Chapter 7 Part C

The Skeleton

PowerPoint® Lecture Slides

prepared by
Karen Dunbar Kareiva
© Annie Leibovitz/Contact Press Images
© 2016 Pearson Education, Inc. Ivy Tech Community College
 Part 2: The Appendicular Skeleton

• Consists of bones of the limbs and their girdles

– Pectoral girdle
• Attaches upper limbs to body trunk
– Pelvic girdle
• Attaches lower limbs to body trunk

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 7.4 The Pectoral Girdle

• Pectoral girdle (shoulder girdle) consists of

clavicles (anteriorly) and scapulae (posteriorly)
– Attach upper limbs to axial skeleton
– Provide attachment sites for muscles that move
upper limbs
– Offer great degree of mobility because:
• Scapulae are not attached to axial skeleton
• Socket of shoulder joint is shallow and does not
restrict movement

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Figure 7.25 The pectoral girdle with articulating bones.

Acromio-
clavicular
joint
Clavicle

Scapula

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 Clavicles

• Also called collarbones

• S-shaped sternal end articulates with sternum
medially
• Flattened acromial end articulates laterally with
scapula
• Anchor muscles and act as braces to hold the
scapulae and arms out laterally

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Figure 7.26a The clavicle.

Sternal (medial)
end

Posterior

Anterior
Acromial (lateral)
end
Right clavicle, superior view

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Figure 7.26b The clavicle.

Acromial end

Trapezoid line Anterior

Sternal end

Posterior

Conoid tubercle
Right clavicle, inferior view

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 Scapulae

• Also called shoulder blades; thin, triangular flat

bones on dorsal surface of rib cage, between
ribs 2 and 7
• Each scapula has three borders
– Superior: shortest, sharpest border
– Medial (vertebral): runs parallel to spine
– Lateral (axillary): near armpit, ends superiorly in
glenoid cavity fossa (shoulder joint)

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 Scapulae (cont.)

• Each scapula has three angles where borders

meet:
– Superior angle: between superior and medial
– Lateral angle: between superior and lateral
– Inferior angle: between medial and lateral

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 Scapulae (cont.)

• Bone features
– Spine: prominent ridge posteriorly
– Acromion: lateral projection that articulates with
acromial end of clavicle to form
acromioclavicular joint
– Coracoid process: anterior projection that
anchors bicep muscle of arm
– Suprascapular notch: opening for nerves
– Several large fossae named according to
location

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Figure 7.27a The scapula.

Acromion Suprascapular Superior border

notch
Coracoid
Superior
process
angle
Glenoid
cavity

Subscapular
Lateral border
fossa
Medial border

Inferior angle
Right scapula, anterior aspect
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Figure 7.27b The scapula.

Coracoid process
Suprascapular notch
Superior
angle Acromion
Supraspinous
fossa
Glenoid
Spine cavity
Infraspinous at lateral
fossa angle

Medial border Lateral border

Right scapula, posterior aspect

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Figure 7.27c The scapula.

Supraspinous fossa
Supraspinous Acromion Supraglenoid
fossa tubercle

Coracoid
Infraspinous Subscapular process
fossa fossa Glenoid
Spine
Posterior Anterior cavity
Infraspinous Infraglenoid
fossa tubercle
Subscapular
fossa

Inferior angle

Right scapula, lateral aspect

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 7.5 The Upper Limb

• 30 bones form skeletal framework of each upper

limb
– Arm
• Humerus
– Forearm
• Radius and ulna
– Hand
• 8 carpal bones in the wrist
• 5 metacarpal bones in the palm
• 14 phalanges in the fingers

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 Arm

• Humerus: only bone of the arm; the largest and

longest bone of upper limb
• Articulates superiorly with glenoid cavity of
scapula
• Articulates inferiorly with radius and ulna

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 Arm (cont.)

• Bone features
– Head: proximal end that fits into glenoid cavity of
scapula
– Anatomical neck: slight constriction inferior to
head
– Greater tubercle is separated from lesser
tubercle by the intertubercular sulcus
• Sites of attachment of rotator cuff muscles
– Surgical neck: most frequently fractured part of
humerus

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 Arm (cont.)

• Bone features (cont.)

– Deltoid tuberosity: about midway down shaft;
site of deltoid muscle attachment
– Radial groove: carries radial nerve
– Trochlea: distal hourglass-shaped condyle
– Capitulum: distal ball-like condyle
– Medial and lateral epicondyles: points of
muscle attachment
– Medial and lateral supracondyle ridges
– Fossae: coronoid, olecranon, and radial

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Figure 7.28 The humerus of the right arm and detailed views of articulation at the elbow.

Greater
Head of tubercle Head of Greater
humerus humerus tubercle
Lesser
Greater
tubercle Anatomical
tubercle
Inter- neck Surgical
tubercular neck
sulcus

Radial groove
Deltoid Deltoid
tuberosity tuberosity

Medial
Lateral supracondylar
supracondylar ridge
ridge
Coronoid Olecranon
fossa fossa
Radial Radial fossa Medial
Lateral
fossa epicondyle
epicondyle
Capitulum

Trochlea
Photo, anterior view Illustration, anterior view Illustration, posterior view
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Figure 7.28 The humerus of the right arm and detailed views of articulation at the elbow (continued).

Humerus
Humerus Coronoid Olecranon
fossa fossa

Capitulum Medial Olecranon

epicondyle
Lateral
epicondyle
Medial
Head of Trochlea epicondyle
radius
Coronoid
process of Head
Radial
tuberosity ulna
Neck
Radial notch
Radius Ulna Ulna Radius

Anterior view at the elbow region Posterior view of extended elbow

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 Forearm

• Two parallel bones form forearm skeleton: ulna

and radius
• Proximal ends articulate with humerus and each
other
• Distally articulate with each other at the
radioulnar joint
• Interosseous membrane connects radius and
ulna along their entire length

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 Forearm (cont.)

• Ulna
– Medial bone in forearm
– Forms major portion of elbow joint with humerus
– Bone features
• Olecranon and coronoid processes: grip trochlea of
humerus, forming hinge joint
– Processes separated by trochlear notch
• Radial notch: articulates with head of radius
• Ulnar head: knoblike distal portion
• Ulnar styloid process: ligament attachment

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 Forearm (cont.)

• Radius
– Lateral bone in forearm
– Bone features
• Head: articulates with capitulum of humerus and radial
notch of ulna
• Radial tuberosity: anchors biceps
• Ulnar notch: articulates with ulna
• Radial styloid process: anchors ligaments

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Figure 7.29 Radius and ulna of the right forearm.

Radial
Olecranon notch of Olecranon
the ulna
Coronoid Head Trochlear Head of
Head process Neck notch radius
Neck Coronoid process
Radial Neck of
Radial tuberosity Proximal radius
tuberosity radioulnar
joint

Interosseous
membrane

Ulna Ulna

Radius Radius

Ulnar notch Radius

of the radius
Head of ulna
Ulnar styloid
process Ulnar styloid
process
Radial styloid Radial styloid Distal radioulnar Radial styloid
process process joint process

Photo, anterior view Illustration, anterior view r

Illustration, posterior view
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Figure 7.29 Radius and ulna of the right forearm (continued).

Ulnar notch of radius

Olecranon
Articulation
View Trochlear
for lunate
notch
Articulation
Coronoid for scaphoid
process Radial
Radial styloid
notch process Head of
View ulna Ulnar styloid
process
Proximal portion of ulna, Distal ends of the radius and ulna
lateral view at the wrist

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 Clinical – Homeostatic Imbalance 7.5

• Colles’ fracture: break in distal end of radius

• Very common fracture because person falling
attempts to break fall with outstretched hands

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 Hand

• Bones of the hand include carpus,

metacarpus, and phalanges
• Carpus (wrist): eight bones in two rows
• Proximal row: lateral to medial
– Scaphoid, lunate, triquetrum, and pisiform
• Distal row: lateral to medial
– Trapezium, trapezoid, capitate, and hamate
– Only scaphoid, lunate, and triquetrum form wrist
joint

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 Hand (cont.)

• Metacarpus (palm)
– Five metacarpal bones (I to V from thumb to little
finger) form the palm
• Bases articulate with carpals, and heads articulate with
proximal phalanges
• Phalanges (fingers)
– Fingers (digits): numbered I to V starting at
thumb (pollex)
– Digit I (pollex) has two bones: no middle phalanx
– Digits II to V have three bones: distal, middle, and
proximal phalanx
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Figure 7.30 Bones of the right hand.

Phalanges
• Distal
• Middle
• Proximal

Metacarpals
• Head
Sesamoid • Shaft
bones • Base
Carpals IV III II
V I III IV V
• Hamate Carpals I
II
• Capitate • Trapezium Carpals
• Hamate
• Pisiform • Trapezoid
• Capitate
• Triquetrum • Scaphoid
• Triquetrum
• Lunate
• Lunate
Ulna
Radius
Ulna

Anterior view Posterior view

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 Clinical – Homeostatic Imbalance 7.4

• Median nerve and tendons travel through carpal

tunnel
– Tunnel formed by ligaments through wrist
• Carpal tunnel syndrome can occur from overuse
and inflammation of tendons, which can
compress median nerve, causing tingling and
numbness

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 7.6 The Pelvic Girdle

• Also called hip girdle; is formed by 2 hip bones

(coxal bones, or os coxae) and sacrum
– Attach lower limbs to axial skeleton with strong
ligaments
– Transmit weight of upper body to lower limbs
– Support pelvic organs
• Less mobility but more stability than shoulder joint
• Three fused bones form coxal bone
– Ilium, ischium, and pubis
– Deep socket, acetabulum, formed at point of fusion
receives head of femur
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Figure 7.31 Pelvis.

Base of sacrum

Iliac crest
Sacroiliac
joint
Iliac fossa
Anterior
superior iliac
spine
llium
Sacral promontory
Hip bone Sacrum
Anterior
(coxal bone inferior iliac
or os coxae) spine
Pubis Coccyx Pelvic brim
Acetabulum
Pubic tubercle
Ischium Pubic crest
Pubic symphysis
Pubic arch

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 Ilium

• Ilium
– Superior region of coxal bone
– Auricular surface articulates with sacrum
(sacroiliac joint)
• Ischium
– Posteroinferior part of hip bone
• Pubis
– Anterior portion of hip bone
– Pubis joins at pubic symphysis joint

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 Ilium (cont.)

• Superior region of hip bone

• Consists of body and winglike ala
– Iliac crests: thickened superior margin of ala
– Iliac crest ends at anterior superior iliac spine
and posterior superior iliac spine
• Greater sciatic notch: sciatic nerve passage
• Gluteal surface contains three ridges:
posterior, anterior, and inferior gluteal lines
• Iliac fossa: concavity on ala
• Auricular surface articulates with sacrum
• Arcuate line: defines pelvic brim
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 Ischium

• Posteroinferior part of hip bone

• Consists of body and ramus
• Three important markings:
– Ischial spine
– Lesser sciatic notch
– Ischial tuberosity

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 Pubis

• V-shaped anterior portion of hip bone

• Consists of the body and superior and inferior
pubic rami
• Anterior border forms the pubic crest
• Lateral end forms pubic tubercle
• Obturator foramen: large opening formed by
rami and body
• Pubic bones join at pubic symphysis
• Pubic arch (subpubic angle): formed by rami;
main difference between male and female pelves
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Figure 7.32a The hip (coxal) bones.

Ilium
Anterior gluteal Ala
line
Posterior Iliac crest
gluteal line

Posterior Anterior
superior superior
iIiac spine iliac spine
Inferior gluteal line
Posterior
inferior Anterior inferior
iliac spine iliac spine
Greater sciatic Acetabulum
notch

Ischial body

Ischial spine
Pubic body
Lesser sciatic
notch Pubis

Ischium
Ischial
tuberosity
Obturator Inferior pubic
Ischial ramus foramen ramus
Lateral view, right hip bone
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Figure 7.32b The hip (coxal) bones.

Ilium

Posterior
Iliac crest
superior
Iliac iliac spine
fossa
Anterior
superior
iliac spine
Posterior
inferior
Anterior inferior iliac spine
iliac spine Body of
Auricular
Arcuate line the ilium
surface
Superior pubic Greater sciatic notch
ramus
Ischial spine
Pubic tubercle
Lesser sciatic notch
Obturator
Pubis foramen
Articular surface
Ischium
of pubis (at pubic
symphysis)
Ischial ramus
Inferior pubic
ramus
Medial view, right hip bone
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 Pelvic Structure and Childbearing

• Pelvis: formed by hip bones, sacrum, and coccyx

• Female pelvis tends to be wider, shallower, lighter,
and rounder than male’s
– Adapted for childbearing
• Pelvic brim (pelvic inlet): continuous oval ridge
that runs from pubic crest through arcuate line and
sacral promontory
• False pelvis: superior to pelvic brim
• True pelvis: inferior to pelvic brim; defines birth
canal
– Pelvic outlet: inferior margin of true pelvis
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Table 7.4-1 Comparison of the Male and Female Pelves

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Table 7.4-2 Comparison of the Male and Female Pelves (continued)

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Table 7.4-3 Comparison of the Male and Female Pelves (continued)

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 7.7 The Lower Limb

• Carries entire weight of erect body

• Subjected to exceptional forces during jumping
or running
• Three segments of lower limb
– Thigh
– Leg
– Foot

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 Thigh

• Femur is largest and strongest bone in the

body, making up about one-fourth of person’s
height
• Articulates proximally with acetabulum of hip
and distally with tibia and patella
• Patella: sesamoid bone in quadriceps tendon
that protects knee joint

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 Thigh (cont.)

• Bone features
– Fovea capitis: small pit in ball-like head
– Greater and lesser trochanters: muscle
attachment sites
• Trochanters connected by intertrochanteric line and
intertrochanteric crest
– Gluteal tuberosity blends into linea aspera,
which diverges into medial and lateral
supracondylar lines

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 Thigh (cont.)

• Bone features (cont.)

– Distally, femur ends in lateral and medial
condyles that articulate with tibia
– Medial and lateral epicondyles: sites of muscle
attachment
• Adductor tubercle: medial epicondyle bump
– Patellar surface: articulates with patella
– Intercondylar fossa: lies between condyles

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Figure 7.33 Bones of the right knee and thigh.

Neck Fovea Greater

capitis trochanter
Head
Inter-
Lesser trochanter trochanteric
Intertrochanteric crest
line
Gluteal tuberosity

Linea aspera
Apex
Anterior

Facet for lateral Medial and

Facet for condyle of femur lateral supra-
Lateral
medial condylar lines
condyle
condyle
of femur Intercondylar fossa Lateral
Surface for Medial condyle epicondyle
patellar Lateral
Adductor
ligament Posterior epicondyle
tubercle
Patella (kneecap) Medial
Patellar epicondyle
surface
Anterior view Posterior view
Femur (thigh bone)
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Table 7.5-2 Bones of the Appendicular Skeleton, Part 2: Pelvic Girdle and Lower Limb (continued)

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 Leg

• Made up of two parallel bones, tibia and fibula

– Connected by interosseous membrane
• Tibia: medial leg bone that receives weight of
body from femur; transmits to foot
• Fibula
– Not weight bearing; no articulation with femur
– Several muscles originate from fibula
– Articulates proximally and distally with tibia

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 Leg (cont.)

• Bone features
– Tibia
• Medial and lateral condyles
• Intercondylar eminence
• Tibial tuberosity
• Anterior border
• Medial malleolus
• Fibular notch
– Fibular:
• Head
• Lateral malleolus
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Figure 7.34a The tibia and fibula of the right leg.

Intercondylar
eminence
Lateral
condyle Medial
Head condyle
Superior
Tibial
tibiofibular
tuberosity
joint

Interosseous
membrane
Anterior
border

Fibula Tibia

Inferior
tibiofibular Medial
joint malleolus
Lateral Inferior articular
malleolus surface
Anterior view
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Figure 7.34 The tibia and fibula of the right leg (continued).

Lateral
condyle
Lateral
condyle Fibula
articulates
Tibial here
tuberosity
Line for
soleus
muscle

Anterior view, Posterior view,

proximal tibia proximal tibia

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 Clinical – Homeostatic Imbalance 7.4

• Pott’s fracture occurs at distal end of fibula, the

tibia, or both
• Common sports injury

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Figure 7.34c The tibia and fibula of the right leg.

Parts of
fractured
fibula

X ray of Pott’s fracture

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of the fibula
 Foot

• Skeleton of foot includes bones of tarsus,

metatarsus, and phalanges
• Tarsus: 7 tarsal bones form posterior half
– Body weight carried primarily by talus and
calcaneus (heel)
– Calcaneal tuberosity: part that touches ground
• Sustentacular tali (talar shelf): supports talus
– Other tarsal bones: cuboid, navicular, and
medial, intermediate, and lateral cuneiform
bones

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 Foot (cont.)

• Metatarsals
– Five metatarsal bones (I to V from hallux to little
toe)
– Enlarged head of metatarsal I forms “ball of the
foot”
• Phalanges
– 14 bones of toes
– Digit I (hallux, great toe) has two bones: no
middle phalanx
– Digits II to V have three bones: distal, middle,
and proximal phalanx
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Figure 7.35a Bones of the right foot.

Phalanges
Distal
Middle
Proximal

Medial I ll lll Metatarsals

cuneiform IV
V
Intermediate Lateral
cuneiform cuneiform
Navicular Cuboid
Tarsals
Talus
Trochlea
of talus
Calcaneus

Superior view
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Figure 7.35b Bones of the right foot.

Medial
Talus malleolar
Navicular facet
Intermediate Sustentac-
cuneiform ulum tali
First metatarsal (talar shelf)

Calcaneus
Medial
cuneiform Calcaneal
tuberosity
Medial view

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Figure 7.35c Bones of the right foot.

Lateral Navicular Intermediate cuneiform

malleolar facet
Lateral cuneiform

Talus

Calcaneus Cuboid Fifth metatarsal

Lateral view

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 Foot (cont.)

• Arches of the foot

– Maintained by interlocking foot bones, ligaments,
and tendons
– Allow foot to bear weight
– Three arches
• Lateral longitudinal: low curve that elevates lateral
part of foot
• Medial longitudinal: arch curves upwards
• Transverse: runs obliquely from one side of foot to
other

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Figure 7.36a Arches of the foot.

Medial longitudinal arch

Transverse arch

Lateral longitudinal
arch

Lateral aspect of right foot

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Figure 7.36b Arches of the foot.

X ray, medial aspect of right foot

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 Clinical – Homeostatic Imbalance 7.4

• Fallen arches, also called “flat feet,” result from

stress on tendons and ligaments of feet
• Can be caused by:
– Standing immobile for extended periods of time
– Running on hard surfaces without proper arch
support

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 Developmental Aspects of the Skeleton

• Infant skull has more bones than adult skull

– Skull bones such as mandible and frontal bones
are unfused
– Skull bones connected by fontanelles
• Unossified remnants of fibrous membranes
• Ease birth and allow brain growth
• Four fontanelles
– Anterior, posterior, mastoid, and sphenoidal

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Figure 7.37 Skull of a newborn.

Frontal suture
Frontal bone Anterior
fontanelle

Ossification
center
Parietal bone

Posterior fontanelle
Occipital
bone
Superior view

Frontal bone
Sphenoidal
Parietal bone
fontanelle
Ossification
center
Posterior
fontanelle
Mastoid
fontanelle
Occipital bone
Temporal bone (squamous part)
Lateral view
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 Clinical – Homeostatic Imbalance 7.4

• Congenital abnormalities may distort skull

• Cleft palate is the most common condition
– No medial fusion of right and left halves of palate
– Interferes with sucking
– Can lead to aspiration of food into lungs, which
may result in aspiration pneumonia

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Figure 7.38 Cleft lip and palate.

A boy born with a cleft The boy as a toddler,

palate and lip following surgical repair
during infancy

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 Developmental Aspects of the Skeleton

• At birth, cranium is huge relative to face

• At 9 months, cranium is half the adult size
• Mandible and maxilla are foreshortened but
lengthen with age
• Arms and legs grow at faster rate than head and
trunk, leading to adult proportions

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Figure 7.39a Different growth rates of body parts determine body proportions.

Human newborn Human adult

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Figure 7.39b Different growth rates of body parts determine body proportions.

Newborn 2 yrs 5 yrs 15 yrs Adult

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 Developmental Aspects of the Skeleton

• Primary curvatures of thorax and sacrum are

convex at birth, resulting in C-shaped spine
• Secondary curvatures of cervical and lumbar
regions convex anteriorly as child develops

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Figure 7.40 The C-shaped spine of a newborn infant.

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 Developmental Aspects of the Skeleton

• As we age, intervertebral discs become thin,

less hydrated, and less elastic
– Risk of disc herniation increases
• Several centimeters of height loss is common
by age 55
• Costal cartilages ossify
– Rigid thorax causes shallow breathing and less
efficient gas exchange
• All bones lose mass, so fracture risk increases

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 Clinical – Homeostatic Imbalance 7.10

• Appendicular skeleton can suffer from

congenital abnormalities
• Hip dysplasia occurs in a little over 1% of infants
– Acetabulum forms incompletely or ligaments are
loose, allowing head of femur to slip out of
socket
– Treatments include splints or harness to hold
femur in place or surgery to tighten ligaments

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