Anatomy and Physiology 1st Edition

McKinley Solutions Manual

Visit to download the full and correct content document: https://testbankdeal.com/dow
nload/anatomy-and-physiology-1st-edition-mckinley-solutions-manual/
CHAPTER 8: Skeletal System: Axial and
Appendicular Skeleton

CHAPTER OVERVIEW
This chapter is designed to introduce students to the 206 named bones of the skeletal
system. Students will also view the overall construct of the bones in terms of their
anatomic positions in the body and their articulations. Bones differ in size, shape, and
weight; the diversity of bones is directly related to the function of the bone. Functions
of some of the bones will be presented. How the skeleton developed is introduced.

The fields of criminology, pathology, and anthropology utilize features of bones in the
solving of a crime, the identification of human skeletal remains, and a myriad of other
reasons. Students will learn how bones can be used to determine the age of an
individual at the time of death. Students will also learn how to use bones to determine
the sex of an individual. Certain pathological conditions concerning the skeletal system
are presented in this chapter.

KEY POINTS TO EMPHASIZE WHEN TEACHING THE BIOLOGY

OF THE AXIAL AND APPENDICULAR SKELETON
An instructional understanding: Students taking a course in human anatomy and
physiology need to understand the overall construct of the axial and appendicular
skeleton. It is important to explain why certain bones have their certain density, size,
and shape. A student should understand the rationale behind certain bone markings.
Changes in the skeleton as a result of aging should be introduced. Since the majority of
students taking a human anatomy and physiology course are seeking healthcare fields,
integration of pathological conditions is important.

1. List the bones comprising both the axial and appendicular skeleton and discuss
bone markings.
2. Use figure 8.2 (p. 240) to list the bones of the axial skeleton and appendicular
skeleton.
3. Use figure 8.1 (p. 239) to list and explain the generic terms used to name bone
markings.
4. Explain that the axial skeleton is termed axial in that it is composed of bones that
are located along the central axis of the body.
5. Explain that the appendicular skeleton is termed appendicular in that it is composed
of bones found in the upper and lower extremities.
6. Show, list, explain, and discuss the features of the skull in terms of cranial bones
and facial bones.
a. Explain that the cranial bones completely surround the brain and are divided
into a roof set of bones and a base set; the roof set is termed the calvaria.
b. Show, explain, and discuss the roof set of cranial bones: frontal bone, parietal
bones, and part of the occipital bone.

112
 c. Show, explain, and discuss the base set of cranial bones: portions of the
ethmoid, sphenoid, occipital, and temporal bones.
d. Explain that the facial bones form the bony construct of the face and protect the
entrances to the digestive and respiratory systems.
e. Show, explain, and discuss the facial bones: zygomatic bones, lacrimal bones,
nasal bones, inferior nasal conchae, palatine bones, maxillae, vomer, and the
mandible.
7. Use table 8.1 (p. 243) to list and discuss the functions of the various passageways
within the skull.
8. Using a PowerPoint slide of figure 8.3 (p. 242), show, explain, and discuss the major
cavities in the skull.
9. Using PowerPoint slides of figures 8.4 (p. 244), 8.5 (p. 245), 8.6 (p. 246), 8.7 (p. 248),
and 8.8 (p. 249), show, explain, and discuss the anatomic constructs of the various
bones, markings, sutures, and passageways found in the skull.
10. Using PowerPoint slides of table 8.2 (pp. 250–252), show, explain, and discuss some
isolated features of the individual cranial bones.
11. Using PowerPoint slides of table 8.3 (pp. 253–255), show, explain, and discuss some
isolated features of the individual facial bones.
12. Show pictures of and explain the pathology associated with cleft lip and cleft palate;
discuss the anatomical problems associated with cleft lip and cleft palate.
13. Using a PowerPoint slide of figure 8.10 (p. 256), show, explain and discuss the
cranial fossae and its components: anterior cranial fossa, middle cranial fossa, and
posterior cranial fossa.
14. Define cranial sutures as immovable joints that form boundaries between cranial
bones; mobility of sutures will be further discussed in chapter nine.
15. Using PowerPoint slides of figure 8.5 (p. 245) and figure 8.6 (p. 246), show and
explain the cranial sutures.
16. Explain, show, and discuss craniosynostosis and plagiocephaly.
a. Explain that craniosynostosis is a result of premature closure of a cranial suture.
b. Explain that plagiocephaly is a term used to describe an asymmetric head shape,
where one part of the skull (usually the frontal or occipital region) has an
oblique flattening.
17. Using a PowerPoint slide of figure 8.11 (p. 258), show, explain, and discuss the
anatomical construct of the bony orbit.
18. Using a PowerPoint slide of figure 8.12 (p. 258), show, explain, and discuss the
anatomical construct of the nasal complex.
19. Using a PowerPoint slide of figure 8.13 (p. 259), show, explain, and discuss the
anatomical construct of the paranasal sinuses; explain that the paranasal sinuses
will be further discussed in terms of function in chapter 23, which is the respiratory
chapter.
20. Show, explain, and discuss the auditory ossicles and the hyoid bone.
a. List the tiny bones of the middle ear, known as the ossicles; the ossicles will be
further discussed in terms of anatomy and function in chapter 16, which is the
neurological senses chapter.
b. Using a PowerPoint slide of figure 8.14 (p. 259), show, explain and discuss the
hyoid bone; the hyoid bone will again be discussed in chapter 23, which is the
respiratory chapter.

113
21. Using a PowerPoint slide of table 8.4 (p. 261), discuss the sexual dimorphism of the
human skull.
a. Define sexual dimorphism.
b. Inform students that certain racial differences may alter sexual dimorphism of
the skull.
c. Inform students that infant and juvenile skulls can generally not be used to
determine sex of an individual, because skull characteristics remain female like
until puberty.
22. Explain and discuss changes that occur in the skull due to aging.
a. Inform students that the most significant growth in the skull occurs before
age 5.
b. Inform students that brain growth is 90–95% complete by age 5.
c. Explain to students the difference between a cranial suture and a cranial
fontanelle.
d. Using a PowerPoint slide of figure 8.15 (p. 262), list, show, explain, and discuss
all the fontanelles: anterior fontanelle, posterior fontanelle, anterior lateral
(sphenoidal) fontanelles, and posterior lateral (mastoid) fontanelles.
23. Show, explain, and discuss the vertebral column.
a. Using a PowerPoint slide of figure 8.16 (p. 263), show, explain, and discuss the
26 vertebrae comprising the vertebral column; name and identify the vertebrae
in each of the five vertebral column divisions: cervical, thoracic, lumbar, sacral,
and coccygeal.
b. Show, explain, and discuss how the individual vertebrae anatomically align to
form the vertebral column.
c. Show, explain, and discuss the architecture of the intervertebral disc, naming its
two main parts: anulus fibrosus and nucleus pulposus.
d. Using a PowerPoint slide of figure 8.16 (p. 263), show and explain the normal
curvatures of the spinal column; discuss the development of the spinal
curvature as an individual ages through fetal, newborn, and child development
stages.
e. Show, explain, and discuss the three main spinal curvature deformities:
kyphosis, lordosis, and scoliosis.
24. Show, explain, and discus individual vertebrae anatomy.
a. Using a PowerPoint slide of figure 8.17 (p. 264), show and name the various
parts of a typical vertebrae; explain that depending on the specific vertebrae,
there can be more or less parts.
b. Using PowerPoint slides of table 8.5 (pp. 264–265), show the characteristic
features of the vertebrae in the five divisions of the vertebral column.
c. Using a PowerPoint slide of figure 8.18 (p. 267), show that cervical vertebrae
can be identified by their transverse foramina, which houses the vertebral
artery and vein.
d. Using a PowerPoint slide of figure 8.18 (p. 267), show the anatomy of the atlas
(C1) and axis (C2); show and explain how the first two cervical vertebrae align
with one another.
e. Using a PowerPoint slide of table 8.5 (p. 265), show and explain specific
characteristics of the thoracic vertebrae.
f. Using a PowerPoint slide of table 8.5 (p. 265), show and explain specific
characteristics of the lumbar vertebrae.

114
 g. Using a PowerPoint slide of figure 8.19 (p. 268), show and explain some specific
characteristics of the sacrum and coccyx.
h. Show, explain, and discuss the pathology and symptoms involved in a herniated
disc; discuss some possible treatment options for a herniated disc.
25. Using a PowerPoint slide of figure 8.20 (p. 269), show, explain, and discuss the
overall anatomical architecture of the thoracic cage.
a. Using a PowerPoint slide of figure 8.20 (p. 269), show and name the
components of the thoracic cage, which are the ribs and sternum.
b. Show and discuss the anatomical features of the sternum.
c. Using a PowerPoint slide of figure 8.21 (p. 271), show and discuss the
anatomical architecture of the various ribs; discuss the usual 12 ribs,
differentiating the true ribs, false ribs, and floating ribs.
d. Discuss the somewhat rare (4–10% of adults) sternal foramen; discuss some
forensic and clinical problems associated with a sternal foramen.
e. Discuss some variations in rib development along with their clinical problems.
26. Using the Concept Overview presented in figure 8.22 (pp. 272–273), show, explain,
and discuss the similarities and differences in the upper limbs and lower limbs.
27. Using a PowerPoint slide of figure 8.23 (p. 274), show, explain, and discuss the
anatomical construct of the pectoral girdle.
a. Using a PowerPoint slide of figure 8.23 (p. 274), show and explain the
anatomical components of the clavicle.
b. Using a PowerPoint slide of figure 8.24 (p. 275), show and explain the
anatomical components of the scapula.
28. Show and explain the anatomical construct of the upper limb.
a. Name the bones of the upper limb: humerus, radius, ulna, 8 carpals,
5 metacarpals, and 14 phalanges.
b. Using a PowerPoint slide of figure 8.25 (p. 276), show, explain, and discuss the
anatomical features of the humerus; discuss anatomical significance of certain
parts of the humerus, like the radial groove is where the radial nerve travels.
c. Using PowerPoint slide of figure 8.26 (p. 277), show, explain, and discuss the
anatomical features of the radius and ulna; explain how the radius and ulna
articulate with each other and superiorly with the humerus and inferiorly with
the carpal bones.
d. Show and explain the construct and mechanical significance of the interosseus
membrane between the radius and ulna.
e. Demonstrate and explain how the radius and ulna rotate during supination and
pronation of the palm.
f. Using a PowerPoint slide of figure 8.27 (p. 278), show, explain, and discuss the
anatomical construct and features of the carpal bones, metacarpal bones, and
phalanges.
g. Name and identify the anatomic locations of the eight carpal bones: trapezium,
trapezoid, capitate, hamate, scaphoid, lunate, triquetrum, and pisiform.
h. Identify the anatomic locations of the various metacarpal bones.
i. Name and identify the anatomic locations of the phalanges; show the proximal
phalanx, middle phalanx, and distal phalanx.
j. Discuss scaphoid fractures, informing students that the scaphoid bone is the
most commonly fractured carpal bone.

115
29. Using a PowerPoint slide of figure 8.28 (p. 279), show, explain, and discuss the
anatomical construct of the pelvic girdle; show how the os coxae articulate with the
sacrum, and how one os coxae articulates with the other os coxae at the pubic
symphysis.
a. Using a PowerPoint slide of figure 8.29 (p. 281), show, explain, and discuss the
os coxae; show and discuss the parts of the os coxae.
b. Discuss the borders of the pelvic inlet; discuss the pelvic inlet’s role in the
separation of the true pelvis from the false pelvis.
c. Show, explain, and discuss the borders of the entrance into the false pelvis.
d. Show, explain, and discuss the borders of the entrance into the true pelvis.
e. Show, explain, and discuss the borders of the pelvic outlet.
f. Using table 8.6 (p. 283), show, explain, and discuss the differences between the
female pelvis and male pelvis.
g. Discuss how osteologists can use the os coxae to determine human age.
30. Show and explain the anatomical construct of the lower limb.
a. Name the bones of the lower limb: femur, patella, tibia, fibula, 7 tarsals,
5 metatarsals, and 14 phalanges.
b. Using a PowerPoint slide of figure 8.31 (p. 285), show, explain, and discuss the
anatomical features of the femur; discuss anatomical significance of certain
parts of the femur, like the pectineal line is where the pectineus muscle
attaches.
c. Using PowerPoint slide 8.32 (p. 286), show, explain, and discuss the anatomical
features of the patella; explain that the patella is a sesamoid bone, which is a
bone formed within a tendon.
d. Using a PowerPoint slide of figure 8.33 (p. 287), show, explain, and discuss the
anatomical features of the tibia and fibula; explain how the tibia and fibula
articulate with each other and superiorly with the femur and inferiorly with the
tarsal bones.
e. Explain to the students the comparison of the interosseus membrane between
tibia and fibula to that between the radius and ulna.
f. Using a PowerPoint slide of figure 8.34 (p. 289), show, explain, and discuss the
anatomical construct and features of the tarsal bones, metatarsal bones, and
phalanges.
g. Name and identify the anatomic locations of the seven tarsal bones: calcaneus,
talus, navicular, cuboid, lateral cuneiform, intermediate cuneiform, and
medial cuneiform.
h. Identify the anatomic locations of the various metacarpal bones.
i. Name and identify the anatomic locations of the phalanges; show the proximal
phalanx, middle phalanx, and distal phalanx.
j. Using the skeleton show that the talus receives the entire body weight in that
the talus articulates with it.
k. Using a PowerPoint slide of figure 8.35 (p. 290), show, explain, and discuss the
three normal foot arches; medial longitudinal, lateral longitudinal, and the
transverse arch.
l. Explain that the primary function of the foot arches is to help support the
weight of the body and ensure that the blood vessels and nerves on the sole of
the foot are not pinched when standing.

116
 m. Show, explain, and discuss five pathologies of the foot: a bunion, pes cavus,
talipes equinovarus, pes planus, and a metatarsal stress fracture.
31. Using a PowerPoint slide of figure 8.36 (p. 291), show, explain, and discuss the
development of the skeleton.
a. Present a timeline for major developmental steps in skeletal formation.
b. Explain the development of limb buds, hand plates, and foot plates.
c. Explain the role of mesoderm and ectoderm in the development of limb buds.
32. Explain and discuss five malformations that can occur in the limbs: polydactyly,
ectrodactyly, syndactyly, Amelia, and phocomelia; carefully explain the genetic and
environmental causes for limb malformations.

ADDITIONAL TOPICS FOR DISCUSSION

1. Explain and discuss blowout fractures of the bony orbit.
2. Discuss the clinical use of the sternal angle in determination of central venous
pressure.
3. Explain and discuss pectus excavatum.
4. Discuss the clinical importance of palpation of certain bony prominences in the
physical examination.
5. Show, explain, and discuss the four types of pelvises: android, anthropoid,
gynecoid, and platypelloid.
6. Explain and discuss the use of pelvimetry in obstetrics.
7. Define and show the auricular surfaces of the pelvis.
8. Define the term sesamoid bone; discuss the locations of sesamoid bones in the
human body.

SUGGESTED CHAPTER OUTLINE

8.1 Components of the Skeleton: There are names for characteristic markings
on bones, and the two subdivisions of the skeleton are the axial and
appendicular skeletons. (pp. 239–241)
A. Bone Markings (pp. 239–241)
1. Projections mark the point where muscles, tendons, and ligaments attach.
2. Sites of articulation between adjacent bones tend to be smooth areas.
3. Depressions, grooves, and openings through bones indicate sites where
blood vessels and nerves travel.
4. Types of articulating surfaces include the condyle, facet, head, and trochlea.
5. Types of depressions include the alveolus, fossa, and sulcus.
6. Types of projections of tendon and ligament attachment include the crest,
epicondyle, line, process, ramus, spine, trochanter, tubercle, and tuberosity.
7. Types of openings or spaces include the canal, fissure, foramen, meatus,
and sinus.
B. Axial and Appendicular Skeleton (p. 241)
1. The axial skeleton is composed of the bones along the central axis of the
body.
2. The axial skeleton is divided into three regions: the skull, the vertebral
column, and the thoracic cage.

117
 3. Functions of the axial skeleton include forming a support framework,
protecting the organs, and blood cell formation.
4. The appendicular skeleton includes bones of the upper and lower limbs, and
the girdles of bones that attach the limbs to the axial skeleton.
5. The pectoral girdle holds the upper limbs in place.
6. The pelvic girdle holds the lower limbs in place.
8.2 Bones and Features of the Skull: The skull is the skeleton’s most complex
structure and is comprised of 22 bones. (pp. 241–259)
A. General Anatomy of the Skull (pp. 241–242)
1. The skull is composed of both cranial and facial bones.
2. Cranial bones form the rounded cranium, which completely surrounds and
encloses the brain.
3. The calvaria, or skullcap, is the roof of the cranium and consists of the
frontal bone, the parietal bones, and part of the occipital bone.
4. The base of the cranium is composed of portions of the ethmoid, sphenoid,
occipital, and temporal bones.
5. Facial bones form the face, protect entrances to the digestive and
respiratory systems, give shape and individuality to the face, form part of
the orbit and nasal cavities, support the teeth, and provide for the
attachment of muscles involved in facial expression.
6. The fourteen facial bones include the zygomatic bones, lacrimal bones,
nasal bones, inferior nasal conchae, palatine bones, maxillae, and the vomer
and mandible.
7. The skull contains the large cranial cavity, and several smaller cavities,
including the orbits, the oral cavity, the nasal cavity, and the paranasal
sinuses.
B. Views of the Skull and Landmark Features (pp. 242–256)
1. The skull has numerous bone markings, such as canals, fissures, and
foramina that serve as passageways for blood vessels and nerves.
2. The frontal bone, nasal bones, maxillae, and mandible are prominent in the
anterior view of the skull.
3. The frontal bone forms the forehead.
4. The left and right orbits each contain large openings called the superior
orbital fissure and the inferior orbital fissure.
5. The superciliary arches, or brow ridges, are superior to the orbits on the
anterior of the frontal bone.
6. The left and right nasal bones form the bony ridge of the nose.
7. The glabella is a landmark area superior to the nasal bones and between the
orbits.
8. The left and right maxillae fuse in the midline to form most of the upper jaw
and the lateral boundaries of the nasal cavity, the floor of each orbit, and
the roof of the oral cavity.
9. The infraorbital foramen in the maxilla conducts blood vessels and nerves to
the face.
10. The lower jaw is formed by the mandible.
11. The prominent “chin” of the mandible is called the mental protuberance.
12. The alveolar processes of the maxillae and mandible contain the teeth.
13. The anterior nasal spine marks the inferior border of the nasal cavity.

118
14. The nasal septum divides the nasal cavity into left and right halves.
15. The inferior nasal conchae are scroll-shaped bones along the inferolateral
walls of the nasal cavity.
16. The superior view of the skull shows the major sutures and flat bones of the
skull.
17. The four cranial bones shown by the superior view are the frontal bone,
both parietal bones, and the occipital bone.
18. The coronal suture is the articulation between the frontal and parietal
bones.
19. The sagittal suture connects the left and right parietal bones along the
midline of the skull.
20. The parietal foramen or foramina serve as the passage of small veins
between the brain and scalp.
21. The parietal eminence is a rounded, smooth area on the lateral surface of
the parietal bones.
22. The lambdoid suture is the articulation between the occipital bone and both
parietal bones.
23. The posterior view of the skull is dominated by the occipital and parietal
bones, but also includes the temporal bones.
24. Within the lambdoid suture there may be one or more sutural bones, or
Wormian bones.
25. The external occipital protuberance is a prominence on the posterior aspect
of the skull.
26. The superior and inferior nuchal lines intersect the external occipital
protuberance.
27. A lateral view of the skull shows one parietal bone, temporal bone, and
zygomatic bone, as well as parts of the maxilla, mandible, frontal bone, and
occipital bone.
28. The superior and inferior temporal lines arc across the surface of the
parietal and frontal bones and mark the attachment site of the temporalis
muscle.
29. The small lacrimal bone articulates with the maxilla anteriorly and with the
ethmoid bone posteriorly.
30. A portion of the sphenoid bone articulates with the frontal, parietal, and
temporal bones, forming a region called the pterion.
31. The temporal process of the zygomatic bone and the zygomatic process of
the temporal bone fuse to form the zygomatic arch.
32. The mandibular fossa of the temporal bone is where the temporal bone
articulates with the mandible, forming the temporomandibular joint, or
TMJ.
33. The external acoustic meatus is the external auditory canal and is
surrounded by the tympanic part of the temporal bone.
34. The mastoid process is a bump behind inferior and posterior to the external
acoustic meatus.
35. A sagittal sectional view reveals bones that form the endocranium and the
nasal cavity, including the frontal, parietal, temporal, occipital, ethmoid, and
sphenoid bones.
36. The frontal sinus and sphenoid sinus are also visible in a sagittal view.

119
37. The nasal septum is formed by the perpendicular plate of the ethmoid
superiorly, and the vomer inferiorly.
38. The palatine process of the maxillae and the palatine bones form the hard
palate, which acts as both the floor of the nasal cavity and a portion of the
roof of the mouth.
39. An inferior (basal) view, the most anterior structure is the hard palate.
40. The medial and lateral pterygoid plates of the sphenoid bone form a
pterygoid process.
41. The choanae are the internal openings of the nasal cavity.
42. The jugular foramen is an opening between the temporal and occipital
bones that provides passageway for the internal jugular vein and several
nerves.
43. The carotid canal is anteromedial to the jugular foramen and provides
passageway for the internal carotid artery.
44. The styloid process is a thin, pointed projection of bone located
anteromedial to the mastoid process, which serves as an attachment site for
several hyoid and tongue muscles.
45. The foramen magnum is the largest foramen of the skull and allows the
spinal cord to enter the cranial cavity.
46. The occipital condyles are located on either side of the foramen magnum
and articulate with the first cervical vertebra of the vertebral column.
47. Hypoglossal canals, through which the hypoglossal nerves extend, are
located at the anteromedial edge of each occipital condyle.
48. An internal view of the cranial base reveals the frontal bone surrounding the
cribriform plate of the ethmoid bone.
49. Cribriform foramina are perforations in the cribriform plate of the ethmoid
bone that allow passageway for the olfactory nerves into the nasal cavity.
50. The crista galli is an elevation of the cribriform plate of the ethmoid bone to
which the cranial dural septa of the brain attach.
51. The sphenoid is often called a “bridging bone” because it unites the cranial
and facial bones.
52. The lateral expansions of the sphenoid bone are called the greater wings
and lesser wings of the sphenoid.
53. The sella turcica is a bony depression in the base of the sphenoid which
houses the pituitary gland.
54. The petrous parts of each temporal bone form the lateral regions of the
cranial base.
55. The internal acoustic meatus opens in the more medial portion of the
temporal bone.
56. The internal occipital protuberance and internal occipital crest are internal
landmarks of the occipital bone.
57. The cranial fossae are three curved depressions in the floor of the cranial
cavity.
58. The anterior cranial fossa is the shallowest depression and houses the
frontal lobes of the brain.
59. The middle cranial fossa houses the temporal lobes of the brain and the
pituitary gland.

120
 60. The posterior cranial fossa is the deepest depression and supports the
cerebellum and part of the brainstem.
61. Clinical View: Cleft Lip and Palate (p. 255)
a. A cleft lip is the incomplete fusion of upper jaw components, resulting
in a split upper lip extending from the mouth to the side of one nostril.
b. Cleft lip is caused by both genetic and environmental factors, such as
cigarette smoking or alcohol ingestion during pregnancy.
c. A cleft palate is a congenital fissure in the midline of the palate, which
results when the left and right maxillary and palatine bones fuse
incompletely.
d. Cleft palate can cause swallowing and feeding problems.
e. The etiology of cleft palate is similar to that of cleft lip, and they
sometimes occur in conjunction.
C. Sutures (pp. 256–257)
1. Sutures are immovable joints connected by dense regular connective tissue
that form the boundaries between the cranial bones.
2. The coronal suture extends laterally across the superior surface of the skull
and represents the articulation between the frontal bone and the parietal
bones.
3. The lambdoid suture extends like an arc across the posterioir surface of the
skull, articulating with the parietal bones and the occipital bone.
4. The sagittal suture extends between the coronal and lambdoid sutures
along the midsagittal plane and articulates the right and left parietal bones.
5. The squamous suture on each side of the skull articulates the temporal
bone and the parietal bone.
6. Sutural bones, or Wormian bones, are a common variation in sutures and
are most numerous and common in the lambdoid suture.
7. The obliteration of sutures in adulthood can help determine approximate
age of death, with the coronal suture closing in the late 20s to early 30s,
followed by the sagittal suture in the 30s or later, the lambdoid suture in
the 40s, and the squamous suture in the 60s or later.
8. Clinical View: Craniosynostosis and Plagiocephaly (p. 257)
a. Craniosynostosis refers to the premature fusion or closing of one
or more cranial sutures and can result in unusual craniofacial
shape.
b. Sagittal synostosis is the premature fusion of the sagittal suture,
resulting in a very elongated, narrow skull shape called
scaphocephaly.
c. Coronal synostosis refers to premature fusion of the coronal
suture, which causes the skull to be abnormally short and wide.
d. Plagiocephaly is an asymmetric head shape, where one part of
the skull has anoblique flattening; this can be caused by
unilateral coronal craniosynostosis, asymmetric lambdoid
synostosis, or normal deformational factors.
D. Orbital and Nasal Complexes, Paranasal Sinuses (pp. 258–259)
1. The orbital complex encloses and protects the eye and consists of parts of
the frontal bone, zygomatic bone, maxilla, lacrimal bone, ethmoid bone,
and sphenoid bone.

121
 2. The nasal complex is composed of bones and cartilage that enclose the
nasal cavity and the paranasal sinuses, including the frontal bone, ethmoid
bone, palatine bone, sphenoid bone, maxilla, nasal conchae, and lacrimal
bone.
3. The paranasal sinuses are air-filled chambers that open into the nasal
cavities and include the ethmoidal, frontal, maxillary, and sphenoidal
sinuses.
4. The sinuses have a mucous membrane lining that humidifies and warms
inhaled air; they also lighten the skull bones and give resonance to the
voice.
8.3 Bones Associated with the Skull: The auditory ossicles and the hyoid bone
are bones of the axial skeleton associated with the skull. (p. 259)
A. The auditory ossicles are three tiny ear bones housed within the petrous part of
each temporal bone, including the malleus, the incus, and the stapes.
B. The hyoid bone is a slender, curved bone located inferior to the skull between
the mandible and the larynx.
C. The hyoid does not articulate with any other bone in the skeleton.
D. The hyoid has a medial body and two paired hornlike processes, the greater
cornua and the lesser cornua, which serve as attachment sites for tongue and
larynx muscles and ligaments.
8.4 Sex and Age Determination from Analysis of the Skull: The skull can provide
insight about the sex and age of an individual. (pp. 260–262)
A. Sex Differences in the Skull (pp. 260–261)
1. Human skulls display sexual dimorphism, or different features between the
sexes.
2. Female skulls tend to be more gracile, including a thin or sharp supraorbital
margin, nonprominent superciliary arches, a triangular mental
protuberance, rounded frontal bone, obtuse mandibular angle, and smooth
external occipital protuberance.
3. Male skulls tend to be more robust, including a blunt supraorbital margin,
prominent superciliary arch, squarish chin, sloping frontal bone, flared and
narrower mandibular angle, and prominent external occipital protuberance.
4. Skeletal features vary among populations, and the most accurate method of
determining sex is to look at multiple skeletal features and make a judgment
based on the majority of features present.
B. Aging of the Skull (pp. 260–262)
1. The shape and structure of cranial elements differ between infants and
adults.
2. By the age of 5, cranial growth is close to completion and the cranial sutures
are almost fully developed.
3. Fontanelles are flexible areas of dense regular connective tissue membrane
that connect the cranial bones in infants.
4. The mastoid and sphenoid fontanelles close relatively quickly after birth,
whereas the posterior fontanelle normally closes around 9 months of age,
and the anterior fontanelle doesn’t close until 15 months of age.
5. The maxillary sinus becomes more prominent after age 5.
6. The frontal sinus becomes well formed by age 10.

122
 7. The teeth start to wear down from use as a person ages, a process called
dental attrition.
8. If an individual loses some or all of his or her teeth, the alveolar processes of
the maxillae and mandible regress and eventually disappear.
8.5 Bones of the Vertebral Column: The vertebral column consists of 26 bones,
separated into five different regions. (pp. 262–269)
A. Types of Vertebrae (pp. 262–263)
1. The vertebral column is partitioned into five divisions or regions.
2. Vertebrae are identified by using a capital letter to denote their region,
followed by a numerical subscript that indicates their sequence going from a
superior to an inferior location.
3. Seven cervical vertebrae (C1–C7) form the cervical region, or the bones of
the neck.
4. Twelve thoracic vertebrae (T1–T12) form the thoracic region, or the superior
region of the back.
5. Five lumbar vertebrae (L1–L5) form the lumbar region, or the “small” of the
back.
6. The sacrum is formed from five sacral vertebrae (S1–S5) that fuse into a
single bony structure.
7. The coccyx, or “tailbone,” is formed from four coccygeal vertebrae (Co1–Co4)
that unite during puberty.
B. Spinal Curvatures (p. 263)
1. The adult vertebral column has four spinal curvatures: the cervical, thoracic,
lumbar, and sacral curvatures.
2. The primary curves are the thoracic and sacral curvatures, which are present
in the newborn.
3. The secondary curves are the cervical and thoracic curvatures, which appear
when a child is first able to hold up its head, and when a child is learning to
stand and walk, respectively.
4. The secondary curves are also known as compensation curves because they
help shift the trunk weight over the legs.
5. Clinical View: Spinal Curvature Abnormalities (p. 263)
a. Kyphosis is an exaggerated thoracic curvature that is directed
posteriorly, producing a “hunchback” look; it often results from
osteoporosis, but also may occur due to a vertebral compression
fracture, osteomalacia, abnormal vertebral growth, or chronic
contractions in muscles that insert on the vertebrae.
b. Lordosis is an exaggerated lumbar curvature, often called swayback,
that isobserved as a protrusion of the abdomen and buttocks; it may
have the same causes as kyphosis, or may result from pregnancy or
obesity.
c. Scoliosis is an abnormal lateral curvature and is the most common
spinal curvature deformity; it sometimes results during development,
from unilateral muscular paralysis, or spasm in the back.
C. Vertebral Anatomy (pp. 264–269)
1. The anterior region of each vertebra is a thick cylindrical body, or centrum,
which is the weight-bearing structure of each vertebra.

123
2. Posterior to the vertebral body is the vertebral arch, also called the neural
arch.
3. The body together with the vertebral arch enclose an opening called the
vertebral foramen.
4. All the stacked vertebral foramina collectively form a vertebral canal that
contains the spinal cord.
5. Lateral openings between adjacent vertebrae are the intervertebral
foramina, providing passageways through which spinal nerves extend to
various parts of the body.
6. The vertebral arch is composed of two pedicles, which originate from the
posterolateral margins of the body, and two laminae, which extend
posteromedially from the posterior edge of each pedicle.
7. A spinous process projects posteriorly from the junction of the left and right
laminae.
8. Transverse processes project laterally on both sides of the vertebral arch.
9. Each vertebra has superior and inferior articular processes that originate at
the junction between the pedicles and laminae; each articular process has a
smooth surface called an articular facet.
10. Adjacent vertebral bodies are separated by pads of fibrocartilage, called the
intervertebral discs, which act as shock absorbers and permit the vertebral
column to bend.
11. Intervertebral discs are composed of an outer ring of fibrocartilage, called
the annulus fibrosus, and an inner gelatinous circular region, called the
nucleus pulposus.
12. In general, the vertebrae are smallest near the skull and become gradually
larger moving inferiorly through the body trunk.
13. The cervical vertebrae are the most superiorly placed vertebrae; they
typically have kidney-bean shaped bodies that are relatively small, have
transverse foramina in their transverse processes, and often have bifid
spinous processes.
14. The first cervical vertebra, called the atlas (C1) supports the head through its
articulation with the occipital condyles of the occipital bone.
15. The atlas has lateral masses that are connected by semicircular anterior and
posterior arches, each containing slight protuberances, the anterior and
posterior tubercles; it also has depressed, oval superior and inferior articular
facets and an articular facet for dens on its anterior arch.
16. The body of the atlas separates from the atlas and fuses during
development to the body of the second cervical vertebra, called the axis
(C2).
17. The prominent dens, or odontoid process, is a result of the fusion of the
atlas body and axis; the articulation between the atlas and axis is called the
atlantoaxial joint.
18. The vertebra prominens (C7) represents a transition from cervical to thoracic
vertebral region; the spinous process is nonbifid and is much longer than
the other cervical vertebrae.
19. Thoracic vertebrae typically have heart-shaped bodies and are distinguished
from other types of vertebrae by costal facets or costal demifacets on the

124
 lateral side of the body and on the sides of the transverse processes, where
the ribs articulate with the vertebrae.
20. The lumbar vertebrae are the largest vertebrae and typically have thicker
bodies, no transverse foramina, no costal facets, and thick spinous
processes.
21. The sacrum is an anteriorly curved, somewhat triangular bone that forms
the posterior wall of the pelvic cavity.
22. The apex of the sacrum points inferiorly, whereas the bone’s broad superior
surface forms the base.
23. The horizontal lines of fusion produced when the five sacral vertebrae fuse
are called transverse ridges.
24. Superiorly, the sacrum articulates with L5 via a pair of superior articular
processes.
25. The sacral canal is a narrow continuation of the vertebral canal and
terminates in an inferior opening called the sacral hiatus; the sacral cornua
are bony projections on either side of the sacral hiatus.
26. The anterosuperior edge of the first sacral vertebra bulges anteriorly into
the pelvic cavity, forming the promontory.
27. The paired anterior and posterior sacral foramina permit the passage of
nerves to the pelvic organs and the gluteal region, respectively.
28. A dorsal ridge, termed the median sacral crest, is formed by the fusion of
the spinous processes of individual sacral vertebrae.
29. The ala is on each lateral surface of the sacrum; on the lateral surface of the
ala is the auricular surface, which marks the site of articulation with the os
coxae, forming the sacroiliac joint.
30. Four small coccygeal vertebrae fuse to form the coccyx, which is an
attachment site for several ligaments and muscles.
31. The prominent laminae of the first coccygeal vertebrae are known as the
coccygeal cornua, which curve to meet the sacral cornua.
32. Clinical View: Herniated Discs (p. 266)
a. A herniated disc occurs when the gelatinous nucleus pulposus protrudes
into or through the annulus fibrosus, which produces a bulging of the
disc contents into the vertebral canal and pinches spinal cord and/or
nerves of the spinal cord.
b. Cervical herniated discs can cause neck pain and pain down the upper
limb, whereas lumbar herniated discs can low back back and pain the
entire lower limb, a condition known as sciatica.
c. Treatment options include “wait-and-see,” NSAIDS, steroidal drugs,
physical therapy, and surgical treatments such as microdiscectomy and
discectomy.
8.6 Bones of the Thoracic Cage: The thoracic cage is the bony framework of the
chest and consists of the thoracic vertebrae, ribs, and sternum. (pp. 269–271)
A. Sternum (p. 270)
1. The sternum, also referred to as the “breastbone,” is a flat bone that forms
in the anterior midline of the thoracic wall; it is composed of three parts:
the manubrium, the body, and the xiphoid process.
2. The manubrium is the widest and most superior portion of the sternum.

125
 3. Two clavicular notches articulate the sternum with the left and right
clavicles; the shallow superior indentation between the clavicular notches is
called the suprasternal notch.
4. A single pair of costal notches represent articulations for the first ribs’ costal
cartilages.
5. The body is the longest part of the sternum and forms its bulk; individual
costal cartilages from ribs 2–7 are attached to the body at indented articular
costal notches.
6. The body and the manubrium articulate at the sternal angle, which is a
horizontal ridge.
7. The xiphoid process is a small, inferiorly pointed cartilaginous projection of
the sternum that often does not ossify until after age 40.
8. Clinical View: Sternal Foramen (p. 270)
a. In up to 4–10% of adults, a midline sternal foramen is present in the
body of the sternum.
b. The sternal foramen represents failure of the left and right ossification
centers of the sternal body to fuse completely.
c. The sternal foramen can be misidentified as a bullet wound or, in rare
instances, allow acupuncture needles to be inserted into the heart.
B. Ribs (pp. 270–271)
1. The ribs are elongated, curved, flattened bones that originate on or
between the thoracic vertebrae and end in the anterior wall of the thorax.
2. Humans have twelve pairs of ribs.
3. Ribs 1–7 are called true ribs, which connect individually to the sternum by
separate cartilaginous extensions called costal cartilages.
4. Ribs 8–12 are called false ribs because their costal cartilages do not attach
directly to the sternum; rather, the costal cartilages of ribs 8–10 fuse to the
costal cartilage of rib 7.
5. Ribs 11 and 12 are called floating ribs because they have neither direct nor
indirect connection with the sternum.
6. The vertebral end of a typical rib articulates with the vertebral column at the
head.
7. The articular surface of the head is divided by an interarticular crest into
superior and inferior articular facets, which articulate with the costal
demifacets or facets on the bodies of the thoracic vertebrae.
8. The neck of the rib lies between the head and the tubercle.
9. The tubercle of the rib has an articular facet for the costal facet on the
transverse process of the thoracic vertebra.
10. The angle of the rib indicates the site where the tubular shaft begins to
curve anteriorly toward the sternum.
11. A prominent costal groove along the inferior internal border of the shaft
marks the path of nerves and blood vessels to the thoracic wall.
12. Clinical View: Variation in Rib Development (p. 270)
a. In one out of every 200 people, the costal element of the seventh
cervical vertebra elongates and forms a rudimentary cervical rib,
which may compress blood vessels and nerves of the upper limb,
producing a tingling or pain.

126
 b. An extra pair of ribs may form from the costal elements of the first
lumbar vertebra.
c. Some individuals lack a pair of twelfth ribs due to the costal elements of
the twelfth thoracic vertebra failing to elongate.
d. Fused (bicipital) ribs are another rib anomaly.
e. A bifid rib occurs when a rib splits into two separate portions when it
reaches the sternum.
8.7 The Upper and Lower Limbs: A Comparison: Our upper and lower limb
skeletons share some common features based on evolutionary history, and
exhibit some differences based on the primary functions of each limb.
(pp. 271–274)
A. The lower limbs normally support our upper body weight and propel our
bodies when we walk or run, whereas the upper limbs grasp objects and
utilize tools with our hands.
B. The proximal parts of both upper and lower limbs are support by a “girdle” of
bones.
C. The pectoral girdle is composed of the clavicles and scapulae and holds the
upper limbs in place.
D. The pelvic girdle (both ossa coxae) articulates with the lower limb.
E. The proximal part of each limb has one large bone, the humerus in the upper
limb and the femur in the lower limb.
F. The distal part of each limb contains two bones, which are able to pivot
slightly about one another.
G. Both the wrist and the proximal foot contain multiple bones (carpal and
tarsal bones, respectively) that allow for a range of movement.
H. The feet and hands are very similar in that both contain either 5 metacarpals
or 5 metatarsals, and each contains a total of 14 phalanges.
I. Since the lower limb is weight bearing and is used for locomotion, some
mobility has been sacrificed for greater stability.
J. The upper limb is relatively smaller and lighter, and has greater mobility, as it
is not weight bearing.
8.8 The Pectoral Girdle and Its Functions: The pectoral girdle consists of the
clavicles and scapulae; it articulates with the trunk and supports the lower
limbs. (pp. 274–275)
A. Clavicle (p. 274)
1. The clavicle, commonly known as the collarbone, is an elongated S-shaped
bone that extends between the manubrium of the sternum and the
acromion of the scapula.
2. The sternal end (medial end) is roughly pyramidal and articulates with the
manubrium of the sternum, forming the sternoclavicular joint.
3. The acromial end (lateral end) of the clavicle is broad and flattened; it
articulates with the acromion of the scapula, forming the acromioclavicular
joint.
4. The conoid tubercle is a rough tuberosity on the inferior surface near the
acromial end of the clavicle.
5. The costal tuberosity is the inferiorly located prominence at the sternal end
of the clavicle.

127
 B. Scapula (pp. 274–275)
1. The scapula is a broad, flat, triangular bone that forms the shoulder blade.
2. The spine of the scapula is a ridge of bone on the posterior aspect of the
scapula, which is continuous with a larger, posterior process called the
acromion.
3. The coracoid process is the smaller, more anterior projection that is a site for
muscle attachment.
4. The superior border is the horizontal edge of the scapula superior to the
spine.
5. The medial border (also called the vertebral border) is the edge of the
scapula closest to the vertebrae.
6. The lateral border (also called the axillary border) is closest to the axilla.
7. A suprascapular notch (sometimes suprascapular foramen) in the superior
border provides passage for the suprascapular nerve and blood vessels.
8. The superior angle is located between the superior and medial borders.
9. The inferior angle is located between the medial and lateral borders.
10. The lateral angle is made up of the cup-shaped, shallow glenoid cavity, or
glenoid fossa, which articulates with the humerus.
11. The subscapular fossa is the broad, relatively smooth, anterior surface of the
scapula, which is overlaid by the subscapularis muscle.
12. The spine subdivides the posterior surface of the scapula into two shallow
fossae; the depression superior to the spine is the supraspinous fossa, and
inferior to the spine is the infraspinous fossa.
8.9 Bones of the Upper Limb: The upper limb consists of the brachium (arm),
antebrachium (forearm), and hand and contains 30 bones. (pp. 275–277)
A. Humerus (pp. 275–277)
1. The humerus is the longest and largest upper limb bone.
2. The proximal end has a hemispherical head that articulates with the glenoid
cavity of the scapula.
3. The greater tubercle is lateral to the head and helps form the rounded
contour of the shoulder.
4. The lesser tubercle is smaller and located more medial to the head.
5. The intertubercular sulcus is between the two tubercles and contains the
tendon of the biceps brachii muscle.
6. The anatomical neck is an almost indistinct groove that marks the location of
the former epiphyseal plate between the tubercles and the head of the
humerus; the surgical neck is a narrowing of the bone immediately distal to
the tubercles.
7. The shaft of the humerus has a roughened area termed the deltoid
tuberosity, which extends along its lateral surface and is the attachment site
for the deltoid muscle.
8. The radial groove is located adjacent to the deltoid tuberosity and is where
the radial nerve and some blood vessels travel.
9. The medial and lateral epicondyles are bony side projections on the distal
humerus that provide surfaces for muscle attachment.
10. The distal end of the humerus has the rounded capitulum, which is located
and articulates with the head of the radius, and the pulley-shaped trochlea,

128
 which is located medially and articulates with the trochlear notch of the
ulna.
11. The anterolaterally placed radial fossa accommodates the head of the
radius; the anteromedially placed coronoid fossa accommodates the
coronoid process of the ulna; and the posterior depression, called the
olecranon fossa, accommodates the olecranon of the ulna.
B. Radius and Ulna (pp. 277–278)
1. The radius and ulna form the forearm and are parallel in anatomical
position, with the radius located more laterally.
2. The proximal end of the radius has a distinctive disc-shaped head that
articulates with the capitulum of the humerus.
3. A narrow neck extends from the radial head to the radial tuberosity, an
attachment site for the biceps brachii muscle.
4. The shaft of the radius curves slightly and leads to a wider distal end where
there is a laterally placed styloid process.
5. On the distal medial surface of the radius is an ulnar notch, which articulates
with the medial surface of the distal end of the ulna.
6. The ulna is the longer, medially placed bone of the forearm.
7. At the proximal end of the ulna, a C-shaped trochlear notch interlocks with
the trochlea of the humerus.
8. The posterosuperior aspect of the trochlear notch is the olecranon.
9. The inferior lip of the trochlear notch is the coronoid process.
10. Lateral to the coronoid process is a smooth, curved radial notch that helps
form the proximal radioulnar joint.
11. The tuberosity of ulna is located at the proximal end of the bone.
12. At the distal end of the ulna, the shaft narrows and terminates in a knoblike
head that has a posteromedial styloid process.
13. Both the radius and the ulna exhibit interosseous borders, which face each
other and are connected by an interosseous membrane.
14. In anatomic position, the bones of the forearm are said to be in supination;
during pronation, the radius crosses over the ulna and both bones pivot
along the interosseous membrane.
15. The carrying angle of the elbow positions the bones of the forearms such
that the forearms will clear the hips during walking as the forearms swing.
C. Carpals, Metacarpals, and Phalanges (pp. 278–279)
1. The carpals, metacarpals, and phalanges form the wrist and hand.
2. The carpals are small, short bones that form the wrist and are arranged in
two rows of four bones each.
3. The proximal row of carpal bones, listed from lateral to medial, are the
scaphoid lunate, triquetrum, and pisiform.
4. The distal row of the carpal bones, listed from lateral to medial, are the
trapezium, trapezoid, capitate, and hamate.
5. Bones in the palm of the hand are called metacarpals, which articulate with
the distal carpal bones; the metacarpals are denoted by the Roman
numerals I–V, starting laterally.
6. The fourteen phalanges comprise the digits; three phalanges are found in
each of the second through fifth fingers, but only two phalanges comprise
the pollex, or thumb.

129
 7. The proximal phalanx articulates with the head of a metacarpal, while the
distal phalanx is the bone in the very tip of the finger; the middle phalanx
lies between the proximal and distal phalanges and is absent in the thumb.
8. Clinical View: Scaphoid Fractures (p. 279)
a. A scaphoid bone is one of the more commonly fractured carpal bones.
b. Usually, blood vessels are torn on the proximal part of the scaphoid,
resulting in avascular necrosis, and death of the bone tissue occurs due
to inadequate blood supply.
c. Scaphoid fractures take a very long time to heal properly.
8.10 The Pelvic Girdle and Its Functions: The adult pelvis is composed of four
bones: the sacrum, the coccyx, and the right and left ossa coxae; the two os
coxae form the pelvic girdle. (pp. 279–284)
A. Os Coxae (pp. 280–281)
1. The os coxae is commonly referred to as the hip bone and is formed from
three separate bones: the ilium, ischium, and pubis, which fuse during
puberty.
2. Each os coxae articulates posteriorly with the sacrum at the sacroiliac joint.
3. A deep, curved depression on the lateral surface of the os coxae called the
acetabulum articulates with the femur via the lunate surface.
4. The ilium is the largest of the three coxal bones and forms the superior
region of the os coxae and part of the acetabular surface.
5. The wide, fan-shaped portion of the ilium is called the ala, which terminates
inferiorly at a ridge called the arcuate line on the medial surface.
6. On the medial side of the ala is a depression termed the iliac fossa. On the
lateral surface of the ilium, the anterior, posterior, and inferior gluteal lines
are attachment sites for the gluteal muscles.
7. The auricular surface is where the ilium articulates with the sacrum.
8. The superiormost ridge of the ilium is the iliac crest, which arises anteriorly
from a projection called the anterior superior iliac spine and extends
posteriorly to the posterior superior iliac spine.
9. Inferior to the ala of the ilium are the anterior inferior iliac spine and the
posterior inferior iliac spine.
10. The sciatic nerve travels to the lower limb through the greater sciatic notch.
11. The ilium fuses with the ischium near the superior and posterior margins of
the acetabulum.
12. The ischial spine projects medially posterior to the acetabulum.
13. The ischial body is the bulky bone superior to the ischial spine.
14. The lesser sciatic notch is a depression inferior to the ischial spine.
15. The ischial tuberosities are roughened projections that support the weight
of the body when seated.
16. An elongated ramus of the ischium extends from the ischial tuberosity
toward its anterior fusion with the pubis.
17. The pubis fuses with the ilium and ischium at the acetabulum.
18. The inferior pubic ramus fuses with the ischial ramus to form the ischiopubic
ramus.
19. The obturator foramen is a space in the os coxae that is encircled by both
pubic and ischial rami.

130
 20. The pubic crest is a roughened edge located on the anterosuperior surface
of the superior pubic ramus and ends at the pubic tubercle.
21. The symphysial surface denotes the site of articulation between
pubic bones.
22. The pectineal line originates on the medial surface of the pubis and extends
diagonally to merge with the arcuate line.
B. True and False Pelves (p. 282)
1. The pelvic brim is a continuous oval ridge that extends from the pubic crest,
pectineal line, and arcuate line to the rounded inferior edges of the sacral
ala and promontory.
2. The pelvic brim subdivides the pelvis into a true pelvis and a false pelvis.
3. The true pelvis lies inferior to the pelvic brim and encloses the pelvic cavity,
which houses the pelvic organs.
4. The false pelvis lies superior to the pelvic brim and is enclosed by the alae of
the ilia; it houses abdominal organs.
5. The pelvic inlet is the superiorly positioned space enclosed by the pelvic
brim that forms the boundary between the true and false pelves.
6. The pelvic outlet is the inferiorly placed opening bounded by the coccyx, the
ischial tuberosities, and the inferior border of the symphysial surface.
7. The perineum is the body region that covers the pelvic outlet externally.
C. Sex Differences in the Pelvis (pp. 282–283)
1. The most reliable skeletal indicator of sex is the pelvis, primarily the ossa
coxae, which are the most sexually dimorphic bones in the body.
2. The female ilium flares more laterally, is less massive, has more gracile
processes, and has less prominent muscle markings than that of the male.
3. The pelvic inlet of the female is spacious, wide, and oval, whereas the pelvic
inlet of the male is heart-shaped.
4. The greater sciatic notch of the female is wide and shallow, whereas the
greater sciatic notch of the male is narrow, U-shaped, and deep.
5. The obturator foramina of the female are smaller and more triangular than
those of the male.
6. The female subpubic angle is usually greater than 100 degrees; the male
subpubic angle is usually less than 90 degrees.
7. The body of the female pubis is generally longer and more rectangular than
that of the male.
8. The female pelvis has a preauricular sulcus; the male usually does not.
9. The female sacrum is short and wide and has a flatter sacral curvature; the
male sacrum is narrower and longer, with a more curved sacral curvature.
10. The female ischial spine rarely projects into the pelvic outlet, unlike
the male.
D. Age Differences in the Ossa Coxae (p. 284)
1. The ossa coxae are an excellent indicator of age and can provide a reliable
estimate of age at death, given in age ranges.
2. The auricular surface of a young adult typically has some billowing texture to
it, and the surface is fine-grained.
3. As the auricular surface ages, the billowing flattens out and becomes more
coarse and granular.

131
 4. In much older people, the surface may develop some bony lipping and
become even more rough and irregular.
5. In a young adult (age range 15–24), the symphysial surface is billowed,
and no well-formed rim is found.
6. The bony rim of the symphysial surface is complete about ages 35–50.
7. Once the rim is complete, the symphysial surface becomes depressed and
concave and may become pitted; the rim may start to break down and bony
lipping develops after the age of 50.
8.11 Bones of the Lower Limb: The lower limb comprises the thigh, leg, and
foot and contains 30 bones. (pp. 284–290)
A. Femur and Patella (pp. 284–286)
1. The femur is the longest bone in the body as well as the strongest
and heaviest.
2. The nearly spherical head of the femur articulates with the os coxae at the
acetabulum.
3. The fovea is a tiny depression within the head of the femur where a ligament
connects the head of the femur to the acetabulum.
4. Distal to the head, an elongated, constricted neck joins the shaft of the
femur at an angle.
5. The greater trochanter projects laterally from the junction of the neck and
shaft, and the lesser trochanter is on the femur’s posteromedial surface;
these are connected on the posterior surface by a thick ridge of bone called
the intertrochanteric crest.
6. An intertrochanteric line marks the distal edge of the hip joint
capsule anteriorly.
7. The pectineal line marks the attachment of the pectineus muscle, and the
gluteal tuberosity marks the attachment of the gluteus maximus muscle;
these merge into an elevated, midline ridge called the linea aspera.
8. The linea aspera branches distally into medial and lateral supracondylar
lines, which surround the popliteal surface.
9. The medial supracondylar ridge terminates in the adductor tubercle.
10. The medial and lateral condyles are smooth, oval articulating surfaces on the
distal, inferior surface of the femur.
11. Superior to the condyles are the medial epicondyle and lateral epicondyle.
12. The deep intercondylar fossa separates the two condyles.
13. The patellar surface is a smooth medial depression on the anterior
surface where the femur articulates with the patella.
14. The patella, or kneecap, is a sesamoid bone housed within the tendon of the
quadriceps femoris muscle.
15. The superior base of the patella is broad, whereas the apex is pointed.
16. The posterior aspect of the patella has an articular surface that articulates
with the femur.
B. Tibia and Fibula (pp. 286–287)
1. The crural region has two parallel bones: the thick, strong tibia, and
a slender fibula.
2. The tibia and fibula are connected by an interosseous membrane that
extends between their interosseous borders.

132
 3. The tibia is the medially placed bone and is the only weight-bearing bone of
the crural region.
4. The head of the tibia has two relatively flat surfaces, the medial and lateral
condyles, separated by the intercondylar eminence.
5. On the proximal posterolateral side of the tibia is a fibular articular surface
joint, where the head of the fibula articulates to form the superior
tibiofibular joint.
6. The tibial tuberosity is the rough anterior surface near the
proximal condyles.
7. The anterior border, or shin, is a prominent ridge on the anterior surface.
8. The medial malleolus is a large, prominent process at the tibia’s
medial border.
9. The fibular notch on the distal posterolateral side of the tibia where the
fibula articulates forms the inferior tibiofibular joint.
10. The smooth inferior articular surface is located inferiorly on the tibia and
articulates with the talus.
11. The fibula is the long, thin, laterally placed bone of the leg which does not
bear any weight.
12. The rounded, knoblike head of the fibula is slightly inferior and posterior to
the lateral condyle of the tibia.
13. Distal to the fibular head is the neck of the fibula, followed by its shaft.
14. The fibula’s distal tip is called the lateral malleolus, which extends laterally
to the ankle joint, providing lateral stability.
C. Tarsals, Metatarsals, and Phalanges (pp. 288–289)
1. The bones that form the ankle and foot are the tarsals, metatarsals, and
phalanges.
2. The talus, calcaneus, and navicular bone are the proximal row of
tarsal bones.
3. The talus is the superiormost and second largest tarsal bone, which
articulates with the tibia.
4. The calcaneus is the largest tarsal bone and forms the heel.
5. The navicular bone is on the medial side of the ankle.
6. The distal row of four tarsal bones includes the cuneiforms and the
cuboid bone.
7. The medial cuneiform, intermediate cuneiform, and the lateral cuneiform
bones are wedge-shaped bones that articulate with and are positioned
anterior to the navicular bone.
8. The laterally placed cuboid bone articulates with the lateral cuneiform and
the calcaneus.
9. The metatarsals of the foot are five long bones that form the arched sole of
the foot and are identified with Roman numerals I–V, proceeding medially
to laterally.
10. The metatarsals articulate proximally either with the cuneiform bones or the
cuboid bone; distally, each metatarsal bone articulates with a proximal
phalanx.
11. The bones of the toes are called phalanges; each toe has three phalanges,
except the hallux, or great toe, which has two.
12. Clinical View: Pathologies of the Foot (p. 288)

133
 a. A bunion is a localized swelling at the first metatarsophalangeal joint
that causes the toe to point toward the second toe instead of in a purely
anterior direction.
b. Pes cavus, or clawfoot, is characterized by excessively high longitudinal
arches.
c. With talipes equinovarus, or congenital clubfoot, the feet are
permanently inverted, and the ankles are plantar flexed, as if the
patient were trying to stand on tiptoe.
d. Pes planus, or flat feet, is where the medial longitudinal arch is flattened
so that the entire sole touches the ground.
e. A metatarsal stress fracture usually results when repetitive pressure or
stress on the foot causes a small crack to develop in the outer surface of
the bone.
D. Arches of the Foot (pp. 289–290)
1. The sole of the foot is arched, which helps it support the weight of the body.
2. The medial longitudinal arch is the highest of the three arches and extends
from the heel to the hallux, and is formed from the calcaneus, talus,
navicular, cuneiform bones, and metatarsals I–III.
3. The lateral longitudinal arch extends between the little toe and the heel, and
is formed from the calcaneus and cuboid bones, and metatarsals IV and V.
4. The transverse arch is formed from the distal row of tarsals and the bases of
all five metatarsals.
8.12 Development of the Skeleton: Bones are formed by either
intramembranous ossification or endochondral ossification. (pp. 291–292)
1. The appendicular skeleton begins to develop during the fourth week, when
limb buds appear as small ridges along the lateral sides of the embryo.
2. Lower limb development lags behind upper limb development by 2–4 days.
3. The limbs form proximodistally, meaning the proximal parts of the limbs
form first.
4. Early limb buds are composed of lateral plate mesoderm and covered by a
layer of ectoderm; the musculature of the limbs forms from somatic
mesoderm.
5. At the apex of each limb bud, part of the ectoderm forms an elevated
thickening called the apical ectodermal ridge, which “signals” the underlying
tissue to form the components of the limb.
6. The distal portions of the upper limb buds form a rounded, paddle-shaped
hand plate in the fifth week; a corresponding foot plate forms during the
sixth week.
7. The hand and foot plates develop longitudinal thickenings called digital rays
in the sixth and seventh weeks, respectively, which eventually form the
digits.
8. The digital rays initially are connected by intermediately placed tissue,
which later undergoes apoptosis, forming separate digits by the eighth
week.
9. Clinical View: Limb Malformations (p. 292)
a. Polydactyly is the condition of having extra digits and appears to
have a genetic component.

134
 b. Ectrodactyly is the absence of a digit and also appears to run in
families.
c. Syndactyly refers to “webbing” or abnormal fusion of the digits,
which occurs when the intermediate tissue between the digital
rays fails to undergo apoptosis.
d. Amelia refers to the complete absence of a limb, whereas
meromelia refers to the partial absence of the limb.
e. Phocomelia refers to a short, poorly formed limb that resembles
the flipper of a seal.
f. A notable instance of limb malformation involved the drug
thalidomide, which was prescribed in 1954 to help with morning
sickness in pregnant mothers.
g. In the late 1950s and early 1960s, the incidence of limb
malformations skyrocketed, and thalidomide was later found to
bind to particular regions of DNA, “locking up” specific genes and
preventing their expression.
h. Thalidomide is a classic example of how teratogens can affect the
delicate cycle.

Discussions, In Class Visuals, and Demonstrations

1. Demonstrate the important differences between the fetal and the adult skull.
2. Show students how to palpate skull markings.
3. Discuss the importance of the intervertebral discs and spinal curvatures.
4. Chart the bones of the axial skeleton, and the importance of the markings on
each one of them.
5. Show students how to examine the normal spinal curvatures; discuss abnormal
spine curvatures.
6. Demonstrate the relationship between the ribs and the vertebrae.
7. Using the SMART Board, compare and contrast the relative functions and the
stability of the two girdles (pectoral and pelvic).
8. Show students how to palpate the surface anatomy of the pectoral girdle and
the upper limb.
9. Show students how to palpate the surface anatomy of the pelvic girdle.
10. Using the SMART Board, compare and contrast the male and female pelvises.
11. Demonstrate how to construct a skeleton.
12. Demonstrate how to arrange unmarked, disarticulated bones in proper relative
position to form a skeleton.

Related Media
The Axial Skeleton DVD, Standard Deviants.
Anatomy for Artists: The Human Head DVD, Larry Withers.
HD Bones Anatomy 1.0, Jose Barrientos.
Biology: The Axial Skeleton, Thinkwell.
Atlas of Human Anatomy, #4 - Head & Neck, Part 1 DVD, Robert Acland.

135
Axial Skeleton, Films Media Group.
Kinesiology: The Skeletal System and Muscle Function DVD, Elsevier Inc.
Biomechanics; Insight media
Scoliosis: an abnormal curvature of the spine; NIMCO
Anatomy trainer; NIMCO
Interactive atlas of clinical anatomy; NIMCO

136