Really it matters…

At entrance gate of a University in South Africa, the following

message was posted for contemplation
‘’Destroying any nation does not require the use of atomic bombs
or the use of long range missiles…it only requires lowering the
quality of education and allowing cheating in the examinations by
the students…”
Patients die at the hands of such doctors…
Buildings collapse at the hands of such engineers…
Money is lost at the hands of such economists and accountants…
Humanity dies at the hands of such religious scholars…
Justice is lost at the hands of such judges…
“The collapse of education is the collapse of the
nation”
 A L
E T
E L M
SK STE
SY
Skeletal system
Functions of the Bones
1.Support
2. Protection
3. Movement
4.Storage
5.Haematopoiesis/blood cell formation/
 CLASSIFICATION of BONES

 According to structure

1. compact = solid mass; dense & hard

 forms the outer layer of bone structure
 functional unit --- Haversian system-opening
in the center
of an osteon which carries blood vessels and nerves
2. cancellous or spongy = contain spaces filled with bone
marrow
 incomplete Haversian system
 ...cnt
 According to shape
1. long bones  Typically longer than wide
 ...cnt.
2. short bones
 cuboidal in shape
 its majority is spongy bone with thin coat of compact bone
e.g. carpals (wrist), tarsal (ankle) bones, sesamoid bone (e.g-
patella(largest sesamoid bone)
3. flat bones
 thin & flattened, usually curved & thin layer of compact around
spongy bone
 for protection & muscle attachments
 composition: 2 thin layers of compact enclosing a thin layer of
spongy bone
e.g. bones of the skull, sternum, ribs, scapula
4.Irregular bones-irregular in shape
Do not fit into other bone classifications e.g-vertebra, hip bone
...cnt

4. Irregular bones  all other bones not assigned to the

previous groups

e.g. vertebrae
pelvic bones
sphenoid
ethimoid bone
5. Sesamoid bones  short bone embedded in a
tendon e.g. Patella,fibella,pisiform
 Anatomy of a Long Bone
• Diaphysis
– Shaft
– Composed of
compact bone
• Epiphysis
– Ends of the bone
– Composed mostly
of spongy bone
 …cnt
• Periosteum
– Outside covering of the
diaphysis
– Fibrous connective tissue
membrane
• Sharper's fibers
– Secure periosteum to
underlying bone
• Arteries
– Supply bone cells with
nutrients
 …cnt
Articular cartilage
• Covers the external surface of the
epiphyses
• Made of hyaline cartilage
• Decreases friction at joint surfaces
Epiphyseal plate
– Flat plate of hyaline cartilage
seen in young, growing bone
Epiphyseal line
– Remnant of the epiphyseal plate
– Seen in adult bones
Medullary cavity -Contains yellow
marrow (mostly fat) in adults
– Contains red marrow (for blood cell
formation) in infants
 Bone Markings
• Surface features of bones
– Sites of attachments for muscles, tendons, and
ligaments
– Passages for nerves and blood vessels
• Categories of bone markings
– Projections or processes—grow out from the
bone surface
– Depressions or cavities—indentations
Some Anatomical terms concerning the bones
…cnt
 Microscopic Anatomy of Bone
 Osteon (Haversian System)
A subunit of compact bone

 Central (Haversian) canal

Opening in the center of an osteon
Carries blood vessels and nerves
 …cnt

 Lacuna(e)
 Cavities containing
osteocytes
 Arranged in
concentric rings
 Lamella(e)
√ Rings of compact
bone
√ Lacunae lie between
rings
 …cnt

 Canaliculi (-us)
 Tiny canals
 Radiate from the
central canal to
lacunae
 Form a transport
system
 Types of Bone Cells

 Osteocytes
 Mature bone cells (bone maintenance)
 Osteoblasts
 Bone-forming cells
 Osteoclasts
 Bone-destroying cells
 Break down bone matrix for remodeling and
release of calcium
...cnt
 According to development
1.Membranous  starts as fibrous membrane,
calcium gradually deposited until structure becomes
ossified.
 also called intramembranous ossification
e.g.: bones of the skull, mandible ,clavicle
2. Cartilagenous  starts as cartilage, gradually
Ossified endochondral or intracartilagenous ossification.
e.g.: long bones
 Cartilagenous Bone Growth:
1)A cartilage model is produced by chondrocytes

 It is surrounded by perichondrium, a membrane

2) A bone “collar” is produced by osteocytes

 The perichondrium of the diaphysis is now termed

periosteum

3) Chondrocytes hypertrophy (enlarge) and cartilage is

calcified
 …cnt
4) A primary ossification center forms

 Blood vessels and osteoblasts invade the calcified cartilage

 Osteoblasts lay down bone matrix

 Trabeculae are formed

5) Around the time of birth, secondary ossification centers form in

the epiphyses

 Bone formation is incomplete at birth

 The skeleton is not complete until the late teens (females)

or early twenties (males)
 …cnt
Epiphyseal plates allow for growth of long
bone during childhood
 New cartilage is continuously formed

 Older cartilage becomes ossified

Cartilage is broken down

Bone replaces cartilage

...cnt

 According to location

Axial

skull 22
hyoid 1
auditory ossicles 6
vertebrae 26
ribs & sternum 25_

Total = 80
...According
... to location

APPENDICULAR
Upper Extremities
Lower Extremities
clavicle 2 hip bone 2
scapulae 2 femur 2
humerus 2 patella 2
radius 2 tibia 2
ulna 2 fibula 2
carpals 16 tarsals 14
metacarpals 10 metatarsals 10
phalanges 28__ phalanges 28__
64 62

Totol =126
Fig. 6.10
 Axial Skeleton
1.Skull
 skeleton of head & face
 Flattened & irregular
 United by joints(sutures)
Skull bones

• Facial bones form the anterior aspect

• The cranial bones enclose the brain
Fig. 6.11
Fig. 6.14
 Divisions of the bones of the skull
a. Cerebral / cranial bones / brain case (8 bones)
unpaired (4) paired (4)
1. occipital 1. parietal
2. frontal 2. temporal
3. sphenoid
4. ethmoid
b. Facial or visceral cranium
paired (12) unpaired (2)
a. Nasal a. Vomer
b. Lacrimal b. Mandible
c. Maxilla
d. Zygomatic / malar / cheek bones
e. Palatine
f. Inferior nasal concha or turbinate
Fig. 6.13
 Fontanelles
Regions of the skull that remain as membrane at
birth. Also Called “Little fountains” ,Six in number

1.Anterior
2.posterior
3.2antero lateral (sphenoidal)
4.2posterolateral (mastoidal)
2.HYOID BONE
= small U-shape; lies in
front of the neck
= base of the tongue is
attached
= lies between mandible
& thyroid cartilage

3.OSSICLES
= small bones of the
ear
a. Stapes (stirrup) 2
b. Incus (anvil) 2
c. Malleus (hammer)2
4.VERTEBRAL COLUMN
= curved, slightly movable pillar
= united together by cartilage & ligaments
= 71 – 75 cm. Long,
= irregular bone
= formed by series of bones -- vertebrae
 Formed from 26 irregular bones
 There are 24 vertebrae, a sacrum (5 fused) and a coccyx
(4 fused)
 It contains four distinct curvatures
 Separated by intervertebral discs
FUNCTION:
 Provide axial support for the trunk
 Transmits weight of trunk to lower limbs
 Protects spinal cord
 Attachment site for ribs and muscles
 VERTEBRAL COLUMN
Regions of vertebral column young adult
cervical 7 7
thoracic 12 12
lumbar 5 5
sacral 5 1
coccygeal 4 1
33 26

Intervertebral discs = flattened plates of fibrocartilage that

are interposed between the adjacent surfaces of the
bodies of vertebrae
 …Intervertebral Discs
Cushion like fibrocartilage pads
interposed between vertebrae
bodies
Function
• uniting medium b/n vertebrae
• Main shock absorber
• Give flexibility and movement to
the whole vertebral column

53
 Parts of IV discs
• Has 2 parts
1.Annulus fibrosus
– surrounds the
outer margin
– collagen fibers
2.Nucleus pulposus
– semi fluid substance
which shifts under
body weight &
pressure Herniation
of disk

54
 General parts of vertebrae

1.Body
2.Transverse process
3.Arch
4. Articular process
5.Pedicle or root
6. Spinous process
7.Lamina
8. Spinal/vertebral foramen
 Regional characteristics of vertebrae
A. Cervical vertebrae (7) = forms the skeleton of the neck, all have transverse
Foramen. Grouped as typical and atypical
atypical cervical vertebrae includes:
1. atlas -- 1st
2. axis = 2nd
3. 7th cervical vertebrae = long spinous process & not bifid, small transverse foramen

B. Thoracic vertebrae (12) = costal pits - rib attachment

= circular vertebral canal
C. Lumbar vertebrae (5) =
= triangular vertebral foramen
have large bodies

D. Sacrum = inverted triangular bone situated between hip bones

E. Coccygeal vertebrae (1) = 4 small incomplete vertebrae

fused to form the coccyx / tail bone; triangular
Fig. 6.17
Fig. 6.18
Fig. 6.20
 Sacrum
• Triangular shaped,
formed by five fused
vertebrae
• Forms the posterior
wall of the pelvis
• Articulates with L5
and iliac bone
• Transfers the weight
of the body to the
lower extremities

62
 Coccyx
• Tail bone
• Composed of 4 fused vertebrae
• Articulates with sacrum

64
 Interlocking pattern of vertebra

• Superior and inferior

processes interlock
• Pedicles have notches on
their superior and
inferior borders
• Lateral openings formed
are called intervertebral
foramen
• Spinal nerves from spinal
cord exit through these
foramina

65
 Ligaments of vertebral column
• Ligaments hold
the vertebral
column in an
upright position
– The broad
Anterior
longitudinal
ligament
– The cord like
Posterior
longitudinal
ligament

66
 …Ligaments
• Ligaments
also connect
specific
vertebra and
support disc
position
– Supraspinou
s ligament
– Ligamentum
flavum
– Interspinous
ligament

67
Curvatures
• Curvatures-normal
– Cervical: convex
– Thoracic: concave
– Lumbar: convex
– Sacral: concave

68
 Clinical deviations-abnormal
• Scoliosis
– An abnormal lateral curvature of the spinal column
– Curvature can occur in an “S” or “C” deviation
• Lordosis
– Accentuated lumbar curvature
– Cause: overweight or pregnancy
• Kyphosis
– An exaggerated dorsal curvature
– Common in aged individuals

69
70
Abnormal spinal curvature
5.STERNUM (breast bone)
= flat bone, found -- anterior thoracic wall
= composed of 2 plates of compact bone
with a layer of spongy bone in between
containing red bone marrow

PARTS:
a. Manubrium
b. Corpus or body
c. Xiphoid process
6.RIBS (12 pairs)
= narrow arched flat bones with 2 ends
1. vertebral - posterior; attaches with thoracic vertebrae
2. sternal - anterior; attaches with costal cartilages

Classification of ribs:
a. Sternal or true ribs (1st to 7th)
- ribs whose costal cartilages are directly
attached to sternum
b. false ribs (8th to 12th)
- ribs whose costal cartilages are not attached
directly to the sternum but to 7th

subdivisions: 1. false rib proper - 8th, 9th, 10th ribs

2. floating or hanging ribs – 11th & 12th
Fig. 6.21
 APPENDICULAR SKELETON

BONES of the UPPER EXTREMITY (UE)

1. Clavicle (collar bone)

2. Scapula (shoulder blade) – articulates with humerus &
clavicle
3. Humerus (arm bone) - longest & largest bone of
UE
articulates with scapula (above) radius & ulna (below)
4. Radius - lateral bone of the forearm; cup shaped head
5. Ulna - principal bone of the forearm;
longer & larger than radius
 ...cnt

6. Carpals (wrist bone) - 8 bones arranged into 2 rows

- proximal & distal rows
7. Metacarpals (bones of the hand) - 5 long bones
placed between carpals & phalanges
- numbered from lateral to medial
1. Phalanges (bones of the fingers) = 14 long bones of the
fingers -- 3 bones except thumb - 2 bones
Fig. 6.22
Fig. 6.26
Fig. 6.27
 BONES of the LOWER EXTREMITY (LE)

1. Hip bone (innominate bone)

right & left hip bones + sacrum+cocyx = pelvic girdle

3 bones has: 1. ilium* *Converge on acetabulum  a

2. ischium* concave fossa -- articulates with
head of femur  form hip joint
3. pubis*
2. Femur (thigh) = longest, strongest, largest bone in the body
3.Patella...largest sesamoid bone
4. Tibia (shin bone) = long bone; anterior, medial,
& larger of the 2 bones of the leg
5. Fibula (peroneal bone)
 Long slender bone
Placed parallel with the tibia but located laterally
Commonly used for bone transplantation
Not involved in weight bearing
Fig. 6.29
Fig. 6.30
Fig. 6.31
Fig. 6.32
Fig. 6.33
Fig. 6.34
6. Tarsals (ankle bone) = short bones
7. Metatarsals (bones of foot) = 5 long bones
numbered from medial to lateral
8. Phalanges (bones of toes) = similar to bones of the
fingers
 Arches of the Foot
1.Longitudinal arch is divided
into medial and lateral parts.
Medial -calcaneus, talus,
navicular,cunieforms & first
three metatarsal bones.Talus is
the key
Lateral -calcaneus, cuboid, and
fourth and fifth metatarsal bones.
cuboid is the keystone bone of
this arch.
2.Transverse - is formed by
cuboid, cuneiforms, and
proximal heads of the
metatarsals
96
 Types & patterns of Bone fractures

Types Patterns
1.Simple, or closed 1.Greenstick fracture
 = when the bone breaks but bone does not break all of the way
the skin does not through. common in children
2.Compound, or open 2.Complete
 = when the broken bone tears 3.Incomplete
through the skin, introducing 4.Transverse
the dangerous possibility of 5.Oblique
infection 6.Spiral
7.Impacted
8.Comminuted
 Types of bone
fracture

Bone fractures are

treated by reduction
and immobilization
 Realignment of
the bone
Fig. 6B
 Repair of Bone Fractures

 Hematoma (blood clot) is formed

 Break is splinted by fibrocartilage

forms a callus-formation of fibrous tissue &

cartilage (chondroblasts, other cells, and vessels)

 Callus is replaced by a bone (osteoblasts)

 Bony callus is remodeled (osteoclasts

 Fig. 6.8

…cnt

Fracture Repair
 Hematoma
formation (A)

 Callus formation (B)

 Bone replacement
(C )

 Bone remodeling
(D)
 Osteoporosis
 Most common in post-menopausal women
Also occurs in males

 Due to decrease in estrogen levels

Estrogen receptors on osseous tissue affect calcium
deposition
Bone becomes porous, brittle

 Weight-bearing exercise, calcium supplements, estrogen will

help prevent osteoporosis
Bone Deformation

Rickets
can result from insufficient vitamin
D in the diet or from insufficient
amounts of ultraviolet radiation from
the sun.
It can lead to skeletal deformation,
such as vertebral or leg curvature
 JOINTS
• Joints or articulations are sites where two or
more bones meet
• Functions
provide skeletal mobility
hold the skeleton together
• Weakest parts of the skeleton but have ability
to resist the forces that tear them apart

104
 Classification of Joints
• Structural classification
focuses on the material binding the bones
together and whether or not there is a joint cavity
• Functional classification
based on the amount of movement allowed at the
joint

105
 Functional Classification
1.Synarthroses
– Immovable joints
2.Amphiarthroses
– Slightly movable joints
3.Diarthroses
– Freely movable joints

106
 Structural Classification
1.Fibrous
– Joined by fibrous tissue
2.Cartilaginous
– Joined by cartilage
3.Synovial
– Joined and surrounded by a joint cavity

107
 Summary of Joint Classes
Fibrous joints
– Suture
– Syndesmoses
– Gomphoses
Cartilaginous joints
– Synchondroses
– Symphyses
Synovial
– gliding
– hinge
– Pivot
– Condyloid
– Saddle
– ball and socket 108
 Fibrous Joints
• Bones are joined by fibrous tissue
• Types
A. Sutures
• Dense fibrous connective tissue
B. Syndesmosis
• A cord or band of connective tissue
C. Gomphosis
• Peg-in-socket arrangement surrounded by fibrous
tissue or peridontal ligament

109
 Suture
•Occurs only
between bones of
the skull
•Wavy articulating
bone edges interlock
•Junction is filled by
connective tissue

110
 Syndesmosis
Bones are united by
sheet of fibrous tissue
Permits the joint to flex
True movement is not
possible
E.g-joint b/n distal tibia
and fibula

111
 Gomphosis
Unique joint b/n a
tooth & its socket
Fibrous tissue holds
teeth in their sockets

112
 Cartilaginous Joints
• The articulating bones are united by cartilage
Types
1.Synchondroses
• Hyaline cartilage unites the bones
2.Symphyses
• Fibrous cartilage unites the bones

113
 Synchondroses
Hyaline cartilage unites the
bones
E.g.. Epiphyseal plates in
growing children and joint
between the first rib’s costal
cartilage and the manubrium
of the sternum.
Provide for bone growth
When growth ends all
synchondroses become
immovable

114
 Symphyses
Bone surfaces are
covered with articular
hyaline cartilage which is
fused to a pad of
fibrocartilage
Fibrocartilage is resilient
and acts as a shock
absorber and permits
limited movement
e.g- pubic symphysis
Pubic Symphysis

115
 Synovial Joints
• Articulating bones are located within a fluid
containing joint cavity
• Permit substantial range of motion

116
 Structures of Synovial Joint
A. Articular cartilage
– Hyaline cartilage on opposing bone surfaces
B. Joint (synovial) cavity
– Space filled with fluid
C. Articular capsule
– Capsule to confine fluid
D. Synovial fluid
– Fluid to lubricate joints
E. Reinforcing ligaments
– Maintain joint alignment
117
 Articular Cartilage
Hyaline cartilage
covers the bone
surfaces
Cartilage absorbs the
compression placed on
the joint
Cartilage keeps the
bone ends from being
crushed

118
 Synovial cavity
Unique to synovial
joints
filled with synovial fluid

119
 Articular capsule
The joint cavity is
enclosed by a double
layered articular capsule
The external layer is a
tough flexible fibrous
capsule
The inner synovial
membrane

120
 Synovial Fluid
lubricates joint
nourishing cells

Synovial
Fluid

121
Reinforcing ligaments
Ligaments reinforce
joint
oExtracapsular
oIntracapsular

122
 Additional features of Synovial
Joints in some joints
• Fatty pads cushion the
knee and hip joints
• Fibrocartilage articular
discs separates articular
surfaces (menisci)
• Articular discs improve
the fit between the
articulating surface
• E.g knee joint

123
 Bursae and Tendon Sheaths
• Bursae and tendon sheaths are closely
associated with synovial joints
• Essentially sacs of lubricant
• Function: reduce friction between adjacent
structures

124
 Bursae
Are flattened fibrous sacs
lined with synovial
membrane and containing
a thin film of synovial fluid
Common at sites where
ligaments, skin, muscles or
tendons rub against a bone

125
 Types of bursae
• Subcutaneous bursae:-
occur in subcutaneous tissue
b/n skin & bony
prominences, such as at the
elbow or knee
• Subfascial bursae:- lie
beneath deep fascia
• Subtendinous bursae:-
facilitate movement of
tendons over bone.

126
127
 Tendon Sheaths

An elongated bursa that

wraps completely around a
tendon subjected to friction.
Tendon slides within this
lubricated sleeve
Common at sites where the
tendon is subject to friction
from other tendons or bone
features

128
 Factors Influencing Synovial Joint Stability

• The nature of the articular surfaces

• The number and positioning of the ligaments
• The tone and strength of the muscles acting
upon the joint

129
 Movements Allowed by Synovial Joints

• Nonaxial: no rotation around an axis

• Uniaxial: motion is within a single plane
• Biaxial: allow movement in two planes
• Multiaxial: movement is possible in all planes

130
 Types of Synovial Joints
– Plane (sliding)
– Hinge
– Pivot
– Condyloid
– Saddle
– ball and socket

131
 Plane Joint

•Articular surfaces are

essentially flat
•Allow only short slipping
or gliding movements
•Nonaxial joint
•Examples
–Intercarpals
–Intertarsals
–Vertebrae
132
 Hinge Joint

Cylindrical shaped
projection of bone fits into a
trough shaped surface of
another bone.
Motion is within a single
plane (uniaxial)
Joint components resemble
that of a mechanical hinge
Example
elbow joint
Knee joint

133
Pivot Joint
The rounded end of a bone
protrudes into a ring of bone
and ligaments on another
bone
Only movement allowed is
rotation of bone around long
axis
Example
the joint between the
atlas and axis.
proximal radioulnar joint

134
 Condyloid Joints

The oval articular surface of

one bone fits into a
complementary concavity in
another
Both articulating surfaces
are oval shaped
Biaxial joints
Example:
-Metacarpo- phalangeal
joints

135
 Saddle Joints

Each surface has both a

concave and a convex
surface that fit together
Example;
-Carpometacarpal
joint

Biaxial movement

136
 Ball and Socket Joint

The spherical head of one

bone articulates with the
cuplike socket of another
Multiaxial
The most freely moving
synovial joint
Movements in all planes is
allowed
Examples
o Gleno-humeral joint
o Hip joint

137
 Injuries of Joints
• Sprains- Ligament supporting a joint are stretched or
torn
• Strains - Tendons or muscle fibers are stretched or
torn
• Cartilage tear - fragmentation of the cartilaginous
tissue
• Dislocation - bones are forced out of their normal
alignments at a joint
• Bursitis/Tendonitis - inflammation caused by trauma
or more frequently overuse
138
Joint Vasculature
• Receive blood from articular
arteries that arise from the
vessels around the joint
• The arteries often
anastomose (communicate)
to form networks
(periarticular arterial
anastomoses) to ensure a
blood supply to and across
the joint in the various
positions assumed by the
joint
• Articular veins are
communicating veins that
accompany arteries 139
 Joint Innervation
• Joints have a rich nerve supply; the nerve endings are in
the joint capsule
• In the distal parts of the limbs (hands and feet), the
articular nerves are branches of the cutaneous nerves
supplying the overlying skin
• However, most articular nerves are branches of nerves
that supply the muscles that cross and therefore move
the joint
• Hilton's Law states that “The nerves supplying a joint
also supply the muscles moving the joint or the skin
covering their distal attachments”
140
05/18/24 141