INTRODUCTION

TO ANATOMY
For Midwifery Nursing Students

B y :-Dereje Gizaw(MSc)
 INTRODUCTION
DEFINITION OF ANATOMY
The word anatomy derived from a Greek
term “Anatome”
ana= apart & tome = meaning- cutting apart
Present definition:- the study of normal
structures of the body & their relationships
• DIVISIONS OF ANATOMY
Divides into major spheres
• Gross Anatomy-the study of structure without
using microscope
• Histology- ( microscopic Anatomy):- study of
body tissues
• Embryology -the study of development from
the fertilized egg to adult form
• Cytology: - chemical & microscopic study of
the structure of cells.
• Other applied fields of Anatomy
Clinical Anatomy
Pathological Anatomy
Surface Anatomy
• ANATOMICAL POSITION
Definition:- the body stands in erect upright
position facing the observer, with feet flat on
the floor, arms placed at the sides & the palms
of the hands turned forward.
• NB=Terms of position, planes, direction and
movement must be used in reference to the
anatomical position.
• LEVELS OF STRUCTURAL ORGANIZATION OF
HUMAN BODY
[Link] level
• Includes all atoms and molecules essential for
maintaining life.
• Major atoms:- C,H,O,N,Ca,K & Na
• Molecules: - proteins, carbohydrates, fats &
vitamins
2. Cellular level
• Cells are the basic structural & functional unit of life
• Cells have 4 principal parts
a. Plasma (cell) membrane
• Outer limiting membrane separating the cell’s internal
components from the extracellular materials.
b. Cyosol
• Thick semifluid portion of the cytoplasm.
• Cytoplasm refers to all cellular contents b/n the plasma
membrane & the nucleus.
• Contains many soluble proteins & enzymes, nutrients,
ions and other small molecules.
• Organelles & inclusions are suspended in it.
c. Organelles
• Highly organized structures with characteristic
shapes that are specialized for specific cellular
activities.
d. Inclusions
• Temporary structures that contain secretions
& storage products of the cell.
3. Tissue level
• Tissue are groups of similar cells & substance surrounding them
that work together to perform a particular function.
• 4 basic types of tissues:- epithelial, muscle, connective & nervous
4. Organ level
• Organs are composed of two or more d/t tissues that have
specific functions & usually have recognizable shape.
5. System level
• A system consists of several related organs have a common
function e.g. digestive system:- breakdown of food & absorption.
6. Organism level
• All parts of the body functioning with one another comprise the
total organism
APPROACHES TO STUDY ANATOMY
A. Systemic anatomy
• Studies specific systems of the body
• About 11 systems are found in human body
Integumentary
Skeletal
Muscular
Nervous
Endocrine
Cardiovascular
Lymphatic and immune
Respiratory
Digestive
Urinary
Reproductive
2. Regional Anatomy
• Deals several systems located in specific
region of the body Six regions,
• Limb (upper and lower)
• Back
• Thorax
• Abdomen
• Pelvis and perineum
• Head and neck
3. Practical or surgical anatomy
• Emphasize on certain features of practical importance
BODY PLANES AND SECTIONS
• The body is divided by the following planes
1. Sagittal plane
• A vertical plane that divides the body or organ into
right & left sides.
• Midsagittal (median) plane - If the plane passes
through the midline of the body or organ & divides it
into equal right & left sides.
• Parasagittal plane - the plane does not pass through
the midline but divides the body (organ) in to unequal
right & left sides.
[Link] (coronal) plane
• Divide the body or an organ into anterior & posterior
portions.
3. Transverse (cross _ sectional or horizontal) plane
• Divides the body or organ into superior & inferior
portions.
• The above planes are all at right angles to one another.
4. Oblique plane
• Passes through the body or organ at an angle b/n the
transverse, sagittal or coronal plane.
• When we cut organ through these planes resulting flat
surface in section e.g. transverse plane gives transverse
section
TERMS OF POSITION AND RELATION
• Most of the terms are appeared in pairs of antonyms
Anatomical terms Direction
• Superior Above
Inferior Below
• Cephalic (cranial, rostral) Nearer to the head
• Caudal Nearer to the tail
• Anterior In front
• Posterior Behind
• Ventral In the direction of the
abdomen
• Dorsal In the direction of the back
• Medial Nearer to the midline
• Lateral Further from the midline
• Intermediate Between the two structures
• Ipsilateral On the same side of the body
• Contralateral On opposite side of the body
• Proximal Nearer to the upper
• Distal nearer to the lower
• Superficial Towards the surface of the body
• Deep Away from the surface of the body
• Parietal Forming the outer wall of a body cavity
• Visceral to the covering of an organ
• Combined terms
Eg .Superiomedially
BODY MOVEMENTS
• Body movements are described based on the three
main axes
Longitudinal (Vertical) axis:- run from center of head to
sole of foot
• Movements are:- medial rotation
- Lateral rotation
- Supination
- Pronation
Transverse (Horizontal) axis:- run from right to left
Movements are: - flexion
- Extension
Sagittal axis:- run from back to front aspect of
the body
• Movement are: - adduction
- Abduction
• If all the axes are involved – Circumduction
• Anatomy is concerned with the living body.
Therefore various terms are used to describe
d/t body movements
Commonly used terms of movement

• Flexion = Bending or decreasing the angle b/n body parts

• Extension =Straightening or increasing the angle b/n body parts

• Abduction= Moving away from the median plane

• Adduction= Moving towards the median plane

• Rotation = Moving around the long axis

• Circumduction= Circular movement combining flexion , extension abduction & adduction

• Eversion = Moving the sole of the foot away from the median plane

• Inversion= “ “ “ “ “ towards “ “ “

• Supination =Rotating forearm & hand so that the palm faces interiorly

• Pronation= “ “ “ “ “ “ “ “ posterior

• Protrusion= Moving anteriorly

• Retrusion = Moving posteriorly

THE TISSUES
• Formed from group of cells
• There are four basic types of tissues
 Epithelial tissue
 Connective and supporting tissues
 Muscle tissue
 Nervous tissue
Epithelial tissue
• Specialized layer of cells lining body parts
• Consist of tight sheet of cells
• Avascular
• Originated from ectoderm, mesoderm & endoderm
Function:- 1. Protection
2. Absorption of materials
3. Transportation
4. Secretion
5. Selective permeability
6. Gas exchange
7. Reception of stimuli
Classification of Epithelial Tissues
• Based on the form of the cells
 Squamous epithelium
 Cuboidal epithelium
 Columnar qpitheliuan
• Based on the arrangement of the cells
 Simple epithelium
 Stratified epithelium
• All the cells do not touch the basement memb
 Pseudostratified epithelium
• Formed by single layer of cells
• Cells have d/t heights & shapes
• All cells not on the basement membrane
• Only tall cells near the free epith. surface
Connective Tissue
• Most abundant & widely distributed
• Responsible for giving
Form ,Support , Defense
• Consist of a group of cells with extracellular substances
• Can be found in more varied forms
• It includes
 Adipose or fatty tissue
 Fibrous connective tissue
 Cartilages
 Bones
 Blood
 Muscle Tissue
• is Contractile tissue
• Mainly develop from embryonic mesoderm
• Includes three kinds of muscle tissues:
 Skeletal
 Cardiac
 Visceral or smooth
Nervous Tissue
• Develop from ectoderm
• Composed of neurons & neuroglial cells
• Provides rapid communication
GLANDS
• Single or group of specialized epith. cells
• Synthesize & release specific secretions
• Most are derived from the surface epithelium
• Each gland has importance to the organism
• E.g. Sweet glands: - temperature regulation
Gastric glands: - release of digestive
substances
Mammary glands: - production of milk
 Can be classified as:
• Exocrine glands:- release secretions through
ducts
• Endocrine glands:- ductless glands,i.e to
circulatory system
• Paracrine glands:- similar is endocrine glands
-This secretion diffuse locally to cellular
targets
E.g. Neurohypophysis
 Classification of Exocrine Glands
 Based on the way secretions leave the cell
• Apocrine:- secretion discharged is part of
apical cytoplasm
E.g. Mammary glands
• Holocrine: - secretion is shed with the whole
cell
E.g. sebaceous glands
• Merocrine:- Secretions leave the cell by
exocytosis
Based on the type of secretion
1. Serous glands:- produce thin watery fluid
- contain proteins and enzymes
eg. parotid gland, lacrimal gland ….
2. Mucous glands:- secrete viscous free of enzymes

eg. palatine glands

3. Mixed glands:- secretary part consists of both
serous & mucus glands
E.g- Submandibular gland
-Sublingual gland …..
Tissues of the Skeletal system
• Bone – Compact bone (dense)
- Spongy bone
• Cartilage – Hyaline
- Fibrocartilage
- Elastic
• Fibrous connective tissue
-Tendon (connects bone to muscle)
- Ligament (connects bone to bone)
Bone Tissue
• Consists of cells (osteocytes) enclosed in
chambers (lacunae)
• Derived from osteoblasts
• Consists of matrix
• Composed of minerals (calcium phosphate)
• Can exist as spongy or compact
Classification of bone (based on gross nature)
Spongy Bone
• Unorganized appearance
• Contains thin plates (trabeculae) separated by
unequal spaces
• Spaces filled with red bone marrow
• Found in the ends of long bones
Compact Bone
• Highly organized
• Composed of tubular units (osteons)
• Found in the shaft of long bones
Osteon (Haversian system)
• Osteocytes lie in lacunae
• Arranged in concentric circles around central
canal
• Contains blood vessels, lymphatic vessels and
nerves
• Spaces between lacunae are filled with
mineralized matrix
Cartilage
• Consists of cells (chondrocytes) in lacunae
• Matrix is gel – like
• Contains collagenic and elastic fibers
• Has no blood vessel
a. Hyaline Cartilage
• Firm and somewhat flexible
• Matrix contains many collagenic fibers
• Found at end of long bones (articular), in
nose, at ends of ribs
Fibrocartilage

• Matrix contains wide rows of thick collagenous fibers

• Able to with stand tension and pressure
• Found in menisci in knee and discs between
vertebrae
Elastic Cartilage

• Matrix contains elastic fibers

• Very flexible
• Found in epiglottis and ear flaps
Fibrous Connective Tissue
• Contains rows of cells separated by bundles of
collagenous fibers
• Makes up ligaments (connect bones to bones)
• Makes up tendons (connect bones to muscles)
Structure of long bone
• Expanded ends are called epiphyses
• Composed largely of spongy bone
• Coated with a thin layer of hyaline cartilage
• Shaft is called diaphysis
• Has medullar canal which is filled with yellow marrow in
adult
• Lined with endosteum
• Composed of compact bone
• Covered with layer of fibrous connective tissue
(periosteum)
• Contains blood and lymph vessels and nerves
Bone formation (ossification)
• Ossification begins at about the 4th week
• Ossification centers are readily visible after
10th week
• Bone tissues are derived from mesenchyme
• Bone is formed in two ways:
 Intramembranous ossification
 Endochondral ossification
 Intramembranous ossification
• It is a source of most flat bones & sesamoid
bones
• Contributes for the growth of short bones
• Helps for the thickening of long bones
• Mesenchymal cells develop directly into bone
• The starting point for ossification is called primary
ossification center
• Mesenchyme…osteoblasts…..produce Bone
matrix….. calcification follows and
resulting in encapsulation
Of some osteoblasts
Endochodral Ossification
• Takes place with in a piece of hyaline cartilage
• Shape of cartilage resembles a model of bone to
be formed
• Some mesenchymal cells transform into
chondroblasts & develop into cartilage matrix later
replaces by bone
• Most of the skeleton is formed by this form
• In the long bones primary ossification center is
formed in the central part
• secondary ossify center is formed of the swelling
of extremities on the cartilage model.
The Skeletal system
Definition:- the skeletal system is defined as a
frame work of the body which consist of
bones and related cartilage
Functions of the skeletal system
• Supports the body
• Protects soft body parts
• Produces blood cells (haematopoisis)
• Mineral storage
• Permits movement
• Serve as attachment for muscles
Shapes of Bones
The bones of the skeleton are classified in to 4 principal
types based on shape
• Long bones:- are longer than their width e.g. most
lower & upper limb bones
• Short bones:- are mostly cube – shaped & found in
confined spaces where they transfer forces e.g. wrist &
ankle
• Flat bones :- have broad dense surface for muscle
attachment & protection e.g. cranium, ribs & bones of
shoulder girdle
• Irregular bones:- have varied shapes & many surface
markings for muscular attachment e.g. certain bones
of the skull.
THE SKELETON
• Divided in to: -
1. Axial skeleton: - bones that lies in longitudinal
axis of the body
2. Appendicular skeleton:- bones of the pectoral
girdle, upper limb, pelvic girdle and lower limb
A. The Axial Skeleton
• - Consist of bones that form the axis of the
body, gives support & protection
• - includes bones of skull, hyoid bone, vertebral
column & bones of the rib cage
• Skull bones: - Consist of cranial and facial
bones
- Possess sinuses (frontal,
maxillary, ethmoidal & sphenoid) helps to
reduce weight of skull and give resonance to
voice
• Have foramina to permit passage of blood
vessels, nerves and other structures.
• Foramen magnum is the largest of all, which
allows part of brain, spinal cord and vertebral
vessels.
i) Cranial Bones
• Protects brain
• Composed of 8 flat bones (fibrous joints in adults, fontanels in new
borns)
• Frontal bone (1) :- forms anterior roof of cranium, nasal cavity &
orbit
• Parietal bone (2) :- separated from frontal bone by coronal suture
• Occipital bone (1) :- forms the back & much of the base of the skull
• Temporal (2) :- forms the lower sides of the cranium & has 4 parts
=Squamous part :- flattened plate at the side of the skull
=Tympanic part:- contains external acoustic meatus & styloid
process
=Mastoid part:- the part on which mastoid process projects
=Petrous part:- houses the structures of middle & inner ear
• Sphenoid bone (1) :- Keystone bone (all other
bones articulate with it) ,shaped like bat with
outstretched wings
=completes sides of skull and contributes to
orbits
• Ethamoid bone (1) :- lies in front of sphenoid

- =forms orbits and nasal septum

Features of cranial bones
Sutures:- are fibrous joints where cranial bones
meet
-coronal, sagital, lambdiod & squamous
sutures
Fontanels: - areas where sutures meet are feature
of fetal skull
-permit molding during birth and rapid brain
growth
 -anterior, posterior. Anterolateral &
posterolateral fontanels
ii) Facial Bones:- Provide the basic shapes of the
face
• -All are paired except vomer & mandible
• - consist of about 14 bones
• - Mandible (1):- forms the lower bone
-The Only movable bone of skulls &
allows for chewing
- attached to the cranium by
temporomandibular articulations
- has 3 parts :-body, ramus, and
condyloid & coronoid processes
• Maxilla (2):- holds the upper teeth
=Forms anterior portion of hard palate
• Zygomatic bones (2):- forms the cheek bone of the face
=Posteriorly forms zygomatic arch with temporal bone
• Nasal bone (2):- helps to support the flexible cartilaginous
plates
• Nasal concha (2):- classified into superior, middle & inferior
=Has mucous memb, cover to warm & moisten inhaled air
• Vomer(1) :- thin elongated bone which forms the lower
part of nasal septum
• Lacrimal bone (2):- forms anterior part of the medial wall of
each orbit
• Palatine bone:- forms posterior part of hard palate, part of
orbit & nasal cavity.
• Auditory ossicles:- three auditory ossicles in the
middle ear of each ear (malleus, incus &
stapes) – helps to transmit sound impulses
• Hyoid Bone:- located superior to larynx
-does not articulate with any other bone
- has two wings i.e lesser cornu & greater cornu
- anchors the tongue
Vertebral column
formed of the vertebral bones
• Extends from skull to pelvis
• Composed of a total of 33 vertebral bones
• Has four curvatures in adults
• Cervical, thoracic & lumbar curves are identified by
type of vertebra they contain and pelvic curve is
formed by the shape of sacrum & coccyx
• Thoracic & pelvic curves are called primary curves
• Cervical & lumbar curves are called secondary curves
• The curves function in:- increasing the strength
–maintaining balance
Abnormal curvatures include:-

• Scoliosis (abnormal lateral curvature)

• Kyphosis abnormal posterior curvature -hunchback)
• Lordosis (abnormal anterior curvature – swayback

Function of the vertebral column

• Supports head, trunk & upper extremities allowing
movement
• Protects spinal cord and nerves
• Provide attachment for muscles, ribs & visceral
structures
Vertebrae

• Join at articular facets (flattened areas)

• Form canal for spinal cord (foramina line up)
• Spinous processes felt at midline of back
General characteristics of a typical vertebral
bone

• Body
• Arch with pedicle and laminae
• Processes:- spinous, transverse, superior
articular and inferior articular
• Foramen :- vertebral & intervertebral
Regional characteristics of vertebrae

– Cervical vertebrae

• 7 bones in neck region

• Have transverse foramina

• Contain bifid sinous process (2nd to 6th)

==1st cervical vertebra called Atlas

• Articulate with the head

• Allow “yes” movement by nodding
• Has short rounded spinous process called
posterior tubercle
• Has no body

==2nd cervical vertebra called Axis

• Has projection superiorly called dens (odontoid
process)
 Thoracic vertebrae

• 12 bones in the region of thorax

• Increase in size from T1 to T12

• Serve as attachment for the ribs

• Have extra articular process for attachment of ribs

• Have long spinous processes that slope obliquely

downward
 – Lumbar Vertebrae
• 5 bones in the lumbar region
• Are the largest vertebrae of the column
• Have large bodies, and thick processes

Sacrum
== 5 fused bones in the sacral region
== with important four anterior and posterior sacral foramina
== important for sacral spinal nerve passage

– Coccyx
• Composed of 4 or 5 fused vertebrae
In vertebral Disks

• Composed of fibro cartilage

• Act as padding shock absorbers

• Sometimes slide or rupture in danger

Skeleton of thorax: Ribs and costal cartilages
• Twelve pairs

• Ribs 1-7 attach directly to sternum by

separate costal cartilages - true ribs
(vertebrosternal)

• Ribs 8-10 =attach indirectly to sternum

by attaching to costal cartilages
immediately above (vertebrochondral)

• Ribs 11-12 have no anterior

attachments - floating ribs 83
• Ribs are bowed flat bones with long shaft
• Head: has 2 facets to articulate with its
vertebrae and the one above

• Tubercle: articulates with transverse process of

corresponding vertebra

• Neck: between head and tubercle

• Shaft (body): flat, curved

• Angle of rib: point of greatest change in

curvature

• Costal groove: on inferior border, protect

intercostal nerve and vessels
Sternum

• Flat bone located anteriorly

• Has 3 fused bones manubrium, body & xiphoid
process

• On its side it has costal & clavicular notches and

superiorly jugular notch

• Sternal angle is palpated b/n manubrium &

body
 The Appendicular Skeleton

• Consisting of bones of the upper and lower limbs

(extremities or appendages)

Pectoral Girdle and Upper Extremity

Pectoral Girdle:- the two scapulae & two clavicles

form it
- attached only anteriorly to the
axial skeleton on sternum
- Functions in muscle attachment
Scapula :- large triangular flat bone located
posteriorly

- Has spine on the posterior aspect

-Has 3 fossa: supraspinous, infraspinous &

subscapular fossa

-Glenoid cavity for head of humerus lies

laterally
• Clavicle :- slender S-shaped, collar bone
=Form sternoclavicular joint anteriorly
=Laterally articulate with acromion
process of scapula

• Humerus :- the longest bone of upper extremity

==Consist of head, shaft (body) ,Anatomical &

surgical necks, tubercles (greater & lesser) and
intertubercular groove in b/n.

==Distal end has 2 articular surfaces (capitulum

• Ulna:- proximal end articulate with trochlea of humerus
-Coronoid process from the anterior lip & olecranon
form posterior part
=Distal end forms the head with styloid process
• Radius:- the head articulate with the capitulum of
humerus
-Distal end forms the styloid process
• Carpals Bones:- 8 bones which form the wrist
-Arranged in two transverse rows of 4 bones each
=Proximal row has scaphoid, lunate, triquetrum &
pisiform
=Distal row has trapezium, trapezoid, capitates &
hamate
• Metacarpal Bones:- 5 bones which form palm of
the hand
-each has proximal base, shaft & distal
head
• Phalanges:- these are 14 bones

• Medial 4 digits have proximal, middle & distal

phalanx

• Thumb has only proximal & distal phalanx

Pelvic Girdle and Lower Extremity

• Pelvic Girdle:- Made up of 2 coxal (hip) bones

• Attached posteriorly to the sacrum
• Each coxa consists of 3 fused bones (ilium,
ischium & pubis)
• 3 bones at their fusion forms a depression
called acetabulum
• Support weight of the body & pelvic organs
Ilium:- the largest & uppermost of the three pelvic bones
• Contains a crest known as iliac crest
• Has 4 spines and 2 notches (sciatic notches)

Ischium:- postero inferior component of the coax.

• Has Ischial spine inferior to the greater sciatic notch
• Has ischial tuberosity that supports body during sitting

Pubis:- forms the anterior component of the coax

• Has two rami (inf. & sup) which supports its body
99
Femur:- the longest, heaviest & strongest bone in
the body
• Proximal rounded head articulates with
acetabulum
• On the head fovea capitis femoris provide
attachment for ligaments
• The neck is the most commonly fractured site
• Proximal side of shaft has trochanter (greater &
lesser) and intertrochanteric line in b/n
• Vertical ridge on the posterior surface of shaft is
called line aspera
• Distal end articulates with tibia; and has medial
& lateral condyles
Patella:- triangular, sesamoid bone lie on the
anterior side of knee

• Has base, apex & articular facets

• Function to protect knee joint & strengthen the

quadriceps tendon
Tibia:- articulate proximally with femur at knee joint

• Distally articulate with the thalus of ankle

• Has medial & lateral condyles, and intercondylar
eminence in b/n

• Has tibial tuberosity anteriorly where patellar

ligament attaches

• Distally it has medial malleolus

Fibula:- long narrow bone on the lateral side of
leg
• More important for muscle attachment than for
support
• Has head, neck & lateral malleolus

• Tarsal Bones:- 7 bones which form the ankle

joint

• Includes:- thalus, calcaneus, navicular, 3

cuneiforms & cuboid
Metatarsal Bones:- 5 bones which form part of the foot

• Each bone has base, body & head

• Forms tarsometatarsal & metatarsophalangeal joints

Phalanges:-
• 14 bones

• Lateral four digits have proximal, middle & distal phalanx

• Great toe (hallux) has only proximal & distal phalanx
• Each phalanx has base, body & head
• Menisci (sing, meniscus):- crescent _ shaped
pieces of cartilage found in knee joint
• Bursae (sing, bursa):- fluid _ filled sacs which
decrease friction between tendons and
ligaments
JOINTS
• The study of joints is called arthrology (G. arthros = joint,
logos=study) terms of movement

Classification of joints
• Based on the type of material uniting or binding the
articulation bones joints can be classified as:-

Fibrous joints
• Bones are united by fibrous tissue
• This type of joint includes:
• Sutures:- held by strong connective tissue & common in skull
• Syndesmoses:- bones are united by sheet of fibrous tissue e.g.
Interosseous memb.
• Gomphosis:- unique joint b/n a tooth & its socket
Cartilaginous joints
• Bones are united by either hyaline cartilage or
fibro cartilage
• This joint also includes two types of joints
Synchondroses:- bones unite by hyaline cartilage
- permit slight bending during early life
E.g. b/n epiphyses & diaphysis

Symphyses:- bones are united by fibro cartilage

• Are strong slightly movable joints
• E.g. b/n vertebral bodies, pubic symphysis
Synovial joints
• Most common & important one
• Provide free movement in most parts
• Has lubricating fluid (synovial fluid) lined with
synovial membrane (capsule)
• Has three unique features
1) joint cavity
2) Articular cartilage
3) Articular capsule with
membrane
• Types of synovial joints
• Plane joints:- allow gliding or sliding movement e.g. b/n
scapula & Clavicle (uniaxial joint)
• Hinge joints :- permit flexion & extension only (uniaxial joint)
• Condyloid joints:- allow movement in two direction (biaxial
joint)
• Saddle joints:- opposing surfaces of bones are like a saddle
(biaxial joint)
• Ball & socket joints:- allow multi directional movement
(multiaxial joint)
• Pivot joints:- uniaxial joint that allow rotating e.g. atlantoaxial
joint)