o Sitting, standing, walking, picking up a pencil, and taking a breath all involve the skeletal system.

Without
the skeletal system, there would be no rigid framework to support the soft tissues of the body and no
system of joints and levers to allow the body to move.
o The skeletal system consists of bones, as well as their associated connective tissues, which include
cartilage, tendons, and ligaments.
o The term skeleton is derived from a Greek word meaning dried. But the skeleton is far from being dry and
nonliving. Rather, the skeletal system consists of dynamic, living tissues that are able to grow, detect pain
stimuli, adapt to stress, and undergo repair after injury.

The major functions of the skeletal system include

1. Support - Rigid, strong bone is well suited for bearing weight and is
the major supporting tissue of the body.
2. Protection- Bone is hard and protects the organs it surrounds.
3. Movement-Tendons, strong bands of connective tissue, attach
skeletal muscles to bones.
4. Storage-Some minerals in the blood—principally, calcium and
phosphorus—are stored in bone.
5. Blood cell production- Many bones contain cavities filled with red
bone marrow, which produces blood cells and platelets.

EXTRACELLULAR MATRIX

o The bone, cartilage, tendons, and ligaments of the skeletal system are all connective tissues. Their
characteristics are largely determined by the composition of their extracellular matrix. The matrix always
contains collagen, ground substance, and other organic molecules, as well as water and minerals.
 Collagen - is a tough, ropelike protein.
 Proteoglycans - are large molecules consisting of many polysaccharides attaching to and encircling
core proteins.
 Tendons and Ligaments - contains large amounts of collagen fibers, making these structures very tough,
like ropes or cables.
 Cartilage - contains collagen and proteoglycans.
 Collagen - makes cartilage tough, whereas the water-filled proteoglycans make it smooth and resilient.
 Hydroxyapatite - most of the mineral in bone is in the form of calcium phosphate crystals
 Brittle bone disease, or osteogenesis imperfect - which literally means imperfect bone formation, is a rare
disorder caused by any one of a number of faulty genes that results in either too little collagen
formation, or poor quality collagen.

GENERAL FEATURES OF BONE

There are four categories of bone, based on their shape: long, short, flat, and irregular.

1. Long bones are longer than they are wide. This shape enhances their function in movement of
appendages. Most of the bones of the upper and lower limbs are long bones.
2. Short bones are approximately as wide as they are long; examples are the bones of the wrist and ankle.
Short bones help transfer force between long bones.
3. Flat bones have a relatively thin, flattened shape. Flat bones are well-suited to providing a strong barrier
around soft organs such as the brain and heart.
4. Irregular bones include the vertebrae and facial bones, which have shapes that do not fit readily into
the other three categories. These bones tend to have specialized functions, such as providing
protection while allowing bending and flexing of certain body regions such as the spine.

Structure of a Long Bone

 A long bone serves as a useful model for illustrating the parts of a typical bone.
 Diaphysis - is the main or midsection of a long bone. It is
made up of cortical bone and usually contains bone marrow
and adipose tissue. It is a middle tubular part composed of
compact bone which surrounds a central marrow cavity
which contains red or yellow marrow.
 Epiphysis - is one of the rounded ends or tips of a long bone
that ossify from a secondary center of ossification. Between
the epiphysis and diaphysis lies the metaphysis, including the
epiphyseal plate.
 Articular cartilage - is a type of specialized connective tissue
present in synovial joints.
 Epiphyseal plate - is a hyaline cartilage plate in the
metaphysis at each end of a long bone. It is the part of a
long bone where new bone growth takes place; that is, the
whole bone is alive, with maintenance remodeling
throughout its existing bone tissue, but the growth plate is the
place where the long bone grows longer.
 Epiphyseal line - is a thin layer of cartilage that separates the
growing end of a long bone from the shaft
 Medullary cavity - is the central cavity of bone shafts where
red bone marrow and/or yellow bone marrow is stored;
hence, the medullary cavity is also known as the marrow
cavity.
 Yellow marrow - consists mostly of adipose tissue.
 Red marrow - consists of blood-forming cells and is the only site of blood formation in adults
 Periosteum - which consists of two layers and contains blood vessels and nerves
 Endosteum – is a thin vascular membrane of connective tissue that lines the inner surface of the bony
tissue that forms the medullary cavity of long bones.

Histology of Bone

o Osteoblasts - which function in the formation of

bone, as well as in the repair and remodeling of
bone.
o Osteocytes - when osteoblasts become
surrounded by matrix
o Osteoclasts - are also present and contribute to
bone repair and remodeling by removing existing
bone, called bone reabsorption.
o Lamellae - is a small plate or flake, from the Latin, and may also be used to refer to collections of fine
sheets of material held adjacent to one another, in a gill-shaped structure, often with fluid in between
though sometimes simply a set of 'welded' plates.
o Lacunae - are situated between the lamellae, and consist of a number of oblong spaces. In an ordinary
microscopic section, viewed by transmitted light, they appear as fusiform opaque spots.
o Canaliculi - A small canal or duct in the body, such as the minute channels in compact bone.
o Compact bone - is mostly solid matrix and cells.
o Spongy bone - consists of a lacy network of bone with many small, marrow-filled spaces

Compact Bone

o Compact bone or cortical bone forms the perimeter of the diaphysis of a long bone and the thinner
surfaces of all other bones. Compact bone has more matrix and is denser, with fewer pores than spongy
bone.
 Osteons – is the fundamental functional unit of much compact bone. Osteons are roughly cylindrical
structures that are typically between 0.25 mm and 0.35 mm in diameter.
 Central canal, or haversian canal – is the cerebrospinal fluid-filled space that runs through the spinal cord.
The central canal lies below and is connected to the ventricular system of the brain, from which it
receives cerebrospinal fluid, and shares the same ependymal lining. The central canal helps to transport
nutrients to the spinal cord as well as protect it by cushioning the impact of a force when the spine is
affected.

Spongy Bone

o Spongy bone is very porous and is located in the epiphyses of long bones and lines the medullary cavity of
long bones. It has less bone matrix and more open space than compact bone.
 Trabeculae - which resemble the beams or scaffolding of a building. Like scaffolding, the trabeculae
add strength to a bone without the added weight that would be present if the bone were solid
mineralized matrix.

Bone Ossification

o Ossification - is the formation of bone by osteoblasts. After an osteoblast becomes completely

surrounded by bone matrix, it becomes a mature bone cell, or osteocyte.
o Intramembranous ossification - occurs when osteoblasts begin to produce bone within connective tissue
membranes.
o Endochondral ossification - bone formation that occurs inside hyaline cartilage
o Ossification centers - is a point where ossification of the cartilage begins. The first step in ossification is that
the cartilage cells at this point enlarge and arrange themselves in rows. The matrix in which they are
imbedded increases in quantity, so that the cells become further separated from each other.
o Chondrocytes - increase in number, causing the cartilage model to increase in size. Soon, chondrocytes
in the center of the model absorb some of the cartilage matrix and enlarge. The chondrocytes release
matrix vesicles, which initiate the formation of hydroxyl apatite crystals
o Primary ossification center - The center part of the diaphysis, where bone first begins to appear
o Secondary ossification centers - form in the epiphyses

Bone Growth

o Bone growth occurs by the deposition of new bone lamellae onto existing bone or other connective
tissue. As osteoblasts deposit new bone matrix on the surface of bones between the periosteum and
the existing bone matrix, the bone increases in width, or diameter.
o This type of bone growth occurs through endochondral ossification. Chondrocytes increase in number
on the epiphyseal side of the epiphyseal plate. They line up in columns parallel to the long axis of the
bone, causing the bone to elongate. Then the chondrocytes enlarge and die. The cartilage matrix
becomes calcified. Much of the cartilage that forms around the enlarged cells is removed by
osteoclasts, and the dying chondrocytes are replaced by osteoblasts.

Bone Remodeling

o Bones are dynamic structures. The shape and composition of bones are constantly changing through
bone remodeling. Bone remodeling is the removal of existing bone by osteoclasts and the deposition of
new bone by osteoblasts and occurs in all bone. Remodeling is responsible for changes in bone shape,
the adjustment of bone to stress, bone repair, and calcium ion regulation in the body fluids. Remodeling
is also involved in bone growth when newly formed spongy bone in the epiphyseal plate forms
compact bone.

Bone Repair

o Sometimes a bone is fractured and needs to be repaired. When this occurs, blood vessels in the bone
are also damaged.
o Two to three days after the injury, blood vessels and cells from surrounding tissues begin to invade the
clot. Some of these cells produce a fibrous network of connective tissue between the fractured bones,
which holds the bone fragments together and fills the gap between them. Other cells produce islets of
cartilage in the fibrous network. The network of fibers and islets of cartilage between the two bone
fragments is called a callus.
o Osteoblasts enter the callus and begin forming spongy bone . Spongy bone formation in the callus is
usually complete 4–6 weeks after the injury. Immobilization of the bone is critical up to this time because
movement can refracture the delicate new matrix. Subsequently, the spongy bone is slowly remodeled
to form compact and spongy bone, and the repair is complete
o Modern therapy attempts to balance bone immobilization with enough exercise to keep muscle and
bone from decreasing in size and strength and to maintain joint mobility. These goals are accomplished
by limiting the amount of time a cast is left on the patient and by using “walking casts,” which allow
some stress on the bone and some movement. Total healing of the fracture may require several months.

BONE AND CALCIUM HOMEOSTASIS

o Bone is the major storage site for calcium in the body, and movement of calcium into and out of bone
helps determine blood calcium levels, which is critical for normal muscle and nervous system function.
Calcium (Ca2+) moves into bone as osteoblasts build new bone and out of bone as osteoclasts break
down bone.
o Calcium homeostasis is maintained by three hormones: parathyroid hormone (PTH) from the parathyroid
glands, vitamin D from the skin or diet, and calcitonin from the thyroid gland.

PTH works through three simultaneous mechanisms to increase blood calcium levels.

1. PTH indirectly stimulates osteoclasts to break down bone, which releases stored calcium into the blood.
2. PTH stimulates the kidney to take up calcium from the urine and return it to the blood.
3. PTH stimulates the formation of active vitamin D, which, in turn, promotes increased calcium absorption
from the small intestine
o Calcitonin works to decrease blood calcium levels by inhibiting osteoclast activity. Even in the absence of
osteoclast activity, osteoblast activity continues, removing calcium from the blood and depositing it into
the bone

GENERAL CONSIDERATIONS OF BONE ANATOMY

A foramen usually exists in a bone because some structure, such as a nerve or blood vessel, passes through the
bone at that point.

 Canal or a meatus - is elongated into a tunnel-like passage through the bone

 Fossa - is a depression or hollow usually in a bone, such as the hypophyseal fossa.
 Tubercle or Tuberosity - a tubercle, tuberosity or apophysis is a protrusion or eminence that serves as an
attachment for skeletal muscles.
 Condyle - is the round prominence at the end of a bone, most often part of a joint – an articulation with
another bone.

AXIAL SKELETON

Skull

The 22 bones of the skull are divided into those of the

braincase and those of the face. The braincase
(neurocranium), which encloses the cranial cavity,
consists of 8 bones that immediately surround and protect
the brain; 14 facial bones form the structure of the face.
Thirteen of the facial bones are rather solidly connected
to form the bulk of the face. The mandible, however,
forms a freely movable joint with the rest of the skull. There
are also three auditory ossicles.

Lateral View

The parietal bones and temporal bones form a large portion of the side of the head. (The word temporal
refers to time, and the temporal bone is so named because the hairs of the temples turn white, indicating the
passage

 Squamous suture - is the cranial suture between the temporal and parietal bones bilaterally.
 Coronal suture - is a dense and fibrous association of connection tissue located in between the frontal
and parietal bones of the skull.
 Lambdoid suture - is a dense, fibrous connective tissue joint on the posterior aspect of the skull that
connects the parietal bones with the occipital bone.
 External auditory canal - a canal that enables sound waves to reach the eardrum.
 Mastoid - process of the temporal bone can be seen and felt as a prominent projection just posterior to
the ear.
 Sphenoid bone - is one of the eight bones that make up the cranium – the superior aspect of the skull
that encloses and protects the brain.
 Zygomatic bone - is a paired facial bone. Both zygoma or cheek bones are irregular and articulate with
other bones of the cranium and face. They are important contributors to mastication or chewing,
providing an attachment point for the masseter muscle – a jaw adductor that closes the jaw.
 Zygomatic arch - which consists of joined processes of the temporal and zygomatic bones, forms a
bridge across the side of the face and provides a major attachment site for a muscle moving the
mandible.
 Maxilla forms the upper jaw the maxilla articulates by sutures to the temporal bone. The maxilla contains
the superior set of teeth
 Mandible forms the lower jaw, contains the inferior set of teeth.

Frontal View

The major structures seen from the frontal view are the frontal bone, the zygomatic bones, the maxillae, and
the mandible. The teeth are very prominent in this view.

 Orbits - are cone-shaped fossae, so named because the eyes rotate within them. The bones of the
orbits provide both protection for the eyes and attachment points for the muscles that move the eyes.
The orbit is a good example of why it is valuable to study the skull as an intact structure.
 Superior and Inferior orbital fissures - they provide openings through which nerves and blood vessels
communicate with the orbit or pass to the face.
 Optic foramen -the opening through which the optic nerve runs back into the brain and the large ophthalmic
artery enters the orbit.
 Nasolacrimal canal - passes from the orbit into the nasal cavity. It contains a duct that carries tears from
the eyes to the nasal cavity.
 Acrimal bone - can be seen in the orbit just above the opening of this canal
 Nasal septum - divides the nasal cavity into right and left halves. Two structures form the nasal septum:
the vomer bone and the perpendicular plate of the ethmoid bone.
 Nasal bones - are two small, symmetrical oblong bones, each having two surfaces and four borders.
 Nasal conchae - is to increase the surface area of the nasal cavities in order to provide warming and
humidification of air as it passes to the lungs.
 Paranasal sinuses - which open into the nasal cavity. The sinuses decrease the weight of the skull and
act as resonating chambers during voice production.
 Mastoid air cells - which are located inside the mastoid processes of the temporal bone. These air cells
open into the middle ear instead of into the nasal cavity.

Interior of the Cranial Cavity

The bones forming the floor of the cranial cavity, from anterior to posterior, are the frontal, ethmoid, sphenoid,
temporal, and occipital bones. Several foramina can be seen in the floor of the middle fossa. These allow
nerves and blood vessels to pass through the skull.

 Foramen magnum - through which the spinal cord joins the brain, is located in the posterior fossa.
 Sella turcica - which contains the pituitary gland.

Base of Skull Viewed from Below

Many of the same foramina that are visible in the interior of the skull can also be seen in the base of the skull,
when viewed from below, with the mandible removed . Other specialized structures, such as processes for
muscle attachments, can also be seen. The foramen magnum is located in the occipital bone near the center
of the skull base.
 Occipital condyles - the smooth points of articulation between the skull and the vertebral column, are
located beside the foramen magnum.
 Styloid - processes project from the inferior surface of the temporal bone.
 Mandibular fossa - where the mandible articulates with the temporal bone, is anterior to the mastoid
process.
 Hard palate - forms the roof of the mouth, which is also the floor of the nasal cavity
 Palatine bones -It participates in building the three cavities within the skull; the oral cavity, nasal cavity
and the orbits.
 Soft palate - makes up the posterior third of the palate and is a posterior continuation of the hard
palate. The soft palate consists of muscle fibers and connective tissue covered by a mucus membrane
consisting of a stratified squamous epithelium with secretory salivary glands.

Hyoid Bone

 The hyoid bone is an unpaired, U-shaped bone. The hyoid bone provides an attachment for some tongue
muscles, and it is an attachment point for important neck muscles that elevate the larynx during speech or
swallowing.

Vertebral Column

The vertebral column, or spine, is the central axis of the skeleton, extending from the
base of the skull to slightly past the end of the pelvis.

In adults, it usually consists of 26 individual bones, grouped into five regions : 7 cervical
vertebrae , 12 thoracic vertebrae, 5 lumbar vertebrae, 1 sacral bone, and 1

 Each of the five regions is identified by a letter, and the vertebrae within each
region are numbered: C1–C7, T1–T12, L1–L5, S, and CO.
 The number of vertebrae in the non-fused regions of the spine by remembering
meal times: 7, 12, and 5.
 Kyphosis - is an abnormal posterior
curvature of the spine, mostly in the
upper thoracic region, resulting in a
hunchback condition.
 Lordosis - is an abnormal anterior
curvature of the spine, mainly in the
lumbar region, resulting in a swayback
condition.
 Scoliosis - is an abnormal lateral
curvature of the spine.

The vertebral column performs the following five major functions: (1) supports the weight of the head and
trunk; (2) protects the spinal cord; (3) allows spinal nerves to exit the spinal cord; (4) provides a site for muscle
attachment; and (5) permits movement of the head and trunk

General Plan of the Vertebrae

There is one spinous process posteriorly and two transverse processes laterally. The weight-bearing portion of
each vertebra is the body.

 Intervertebral disks -to allow movement between adjacent vertebral bodies, to absorb shock, and to
transmit loads through the vertebral column.
 Vertebral arch - consists of the pedicles, which attach to the vertebral body, and the laminae, which
come together to form the roof of the arch.
 Vertebral foramen - The vertebral foramen begins at cervical vertebra #1 (C1 or atlas) and continues
inferior to lumbar vertebra #5 (L5). The vertebral foramen houses the spinal cord and its meninges.
 Vertebral canal - is an anatomical space formed by the vertebral column that stores an integral portion
of the central nervous system
 Pedicles - which extend from the body to the transverse process of each vertebra
 laminae - which extend from the transverse processes to the spinous process.
 Vertebral foramina - are formed by notches in the pedicles of adjacent vertebrae
 Articular process - where the vertebrae articulate with each other

Regional Differences in Vertebrae

 Cervical vertebrae - have very small bodies, except for the atlas, which has no body.
 Atlas –the first cervical vertebra because it holds up the head, as Atlas in classical mythology held up
the world.
 Axis –the second cervical vertebra, because a considerable amount of rotation occurs at this vertebra,
as in shaking the head “no.”
 Dens -this rotation occurs around a process, which protrudes superiorly from the axis.
 Lumbar vertebrae - have large, thick bodies and heavy, rectangular transverse and spinous processes.
 Sacrum -is a shield-shaped bony structure that is located at the base of the lumbar vertebrae and that is
connected to the pelvis. The sacrum forms the posterior pelvic wall and strengthens and stabilizes the
pelvis.
 Median sacral crest - forms from the fusion of the first three sacral spinous processes. It serves as the
attachment point for the supraspinous ligament. The intermediate sacral crests form by the fusion of the
articular processes.
 Sacral hiatus - is an opening present at the lower end of the sacral canal. The anatomy of the sacral
hiatus and its variations are clinically important during administration of caudal epidural block (CEB) in
obstetrics and gynecology, orthopedic, urology and general surgical practices.
 Sacral promontory - a landmark that can be felt during a vaginal examination. It is used as a reference
point to determine if the pelvic openings are large enough to allow for normal vaginal delivery of a
baby.

Rib Cage

 The rib cage protects the vital organs within the thorax
and prevents the collapse of the thorax during
respiration. It consists of the thoracic vertebrae, the ribs
with their associated cartilages, and the sternum

Ribs and Costal Cartilages

 The 12 pairs of ribs can be divided into true ribs and

false ribs. The true ribs, ribs 1–7, attach directly to the
sternum by means of costal cartilages. The false ribs, ribs
8–12, do not attach directly to the sternum. Ribs 8–10
attach to the sternum by a common cartilage; ribs 11
and 12 do not attach at all to the sternum and are
called floating ribs.

Sternum
The sternum or breastbone is divided into three parts: the manubrium, the body, and the xiphoid process.

 Jugular notch - is located between the ends of the clavicles where they articulate with the sternum.
 Sterna l angle - can be felt at the junction of the manubrium and the body of the sternum.

APPENDICULAR SKELETON

 The appendicular skeleton consists of the bones of the upper and lower limbs, as well as the girdles, which
attach the limbs to the axial skeleton.

Pectoral Girdle

 Pectoral girdle or shoulder girdle - consists of four bones, two

scapulae and two clavicles, which attach the upper limb to the
body.
 Scapula or shoulder blade - is a flat, triangular bone with three large
fossae where muscles extending to the arm are attached
 Glenoid cavity - is where the head of the humerus connects to the
scapula.
 Spine - runs across the posterior surface of the scapula.
 Acromion process - extends from the scapular spine to form the
point of the shoulder.
 Clavicle or collarbone - articulates with the scapula at the acromion
process. The clavicle is the first bone to begin ossification in the
fetus. This relatively brittle bone may be fractured in the newborn
during delivery.
 Coracoids process - of the scapula curves below the clavicle and
provides for the attachment of arm and chest muscles.

Upper Limb

 The upper limb consists of the bones of the arm, forearm, wrist, and hand.

Arm

 The arm is the region between the shoulder and the elbow; it contains the humerus. The proximal end of the
humerus has a smooth, rounded head, which attaches the humerus to the scapula at the glenoid cavity.
Around the edge of the humeral head is the anatomical neck.
 Greater tubercle - is the most lateral bony point of the humerus and is palpable at the posterolateral
aspect of the shoulder.
 Lesser tubercle - is located on the craniomedial part of the proximal extremity of humerus. It gives
insertion for the muscles of the shoulder blade (infraspinous and supraspinous muscles).
 Deltoid tuberosity - where the deltoid muscle attaches. Because mechanical stress promotes bone
remodeling, the size of the deltoid tuberosity can increase as the result of frequent and powerful pulls
from the deltoid muscle.
 Epicondyles - on the distal end of the humerus, just lateral to the condyles, provide attachment sites for
forearm muscles.

Forearm

 The forearm has two bones: the ulna (ul′na) on the medial (little finger) side of the forearm and the radius
on the lateral (thumb)
 Trochlear notch - that fits tightly over the end of the humerus, forming most of the elbow joint.
 Olecranon process - which can be felt as the point of the elbow
 Coronoid process - which helps complete the “grip” of the ulna on the distal end of the humerus.
 Styloid process - is located on its medial side. The ulnar head can be seen as a prominent projection
on the posterior ulnar side of the wrist. A styloid process is located on the lateral side of the distal end
of the radius.
 Radial tuberosity - where one of the arm muscles, the biceps brachii, attaches

Wrist

 The wrist is a relatively short region between the forearm and the hand; it is composed of eight carpal
bones

These eight bones are: the scaphoid, lunate, triquetrum, pisiform, trapezium , trapezoid, capitate , and hamate.

 The following one allows students to remember them in order from lateral to medial for the proximal row
(top) and from medial to lateral (by the thumb) for the distal row: So Long Top Part, Here Comes The
Thumb—that is, Scaphoid, Lunate, Triquetrum, Pisiform, Hamate, Capitate, Trapezoid, and Trapezium

Hand

 Five metacarpal bones are attached to the carpal bones and form the bony framework of the hand. The
metacarpal bones are aligned with the five digits: the thumb and fingers. They are numbered 1 to 5, from
the thumb to the little finger.
 Phalanges - named after the Greek phalanx, a wedge of soldiers holding their spears, tips outward, in
front of them. The phalanges of each finger are called proximal, middle, and distal, according to
their position in the digit. The thumb has two phalanges, proximal and distal. The digits are also
numbered 1 to 5, starting from the thumb.

Pelvic Girdle

 Pelvic girdle - is the place where the lower limbs attach to the
body
 Hip bones - is comprised of the three parts; the ilium, pubis
and ischium. Prior to puberty, the triradiate cartilage separates
these parts – and fusion only begins at the age of 15-17.
 Sacrum - is a shield-shaped bony structure that is located at the
base of the lumbar vertebrae and that is connected to the
pelvis. The sacrum forms the posterior pelvic wall and
strengthens and stabilizes the pelvis.
 Pelvis - is the lower part of the trunk, between the abdomen
and the thighs (sometimes also called pelvic region), together
with its embedded skeleton (sometimes also called bony pelvis,
or pelvic skeleton).
 Ilium - makes up the upper portion of the hip bone and pelvis.
It is the largest and uppermost bone of the hip and is an
essential part of the pelvic girdle.
 Ischium - is a paired bone of the pelvis that forms the lower and back part of the hip bone, as well as
the posterior and inferior boundary of the obturator foramen.
 Iliac crest - is the curved area at the top of the ilium bone, the largest of three bones that make up the
pelvis.
 Anterior superior iliac spine - an important hip landmark, is located at the anterior end of the iliac crest.
 Pubic Symphisis - is a joint sandwiched between your left pelvic bone and your right pelvic bone. It helps
your pelvis absorb some of the weight from your upper body before it travels to your lower body.
 Sacroiliac joints - connects the hip bones (iliac crests) to the sacrum, the triangular bone between the
lumbar spine and the tailbone (coccyx).
 Acetabulum - is the socket of the hip joint.
 Obturator foramen - is the large hole in each hip bone that is closed off by muscles and other structures
 Pelvic inlet - is formed by the pelvic brim and the sacral promontory.
 Pelvic outlet - is bounded by the ischial spines, the pubic symphysis, and the coccyx

Lower Limb

 The lower limb consists of the bones of the thigh, leg, ankle, and foot

Thigh

The thigh is the region between the hip and the knee. It contains a single bone called the femur.

 Head of the femur articulates with the acetabulum of the hip bone.
 Condyles - articulate with the tibia.
 Epicondyles - located medial and lateral to the condyles, are points of ligament attachment.
 Trochanters - is a tubercle of the femur near its joint with the hip bone.
 Patella - is located within the major tendon of the anterior thigh muscles and enables the tendon to bend
over the knee.
 Sesamoid bone – is a small bone commonly found embedded within a muscle or tendon near joint
surfaces, existing as focal areas of ossification and functioning as a pulley to alleviate stress on that
particular muscle or tendon.

Leg

 The leg is the region between the knee and the ankle.

It contains two bones: the medial tibia and the lateral fibula

 Tibia - is the larger of the two and is the major weight-bearing bone of the leg.
 Fibula - does not articulate with the femur, but its head is attached to the proximal end of the tibia.
 Tibial tuberosity - where the muscles of the anterior thigh attach.

Ankle

The ankle consists of the distal ends of the tibia and fibula forming a partial socket that articulates with a bone
of the foot.

 Medial malleolus - the small prominent bone on the inner side of the ankle at the end of the tibia.
 Posterior malleolus — the back part of the tibia.
 Lateral malleolus - the prominent bone on the outer side of the ankle at the end of the fibula.

Foot

 Tarsal bones - any of several short, angular bones that in humans make up the ankle and that—in
animals that walk on their toes (e.g., dogs, cats) or on hoofs—are contained in the hock, lifted off the
ground. The tarsals correspond to the carpal bones of the upper limb.
 Talus - is the bone that makes up the lower part of the ankle joint (the tibia and fibula make up the
upper part).
 Calceneus - is the largest bone in the foot. It projects posterior to the tibia and fibula and acts as a short
lever for the calf muscles (gastrocnemius and soleus) which insert onto its posterior surface via the
Achilles tendon. It also plays an important role in weight bearing and stability.
 Cuboid - is one of the seven bones which make up the tarsus of the Ankle and Foot and it is one of the
five bones of the midfoot. It is located on the lateral aspect of the foot, anterior to the calcaneus, next
to the navicular and lateral cuneiform bones, and posterior to the 4th and 5th metatarsal.
 Navicular - is one of the seven bones which make up the tarsus of the Ankle and Foot. It is located on the
medial aspect of the foot, next to the cuboid bone, anterior to the head of the talus and posterior to
the cuneiform bones.
o A mnemonic for the distal row is MILC—that is, Medial, Intermediate, and Lateral cuneiforms and the
Cuboid. A mnemonic for the proximal three bones is No Thanks Cow—that is, Navicular, Talus, and
Calcaneus.
o Metatarsal bones and phalanges of the foot are arranged and numbered in a manner very similar to the
metacarpal bones and phalanges of the hand. The metatarsal bones are somewhat longer than the
metacarpal bones, whereas the phalanges of the foot are considerably shorter than those of the hand.
o Arches in the foot, formed by the positions of the tarsal bones and metatarsal bones, and held in place by
ligaments.

The arches serve as an adjustable lever to assist in the two main functions of the foot:

1) to support the body in its upright position both while standing and in forward movement during
walking and
2) to push the body forward during walking and to absorb the shock when the foot contacts the ground.
The arches function similarly to the springs of a car, allowing the foot to give and spring back.

Joint

 Joints, or articulations, are commonly named according to the bones or portions of bones that join
together; for example, the temporomandibular joint is between the temporal bone and the mandible.
Some joints are given the Greek or Latin equivalent of the common name, such as cubital joint for the
elbow joint.
 Joints - are classified structurally as fibrous, cartilaginous, or synovial, according to the major
connective tissue type that binds the bones together and whether a fluid-filled joint capsule is present.
Joints can also be classified in functional categories according to their degree of motion as
synarthroses (nonmovable joints),amphiarthroses (slightly movable joints), or diarthroses (freely
movable joints).
 Fibrous joints - are the articulating surfaces of two bones united by fibrous connective tissue. They
have no joint cavity and exhibit little or no movement. Joints in this group are further subdivided on
the basis of structure as sutures, syndesmoses, or gomphoses
 Sutures - are fibrous joints between the bones of the skull .
 Fontanels or soft spots - they allow flexibility in the skull during the birth process, as well as growth of
the head after birth.
 Syndesmoses - are fibrous joints in which the bones are separated by some distance and held together
by ligaments.
 Gomphoses - consist of pegs fitted into sockets and held in place by ligaments. The joint between a
tooth and its socket is a gomphosis.

Cartilaginous Joints

Cartilaginous joints unite two bones by means of cartilage. Only slight movement can occur at these joints. The
connecting cartilage can be either hyaline cartilage or fibrocartilage. Joints containing hyaline cartilage are
called synchondroses; joints containing fibrocartilage are called symphyses.
Synovial Joints

 Synovial joints - are freely movable joints that contain fluid in a cavity
surrounding the ends of articulating bones
 Articular cartilage - which provides a smooth surface where the
bones meet.
 Joint cavity -
 Joint capsule - which helps hold the bones together while still
allowing for movement.
 Synovial membrane - lines the joint cavity everywhere except over the
articular cartilage.
 Synovial fluid - which is a complex mixture of polysaccharides,
proteins, lipids, and cells. Synovial fluid forms a thin, lubricat ing film
covering the surfaces of the joint.
 Bursa - bursae are located between structures that rub together, such
as where a tendon crosses a bone; they reduce friction, which could
damage the structures involved.
 Bursitis - inflammation of a bursa, often resulting from abrasion

Types of Synovial Joints

 Synovial joints - are classified according to the shape of the adjoining articular surfaces.
 Plane joints, or gliding joints - consist of two opposed flat surfaces that glide over each other.
 Saddle joints - consist of two saddle-shaped articulating surfaces oriented at right angles to each other.
 Hinge joints - permit movement in one plane only. They consist of a convex cylinder of one bone
applied to a corresponding con cavity of the other bone.
 Menisci - the flat condylar surface of the knee joint is modified into a concave surface by shock-
absorbing fibrocartilage pads
 Pivot joints - restrict movement to rotation around a single axis. Each pivot joint consists of a cylin drical
bony process that rotates within a ring composed partly of bone and partly of ligament.
 Ball-and-socket joints - 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.
 Ellipsoid joints or condyloid joints - are elongated ball-and-socket joints. The shape of the joint limits its
range of movement nearly to that of a hinge motion, but in two planes.
Types of Movement

 The types of movement occurring at a given joint are related to the structure of that joint. Some joints are
limited to only one type of movement, whereas others permit movement in several directions. All the
movements are described relative to the anatomical position.

Flexion - is a bending movement that decreases the angle of the joint to bring the articulating bones closer
together.
Extension - is a straightening movement that increases the angle of the joint to extend the articulating bones.
These bending and extend ing movements can easily be seen at the elbow and knee joints .
Hyperextension - is usually defined as extension of a joint beyond 180 degrees . Hyperextension can be a
normal movement, such as looking up at the stars, but it can also result in injury.
Plantar flexion - the movement of the foot in a downward motion away from the body.
Dorsiflexion - is the backward bending and contracting of your hand or foot.
Abduction - is a movement away from the midline – just as abducting someone is to take them away.
Adduction - is a movement towards the midline. Adduction of the hip squeezes the legs together.
Pronation - is rotation of the forearm so that the palm is down
Supination - is rotation of the forearm so that the palm faces up
Eversion - is turning the foot so that the plantar surface (bottom of the foot) faces laterally
inversion - is turning the foot so that the plantar surface faces medially
Rotation - is the turning of a structure around its long axis, as in shaking the head “no.” Rotation of the arm can
best be demonstrated with the elbow flexed so that rotation is not confused with supination and pronation of
the forearm.
Circumduction - occurs at freely movable joints, such as the shoulder.

In addition to the movements pictured, several other movement types have been identified:

1. Protraction is a movement in which a structure, such as the mandible, glides anteriorly.

2. In retraction the structure glides posteriorly.
3. Elevation is movement of a structure in a superior direction. Closing the mouth involves elevation of the
mandible.
4. Depression is movement of a structure in an inferior direction. Opening the mouth involves depression of
the mandible.
5. Excursion is movement of a structure to one side, as in moving the mandible from side to side.
6. Opposition is a movement unique to the thumb and little finger. It occurs when the tips of the thumb
and little finger are brought toward each other across the palm of the hand. The thumb can also
oppose the other digits.
7. Reposition returns the digits to the anatomical position.
 Most movements that occur in the course of normal activities are combinations of movements. A complex
movement can be described by naming the individual movements involved.
 Sprain results - when the bones of a joint are forcefully pulled apart and the ligaments around the
joint are pulled or torn,
 Separation - exists when the bones remain apart after injury to a joint.
 Dislocation - is when the end of one bone is pulled out of the socket in a ball-and-socket, ellipsoid,
or pivot joint.

REPRESENTIVE DISEASES AND DISORDERS : Skeletal System

condition Description
Skeletal disorders
Growth and Developmental Disorders
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
Rickets -Growth retardation due to nutritional deficiencies in
minerals (Ca2+) or vitamin D; results in bones that are
soft, weak, and easily fractured
Bacterial Infections
Tuberculosis -Typically, a lung bacterium that can also affect bone
Decalcification
Osteomalacia -Softening of adult bones due to calcium depletion;
often caused by vitamin D deficiency
JOINT DISORDERS
Arthritis -Inflammation of a joint; causes include infectious
Rheumatoid arthritis agents, metabolic disorders, trauma, and immune
Gout disorders
-General connective tissue autoimmune disease
Increased production and accumulation of uric acid
crystals in tissues, including joint capsules
Burtsitis and bunions
Bursitis -Inflammation of a bursa
Bunion -Most bunions are deformations of the first metatarsal
(the great toe); bursitis may accompany this
deformity; irritated by tight shoes