Chapter 5

THE SKELETAL AND JOINT SYSTEM

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,

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THE SKELETAL AND JOINT SYSTEM

· Parts of the skeletal system

· Bones (skeleton)
· Joints
· Cartilages
· Ligaments (bone to bone)(tendon=bone to muscle)

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Skeletal System
Divided into two divisions
1. The axial skeleton consists of the bones of:
- head (cranium)
- neck (cervical vertebrae)
- trunk (Thoracic vertebrae)
- Abdomen (Lumbar vertebrae),
- Sacral vertebrae
- coxgial vertebrae and
- ribs, sternum
1. The appendicular skeleton consists of the bones of
the limbs, including those forming the pectoral
girdles(shoulder) and pelvic girdles.
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Functions of Bones

1. Protection- of soft tissues and organs.

2. Assistance in movement – muscles attached to
bones= function as levers.
3. Storage – of minerals (Calcium and
Phosphorous) and lipids ( yellow marrow)
4. Blood Cell Formation- hematopoiesis- occurs
within the red-marrow of the bone.
5. Support- for the entire body; Individual bones
provide a framework for attachment of soft
tissues and organs.
6. Triglyceride storage
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Rickets develops from an improper diet
and also from lack of the sunlight needed to synthesize
vitamin D.

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 Types of bones tissues
· The skeleton has 206 bones
· Two basic types of bone tissue
· Compact bone
· Dense bone tissue
· Homogeneous
(minor spaces)
· Spongy bone
· Surrounded by dense bone(compact bone)
· Small pieces of bone (trabeculae)
· Many open spaces lie b/n trabeculae, filled with RBM

compact & sponge bones they differs each other by their arrengement
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Types of Bone Cells
· Osteocytes
· Mature bone cells
· Osteoblasts
· Bone-forming cells
· Osteoclasts
· Bone-destroying cells
· Break down bone matrix for remodeling and release of
calcium
· Bone remodeling is a process by both osteoblasts and
osteoclasts
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Red bone marrow (RBM)
• Is found in the spaces of spongy bones
• a specialized tissue that produces blood cells by the
process called hematopoiesis,
• In infants, hematopoiesis occurs in the RBM’s of
almost all bones

• In adults, hematopoiesis is limited in the spongy

bone of the flat and irregular bones, and in the
proximal ends of the humerus and femure (long
bone).
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Histology of Compact Bone
• contains many cylinder-shaped structural units
called osteons (haversian system).
• The osteocytes (bone cells) are in tiny chambers
called lacunae that occur between concentric
layers of matrix called lamellae.
• The matrix of each lamellae contains
collagenous protein fibers and mineral deposits,
primarily of calcium and phosphorus salts.
• Small canals communicating the lacunae of an
osteon transversely are
01/11/2024 called canaliculi
By: L.Y. 12
· The canaliculi convey neurovascular structures
from central canal (haversian canal) to
lacunae or from one lacunae to the other.
· The central canal is a single longitudinal canal
in the center of the osteon
· Perforating (Volkman’s) canal
· Canal traversing an osteon perpendicular to the
central canal
· Carries blood vessels and nerves the central canal
of an osteon
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Microscopic Anatomy of Bone

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Microscopic Anatomy of Bone

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Classification of Bones
1. Long bones 2. Short bones
· Typically longer than · Generally cube-
wide
shape
· Have a shaft with
· Contain mostly
heads at both ends
spongy bone
· Contain mostly
compact bone · Examples:
Carpals, tarsals
• Examples: Femur,
humerus
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3. Flat bones 4. Irregular bones
· Thin and flattened · Irregular shape
· Usually curved · Do not fit into other
· Thin layers of compact bone classification
bone around a layer of categories
spongy bone
· Example:
· Examples: Skull, Vertebrae and hip
ribs, sternum,
scapula
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Classification of Bones on the Basis of Shape

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 5. Sesamoid bone:
– is a special type of short bone
– forms in a tendon where there is
physical stress
e.g. the patella

The function of sesamoid bones is

 to protect tendon from excessive
wear and tear.

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• A

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 Gross Anatomy of a Long Bone
· Diaphysis
· Shaft
· Composed of compact
bone surrounding
medullary cavity filled
with yellow marrow
· Epiphysis
· Ends of the bone
· Composed mostly a core of
spongy bone with RBM
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· Hyaline cartilageous plate b/n
epiphysis and diaphysis is
called epiphysial plate
· Becomes epiphysial line when
growth stops (completely
ossified)

· Articular cartilage
· Covers the articulating ends of
bones
· Made of hyaline cartilage
· Decreases friction at joint surfaces
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 Structures of a Long Bone

· Periosteum
· Outside dense fiberous
covering of the bone

· Contains vessels and nerves to

the bone tissue

· Is essential for bone growth,

repair, and nutrition; a
point of attachment for
ligaments and tendons
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 .

• Endosteum: Is a
connective tissue
membrane that lines the
internal surfaces of all
bones

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 Bone development
All bones derived from mesenchyme by two processes
1. Intramembranous ossification:- mesenchymal
model of bones form during embryonic period &
direct ossification of mesenchyme begins in the fetal
period membranous bones.
a. development of ossification center
b. calcification
c. formation of tuberculae
d. development of periosteum
2. Endochondral ossification:- cartilage models of the
bones form from mesenchyme during fetal period &
bone subsequently replaces most of the
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cartilage/cartilagenous bones
cont..
endochondrial ossification
a. development of cartilage model
b. growth of cartilage model
c.development of primary ossification center
d. development of medullary(marrow) cavity
e. development of secondary ossification center
f. formation of articular cartilage & the
epiphyseal (growth) plate

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Bone developement

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 Bone Growth
Two types of growth are involved :
(i) Interstitial growth - a growth from within
(epiphysial plate), results in an increase in length.
consists of four zones
1. zone of resting cartilage
2. zone of proliferating cartilage
3. zone of hypertrophic cartilage
4. zone of calcified cartilage
(ii) Appositional growth - a growth by which matrix
is deposited on its surface (from outside) = girth
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· Epiphyseal plates allow for growth of long bone during
childhood
· New cartilage is continuously formed
· Older cartilage becomes ossified
· Cartilage is broken down
· Bone replaces cartilage
· Bones are remodeled and lengthened until growth stops
· Bones change shape somewhat
· Bones grow in width

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Arthrology (Joint system)
Joints (articulations)
• Where parts of skeleton meet
• Allows varying amounts of mobility
• Classified by structure or function
• Arthrology: study of joints

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 Classification of Joints

• By Function/degree of movement:
– Synarthroses (fiberous) = no/little
movement

– Amphiarthroses (cartilageous) = slight

movement

– Diarthroses (synovial)= great movement

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 Joints by Functional Classification
Type Movement Example
Synarthroses None (minimal) Sutures, Teeth,
Epiphyseal plates,

Amphiarthroses Slight Intervertebral discs

Pubic symphysis

Diarthroses Great Glenohumeral joint

Knee joint
TMJ (Temporo
Mandibular Joint)
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 Joint Classification by Structure
– Cartilagenous
• Synchondrosis: connected by hyaline cartilage
(synarthrosis)Ex. first sternocostal joint
• Symphysis: connected by fibrocartilage
(amphiarthrosis). Ex. Symphysis pubis
– Fibrous
• Sutures: connected by short strands of dense CT fibers
(synarthrosis)
• Gomphosis: peg like short ligament in socket
(synarthroses). Ex. Teeth (Dentoalviolar socket)
• Syndesmosis: connected by ligaments. Ex. B/n Tibia and
Fibula
– Synovial (diarthrosis)-with synovial membrane & cavity
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 Joints by Structural Classification
Structure Type Example
Cartilagenous Synchondrosis Epiphyseal plates
Symphysis Intervertebral discs

Fibrous Sutures Skull

Syndesmosis Distal Tibia/fibula
Gomphosis Teeth in sockets

Synovial Glenohumeral joint

Knee joint
TMJ (Temporomandibular
joint)
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 Components of SYNOVIAL JOINTS:

• Articular cartilage: covers ends of both bones

• Synovial (joint) cavity: space holding synovial
fluid
• Articular capsule: Made of 2 layers
– Fibrous: external, dense CT for strength
– Synovial membrane: internal, produces synovial fluid

• Reinforcing ligaments: extracapsular/intracapsular

• Nerves + vessels: Highly innervated, Highly
vascular
• Meniscus (in some): fibrocartilage; improves the
fit of two bones to increase
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stability 37
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Types of synovial joint:
by shape

• Hinge: cylindrical end of one bone

fits into trough shape of other end
– angular movement-one plane (eg)
elbow, ankle, interphalangal

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cont..

• Plane: articular surface in flat plane

– Short gliding movement
– (eg) intertarsal, articular processes of
vertebrae

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 Plane joint permit gliding or sliding movements
Example: Auricular process of vertebrae

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 cont..

• Condyloid: egg-shape articular surface +

oval concavity
– side-to-side, back + forth movement
– (eg) metacarpophalangeal (knuckle)

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 cont..

• Pivot: round end fits into ring of bone +

ligament
– rotation on long axis
– (eg) proximal radio-ulna, atlanto-axial joint

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 cont.

• Saddle: articular surface both concave +

convex
– side-to-side, back-forth movement
– (eg) carpometacarpal joint of thumb

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 cont..

• Ball + Socket: spherical head + round

socket
– multiaxial movement
– (eg) shoulder, femur

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 The Axial Skeleton

· Forms the
longitudinal part
of the body
· Divided into
three parts
· Skull
· Vertebral column
· Bony thorax
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The Skull
· Two sets of bones
· Cranium (8 bones)
· Facial bones (14)

· Bones are joined by

sutures
· Only the mandible
is attached by a
freely movable joint
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 Cranial Bones
• The cranial bones makeup the protective frame of
bone around the brain. The cranial bones are:
• The frontal forms part of the cranial cavity as well
as the forehead, the brow ridges and the roof of
nasal cavity.
• The left and right parietal forms much of the
superior and lateral portions of the roof of
cranium.
• The left and right temporal form the lateral walls
of the cranium as well as housing the ears.
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 Cranial Bones..cont’d

• The occipital forms the posterior and inferior

portions of the cranium.
• Many neck muscles attach here as this is the point
of articulation with the neck.
• The sphenoid forms part of the eye orbit and helps
to form the floor of the cranium.
• The ethmoid forms the medial portions of the
orbits and the roof and lateral wall of the nasal
cavity.

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 Facial Bones
• The facial bones makeup the upper and lower jaw
and other facial structures.
• The facial bones are:
• The mandible is the lower jawbone.
• It articulates with the temporal bones at the
temporomandibular joints.
• This forms the only freely moveable joint in the
head.
• It provides the chewing motion.

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Facial Bones..cont’d

• The left and right maxilla are the upper jaw

bones. They form part of the nose, orbits, and
roof of the mouth (hard palate).
• The left and right palatine form a portion of
the nasal cavity and the posterior 1/3 rd of hard
palate.
• The left and right zygomatic bones (cheek
bones). They form portions of the orbits as
well.

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 cont’d

• The left and right nasal form the superior portion

of the bridge of the nose.
• The left and right lacrimal help to form the medial
wall of the orbits.
• The vomer forms part of the nasal septum (divide
the nasal cavity in to two).
• The left and right inferior nasal concha project
from the lateral walls of the nasal cavity and
increases the surface area of the nasal cavity.

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• Sutures:
– Found only b/n the bones of the skull
– characterized by a thin layer of dense regular
connective tissue that binds the articulating
bones.
– Examples
1. coronal suture- between the parietal bones
and the frontal bone
2. lambdoidal suture- between the parietal
bones and occipital bone
3. squamosal suture- between each parietal
bone and each temporal bone
4. sagittal suture- between the parietal bones
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The Fetal Skull
• The fetal skull is large
compared to the infants
total body length
· Fontanelles – fibrous
membranes connecting
the cranial bones
· Allow the brain
to grow
· Convert to bone within
24 months after birth
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 Fontanells
1. anterior fontanel
– located at the midline among
the two parietal bones and the
frontal bones
– is roughly diamond-shaped
– is the largest fontanel.
– closes 18 to 24 months after
birth.
2. posterior fontanel
– located at the midline among
the two parietal bones and the
occipital bone.
– closes about 2 months after
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birth.
 Fontanells
3. Sphenoidal fontanel
– located laterally among the
frontal, parietal, temporal, and
sphenoid bones
– are small and irregular in shape.
– close about 3 months after birth.
4. Mastoid fontanel
– located laterally among the
parietal, occipital, and temporal
bones
– are irregularly shaped.
– begin to close 1 to 2 months
after birth
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 The Vertebral Column

· The vertebral column (also

called the backbone, spine, or
spinal column) consists of a
series of irregularly shaped
bones, called vertebrae.
· The vertebrae are 33 bones in
chidrens and reduced to 26 in
adults
· are divided into five categories
depending on where they are
located in the backbone. By: L.Y.
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• The first seven vertebrae are called the cervical vertebrae.
Located at the top of the spinal column, these bones form a
flexible framework for the neck and support the head. The
first cervical vertebrae is called the atlas and the second is
called the axis. The atlas' shape allows the head to nod "yes
movement" and the axis' shape allows the head to shake "no
movement".
• The next twelve vertebrae are called the thoracic vertebrae.
These bones articulate with the ribs to form rib cage.
Thoracic vertebrae are larger than cervical vertebrae and
increase in size from top to bottom.
• After the thoracic vertebrae, come the lumbar vertebrae on
the posterior abdominal wall. These five bones are the
largest vertebrae in the spinal column. These vertebrae
support most of the body's weight and are attached to many
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of the back muscles.
• The sacrum is a triangular bone located just below the
lumbar vertebrae. It consists of four or five sacral
vertebrae in a child, which become fused into a single
bone after age 26.
• The lower tip of the spinal column is called the coccyx or
tailbone. It consists of 4-5 bones that are fused together
in an adult. Many muscles connect to the coccyx.
• Fusion of sacral and coccygeal bones, reduces the total
number of 33 vertebrae in children to 26 movable parts
in an adult.
• In b/n the vertebrae are intervertebral discs made of
fibrous cartilage that act as shock absorbers and allow
the back to move slightly.
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• When looked at from the side, the spine forms four
curvitures. These curves are called the cervical,
thoracic, lumbar, and sacral curvitures
• The cervical curve is located at the top of the spine and
is composed of cervical vertebrae. Next come the
thoracic and lumbar curvitures composed of thoracic and
lumbar vertebrae respectively.
• The final curve called the pelvic or sacral curviture is
formed by the sacrum and coccyx.
• These curves allow human beings to stand upright and
help to maintain the balance of the upper body.

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• The cervical and lumbar curves are not present in an
infant. The cervical curves forms around the age of 3
months when an infant begins to hold its head up and the
lumbar curve develops when a child begins to walk.

• In addition to allowing humans to stand upright and

maintain their balance, the vertebral column serves several
other important functions. It helps to support the head and
arms, while permitting freedom of movement. It also
provides attachment for many muscles, the ribs, and some
of the organs and protects the spinal cord, which controls
most bodily functions.
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The Bony Thorax

• Forms a cage to
protect major organs
· Made-up of three
parts
· Sternum
· Ribs
· Thoracic vertebrae
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Ribs
• There are three types of ribs based on their attachment:
1. True (vertebrocostal) ribs (1st-7th ribs):
– They attach directly to the sternum through their own costal
cartilages.
2. False (vertebrochondral) ribs (8th, 9th, and 10th
ribs):
– Their cartilages are connected to the cartilage of the rib
above them; thus their connection with the sternum is
indirect.
3. Floating (vertebral, free) ribs (11th and 12th ribs):
– These ribs do not connect even indirectly with the sternum;
instead they end in the posterior
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of abdominal musculature. 68
• Based on typical features the ribs contain:

• Typical ribs (3rd-9th) have the following

components:
– Head: wedge-shaped and has two facets, separated
by the crest of the head
– Neck: connects the head of the rib with the body at
the level of the tubercle.
– Tubercle: located at the junction of the neck and
body
– Body (shaft): thin, flat, and curved, most markedly
at the costal angle where
01/11/2024 the rib turns anterolaterally. 69
By: L.Y.
 Sternum (breast bone)

•an elongated, flattened bony

plate
•consist of three parts:
manubrium (upper part)
Body(the central part), and
xiphoid process
•another uncounted
components are
• sternal angle
• sternoxiphoid joint

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The Appendicular Skeleton

· Limbs
(appendages)
· Pectoral girdle
· Pelvic girdle

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 The Pectoral Girdle

· Composed of two bones

· Clavicle- S-shaped bone on
the root of neck anteriorly
· Scapula – triangular plate of
bone at the back of the chest

· These bones connect the

free upper limb with axial
skeleton
· allow the upper limb to
have free movement
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Bones of the Upper Limb
· The arm has
· Humerus- is the largest bone of upper limb.
· Its proximal end is the head of humerus

• The forearm has two bones

• Ulna- medially
• Radius- laterally
• Only the ulna, which is larger proximally,
articulates with humerus at elbow joint
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The Arm
• The arm, or brachium, is technically only the region
between the shoulder and elbow. It consists of a single
long bone called the humerus. The humerus is the
longest bone in the upper extremity.
• The proximal end, or head, is large, smooth, and
rounded and fits into the scapula to form the shoulder
joint
• The distal end of the humerus protects the ulnar nerve
and is commonly known as the "funny bone" because
striking the elbow on a hard surface stimulates the
ulnar nerve and produces a tingling sensation
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The Forearm
• The forearm is the region b/n the elbow and the
wrist.
• It is formed by the radius on the lateral side and
the ulna on the medial side when the forearm is
viewed in the anatomical position.
• The two bones are connected with each other by
fibrous membrane called interosseous membrane
• The ulna is longer than the radius and connected
more firmly to the humerus at elbow joint
• The radius, however, contributes more to the
movement of the wrist and hand than the ulna.
• During pronation, the radius crosses over the ulna.
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Arm and forearm bones

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 .

· The hand
· Carpals – wrist bone, are cuboid in shape
· The carpals are arranged as.
· proximal row (lateral to medial) scaphoid, lunate, triquetrum, and pisiform
(She Likes To Play)
· distal row (lateral to medial) are the trapezium, trapezoid, capitate, and
hamate (Try To Catch Her)
Another Version: Some Lovers Try Positions That They Can't Handle"

· Metacarpals – palm bones

· Numbered 1 to 5 from lateral (thumb) to medial side (little finger).

· Phalanges – finger bones

· Except the thumb, which contains only two phalynx, the other four
digits have three (proximal, middle and distal phalynx)
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Bones of the lower limb
Pelvic Girdle
· Is a ring of bones formed by two hip bones,
sacrum and coccyx. Surrounds and protects the
pelvic organs like bladder, uterus, rectum, glands.
· Hip bones
· Formed by fusion of three bones: these are
· Ilium- broader upper part, articulates with sacrum
at sacroiliac join
· Ischium- infero-posterior part, which transfers the
weight of the upper body to the chair in sitting
position
· Pubic bone- anterio-medial part, which articulates
with contralateral side at pubic symphysis
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 Bones of the Pelvic girdle

• The bones are

– left & right
pelvic bones
– Sacrum
– Coccyx

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 Pelvic girdle
• The hip bone is
originally made
up of 3 bones
that have fused:

1. ilium
2. pubis
3. ischium

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Parts of the pelvis:-
1. Greater pelvis is part of
pelvis:
– Superior to pelvic inlet.
– Occupied by abdominal
viscera.

2. Lesser pelvis is part of

pelvis:
– Between pelvic inlet and
outlet.
– It includes the true pelvic
cavity and deep partsBy:ofL.Y.
01/11/2024 83
perineum.
Regions of true pelvis and their measurement

• Are pelvic inlet, cavity &

outlet.
1. Pelvic inlet/ pelvic brim or
upper pelvic aperture:-
– oval (female) or heart-
shaped (male) opening.
– Is larger in females than
males.
– periphery is demarcated
by linea terminalis
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2. Pelvic cavity:-
 is longer in its posterior
wall than its anterior.
 it contains rectum,
bladder, &
reproductive organs.

3. pelvic outlet or lower pelvic

aperture:-
 diamond shaped opening
w/c is wider in females
than males.

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Diameters of the outlet are :-
a. Anterio-posterior diameter –
• from apex of coccyx to mid point of the
lower pubic symphysis.
• Measures 8 cm in male & 12.5 cm in female.

b. Transverse diameter -
• is b/n ischial tuberosities from lower border of
their medial surfaces.
• 8.5 cm in male & 13.5 cm in female.

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01/11/2024 By: L.Y. 87
Types of female pelvis
• On the basis of shape & size of pelvic inlet the
following four types are distinguished:

1. Gynecoid pelvis:-
– found in 41- 44% of females.
– transverse diameter is greater than
AP diameter.
– the sub pubic arch corresponds to
that b/n an extremely abducted
thumb and index finger (app. 90ᵒ).
– This is a typical female pelvis.
– its pelvic inlet typically has a
rounded oval shape and a wide
transverse diameter
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2. Android pelvis (male like):-

– is found 23-32% of female .

– heart shaped inlet &
contracted outlet.
– AP diameter is short.
Therefore, pelvic cavity is
smaller.
– the sub pubic angle
corresponds to the angle b/n
the abducted index & middle
fingers (70ᵒ ).
– arrest of fetal head may
occur during delivery.
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3. Anthropoid pelvis (ape like):

– found in 23-28% of female .

– it is long, narrow & oval In shape.
– It is more common in non-white
females (it makes up about 25% of
pelvic type in white women and
close to 50% in non-white women).
– at inlet long AP diameter & a short
transverse diameter.
– fetal head during delivery is
engaged with head in AP diameter.
– Delivery is usually easy.

01/11/2024 By: L.Y. 90

 4. Platypelloid (flat)
pelvis:
– found in about 2-5% of
females.
– it is wide pelvis flattened at
the inlet
– the AP diameter of the pelvic
outlet is short
– therefore, delivery is usually
difficult.
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COMPARISON OF FEMALE AND
MALE PELVES
 The female’s pelvis is wider and shallower
than the male’s
 Consequently, there is more space in the true
pelvis of the female, especially in the pelvic
inlet and pelvic outlet,
 Important to accommodate the passage of the
infant’s head at birth

01/11/2024 By: L.Y. 92

COMPARISON OF MALE & FEMALE BONY PELVIS

Bony pelvis male Female

General structure Thick & heavy Thin & light

Greater pelvis Deep Shallow

Lesser pelvis Narrow & deep, tapering Wide & shallow, cylindrical

Pelvic inlet Heart - shaped, narrow Oval & round; wide

Pelvic outlet Comparatively small Comparatively large

Pubic arch & sub pubic Narrow (<70ᵒ) Wide (>80ᴼ)

angle

Obturator foramen Round Oval

Acetabulum Large Small

Greater sciatic notch

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Narrow (~70ᴼ)
By: L.Y.
Almost 90ᴼ 93
 Heart shaped,
Oval and rounded; wide
narrow

large small

Narrow and
Wide and
deep tapered
shallow,
cylindrical
obtuse angle
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acute
01/11/2024 By: L.Y. 95
 Obtuse angle Acute angle

01/11/2024 By: L.Y. 96

Female Male
 Bones of the Lower Limbs
•The lower extremity is composed of the bones of the
thigh, leg, foot, and the patella (commonly known as the
kneecap).

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The Thigh
• The thigh is the region between the hip and the knee and is
composed of a single bone called the femur or thighbone.
The femur is the longest, largest, and strongest bone in the
body.

The Leg
• The leg is technically only the region from the knee to the
ankle. It is formed by two bones, the fibula on the lateral
side and the tibia, also called the shin bone, on the medial
side. The two bones are connected by the interosseous
membrane
• The tibia connects to the femur to form the knee joint and
with the talus, a foot bone, to form ankle joint
• The tibia is larger than the fibula because it bears most of the
weight, while the fibula serves
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By: L.Y. 98
The Patella
• The patella or kneecap is a large, triangular sesamoid
bone between the femur and the tibia anterior to the knee
joint.
• It is formed in response to the strain in the quadriceps
tendon that crosses the knee joint. The patella protects
the knee joint
• The bones of the lower extremities are the heaviest,
largest, and strongest bones in the body because they
must bear the entire weight of the body when a person is
standing in the upright position.

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Bones of the Lower Limbs

· The foot
· Tarsus(7) – ankle
· Metatarsals(5) –
sole
· Phalanges(14) –
toes

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The Foot
• The ankle, or tarsus, is composed of the 7 tarsal
bones which correspond to the carpals in the
wrist.
• The largest tarsal bone is called the calcaneus or
heel bone.
• The talus rests on top of the calcaneus and is
connected to the tibia above forming ankle joint.
• Directly anterio-inferior to the talus is the
navicular bone.
• The remaining bones from medial to lateral are
the medial, intermediate,
01/11/2024 By: L.Y. the lateral cuneiform101
• The five metatarsal bones are numbered I to V
starting on the medial side with the big toe.
• The first metatarsal bone is larger than the
others because it plays a major role in
supporting the body's weight.
• The 14 phalanges of the toe are organized as of
the fingers of hand
– except the big toe (hallux), which have only a
proximal and distal phalanx, in the remaining
four digits arranged in a proximal row, a
middle row, and a distal row
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Arches of foot

• longitudinal arch has two parts

– Medial longitudinal arch: calcaneus, talus,
navicular, three cuneiforms, and heads of the three
medial metatarsals.
– lateral longitudinal arch: calcaneus, cuboid and
heads of the two lateral metatarsals.

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Arches of foot
• transverse arch formed by:
navicular/medially/, three cuneiforms, and the
bases of the five metatarsals.

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