chapter 8 *lecture outline copyright © the mcgraw-hill companies, inc. permission required for...

Chapter 8

*Lecture Outline

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

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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 borders, three angles

• Articulations– Lateral: glenoid cavity for head of

humerus

• Other features– Posterior: bony ridge = spine– Lateral: acromion process– Anterior projection: coracoid process

Scapula

Figure 8.3

Upper Limb• 30 bones per “arm”

–Humerus in brachium (upper arm)

–Radius and ulna in antebrachium (forearm)

–8 carpal bones in wrist–5 metacarpals in palm–14 phalanges in fingers

HumerusProximal features:

• Head: articulates with scapula

• Anatomical and surgical necks

• Greater and lesser tubercles: for muscle attachment

• Intertubercular sulcus: for biceps brachii tendon

HumerusAnterior View

Figure 8.4

Anatomical neck

Head

HeadGreatertubercle

Lessertubercle

Intertubercularsulcus

Surgical neck

Deltoidtuberosity

Shaft

Coronoid fossa

Radial fossa

Coronoid fossa

(a) Right humerus, anterior view

CapitulumCapitulum Trochlea

Medialepicondyle

Lateral epicondyle

Trochlea


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

Humerus• Distal features:

– Shaft– Deltoid tuberosity for attachment

of deltoid

– Medial and lateral epicondyles for muscle attachments

– Capitulum: round lateral articulation for radius

– Trochlea: spool-like medial articulation for ulna

HumerusDistal fossae (depressions):• Anterior

– Radial: lateral depression for radius

– Coronoid: medial, for anterior ulna

• Posterior– Olecranon: largest, for posterior

ulna

Humerus – Posterior View

Figure 8.4


Head

Greatertubercle

Anatomicalneck

Surgicalneck

Deltoidtuberosity

Radialgroove

Olecranonfossa

Lateralepicondyle

(d) Right humerus, posterior viewTrochlea

Lateralepicondyle

Medialepicondyle

Trochlea

Medialepicondyle

Olecranonfossa

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

Radius and Ulna

• Antebrachial bones–parallel to each other

–in anatomical position,

radius is lateral to ulna

Figure 8.5


Olecranon Olecranon

Trochlearnotch

Coronoid process

Radialtuberosity

Neck

Proximalradioulnar joint

Head

Neck

Radius

UlnaRadius

Shaft

Ulna

Interosseousmembrane

Interosseousborders

Styloidprocess

(a) Right radius and ulna, anterior view

Styloidprocess

Distal

Styloid process

Head

radioulnar joint

Head

Tuberosity of ulna

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:

– Styloid process: lateral “wrist bump”– Ulnar notch: medial dent for head of ulna

Ulna• Proximal features:

– Trochlear notch: for trochlea of humerus– Olecranon: posterior “elbow bump” for

triceps brachii muscle– Coronoid process: anterior tip of

trochlear notch– Radial notch: lateral, for head of radius

• Distal features:– Head: knoblike end– Styloid process: posteromedial “wrist

bump”

Radius and Ulna

Figure 8.5


OlecranonOlecranon

Head

Neck

Proximalradioulnar joint

RadiusUlna

Shaft

Radius

Interosseousmembrane

Interosseousborders

(f) Right ulna and radius, posterior view

Styloid processes

Head

Distalradioulnar joint

Styloid processes

Head

Ulna


Posterior View

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

(lateral to medial)1. Scaphoid

2. Lunate

3. Triquetrum

4. Pisiform

Distal Row

(lateral to medial)5. Trapezium

6. Trapezoid

7. Capitate

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 acetabulum

• 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– Iliac fossa: large depression on medial

surface– Anterior, posterior, and inferior gluteal

lines: lateral site of muscle attachments

Ilium

Figure 8.9


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

Iliac crest

Ala

Anterior gluteal line

Posterior superior iliac spine

Posterior gluteal line

Posterior inferior iliac spine

Greater sciatic notch

Body of ischium

Ischial spine

Lesser sciatic notch

Ischial tuberosity

Ilium

Anterior

Pubis

Posterior

Ischium

Lateral view






Body of ischium

Ischial spine


Ischial tuberosity

(a) Right os coxae, lateral view

Ramus of ischium

Obturator foramen

Superior pubic ramus

Pubic crest

Pubic tubercleInferior pubic ramus

Lunate surface

Acetabulum

Anterior superior iliac spine

Anterior inferior iliac spine

Inferior glutealline

Iliaccrest

Ala

Ramus of ischium

Obturator foramen


Inferior pubic ramus

Pubic crest

Pubic tubercle

Anterior super ioriliac spine

Inferior gluteal line


Lunate surface

Acetabulum

Iliac crest

Iliac fossa



Arcuate line

Posterior superiorIliac spine

Auricular surface



Ischial spine


Body of ischium

Ischial tuberosity

Ramus of ischium

Iliac crest

Posterior superioriliac spine

Iliac fossa

Auricular surface

Posterior inferioriliac spine

Ramus of ischium

Greater sciaticnotch

Ischial spine

Lesser sciaticnotch

Body of ischium

(b) Right os coxae, medial view

Pectineal line

Superior pubicramus

Symphysial surface

Obturator foramen

Inferior pubic ramusIlium

Anterior Posterior

IschiumPubis

Medial view



Arcuate line

Inferior pubicramus

Symphysial surface

Obturator foramen

Pectineal line

Superior pubicramus

Pubic tubercle

Ischial tuberosity

Pubic tubercle

Ilium• Additional features:

– Iliac crest: superior ridge

– Anterior and posterior, superior and inferior iliac spines: projections along iliac crest

– Greater sciatic 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 tuberosity: rough inferior region that supports weight of body when seated

– Ischial ramus: bridge from tuberosity to pubis

Ischium

Figure 8.9


Iliac crest

Ala




Posterior inferior iliac spineGreater sciatic notch

Body of ischiumIschial spine


Ischial tuberosity

Ilium

Anterior

Pubis

Posterior

Ischium

Lateral view

Anterior gluteal linePosterior gluteal linePosterior superior iliac spine

Posterior inferior iliac spineGreater sciatic notch

Body of ischiumIschial spine


Ischial tuberosity

(a) Right os coxae, lateral view

Ramus of ischiumObturator foramen


Pubic crestPubic tubercleInferior pubic ramus

Lunate surface

Acetabulum


Anterior inferior iliac spineInferior glutealline

Iliaccrest

Ala

Ramus of ischiumObturator foramen


Inferior pubic ramus

Pubic crestPubic tubercle

Anterior super ioriliac spine

Inferior gluteal line


Lunate surface

Acetabulum

(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 crest: rough ridge on anterosuperior of superior ramus; ends as pubic tubercle

– Obturator foramen: large space bordered by pubic and ischial rami

– Pectineal 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 inlet: superior entrance to true pelvis, at pelvic brim

• Pelvic outlet: 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 PelvisCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Anterior View

Features Female Characteristic Male Characteristic

Table 8.1 Sex Differences Between the Female and Male Pelves

Male PelvisFemale PelvisView

Medial View

General Appearance

General Width

Superior Inlet

Acetabulum

Greater Sciatic Notch

Ilium

Obturator Foramen

Subpubic Angle

Body of Pubis

Preauricular Sulcus

Sacrum

Coccyx

Tilt of Pelvis

Ischiopubic Ramus

Ischial Spine Rarely projects into pelvic outlet

Narrow and sharp

Frequently rotated inward, projects into pelvic outlet

Broad and fl at

Anterior tilt to superior end of pelvis

Narrow greatersciatic notch

Triangularpubic body

Large, ovalobturatorforamen

Narrow subpubic angle

Rectangularpubic body

Triangularobturatorforamen

Preauricularsulcus

Wide greatersciatic notch

Wide subpubic angle

More massive; more robust processes, more prominent musclemarkings

Less massive; gracile processes, less prominent musclemarkings

Hips are wider, more flared

Spacious, wide, and oval

Smaller

Wide and shallow

Shallow: Does not project far above sacroiliac joint

Smaller and triangular

Broader, more convex, usually greater than 100 degrees

Longer, more rectangular

Usually present

Shorter and wider; flatter sacral curvature

Posterior tilt

Hips are narrower and more vertically oriented, less flared

Heart-shaped

Larger

Narrow and U-shaped, deep

Deep: Projects farther above sacroiliac joint

Larger and oval

Narrow, V-shaped, usually less than 90 degrees

Shorter, triangular

Usually absent

Narrower and longer; more curved (greater sacral curvature)

Vertical

Superior end of pelvis relatively vertical

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

Lower Limb• 30 bones per “leg”

– femur in the femoral region (thigh)

– patella (kneecap) in the patellar region

– tibia and fibula 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– Fovea: dent in head for ligament to

acetabulum– Neck: constricted region just distal to head– Greater and lesser trochanters: massive

processes for attachment of powerful hip and thigh muscles

Femur

Figure 8.11


Greatertrochanter

Neck Head

Fovea

Greatertrochanter

Lesser trochanter

Intertrochanteric line

Head

Fovea

Neck

Shaft

(b) Right femoral head, medial view

Medialcondyle

(c) Right femur, inferior view

Lateralcondyle

Intercondylarfossa

Patellarsurface

Shaft

Medialcondyle

Medialepicondyle

Adductortubercle

Lateralepicondyle

Lateralepicondyle

Lateralcondyle

(a) Right femur, anterior view

Medialcondyle

Patellarsurface Patellar

surface

Lateralcondyle

Medialepicondyle

Adductortubercle

Head

Greatertrochanter

Neck

Intertrochantericcrest

Lesser trochanter

Shaft

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

Anterior View

Femur• Additional features:

– Intertrochanteric line: anterior between trochanters marking the distal edge of the hip capsule

– Gluteal tuberosity: posterior rough region for attachment of the gluteus maximus muscle

– Linea aspera: ridge on posterior shaft for attachment of many thigh muscles

– Distally, linea aspera splits into medial and lateral supracondylar lines

Femur

Figure 8.11

Posterior view

Femur• Distal features:

– Medial and lateral condyles: smooth, rounded articular surfaces

– Medial and lateral epicondyles: projections just superior to the condyles

– Intercondylar fossa: deep posterior depression that separates the condyles

– Patellar surface: smooth anterior region between condyles where patella articulates with the femur

Patella• The “kneecap”

– Triangular with broad superior border and inferiorly pointed apex

– Articulates with patellar surface of femur

Figure 8.12 Figure 8.13

Tibia and Fibula

• 2 bones in the leg–parallel to each

other

–tibia is medial to fibula

Figure 8.13


Tibia

Medialmalleolus

Inferior articularsurface

(a) Right tibia and fibula, anterior view

Lateralmalleolus

Fibula

Articularfacet

Head

Neck

Medialmalleolus

Anterior border

Tibia Fibula

Shaft

Interosseousborders

Neck

Tibial tuberosity

Medial condyleLateral condyle

Superiortibiofibularjoint

Head

Lateralcondyle

Intercondylareminence

Medialcondyle

Lateralmalleolus

Inferior articular surface

Inferiortibiofibularjoint

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

Tibia• Medial bone in crural region

• Proximal features:– Medial and lateral condyles:

smooth surfaces for articulation with femur

– Fibular articular facet: articulation site for head of fibula under lateral condyle

Tibia- Posterior View

Figure 8.13

(e) Right knee joint, posterior view


Intercondylarfossa

Lateralcondyles

FibulaTibia

Medialcondyles

Femur

© The McGraw-Hill Companies, Inc./Photo by Christine Eckel



(d) Right tibia and fibula, posterior view

Lateral malleolus

Medialmalleolus

Fibularnotch


Medialmalleolus

Lateral malleolus

Tibia Tibia


Lateralcondyle

Medialcondyle


Head

Neck

Fibula

Interosseousborders

Shaft

Medialcondyle


Lateralcondyle

Fibular articularfacet


Tibia• Other features:

– Tibial 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”

– Medial malleolus: inferiormost prominent medial process; “ankle bump”

– Articular surface: inferior surface articulates with the talus

Tibia- Posterior View

Figure 8.13



Lateral malleolus

Medialmalleolus

Fibularnotch


Medialmalleolus

Lateral malleolus

Tibia Tibia


Lateralcondyle

Medialcondyle


Head

Neck

Fibula

Interosseousborders

Shaft

Medialcondyle


Lateralcondyle



Fibula• 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 lateral malleolus

Fibula

Figure 8.13



Lateral malleolus

Medialmalleolus

Fibularnotch


Medialmalleolus

Lateral malleolus

Tibia Tibia


Lateralcondyle

Medialcondyle


Head

Neck

Fibula

Interosseousborders

Shaft

Medialcondyle


Lateralcondyle



Articulation of Head of Fibula with Tibia

Figure 8.13

Posterior View

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

Figure 8.14


I

V

I

V

I

V

I

V

Distal phalanxof hallux

Proximal phalanxof hallux(great toe)

Distal phalanx

Middle phalanx

II IIIIV

II IIIIV

IIIIIIV

IVIII

II

(b) Right foot, inferior view

Calcaneus

Tarsals

Phalanges

Medial cuneiform

Navicular

Intermediatecuneiform

Talus

Tarsals

Metatarsals

Cuboid

Lateralcuneiform

Calcaneus

Lateral cuneiform

Cuboid

Talus

Navicular

Medialcuneiform


(Sesamoid bonesfor flexor hallucisbrevis tendons)

Phalanges

(a) Right foot, superior view

Calcaneus

Distal phalanx

Middle phalanx

Proximal phalanx

Metatarsals

Distal phalanx

Middle phalanx

Proximalphalanx

Calcaneus

TalusTarsals

Talus Tarsals

Cuboid

Navicular

Medial cuneiform

Navicular


Cuboid

Lateralcuneiform

Metatarsals


Phalanges

Proximal phalanx

Distal phalanx

Middle phalanx

Proximal phalanxPhalanges


Metatarsals


Medialcuneiform

Lateral cuneiform

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

Figure 8.14


I

V

I

V

I

V

I

V



Distal phalanx

Middle phalanx

II IIIIV

II IIIIV

IIIIIIV

IVIII

II

(b) Right foot, inferior view

Calcaneus

Tarsals

Phalanges

Medial cuneiform

Navicular


Talus

Tarsals

Metatarsals

Cuboid

Lateralcuneiform

Calcaneus

Lateral cuneiform

Cuboid

Talus

Navicular

Medialcuneiform


(Sesamoid bonesfor flexor hallucisbrevis tendons)

Phalanges

(a) Right foot, superior view

Calcaneus

Distal phalanx

Middle phalanx

Proximal phalanx

Metatarsals

Distal phalanx

Middle phalanx

Proximalphalanx

Calcaneus

TalusTarsals

Talus Tarsals

Cuboid

Navicular

Medial cuneiform

Navicular


Cuboid

Lateralcuneiform

Metatarsals


Phalanges

Proximal phalanx

Distal phalanx

Middle phalanx

Proximal phalanxPhalanges


Metatarsals


Medialcuneiform

Lateral cuneiform

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

Foot Arches

• 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

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