Skeletal System

BONE TERMINOLOGY

Skeletal system

A RT I C U L A R FAC E T

• The smooth surface of a bone that is covered by articular
cartilage and takes part in a joint.
• Example:
ARTICUL AR PROCESS
• A general term for the (nonrounded) elevation of a bone that
has a joint surface on it.
CONDYLE
• A rounded projection at the end of a bone, incorporating a joint
surface.
CREST
• A ridge or linear elevation on a bone
DEMIFACET
• A joint surface that is in the shape of a half moon.
EMINENCE
• A low, rounded projection of a bone or internal organ.
EPICONDYLE
• The eminence of a bone lying immediately above its condyle.
FORAMEN
• An opening or hole in a bone, usually for transmission of
nerves or vessels.
FOSSA
• A depression on the surface of the body or a bone.
PROCESS
• A pointed projection oof a bone. Some may have joint surfaces
on them.
RAMUS
• A process of bone projecting like a branch from the main body
of the bone.
foredyfess
SESAMOID BONE
• A small bone embedded within a tendon, serve as a pulleys,
changing the direction of force applied by a muscle at a joint.
• The patella is an example.
foot hand
connects bonusto
theskull
SUTURE
• The line of junction of two bones by a Qbrous joint.
TROCHANTER
• One of two processes on the upper end of the femur.
• They provide attachment for muscles
skeletal
serveaffchement formuscle
TUBERCLE
• A medium sized (0.4-0.8 inch/1-2 cm diameter) rounded
projection on a bone.
• Example: proximal humerus, distal femur
TUBEROSITY
• A roughened projection of a bone.
Tubercle: a small, usually rugose eminence; often a site of tendon or ligament
attachment. Trochanter: one of two large, prominent, blunt, rugose processes
found only on the femur. The larger of these is called the greater trochanter; the
smaller is the lesser trochanter.
The Skeletal
System:
Structure, Function,
and Diseases
of the bones and

joints
Is this the correct anatomical position?
The answer is? What is your answer?
The Skeletal System
 Parts of the skeletal system
 Bones (skeleton)
 Joints
 Cartilages
 Ligaments (bone to bone)(tendon=bone to
muscle)
 Divided into two divisions
 Axial skeleton- skull, spinal column
 Appendicular skeleton – limbs and girdle
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Functions of Bones
 Support of the body
 Protection of soft organs
 Movement due to attached skeletal
muscles
 Storage of minerals and fats
 Blood cell formation
Bones of the Human Body
 The skeleton has 206 bones
 Two basic types of bone tissue
 Compact bone
 Homogeneous
 Spongy bone
 Small needle-like
pieces of bone
Figure 5.2b
 Many open spaces
Bones are classi<ed by their
shape:
1.Long- bones are longer than
they are wide (arms, legs)
2.Short- usually square in
shape, cube like (wrist, ankle)
3.Flat- >at , curved (skull,
Sternum)
4.Irregular- odd shapes
(vertebrae, pelvis)
Classification of Bones on the
Basis of Shape
Figure 5.1
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
Changes in the Human Skeleton
 In embryos, the skeleton is primarily
hyaline cartilage
 During development, much of this cartilage
is replaced by bone
 Cartilage remains in isolated areas
 Bridge of the nose
 Parts of ribs
 Joints
Axial skeleton supports and
protects organs of head, neck
and trunk
Axial skeleton:
skull (cranium and facial bones)
hyoid bone (anchors tongue and

muscles associated with swallowing)
vertebral column (vertebrae and

disks)
bony thorax (ribs and sternum)
Appendicular skeleton includes
bones of limbs and
bones that anchor them to the
axial skeleton
Appendicular skeleton:
pectoral girdle (clavicle,
scapula)
upper limbs (arms)
pelvic girdle (sacrum, coccyx)
lower limbs (legs)
Articulation- where joints meet,
connect, and are formed.
The Axial Skeleton
 Forms the longitudinal part of the body
 Divided into three parts
 Skull
 Vertebral Column
 Rib Cage
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.20a
The Axial Skeleton
Figure 5.6
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.20b
The Skull
•8 sutured bones in cranium
•Facial bones: 13 sutured
bones 1 mandible
Cranium
encases brain
attachments for muscles
sinuses
Bones of the Skull
Figure 5.11
Allows for
growth
Paranasal Sinuses
 Hollow portions of bones surrounding
the nasal cavity
Figure 5.10
The Hyoid Bone
 U shaped bone situated at the root of the tongue in the
front of the neck and betweent the lower jaw
and the largest cartilage of the larynx.
 The only bone that does
not articulate with another
bone
 Serves as a moveable base
for the tongue, and other
muscle attachments
 Serve as an anchoring
structure for the tongue.
Figure 5.12
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.26
The Vertebral Column 33 vertebrae

in total
 Vertebrae
separated by verte
intervertebral discs Colum
made of cartilage
 The spine has a
normal S curvature
 Each vertebrae is
at
given a name
look
spinous
according to its the
location process
Figure 5.14
enght to identify Slide 5.28
shape
dense
atlas
starts
spinous process
bifid
axis
at
transverse process
in
not present
Thoracic cage
ribs
thoracic
Vertebrae
sternum
costal cartilages
•True ribs are directly
attached to the
sternum
(Nrst seven pairs)
•Three false ribs are
joined to the 7th rib
•Two pairs of >oating
ribs
Joints
A joint, or articulation, is the place where two
bones come together.
• Fibrous- Immovable:connect bones, no
movement. (skull and pelvis).
• Cartilaginous- slightly movable, bones are
attached by cartilage, a little movement (spine
or ribs).
• Synovial- freely movable, much more
movement than cartilaginous joints. Cavities
between bones are filled with synovial fluid.
This fluid helps lubricate and protect the
bones.
The Synovial Joint
Figure 5.28
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.51
Types of Synovial Joints Based on
Shape
Figure 5.29a–c
Types of Synovial Joints Based on
Shape
Figure 5.29d–f
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.52b
Types of Joints
Hinge- A hinge joint allows extension and
retraction of an appendage. (Elbow,
Knee)
Ball and Socket- A ball and socket joint

allows for radial movement in almost
any direction. They are found in the hips
and shoulders. (Hip, Shoulder)
Gliding- In a gliding or plane joint bones
slide past each other. Mid-carpal and mid-
tarsal joints are gliding joints. (Hands,
Feet)
Saddle- This type of joint occurs when
the touching surfaces of two bones have
both concave and convex regions with
the shapes of the two bones
complementing one other and allowing
a wide range of movement. (Thumb)
Diseases and
Conditions
of the Skeletal
System
• Bone Fractures
 A break in a bone
 Types of bone fractures
 Closed (simple) fracture – break that does not
penetrate the skin
 Open (compound) fracture – broken bone penetrates
through the skin
 Greenstick- frays, hard to repair, breaks like a green
twig
 Bone fractures are treated by reduction and
immobilization
 Realignment of the bone
Arthritis
Bursitis
• In>ammation of the Bursa (>uid
Nlled sac surrounding the joint).
• A bursa can become in>amed from
injury, infection (rare in the

shoulder), or due to an underlying
rheumatic condition.
• Bursitis is typically identiNed by
localized pain or swelling,
tenderness, and pain with motion
of the tissues in the aSected area.
Tendonitis
• Sometimes the tendons become in>amed
for a variety of reasons, and the action of
pulling the muscle becomes irritating. If
the normal smooth gliding motion of your
tendon is impaired, the tendon will
become in>amed and movement will
become painful. This is called
tendonitis, and literally means
in>ammation of the tendon.
• The most common cause of tendonitis is
overuse.
Carpal Tunnel Syndrome
• Any condition that causes swelling
or a change in position of the tissue
within the carpal tunnel can

squeeze and irritate the median
nerve. Irritation of the median nerve
in this manner causes tingling and

numbness of the thumb, index, and
the middle Nngers, a condition
known as "carpal tunnel syndrome."
Osteoporosis
• Osteoporosis is a term that means
"porous bones." It is a skeletal disease
aSecting women and men. Osteoporosis
is a condition in which bones have lost
minerals especially calcium ﾑ making
them weaker, more brittle, and
susceptible to fractures (broken bones).
Any bone in the body can be aSected by

osteoporosis, but the most common
places where fractures occur are the
back (spine), hips, and wrists.
Scoliosis
• Scoliosis is an abnormal curvature of
the spine. If your child has scoliosis, the
view from behind may reveal one or
more abnormal curves.Scoliosis runs in
families, but doctors often don't know
the cause. More girls than boys have
severe scoliosis. Adult scoliosis may be
a worsening of a condition that began in
childhood, but wasn't diagnosed or
treated. In other cases, scoliosis may
result from a degenerative joint
condition in the spine.
Kyphosis
• With kyphosis, your spine may look
normal or you may develop a hump.
Kyphosis can occur as a result of
developmental problems; degenerative
diseases, such as arthritis of the spine;
osteoporosis with compression fractures
of the vertebrae; or trauma to the spine.
It can aSect children, adolescents and
adults.
Lordosis
• A normal spine, when viewed from

behind appears straight. However,
a spine aSected by lordosis shows
evidence of a curvature of the

back bones (vertebrae) in the
lower back area, giving the child a
"swayback" appearance.
Tuberculosis of the
Spine- Pott’s Disease
• As a form of extrapulmonary tuberculosis that impacts
the spine, Pott’s disease has an eSect that is sometimes
described as being a sort of arthritis for the vertebrae
that make up the spinal column. More properly known
as tuberculosis spondylitis, Pott’s disease is named after
Dr. Percivall Pott, an eighteenth century surgeon who
was considered an authority in issues related to the
back and spine.Pott's disease is often experienced as a
local phenomenon that begins in the thoracic section of
the spinal column. Early signs of the presence of Pott’s
disease generally begin with back pain that may seem
to be due to simple muscle strain. However, in short
order, the symptoms will begin to multiply.
Rickets
• Rickets is the softening and

weakening of bones in children,
usually because of an extreme and
prolonged vitamin D deNciency.
• Some skeletal deformities caused
by rickets may need corrective

surgery.
Scurvy
• The human body lacks the ability to
synthesize and make vitamin C and
therefore depends on exogenous dietary
sources to meet vitamin C needs.
Consumption of fruits and vegetables or
diets fortiNed with vitamin C are essential
to avoid ascorbic acid deNciency. Even
though scurvy is uncommon, it still occurs
and can aSect adults and children who
have chronic dietary vitamin C deNciency.
Gout
• Gout is a disease that results from an
overload of uric acid in the body. This
overload of uric acid leads to the formation
of tiny crystals of urate that deposit in
tissues of the body, especially the joints.
When crystals form in the joints it causes
recurring attacks of joint in>ammation
(arthritis). Chronic gout can also lead to
deposits of hard lumps of uric acid in and
around the joints and may cause joint
destruction, decreased kidney function, and
kidney stones.
Acromegaly
• Acromegaly is a serious condition that occurs
when the body produces too much of the
hormones that control growth. ･ The hormone
most often aSected is called growth hormone,
or GH. It ﾊ is produced by the pituitary gland, a
tiny organ at the base of the brain. ･･ Growth
hormone ﾊ promotes growth of bone, cartilage,
muscle, organs, and other tissues. ･･ When
there is too much growth hormone in the body,
these tissues grow larger than normal. This
excessive growth can cause serious disease
and even premature death.
Poliomyelitis
• Poliomyelitis (polio) is a highly infectious disease caused by a
virus. It invades the nervous system, and can cause total paralysis
in a matter of hours. It can strike at any age, but aSects mainly
children under three (over 50% of all cases). The virus enters the
body through the mouth and multiplies in the intestine. Initial
symptoms are fever, fatigue, headache, vomiting, stiSness in the
neck and pain in the limbs. One in 200 infections leads to
irreversible paralysis (usually in the legs). Amongst those
paralysed, 5%-10% die when their breathing muscles become
immobilized. Although polio paralysis is the most visible sign of
polio infection, fewer than 1% of polio infections ever result in
paralysis. Poliovirus can spread widely before cases of paralysis
are seen. As most people infected with poliovirus have no signs of
illness, they are never aware they have been infected. After initial
infection with poliovirus, the virus is shed intermittently in faeces
(excrement) for several weeks. During that time, polio can spread
rapidly through the community.
Spina BiNda
• Spina biNda is a birth defect that involves
the incomplete development of the spinal
cord or its coverings. The term spina
biNda comes from Latin and literally
means "split" or "open" spine.Spina biNda
occurs at the end of the Nrst month of
pregnancy when the two sides of the ﾊ
embryo's spine fail to join together,
leaving an open area. In some cases, the
spinal cord or other membranes may
push through this opening in the back.
The condition usually is ﾊ detected before
a baby is born and treated right away.
Talipes Equinovarus-
“Clubfoot”
• Clubfoot is a deformity of the whole foot
that is present at birth. There are several
types of clubfoot that are jointly known as
'talipes', as the deformity is mostly in the
talus (a bone in the ankle). The most
common of the talipes is what is known as
"talipes equino varus" - it is so common
that the word clubfoot is commonly used
to refer to this. In talipes equino varus, the
child is born with the foot pointing down
and twisted inwards at the ankle.
Sarcoma
• Osteosarcoma-The most common

type of bone cancer. It arises in
bone and is most commonly found
in children and adolescents but a

rare form occurs in adults,
particularly in patients who have
been cured of other cancers with
radiation therapy.
Myeloma
• Multiple myeloma is a cancer in which
abnormal cells collect in the bone marrow and
form tumors. Sometimes these abnormal cells
(called myeloma cells) collect in only one bone
and form a single tumor known as a
plasmacytoma. However, in most cases, the
myeloma cells collect in many bones, forming
several tumors and causing other problems.
When this happens, the disease is called
multiple myeloma.
Leukemia
• Leukemia is cancer of the blood cells. It starts
in the bone marrow, the soft tissue inside most
bones. Bone marrow is where blood cells are
made.When you are healthy, your bone
marrow makes: ･ White blood cells, which help
your body Nght infection. ･ Red blood cells,
which carry oxygen to all parts of your body. ･
Platelets, which help your blood clot.When you
have leukemia, the bone marrow starts to
make a lot of abnormal white blood cells,
called leukemia cells. They don't do the work
of normal white blood cells, they grow faster
than normal cells, and they don't stop growing
when they should.
Bone Marrow Biopsy
Introduction to Anatomy: The Skeletal System

Welcome

Introduction

The Skeletal System

Shapes of Bones

Skull

Bones

Vertebrae (Spine) 1 Introduction to Anatomy:

Vertebrae (Spine) 2 The Skeletal System

Vertebrae

(Spine) 3

Upper Limb Bones

Hip

(Coxal) Bones

Lower Limb Bones

Quiz 1

Quiz

2

Quiz Answer Keys

Index: Bones by Shape

Acknowledgements


Welcome

Introduction
Introduction When you first start studying Anatomy, it can feel a lot like trying to learn a new language! There

are a lot of new concepts and words to learn, which can feel overwhelming.
The Skeletal System

Shapes of Bones This tutorial will introduce you to the skeletal system. It provides information about the

functions of the skeletal system, the shapes of bones, and introduces the major bones of the
Skull

Bones

skeleton. The goal is to provide a basic foundation you can build upon as you learn and become
Vertebrae (Spine) 1 more confident with Anatomy.

Vertebrae (Spine) 2

Each labelled slide is followed by an unlabelled one, allowing you to practice.
Vertebrae

(Spine) 3

Upper Limb Bones There are two quizzes at the end of this module to help test your knowledge.

Hip

(Coxal) Bones
Good luck!

Lower Limb Bones

Quiz 1 Navigation

There are two ways to move through this module:
Quiz

2
1) Scroll through the PDF

Quiz Answer Keys

2) Click on the title headings on the left side of the screen (Note: this will take you to the

Index: Bones by Shape first/labelled page in each section; scroll down to find the unlabelled page)

Acknowledgements


Welcome

The Skeletal System has many important functions:

Introduction

• Providing support for the body
The Skeletal

Skeletal System
System • Storing minerals (calcium, phosphate)

Shapes of Bones • Producing red blood cells

• Protecting the organs and tissues
Skull

Bones • Allowing movement (the bones act as levers)

Vertebrae (Spine) 1

Vertebrae (Spine) 2 The skeleton can be subcategorized into two divisions:

Vertebrae

(Spine) 3
The Axial Skeleton (left, in blue)

Upper Limb Bones Includes: Bones of the skull, vertebrae, sternum, ribs,

and sacrum
Hip

(Coxal) Bones

Lower Limb Bones The Appendicular Skeleton (right, in pink)

Quiz 1 Includes: Bones of the upper and lower limbs,

scapula, clavicles, and hip bones,
Quiz

2

Quiz Answer Keys


Acknowledgements


Welcome

Bones can be classified according to

Introduction

their shape:
The Skeletal System Irregular Bones

Shapes of Bones
Bones Bones that have complex,

Long Bones irregular shapes
Skull

Bones
Bones that are longer than they Example: Spinal vertebrae

Vertebrae (Spine) 1

are wide Flat Bones

Vertebrae (Spine) 2 Examples: Humerus

Bones that are flat and light

Example: Rib bones
Vertebrae

(Spine) 3

Short Bones
Upper Limb Bones

Bones that are as wide as they
Hip

(Coxal) Bones are long

Lower Limb Bones Example: Carpal bones in the

hands Sesamoid Bones

Quiz 1

Bones that are flat, small, and
Quiz

2
round

Quiz Answer Keys Example: Patella (kneecap)


Acknowledgements


Welcome

Bones of the Skull

Introduction

The Skeletal System

Parietal bone

Shapes of Bones

Frontal bone
Skull

Bones
Bones

Vertebrae (Spine) 1

Vertebrae (Spine) 2 Nasal bone Sphenoid bone

Vertebrae

(Spine) 3 Zygomatic bone Occipital bone

Upper Limb Bones Temporal bone

Hip

(Coxal) Bones Maxilla

Lower Limb Bones

Quiz 1

Mandible
Quiz

2

Quiz Answer Keys


Acknowledgements


Welcome

Bones of the Skull

Introduction

The Skeletal System

Parietal bone

Shapes of Bones

Frontal bone
Skull

Bones
Bones

Vertebrae (Spine) 1

Vertebrae (Spine) 2 Nasal bone Sphenoid bone

Vertebrae

(Spine) 3 Zygomatic bone Occipital bone

Upper Limb Bones Temporal bone

Hip

(Coxal) Bones Maxilla

Lower Limb Bones

Quiz 1

Mandible
Quiz

2

Quiz Answer Keys


Acknowledgements


Welcome

Spinal Vertebrae

Introduction

The Skeletal System The Spinal Vertebrae are categorized into 5 types/regions:

Shapes of Bones

Memorization Hint: Cervical: 7 Bones
Skull

Bones To remember the

number of bones in
Vertebrae (Spine)
(Spine) 11 the CERVICAL,

Thoracic: 12 bones

Vertebrae (Spine) 2 THORACIC, and

LUMBAR spine, use
Vertebrae

(Spine) 3 the following memory

aid: Lumbar: 5 Bones
Upper Limb Bones

Hip

(Coxal) Bones Cereal (CERVICAL) for

breakfast at 7:00 am Sacrum: 5 fused bones
Lower Limb Bones

Quiz 1 Tasty lunch

(THORACIC) at 12:00
Quiz 2 pm Coccyx (Tail bone): 3-5 fused bones

Quiz Answer Keys

Light dinner (LUMBAR)

Index: Bones by Shape at 5:00 pm

Acknowledgements


Welcome

Spinal Vertebrae

Introduction

The Skeletal System The Spinal Vertebrae are categorized into 5 types/regions:

Shapes of Bones

Cervical: 7 Bones
Skull

Bones

Vertebrae (Spine)
(Spine) 11

Thoracic: 12 bones

Vertebrae (Spine) 2

Vertebrae

(Spine) 3

Lumbar: 5 Bones
Upper Limb Bones

Hip

(Coxal) Bones

Sacrum: 5 fused bones
Lower Limb Bones

Quiz 1

Quiz 2 Coccyx (Tail bone): 3-5 fused bones

Quiz Answer Keys


Acknowledgements


Welcome

Cervical Vertebrae

Introduction

There are three types of cervical bones:
The Skeletal System

Shapes of Bones

Skull

Bones

Vertebrae (Spine) 1

Vertebrae (Spine)
(Spine) 22

Vertebrae

(Spine) 3

Upper Limb Bones

Hip

(Coxal) Bones C1/Atlas C2/Axis C3-C7

Articulates with the Skull Articulates with C1 (Atlas)
Lower Limb Bones

Allows nodding (“Yes”) Allows rotation of head (“No”)

Quiz 1

Quiz

2
Memorization Hint:

Quiz Answer Keys In Greek mythology, Atlas was a Titan who led a (failed) rebellion against Zeus.

As punishment, Atlas was condemned to carry the weight of the world on his shoulders for eternity.

Index: Bones by Shape Imagine C1/Atlas as holding up the weight of the head, which is spherical and heavy like a globe.

Acknowledgements


Welcome

Thoracic, Lumbar, and Sacral Vertebrae

Introduction

The Skeletal System

Shapes of Bones

Skull

Bones

Vertebrae (Spine) 1

Vertebrae (Spine) 2

Vertebrae

(Spine)
(Spine) 33

Upper Limb Bones

Thoracic
Hip

(Coxal) Bones
Lumbar Sacrum

12 bones 5 bones 5 fused bones

Lower Limb Bones Long spinous processes Thick vertebral bodies Articulates with Coxal bones

Quiz 1 Articulate with the ribs

Quiz

2

Quiz Answer Keys Did You Know?

The bones of the SACRUM start to fuse at puberty, and are fully fused by 25-30 years of age.

Index: Bones by Shape The bones of the COCCYX (not pictured) begin to fuse at around age 26, and are not fully fused until late life.

Acknowledgements


Welcome

Clavicle
Bones of the Upper Limb

Introduction

Scapula
The Skeletal System

Memorization Hint: (Sternum*)

Shapes of Bones The RADIUS is rad!

The RADIUS is the forearm bone
Skull

Bones closest to your thumb. Give
Humerus

Vertebrae (Spine) 1 a thumbs up to get oriented!

Vertebrae (Spine) 2

Did you know?
Vertebrae

(Spine) 3 When you hit your funny bone, it

feels strange and HUMERUS.
Upper Limb Bones
Bones Ulna

The tingling sensation you feel is
Hip

(Coxal) Bones produced when the Ulnar Nerve
is compressed against Radius

Lower Limb Bones the HUMERUS bone.

Quiz 1

Quiz 2 Carpals

Metacarpals
Quiz Answer Keys

Index: Bones by Shape Phalanges (fingers)

* The Sternum is not a bone of the upper limb.
It is included here for reference.
Acknowledgements


Welcome

Clavicle
Bones of the Upper Limb

Introduction

Scapula
The Skeletal System

Shapes of Bones

Skull

Bones
Humerus

Vertebrae (Spine) 1

Vertebrae (Spine) 2

Vertebrae

(Spine) 3

Upper Limb Bones

Bones Ulna

Hip

(Coxal) Bones Radius

Lower Limb Bones

Quiz 1

Quiz 2 Carpals

Metacarpals
Quiz Answer Keys

Index: Bones by Shape Phalanges

Acknowledgements


Welcome

Coxal bones (also called Hip bones, Pelvic bones)

Introduction

The Skeletal System The Coxal bones are comprised of three bones:

Shapes of Bones

Skull Bones Iliac bone

Vertebrae (Spine) 1

Vertebrae (Spine) 2

Vertebrae

(Spine) 3 Coxal Bone

Upper Limb Bones

Pubic bone
Hip

(Coxal)
(Coxal) Bones
Bones

Lower Limb Bones

Ischium bone

Quiz 1

Quiz

2


The Coxal bones are fully

Index: Bones by Shape fused by age 25.

Acknowledgements


Welcome


Introduction

The Skeletal System The Coxal bones are comprised of three bones:

Shapes of Bones


Vertebrae (Spine) 1

Vertebrae (Spine) 2

Vertebrae

(Spine) 3 Coxal Bone

Upper Limb Bones

Pubic bone
Hip

(Coxal)
(Coxal) Bones
Bones

Lower Limb Bones

Ischium bone

Quiz 1

Quiz

2


The Coxal bones are fully

Index: Bones by Shape fused by age 25.

Acknowledgements


Welcome


Introduction

The Skeletal System

Shapes of Bones


Vertebrae (Spine) 1

Vertebrae (Spine) 2
Coxal Bone

Vertebrae

(Spine) 3

Upper Limb Bones

Pubic bone
Hip

(Coxal)
(Coxal) Bones
Bones

Lower Limb Bones

Ischium bone

Quiz 1

Quiz

2

Quiz Answer Keys


Acknowledgements


Welcome

Bones of the Lower Limb

Introduction

The Skeletal System

Memorization Hint:

Shapes of Bones The PATELLA is a Sesamoid bone.

Femur
Skull Bones Think of it as shaped like a giant

upside-down sesame seed.

Vertebrae (Spine) 1

Vertebrae (Spine) 2 Did you know?

The FEMUR is the longest bone Patella (Kneecap)
Vertebrae

(Spine) 3
in the body. Its length is roughly

Upper Limb Bones 1/4th that of a person’s total

height! Tibia
Hip

(Coxal) Bones
Fibula

Lower Limb Bones

Bones

Quiz 1

Quiz

2 Tarsals

Quiz Answer Keys Metatarsals

Index: Bones by Shape Phalanges (Toes)

Acknowledgements


Welcome

Bones of the Lower Limb

Introduction

The Skeletal System

Shapes of Bones

Femur
Skull

Bones

Vertebrae (Spine) 1

Vertebrae (Spine) 2

Patella (Kneecap)
Vertebrae

(Spine) 3

Upper Limb Bones

Tibia
Hip

(Coxal) Bones
Fibula

Lower Limb Bones

Bones

Quiz 1

Quiz

2 Tarsals

Quiz Answer Keys Metatarsals

Index: Bones by Shape Phalanges (Toes)

Acknowledgements


Welcome

Introduction Quiz 1

Choose the correct Anatomical region:
The Skeletal System

(Write your answers on paper and check with the Quiz Answer Key at the end)
Shapes of Bones

Skull

Bones
1) Pubic bone

Vertebrae (Spine) 1

Vertebrae (Spine) 2

Vertebrae

(Spine) 3
2) Radius

Upper Limb Bones

Hip

(Coxal) Bones

Lower Limb Bones

3) Mandible

Quiz 1

Quiz

2

Quiz Answer Keys

4) C1/Atlas (Cervical Vertebrae)


Acknowledgements


Welcome

Introduction Quiz 2

Match:
The Skeletal System

(Write your answers on paper and check with the Quiz Answer Key at the end)
Shapes of Bones

1) Long bone of the Upper Limb A) Phalanges
Skull

Bones

2) Sesamoid bone B) Flat bone(s)
Vertebrae (Spine) 1

3) Anatomical name for bones of Fingers C) Five

Vertebrae (Spine) 2

4) Anatomical name for Hip Bones D) Femur
Vertebrae

(Spine) 3
5) Includes Skull, Vertebra, Sternum, Ribs E) Appendicular Skeleton

Upper Limb Bones

6) Skull bones are this shape F) Humerus
Hip

(Coxal) Bones 7) Number of fused bones in Sacrum G) Axis

Lower Limb Bones

8) Long bone of the Lower Limb H) Ischium

Quiz 1 9) Includes Limb bones, Scapula, Hip bones I) Axial Skeleton

Quiz

2 10) Number of Thoracic vertebrae J) Coxal Bones

Quiz Answer Keys 11) Name of C2 Cervical Bone K) Twelve

Index: Bones by Shape 12) Name of one of the Coxal Bones L) Patella (Kneecap)

Acknowledgements


Welcome

Quiz Answer Keys

Introduction

Quiz 1 Answers Quiz 2 Answers
The Skeletal System

1) Long bone of the Upper Limb F) Humerus

Shapes of Bones

1) Pubic Bone 2) Sesamoid bone L) Patella (Kneecap)
Skull

Bones
3) Anatomical name for bones of A) Phalanges

Vertebrae (Spine) 1 Fingers

Vertebrae (Spine) 2 4) Anatomical name for Hip Bones J) Coxal Bones

2) Radius 5) Includes Skull, Vertebra, Sternum, I) Axial Skeleton
Vertebrae

(Spine) 3
Ribs

Upper Limb Bones 6) Skull bones are this shape B) Flat bones

Hip

(Coxal) Bones 7) Number of fused bones in C) Five

Sacrum
Lower Limb Bones 3) Mandible

8) Long bone of the Lower Limb D) Femur

Quiz 1
9) Includes Limb bones, Scapula, Hip E) Appendicular Skeleton

bones
Quiz

2

10) Number of Thoracic vertebrae K) Twelve
Quiz Answer
Answer Keys
Keys 4) C1/Atlas

11) Name of C2 Cervical Bone G) Axis


12) Name of one of the Coxal Bones H) Ischium
Acknowledgements


Welcome

Bones found in this module, organized alphabetically by shape:

Introduction

The Skeletal System Flat Irregular Long Short Sesamoid

Shapes of Bones Rib bones Coxal Bones Femur Carpals Patella

Skull

Bones Scapulae Vertebrae Fibula Tarsals

Vertebrae (Spine) 1 Skull bones Humerus

Vertebrae (Spine) 2 Sternum Metacarpals

Metatarsals
Vertebrae

(Spine) 3

Upper Limb Bones Phalanges

Tibia
Hip

(Coxal) Bones

Lower Limb Bones

Quiz 1

Quiz

2

Quiz Answer Keys

Index: Bones
Bones by
by Shape
Shape

Acknowledgements


Welcome

Introduction Acknowledgements

Created for UBC MDUP FLEX 429, Spring 2020
The Skeletal System

Student: Kimberlee Hart (Island Medical Program, Class of 2022)

Shapes of Bones Supervisor: Kurt McBurney, Associate Teaching Professor, Island Medical Program

Skull

Bones Inspired by EPHE 141 Human Anatomy Lab and the EPHE 141 Lab Manual (University of Victoria)

Vertebrae (Spine) 1

References

Vertebrae (Spine) 2 Cohen, B. J., & DePetris, A. (2014). Medical Terminology. Medical Terminology: An Illustrated Guide.

Baltimore, MD: Lippincott Williams & Wilkins.
Vertebrae

(Spine) 3

Upper Limb Bones Jones, B. D. (2016). Comprehensive Medical Terminology, Fifth Edition. Boston, MA: Cengage Learning.

Hip

(Coxal) Bones Martini, F. H., Timmons, M. J., & Tallitsch, R. B. (2015). Human Anatomy, Eighth Edition. Toronto, ON:

Pearson Education Inc.
Lower Limb Bones

Quiz 1 Moore, K.L., Dalley, A.F., & Agur, A. M. M. (2018). Clinically Oriented Anatomy, Eighth Edition. New York:

Wolters Kluwer.
Quiz

2

Quiz Answer Keys Medical Illustrations

Paige Blumer


Acknowledgements
Acknowledgements

CHAPTER 4
Bones of the Human Body
CHAPTER OUTLINE
Axial Skeleton Section 4.8 Bones of the Foot
Section 4.1 Bones of the Head
Appendicular Skeleton, Upper Extremity

Section 4.2 Bones of the Spine (and Hyoid)
Section 4.9 Entire Upper Extremity

Section 4.3 Bones of the Ribcage and Sternum
Section 4.10 Bones of the Shoulder Girdle and
Appendicular Skeleton, Lower Extremity Shoulder Joint
Section 4.4 Entire Lower Extremity Section 4.11 Bones of the Arm and Elbow Joint
Section 4.5 Bones of the Pelvis and Hip Joint Section 4.12 Bones of the Forearm, Wrist Joint,
Section 4.6 Bones of the Thigh and Knee Joint and Hand
Section 4.7 Bones of the Leg and Ankle Joint
CHAPTER OBJECTIVES
After completing this chapter, the student should be able to perform the following:
1. List the major divisions of the skeleton. 7. Name and locate the bony landmarks of the
2. Name and locate the bones of the axial skeleton. upper extremity skeleton.
3. Name and locate the bones of the lower extremity 8. Name and locate the joints of the axial skeleton.
skeleton. 9. Name and locate the joints of the lower extremity
4. Name and locate the bones of the upper skeleton.
extremity skeleton. 10. Name and locate the joints of the upper extremity
5. Name and locate the bony landmarks of the axial skeleton.
skeleton. 11. Define the key terms of this chapter.
6. Name and locate the bony landmarks of the lower 12. State the meanings of the word origins of this
extremity skeleton. chapter.
KEY TERMS
Accessory (ak-SES-or-ee) Articular (are-TIK-you-lar)
Acetabulum (AS-i-TAB-you-lum) Atlanto/atlas (at-LAN-to/AT-las)
Acromion (a-KROM-ee-on) Auditory (AW-di-tore-ee)
Ala, pl. alae (A-la, A-lee) Auricular (or-IK-you-lar)
Alveolar (al-VEE-o-lar) Axis (AKS-is)
Apex, pl. apices (A-peks, A-pi-sees) Base/basilar (BASE/BAZE-i-lar)
Arch (ARCH) Bicipital (bye-SIP-i-tal)
Arcuate (ARE-cue-at) Bifid (BYE-fid)
66
Calcaneus, pl. calcanei (kal-KAY-nee-us, Lordotic (lor-DOT-ik)
kal-KAY-nee-eye) Lumbar (LUM-bar)
Canine (KAY-nine) Lunate (LOON-ate)
Capitate, capitulum (KAP-i-tate, ka-PICH-you-lum) Magnum (MAG-num)
Carotid (ka-ROT-id) Malleolus, pl. malleoli (mal-EE-o-lus, mal-EE-o-lie)
Carpal (CAR-pull) Mamillary (MAM-i-lary)
Cervical (SERV-i-kul) Mandible (MAN-di-bul)
Clavicle (KLAV-i-kul) Manubrium, pl. manubria (ma-NOOB-ree-um,
Coccyx, pl. coccyges (KOK-siks, KOK-si-jeez) ma-NOOB-ree-a)
Concha, pl. conchae (KON-ka, KON-kee) Mastoid (MAS-toyd)
Condyle (KON-dial) Maxilla, pl. maxillae (MAX-i-la, MAX-i-lee)
Conoid (CONE-oid) Meatus (me-ATE-us)
Coracoid (CORE-a-koyd) Mental/menti (MEN-tal/MEN-tee)
Cornu, pl. cornua (KORN-oo, KORN-oo-a) Metacarpal (MET-a-CAR-pal)
Coronoid (CORE-o-noyd) Metatarsal (MET-a-TARS-al)
Costal (COST-al) Mylohyoid (MY-low-HI-oyd)
Coxal (COCK-sal) Nasal (NAY-sul)
Cranium (KRAY-nee-um) Navicular (na-VIK-you-lar)
Cribriform (KRIB-ri-form) Nuchal (NEW-kul)
Crista galli (KRIS-ta GA-li) Obturator (OB-tour-ate-or)
Cuboid (KEW-boyd) Occipital (ok-SIP-i-tal)
Cuneiform (kew-NEE-a-form) Odontoid (o-DONT-oyd)
Deltoid (DEL-toyd) Olecranon (o-LEK-ran-on)
Dens, pl. dentes (DENS, DEN-tees) Optic (OP-tik)
Disc (DISK) Palatine (PAL-a-tine)
Dorsum sellae (DOOR-sum SELL-ee) Parietal (pa-RYE-it-al)
Epicondyle (EP-ee-KON-dial) Patella, pl. patellae (pa-TELL-a, pa-TELL-ee)
Ethmoid (ETH-moyd) Pedicle (PED-i-kul)
Facet (fa-SET) Pelvic bone (PEL-vik)
Femur, pl. femora (FEE-mur, FEM-or-a) Petrous (PEE-trus)
Fibula (FIB-you-la) Phalanx, pl. phalanges (FAL-anks, fa-LAN-jeez)
Fovea (FOE-vee-ah) Pisiform (PIES-a-form)
Frontal (FRON-tal) Promontory (PROM-on-tor-ee)
Glabella (gla-BELL-a) Pterygoid (TER-i-goid)
Glenoid (GLEN-oyd) Pubis, pl. pubes (PYU-bis, PYU-bees)
Gluteal (GLUE-tee-al) Radius, pl. radii (RAY-dee-us, RAY-dee-eye)
Hamate (HAM-ate) Ramus, pl. rami (RAY-mus, RAY-my)
Hamulus, pl. hamuli (HAM-you-lus, HAM-you-lie) Sacrum (SA-krum)
Hemifacet (HEM-ee-fa-SET) Sagittal (SAJ-i-tal)
Hiatus (hi-ATE-us) Scaphoid (SKAF-oyd)
Humerus, pl. humeri (HUME-er-us, HUME-er-eye) Scapula, pl. scapulae (SKAP-you-la, SKAP-you-lee)
Hyoid (HI-oyd) Sciatic (sigh-AT-ik)
Ilium, pl. ilia (IL-lee-um, IL-ee-a) Sella turcica (SEL-a TER-si-ka)
Incisive (in-SISE-iv) Sesamoid (SES-a-moid)
Infraspinatus (IN-fra-spine-ATE-us) Soleal (SO-lee-al)
Inion (IN-yon) Sphenoid (SFEE-noyd)
Innominate (i-NOM-i-nate) Spine/spinous (SPINE/SPINE-us)
Intercostal (IN-ter-KOST-al) Squamosal (squaw-MOS-al)
Interosseus (IN-ter-oss-ee-us) Sternum (STERN-um)
Ischium, pl. ischia (IS-kee-um, IS-kee-a) Styloid (STI-loyd)
Jugular (JUG-you-lar) Subscapular (SUB-SKAP-you-lar)
Kyphosis (ki-FOS-is) Subtalar (sub-TAL-ar)
Lacerum (LA-ser-um) Sulcus, pl. sulci (SUL-kus, SUL-ki)
Lacrimal (LAK-ri-mal) Superciliary (SOO-per-CIL-ee-air-ee)
Lambdoid (LAM-doyd) Supernumerary bone (SOO-per-noom-air-ee)
Lamina, pl. laminae (LAM-i-na, LAM-i-nee) Supraorbital (SOO-pra-OR-bi-tal)
Lingula (LING-you-la) Supraspinatus (SOO-pra-spine-ATE-us)
67
Sustentaculum (sus-ten-TAK-you-lum) Trochanter (tro-CAN-ter)
Suture (SOO-cher) Trochlea (TRO-klee-a)
Symphysis (SIM-fi-sis) Tubercle (TWO-ber-kul)
Talus, pl. tali (TA-lus, TA-lie) Tuberosity (TWO-ber-OS-i-tee)
Tarsal (TAR-sal) Ulna, pl. ulnae (UL-na, UL-nee)
Temporal (TEM-por-al) Uncus (UN-kus)
Thoracic (thor-AS-ik) Vomer (VO-mer)
Tibia, pl. tibiae (TIB-ee-a, TIB-ee-ee) Wormian bones (WERM-ee-an)
Transverse (TRANS-vers) Xiphoid (ZI-foyd)
Trapezium, trapezoid (tra-PEEZ-ee-um, TRAP-i-zoyd) Zygomatic (ZI-go-MAT-ik)
Triquetrum (try-KWE-trum)
WORD ORIGINS
❍ Accessory—From Latin accessorius, meaning ❍ Coccyx, pl. coccyges—From Greek kokkyx, meaning
supplemental cuckoo bird
❍ Acetabulum—From Latin acetum, meaning ❍ Concha—From Greek konch, meaning shell
vinegar, and Latin abulum, meaning small ❍ Condyle—From Greek kondylos, meaning knuckle
receptacle, cup ❍ Conoid—From Greek konos, meaning cone, and
❍ Acromion—From Greek akron, meaning tip and Greek eidos, meaning resemblance
Greek omos, meaning shoulder ❍ Coracoid—From Greek korax, meaning raven, and
❍ Ala, pl. alae—From Latin ala, meaning wing Greek eidos, meaning resemblance
❍ Alveolar—From Latin alveolus, meaning a concavity, ❍ Cornu, pl. cornua—From Latin cornu, meaning
a bowl horn
❍ Apex, pl. apices—From Latin apex, meaning tip ❍ Coronoid—From Greek korone, meaning crown,
❍ Arch—From Latin arcus, meaning a bow and Greek eidos, meaning resemblance
❍ Arcuate—From Latin arcuatus, meaning bowed, ❍ Costal—From Latin costa, meaning rib
shaped like an arc ❍ Coxal—From Latin coxa, meaning hip
❍ Articular—From Latin articulus, meaning joint ❍ Cranium—From Latin cranium, meaning skull
❍ Atlanto/atlas—From Greek Atlas, the Greek figure ❍ Cribriform—From Latin cribum, meaning sieve, and
who supports the world (the first cervical vertebra Latin forma, meaning shape
supports the head) ❍ Crista galli—From Latin crista, meaning crest or
❍ Auditory—From Latin auditorius, meaning plume, and Latin gallus, meaning rooster
pertaining to the sense of hearing ❍ Cuboid—From Greek kubos, meaning cube, and
❍ Auricular—From Latin auricula, meaning a little ear Greek eidos, meaning resemblance
❍ Axis—From Latin axis, meaning axis (an imaginary ❍ Cuneiform—From Latin cuneus, meaning wedge,
line about which something revolves) and Latin forma, meaning shape
❍ Base/basilar—From Latin basilaris, meaning the base ❍ Deltoid—From Latin deltoides, meaning shaped like
of something a delta (∆), and Greek eidos, meaning resemblance
❍ Bicipital—From Latin bi, meaning two, and Greek ❍ Dens, pl. dentes—From Latin dens, meaning tooth
kephale, meaning head ❍ Disc—From Greek diskos, meaning a flat round
❍ Bifid—From Latin bis, meaning twice, and Latin structure
findere, meaning to cleave ❍ Dorsum sellae—From Latin dorsum, meaning back,
❍ Calcaneus, pl. calcanei—From Latin calcaneus, and Latin sella, meaning saddle (the dorsum sellae
meaning heel bone is the posterior wall of the sella turcica)
❍ Canine—From Latin caninus, meaning pertaining to ❍ Epicondyle—From Greek epi, meaning upon, and
a dog (refers to proximity to canine tooth) Greek kondylos, meaning knuckle
❍ Capitate, capitulum—From Latin caput, meaning a ❍ Ethmoid—From Greek ethmos, meaning sieve, and
small head Greek eidos, meaning resemblance
❍ Carotid—From Greek karoun, meaning to plunge ❍ Facet—From French facette, meaning a small face
into sleep or stupor (because compression of the ❍ Femur, pl. femora—From Latin femur, meaning
carotid arteries can result in unconsciousness) thighbone
❍ Carpal—From Greek karpos, meaning wrist ❍ Fibula—From Latin fibula, meaning that which
❍ Cervical—From Latin cervicalis, meaning pertaining clasps or clamps
to the neck ❍ Fovea—From Latin fovea, meaning a pit
❍ Clavicle—From Latin clavicula, meaning a small key ❍ Frontal—From Latin frontalis, meaning anterior
68
❍ Glabella—From Latin glaber, meaning smooth ❍ Metacarpal—From Greek meta, meaning after, and
❍ Glenoid—From Greek glene, meaning socket, and Greek karpos, meaning wrist
Greek eidos, meaning resemblance ❍ Metatarsal—From Greek meta, meaning after, and
❍ Gluteal—From Greek gloutos, meaning buttock from Greek tarsas, referring to the tarsal bones
❍ Hamate—From Latin hamatus, meaning hooked ❍ Mylohyoid—From Greek myle, meaning mill (refers
❍ Hamulus, pl. hamuli—From Latin hamulus, meaning to molar teeth that grind food), and Greek
a small hook hyoeides, meaning U-shaped
❍ Hemifacet—From Greek hemi, meaning half, and ❍ Nasal—From Latin nasus, meaning nose
French facette, meaning small face ❍ Navicular—From Latin navicula, meaning boat
❍ Hiatus—From Latin hiatus, meaning an opening ❍ Nuchal—From Latin nucha, meaning back of the
❍ Humerus, pl. humeri—From Latin humerus, neck
meaning shoulder ❍ Obturator—From Latin obturare, meaning to stop
❍ Hyoid—From Greek hyoeides, meaning U-shaped up
❍ Ilium, pl. ilia—From Latin ilium, meaning groin, ❍ Occipital—From Latin occipitalis, meaning back of
flank the head
❍ Incisive—From Latin incisus, meaning to cut (refers ❍ Odontoid—From Greek odous, meaning tooth, and
to proximity to incisor teeth) Greek eidos, meaning resemblance
❍ Infraspinatus—From Latin infra, meaning beneath ❍ Olecranon—From Greek olecranon, meaning elbow
(the spine of the scapula) ❍ Optic—From Greek optikos, meaning pertaining to
❍ Inion—From Greek inion, meaning back of the the sense of sight (the optic foramen contains the
neck optic nerve)
❍ Innominate—From Latin innominatus, meaning ❍ Palatine—From Latin palatinus, meaning concerning
nameless, unnamed the palate
❍ Intercostal—From Latin inter, meaning between, ❍ Parietal—From Latin parietalis, meaning pertaining
and Latin costa, meaning rib to the wall of a cavity
❍ Interosseus—From Latin inter, meaning between, ❍ Patella, pl. patellae—From Latin patella, meaning a
and Latin ossis, meaning bone plate
❍ Ischium, pl. ischia—From Greek ischion, meaning ❍ Pedicle—From Latin pediculus, meaning small foot
hip ❍ Pelvic bone—From Latin pelvis, meaning basin
❍ Jugular—From Latin jugularis, meaning neck (refers ❍ Petrous—From Latin petra, meaning stone
to jugular vein) ❍ Phalanx, pl. phalanges—From Latin phalanx,
❍ Kyphosis—From Greek kyphos, meaning bent, meaning a line of soldiers
humpback ❍ Pisiform—From Latin pisum, meaning pea, and
❍ Lacerum—From Latin lacerare, meaning to tear Latin forma, meaning shape
❍ Lacrimal—From Latin lacrimal, meaning tear ❍ Promontory—From Latin promontorium, meaning a
❍ Lambdoid—From Greek letter lambda (λ), and projecting process or part
Greek eidos, meaning resemblance ❍ Pterygoid—From Greek pterygion, meaning wing
❍ Lamina, pl. laminae—From Latin lamina, meaning a ❍ Pubis, pl. pubes—From Latin pubes, meaning
thin flat layer or plate grown up
❍ Lingula—From Latin lingua, meaning tongue ❍ Radius, pl. radii—From Latin radius, meaning rod,
❍ Lordotic—From Greek lordosis, meaning a bending spoke of a wheel

backward ❍ Ramus, pl. rami—From Latin ramus, meaning
❍ Lumbar—From Latin lumbus, meaning loin, low back branch
❍ Lunate—From Latin luna, meaning moon ❍ Sacrum—From Latin sacrum, meaning sacred
❍ Magnum—From Latin magnum, meaning large ❍ Sagittal—From Latin sagittal, meaning arrow (refers
❍ Malleolus, pl. malleoli—From Latin malleolus, to a posterior/anterior direction)
meaning little hammer ❍ Scaphoid—From Greek skaphe, meaning a skiff or
❍ Mamillary—From Latin mamma, meaning breast boat, and Greek eidos, meaning resemblance
❍ Mandible—From Latin mandere, meaning to chew ❍ Scapula, pl. scapulae—From Latin scapulae,
❍ Manubrium, pl. manubria—From Latin manubrium, meaning shoulder blades
meaning handle ❍ Sciatic—From Latin sciaticus, meaning pertaining to
❍ Mastoid—From Greek mastos, meaning breast, and ischium (i.e., hip)
Greek eidos, meaning resemblance ❍ Sella turcica—From Latin sella, meaning saddle, and
❍ Maxilla, pl. maxillae—From Latin maxilla, meaning Latin turcica, meaning Turkish
jawbone (especially the upper one) ❍ Sesamoid—From Greek sesamon, meaning sesame
❍ Meatus—From Latin meatus, meaning a passage seed, and Greek eidos, meaning resemblance
❍ Mental/menti—From Latin mentum, meaning mind ❍ Soleal—From Latin solea, meaning sole of the foot
69
❍ Sphenoid—From Greek sphen, meaning wedge, ❍ Tarsal—From Greek tarsos, meaning a broad flat
and Greek eidos, meaning resemblance surface
❍ Spine/spinous—From Latin spina, meaning thorn ❍ Temporal—From Latin temporalis, meaning
❍ Squamosal—From Latin squamosus, meaning scaly pertaining to or limited in time (refers to the
❍ Sternum—From Greek sternon, meaning chest, temple region of the head)
breastbone ❍ Thoracic—From Greek thorax, meaning chest
❍ Styloid—From Greek stylos, meaning pillar or post, ❍ Tibia, pl. tibiae—From Latin tibia, meaning the
and Greek eidos, meaning resemblance large shinbone
❍ Subscapular—From Latin sub, meaning under ❍ Transverse—From Latin transversus, meaning lying
(referring to the underside [i.e., the anterior side] of across
the scapula) ❍ Trapezium, trapezoid—From Greek trapeza,
❍ Subtalar—From Latin sub, meaning under, and meaning a (four-sided) table
talar, referring to the talus ❍ Triquetrum—From Latin triquetrus, meaning
❍ Sulcus, pl. sulci—From Latin sulcus, meaning triangular
groove ❍ Trochanter—From Greek trochanter, meaning to
❍ Superciliary—From Latin super, meaning above, and run
Latin cilium, meaning eyebrow ❍ Trochlea—From Latin trochlear, meaning pulley
❍ Supraorbital—From Latin supra, meaning above, ❍ Tubercle—From Latin tuberculum, or tuber,
and Latin orbis, meaning circle, orb meaning a small knob, swelling, tumor
❍ Supraspinatus—From Latin supra, meaning above ❍ Tuberosity—From Latin tuberositas, or tuber,
(the spine of the scapula) meaning a knob, swelling, tumor
❍ Sustentaculum—From Latin sustentaculum, ❍ Ulna, pl. ulnae—From Latin ulna, meaning elbow
meaning support ❍ Uncus—From Latin uncus, meaning hook
❍ Suture—From Latin sutura, meaning a seam ❍ Vomer—From Latin vomer, meaning ploughshare
❍ Symphysis—From Greek sym, meaning with or ❍ Xiphoid—From Greek xiphos, meaning sword, and
together, and Greek physis, meaning nature, Greek eidos, meaning resemblance
body ❍ Zygomatic—From Greek zygon, meaning to join, a
❍ Talus, pl. tali—From Latin talus, meaning ankle yolk
The following key terms are a number of general terms Groove—A narrow elongated depression within a bone,
that are used to describe landmarks on bones. Many bony often containing a tendon, nerve, or vessel.
landmarks are raised aspects of a bone’s surface that serve Head—The expanded rounded end (epiphysis) of a long
as muscle and/or ligament attachment sites. bone; usually separated from the body (i.e., shaft) of
Angle—A corner of a bone. the bone by a neck.
Articular surface—The surface of a bone that articulates Hiatus—An opening in a bone.
with another bone (i.e., the joint surface). Impression—A shallow groove on a bone, often formed
Body—The main portion of a bone; the body of a long by a tendon, nerve, or vessel.
bone is the shaft. Line—A mildly raised ridge of bone (usually less than a
Condyle—Rounded bump found at the end of a long crest); often a site of muscle attachment.
bone (part of the epiphysis); usually part of a joint Lip—A raised liplike structure that forms the border of a
fitting into a fossa of an adjacent bone. groove or opening.
Crest—A moderately raised ridge of bone; often a site of Margin—The edge of a bone.
muscle attachment. Meatus—A tubelike channel within a bone.
Eminence—A raised prominent area of a bone. Neck—A narrowed portion of a bone that separates the
Epicondyle—A small bump found on a condyle; often a head from the body (i.e., shaft) of a bone.
site of muscle attachment. Notch—A V-shaped or U-shaped depression in a bone.
Facet—A smooth (usually flat) surface on a bone that Process—A projection of a bone; may be involved with an
forms a joint with another facet or flat surface of an articulation or may be a site of muscle attachment.
adjacent bone. Protuberance—A bump on a bone; often the site of muscle
Fissure—A cleft or cracklike hole in a bone that allows the attachment.
passage of nerves and/or vessels. Ramus—A portion of bone that branches from the body
Foramen—A hole within a bone that allows the passage of the bone (plural: rami).
of a nerve and/or vessel (plural: foramina). Sinus—A cavity within a bone.
Fossa—A depression in a bone that often receives an artic- Spine—A thornlike, sharp, pointed process of a bone;
ulating bone (plural: fossae). often a site of muscle attachment.
70
PART II Skeletal Osteology: Study of the Bones 71
Sulcus—A groove or elongated depression in a bone girdle (pelvic bones). Figures 4-1 and 4-2 illustrate the
(plural: sulci). axial and appendicular skeletons. Table 4-1 lists the
Trochanter—A large bump on a bone (larger than a tuber- bones of the human body.
cle/tuberosity); usually a site of muscle attachment. ❍ Note: Whenever a bone exists on both sides of the
Tubercle/tuberosity—A moderately sized bump on a body, the right-sided bone is shown in this chapter.
bone; often a site of muscle attachment. A tubercle is
usually considered to be smaller than a tuberosity. BOX 4-1
The stated number of 206 bones in the human body is variable.
THE SKELETAL SYSTEM: Sesamoid bones in addition to the patellae usually exist, and
❍ The human skeleton is usually said to have 206 bones small islets of bone located within the sutures of the skull called
(Box 4-1). wormian bones are often present. Furthermore, occasional
❍ This number is based on the axial skeleton having anomalous bones may exist. Any bone beyond the usual number
80 bones and the appendicular skeleton having 126. of 206 may be called a supernumerary bone.
The axial skeleton makes up the central vertical axis of
the body and is composed of the bones of the head,

BOX 4-2
neck, trunk, and the sacrum and coccyx (Box 4-2).
❍ The appendicular skeleton is made up of the append- Another way to look at the axial skeleton is to say that it is
ages that attach onto the axial skeleton (i.e., the upper composed of the bones of the head, spinal column (the sacrum
and lower extremities), including the bones of the and coccyx are part of the spinal column), ribcage, and hyoid.
shoulder girdle (scapulae and clavicles) and the pelvic
TABLE 4-1 Bones of Skeleton (206 Total)
Axial Skeleton (80 Bones Total) Appendicular Skeleton (126 Bones Total)
Part of Body Name of Bone(s) Part of Body Name of Bone(s)
Skull (28 bones total) Upper extremities (including Clavicle (2)
Cranium (8 bones) Frontal (1) shoulder girdle) (64 bones Scapula (2)
Parietal (2) total) Humerus (2)
Temporal (2) Radius (2)
Occipital (1) Ulna (2)
Sphenoid (1) Carpals (16)
Ethmoid (1) Metacarpals (10)
Face (14 bones) Nasal (2) Phalanges (28)
Maxillary (2) Lower extremities (including Pelvis (2)
Zygomatic (2) pelvic girdle) (62 bones total) Femur (2)
Mandible (1) Patella (2)
Lacrimal (2) Tibia (2)
Palatine (2) Fibula (2)
Inferior nasal conchae (2) Tarsals (14)
Vomer (1) Metatarsals (10)
Ear bones (6 bones) Malleus (2) Phalanges (28)
Incus (2)
Stapes (2)
Hyoid bone (1)
Spinal column (26 bones total) Cervical vertebrae (7)
Thoracic vertebrae (12)
Lumbar vertebrae (5)
Sacrum (1)
Coccyx (1)
Sternum and ribs (25 bones total) Sternum (1)
True ribs (14)
False ribs (10)
From Thibodeau GA, Patton KT: Anatomy and physiology, ed 5, St Louis, 2003, Mosby.
72 CHAPTER 4 Bones of the Human Body
FULL SKELETON—ANTERIOR VIEW
Skull (cranium)
Mandible
Cervical vertebrae
Clavicle
Sternum
Scapula
Ribcage
Humerus
Thoracic vertebrae
Lumbar vertebrae
Radius
Sacrum
Ulna
Pelvic bone
Carpals
Metacarpals
Phalanges
Femur
Patella
Fibula
Tibia
Tarsals
Metatarsals
Phalanges
FIGURE 4-1 Bones colored beige are bones of the appendicular skeleton; bones colored green are bones
of the axial skeleton.
FULL SKELETON—POSTERIOR VIEW
Skull (cranium)
Mandible
Clavicle Cervical vertebrae
Scapula
Thoracic vertebrae
Humerus
Radius Ribcage
Carpals
Metacarpals
Ulna
Phalanges
Lumbar vertebrae
Sacrum Pelvic bone
Coccyx
Femur
Fibula
Tibia
Tarsals
Metatarsals
Phalanges
FIGURE 4-2 Bones colored beige are bones of the appendicular skeleton; bones colored green are bones
of the axial skeleton.
4.1 BONES OF THE HEAD
SKULL—ANTERIOR VIEW (COLORED)
Superior
Frontal bone
Parietal bone
Temporal bone
Sphenoid bone
Zygomatic bone
Maxilla
Mandible
R
i L
Nasal bone
g e
h f
Lacrimal bone
t
t
Ethmoid bone
Vomer
Palatine bone
Inf. nasal concha
Inferior
FIGURE 4-3
Frontal bone
Parietal bone
Occipital bone (not seen)
Temporal bone
NOTES
Sphenoid bone 1. Embryologically, two maxillary bones (left and right) exist.
Zygomatic bone However, these two bones fuse to form one maxilla (an
Maxilla incomplete fusion results in a cleft palate). For this
Mandible reason, we may speak of one maxilla (singular) or of two
Nasal bone maxillary bones (plural).
Lacrimal bone 2. The frontal, sphenoid, zygomatic, maxillary, lacrimal, and
Ethmoid bone ethmoid bones all have a presence in the orbital cavity.
Vomer 3. The ethmoid, vomer, and inferior nasal concha are all
Palatine bone visible in this anterior view of the nasal cavity.
Inferior nasal concha
SKULL—ANTERIOR VIEW
FIGURE 4-4 Superior
1 Frontal bone (#1-6)
2 Superciliary arch
3 Supraorbital margin
4 Supraorbital notch
5 Glabella
6 Orbital surface 1
7 Nasal bone
8 Internasal suture
9 Frontonasal suture
43
10 Nasomaxillary suture
11 Orbital cavity
4 2
12 Superior orbital fissure
42 5
13 Inferior orbital fissure 3

6
14 Greater wing of sphenoid

8 9 15
15 Lesser wing of sphenoid 22

26
11 7
16 Lacrimal bone 16 17
R 12 14
17 Ethmoid bone 13 18 L
i
10 e
18 Middle nasal concha (of ethmoid bone) g
f
19 Inferior nasal concha h

23 21 t
t 24
20 Vomer
19 20
21 Palatine bone 25 27
22 Frontozygomatic suture
23 Infraorbital margin 28 31
24 Zygomatic bone 30 32 29
25 Zygomaticomaxillary suture
34
Maxilla (#26-31):
26 Frontal process
27 Infraorbital foramen 35
28 Canine fossa 38
29 Incisive fossa (indicated by dotted line) 37 36
30 Alveolar process (indicated by dashed line) 33

31 Anterior nasal spine 39
32 Intermaxillary suture 40
Mandible (#33-43): 41 Inferior
33 Body
34 Ramus
35 Angle
36 Mental foramen NOTES
37 Incisive fossa (indicated by dotted line) 1. The term cranium is usually considered to be synonymous with
38 Alveolar fossa (indicated by dashed line) the term skull. Some sources exclude the mandible and/or other
39 Symphysis menti facial bones from the term cranium.
40 Mental tubercle 2. The glabella is a smooth prominence on the frontal bone, just
41 Oblique line (indicated by solid line) superior to the nose.
42 Temporal bone 3. The inferior nasal concha is an independent bone. The middle
43 Parietal bone and superior nasal conchae are landmarks of the ethmoid bone.
4. The vomer and ethmoid both contribute to the nasal septum,
which divides the nasal cavity into left and right nasal passages.
5. The supraorbital margin is wholly located on the frontal bone;
the infraorbital margin is located on the maxilla and the
zygomatic bone.
SKULL—RIGHT LATERAL VIEW (COLORED)
Superior
Frontal bone
Parietal bone
Temporal bone
Sphenoid bone
Zygomatic bone
P Maxilla
A
o
Mandible n
s t
t e
e Occipital bone
r
r i
i Nasal bone
o
o r
r Lacrimal bone
Inferior
FIGURE 4-5
Frontal bone
Parietal bone NOTES
Temporal bone 1. The occipital bone is often referred to as the occiput.
Sphenoid bone 2. In this lateral view, the sphenoid bone is visible posterior
Zygomatic bone to the maxilla (between the condyle and coronoid process
Maxilla of the mandible).
Mandible
Occipital bone
Nasal bone
Lacrimal bone
SKULL—RIGHT LATERAL VIEW
FIGURE 4-6 Superior
1 Frontal bone
2 Glabella
3 Coronal suture
4 Frontozygomatic suture
5 Superior temporal line 6

3
1
6 Parietal bone
7 Lambdoid suture
8 Occipital bone 5
9 External occipital protuberance

2
(EOP)
15
10 Temporal bone (#11-14) P

4 A
11 Mastoid process o
10 n
12 Styloid process s 7 18
t
t 25 21
13 External auditory meatus e 17 e

14 Zygomatic arch 24 r
r
15 Squamosal suture 8 14 16 i
i 20
9 13 30 o
16 Zygomaticotemporal suture o 23
r
19 r
17 Temporomandibular joint (TMJ)

18 Greater wing of sphenoid bone 11 29
22
19 Lateral pterygoid plate (of the

pterygoid process) of the 12 28
sphenoid bone
20 Zygomatic bone
21 Nasal bone 27
22 Maxilla 26
23 Anterior nasal spine 31
24 Frontal process of maxilla 32
25 Lacrimal bone
Inferior
Mandible (#26-32):
26 Body
27 Angle
28 Ramus
29 Coronoid process
30 Condyle
31 Mental foramen
32 Mental tubercle
NOTES
1. The temporal fossa (the attachment site of the temporalis 4. The squamosal suture is named for being next to the
muscle) is a broad area of the skull that overlies the squamous portion (the superior aspect near the parietal
temporal, parietal, frontal, and sphenoid bones. The bone) of the temporal bone. The squamous portion of the
superior margin of the temporal fossa is the superior temporal bone is so named because it usually has a scaly
temporal line, visible on the frontal bone (#5). appearance (squamous means scaly).
2. The external auditory meatus is the opening into the middle 5. The lateral pterygoid plate (of the pterygoid process) of the
ear cavity, which is located within the temporal bone. sphenoid bone (visible as #19) is the medial attachment
3. The zygomatic arch is usually spoken of as being a site of the lateral and medial pterygoid muscles. The medial
landmark only of the temporal bone. However, technically pterygoid muscle attaches to its medial surface; the lateral
the zygomatic arch is a landmark of both the temporal and pterygoid muscle attaches to its lateral surface (visible as
zygomatic bones formed by the zygomatic process of the #19).
temporal bone and the temporal process of the zygomatic
bone (see Figure 4-15, C).
SKULL—POSTERIOR VIEWS
Superior Superior
1 1
3
4
R R
L L
i 6 i
e e 7
f
g
f
g
h 11 11 h
t t
t 8 t
26 9
19
18 10 12
15
16
23 13 17 14
25
24
Parietal bone Zygomatic bone Occipital bone 20
Temporal bone Maxilla Vomer
Sphenoid bone Mandible Palatine bone

22
21
A Inferior B Inferior
FIGURE 4-7 Mandible (#20-25):
1 Parietal bone 20 Mandible
2 Sagittal suture 21 Inferior and superior mental spines
3 Lambdoid suture 22 Mylohyoid line

23 Lingula
Occipital bone (#4-10): 24 Angle
4 Occipital bone 25 Ramus
5 Highest nuchal line 26 Zygomatic bone
6 Superior nuchal line
7 External occipital protuberance (EOP)
8 Inferior nuchal line
9 External occipital crest
10 Condyle NOTES
11 Temporal bone
1. The external occipital protuberance (EOP) is also known

12 Mastoid process of the temporal bone as the inion.
13 Maxilla
2. The EOP is located in the middle of the superior nuchal

14 Tuberosity of the maxilla line of the occiput.
3. The lateral and medial pterygoid plates are landmarks of

Sphenoid bone (#15-17): the pterygoid process of the sphenoid bone.
15 Lateral pterygoid plate of the pterygoid process 4. The lateral pterygoid muscle attaches to the lateral
16 Medial pterygoid plate of the pterygoid process surface of the lateral pterygoid plate of the sphenoid; the
17 Pterygoid hamulus medial pterygoid muscle attaches to the medial surface of
18 Vomer the lateral pterygoid plate of the sphenoid.
19 Palatine bone
SKULL—INFERIOR VIEWS
Anterior Anterior
29
27
25 26
23 24
19
17 18 20 14
22 21
R R
L L
i i
e 9 28 e
g g 15
f 7 f
h h 13
t 10 16 t
t t
6
11
8 12
30
2
Sphenoid bone
Frontal bone Zygomatic bone Occipital bone
4
3
Parietal bone Maxilla Vomer
Temporal bone Mandible Palatine bone
A Posterior B Posterior
FIGURE 4-8 23 Palatine bone
Occipital bone (#1-9): 24 Posterior nasal spine of palatine bones
1 External occipital crest 25 Maxilla
2 Inferior nuchal line 26 Zygomatic bone
3 Superior nuchal line 27 Mandible
4 External occipital protuberance (EOP) 28 Angle of the mandible
5 Foramen magnum 29 Frontal bone
6 Condyle 30 Parietal bone
7 Basilar part
8 Jugular process
9 Foramen lacerum NOTES
1. The foramen magnum is the division point between the
Temporal bone (#10-15): brain and spinal cord. The brain and spinal cord are
10 Temporal bone actually one structure; superior to the foramen magnum is
11 Mastoid process the brain; inferior to it is the spinal cord.
12 Mastoid notch 2. The foramen lacerum is mostly blocked with cartilage,
13 Styloid process allowing only a small nerve, the nerve of the pterygoid
14 Zygomatic arch canal, to pass through.
15 Carotid canal 3. The carotid canal provides a passageway for the internal
16 Jugular foramen (of the occipital bone) carotid artery to enter the cranial cavity.
17 Vomer 4. The jugular foramen provides a passageway for cranial
nerves (CNs) IX, X, and XI to pass from the brain to the

Sphenoid bone (#18-22): neck. Venous blood draining from the brain to the internal
18 Medial pterygoid plate of pterygoid process
jugular vein also passes through the jugular foramen.

19 Pterygoid hamulus 5. The foramen ovale provides a passageway for the
20 Lateral pterygoid plate of pterygoid process
mandibular division of the trigeminal nerve (CN V) to pass

21 Greater wing of sphenoid from the brain to the neck.
22 Foramen ovale
SKULL—INTERNAL VIEWS
Anterior Anterior
22 21
18
19
17
24 20
16
11
10
12
23 15
9 13
R R
L
i
L
i
e e 14
g g
f f 7
t
h
t
4 h
t 8
t
6
1
Frontal bone Sphenoid bone Occipital bone 2
Parietal bone Zygomatic bone Nasal bone
Temporal bone Maxilla Ethmoid bone
FIGURE 4-9 21 Nasal bone
Occipital bone (#1-5): 22 Maxilla
1 Occipital bone 23 Zygomatic arch of temporal bone
2 Internal occipital protuberance 24 Temporal arch of zygomatic bone
3 Foramen magnum
4 Basilar part
5 Jugular foramen
6 Parietal bone NOTES
7 Squamous part of temporal bone 1. The sella turcica of the sphenoid is where the pituitary
8 Petrous part of temporal bone gland sits (sella turcica literally means Turkish saddle).
9 Foramen lacerum 2. The optic foramen allows passage of the optic nerve
(cranial nerve [CN] II) from the eye to the brain.
Sphenoid bone (#10-16): 3. From this view, the eyeball is located deep to the orbital
10 Sphenoid bone part of the frontal bone (#17).
11 Lesser wing 4. The crista galli of the ethmoid is an attachment site of the
12 Greater wing falx cerebri of the dura mater, one of the meninges of the
13 Sella turcica brain.
14 Dorsum sellae 5. Receptor cells for the sense of smell from the nasal cavity
15 Foramen ovale pierce the cribriform plate of the ethmoid bone to connect
16 Optic foramen with the olfactory bulb (CN I) of the brain.
17 Frontal bone (orbital part) 6. The basilar portion of the occiput and the most posterior
18 Frontal crest portion of the sphenoid are often collectively called the
19 Crista galli of ethmoid bone clivus.
20 Cribriform plate of ethmoid bone
SKULL—SAGITTAL SECTION AND THE ORBITAL CAVITY
Coronal suture
A P
Sphenoid bone I
Parietal bone
Frontal bone Temporal bone
Frontal sinus
Sella turcica
Crista galli of ethmoid bone
Lambdoidal suture
Nasal bone
Perpendicular plate of ethmoid bone Occipital bone
Inferior concha
Maxilla
Sphenoid sinus
Vomer
Pterygoid process
of sphenoid bone
Mandible
Frontal bone
Superior orbital fissure
Optic foramen
Sphenoid bone
Ethmoid bone
Zygomatic bone
Lacrimal bone
Inferior orbital fissure
Maxilla
L M
I
Infraorbital foramen B
FIGURE 4-10 A, Right half of the skull viewed from within. B, Bones that form the right orbit. (Modified
from Patton KT, Thibodeau GA: Anatomy and physiology, ed 7, St Louis, 2010, Mosby.)
MANDIBLE
Superior
Posterior Left
12
13
11
10
P
A 14
o
n
s
t 12
t 9 11 10
e
e
13 B
r
r
i 15 6
i
o
9
o 8
6
r
r 3 7
1 6
2 8 3 7
1
4 2 4 5
Right Anterior
A Inferior
Anterior
5 7 4
1 R
L i
e g
f 8
h
t t
10
14 9
11
13
12
C Posterior
FIGURE 4-11 A, Right lateral view. B, Oblique view. C, Superior view.
NOTES
1 Body 1. The symphysis menti is where the left and right sides of
2 Mental foramen
the mandible fuse together.

3 Oblique line 2. The word ramus means branch. The ramus of the
4 Mental protuberance
mandible branches from the body of the mandible.

5 Symphysis menti 3. The coronoid process and condyle are landmarks of the
6 Alveolar process (indicated in light pink)
ramus of the mandible.

7 Incisive fossa (indicated in dark pink) 4. The condyle of the mandible articulates with the temporal
8 Angle bone, forming the temporomandibular joint (TMJ).
9 Ramus 5. The head of the condyle is easily palpable just anterior to
10 Coronoid process the ear while the mouth is opened and closed (elevating
11 Mandibular notch and depressing the mandible at the TMJ). Alternately,
12 Head of condyle place your palpating finger inside your ear and press
13 Neck of condyle anteriorly while opening and closing the mouth.
14 Lingula 6. The mylohyoid line is the attachment site on the internal
15 Mylohyoid line mandible of the mylohyoid muscle.
PARIETAL, TEMPORAL, AND FRONTAL BONES
Superior
temporal line Parietal
bone
Inferior
temporal line
A
Temporal
bone
Squamous
portion
External Mandibular
fossa
auditory
meatus
Zygomatic
arch (process)
Mastoid
process
Styloid process
Frontal
bone
Supraorbital
notch
Supraorbital
margin
Zygomatic
process
Orbital plate Glabella
Nasal spine
FIGURE 4-12 A, Lateral view at the right parietal bone. B, Lateral view of the right temporal bone.
C, Anterior view of the frontal bone. (Modified from Patton KT, Thibodeau GA: Anatomy and physiology,
ed 7, St Louis, 2010, Mosby.)
OCCIPITAL AND SPHENOID BONES
Occipital
condyle
Foramen
magnum
External
Inferior
nuchal occipital
line crest
External
Superior occipital
nuchal protuberance
line
Optic Lesser
foramen wing
Superior
orbital
fissure
Greater
wing
Foramen ovale
B
Sella
turcica
Superior orbital Lesser
fissure wing
Greater
wing
Body
Lateral pterygoid plate
Medial pterygoid plate
Pterygoid hamulus
FIGURE 4-13 A, Inferior view of the occipital bone. B, Superior view of the sphenoid bone (within the
cranial cavity). C, Posterior view of the sphenoid bone. (Modified from Patton KT, Thibodeau GA: Anatomy
and physiology, ed 7, St Louis, 2010, Mosby.)
ETHMOID AND VOMER
Anterior
Perpendicular
plate
Crista galli
Crista galli Ethmoidal sinus Ethmoidal sinus
Cribriform
plate
Posterior Anterior
Perpendicular
plate
Posterior Middle
A nasal B
concha
Crista galli
Ethmoid bone
Ethmoidal
sinus
Superior
nasal
concha
Middle
nasal
C concha
Perpendicular
plate
Vomer
Ala
Ala
Vertical plate
D E
FIGURE 4-14 A, Superior view of the ethmoid bone. B, Right lateral view of the ethmoid bone. C, Anterior
view of the ethmoid bone. D, Anterior view of the vomer. E, Right lateral view of the vomer. (Modified from
Patton KT, Thibodeau GA: Anatomy and physiology, ed 7, St Louis, 2010, Mosby.)
MAXILLARY AND ZYGOMATIC BONES
Frontal
process
Maxilla
Maxillary
Alveolar sinus
process
Palatine
process
Notch for
lacrimal bone
Frontal
Orbital process
Incisors Premolars Molars

surface
Canine
Infraorbital
foramen
Zygomatic
process
Anterior nasal spine
Alveolar process
Molars Premolars Incisors
Canine
Frontal process
Temporal
process Infraorbital
margin
Zygomaticofacial Zygomatic bone
foramen
FIGURE 4-15 A, Medial view of the right maxilla. B, Lateral view of the right maxilla. C, Lateral view of the
right zygomatic bone. (Modified from Patton KT, Thibodeau GA: Anatomy and physiology, ed 7, St Louis, 2010,
Mosby.)
PALATINE, LACRIMAL, AND NASAL BONES
Vertical plate Palatine

bone
Horizontal
Horizontal
plate plate
A B
Lacrimal bone
Nasal bone
FIGURE 4-16 A, Medial view of the right palatine bone. B, Anterior view of the right palatine bone.
C, Anterior view of the right lacrimal bone. D, Anterior view of the right nasal bone. (From Patton KT, Thibodeau
GA: Anatomy and physiology, ed 7, St Louis, 2010, Mosby.)
4.2 BONES OF THE SPINE (AND HYOID)
SPINAL COLUMN—POSTERIOR VIEW
C1 (atlas)
C2 (axis)
Cervical
spine (C1-C7)
C7
T1
Transverse
processes
(TPs)
Thoracic
spine (T1-T12)
Spinous
processes
(SPs)
NOTES
1. The spine is part of the axial skeleton and is
T12
composed of five regions: the cervical, thoracic,
lumbar, sacral, and coccygeal spines.
L1 2. The spine has seven cervical vertebrae (named
C1-C7), 12 thoracic vertebrae (named T1-T12),
five lumbar vertebrae (named L1-L5), one sacrum
Lumbar (composed of five fused sacral vertebrae, named
spine (L1-L5)
S1-S5), and one coccyx (usually composed of four
rudimentary vertebrae, named Co1-Co4).
3. Vertebra is singular; vertebrae is plural.
4. The spinal column is composed of 24 vertebrae,

L5
a sacrum, and a coccyx.
5. The cervical spine is located within the neck.
6. The thoracic and lumbar spines are located in the

Sacrum
(sacral spine, trunk.
S1-S5) 7. The thoracic spine constitutes the thorax; the
lumbar spine constitutes the abdomen.
8. The thoracic spine is defined by having the
ribcage attach to it; hence humans have 12 pairs

Coccyx (coccygeal spine,
Co1-Co4) of ribs and 12 thoracic vertebrae.
9. The sacrum and coccyx are located within the
pelvis.
FIGURE 4-17
SPINAL COLUMN—RIGHT LATERAL VIEW
Superior
C1
C2
Cervical
spine
(C1-C7)
C7
Transverse T1
processes
(TPs)
Spinous
processes
(SPs)
Thoracic
spine
(T1-T12)
Facet joints
P A
o n
s Disc spaces t
t e
e r
r i
i T12 o
o r
r L1
NOTES
Lumbar 1. Curves of the spine: The cervical and lumbar spines
spine
(L1-L5)
are lordotic (i.e., concave posteriorly); the thoracic
Intervertebral and sacral (sacrococcygeal) spines are kyphotic
foramina
(i.e., concave anteriorly).
2. Generally a disc joint and paired right and left
facet joints are found between each two
L5 contiguous vertebrae.
3. Intervertebral foramina (singular: foramen) are
where spinal nerves enter/exit the spine.
Sacrum 4. Spinous processes (SPs) project posteriorly and are

(sacral spine,
S1-S5) usually easily palpable. (Note: The word spine
means thorn; SPs are pointy like thorns.)
5. Transverse processes (TPs) project laterally in the
Coccyx transverse plane (hence their name).

(coccygeal spine,
Co1-Co4)
6. Because the spine is a weight-bearing structure,
the bodies of the vertebrae (the weight-bearing
aspect of the spinal column) get progressively

Inferior
larger from superior to inferior.

FIGURE 4-18
CERVICAL SPINE AND HYOID
Superior
C1 (atlas)
C2 spinous
C2
process
(axis) S
P 3 2 P A
A
o 1
C3 n I
s
t
t
e
e C4 B
C7 spinous r
r process i
i
o C5
o
r
r
C6
C7 Superior
C1 S
T1
R L
A Inferior
C1-C2 facet I
joint C2
Intervertebral
foramen 3 2
(C2-C3)
C3 1
R
L
i D
g
e
C4
f
h
t
t
C5
Facet joint
(C3-C4)
C6
Disc joint
space (C3-C4)
C7
T1
C Inferior
FIGURE 4-19 A, Right lateral view of the cervical spine. B, Right lateral NOTES
view of the hyoid bone. C, Anterior view of the cervical spine. D, Anterior
view of the hyoid bone. 1. The hyoid is located at the level of the C3 vertebra.
1 Body 2. The greater cornu and lesser cornu of the hyoid are also
2 Lesser cornu known as the greater and lesser horns.
3 Greater cornu 3. The hyoid bone serves as an attachment site for the hyoid
muscle group, as well as many muscles of the tongue.
4. The hyoid is the only bone in the human body that does
not articulate with another bone.
5. The lordotic (i.e., concave posteriorly) curve of the cervical
spine is indicated by the line drawn anterior to the
cervical spine.
6. The spinous processes (SPs) of C2 and C7 are very
palpable and serve as excellent landmarks.
CERVICAL SPINE (CONTINUED)
Superior Superior
Atlanto-
odontoid
2 joint
4 C2
C1 (atlas) C2
spinous
C2 process
C3
6 C3
R Intervertebral
L foramen
C4 i C4
e (C3-C4)
g
f
h
t C5 C7
t spinous C5
process
C6
C7 C6
T1
C7
C7 spinous
T1
process
A B
Inferior Inferior
Posterior view Anterolateral oblique view
Anterior Right
Atlanto-odontoid
joint 3
1 Right C1-C2
facet joint
2
C 4
Left Posterior
Posterosuperior oblique view
FIGURE 4-20 A, Posterior view. B, Anterolateral oblique view.
NOTES
C, Posterosuperior oblique view.
1. The oblique view of the cervical spine demonstrates the

1 Anterior arch of C1 (atlas)
intervertebral foramina well (the right C3-C4 intervertebral

2 Dens of C2 (axis)
foramen is labeled). The intervertebral foramen is where

3 Superior articular process/facet of C1
the spinal nerve enters/exits the spinal cord.

4 Body of C2
2. The posterosuperior oblique view demonstrates the

5 Posterior tubercle of C1
atlantoaxial joint complex well (Figure 4-20, C).

6 Spinous process (SP) of C2
ATLAS (C1)
Anterior Anterior
2 2
1
5
3 4 7 6 R R 6 3
L i i
7 L
e g e
10 g
f f
h h 10
t t t
t
8
9 9
A Posterior Posterior B
Superior Superior
4 10
R 1 4 R
i L L 3 i
7
g 11 1 2 e e g
h 6 f f 9 8 6 h
t t t t
5
5
C Inferior Inferior D
Superior
P
A
o
n
s
t
t 9 7
e 2
e
8 r
r
i
i
o
o 6 r
r
E Inferior
FIGURE 4-21 A, Superior view. B, Inferior view. C, Anterior view. NOTES
D, Posterior view. E, Right lateral view.
1. Unlike the other vertebrae, the atlas has no body. What

1 Anterior arch
would have been the body of the atlas became the dens
2 Anterior tubercle
of the axis (C2).

3 Facet for dens of axis (C2)
2. Also unique to the atlas are the anterior and posterior

4 Superior articular process/facet
arches. The centers of these arches have the anterior and

5 Inferior articular process/facet
posterior tubercles, respectively.

6 Transverse process (TP)
3. The superior articular processes of the atlas articulate with

7 Transverse foramen
the occipital condyles at the atlanto-occipital joint; the

8 Posterior arch
inferior articular processes of the atlas articulate with the

9 Posterior tubercle
superior articular processes of the axis at the atlantoaxial

10 Vertebral foramen
(C1-C2) joint.
11 Lateral mass
4. The superior and inferior articular processes of the atlas
create what is termed the lateral mass (labeled in the
anterior view).
AXIS (C2)
Anterior Anterior
1 2
4 4 5 10
6 R R 6
L L
10 i i
e 3 e
g g 3 9
f 9 f
7 h h
t 7 t
t t
8 8
8 8
A B
Posterior Posterior
Superior Superior
11
R R
L L 2
i i
e e 10 5 g
g 2 6
f f
h 4 h
t t 7
t t
10 3
3 8
4
8
8
C D
Inferior Inferior
Superior
1 11 A
o
n
s
t
t
2 e
e
8 6 r
r 7
i
i 5
o
o
3 10 r
r 4
E Inferior
D, Posterior view. E, Right lateral view.
1. The dens of the axis creates an axis of rotation for the

1 Dens (odontoid process)
atlas to rotate about, hence the name C2 (i.e., the axis).

2. The superior articular processes of the axis articulate with

the inferior articular processes of the atlas.

3. The spinous process (SP) of C2 is very large and an

excellent landmark when a client’s posterior neck is

6 Pedicle
palpated. It will be the first large structure felt midline,

7 Lamina
inferior to the skull.

8 Spinous process (SP) (bifid)
4. The SP of the axis is bifid. Furthermore, the two bifid

9 Vertebral foramen
points are often asymmetric in size and shape.

10 Body
5. The facet on the dens articulates with the anterior arch of

11 Facet on dens
the atlas, forming the atlanto-odontoid joint.
C5 (TYPICAL CERVICAL VERTEBRA)
Anterior Anterior
3 3
5 5
1 2 6 6 1
4 4
7 7
L
R R
L
8 i i
e 12 g g
9 12 e
f h h f
t 10
t t 10 t
9
11 11
11 11
Superior
Superior 3
8 2 8
1
R 4
R
i L L i
3 e e
g g
h 4 f f 10
h
1
t t t t
11 11
C Inferior
D Inferior
FIGURE 4-23 A, Superior view. B, Inferior view. C, Anterior view.
NOTES
D, Posterior view.
1. The articular process is the entire structural landmark that

1 Body
projects outward from the bone; the articular facet is the

2 Uncus of body
smooth articular surface located on the articular process.

3 Anterior tubercle of transverse process (TP)
2. The plural of foramen is foramina.

4 Posterior tubercle of TP
3. The cervical vertebrae possess a number of structures that

5 Groove for spinal nerve (on TP)
the other vertebrae do not: an uncus is located on the left

and right sides of the body; they have bifid (i.e., two
7 Pedicle
points on their) spinous processes (SPs); their transverse

processes (TPs) have an anterior and posterior tubercle;

and they have a foramen located within the TP (hence the

10 Lamina
name transverse foramen).

4. The bifid SP of a cervical vertebra is often asymmetric.
This may lead one to conclude on palpatory examination
that the vertebra is rotated when it is not.
5. The cervical transverse foramen allows passage up to the
skull of the vertebral artery.
C5 (CONTINUED) AND CERVICAL ENDPLATES
Superior Left Anterior
2 2
P 8 8
A 1
o 3 7 3
s
6 n 6
t
t 9 5
e
e
4 5 r 12 4
r 10
i
i 10
1 o
o 9
r
11 r
11 11
E Inferior Posterior F Right
Anterior
C1
C2
L
i
e
g
f
h
t
C3 C4 C5 C6 C7
Posterior
FIGURE 4-23 E, Right lateral view. F, Oblique posterior view; and NOTES
FIGURE 4-24
1. Figure 4-24 shows the superior view of all seven cervical
1 Body
vertebrae (cervical endplate view). The differences from
2 Uncus of body
one cervical level to another can be seen.
3 Anterior tubercle of transverse process (TP)

2. C1 is also known as the atlas; C2 is also known as the
4 Posterior tubercle of TP
axis.
5 Groove for spinal nerve (on TP)
3. The anterior tubercle of the transverse process (TP) of C6

is larger than the other anterior tubercles and is known as

7 Pedicle
the carotid tubercle.

4. The large spinous process (SP) of C7 more closely

resembles the SPs of the thoracic vertebrae than it does

10 Lamina
those of the other cervical vertebrae. This large SP gives

C7 its name, the vertebra prominens.

THORACIC SPINE—RIGHT LATERAL VIEW
Superior
T1
T2
T3
Inferior vertebral
notch
Superior vertebral T4
notch
Intervertebral foramen T5
(T5-T6) Body of T6
P T6 A
o
n
s
t
t
T7 e
e
r
r
i
i
o
o T8
r
r
Spinous process Costal hemifacets

of T6 T9 for rib (#9)
Transverse costal
facet for rib (#8)
T10
Transverse process
of T10 Disc joint

space (T10-T11)
T11
Facet joint
(T10-T11)
T12
Inferior
FIGURE 4-25
NOTES
1. The kyphotic (i.e., concave anteriorly) curve of the thoracic 4. The SPs of the thoracic spine are easily palpable (the word
spine is indicated by the line drawn anterior to the thoracic spine means thorn [i.e., a pointy projection]).
spine. 5. The vertebral body costal hemifacets for a rib (i.e., for the
2. The lateral view of the thoracic spine demonstrates the costovertebral joint) are labeled at the T8-T9 level. They are
intervertebral foramina well (the right T5-T6 intervertebral located on two contiguous vertebral bodies and span across
foramen is labeled). The intervertebral foramen is where the the disc that is located between.
spinal nerve enters/exits the spinal cord. 6. The transverse costal facet for a rib (i.e., for the
3. The long downward-slanted orientation of the thoracic costotransverse joint) is labeled at the T8 level.
spinous processes (SPs), especially of the midthoracic spine, 7. The gradual increase in size of the thoracic vertebral bodies
can be seen. The tip of a thoracic SP is at the level of the from T1 to T12 can be seen.
body of the vertebra below it (e.g., see the body and SP of
T6, labeled).
THORACIC SPINE—POSTERIOR VIEW
Superior
T1
T2
T3
Lamina
(T4) T4
T5
T7 Transverse T6
process
R
L T7
i
e
f
g
h
t T8 t
T6 Spinous
process
T9
Facet joint
(T9-T10)
T10
T11
T12
Inferior
FIGURE 4-26
NOTES
1. The differences in spinous processes (SPs) from T1 to T12 can 3. The TPs of the spine project laterally into the transverse
be seen. plane, hence their name.
2. The SP of T6 and the transverse process (TP) of T7 are 4. The crooked SP of T7 of this specimen can be seen; bones of
labeled, illustrating the relative location of a vertebral TP the body often have slight asymmetries such as this. A
relative to the more palpable SP of the vertebra above. When flexible understanding of the shapes of bones is important;
palpating the thoracic spine (especially the midthoracic spine), otherwise the crooked SP of T7 in this case could be
the downward slope of the SPs should be kept in mind. interpreted as a rotated vertebra when in fact it is not.
T5 (TYPICAL THORACIC VERTEBRA)
Anterior Anterior
1 1
R R
L
i i
L
e 2 8 e
8 2 g g
f f
t
h h 3
t
3 t t 4
6 6
5
7 7
A B
Posterior Posterior
Superior Superior
3 3
5
5
R R
1 L L 6
i i
e e 4
g g
f f
h h
t t
t t
7 7
C D
Inferior Inferior
D, Posterior view.
1. The pedicle of a vertebra is the structure that connects

1 Body
the body to the rest of the structures of the vertebra. If

2 Pedicle
one looks at the superior or inferior view of a vertebra

such that the body is at the bottom of the page, the

pedicles may be viewed as the feet (ped means foot) of a

statue that is standing on its base or pedestal (the body

6 Lamina
of the vertebra being analogous to the base or pedestal

7 Spinous process (SP)
of the statue).
8 Vertebral foramen
3. The laminae (singular: lamina) may be viewed as
laminating together to form the spinous process (SP) of a
vertebra.
4. Plural of foramen is foramina.
5. The vertebral foramina of the spinal column create the
spinal canal, though which the spinal cord runs.
T5 (CONTINUED) AND THORACIC ENDPLATES
Superior
13
P 2 8
10 5 A 2
o 1
n 1
s
11 t S A 5 10
t
e
e 4 r 11
r 6 P I
9 i 12
i 6 9
o
o 4
r
r
7 7
E F
Inferior
Anterior
T1 T2 T3 T4 T5 T6
R
L
i
e
g
f
h
t
t
T7 T8 T9 T10 T11 T12
Posterior
FIGURE 4-27 E, Right lateral view. F, Posterior oblique view; and
NOTES
FIGURE 4-28
1. The superior and inferior costal hemifacets on the bodies are the
1 Body
vertebral articular surfaces for the costovertebral joint; the

2 Pedicle
transverse costal facet on the transverse process (TP) is the

vertebral articular surface for the costotransverse joint.

2. The lateral view of a thoracic vertebra is ideal for visualizing the

intervertebral foramen, which is formed by the inferior vertebral

6 Lamina
notch of the superior vertebra (see #12) juxtaposed next to the

superior vertebral notch of the inferior vertebra (see #13).

8 Superior costal hemifacet
3. Figure 4-28 shows a superior view of all twelve thoracic

9 Inferior costal hemifacet
vertebrae (thoracic endplate view). A gradual change in the

10 Transverse costal facet
shape of the thoracic vertebrae is seen from superior to inferior.
11 Intervertebral foramen
Specifically, the change in the shape of the spinous processes
12 Inferior vertebral notch

(SPs) and bodies can be seen.
13 Superior vertebral notch

4. Costal hemifacets on the bodies of thoracic vertebrae usually
create the articular surface for the costovertebral joints of ribs #2
through #10. Usually, T1, T11, and T12 have full facets for ribs
#1, #11, and #12, respectively (see Figure 4-25).
LUMBAR SPINE—RIGHT LATERAL VIEW
Superior
L1
Body (L2)
L2
Inferior vertebral
notch
Spinous process (L3)
Superior vertebral
L3 notch
P
A
o
n
s
t
t
e
e
r
r
L4 i
i
o
o
r
Intervertebral foramen
Lumbosacral (L5-S1)
facet joint
(L4-L5)
L5
Lumbosacral (L5-S1)
disc joint space
Sacrum
Inferior
FIGURE 4-29
NOTES
1. Note the lordotic (concave posteriorly) curve of the lumbar 3. Note the large blunt quadrate-shaped lumbar spinous
spine (indicated by the line drawn anterior to the lumbar processes.
spine). 4. The spinous processes of the lumbar spine may be difficult
2. The lateral view of the lumbar spine demonstrates the to palpate depending on the degree of the client’s lordotic
intervertebral foramina (the right L4-L5 intervertebral curve.
foramen is labeled). The intervertebral foramen is where the 5. The disc joint spaces are well visualized in the lateral view.
spinal nerve enters/exits the spinal cord.
LUMBAR SPINE—POSTERIOR VIEW
Superior
L1
Facet joint
(L1-L2)
L2
Mamillary
process (L3)
Transverse
process (L3)
L3
R
L
i
e
g
f
h
t
Spinous L4
process (L4)
Lumbosacral
(L5-S1) facet
joint
L5
Sacrum
Inferior
FIGURE 4-30
NOTES
1. The facet joints of the lumbar spine are well visualized in the
posterior view because they are oriented in the sagittal plane.
2. The lumbosacral (L5-S1) facet joints change their orientation;
they are oriented more toward the frontal plane than are the
other lumbar facet joints.
3. The prominence of the mamillary processes of the lumbar spine
can be seen.
L3 (TYPICAL LUMBAR VERTEBRA)
Anterior Anterior
1 1
R R
L L
2 i i 2
e e
10 g g 10
f f
h h
t 3 6 6 7 t
7 t t 5
8 5 43
4 8
9 9
Superior Superior
4
3 3
1 4
R R
L L
i
e e 8 7 6 i
6
g 1 g
f f
h 7 h
t
t t
t
5
5
C Inferior D Inferior
D, Posterior view.
1. The bodies of lumbar vertebrae are very large because
1 Body
they need to bear all the body weight from above.
2 Pedicle

4 Mamillary process

3. Lumbar vertebrae are unique in that they possess two

additional landmarks, mamillary, and accessory processes.
7 Accessory process
The mamillary process is located on the superior articular
8 Lamina
process; the accessory process is located on the transverse

process.
4. Plural of foramen is foramina.
L3 (CONTINUED) AND LUMBAR ENDPLATES
Superior Posterior Left
3 12
P A
4
o n
s 3
2 t
t 4
1 e
e r
r 9 8 11
7 10 i 9
1
i o
o
2
r
r 5 6
E Inferior
Right F Anterior
Anterior
L1 L2 L3
L
i
e
g
f
h
t
L4
L5
Posterior
FIGURE 4-31 E, Right lateral view. F, Anterior oblique view; and NOTES
FIGURE 4-32
1. Lumbar vertebrae possess large, blunt, quadrate-shaped

1 Body
spinous processes (SPs), as evident in the lateral view.

2 Pedicle
2. Figure 4-32 shows a superior view of all five lumbar

vertebrae (lumbar endplate view). The transition in shape

4 Mamillary process
from superior to inferior can be seen.

7 Accessory process
8 Lamina
10 Intervertebral foramen
11 Inferior vertebral notch
12 Superior vertebral notch
SACROCOCCYGEAL SPINE
Superior Superior
5 5
6 15
6
1 7 16
3 4
R R 17
L L
2 i i 18
e 8
g g
e
f f
h h
t 2 t
t t
9 10
11 11
13
12 13 12
14 14
FIGURE 4-33 A, Posterior view. B, Anterior view. NOTES
1 Median sacral crest 1. The sacrum is formed by the fusion of five sacral
2 Tubercles along the median sacral crest vertebrae.
3 Intermediate sacral crest 2. The sacrum is shaped like an upside-down triangle. The
4 Lateral sacral crest sacral base is located superiorly; the sacral apex is located
5 Superior articular process/facet inferiorly.
6 Ala (wing) 3. The medial crest is the fusion of the sacral spinous
7 Auricular surface (articular surface for ilium) processes (SPs); the intermediate crest is the fusion of the
8 Third posterior foramen articular processes; the lateral crest is the fusion of the
9 Sacral hiatus transverse processes (TPs).
10 Sacral cornu 4. The median sacral crest often has projections (remnants of
11 Apex SPs) that are called sacral tubercles. This specimen has
12 First coccygeal element prominent first (asymmetric) and third sacral tubercles.
13 Coccygeal transverse process (TP) 5. The superior articular processes of the sacrum articulate
14 Second to fourth coccygeal elements (fused) with the inferior articular processes of L5 (forming the
15 Sacral base lumbosacral [L5-S1] facet joints).
16 Sacral promontory 6. The sacral ala is the winglike superolateral aspect of the
17 First anterior foramen sacrum (ala means wing).
18 Fusion of second and third sacral vertebrae 7. Four pairs of posterior and four pairs of anterior sacral
foramina exist where sacral spinal nerves enter/exit the
spinal canal.
8. The sacral hiatus is the inferior opening of the sacral
canal.
9. The coccyx is usually composed of four rudimentary
vertebrae; however, the number may vary from two to
five. Some sources state that the coccyx is the
evolutionary remnant of a tail.
SACROCOCCYGEAL SPINE (CONTINUED)
Superior
3 1
P
A
o 4
s 6 n
t
t
e
e
r
r 6 i
i
o
o
r
r
10
C Inferior
Posterior
13 6
12
R 3
L
i
e
g
f
h
t
t 11
1
D Anterior
FIGURE 4-33 C, Right lateral view. D, Superior view. NOTES
1 Base
1. The kyphotic (i.e., concave anteriorly) curve of the

2 Promontory sacrococcygeal spine is indicated by the line drawn
3 Superior articular process
anterior to the sacrococcygeal spine.

4 Auricular surface (articular surface for ilium) 2. The body of L5 sits on the base of the sacrum, forming
5 First posterior foramen
the lumbosacral (L5-S1) disc joint.

6 (Tubercles of) median sacral crest 3. The sacral promontory is the portion of the base of the
7 Cornu
sacrum that projects anteriorly.

8 Apex 4. The cauda equina of nerves from the spinal cord travels
9 First coccygeal element
through the sacral canal.

10 Second to fourth coccygeal elements
11 Ala (wing)
12 Sacral canal
13 Lateral sacral crest
4.3 BONES OF THE RIBCAGE AND STERNUM
RIBCAGE—ANTERIOR VIEW
Superior Superior
Acromioclavicular 18
(AC) joint Sternoclavicular
8
(SC) joint
C7
1 T1 19
2 3 8
6 9
5 7
9
4
10
10
Sternocostal 11 20
R joints R
L L
i (#s 3 and 4) i
e e
g 13 g
14 f f
h h
t t
t t
21
12
16 11
T12
22
17
15
L1 23
25
24
FIGURE 4-34 NOTES
1 Clavicle 1. The sternal notch is also known as the jugular notch.
2 Acromion process 2. The lateral border of the sternal notch is a good landmark
3 Coracoid process to palpate movement of the sternoclavicular (SC) joint.
4 Glenoid fossa 3. The sternal angle is also known as the angle of Louis and
5 Subscapular fossa is the joint between the manubrium and body of the
6 First rib sternum. It is located at the junction of the second costal
7 Cartilage of first rib cartilage with the sternum and is often palpable.
8 Sternal notch 4. The xiphoid process remains cartilaginous long into life
9 Manubrium of sternum and is also a landmark used to locate the proper location
10 Sternal angle to administer cardiopulmonary resuscitation (CPR).
11 Body of sternum 5. The ribcage is composed of 12 pairs of ribs. Of these, the
12 Xiphoid process of sternum first seven pairs (#1-7) are called true ribs, because their
13 Fifth rib costal cartilages articulate directly with the sternum. The
14 Cartilage of fifth rib last five pairs (#8-12) of ribs are called false ribs, because
15 Tenth rib they do not articulate directly to the sternum; pairs #8-10
16 Eleventh rib have their cartilage join the costal cartilage of rib #7, and
17 Twelfth rib ribs #11 and #12 do not articulate with the sternum at
18 Clavicular notch of the manubrium all. Because the last two pairs of false ribs do not attach
19 Notch for first costal cartilage to the sternum at all, they are called floating ribs.
20 Notch for second costal cartilage 6. The attachment of a rib to the sternum via its costal
21 Notch for third costal cartilage cartilage is called a sternocostal joint.
22 Notch for fourth costal cartilage 7. The sternums in A and B are not the same. The
23 Notch for fifth costal cartilage differences in the shape of the manubrium and body of
24 Notch for sixth costal cartilage these two specimens can be seen.
25 Notch for seventh costal cartilage
RIBCAGE—RIGHT LATERAL VIEW
Superior
5 1
2
6 3
4 10
9
A
o
11 n
s 7 12 t
t 13
e
e
r
r
i
i
o
o
r
17
14
16
15
Inferior
FIGURE 4-35 NOTES
1 Clavicle 1. The ribs articulate with the spine posteriorly and the
Scapula (#2-7): sternum anteriorly (except for the floating ribs [#11 and
2 Acromion process #12], which do not articulate with the sternum).
3 Coracoid process 2. Eleven intercostal spaces are located between ribs. They
4 Glenoid fossa are named for the rib that is located superior to the
5 Superior angle space.
6 Spine of scapula 3. The intercostal spaces contain intercostal muscles that
7 Inferior angle often become tight in people with chronic obstructive
8 First rib pulmonary disorders (COPD) such as asthma, emphysema,
9 Cartilage of first rib and chronic bronchitis.
10 First intercostal space 4. The lateral view of the thorax nicely demonstrates the
11 Fifth rib plane of the scapula, which lies neither perfectly in the
12 Fifth intercostal space sagittal nor in the frontal plane.
13 Sixth rib
14 Tenth rib
15 Eleventh rib
16 Twelfth rib
17 Vertebral spinous processes (SPs)
COSTOSPINAL JOINTS
Posterior
2 12
6
5
R 11
i L
g
4 10 e
7
h 3 f
t t
8
1
Rib #5
T5
A Anterior
Superior
9
11
15
16 10
T4
14
P 13
4 A
o 3
n
s
10 t
t 8 T5
12 e
e 2
r
r
i
i
o
o 6 r
12
Rib #5
B Inferior
FIGURE 4-36 A, Superior view. B, Right lateral view. NOTES
1 Costovertebral joint 1. A rib articulates with the spinal column in two places,
2 Costotransverse joint forming two costospinal joints, the costovertebral joint
3 Head of rib and the costotransverse joint.
4 Neck of rib
2. The costovertebral joint is typically formed by the head of

5 Tubercle of rib the rib articulating with the (vertebral costal hemifacets
6 Angle of rib
of the) bodies of two contiguous vertebrae, as well as the

7 Body of rib disc that is located between them. Usually ribs #1, #11,
8 Vertebral body
and #12 articulate with only one (full vertebral costal

9 Transverse process (TP) facet of a) vertebral body.
10 Pedicle
3. The costotransverse joint is formed by the tubercle of a rib

11 Superior articular process/facet articulating with the (transverse costal facet of the)
transverse process of a vertebra.

13 Disc space (T4-T5)
14 Intervertebral foramen (T4-T5)
15 Costal hemifacet for rib #4
16 Transverse costal facet for rib #4
RIGHT RIBS
Superior Superior
1 2
Superior border 1 2
3
P 3 P
A A
o 4 4 o
n n Superior border
s s
t Inferior border
t t
t
5 e e 5
e e
r r
r
i i
r
i i
o o Inferior border
o o
6 r r 6
r r
Posterior
1 2 3 4 5 6 7
R
L
i
e
g
f
h
t
t
8 9 10 11 12
C Anterior
FIGURE 4-37 A, Posterior view. B, Medial view. C, Superior view. NOTES
1 Head 1. The head of the rib articulates with the vertebral body (or
2 Neck bodies) to form the costovertebral joint.
3 Tubercle 2. The tubercle of the rib articulates with the vertebral
4 Angle transverse process (TP) to form the costotransverse joint.
5 Body 3. The anterior end of the rib meets the sternum via costal
6 Anterior end cartilage.
4. The first seven pairs of ribs (#1-7) are called true ribs.
5. The last five pairs of ribs (#8-12) are called false ribs.
6. The last two pairs of false ribs (#11-12) are called floating
ribs.


4.4 ENTIRE LOWER EXTREMITY

RIGHT LOWER EXTREMITY

supportintestine

Proximal andcontainsthe Proximal

kind productive

organs Pelvic

hipbone bone

Your femur has several important

jobs, including: Holding the

weight of your body when you

stand and move. Stabilizing you

as you move. Connecting

G
muscles, tendons and ligaments

in your hips and knees to the rest

of your body.

rounded Femur
flat

triangular

P
A

L
M
o
n

a s
e t
t t

e
d
e
e

i r
r r
a i

a i
l o

l o
r

r
kneecap

Patella
f
to improve the
Patella

Tibia
e ective extension
Fibula
capacity of the
quadriceps muscle
by increasing the
Calfbone
moment arm of the
patellar ligament.
The patella is attached to Metatarsals

the tendon of the
quadriceps femoris muscle,

Phalanges
Bones
which contracts to extend/
of the
straighten the knee
foot

Tarsals
A B

Distal Distal

FIGURE 4-38 A, Anterior view. B, Right lateral view.

NOTE

The femur is in the thigh; the tibia and fibula are in the leg;

and the tarsals, metatarsals, and phalanges are in the foot.

The tibia is weight-bearing, which means it supports your body when you stand and move. The fibula is closer to the outside
of your body (lateral) than the tibia.
The fibula doesn't support as much weight and mostly provides structure to your leg.
Tarsal bones of the foot act as important
attachment points for muscles of the leg and
foot and aid in maintaining the arches of the
o connecting bone
foot. The talus forms the
between the leg and foot.
The metatarsal bones are the bones of the forefoot that connect the distal aspects of the cuneiform (medial, intermediate and
lateral) bones and cuboid bone to the base of the five phalanges of the foot.
There are five metatarsal bones, numbered one to five from the hallux (great toe) to the small toe.
pelvic

blue

green
infrontofandtowardsthemidlineofthebody

yellow
4.5 BONES OF THE PELVIS AND HIP JOINT
FULL PELVIS
wall strengthensandstabilizes
formsthe
posterior pelvic
Right SI
garum Left SI Left SI
the pelvis
Right SI
joint Proximal joint joint Proximal joint
1 2 2 1
3
R R
L
i i
e
g g
f
h h
t
t t
4
4
coccyx
A Distal Pubic Pubic symphysis Distal B
sight support symphysis

joint
joint
organ
Pubic
the pelvic abone of symphysis
for
actually
joint
Anterior
but
use
little
1 R
L
i
e
g
f
h
t
t
Left SI joint Posterior Right SI joint
FIGURE 4-39 A, Anterior view. B, Posterior view. C, Superior view. NOTES
1 Right pelvic bone 1. On the pelvis, either proximal/distal or superior/inferior
2 Left pelvic bone terminology can be used.
3 Sacrum 2. There are two sacroiliac (SI) joints, paired left and right.
4 Coccyx There is one pubic symphysis joint.
insertion site for multiple muscles, ligaments, and tendons, it also serves as one leg of the
tripod—along with the ischial tuberosities—that provides weight-bearing support to a
person in the seated position.
RIGHT PELVIC BONE—ANTERIOR VIEWS
Proximal
Right sacroiliac joint
Right
pelvic
bone Sacrum
Proximal
Right hip
R joint L
i Coccyx
g e
f 2
h
t 2
t
Right
femur
1 3
21
5
A Distal L
a
M
20 e
t 19 d
e
i
r
a
a
l
l 18
17 6 8
10 11
15 16
FIGURE 4-40
12
1 Wing of the ilium (iliac fossa on internal surface)
2 Iliac crest
13
3 Posterior superior iliac spine (PSIS)
14
4 Articular surface for sacroiliac joint
5 Posterior inferior iliac spine (PIIS)
6 Superior ramus of pubis
B Distal
7 Pectineal line of pubis
8 Pubic crest
9 Pubic tubercle
10 Body of pubis
11 Articular surface for pubic symphysis
12 Inferior ramus of pubis
13 Ramus of ischium
14 Ischial tuberosity
15 Body of ischium
16 Obturator foramen
17 Acetabulum NOTE
18 Rim of acetabulum The articular surface of the ilium for the sacroiliac joint is also
19 Body of ilium known as the auricular surface because it has the shape of an
20 Anterior inferior iliac spine (AIIS) ear (auricle means ear).
21 Anterior superior iliac spine (ASIS)
RIGHT PELVIC BONE—POSTERIOR VIEWS
Proximal
Right
pelvic
Sacrum bone
Right hip Proximal
joint
Coccyx R
L 2
i 19
e
g 2
f
h
t
Right 1
femur
18
16
3
15 L
A Distal M
17 a
e
d 14
t
e
i 20
r
a
a
l
12 l
11 4
10
FIGURE 4-41 13
1 Wing of the ilium (iliac fossa on internal surface)
6
2 Iliac crest 9 21
4 Rim of acetabulum 8
5 Ischial spine 7
6 Body of ischium
B Distal
8 Ramus of ischium
10 Body of pubis
14 Body of ilium
17 Inferior gluteal line (dashed line)
18 Anterior gluteal line (dashed line) NOTE
19 Posterior gluteal line (dashed line) The obturator internus and obturator externus muscles are
20 Greater sciatic notch named for their attachment relative to the obturator foramen.
21 Lesser sciatic notch
RIGHT PELVIC BONE—LATERAL VIEWS
Proximal
Proximal
Right
pelvic 2 3
bone
P Right 2
o hip A
Sacrum joint n
s
t
t Coccyx e
e 4
r 23
r 22 20
i 1
i
o
o
r
r
P 5 21
A
o
n
Right
s 19
t
t 18
femur e
e
r
r
6 i
i
o
o
A Distal r
15
7 16
13
8
9 17
12
FIGURE 4-42 14
1 Wing of the ilium (external/gluteal surface)

10
2 Iliac crest
3 Tubercle of the iliac crest 11

6 Greater sciatic notch
B Distal
7 Ischial spine
8 Lesser sciatic notch
9 Body of ischium
11 Ramus of ischium
12 Inferior ramus of pubis NOTES
13 Body of pubis 1. The pelvic bone is also known as the coxal, hip, or
14 Obturator foramen innominate bone.
15 Acetabulum
2. The pelvic bone is formed by the union of the ilium,

16 Rim of acetabulum ischium, and pubis (see colored shading: the ilium is blue,
17 Notch of acetabulum the ischium is pink, and the pubis is yellow).
18 Body of ilium 3. All three bones of the pelvis (ilium, ischium, and pubis)
19 Anterior inferior iliac spine (AIIS) come together in the acetabulum.
20 Anterior superior iliac spine (ASIS) 4. The ramus of the ischium (#11) and inferior ramus of the
21 Inferior gluteal line (dashed line) pubis (#12) are often grouped together and called the
22 Anterior gluteal line (dashed line) ischiopubic ramus.
23 Posterior gluteal line (dashed line)
RIGHT PELVIC BONE—MEDIAL VIEWS
Proximal
Sacrum
Proximal
Right 2
pelvic
bone
A
Coccyx o 2
n 4
s
t
t 1
e
e
r
r 3
i 24
i
o
r
o
r 5
20 P
22 o
Right n 23
s
femur t
t
e
7 e
r
i
r
i
o 19 o
A Distal r 17 r
16
15 8
FIGURE 4-43
18
1 Wing of the ilium (iliac fossa on internal 14

9
surface)
10
2 Iliac crest 13
21

4 Iliac tuberosity
5 Articular surface of ilium for sacroiliac joint
11
6 Posterior inferior iliac spine (PIIS) 12
7 Greater sciatic notch
8 Ischial spine
9 Lesser sciatic notch B Distal
10 Body of ischium
12 Ramus of ischium
14 Articular surface of pubis for pubis symphysis
15 Pubic tubercle
18 Body of pubis
19 Iliopectineal line
20 Arcuate line of the ilium
22 Body of ilium NOTE
23 Anterior inferior iliac spine (AIIS) The iliopectineal line is located on the ilium and pubis.
The iliac crest provides attachment for the hip flexors, the abdominal muscles, and the
muscles that rotate the hip. Direct impact on the iliac crest can cause contusion,
bruising, and inflammation of tissue or even bone fracture.
4.6 BONES OF THE THIGH AND KNEE JOINT
RIGHT FEMUR—ANTERIOR AND POSTERIOR VIEWS
Proximal FIGURE 4-44
1 Head
2 Fovea of the head
2 2
1 1 3 Neck
4 4
4 Greater trochanter
3
3 5 Lesser trochanter
7 6 Intertrochanteric line
6
5 7 Intertrochanteric crest
5
8 Gluteal tuberosity
9 8 9 Pectineal line
10 Lateral lip of linea aspera
11 Medial lip of linea aspera
12 Body (shaft)
13 Lateral supracondylar line

11 14 Medial supracondylar line
10
15 Popliteal surface
16 Lateral condyle
L L 17 Lateral epicondyle
a M 18 Medial condyle
a
t 12 e
12 t 19 Medial epicondyle
e d
e 20 Adductor tubercle
r i
r 21 Articular surface for
a a
a patellofemoral joint
l l
l 22 Intercondylar fossa
23 Articular surface for knee
(tibiofemoral) joint
14
13
15
20
17
19 17
18 16
16 18
A 23 B
21
Distal 23 22
NOTES
1. The fovea of the head of the femur is the attachment site branching distally to give rise to the lateral and medial
for the ligamentum teres of the hip joint. supracondylar lines.
2. The intertrochanteric line runs between the greater and 4. The gluteal tuberosity is a distal attachment of the gluteus
lesser trochanters anteriorly; the intertrochanteric crest maximus.
runs between the greater and lesser trochanters 5. The pectineal line is the distal attachment of the pectineus.
posteriorly. 6. The adductor tubercle is a distal attachment site for the
3. The linea aspera is an attachment site for seven muscles. adductor magnus.
The linea aspera can be looked at as branching proximally 7. The borders of the lateral and medial condyles are shown
to give rise to the gluteal tuberosity and pectineal line, and by dashed lines.
RIGHT FEMUR—LATERAL AND MEDIAL VIEWS
Proximal Proximal
1 2 1 4
4 8
3 7
6 6 5
P P
A A
o o
n n
s
t t
s
t t
10 e e
e 10 e
r r
r r
i i
i i
o o
o o
r r
r r
17
16
15
12 14
11
A 13 B
Distal Distal
FIGURE 4-45 A, Lateral view. B, Medial view.
1 Head
2 Fovea of the head
3 Neck
4 Greater trochanter
5 Lesser trochanter
6 Intertrochanteric line
7 Intertrochanteric crest
NOTES
8 Trochanteric fossa 1. The shaft of the femur, when viewed from the lateral or
9 Pectineal line
medial perspective, is not purely vertical; rather a bow to

10 Body (shaft) the shaft exists.
11 Lateral condyle 2. The pectineal line of the femur should not be confused
12 Lateral epicondyle with the pectineal line of the pubis (they are the distal
13 Groove for popliteus tendon and proximal attachments of the pectineus).
14 Medial condyle 3. The femoral condyles articulate with the tibia, forming the
15 Medial epicondyle knee (i.e., tibiofemoral) joint. The epicondyles are the
16 Adductor tubercle most prominent points on the condyles.
17 Impression for lateral gastrocnemius
The condyle is the smooth surface area at the end of a bone that forms part of a joint. The epicondyle is a rounded
protuberance at the end of a bone, serving as a place of attachment for ligaments, tendons, and muscles.
RIGHT FEMUR—PROXIMAL AND DISTAL VIEWS
Anterior
M
a
e 2
10 t
d 1
e
i
3 r
a
a
l
4 l
5 7
A Posterior
Proximal
4
8
M
a
e
t
d
e
i
r 13
a
a
l
l
12
11
9 10
14
B Distal
FIGURE 4-46 A, Proximal (superior) view. B, Distal (inferior) view.
1 Head
2 Fovea of the head
3 Neck
NOTES
4 Greater trochanter 1. The neck of the femur deviates anteriorly (usually
5 Lesser trochanter
approximately 15 degrees) from the greater trochanter to

6 Intertrochanteric crest the head. (See proximal view.)
7 Trochanteric fossa 2. The lesser trochanter is medial, and it projects somewhat
8 Body (shaft), anterior surface posteriorly as well.
9 Lateral condyle 3. From a distal perspective, it is clear that the two condyles
10 Medial condyle of the distal femur are distinct from each other. For this
11 Lateral epicondyle reason, some speak of the knee (i.e., tibiofemoral) joint as
12 Medial epicondyle having two aspects: a medial tibiofemoral joint and a
13 Articular surface for patellofemoral joint lateral tibiofemoral joint.
14 Articular surface for knee (tibiofemoral) joint
RIGHT KNEE JOINT AND PATELLA
Proximal Proximal
Femur
Patella
Femur
Patella
L o
A
M n
a s
e t
t
d t
e
e e
i r
r r
a
a i
l i
l o
o
r
r
Knee
(tibiofemoral) Knee
joint (tibiofemoral)
joint
Tibia Tibia
Fibula Fibula
A Distal B Distal
Anterior L
M
a
e
d t
1 e
i
r
a 3
Proximal l 4 a
Proximal
l
1 Posterior
L L
a M M a
t e e 4 t
e d d
5 3
e
r i i r
a a a a
l l l l
2 2
Distal Distal
C D E
FIGURE 4-47 A, Anterior view. B, Lateral view. C, Anterior view.
D, Proximal (superior) view. E, Posterior view. NOTES
1 Base 1. The lateral facet of the posterior patella is larger than the
2 Apex medial facet.
3 Facet for lateral condyle of femur 2. The articular surfaces of the lateral and medial facets do
4 Facet for medial condyle of femur not extend to the apex of the patella.
5 Vertical ridge
4.7 BONES OF THE LEG AND ANKLE JOINT
RIGHT TIBIA/FIBULA—ANTERIOR AND PROXIMAL VIEWS
Proximal
FIGURE 4-48 A, Anterior view. B, Proximal view.
1 3 2
11
Tibial landmarks:
18
10
1 Lateral condyle
19
2 Medial condyle
3 Intercondylar eminence
20
4 Lateral tubercle of intercondylar eminence
5 Medial tubercle of intercondylar eminence
13 14 6 Anterior intercondylar area
7 Posterior intercondylar area
12 8 Lateral facet (articular surface for knee [i.e., tibiofemoral]
joint)
9 Medial facet (articular surface for knee [i.e., tibiofemoral]
L
a M joint)
t 21 15
e 10 Tuberosity
e d 11 Impression for iliotibial tract
r i 12 Crest (i.e., anterior border)
a a
l
13 Interosseus border
l
14 Medial border
15 Body (shaft)
16 Medial malleolus
17 Articular surface for ankle joint
Fibular landmarks:
18 Head
19 Neck
21 Body (shaft)
22 Lateral malleolus
16
22
23 17 NOTES
A 1. The entire proximal surface of the tibia is often referred to
Distal as the tibial plateau.
2. The impression on the tibia for the iliotibial tract is often

Anterior referred to as Gerdy ’s tubercle.
3. The body (i.e., shaft) of the tibia has three borders:

10
1 anterior (the crest), medial, and interosseus.
2 L 4. The anterior intercondylar area of the tibia is the

M 6 a attachment site of the anterior cruciate ligament; the
e t posterior intercondylar area of the tibia is the attachment
d e
i site of the posterior cruciate ligament.
8 r
a 9 4 a 5. At the knee joint, the lateral facet of the tibia accepts the
5
l 18 l lateral condyle of the femur, forming the lateral
7 tibiofemoral joint of the knee joint; the medial facet of the
B tibia accepts the medial condyle of the femur, forming the
medial tibiofemoral joint of the knee joint.
Posterior
RIGHT TIBIA/FIBULA—POSTERIOR AND DISTAL VIEWS
3 4 Tibial landmarks:
5 6
1 Lateral condyle
1 17 2 Medial condyle
2 7
16 3 Intercondylar eminence
4 Lateral facet (articular surface for knee [i.e., tibiofemoral]

18 joint)
10 5 Medial facet (articular surface for knee [i.e., tibiofemoral]
9 8 joint)
6 Posterior intercondylar area
7 Groove for semimembranosus muscle
9 Medial border
10 Soleal line
11 Body (shaft)
12 Medial malleolus
L 13 Groove for tibialis posterior
M
a 14 Articular surfaces for ankle joint
e
t 15 Tuberosity
d 19
11 e
i
r
a Fibular landmarks:
a
l 16 Head
l
17 Apex of head
18 Neck
19 Body (shaft)
20 Lateral surface
22 Groove for fibularis brevis muscle
20
13
22
12
23 21
A 14
Distal
Anterior
NOTES
15 1. The apex of the fibular head is also known as the styloid
1 M process of the fibula.

L 2. The soleal line of the tibia is part of the proximal
a e
d attachment of the soleus muscle.

t 2
e
16 i 3. The groove for the fibularis brevis is created by the distal
r a tendon of the fibularis brevis muscle as it passes posterior
23 12
a 14 l to the lateral malleolus to enter the foot.
l 21 4. The lateral malleolus of the fibula extends further distally
13 than the medial malleolus of the tibia. This configuration
B 22 results in a range of motion of the foot that involves less
eversion than inversion.
Posterior
RIGHT TIBIA/FIBULA—LATERAL VIEWS
Proximal Proximal FIGURE 4-50 A, Lateral view of the tibia and

fibula articulated. B, Lateral view of just the tibia.
3 3
1
2 1 2 Tibial landmarks:
4 1 Lateral condyle
11
10 2 Medial condyle
5 5 3 Intercondylar eminence
12 4 Articular facet for proximal tibiofibular joint
5 Tuberosity
7 Body (shaft)
6 8 Fibular notch
6
9 Medial malleolus
Fibular landmarks:
10 Head
11 Apex of head
12 Neck
13 Body (shaft)
14 Triangular subcutaneous area
P P 15 Lateral malleolus
A A
o o
7 n n
s 13 s
t t
t t 7
e e
e e
r r
r r
i i
i i
o o
o o
r r
r r
14
15 9
A B
Distal Distal
NOTES
1. The interosseus border on the lateral tibia is the site of 3. The articular facet for the proximal tibiofemoral joint on the
attachment for the interosseus membrane of the leg. lateral proximal tibia accepts the head of the fibula.
2. The triangular subcutaneous area is a triangular area of the 4. The fibular notch on the lateral distal tibia accepts the
distal lateral shaft of the fibula that is palpable through the distal fibula, forming the distal tibiofibular joint.
skin.
RIGHT TIBIA/FIBULA—MEDIAL VIEWS
Proximal Proximal FIGURE 4-51 A, Medial view of the tibia and fibula articulated.
10 B, Medial view of just the fibula.

2 9
8 Tibial landmarks:
1
3 1 Medial condyle
11
2 Intercondylar eminence
4 3 Groove for semimembranosus muscle
4 Tuberosity
5 Body (shaft)
6 Medial malleolus
7 Groove for tibialis posterior muscle
Fibular landmarks:
8 Head
9 Apex of head
13 10 Articular surface for proximal tibiofibular joint
5
11 Neck
13 13 Body (shaft)
P P
A A 15 Articular surface for ankle joint
o o
n n
t
s
t
s
t t
e e
e e
r r 12 r
r
i 12 i
i i
o o
o o
r r
r r
7
6 15
14
14
A B NOTES
Distal Distal 1. The interosseus border on the medial fibula is the site of
attachment for the interosseus membrane of the leg.
2. The medial view of the tibia demonstrates the groove for
the semimembranosus muscle proximally and the groove
for the tibialis posterior muscle distally.
RIGHT ANKLE JOINT
down
plantar flexion
porsiflexion
Proximal
up Proximal
down
dullard
pYficert
2 1
movementofthefoot
ftp
Ankle
on joint
2
1
Tarsal sinus Transverse
tarsal joint P
A
L o
3 M n
a 4 s
t
e
t
t
5 d Ankle joint e
e e
i r
r 6 r
7 a Transverse i
a 8 11 10 i
l tarsal joint o
l o
9 5 r
r
4
7
9
Proximal
interpha- Tarsometatarsal 10
langeal 16 15 14 13 12
joint
11 12
joint
13
6
Metatarso- 14
24 phalangeal
joints 15
19 17 16
23 Interphalangeal Tarsal sinus

18 joint
22 20 Tarsometatarsal
Distal
21
A interphalangeal joint B
joint
Distal Distal
FIGURE 4-52 A, Anterior view. B, Lateral view. 20 Middle phalanx of second toe
1 Tibia 21 Distal phalanx of second toe
2 Fibula 22 Distal phalanx of third toe
3 Medial malleolus (of tibia) 23 Middle phalanx of fourth toe
4 Lateral malleolus (of fibula) 24 Proximal phalanx of little toe (i.e., fifth toe)
5 Talus
6 Calcaneus
7 Navicular NOTES
8 Cuboid
1. The ankle joint is formed by the talus being held between

9 First cuneiform the malleoli of the tibia and fibula. The ankle joint is also
10 Second cuneiform
known as the talocrural joint.

11 Third cuneiform 2. The subtalar joint is located between the talus and
12 First metatarsal calcaneus (i.e., under the talus). The subtalar joint is
13 Second metatarsal located between tarsal bones; hence it is a tarsal joint.
14 Third metatarsal 3. The transverse tarsal joint is composed of the
15 Fourth metatarsal talonavicular joint and the calcaneocuboid joint.
16 Fifth metatarsal 4. The tarsometatarsal joint is located between the
17 Proximal phalanx of big toe cuneiforms and cuboid proximally (posteriorly), and the
18 Distal phalanx of big toe metatarsals distally (anteriorly).
19 Proximal phalanx of second toe
4.8 BONES OF THE FOOT
RIGHT SUBTALAR JOINT
22
10 18 10
9
10 18
11 12 20 23 13
26 22
11
12
9 24
8
4 14 15 20
23
3 26
5 24
21
6
1 1
21
27
19 27
19
25 25
A B
Lateral view Lateral view, subtalar joint open
10 17
10 7
12
18
25 9 5
15
14
12 11 L 4 6 L
a
16
a
22
20 t 3 t
2 e 13 e
26 r r
9
1 a a
21 M
l l
Inferior e 1
19 (distal) view d
i
27
a Superior
25 l (proximal) view
C D
Medial view Subtalar joint, articular surfaces
FIGURE 4-53 A, Right lateral view. B, Right lateral view, subtalar joint 20 Navicular
open. C, Medial view. D, Subtalar joint, articular surfaces. 21 Cuboid
1 Calcaneus (#1-7) 22 First cuneiform
2 Sustentaculum tali 23 Second cuneiform
3 Calcaneal posterior facet (of subtalar joint) 24 Third cuneiform
4 Calcaneal middle facet (of subtalar joint) 25 Tarsometatarsal joint
5 Calcaneal anterior facet (of subtalar joint) 26 First metatarsal
6 Sulcus (of calcaneus) 27 Fifth metatarsal
7 Articular surface for calcaneocuboid joint (of transverse
tarsal joint) NOTES
8 Tarsal sinus 1. The subtalar joint between the talus and calcaneus is
9 Talus (#9-17) composed of three articular surfaces: posterior, middle,

10 Articular surface for ankle joint and anterior. The posterior articulation is formed by the
11 Neck of talus posterior facets of each bone; the middle articulation is
12 Head of talus formed by the middle facets of each bone; the anterior
13 Talar posterior facet (of subtalar joint) articulation is formed by the anterior facets of each bone.
14 Talar middle facet (of subtalar joint) 2. The posterior aspect of the subtalar joint is the largest
15 Talar anterior facet (of subtalar joint) of the three.
16 Sulcus (of talus) 3. The tarsal sinus is formed by the sulcus of the calcaneus
17 Articular surface for talonavicular joint (of transverse tarsal and the sulcus of the talus.
joint) 4. The transverse tarsal joint is formed by the talonavicular
18 Talonavicular joint (of transverse tarsal joint)
and calcaneocuboid joints.

19 Calcaneocuboid joint (of transverse tarsal joint)
RIGHT FOOT—DORSAL VIEW
Anterior FIGURE 4-54
(distal) 1 Calcaneus
2 Fibular trochlea of calcaneus
3 Articular surface of talus for ankle joint
4 Medial tubercle of talus

24
5 Lateral tubercle of talus
6 Neck of talus
27 28 29
7 Head of talus
26 8 Navicular
23 9 Navicular tuberosity
25
10 Cuboid
11 Groove for fibularis longus

12 First cuneiform
17 13 Second cuneiform
14 Third cuneiform
15 Base of first metatarsal
22
21 16 Body (shaft) of first metatarsal
16
17 Head of first metatarsal
18 Tuberosity of base of fifth metatarsal
L
M 19 Base of fifth metatarsal
20 a
e 15 20 Body (shaft) of fifth metatarsal
d
t
21 Head of fifth metatarsal
e
i 22 Sesamoid bone of big toe
r
a 23 Proximal phalanx of big toe
a
l 12
13
19
l 24 Distal phalanx of big toe
14 25 Base of proximal phalanx of second toe
18
26 Body (shaft) of proximal phalanx of second toe
8 10
27 Head of proximal phalanx of second toe
28 Middle phalanx of third toe

11
9 7
29 Distal phalanx of fourth toe
NOTES
1. The word phalanx is singular only; plural of phalanx is
4 phalanges.
5 2. The articular surface of the talus for the ankle joint is

1 called the trochlea of the talus.
3. The first, second, and third cuneiforms are also known as
the medial, intermediate, and lateral cuneiforms,
Posterior respectively.
(proximal) 4. The first cuneiform articulates with the first metatarsal;
the second cuneiform articulates with the second

metatarsal; the third cuneiform articulates with the third
metatarsal; and the cuboid articulates with the fourth and
fifth metatarsals.
5. All metatarsals and phalanges have a base proximally, a
body (i.e., shaft) in the middle, and a head distally.
6. The middle and distal phalanges of the little toe in this
specimen have fused together.
RIGHT FOOT—PLANTAR VIEW
Anterior (distal) FIGURE 4-55
1 Calcaneus
2 Medial process of calcaneal tuberosity
3 Lateral process of calcaneal tuberosity
4 Sustentaculum tali of calcaneus
26
22 5 Groove for distal tendon of flexor hallucis longus muscle (on
27
25 sustentaculum tali)
6 Anterior tubercle of calcaneus
24
7 Head of talus
21 8 Navicular
23
9 Navicular tuberosity
10 Cuboid
11 Tuberosity of cuboid
12 Groove for distal tendon of fibularis longus muscle
20 20
13 First cuneiform
14 Second cuneiform
19
15 Third cuneiform
17 Base of fifth metatarsal

L
a M 18 Body (shaft) of fifth metatarsal
t 18 e
d 19 Head of fifth metatarsal
e
i 20 Sesamoid bone of big toe
r
a a 21 Proximal phalanx of big toe
l l 22 Distal phalanx of big toe
23 Base of proximal phalanx of second toe

17 13
15 14
24 Body (shaft) of proximal phalanx of second toe
16 25 Head of proximal phalanx of second toe
12
11 26 Middle phalanx of third toe
27 Distal phalanx of fourth toe

8 9
10
NOTES
6 1. On the calcaneal tuberosity, the medial process is much
5 4 larger than the lateral process.
2. The base of the fifth metatarsal bone has a large palpable
1 tuberosity.
3. The big toe usually has two sesamoid bones.
4. The groove for the distal tendon of the fibularis longus
3 2 tendon is clearly visible on the plantar surface of the
cuboid, demonstrating its passage deep in the plantar
foot.
5. The middle and distal phalanges of the little toe have
fused together in this specimen.
Posterior (proximal)
RIGHT FOOT—MEDIAL VIEW

128
First
Interphalangeal metatarsophalangeal Tarsometatarsal Talonavicular
(IP) joint (of big toe) joint joint Dorsal joint Subtalar joint
9 7
8
6
12
10 3
Anterior Posterior
13
(distal) (proximal)
11 1
14 15 4
17
19 16
20
18
2
CHAPTER 4 Bones of the Human Body
Plantar
FIGURE 4-56 NOTES

1 Calcaneus (medial surface) 1. The sustentaculum tali of the calcaneus forms a ledge on
2 Medial process of calcaneal tuberosity which the talus sits.
3 Sustentaculum tali of calcaneus 2. On the medial side of the foot, the sustentaculum tali of
4 Anterior tubercle of calcaneus the calcaneus and the navicular tuberosity are easily
5 Articular surface of talus for (medial malleolus of) ankle joint palpable landmarks.
6 Medial tubercle of talus 3. The second metatarsal is not visible in this view.
7 Neck of talus 4. The subtalar joint is located between the talus and the
8 Head of talus calcaneus.
9 Navicular 5. The talonavicular joint (of the transverse tarsal joint) is
10 Navicular tuberosity located between the talus and the navicular.
11 Cuboid 6. The arch (i.e., medial longitudinal arch) of the foot is
12 First cuneiform apparent in a medial view.
13 First metatarsal
14 Third metatarsal
15 Fourth metatarsal
16 Fifth metatarsal
18 Sesamoid bone of big toe
19 Proximal phalanx of big toe
20 Distal phalanx of big toe
RIGHT FOOT—LATERAL VIEW
Dorsal
6 13
8 9 10 14
7
16
15
5
Posterior 17
Anterior
(proximal) 11 (distal)
3 18
1 4 19 22
23
20
21
12 24
25
2
26
Calcaneocuboid Tarsometatarsal Plantar Metatarso- Proximal Distal

joint joint phalangeal interphalangeal interphalangeal
(MTP) joint (PIP) joint (DIP) joint
FIGURE 4-57 20 Fifth metatarsal

1 Calcaneus (lateral surface) 21 Tuberosity of base of fifth metatarsal
2 Lateral process of calcaneal tuberosity 22 Proximal phalanx of big toe
3 Fibular trochlea 23 Distal phalanx of big toe
4 Groove for distal tendon of fibularis longus muscle 24 Proximal phalanx of little toe
5 Tarsal sinus 25 Middle phalanx of little toe
6 Articular surface of talus for (lateral malleolus of) ankle joint 26 Distal phalanx of little toe
7 Lateral tubercle of talus
8 Neck of talus NOTES
9 Head of talus 1. The tuberosity of the base of the fifth metatarsal is easily
10 Navicular palpable on the lateral side of the foot.
11 Cuboid 2. The subtalar joint is located between the talus and the
12 Groove for distal tendon of fibularis longus muscle calcaneus.
13 First cuneiform 3. The tarsal sinus is a space located between the talus and
14 Second cuneiform
PART II Skeletal Osteology: Study of the Bones
calcaneus.
15 Third cuneiform 4. The calcaneocuboid joint of the transverse tarsal joint is
16 First metatarsal located between the calcaneus and the cuboid.
17 Second metatarsal 5. The middle and distal phalanges of the little toe are fused
18 Third metatarsal together in this specimen.
19 Fourth metatarsal
129
4.9 ENTIRE UPPER EXTREMITY
RIGHT UPPER EXTREMITY
Clavicle
Scapula
Humerus
Ulna
Radius
Carpals
Metacarpals
Phalanges
A B
Anterior view Posterior view
FIGURE 4-58 A, Anterior view. B, Posterior view.
NOTES
1. The upper extremity is composed of the bones of the 3. The forearm contains the radius, which is lateral, and the
shoulder girdle, arm, forearm, and hand. ulna, which is medial.
2. The shoulder girdle is composed of the scapula and clavicle, 4. The hand contains eight carpals, five metacarpals, and 14
and the arm contains the humerus. phalanges.

sigmoid
shape

• The Clavicle plays an essential role in functional movement, serving as the connection between the axial skeleton and the
pectoral girdle. This allows the clavicle to act as a brace for the shoulder, allowing weight to be transferred from the upper
limbs to the axial skeleton.
• The clavicle is a sigmoid-shaped long bone with a convex surface along its medial end when observed from cephalad
position. It serves as a connection between the axial and appendicular skeleton in conjunction with the scapula, and each of
these structures forms the pectoral girdle.
Scapula
• The scapula or shoulder blade is the bone that connects the clavicle to the humerus. The scapula forms the posterior of the
shoulder girdle. It is a sturdy, flat, triangular bone. The scapula provides attachment to several groups of muscles.
The humerus bone

• The humerus — also known as the upper arm bone — is a long
bone that runs from the shoulder and scapula (shoulder blade)
to the elbow.
humerus to move
arm
your
Ulna
The ulna is the longer of the two bones in your forearm. It
helps you move your arm, wrist and hand. Your ulna also
supports lots of important muscles, tendons, ligaments and
blood vessels.
Function: The radius permits the forearm and hand to pronate
and supinate, flex and extend at the elbow, and adduct,
abduct, extend, flex, and circumduct the wrist.
point the palm upward (i.e. supination) or downward (i.e.

pronation
The bones of the hand provide support and flexibility to the
soft tissues. They can be divided into three categories:
• Carpal bones (Proximal) – A set of eight irregularly shaped

bones. These are located in the wrist area.
• Metacarpals – There are five metacarpals, each one related

to a digit
• Phalanges (Distal) – The bones of the fingers. Each finger

has three
phalanges,
except for the
thumb, which
has two.
In this article, we
shall look at the
anatomical
features of the
bones of the
hand.
4.10 BONES OF THE SHOULDER GIRDLE AND SHOULDER JOINT
RIGHT SHOULDER JOINT
Acromioclavicular
joint
Acromion process Head of
of scapula Proximal Clavicle humerus
Shoulder
(glenohumeral)
joint
Glenoid fossa
of scapula
L
M
a Acromioclavicular
e
t joint
d
e Acromion process
i
r Clavicle Proximal of scapula
a
a
l
l
Scapula
L
M
a
Distal e
A t
d
e
i
r
a
a
l
l
Shoulder
(glenohumeral)
joint
Humerus
B Distal
NOTES
1. The shoulder joint is formed by the head of the humerus 3. The acromioclavicular (AC) joint is formed by the acromion
articulating with the glenoid fossa of the humerus. It is also process of the scapula articulating with the lateral end of
known as the glenohumeral joint. the clavicle.
2. Even though the glenohumeral joint is a ball-and-socket
joint, the glenoid fossa (i.e., the socket) is shallow.
RIGHT SCAPULA—POSTERIOR AND DORSAL VIEWS
Superior
16
1
13 15
14 2
12
11
3
5
L
M 10
4 a
e
t
d
e
i
r
a
9 8 a
l Superior
6 l
13 15
16
14 1
12
11
2
10 5 3 L
M
a
e
t
7 d
e
i 9 4
8 r
A Inferior a
a
l
6 l
B Inferior
FIGURE 4-60 A, Posterior view. B, Dorsal view. NOTES

1 Acromion process 1. A is a pure posterior view of the scapula as it sits on the
2 Acromial angle body; B is a view of the dorsal surface of the scapula
3 Glenoid fossa itself. The difference in these two perspectives can be
4 Infraglenoid tubercle seen.
5 Neck 2. The medial border is also known as the vertebral border.
6 Lateral border 3. The lateral border is also known as the axillary border.
7 Inferior angle 4. The supraspinous and infraspinous fossae are proximal
8 Infraspinous fossa attachment sites of the supraspinatus and infraspinatus
9 Medial border muscles.
10 Root of the spine 5. The infraglenoid tubercle and the suprascapular notch are
11 Spine not well developed on this scapula and therefore not well
12 Supraspinous fossa visualized.
13 Superior angle
14 Superior border
15 Suprascapular notch
16 Coracoid process
RIGHT SCAPULA—ANTERIOR AND SUBSCAPULAR VIEWS
Superior
12 6
4
3
1 2 5
13
11
L 7 M
a
e
t
14 d
e
i
r
10 a
a
l
l Superior
9 1 4
6
2
3
5
11 13
8 L
M
a
A Inferior e
t
7 d
e 14
10 i
r
a
a
l
l
9
B Inferior
FIGURE 4-61 A, Anterior view. B, Subscapular view.
1 Acromion process
2 Apex of coracoid process
3 Base of coracoid process NOTES
4 Suprascapular notch 1. A is a pure anterior view of the scapula as it sits on the
5 Superior border body; B is a view of the subscapular (i.e., costal) surface
6 Superior angle of the scapula itself. The differences in these two
7 Medial border perspectives can be seen.
8 Inferior angle 2. The coracoid process projects anteriorly; it also points
9 Lateral border laterally.
10 Infraglenoid tubercle 3. The subscapular fossa is the proximal attachment site
11 Glenoid fossa of the subscapularis muscle.
12 Supraglenoid tubercle 4. The supraglenoid tubercle is not well developed on this
13 Neck scapula and therefore not well visualized.
14 Subscapular fossa
RIGHT SCAPULA—LATERAL AND SUPERIOR VIEWS
Superior
1
2
5
14 3
4
13 6
7
P
A
o
n
s
t
t
e
e 12 11
r
r
i
i 8 o
o
r
r
Posterior
13
10
A Inferior 2
L
M
a
e
t 7 6 d
e
i
r 14 a
a
l
l 5 3
FIGURE 4-62 A, Lateral view. B, Superior view. 4
1 Superior angle 15
17
2 Acromion process 16
3 Supraspinous fossa 1 12
4 Apex of coracoid process B Anterior
5 Base of coracoid process
6 Supraglenoid tubercle
7 Glenoid fossa
8 Infraglenoid tubercle
9 Lateral border
10 Inferior angle
11 Infraspinous fossa
12 Medial border NOTES
13 Acromial angle 1. The supraglenoid tubercle is the proximal attachment site
14 Spine of the long head of the biceps brachii muscle.
15 Root of the spine 2. The infraglenoid tubercle is the proximal attachment site
16 Superior border of the long head of the triceps brachii muscle.
17 Suprascapular notch
RIGHT CLAVICLE
Posterior
L
M
a 1
e
t
d
e
7 i
r
3 a
a 4
l
l
A Anterior
Anterior
L 4
3 6 M
a
7 e
t 5
8 d
e
2 i
r
a
a 1
10 l
l
9
B Posterior
Superior
L
2 M
a 11 e
t 1 12
d
e 4
9 i
r
a
a 10 5 l
l
C Inferior
Superior
L
M
11 a
e
12 1 t
d
e
i 4 6 9 r
a
a
l
l
D Inferior

D, Posterior view. 1. The acromial end is the lateral (distal) end.
1 Acromial end 2. The sternal end is the medial (proximal) end.
2 Articular surface for acromioclavicular (AC) joint 3. The sternal end of the clavicle is more bulbous, whereas
3 Anterior border the acromial end is flatter.
4 Sternal end 4. The medial 2 3 of the clavicle is convex anteriorly; the
5 Articular surface for sternoclavicular joint lateral 13 is concave anteriorly.
6 Costal tubercle 5. The conoid tubercle is the attachment site of the conoid
7 Posterior border ligament of the coracoclavicular ligament.
8 Subclavian groove 6. The trapezoid line is the attachment site of the trapezoid
9 Conoid tubercle ligament of the coracoclavicular ligament.
10 Trapezoid line 7. The costal tubercle is the attachment site of the
11 Superior border costoclavicular ligament.
12 Inferior border
4.11 BONES OF THE ARM AND ELBOW JOINT
RIGHT HUMERUS—ANTERIOR AND POSTERIOR VIEWS
Proximal Proximal FIGURE 4-64 A, Anterior view. B, Posterior view.

1 Head
2 2
2 Anatomic neck
1 3 Greater tubercle
3 1 3 4 Lesser tubercle
5
4 5 Bicipital groove
6 Surgical neck
7 Deltoid tuberosity
8 Body (shaft)
9 Groove for radial nerve
6 6
10 Lateral supracondylar ridge
11 Medial supracondylar ridge
12 Lateral condyle
13 Medial condyle
14 Lateral epicondyle
15 Medial epicondyle
16 Radial fossa
17 Coronoid fossa
18 Olecranon fossa
7 19 Trochlea
20 Capitulum
7
9
L L
M
a a
e
t t
d
e e
i
r r
a 8
a a
8 l
l l
NOTES
1. Proximally, the anatomic and surgical
necks are indicated by dashed lines;
distally, the borders of the lateral and
medial condyles are indicated by dashed
lines.
2. The radial and coronoid fossae accept the
head of the radius and the coronoid
process of the ulna, respectively, when
the elbow joint is flexed; the olecranon
fossa accepts the olecranon process of
11 10 the ulna when the elbow joint is
10 11 extended.
12 3. The bicipital groove (so named because
13
14
13
the biceps brachii long head tendon runs
12 through it) is also known as the
16 18
17 intertubercular groove (so named because
15 15 it is located between the greater and
14 lesser tubercles).
20 19 19 20 4. The groove for the radial nerve is also
known as the spiral groove.
A Distal B Distal
RIGHT HUMERUS—LATERAL AND MEDIAL VIEWS
Proximal Proximal FIGURE 4-65 A, Lateral view. B, Medial view.

1 Head
2 2 Anatomic neck
4
1 1 3 Greater tubercle
4 4 Lesser tubercle
5 Surgical neck
6 Lateral lip of bicipital groove
7 Medial lip of bicipital groove
2
5 8 Deltoid tuberosity
3
5 9 Body (shaft)
6
10 Lateral supracondylar ridge
7 11 Medial supracondylar ridge
13 Medial epicondyle
14 Trochlea
15 Capitulum
P P
A
o o
n
s s
t
t t
9 e
e e
r
r r NOTES
i
i 9 i 1. The anatomic and surgical necks are
o
o o
r indicated by dashed lines.
r r
2. The lateral epicondyle and capitulum are
landmarks on the lateral condyle; the
medial epicondyle and trochlea are
landmarks on the medial condyle.
3. The lateral and medial epicondyles are
the most prominent points on the lateral
and medial condyles, respectively.
4. The medial epicondyle is the attachment
site of the common flexor tendon of many
of the anterior forearm muscles; the
lateral epicondyle is the attachment site
of the common extensor tendon of many
of the posterior forearm muscles.
10
5. The deltoid tuberosity is the distal
attachment site of the deltoid muscle.
11
15
12
13
14
A Distal B Distal
RIGHT HUMERUS—PROXIMAL AND DISTAL VIEWS
Anterior
9
10 13
12 6
8 7
5
L
M
a
e
4 t
d
e
i
r
a
a
l
l
6
5
2
A 3
Posterior
4
1
13
FIGURE 4-66 A, Proximal (superior) view. B, Distal (inferior) view.
1 Head 12
2 Anatomic neck 14 8
3 Surgical neck 7
4 Greater tubercle
5 Lesser tubercle
11
6 Bicipital groove B
8 Medial epicondyle
9 Radial fossa
10 Coronoid fossa
11 Olecranon fossa
12 Trochlea
13 Capitulum
14 Groove for ulnar nerve
NOTES
1. The anatomic and surgical necks are indicated by dashed
lines.
2. The ulnar nerve runs in a groove that is located between
the medial epicondyle and trochlea of the humerus (it can
easily be palpated at this location). The ulnar nerve at this
site is often referred to as the funny bone.
RIGHT ELBOW JOINT
Proximal Proximal
Humerus
Capitulum
of
humerus
Humeroradial
joint
Humeroradial Trochlea of
joint humerus
L L
M M
a a
e e
t t
d d
e e
i i
r r
a a
a a
l l
l l
Head of
radius
Humeroulnar Radius
joint
Ulna
A B
Distal Distal
NOTES
1. The elbow joint is composed of the humeroulnar and humeroradial articulation is formed between the capitulum
humeroradial joints. of the humerus and the head of the radius.
2. The major articulation of the elbow joint is the humeroulnar 4. The proximal radioulnar joint between the head of the
joint, where the trochlea of the humerus articulates with radius and the radial notch of the ulna is anatomically
the trochlear notch of the ulna (see Figure 4-68). within the same joint capsule as the elbow joint. However,
3. The humeroradial articulation is not very important functionally it is distinct from the elbow joint.
functionally to movement at the elbow joint; the
4.12 BONES OF THE FOREARM, WRIST JOINT, AND HAND
RIGHT RADIUS/ULNA—ANTERIOR VIEW
Proximal
6 Landmarks of the radius:
radioulnar 1 Head
joint 7 2 Neck
3 Tuberosity
4 Interosseus crest
1
5 Styloid process
2 8
Landmarks of the ulna:
9 6 Olecranon process
3
7 Trochlear notch
8 Coronoid process
9 Tuberosity
10 Interosseus crest
11 Head
12 Styloid process
4 10
Lateral Medial
(radial) (ulnar)
Radius
(anterior Ulna
surface) (anterior
surface)
NOTES
1. The radius and ulna articulate with each other both
Distal
radioulnar proximally (at the proximal radioulnar joint) and distally
joint (at the distal radioulnar joint).
2. The interosseous crests of the radius and ulna are the
attachment sites of the interosseus membrane of the
11 forearm (this interosseus membrane uniting the radius and
ulna creates the middle radioulnar joint).
5 12 3. The styloid process of the radius projects laterally; the
styloid process of the ulna projects posteriorly.
Distal
RIGHT RADIUS/ULNA—POSTERIOR VIEW
FIGURE 4-69 Proximal
Landmarks of the radius: 6 Proximal

1 Head radioulnar
2 Neck joint
7
3 Interosseus crest
4 Dorsal tubercle
5 Styloid process 1
2
6 Olecranon process 8
7 Coronoid process
8 Supinator crest
9 Interosseus crest
10 Head
11 Styloid process
9 3
Medial Lateral
(ulnar) (radial)
Radius
Ulna (posterior
(posterior surface)
surface)
NOTES
1. The dorsal tubercle of the radius is also known as Lister ’s
tubercle.
2. The distal tendons of the extensors carpi radialis longus
and brevis muscles pass between the dorsal tubercle and
Distal
styloid process of the radius. radioulnar
3. The distal tendons of the extensor digitorum, extensor joint
indicis, and extensor pollicis longus muscles pass medial 11
10
to the dorsal tubercle of the radius. 4
4. The distal tendon of the extensor carpi ulnaris muscle is
located within a groove located between the styloid 5
process and head of the ulna.
Distal
RIGHT RADIUS/ULNA—LATERAL VIEWS
Proximal FIGURE 4-70 A, Lateral view of the radius and ulna articulated.
B, Lateral view of just the ulna.
9 9
Landmarks of the radius:
10 10 1 Head
2 Neck
1 3 Radial tuberosity
12 4 Grooves for the abductor pollicis longus and extensor
2
11 11 pollicis brevis
5 Styloid process
14 6 Groove for the extensor carpi radialis longus
3
7 Groove for the extensor carpi radialis brevis
8 Dorsal tubercle

15 9 Olecranon process
10 Trochlear notch
11 Coronoid process
12 Radial notch
13 Interosseus crest
P 13 14 Tuberosity
o A 15 Supinator crest
s n 16 Head
t t 17 Styloid process
13
e e
r r
i i
o o
r r
Ulna Ulna
(lateral (lateral
surface) surface)
Radius
(lateral
surface)
NOTES
1. The head of the radius articulates with the ulna at
the radial notch.
2. The lateral view of the ulna (B) nicely demonstrates
the interosseous crest of the ulna.
3. The grooves for the abductor pollicis longus and
8 extensor pollicis brevis distal tendons are located
just anterior to the styloid process of the radius.
17 5
7 6 4 17 16 4. The tuberosity of the ulna is not well developed on
this ulna and therefore is not well visualized.
A Distal B
RIGHT RADIUS/ULNA—MEDIAL VIEWS
FIGURE 4-71 A, Medial view of the radius and ulna articulated. Proximal
B, Medial view of just the radius.
1 7
2
1 Head 8
2 Neck
3 Tuberosity
9
4 Interosseus crest
5 Ulnar notch 3 1
6 Styloid process 2 10

3
7 Olecranon process
8 Trochlear notch
9 Coronoid process
10 Tuberosity
11 Head
12 Styloid process
4
P
A
o
n
s
t 4 t
e
e
r
r
i
i
o
o
r
r
Radius
(medial
surface)
Ulna
(medial
surface)
NOTES
11
1. The distal end of the ulna articulates with the radius at 5
the ulnar notch of the radius. 6 6
2. The medial view of the radius (B) nicely demonstrates the 12
interosseous crest of the radius.
A Distal B
RIGHT RADIUS/ULNA—PRONATED

6
Proximal 1 Head
radioulnar 7 2 Neck
joint 3 Interosseus crest
4 Dorsal tubercle
1 5 Styloid process
8
2
9
6 Olecranon process
7 Trochlear notch
8 Coronoid process
Ulna
9 Tuberosity
Radius 10 Interosseus crest
11 Head
12 Styloid process
10
Lateral 3 Medial
(radial) (ulnar)
NOTES
Distal 1. Pronation of the forearm bones causes the bones to cross
radioulnar each other from the anterior perspective.
joint 2. Pronation and supination of the forearm occur at the
radioulnar joints and usually involve a mobile radius
11 4 moving around a fixed ulna. The head of the radius
rotates relative to the ulna, and the distal radius swings
5
12 around the distal ulna (from this anterior perspective, we
see the posterior surface of the distal radius).
Distal
RIGHT RADIUS/ULNA—PROXIMAL AND DISTAL VIEWS
Anterior
15
3
14 3
Radius
Ulna
Medial 1 Lateral
(ulnar) 13 (radial)
A Posterior Proximal
radioulnar joint Distal
radioulnar
Anterior joint
15
1
2
Radius
16 Ulna
Lateral Medial
(radial) (ulnar)
6 4
18
5 3
17
7
19
8 9
10 11 12
B Posterior
FIGURE 4-73 A, Proximal (superior) view of the radius and Landmarks of the ulna:
ulna articulated. B, Distal (inferior) view of the radius and ulna 13 Olecranon process
articulated. 14 Trochlear notch
15 Coronoid process
Landmarks of the radius: 16 Tuberosity
1 Head 17 Distal end of the ulna
2 Tuberosity 18 Head
3 Distal end of the radius 19 Styloid process
4 Articular surface for lunate
5 Articular surface for scaphoid
6 Styloid process NOTES
7 Groove for extensor carpi radialis longus tendon 1. The head of the radius has a concavity at its proximal end
8 Groove for extensor carpi radialis brevis tendon to accept the capitulum of the humerus (at the
9 Dorsal tubercle humeroradial joint).
10 Groove for extensor pollicis longus tendon 2. The distal end of the ulna articulates with the radius at the
11 Groove for extensor digitorum and extensor indicis tendons ulnar notch of the radius (at the distal radioulnar joint).
12 Ulnar notch
RIGHT CARPAL BONES (SEPARATED)—ANTERIOR VIEW
Proximal
3
1
4
2
5 7
10 6 8 9
11
Lateral 14 15 Medial
(radial) 13 (ulnar)
12
16
17
18 20
19
Distal
FIGURE 4-74
1 Radius
2 Styloid process of radius NOTES
3 Ulna 1. Eight carpal bones are arranged in two rows: proximal
4 Styloid process of ulna and distal. The proximal row (radial to ulnar) is composed
5 Scaphoid of the scaphoid, lunate, triquetrum, and pisiform; the
6 Tubercle of scaphoid distal row (radial to ulnar) is composed of the trapezium,
7 Lunate trapezoid, capitate, and hamate.
8 Triquetrum 2. A mnemonic can be used to learn the names of the carpal
9 Pisiform bones. From proximal row to distal row (always radial to
10 Trapezium ulnar), it is: Some Lovers Try Positions That They Can’t
11 Tubercle of trapezium Handle.
12 Trapezoid 3. The flexor retinaculum, which forms the ceiling of the
13 Capitate carpal tunnel, attaches to the tubercles of the scaphoid
14 Hamate and trapezium on the radial side and the hook of the
15 Hook of hamate hamate and pisiform on the ulnar side.
16 First metacarpal (of thumb) 4. The pisiform is a sesamoid bone (explaining why humans
17 Second metacarpal (of index finger) have eight carpal bones and seven tarsal bones).
18 Third metacarpal (of middle finger) 5. The metacarpal bones are numbered 1 to 5 (numbering
19 Fourth metacarpal (of ring finger) begins on the radial [i.e., thumb] side).
20 Fifth metacarpal (of little finger)
RIGHT CARPAL BONES (SEPARATED)—POSTERIOR VIEW
Proximal
1
4
3
5
2
7
6
8
9
10
Medial Lateral
12 11
(ulnar) 13 (radial)
14
18
15
17 16
Distal
FIGURE 4-75 NOTES

1 Radius 1. The trapezium articulates with the first metacarpal (of the
2 Styloid process of radius thumb); the trapezoid articulates with the second
3 Dorsal tubercle of radius metacarpal (of the index finger); the capitate articulates
4 Ulna with the third metacarpal (of the middle finger); and the
5 Styloid process of ulna hamate articulates with the fourth and fifth metacarpals
6 Scaphoid (of the ring and little fingers).
7 Lunate 2. The joint between the trapezium and first metacarpal (of
8 Triquetrum the thumb) is the first carpometacarpal joint, also known
9 Pisiform as the saddle joint of the thumb.
10 Trapezium 3. At the wrist region, it is the radius that articulates with
11 Trapezoid the carpal bones, not the ulna; the wrist joint is often
12 Capitate referred to as the radiocarpal joint.
13 Hamate 4. The scaphoid is the most commonly fractured carpal bone.
14 First metacarpal (of thumb) The lunate is the most commonly dislocated carpal bone.
15 Second metacarpal (of index finger)
16 Third metacarpal (of middle finger)
17 Fourth metacarpal (of ring finger)
18 Fifth metacarpal (of little finger)
RIGHT WRIST/HAND—ANTERIOR VIEW
Proximal
Radiocarpal
(wrist)
joint 1 2
Carpometacarpal
(CMC) joint 3
5
4 6
8 Carpometacarpal
9 12 7 (CMC) joint
14 10 11
13
25
15
Metacarpophalangeal
(MCP) joint
16 26
Interphalangeal 19 Metacarpophalangeal
(IP) joint (MCP) joint
17
27
Lateral Medial
(radial) (ulnar)
18
Proximal
interphalangeal
(PIP) joint
20
Distal
interphalangeal
(DIP) joint
FIGURE 4-76
1 Radius 21
2 Ulna
3 Scaphoid 22
4 Tubercle of scaphoid 24
5 Lunate 23
6 Triquetrum
7 Pisiform
8 Trapezium
9 Tubercle of trapezium
10 Trapezoid Distal
11 Capitate
12 Hamate
13 Hook of hamate
14 Base of first metacarpal (of thumb)
15 Body (shaft) of first metacarpal (of thumb) NOTES
16 Head of first metacarpal (of thumb) 1. The thumb has two phalanges—proximal and distal; the
17 Proximal phalanx of thumb other four fingers each have three phalanges—proximal,
18 Distal phalanx of thumb middle, and distal.
19 Second metacarpal (of index finger) 2. All metacarpals and phalanges have the following
20 Proximal phalanx of index finger landmarks: a base proximally, a body (shaft) in the
21 Base of middle phalanx of middle finger middle, and a head distally.
22 Body (shaft) of middle phalanx of middle finger 3. The length of a metacarpal of a ray is equal to the length
23 Head of middle phalanx of middle finger of the proximal and middle phalanges of that ray added
24 Distal phalanx of ring finger together; the length of a proximal phalanx of a ray is
25 Base of fifth metacarpal (of little finger) equal to the length of the middle and distal phalanges of
26 Body (shaft) of fifth metacarpal (of little finger) that ray added together.
27 Head of fifth metacarpal (of little finger)
RIGHT WRIST/HAND—POSTERIOR VIEW
Proximal
2 1
Radiocarpal
(wrist)
joint
Midcarpal
joint 4 3
5 Carpometacarpal
6 (CMC) joint
Carpometacarpal 8 7
9
(CMC) joint
13 Metacarpophalangeal
10 (MCP) joint
Metacarpophalangeal 14 Interphalangeal
(MCP) joint 11 (IP) joint
Medial Lateral
(ulnar) (radial)
12
15
Proximal 16
interphalangeal
(PIP) joint
Distal 17
interphalangeal
(DIP) joint
20 18
19
Distal
FIGURE 4-77 16 Base of proximal phalanx of middle finger

1 Radius 17 Body (shaft) of proximal phalanx of middle finger
2 Ulna 18 Head of proximal phalanx of middle finger
3 Scaphoid 19 Middle phalanx of ring finger
4 Lunate 20 Distal phalanx of little finger
5 Triquetrum
6 Trapezium
7 Trapezoid NOTES
8 Capitate 1. The wrist joint is composed of the radiocarpal and
9 Hamate midcarpal joints.
10 First metacarpal (of thumb) 2. The radiocarpal joint is located between the radius and
11 Proximal phalanx of thumb the proximal row of carpal bones. The midcarpal joint is
12 Distal phalanx of thumb located between the proximal and distal rows of carpal
13 Base of metacarpal of index finger bones. In Figure 4-77, the radiocarpal joint is indicated in
14 Body (shaft) of metacarpal of index finger green and the midcarpal joint is indicated in yellow.
15 Head of metacarpal of index finger
RIGHT WRIST/HAND—MEDIAL VIEW
Proximal
1 3
4
11 2
6
5 7
1st Carpometacarpal (CMC) 5th Carpometacarpal (CMC)
joint 9 8 joint
12
10
1st Metacarpophalangeal (MCP) 13
joint 5th Metacarpophalangeal (MCP)
joint
16
Lateral Medial
(radial) 14 (ulnar)
Interphalangeal (IP) 15 Proximal interphalangeal (PIP)

joint joint
17
Distal interphalangeal (DIP)
joint
18 19
FIGURE 4-78
1 Radius Distal
2 Styloid process of the radius
3 Ulna NOTES
4 Styloid process of the ulna 1. The thumb has only two phalanges, hence only one
5 Scaphoid interphalangeal joint.
6 Lunate 2. The other fingers have three phalanges, hence two
7 Triquetrum interphalangeal joints—a proximal interphalangeal joint
8 Pisiform and a distal interphalangeal joint.
9 Trapezium 3. An interphalangeal joint is often abbreviated as an IP
10 Trapezoid joint.
11 Capitate 4. The proximal interphalangeal joint is often abbreviated
12 Hamate as the PIP joint.
13 First metacarpal (of thumb) 5. The distal interphalangeal joint is often abbreviated as the
14 Proximal phalanx of thumb DIP joint.
15 Distal phalanx of thumb 6. The carpometacarpal joint is often abbreviated as the
16 Metacarpal of index finger CMC joint.
17 Proximal phalanx of middle finger 7. The metacarpophalangeal joint is often abbreviated as the
18 Middle phalanx of ring finger MCP joint.
19 Distal phalanx of little finger
RIGHT WRIST/HAND (FLEXED) AND CARPAL TUNNEL
Distal
17
14
13
16
18
Medial Lateral
(ulnar) (radial)
15
12
8
11 7
5
10 9 2
6
4
3 1
A Proximal
Anterior (palmar)
11 Carpal tunnel
7
5
9 8
10 2
Medial Lateral
(ulnar) 6 (radial)
4
3 1
B Posterior (dorsal)
FIGURE 4-79 A, Proximal view of right wrist and hand with fingers 16 Proximal phalanx of middle finger
flexed. B, Proximal view of right carpal tunnel. 17 Middle phalanx of ring finger
1 Scaphoid 18 Distal phalanx of little finger
2 Tubercle of scaphoid
3 Lunate
4 Triquetrum
5 Pisiform
6 Trapezium NOTES
7 Tubercle of trapezium 1. In figure A, the hand is shown with flexion of the fingers
8 Trapezoid at the metacarpophalangeal and interphalangeal joints.
9 Capitate 2. Figure B is a proximal to distal view demonstrating the
10 Hamate tunnel that is formed by the carpal bones known as the
11 Hook of hamate carpal tunnel.
12 First metacarpal (of thumb) 3. The flexor retinaculum encloses and forms the ceiling of
13 Proximal phalanx of thumb the carpal tunnel by attaching to the tubercles of the
14 Distal phalanx of thumb scaphoid and trapezium on the radial side and the
15 Second metacarpal (of index finger) pisiform and hook of the hamate on the ulnar side.
BONE TERMINOLOGY
- 206 bones in adult
- Contains mainly flat bones
- Bones provide shape to the body.
- Bones act as a protection to
internal organs like brain, heart,
lungs etc.. Image:
- Provides support to the body and
3. Occipital Bone Forms the posterior brain case. ->
anchors muscles. Back + lower part of skull
- Bones serve as storage space for
minerals like calcium and
phosphate
- Bones helps in facilitating body
movements. Image:
- Bones serve as the birthplace for
red blood cells. 4. Sphenoid Bone Helps to form the base of the
cranium, the sides of the skull and
the floors and sides of the orbits
(eye sockets). -> Situated in the
middle of the skull.
5+6. Parietal Form the middle portion of the

Bones brain case. The bones are joined
together by the mid-line of the
sagittal suture.
AXIAL SKELETONS
Image:
7+8. Temporal Pair of bones situated at the sides

Question Answer
Bones and base of the skull. Supports the
How many bones 22 bones - 8 cranial bones - 14 temple of the face + encloses the
are in the skull? facial bones ear.
8 cranial bones 1. Ethmoid bone 2. Frontal bone 3.

(Elephants Occipital 4. Sphenoid bone 5+6.
Fathers Only Parietal bones X2 7+8. Temporal
Image:
Sleep Past Ten) bones X2
123456 1 = Frontal Bone 2. Parietal Bone
1. Ethmoid Bone Forms the inner core of the facial
Image: 3. Sphenoid Bone 4. Temporal
skeleton. Located at the roof of the
Bone 5. Occipital Bone 6. Ethmoid
nose between the 2 orbits.
Bone
Separates the nasal cavity from
the brain.
2. Frontal Bone Forms the forehead.

14 facial bones 1. Mandible 2. Vomer 3+4. Inferior = light blue 7+8. Maxilla = yellow
(Many Vermin In Nasal Cochae X2 5+6. Lacrimal 9+10. Nasal = pink 11+12. Palatine
London Make Bones X2 7+8. Maxillae X2 9+10. = red 13+14. Zygomatic = dark
Nuns Pity Zebras) Nasal Bones X2 11+12. Palatine green
Bones X2 13+14. Zygomatic
Bones X2
1. Mandible Lower jaw bone. Begins as a

paired bone but fuses at the
mid-line at 1 year. Largest, SKULL- 22 bones
strongest + lowest bone in the Compose of…..
face. Holds lower teeth in place.
2. Vomer Forms a large part of the nasal CRANIAL BONES

septum between the left and right
cavities of the nose.
3+4. Inferior Small, scroll-like bones placed on

Nasal Cochae the lateral surface of the nasal
cavity.
5+6. Lacrimal Small bones almost completely

Bones hidden in the intact skull. Form part
of the eye socket. Smallest + most
fragile bones of the face.
Image:
7+8. Maxillae Upper jaw -> make up the hard

Bones palate, nose and upper dental
ridge.
- Protects the brain

- All parts are connected by sutures
(Serrated line)
Image:
1. Frontal bone. This is the flat bone that
9+10. Nasal Make up the superior surface or makes up your forehead. It also forms the
Bones 'bridge' of the nose. upper portion of your eye sockets.
11+12. Palatine Form part of the hard palate +
2. Parietal bones (2). This a pair of flat bones
Bones nasal cavity located on either side of your head,
behind the frontal bone.
13+14. Zygomatic Make up the prominent structure of 3. Temporal bones (2). This is a pair of
Bones the cheekbones and outer side of
irregular bones located under each of the
the eye sockets.
parietal bones.
Image: 1. Mandible = purple 2. Vomer = 4. Occipital bone. This is a flat bone located
dark blue 3+4. Inferior Nasal in the very back of your skull. It has an
Cocha = light green 5+6. Lacrimal
opening that allows your spinal cord to the 1st cervical vertebra (atlas), the facial bones,
connect to your brain. and the mandible (jaw).
5. Sphenoid bone. Butterfly-shaped bone
This is an irregular bone that sits below
the frontal bone. It spans the width of your
skull and forms a large part of the base of
your skull.
6. Ethmoid bone. This is an irregular bone
located in front of the sphenoid bone. It
makes up part of your nasal cavity.
Anatomically, the cranium can be subdivided into

a roof and a base:
Cranial roof – comprised of the frontal, occipital

and two parietal bones. It is also known as the - these three together produce the cranial
calvarium. cavity that houses the brain
FACIAL BONES
- give structure to the face
Cranial base – most inferior area, comprised of

the frontal, sphenoid, ethmoid, occipital, parietal,
and temporal bones. These bones articulate with
curves inward again. This structure gives
the spinal column great strength and
shock-absorbing qualities.
VERTEBRAL COLUMN/SPINAL
COLUMN
The vertebral column can be divided into 5
regions:
● Cervical spine: 7 vertebrae of the neck
(C1-C7)
● C1 is the atlas
● C2 is the axis
● Thoracic spine: 12 vertebrae of the
mid-back (T1-T12)
● Lumbar spine: 5 vertebrae of the lower
back (L1-L5)
● Sacrum- (or sacral spine) is a
triangular-shaped bone located below the
last lumbar spinal vertebrae. The sacrum
sits between the hip bones (called iliac
bones) and forms the back of the pelvis.
The sacrum connects to the pelvis at the
left and right sides by the sacroiliac joints
(SI joints).
● Coccyx- Immediately below the sacrum
are 3 to 5 small bones that naturally fuse
together at adulthood forming the coccyx
or tailbone. Sometimes the coccyx is
All vertebrae share a basic common structure.
termed the coccygeal vertebrae. Although
They each consist of an anterior vertebral body,
the tailbone is very small and may seem
and a posterior vertebral arch.
insignificant, it plays an important role in
supporting your weight when you sit.y
- A normal vertebral column creates a

graceful, double-S curve when viewed
from the side of the body. The cervical
vertebrae gently curve inward, while the
thoracic spine curves gently outward,
followed by the lumbar spine, which
● Vertebral body- ● The C1 to C6 vertebrae contain small
- anterior part of each vertebrae holes that Allow the vertebral artery, vein,
- Weight-bearing function and sympathetic nerves to pass through
- Lined with hyaline cartilage superiorly and and carry blood to the brain. This is a
inferiorly unique feature of the cervical vertebrae as
● Vertebral arch- no other spine bones have such holes.
- forms the lateral and posterior aspect of
each vertebrae. There are seven cervical vertebrae in the human
- Encloses the vertebral canal body. They have three main distinguishing
Vertebral arch consists of the following features:
components:
1. Spinous processes – each vertebra has a

single spinous process, centred posteriorly
at the point of the arch.
2. Transverse processes – each vertebra
has two transverse processes, which
extend laterally and posteriorly from the
ATLAS AND AXIS
vertebral body. In the thoracic vertebrae,
the transverse processes articulate with
the ribs.
3. Pedicles – connect the vertebral body to
the transverse processes.
4. Lamina – connect the transverse and
spinous processes.
5. Articular processes – form joints between
one vertebra and its superior and inferior
counterparts. The articular processes are
located at the intersection of the laminae ● C1 and C2 are specially named because
and pedicles. of their unique functions.
1. Atlas (C1):
Classifications of Vertebrae - Supports the entire skull
- Does not possess a vertebral body
CERVICAL VERTEBRAE - Primary function is to allow the head to
nod up and down.
● Support the head’s weight and allow a 2. Axis (C2):
wide range of head and neck movements, - Possesses a bony projection called the
like nodding and rotation. dens (also known as odontoid process):
● Protect the spinal cord as it passes - Serves as a pivot point to allow head to
through the hollow space encircled by the rotate side to side
7 bones.
- Commonly fractured during high-impact ● The articular facets are flat and of an oval
injuries appearance:
- Has a bifid spinous process - Superior articular facet faces backward,
upward, and slightly medially.
TYPICAL VERTEBRA (C3-C7) - Inferior articular facet faces forward,
downward, and slightly laterally.
The next five vertebrae, C3-C7, have the typical ● The transverse processes of the typical
structure for all the other vertebrae in the spine. cervical (C3-C7) vertebrates are short,
which, in the upper six cervical vertebrae,
gives access to the vertebral artery and
vein, and plexus of the sympathetic
nerves. Each transverse process consists
of an anterior and a posterior part. These
two parts are joined, outside the foramen,
and passage of the corresponding spinal
nerve.
THORACIC VERTEBRAE
Based on the features, the thoracic vertebrae are

classified into 2 types:
● vertebral foramen is large, triangular in ● Typical: 2nd to eighth
shape. ● Atypical: first and ninth to twelfth
● The typical cervical (C3-C7) vertebrates
pedicles are short and project TYPICAL THORACIC VERTEBRAE
posterolaterally. They are attached to the - 2nd to eighth
body midway within its upper and lower
borders so that the superior vertebral
notch of the typical cervical (C3-C7)
vertebrates is as deep as the inferior.
● The laminae of the typical cervical
(C3-C7) vertebrates are long, narrow, and
thinner above than below. They curve
posteromedially.
● The spinous process is short and bifid.
Because the spinous processes are so ● Presence of articular facets on every side
short, certain superficial muscles of the body and on front of transverse
(trapezius and the splenius capitis) attach processes for articulation with the ribs.
to the nuchal ligament rather than directly ● Body is heart shaped, especially in the
to the vertebrae; the nuchal ligament midthoracic region when seen from above.
connecting to the spinous processes of Its transverse and anteroposterior
the C2-C7 and the posterior tubercle of measurements are just about equivalent.
the atlas. ● Vertebral foramen is circular.
● The superior and inferior articular ● Spinous process is long, thin, and pointed
processes of cervical vertebrae have downwards.
fused on either or both sides to develop ● Pedicle is connected to the upper part of
articular pillars, columns of bone that the body, so making the inferior vertebral
project laterally of the junction of the notch deeper.
pedicle and the lamina.
ATYPICAL THORACIC VERTEBRAE - It can be noted that T11 and T12 begin
- first and ninth to twelfth transitioning to shorter, more
posteriorly-oriented spinous processes
similar to the lumbar vertebrae.
LUMBAR VERTEBRAE
T1
- The superior-most thoracic vertebra
contains a complete facet for the first rib
and a demi-facet for the second rib. ● There are five lumbar vertebrae in most
- The other distinguishable feature of T1 is humans, which are the largest in the
that it has a straighter spinous process vertebral column. They are structurally
that more closely resembles C7 than other specialised to support the weight of the
thoracic vertebrae. torso.
T9 ● Lumbar vertebrae have very large
- T9 has no inferior demi-facet, meaning it vertebral bodies, which are kidney
only connects to the ninth rib, and not the shaped. They lack the characteristic
tenth rib as well. features of other vertebrae, with no
T10 transverse foramina, costal facets, or bifid
- Often, but not always, shares features with spinous processes.
T11 and T12 such as having a single ● However, like the cervical vertebrae, they
costal facet for articulation with the tenth have a triangular-shaped vertebral
rib. foramen. Their spinous processes are
T11 and T12 shorter than those of thoracic vertebrae
- Contain a single costal facet that and do not extend inferiorly below the
articulates with the 11th and 12th ribs (T11 level of the vertebral body.
and T12 respectively). There is no ● Their size and orientation permits needle
transverse costal facet for stabilisation of access to the spinal canal and spinal cord
the eleventh rib. (which would not be possible between
thoracic vertebrae). Examples include
epidural anaesthesia administration and
lumbar puncture.
SACRUM AND COCCYX
RIBS
● Sacrum
- Consists of 5 fused vertebrae below the
lumbar vertebrae
- Represents the terminal portion of the
vertebral canal
- Articulates with the ilium (hip bone) to form
the pelvic girdle
● Coccyx
- Consists of 3–5 fused vertebrae
- Articulates with the inferior sacrum
THORACIC CAGE
Comprises of: ● The ribs form the main structure of the
thoracic cage protecting the thoracic
STERNUM
organs, however their main function is to
- Your sternum, along with your ribs, works
aid respiration.
to protect the organs of your torso, such
● Ribs are flat bones
as your heart, lungs, and chest blood
● There are twelve pairs of ribs.
vessels. Support.
- Your sternum also provides a connection
According to their attachment to the sternum, the
point for other parts of your skeletal
ribs are classified into 3 groups: true, false, and
system, including your collarbone and
floating ribs.
most of your ribs.
1. The true ribs are the ribs that directly

articulate with the sternum with their costal
cartilages - ribs 1-7. They articulate with
the sternum by the sternocostal joints. The
first rib is an exception to that rule; it is a
synarthrosis and the first rib could
uniquely articulate with the clavicle by the
costoclavicular joint
2. The false ribs (8,9,10) are the ribs that
indirectly articulate with the sternum, as
their costal cartilages connect with the
seventh costal cartilage by the ● protect the contents of the thoracic cavity
costochondral joint. and mediastinum
3. The floating ribs (11,12) do not articulate ● move superiorly, inferiorly, anteriorly and
with the sternum at all (distal two ribs). posteriorly to facilitate breathing (their
flexibility in their movement
Typically, the ribs have the following anatomical increases/decreases the size of the
components: thoracic cavity; assisting the lungs in
respiration. Control of these movements is
● Head with two articular facets via the diaphragm, external intercostals,
● Tubercle and the intercartilaginous portion of the
● Neck internal intercostals).
● Shaft ● provide a place where some muscles
● Costal groove originate or attach
● play a role in erythropoiesis during
Most of the ribs are typical ribs i.e. they have all development (at birth, the erythropoiesis
these features. The atypical ribs which do not sites change, it recedes in long bones and
have all these features are: persists in flat bones, like ribs)
Appendicular skeleton
➔ The appendicular skeleton is the
part of the human skeletal system
that supports the appendages. It
consists of 186 bones including the
bones of the limbs as well as
supporting the pelvic and pectoral
girdles.
➔ The appendicular skeleton is
divided into 6 regions.
1. Shoulder girdle
2. Arms and forearms
3. Hands
4. Pelvis
5. Thighs and legs
6. Feet and ankles
● First rib (wide and short, has two costal

grooves, and one articular facet)
● Second rib (thin, long, and has a
tuberosity on its superior surface for the
attachment of the serratus anterior
muscle)
● Tenth rib (only one articular facet)
● Eleventh rib, Twelfth rib (one articular
facet with no neck)
The functions of the ribs are critical, as they:

II. Arms and Forearms
● The arm and forearm are
constituted of 6 bones. The large
bones of the arm include:
○ Humerus – Humerus runs
from the shoulder socket and
joins the radius and ulna at
the elbow.
○ Radius – Radius is a forearm
which runs from the elbow to
the thumb side of the wrist.
○ Ulna – Ulna, a forearm which
runs from the elbow to the
‘pinky’ side of the elbow.
I. Shoulder Girdle
A. The shoulder girdle or the
pectoral girdle is a set of 4
bones which connects to the
arm on each side.
B. The pectoral girdle is part of
the appendicular skeleton
which is for the upper limbs. III. Hands
In human beings, the pectoral ● The hands consist of 54 bones
girdle consists of the scapula which provide support and
and the clavicle. flexibility to the soft tissues. The
bones of hands are categorised
into three:
○ Carpals – Carpals are a set of
8 irregularly shaped bones
located in the wrist area.
○ Metacarpals – Metacarpals
are bones which are related
to each digit, there are 5
metacarpal bones.
○ Phalanges – Phalanges are
the bones of the fingers.
There are 3 phalanges in
each finger, except for the
thumb which has two
phalanges only.
V. Thighs and Legs
● The bones of the legs and thighs are
part of the appendicular skeletal
system which supports the muscles of
the lower limbs. These muscles help in
walking, running, standing and
jumping.
○ The Femur or thigh bone is the
largest and heaviest bone in
the human body. At the
proximal end of Femur, there is
a rounded prominence which
is called as the Head of the
Femur.
○ The Tibia and Fibula are the
two long bones in the lower leg.
They are two separate bones
but are closely linked at the
IV. Pelvic Girdle knee and the ankle.
● The pelvic girdle is located in the ○ The top of Tibia connects to
lower part of the trunk. It a ring-like the knee joint and bottom
bony structure. The pelvic girdle connects to the ankle joint.
consists of two bones, sacrum and Although Tibia carries all the
the coccyx. body weight, it needs the
● The pelvic girdle is formed of paired support of Fibula.
hip bones each made up of ilium,
ischium and pubis.
○ It transfers the weight of the
body from the axial skeleton to
the appendicular components,
especially during the
movement.
○ Provides attachment from a
number of muscles and
ligaments enabling movement.
● The majority of women have a
gynaecoid pelvis and males have an
android pelvis. The di erences in the
structure creates a great pelvic outlet
enabling the process of childbirth.
VI. Feet and Ankles
● The foot is a firm platform which
supports the weight of the body. It is
formed of many bones such as the
tarsals, metatarsals and phalanges.
○ Tarsals: A set of 8 irregular
bones situated proximally in
the foot in the ankle area.
○ Metatarsals: A set of 5 bones
each one for a digit. These
bones connect tarsals with the
phalanges.
○ Phalanges: Each toe has 3
phalanges namely the
proximal, intermediate and
distal.
Bony Framework of Pelvis
L2
Transverse processes of lumbar vertebrae
Inner lip Sacral
promontory L3 Iliac tuberosity
Intermediate
Iliac zone
crest Iliac crest
L4
Outer lip
Ala of ilium
Tubercle
L5
Greater
sciatic
notch
Arcuate line
Anterior superior
Ischial spine
iliac spine
Sacrum Lesser
Anterior inferior
iliac spine sciatic notch
Iliopubic Greater trochanter

eminence Coccyx of femur
Superior Pecten pubis

pubic ramus
Obturator
Pubic symphysis
foramen
Pubic tubercle Ischial tuberosity
Inferior Lesser trochanter

pubic ramus Pubic arch of femur
Inferior pubic ligament
Plate 334 Bones and Ligaments
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Sex Differences of Pelvis: Measurements
See also Plate 250
Female pelvis/female pelvic

inlet: anterior view
Sacroiliac joint
Sacral promontory
Diagonal conjugate (~12 cm)
Diameters of
Transverse (~13 cm)
the pelvis
Oblique (~12.5 cm)
Ischial spine
Iliopubic eminence
Pubic symphysis
Ischial tuberosity
Pubic arch
Male pelvis/male pelvic

inlet: anterior view
Diagonal All measurements slightly shorter in

conjugate relation to body size than in female
is only Pelvic inlet oriented more antero-
diameter of posteriorly than in female, where
pelvic it tends to be transversely oval
inlet that Pubic symphysis deeper (taller)
can be Pubic arch (subpubic angle) narrower
measured Ischial tuberosities less far apart
clinically Iliac wings less flared
Pubic
Transverse symphysis
diameter of pelvic
outlet (~11 cm)
True conjugate
Sacral is ~1.5 cm
promontory shorter than
diagonal
conjugate
t
inle
lvic
True conjugate
f pe
diameter
eo
of pelvic inlet
(~11 cm)
Plan
Ischial
tuberosity
tle t
Anteroposterior Ischial spine lvic ou
diameter of
eof pe
pelvic outlet Diagonal Plan
(varies 9.5–11.5 cm conjugate Anteroposterior
because of mobility diameter of
Tip of coccyx Pubic pelvic outlet
of coccyx) symphysis (9.5–11.5 cm)
Transverse diameter is the widest distance of pelvic inlet
Female pelvis/female pelvic outlet:
inferior view Female: sagittal section
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Bones and Ligaments of Pelvis 6
See also Plate 167
Iliolumbar ligament
Iliac crest
Supraspinous ligament
Posterior superior iliac spine
Posterior sacroiliac ligaments
Iliac tubercle
Posterior sacral foramina
Greater sciatic foramen
Anterior superior iliac spine

Sacrospinous ligament
Sacrotuberous ligament
Lesser sciatic foramen
Acetabular margin
Ischial tuberosity
Tendon of long head of Anterior
biceps femoris muscle longitudinal
ligament
Iliolumbar
ligament
Deep Posterior Iliac

sacrococcygeal fossa
Superficial ligaments
Lateral sacrococcygeal Anterior sacroiliac ligament

ligament
Sacral promontory
Posterior view
Anterior inferior iliac spine

Anterior
Ischial spine sacral
foramina
Lesser sciatic foramen Coccyx
Anterior
Iliopubic eminence sacrococcygeal
ligaments
Superior pubic ramus
Ischiopubic ramus
Pubic tubercle Pubic
Anterior view
symphysis
Bones and Ligaments Plate 337
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Bones and Ligaments of Pelvis (continued)
See also Plate 167
Median (sagittal) section

Body of L5 vertebra
Iliac Intermediate zone Greater pelvis
crest Inner lip
Lumbosacral (L5–S1) intervertebral disc
Iliac fossa Sacral promontory
Anterior superior Greater sciatic foramen
iliac spine
Lesser pelvis
Arcuate line
Ischial spine
Anterior inferior
iliac spine Sacrospinous ligament
Iliopubic eminence Lesser sciatic foramen
Obturator canal Sacrotuberous ligament
Superior pubic ramus Coccyx
Pecten pubis Ischial tuberosity
Pubic tubercle
Symphyseal
surface
Obturator membrane Body of L4 vertebra
Intermediate zone
Lateral view Supraspinous ligament Outer lip Iliac crest
Iliac tubercle
Posterior, anterior, and
inferior gluteal lines Ala of ilium
(gluteal surface)
Posterior superior iliac spine Body of ilium
Anterior superior
Median sacral crest iliac spine
Posterior inferior iliac spine Anterior inferior
iliac spine
Posterior sacroiliac ligament Acetabulum
Greater sciatic foramen Acetabular labrum
Sacrospinous ligament Acetabular margin

Lunate (articular) surface
Posterior and lateral
sacrococcygeal ligaments Acetabular notch
Sacrotuberous ligament Transverse acetabular

ligament
Ischial spine Superior pubic ramus
Pubic tubercle
Lesser sciatic foramen
Obturator crest
Ischial tuberosity
Obturator canal
Ischiopubic ramus
Obturator membrane
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Pelvic Diaphragm: Female 6
See also Plate 373
Medial view
Piriformis
muscle
Arcuate line
Ischial
Obturator internus muscle spine
and obturator fascia (cut)
Tendinous arch of levator ani muscle
Obturator canal
Iliococcygeus muscle
(part of levator ani muscle)
Urethra Coccygeus
muscle
Pubococcygeus muscle
Left levator ani
Vagina muscle (cut)
Sphincter urethrae muscle External anal

sphincter muscle
Left puboanalis (puborectalis)
muscle and perineal membrane
Compressor urethrae muscle and urethrovaginal Superficial and deep

sphincter (portions of sphincter urethrae muscle) Rectum transverse perineal muscles
Piriformis muscle
Lateral view Greater sciatic foramen
Sacrotuberous ligament (cut) Ischial spine

Median sacral crest Tendinous arch of levator ani muscle
Puboanalis (puborectalis) muscle
Coccygeus muscle (part of levator ani muscle)
Sacrospinous ligament (cut)

Pubic bone
(cut surface)
Coccyx
Deep dorsal vein
of clitoris
Urethra
Rectum Vagina
Pelvic Floor and Contents Plate 339
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Pelvic Diaphragm: Female (continued)
For urogenital diaphragm see Plate 360
Medial view Pubic bone (cut surface)
Obturator internus muscle

and obturator fascia (cut)
Obturator canal
Urethra Arcuate line of ilium
Vagina
Tendinous arch of
levator ani muscle Ischial
spine
Rectum
Iliococcygeus muscle Piriformis
muscle
Coccygeus
Coccyx
Superior view Inferior (arcuate) pubic ligament

Pubic symphysis Deep dorsal vein of clitoris
Transverse perineal ligament
Inguinal ligament Fascia of deep perineal muscles
(Poupart’s)
Urethra
Vagina
Obturator canal
Obturator fascia
(over obturator
internus muscle)
(part of levator ani
muscle)
Tendinous arch of
levator ani muscle
Rectum
Ischial spine
Levator plate (median raphe)
of levator ani muscle
Coccygeus muscle
Piriformis muscle
Coccyx
Anterior sacro-
coccygeal ligament
Sacral promontory
Plate 340 Pelvic Floor and Contents
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Pelvic Diaphragm: Female (continued) 6
See also Plate 361
Pubic symphysis
Urethra
Vagina
Puboanalis
(puborectalis)
Levator
Pubococcygeus ani muscle
Iliococcygeus
Anus
Anococcygeal body (ligament)
Inferior view
Musculofascial extensions to urethra
Pubic symphysis Musculofascial extensions to vagina
Inferior (arcuate) Interdigitating fibers of perineum
pubic ligament
Puboanalis (puborectalis) muscle
Deep dorsal (part of levator ani muscle)
vein of clitoris
Inferior pubic ramus (part of levator ani muscle)
Urethra Tendinous arch of levator ani muscle
Vagina Obturator internus muscle

Rectum (part of levator ani muscle)
Ischial tuberosity
Ischial spine
Obturator internus
tendon
Piriformis muscle
Ischial spine Median raphe

Coccygeus
muscle Anococcygeal body (ligament)
(attachment of external anal sphincter muscle)
Piriformis muscle (cut)
Sacrospinous ligament (cut) Tip of coccyx
Sacrotuberous ligament (cut)
Sacrum
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Pelvic Diaphragm: Male
See also Plate 343
Inferior (arcuate) pubic ligament

Superior view Pubic symphysis
(viscera removed) Hiatus for deep dorsal vein of penis
Pubic crest
Transverse perineal ligament
Pubic tubercle (anterior thickening of
Perineal membrane)
Pecten pubis
Superior ramus of pubis Hiatus for urethra

Muscle fibers from levator ani to
conjoined longitudinal muscle of anal canal
Obturator canal
Puboanalis
(puborectalis) Levator ani
Obturator fascia Pubococcygeus muscle
Iliococcygeus
Iliopubic eminence
Tendinous arch of
Acetabular margin levator ani muscle
Anterior inferior Obturator

iliac spine internus muscle
Ala of ilium
Arcuate line
Coccygeus muscle
Ischial spine
Piriformis muscle
Anterior sacral (pelvic) foramina

Sacroiliac joint
Anterior sacrococcygeal ligament
Sacrum
Sacral canal Anorectal hiatus
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Pelvic Diaphragm: Male (continued) 6
For urogenital diaphragm see Plate 365
Inferior view Deep dorsal veins of penis Pubic symphysis

Fat in retropubic (prevesical) space Inferior pubic (arcuate) ligament
Perineal body
Sphincter urethrae muscle ascending Fibromuscular extensions of levator
anterior aspect of prostate gland ani muscle to prostate gland
Urethra Pubic tubercle
Rectourethralis superior muscle
Rectoprostatic (Denonvilliers’) fascia
Prerectal muscle fibers (of Luschka)
Medial border (pillar) from levator ani muscle
Muscle fibers from levator
Perineal membrane (cut away) ani to conjoined longitudinal
muscle of anal canal
Ischiopubic
ramus
Obturator
internus
tendon
Ischial tuberosity

Gluteus maximus
Sacrospinous ligament (cut) muscle
Obturator internus muscle
Coccygeus muscle Tendinous arch of
levator ani muscle
Sacrospinous ligament (cut)
Iliococcygeus
Pubococcygeus Levator ani muscle
Puboanalis (puborectalis)
Tip of coccyx
Circular muscle layer of anorectal junction
Conjoined longitudinal muscle
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Pelvic Contents: Female
Superior view Uterus (fundus) Linea alba Urinary bladder and transverse vesical fold
Proper ovarian ligament (ligament of ovary) Median
umbilical Rectus abdominis muscle
Ovary fold and Medial umbilical fold and ligament
Uterine (fallopian) tube ligament (fibrous part of umbilical artery)
Round ligament of uterus (urachus)
Rectum
Broad ligament
Inferior epigastric vessels and
lateral umbilical fold
Femoral ring Uterosacral fold
Deep inguinal ring Ureteric fold
Iliopubic tract Suspensory ligament
(covered by peritoneum) of ovary (contains
ovarian vessels)
External iliac vessels
Iliac fossa Cecum
(greater pelvis) Cecal folds
Left Right
paracolic paracolic
gutter gutter
Sigmoid colon Ovarian

Quadratus vessels Transversalis
lumborum Psoas major fascia
and minor Pararectal fossa
muscle Parietal peritoneum
muscles
Descending colon Inferior vena cava Ascending colon
Transversus Sympathetic trunk
Terminal ileum
abdominis Abdominal Anterior Abdominal aorta
Internal oblique longitudinal ligament Ureter
muscles
External oblique Superior hypogastric plexus Root of mesentery
Body of L3 vertebra
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Pelvic Viscera and Perineum: Female 6
Paramedian (sagittal) dissection
Ureter
Uterine (fallopian)
tube Rectouterine pouch
(of Douglas)
Ovary
Proper ovarian Peritoneum (cut edge)
ligament (ligament Vesicouterine pouch
of ovary)
Rectum
Round ligament
of uterus Ureter
Broad ligament (cut) Urinary bladder

Vagina
Superior pubic ramus (cut) Pelvic diaphragm
(levator ani muscle)
Inferior pubic ramus (cut)
Deep transverse
perineal muscle (cut)
Ischiocavernosus muscle
External anal
sphincter muscle
Body of clitoris
Labia minus
Labium majus
Median (sagittal) section

Sacral promontory
Ureter Uterosacral ligament
Suspensory ligament of ovary Vesicouterine pouch
Uterine (fallopian) tube Rectouterine pouch
Ovary (of Douglas)
External iliac vessels Cervix of uterus
Proper ovarian ligament Posterior vaginal
(ligament of ovary) fornix
Body of uterus Anterior vaginal
Round ligament of uterus fornix
(ligamentum teres uteri) Rectum
Fundus of uterus Vagina
Urinary bladder
Perineal
Pubic symphysis membrane
Urethra Levator ani
muscle
Sphincter urethrae
External
Deep transverse perineal muscle anal
Deep dorsal vein of clitoris sphincter
muscle
Crus of clitoris
External urethral orifice
Labium minus Anus
Labium majus
Vaginal orifice
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Pelvic Viscera: Female
Superior view with peritoneum intact
Vesicouterine Urinary bladder

pouch
Fundus of uterus
Paravesical Deep inguinal ring
fossa
Round ligament of uterus
Body of uterus
Broad ligament
Proper ovarian ligament
(ligament of ovary)
Mesosalpinx (of broad ligament)
Cervix of uterus
Ovary
Rectouterine pouch (of Douglas)
Rectouterine fold
Uterine (fallopian) tube
Pararectal fossa
Suspensory ligament of ovary
(contains ovarian vessels)
Ureteric fold
Urinary bladder
Vesical fascia (cut edge)
Obturator fascia
Sigmoid colon
Sacral promontory
Median sacral vessels
Abdominal aorta
Obturator canal
Obturator artery
Cervix of uterus and uterovaginal fascia
Uterine vessels
Cardinal (Mackenrodt’s) ligament

Rectocervical and rectovaginal (potential) spaces
Rectal fascia (cut edge)
Rectouterine (sacrouterine)
ligament
Ureter
Sacral promontory
Superior view with peritoneum and uterus removed
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Shoulder and Axilla • Plate 408-420
408 Clavicle and Sternoclavicular Joint
409 Humerus and Scapula: Anterior Views
410 Humerus and Scapula: Posterior Views
411 Shoulder: Anteroposterior Radiograph
412 Shoulder with Details of Glenohumeral Joint
413 Muscles of Shoulder
414 Axilla: Posterior Wall
415 Muscles of Rotator (Compressor) Cuff
416 Pectoral, Clavipectoral, and Axillary Fasciae
417 Scapulothoracic and Shoulder Dissection
418 Axillary Artery and Anastomoses Around Scapula
419 Axilla: Anterior View
420 Brachial Plexus: Schema
Arm • Plates 421-425

421 Muscles of Arm: Anterior Views
422 Muscles of Arm: Posterior Views
423 Brachial Artery in Situ
424 Arteries of Arm and Proximal Forearm
425 Arm: Serial Cross Sections
Elbow and Forearm • Plates 426-441

426 Bones of Elbow
427 Elbow: Radiographs
428 Ligaments of Elbow
429 Bones of Forearm
430 Individual Muscles of Forearm: Rotators of Radius
431 Individual Muscles of Forearm: Extensors of Wrist and Digits
432 Individual Muscles of Forearm: Flexors of Wrist
433 Individual Muscles of Forearm: Flexors of Digits
434 Muscles of Forearm (Superficial Layer): Posterior View
435 Muscles of Forearm (Deeper Layer): Posterior View
436 Muscles of Forearm (Superficial Layer): Anterior View
437 Muscles of Forearm (Intermediate Layer): Anterior View
438 Muscles of Forearm (Deep Layer): Anterior View
439 Attachments of Muscles of Forearm: Anterior View
440 Attachments of Muscles of Forearm: Posterior View
441 Forearm: Serial Cross Sections, Anterior View
Wrist and Hand • Plates 442-461

442 Carpal Bones
443 Movements of Wrist
444 Ligaments of Wrist
445 Ligaments of Wrist (continued)
446 Bones of Wrist and Hand
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Carpal Bones 7
See also Plate 447
Metacarpal bones
4 3 2
1
5
Anterior (palmar) view
Capitate bone
Hook of hamate bone Trapezoid bone
Hamate bone Tubercle of trapezium bone
Pisiform bone Trapezium bone
Triquetrum bone Tubercle of scaphoid bone
Lunate bone Scaphoid bone
Ulnar styloid process Radial styloid process
Ulna Radius
Metacarpal bones
2 3
4
1 5
Posterior (dorsal) view
Capitate bone
Hamate bone
Trapezoid bone
Triquetrum bone
Trapezium bone
Radial styloid process

Lunate bone
Scaphoid bone
Ulnar styloid process
Dorsal radial tubercle (Lister’s)
Ulna
Radius
Wrist and Hand Plate 442
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Movements of Wrist
See also Plates 446, 447
Sesamoid
bones
Metacarpal
bones 5 Metacarpal
1 bones
4
3 2
Hamate bone
2 3
4
Pisiform bone 1 Trapezium
5 bone
Sesamoid Trapezoid
Triquetrum bone bones
Hamate bone bone
Trapezium bone
Capitate
Lunate bone bone
Trapezoid bone Pisiform bone
Scaphoid
bone
Capitate bone Triquetrum bone
Scaphoid bone Lunate bone
Ulna Radius Ulna Radius
Position of carpal bones with hand in abduction: Position of carpal bones with hand in adduction:
anterior (palmar) view anterior (palmar) view
Palm Dorsum
Palm
Carpometacarpal joint
3rd metacarpal bone Midcarpal joint
Radius
Radiocarpal (wrist) joint
Carpometacarpal Hand in flexion
joint
Capitate bone Palm
Midcarpal
joint
Lunate bone
Articular disc
of radiocarpal
(wrist) joint Carpometacarpal joint
Radiocarpal
(wrist) joint Midcarpal joint
Hand in
Radius anatomical
position
Radiocarpal (wrist) joint
Sagittal sections through wrist and
middle finger Hand in extension
Plate 443 Wrist and Hand
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Ligaments of Wrist 7
Deep palm Metacarpal bones
4 3 2
5 1
Flexor retinaculum
(transverse carpal ligament)
Hook of hamate bone
Tubercle of trapezium bone
Pisohamate ligament
Deep palmar branch of ulnar artery Tubercle of scaphoid
and deep branch of ulnar nerve
Palmar aponeurosis
Pisometacarpal ligament
Median nerve
Pisiform bone
Flexor pollicis longus tendon
Flexor digitorum
superficialis tendons Flexor carpi radialis tendon
Flexor digitorum
profundus tendons Radial artery and
superficial palmar branch
Flexor carpi ulnaris tendon
Palmar carpal ligament
(thickening of deep antebrachial
Ulnar artery and nerve fascia) (cut and reflected)
Interosseous membrane Palmaris longus tendon
Ulna Radius
Flexor retinaculum removed:

palmar view Metacarpal bones
4 3 2
1 Trapeziocapitate ligament
5
Capitohamate ligament
Triquetrocapitate ligament
Triquetrohamate ligament
Trapeziotrapezoid ligament
Lunotriquetral ligament Scaphocapitate ligament
Ulnotriquetral ligament
Scaphotrapeziotrapezoid ligament
Palmar
ulnocarpal Ulnocapitate ligament
ligament Radioscaphocapitate ligament
Ulnolunate ligament
Long radiolunate ligament
Palmar radiolunate ligament
Short radiolunate ligament
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Ligaments of Wrist (Continued)
See also Plate 447
Posterior (dorsal) view Metacarpal bones
2 3
1 4
5
Capitohamate ligament
Trapeziocapitate ligament
Dorsal intercarpal ligament
Trapeziotrapezoid ligament
Triquetrohamate ligament
Scapholunate ligament Ulnotriquetral ligament (dorsal view)
Dorsal radioulnar ligament

Dorsal radiocarpal ligament
Dorsal radial metaphyseal arcuate ligament
Coronal section: dorsal view Metacarpal bones
2 3 4 5
1
Capitate bone
Intermetacarpal joints
Hamate bone
Carpometacarpal joint
Triquetrum bone
Trapezium bone
Interosseous intercarpal ligaments
Trapezoid bone
Pisiform bone
Midcarpal joint
Meniscus
Scaphoid bone
Articular disc of radiocarpal
Radiocarpal (wrist) joint (wrist) joint
Lunate Distal radioulnar joint
Radius Ulna
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Bones of Wrist and Hand 7
See also Plate 447
Right hand: anterior (palmar) view

Distal phalangeal bones
Head
Tuberosity
Shafts
Base
Middle phalangeal bones
Head
Shafts
Base
Proximal phalangeal bones
Head
Shafts
Base
Metacarpal bones
5
4 3 Sesamoid
Head 2 bones
Shafts
Base Carpal bones
1
Carpal bones Trapezoid
Hook of hamate Tubercle
and hamate and
Capitate Trapezium
Pisiform Tubercle
Triquetrum and
Lunate Scaphoid
Right hand: posterior (dorsal) view
Distal phalangeal bones

Head
Tuberosity
Shafts
Base
Middle phalangeal bones
Head
Shafts
Base
Proximal phalangeal bones
Head
Shafts
Base
Metacarpal bones
Head
3 4 Shafts
2 5 Base
1
Carpal bones Carpal bones
Trapezium Hamate
Trapezoid Triquetrum
Capitate
Scaphoid
Lunate
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Metacarpophalangeal and Interphalangeal Ligaments 7
See also Plate 451
Flexor digitorum profundus tendons
Flexor digitorum
superficialis tendons (cut)
Cut margins of fibrous

digital sheaths
Palmar ligaments
(palmar plates)
Collateral ligaments
Deep transverse (radial and ulnar aspects)
metacarpal ligaments
Palmar metacarpal ligaments Joint capsule
Palmar carpometacarpal ligaments

Trapezium bone
Hook of hamate bone
Pisiform bone
Metacarpophalangeal (MP) joint
Accessory collateral Proximal interphalangeal (PIP) joint
Metacarpal bone ligament
Dorsal surface Collateral Distal interphalangeal
ligament (DIP) joint
In extension:
medial view
Palmar surface
Proximal Middle Distal
Palmar ligament (palmar plate)
Phalangeal bones
Accessory
collateral
ligament
In flexion:
medial view
Collateral ligament
Palmar ligament (palmar plate)
Note: Ligaments of metacarpophalangeal

and interphalangeal joints are similar.
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Intrinsic Muscles of Hand
Lumbrical muscles (reflected)
Branches from deep

branch of ulnar nerve
to 3rd and 4th lumbrical
muscles and to all
interosseous muscles
Deep transverse metacarpal ligaments
1st dorsal
Common palmar digital arteries interosseous muscle
Palmar metacarpal arteries Adductor pollicis

Deep palmar (arterial) arch muscle
Opponens digiti minimi muscle Flexor pollicis

brevis muscle
Flexor digiti minimi brevis muscle (cut)
Abductor pollicis
Deep palmar branch of ulnar artery brevis muscle (cut)
and deep branch of ulnar nerve
Branches of median nerve
Abductor digiti minimi muscle (cut) to thenar muscles and to 1st
Median nerve and 2nd lumbrical muscles
Pisiform bone Opponens pollicis muscle

Palmar carpal arterial arch Flexor retinaculum (transverse
Flexor carpi ulnaris tendon carpal ligament) (reflected)
Ulnar artery and palmar carpal branch Superficial palmar branch of radial artery
Ulnar nerve Radius

Pronator quadratus muscle
Radial artery and palmar carpal branch

Tendinous slips
to extensor
expansions
(hoods)
1 2 3 3 2 1
Dorsal 4
interosseous
muscles
(bipennate) Palmar interosseous
Abductor digiti muscles (unipennate)
minimi muscle
Abductor pollicis
brevis muscle
Radial artery
Radius
Ulna
Radius Ulna Anterior
(palmar) view
Posterior
(dorsal) view Note: Arrows indicate action of muscles.
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Arteries and Nerves of Hand: Palmar Views 7
See also Plate 424
Branches of proper
palmar digital nerves
and arteries to dorsum
of middle and distal
phalangeal bones
Flexor tendons, synovial
and fibrous sheaths
Proper palmar digital Branches of median nerve to

nerves and arteries 1st and 2nd lumbrical muscles
Communicating branch between Adductor pollicis muscle

median nerve with ulnar nerve
Common palmar digital nerves Proper palmar
and arteries digital nerves and
arteries to thumb
Superficial palmar (arterial) arch
Flexor pollicis brevis muscle
Common flexor sheath
Recurrent (motor) branch of
median nerve to thenar muscles
Superficial branch of ulnar nerve
Opponens pollicis muscle
Deep palmar branch of ulnar artery
and deep branch of ulnar nerve Abductor pollicis brevis muscle (cut)
Flexor retinaculum (transverse
carpal ligament) Superficial palmar branch of radial artery
Palmar carpal ligament (continuous Median nerve and palmar branch

with extensor retinaculum)
Ulnar artery and nerve Radial artery
Proper palmar digital

nerves of ulnar nerve Proper palmar digital nerves of median nerve
Communicating branch
of median nerve with
ulnar nerve Palmar digital arteries
Deep palmar branch of
ulnar nerve to 3rd and Common palmar digital arteries
4th lumbricals, all
interosseous, adductor Palmar metacarpal arteries
pollicis, and deep head
of flexor pollicis brevis Radialis indicis artery
muscles
Hook of hamate bone

Proper digital arteries
Superficial branch of and nerves of thumb
ulnar nerve
Ulnar nerve branches Princeps pollicis artery
to hypothenar muscles
Deep palmar (arterial) arch and
Deep palmar branch of deep branch of ulnar nerve
ulnar artery and deep
branch of ulnar nerve Superficial palmar branch of radial artery
Pisiform bone Median nerve
Palmar carpal branches of
radial and ulnar arteries Radial artery
Ulnar artery and nerve
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Wrist and Hand: Superficial Dissection
See also Plate 469
*Snuffbox contents (superficial to deep)

Radial nerve (dorsal digital branch)
Cephalic vein branches (cut away)
Radial artery and branches
Scaphoid bone
Trapezium
Base of 1st metacarpal
Extensor pollicis
longus tendon Muscular fascia over 1st
dorsal interosseous muscle
Extensor pollicis 1st dorsal interosseous muscle

brevis tendon
Radial artery
1st metacarpal bone
Extensor carpi
radialis longus
Abductor pollicis tendon
longus tendon
Extensor carpi
Trapezium bone radialis brevis
tendon
Radial artery in anatomical snuffbox*
Dorsal carpal branch
Scaphoid bone* of radial artery
Dorsal digital branches of radial nerve*
Extensor retinaculum
Superficial branch of radial nerve
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Wrist and Hand: Superficial Dorsal Dissection 7
See also Plate 406
Dorsal branches of proper

palmar digital nerves
Dorsal digital nerves and veins
Intercapitular veins
Probe in dorsal
subaponeurotic space
(between opened dorsal
fascia of hand and dorsal
interosseous fascia)
Dorsal metacarpal veins
Dorsal venous
network of hand
Dorsal branch of ulnar nerve
Basilic vein
Communicating branches
of radial and ulnar nerves
Extensor retinaculum (thickening

of antebrachial fascia)
Superficial branch of radial nerve
Cephalic vein
Posterior antebrachial cutaneous

nerve (from radial nerve)
Note: Lymphatic pathways shown in black;

arrows indicate direction of drainage.
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Nerves and Arteries of Dorsal Hand and Wrist
See also Plate 460
Dorsal branches of proper palmar digital

branches of median nerve and of
proper palmar digital arteries to
dorsum of middle and distal phalangeal bones
of 2nd, 3rd, and radial half of 5th digits Dorsal branches of
proper palmar digital
branches of ulnar
nerve and of proper
palmar digital arteries
to dorsum of middle
and distal phalangeal
bones of 5th and ulnar
half of 4th digits
Dorsal digital branches of superficial

branch of radial nerve to 1st, 2nd,
3rd, and radial half of 4th digits
Dorsal digital branches

of dorsal branch
of ulnar nerve
Dorsal digital arteries Dorsal metacarpal arteries
Dorsal carpal (arterial) arch

Extensor carpi radialis brevis
tendon
Extensor carpi radialis longus Extensor carpi ulnaris tendon
tendon
Extensor pollicis longus tendon
Dorsal carpal branch
Extensor pollicis brevis tendon of ulnar artery
Abductor pollicis longus tendon
Dorsal branch of ulnar nerve

Radial artery
Extensor digitorum, extensor digiti minimi,
and extensor indicis tendons (cut)
Posterior antebrachial
cutaneous nerve
Superficial branch of radial nerve (branch of radial nerve)
Medial antebrachial
Lateral antebrachial cutaneous nerve cutaneous nerve
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Extensor Tendons at Wrist 7

(Dorsal carpal tendinous Transverse fibers of
sheaths are numbered) extensor expansions (hoods)
Intertendinous connections
Dorsal interosseous muscles

Abductor digiti
minimi muscle
Radial artery in anatomical snuffbox
Extensor pollicis brevis Plane of cross section

1 shown below
Abductor pollicis longus
Extensor carpi radialis longus

2
Extensor carpi radialis brevis
3 — Extensor pollicis longus
Extensor indicis
4
Extensor digitorum
5 — Extensor digiti minimi
6 — Extensor carpi ulnaris
Cross section of most distal portion of forearm

Extensor pollicis longus — 3
Extensor digitorum and
4
Extensor indicis Extensor carpi
radialis brevis
2
Extensor Extensor carpi
5
digiti minimi radialis longus
5 3 2
4
6 Extensor
Extensor 1 pollicis brevis
6 carpi 1
ulnaris Abductor
pollicis longus
Ulna Radius
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Nerves of Upper Limb 7
See also Plates 404, 414, 420
Lateral Cords of
Posterior brachial
Medial plexus
Medial brachial
Axillary nerve cutaneous nerve
Medial antebrachial
cutaneous nerve
Musculocutaneous nerve
(dominant nerve to anterior
compartment muscles of arm)
Median nerve
(dominant nerve to anterior Anterior
compartment muscles of
forearm and thenar eminence
muscles)
Radial nerve
(nerve to posterior
compartment muscles of
arm and forearm)
Radial nerve T2 (from
(posterior brachial intercostobrachial nerve)
cutaneous nerve)
Posterior
Ulnar nerve
(dominant nerve to Musculocutaneous nerve T1
muscles of hand and to flexor (lateral antebrachial
carpi ulnaris muscle and cutaneous nerve)
medial half of flexor
digitorum profundus Radial nerve
muscle in forearm) (superficial branch)
Ulnar nerve
T2
Median nerve Radial nerve
(posterior brachial
cutaneous nerve)
T1
(lateral antebrachial cutaneous
nerve) Posterior
antebrachial
cutaneous
nerve
Radial nerve
(superficial branch)
Ulnar nerve
Median nerve
(innervates nail matrix)
Neurovasculature Plate 464
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Musculocutaneous Nerve: Anterior View
See also Plate 421
Note: Only muscles innervated

by musculocutaneous
nerve shown.
Musculocutaneous nerve (C5, 6, 7)

Medial Cords of
Posterior brachial
Lateral plexus
Coracobrachialis muscle
Medial brachial
cutaneous nerve
Medial antebrachial
Biceps brachii muscle cutaneous nerve
(retracted)
Ulnar nerve
Median nerve
Radial nerve
Brachialis muscle
Axillary nerve
Articular branch
Lateral antebrachial
cutaneous nerve
Anterior branch
Posterior branch
Cutaneous
innervation
(via lateral
antebrachial
cutaneous
nerve)
Anterior (palmar) view Posterior (dorsal) view
Plate 465 Neurovasculature
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Median Nerve 7
Note: Only muscles innervated by median nerve shown.
Median nerve (C6, 7, 8, T1)

Medial Cords of
Inconstant contribution
Posterior brachial
Lateral plexus
Pronator teres muscle (superficial head)

Medial brachial
cutaneous nerve
Articular branch
Medial antebrachial
cutaneous nerve
Flexor carpi radialis muscle
Axillary nerve
Palmaris longus muscle
Radial nerve
Pronator teres muscle (deep head)
Ulnar nerve
Flexor digitorum superficialis muscle
(turned up)
Flexor digitorum profundus muscle

(lateral part supplied by median
[anterior interosseous] nerve; medial
part supplied by ulnar nerve)
Anterior interosseous nerve
Flexor pollicis longus muscle
Pronator quadratus muscle
Palmar branch of median nerve Cutaneous
innervation
Abductor pollicis brevis

Opponens pollicis
Thenar Superficial head of
muscles flexor pollicis brevis
(deep head often
supplied by
ulnar nerve) Palmar view
Communicating branch
of median nerve with
1st and 2nd ulnar nerve
lumbrical muscles
Common palmar
digital nerves
Proper palmar
digital nerves
Dorsal branches to skin of
dorsum of middle and
distal phalangeal bones
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Femur 8
See also Plate 495
Head Trochanteric fossa Greater

Greater Neck
trochanter
trochanter Head
Fovea for
ligament of Fovea for
head ligament of
head
Retinacular foramina Neck

Intertrochanteric crest
Lesser trochanter
Lesser trochanter Quadrate

Intertrochanteric line tubercle
Pectineal line
Gluteal tuberosity
Medial lip
Linea aspera
Lateral lip
Nutrient
foramen
Body Body
Line of attachment of border of
synovial membrane
Line of reflection of synovial membrane
Line of attachment of fibrous capsule
Line of reflection of fibrous

capsule (unattached)
Popliteal surface
Medial supracondylar line

Lateral
supracondylar
Adductor tubercle line
Lateral epicondyle
Medial epicondyle Lateral epicondyle
Lateral condyle
Medial condyle
Lateral condyle Patellar surface Intercondylar fossa
Hip and Thigh Plate 479
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Knee: Cruciate and Collateral Ligaments
Right knee in flexion: anterior view
Anterior cruciate ligament Posterior cruciate ligament
Lateral condyle of
femur (articular Medial condyle of femur (articular surface)
surface)
Medial meniscus
Popliteus tendon
Fibular collateral Tibial collateral ligament

ligament (superficial and deep fibers)
Lateral meniscus Medial condyle of tibia
Transverse
ligament of knee Tibial tuberosity
Head of fibula
Right knee in extension:
posterior view
Tubercle of
iliotibial tract
(Gerdy’s tubercle)
Posterior cruciate ligament
Anterior cruciate ligament
Posterior meniscofemoral
ligament
Adductor tubercle on
medial condyle of femur
Lateral condyle of
femur (articular
Medial condyle of femur (articular surface) surface)
Popliteus tendon
Tibial collateral ligament
(superficial and deep fibers)
Fibular collateral
ligament
Medial meniscus
Lateral meniscus
Medial condyle of tibia Head of fibula
Plate 500 Knee
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Tibia and Fibula
Bones of
right leg Anterior view Posterior view
Intercondylar eminence Intercondylar eminence
Lateral Medial Medial Lateral
intercondylar intercondylar intercondylar intercondylar
Anterior tubercle tubercle tubercle tubercle
intercondylar area Posterior Superior
intercondylar articular surfaces
area (medial and
Lateral condyle lateral facets)
Medial
condyle
Apex, Lateral condyle
Head, Tubercle of
Neck iliotibial tract Apex,
of (Gerdy’s tubercle) Head,
fibula Neck
of
Oblique line fibula
Groove for
Tibial tuberosity insertion of
semimembranosus
Soleal line tendon
Lateral
surface Lateral surface
Nutrient
foramen
Anterior border
Anterior
border
Interosseous border Posterior
Interosseous surface
border
Posterior
Medial surface surface
Medial crest
Medial surface
Medial border
Lateral surface
Fibula Tibia
Fibula
Posterior
border
Groove for
tibialis posterior
and flexor digitorum
longus tendons
Fibular notch
Lateral
malleolus Lateral
Medial malleolus malleolus
Malleolar fossa
Articular facet Inferior Inferior of lateral
of lateral articular Articular facet of medial malleolus articular malleolus
malleolus surface surface
Plate 504 Leg
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Tibia and Fibula (continued) 8
See also Plate 499
Anterior view with ligament attachments Superior view

Iliotibial tract Posterior Cruciate Posterior ligament Posterior
Anterior ligaments of fibular head intercondylar area
Fibular (origin of posterior
collateral Apex cruciate ligament)
Tibial
ligament collateral Head
ligament Intercondylar
Biceps Posterior eminence
Fibula
femoris
tendon Anterior ligament Tibia
of fibular head
Head of Medial condyle
fibula Lateral
condyle Superior
Anterior Patellar
ligament articular surface
ligament Superior (medial facet)
of fibular articular surface
head (lateral facet)
Tibial Anterior Medial Intercondylar
Tubercle of tuberosity Anterior Lateral tubercles
iliotibial tract intercondylar area
(Gerdy’s (origin of anterior
tubercle) cruciate ligament) Tibial tuberosity
Anterior Anterior
border border
Cross section
Interosseous Interosseous
border border Interosseous border Lateral surface
Interosseous membrane Anterior border

Interosseous
Lateral membrane
surface Medial surface
Interosseous border
Tibia
Lateral Anterior border
surface Medial border
Lateral surface Posterior surface
Fibula Tibia
Fibula Medial surface
Posterior border Medial crest
Posterior surface
Inferior view
Anterior
Anterior tibiofibular ligament Articular
tibiofibular facet of
ligament Anterior
Posterior Articular facet medial
talofibular of lateral malleolus malleolus
ligament
Medial Fibula Medial
Lateral
malleolus malleolus malleolus
Anterior Malleolar
talofibular fossa of
lateral malleolus Tibia
ligament Medial Posterior
collateral
Calcaneofibular (deltoid) Posterior Inferior articular
ligament ligament tibiofibular ligament surface of tibia
of ankle
Leg Plate 505
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Bones of Foot 8
Dorsal view
Base
Head
Phalangeal bones
Body
Distal
Base
Middle
Head
Proximal
Body 2 3
1 4 5
Base Metatarsal bones

Tarsometatarsal joint
Medial
Cuneiform Intermediate
bones Lateral Tuberosity of 5th metatarsal bone
Tuberosity
Navicular Cuboid bone
Head Transverse tarsal joint

Neck Tarsal sinus
Trochlea Calcaneus
Plantar view
Groove for tendon Fibular
Talus trochlea
of flexor hallucis
Distal
Posterior longus muscle
process Medial tubercle Body Phalangeal
Middle bones
Lateral tubercle
Proximal
Base
Head
Base Lateral
Sesamoid bones
Medial
Head
2 1
Body 3 Metatarsal bones
4
Base 5
Head Tarsometatarsal joint
Body
Medial
Intermediate Cuneiform
Base bones
Lateral
Tuberosity of 5th metatarsal bone
Tuberosity
Cuboid bones
Navicular
Groove for fibularis (peroneus) longus tendon
Tuberosity Transverse tarsal joint
Calcaneus
Fibular trochlea Head
Groove for tendon of flexor hallucis longus muscle Posterior process
Sustentaculum tali Talus
Medial tubercle
Lateral process
Medial process Lateral tubercle
Tuberosity
Ankle and Foot Plate 515
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Bones of Foot (continued)
See also Plate 535
Lateral view
Neck Navicular
Talus
Trochlea Intermediate
Cuneiform bones
Lateral
Lateral process
Posterior process
Metatarsal bones
Phalangeal
Tarsal sinus bones
2
Body 3
4
Fibular 5
trochlea
Calcaneus Tuberosity
Groove for Cuboid bone Tuberosity of
fibularis 5th metatarsal bone
longus Tuberosity
tendon
Groove for fibularis
(peroneus) longus tendon
Medial view
Transverse tarsal joint
Navicular
Tuberosity Neck Talus
Head
Intermediate
Cuneiform bones
Medial Trochlea
Tarsometatarsal joint Posterior

process
Metatarsal bones
Phalangeal bones
2
1
Tuberosity
Tuberosity of
1st metatarsal bone Groove for tendon of Calcaneus
flexor hallucis longus
Sesamoid bone muscle
Sustentaculum tali
Plate 516 Ankle and Foot
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Calcaneus 8
See also Plate 535
Right foot
Posterior talar Middle talar Anterior talar Articular surface
articular surface articular surface articular surface for cuboid bone
Anterior talar
Body articular surface
Middle talar
articular surface
Posterior
Articular surface talar
for cuboid bone articular
surface
Fibular Fibular
Tuberosity trochlea trochlea
Sustentaculum tali
Lateral process Groove for fibularis

of tuberosity longus tendon Body
Lateral view Calcaneal sulcus
Middle talar articular surface Tuberosity
Anterior talar
articular surface Posterior talar
articular surface Superior view
Articular Middle talar articular surface

surface
for cuboid Tuberosity Posterior talar
bone articular surface
Sustentaculum tali
Groove for
Sustentaculum tali Medial tendon of flexor
Groove for tendon of flexor process of hallucis longus Fibular
hallucis longus muscle tuberosity muscle trochlea
Medial view Medial
process of Lateral
tuberosity process of
Fibula
Tibia tuberosity
Tuberosity
Interosseous membrane
Posterior Posterior view
tibiofibular
Talus ligament
Posterior
Medial talofibular
collateral ligament
(deltoid)
ligament Calcaneofibular
of ankle ligament
Fibular tendons
Posterior in inferior fibular
talocalcaneal retinaculum
ligament
Posterior view
with ligaments
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Ligaments and Tendons of Ankle
See also Plate 535
Tibia Right foot: lateral view

Posterior talofibular ligament Components of lateral
Fibula Calcaneofibular ligament (collateral) ligament
Anterior talofibular ligament of ankle
Anterior and Interosseous talocalcaneal ligament

Posterior Dorsal talonavicular ligament
tibiofibular
ligaments Calcaneonavicular ligament
Calcaneocuboid ligament Bifurcate ligament
Dorsal cuboideonavicular ligament
Superior fibular (peroneal) Dorsal cuneonavicular ligaments
retinaculum
Dorsal intercuneiform ligaments
Dorsal tarsometatarsal ligaments
Calcaneal (Achilles)
tendon (cut)
Inferior
fibular
retinaculum
Dorsal metatarsal ligaments

Lateral talocalcaneal ligament
Long plantar ligament Dorsal cuneocuboid ligament
Cuboid bone
Fibularis (peroneus) longus tendon
Dorsal calcaneocuboid ligament
Fibularis (peroneus) brevis tendon
Right foot: medial view Tibia

Posterior tibiotalar part
Medial collateral Tibiocalcaneal part Medial talocalcaneal ligament
(deltoid) ligament
of ankle Tibionavicular part
Anterior tibiotalar part Posterior process of talus
Dorsal talonavicular ligament
Navicular bone Posterior talocalcaneal
ligament
Dorsal cuneonavicular ligaments
Medial cuneiform bone Calcaneal
Dorsal intercuneiform ligament (Achilles)
tendon
Dorsal tarsometatarsal ligaments (cut)
1st metatarsal bone
Tuberosity
Sustentaculum
Short plantar tali
Tibialis anterior tendon ligament
Tibialis posterior tendon Plantar calcaneo- Long plantar ligament
navicular (spring) ligament
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Ligaments and Tendons of Foot: Plantar View 8
Flexor digitorum longus tendon to 2nd toe (cut) Distal phalanx of great toe
Flexor digitorum brevis tendon to 2nd toe (cut) Interphalangeal (IP) joint
4th distal phalanx
Flexor hallucis longus tendon (cut)
4th middle phalanx
Proximal phalanx of great toe
Deep transverse metatarsal ligaments
Flexor hallucis brevis tendon
5th proximal phalanx (medial and lateral heads)
4th lumbrical tendon (cut) Metatarsophalangeal (MTP) joint
Abductor digiti minimi Sesamoid bones

and flexor digiti minimi
brevis tendons (cut) Abductor hallucis tendon
Plantar ligaments (plates) Adductor hallucis tendon
Interosseous muscles (cut) 1st metatarsal bone
5th metatarsal bone Plantar tarsometatarsal ligaments

Plantar metatarsal ligaments
Medial cuneiform bone
Tibialis anterior tendon (cut)
Fibularis (peroneus)
brevis tendon Plantar cuneonavicular ligament
Cuboid bone Plantar cuboideonavicular ligament

longus tendon Tuberosity of navicular bone
Tuberosity of cuboid bone Plantar calcaneonavicular (spring) ligament
Long plantar ligament Tibialis posterior tendon
Plantar calcaneocuboid Flexor digitorum longus tendon (cut)

(short plantar) ligament
Calcaneus Sustentaculum tali
Medial process Flexor hallucis longus tendon (cut)

and
Lateral process Posterior process of talus
of (medial and lateral tubercles)
Tuberosity
of calcaneus
Phalangeal bones
Joint capsule
Proximal Metatarsal bone

Distal Middle
Capsules and ligaments of

metatarsophalangeal and
interphalangeal joints:
lateral view
Collateral ligaments Plantar ligament (plate)
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Muscles of Dorsum of Foot: Superficial Dissection 8
See also Plate 533
Superficial fibular nerve (cut) Tibialis anterior tendon
Fibularis brevis muscle Anterior tibial artery and

deep fibular nerve
Fibularis longus tendon
Tibia
Extensor digitorum
longus muscle and tendon Extensor hallucis longus tendon
Superior extensor retinaculum Tendinous sheath of

extensor digitorum longus muscle
Fibula Medial malleolus
Perforating branch of Tendinous sheath of

fibular artery tibialis anterior muscle
Lateral malleolus and anterior Tendinous sheath of

lateral malleolar artery extensor hallucis longus muscle
Inferior extensor retinaculum Anterior medial malleolar artery
Lateral tarsal artery and lateral Dorsalis pedis artery and medial branch
branch of deep fibular nerve of deep fibular nerve
(to muscles of dorsum of foot)
Medial tarsal artery
Arcuate artery
Deep plantar artery passing between
heads of 1st dorsal interosseous
Fibularis tertius tendon muscle to join plantar arch
Extensor digitorum brevis and Extensor hallucis longus tendon

extensor hallucis brevis muscles
Extensor expansions
Extensor digitorum
longus tendons
Lateral dorsal cutaneous Dorsal digital branches of

nerve (continuation of deep fibular nerve
sural nerve) (cut)
Dorsal metatarsal arteries Dorsal digital branches

of superficial fibular
nerve
Dorsal digital arteries
Proper plantar digital

arteries and nerves
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Dorsum of Foot: Deep Dissection
See also Plate 527
Superficial fibular nerve (cut)
Fibularis longus tendon Tibialis anterior muscle and tendon
Fibularis brevis Tibia

muscle and tendon
Extensor digitorum longus Anterior tibial artery and

muscle and tendon deep fibular (peroneal) nerve
Fibula Extensor hallucis longus

muscle and tendon
Perforating branch
of fibular artery
Anterior medial malleolar artery
Anterior lateral malleolar artery
Medial malleolus
Lateral malleolus
Lateral branch of deep fibular nerve Medial branch of deep fibular

(to muscles of dorsal region of foot) nerve
and lateral tarsal artery
Medial tarsal arteries
Fibularis longus tendon (cut)
Dorsalis pedis artery
Extensor digitorum brevis and extensor
hallucis brevis muscles (cut) Arcuate artery
Fibularis brevis tendon (cut) Posterior perforating branches

from plantar arch
Fibularis
tertius tendon (cut) Deep plantar artery
to plantar arch
Abductor digiti minimi muscle
Abductor hallucis muscle
Dorsal metatarsal arteries
Extensor hallucis longus tendon
Metatarsal bones
Extensor hallucis brevis tendon
Dorsal interosseous muscles (cut)
Lateral dorsal cutaneous Extensor digitorum brevis

nerve (continuation of tendons (cut)
sural nerve) (cut)
Extensor digitorum
Anterior perforating branches longus tendons (cut)
from plantar metatarsal arteries
Extensor expansions
Dorsal digital branches of
deep fibular nerve
arteries and nerves Dorsal digital branches
nerve
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Plantar Region of Foot: Superficial Dissection 8
Superficial transverse
metatarsal ligaments

arteries and nerves
Superficial branch of
medial plantar artery
Transverse fasciculi
Digital slips of
plantar aponeurosis
Medial plantar fascia

Lateral plantar fascia
Cutaneous branches
of lateral plantar
artery and nerve
Cutaneous branches of medial
plantar artery and nerve
Plantar aponeurosis
Lateral band of plantar aponeurosis
(calcaneometatarsal ligament)
Medial calcaneal branches of tibial

nerve and posterior tibial artery
Overlying fat
pad (partially cut away)
on tuberosity of calcaneus
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Muscles of Plantar Region of Foot: First Layer
See also Plate 532
First layer muscles in bold

nerves
Proper plantar
digital nerves
Proper plantar
digital arteries
Common plantar digital arteries

Lumbrical muscles
Fibrous sheaths Superficial branch of

of flexor tendons medial plantar artery
Lateral head
Flexor digitorum brevis tendons and
overlying Medial head
Flexor digitorum longus tendons of flexor hallucis
brevis muscle
Flexor hallucis longus tendon

Plantar metatarsal branch of
lateral plantar artery
and tendon
Flexor digiti minimi brevis muscle

Flexor digitorum brevis muscle

(deep to lateral plantar fascia)
Plantar aponeurosis (cut)
Medial process
and
Lateral process Medial calcaneal branches of tibial
of nerve and posterior tibial artery
Tuberosity
of calcaneus
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Muscles of Plantar Region of Foot: Second Layer 8
See also Plate 532
Second layer tendons Proper plantar digital

and muscles in bold nerves
Flexor digitorum longus tendons

nerves Flexor digitorum brevis tendons
Fibrous sheaths (opened)
Sesamoid bones
Common plantar digital

nerves and arteries
Lumbrical muscles
Lateral head
and
Medial head of
Flexor digiti minimi Flexor hallucis brevis muscle
brevis muscle
Superficial branch Abductor hallucis tendon

and and muscle (cut)
Deep branch
of lateral Flexor digitorum longus tendon
plantar nerve
Superficial and deep branches

of medial plantar artery
Lateral plantar nerve and artery
Medial plantar artery and nerve

Quadratus plantae muscle
Tibialis posterior tendon
Abductor digiti minimi muscle (cut) Flexor hallucis longus tendon
Nerve to abductor digiti minimi muscle Posterior tibial artery and

(from lateral plantar nerve) tibial nerve (dividing)
Flexor retinaculum
and plantar aponeurosis (cut)
Abductor hallucis muscle (cut)
Lateral calcaneal nerve and artery (from Medial calcaneal artery and nerve
sural nerve and fibular artery)
Tuberosity of calcaneus
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Muscles of Plantar Region of Foot: Third Layer
Third layer muscles in bold Proper plantar digital nerves
Proper plantar digital nerves
Plantar digital artery proper

of superficial branch
Anterior perforating branches

to dorsal metatarsal arteries
Tendons of lumbrical muscles (cut)
Sesamoid bones
Flexor digitorum Transverse head

longus tendons (cut) and
Oblique head of
Flexor digitorum Adductor hallucis muscle
brevis tendons (cut)
Medial head
Flexor digiti minimi and
brevis muscle Lateral head of
Flexor hallucis brevis muscle
Plantar metatarsal arteries Superficial branches of medial
Plantar interosseous muscles
lateral plantar nerve Abductor hallucis muscle (cut)
Deep plantar arterial arch and Deep branches of medial

deep branches of lateral plantar nerve plantar artery and nerve
Tuberosity of 5th metatarsal bone Flexor digitorum longus tendon (cut)
Fibularis brevis tendon Tibialis posterior tendon
Fibularis Medial plantar artery and nerve

longus tendon
and fibrous sheath Flexor hallucis longus tendon
(cut and slightly retracted) Flexor retinaculum

Lateral plantar artery and nerve
Abductor digiti minimi muscle (cut) Flexor digitorum brevis muscle

Lateral calcaneal artery and nerve
Medial calcaneal artery and nerve
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Interosseous Muscles and Deep Arteries of Foot 8
Dorsal view
Navicular bone
Fibularis (peroneus) Medial tarsal artery
longus tendon (cut)
Lateral
Fibularis (peroneus) Cuneiform bones
Intermediate
brevis tendon (cut)
Medial
Cuboid bone
Lateral tarsal artery
Tuberosity of 5th metatarsal bone Dorsal metatarsal ligaments
Fibularis Arcuate artery

tertius tendon (cut)
Deep plantar artery passes to
Posterior perforating branches contribute to plantar arch
(from plantar arterial arch)
Dorsal metatarsal arteries Dorsal interossei muscles
Extensor digitorum Metatarsal bones

longus tendons (cut)
Extensor expansions Extensor hallucis longus tendon (cut)
Anterior perforating branches Extensor digitorum brevis and

(from plantar metatarsal arteries) extensor hallucis brevis tendons (cut)

Plantar view
Plantar digital arteries proper (to dorsal metatarsal arteries)
Sesamoid bones
Insertion of adductor hallucis
Lumbrical muscles (cut) and lateral head of flexor hallucis
brevis muscles (cut)
Deep transverse metatarsal ligament
and plantar ligaments (plates) Insertion of abductor hallucis
and medial head of flexor hallucis
Interossei muscles Plantar brevis muscles (cut)
Dorsal
Medial head of flexor hallucis
Abductor digiti minimi muscles (cut) brevis muscle (cut)
Deep plantar artery (from dorsalis
Plantar metatarsal arteries pedis artery)
Flexor digiti minimi brevis muscle Posterior perforating branches
(to dorsal metatarsal arteries)
Plantar arch
Plantar metatarsal ligaments (between
Lateral plantar artery (cut) bases of metatarsal bones)
Tuberosity of 5th metatarsal bone Medial cuneiform bone
Lateral origin of flexor hallucis
Fibularis (peroneus) brevis tendon (cut) brevis tendon (cut)
Tuberosity of cuboid bone Tuberosity of navicular bone
Tibialis posterior tendon (cut)
Long plantar ligament
Plantar calcaneonavicular
Calcaneocuboid (short plantar) ligament (spring) ligament
Fourth layer muscles in bold
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Muscle Tables
PROXIMAL DISTAL
MUSCLE ATTACHMENT ATTACHMENT
MUSCLE GROUP (ORIGIN) (INSERTION) INNERVATION BLOOD SUPPLY MAIN ACTIONS
Abductor digiti Foot Medial and lateral Lateral side of base of Lateral plantar Mediolateral plantar Abducts and flexes 5th
minimi tubercles of proximal phalanx of nerve artery, plantar digit
tuberosity of 5th digit metatarsal and
calcaneus, plantar plantar digital
aponeurosis, and arteries to 5th digit
intermuscular
septum
Abductor hallucis Foot Medial tubercle of Medial side of base of Medial plantar Medial plantar and 1st Abducts and flexes 1st
tuberosity of proximal phalanx of nerve plantar metatarsal digit
calcaneus, flexor 1st digit arteries
retinaculum, and
plantar aponeurosis
Adductor brevis Medial thigh Body and inferior Pectineal line and Obturator nerve Profunda femoris, Adducts thigh at hip,
pubic ramus proximal part of medial circumflex weak hip flexor
linea aspera of femoral, and
femur obturator arteries
Adductor hallucis Foot Oblique head: bases Tendons of both Deep branch of Medial and lateral Adducts 1st digit,
of 2nd through 4th heads lateral to lateral plantar plantar arteries and maintains transverse
metatarsals side of base of nerve plantar arch, plantar arch of foot
Transverse head: proximal phalanx of metatarsal arteries
ligaments of 1st digit
metatarsophalangeal
joints of digits 3–5
Adductor longus Medial thigh Body of pubis inferior Middle third of linea Obturator nerve Profunda femoris and Adducts thigh at hip
to pubic crest aspera of femur (anterior medial circumflex
division) femoral arteries
Adductor magnus Medial thigh Inferior pubic ramus, Gluteal tuberosity, Adductor part: Femoral, profunda Adductor part: adducts
ramus of ischium linea aspera, medial obturator nerve femoris, and and flexes thigh
supracondylar line obturator arteries
Hamstring part: ischial Hamstring part: Hamstring part: Hamstring part:
tuberosity adductor tubercle sciatic nerve extends thigh
of femur (tibial division)
Articularis genus Anterior thigh Distal femur on Suprapatellar bursa Femoral nerve Femoral artery Pulls suprapatellar
anterior surface bursa superiorly with
extension of knee
Biceps femoris Posterior thigh Long head: ischial Lateral side of head of Long head: sciatic Perforating branches Flexes and laterally
tuberosity fibula nerve (tibial of profunda rotates leg, extends
division) (L5–S2) femoris, inferior thigh at hip
Short head: Linea Short head: sciatic gluteal, and medial
aspera and lateral nerve (common circumflex femoral
supracondylar line fibular division) arteries
of femur
Dorsal interossei Foot Adjacent sides of 1st 1st: medial side of Lateral plantar Arcuate artery, dorsal Abduct 2nd through 4th
(four muscles) through 5th proximal phalanx of nerve and plantar digits of foot, flex
metatarsals 2nd digit metatarsal arteries metatarsophalangeal
2nd through 4th: joints, and extend
lateral sides of phalangeal bones
digits 2–4
Extensor digitorum Foot Superolateral surface First tendon into Deep fibular nerve Dorsalis pedis, lateral Aids extensor digitorum
brevis and of calcaneus, lateral dorsal surface of tarsal, arcuate, and longus in extending
extensor hallucis talocalcaneal base of proximal fibular arteries of 4 medial digits at
brevis ligament, deep phalanx of great metatarsophalangeal
surface of inferior toe; other three and interphalangeal
extensor tendons into lateral joints
retinaculum sides of tendons of
extensor digitorum
longus to digits 2–4
Extensor digitorum Anterior leg Lateral condyle of Middle and distal Deep fibular nerve Anterior tibial artery Extends lateral four
longus tibia, proximal 3/4 phalangeal bones digits and dorsiflexes
of anterior surface of lateral four digits foot at ankle
of interosseous
membrane and
fibula
Extensor hallucis Anterior leg Middle part of anterior Dorsal aspect of base Deep fibular nerve Anterior tibial artery Extends great toe,
longus surface of fibula of distal phalanx of dorsiflexes foot at
and interosseous great toe ankle
membrane
Variations in spinal nerve contributions to the innervation of muscles, their arterial supply, their attachments, and their actions are common
themes in human anatomy. Therefore, expect differences between texts and realize that anatomical variation is normal.
Table 8.3 Muscle Tables
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Muscle Tables 8
PROXIMAL DISTAL
Fibularis brevis Lateral leg Distal 2/3 of lateral Dorsal surface of Superficial fibular Anterior tibial and Everts foot and weakly
surface of fibula tuberosity on lateral nerve fibular arteries plantarflexes foot at
side of 5th ankle
metatarsal
Fibularis longus Lateral leg Head and proximal 2/3 Plantar base of 1st Superficial fibular Anterior tibial and Everts foot and weakly
of lateral fibula metatarsal and nerve fibular arteries plantarflexes foot at
medial cuneiform ankle
bone
Fibularis tertius Anterior leg Distal third of anterior Dorsum of base of 5th Deep fibular nerve Anterior tibial artery Dorsiflexes foot at
surface of fibula metatarsal ankle and aids in
and interosseous eversion of foot
membrane
Flexor digiti minimi Foot Base of 5th metatarsal Lateral base of Superficial branch Lateral plantar artery, Flexes proximal phalanx
brevis proximal phalanx of of lateral plantar plantar digital artery of 5th digit
5th digit nerve to 5th digit, arcuate
artery
Flexor digitorum Foot Medial tubercle of Both sides of middle Medial plantar Medial and lateral Flexes 2nd through 5th
brevis tuberosity of phalangeal bones nerve plantar arteries and digits
calcaneus, plantar of lateral four digits plantar arch, plantar
aponeurosis, and metatarsal and
intermuscular plantar digital
septum arteries
Flexor digitorum Posterior leg Medial part of Plantar bases of distal Tibial nerve Posterior tibial artery Flexes lateral four digits
longus posterior tibia phalangeal bones and plantarflexes
inferior to soleal of lateral four digits foot at ankle;
line supports longitudinal
arches of foot
Flexor hallucis brevis Foot Plantar surfaces of Both sides of base of Medial plantar Medial plantar artery, Flexes proximal phalanx
cuboid bone and proximal phalanx of nerve 1st plantar of 1st digit
lateral cuneiform 1st digit metatarsal artery
bone
Flexor hallucis longus Posterior leg Distal 2/3 of posterior Base of distal phalanx Tibial nerve Fibular artery Flexes all joints of great
fibula and of great toe toe, weakly
interosseous plantarflexes foot at
membrane ankle
Gastrocnemius Posterior leg Lateral head: lateral Posterior aspect of Tibial nerve Popliteal and posterior Plantarflexes foot at
aspect of lateral calcaneus via tibial arteries ankle joint, assists in
condyle of femur calcaneal tendon flexion of knee joint
Medial head: popliteal
surface above
medial condyle of
femur
Gluteus maximus Gluteal region Ilium posterior to Most fibers end in Inferior gluteal Inferior gluteal arteries Extends flexed thigh,
posterior gluteal iliotibial tract that nerve mainly, and assists in lateral
line, dorsal surface inserts into lateral superior gluteal rotation, and abducts
of sacrum and condyle of tibia; arteries thigh
coccyx, some fibers insert occasionally
sacrotuberous into gluteal
ligament tuberosity of femur
Gluteus medius Gluteal region Lateral surface of Lateral surface of Superior gluteal Superior gluteal artery Abducts and medially
ilium between greater trochanter nerve rotates thigh at hips;
anterior and of femur steadies pelvis on
posterior gluteal leg when opposite
lines leg is raised
Gluteus minimus Gluteal region Lateral surface of Anterior surface of Superior gluteal Main trunk and deep Abducts and medially
ilium between greater trochanter nerve branch of superior rotates thigh at hips;
anterior and inferior of femur gluteal artery steadies pelvis on
gluteal lines leg when opposite
leg is raised
Gracilis Medial thigh Body and inferior Superior part of Obturator nerve Profunda femoris Adducts thigh, flexes
ramus of pubis medial surface of artery, medial and medially rotates
tibia circumflex femoral leg
artery
Iliacus (iliopsoas) Anterior thigh Superior 2/3 of iliac Lesser trochanter of Femoral nerve Iliac branches of Flexes thigh at hips and
fossa, iliac crest, femur and shaft iliolumbar artery stabilizes hip joint,
ala of sacrum, inferior to it, to acts with psoas
anterior sacroiliac psoas major tendon major
ligaments
Inferior gemellus Gluteal region Ischial tuberosity Medial surface of Nerve to quadratus Medial circumflex Laterally rotates
greater trochanter femoris muscle femoral artery extended thigh and
of femur abducts flexed thigh
Muscle Tables Table 8.4
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Muscle Tables
PROXIMAL DISTAL
Lumbricals Foot Tendons of flexor Medial side of dorsal Medial one: medial Lateral plantar artery Flexes proximal
digitorum longus digital expansions plantar nerve and plantar phalangeal bones at
of lateral four digits Lateral three: metatarsal arteries metatarsophalangeal
lateral plantar joint, extends
nerve phalangeal bones at
proximal
interphalangeal and
distal interphalangeal
joints
Obturator externus Medial thigh Margins of obturator Trochanteric fossa of Obturator nerve Medial circumflex Laterally rotates thigh,
foramen, obturator femur femoral artery, stabilizes head of
membrane obturator artery femur in acetabulum
Obturator internus Gluteal region Pelvic surface of Medial surface of Nerve to obturator Internal pudendal and Laterally rotates
obturator greater trochanter internus muscle obturator arteries extended thigh,
membrane and of femur abducts flexed thigh
surrounding bone at hip
Pectineus Medial thigh Superior ramus of Pectineal line of femur Femoral nerve and Medial circumflex Adducts and flexes
pubis sometimes femoral artery, thigh at hip
obturator nerve obturator artery
Piriformis Gluteal region Anterior surface of Superior border of Ventral rami of L5, Superior and inferior Laterally rotates
sacral segments greater trochanter S1, S2 gluteal arteries, extended thigh,
2–4, sacrotuberous of femur internal pudendal abducts flexed thigh
ligament (inconstant) artery at hip
Plantar interossei Foot Bases and medial Medial sides of bases Lateral plantar Lateral plantar artery Adduct digits (3-5) and
(three muscles) sides of 3rd of proximal nerve and plantar arch, flex
through 5th phalangeal bones plantar metatarsal metatarsophalangeal
metatarsals of 3rd through 5th and plantar digital joint and extend
digits arteries phalangeal bones
Plantaris Posterior leg Inferior end of lateral Posterior aspect of Tibial nerve Popliteal artery Weakly assists
supracondylar line calcaneus via gastrocnemius
of femur and calcaneal tendon
oblique popliteal
ligament
Popliteus Posterior leg Lateral aspect of Posterior tibia superior Tibial nerve Inferior medial and Weakly flexes knee and
lateral condyle of to soleal line (L4–S1) lateral genicular unlocks it by rotating
femur, lateral arteries femur on fixed tibia
meniscus
Psoas major Anterior thigh Transverse processes Lesser trochanter of Anterior rami of Lumbar branches of Acting superiorly with
(iliopsoas) of lumbar femur first three lumbar iliolumbar artery iliacus, flexes hip;
vertebrae, sides of nerves acting inferiorly,
bodies of T12–L5 flexes vertebral
vertebrae, column laterally;
intervening used to balance
intervertebral discs trunk in sitting
position; acting
inferiorly with iliacus,
flexes trunk
Quadratus femoris Gluteal region Lateral margin of Quadrate tubercle on Nerve to quadratus Medial circumflex Laterally rotates thigh
ischial tuberosity intertrochanteric femoris muscle femoral artery at hip
crest of femur
Quadratus plantae Foot Medial and lateral Posterolateral edge of Lateral plantar Medial and lateral Corrects for oblique pull
sides of plantar flexor digitorum nerve plantar arteries and of flexor digitorum
surface of longus tendon deep plantar longus tendon, thus
calcaneus arterial arch assisting in flexion of
digits of foot
Rectus femoris Anterior thigh Anterior inferior iliac Base of patella and to Femoral nerve Profunda femoris and Extends leg at knee
(quadriceps) spine and ilium tibial tuberosity via lateral circumflex joint and flexes thigh
superior to patellar ligament femoral arteries at hip joint
acetabulum
Sartorius Anterior thigh Anterior superior iliac Superior part of Femoral nerve Femoral artery Abducts, laterally
spine and superior medial surface of rotates, and flexes
part of notch below tibia thigh; flexes knee
it joint
Semimembranosus Posterior thigh Ischial tuberosity Posterior part of Sciatic nerve (tibial Perforating branch of Flexes leg, extends
medial condyle of division) profunda femoris thigh
tibia and medial
circumflex femoral
arteries
Table 8.5 Muscle Tables
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Muscle Tables 8
PROXIMAL DISTAL
Semitendinosus Posterior thigh Ischial tuberosity Superior part of Sciatic nerve (tibial Perforating branch of Flexes leg, extends
medial surface of division) profunda femoris thigh
tibia and medial
circumflex femoral
arteries
Soleus Posterior leg Posterior aspect of Posterior aspect of Tibial nerve Popliteal, posterior Plantarflexes foot at
head of fibula, calcaneus via tibial, and fibular ankle, stabilizes leg
proximal 1/4 of calcaneal tendon arteries over foot
posterior surface of
fibula, soleal line of
tibia
Superior gemellus Gluteal region Outer surface of Medial surface of Nerve to obturator Inferior gluteal and Laterally rotates
ischial spine greater trochanter internus muscle internal pudendal extended thigh and
of femur arteries abducts flexed thigh
Tensor fasciae latae Gluteal region Anterior superior iliac Iliotibial tract that Superior gluteal Ascending branch of Abducts, medially
spine and anterior attaches to lateral nerve lateral circumflex rotates, and flexes
part of iliac crest condyle of tibia femoral artery thigh at hip; helps to
keep knee extended
Tibialis anterior Anterior leg Lateral condyle, Medial plantar Deep fibular nerve Anterior tibial artery Dorsiflexes foot at
proximal half of surfaces of medial ankle and inverts
lateral tibia, cuneiform bone foot
interosseous and base of 1st
membrane metatarsal bone
Tibialis posterior Posterior leg Posterior tibia below Tuberosity of navicular Tibial nerve Fibular artery Plantarflexes foot at
soleal line, bone, all ankle and inverts
interosseous cuneiforms, cuboid, foot
membrane, and bases of 2nd
proximal half of through 4th
posterior fibula metatarsal bones
Vastus intermedius Anterior thigh Anterior and lateral Base of patella and to Femoral nerve Lateral circumflex Extends leg at knee
(quadriceps) surfaces of body of tibial tuberosity via femoral and joint
femur patellar ligament profunda femoris
arteries
Vastus lateralis Anterior thigh Greater trochanter, Base of patella and to Femoral nerve Lateral circumflex Extends leg at knee
(quadriceps) lateral lip of gluteal tibial tuberosity via femoral and joint
tuberosity, lateral lip patellar ligament profunda femoris
of linea aspera arteries
Anterior thigh Intertrochanteric line,

Base of patella and to Femoral nerve Femoral and profunda Extends leg at knee
greater trochanter,
Vastus medialis tibial tuberosity via femoris arteries joint
(quadriceps) lateral lip of gluteal patellar ligament
tuberosity, and
lateral lip of linea
aspera
Muscle Tables Table 8.6
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Coxal Bone
Lateral view Intermediate zone

Tuberculum Iliac crest
Posterior Outer lip
Gluteal
lines Anterior
Inferior Ala of ilium
(gluteal surface)
Posterior Anterior superior iliac spine

superior
iliac spine
Anterior inferior iliac spine
Posterior
inferior
iliac spine
Acetabulum
Lunate surface
Acetabular margin
Acetabular notch
Greater sciatic notch
Body of ilium
Ischial spine Pubic tubercle
Lesser sciatic notch
Body of ischium Obturator crest
Obturator
foramen Inferior pubic ramus Intermediate zone Iliac
Ischial tuberosity Inner lip crest
Iliac tuberosity
Ramus of ischium
Anterior superior iliac spine Posterior

superior
iliac spine
Ala of ilium
(iliac fossa)
Auricular
Anterior inferior iliac spine surface
(for sacrum)
Arcuate line
Posterior
Iliopubic eminence inferior
iliac spine
Greater sciatic notch
Ischial spine
Pecten pubis
Body of ilium
Pubic tubercle
Obturator Lesser sciatic notch
Symphyseal surface foramen
Ilium Body of ischium
Ischium Obturator groove

Ischial tuberosity
Pubis Inferior pubic ramus
Ramus of ischium
Medial view
Plate 476 Hip and Thigh
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Hip Joint 8
Anterior view
Iliofemoral ligament (Y ligament of Bigelow)
Anterior Iliopectineal bursa (over gap in ligaments)

superior
iliac spine
Pubofemoral ligament
Anterior inferior
iliac spine Superior pubic ramus
Greater Inferior pubic ramus

trochanter
Posterior view
Iliofemoral ligament
Ischiofemoral ligament
Zona orbicularis
Greater
trochanter
Ischial
Lesser trochanter spine
Ischial
tuberosity
Protrusion
Intertrochanteric line
of synovial
membrane
Intertrochanteric
Joint opened: crest
lateral view
Lesser trochanter

Lunate (articular)
surface of Anterior inferior iliac spine
acetabulum
Iliopubic eminence
Articular cartilage Acetabular labrum (fibrocartilaginous)
Fat in acetabular fossa (covered by

Greater synovial membrane)
trochanter
Obturator artery
Head of femur Anterior branch
Posterior branch
Acetabular branch
Neck of femur
Intertrochanteric Obturator membrane

line Transverse acetabular ligament
Ligament of Ischial tuberosity

head of femur
(cut) Lesser trochanter
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Femur 8
See also Plate 495
Head Trochanteric fossa Greater

Greater Neck
trochanter
trochanter Head
Fovea for
ligament of Fovea for
head ligament of
head
Retinacular foramina Neck

Intertrochanteric crest
Lesser trochanter
Lesser trochanter Quadrate

Intertrochanteric line tubercle
Pectineal line
Gluteal tuberosity
Medial lip
Linea aspera
Lateral lip
Nutrient
foramen
Body Body
Line of attachment of border of
synovial membrane
Line of reflection of synovial membrane
Line of attachment of fibrous capsule
Line of reflection of fibrous

capsule (unattached)
Popliteal surface
Medial supracondylar line

Lateral
supracondylar
Adductor tubercle line
Lateral epicondyle
Medial epicondyle Lateral epicondyle
Lateral condyle
Medial condyle
Lateral condyle Patellar surface Intercondylar fossa
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Bony Attachments of Muscles of Hip and Thigh: Anterior View
Iliacus muscle
Sartorius muscle
Piriformis muscle
Rectus femoris muscle
Pectineus muscle
Obturator internus
and superior and inferior
gemellus muscles Adductor longus muscle
Piriformis muscle Adductor brevis muscle
Gluteus minimus muscle

Gracilis muscle
Vastus lateralis muscle
Obturator externus muscle
Iliopsoas muscle
(iliacus and psoas major) Adductor magnus muscle
Vastus medialis muscle Quadratus femoris muscle
Vastus intermedius muscle
Origins (proximal attachment)

Insertions (distal attachment)
Articularis genu muscle
Adductor magnus muscle
Iliotibial tract
Biceps femoris muscle

Sartorius muscle
Quadriceps femoris muscle Gracilis muscle Pes anserinus

(rectus femoris,
vastus lateralis,
vastus intermedius, Semitendinosus muscle
and vastus medialis
via patellar ligament)
Plate 480 Hip and Thigh
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Bony Attachments of Muscles of Hip and Thigh: Posterior View 8
See also Plate 478
Gluteus medius muscle
Gluteus minimus muscle
Tensor fasciae latae muscle

Gluteus maximus muscle
Sartorius muscle
Rectus femoris muscle

Superior gemellus muscle
Inferior gemellus muscle

Gluteus medius muscle
Quadratus femoris muscle Quadratus femoris muscle
Obturator internus muscle Iliopsoas muscle
Adductor magnus muscle Gluteus maximus muscle
Biceps femoris (long head) Vastus lateralis muscle

and semitendinosus muscles
Semimembranosus muscle
Adductor brevis muscle
Vastus intermedius muscle

Pectineus muscle
Vastus medialis muscle Biceps femoris muscle (short head)

Origins (proximal
attachment) Adductor magnus muscle
Adductor longus muscle
Insertions
(distal attachment) Vastus lateralis muscle
Plantaris muscle
Gastrocnemius muscle (lateral head)
Gastrocnemius muscle (medial head)
Popliteus muscle
Semimembranosus muscle
Popliteus muscle
Note: Width of zone of attachments to posterior aspect

of femur (linea aspera) is greatly exaggerated.
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Arteries of Lower Limb: Schema 8
External iliac artery

Deep circumflex iliac artery Inferior epigastric artery
Superficial Superficial epigastric artery
circumflex iliac artery
Superficial external pudendal artery
Femoral artery Obturator artery
Deep external pudendal artery
Medial circumflex femoral artery
Ascending branch,
Transverse branch,
Descending branch of Femoral artery
Lateral circumflex
femoral artery
Muscular branches
Profunda femoris
(deep femoral)
artery
Perforating branches
Femoral artery passing through

adductor hiatus within Descending genicular artery
adductor magnus muscle Articular branch
Saphenous branch
Superior medial genicular artery

Superior lateral genicular artery
Popliteal artery (phantom)
Patellar anastomosis
Middle genicular artery (phantom)
Inferior lateral genicular artery
(partially in phantom)
Inferior medial genicular artery
Posterior tibial recurrent (partially in phantom)
artery (phantom)
Anterior tibial recurrent artery
Circumflex fibular branch
Anterior tibial artery Posterior tibial artery (phantom)
Interosseous membrane Fibular artery (phantom)
Fibular artery (phantom)
Anterior tibial artery

Perforating branch
Anterior lateral malleolar artery Anterior medial malleolar artery

Lateral tarsal artery Arcuate artery
Posterior perforating branch
Plantar arch Deep plantar artery

Knee Plate 503
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Tibia and Fibula
Bones of
right leg Anterior view Posterior view
Intercondylar eminence Intercondylar eminence
Lateral Medial Medial Lateral
intercondylar intercondylar intercondylar intercondylar
Anterior tubercle tubercle tubercle tubercle
intercondylar area Posterior Superior
intercondylar articular surfaces
area (medial and
Lateral condyle lateral facets)
Medial
condyle
Apex, Lateral condyle
Head, Tubercle of
Neck iliotibial tract Apex,
of (Gerdy’s tubercle) Head,
fibula Neck
of
Oblique line fibula
Groove for
Tibial tuberosity insertion of
semimembranosus
Soleal line tendon
Lateral
surface Lateral surface
Nutrient
foramen
Anterior border
Anterior
border
Interosseous border Posterior
Interosseous surface
border
Posterior
Medial surface surface
Medial crest
Medial surface
Medial border
Lateral surface
Fibula Tibia
Fibula
Posterior
border
Groove for
tibialis posterior
and flexor digitorum
longus tendons
Fibular notch
Lateral
malleolus Lateral
Medial malleolus malleolus
Malleolar fossa
Articular facet Inferior Inferior of lateral
of lateral articular Articular facet of medial malleolus articular malleolus
malleolus surface surface
Plate 504 Leg
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Tibia and Fibula (continued) 8
See also Plate 499
Anterior view with ligament attachments Superior view

Iliotibial tract Posterior Cruciate Posterior ligament Posterior
Anterior ligaments of fibular head intercondylar area
Fibular (origin of posterior
collateral Apex cruciate ligament)
Tibial
ligament collateral Head
ligament Intercondylar
Biceps Posterior eminence
Fibula
femoris
tendon Anterior ligament Tibia
of fibular head
Head of Medial condyle
fibula Lateral
condyle Superior
Anterior Patellar
ligament articular surface
ligament Superior (medial facet)
of fibular articular surface
head (lateral facet)
Tibial Anterior Medial Intercondylar
Tubercle of tuberosity Anterior Lateral tubercles
iliotibial tract intercondylar area
(Gerdy’s (origin of anterior
tubercle) cruciate ligament) Tibial tuberosity
Anterior Anterior
border border
Cross section
Interosseous Interosseous
border border Interosseous border Lateral surface
Interosseous membrane Anterior border

Interosseous
Lateral membrane
surface Medial surface
Interosseous border
Tibia
Lateral Anterior border
surface Medial border
Lateral surface Posterior surface
Fibula Tibia
Fibula Medial surface
Posterior border Medial crest
Posterior surface
Inferior view
Anterior
Anterior tibiofibular ligament Articular
tibiofibular facet of
ligament Anterior
Posterior Articular facet medial
talofibular of lateral malleolus malleolus
ligament
Medial Fibula Medial
Lateral
malleolus malleolus malleolus
Anterior Malleolar
talofibular fossa of
lateral malleolus Tibia
ligament Medial Posterior
collateral
Calcaneofibular (deltoid) Posterior Inferior articular
ligament ligament tibiofibular ligament surface of tibia
of ankle
Leg Plate 505
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Bones of Foot (continued)
See also Plate 535
Lateral view
Neck Navicular
Talus
Trochlea Intermediate
Cuneiform bones
Lateral
Lateral process
Posterior process
Metatarsal bones
Phalangeal
Tarsal sinus bones
2
Body 3
4
Fibular 5
trochlea
Calcaneus Tuberosity
Groove for Cuboid bone Tuberosity of
fibularis 5th metatarsal bone
longus Tuberosity
tendon
Groove for fibularis
(peroneus) longus tendon
Medial view
Transverse tarsal joint
Navicular
Tuberosity Neck Talus
Head
Intermediate
Cuneiform bones
Medial Trochlea
Tarsometatarsal joint Posterior

process
Metatarsal bones
Phalangeal bones
2
1
Tuberosity
Tuberosity of
1st metatarsal bone Groove for tendon of Calcaneus
Sesamoid bone muscle
Sustentaculum tali
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Calcaneus 8
See also Plate 535
Right foot
Posterior talar Middle talar Anterior talar Articular surface
articular surface articular surface articular surface for cuboid bone
Anterior talar
Body articular surface
Middle talar
articular surface
Posterior
Articular surface talar
for cuboid bone articular
surface
Fibular Fibular
Tuberosity trochlea trochlea
Sustentaculum tali
Lateral process Groove for fibularis

of tuberosity longus tendon Body
Lateral view Calcaneal sulcus
Middle talar articular surface Tuberosity
Anterior talar
articular surface Posterior talar
articular surface Superior view
Articular Middle talar articular surface

surface
for cuboid Tuberosity Posterior talar
bone articular surface
Sustentaculum tali
Groove for
Sustentaculum tali Medial tendon of flexor
Groove for tendon of flexor process of hallucis longus Fibular
hallucis longus muscle tuberosity muscle trochlea
Medial view Medial
process of Lateral
tuberosity process of
Fibula
Tibia tuberosity
Tuberosity
Interosseous membrane
Posterior Posterior view
tibiofibular
Talus ligament
Posterior
Medial talofibular
collateral ligament
(deltoid)
ligament Calcaneofibular
of ankle ligament
Fibular tendons
Posterior in inferior fibular
talocalcaneal retinaculum
ligament
Posterior view
with ligaments
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Ligaments and Tendons of Ankle
See also Plate 535
Tibia Right foot: lateral view

Posterior talofibular ligament Components of lateral
Fibula Calcaneofibular ligament (collateral) ligament
Anterior talofibular ligament of ankle
Anterior and Interosseous talocalcaneal ligament

Posterior Dorsal talonavicular ligament
tibiofibular
ligaments Calcaneonavicular ligament
Calcaneocuboid ligament Bifurcate ligament
Dorsal cuboideonavicular ligament
Superior fibular (peroneal) Dorsal cuneonavicular ligaments
retinaculum
Dorsal intercuneiform ligaments
tendon (cut)
Inferior
fibular
retinaculum
Dorsal metatarsal ligaments

Lateral talocalcaneal ligament
Long plantar ligament Dorsal cuneocuboid ligament
Cuboid bone
Dorsal calcaneocuboid ligament
Right foot: medial view Tibia

Posterior tibiotalar part
Medial collateral Tibiocalcaneal part Medial talocalcaneal ligament
(deltoid) ligament
of ankle Tibionavicular part
Anterior tibiotalar part Posterior process of talus
Dorsal talonavicular ligament
Navicular bone Posterior talocalcaneal
ligament
Dorsal cuneonavicular ligaments
Medial cuneiform bone Calcaneal
Dorsal intercuneiform ligament (Achilles)
tendon
Dorsal tarsometatarsal ligaments (cut)
1st metatarsal bone
Tuberosity
Sustentaculum
Short plantar tali
Tibialis anterior tendon ligament
Tibialis posterior tendon Plantar calcaneo- Long plantar ligament
navicular (spring) ligament
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Ligaments and Tendons of Foot: Plantar View 8
Flexor digitorum longus tendon to 2nd toe (cut) Distal phalanx of great toe
Flexor digitorum brevis tendon to 2nd toe (cut) Interphalangeal (IP) joint
4th distal phalanx
4th middle phalanx
Deep transverse metatarsal ligaments
Flexor hallucis brevis tendon
5th proximal phalanx (medial and lateral heads)
4th lumbrical tendon (cut) Metatarsophalangeal (MTP) joint
Abductor digiti minimi Sesamoid bones

and flexor digiti minimi
brevis tendons (cut) Abductor hallucis tendon
Plantar ligaments (plates) Adductor hallucis tendon
Interosseous muscles (cut) 1st metatarsal bone
5th metatarsal bone Plantar tarsometatarsal ligaments

Plantar metatarsal ligaments
Medial cuneiform bone
brevis tendon Plantar cuneonavicular ligament
Cuboid bone Plantar cuboideonavicular ligament

longus tendon Tuberosity of navicular bone
Tuberosity of cuboid bone Plantar calcaneonavicular (spring) ligament
Long plantar ligament Tibialis posterior tendon
Plantar calcaneocuboid Flexor digitorum longus tendon (cut)

(short plantar) ligament
Calcaneus Sustentaculum tali
Medial process Flexor hallucis longus tendon (cut)

and
Lateral process Posterior process of talus
of (medial and lateral tubercles)
Tuberosity
of calcaneus
Phalangeal bones
Joint capsule
Proximal Metatarsal bone

Distal Middle
Capsules and ligaments of

metatarsophalangeal and
interphalangeal joints:
lateral view
Collateral ligaments Plantar ligament (plate)
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Tendon Sheaths of Ankle
See also Plate 510
Lateral view
Soleus muscle
Extensor digitorum longus muscle
Fibularis
longus muscle Superior extensor retinaculum
Fibularis Tendinous sheath of tibialis anterior muscle

brevis muscle
Lateral malleolus of fibula and subcutaneous bursa
Calcaneal (Achilles) tendon Inferior extensor retinaculum
Common tendinous sheath Tendinous sheath of extensor digitorum
of fibularis longus and longus and fibularis tertius muscles
brevis muscles
Tendinous sheath of
Subcutaneous calcaneal bursa extensor hallucis longus muscle
(Subtendinous) bursa
of calcaneal tendon
Superior and
Inferior
fibular
retinacula
Calcaneus
Extensor digitorum brevis muscle Fibularis tertius tendon

Fibularis Fibularis
longus brevis
Abductor digiti minimi muscle tendon tendon Tuberosity of 5th metatarsal bone
Medial view
Tibialis anterior tendon and sheath tendon
Tibia Tendinous sheath

Sheath of tibialis posterior tendon of flexor digitorum
longus muscle
Superior extensor retinaculum Posterior tibial artery
and tibial nerve
Medial malleolus and subcutaneous bursa
Inferior extensor retinaculum Tendinous sheath of
Tibialis posterior tendon and sheath muscle
Tibialis anterior tendon and sheath Subcutaneous
calcaneal bursa
Tendinous sheath
of extensor hallucis longus
(Subtendinous) bursa
of calcaneal tendon
Flexor retinaculum
Calcaneus
Medial plantar nerve Abductor hallucis muscle (cut)
1st metatarsal bone and artery
Tendinous sheath of Tendinous sheath of
flexor hallucis longus muscle flexor digitorum longus muscle Flexor digitorum brevis muscle (cut)
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Muscles of Dorsum of Foot: Superficial Dissection 8
See also Plate 533
Superficial fibular nerve (cut) Tibialis anterior tendon
Fibularis brevis muscle Anterior tibial artery and

deep fibular nerve
Fibularis longus tendon
Tibia
Extensor digitorum
longus muscle and tendon Extensor hallucis longus tendon
Superior extensor retinaculum Tendinous sheath of

extensor digitorum longus muscle
Fibula Medial malleolus
Perforating branch of Tendinous sheath of

fibular artery tibialis anterior muscle
Lateral malleolus and anterior Tendinous sheath of

lateral malleolar artery extensor hallucis longus muscle
Inferior extensor retinaculum Anterior medial malleolar artery
Lateral tarsal artery and lateral Dorsalis pedis artery and medial branch
branch of deep fibular nerve of deep fibular nerve
(to muscles of dorsum of foot)
Arcuate artery
Deep plantar artery passing between
heads of 1st dorsal interosseous
Fibularis tertius tendon muscle to join plantar arch
Extensor digitorum brevis and Extensor hallucis longus tendon

extensor hallucis brevis muscles
Extensor expansions
Extensor digitorum
longus tendons
Lateral dorsal cutaneous Dorsal digital branches of

nerve (continuation of deep fibular nerve
sural nerve) (cut)
Dorsal metatarsal arteries Dorsal digital branches

nerve

arteries and nerves
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Dorsum of Foot: Deep Dissection
See also Plate 527
Superficial fibular nerve (cut)
Fibularis longus tendon Tibialis anterior muscle and tendon
Fibularis brevis Tibia

muscle and tendon
Extensor digitorum longus Anterior tibial artery and

muscle and tendon deep fibular (peroneal) nerve
Fibula Extensor hallucis longus

muscle and tendon
Perforating branch
of fibular artery
Anterior medial malleolar artery
Anterior lateral malleolar artery
Medial malleolus
Lateral malleolus
Lateral branch of deep fibular nerve Medial branch of deep fibular

(to muscles of dorsal region of foot) nerve
and lateral tarsal artery
Medial tarsal arteries
Fibularis longus tendon (cut)
Extensor digitorum brevis and extensor
hallucis brevis muscles (cut) Arcuate artery
Fibularis brevis tendon (cut) Posterior perforating branches

from plantar arch
Fibularis
tertius tendon (cut) Deep plantar artery
to plantar arch
Dorsal metatarsal arteries
Extensor hallucis longus tendon
Metatarsal bones
Extensor hallucis brevis tendon
Dorsal interosseous muscles (cut)
Lateral dorsal cutaneous Extensor digitorum brevis

nerve (continuation of tendons (cut)
sural nerve) (cut)
Extensor digitorum
Anterior perforating branches longus tendons (cut)
Extensor expansions
Dorsal digital branches of
deep fibular nerve
arteries and nerves Dorsal digital branches
nerve
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Plantar Region of Foot: Superficial Dissection 8
Superficial transverse
metatarsal ligaments

arteries and nerves
medial plantar artery
Transverse fasciculi
Digital slips of
plantar aponeurosis
Medial plantar fascia

Lateral plantar fascia
Cutaneous branches
of lateral plantar
artery and nerve
Cutaneous branches of medial
Plantar aponeurosis
Lateral band of plantar aponeurosis
(calcaneometatarsal ligament)
Medial calcaneal branches of tibial

nerve and posterior tibial artery
Overlying fat
pad (partially cut away)
on tuberosity of calcaneus
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Muscles of Plantar Region of Foot: First Layer
See also Plate 532
First layer muscles in bold

nerves
Proper plantar
digital nerves
Proper plantar
digital arteries

Lumbrical muscles
Fibrous sheaths Superficial branch of

of flexor tendons medial plantar artery
Lateral head
Flexor digitorum brevis tendons and
overlying Medial head
Flexor digitorum longus tendons of flexor hallucis
brevis muscle

Plantar metatarsal branch of
lateral plantar artery
and tendon
Flexor digiti minimi brevis muscle


(deep to lateral plantar fascia)
Medial process
and
Lateral process Medial calcaneal branches of tibial
of nerve and posterior tibial artery
Tuberosity
of calcaneus
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Muscles of Plantar Region of Foot: Second Layer 8
See also Plate 532
Second layer tendons Proper plantar digital

and muscles in bold nerves
Flexor digitorum longus tendons

nerves Flexor digitorum brevis tendons
Fibrous sheaths (opened)
Sesamoid bones
Common plantar digital

nerves and arteries
Lumbrical muscles
Lateral head
and
Medial head of
Flexor digiti minimi Flexor hallucis brevis muscle
brevis muscle
Superficial branch Abductor hallucis tendon

and and muscle (cut)
Deep branch
of lateral Flexor digitorum longus tendon
plantar nerve
Superficial and deep branches

Medial plantar artery and nerve

Tibialis posterior tendon
Abductor digiti minimi muscle (cut) Flexor hallucis longus tendon
Nerve to abductor digiti minimi muscle Posterior tibial artery and

(from lateral plantar nerve) tibial nerve (dividing)
Flexor retinaculum
Lateral calcaneal nerve and artery (from Medial calcaneal artery and nerve
sural nerve and fibular artery)
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Muscles of Plantar Region of Foot: Third Layer
Third layer muscles in bold Proper plantar digital nerves
Proper plantar digital nerves
Plantar digital artery proper

of superficial branch

to dorsal metatarsal arteries
Tendons of lumbrical muscles (cut)
Sesamoid bones
Flexor digitorum Transverse head

longus tendons (cut) and
Oblique head of
Flexor digitorum Adductor hallucis muscle
brevis tendons (cut)
Medial head
Flexor digiti minimi and
brevis muscle Lateral head of
Flexor hallucis brevis muscle
Plantar metatarsal arteries Superficial branches of medial
Plantar interosseous muscles
lateral plantar nerve Abductor hallucis muscle (cut)
Deep plantar arterial arch and Deep branches of medial

deep branches of lateral plantar nerve plantar artery and nerve
Tuberosity of 5th metatarsal bone Flexor digitorum longus tendon (cut)
Fibularis brevis tendon Tibialis posterior tendon
Fibularis Medial plantar artery and nerve

longus tendon
and fibrous sheath Flexor hallucis longus tendon
(cut and slightly retracted) Flexor retinaculum

Lateral plantar artery and nerve
Abductor digiti minimi muscle (cut) Flexor digitorum brevis muscle

Lateral calcaneal artery and nerve
Medial calcaneal artery and nerve
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Interosseous Muscles and Deep Arteries of Foot 8
Dorsal view
Navicular bone
Fibularis (peroneus) Medial tarsal artery
longus tendon (cut)
Lateral
Fibularis (peroneus) Cuneiform bones
Intermediate
brevis tendon (cut)
Medial
Cuboid bone
Lateral tarsal artery
Tuberosity of 5th metatarsal bone Dorsal metatarsal ligaments
Fibularis Arcuate artery

tertius tendon (cut)
Deep plantar artery passes to
Posterior perforating branches contribute to plantar arch
(from plantar arterial arch)
Dorsal metatarsal arteries Dorsal interossei muscles
Extensor digitorum Metatarsal bones

longus tendons (cut)
Extensor expansions Extensor hallucis longus tendon (cut)
Anterior perforating branches Extensor digitorum brevis and

(from plantar metatarsal arteries) extensor hallucis brevis tendons (cut)

Plantar view
Plantar digital arteries proper (to dorsal metatarsal arteries)
Sesamoid bones
Insertion of adductor hallucis
Lumbrical muscles (cut) and lateral head of flexor hallucis
brevis muscles (cut)
Deep transverse metatarsal ligament
and plantar ligaments (plates) Insertion of abductor hallucis
and medial head of flexor hallucis
Interossei muscles Plantar brevis muscles (cut)
Dorsal
Medial head of flexor hallucis
Abductor digiti minimi muscles (cut) brevis muscle (cut)
Deep plantar artery (from dorsalis
Plantar metatarsal arteries pedis artery)
Flexor digiti minimi brevis muscle Posterior perforating branches
(to dorsal metatarsal arteries)
Plantar arch
Plantar metatarsal ligaments (between
Lateral plantar artery (cut) bases of metatarsal bones)
Tuberosity of 5th metatarsal bone Medial cuneiform bone
Lateral origin of flexor hallucis
Fibularis (peroneus) brevis tendon (cut) brevis tendon (cut)
Tuberosity of cuboid bone Tuberosity of navicular bone
Tibialis posterior tendon (cut)
Long plantar ligament
Plantar calcaneonavicular
Calcaneocuboid (short plantar) ligament (spring) ligament
Fourth layer muscles in bold
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Interosseous Muscles of Foot
See also Plate 527
Dorsal view
Distal phalanx of great toe

Distal phalanx
Little
Middle phalanx (5th)
toe
Proximal phalanx
1st metatarsal bone

5th metatarsal bone
Dorsal interossei muscles

(bipennate)
Medial
Cuneiform bones Intermediate
Lateral
Navicular Cuboid bone
Distal phalanx of great toe

Plantar view
Distal phalanx Sesamoid bones

Little
(5th) Middle phalanx
toe
Proximal phalanx
1st metatarsal bone
Plantar interossei muscles

(unipennate)
5th metatarsal bone Lateral

Intermediate Cuneiform bones
Medial
Navicular
Cuboid bone
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Femoral Nerve and Lateral Femoral Cutaneous Nerve 8
T12
Lateral femoral cutaneous nerve (L2, 3) L1
L2 Anterior rami forming
L3 lumbar plexus
Femoral nerve (L2, 3, 4)
L4
Obturator nerve
Lumbosacral trunk
Iliacus muscle
Psoas major muscle
Articular branch
Sartorius muscle
(cut and reflected)
Lateral femoral
Pectineus muscle cutaneous nerve
Rectus femoris Anterior femoral

muscle (cut cutaneous branches
and reflected)
Quadriceps Vastus
femoris intermedius muscle Sartorius muscle
muscle (cut and reflected)
Vastus
medialis muscle
Vastus Saphenous nerve
lateralis muscle
Articularis genu muscle
Infrapatellar branch
of saphenous nerve
Medial crural
cutaneous branches of
saphenous nerve
Cutaneous
innervation
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Obturator Nerve
See also Plate 491
L1
Iliohypogastric nerve
L2
Anterior rami forming
L3 lumbar plexus
Ilioinguinal nerve
L4
Genitofemoral nerve Lumbosacral trunk
Lateral femoral
cutaneous nerve
Femoral nerve

Obturator nerve
(L2, 3, 4)
Note: Only muscles
innervated by obturator
nerve shown
Posterior branch
Articular branch
Adductor brevis muscle
Anterior branch Adductor longus muscle (cut)

Posterior branch (ischiocondylar, or
“hamstrings,” part supplied
by sciatic [tibial] nerve)
Cutaneous branch Gracilis muscle
Articular branch
Adductor hiatus
Cutaneous
innervation
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Sciatic Nerve and Posterior Femoral Cutaneous Nerve 8
See also Plate 492
Posterior femoral
cutaneous nerve
(S1, 2, 3)
Inferior cluneal nerves
Sciatic nerve (L4, 5, S1, 2, 3)

Perineal branches
Tibial division
of sciatic nerve Common fibular division
(L4, 5, S1, 2, 3) of sciatic nerve (L4, 5, S1, 2)
Long head (cut) of

Short head of
biceps femoris muscle
biceps femoris muscle
Cutaneous innervation

(also supplied by obturator Long head (cut)
nerve) of biceps femoris
muscle
Semitendinosus muscle
Semimembranosus muscle Common fibular nerve
Tibial nerve
Articular
branch Posterior femoral
cutaneous nerve
Articular branch
Lateral sural
Plantaris muscle cutaneous nerve
Medial sural
cutaneous nerve Sural
communicating
branch
Common fibular
Gastrocnemius muscle nerve via lateral
sural cutaneous
nerve
Sural nerve
Medial sural
cutaneous nerve
Soleus muscle From sciatic
nerve Superficial fibular
nerve
Tibial nerve
Sural nerve
Lateral calcaneal Tibial nerve
Medial branches via medial
calcaneal branches calcaneal
branches
Lateral dorsal
Medial and lateral cutaneous nerve
plantar nerves
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Tibial Nerve
Common fibular nerve

Tibial nerve
(L4, 5, S1, 2, 3) Articular branch
Lateral sural cutaneous nerve (cut)
Medial sural Sural nerve

cutaneous nerve (cut) (S1, 2) via
lateral calcaneal
and lateral dorsal
Articular branches cutaneous
branches
Plantaris muscle Saphenous nerve

(L3, 4)
Gastrocnemius Lateral
muscle (cut) plantar nerve
(S1, 2)
Medial From
Nerve to popliteus muscle plantar nerve tibial nerve
(L4, 5)
Medial calcaneal
Popliteus muscle branches
(S1, 2)
Crural interosseous nerve Cutaneous innervation of plantar region
Soleus muscle (cut and Proper

partly retracted) plantar
digital
Common plantar nerves
digital nerves
Flexor digitorum
longus muscle
Deep branch to
Adductor Common plantar
hallucis muscle, digital nerves
Tibialis posterior muscle 2nd, 3rd, and 4th
lumbrical muscles, 1st lumbrical
and interossei muscle and
Flexor hallucis muscles
longus muscle nerve
Superficial Flexor hallucis
branch to brevis muscle
Flexor digiti minimi and nerve
Sural nerve (cut) brevis muscle
Abductor hallucis
and
muscle and nerve
4th interosseous
muscle Flexor digitorum
Lateral calcaneal branch brevis muscle
Abductor digiti (cut) and nerve
minimi muscle Medial plantar
Medial Quadratus plantae nerve
calcaneal branch muscle and nerve Medial
Nerve to abductor calcaneal
digiti minimi muscle branch
Flexor retinaculum (cut) Tibial
Lateral
plantar nerve nerve
Lateral dorsal Lateral calcaneal Flexor

cutaneous nerve branch of sural nerve retinaculum
(cut)
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Common Fibular Nerve 8
Lateral sural cutaneous nerve (phantom)

Common fibular
nerve (phantom)
Articular branch
Biceps femoris tendon

Recurrent articular branch
of common fibular nerve
Common fibular
nerve (L4, 5, S1, 2)
Extensor digitorum longus muscle (cut)
Head of fibula
Deep fibular nerve
Fibularis
longus muscle (cut) Tibialis anterior muscle
Superficial Cutaneous innervation

fibular nerve
Branches of lateral Extensor digitorum

sural cutaneous nerve longus muscle
Fibularis
longus muscle Extensor hallucis
longus muscle
Fibularis
brevis muscle
Lateral sural
cutaneous nerve
Medial dorsal cutaneous nerve Superficial

fibular nerve
Intermediate dorsal Lateral branch of

cutaneous nerve deep fibular
nerve to
Extensor hallucis brevis
muscle
Inferior extensor Extensor digitorum brevis
retinaculum (partially cut) muscle
Deep
fibular
Medial branch of nerve
deep fibular
Lateral dorsal cutaneous nerve nerve
(branch of sural nerve)
Sural nerve
via lateral dorsal
cutaneous branch
Dorsal digital nerves of foot
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Otic capsule, 109 Palatine vessels Pancreaticoduodenal arteries (Continued)
Otic ganglion, 25, 56, 59–60, 107, 133–134, greater, 19 inferior, 291, 293, 303
136, 142, 144–146, 173 lesser, 19 superior, 290–291, 293, 303
schema of, 145 Palatoglossal arch, 65, 71–72 Pancreaticoduodenal vein
Ova, BP95 Palatoglossus muscle, T2.7, 67, 70–72, 137 anterior
Ovarian artery, 382, 394, 397. See also Palatomaxillary suture, 17 inferior, 296, 298
Testicular artery Palatopharyngeal arch, 65, 71–72, 79 superior, 296, 299
uterine, 386 Palatopharyngeal ridge, 78 posterior
Ovarian cycle, BP92 Palatopharyngeus muscle, T2.7, 67, 70–72, 75, inferior, 296, 298
Ovarian hormone, BP92 78, 80, 137 superior, 296, 299
Ovarian plexus, 394, 397 Palm, 443 Papilla, 74
Ovarian vein, 267, 382. See also Testicular vein Palmar aponeurosis, 406, 432, 436, 444, keratinized tip of, 71
Ovarian vessels, 316, 344, 347, 386 449–450, 453 Papillary muscle, 220, 248
tubal branches of, 386 Palmar arch, 4 inferior, 224–225, 227
Ovaries, BP95, T6.2, BP10, 316, 344–346, 353, carpal, 455 anterior, 229
355, 371, 382, 394, 397 deep, BP101, BP99, 424, 455 left, 228
blood vessels, BP95 superficial, BP101, BP99, 424, 452, 456, 463 right, 228
corpus albicans of, 355 Palmar digital veins, 5 septal, 227–228
corpus luteum of, 355 Palmar ligament, 448, 451, 454, 460–461 superoposterior, 224–225, 227
follicle (graafian), 355 Palmar longus muscle, 438 anterior, 229
infant, BP95 Palmar plate, BP106 left, 228
left, 356 Palmar region, 2 right, 228
ligaments of, 344, 356, 371 Palmar venous arches, 5 Parabrachial nucleus, 146
proper, 345–346, 353–355 Palmaris brevis muscle, T7.5, 449, 467 Paracentral artery, 152–153
suspensory, 344–347, 355–357, 371, 382 Palmaris longus muscle, T7.5, 432, 436, 439, Paracentral lobule, 117
right, 356–357 441, 466 Paracentral sulcus, 117
Ovum, BP95, 91–92 Palmaris longus tendon, 402, 436–437, 441, Paracolic gutter
stages of, BP95 444, 449–450, 452 left, 272, 344, 348
Palpebral arterial arches right, 272, 280, 344, 348
P inferior, 99 Paracolic nodes, BP82
superior, 99 Paradidymis, 371
Pacinian corpuscle, BP1 Palpebral artery Paraduodenal fossa, 271
Pain, referred visceral, sites of, BP13 lateral, 99 Parahippocampal gyrus, 117–119, 130
Palate inferior, 99 Parallel fibers, 497
growth of, 52 superior, 99 Paramesonephric (Müllerian) duct, 371
innervation of, 173 medial, 99 Paranasal sinuses, 21–22
postsynaptic fibers to, 62 inferior, 99 bones of, 52
uvula of, 65, 72, 75, 79 superior, 99 changes with age, 52
Palatine aponeurosis, 67, 78 Palpebral conjunctiva, BP26, 94 coronal section of, 50
Palatine artery inferior, 94 innervation of, 173
ascending, 57, 72, 83 superior, 94 sagittal view of, 51
tonsillar branch of, 72 Palpebral ligament transverse section of, 50
descending, 63–64, 83 lateral, BP26 Pararectal fossa, 344, 346, 348, 374
greater, 47, 57, 63–64, 67 medial, BP26, 94 Pararenal fat, 185
lesser, 47, 57, 63–64, 67, 72 Pampiniform (venous) plexus, T6.2, BP98, Paraspinal muscle, BP38
tonsillar branch of, 72 259, 369 Parasternal lymph nodes, 190–191
Palatine bone, 15, 17, 44 Pancreas, BP38, BP56, T5.1, BP9, 137, 173, Parasympathetic fibers, 309
horizontal plate of, BP29, 11, 17, 23, 43–45, 185, 274, 276, 323–324, 329 of autonomic reflex pathways, 307
67, 73 autonomic innervation of, 310 of kidneys and upper ureters, 321
nasal crest of, 45 body of, 273, 276, 288 of lower ureter, 399
nasal spine of, posterior, 17, 44–45 head of, 273, 276, 278–279, 287, 327 postsynaptic, BP41
of newborn, 21, 52 arteries of, 293 presynaptic, BP41
orbital process of, 11, 44 as site of referred visceral pain, BP13 in reproductive organs, 397
palatine foramen of innervation to, 172 male, 398
greater, 17, 45 lymph vessels and nodes of, BP80 of tracheobronchial tree, 214
lesser, 17, 45 in situ, 288 of urinary bladder, 399
perpendicular plate of, 11, 44–45 Pancreatic arteries, 291 Parasympathetic nervous system, BP40
pyramidal process of, 17, 21, 23 dorsal, 290–291, 294 general topography, BP40
sphenoidal process of, 44 great, 291 schema of, 173
Palatine fold, transverse, 67 inferior, 291, 293–294 Parathyroid gland, BP10, 76, 89
Palatine foramen Pancreatic duct, BP62, BP87, BP67, 287–288 inferior, 88–89
greater, 19, 44, 47, 67, 73 accessory (of Santorini), 279, 288 superior, 88–89
lesser, 19, 44, 47, 67, 73 sphincter of, 287 Paratracheal lymph nodes
Palatine gland, 67, 72, 77 variations in, 67–68 left, 212
Palatine nerve, 46, 144 of Wirsung, 279 right, 212
descending, 144 Pancreatic islets, BP10 Paratracheal nodes, 242
greater, 46, 48, 62–64, 67, 82, 133, 142, 144 Pancreatic pain, areas of referred pain in, Paraumbilical veins, T5.2, 299
in greater palatine foramen, 19 310 in round ligament of liver, 259
posterior inferior lateral nasal branch of, 46, Pancreatic tail, BP87, 273, 289, 291 tributaries of, 259
48, 142 Pancreatic veins, 296, 298 Paraurethral glands, primordium of, 371
lesser, 46, 48, 62–64, 67, 82, 133, 142, 144 great, 296 Paraurethral (Skene’s) ducts, BP90
in lesser palatine foramen, 19 Pancreaticoduodenal arteries openings of, 358
Palatine process, 15, 23 anterior Paraurethral (Skene’s) gland, 371
Palatine raphe, 67 inferior, 291, 293, 303 Paravertebral anastomoses, 177
Palatine tonsil, 65, 67–68, 71–72, 77, 79 superior, 273, 290–291, 293–294, 303 Paravesical endopelvic fascia, 352
Palatine vein, 84 inferior, 291, 293–295, 304 Paravesical fossa, 346
external, 84 posterior Parental generation, BP91
Atlas of Human Anatomy I-25

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Parietal artery, 10 Pectoralis major muscle, T4.3, T7.5, 32, 36, 38, Pelvis (Continued)
anterior, 152–153 187–188, 191, 194–195, 197, 204, 220–221, ligaments of, 357
posterior, 152–153 244–249, 252–254, 402, 408–409, 414, 416, linea terminalis of, 347–348
Parietal bone, BP17, 11, 13–18 419, 421, 423, 425 male
mastoid angle of, 18 abdominal part of, 413 arteries of, BP98, 385
middle meningeal vessels of, groove for, 18 clavicular head of, 187, 413 bladder-prostate gland junction, 400
of newborn, 21 pectoral fasciae and, 188 contents, 348
tuber (eminence) of, 21 sternal head, 187 diaphragm, 342–343
Parietal emissary vein, 10, 111 sternocostal head of, 413 fasciae of, BP88
Parietal foramen, 16 Pectoralis major tendon, 423, 425 lymph nodes of, 390
Parietal lobule, superior, 116 Pectoralis minor muscle, T4.3, T7.5, 194–195, lymph vessels of, 390
Parietal nodes, posterior, 242 204, 221, 245–247, 409, 414, 416, 419, 423 measurements of, 336
Parietal peritoneum, BP84, 264, 272, 274–275, Pectoralis minor tendon, 414, 417, 419, 421 radiograph of, 335
309, 324, 332, 344, 348 Pedicle, BP33, 163, 167–168 veins of, BP98, 385
Parietal pleura of C5, BP34 viscera of, 349
cervical, 202–203, 234 cervical, 27 sagittal T2-weighted MRIs in, 379
costal part of, 199–200, 204, 210, 215, 235 of L1, BP36 surface anatomy of, 333
left border, 203 of L3, BP37 Penile fascia, superficial, BP88
right border, 203 of L4, 165 Penile urethra, BP93
costal pleura, 234 lumbar, 164 Penis, 364, 379
diaphragmatic part of, BP44, 199–200, 204, thoracic, 163 arteries of, T6.2
210, 215, 236 Pedis artery body (shaft) of, 333, 370
mediastinal part of, BP44, 199–200, 204, 210, dorsal, BP110, 503, 521–522 bulb of, 364–365, 367
215–216, 219–220, 235–236 medial tarsal branch of, BP110 artery of, 365, 387
Parietal region, 3 dorsalis, BP115 cavernous nerves of, 392, 398
Parietal vein, 10 Pelvic brim, 353 corpora cavernosa of, 364–365
Parietooccipital sulcus, 116–117 sacral part of, 166 crus of, 352, 363–364, 367
Paroöphoron, 371 Pelvic cavity, BP3 Dartos fascia of, 349, 362–364, 369
Parotid duct (of Stensen), 53–56, 83 contrast medium in, 357 deep arteries of, 363, 365, 367, 387
Parotid fascia, 31 Pelvic diaphragm, 349 deep (Buck’s) fascia of, BP88, BP98,
Parotid gland, BP41, T2.1, BP40, 32, 36, 38, fascia of, 378 252–254, 324, 349, 362–365, 369,
49, 53–54, 60, 68, 79, 105, 136, 145, 173 female, 339–341 377–378, 387
accessory, 53 inferior fascia of, 359–360, 364, 374, 376, 387 dorsal arteries of, 363, 365, 383, 387
innervation to, 172 levator ani muscle of, 345, 364, 373–374, 378 deep, BP98, 387
Parotid lymph node, superficial, 85 male, 342–343 left, 385
Parotid space, 41 superior fascia of, 347, 350, 359, 374, 376 dorsal nerves of, 363, 365, 387, 391–393, 395,
Parous introitus, BP96 Pelvic fascia, tendinous arch of, 347, 352 398, 487, 493
Pars distalis, 158 Pelvic floor, T6.1 dorsal veins of
Pars flaccida, 106 Pelvic foramina, anterior, 342 deep, BP98, 342–343, 349, 363, 365, 383,
Pars interarticularis, 164 Pelvic girdle, BP4 385
Pars intermedia, 158 Pelvic outlet, measurements of, 336 superficial, BP98, 252, 259, 333, 363,
Pars tensa, BP27, 106 Pelvic plexus 385
Pars tuberalis, 158 inferior, 391–392, 394, 396–399 fundiform ligament of, 262
Parturition, neuropathways in, 396 superior, 391 glans, 333, 349, 364, 370
Passavant’s ridge, 78 uterovaginal, 397 corona, 364
Patella, BP4, 113–114, 471, 482–484, 491, Pelvic sacral foramina. See Sacral foramina, neck, 364
497–498, 502, 510–511 anterior ligament of
articular surface of, BP114 Pelvic splanchnic nerves, BP41, 487 fundiform, 349
Patellar anastomosis, BP110, BP108, S2-4, BP40 suspensory, 349
490–491 Pelvic surface, 166 raphe of, 370
Patellar ligament, T8.1, 471, 482–484, 491, Pelvic viscera skin of, 362–364, 369
497–499, 502, 505, 510–512 female, 345–346 superficial fascia of, 253–254
insertion of, BP111 nerves of, 394 suspensory ligament of, BP58, 253
Patellar nerve plexus, 473 male, 349 Perforated substance
Patellar retinaculum nerves of, 392 anterior, 118, 124, 130
lateral, 482, 484, 497–498, 510–512 Pelvis, 333–401 posterior, 118
medial, 482–483, 491, 497–499, 511–512 arcus tendineus fasciae, 354 Perforating artery
Patellar tendon, BP113 bones and ligaments of, 337–338 first, 492
Pecten, 375 bony framework of, 334 fourth, 492
Pecten pubis, 250, 334, 338, 476 electronic bonus plates in, BP97, BP92, BP93, second, 492
Pectinate (dentate) line, 375 BP96, 88–89 third, 492
Pectinate ligament, 101 female Perforating branches, 491
Pectinate muscles, 224 arteries of, 382–383 anterior, 527
Pectineal fascia, 254 contents, 344 posterior, 527
Pectineal ligament (Cooper’s), 253–254, 256, diaphragm, 339–341 Perforating cutaneous nerves, 393, 395
262, 264–265 fasciae of, BP88 Perforating radiate artery, 314
Pectineus muscle, T8.5, BP109, 400–401, lymph nodes of, 388 Perforating veins, BP99, 405–406, 513
480–483, 490–491, 495–496, 529 lymph vessels of, 388 anterior, 198
Pectoral fasciae, 188, 416 measurements of, 336 Perianal skin, 376
Pectoral girdle, BP4 radiograph of, 335 sweat glands in, 375
Pectoral lymph nodes, 190–191 relationships, 356 Perianal space, 374–375, 378
Pectoral nerve urethra, 401 Perianal tissues, 370
lateral, 194, 416, 419–420 vagina, 401 Pericallosal artery, 152–153
medial, 194, 419–420 veins of, 382 Pericardiacophrenic artery, 196, 210, 215–216,
Pectoral region viscera, 345 220, 234–235, 258
anterior, 2 greater, 338 left, 199–200
lateral, 3 lesser, 338 right, 199
I-26 Atlas of Human Anatomy

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Skeletal System: Bones and Joints 129
where they articulate with the sternum. A slight elevation, called

the sternal angle, can be felt at the junction of the manubrium and Clavicle
the body of the sternum. This junction is an important landmark Pectoral girdle
because it identifies the location of the second rib. This identifica- Scapula
tion allows the ribs to be counted; for example, it can help a health
professional locate the apex of the heart, which is between the fifth
and sixth ribs.
The xiphoid process is another important landmark of the
sternum. During cardiopulmonary resuscitation (CPR), it is very Humerus
important to place the hands over the body of the sternum rather
than over the xiphoid process. Pressure applied to the xiphoid
process can drive it into an underlying abdominal organ, such as
the liver, causing internal bleeding.
6.7 APPENDICULAR SKELETON

Learning Outcomes After reading this section, you should be able to Ulna
Upper limb
A. Identify the bones that make up the pectoral girdle, and
relate their structure and arrangement to the function of Radius
the pectoral girdle.
B. Name and describe the major bones of the upper limb.
C. Name and describe the bones of the pelvic girdle and
explain why the pelvic girdle is more stable than the Carpal bones
pectoral girdle. Metacarpal bones
D. Name the bones that make up the hip bone. Distinguish
between the male and female pelvis.
E. Identify and describe the bones of the lower limb. Phalanges
The appendicular (ap′en-dik′ū-lăr; appendage) skeleton consists Anterior view

of the bones of the upper and lower limbs, as well as the girdles,
which attach the limbs to the axial skeleton.
Figure 6.23 Bones of the Pectoral Girdle and Right Upper Limb
Anterior view of the bones of the pectoral girdle and upper limb.
Pectoral Girdle
The pectoral (pek′tō-răl) girdle, or shoulder girdle (figure 6.23),
consists of four bones, two scapulae and two clavicles, which
attach the upper limb to the body. The scapula (skap′ū-lă), or
shoulder blade, is a flat, triangular bone with three large fossae Upper Limb
where muscles extending to the arm are attached (figures 6.25 The upper limb consists of the bones of the arm, forearm, wrist,
and 6.26; see figure 6.11). A fourth fossa, the glenoid (glen′oyd) and hand (see figure 6.23).
cavity, is where the head of the humerus connects to the scapula.
A ridge, called the spine, runs across the posterior surface of
the scapula. A projection, called the acromion (ă-krō′mē-on; Arm
akron, tip + omos, shoulder) process, extends from the scapular The arm is the region between the shoulder and the elbow;
spine to form the point of the shoulder. The clavicle (klav′i- it contains the humerus (hū′mer-ŭs; shoulder) (figure 6.27).
kl), or collarbone, articulates with the scapula at the acromion The proximal end of the humerus has a smooth, rounded head,
process. The proximal end of the clavicle is attached to the which attaches the humerus to the scapula at the glenoid cavity.
sternum, providing the only bony attachment of the scapula to Around the edge of the humeral head is the anatomical neck.
the remainder of the skeleton. The clavicle is the first bone to When the joint needs to be surgically replaced, this neck is not
begin ossification in the fetus. This relatively brittle bone may easily accessible. A more accessible site for surgical removal is
be fractured in the newborn during delivery. The bone remains at the surgical neck, located at the proximal end of the humeral
slender in children and may be fractured as a child attempts to shaft. Lateral to the head are two tubercles, a greater tubercle
take the impact of a fall on an outstretched hand. The clavicle is and a lesser tubercle. Muscles originating on the scapula attach
thicker in adults and is less vulnerable to fracture. Even though to the greater and lesser tubercles and hold the humerus to the
it is the first bone to begin ossification, it is the last to complete scapula. Approximately one-third of the way down the shaft of the
ossification. The coracoid (kōr′ă-koyd) process of the scapula humerus, on the lateral surface, is the deltoid tuberosity, where
curves below the clavicle and provides for the attachment of arm the deltoid muscle attaches. Because mechanical stress promotes
and chest muscles. bone remodeling, the size of the deltoid tuberosity can increase as
130 Chapter 6
the result of frequent and powerful pulls from the deltoid muscle. the humerus as the ulna does. The radial head rotates against the
For example, in bodybuilders, the deltoid muscle and the del- humerus and ulna. Just distal to the radial head is a radial tuber-
toid tuberosity enlarge substantially. Anthropologists, examining osity, where one of the arm muscles, the biceps brachii, attaches.
ancient human remains, can use the presence of enlarged deltoid The distal end of the radius articulates with the wrist bones. A
tuberosities as evidence that a person was engaged in lifting heavy styloid process is located on the lateral side of the distal end of the
objects during life. In some societies, that would mean the person radius. The radial and ulnar styloid processes provide attachment
was a slave and was required to perform heavy manual labor. The sites for ligaments of the wrist.
distal end of the humerus is modified into specialized condyles
that connect the humerus to the forearm bones. Epicondyles (ep′i- Wrist
kon′dīlz; epi, upon) on the distal end of the humerus, just lateral to The wrist is a relatively short region between the fore-
the condyles, provide attachment sites for forearm muscles. arm and the hand; it is composed of eight carpal (kar′păl;
wrist) bones (figure 6.29). These eight bones are the scaphoid
Forearm (skaf′oyd), lunate (lū′nāt), triquetrum (trī-kwē′trŭm), pisiform
The forearm has two bones: the ulna (ŭl′nă) on the medial (little (pis′i-fōrm), trapezium (tra-pē′zē-ŭm), trapezoid (trap′ĕ-zoyd),
finger) side of the forearm and the radius on the lateral (thumb) capitate (kap′i-tāt), and hamate (ha′māt). The carpal bones are
side (figure 6.28). Recall from chapter 1 that the body is in ana- arranged in two rows of four bones each and form a slight curva-
tomical position when the palm of the hand faces anteriorly. Thus, ture that is concave anteriorly and convex posteriorly. A number
the radius and ulna lie parallel to each other in anatomical posi- of mnemonics have been developed to help students remember
tion. The proximal end of the ulna forms a trochlear notch that the carpal bones. The following one allows students to remember
fits tightly over the end of the humerus, forming most of the elbow them in order from lateral to medial for the proximal row (top)
joint. Just proximal to the trochlear notch is an extension of the and from medial to lateral (by the thumb) for the distal row: So
ulna, called the olecranon (ō-lek′ră-non; elbow) process, which Long Top Part, Here Comes The Thumb—that is, Scaphoid,
can be felt as the point of the elbow (see figure 6.30). Just distal Lunate, Triquetrum, Pisiform, Hamate, Capitate, Trapezoid, and
to the trochlear notch is a coronoid (kōr′ŏ-noyd) process, which Trapezium.
helps complete the “grip” of the ulna on the distal end of the
humerus. The distal end of the ulna forms a head, which articu- Hand
lates with the bones of the wrist, and a styloid process is located Five metacarpal (met′ă-kar′păl) bones are attached to the
on its medial side. The ulnar head can be seen as a prominent pro- carpal bones and form the bony framework of the hand (fig-
jection on the posterior ulnar side of the wrist. The proximal end ure 6.29). The metacarpal bones are aligned with the five
of the radius has a head by which the radius articulates with both digits: the thumb and fingers. They are numbered 1 to 5,
the humerus and the ulna. The radius does not attach as firmly to from the thumb to the little finger. The ends, or heads, of the
CLINICAL IMPACT Carpal Tunnel Syndrome
The bones and ligaments

that form the walls of the carpal tun-
nel do not stretch. Edema (fluid build-
Median nerve
up) or connective tissue deposition may
occur within the carpal tunnel as a result Carpal ligament
of trauma or some other problem. The
edema or connective tissue may apply Carpal tunnel
pressure against the nerve and vessels
passing through the tunnel, causing car-
pal tunnel syndrome, which is character-
Trapezium Hamate
ized by tingling, burning, and numbness in
the hand (figure 6.24). The vast majority Trapezoid Capitate
of carpal tunnel syndrome cases have no
Carpal bones
known cause, but certain conditions pre-
dispose a person to develop it. For exam-
ple, pregnancy, rheumatoid arthritis, too Figure 6.24 Carpal Tunnel
little thyroid hormone, and diabetes are The carpal tunnel is bordered by carpals on the posterior side of the hand and the carpal ligament on
all associated with an increased tendency the anterior side of the hand. Compression of the median nerve causes numbness of the hand.
to develop carpal tunnel syndrome.

Acromion process
Acromion process
Coracoid process
Coracoid process
Glenoid cavity
Glenoid cavity Supraspinous
fossa
Spine
Subscapular
Lateral border fossa
Infraspinous fossa
Medial border
View
in (d) Lateral border
Inferior angle
(a) Anterior view (b) Posterior view
Spine of scapula Posterior
Body of clavicle Supraspinous

fossa of scapula
Acromion process
of scapula
Proximal end Distal end

of clavicle
Coracoid process
Distal end of scapula
Body of clavicle Anterior
(c) Superior view (d) Superior view
Figure 6.25 Right Scapula and Clavicle

(a) Right scapula, anterior view. (b) Right scapula, posterior view. (c) Right clavicle, superior view. (d ) Photograph of the right scapula and clavicle from a
superior view, showing the relationship between the distal end of the clavicle and the acromion process of the scapula. (d) ©Trent Stephens
five metacarpal bones associated with the thumb and fingers part of the pelvis but are also part of the axial skeleton. Each hip
form the knuckles (figure 6.30). Each finger consists of three bone is formed by three bones fused to one another to form a
small bones called phalanges (fă-lan′jēz; sing. phalanx, single bone: the ilium, the ischium, and the pubis (figure 6.33).
fā′langks), named after the Greek phalanx, a wedge of soldiers The ilium (il′ē-ŭm) is the most superior, the ischium (is′kē-ŭm)
holding their spears, tips outward, in front of them. The pha- is inferior and posterior, and the pubis (pū′bis) is inferior and
langes of each finger are called proximal, middle, and distal, anterior. An iliac crest can be seen along the superior margin of
according to their position in the digit. The thumb has two each ilium, and an anterior superior iliac spine, an important
phalanges, proximal and distal. The digits are also numbered hip landmark, is located at the anterior end of the iliac crest. The
1 to 5, starting from the thumb. hip bones converge anteriorly at the pubic (pū′bik) symphy-
sis and articulate with the sacrum posteriorly at the sacroiliac
Pelvic Girdle (sā-krō-il′ē-ak) joints (see figure 6.32). The acetabulum (as-ĕ-
The pelvic girdle is the place where the lower limbs attach to the tab′ū-lŭm; vinegar cup) is the socket of the hip joint. The obtura-
body (figure 6.31). The right and left hip bones join each other tor (ob′too-rā-tŏr) foramen is the large hole in each hip bone that
anteriorly and the sacrum posteriorly to form a ring of bone called is closed off by muscles and other structures.
the pelvic girdle. The pelvis (pel′vis; basin) includes the pelvic The male pelvis can be distinguished from the female pelvis
girdle and the coccyx (figure 6.32). The sacrum and coccyx form because it is usually larger and more massive, but the female pelvis
132 Chapter 6
Spinous process of
seventh cervical
vertebra
Distal end of clavicle
Jugular notch Superior border
of scapula
Acromion
process Spine of scapula
Clavicle
Scapula
Sternum
Medial border
of scapula
Inferior angle
of scapula
Lumbar spinous
processes
(a) (b)
Figure 6.26 Surface Anatomy of the Pectoral Girdle and Thoracic Cage
(a) Bones of the pectoral girdle and the anterior thorax. (b) Bones of the scapula and the posterior vertebral column. (a,b) ©McGraw-Hill Education/Andy Resek
Head Greater tubercle

Greater tubercle
Anatomical neck
Lesser tubercle
Surgical neck
Deltoid tuberosity
Olecranon fossa
Lateral epicondyle Lateral epicondyle

Medial epicondyle
Capitulum
Condyles
Trochlea Trochlea
(a) Anterior view (b) Posterior view (c) Anterior view
Figure 6.27 Right Humerus

(a) Anterior view of the right humerus. (b) Posterior view of the right humerus. (c) Photo of the anterior view of the right humerus. (c) ©McGraw-Hill Education/
Christine Eckel
Olecranon Radius
process Ulna
Trochlear
notch
Head Carpal Scaphoid
Coronoid bones Hamate Carpal
Lunate
process (proximal Capitate bones
Triquetrum
Radial tuberosity row) Pisiform Trapezoid (distal
Trapezium row)
Ulna 1
Radius Metacarpal
(shaft) (shaft) bones 2
5 3
4
Proximal
phalanx
of thumb
Distal
phalanx
of thumb
Digits Proximal
phalanx
of finger
Head Middle phalanx

Styloid process Styloid of finger
process
(a) Anterior view (b) Anterior Distal phalanx
view of finger
Posterior view
Olecranon
process
Figure 6.29 Bones of the Right Wrist and Hand
Head of radius Trochlear
notch Posterior view of the bones of the right wrist and hand.
Coronoid process
(c) Superior view
Heads of
Figure 6.28 Right Ulna and Radius metacarpal Acromion
bones process
(a) Anterior view of the right ulna and radius. (b) Photo of the same view of
(knuckles)
the right ulna and radius. (c) Proximal ends of the right ulna and radius.
Medial
(b) ©McGraw-Hill Education/Christine Eckel
border of
Head scapula
of ulna
Olecranon
process
tends to be broader (figure 6.34; table 6.3). Both the inlet and the
outlet of the female pelvis are larger than those of the male pelvis,
and the subpubic angle is greater in the female (figure 6.34a,b).
Olecranon
The increased size of these openings helps accommodate the process
fetus during childbirth. The pelvic inlet is formed by the pelvic
brim and the sacral promontory. The pelvic outlet is bounded
by the ischial spines, the pubic symphysis, and the coccyx Figure 6.30 Surface Anatomy Showing Bones of the Pectoral
(figure 6.34c). Girdle and Upper Limb
Lateral view of the pectoral girdle and upper limb surface anatomy.
©Eric Wise
Lower Limb
The lower limb consists of the bones of the thigh, leg, ankle, and
foot (see figure 6.31). of the femur, the condyles articulate with the tibia. Epicondyles,
located medial and lateral to the condyles, are points of ligament
Thigh attachment. The femur can be distinguished from the humerus
The thigh is the region between the hip and the knee (figure 6.35a). by its long neck, located between the head and the trochanters
It contains a single bone called the femur. The head of the femur (trō′kan-terz). In everyday terms, a “broken hip” is usually a
articulates with the acetabulum of the hip bone. At the distal end break of the femoral neck. A fractured hip is difficult to repair
134 Chapter 6
Differences Between Male and

TABLE 6.3
Sacrum Female Pelvic Girdles
Hip bone Pelvic girdle
Area Description of Difference
General Female pelvis somewhat lighter in weight and
wider laterally but shorter superiorly to
inferiorly and less funnel-shaped; less obvious
muscle attachment points in female than in male
Sacrum Broader in female, with the inferior portion
Femur
directed more posteriorly; the sacral
promontory projects less anteriorly in female
Pelvic inlet Heart-shaped in male; oval in female
Pelvic outlet Broader and more shallow in female
Patella Subpubic angle Less than 90 degrees in male; 90 degrees or

more in female
Ilium More shallow and flared laterally in female
Tibia Ischial spines Farther apart in female
Lower limb
Ischial Turned laterally in female and medially in male
tuberosities (not shown in figure 6.34)
Fibula
(pa-tel′ă), or kneecap (figure 6.35c), is located within the major

Tarsal bones tendon of the anterior thigh muscles and enables the tendon to
Metatarsal bend over the knee. The patella is a uniquely shaped bone, called
bones
Phalanges a sesamoid bone.
Anterior view
Leg
Figure 6.31 Bones of the Pelvic Girdle and Right Lower Limb The leg is the region between the knee and the ankle (figure 6.36).
Anterior view of the bones of the pelvic girdle and right lower limb. It contains two bones: the medial tibia (tib′ē-ă; shinbone) and the
lateral fibula (fib′ū-lă). The tibia is the larger of the two and is
the major weight-bearing bone of the leg. The rounded condyles
and often requires pinning to hold the femoral head to the shaft. of the femur rest on the flat condyles on the proximal end of the
A major complication can occur if the blood vessels between the tibia. Just distal to the condyles of the tibia, on its anterior surface,
femoral head and the acetabulum are damaged. If this occurs, is the tibial tuberosity, where the muscles of the anterior thigh
the femoral head may degenerate from lack of nourishment. attach. The fibula does not articulate with the femur, but its head
The trochanters are points of muscle attachment. The patella is attached to the proximal end of the tibia.
Sacroiliac joint
Iliac crest Sacrum
Sacral promontory
Ilium
Anterior superior
iliac spine
Coccyx
Hip
Pubis bone
Acetabulum
Pubic symphysis
Obturator Ischium
foramen
Subpubic angle
Anterosuperior view
Figure 6.32 Pelvis

Anterosuperior view of the bones of the articulated pelvis.
Iliac crest Articular

surface (area
of articulation
Ilium with sacrum)
Iliac
fossa
Pelvic
brim
Greater
Acetabulum sciatic
Greater
notch
sciatic notch
Pubis
Ischial spine Ischial
spine
Pubic
Ischium
symphysis Ischium
Ischial Obturator
tuberosity foramen
(a) Lateral view (b) Medial view (c) Lateral view
Figure 6.33 Right Hip Bone

(a) Lateral view of the right hip bone. The three fused bones of the hip—the ilium (green), ischium (yellow), and pubis (blue)—converge at the acetabulum.
(b) Medial view of the right hip bone. (c) Photo of the lateral view of the right hip bone. (c) ©McGraw-Hill Education/Christine Eckel
Sacral
Pelvic promontory
Ischial
inlet spine
(red Pelvic Pelvic
dashed brim outlet
line) (blue
Coccyx
Pubic dashed
symphysis line)
Pubic
symphysis
Subpubic angle
Male Female
(a) Anterosuperior view (b) Anterosuperior view
Sacral
promontory
Pelvic
brim
Figure 6.34 Comparison of the Male Pelvis to the Female Pelvis Pelvic inlet
(a) In a male, the pelvic inlet (red dashed line) and outlet (blue dashed line) are
small, and the subpubic angle is less than 90 degrees. (b) In a female, the pelvic Coccyx
inlet (red dashed line) and outlet (blue dashed line) are larger, and the subpubic Pelvic outlet
angle is 90 degrees or greater. (c) A midsagittal section through the pelvis shows
the pelvic inlet (red arrow and red dashed line) and the pelvic outlet (blue arrow
and blue dashed line). (c) Medial view
136 Chapter 6
Head Head
Greater Greater trochanter
trochanter Neck
Neck
Lesser trochanter
Linea aspera
Body (shaft) of femur
Medial
epicondyle
Lateral epicondyle
Lateral Intercondylar fossa
epicondyle
Medial Lateral condyle
condyle
Patellar groove
(a) Anterior view Posterior view (b) Anterior view
Anterior
surface
(c) Anterior view
Figure 6.35 Bones of the Thigh

(a) Anterior and posterior view of the right femur. (b) Photo of anterior view of the right femur. (c) Anterior view of the patella. (b) ©McGraw-Hill Education/Christine Eckel
Ankle The metatarsal (met′ă-tar′săl) bones and phalanges of the

The ankle consists of the distal ends of the tibia and fibula foot are arranged and numbered in a manner very similar to the
forming a partial socket that articulates with a bone of the metacarpal bones and phalanges of the hand (see figure 6.37).
foot (the talus) (figure 6.37). A prominence can be seen on each The metatarsal bones are somewhat longer than the metacarpal
side of the ankle (see figure 6.36). These are the medial malleolus bones, whereas the phalanges of the foot are considerably shorter
(mal-ē′ō-lŭs) of the tibia and the lateral malleolus of the fibula. than those of the hand.
There are three primary arches in the foot, formed by the
positions of the tarsal bones and metatarsal bones, and held in
Foot place by ligaments. Two longitudinal arches extend from the heel
There are seven tarsal (tar′săl; the sole of the foot) bones to the ball of the foot, and a transverse arch extends across the foot.
(see figure 6.37). The tarsal bones are the talus (tā′lŭs; ankle The transverse arch is located at the connection between the five
bone), calcaneus (kal-kā′nē-ŭs; heel), cuboid (kū′boyd), and metatarsal and the three cuneiforms and the cuboid. The arches
navicular (nă-vik′yū-lăr), and the medial, intermediate, and serve as an adjustable lever to assist in the two main functions of
lateral cuneiforms (kū′nē-i-fōrmz) (figure 6.38). A mnemonic the foot: (1) to support the body in its upright position both while
for the distal row is MILC—that is, Medial, Intermediate, and standing and in forward movement during walking and (2) to push
Lateral cuneiforms and the Cuboid. A mnemonic for the proxi- the body forward during walking and to absorb the shock when
mal three bones is No Thanks Cow—that is, Navicular, Talus, the foot contacts the ground. The arches function similarly to the
and Calcaneus. springs of a car, allowing the foot to give and spring back.
Lateral Medial 6.8 JOINTS

condyle condyle
Learning Outcomes After reading this section, you should be able to
Head Tibial
tuberosity A. Describe the two systems for classifying joints.
B. Explain the structure of a fibrous joint, list the three types,
and give examples of each type.
C. Give examples of cartilaginous joints.
D. Illustrate the structure of a synovial joint and explain the
roles of the components of a synovial joint.
E. Classify synovial joints based on the shape of the bones in
the joint and give an example of each type.
F. Demonstrate the difference between the following pairs
Fibula Tibia of movements: flexion and extension; plantar flexion
and dorsiflexion; abduction and adduction; supination
and pronation; elevation and depression; protraction
and retraction; opposition and reposition; inversion and
eversion.
Joints, or articulations, are commonly named according to

the bones or portions of bones that join together; for example,
the temporomandibular joint is between the temporal bone and
Lateral Medial the mandible. Some joints are given the Greek or Latin equivalent
malleolus malleolus
of the common name, such as cubital (kū′bi-tăl; cubit, elbow or
(a) Anterior view (b) Anterior
forearm) joint for the elbow joint.
view Joints are classified structurally as fibrous, cartilaginous,
or synovial, according to the major connective tissue type that
binds the bones together and whether a fluid-filled joint capsule
Figure 6.36 Bones of the Leg
is present. Joints can also be classified in functional categories
(a) Anterior view of the articulated right tibia and fibula bones. (b) Photo of
the anterior view of the articulated right tibia and fibula bones. (b) ©McGraw-
according to their degree of motion as synarthroses (nonmovable
Hill Education/Christine Eckel joints), amphiarthroses (slightly movable joints), or diarthroses
Calcaneus
Talus
Tarsal bones
Cuboid
Navicular
Medial cuneiform Fibula

Metatarsal Intermediate cuneiform
bones Tibia
5 Lateral cuneiform
Navicular
4
3 2 1
Talus
Proximal phalanx
Digits
Middle phalanx
Distal phalanx Proximal phalanx
of great toe
Cuboid Calcaneus
Distal phalanx
of great toe Phalanges Metatarsal bones Tarsal bones
(a) Superior view (b) Medial view
Figure 6.37 Bones of the Right Foot

(a) Superior view of the articulated right ankle and foot. (b) Medial view of the articulated right ankle and foot.
138 Chapter 6
Medial epicondyle of femur Parietal

bone
Frontal
Squamous bone
suture
Head of fibula Coronal
Patella suture
Tibial tuberosity
Calcaneus
Anterior crest
of tibia
Lateral epicondyle
of femur Occipital
Lateral bone
malleolus
Lambdoid
Medial malleolus
suture
Mastoid (posterolateral)
fontanel
Sphenoidal
Figure 6.38 Surface Anatomy Showing Bones of the Lower Limb (anterolateral)
Lateral view of the lower limbs showing surface anatomy. ©Eric Wise
fontanel
Temporal bone
(a) Lateral view
(freely movable joints). In general, fibrous and cartilaginous Frontal bones

joints have little or no movement, while synovial joints have (not yet fused
considerable movement. Because this functional classification is into a single
bone)
somewhat limited, our discussions are based on the more precise
structural classification scheme.
Fibrous joints are the articulating surfaces of two bones Frontal
united by fibrous connective tissue. They have no joint cavity (anterior)
and exhibit little or no movement. Joints in this group are further fontanel
subdivided on the basis of structure as sutures, syndesmoses, or
gomphoses.
Sutures (soo′choorz) are fibrous joints between the bones of Parietal
the skull (see figure 6.12). In a newborn, some parts of the sutures Sagittal
bone
suture
are quite wide and are called fontanels (fon′tă-nelz′), or soft spots
(figure 6.39). They allow flexibility in the skull during the birth
process, as well as growth of the head after birth. Occipital
Syndesmoses (sin′dez-mō′sēz) are fibrous joints in which the (posterior)
fontanel
bones are separated by some distance and held together by liga- Occipital
bone
ments. An example is the fibrous membrane connecting most of
(b) Superior view
the distal parts of the radius and ulna.
Gomphoses (gom-fō′sēz) consist of pegs fitted into sockets
and held in place by ligaments. The joint between a tooth and its Figure 6.39 Fetal Skull Showing Fontanels and Sutures
socket is a gomphosis. (a) Lateral view of the fetal skull fontanels and sutures. (b) Superior view of
the fetal skull fontanels and sutures.
Cartilaginous Joints
Cartilaginous joints unite two bones by means of cartilage.
Only slight movement can occur at these joints. The connecting
cartilage can be either hyaline cartilage or fibrocartilage. Joints of the axial skeleton are not. This pattern reflects the greater
containing hyaline cartilage are called synchondroses; joints con- mobility of the appendicular skeleton compared to that of the
taining fibrocartilage are called symphyses. axial skeleton.
Several features of synovial joints are important to their func-
Synovial Joints tion (figure 6.40). The articular surfaces of bones within synovial
Synovial (si-nō′vē-ăl) joints are freely movable joints that con- joints are covered with a thin layer of articular cartilage, which
tain fluid in a cavity surrounding the ends of articulating bones. provides a smooth surface where the bones meet. The articular
Most joints that unite the bones of the appendicular skeleton are surfaces are enclosed within a fluid-filled joint cavity. The cav-
synovial joints, whereas many of the joints that unite the bones ity is surrounded by a joint capsule, which helps hold the bones
Bone
Synovial membrane
Joint
Blood vessel Fibrous part of joint capsule
Nerve capsule
Bursa
Joint cavity (filled

with synovial fluid)
Articular
cartilage
Tendon
sheath
Tendon
Outer layer
Bone Periosteum
Inner layer
Figure 6.40 Structure of a Synovial Joint

Synovial joints are highly movable connections between bones. A membrane-lined and fluid-filled cavity separates the bones.
together while still allowing for movement. Portions of the fibrous can occur in two planes. The joint between the metacarpal bone
part of the joint capsule may be thickened to form ligaments. In and the carpal bone (trapezium) of the thumb is a saddle joint.
addition, ligaments and tendons outside the joint capsule contrib- Hinge joints permit movement in one plane only. They consist
ute to the strength of the joint. of a convex cylinder of one bone applied to a corresponding con-
A synovial membrane lines the joint cavity everywhere cavity of the other bone. Examples are the elbow and knee joints
except over the articular cartilage. The membrane produces (figure 6.42a,b). The flat condylar surface of the knee joint is
synovial fluid, which is a complex mixture of polysaccharides, modified into a concave surface by shock-absorbing fibrocartilage
proteins, lipids, and cells. Synovial fluid forms a thin, lubricat- pads called menisci (mĕ-nis′sī). Pivot joints restrict movement to
ing film covering the surfaces of the joint. In certain synovial rotation around a single axis. Each pivot joint consists of a cylin-
joints, the synovial membrane may extend as a pocket, or sac, drical bony process that rotates within a ring composed partly of
called a bursa (ber′să; pocket). Bursae are located between bone and partly of ligament. The rotation that occurs between the
structures that rub together, such as where a tendon crosses a axis and atlas when shaking the head “no” is an example. The
bone; they reduce friction, which could damage the structures articulation between the proximal ends of the ulna and radius is
involved. Inflammation of a bursa, often resulting from abra- also a pivot joint.
sion, is called bursitis. A synovial membrane may extend as Ball-and-socket joints consist of a ball (head) at the end of
a tendon sheath along some tendons associated with joints one bone and a socket in an adjacent bone into which a portion
(figure 6.40). of the ball fits. This type of joint allows a wide range of move-
ment in almost any direction. Examples are the shoulder and hip
Types of Synovial Joints joints (figure 6.42c,d). Ellipsoid (ē-lip′soyd) joints, or condyloid
Synovial joints are classified according to the shape of the adjoin- (kon′di-loyd) joints, are elongated ball-and-socket joints. The
ing articular surfaces (figure 6.41). Plane joints, or gliding joints, shape of the joint limits its range of movement nearly to that of a
consist of two opposed flat surfaces that glide over each other. hinge motion, but in two planes. Examples of ellipsoid joints are
Examples of these joints are the articular facets between vertebrae. the joint between the occipital condyles of the skull and the atlas
Saddle joints consist of two saddle-shaped articulating surfaces of the vertebral column and the joints between the metacarpal
oriented at right angles to each other. Movement in these joints bones and phalanges.
140 Chapter 6
Class and Example Structures Joined Movement

of Joint
Plane
Acromioclavicular Acromion process of Slight
scapula and clavicle
Carpometacarpal Carpals and metacarpals 2–5 Slight
Costovertebral Ribs and vertebrae Slight
Intercarpal Between carpal bones Slight
Intermetatarsal Between metatarsal bones Slight
Intertarsal Between tarsal bones Slight
Intervertebral Between articular processes of Slight
adjacent vertebrae
Sacroiliac Between sacrum and hip bone Slight
Plane Intervertebral (complex joint with several
planes and synchondroses)
Tarsometatarsal Tarsal bones and metatarsal Slight
bones
Saddle
Carpometacarpal Carpal and metacarpal Two axes
pollicis of thumb
Intercarpal Between carpal bones Slight
Sternoclavicular Manubrium of sternum Slight
and clavicle
Saddle Carpometacarpal
Hinge
Cubital (elbow) Humerus, ulna, and radius One axis
Knee Femur and tibia One axis
Interphalangeal Between phalanges One axis
Talocrural (ankle) Talus, tibia, and fibula Multiple axes;
one predominates
Hinge Cubital
Pivot
Atlantoaxial Atlas and axis Rotation
Proximal radioulnar Radius and ulna Rotation
Distal radioulnar Radius and ulna Rotation
Pivot Proximal radioulnar
Ball-and-Socket
Hip Hip bone and femur Multiple axes
Glenohumeral Scapula and humerus Multiple axes
(shoulder)
Ball-and-socket Glenohumeral
Ellipsoid
Atlantooccipital Atlas and occipital bone Two axes
Metacarpopha- Metacarpal bones and Two axes
langeal (knuckles) phalanges
Metatarsopha- Metatarsal bones and Two axes
langeal (ball of f oot) phalanges
Radiocarpal (wrist) Radius and carpal bones Multiple axes
Temporomandibular Mandible and temporal bone Multiple axes;
one predominates
Ellipsoid Atlantooccipital
Figure 6.41 Types of Synovial Joints

There are six types of synovial joints found throughout the body. The degree of movement varies with the specific joint type.
Quadriceps
femoris
Humerus tendon
Suprapatellar
Joint capsule Femur bursa
Synovial membrane Subcutaneous
Fat pad prepatellar
Joint cavity bursa
Articular cartilage Olecranon Patella

bursa Articular Fat pad
Coronoid cartilage
process Patellar
Trochlea ligament
Meniscus
Elbow Deep
Ulna infrapatellar
bursa
Articular Knee
cartilage of the Tibia
trochlear notch
(a) Sagittal section (b) Sagittal section
Acromion process
(articular surface) Hip bone
Subacromial bursa Articular cartilage Articular cartilage
over head of
Joint cavity
humerus Joint cavity
Articular cartilage Joint capsule Ligamentum teres
over glenoid cavity Head of femur
Tendon sheath Greater
on tendon of Scapula trochanter
(cut surface) Neck of femur
long head of
biceps brachii
Biceps brachii Shoulder

tendon
Joint
capsule Hip
Humerus Lesser
Biceps brachii trochanter
muscle Femur
(c) Frontal section (d) Frontal section
Figure 6.42 Examples of Synovial Joints

(a) The elbow joint is formed between the humerus, radius, and ulna. (b) The knee joint is formed between the femur and the tibia. (c) The shoulder joint is
formed between the humerus and the scapula. (d ) The hip joint is formed between the femur and the hip bone.
Types of Movement Extension is a straightening movement that increases the angle of

The types of movement occurring at a given joint are related to the joint to extend the articulating bones. These bending and extend-
ing movements can easily be seen at the elbow and knee joints
the structure of that joint. Some joints are limited to only one
(figure 6.43a,b). Hyperextension is usually defined as extension of
type of movement, whereas others permit movement in several
a joint beyond 180 degrees (figure 6.43b). Hyperextension can be
directions. All the movements are described relative to the ana- a normal movement, such as looking up at the stars, but it can also
tomical position. Because most movements are accompanied by result in injury. For example, when a person attempts to break a fall
movements in the opposite direction, they are often illustrated in by putting out a hand, the force of the fall can result in hyperexten-
pairs (figure 6.43). sion of the wrist, resulting in a sprained joint or broken bone.
Flexion and extension are common opposing movements There are special cases of flexion when describing the move-
(figure 6.43). Flexion is a bending movement that decreases the ment of the foot. Movement of the foot toward the plantar surface,
angle of the joint to bring the articulating bones closer together. as when standing on the toes, is commonly called plantar flexion;
142 Chapter 6
Abduction
Abduction
Anterior to Posterior to
frontal plane frontal plane
Flexion Extension
Adduction
Flexion
Extension
(a) (b) Frontal plane (c)
Pronation
(d) Supination
Circumduction
Medial rotation Lateral rotation
(e) (f)
Figure 6.43 Types of Movement

(a) Flexion and extension of the elbow. (b) Flexion and extension of the neck. (c) Abduction and adduction of the fingers. (d) Pronation and supination of the
hand. (e) Medial and lateral rotation of the arm. (f ) Circumduction of the arm. (a, d-f): ©Eric Wise; (b, c): ©McGraw-Hill Education/Tamara Klein
movement of the foot toward the shin, as when walking on the hereditary “loose” joints and are more likely to experience a
heels, is called dorsiflexion (figure 6.43a,b). dislocation.
Abduction (ab-dŭk′shun; to take away) is movement away
Apply It 5
from the median or midsagittal plane; adduction (to bring togeth-
What combination of movements at the shoulder and elbow joints
er) is movement toward the median plane (figure 6.43c). Moving
allows a person to perform a crawl stroke in swimming?
the legs away from the midline of the body, as in the outward
movement of “jumping jacks,” is abduction, and bringing the legs
back together is adduction.
Pronation (prō-nā′shŭn) and supination (soo′pi-nā′shun) 6.9 EFFECTS OF AGING ON THE
refer to the unique rotation of the forearm. They are best dem- SKELETAL SYSTEM AND JOINTS
onstrated with the elbow flexed at a 90-degree angle. When the
elbow is flexed, pronation is rotation of the forearm so that the Learning Outcome After reading this section, you should be able to
palm is down, and supination is rotation of the forearm so that the A. Describe the effects of aging on bone matrix and joints.
palm faces up (figure 6.43d ).
Eversion (ē-ver′zhŭn) is turning the foot so that the plantar The most significant age-related changes in the skeletal system affect
surface (bottom of the foot) faces laterally; inversion (in-ver′zhŭn) the joints as well as the quality and quantity of bone matrix. The
is turning the foot so that the plantar surface faces medially. bone matrix in an older bone is more brittle than in a younger bone
Rotation is the turning of a structure around its long axis, as because decreased collagen production results in relatively more
in shaking the head “no.” Rotation of the arm can best be dem- mineral and less collagen fibers. With aging, the amount of matrix
onstrated with the elbow flexed (figure 6.43e) so that rotation is also decreases because the rate of matrix formation by osteoblasts
not confused with supination and pronation of the forearm. With becomes slower than the rate of matrix breakdown by osteoclasts.
the elbow flexed, medial rotation of the arm brings the forearm Bone mass is at its highest around age 30, and men generally
against the anterior surface of the abdomen, and lateral rotation have denser bones than women because of the effects of testos-
moves it away from the body. terone and greater body weight. Race and ethnicity also affect
Circumduction (ser-kŭm-dŭk′shŭn) occurs at freely movable bone mass. African-Americans and Latinos have higher bone
joints, such as the shoulder. In circumduction, the arm moves so masses than caucasians and Asians. After age 40, both men and
that it traces a cone where the shoulder joint is at the cone’s apex women experience a loss of bone of 0.3–0.5% a year. This loss can
(figure 6.43f ). increase 10-fold in women after menopause, when they can lose
In addition to the movements pictured in figure 6.43, several bone mass at a rate of 3–5% a year for approximately 5–7 years
other movement types have been identified: (see Systems Pathology, “Osteoporosis”).
Significant loss of bone increases the likelihood of bone
∙ Protraction (prō-trak′shŭn) is a movement in which a
fractures. For example, loss of trabeculae greatly increases
structure, such as the mandible, glides anteriorly.
the risk of fractures of the vertebrae. In addition, loss of bone
∙ In retraction (rē-trak′shŭn), the structure glides posteriorly.
and the resulting fractures can cause deformity, loss of height,
∙ Elevation is movement of a structure in a superior direction.
pain, and stiffness. Loss of bone from the jaws can also lead to
Closing the mouth involves elevation of the mandible.
tooth loss.
∙ Depression is movement of a structure in an inferior direction.
A number of changes occur within many joints as a person
Opening the mouth involves depression of the mandible.
ages. Changes in synovial joints have the greatest effect and often
∙ Excursion is movement of a structure to one side, as in
present major problems for elderly people. With use, the cartilage
moving the mandible from side to side.
covering articular surfaces can wear down. When a person is
∙ Opposition is a movement unique to the thumb and little
young, production of new, resilient matrix compensates for the
finger. It occurs when the tips of the thumb and little finger
wear. As a person ages, the rate of replacement declines, and
are brought toward each other across the palm of the hand.
the matrix becomes more rigid, thus adding to its rate of wear.
The thumb can also oppose the other digits.
The production rate of lubricating synovial fluid also declines
∙ Reposition returns the digits to the anatomical position.
with age, further contributing to the wear of the articular car-
Most movements that occur in the course of normal activities tilage. Many people also experience arthritis, an inflammatory
are combinations of movements. A complex movement can be degeneration of the joints, with advancing age. In addition, the
described by naming the individual movements involved. ligaments and tendons surrounding a joint shorten and become
When the bones of a joint are forcefully pulled apart and the less flexible with age, resulting in decreased range of motion.
ligaments around the joint are pulled or torn, a sprain results. A Furthermore, many older people are less physically active, which
separation exists when the bones remain apart after injury to a causes the joints to become less flexible and decreases their
joint. A dislocation is when the end of one bone is pulled out range of motion.
of the socket in a ball-and-socket, ellipsoid, or pivot joint. Most The most effective preventative measure against the effects
dislocations result in stretching of the joint capsule. Once the of aging on the skeletal system is the combination of increasing
joint capsule has been stretched by a dislocation, the joint may physical activity and taking dietary calcium and vitamin D supple-
be predisposed to future dislocations. Some individuals have ments. Intensive exercise can even reverse loss of bone matrix.
SYSTEMS PATHOLOGY
Osteoporosis In men, reduction in testosterone levels can cause loss of bone
tissue. However, this is less of a problem in men than in women
because men have denser bones than women, and testosterone lev-
Background Information els generally don’t decrease significantly until after age 65.
Betty has been diagnosed with osteoporosis. Osteoporosis is one of Inadequate dietary intake or absorption of calcium, some-
several disorders of the skeletal system that can arise (table 6.4). times due to certain medications, can also contribute to osteo-
Betty is 65 years old and is a heavy smoker. She also does not exer- porosis. Absorption of calcium from the small intestine decreases
cise, has a poor diet, and seldom goes outdoors. Osteoporosis involves with age. Finally, too little exercise or disuse from injury can all
many systems of the body (figure 6.44). Radiographs revealed signifi- cause osteoporosis. Significant amounts of bone are lost after only
cant loss of bone density (figure 6.45) and a fractured femur neck. 8 weeks of immobilization.
Osteoporosis, or porous bone, is a loss of bone matrix. This loss of Early diagnosis of osteoporosis can lead to more preventative
bone mass makes bones so porous and weakened that they become treatments. Instruments that measure the absorption of photons (par-
deformed and prone to fracture (see figure 6.46). The occurrence of ticles of light) by bone are currently used; of these, dual-energy x-ray
osteoporosis increases with age. In both men and women (although absorptiometry (DEXA) is considered the best. Supplementation of
it is 2.5 times more common in women), bone mass starts to decrease dietary calcium and vitamin D and exercise are the best preventa-
at about age 40 and continually decreases thereafter. Women can tive and rehabilitory measures to prevent bone loss or regain mild
eventually lose approximately one-half, and men one-quarter, of bone loss. Calcitonin (Miacalcin) inhibits osteoclast activity, and
their spongy bone. alendronate (Fosamax), which binds to hydroxyapatite, also inhibits
In women, decreased production of the female reproduc- osteoclasts. Although osteoporosis is linked to estrogen loss, estro-
tive hormone estrogen can cause osteoporosis, mostly in spongy gen therapy has been associated with many side effects, including
bone, especially in the vertebrae of the spine and the bones of the breast cancer, and is no longer recommended as a treatment.
forearm. Collapse of the vertebrae can cause a decrease in height
or, in more severe cases, kyphosis in the upper back (figure 6.47). Apply It 6
Estrogen levels decrease as a result of menopause; removal of What advice should Betty give to her granddaughter so that the
the ovaries; amenorrhea (lack of menstrual cycle) due to extreme granddaughter will be less likely to develop osteoporosis when
she is Betty’s age?
exercise or anorexia nervosa (self-starvation); or cigarette smoking.
TABLE 6.4 REPRESENTATIVE DISEASES AND DISORDERS: Skeletal System

Condition Description
SKELETAL DISORDERS
Growth and Developmental Disorders
Gigantism Abnormally increased body size due to excessive growth at the epiphyseal plates
Dwarfism Abnormally small body size due to improper growth at the epiphyseal plates
Rickets Growth retardation due to nutritional deficiencies in minerals (Ca2+) or vitamin D; results in bones that are
soft, weak, and easily fractured
Bacterial Infections
Tuberculosis Typically, a lung bacterium that can also affect bone
Decalcification
Osteomalacia Softening of adult bones due to calcium depletion; often caused by vitamin D deficiency
JOINT DISORDERS
Arthritis Inflammation of a joint; causes include infectious agents, metabolic disorders, trauma, and immune disorders
Rheumatoid arthritis General connective tissue autoimmune disease
Gout Increased production and accumulation of uric acid crystals in tissues, including joint capsules
Bursitis and bunions
Bursitis Inflammation of a bursa
Bunion Most bunions are deformations of the first metatarsal (the great toe); bursitis may accompany this
deformity; irritated by tight shoes
144

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BONE TERMINOLOGY

• The smooth surface of a bone that is covered by articular

cartilage and takes part in a joint.

• A general term for the (nonrounded) elevation of a bone that

has a joint surface on it.

• A rounded projection at the end of a bone, incorporating a joint

• A ridge or linear elevation on a bone

• A joint surface that is in the shape of a half moon.

• A low, rounded projection of a bone or internal organ.

• The eminence of a bone lying immediately above its condyle.

• An opening or hole in a bone, usually for transmission of

• A depression on the surface of the body or a bone.

• A pointed projection oof a bone. Some may have joint surfaces

• A process of bone projecting like a branch from the main body

• A small bone embedded within a tendon, serve as a pulleys,

changing the direction of force applied by a muscle at a joint.

• The patella is an example.

• The line of junction of two bones by a Qbrous joint.

• One of two processes on the upper end of the femur.

• They provide attachment for muscles

• A medium sized (0.4-0.8 inch/1-2 cm diameter) rounded

• Example: proximal humerus, distal femur

• A roughened projection of a bone.

Tubercle: a small, usually rugose eminence; often a site of tendon or ligament

attachment. Trochanter: one of two large, prominent, blunt, rugose processes

smaller is the lesser trochanter.

of the bones and

Is this the correct anatomical position?

The answer is? What is your answer?

The Skeletal System

 Parts of the skeletal system

 Ligaments (bone to bone)(tendon=bone to

 Divided into two divisions

 Axial skeleton- skull, spinal column

 Appendicular skeleton – limbs and girdle

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

 Support of the body

 Protection of soft organs

 Movement due to attached skeletal

 Storage of minerals and fats

 Blood cell formation

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Bones of the Human Body

 The skeleton has 206 bones

 Two basic types of bone tissue

 Many open spaces

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Bones are classi<ed by their

1.Long- bones are longer than

they are wide (arms, legs)

2.Short- usually square in

shape, cube like (wrist, ankle)

3.Flat- >at , curved (skull,

4.Irregular- odd shapes

Classification of Bones on the

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Types of Bone Cells

 Mature bone cells

 Break down bone matrix for remodeling and

 Bone remodeling is a process by both