FINAL

PRACTICAL EXAM REVIEW

 AXIAL
• Runs through the medial axis of
the body
• Skull
• skull bone
• ear ossicles
• Hyoid bone
• Sternum,ribs
• thorax or thoracic cavity
• Vertebral column
APPENDICULAR
• Upper extremities
• Pectoral girdle
• clavicle + scapula
• Lower extremity
• Pelvic girdle= 3
bones
• 1.Ilium
• 2.ischium
• (where we are
sitting on)
• 3. pubic bone
 _____SKULL BONES ____CRANIAL
____ FACIAL
____ HYOID
____ STERNUM
____RIBS ___TRUE RIBS
___ FALSE RIBS
AXIAL BONES ___FLOATING RIBS
___ CERVICAL
___ THORACIC
____ VERTEBRAE ___LUMBAR
___ SACRAL (FUSED)
___ COCCYGEAL (FUSED)
___ EAR OSSICLES
SUB-TOTAL AXIAL=_____
___CLAVICLE
___PECTORAL GIRDLE ___ SCAPULA
___HUMERUS
UPPER LIMBS + PECTORAL GIRDLE ___RADIUS
___ UPPER LIMBS ___ ULNA
___CARPALS
___ METACARPALS
___PHALANGES
SUB-TOTAL UPPER LIMBS=
___ ILIUM
___ PELVIC GIRDLE ___ISCHIUM
___PUBIS
___ FEMUR
LOWER LIMBS + PELVIC GIRLDE ___ TIBIA
___ LOWER LIMBS ___FIBULA
___ TARSALS
___ METATARSALS
___PHALANGES
SUB-TOTAL UPPER LIMBS=
____ AXIAL
TOTAL AXIAL + APPENDICULAR = ____ UPPER LIMBS + PECTORAL
________________ ____LOWER LIMBS + PELVIC
Pectoral Girdle
• Consists of two
bones
• Clavicle (2) = anteriorly
• Scapula (2)= posteriorly
Pelvic Girdle
• Carpal/wrist bones
• 8 bones/ 2 rows of 4
bones each
• Metacarpals /palms
• 5 bones
• Heads make up the
knuckles
• Phalanges
• 3 fingers
• 2 thumb
 VERTEBRAL COLUMN
• 33 Bones
• MOVABLE /FLEXIBLE
• 7 cervical (neck)
• 12 thoracic
• IMMOVABLE
• 5 Lumbar
• 5 Sacral
• 4 Coccygeal
 Atypical vertebrae

• C1 (atlas)
• Articulating with the
occipital bone and with C2
• Has no body, just the ring
• C2
• Odontoid process (Tooth -
like process)
• body of C1 process to body
of C2
Atypical vertebrae
Thoracic vertebrae Lumbar
• Facets for ribs
¨ Larger bodies
• Larger spines, longer spines
 INTERVERTEBRAL DISCS

• Located between adjacent vertebrae

• Functions
• Provide support
• Prevent vertebrae rubbing
• Cushions between bodies of vertebra
• ANNULUS FIBROSIS
• Rings of fibrocartilage
• NUCLEUS PULPOSUS
• Soft gelatinous center
12 PAIRS of ribs
• 7 true ribs
• 1 to 7 ribs= costal cartilages attach
directly to the sternum
• 3 false ribs
• don’t attach directly to sternum
• 3 of them attach to superior costal
cartilage
• 2 FLOATING RIBS
• 2 of them do not attach anteriorly at all-
• ALL ribs have posterior attachment to
the THORACIC VERTEBRAE
• Thoracic cage
Sternum
• Breastbone
• 3 Major parts
• 1st part: manubrium
• 2nd part: body
• 3rd part: xiphoid process
• Sternal angle
• Important landmark for
counting ribs to locate
areas of the heart
Microscopic Anatomy
of Skeletal Muscle

• Sarcomere
• Contractile unit of a muscle
fiber
• Smallest functional unit of
skeletal muscle
 Components of
Sarcomeres
• Composed of interdigitating
thick and thin filaments ( myosin
vs actin)

• I- band
• A-band
• H-zone
• M-line
• Z-Disk ( Z line)
 Components of
Sarcomeres
• Composed of various
microfilaments and supporting
structures
• Titin
• largest known elastomeric
protein
• Connects myosin to z-disc
• thought to be critical in the
development of sarcomeres
Microscopic Anatomy of
Skeletal Muscle
• Organization of the sarcomere
• Thick filaments = Myosin filaments
• Composed of the protein myosin
• Has ATPase enzymes
Microscopic Anatomy
of Skeletal Muscle
• Myosin consists of
• Tail
• Hinge
• Heads
• contain active sites for Actin &
ATP
• M-line
• stabilize the myosin filaments
• aid in transmission of force from
sarcomere to cytoskeletal
intermediate filaments
Microscopic Anatomy
of Skeletal Muscle
• Thin filaments are composed of
• G-actin molecules in a helical
arrangement
• Contain myosin binding sites
• Tropomyosin filaments
• Troponin (complex of three
molecules) attached to tropomyosin
• Has binding sites for Ca2+
• Nebulin
• Filament that forms internal
support and attachment for actin
 MUSCLE
ANATOMY:
ANTERIOR
VIEW
 MUSCLE
ANATOMY:
POSTERIOR
VIEW
• Occipitalis
• Frontalis
• Temporalis
• Obicularis Oculi
• Obicularis Oris
• Buccinator
• Masseter
• Platysma
• Sternocleidomastoid
• Zygomaticus
•
Rotator cuff

• Supraspinatus
• Infraspinatus
• Teres minor
• Subscapularis
Forearm extensors (posterior)

• Triceps brachii
• Anconeus
FOREARM FLEXORS (ANTERIOR)
• Trapezius
• Deltoid
• Latissimus dorsi
• Rhomboidus Major
• Levator Scapula
• Supraspinatus
• Infraspinatus
• Teres Minor
• Teres Major
• Serratus Anterior
•
•
Muscles moving the scapula
trapezius
levator scapulae
rhomboids

posterior
Superficial Anterior
Chest Muscles
• Sternocleidomastoid
• Pectoralis major
THORACIC AND ABDOMINAL WALL MUSCLES
Deep muscles of the
thorax: breathing

• Diaphragm
• prime mover of inspiration
• Floor of thoracic cavity:
when flattens, air moves in
Muscles that flex thigh
at hip
• Originate from vertebral column
and pelvis and pass anterior to
hip joint
• Sartorius
• Iliopsoas
• Tensor fasciae lata
• Rectus femoris
• only quad with origin on pelvis
• Pectineus
• medial compartment
Thigh extensors (posterior)

• Gluteus maximus
• Hamstrings
• cross hip and knee joints
• extend thigh & flex knee
• Biceps femoris
• Semitendinosus
• Semimembranosus
• antagonists of quads
Abductors of thigh
• Buttocks muscles that lie lateral to
hip joint
• Gluteus medius
• Gluteus minimus (under medius)
• Tensor fascia lata
Lateral rotators

• Piriformis
• laterally rotates hip
• helps abduct hip if it is
flexed
Adduction of thigh

• Gracilis
• Adductor magnus
• Adductor longus
• Adductor brevis
• Pectineus
 Knee extensors

• Quadraceps femoris
• the only extensors of
the leg (lower leg) at the
knee
• Rectus femoris (only
quad with origin on
pelvis)
• Vastus lateralis
• Vastus intermedius
• Vastus medialis
• Antagonized by hamstrings
Posterior
compartment of leg
u Superficial
u plantarflex foot
u Gastrocnemius
u Soleus
u Plantaris
Anterior leg extensors
• Mainly extend toes and dorsiflex foot

• Tibialis anterior
• Extensor digitorum longus
• Extensor hallucis longus
 Lateral compartment
of leg

• Fibularis (peroneus)
longus:
• to first metatarsal and
cuneiform
• Fibularis (peroneus)
brevis:
• to fifth metatarsal
Articulations and
Movement
• Plane/Gliding Joint
• Saddle Joint
6 Types of Synovial Joints
• Hinge Joint
• Pivot Joint
• Ball and Socket Joint
• Condyloid/ellipsoid Joint
3 Movements at Synovial Joints

• Uniaxial
– Occur around ONE AXIS
• Biaxial
– Occur around TWO AXES
situated at right angles to each
other
• Multiaxial
– SEVERAL AXES

8-49
 Plane/Gliding Joints

• Uniaxial/monoaxial
• allow flexion and extension
through a slight gliding motion
• Ex:
– between the ends of small bones
such as hands and feet
– Articular process between
vertebrae
Pivot Joint
• Uniaxial/monoaxial
• allow only rotation
– the end of one bone having a “peg” which
fits into a “ring” formed by the other bone
• top of the spinal column
– between the axis and atlas bones
of the neck
• This allows us to turn, raise and lower
our heads
• Head of the radius and proximal end
of ulna
 Saddle Joints
• biaxial
• allow the movement of the
joint
– forward and backwards
– right to left
• Examples
– Carpometacarpal joint of
thumb
 Hinge Joints

• Uniaxial/monoaxial
• allow extensive flexion and Elbow and Knee Joints
extension (Bending and
straightening)
– with only a small amount of
rotation
 Ball and Socket Joints

Ball and socket

Ball and Socket joint

• multiaxial
• allows the greatest range of
movement
– one end of the bone is shaped Two main Ball and Socket Joints:
like a ball, and it fits into a
Shoulder and hip joints
hollow socket at the end of
another joint
– Held together by ligaments and
tendons
 Ellipsoid/Condyloid Joints
• Biaxial
– (almost like a hinge joint)
• Modified ball-and-socket
• Example
– Condyloid joint in the wrist
– Atlantooccipital joint
 Types of Movement
• Gliding • Special
– Limited movement in all – Elevation & depression
direction – Protraction & Retraction
• Angular – Excursion
– Opposition & Reposition
– Flexion and Extension
– Inversion & Eversion
• Hyperextension
• Plantar and Dorsiflexion • Combination
– Abduction and Adduction
• Circular
– Rotation
– Pronation and Supination
– Circumduction

8-56
I-Gliding

• Simplest of all types

• Occur in plane joints
between two flat surfaces
that slide or glide over each
other
• Slight movement
• Example:
– Carpal bones

8-57
II-Angular

• One part of a linear structure

bends relative to another part • Flexion and extension
of a structure • Abduction and adduction
– thereby changing the
angle between two parts

8-58
 Flexion Extension
When the angle of the When the angle of the
joint decreases joint increases
 Flexion Extension
Movement anterior to Movement posterior to
coronal plane coronal plane

EXCEPT KNEE: flexion bends EXCEPT KNEE: extension straighten

knee in posterior direction knee in anterior direction
Flexion and Extension

8-61
 Dorsiflexion
-decreases the angle between the dorsum
(superior surface) of the foot and the leg
-toes are brought closer to the shin
-upward movement of the foot at the ankle
joint
Plantarflexion (or plantar flexion)
-increases the approximate 90
degree angle between the front part
of the foot and the shin
-as when pressing down on a car
pedal
Dorsiflexion and Plantar Flexion

8-63
• Hyperextension
– Abnormal forced extension of a
joint beyond its normal range of
motion

8-64
Adduction Abduction
Movement towards the Movement away from the
midline of the body midline of the body
Abduction and Adduction

8-66
II-Circular
• Rotating a structure around an • Rotation
axis • Pronation and supination
• Moving the structure in an arc • Circumduction

8-67
Rotation • Turning of a structure along its
long axis
• Ex.
– Rotating the head of humerus
or entire body

8-68
 Pronation and Supination
Supination
-The opposite of pronation
-the rotation of the forearm so that the
palm faces anteriorly, or palm facing up
-The hand is supine (facing anteriorly) in
the anatomical position
Pronation
- A rotation of the forearm
- Moves the palm from an anterior-
facing position to a posterior-
facing position, or palm facing
down
- NOT medial rotation
- MUST be performed when the
arm is half flexed
Circumduction

• Combination of flexion,
extension, abduction and
adduction
• Occurs at freely movable joints

8-70
 IV-Special Movements

• Unique to only one or two joints

• Types
– Elevation and Depression
– Protraction and Retraction
– Opposition and Reposition
– Inversion and Eversion

8-71
Elevation and Depression

• Elevation
– Moves the structure
superiorly
• Depression
– Moves the structure
inferiorly

8-72
 Protraction and Retraction

• Protraction
– Gliding motion
– Moves the structure in
ANTERIOR direction

• Retraction
– Moves the structure back to
its anatomical position or
even more posteriorly

8-73
Protraction and Retraction

8-74
 Excursion

• Lateral excursion
– Moving the mandible
either left or right
– As in chewing
• Medial excursion
– Returns the mandible
to midline position

8-75
 Opposition and Reposition

• Opposition
– Movement of thumb and
little finger
– These two digits are
brought toward each other
across the palm of hand
• Reposition
– Returns the thumb and little
finger to neutral, anatomical
position

8-76
Inversion and Eversion

• Inversion
– Turns the ankle
– Plantar surface of the
foot faces MEDIALLY
• Eversion
– Turns the ankle
– Plantar surface faces
LATERALLY

8-77
V- Combination
• MOST MOVEMENTS that we perform are combinations of
the movements named previously

8-78
Extension: Flexion: Bending Abduction: Moving
straightening or or flexing a limb. a limb away from
extending a limb. (Closing a joint) the centre line of
(Opening a Joint) the body.
Rotation: This is a Circumduction: Adduction:
turning or rotational The ability of a moving a limb
movement of a limb to be moved towards the centre
limb or body part. in circles. line of the body
 Brain

• Parts of the brain

• Brainstem
• Cerebellum
• Diencephalon
• Cerebrum
 Brainstem
• Connects spinal cord to brain
• responsible for automatic
survival functions
• Parts
• Medulla oblongata
• Pons
• Midbrain
Cerebellum
• the “little brain” attached to
the rear of the brainstem
• control balance, gross motor
coordination & fine motor
coordination
Diencephalon
• Components
• Thalamus
• Subthalamus
• Epithalamus
• Hypothalamus
 Limbic System
• Hippocampus
• Memory processing
• Amygdala
• Aggression (fight) and fear (flight)
• Hypothalamus
• Hunger, thirst, body temperature,
pleasure; regulates pituitary
gland (hormones)
 Cerebrum
• Largest portion of brain
• cortex of the cerebrum
folded into
• ridges called gyri
• grooves called sulci, or
fissures
 Planning, decision
Sensory
making speech

Vision
Auditory

THE LOBES OF THE CEREBRAL HEMISPHERES

MENINGES
• Dura mater
• attaches to the skull
• has two layers
• Arachnoid mater
• subarachnoid space contains CSF,
which helps cushion the brain
• Pia mater attaches directly to the
brain
Cranial Nerves
Spinal Cord and Spinal Nerves
Spinal cord Spinal Nerves
 White mater
Posterior
median sulcus

Dorsal horn

Lateral horn

Gray mater

Ventral horn

Anterior median fissure

31 Pairs of Spinal Nerves
• 8 pairs cervical
• 12 pairs thoracic
• 5 pairs lumbar
• 5 pairs sacral
• 1 pair coccygeal
 C1 Cervical
2
3 plexus
Cervical 4
5
(C1–C4)
nerves 6
7 Brachial
8 plexus
T1 (C5–T1)
2
3
4
5

Organization of Spinal Nerves

6
Thoracic 7 Duramater
nerves 8
9
10
11
12

L1 Lumbar
2
plexus
Lumbar 3
(L1–L4)
Lumbo-
nerves 4 sacral
5
plexus
Sacral (L1–S4)
S1
S2 plexus
Sacral nerves S3 (L4–S4)
S4
S5
Coccygeal nerves Coccygeal
Co plexus
(S5–Co)
Posterior view
 Cervical Plexus
• Ventral rami of C1-C4 spinal
nerves
• Supplies some muscles and the
skin of the neck and shoulder
• Phrenic nerve
• Root value – C3, C4, C5
• innervates the Diaphragm muscle

Phrenic nerve root value: C3, C4, C5 spinal

nerve.
 Brachial Plexus (C5-T1)
C5
Axillary nerve • Ventral rami of C5, C6, C7 , C8, T1
spinal nerves
Radial nerve C6 • give motor supply to the
upper limb muscles
C7 • Branches/nerves of this plexus
• Axillary
Musculocuteneous nerve • Radial
C8 • Musculocutaneous
Median nerve
• Ulnar
T1
• Median
Ulnar nerve
Lumbar and Sacral Plexuses L1

L4
Roots ( ventral rami)

• Lumbar plexus S4
Posterior divisions
Anterior divisions
Nerves

• formed by ventral rami of L1-L4 L1

spinal nerve L2

• Sacral plexus Iliohypogastric

Ilioinguinal L3

• Formed by ventral rami of L4-S4 Lateral femoral

cutaneous

• Four major nerves exit and enter

L4
Genitofemoral

lower limb and give supply to the Femoral

Obturator
L5

muscles and skin of that area.

Lumbosacral
trunk
Superior gluteal S1

• Obturator
Inferior gluteal

Common S2

• Femoral fibular
(peroneal)

• Tibial Sciatic S3
Tibial

• Common fibular (peroneal) Posterior femoral

cutaneous
S4

S5

Pudendal Anterior view

 Coccygeal Plexus

• Formed by the Spinal nerve

S5 and the coccygeal nerve
• supplies the muscles of the
pelvic floor and the skin over
the coccyx