Appendicular Bones.Pdf

Chapter 8 Outline

• Pectoral Girdle • Upper Limb • Pelvic Girdle • Lower Limb • Aging of the Appendicular Skeleton • Development of the Appendicular Skeleton Appendicular Skeleton

Figure 8.1 Pectoral Girdle

• Clavicle • Scapula

Figure 8.2 Clavicle

• S-shaped • Articulations – medially with manubrium of sternum – laterally with acromion of scapula

Figure 8.2 Scapula

• Broad, flat triangle – three ______, three ______• Articulations – Lateral: ______cavity for head of humerus • Other features – Posterior: bony ridge = ______– Lateral: ______process – Anterior projection: ______process Scapula

Figure 8.3 Upper Limb

• 30 bones per “arm” – ______in brachium (upper arm) – ______and ______in antebrachium (forearm) – 8 carpal bones in wrist – 5 metacarpals in palm – 14 phalanges in fingers Humerus

Proximal features: • Head: articulates with scapula • Anatomical and surgical necks • Greater and lesser ______: for muscle attachment • ______sulcus: for biceps brachii tendon Humerus

Anatomical neck Head Greater Head tubercle Lesser tubercle

Intertubercular sulcus

Surgical neck

Deltoid tuberosity

Shaft

Coronoid fossa

Radial fossa

Coronoid fossa Lateral epicondyle Medial epicondyle

Capitulum Trochlea Capitulum Trochlea (a) Right humerus, anterior view

Figure 8.4 right: © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Humerus • Distal features: – ______– ______tuberosity for attachment of deltoid – ______and ______epicondyles for muscle attachments – ______: round lateral articulation for radius – ______: spool-like medial articulation for ulna Humerus

Distal fossae (depressions): • Anterior – Radial: lateral depression for radius – Coronoid: medial, for anterior ulna • Posterior – ______: largest, for posterior ulna Humerus

Head Greater tubercle

Anatomical neck

Surgicalneck

Deltoid tuberosity Radial groove

Lateral epicondyle Olecranon fossa Olecranon fossa Medial epicondyle Lateral Medial epicondyle epicondyle

Trochlea Trochlea Figure 8.4 (d) Right humerus, posterior view (right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Radius and Ulna Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Olecranon Olecranon

Trochlear • Antebrachial bones notch

Coronoid process Head Head Proximal – parallel to each other Neck radioulnar joint Tuberosity of ulna Neck Radial – in anatomical position, tuberosity

radius is lateral to ulna Shaft Radius Ulna

Radius Ulna

Interosseous membrane

Interosseous borders

Distal radioulnar joint

Head Styloid Styloid process Styloid process Figure 8.5 process (a) Right radius and ulna, anterior view

a(right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Radius

• Proximal features: – Head: articulates with capitulum of humerus – Neck: narrowest region – Radial tuberosity: for biceps brachii muscle • Shaft • Distal features: – ______process: lateral “wrist bump” – ______notch: medial dent for head of ulna Ulna

• Proximal features: – Trochlear notch: for trochlea of humerus – ______: posterior “elbow bump” for triceps brachii muscle – ______process: anterior tip of trochlear notch – Radial notch: lateral, for head of radius • Distal features: – Head: knoblike end – ______process: posteromedial “wrist bump” Radius and Ulna

Olecranon Olecranon

Head

Proximal radioulnar joint

Neck

Shaft Ulna Radius

Ulna Radius

Interosseous membrane

Interosseous borders

Head Head Distal radioulnar joint Figure 8.5 Styloid processes Styloid processes (f) Right ulna and radius, posterior view (right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Radius and Ulna (proximal and distal features)

Figure 8.5 Carpus

• 8 “wrist” bones – Two rows (1 proximal and 1 distal) of four

Figure 8.6 Carpals

Proximal Row Distal Row (lateral to medial) (lateral to medial) 1. Scaphoid 5. Trapezium 2. Lunate 6. Trapezoid 3. Triquetrum 7. Capitate 4. Pisiform 8. Hamate Metacarpals

• 5 in palm – named by Roman numerals I–V from medial to lateral

Figure 8.6 Phalanges

• 14 per hand – 3 per finger #2–5 • Proximal, middle, and distal – 2 in pollex (thumb) • Proximal and distal

Figure 8.6 Pelvic Girdle

• Girdle = right and left ossa coxae – with sacrum and coccyx = the pelvis

Figure 8.7 Os Coxae

• The “hip bone” – fusion of ilium, ischium, and pubis at 13–15 years of age • Articulations: – anteriorly with other os coxae – posteriorly with the sacrum – laterally with femur at ______• all three bones of the os coxae contribute to the acetabulum Acetabulum

Figure 8.9 Ilium

• Largest of the three fused bones • Superior portion of os coxae and acetabulum • Features: – Ala: wide, fan-shaped portion – Arcuate line: ridge along inferior border of the ala – ______fossa: large depression on medial surface – ______, ______, and ______gluteal lines: lateral site of muscle attachments Ilium

Iliac crest Iliac crest

Ala

Iliac fossa Anterior gluteal line

Posterior gluteal line Posterior superior Anterior super ioriliac spine Anterior superior iliac spine Iliac spine Posterior superior iliac spine

Inferior gluteal line Auricular surface Anterior inferior iliac spine Posterior inferior iliac spine Anterior inferior iliac spine Posterior inferior iliac spine Greater sciatic notch Arcuate line Greater sciatic notch Lunate surface

Acetabulum Body of ischium Ischial spine Pectineal line Ischial spine Superior pubic Lesser sciatic notch Lesser sciatic notch Superior pubic ramus ramus Body of ischium Pubic crest Pubic tubercle Pubic tubercle Ischial tuberosity Symphysial surface Inferior pubic ramus Obturator foramen Ischial tuberosity Obturator foramen Inferior pubic ramus Ilium Ilium Ramus of ischium Ramus of ischium

Anterior Posterior Posterior Anterior Iliaccrest Iliac crest

Pubis Ischium Ischium Pubis

Medial view Lateral view Ala Posterior superior Anterior gluteal line iliac spine Posterior gluteal line Iliac fossa Posterior superior iliac spine Anterior superior iliac spine Auricular surface Anterior superior iliac spine Posterior inferior iliac spine Inferior glutealline Posterior inferior iliac spine Greater sciatic notch Anterior inferior iliac spine Anterior inferior iliac spine

Arcuate line Lunate surface Greater sciatic notch

Body of ischium Acetabulum Ischial spine Ischial spine

Lesser sciatic notch Pectineal line Lesser sciatic Superior pubic notch Superior pubic ramus ramus Body of ischium Ischial tuberosity Pubic tubercle Pubic crest Pubic tubercle Symphysial surface Inferior pubic ramus Obturator foramen Ischial tuberosity Obturator foramen Ramus of ischium Inferior pubic Ramus of ischium ramus

(b) Right os coxae, medial view (a) Right os coxae, lateral view Figure 8.9 (bott):© The McGraw-Hill Companies, Inc./Photo by Christine Eckel Ilium

• Additional features: – ______crest: superior ridge – ______and ______, superior and inferior iliac spines: projections along iliac crest – ______notch: for sciatic nerve entering lower limb – Auricular surface: medial articulation with sacrum Ischium

• Superior/posterior margin of acetabulum • Features: – Ischial spine: prominent medial process – Ischial ______: rough inferior region that supports weight of body when seated – Ischial ______: bridge from tuberosity to pubis Ischium Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Iliac crest

Ala

Anterior gluteal line

Posterior gluteal line Anterior super ioriliac spine Posterior superior iliac spine Inferior gluteal line

Posterior inferior iliac spine Anterior inferior iliac spine Greater sciatic notch Lunate surface

Body of ischium Acetabulum Ischial spine

Lesser sciatic notch Superior pubic ramus Pubic crest Pubic tubercle Ischial tuberosity Inferior pubic ramus

Obturator foramen Ilium Ramus of ischium

Posterior Anterior Iliaccrest

Ischium Pubis

Lateral view Ala Anterior gluteal line Posterior gluteal line Posterior superior iliac spine Anterior superior iliac spine

Posterior inferior iliac spine Inferior glutealline Greater sciatic notch Anterior inferior iliac spine

Lunate surface

Body of ischium Acetabulum Ischial spine Lesser sciatic notch

Superior pubic ramus Ischial tuberosity Pubic crest Pubic tubercle Inferior pubic ramus Obturator foramen Figure 8.9 Ramus of ischium (a) Right os coxae, lateral view

(bottom): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Pubis

• Anterior region of os coxae • Features: – Superior and Inferior rami: struts to acetabulum and ischial ramus – Pubic ______: rough ridge on anterosuperior of superior ramus; ends as pubic tubercle – ______foramen: large space bordered by pubic and ischial rami – ______line: ridge on medial surface of pubis continuing from arcuate line of ilium Pubis

Figure 8.7 True vs. False Pelvis

• True pelvis: bony basin inferior to pelvic brim containing pelvic organs • False pelvis: superior to pelvic brim bound by ilia laterally and abdominal wall anteriorly – Pelvic brim: continuous oval ridge formed by pubic crest, pectineal line, arcuate line, and sacral promontory • Pelvic ______: superior entrance to true pelvis, at pelvic brim • Pelvic ______: exit of true pelvis, defined by coccyx, ischial tuberosities, and inferior border of pubic symphysis Features of the Pelvis

Figure 8.10 Female vs. Male Pelvis

• Most reliable indicator of the sex of a skeleton is the pelvis, due to the requirements of pregnancy and childbirth • Major differences: – female ilia laterally flared = wider pelvis – female pelvic inlet = wide oval, male’s = heart-shaped – female subpubic angle wider, >100º vs. <90º in males Female vs. Male Pelvis

Table 8.1 Sex Differences Between the Female and Male Pelves View Female Pelvis Male Pelvis

Medial View

Preauricular sulcus

Wide greater Narrow greater sciatic notch sciatic notch

Anterior View

Rectangular Triangular pubic body pubic body Triangular Large, oval obturator obturator foramen foramen Wide subpubic angle Narrow subpubic angle

Features Female Characteristic Male Characteristic

General Appearance Less massive; gracile processes, less prominent muscle More massive; more robust processes, more prominent muscle markings markings

General Width Hips are wider, more flared Hips are narrower and more vertically oriented, less flared

Superior Inlet Spacious, wide, and oval Heart-shaped

Acetabulum Smaller Larger

Greater Sciatic Notch Wide and shallow Narrow and U-shaped, deep

Ilium Shallow: Does not project far above sacroiliac joint Deep: Projects farther above sacroiliac joint

Obturator Foramen Smaller and triangular Larger and oval

Subpubic Angle Broader, more convex, usually greater than 100 degrees Narrow, V-shaped, usually less than 90 degrees

Body of Pubis Longer, more rectangular Shorter, triangular

Preauricular Sulcus Usually present Usually absent

Sacrum Shorter and wider; flatter sacral curvature Narrower and longer; more curved (greater sacral curvature)

Coccyx Posterior tilt Vertical

Tilt of Pelvis Anterior tilt to superior end of pelvis Superior end of pelvis relatively vertical

Ischiopubic Ramus Narrow and sharp Broad and fl at

Ischial Spine Rarely projects into pelvic outlet Frequently rotated inward, projects into pelvic outlet

a-b: © David Hunt/ Smithsonian Institution; c-d: © L. Bassett/ Visuals Unlimited Lower Limb

• 30 bones per “leg” – ______in the femoral region (thigh) – ______(kneecap) in the patellar region – ______and ______in the crural region (leg) – 7 tarsals in ankle and proximal foot – 5 metatarsals in sole of foot – 14 phalanges in the toes Femur

• Longest, strongest, and heaviest bone in the body • Proximal features: – Head: articulates with os coxae at acetabulum – ______: dent in head for ligament to acetabulum – Neck: constricted region just distal to head – ______and ______trochanters: massive processes for attachment of powerful hip and thigh muscles Femur Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Greater Neck Head trochanter Greater trochanter Head

Fovea Fovea

Greater trochanter Neck

Intertrochanteric line

Neck

Lesser trochanter Intertrochanteric crest Lesser trochanter

Shaft

(b) Right femoral head, medial view

Head

Shaft

Patellar surface

Shaft

Lateral Intercondylar Medial condyle fossa condyle

Lateral epicondyle

Adductor Adductor tubercle Lateral tubercle epicondyle Medial Medial epicondyle epicondyle

Lateral condyle Lateral condyle Figure 8.11 Patellar Medial surface condyle Patellar Medial surface condyle (a) Right femur, anterior view

a(right), b,c: © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Femur

• Additional features: – Intertrochanteric line: anterior between trochanters marking the distal edge of the hip capsule – ______tuberosity: posterior rough region for attachment of the gluteus maximus muscle – ______: ridge on posterior shaft for attachment of many thigh muscles – Distally, linea aspera splits into medial and lateral supracondylar lines Femur

Figure 8.11 Femur

• Distal features: – ______and ______condyles: smooth, rounded articular surfaces – ______and ______epicondyles: projections just superior to the condyles – Intercondylar fossa: deep posterior depression that separates the condyles – ______surface: smooth anterior region between condyles where patella articulates with the femur Patella

• The “kneecap” – Triangular with broad superior border and inferiorly pointed ______– Articulates with patellar surface of femur

Intercondylar eminence Lateral condyle Medial condyle Lateral Medial • 2 bones in the leg condyle condyle Articular facet Superior tibiofibular joint

Head Head – parallel to each other Tibial tuberosity Neck – tibia is medial to fibula Neck

Anterior border

Fibula Tibia Fibula Tibia

Shaft

Interosseous borders

Inferior Medial tibiofibular malleolus joint

Figure 8.13 Lateral Inferior articular surface Lateral malleolus malleolus

Inferior articular Medial surface malleolus (a) Right tibia and fibula, anterior view

a(right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Tibia

• Medial bone in crural region • Proximal features: – ______and ______condyles: smooth surfaces for articulation with femur – Fibular articular facet: articulation site for head of fibula under lateral condyle Tibia Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Intercondylar eminence Intercondylar Medial Lateral eminence condyle condyle Medial Lateral condyle condyle Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Superior Intercondylar Intercondylar tibiofibularjoint fossa eminence Head

Fibular articular Neck facet Femur

Tibia Tibia

Medial Lateral

condyles condyles Fibula

Tibia Fibula

Interosseous borders

Shaft

(e) Right knee joint, posterior view

Medial malleolus Medial Fibular malleolus notch Inferior tibiofibularjoint

Lateral malleolus Lateral malleolus

(d) Right tibia and fibula, posterior view Figure 8.13 (right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Tibia

• Other features: – ______tuberosity: rough anterior projection inferior to condyles; can be palpated just inferior to the patella; for attachment of patellar ligament – Tibial border: ridge along anterior surface extending from tuberosity distally; the “shin” – ______malleolus: inferiormost prominent medial process; “ankle bump” – Articular surface: inferior surface articulates with the talus Tibia

Intercondylar eminence Intercondylar Medial Lateral eminence condyle condyle Medial Lateral condyle condyle

Superior tibiofibularjoint

Head

Fibular articular Neck facet

Tibia Tibia

Fibula

Interosseous borders

Shaft

Medial malleolus Medial Fibular malleolus notch Figure 8.13 Inferior tibiofibularjoint

Lateral malleolus Lateral malleolus

(d) Right tibia and fibula, posterior view

• Long, thin, lateral crural bone – Not weight-bearing • Features: – proximal head with flat articular facet for articulation with the tibia – narrow neck and slender shaft – distal end expands into ______malleolus Fibula

Intercondylar eminence Intercondylar Medial Lateral eminence condyle condyle Medial Lateral condyle condyle

Superior tibiofibularjoint

Head

Fibular articular Neck facet

Tibia Tibia

Fibula

Interosseous borders

Shaft

Medial malleolus Medial Fibular malleolus notch Inferior Figure 8.13 tibiofibularjoint Lateral malleolus Lateral malleolus

(d) Right tibia and fibula, posterior view

Figure 8.13 Tarsus

• 7 bones form ankle and proximal foot – Calcaneus: largest; forms the heel – Talus: superior-most; weight-bearing; articulates with tibia – Navicular – Cuneiforms: medial, intermediate and lateral – Cuboid Tarsals

Distal phalanx Distal phalanx Distal phalanx of hallux of hallux Distal phalanx Middle phalanx Middle phalanx Proximal phalanx Proximal phalanx of hallux Phalanges (great toe) Phalanges Proximal phalanx Proximal phalanx of hallux (great toe)

II I III I II III IV IV

V Metatarsals V Metatarsals

Medial cuneiform Medial Intermediate cuneiform cuneiform Intermediate Lateral cuneiform Lateral cuneiform cuneiform Navicular Cuboid Navicular Cuboid

Tarsals Talus Talus Tarsals

Calcaneus Calcaneus

(a) Right foot, superior view

Distal phalanx Distal phalanx

Middle phalanx Middle phalanx Phalanges Phalanges Proximal phalanx Proximalphalanx

(Sesamoid bones II I for flexor hallucis Metatarsals II brevis tendons) Metatarsals III III I IV IV V V Medial cuneiform Medialcuneiform Lateral cuneiform Intermediate Intermediate cuneiform Lateral cuneiform cuneiform Cuboid Navicular Navicular Cuboid

Tarsals Tarsals

Talus Talus

Calcaneus Calcaneus

Figure 8.14 (b) Right foot, inferior view a(right), b(right): © The McGraw-Hill Companies, Inc./Photo by Christine Eckel Metatarsals

• 5 bones in sole of foot • Articulations: – proximally with tarsals – distally with phalanges • Identified by Roman numerals I–V from medial to lateral Phalanges

• 14 bones per foot – 3 phalanges per toes 2–5 • Proximal, middle, and distal – Great toe (hallux) only 2 • Proximal and distal Foot Bones

II I III I II III IV IV

V Metatarsals V Metatarsals

Medial cuneiform Medial Intermediate cuneiform cuneiform Intermediate Lateral cuneiform Lateral cuneiform cuneiform Navicular Cuboid Navicular Cuboid

Tarsals Talus Talus Tarsals

Calcaneus Calcaneus

(a) Right foot, superior view

Distal phalanx Distal phalanx

Middle phalanx Middle phalanx Phalanges Phalanges Proximal phalanx Proximalphalanx

Tarsals Tarsals

Talus Talus

Calcaneus Calcaneus Figure 8.14 (b) Right foot, inferior view

• To prevent pinching of muscles, nerves, and blood vessels feet do not rest flat on floor • Three major arches: – Medial: from heel to hallux; highest arch – Lateral: from heel to 5th toe; lowest arch – Transverse: perpendicular to other arches; along distal row of tarsals Foot Arches

Figure 8.15