Anatomy and Physiology

THE SKELETAL SYSTEM

INTRODUCTION
• Many organs are named for their relationships to THE SKULL
nearby bones Expected Learning Outcomes
• Understanding muscle movements also depends on - Distinguish between cranial and facial bones. - Name the
knowledge of skeletal anatomy bones of the skull and the anatomical features.
• Positions, shapes, and processes of bones can serve - Identify the cavities in the skull and in some of its individual
as landmarks for clinicians bones.
BONES OF THE SKELETAL SYSTEM - Name the principal sutures that join the bones of the skull.
• Number of bones - Describe some bones that are closely associated with the skull.
- Describe the development of the skull from infancy through
- 206 in typical adult skeleton childhood.

• Varies with development of) sesamoid bones (patella) THE SKULL

- Bones that form within some tendons in response to Skull- the most complex part of the skeleton
stress
⚫ 22 bones joined together by sutures (immovable joints)
• Varies with presence of sutural (wormian) bones in skull
- Extra bones that develop in skull suture lines ⚫ 8 cranial bones surround cranial cavity which encloses the
brain
- 270 bones at birth, decreases with fusion
Other cavities - orbits, nasal cavity, oral (buccal) cavity, middle-
• Surface markings and inner-ear cavities, and paranasal sinuses

- Ridges, spines, bumps, depressions, canals, pores, slits,

cavities, and articular surfaces ⚫ Paranasal sinuses - frontal, sphenoid, ethmoid, and
maxillary
ANATOMICAL FEATURES OF BONES
- Lined by mucous membrane and air-filled
• Bone markings - ridges, spines, bumps, depressions, canals, - Lighten the anterior portion of the skull
pores, slits, cavities, and articular surfaces - Act as chambers that add resonance to the voice

• Ways to study bones ⚫ Foramina - holes that allow passage for nerves and blood
vessels
- Articulated skeleton: held together by wire and rods,
show spatial relationship to each other ⚫ 14 facial bones support teeth, facial, and jaw muscles
- Disarticulated bones: bones taken apart so their
CRANIAL BONES
surface features can be studied in more detail
Cranium (braincase)-protects the brain and associated sense
organs

- Meninges separates brain from direct contact with bones-that

is, dura mater
- Swelling of the brain inside the rigid cranium may force tissue
through foramen magnum (large hole, exit for spinal cord)
resulting in death
- Consists of two parts: calvaria (skullcap) and cranial base

Base is divided into three basins that comprise the cranial floor
- Anterior cranial fossa holds the frontal lobe of the brain

- Middle cranial fossa holds the temporal lobes of the brain

- Posterior cranial fossa contains the cerebellum

⚫ 8 cranial bones: 1 frontal, 2 parietal, 2 temporal, 1

occipital, 1 sphenoid, 1 ethmoid

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• Mastoid notch

• Stylomastoid foramen

• Mastoid foramen

- Petrous part

• Part of cranial floor

• Separates middle from posterior cranial fossa

• Houses middle- and inner- ear cavities

• Receptors for hearing and sense of balance

THE PARIETAL BONES • Internal auditory meatus-opening for CN VII

(vestibulocochlear nerve)
• Form most of cranial roof and part of its lateral walls
• Carotid canal
• Bordered by four sutures
• Jugular foramen
- Sagittal: between parietal bones
THE OCCIPITAL BONE
– Coronal: at anterior margin
• Rear and base of skull
- Lambdoid: at posterior margin • Foramen magnum holds spinal cord
• Basilar part, thick median plate
- Squamous: at lateral border
• Skull rests on atlas at occipital condyles
• Two temporal lines serve as attachment of the temporalis - Condylar canal, posterior to each occipital condyle
muscle
• Hypoglossal canal transmits hypoglossal nerve (CN XII)
THE FRONTAL BONE supplying tongue muscles
Forms forehead and part of the roof of the cranium
• External occipital protuberance for nuchal ligament
• Coronal suture - posterior boundary of frontal bone
• Superior and inferior nuchal lines mark neck muscles
• Supraorbital margin forms roof of the orbit
THE SPHENOID BONE
• Supraorbital foramen provides passage for nerve, artery, and • Body
vein
• Greater wing
• Glabella - smooth area above root of the nose
• Lesser wing Optic foramen
• Contains frontal sinus
• Anterior clinoid processes
THE TEMPORAL BONES
• Superior orbital fissure
• Lateral wall and part of floor of cranial cavity
THE ETHMOID BONE
- Squamous part
• Encircled by squamous suture
• Anterior cranial bones located between the eyes
• Zygomatic process
• Contributes to medial wall of orbit Lateral walls and roof
• Mandibular fossa
of nasal cavity, and nasal septum

• Three major portions of this porous, delicate bone

- Tympanic part
• External auditory meatus
• Perpendicular plate forms superior two-thirds of nasal
• Styloid process
septum

• Cribriform plate - forms roof of nasal cavity

- Mastoid part
- Crista galli: attachment point for meninges
• Mastoid process
- Cribriform (olfactory) foramina
- Mastoiditis from ear infection

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Figure 8.13 - Infraorbital foramen

- Inferior orbital fissure
• Labyrinth - large mass on each side of perpendicular plate
• Forms most of the hard palate
- Ethmoidal cells make up the ethmoid sinus - Palatine process
- Orbital plate - Palate: forms roof of mouth and floor of nasal cavity
- Incisive foramen
• Superior and middle nasal conchae – scroll-like plates project - Palate allows us to chew while breathing
into the nasal fossa - Cleft palate and cleft lip

• Inferior nasal concha – separate bone

THE PALATINE BONES
• Three chonchae occupy most of the nasal cavity, create
turbulence of airflow, humidify air before it reaches the lungs.
• L-shaped bone

FACIAL BONES • Form the posterior portion of the hard palate

Facial bones (14) - those that have no direct contact with the
brain or meninges • Part of lateral nasal cavity wall

- Support the teeth • Part of the orbital floor

- Give shape and individuality to the face -Form part of
the orbital and nasal cavities • Greater palatine foramina

- Provide attachments for muscles of facial expression

and mastication THE ZYGOMATIC BONES
2 maxillae 2 nasal bones
• Forms angles of the cheekbones and part of lateral orbital wall
2 palatine bones 2 Inferior nasal conchae
• Zygomaticofacial foramen
2 zygomatic bones 1 vomer
• Zygomatic arch is formed from temporal process of
2 lacrimal bones 1 mandible zygomatic bone and zygomatic process of temporal bone

THE LACRIMAL BONES

Form part of medial wall of each orbit

• Smallest bone of skull

• Lacrimal fossa houses lacrimal sac in life

- Tears collect in lacrimal sac and drain into nasal cavity

THE NASAL BONES

• Forms bridge of nose

THE MAXILLAE • Supports cartilages that shape lower portion of the nose
• Largest facial bones
• Often fractured by blow to the nose
• Forms upper jaw and meets at median intermaxillary suture

- Alveolar processes: bony points between teeth THE INFERIOR NASAL CONCHAE
- Alveolus: sockets that hold teeth • Three conchae in the nasal cavity
- Superior and middle are part of the ethmoid bone
Cont.
• Inferior nasal concha is a separate bone
• Forms inferomedial wall of orbit - Largest of the three

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THE SKULL IN INFANCY AND CHILDHOOD

THE VOMER
• Inferior half of the nasal septum • Fontanels-spaces between unfused bones
- Superior half formed by perpendicular plate of ethmoid
- Filled with fibrous membrane
• Supports cartilage that forms the anterior part of the nasal
septum - Allow shifting of bones during birth and growth of brain

- Anterior, posterior, sphenoid (anterolateral), and

THE MANDIBLE mastoid (posterolateral) fontanels
• Strongest bone of the skull
• Two frontal bones fuse by age 6 (metopic suture)
- Only bone of skull that moves noticeably
- Supports lower teeth • Skull reaches adult size by 8 or 9 years of age

• Provides attachments for muscles of facial expression and

mastication

• Mental symphysis - median cartilaginous joint in fetus

- Develops as two separate bones in fetus

- Ossifies in early childhood

• Mental protuberance- point of chin

• Two major parts on each side

- Body: supports teeth

- Ramus: articulates with cranium

• Angle-where body and ramus meet

• Alveolar processes between teeth

• Mental foramen - permits passage of nerves and BVs

• Mental spines
GENERAL FEATURES OF THE VERTEBRAL
COLUMN
• Condylar process bears the mandibular condyle-oval knob • Functions
that articulates with the mandibular fossa of the temporal bone
forming the hinge temporomandibular joint (TMJ) - Supports the skull and trunk

• Coronoid process-point of insertion of temporalis muscle - Allows for their movement

• Mandibular notch - Protects the spinal cord

• Mandibular foramen - BVs, nerves supply lower teeth - Absorbs stress of walking, running, and lifting

BONES ASSOCIATED WITH THE SKULL - Provides attachments for limbs, thoracic cage, and
• Auditory ossicles postural muscles
- Three in each middle-ear cavity
- Malleus, incus, and stapes • 33 vertebrae with intervertebral discs of fibrocartilage
between most of them
• Hyoid bone

- Slender U-shaped bone between the chin and larynx

- Does not articulate with any other bone • Five vertebral groups
- Suspended from styloid process of skull by muscle and
ligament - 7 cervical in the neck
- Body and greater and lesser horns (cornua) - 12 thoracic in the chest
- Fractured hyoid bone is evidence of strangulation - 5 lumbar in lower back
- 5 fused sacral at base of spine
- 4 fused coccygeal

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• Variations in number of lumbar and sacral vertebrae occur in 1

in 20 people
GENERAL STRUCTURE OF VERTEBRA
• Spine exhibits one continuous C-shaped curve at birth • Body (centrum)
- Mass of spongy bone that contains red bone marrow
• Known as primary curvature - Covered with thin shell of compact bone
- Weight-bearing portion
• S- shaped vertebral column with four normal curvatures - Rough superior and inferior surfaces provide firm
- Cervical attachment for intervertebral discs
- Thoracic • Vertebral foramina
- Lumbar - Collectively form vertebral canal for spinal cord
- Pelvic
• Vertebral arch
- Composed of two parts on each side
- Pedicle: pillarlike and lamina: platelike

• Spinous process
- Projection extending from the apex of arch
- Extends posteriorly and downward

• Transverse process
- Extends laterally from point where pedicel and lamina
meet

• Superior articular processes

- Project upward from one vertebra and meets inferior
articular processes from the vertebra above

• Facets
- Flat articular surfaces covered with hyaline cartilage

ABNORMAL SPINAL CURVATURES

• From disease, paralysis of trunk muscles, poor posture,
pregnancy, or congenital defect

• Scoliosis - abnormal lateral curvature

- Most common
- Usually in thoracic region • Intervertebral foramen
- Particularly of adolescent girls - When two vertebrae are joined they exhibit an opening
- Developmental abnormality in which the body and arch between their pedicles
fail to develop on one side of the vertebrae - Passageway for spinal nerves
- Inferior vertebral notch in the pedicle of the upper
• Kyphosis (hunchback)-exaggerated thoracic curvature vertebra
- Usually from osteoporosis, also osteomalacia or spinal - Superior vertebral notch in the pedicle of the lower
tuberculosis, or wrestling or weight lifting in young boys vertebra

• Lordosis (swayback) exaggerated lumbar curvature • Intervertebral discs (23)

- From pregnancy or obesity - First one between C2 and C3
- Last one between L5 and sacrum
- Pad consisting of:
• Nucleus pulposus - inner gelatinous mass
• Anulus fibrosus - outer ring of fibrocartilage

- Bind vertebrae together Support weight of the body

- Absorb shock

- Herniated disc ("ruptured" or "slipped" disc) puts

painful pressure on spinal nerve or spinal cord

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THE CERVICAL VERTEBRAE • Larger body than cervical, but smaller than lumbar • Costal
facets for attachment of ribs
• Cervical vertebrae-atlas (C1) - On body as small, smooth, slightly concave spots
• Transverse costal facets at end of each transverse process
- Supports the head T1-T10
- Has no body - Provide second point of articulation for ribs 1-10
- Delicate ring surrounding a large vertebral foramen • Inferior and superior costal facets on vertebral body
- In most cases, ribs insert between the two vertebra
- Lateral masses with superior articular facets
THE LUMBAR VERTEBRAE
• Articulates with occipital condyles • Five lumbar vertebrae (L1-L5)
• Thick, stout body
• Allows nodding motion of skull gesturing "yes" • Blunt, squarish spinous process
• Superior articular processes face medially
- Inferior articular facets articulate with C2 - Lumbar region resistant to twisting movements

- Anterior and posterior arches

- Anterior and posterior tubercles

THE CERVICAL VERTEBRAE

• C1 to C7 are smallest and lightest vertebrae, other than the
coccygeals
• Bifid or forked spinous processes in C2 to C6

• Small body and larger vertebral foramen

• Transverse foramen in each short transverse process

- Provides passage and protection for vertebral arteries
(supply blood to brain) and vertebral veins (drain blood
from various neck structures)
- Transverse foramen only found in cervical vertebrae
• C7 vertebra prominens - spinous process not bifid and
especially long
- Prominent bump on lower back of neck; convenient
landmark for counting vertebrae

THE SACRUM
• Sacrum-bony plate that forms posterior wall of pelvic cavity
• Once considered seat of the soul
• In children, five separate sacral vertebrae (S1-S5)
• Begin fusion around age 16 and complete fusion by age 26
• Anterior surface
- Smooth and concave
- Four transverse lines indicate line of fusion of
vertebrae
- Four pairs of large anterior sacral (pelvic) foramina
- Allow for passage of nerves and arteries into
pelvic organs
THE THORACIC VERTEBRAE • Sacral promontory on S1 supports L5
⚫12 thoracic vertebrae (T1-T12)
• Posterior surface very rough
• Median sacral crest
- Corresponds to the 12 pairs of ribs attached to them
- Formed from fusion of spinous processes
• Lateral sacral crest
• Spinous processes pointed and angled sharply downward

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- Less prominent, and on either side of median

sacral crest
- Formed from the fusion of the transverse
processes
• Posterior sacral foramina
- Four pairs of openings for spinal nerves that supply
gluteal region and lower limbs
• Sacral canal runs through sacrum and ends as sacral hiatus
- Contains spinal nerve roots
• Auricular surface is part of sacroiliac (SI) joint formed with hip
bone
• Superior articular processes on S1; articulates with L5

• Alae pair of large, rough, winglike extensions lateral to the

superior articular processes

THE STERNUM
⚫ Sternum (breastbone)-bony plate anterior to the heart

⚫ Divided into three regions

- Manubrium
• Broad superior portion
• Suprasternal (jugular) notch medially
• Clavicular notches - articulate with clavicle
• Ribs attach along scalloped lateral margins

⚫ Body (gladiolus)
• Longest part of sternum
• Sternal angle - point where body joins manubrium
• Ribs attach along scalloped lateral margins

⚫ Xiphoid
• Inferior end of sternum
• Attachment for some abdominal muscles
• In cardiopulmonary resuscitation, improperly
performed chest compressions can drive xiphoid
process into the liver and cause a fatal hemorrhage

THE THORACIC CAGE

• Consists of thoracic vertebrae, sternum, ribs
• Forms conical enclosure for lungs and heart
• Provides attachment for pectoral girdle and upper limbs
• Broad base and narrower apex
• Rhythmically expanded by respiratory muscles to draw air into
lungs
• Costal margin - inferior border of thoracic cage formed by
downward arc of ribs
• Protect thoracic organs, but also spleen, most of liver, and to
some extent the kidneys

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THE RIBS
⚫ 12 pairs of ribs THE SCAPULA
• No difference between sexes ⚫ Suprascapular notch-conspicuous notch on superior border
• Posterior (proximal) end attached to vertebral - Provides passage for a nerve
column
• Anterior (distal) ends mostly attached to the sternum ⚫ Spine - transverse ridge on posterior surface
• Costal cartilage composed of hyaline cartilage - Supraspinous fossa: indentation superior to the spine
attach anterior ends to sternum - Infraspinous fossa: broad surface inferior to the spine
⚫ Head – portion of rib that articulates with thoracic vertebrae
- Superior articular facet • Subscapular fossa - concave, anterior surface of scapula
- Inferior articular facet
• Complex lateral angle of scapula has three main features
- Acromion: platelike extension of the spine
• Forms apex of the shoulder
• Articulates with the clavicle-the sole point
of attachment of the scapula and the upper
limb to the rest of the skeleton

THE PECTORAL GIRDLE AND UPPER LIMB

Expected Learning Outcome
- Identify and describe the features of the clavicle,
scapula, humerus, radius, ulna, and bones of the wrist
and hand.

THE PECTORAL GIRDLE

⚫ Pectoral girdle (shoulder girdle) supports the arm
THE UPPER LIMB
⚫ Consists of two bones on each side of the body • Upper limb is divided into four regions containing a total of 30
- Clavicle (collarbone) and scapula (shoulder blade) bones per limb

⚫ Clavicle articulates medially to the sternum and laterally to the - Brachium (arm proper): extends from shoulder to
scapula elbow
- Sternoclavicular joint • Contains only 1 bone-humerus
- Acromioclavicular joint
- Antebrachium (forearm): extends from elbow to wrist
⚫ Scapula articulates with the humerus • Contains 2 bones-radius and ulna
- Glenohumeral joint: shoulder joint - Carpus (wrist)
- Easily dislocated due to loose attachment • Contains 8 small bones arranged in two rows
- Manus (hand)
• 19 bones in two groups
THE CLAVICLE • 5 metacarpals in palm
⚫ Clavicle – S-shaped, somewhat flattened bone • 14 phalanges in fingers
⚫ Inferior – grooves and ridges for muscle attachment
⚫ Sternal end – rounded head THE HUMERUS
• Proximal end
- Hemispherical head that articulates with the
glenoid cavity of scapula
- Anatomical neck
- Greater and lesser tubercles and deltoid
tuberosity
- Intertubercular sulcus holds biceps tendon
- Surgical neck

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THE ULNA
• Ulna
- Trochlear notch articulates with trochlea of humerus
- Olecranon: bony point at back of elbow
- Coronoid process Radial notch holds head of Radius
- Styloid process

• Interosseous membrane
- Ligament attaches radius to ulna along interosseous
margin of each bone
- Enables the two elbow joints to share the load

THE RADIUS
• Radius
- Head: disc-shaped, allows for rotation around the
longitudinal axis of the bone during pronation and
supination of hand
• Superior surface articulates with capitulum
on humerus
• Side of disc spins on radial notch on ulna

- Neck
- Radial tuberosity for biceps muscle
- Styloid process can be palpated near thumb
- Ulnar notch
THE CARPAL BONES
• Eight bones form wrist
- Allow movements of flexion, extension, abduction, and
adduction

• Two rows (four bones each)

- Proximal row: scaphoid, lunate, triquetrum, and pisiform

• Pisiform is a sesamoid developed by age 9 to 12 in
tendon of flexor carpi ulnaris muscle
- Distal row: trapezium, trapezoid, capitate, and hamate

THE METACARPAL BONES AND THE PHALANGES

• Metacarpals-bones of the palm

- Metacarpal I proximal to base of thumb
- Metacarpal V proximal to base of little finger
- Proximal base, body, and distal head

• Phalanges-bones of the fingers

- Thumb or pollex has two phalanges
• Proximal, distal phalanx
- Fingers have three phalanges
• Proximal, middle, distal phalanx

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Lateral and Posterior muscles of the hip

Tensor fasciae latae

- Extends knee, laterally rotates knee

Gluteus maximus
- Forms mass of the buttock
- Prime hip extensor
- Provides most of lift when you climb stairs

Gluteus medius and minimus

- Abduct and medially rotate thigh

THE PELVIC GIRDLE AND LOWER LIMB

Expected Learning Outcomes
- Identify and describe the features of the pelvic girdle, femur,
patella, tibia, fibula, and bones of the foot.
- Compare the anatomy of the male and female pelvic girdles
and explain the functional significance of the differences.

MUSCLES ACTING ON THE HIP AND LOWER LIMB

- Largest muscles found in lower limb
- Less for precision, more for strength needed to stand,
maintain balance, walk, and run
- Several cross and act on two or more joints

Leg
- the part of the limb between the knee and ankle

Foot
- includes tarsal region (ankle), metatarsal region, and the toes

MUSCLES ACTING ON THE HIP AND FEMUR

Anterior muscles of the hip

- iliacus
o Flexes thigh at hip
o Iliacus portion arises from iliac crest and fossa

- Psoas major
o Flexes thigh at hip
o Arises from lumbar vertebrae

- They share a common tendon on the femur

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- Medial (adductor) compartment of thigh

- Five muscles act as primary adductors of the thigh

• Adductor brevis
• Adductor longus
• Adductor magnus
• Gracilis
• Pectineus

MUSCLES ACTING ON THE KNEE AND LEG

• Anterior (extensor) compartment of the thigh
- Contains large quadriceps femoris muscle
- Prime mover of knee extension
- Most powerful muscle in the body
- Has four heads – rectus femoris, vastus lateralis,
vastus medialis, and vastus intermedius
- All converge on single quadriceps (patellar) tendon
- Extends to patella
- Then continues as patellar ligament
- Inserts on tibial tuberosity

• Sartorius: longest muscle in the body

- “Tailor’s muscle”

Anterior Thigh Cadaver Muscles MUSCLES ACTING ON THE FOOT

• Crural muscles, acting on the foot, are separated into three

compartments
- Anterior compartment (red)
- Fibular (lateral) compartment (green)
- Posterior compartments (superficial = pink) (deep =
purple)

FUNCTIONAL GROUPS OF MUSCLES

• Prime mover- Brachialis
- Provides the major force for producing a specific
movement
• Synergist – biceps brachii
- Works together with a prime mover to add force or control
• Antagonist – triceps brachii
- Opposes or reverses a particular movement
• Fixator – muscle that holds scapula firmly in place
• Posterior (flexor) compartment of the thigh --Synergist that immobilizes a bone that is a
- Contains hamstring muscles muscle’s origin.
- From lateral to medial: - Rhomboids
Biceps femoris
Semitendinosus
Semimembranosus

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MUSCLES ACTING ON THE FOOT - Popliteus: acts on knees

Anterior (extensor) • Lateral (fibular) compartment – two muscles

compartment of the - Fibularis longus
leg - Fibularis brevis

- Dorsiflex the ankle

- Prevent toes from • Both plantar flex and evert the foot
scuffing when walking
- Fibularis (peroneus) • Provides lift and forward thrust
tertius
- Extensor digitorum INTRINSIC MUSCLES OF FOOT
longus
- Extensor hallucis • Four ventral muscle layers
longus
- Tibialis anterior • Support for arches
- Abduct and adduct the toes
- Flex the toes

• One dorsal muscle

- Extensor digitorum brevis extends toes

COMMON ATHLETIC INJURIES

• Muscles and tendons are vulnerable to sudden and
intense stress

• Posterior compartment – three muscles of the superficial • Proper conditioning and warm-up needed
group
• Common injuries include:
- Gastrocnemius: plantar flexes foot, flexes knee - Compartment syndrome
- Soleus: plantar flexes foot - Shinsplints
- Plantaris: weak synergist of triceps surae - Pulled hamstrings
- Tennis elbow
Triceps surae – collective name for gastrocnemius and - Pulled groin
soleus - Rotator cuff injury
- Inserts on calcaneus by way of the calcaneal
(Achilles) tendon • Treat with rest, ice, compression, and elevation
- Strongest tendon in the body
• “No pain, no gain” is a dangerous misconception

CARPAL TUNNEL SYNDROME

• Repetitive motions cause inflammation and
pressure on median nerve

• Posterior compartment – four muscles in the deep group

- Flexor digitorum longus: flexes phalanges
- Flexor hallucis longus: flexes great toe
- Tibialis posterior: Inverts foot

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