, submandibular, and otic ganglia Sacral: - cell bodies of sacral CC are found in the gray matter in the S2, S3 and S4 segmets of the spinal cord (not sufficient to form lateral grayhorn) - sacral CCs leave the cord from the anterior nerve roots  spinal nerves  then forms Figure A1. Sympathetic Connector Neurons (Red) pelvic-splanchnic nerves - postganglionic fibers occur in ganglia of Synapse = site where two neurons come into close > hypogastric plexuses & visceral walls proximity but not into anatomic continuity Figure A3. Sympathetic Connector Neurons (Red) Excitor Cell (Green) ~ Afferent Fibers Acetycholine = gap between two neurons - have their cell bodies located either in the sensory ganglia of cranial nerves or *Axons of Excitor Neurons leave the ganglion and are posterior root ganglion of the sacro- not myelinated* spinal nerves Excitor Cell (Green) - REMEMBER: Autonomic NS is purely motor!!! - Afferent Fibers carry infor such as muscle “stretch” and “lack of oxygen”

 Mucous Membranes ~ basically composed of epithelial cells and lamina propria (layer of connective tissue). - muscularis mucosa, smooth muscles sometimes found in mucous membranes - may or may not secrete mucus on its surface - linings of organs and passages  Serous Membranes ~ composed of mesothelial cells and supported by a thin layer of connective tissue ~ may be: Parietal Layer = lines cavity wall ** develops from the somatopleure (inner cell layer of mesoderm  also, lateral plate mesoderm) ** innervated by spinal nerves, thus, can feel sensations & pain Visceral Layer = covers the organs ** develops from splanchnopleure ** innervated by autonoimic NS; insensitive to Figure A2. Sympathetic Connector Neurons (Red) touch & temp. But sensitive to stretch Excitor Cell (Green) ~ cavities of the trunk: Figure B. Sympathetic Connector Neurons (Red) > pleural, pericardial, peritoneal 2.) Does Not Synapse; forms 3 Splanchnic Nerves Excitor Cell (Green) ~ serous exudate = liquid in visceral cavities ~ Greater Splanchnic Nerve (T5-T9) ~ Lesser Splanchnic Nerve (T10-T11) (Sympathetic Nervous Sytem, continued...)  Bone ~ Lowest Splanchnic Nerve (T12) [when present] - Splanchnic Nerves are preganglionic Functions of Skeletal System:  see Figure B and Figure 1-27 p.31 - the postganglionic fibers arise in the celiac &  Support renal plexuses as axons of excitor cells  Protection – to vital organs inside the bones - innervate smooth muscles & visceral glands (heart, lungs, brain, spinal cord) - some preganglionic fibers from the greater  Movement splanchnic nerve may even travel up until the  Storage for reservoir of minerals suprarenal medulla (considered modified sympathetic excitor cells) Axial – Spinal Cord and Skull (Sympa. NS. Continued...) Appendicular – Appendiges/Limbs - the Sympathetic Trunk is found all along the entire length of the vertebral column BONE DEVELOPMENT - No. Of Ganglia: 3 at trunk of neck; 11-12 at a. Membranous – bone is directly developed thorax; 4-5 lumbar; 4-5 in the pelvis from connective tissue (skull) - meets at terminal of vertebral column and b. Endochondral – from cartilage to bone (long known as Ganglion Impar. bones) ~ May be ~ Afferent Fibers HARD (due to calcification of extracellular matric) - travel from the viscera through the ELASTIC (due to elastic fibers) sympathetic ganglia without synapsing ~ can be classified according to: - are also myelinated Ω Composition - Pathway: (In order., from periphery) - - Compact Bone > Nerve fibers from Viscera - Solid mass > Whire Rami Communicantes - - Cancellous/Spongy Bone > Spinal Nerve - Branching network of trabeculae resists > Cell Bodies [post. Root ganglia] stress and strains > central axon enters CNS Ω Region TOTAL OF 206 BONES EMBRYOLOGY ◊ Axial Skeleton 1. Zygote Skull 28 Sternum 1 INNER CELL MASS – becomes the embryo Hyoid 1 Ribs 24 OUTER CELL MASS – becomes trophoblast Vertebrae 26 2. Embryonic Disc – From ZYGOTE ◊ Appendicular Skeleton a. Ectoderm – upper layer Clavicle 2 >> Primitive streak neural plate Scapula 2 -Forms MESODERM: ◊ Upper Extremities > Paraxial – becomes bones, Humerus 2 Carpals 16 ligaments, cartilage, vertebral Radius 2 Metacarpals 10 column and skull Ulna 2 Phalanges 28 > Intermediate – Urogenital ◊ Lower Extremities System Femur 2 Tarsals 14 > Lateral – Somatic and Tibia 2 Metatarsals 10 Splanchnic intraembryonic Fibula 2 Phalanges 28 COELUM (becomes Patella 2 pericardial, peritoneal and ◊ Pelvic Girdle pleural cavities) Hip Bone (fused) 2 > Connective tissues of smooth Ω General Shape and cardiac muscles - - Long Bones >> Neural Tube >> CNS - Long than wide b. Endoderm – lower layer - (humerus, femur, metacarpals, >>Alimentary tract >> Thyroid metatarsals, and phalanges) Organs >> Liver >> Pancreas Parts:  Epiphysis o Epiphysial Plate – Separates epiphysis to diaphysis o Spongy bone  Diaphysis - - Short Bones -cuboidal in shape - (scaphoid, lunate, talus, calcaneum) - - Flat Bones (Skull and Sternum)  TABLES – thin inner and outer layer  DIPLOE – layer of cancellous bone - - Irregular Bones - does not conform into a definite shape - (vertebrae and hipbones) - - Sesamoid Bones (vertebrae, pelvic girdle) = found in certain tendon whether rub over bony surfaces CLINICAL ABNORMALITIES 1. Rheumatoid Arthritis - Holes o Affects joint symmetrically - Depressions o (buttonaire’s and swan-like) - Foramen 2. Bursitis – with localized pain and swelling; - Meatus inflamed from injury - Sinus 3. Tendonitis – overused joint - Grove 4. Carpal Tunnel Syndrome o Swelling or change in position Bone Marrow of tissue within the carpal - - in adults: bones of skull, vertebrae, ribs, girdle tunnel squeezes and irritated bones, head of humerus & femur median nerve  At birth: All red and hematopoietic in medullary 5. Osteoporosis “Porous Bones” bone o Loss of mineral in the bone  At 7YO Yellow Marrow begins to appear at making them brittle and weak distal bones of limbs 6. Scoliosis – abnormal curvature of spine 7. Kyphosis – develop a hump; opposite of Cartilage LORDOSIS --Covered by PERICONDRIUM 8. Lordosis – sway-back appearance; “preggy” Types: 9. Rickets – soft and weakening of bones; a. Hyaline Cartilage vitamin D deficiency in children -has high proportion of amorphous matrix 10. Gout – over storage of uric acid -plays important role in the growth of long 11. Acromegaly – too much growth hormone bones 12. Spina bifida – birth defect; incomplete -incapable of repair when fractured yet development of spinal cord filled with fibrous tissue 13. Club foot – deformity at birth foot pointing b. Fibrocartilage down and twisted inwards -has many collagen fibers; found within joints (e.g. temporomandibular joint, sternoclavicular joint, knee joint) c. Elastic (only the one capable of healing themselves with fibrous tissue)

Bone Cells  Osteocytes – Mature bone cells  Osteoblast – Bone forming  Osteoclasts – Bone resorption; specialized type of macrophage  Osteoid – unmineralized bone cells composed of collagens and ground substance