WEEK 13 • Acromion.

The acromion is the enlarged

end of the spine of the scapula and
THE APPENDICULAR SKELETON
connects with the clavicle laterally at the
The appendicular skeleton includes all acromioclavicular joint.
bones of the upper and lower limbs, plus the
• Coracoid. The beaklike coracoid process
bones that attach each limb to the axial
points over the top of the shoulder and
skeleton. There are 126 bones in the
anchors some of the muscles of the arm;
appendicular skeleton of an adult.
just medial to the coracoid process is the
BONES OF THE SHOULDER GIRDLE large suprascapular notch, which serves
as a nerve passageway.
Each shoulder girdle, or pectoral girdle,
consists of two bones – a clavicle and a • Borders of the scapula. The scapula has
scapula. three borders- superior, medial
(vertebral), and lateral (axillary).

• Angles of the scapula. It also has three

angles- superior, inferior, and lateral; the
glenoid cavity, a shallow socket that
receives the head of the arm bone, is in
the lateral angle.

• Factors to free movement of the

shoulder girdle. Each shoulder girdle
attaches to the axial skeleton at only one
point- the sternoclavicular joint; the loose
attachment of the scapula allows it to
slide back and forth against the thorax as
muscles act; and, the glenoid cavity is
shallow, and the shoulder joint is poorly
reinforced by ligaments.

• Clavicle. The clavicle, or collarbone, is a BONES OF THE UPPER LIMB

slender, doubly curved bone; it attaches
to the manubrium of the sternum Thirty separate bones form the skeletal
medially and to the scapula laterally, framework of each upper limb; they form the
where it helps to form the shoulder joint; foundations of the arm, forearm, and hand.
it acts as a brace to hold the arm away 1. Arm
from the top of the thorax and helps
prevent shoulder dislocation. The arm is formed by a single bone, the
humerus, which is a typical long bone.
• Scapulae. The scapulae, or shoulder
blades, are triangular and commonly • Anatomical neck. Immediately inferior to
called “wings” because they flare when the head is a slight constriction called
we move our arms posteriorly. anatomical neck.

• Parts of the scapula. Each scapula has a • Tubercles. Anterolateral to the head are
flattened body and two important two bony projections separated by the
processes- the acromion and the intertubercular sulcus– the greater and
coracoid. lesser tubercles, which are sites of
muscle attachment.
 • Surgical neck. Just distal to the tubercles • Styloid process. Both the ulna and the
is the surgical neck, so named because radius have as styloid process at their
it is the most frequently fractured part of distal end.
the humerus.
• Radial tuberosity. The disc-shaped head
• Deltoid tuberosity. In the midpoint of the of the radius also forms a joint with the
shaft is a roughened area called the capitulum of the humerus; just below the
deltoid tuberosity, where the large, fleshy head is the radial tuberosity, where the
deltoid muscle of the shoulder attaches. tendon of the biceps muscle attaches.

• Radial groove. Nearby, the radial groove • Ulna. When the upper limb is in
runs obliquely down the posterior aspect anatomical position, the ulna is the
of the shaft; this groove marks the medial bone (on the little-finger side) of
course of the radial nerve, an important the forearm.
nerve of the upper limb.
• Trochlear notch. On its proximal end are
• Trochlea and capitulum. At the distal end the coronoid process and the posterior
of the humerus is the medial trochlea, olecranon process, which are separated
which looks somewhat like a spool, and by the trochlear notch; together, these
the lateral ball-like capitulum; both of two processes grip the trochlea of the
these processes articulate with the humerus in a plier-like joint.
bones of the forearm.
3. HAND
• Fossa. Above the trochlea anteriorly is a
The skeleton of the hand consists of carpals,
depression, the coronoid fossa; on the
metacarpals, and the phalanges.
posterior surface is the olecranon fossa;
these two depressions, which are • Carpal bones. The eight carpal bones,
flanked by medial and lateral arranged in two irregular rows of four
epicondyles, allow the corresponding bones each, form the part of the hand
processes of the ulna to move freely called carpus, or, more commonly, the
when the elbow is bent and extended. wrist; the carpals are bound together by
ligaments that restrict movements
2. FOREARM
between them.
Two bones, the radius, and the ulna, form the
• Metacarpals. The metacarpals are
skeleton of the forearm.
numbered 1 to 5 from the thumb side of
• Radius. When the body is in anatomical the hand to the little finger; when the fist
position, the radius is the lateral bone; is clenched, the heads of the
that is, it is on the thumb side of the metacarpals become obvious as the
forearm; when the hand is rotated so that “knuckles “.
the palm faces backward, the distal end
• Phalanges. The phalanges are the
of the radius crosses over and ends up
bones of the fingers; each hand contains
medial to the ulna.
14 phalanges; there are three in each
• Radioulnar Joints. Both proximally and finger (proximal, middle, and distal),
distally the radius and ulna articulate at except in the thumb, which has only two)
small radioulnar joints and the two bones proximal and distal.
are connected along their entire length
by the flexible interosseous membrane.
BONES OF THE PELVIC GIRDLE outlet of the pelvis through which the
baby must pass during the birth process.
The pelvic girdle is formed by two coxal bones,
or ossa coxae, commonly called hip bones. • Greater sciatic notch. Another important
structural feature of the ischium is the
• Pelvic girdle. The bones of the pelvic
greater sciatic notch, which allows blood
girdle are large and heavy, and they are
vessels and the large sciatic nerve to
attached securely to the axial skeleton;
pass from the pelvis posteriorly into the
bearing weight is the most important
thigh.
function of this girdle because the total
weight of the upper body rests on the • Pubis. The pubis, or pubic bone, is the
bony pelvis. most anterior part of the coxal bone.
• Sockets. The sockets, which receives • Obturator foramen. An opening that
the thigh bones, are deep and heavily allows blood vessels and nerves to pass
reinforced by ligaments that attach the into the anterior part of the thigh.
limbs firmly to the girdle.
• Pubic symphysis. The pubic bones of
• Bony pelvis. The reproductive organs, each hip bones fuse anteriorly to form a
urinary bladder, and part of the large cartilaginous joint, the pubic symphysis.
intestine lie within and are protected by
• Acetabulum. The ilium, ischium, and
the bony pelvis.
pubis fuse at a deep socket called the
• Ilium. The ilium, which connects acetabulum, which means “vinegar cup”;
posteriorly with the sacrum at the the acetabulum receives the head of the
sacroiliac joint, is a large, flaring bone thigh bone.
that forms most of the hip bone; when
• False pelvis. The false pelvis is superior
you put your hands on your hips, they
to the true pelvis; it is the area medial to
are resting over the alae, or winglike
the flaring portions of the ilia.
portions, of the ilia.
• True pelvis. The true pelvis is
• Iliac crest. The upper edge of an ala, the
surrounded by bone and lies inferior to
iliac crest, is an important anatomical
the flaring parts of the ilia and the pelvic
landmark that is always kept in mind by
brim; the dimensions of the true pelvis of
those who give intramuscular injections;
the woman are very important because
the iliac crest ends anteriorly in the
they must be large enough to allow the
anterior superior iliac spine and
infant’s head to pass during childbirth.
posteriorly in the posterior superior iliac
spine. • Outlet and inlet. The dimensions of the
cavity, particularly the outlet (the inferior
• Ischium. The ischium is the “sit-down”
opening of the pelvis measured between
bone, so called because it forms the
the ischial spines, and the inlet (superior
most inferior part of the coxal bone.
opening between the right and left sides
• Ischial tuberosity. The ischial tuberosity of the pelvic brim) are critical, and thus
is a roughened area that receives weight they are carefully measured by the
when you are sitting. obstetrician.
• Ischial spine. The ischial spine, superior
to the tuberosity, is another important
anatomical landmark, particularly in
pregnant women, because it narrows the
BONES OF THE LOWER LIMBS the medial and lateral condyles articulate
with the distal end of the femur to form
The lower limbs carry the total body
the knee joint.
weight when we are erect; hence, it is not
surprising that the bones forming the three • Tibial tuberosity. The patellar (kneecap)
segments of the lower limbs (thigh, leg, and ligament attaches to the tibial tuberosity,
foot) are much thicker and stronger than the a roughened area on the anterior tibial
comparable bones of the upper limb. surface.

1. THIGH • Medial malleolus. Distally, a process

called medial malleolus forms the inner
The femur, or thigh bone, is the only bone
bulge of the ankle.
in the thigh; it is the heaviest, strongest bone in
the body. • Anterior border. The anterior surface of
the tibia is a sharp ridge, the anterior
• Parts. Its proximal end has a ball-like
border, that is unprotected by the
head, a neck, and greater and lesser
muscles; thus, it is easily felt beneath the
trochanters (separated anteriorly by the
skin.
intertrochanteric line and posteriorly by
the intertrochanteric crest). • Fibula. The fibula, which lies along the
tibia and forms joints with it both
• Gluteal tuberosity. These markings and
proximally and distally, is thin and
the gluteal tuberosity, located on the
sticklike; the fibula has no part in forming
shaft, all serve as sites for muscle
the knee joint.
attachment.
• Lateral malleolus. Its distal end, the
• Head. The head of the femur articulates
lateral malleolus, forms the outer part of
with the acetabulum of the hip bone in a
the ankle.
deep, secure socket.
3. FOOT
• Neck. However, the neck of the femur is
a common fracture site, especially in old The foot, composed of the tarsals,
age. metatarsals, and phalanges, has two important
functions.; it supports our body weight and
• Lateral and medial condyles. Distally on
serves as a lever that allows us to propel our
the femur are the lateral and medial
bodies forward when we walk and run.
condyles, which articulate with the tibia
below; posteriorly these condyles are • Tarsus. the tarsus, forming the posterior
separated by the deep intercondylar half of the foot, is composed of seven
fossa. tarsal bones.

• Patellar surface. Anteriorly on the distal • Calcaneus and Talus. Body weight is
femur is the smooth patellar surface, carried mostly by the two largest tarsals,
which forms a joint with the patella, or the calcaneus, or heel bone, and the
kneecap. talus (ankle), which lies between the tibia
and the calcaneus.
2. LEG
• Metatarsals. Five metatarsals form the
Connected along their length by an
sole.
interosseous membrane, two bones, the tibia
and fibula, form the skeleton of the leg. • Phalanges. 14 phalanges form the toes;
each toe has three phalanges, except
• Tibia. The tibia, or shinbone, is larger
the great toe, which has two.
and more medial; at the proximal end,
 • Arches. The bones in the foot are • Syndesmoses. In syndesmoses, the
arranged to form three strong arches: connecting fibers are longer than those
two longitudinal (medial and lateral) and of sutures; thus the joint has more “give”;
one transverse. the joint connecting the distal ends of the
tibia and fibula is a syndesmosis.
JOINTS
2. CARTILAGINOUS JOINTS
Joints, also called articulations, have two
functions: they hold the bones together In cartilaginous joints, the bone ends are
securely, but also give the rigid skeleton connected by cartilage.
mobility.
• Examples. Examples of this joint type
• Classification. Joints are classified in two that are slightly movable are the pubic
ways- functionally and structurally. symphysis of the pelvis and the
intervertebral joints of the spinal column,
• Functional classification. The functional
where the articulating bone surfaces are
classification focuses on the amount of
connected by pads (discs) of
movement the joint allows.
fibrocartilage.
• Types of functional joints. There are
• Synarthrotic cartilaginous joints. The
synarthroses or immovable joints;
hyaline cartilage epiphyseal plates of
amphiarthroses, or slightly movable
growing long bones and the cartilaginous
joints, and diarthrosis, or freely movable
joints between the first ribs and the
joints.
sternum are immovable cartilaginous
• Diarthroses. Freely movable joints joints.
predominate in the limbs, where mobility
3. SYNOVIAL JOINTS
is important.
Synovial joints are joints in which the
• Synarthroses and amphiarthroses.
articulating bone ends are separated by a joint
Immovable and slightly movable joints
cavity containing a synovial fluid; they account
are restricted mainly to the axial
for all joints of the limbs.
skeleton, where firm attachments and
protection of internal organs are • Articular cartilage. Articular cartilage
priorities. covers the ends of the bones forming the
joints.
• Structural classification. Structurally,
there are fibrous, cartilaginous, and • Fibrous articular capsule. The joint
synovial joints; these classifications are surfaces are enclosed by a sleeve or a
based on whether fibrous tissue, capsule of fibrous connective tissue, and
cartilage, or a joint cavity separates the their capsule is lined with a
bony regions at the joint. smooth synovial membrane (the reason
these joints are called synovial joints).
1. FIBROUS JOINTS
• Joint cavity. The articular capsule
In fibrous joints, the bones are united by
encloses a cavity, called the joint cavity,
fibrous tissue.
which contains lubricating synovial fluid.
• Examples. The best examples of this
• Reinforcing ligaments. The fibrous
type of joint are the sutures of the skull;
capsule is usually reinforced with
in sutures, the irregular edges of the
ligaments.
bones interlock and are bound tightly
together by connective tissue fibers, • Bursae. Bursae are flattened fibrous
allowing essentially no movement. sacs lined with synovial membrane and
 containing a thin film of synovial fluid; oval concavity in another; condyloid
they are common where ligaments, joints allow the moving bone to travel (1)
muscles, skin, tendons, or bones rub from side to side and (2) back and forth
together. but the bone cannot rotate around its
long axis; movement occurs around two
• Tendon sheath. A tendon sheath is
axes, hence these are biaxial joints.
essentially an elongated bursa that
wraps completely around a tendon 5. Saddle joints. In saddle joints, each
subjected to friction, like a bun around a articular surface has both convex and
hotdog. concave areas, like a saddle; these
biaxial joints allow essentially the same
TYPES OF SYNOVIAL JOINTS BASED ON
movements as condyloid joints; the best
SHAPE
examples of saddle joints are the
The shapes of the articulating bone carpometacarpal joints in the thumb.
surfaces determine what movements are
6. Ball-and-socket joint. In a ball-and-
allowed at a joint; based on such shapes, our
socket joint, the spherical head of one
synovial joints can be classified as plane, hinge,
bone fits into a round socket in another;
pivot, condyloid, saddle, and ball-and-socket
these multiaxial joints allow movement in
joints.
all axes, including rotation, and are the
1. Plane joint. In a plane joint, the articular most freely moving synovial joints; the
surfaces are essentially flat, and only shoulder and hip are examples.
short slipping or gliding movements are
allowed; the movements of plane joints
are nonaxial, that is, gliding does not
involve rotation around any axis; the
intercarpal joints of the wrist are best
examples of plane joints.

2. Hinge joint. In a hinge joint, the

cylindrical end of one bone fits into a
trough-shaped surface on another bone;
angular movement is allowed in just one
plane, like a mechanical hinge; hinge
joints are classified as uniaxial; they
allow movement in only one axis, and
examples are the elbow joint, ankle joint,
and the joints between the phalanges of
the fingers.
3. Pivot joint. In a pivot joint, the rounded
end of one bone fits into a sleeve or ring
of bone; because the rotating bone can
turn only around its long axis, pivot joints
are also uniaxial joints; the proximal
radioulnar joint and the joint between the
atlas and the dens of the axis are
examples.
4. Condyloid joint. In a condyloid joint, the
egg-shaped articular surface fits into an