The A to Z of Bones, Joints and Ligaments and the Back

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The

A to Z of Bones,

Joints, Ligaments

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together are forming a set covering the all structural elements of the human body.

Now as an adjunct to this book – the first in the series of the new The A to Z of…failure books is the The A to Z of Bone and Joint Failure, which builds upon the knowledge of the material in this book. Eventually there will be a companion book to each of the current and future A to Zs - the sick and the well.

So... If there is a structure / subject you want to see in the A to Zs let us know, as the feedback often determines the order of the new books. The A to Zs may be viewed on 2 sites –

www.amandasatoz.com and

http://www.aspenpharma.com.au/atlas/student.htm

Acknowledgement

Thank you Aspenpharmacare Australia for your support and assistance in this valuable project, particularly Mr. Greg Lan and Rob Koster. Thank you also Ante Mihaljevic and everyone who provided valuable feedback.

Dedication

To aging “healthily” – if not necessarily gracefully!!

How to use this book

The first section consists of the basic anatomical concepts, movement planes, classification and definitions of all terms discussed in this book. Additional images of articulated bones are included to help with regionalization, and colour tags added to the base of each page to remind the reader where the bone or joint is located.

Bones, Joints and Ligaments are then listed alphabetically and

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JOINT is the GLENOHUMERAL JOINT and the COLLAR BONE is the CLAVICLE).

Each bone and joint is shown from at least 2 aspects. Throughout the book, bones or groups of bones are also shown “in situ”, or as an “overview” to relate them to the whole body structure, in other words as they lay in body or cavity

anatomically. For example the RIBS together form the RIB CAGE and anatomically this bony structure is the way the ribs function. There is a separate section at the back to discuss the BACK! And even the back cover has been modified so that there is an additional fold over which serves as a means of identifying the book on the shelf (i.e. the fold over has the title down the “spine”). Books can now be placed on the shelf and still identified. The fold over is also a fold in if not used as a book mark it can be folded in on itself and lays flat on the cover.

Thank you A. L. Neill BSc MSc MBBS PhD FACBS medicalamanda@gmail.com ISBN 978-1-921-930-19-5

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HOW TO USE THIS BOOK 3

ABBREVIATIONS 7

COMMON TERMS USED IN OSTEOLOGY / SKELETAL ANATOMY 8

ANATOMY Anatomical planes & relations Joint movements Neck 20

Back 21

Shoulder & Upper Limb 22

Hips & Lower Limb 24

Structure of bone tissue 26

BONES in situ UPPER 28

BONES in situ LOWER 30

Classification of bones 32

Structure of a Long Bone 34

Regional Skeletons & Disarticulated Bones 36

Classification and Summary of Joints 38

Synovial joint 39

Classification and Summary of Ligaments 40

Bones, Joints & Ligaments index 42

alphabetical listing Common pathologies of Bones 46

benign bone lesions malignant bone lesions

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OVERVIEWS to be found in this book

carpus / wrist overview (including hand bones) 62

chest overview 68

ear bones overview 86

fingers overview 98

foot, toes overview 100

hand, wrist, fingers overview 106

pectoral girdle / overview of the shoulders 160

pelvic girdle / overview of the hips 162

sinuses overview 202

skull overviews 186

teeth overview 210

vertebral column overview 230

vertebrae overview 238

cervical spine overview 248

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alt. = alternative ant. = anterior

art. = articulation (joint w/o the additional support structures) AS = Alternative Spelling, generally referring to the diff. b/n British & American spelling b/n = between BM = bone marrow BS = blood supply BV = blood vessel C = carpal / carpo co = cortex c.f. = compared to CNS = central nervous system collat. = collateral CSF = Cerebrospinal fluid CT = connective tissue D = diaphysis E = epiphysis e.g. = example

EC = extracellular (outside the cell) ext. = extensor (as in muscle to

extend across a joint) GC = giant cells Gk. = Greek IC = intercarpal / intercarpo IP = interphalangeal IT = intertarsal / intertarso jt(s) = joints = articulations L = Left / Lumbar LB = long bones LL = lower limb aka leg Lt. = Latin lig. = ligament M = metaphysis MC = metacarpal / metacarpo med = medial / medula Met = metastasis MT = metatarsal / metatarso NS = nervous system / nerve supply NT = nervous tissue

OC = osteoclast

PS = public symphysis R = Right

ROM = range of movement sing. = singular SC = spinal cord SN = spinal nerve SP = spinous process TP = transverse process UL = upper limb aka arm V = vertebra(e) / vein VB = vertebral body VC = vertebral column w/n = within w/o = without & = and

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Common terms in Osteology

and Skeletal Anatomy

Ablation The removal of part of the body, generally a bony part, most commonly the teeth.

Acral in the extremities - bones at the apex or end of limbs.

Acromegaly A continuation of growth of the ends of cartilage covered bone (after fusion of the long bones) hence a gross change in the features (most noticeable in the jaw and digits) without growth in height, due mainly to the over activity of the pituitary gland.

Ala A wing, hence a wing-like process as in the Ethmoid bone pl. - alae. Alveolus Air filled bone - tooth socket adj. - alveolar (as in air filled bone in

the maxilla) - coalescence of alveoli helps in the formation of the sinuses. This device also lightens the weight of the bone particularly the skull. Ankle Bend = angle usually referring to the bend just above the foot, hence

the ankle is the joint b/n the foot and the lower leg. Annulus fibrosis The peripheral fibrous ring around the intervertebral disc. Aperture An opening or space between bones or within a bone. Appendicular Refers to the appendices of the axial i.e. in the skeleton, the limbs

upper and lower which hang from the axial skeleton, this also includes the pectoral and pelvic girdles but not the sacrum.

Areola Small, open spaces as in the areolar part of the Maxilla may lead or develop into sinuses.

Arth- To do with joints hence… Arthritis Inflammation of a joint.

Arthropathy Diseases of the joints. Arthrosis Joint types.

Articulation Joint, description of the bone surfaces joining w/o the supporting structures = point of contact b/n 2 opposing bones hence the articulation of humerus and scapula is the articulation of the shoulder joint. Attrition Tooth wear and tear.

Auditory Pertaining to hearing, hence, pertaining to the ear. (Auditory exostosis = a bony growth on the walls of the External Auditory Meatus). Avulsion Forceable tearing away of a structure or part of a structure as in an

avulsed fracture where a fragment bone is torn away from the main bone. early disease loss of cartilage inflammation of jt laxity of lig &

permanent damage

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Calotte The calotte consists of the calvaria from which the base has been removed Calvaria The calvaria refers to the cranium without the facial bones attached. Canal Tunnel / extended foramen as in the carotid canal at the base of the

skull adj.- canular (canicular - small canal). Cancellous bone = Trabecular bone

A spongy porous bone with spicules (trabeculae) of compact bone. It is found at the ends of long bones and in the bones of the axial skeleton. Red BM is found b/n the spicules.

Caput / Kaput The head or of a head, adj.- capitate = having a head (c.f. decapitate) Carotid To put to sleep; compression of the common or internal carotid artery causes coma. This refers to bony points related to the Carotid vessels. Carpo Wrist.

Cavity An open area or sinus within a bone or formed by two or more bones (adj.- cavernous), may be used interchangeably with fossa. Cavity tends to be more enclosed, fossa a shallower bowl-like space (Orbital fossa-Orbital cavity).

Cavum A cave.

Cephalic Pertaining to the head. Cervico Pertaining to the Neck.

Clinoid Like a bed-post, part of a four poster bed so that clinoid processes look like bed posts eg. in the Sphenoid bone.

Clivus A slope hence in the anterior cranial fossa referring to a slope on the base of the cavity.

Cochlea A snail, hence snail-like shape relating to the Organ of Corti in the ear. Compact bone = Cortical bone = Dense bone

Bone found in the shafts and on external bone surfaces. Highly structured in concentric circles or Haversian systems. It is constantly changing and remodeling depending upon the lines of force. Concha A shell shaped bone as in the ear or nose (pl. conchae adj.-.

chonchoid) old term for this turbinate.

Condyle A rounded enlargement or process possessing an articulating surface. Cornu A horn (as in the Hyoid).

Corona A crown. adj.- coronary, coronoid or coronal; hence a coronal plane is parallel to the main arch of a crown which passes from ear to ear (c.f. coronal suture).

Costa / Costo Pertaining to the ribs.

Cranium The cranium of the skull comprises all of the bones of the skull except for the mandible.

Crest Prominent sharp thin ridge of bone formed by the attachment of

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Cuneate/Cuneus A wedge / wedge-shaped.

Dens A tooth hence dentine and dental relating to teeth, denticulate having tooth-like projections adj.- dentate See also odontoid.

Depression A concavity on a surface.

Detrition Wearing away of the tooth surfaces of OA. Detritus The material left after the wearing away or rubbing.

Diaphysis The shaft or body of a long bone. In the young this is the region

b/n the growth plates and is composed of compact bone. pl.- diaphyses adj.- diaphyseal.

Diploë The cancellous bone between the inner and outer tables of the skull, adj.- diploic.

Edentulous Without teeth.

Elbow Any angular bend often in the arm, usually referring to the joint b/n the arm and the forearm.

Eminence A smooth projection or elevation on a bone as in iliopubic eminence. Endocranium Refers to the interior of the “braincase” adj.- endocranial divided into

the 3 major fossae anterior (for the Frontal lobes) middle (containing Temporal lobes) and posterior (for the containment of the Cerebellum). Endostium A mesodermal CT which lines the inner surface of all bones and is the conduit for the NS and BS of the bone llifting of the endostium causes cancellous bone to be laid down to fill the gap b/n the bone and the cellular layer and this device may be used to encourage bone growth/repair. See periosteum.

Epiphysis The end of a long bone beyond the growth plate or epiphyseal plate. = Metaphysis Generally develops as a secondary ossification centre. There are 2

epiphyses to each long bone. In a long bone the shafts are generally compact bone and the ends = epiphyses are trabecular bone pl.= epiphyses adj.- epiphyseal.

Ethmoid = Cribiform. External Auditory Ear hole. Meatus

Exostosis A bony outgrowth from a bony surface, often due to irritation (as in Swimmer’s ear) and may involve ossification of surrounding tissues such as muscles or ligaments.

Facet A face, a small bony surface (occlusal facet on the chewing surfaces of the teeth) seen in planar joints.

Falciform Relating to shapes that are in a sickle shape so falciform ligaments curve around and end in a sharp point.

Fissure A narrow slit or gap from cleft.

Fontanelle A fountain, associated with the palpable pulsation of the brain as in the anterior fontanelle of an infant. These soft spots on the skull are cartilagenous CT covering “joints” which allow for skull cranial

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Incomplete = Greenstick fracture - where there is an incomplete break along with bending or changing of the bone shape: it is generally seen in in young bones. Pathological fracture - a break which has to do with a disease, generally thinning of the

bone for example in osteoporosis or weakening due to a tumour as in osteosarcoma or from other causes as in osteomalacia (Paget's disease) and causes the bone to break with little or no force.

Gallus / Galli A cock, hence, crista galli, the cock’s comb (i.e. possessive form of gallus). Genu / genio Knee adj.- referring to the knee.

Gigantism - Overgrowth of the length of the long bones due to excess growth hormone before the fusion of the long bones (if this occurs after fusion it is acromegaly).

Gomphosis Joint b/n the roots of the teeth and the jaw bones pl.- gomphoses. Normal Avulsed Comminuted Compound Greenstick =

Incomplete

Simple Spiral Torsion Transverse Torsus

Impacted Longitudinal Oblique Pathologic Segmental

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a long bone. The plate disappears, converting to bone, upon attainment of the full height/length of the bone.

Hallux The big toe = the first toe.

Hamus A hook hence the term used for bones which “hook” around other bones or where other structures are able to attach by hooking - hamulus = a small hook.

Harris lines Lines of increased bone density due to assault. They may occur across the growth plate and arrest growth of the length of the long bone. Haversian canals = secondary osteons = lamellar bone.

The system of concentric circles of bone matrix and osteocytes, which continually forms and reforms, during the life of the bone. Hinge joint Joint with movement in one plane e.g. elbow or knee. Hydroxyapetite A dense organic filling; the second component of bone. Hyoid U-shaped.

Hyperostosis Abnormal bone growth generally overgrowth or ectopic growth. Incisura A notch.

Inter Between. Intra Within.

Introitus An orifice or point of entry to a cavity or space. Joint = Articulation + supporting structures.

Jugum A bridge between 2 halves of a bone pl. juga as in Sphenoid. Knock-knees See Valgus.

Kyphosis Collapse of vertebral body(ies) causing sharp convexity of the spine. Lacerum Something lacerated, mangled or torn e.g. foramen lacerum a small

sharp hole at the base of the skull. This often tears tissues. Lacrimal Related to tears and tear drops. (noun lacrima).

Lambda From the Greek letter a capital ‘L’ and written as an inverted V. (adj.- lambdoid) and used to name the point of connection b/n the 3 skull bones Occipital and Temporals.

Lamellar bone = Haversian system.

Bone with sheets of concentric collagen fibres around Haversian canals in compact bone.

Lamina A plate as in the lamina of the vertebra, a plate of bone connecting the

vertical and transverse spines (pl. laminae). Ligament A band of tissue which connects bones (articular ligaments) or viscera - organs (visceral

ligaments). A Ligament is a tie or a connection. Originally sing. ligamentum pl. ligamenta

from ligate or to tie up is generally composed of collagen fibres. See classification of ligaments.

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connecting the outer ear with the middle ear. Meniscus Gk. crescent.

Mental Relating to the chin (mentum = chin, not mens = mind). Meta An extension of: cf. metacarpal = extension of the wrist.

Metaphysis = Epiphysis The slightly expanded end of the shaft of a bone. (pl. metaphysis). Neurocranium The neurocranium refers only to the braincase of the skull. Notch An indentation in the margin of a structure.

Nucha The nape or back of the neck adj.- nuchal.

Occiput The prominent convexity of the back of the head Occipitum = Occipital bone adj.- occipital.

Occulus An eye.

Odontoid Relating to teeth, toothlike. See Dens. Ontogeny The development of an individual growth pattern.

Orbit A circle; the name given to the bony socket in which the eyeball

rotates;adj.- orbital.

Orifice An opening.

Os A bone or pertaining to bones adj.- osseus.

Ossicle A small bone as in the ear ossicles: stapes (stirrup), incus (anvil) and malleus (hammer).

Ossification The process of turning something into bone, i.e. from one tissue to another as in cartilagenous ossification from cartilage into bone. Two other forms are primary ossification (in the shaft of the long bone where the bone forms from CT and secondary ossification where the bone has formed and secondary centres develop as at the ends of the long bones). Osteitis Inflammation of the bone.

Osteoblasts Bone cells capable of dividing and laying down matrix - ‘baby’ osteocytes Osteochondroma Bone & cartilagenous tumour benign often arising in the ephyseal plate

or line & protrude at right angles, common & asymptomatic. Osteoclasts Multinuclear cells which resorb or phagocytose bone =

resorption of bone = Giant cells.

Osteocytes Bone cells incapable of dividing but maintain the extracelluar matrix of the bone.

Osteogenesis Formation and growth of bone.

Osteoma Tumour of the bone tissue.

Osteocytes Osteoclasts

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Osteomyelitis Inflammatory disease of the bone due to infection. Osteoporosis A thinning of the bones which can

result in bone weakness & fracture. Osteosarcoma Malignant tumour of bone tissue. Ostium A door, an opening, an orifice. Otic Pertaining to the ear. Ovale Oval shaped.

Palate A roof adj.- palatal or platatine.

Parietal Pertaining to the outer wall of a cavity from paries, a wall.

Parotid Pertaining to a region beside or near the ear(par - otic)

Pars A part of / nearby (adj.- para) Pecten A comb.

Perikymata Transverse ridges and the grooves on the surfaces of teeth Periosteum Layer of fascial tissue (connective tissue) on the outside of compact

bone not present on articular (joint) surfaces. See endostium. Periostitis Inflammation on the outer surface of the bone.

Periostosis Abnormal growth of long bones on their outer surfaces. Petrous Pertaining to a rock / rocky / stoney adj.- petrosal.

Phalanx Pertaining to flanks of soldiers - phalanges a row of soldiers used for a row of fingers or toes.

Planar joints Joints which allow for sliding across the joint as in the wrist, foot and ribs movement in one plan.

Pneumatic Air filled see Classification of Bones. Pollex Thumb.

Process A general term describing any marked projection or prominence as in the mandibular process.

Prominens A projection.

Pseudoarthrosis False or new joint due to the nonhealing of a fracture.

Pterion A wing; the region where the tip of the greater wing of the sphenoid meets or is close to the parietal, separating the frontal from the squamous region of the temporal bone. (TERY-on) Alternatively the region where these 4 bones meet.

Pterygoid Wing shaped.

Pubis Hairy, that part of the hip bone with hair over the surface adj.- pubic pl. pubes.

Ramus Branch as in the superior pubic ramus the superior or higher branch of the pubic bone (Pubis).

Recess A secluded area or pocket; a small cavity set apart from a main cavity. Rectus Straight - erect.

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opposed to exaggeration of vertical curves in kyphosis and lordosis). Sella A saddle; adj.- sellar, sella turcica = Turkish saddle.

Sesamoid Grainlike.

Sigmoid S-shaped, from the letter Sigma which is S in Greek.

Sinus A space usually within a bone, lined with mucous

membrane, such as the frontal and maxillary sinuses in the head. A modified BV usually vein, with an enlarged lumen for blood storage & containing no or little muscle in its wall. Sinuses may contain air, venous or arterial blood, lymph or serous fluid depending upon location & health of the subject adj.- sinusoid.

Skull The skull refers to all of the bones that comprise the ‘head’. Spheno- A wedge i.e. the Sphenoid is the bone which wedges in the base of the

skull between the unpaired frontal & occipital bones adj.- sphenoid. Spine A thorn adj.- spinous descriptive of a sharp, slender

process/protrusion.

Splanchocranium The splanchocranium refers to the facial bones of the skull. Stylos An instrument for writing hence adj.- styloid a pencil-like structure. Sulcus Long wide groove often due to a BV indentation.

Sustenaculum A supportive structure as in the sustenaculum tali = a structure which supports the Talus in the foot.

Suture The saw-like edge of a cranial bone that serves as joint b/n bones of the skull.

Symphysis A cartilagenous joint or a growth with bone-cartilage-bone. See Classification of Joints.

Syn- Together i.e... the close proximity of or fusion of 2 structures. Syndesmosis Tight inflexible joints b/n 2 bones little to no movement. Many axial joints are of this type.

Synostosis Fusion of any joints. Synovial joints Any moveable joint with synovial

fluid b/n the 2 opposing bones - most moving joints are synovial. Talus Ankle (Gk. bend).

Tarsus Pertaining to any bones joining the foot with the leg adj.- tarsal (Gk wickerwork referring to the basketlike structure of the os tarsus with its ligaments). Tectum A roof.

Ball & Socket Condyloid Hinge

Pivot Plane Saddle

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Temporal Refers to time and the fact that grey hair (marking the passage of time) often appears first at the site of the temporal bone.

Tendon A tie or cord of collagen fibres connecting muscle with bone (as opposed to articular ligaments which connect bone with bone). Tentorium A tent.

Torus Protruberance pl. tori.

Trabecula A “little” beam i.e. supporting structure or strut pl. trabeculae = spicule. Trephination The practice of making an artificial hole in the cranium practiced in

many ancient religions used to relieve cranial pressure. Trochanter Pertaining to a small wheel or disc. In the femur it is a large disc =

shaped tuberosity.

Trochlea A pulley that part of the bone or ligamentous attachment that pulls the bone in another direction as in the elbow or the ankle (adj.- Trochlear). Tubercle A small process or bump, an eminence.

Tuberculum A very small prominence, process or bump.

Tuberosity A large rounded process or eminence, a swelling or large rough prominence often associated with a tendon or ligament attachment. Turbinate A child’s spinning top, hence shaped like a top. An old term for the

nasal conchae. Tympanum A drum pl. tympani. Ulna = Elbow or arm (adj.- ulnar) Uncus A hook adj.- uncinate. Valgus-Vargus

Volar Pertaining to the palm (hand) or the sole (foot). Wormian bone Extrasutural bone in the skull.

Zygoma A yoke, hence, the bone joining the maxillary, frontal, temporal & sphenoid bones adj.- zygomatic.

For more medical terms in this or other areas see the A to Z of Medical terms.

Normal Vargus Valgus

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Anatomical position and Anatomical planes

This is the anatomical position.

A= Anterior Aspect from the front, Posterior Aspect from the back, used interchangeably with ventral and dorsal respectively. B= Lateral Aspect from either side

C= Transverse / Horizontal plane

D= Midsagittal plane = Median plane; trunk moving away from this plane = lateral flexion or lateral movement moving into this plane medial movement; limbs moving away from this direction = abduction; limbs moving closer to this plane = adduction E = Coronal plane F = Median

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neck flexion

neck extension/hyper-extension

lateral flexion

lateral rotation

Joint movements of the Neck

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extension of the VC

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arm/shoulder movements in the coronal plane commencing from adduction abduction to extension

shoulder/scapula movements in the horizontal plane

Joint movements of the Shoulder

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arm extension in sagittal plane / shoulder movement

shoulder extension in the sagittal plane

shoulder abduction in the coronal plane (with elbow flexion)

shoulder elevation - reverse

wrist extension wrist flexion arm abduction - away from median plane / adduction - towards the median

plane -shoulder movement

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Hip flexion Hip extension

Hip abduction Hip adduction

Hip lateral and medial

rotation Hip circumduction

Joint

Movements of the Hip & Lower Limb

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Foot dorsiflexion Foot plantar flexion Foot inversion Fingers extension Forearm pronation Fingers flexion Forearm supination Foot eversion

Foot normal position

Hand deviation radial/laterally ulna/medially

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Structure of Bone Tissue

Bone is a tissue. It contains osteocytes (mature bone cells -1), osteoblasts (new bone cells -2), osteoclasts (resident monocytes) which may combine to form GIANT cells (3) to remodel bone which occurs constantly.

The tissue may be packaged as COMPACT bone = dense bone for major weight-bearing areas as in the Long bones or as CANCELLOUS bone = spongy bone = trabechular bone, which is present in the axial skeleton and at the heads of most Long bones.

The density of bone is changing all the time. It is one of the most dynamic tissues in the body constantly forming and reforming its structure. Its repair capacity is extensive, but changes in body demands, diet and disease states will affect its integrity.

Loss of bone = Osteoporosis

Excess deposition of bone = Osteopetrosis Deposition of bone in ectopic sites = Ossification

COMPACT BONE - A

It is surrounded by an outer fascial layer – Periosteum (4) and an inner fascial layer – Endostium (5) and has a central cavity filled with Bone Marrow (BM) – either filled with fat cells – YELLOW BM – or haemopoietic tissue (cells related to forming the blood and its component cells) – RED BM. The bone is laid down in circular layers or lamellae (6L) with a central core (6c) for the BS, called HAVERSION systems (7).

CANCELLOUS BONE - B

This consists of long trabeculae or spicules of bone laid along pressure lines surrounded by haemopoietic tissue – RED BM (8). It is highly mobile; the first to be mobilized for mineral needs or changing

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A B 6L 5 6c 1 3 2 8

A

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BONES in situ – UPPER

1 Frontalis - forehead 2 Zygoma

3 Maxilla –upper jaw 4 Mandible – lower jaw 5 Clavicle – collar bone 6 Humerus – arm 7 Manubrium 8 Sternum breastbone 9 Xiphoid process 10 Temporalis 11 Parietalis 12 Occipitalis 13 Atlas - C1 14 Axis – C2

15 Vertebrae – cervical (7) – neck 16 Vertebrae – thoracic (12) – thorax 17 Shoulder joint

18 Elbow joint

19 Scapularis – shoulder blade 20 10th Rib (24 ribs- 12 each side)

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11 12 13 14 15 17 19 16 4 5 7 8 9 6

Posterior

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BONES in situ – LOWER

21 Radius

22 Ulna

23 Femur – thigh bone 24 Patella – kneecap 25 Fibula

26 Tibia – shin

27 Cuniform bones (3 each foot)

28 Metatasal bones – foot bones (5 each foot) 29 Phalanges = digits (14 each foot)

30 Toes / joints

31 Tarsal bones - foot bones (7 each foot)

32 Ankle joint 33 Knee joint 34 Wrist joint 35 Hip joint 36 Os Coxae - Hip bone

37 Sacrum

38 Carpal bones – wrist bones (8 each hands) 39 Ischium (part of the hip bone)

40 Navicula – ankle bone 41 Talus – heel bone

42 Metacarpal bones - hand bones (5 each hand) 43 Coccygeal bones (3-5)

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Posterior

42 39 40 41 21 22 23 24 25 26 27 31 32 33 34 35

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Classification of Bones

Flat bones Thin flattened and usually curved bones: most Skull bones, Scapula, Manubrium generally surrounded by a layer of compact bone with cancellous or spongy bone in b/n.

Irregular bones Various shapes not easily classified Sphenoid, Vertebrae, Hip, Ear Bones irregular growth centres.

Long bones These bones are long with a shaft = diaphysis and 2 ends epiphyses. They have growth centres at each end and grow lengthwise over years via their growth plates at the metaphyses, e.g.: most limb bones: Femur, Fibula

Humerus, Radius, Tibia, Ulna, & digits Phalanges. See diagram. Pneumatic bone/Alveolar bones

Bones filled with air to lighten their weight -

Maxilla, Frontal, Mandible, Ethmoid and bones with “sinuses”.

Sesamoid bonesare completely surrounded by soft tissue w/o joints e.g. Hyoid. small bones around the thumb and big toe.

Short bones Roughly cubic in shape. Most wrist Carpal and ankle Tarsal

bones; many of the bones at the base of the skull.

Sutural bones = “Wormian” bones are small bones which occur w/in the skull sutures. They are sometimes called extra-sutural if the main part f the bone is outside of the suture. They are unnamed, except the Incus - the largest extra-sutural bone.

There are: There are between 600 and 620 bones in the body including the various sesamoid and Wormian bones and other areas where there may be separate or ossified joints. 22 paired skull bones including the ear ossicles / not including the teeth.

5 single bones mainly on the base of the skull. 1 mandible.

1 hyoid.

variable sutural & extra-sutural bones (generally between 3-5). There are: 56 digit bones or Phalanges plus an additional 3 to 4 small sesamoid bones in the foot over the big toe and the thumb.

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Structure of a Long Bone

1 joint surface = articular surface = hyaline cartilage 2 joint space

3 joint capsule + periosteum 4 compact bone

5 endosteum 6 BM red & yellow

7 epiphysis – head of the bone 8 metaphysis – widest part of the shaft 9 BVs entering bone through nutrient foramen 10 neurovascular bundle travelling in 3 11 diaphysis – shaft of the bone 12 cancellous bone – bone spicules

13 ossification of growth plate – fusion of spicules

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2 3 4 5 11 10 9 8 6 12 7

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Anterior Posterior

Regional Skeletons

The colours on these skeletons are placed as colour tags at the bottom of the Bone & Joint pages, and indicate their position on the skeleton.

green shoulders, upper limbs & hands

yellow axial skeleton

pink thorax and rib cage

blue hips, lower limbs and feet

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Classification and Summary of Joints

definition: joint = any BONE something BONE B+?+B i.e whenever 2 or more bones meet

TYPE OF JOINT STRUCTURE MOVEMENT EXAMPLES

GOMPHOSIS BONE - nil teeth / jaw bone

FIBRES

TOOTH

SYNARTHROSES = BONE - little / nil

FIBROUS JOINT FIBRES BONE

eg SUTURE BONE - nil joints in the Skull

(short fibrous FIBRES

-connection b/n bones) BONE joints b/n flat bones

eg SYNDESMOSIS BONE - little Tibiofibula joint

(longer fibres more FIBRES- Radioulna joint

cartilage) BONE

SYNCHONDROSIS = BONE - due to the elasticity 1stcostal cartilage

1º CARTILAGENOUS HYALINE- of the CARTILAGE to the Manubrium

JOINT CARTILAGE - rib cartilage

(Amphiarthrosis) BONE Manubriosternum

SYMPHYSIS BONE - little in all directions MOST joints in axial

(20cartilagenous joint) FIBRO- - skeleton

CARTILAGE - may be influenced eg b/n VERTEBRAL

BONE by HORMONES BODIES b/n Pubic

bones SYNOVIAL BONE - Full movement MOST joints in the

(Diarthrosis) HYALINE type depends appendicular

CARTILAGE upon the shape skeleton, upper limb,

SYNOVIAL FLUID of the bony lower limb, feet and

HYALINE surfaces hand joints

CARTILAGE

BONE

eg PLANE gliding / sliding costovertebral zygapophyseal eg HINGE one directional elbow / knee / finger / toe

eg PIVOT movement around atlanto-axial medial

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2 ligament (bone to bone) 3 bursa

4 bone – compact & cancellous 5 skeletal muscle

6 tendon (bone to muscle)

7 attachment fibres (Sharpey’s fibres) 8 shaft of long bone

9 joint capsule + periosteum

10 articular (joint) surface / d defect in the surface 11 jt space

12 synovium / h-overgrowth inflammatory reaction 1 2 3 10d 12h 5 6 9 10 11 12 4

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Classification and Summary of Ligaments

definition: a band of tissue connecting bones, viscera or other body structures, may be distinct fibrous bands or fascial folds or nonfunctional remnants of foetal structures

NAME DESCRIPTION EXAMPLES SHOWN IN

accessory any “helping” lig. the: palm (palmar), hand overview, foot = supporting/strengthening sole (plantar), overview, TMJ views, collateral the primary lig. generally phalanges (volar) shoulder joint, wrist

used where there are temporomandibular overview many short bones in a joint (Henle),

crowded area humerus and wrist

annular also any circular lig. annulus fibrosis vertebro-vertebral see annular lig. of the joints

retinaculum binding enclosing lig. Radius elbow

arcuate any curved lig. arcuate pubic ligament pelvic girdle overview anterior description of any lig. in ANTERIOR craniovertebral jts

front of the named LONGITUDINAL thoracic cage structure (also used to LIGAMENT = ALL vertebro-vertebral jts describe those fibres in

front of a structure)

bifurcate lig. with 2 insertions calcaneocuboid + ankle joint-subtalar calcaneonavicular dorsum of the hand pisio-hamate +

pisio-metacarpal

collateral any “helping” lig. radial collat. . lig. elbow, knee jts wrist = supporting/strengthening

accessory the primary lig. generally used with outer ligs over

bigger joints cruciform ligaments which CRUCIATE LIGAMENTS knee jt

cross over (of the knee)

cruciate ligs of the atlanto-axial jt

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NAME DESCRIPTION EXAMPLES SHOWN IN

flava ligs with large amounts of LIGAMENTUM FLAVA vertebra-vertebro jts elastic fibres hence yellow

in colour interarticular ligs which enter the long head of Biceps shoulder jt (may also be synovium and are inside cruciate ligs of the knee knee jts called synovial) the joint acetabular lig. hip jt

inter-osseous ligs which span across 2 interosseous membrane forearm radioulna jts bones for a considerable of the forearm lower leg tibiofibular jts length - deep ligs acting interosseous membrane

as a surface for muscle of the lower leg

attachment OBTURATOR LIG. pelvic overview inter-spinous ligs which are b/n 2 spines INTERSPINOUS vertebral column deep ligs acting as a LIGAMENTS overview surface for muscle

attachment.

long ligs which attach 2 bones SUPRASPINOUS vertebro-vertebral jts “interspinous” over long distances acting LIGAMENTUM NUCHAE craniovertebral jts as an extended surface for SACROSPINOUS pelvic girdle overview muscle attachment - more SACROTUBEROUS sacrum

supf than the inter- ligs INGUINAL LIG pelvic girdle posterior description of any lig. POSTERIOR vertebro-vertebral jts behind the named structure LONGITUDINAL

(also used to describe LIGAMENT = PLL those fibres of a lig. behind

a structure) radiate lig. which fans out (smaller radiate lig. of the rib thoracic cage, deltoid shape) costovertebral jts synovial =

interarticular

other ligamentous structures such as the aponeuroses or ligaments of organs such as the Hepatic ligaments.

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The Bones,

Joints and

Ligaments

This is the order of the illustrations in the book.

When beside the name of a structure there is a listing - (see XYZ)… it will be listed at the site XYZ, which may also refer to its alternative name; when beside a structure there is a listing - (also see XYZ)… further information about that structure will be at the site for XYZ, but it will be present in the order listed site as well; this includes structures listed in the BACK section.

Bonesare listed in BLACK; Jointsare listed in DARK YELLOW& ligaments when referred to separately are listed in ORANGE. Generally ligamentswill be referred to in joint diagrams and not listed or demonstrated in separate diagrams. Overviews of regionsare listed in MAROON (DARK RED). Acetabular joint (see HIP JOINT)

Acromioclavicular articulation & joint

ANKLE BONE (see Talus - (biggest of the Tarsal bones aka Tarsus)) ANKLE JOINT = Talocrural joint = Talus + Tibia + Fibula

= Subtalar joints = Talus + Calcaneus + Os Tarsus ARM = Upper limb = Humerus + Radius + Ulna (see Humerus) Atlas (C1 ) - (Vertebra - cervical) also see the Back

Atlanto-Axial joints (C1/C2)

Atlanto-Occipital joint (see Craniovertebral joint) Axial-Occipital joint (see Craniovertebral joint) Auditory Ossicles (see EAR BONES overview) Axis (C2) - (Vertebra - cervical) also see the Back BACK See end of this section the Back = Vertebral Column. BREAST BONE (see Manubriosternum)

Calcaneus (aka HEEL)

Capitate (see Carpus disarticulated, also Hand & Wrist overview) Carpus - carpal bones wrist (Os Carpus = Wrist bones) articulated see Hand & Wrist overview

individual bones

1strow - Trapezium, Scaphoid, Lunate, Triquetral, Pisiform, 2ndrow - Trapezoid, Capitate, Hamate

Carpus - disarticulated

Carpo-Metacarpal joints (see HAND and WRIST joints)

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Cuneiforms (foot)

1st- medial cuniform, 2ndintermediate cuniform, 3rdlateral cuniform EAR BONES overview

ELBOW - articulation, joint (humero-ulnar) Ethmoid bone

Femur (upper leg bone) aka THIGH bone aka LEG bone Fibula (lower leg lateral bone part of the SHIN)

FINGERS articulation overview ((see Hand and Wrist bones overview) FINGER JOINTS = interphalangeal joints + MCP joints

FOREARM (see Radius, Ulna) FOREHEAD (see Frontal bone)

FOOT BONES (tarsal + metatarsal + phalanges) overview (see also Metatarsals)

FOOT JOINTS - aka Intertarsal joints Frontal bone (aka FOREHEAD)

Glenohumeral joint (see SHOULDER JOINT) Hamate (see Carpus disarticulated, also Hand & Wrist) HAND (and WRIST bones) overview

Carpal, Metacarpal bones and Phalanges - articulations HAND BONES (see Metacarpals disarticulated)

HAND JOINTS intercarpal joints = IC joints

Carpometacarpal, intercarpal joints = C-MC, IC joints HANGING joint (see Atlanto-Axial median joint) also see the Back HEAD/SPINE JOINTS (see Craniovertebral joints) also see the Back HEEL (see Calcaneus)

Hip (aka Os Coxae - Innominate) HIPISCHIUM, ILIUM, PUBIS overview HIP joint (also see PELVIC GIRDLE Sacrum) HIPS (also see PELVIC GIRDLE)

Humeroulnar joint (see ELBOW joint) Humerus = ARM bone (upper arm bone) Hyoid

Inferior Nasal Concha (also see Nasal Bones & Cavity) Innominate (see HIP)

Interphalangeal joints of the Foot = TOES

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Ischium (see HIP) JAW (see Mandible) Knee articulations

KNEE CAP (see Knee articulations) aka Patella

KNEE JOINTS (Tibiofemoral + [Tibiofibular]+ Femoropatellar + Tibiopatellar)

Lacrimal (see inf Nasal Concha) Larynx overview (aka VOICEBOX)

LEG = Lower limb = Femur + Patella +Tibia + Fibula Lunate (see Carpus disarticulated, also hand & wrist)

Mandible (aka JAW aka CHIN) Mandibular joint (see Temporomandibular joint)

Manubriocostal joints (see Sternocostal joints)

Manubriosternum = Manubrium + Sternum + Xiphoid process aka BREAST BONE

Manubrium (see Manubriosternum) Maxilla (aka UPPER JAW)

Metacarpals aka HAND BONES (see Hand & Wrist overview) Metacarpal Individual views - disarticulated

1st- the thumb / 2nd- the index / 3rd- the middle

4th- the ring / 5th- to the little finger

Metatarsals (bones b/n the ankle & the toes) aka FOOT BONES see overview

Metatarsals (individual views) disarticulated 1st(bone to the big toe) / 2nd(bone to the second toe)

3rd/ 4th/ 5th (bone to the little toe)

Nasal bones and cavity = NOSE Navicular (ankle)

NOSE (see Nasal Bones & Cavity) Occipital bone / Occiput

Odontoid Joint (see Atlanto-Axial median joint) Os Coxae (see HIP bone)

Palantine bones / Palate Parietal bone

Patella = aka KNEE CAP (see Knee articulations) Pectoral girdle = articulations

PELVIS = HIPS(see Pelvic girdle)

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Sacroiliac joint also see the Back

Sacrum (lower BACK BONE) also see the Back Scaphoid (see Carpus disarticulated, also Hand & Wrist) Scapula (aka SHOULDER BLADE)

SHIN (see Tibia)

SHOULDER JOINT (aka Glenohumeral joint) Sinus overview (see Skull Internal views - coronal) Skull External Views and Internal Views

Sphenoid

SPINE overview see the Back SPINAL JOINTS see the Back Sternoclavicular joints Sternocostal joints

Sternum (see Manubriosternum) Talus (aka Tarsus aka ANKLE) Teeth overview

Temporal bone (aka TEMPLE) Temporomandibular joint (aka TMJ) Thoracic cavity(see CHEST overview) Tibia (aka lower leg bone aka SHIN - shin bone)) Tibiofemoral joint (see KNEE which includes this joint) Tibiofibula joints

TOES = digits = phalanges (see Foot bones overview)

Trapezium (see Carpus disarticulated, also Hand & Wrist overview) Trapezoid (see Carpus disarticulated, also Hand & Wrist overview) Triquetral (see Carpus disarticulated, also Hand & Wrist overview) Ulna (aka FOREARM - also funny bone)

Vertebrae, Vertebral Column and Vertebral joints see the Back VOICE BOX (see Larynx)

Vomer

Wrist bones (see Carpal bones disarticulated also Hand & Wrist overview / Metacarpal bones)

Wrist joint (aka radiocarpal joint) Xiphoid (see Manubriosternum) Zygapophyseal joints see the Back Zygoma (aka CHEEK BONES) see the Back

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nge M:F Bo ne s in o rde r o f f re que nc y -gr ea test to le ast sit e in the bo ne tissue fe at ur es / X-r ay a ppe ar ance Micro sco pic f ea tur es 2:1 Fem ur, Hu m eru s, Tib ia, Feet, Pel vis , Sc apul a heads of thes e bones we ll de limit ed, a re as o f r ar ef ac tio n; pa inf ul ex tre me ce llula rit y & v ar iabilit y, po lyhe dr al ce lls, GC , gl yc oge n, r etic ulin 1:1 Ha nds & F ee t, Ribs, F emur , H ume rus me du lla o f L Bs be gins in t he c av ity o f dia phy sis o f a L B ex pa nds & t hins c or te x ma tur e lo bule s o f c ar tila ge 1:1 Tibia , F emur , F ee t, P elv is near the heads of LBs sha rpl y de fine d, ma y be la rge hy po ce llula r lo bule s w ith int er se ct ing ba nds spindle c ells, O C 1:1 Hume rus, T ibia , P elv is, Ma ndible , mur , Sc apul a ends of s haf ts of LBs lyt ic / ho ne yc ombe d ma tur e f ibr obla st s, a bunda nt c olla ge n 1:1 Sk ull, VBs, Ma ndible me du lla sunbur st t ra be cula tio n 2 ° t o pe rio ste al le va tio n thi ck wal led la ttice pa ttern of ca vern ou s s paces 2:1 sk ull & f ac ial bo ne s ma y pr ot rude inside a pa ra na sa l sinus de nse ma tur e la me lla r bo ne 2:1 fe mur , t ibia , hume rus, ha nds & f ee t, ve rte br ae , f ibula co rte x o f L B luc ent ce nt re <1 5mm pe riphe ra l sc ler ot ic r ea ctio n; pa inf ul sha rpl y de line ate d c ent re : o ste oid line d b y plump o ste obla sts, w /o inf lamma tio n 2:1 VBs, T ibia , F emur , H ume rus, P elv is, Ribs me du lla o f L Bs lar ge r c ent re , a bse nt re ac tiv e bo ne ; no t pa inf ul sha rpl y de line at ed c ent re : o ste oid line d b y plump o ste obla sts, w /o inf lamma tio n 1:1 Fe mur , T ibia , H ume rus, P elv is co rte x o f L Bs gr ow s o ut o ppo sit e t o a dja ce nt jo int ca p o f c ar tila ge co ve re d b y a me mbr ane co nt inuo us w ith t he pe rio ste um 3:1 Hume rus, F emur thin c or te x

BENIGN BONE LESIONS

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n age range M :F Bo ne s in o rde r o f f re que nc y -gr ea test to le ast sit e in the bo ne tissue fe at ur es / X-r ay a ppe ar ance Micro sco pic f ea tur es hr onic ma s 30-60 1: 1 Fem ur, Pel vis , V Bs , T ibi a, Hu meru s, Man dib le, Sku ll, Rib s me du lla of sh aft s o f L Bs bo ne pr oduc tio n & de st ruc tio n ov er a w ide a re a as pe r l ympho ma else whe re dros arcom a 30-60 3: 1 Pel vis , R ibs , Fem ur, Hu m eru s, VB s co rte x of LBs m edul la of cent ral ax ial bones ost eo lyt ic w ith splo tc hy ca lcif ica tio n ra nge o f dif fe re nt iat ion: c ar tila gino us ma trix , la ck o f dir ec t bo ne fo rma tio n ma 40-60 2: 1 Sa cr oc oc cy ge al, S phe no -o cc ipit al, ce rv ica l VBs ost eo lyt ic, ra re ly o st eo bla st ic co rds a nd lo bule s; phy sa life ro us c ells /P NET 5-20 1: 2 Fe mur , P elv is, T ibia , H ume rus, Ribs, Fibula ; Me ts t o lung, ple ur a, o the r bo ne s me du lla o f s ha fts o f L Bs co rtic al t hic ke ning w ith w ide ning of the me dulla ry c ana l; r ea ct ive pe rio st eum she et s o f c ells w ith f ibr ous st ra nds, pse udo ro se tte s, gl yc oge n rc oma 20-60 1: 1 Fe mur , T ibia , Ma ndible , H ume rus me du lla in L Bs os teol yti c “ soa p-b ub ble” as per soft tis su e, no tum ou r os teoi d c ell ur 20-40 4: 5 Fe mur , T ibia , Ra dius heads of thes e bones lyt ic e xpa nsile le sio n w /o sc ler osis o r a pe rio st ea l r ea ct ion st ro ma l c ells, GC s nc hy ma l osa rc oma 20-60 1: 1 Ribs, S kull, Ma ndible , VBs, P elv is, so ft tissue s sh af ts of L Bs lyt ic e xpa nsile le sio n w /o sc ler osis o r a pe rio ste al r ea ctio n dimo rphic : w ell-dif fer ent iat ed c ar tila ge w undif fer ent iat ed st ro ma sa rc oma 10-25 3: 2 Fe mur , T ibia , H ume rus, P elv is, J aw , Fibula me du lla o f L Bs Co dma n’s t ria ngle ; me ta st asize s to : lung, bo ne , ple ur a, he ar t ost eo id pr oduc ed b y t umo ur ce lls w /o int er ve ning c ar tila ge c ell 40-60 2: 1 VBs, P elv is, Ribs, S te rnum, S kull me du lla o f L Bs

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Acromio-Clavicular articulation & joint =

part of the pectoral girdle

anterior (ribs cut away)

BS suprascapular artery, thoracoacromial artery

NS suprascapular, lat. pectoral Ns (C5-C6)

Movements associated with scapula: elevation / depression, protraction/retraction, rotation

1 Acromion

1A Aromio-Clavicular lig. 2 Coracoid process of Scapula 2A Coraco-Acromial lig.

2B Coraco-Clavicular lig.- Trapezoid part 2C Coraco-Clavicular lig. - conoid part 3 supra-scapula notch

3A supra-scapular lig. 4 Clavicle - sternal end 5 Clavicle - acromial end 6 Acromio-Clavicular art.

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1A 2A 2B 2C 3A 5 6 4 1

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ANKLE JOINT = Talocrural joint

medial / lateral / posterior

BS ant. tibial & peroneal arteries

NS deep peroneal (=ant. tibial), tibial (L4-S2)

A dorsiflexion plantarflexion

1D Tibio-Calcaneal (deep) lig. 2D Tibio-Navicular lig. 3D Tibio-Calcaneal lig. 4D Tibio-Talar (deep) lig. 5 ant. Talo-Fibular lig. 6 Tibio-Talar lig. 7 Tibio-Fibular lig. 8 post. Talo-Fibular lig. 9 Talo-Fibular lig. - tibial fibres 10 Calcaneo-Fibular lig. 11 Talonavicular lig.

*D = all parts of the DELTOID lig. -from TIBIA to ankle bones in a “D” shape

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3D 2D 10 8 5 4D 3D 8 2D 10 7 9 1D

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ANKLE JOINTS lower = SUBTALAR joints

lateral / medial

BS* anastomotic network around jts from ant. post. tibial arteries, dorsalis pedis, peroneal arteries

NS medial lateral plantar Ns (L4-S3)

A inversion eversion (foot) gliding and rotation (subtalar joints individually)

1 interosseous Talo-Calcaneal lig. 2 cervical lig.

3 Talo-Navicular lig. 4B* lat. Calcaneo-Navicular lig. 5B* med. Calcaneo-Cuboidal lig. 6 long plantar lig.

7 lat. Talo-Calcaneal lig. 8 subtalar jt

9 med. Talo-Calcaneal lig. 10 Talo-Calcaneo-Navicular jt

11 Spring lig. / plantar Calcaneo-cuboidal lig. 12 short plantar lig.

B* = BIFURCATED lig. (2 heads) also called Bifurcate lig.

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8 3 9 11 10 6 7 3 8 5B 4B 12 6

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Atlas = C1 = First Cervical Vertebra

anterior / superior

(Atlas - Gk demigod who held up the world on his shoulders).

Articulations: Atlanto-Axial jts (3) C1-C2 Atlanto-Occipital jts (2) C1-Occiput

(Base of the skull) Special no vertebral body special anterior features no spinous process facet for dens no articular discs (odontoid process)

1 Facet for odontoid / dens process 2 Ant. tubercle

3 Superior articular facet 4 Inferior articular facet 5 Posterior tubercle 6 Posterior arch

7 Groove for vertebral BVs & suboccipital N 8 Foramen transversarium = transverse foramen 9 TP 10 Lat. mass 11 Vertebral foramen 12 Ant. arch

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Atlanto - Axial joint - median =

ODONTOID JOINT aka hanging joint

BS spinal branches of vertebral art.

NS spinal Ns dorsal rami (C1-2)

A rotation, circumduction

Atlanto-Axial joints - lateral =

zygapophyseal joints of C1/C2

BS spinal branches of vertebral art.

NS spinal Ns dorsal rami (C1-2)

A flexion, extension, lateral flexion, rotation 1 Dens = odontoid process (C2) 2 Transverse lig of axis (C2) 3 Transverse foramen of atlas C1 4 Medial tubercle of atlas (C1) 5 Tranverse foramen of axis (C2) 6 Post arch and tubercle of atlas (C1) 7 Lamina and spine of axis (C2) 8 Body of axis (C2)

9 Superior articular facet of atlanto-occipital jt 10 Ant. arch of atlas (C1)

11 Facet for dens (C2) 12 Ant. tubercle of atlas (C1)

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6 8 7 1 2 3 4 5 9 10 11 12

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Axis = C2 = Second Cervical Vertebra

anterior / superior

(Axis - pivot for movement of the head, all movements but nodding)

Articulations: Atlanto-Axial jts (3) C1-C2 vertebro-axial Axial jts (2) C1-Occiput (Base of the skull)

Special no vertebral body Dens acts as an features dens/odontoid process AXIS for rotation no articular discs at C1

1 Dens = odontoid process (tooth) 2 Attachment of alar ligament 3 Groove for transverse ligament 4 Pedicle

5 Body

6 Vertebral foramen 7 Spinous process 8 Lamina

9 Inferior articular process 10 Transverse process

11 Transverse notch / foramen (if closed) 12 Superior articular facet

13 Facet for odontoid / dens process CHEEK BONES (see Zygoma)

CHIN (see Mandible)

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6 8 7 1 2 3 4 5 9 10 11 12 13 9 12 10

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Calcaneus = Os Calcis = Heel bone

lateral / medial / inferior / superior

(Calcaneus - large quadrangular bone at the back of the Talus - largest of the Tarsal bones/Os Tarsus i.e. foot bones)

Articulations: 3 articular surfaces Calcaneo-navicular for the Os Tarsus Calcaneo-talus (tarsal bones) Calcaneo-cuboid

1 Sulcus Calcanei = Calcaneal sulcus

2 middle articulation surface with foot bones / Os Talus 3 anterior articulation surface with foot bones / Os Tarsus 4 peroneal trochlea

5 attachment for the calcaneofibular ligament 6 posterior surface

7 posterior part of the joint surface for the Talus 8 groove for Flexor Hallicus Longus

9 Sustenaculum Tali 10 articular surface for Cuboid 11 medial process 12 Calcaneal tuberosity 13 lateral process 14 Peroneal tubercle

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Carpus = Carpal Bones = WRIST BONES

& Metacarpus - Metacarpals - HANDBONES

Overview - ARTICULATED

dorsal / palmar

(Carpus = Os Carpus = wrist bones = 2 rows of bones between the fingers and the forearm)

1strow 2ndrow

trapezium, scaphoid, lunate, trapezoid, capitate hamate triquetral, pisiform, 1 Triquetral 2 Capitate 3 Lunate 4 Trapezoid 5 Scaphoid 6 Trapezium 7 Metacarpals = MC 8 head of 5thMC 9 shaft of 5thMC 10 base of 5thMC 11 Hamate 12 Pisiform 13 Hook of Hamate

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6 7 1 2 3 4 5 9 10 11 8 9 10 13 11 12 1 2 3 4 5 6 7

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Carpus = Carpal Bones = WRIST BONES

Overview - DISARTICULATED

Capitate / Hamate / Lunate / Pisiform / Scaphoid dorsal / palmar

These bones allow for small gliding movements in the hand in several directions to increase the mobility of the fingers

Capitate = Os Capitus A

small cap-like bone in the wrist - consists mainly of articulating facets

Hamate B

bone in the shape of a hammer with hook process which attaches to the flexor retinaculum

Lunate = Os Lunatus C

small moonshaped bone of the wrist consists mainly of articulating facets

Scaphoid D

boat shaped bone, most lateral and proximal in the Carpus large pivotal bone similar to the Navicular in the foot - forms part of the attachment of the flexor retinaculum

Pisiform - smallest carpal bone - sesamoid bone E

attaches to the flexor retinaculum

C

1 articulation surface for Lunate 2 palmar surface 3 facet for 3rdMC 4 facet for 4thMC 5 articulation surface for Hamate 6 articulation surface for Scaphoid

10 facet for Triquetral 11 Hamulus - hook of

the Hamate 12 articulation surface

for Capitate 13 facet for the 5thMC

14 facet for Radius 15 facet for Trapezium 16 tubercle

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C

4 3 7 8 3 11 1 12 9 13 4 1 10 2 11 13 4 5 2 9 12 10 9 14 2 6 10 9 12 16 9 15 16 12 14

A

B

D

E

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Carpus = Carpal Bones = WRIST BONES

Overview - DISARTICULATED

Trapezium / Trapezoid / Triquetral dorsal / palmar

These bones allow for small gliding movements in the hand in several directions to increase the mobility of the fingers

Trapezium = Os Trapezius (Lt - greater multi-angular) F

medium-sized irregular bone with large saddleshape articulation for the thumb often broken in trauma

Trapezoid (Lt lesser multi-angular) G

2ndsmallest carpal bone - irregular bone

Triquetral H

irregular bone of the wrist articulates with the Pisiform 1 articulation surface for Lunate

2 articulation surface for Pisiform 3 articulation surface for Hamate 4 tubercle

5 facet for 1stMC

6 articulation surface for Scaphoid 7 articulation surface for Trapezoid 8 facet for 2ndMC

9 articulation surface for Capitate 10 dorsal surface 11 palmar surface

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6 4 8 4 7 7 6 5 8 dorsal palmar 10 6 9 8 10 1 2 3 3 1

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CHEST - overview

Thoracic cavity

ARTICULATIONS anterior synovial joints

RIB 1 with Manubrium see STERNO-COSTAL jt

RIB 2 with the Manubrium & Sternum see STERNO-COSTAL jt RIBS 3-6 (true ribs) with the Sternum directly

cartilagenous joints

RIBS 7-10 (false ribs) with Sternum via costocartilagenous ridge RIBS 11-12 (floating ribs) do not articulate anteriorly

20 fibrocartilagenous joints - ossify with age Manubrium with Sternum

Sternum with Xiphisternum posterior

planar synovial joints

EACH RIB with the same VB and the one above medially + with the TP of the VB laterally

SPECIAL FEATURES

UPPER 6 ribs - pump movement -up & down

LOWER 4 ribs - bucket handle movement -up and out & down and in LOWEST 2 ribs - DO NOT MOVE with respiration - anchor the DIAPHRAGM upper border = thoracic inlet = 1strib + clavicle +manubrium + VB

lower border = thoracic outlet = Xiphisternum + 12thrib + VB

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1 1st rib 2 Clavicle 3 acromion (Scapula) 4 Humerus 6 Manubrium 7 Sternum 8 Xiphoid process 9 12thrib

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8 7 4 5 9 10

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Clavicle = COLLAR BONE

inferior / anterior

Articulations: with Manubrium with acromion proximally (Scapula) distally sterno-clavicular jt acromio-clavicular jt

1 Sternal end of Clavicle 2 facet for first costal cartilage 3 groove for subclavian artery 4 conoid tubercle

5 acromial end of Clavicle 6 trapezoid line (oblique ridge) 7 impression for costoclavicular lig 8 superior surface

9 anterior surface

Coccyx = Os Coccygis

anterior / posterior

(Coccyx = Small tail bones at the base of the spine - functions as an anchor for many regional muscles and ligaments = the vestigial tail -looks like a cuckoo's bill)

Articulations: with each other 3-5 bones S1-3/5 average 4 with the sacrum superiorly sacro-coccygeal

Special less features inferiorly after may fuse with features: S1 no pedicles, laminae or sacrum late in life spinous processes looks like the bill of the cuckoo Variable Shape/Morphology

1 rudimentary superior articular surface = cornua

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9 3 6 7 1 2 3 4 5 1 2 4 1 2 3 4

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Costovertebral joints = RIB/SPINE joints

articulations-superior / joints-superior

(Costovertebral joints = 3 joints in each typical rib, 2 with the bodies of the vertebrae, 1 with the transverse process of the respective thoracic vertebra)

BS posterior intercostals - spinal branches of the thoracic Aorta

NS posterior intercostals Ns spinal branches (C8,T1-12)

A gliding in inspiration

upper 6 elevation (pump handle) lower 4 eversion (bucket handle) lowest 2 no movement

Articulations: with VB demifacets on the 2 demi-joints bodies of 2 adjacent eg RIB 3 articulates vertebrae & their with T2,T3 VB connecting disc with the TP of the transverse costovertebral equivalent vertebra jt = costotransverse eg RIB 3 with T3 jt

1 articular facet for the (TP) transverse process 2 tubercle of rib

3 articular part of rib 4 neck of rib

5 facet on the head of the rib

6 superior demi-facet on the base of the VB 7 articular capsule of the costotransverse jt 8 costotransverse lig.

9 joint capsule

10 intervertebral disc inner - nucleus pulposis

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6 8 7 3 4 5 9 12 13 14 2 4 5 10 11

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Costovertebral joints = RIB/SPINE joints

articulations, joints / lateral

(Costovertebral joints = 3 joints in each typical rib, 2 with the bodies of the vertebrae, 1 with the TP of the respective thoracic vertebra)

BS posterior intercostals - spinal branches of the thoracic Aorta

NS posterior intercostals Ns spinal branches (C8,T1-12)

A gliding in inspiration

upper 6 elevation (pump handle) lower 4 eversion (bucket handle) lowest 2 no movement

Articulations: with VB demifacets on the 2 demi-joints eg bodies of 2 adjacent RIB 3 articulates vertebrae & their with T2,T3 VB connecting disc with the TP of the transverse costovertebral equivalent vertebra jt = costotransverse eg RIB 3 with T3 jt

1 articular facet for TP

2 superior demi-facet on the base of the VB 3 VB = vertebral body

4 radiate lig.

5 ALL = anterior longitudinal lig. 6 intervertebral disc

7 intra-articular lig. 8 head of rib

9 angle and shaft of rib

10 paired synovial joints planar with demi-facets

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Figure

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References

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