Chapter 8 Outline. Pectoral Girdle Upper Limb Pelvic Girdle Lower Limb Aging of the Appendicular Skeleton Development of the Appendicular Skeleton

Transcription

1 Chapter 8 Outline Pectoral Girdle Upper Limb Pelvic Girdle Lower Limb Aging of the Appendicular Skeleton Development of the Appendicular Skeleton

2 Figure 8.1 Appendicular Skeleton

3 Pectoral Girdle Clavicle Scapula Figure 8.2

4 S-shaped Articulations Clavicle medially with manubrium of sternum laterally with acromion of scapula Figure 8.2

5 Scapula Broad, flat triangle three, three Articulations Lateral: cavity for head of humerus Other features Posterior: bony ridge = Lateral: process Anterior projection: process

6 Figure 8.3 Scapula

7 Upper Limb 30 bones per arm in brachium (upper arm) and in antebrachium (forearm) 8 carpal bones in wrist 5 metacarpals in palm 14 phalanges in fingers

8 Humerus Proximal features: Head: articulates with scapula Anatomical and surgical necks Greater and lesser : for muscle attachment sulcus: for biceps brachii tendon

9 Humerus Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Head Anatomical neck Greater tubercle Lesser tubercle Head Intertubercular sulcus Surgical neck Deltoid tuberosity Shaft Coronoid fossa Radial fossa Coronoid fossa Lateral epicondyle Medial epicondyle Figure 8.4 Capitulum Trochlea Capitulum (a) Right humerus, anterior view right: The McGraw-Hill Companies, Inc./Photo by Christine Eckel Trochlea

10 Distal features: Humerus tuberosity for attachment of deltoid and epicondyles for muscle attachments : round lateral articulation for radius : spool-like medial articulation for ulna

11 Humerus Distal fossae (depressions): Anterior Radial: lateral depression for radius Coronoid: medial, for anterior ulna Posterior : largest, for posterior ulna

12 Humerus Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Head Greater tubercle Anatomical neck Surgicalneck Deltoid tuberosity Radial groove Figure 8.4 Olecranon fossa Medial epicondyle Trochlea Lateral epicondyle Medial epicondyle (d) Right humerus, posterior view Trochlea (right): The McGraw-Hill Companies, Inc./Photo by Christine Eckel Olecranon fossa Lateral epicondyle

13 Radius and Ulna Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Antebrachial bones Olecranon Trochlear notch Olecranon parallel to each other in anatomical position, radius is lateral to ulna Head Neck Radius Coronoid process Head Proximal radioulnar joint Tuberosity of ulna Neck Radial tuberosity Ulna Shaft Radius Ulna Interosseous membrane Interosseous borders Distal radioulnar joint Figure 8.5 Styloid process Head Styloid process (a) Right radius and ulna, anterior view Styloid process a(right): The McGraw-Hill Companies, Inc./Photo by Christine Eckel

14 Radius Proximal features: Head: articulates with capitulum of humerus Neck: narrowest region Radial tuberosity: for biceps brachii muscle Shaft Distal features: process: lateral wrist bump notch: medial dent for head of ulna

15 Ulna Proximal features: Trochlear notch: for trochlea of humerus : posterior elbow bump for triceps brachii muscle process: anterior tip of trochlear notch Radial notch: lateral, for head of radius Distal features: Head: knoblike end process: posteromedial wrist bump

16 Radius and Ulna Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Olecranon Olecranon Head Proximal radioulnar joint Neck Ulna Shaft Radius Ulna Radius Interosseous membrane Interosseous borders Figure 8.5 Head Styloid processes Head Distal radioulnar joint (f) Right ulna and radius, posterior view (right): The McGraw-Hill Companies, Inc./Photo by Christine Eckel Styloid processes

17 Radius and Ulna (proximal and distal features) Figure 8.5

18 Carpus 8 wrist bones Two rows (1 proximal and 1 distal) of four Figure 8.6

19 Carpals Proximal Row (lateral to medial) 1. Scaphoid 2. Lunate 3. Triquetrum 4. Pisiform Distal Row (lateral to medial) 5. Trapezium 6. Trapezoid 7. Capitate 8. Hamate

20 Metacarpals 5 in palm named by Roman numerals I V from medial to lateral Figure 8.6

21 Phalanges 14 per hand 3 per finger #2 5 Proximal, middle, and distal 2 in pollex (thumb) Proximal and distal Figure 8.6

22 Pelvic Girdle Girdle = right and left ossa coxae with sacrum and coccyx = the pelvis Figure 8.7

23 Os Coxae The hip bone fusion of ilium, ischium, and pubis at years of age Articulations: anteriorly with other os coxae posteriorly with the sacrum laterally with femur at all three bones of the os coxae contribute to the acetabulum

24 Figure 8.9 Acetabulum

25 Ilium Largest of the three fused bones Superior portion of os coxae and acetabulum Features: Ala: wide, fan-shaped portion Arcuate line: ridge along inferior border of the ala fossa: large depression on medial surface,, and gluteal lines: lateral site of muscle attachments

26 Ilium Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Iliac crest Iliac crest Ala Anterior gluteal line Iliac fossa Posterior gluteal line Posterior superior iliac spine Anterior super ioriliac spine Anterior superior iliac spine Posterior superior Iliac spine Inferior gluteal line Auricular surface Posterior inferior iliac spine Greater sciatic notch Anterior inferior iliac spine Lunate surface Anterior inferior iliac spine Arcuate line Posterior inferior iliac spine Greater sciatic notch Body of ischium Acetabulum Ischial spine Pectineal line Ischial spine Lesser sciatic notch Superior pubic ramus Pubic crest Superior pubic ramus Pubic tubercle Lesser sciatic notch Body of ischium Ischial tuberosity Pubic tubercle Inferior pubic ramus Symphysial surface Obturator foramen Ilium Ramus of ischium Obturator foramen Ilium Inferior pubic ramus Ischial tuberosity Ramus of ischium Posterior Anterior Iliaccrest Anterior Posterior Iliac crest Ischium Pubis Pubis Ischium Lateral view Ala Medial view Anterior gluteal line Posterior superior iliac spine Posterior gluteal line Iliac fossa Posterior superior iliac spine Posterior inferior iliac spine Greater sciatic notch Anterior superior iliac spine Anterior superior iliac spine Inferior glutealline Anterior inferior iliac spine Anterior inferior iliac spine Auricular surface Posterior inferior iliac spine Lunate surface Arcuate line Greater sciatic notch Body of ischium Acetabulum Ischial spine Ischial spine Lesser sciatic notch Ischial tuberosity Superior pubic ramus Pubic crest Pectineal line Superior pubic ramus Pubic tubercle Lesser sciatic notch Body of ischium Pubic tubercle Symphysial surface Inferior pubic ramus Obturator foramen Ramus of ischium Obturator foramen Inferior pubic ramus Ischial tuberosity Ramus of ischium (b) Right os coxae, medial view Figure 8.9 (a) Right os coxae, lateral view (bott): The McGraw-Hill Companies, Inc./Photo by Christine Eckel

27 Ilium Additional features: crest: superior ridge and, superior and inferior iliac spines: projections along iliac crest notch: for sciatic nerve entering lower limb Auricular surface: medial articulation with sacrum

28 Ischium Superior/posterior margin of acetabulum Features: Ischial spine: prominent medial process Ischial : rough inferior region that supports weight of body when seated Ischial : bridge from tuberosity to pubis

29 Ischium Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Iliac crest Ala Anterior gluteal line Posterior gluteal line Posterior superior iliac spine Posterior inferior iliac spine Greater sciatic notch Body of ischium Ischial spine Lesser sciatic notch Ischial tuberosity Ilium Anterior super ioriliac spine Inferior gluteal line Anterior inferior iliac spine Lunate surface Acetabulum Superior pubic ramus Pubic crest Pubic tubercle Inferior pubic ramus Obturator foramen Ramus of ischium Posterior Anterior Iliaccrest Ischium Pubis Lateral view Ala Anterior gluteal line Posterior gluteal line Posterior superior iliac spine Anterior superior iliac spine Posterior inferior iliac spine Greater sciatic notch Inferior glutealline Anterior inferior iliac spine Lunate surface Body of ischium Ischial spine Lesser sciatic notch Acetabulum Figure 8.9 Ischial tuberosity (a) Right os coxae, lateral view Superior pubic ramus Pubic crest Pubic tubercle Inferior pubic ramus Obturator foramen Ramus of ischium (bottom): The McGraw-Hill Companies, Inc./Photo by Christine Eckel

30 Pubis Anterior region of os coxae Features: Superior and Inferior rami: struts to acetabulum and ischial ramus Pubic : rough ridge on anterosuperior of superior ramus; ends as pubic tubercle foramen: large space bordered by pubic and ischial rami line: ridge on medial surface of pubis continuing from arcuate line of ilium

31 Figure 8.7 Pubis

32 True vs. False Pelvis True pelvis: bony basin inferior to pelvic brim containing pelvic organs False pelvis: superior to pelvic brim bound by ilia laterally and abdominal wall anteriorly Pelvic brim: continuous oval ridge formed by pubic crest, pectineal line, arcuate line, and sacral promontory Pelvic : superior entrance to true pelvis, at pelvic brim Pelvic : exit of true pelvis, defined by coccyx, ischial tuberosities, and inferior border of pubic symphysis

33 Features of the Pelvis Figure 8.10

34 Female vs. Male Pelvis Most reliable indicator of the sex of a skeleton is the pelvis, due to the requirements of pregnancy and childbirth Major differences: female ilia laterally flared = wider pelvis female pelvic inlet = wide oval, male s = heart-shaped female subpubic angle wider, >100º vs. <90º in males

35 Female vs. Male Pelvis Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Table 8.1 View Medial View Sex Differences Between the Female and Male Pelves Female Pelvis Male Pelvis Preauricular sulcus Wide greater sciatic notch Narrow greater sciatic notch Anterior View Rectangular pubic body Triangular obturator foramen Wide subpubic angle Narrow subpubic angle Triangular pubic body Large, oval obturator foramen Features Female Characteristic Male Characteristic General Appearance General Width Superior Inlet Acetabulum Greater Sciatic Notch Ilium Obturator Foramen Subpubic Angle Body of Pubis Preauricular Sulcus Sacrum Coccyx Tilt of Pelvis Ischiopubic Ramus Ischial Spine Less massive; gracile processes, less prominent muscle markings Hips are wider, more flared Spacious, wide, and oval Smaller Wide and shallow Shallow: Does not project far above sacroiliac joint Smaller and triangular Broader, more convex, usually greater than 100 degrees Longer, more rectangular Usually present Shorter and wider; flatter sacral curvature Posterior tilt Anterior tilt to superior end of pelvis Narrow and sharp Rarely projects into pelvic outlet More massive; more robust processes, more prominent muscle markings Hips are narrower and more vertically oriented, less flared Heart-shaped Larger Narrow and U-shaped, deep Deep: Projects farther above sacroiliac joint Larger and oval Narrow, V-shaped, usually less than 90 degrees Shorter, triangular Usually absent Narrower and longer; more curved (greater sacral curvature) Vertical Superior end of pelvis relatively vertical Broad and fl at Frequently rotated inward, projects into pelvic outlet a-b: David Hunt/ Smithsonian Institution; c-d: L. Bassett/ Visuals Unlimited

36 Lower Limb 30 bones per leg in the femoral region (thigh) (kneecap) in the patellar region and in the crural region (leg) 7 tarsals in ankle and proximal foot 5 metatarsals in sole of foot 14 phalanges in the toes

37 Femur Longest, strongest, and heaviest bone in the body Proximal features: Head: articulates with os coxae at acetabulum : dent in head for ligament to acetabulum Neck: constricted region just distal to head and trochanters: massive processes for attachment of powerful hip and thigh muscles

38 Femur Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Greater trochanter Neck Head Head Greater trochanter Fovea Fovea Greater trochanter Neck Intertrochanteric line Neck Lesser trochanter Intertrochanteric crest Lesser trochanter Shaft (b) Right femoral head, medial view Head Shaft Patellar surface Shaft Lateral condyle Intercondylar fossa Medial condyle (c) Right femur, inferior view Lateral epicondyle Lateral Adductor tubercle Adductor tubercle epicondyle Medial epicondyle Medial epicondyle Figure 8.11 Lateral condyle Patellar surface Medial condyle Lateral condyle Patellar surface Medial condyle (a) Right femur, anterior view a(right), b,c: The McGraw-Hill Companies, Inc./Photo by Christine Eckel

39 Femur Additional features: Intertrochanteric line: anterior between trochanters marking the distal edge of the hip capsule tuberosity: posterior rough region for attachment of the gluteus maximus muscle : ridge on posterior shaft for attachment of many thigh muscles Distally, linea aspera splits into medial and lateral supracondylar lines

40 Figure 8.11 Femur

41 Femur Distal features: and condyles: smooth, rounded articular surfaces and epicondyles: projections just superior to the condyles Intercondylar fossa: deep posterior depression that separates the condyles surface: smooth anterior region between condyles where patella articulates with the femur

42 The kneecap Patella Triangular with broad superior border and inferiorly pointed Articulates with patellar surface of femur Figure 8.12 Figure 8.13

43 Tibia and Fibula Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 2 bones in the leg Intercondylar eminence Lateral condyle Medial condyle Lateral condyle Medial condyle Articular parallel to each other facet Head Superior tibiofibular joint Head Tibial tuberosity tibia is medial to fibula Neck Neck Anterior border Fibula Tibia Fibula Tibia Shaft Interosseous borders Inferior Figure 8.13 Lateral Inferior articular surface Medial malleolus tibiofibular joint Lateral malleolus malleolus (a) Right tibia and fibula, anterior view Inferior articular surface Medial malleolus a(right): The McGraw-Hill Companies, Inc./Photo by Christine Eckel

44 Tibia Medial bone in crural region Proximal features: and condyles: smooth surfaces for articulation with femur Fibular articular facet: articulation site for head of fibula under lateral condyle

45 Tibia Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Intercondylar Medial Intercondylar eminence Lateral Medial condyle eminence Lateral condyle condyle condyle Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Intercondylar fossa Intercondylar eminence Superior tibiofibularjoint Head Fibular articular Neck Femur facet Tibia Tibia Medial condyles Lateral condyles Fibula Tibia Fibula Interosseous borders Shaft (e) Right knee joint, posterior view The McGraw-Hill Companies, Inc./Photo by Christine Eckel Medial malleolus Fibular notch Medial malleolus Inferior tibiofibularjoint Figure 8.13 Lateral malleolus (d) Right tibia and fibula, posterior view (right): The McGraw-Hill Companies, Inc./Photo by Christine Eckel Lateral malleolus

46 Tibia Other features: tuberosity: rough anterior projection inferior to condyles; can be palpated just inferior to the patella; for attachment of patellar ligament Tibial border: ridge along anterior surface extending from tuberosity distally; the shin malleolus: inferiormost prominent medial process; ankle bump Articular surface: inferior surface articulates with the talus

47 Tibia Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Intercondylar Medial Intercondylar eminence Lateral Medial condyle eminence Lateral condyle condyle condyle Superior tibiofibularjoint Head Fibular articular facet Neck Tibia Tibia Fibula Interosseous borders Shaft Figure 8.13 Medial malleolus Fibular notch Medial malleolus Inferior tibiofibularjoint Lateral malleolus Lateral malleolus (d) Right tibia and fibula, posterior view (right): The McGraw-Hill Companies, Inc./Photo by Christine Eckel

48 Fibula Long, thin, lateral crural bone Not weight-bearing Features: proximal head with flat articular facet for articulation with the tibia narrow neck and slender shaft distal end expands into malleolus

49 Fibula Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Intercondylar Medial Intercondylar eminence Lateral Medial condyle eminence Lateral condyle condyle condyle Superior tibiofibularjoint Head Fibular articular facet Neck Tibia Tibia Fibula Interosseous borders Shaft Medial Medial Fibular malleolus Figure 8.13 malleolus notch Lateral malleolus Inferior tibiofibularjoint Lateral malleolus (d) Right tibia and fibula, posterior view (right): The McGraw-Hill Companies, Inc./Photo by Christine Eckel

50 Articulation of Head of Fibula with Tibia Figure 8.13

51 Tarsus 7 bones form ankle and proximal foot Calcaneus: largest; forms the heel Talus: superior-most; weight-bearing; articulates with tibia Navicular Cuneiforms: medial, intermediate and lateral Cuboid

52 Tarsals Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Distal phalanx of hallux Distal phalanx Distal phalanx of hallux Distal phalanx Middle phalanx Middle phalanx Proximal phalanx of hallux (great toe) Proximal phalanx Phalanges Proximal phalanx Proximal phalanx of hallux Phalanges (great toe) I II III IV I II III IV V Metatarsals V Metatarsals Medial cuneiform Intermediate cuneiform Lateral cuneiform Medial cuneiform Navicular Intermediate cuneiform Lateral cuneiform Navicular Cuboid Cuboid Talus Tarsals Talus Tarsals Calcaneus Calcaneus (a) Right foot, superior view Distal phalanx Distal phalanx Middle phalanx Middle phalanx Phalanges Phalanges Proximalphalanx Proximal phalanx V IV III II I (Sesamoid bones for flexor hallucis brevis tendons) Metatarsals V IV III II I Metatarsals Medial cuneiform Lateral cuneiform Medialcuneiform Intermediate cuneiform Lateral cuneiform Cuboid Intermediate cuneiform Navicular Navicular Cuboid Tarsals Tarsals Talus Talus Figure 8.14 Calcaneus (b) Right foot, inferior view a(right), b(right): The McGraw-Hill Companies, Inc./Photo by Christine Eckel Calcaneus

53 Metatarsals 5 bones in sole of foot Articulations: proximally with tarsals distally with phalanges Identified by Roman numerals I V from medial to lateral

54 Phalanges 14 bones per foot 3 phalanges per toes 2 5 Proximal, middle, and distal Great toe (hallux) only 2 Proximal and distal

55 Foot Bones Copyright The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Distal phalanx of hallux Distal phalanx Distal phalanx of hallux Distal phalanx Middle phalanx Middle phalanx Proximal phalanx of hallux (great toe) Proximal phalanx Phalanges Proximal phalanx Proximal phalanx of hallux Phalanges (great toe) I II III IV I II III IV V Metatarsals V Metatarsals Medial cuneiform Intermediate cuneiform Lateral cuneiform Medial cuneiform Navicular Intermediate cuneiform Lateral cuneiform Navicular Cuboid Cuboid Talus Tarsals Talus Tarsals Calcaneus Calcaneus (a) Right foot, superior view Distal phalanx Distal phalanx Middle phalanx Middle phalanx Phalanges Phalanges Proximalphalanx Proximal phalanx V IV III II I (Sesamoid bones for flexor hallucis brevis tendons) Metatarsals V IV III II I Metatarsals Medial cuneiform Lateral cuneiform Medialcuneiform Intermediate cuneiform Lateral cuneiform Cuboid Intermediate cuneiform Navicular Navicular Cuboid Tarsals Tarsals Talus Talus Figure 8.14 Calcaneus Calcaneus (b) Right foot, inferior view a(right), b(right): The McGraw-Hill Companies, Inc./Photo by Christine Eckel

56 Foot Arches To prevent pinching of muscles, nerves, and blood vessels feet do not rest flat on floor Three major arches: Medial: from heel to hallux; highest arch Lateral: from heel to 5th toe; lowest arch Transverse: perpendicular to other arches; along distal row of tarsals

57 Figure 8.15 Foot Arches