Skeletal System — Study Notes
Bone classification, structure, ossification & joint types
1. Overview
• 206 bones in the adult human skeleton
• Axial skeleton (80 bones): skull, vertebral column, ribs, sternum
• Appendicular skeleton (126 bones): upper limbs + pectoral girdle, lower limbs + pelvic girdle
2. Bone Classification by Shape
Type Examples
Long bones Femur, humerus, tibia, phalanges — length > width, shaft + two ends
Short bones Carpals, tarsals — roughly cube-shaped, mainly cancellous bone
Flat bones Skull bones, sternum, ribs, scapula — thin, protective, hematopoiesis site
Irregular bones Vertebrae, facial bones, hip bones — complex shapes
Sesamoid bones Patella — embedded within tendons, reduce friction/wear
3. Bone Structure
• Diaphysis — shaft of a long bone, mainly compact (cortical) bone
• Epiphysis — end of a long bone, mainly cancellous (spongy) bone, articular cartilage covering
• Metaphysis — region between diaphysis and epiphysis, contains growth plate (epiphyseal plate) in children
• Periosteum — outer fibrous membrane covering bone (except at joint surfaces), site of appositional growth and blood
supply entry
• Medullary cavity — central cavity containing bone marrow (red marrow = hematopoietic, yellow marrow = fatty)
4. Ossification
• Intramembranous ossification — bone forms directly from mesenchyme; flat bones of skull, clavicle
• Endochondral ossification — bone forms from a cartilage model; most bones of the body, including long bones
• Primary ossification center — appears in diaphysis before birth
• Secondary ossification centers — appear in epiphyses after birth, fuse with diaphysis at skeletal maturity
• Epiphyseal (growth) plate fusion timing is used to estimate skeletal age on X-ray in pediatric imaging
5. Joint Classification
Type Examples / Movement
Fibrous (synarthrosis) Sutures (skull) — immobile; syndesmosis (distal tibiofibular) — slight
movement
Cartilaginous (amphiarthrosis) Symphysis pubis, intervertebral discs — slight movement; synchondrosis
(growth plate) — temporary, immobile
Synovial (diarthrosis) Freely movable — subtypes: ball-and-socket (hip, shoulder), hinge
(elbow, knee), pivot (atlantoaxial), saddle (thumb CMC), condyloid
(wrist), plane/gliding (carpals)
6. Vertebral Column Overview
• 33 vertebrae total: 7 cervical, 12 thoracic, 5 lumbar, 5 sacral (fused = sacrum), 4 coccygeal (fused = coccyx)
• Normal curvatures: cervical & lumbar lordosis (concave posteriorly), thoracic & sacral kyphosis (convex posteriorly)
• C1 (atlas) — no vertebral body, articulates with occipital condyles; C2 (axis) — has odontoid process (dens) for rotation
• Typical vertebra: body (anterior, weight-bearing), vertebral arch (pedicles + laminae), spinous process, transverse
processes, superior/inferior articular facets
7. Bone Markings (Relevant to Positioning & Palpation)
• Process — general bony projection (e.g., spinous process)
• Tubercle/Tuberosity — rounded projection, muscle attachment (e.g., greater tubercle of humerus)
• Trochanter — large projection unique to femur (greater/lesser trochanter)
• Condyle — rounded articular projection (e.g., femoral/tibial condyles)
• Epicondyle — projection above/on a condyle, non-articular (e.g., medial/lateral epicondyle of humerus)
• Fossa — shallow depression (e.g., olecranon fossa)
• Foramen — hole/opening for passage of vessels/nerves (e.g., obturator foramen, intervertebral foramen)
8. Imaging Correlation
• Bone density assessment — DEXA scan is the gold standard for osteoporosis, not plain X-ray (X-ray only shows
osteopenia once >30-40% bone loss has occurred)
• Growth plate (physis) is a radiolucent line in children — should not be mistaken for a fracture
• Bone age assessment — compares ossification center appearance/fusion to standard atlases (commonly hand/wrist X-
ray)
• Periosteal reaction patterns on imaging help characterize bone lesions as benign vs aggressive
9. Common Pitfalls
• Don't mistake a normal unfused growth plate (physis) in a child/adolescent for a fracture — smooth, well-corticated
margins and known anatomical location
• Sesamoid bones (e.g., in the hand/foot) are normal variants and shouldn't be misread as loose bone fragments
• Accessory ossicles (e.g., os trigonum in the ankle) are normal variants that can mimic avulsion fractures — smooth
corticated margins and typical locations help differentiate