BACHELOR OF SCIENCE IN NURSING

ANPH 111 (Anatomy and Physiology)

COURSE MODULE COURSE UNIT WEEK
1 4 5
The Skeletal System

ü Read course and unit objectives

ü Read study guide prior to class attendance
ü Read required learning resources; refer to unit terminologies for jargons
ü Proactively participate in classroom discussions
ü Participate in weekly discussion board (Canvas)
ü Answer and submit course unit tasks.

VanPutte, Cinnamon. Regan, Jennifer. Russo, Andrew (2016). Seeley’s Essentials of Anatomy
& Physiology Penn Plaza, New York, New York, McGraw-Hill Education, 10th Edition

Computer device or smartphone with internet access (at least 54 kbps; average data
subscription will suffice)
At the end of the course unit (CM), learners will be able to:

Cognitive

• Explain the functions of the skeletal system.

• Describe the components of the extracellular matrix, and explain the function of each.
• Explain the structural differences between compact bone and spongy bone.
• Outline the processes of bone ossification, growth, remodeling, and repair.
• Describe the common features of the Axial Skeleton
• Name and describe the bones that make up the Appendicular Skeleton

Affective
• Listen attentively during class discussions
• Demonstrate tact and respect of other students’ opinions and ideas
• Accept comments and reactions of classmates openly

Psychomotor
• Participate actively during class discussions
• Follow class rules and observe compliance to Netiquette
• Use critical thinking to identify areas of care that could benefit from additional research or
application of evidence-based practices
• Integrate knowledge of trends in Anatomy and Physiology

Appendicular skeleton - Bones making up the limbs, pelvis, and shoulder areas
Articulation - The site of close approximation of two or more bones
Articular cartilage - Thin layer of hyaline cartilage covering the surface of the epiphysis
Axial skeleton - The skeleton that forms the central supporting axis of the body
Carpal bones - Small bones of the wrist
Condyle - Rounded knob; usually fits into a fossa on another bone to form a joint
Crest - A moderately raised ridge
Diaphysis - The central shaft-like portion of a long bone
Endosteum - Thin epithelial membrane lining the inside of the medullary cavity
Epicondyle - A bump superior to a condyle
Epiphyseal plate - Layer of cartilage separating the epiphysis from the diaphysis at each
end of a long bone It is the site where bone growth occurs
Epiphysis - The head of each end of a long bone
False pelvis - Portion of the pelvis that extends between the edges of the iliac bones
Fontanel - Un-fused area of an infant’s skull
Fossa - A furrow or depression
Foramen - A round opening in a bone, usually a passageway for vessels and nerves
Head - The prominent, expanded end of a bone
Haversian canal - A central canal in compact bone containing blood vessels and nerves;
surrounded by lamellae
Intramembranous ossification - Process in the fetus whereby fibrous connective tissue
evolves into bone
Kyphosis - An exaggerated thoracic curvature
Lacunae - Tiny gaps between rings of lamellae in compact bone
Lamellae - Concentric rings of matrix surrounding Haversian canal in compact bone
Meatus - A tube-like opening
Medullary cavity - The central hollow portion of a long bone that contains bone marrow
Osseous tissue - Bone tissue
Ossification - The creation of new bone
Osteoblast - Bone-forming cell
Osteoclasts - Bone cells that dissolve old or unhealthy bone
Osteocyte - Mature osteoblast
Osteon - Basic structural unit of compact bone consisting of a Haversian canal and
surrounding lamellae
Periosteum - Dense fibrous membrane covering the diaphysis
Process - A projection or raised area
Remodeling - Reshaping or reconstructing part of a bone
Resorption - The destruction of old bone; part of the bone remodeling process
Scoliosis - A lateral curvature of the spine
Sinus: Cavity in the skull filled with air
Spongy bone - Also called cancellous bone. It is found in the ends of long bones and the
middle of most other bones
Sulcus - Groove or elongated depression
Sutures - Immovable joints of the skull
Trabecula - Latticework of osseous tissue that makes up the structure of spongy or
cancellous bone
Trochanter - A large process. It is found only on the femur
True pelvis - Portion of the pelvis that extends between the pelvic brim
Tubercle - A small, rounded process
Tuberosity - A rough, raised bump, usually for muscle attachment
4.1 STRUCTURE AND SKELETAL TISSUES

4.1.1 Extracellular Matrix

The extracellular matrix contains substances that are essential for the make-up of our bones
since the cartilages, tendons, ligaments, and even our bones, are connective tissues. For
instance, collagen, as one of the substances, is a tough and rope-like protein giving our tendons,
ligaments and cartilages great amount of strength like steel bars reinforced in a concrete. The
mineral component, like the concrete itself, gives the bone compression like weight-bearing
strength. Most of the mineral in bone is in the form of calcium phosphate crystals called
hydroxyapatite. (VanPutte, Regan, & Russo, 2016)

Proteoglycans on the other hand, are large molecules consisting of polysaccharides attached
to core proteins, similar to the way needles of a pine tree are attached to the tree’s branches.
The proteoglycans form large aggregates, much as pine branches combine to form a whole tree.
Proteoglycans can attract and retain large amounts of water between their polysaccharide
“needles.” (VanPutte, Regan, & Russo, 2016)

4.1.2 Classification of Bones

Four categories of bone, based on their shape, according to VanPutte, Regan, & Russo,
(2016)

1. Long Bone - are longer than they are wide and have knobby ends where the articulations
form. Long bones are hollow in the middle and more solid on ends. At each ends also
includes a thin layer of hyaline cartilage called articular cartilage, which further
articulates it other bones to form a joint. Their slightly curved structure gives them
strength. Long bones include those of the arms, legs, fingers, and toes. It is covered by
dense connective tissues on the outside called periosteum and a thinner inner lining
called endosteum. Long bones have several parts.
1.1 Diaphysis - shaft or body
1.2 Epiphysis – head of each end of a long bone
1.3 Medullary cavity – marrow cavity or space that contains yellow marrow
2. Short bones - are equal in length and width, making them nearly cube-shaped. Examples
include most bones of the ankles and the wrists.
3. Flat bones - are thin and provide both protection and surfaces for muscle attachments.
The bones of the skull, sternum, and ribs are all at bones.
4. Irregular bones - have complex shapes, such as those of the face and vertebral column.

Figure 4.1 Structure of a Long Bone

*illustrations and content taken from Seeley’s Anatomy and Physiology by VanPutte, Regan & Russo (2016)
(a) Young long bone-the femur, showing the epiphysis, epiphyseal plates and diaphysis (b) adult long bone with epiphyseal lines. (c) Internal
features of a portion of the diaphysis in (a)
4.2 FUNCTIONS OF THE SKELETAL SYSTEM
1. Support - It supports and stabilizes surrounding tissues such as muscles, blood and
lymphatic vessels, nerves, fat, and skin.
2. Protection - It protects vital organs of the body such as the brain, spinal cord, the heart,
and lungs, and it protects other soft tissues of the body.
3. Movement - It assists in body movement by providing attachments for muscles that pull
on the bones that act as levers.
4. Blood cell production - It manufactures blood cells. Red bone marrow, a connective
tissue within bone, produces red blood cells, white blood cells, and platelets in a process
called hemopoiesis.
5. Storage - It is a storage area for mineral salts, especially phosphorus and calcium, and
fats. Moreover, Yellow bone marrow within bone is composed mostly of adipose cells,
which store triglycerides (fats). In a newborn, all bone marrow is red, but it eventually
changes into yellow marrow with increasing age.

4.3 DEVELOPMENT
4.3.1 Bone Histology

The periosteum and endosteum contain osteoblasts, which function in the formation of bone,
as well as in the repair and remodeling of bone. When osteoblasts become surrounded by matrix,
they are referred to as osteocytes. Osteoclasts are also present and contribute to bone repair
and remodeling by removing existing bone.

Bone is formed in thin sheets of extracellular matrix called lamellae, with osteocytes located
between the lamellae within spaces called lacunae. Cell processes extend from the osteocytes
across the extracellular matrix of the lamellae within tiny canals called canaliculi.

There are two types of bone tissue and these are compact or dense bone and cancellous or
spongy bone. In both types of tissue, the osteocytes are the same, but the arrangement of how
the blood supply reaches the bone cells is different. The two types of tissue have different
functions. Compact bone is dense and strong, whereas cancellous bone has many open spaces,
giving it a spongy appearance. It is in these spaces that bone marrow can be found.
 Compact bone is strong and dense, provides protection and support, and resists
the stresses produced by weight and movement. Compact bone is found beneath the
periosteum of all bones and makes up the bulk of long bones. Compact bone is made of
cylindrical units called osteons. Each osteon consists of concentric lamellae, concentric
layers that surround a central canal, or Haversian canal, containing blood and lymph
vessels. Between the lamellae are spaces called lacunae, which contain osteocytes, and
smaller channels called canaliculi that radiate out from the lacunae. These canaliculi allow
nutrients and wastes to be passed more easily from one osteocyte to another within the
osteon.

In contrast to compact bone, spongy bone is lightweight. Spongy bone, also

known as cancellous bone, contains irregular lattices of thin bone columns called
trabeculae. Trabeculae form a supportive framework that is firm but not exceedingly
strong. This tissue must be covered by compact bone or cartilage because it could be
damaged easily if exposed. The spaces between the trabeculae of some bones are filled
with red bone marrow. In such cases, the functions of the trabeculae are to support and
protect the red bone marrow. Spongy bone is found mostly in short, at, and irregular
bones. In long bones, spongy tissue forms the majority of the epiphyses and is also found
around the inner rim of the diaphysis.

4.3.2 Bone Ossification

Bone is formed during ossification and maintained by remodeling. The process of bone
formation, called ossification, occurs in four situations. Initial formation of bones in the embryo
and fetus. Second, bone growth during infancy, childhood, and adolescence prior to adulthood.
There is also bone remodeling, which occurs as old bone tissue is replaced with new bone tissue
throughout life. And lastly, repair of broken bones such as fractures throughout life.

Bones form initially in the embryo by two processes. In the first process, called
intramembranous ossification, bone forms directly from mesenchyme. Intramembranous
ossification occurs in the at bones of the skull, mandible, and clavicle. In the second
process, called endochondral ossification, bone forms within and replaces cartilage.
Intramembranous ossification is the simpler of these two processes.
 Figure 4.2 Endochondral Ossification of a Long Bone
*illustrations and content taken from Seeley’s Anatomy and Physiology by VanPutte, Regan & Russo (2016)

4.3.3 Bone Growth

During infancy, childhood, and adolescence, long bones grow in both length and thickness. The
following section highlight how bones grow in length and in thickness.

Growth in length:

• Within the epiphyseal plate (cartilage) are chondrocytes that divide and form additional
cartilage.
 • New chondrocytes form on the epiphyseal side, while the cartilage on the diaphyseal side
is replaced by bone.
• The thickness of the epiphyseal plate remains the same, but the bone lengthens.
• Cartilage growth stops at adulthood, and bone replaces the remaining cartilage to form
the epiphyseal line.

Growth in thickness:

• As the bone lengthens, it also thickens.

• Cells in the perichondrium differentiate into osteoblasts, which secrete extracellular matrix
that calcifies.
• Osteoblasts differentiate into osteocytes as new lamellae are formed.
• Osteoclasts break down the inner surface of the medullary cavity but at a slower rate
than the bone forms on the outer surface. So, the medullary cavity grows in diameter as
the bone thickens.

Figure 4.3 Endochondral Bone Growth

*illustrations and content taken from Seeley’s Anatomy and Physiology by VanPutte, Regan & Russo (2016)
4.3.4 Bone Remodeling

Throughout life, bone is constantly made and destroyed in an ongoing process called bone
remodeling. At various stages of life, osteoblasts and osteoclasts regulate bone formation and
bone destruction. During some stages, such as childhood, formation exceeds destruction,
allowing for growth of the skeleton. For a short period of time after ossification processes cease,
formation and destruction are fairly equivalent. As a person ages, destruction often exceeds
formation, leading to bone loss. Rates of remodeling vary depending on the location within the
body. The remodeling process allows for mineral homeostasis, as well as repair of damaged
bone tissue.

Remodeling is affected by many factors. Hormones as one of the major factors affect bone
remodeling. For instance, Parathyroid hormone (PTH) stimulates osteoclasts whereas and
Calcitonin stimulates formation of osteoblasts. The Human growth hormone (hGH) and Insulin-
like growth factor (IGF) stimulates cartilage and bone growth. And lastly, sex hormones also
influence sex-related differences in skeletal growth. For one, we are indeed aware that certain
minerals contribute to our osseous tissues. These includes availability of calcium, magnesium,
and phosphorus. This is congruent to the importance of Vitamins such as Vitamins A, C, and D.
but this doesn’t mean that all depends on the aforementioned factors. This is because our activity
level and diet play a major role on how our body can synthesize these hormones, vitamins and
minerals.

4.3.5 Bone Repair

Bones can reform after being fractured (broken). The classification of fractures depends on
whether the bone is splintered (partial), entirely broken (complete), or comminuted. If the broken
bone protrudes through the skin, it is an open fracture. If it remains within the skin, it is a closed
fracture.

Figure 4.4 Bone Repair

*illustrations and content taken from Seeley’s Anatomy and Physiology by VanPutte, Regan & Russo (2016)
4.4 DIVISION OF THE SKELETAL SYSTEM
Anatomists use several common terms to describe the features of bones. For example, a hole
in a bone is called a foramen. A foramen usually exists in a bone because some structure, such
as a nerve or blood vessel, passes through the bone at that point. If the hole is elongated into a
tunnel-like passage through the bone, it is called a canal or a meatus. A depression in a bone
is called a fossa. A lump on a bone is called a tubercle or a tuberosity, and a projection from
a bone is called a process. Most tubercles and processes are sites of muscle attachment on
the bone. Increased muscle pull, as occurs when a person lifts weights to build up muscle mass,
can increase the size of some tubercles. The smooth, rounded end of a bone, where it forms a
joint with another bone, is called a condyle.

TABLE 4.1 ANATOMICAL TERMS FOR FEATURES OF BONES

TERM DESCRIPTION
Major Features
Body, shaft Main portion
Head Enlarged end
Neck Constricted area between head and body
Condyle Smooth, rounded articular surface
Facet Small, flattened articular surface
Crest Prominent ridge
Process Prominent projection
Tubercle, or tuberosity Knob or enlargement
Trochanter Large tuberosity found only on proximal femur
Epicondyle Enlargement near or above a condyle
Openings or Depressions
Foramen Hole
Canal, meatus Tunnel
Fissure Cleft
Sinus Cavity
Fossa Depression
The axial skeleton consists of 80 bones, while the appendicular skeleton consists of 126
bones.

Figure 4.5 Complete Adult Skeleton

*illustrations and content taken from Understanding Anatomy and Physiology: A Visual, Auditory, Interactive Approach by Gale Sloan Thompson (2015)

Note that in the above picture (figure 4.5), the appendicular skeleton is colored turquoise
whereas the other bones are the axial skeleton.
4.4.1 Axial Skeleton

4.4.1.1 The Skull

4.4.1.1.1 Cranial Bones

The skull, which consists of 22 bones, rests on top of the vertebral column. It has two
groups of bones: 8 cranial bones and 14 facial bones. The cranial bones protect the brain
and form attachment points for the meninges on the interior and the muscles that move
the head on the exterior. The facial bones house the openings to the airways and the
digestive system, protect the sensory organs and provide attachments for facial muscles.

• The frontal bone forms the forehead, roofs of the eye sockets, and front part of the cranial
floor. The mucous membrane–lined spaces (frontal sinuses) deep within it resonates
sound.
• The parietal bones (2) form the sides and roof of the cranium
• The temporal bones (2) form the lower side of the cranium and part of the cranial floor.
The temporal bones have several features:
• They form joints with the jawbone (mandible) called the temporomandibular joints (TMJ).
• The external auditory meatus is the canal that leads to the middle ear.
• The mastoid process is a point of attachment for some of the muscles involved in head
movement.
• The carotid artery passes through a foramen called the carotid foramen.
• The styloid process serves as a point of attachment for the tongue and neck muscles.
• The occipital bone forms the back part of the skull and most of the cranial floor. The
medulla, spinal cord, and vertebral and spinal arteries all pass through its foramen
magnum. The first cervical vertebra attaches to the occipital bone at two processes called
the occipital condyles.
• The sphenoid bone is in the middle of the cranial floor and is where all the other cranial
bones attach, like the keystone joining two arches to form a doorway. It contains
sphenoidal sinuses, which drain into the nasal cavity. The pituitary gland sits in a
depression of the sphenoid bone called the sella turcica. The optic nerve passes through
its optic foramen, and the mandibular nerve passes through its foramen ovale.
• The ethmoid bone forms the anterior part of the cranial floor, the medial part of the eye
sockets, and superior portions of the nasal cavity. It has 3 to 18 ethmoidal sinuses (air
spaces) and mucus-lined conchae that warm and moisten inhaled air and trap foreign
particles. The crista galli, a ridge on the superior portion of the ethmoid bone, serves as
an attachment point for the meninges. This is surrounded by the cribriform plate through
which the nerves associated with the receptors for smell pass from the nose into the brain.
 Figure 4.6 The Skull
*illustrations and content taken from Visualizing Anatomy and Physiology by Freudenrich & Tortora (2011)
4.4.1.1.2 Facial Bones

Your face changes and grows from the time you are born until around age 16. Your teeth
form and erupt, the cranial bones grow, and the paranasal sinuses expand. Your facial
bones include the following:

• Nasal bones (2) form the bridge of the nose.

• Maxillae (2) form the upper jawbone and join with all the other facial bones except the
mandible (lower jawbone):

• Each maxilla has a maxillary sinus that empties into the nasal cavity.
• The alveolar process forms the arch that contains the sockets (alveoli) for the
teeth.
• The maxillae form the anterior three-fourths of the roof of the mouth (hard
palate).

• Palatine bones (2) form the posterior portion of the hard palate, part of the lower eye
sockets, and part of the floor and the sides of the nasal cavity.
• The mandible is the largest, strongest facial bone and the only one that moves:
• Each condylar process forms a temporomandibular joint with each temporal
bone.
• Like the maxillae, the mandible has an alveolar process for the lower teeth.
• The mental foramina are holes that allow passage of the mental nerve.
Dentists use the mental foramina as landmarks to inject anesthetics into the
mental nerve.
• Zygomatic bones (2), or cheekbones, form the cheek prominences and part of the
wall of the eye sockets. They form joints with the frontal, maxilla, sphenoid, and
temporal bones.
• Lacrimal bones (2) are the smallest, thinnest bones on the medial eye socket. They
house the tear ducts, which tunnel through to the nasal cavity. This is why your nose
runs when you cry.
• Inferior nasal conchae (2) project into the nasal cavity to filter air before it passes
toward the trachea and lungs.
• The vomer joins with the maxillae and the palatine bones to form the floor of the nasal
cavity. Along with cartilage and the ethmoid bone, the single vomer forms the nasal
septum, which divides the nasal cavity into right and left sides.
 4.4.1.1.3 Features of the Skull

The skull has unique features, such as sutures, sinuses, and fontanels (soft spots at birth
and early infancy):

• A suture is a special type of immovable joint that joins most of the skull bones. There
are 4 major sutures in the skull:
• The coronal suture unites the frontal bone and two parietal bones.
• The sagittal suture attaches the two parietal bones.
• The lambdoid suture joins the parietal bones to the occipital bone.
• The squamous sutures seal the parietal bones to the temporal bones.

• Paranasal sinuses are found in the sphenoid, frontal, ethmoid, and maxillary bones.
They produce mucus, lighten the weight of the skull, and serve as echo chambers, which
produce the unique sounds of your voice.

• Fontanels are mesenchyme-filled spaces between the cranial bones of infants at birth.
These soft spots compress as the baby passes through the birth canal. For a short time
after birth, the fontanels also provide room for the brain to grow. Within the first two
years of life, they are replaced by bone via intramembranous ossification. As the
fontanels close, the bones of the skull fuse to form the sutures.
• The hyoid bone is located in the neck, between the mandible and larynx. It is
suspended from the styloid process of each temporal bone by ligaments and muscle. It
supports the tongue, stabilizes the airways, and provides attachment points for tongue,
neck, and pharyngeal muscles.

4.4.1.2 Vertebral Column

The vertebral column (also called the spine, spinal column, or backbone) protects the spinal
cord, supports the head and neck, permits movement, and provides attachment points for the
back muscles, ribs, and pelvis. The vertebral column consists of 26 bones called vertebrae.
Vertebrae have the following general structures.

• The body is the thick, disc-shaped anterior portion that bears weight.
• The vertebral arch extends posteriorly from the body. It consists of two short, thick
processes called pedicles that project backward and join with two at parts called laminae.
The vertebral foramen is an opening through which the spinal cord passes.
• Seven processes arise from the vertebral arch:
 • Spinous process (1) projects from the laminae; it serves as attachment point for
muscles.
• Transverse processes (2) are lateral extensions that serve as attachment points
for muscles.
• Superior articular processes (2) attach to vertebra above.
• Inferior articular processes (2) attach to vertebra below.

The exact shape and structure of the vertebrae vary with the region where they are located:

• Cervical vertebrae (7) are in the neck region. Each cervical vertebra has three
openings (foramina): a larger, central opening (vertebral foramen) for the spinal
cord, and two transverse foramina, passages for blood vessels and nerves.
• Thoracic vertebrae (12) are posterior to the chest cavity and serve as
attachments for the ribs.
• Lumbar vertebrae (5) form the lower back.
• The sacrum consists of 5 fused vertebrae and forms the posterior wall of the
pelvis. Blood vessels and nerves pass through the openings.
• The coccyx, sometimes referred to as the tailbone, consists of 4 fused vertebrae.

Note that the adult vertebral column has four curved regions: cervical, thoracic, lumbar, and
sacral. The curves develop from a single, concave curve in the fetus. When the infant begins
holding its head erect (at approximately three months of age), the cervical curve develops. The
lumbar curve develops later, when the child starts sitting up, standing, and walking. Sometimes,
abnormal curvatures develop in the spine due to uneven growth or weakening of the bones
and/or musculature associated with the spine.

Scoliosis—A lateral curvature that

causes the spine to “lean” to one
side more than the other. This
condition is seen more commonly
in females than in males.

Kyphosis—An exaggeration of the

thoracic curve that forms a
“humpback” appearance.

Lordosis—An exaggeration of the

lumbar curve that causes a “sway
back.”
Figure 4.7 The Vertebral Curves
*illustrations and content taken from Visualizing Anatomy and Physiology by Freudenrich & Tortora (2011)
 Figure 4.8 The Vertebral Column
*illustrations and content taken from Visualizing Anatomy and Physiology by Freudenrich & Tortora (2011)
4.4.1.3 Thoracic Cage

The ribs and sternum form the framework for the thorax. The sternum is made of three parts
that fuse by age 25.

Figure 4.9 The Thorax and Pectoral Girdle

*illustrations and content taken from Visualizing Anatomy and Physiology by Freudenrich & Tortora (2011)
 • The manubrium articulates with the collarbone, or clavicle, and the first rib.
• The body articulates with part of the second rib and ribs 3 through 10.
• The xiphoid process is made of cartilage that ossifies by age 40. No ribs attach to this
pointed structure, which rescuers use to locate the proper hand position for
cardiopulmonary resuscitation (CPR).

The sternum attaches directly to the first through seventh pairs of ribs by a form of hyaline
cartilage called costal cartilage. The remaining pairs of ribs either attach indirectly to the
sternum (pairs 8–12) or do not attach at all (pairs 11–12). Ribs are named based on how
they attach to the sternum; rib pairs 1 through 7 are called true ribs, rib pairs 8 through 12
are called false ribs, and rib pairs 11 and 12 are referred to as floating ribs. The bones of
the thorax protect the heart and lungs and provide attachment points for muscles, especially
those involved in breathing.

4.4.2 Appendicular Skeleton

4.4.2.1 Pectoral Girdle

The next set of bones in the upper body is the shoulder girdles or pectoral girdles, which attach
the upper limbs to the axial skeleton. The clavicle, or collarbone, attaches to the manubrium of
the sternum and the scapula, or shoulder blade. The coracoid process of the scapula serves
as a point of attachment for muscles and its glenoid cavity forms the shoulder joint with the
head of the humerus (upper arm bone).

4.4.2.2 Upper Limbs

Attached to the scapula is the humerus, the longest bone in the upper body. The humerus has
a rounded head that fits into the glenoid cavity of the scapula. The distal end of the humerus
attaches to

the two bones of the forearm, the ulna and radius. The ulna is medial to the radius. The proximal
end of the radius is rounded and articulates with the humerus, to allow approximately 180° of
forearm rotation. Distal to the ulna and radius are the bones of the wrist, the carpals (8 bones),
which are arranged in two rows of 4 bones each. The distal row attaches to the bones of the
palm of the hand (metacarpals), whose distal heads form the knuckles. Finally, the metacarpals
attach to the bones of the fingers, the phalanges. There are 2 phalanges in the thumb and 3 in
each finger.
 Figure 4.10 The Upper Limb. Wrist and Hand
*illustrations and content taken from Visualizing Anatomy and Physiology by Freudenrich & Tortora (2011)
4.4.2.3 Pelvic girdle

We start our tour of the lower body with the pelvic girdle, which consists of the two hip bones.
The hip bones, also called the coxal bones or os coxa, attach to the sacrum of the vertebral
column posteriorly and with each other anteriorly to form the pubic symphysis. Each coxal
bone is composed of an ilium, an ischium, and a pubis that have fused to form a single unit.
Centrally, on each coxal bone is the acetabulum, the “socket” for the hip joint that articulates
with the femur from the leg.

The bowl-shaped pelvis is formed by the coxal bones, sacrum, and coccyx. The pelvic brim
forms the boundary between the upper pelvis (false pelvis) and the lower pelvis (true pelvis).
The false pelvis is part of the abdomen and contains the urinary bladder and the uterus. The true
pelvis surrounds the pelvic cavity. Blood vessels and nerves to the legs pass through openings
in the lower pelvis called the obturator foramina.

There are a number of structural differences between the male and female pelvis. This is
predominantly because the female must pass the baby through the pelvis during childbirth.

• The angle formed inferior to the pubic bones at the pubic symphysis (pubic arch) is wider in
women (> 90°) than in men (< 90°).
• The pelvic inlet—the superior opening into the bony pelvis—is heart-shaped in males and
oval in females.
• The sacrum is wider and more posteriorly placed in the female than in the male.

4.4.2.4 Lower Limbs

Like the upper limb, the lower limb is composed of a single bone proximally with increasing
numbers of bones as one moves distally. Attached to each coxal bone is a femur (thigh bone),
the longest single bone in the body. Like the humerus, the femur has a rounded, proximal head
where it fits into the acetabulum of the pelvis. The femur bends medially and attaches distally to
the patella (knee cap) and the tibia.

The tibia is the large medial bone of the shin and bears most of the weight. It attaches proximally
with the femur and fibula and distally with the fibula and the talus of the ankle. The patellar
ligament, which holds the patella in place, attaches to the tibia at the tibial tuberosity.

The lateral bone of the shin is called the fibula. The proximal end of the fibula articulates with
the tibia and its rounded distal end and forms a joint with the talus of the ankle. The ankle bones,
or tarsals, consist of 7 bones. Two of these bones, the talus and the calcaneus, are on the
posterior part of the foot. The talus is part of the ankle joint, while the calcaneus forms the heel
of the foot. The rest of the tarsals are anterior to these and attach to the metatarsals.

Figure 4.11 The Pelvic Girdle and Lower Limb

*illustrations and content taken from Visualizing Anatomy and Physiology by Freudenrich & Tortora (2011)
The metatarsals (5) are like the metacarpals of the hand. Attached to the metatarsals are the
phalanges (toes), which have a structure similar to the phalanges in the hand. The calcaneus
forms the posterior portion of the foot. The foot has two raised bends, or arches, in it. The
longitudinal arch spreads from anterior to posterior, while the transverse arch goes from side to
side. The arches are flexible and springy. They absorb shocks, distribute body weight over the
foot, and provide leverage while walking.

Figure 4.12 Skeletal of the Foot

*illustrations and content taken from Visualizing Anatomy and Physiology by Freudenrich & Tortora (2011)
Rizzo, D. C. (2016). Fundamentals of Anatomy and Physiology (Fourth ed.). Boston,
Massachussetts: Cengage Learning.

Thompson, G. S. (2015). Understanding Anatomy & Physiology: A Visual, Auditory, Interactive

Approach,2nd Edition. Philadelphia: F. A. Davis Company.

Tortora, G. J., & Freudenrich, C. C. (2011). Visualizing Anatomy & Physiology. John Wiley &
Sons, Inc. .

VanPutte, C., Regan, J., & Russo, A. (2016). Seeley's Essentials of Anatomy & Physiology. New
York, New York: McGraw-Hill Education.

To set the tone right, we will help each other in the appreciation of the initial phase of
Anatomy and Physiology by accomplishing the Discussion Board and Quiz in Canvas