HUMAN ANATOMY ANDPHYSIOLOGY-I (HAP - I)

Unit II: Integumentary

system, Skeletal
system and Joints

Prepared by: Ms. Malissa Dmello

Assistant Professor
ACPR
Integumentary system
• The meaning of word “integumentary” is covering. It is system which
helps in covering our body.
• The integumentary system is the largest organ of the body that forms a
physical barrier between the external environment and the internal
environment that it serves to protect and maintain. It includes skin and
its accessory organs like hair, nails, sweat gland and sebaceous gland.
• The integumentary system contributes to homeostasis by protecting the
body and helping regulate body temperature. It also allows you to
sense pleasurable, painful, and other stimuli in your external
environment.
Structure and functions of skin

• The skin is the largest organ in the human body and plays a vital role in
protecting the body from external harm. It also serves as a sensory
receptor for touch, pressure, temperature, and pain sensations.
• It has surface area of 1.8 sq.m and companies of 16% of the total body
weight.
• The average thickness of the skin is about 1 to 2 mm.
• In the sole of the foot, and palm of the hand, it is considerably thick,
measuring about 5 mm.
• It is thinnest over eyelids and penis, measuring about 0.5 mm only.
Layers of Skin
Stratum
Corneum (SC)
Stratum
Lucidum (SL)
Stratum
Epidermis
Granulose (SG)
Stratum
Layers of Skin Dermis
Spinosum (SS)
Stratum Basale
Hypodermis
(SB)
Epidermis
 Epidermis is the outer layer of skin. It is formed by stratified epithelium. It does not have blood
vessels, so it is nourished by capillaries of dermis. Presence of Keratinocytes cells (synthesis of keratin).
Thickness: 0.5-1.5 mm.
It having different layers—
1. Stratum corneum— It is the outermost layer and consists of dead cells, which are called
corneocytes. These cells lose their nucleus due to pressure and become dead cell. It mainly helps in
transdermal penetration of drugs.
2. Stratum lucidum (extra layer) — it is made up of flattened epithelial cells. Many cells have
degenerated nucleus and, in some cells, the nucleus is absent. It is only found in thick skin as palm
and sole of feet.
3. Stratum granulosum—It is middle layer of epidermis. In this cytoplasm of the cell appears granular.
4. Stratum spinosum— It is present above the layer stratum basale. In this keratinocytes cells moves
upward to form this layer. It contain Langerhans cells which helps in immunological responses.
5. Stratum basale – It is the deepest layer of the epidermis. It contain dividing and non-dividing
keratinocytes. They contain melanin pigments from melanocytes cells, responsible for the skin
colour. It is also responsible for finger-prints.
Dermis
• Dermis is the inner layer of the skin. It is a connective tissue layer, made up of dense
collagen fibres, fibroblasts and histiocytic. Collagen fibres exhibit elastic property and are
capable of storing or holding water. Collagen fibres contain the enzyme collagenase,
which is responsible for wound healing. It contain blood vessels, glands, hair follicles.

It also having two layers.

1. Superficial papillary layer: It is thin and mainly
consist of loose connective tissue. It is responsible for
the sensation of touch, pain, hot, and cold, etc.
2. Deeper reticular layer: It is thick and mainly consist
of dense connective tissue. It contain fat cells, glands,
hair follicles and blood vessels. It is responsible for the
strength of skin.
Blood vessels

• There is a network of blood vessels which supply blood to sweat glands,

sebaceous glands, hair root, hair follicle and rest part of the dermis.
• The epidermis obtains nutrition and oxygen from the interstitial fluid,
which has been derived from blood vessels present in the papillae
region. The sensory nerve endings respond to touch, temperature,
pressure and pain.
• The skin is the most important sensory organ; thus a person is aware of
pain, temperature touch and pressure. Due to stimulation of nerve
endings, the impulses are generated; these impulses are carried through
the sensory nerve to the sensory area of cerebral cortex of brain.
Sweat gland

• These glands are present throughout the skin and are found in maximum
number in the soles of feet, and palms of the hand. Sweat glands are mainly
made up of the epithelial cells and the glands look coiled in appearance in the
dermis.
• Sweat duct leads away from the gland, goes through dermis, and epidermis and
opens into small pore at the surface of skin where the sweat is poured and some
of the ducts also open into hair follicles.
• The sweat is decomposed by microbes, producing unpleasant odour of sweat.
• Sweat glands assist in regulation of body temperature. The sweat takes away
the heat from the body when evaporation of sweat takes place. Sweat formation
is controlled by temperature regulating centre present in hypothalamus.
• If there is excessive sweating, the individual may suffer from dehydration and
loss of sodium chloride. It can be balanced by taking water and some salt.
Hair Follicle, Hair Bulb, Hair Root
• Below the follicle, there is widened part, this part is called as hair bulb. The cells of bulb multiply and gives
rise to hair, the hair coming from hair root, goes to upper side, away from the nutritional supply, so the
cells die and they are non-keratinized. The hair above skin is known as shaft and remaining lower part is
known as root.
• The colour of the hair depends on the presence of melanin.
• The arrestor pilorum are involuntary muscle fibres, attached to hair follicles. Due to the contraction of
arrestor pilorum, the hair gets pulled downwards, and hence the hair stands erect. These muscles are
stimulated by sympathetic nerve fibres.

Sebaceous Glands
• These glands are present throughout the skin, except sole of feet and palms of hands.
• Sebaceous glands are composed of secretory epithelial cells, secreting oily substance called sebum. The
sebum is poured into the hair follicle. Sebaceous glands are maximal in the face and scalp region.
• Sebum keeps the hair soft and shiny in texture and appearance. It provides waterproofing to the skin and
acts as fungicidal and bactericidal agent, preventing entry of micro-organism into the body. It also prevents
drying of skin when individual is exposed to heat.
Hypodermis/Subcutaneous layer
• It is the last layer of skin and
sometimes it does not consider as a
part of skin.
• It attaches the skin to the
underlying muscles.
• It composed of the loose connective
tissue and adipose tissue, i.e.,
contain fat cells.
Functions of Skin
1. Temperature Regulation in the Body
2. Protection
3. Sensation
4. Absorption
5. Secretion
6. Excretion
7. Synthesis of Vitamin D
Skeletal system
• Skeleton constitutes the bony framework of the body.
• The skeletal system includes all of the bones and joints in the body. Each bone is a
complex living organ that is made up of many cells, protein fibers, and minerals.
• The skeletal system consists of about 206 bones to make a strong, movable living
framework for the body. It supports and protects softer, delicate tissues and organs
and they form joints for the movement of the body and also giving it shape and
form.
• This system is composed of connective tissues including bone, cartilage, tendons
and ligaments.
• The bones making up the skeleton are of various types e.g. long bones, short
bones, flat bones, irregular bones etc.
• Bone tissue makes 18% of the total body weight.
Bones
• Bone is the hardest connective tissue which makes up
the body’s skeletal system and performs various
functions, such as movement, protection and structural
framework.
• Made up from calcium and phosphate.
• It consists of 2 parts:
1. Diaphysis – It is long, cylindrical and main portion of
bone. It contain red and yellow bone marrow (help in
the production of blood).
2. Epiphysis – It is the end part of bone, they are spongy
in nature. Cartilage is present upon these epiphysis and
bones are connected through this (end of the bone).
Types of Bones
• There are mainly 6 types of bones:
1. Long bone: They have longer lengths as compare to the width. They are strong which supports the
body. (e.g., femur, fibula, tibia, humerus, radius, ulna).
2. Short bone: The have almost equal length and width. Helps in movement, bones of ankles and wrist.
(eg., carpals and tarsals)
3. Flat bone: They have thin and flat structures. (e.g., skull bones, sternum {protection to internal
organs})
4. Irregular bone: They have complicated shapes which are different but performs a specific function.
(e.g., vertebral column and facial bones {protection})
5. Sesamoid bone: Small, round bones develop in same tendons (e.g., patellae {knee cap})
6. Sutural bones: these are very small bones found within the sutural joints in between the cranial bones.
(e.g., present in cranium)

[7. Short long bones: Metacarpals and metatarsals

8. Pneumatic bones- Maxilla, ethmoid.
9. Heterotopic bone- Rider’s bone
10. Accessory bones- Sutural bone, Wormian bone.]
Functions of Bones
• The bones perform following important functions:

1. They form the supporting framework of the body.

2. They form boundaries for the cranial, thoracic and pelvic cavities;
3. They give protection to delicate organs;
4. They form joints which are essential for the movement of the body;
5. They provide attachment for the voluntary muscles. This helps in the
movements of joints;
6. They form blood cells in the red bone marrow in cancellous bone; and
7. They act as a store house of calcium salts.
Divisions of skeletal system
1. Axial skeletal system: It consists of the
bones which form the skull, the
vertebral column and the thoracic cage
2. Appendicular skeletal system: It
consists of shoulder girdles, upper
limbs, pelvic girdle and lower limbs

The axial skeleton, shown in blue, consists of the bones of the skull,
ossicles of the middle ear, hyoid bone, vertebral column, and thoracic
cage. The appendicular skeleton, shown in red, consists of the bones
of the pectoral limbs, pectoral girdle, pelvic limb, and pelvic girdle.
Cervical (7), Thoracic
Vertebrae (vertebral
(12), Lumbar (5),
column) - (26)
Sacral (1), Coccyx (1)

Frontal (1), Parietal (2),

Cranium (8) Occipital (1), Temporal (2),
Sphenoid (1), Ethmoid (1)

Maxilla (2), Nasal (2),

Zygomatic (2), Lacrimal (2),
Axial System - Face (14) Vomer (2), Palatine (2),
(80) Inferior nasal concha (2),
Skull - (29) Mandible

Mellitus (2), Incus (2),

Ribs – (24:- 12 Ear ossicle Stapus (2)
pairs)
Human Skeletal
Hyoid bone (1)
System Sternum – (1)
Humerus (2), Radius (2),
Fore Limbs (60) Ulna (2), Carpals (16), Meta
Carpals (10), Phalanges (28)
Limbs Bones (120)
Femur (2), Tibia (2), Fibula
Appendicular (2), Patella (2), Tarsals (14),
Hind Limbs (60)
System – (126) Meta tarsals (10),
Phalanges (28)
Girdles (6)
Axial skeleton
• Axial skeleton forms the longitudinal axis of
the body and protects the brain, spinal cord,
and the organ in the thorax. It provides
support to the skull/head, neck, and trunk
region. These bones helps in the formation of
‘body axis’. Axial skeleton is composed by the
80 bones (in adults) and 87 bones (in
children) segregated into three major regions.
Skull
Vertebral Column
Thoracic cage
Skull
• Most of skull bone are flatted and firmly
united by interlocking joints called
sutures but mandible bone which is
connected to the rest of the skull freely
movable bones. The skull region
articulates with the superior region of
vertebral column with the help of two
occipital condyles (Dicondylic skull). The
skull is situated on the upper end of
vertebral column and its bony structure is
divided into two parts:
a) Cranium
b) Face
1. Frontal Bone: The frontal bone is a large flat bone which forms the forehead
and also the upper part of the orbital cavities. It develops in two parts which
gradually fuse into one bone. It contains two cavities called the frontal
sinuses which lie one over each orbit. They contain air which enters by a
small opening leading from nasal cavities. These sinuses give lightness to the
bone and resonance to the voice, acting as sounding chambers.
2. Parietal Bones: The parietal bones are two flat bones forming sides and roof
of the skull. They articulate with each other and with frontal, occipital and
temporal bones. The inner surface is concave and is grooved by the brain and
blood vessels.
3. Occipital Bone: The occipital bone forms back of the head and part of the
base of the skull. It forms immovable joints with parietal, temporal and
sphenoid bones. On the outer surface, there is a roughened area called
occipital protuberance. In this bone, there is a large opening known as the
foramen magnum, for the passage of spinal cord. oved by the brain and
blood vessels.
4. Temporal Bones: The temporal bones lie on each side of the head.
Each temporal bone is divided into four parts. They are:
(1) The squamous part is the fan shaped portion.
(2) The mastoid process is a thickened part of bone and can be felt
just behind the ear. It contains a large number of small air sinuses
which communicate with middle ear. A styloid process projecting
from it gives attachment to muscles.
(3) The petrous portion is thick and forms a part of the base or floor of
the skull and contains the organ of hearing.
(4) The zygomatic process is directed forward and articulates with the
zygomatic bone to form zygomatic arch.

5. Sphenoid Bone: The sphenoid bone is an irregular bone in the shape

of a bat with its wings outstretched and lies in the centre of the base of
the skull. On the superior surface of the middle of the bone, there is a
depression in which the pituitary gland rests. The wings are perforated
by many openings for the passage of nerves and blood vessels.
6. Ethmoid Bone: The ethmoid bone is a very light,
fragile, irregular bone and occupies an anterior part of
the base of the skull and helps to form the orbital
cavity, the nasal septum and the lateral walls of the
nasal cavity.

• It has a horizontal flattened part called cribriform plate which has many fine
openings like a sieve. The openings are for the passage of the nerves of smell
called the olfactory nerves. It also contains a flat vertical portion between
the two nasal cavities.
• Two spongy portions form an outer wall of the upper part of the nasal cavity
and inner wall of the orbit. On each side, the spongy portions present two
projections into nasal cavities which are called turbinated processes. The
spongy portions contain a number of air cavities which communicate with
the nose.
Face
• There are thirteen bones which form the skeleton of face. They are two zygomatic or
cheek bones; one maxilla; two nasal bones; two lacrimal bones; one vomer; two
palatine bones; two inferior conchae or turbinated bones and one mandible.
• Each zygomatic bone forms the prominence of cheek and part of the floor and lateral
walls of orbital cavity.
• It articulates with zygomatic process of the temporal bone to form a zygomatic arch.
• Maxilla or upper jaw bone forms the upper jaw, the anterior part of the roof of the
mouth, the lateral walls of the nasal cavities and part of the floor of orbital cavities.
• It presents the alveolar ridge which projects downwards and carries the upper teeth.
On each side, there is a large air sinus, the maxillary sinus which is lined with ciliated
mucous membranes and communicates with the nasal cavity.
• The nasal bones are two small bones which form greater part of the lateral
and superior surfaces of the bridge of the nose. They articulate with each
other medially.
• The lacrimal bones are two very small bones located in a position posterior
and lateral to the nasal bones. They also form the inner wall of the orbit.
They are grooved and the groove contains lacrimal sac and nasal duct. It
carries tears or lacrimal fluid from eye down to the nasal cavity.
• The vomer is a thin flat bone which extends upwards from middle of the
hard plate to separate the two nasal cavities.
• The palatine bones are two irregular bones which form the back of the hard
palate and extend up to the outer wall of the nasal cavity into the floor of
the orbit.
• The turbinate bones are two small scroll-shaped flat bones which form a part
of the lateral wall of the nasal cavity.
• The mandible is the strongest bone of the face and is
the only movable bone of the skull. It has two identical
parts. Each part consists of (1) a curved body on the
superior surface of which there is the alveolar ridge
containing the lower teeth and (2) a ramus which
projects upward. At the upper end, the ramus is
divided into two processes; the condyloid process
which articulates with the temporal bone and the
coronoid process which gives attachment to muscles
and ligaments. The point where the ramus joins the
body is called the angle of the jaw.
• The hyoid is an isolated horse-shoe-shaped bone lying in the soft tissue of the
neck.
• It lies at the base of the tongue and gives attachment to the tongue muscle. It
does not articulate with any other bone of the head or trunk but is attached to
the styloid process of the temporal bone by ligaments.
Vertebral Column
• It consists of twenty-four separate, movable, irregular
bones called vertebrae which are divided into three groups
viz.; cervical (seven); thoracic (twelve) and lumbar (five).
• In addition, the sacrum consisting of five fused bones and
the coccyx consisting of four fused bones which also form a
part of the vertebral column. When viewed from the side,
the vertebral column shows four anteroposterior curves.
They are: cervical curve, in the neck which is convex
forwards; thoracic curve, convex backwards; lumbar curve,
convex forwards and the pelvic curve convex backwards.
Posteriorly convex curves, thoracic and pelvic, are called
primary curves and anteriorly convex curves are called
secondary curves.
• Each vertebra consists of: (1) A disc-shaped body lying in the front and (2) An arc of bone pointing
backwards from the body and enclosing a space between body and arch called the neural or
spinal canal through which the spinal cord passes. This arch carries three rough processes for
muscle attachment.
• One spinous process which projects backwards and two transverse processes one on either side.
• On the superior and inferior surfaces of the neural arch, there are two articular processes, which
carry smooth surfaces to articulate with similar processes on the vertebrae above and below.
• The arch carries a notch on either side on the under surface. The narrow part of the arch above
the notch is known as the pedicle.
• The wide part of the arch carrying the spinous process is known as the lamina, which forms the
back wall of the vertebral column.
• The vertebrae lie body over body and arch, over arch forming a continuous column.
• The bodies are joined to each other by thick pads of fibrocartilage called the intervertebral discs.
The discs consists of a ring of fibrocartilage and a softer pulpy centre called the nucleus.
• The discs serve to allow slight movement of bone on bone and yet make very strong joints. They
also absorb shock to prevent its passage to the brain.
• Cervical Vertebrae: These are the smallest separate vertebrae
with relatively large openings; they run down the neck forming a
slightly forward curve. They have two special features:
(a) Each transverse process carries an opening through which a
vertebral artery passes upwards to the brain.
(b) The spinous process is forked or bifid giving attachment to
muscles and ligaments.

• Thoracic Vertebrae: They have two special features:

(a) The spinous processes are long and point downwards, so that they
partly overlap each other.
(b) Since, the vertebrae articulate with the ribs, they have six facets,
out of which four articulate with the ribs.

• The heads of the ribs lie between the vertebrae, and articulate
with one facet on the vertebra above and the other below this
vertebra being numbered according to the rib which lies above it.
• Lumbar Vertebrae: The bodies of these vertebrae are largest and the
vertebral foramina are smallest. The spinous processes are short, flat-
sided and project straight back giving attachment to the powerful muscles
supporting the back.

• Sacral Vertebrae: These are fused together to form one bone known as
sacrum. This runs down the back of the pelvis forming a backward curve
and the upper projecting curve forming the promontory of the sacrum.
The upper part of the base of the bone articulates with the fifth lumbar
vertebra. On each side, it articulates with the ilium to form sacroiliac joint
and at its inferior tip, it articulates with the coccyx. On each side of the
vertebral foramina, there is a series of foramina, one below the other for
the passage of the nerves.

• Coccygeal Vertebrae: Coccyx consists of four terminal vertebrae fused

together to form a small triangular bone, the broad base of which
articulates with the tip of the sacrum. The movements of individual bones
of the vertebral column are very limited. The movements of the column as
a whole which include bending forward, backward, sidewise or turning
around are quite extensive. There are more movements in the cervical
and lumber regions than elsewhere.
Functions of the Vertebral Column
(1) It provides a strong bony protection for the delicate spinal cord lying
within it. Spinal nerves, blood vessels and lymph vessels pass through
intervertebral foramina.

(2) It supports the skull which is protected from shock by the presence
of the intervertebral discs.

(3) It forms the axis of the trunk and gives attachment to the ribs, the
shoulder girdle and the upper limbs, the pelvic girdle and the lower
limbs.
Thoracic Cage
• The bones of the thoracic cage are as follows: 1 sternum; 12
pairs of ribs and 12 thoracic vertebrae.

• Sternum: It is a flat bone in the middle of the chest. It is shaped

like a dragger and is described in three parts.
1. The manubrium is the uppermost part and presents two
articular facets on its lateral borders for articulation with the
clavicles.
2. The body or middle portion is called gladiolus. It presents
facets on the lateral borders for the attachment of the ribs.
3. The Xiphoid process is the tip of the bone which gives
attachment to the diaphragm and muscles of the anterior
abdominal wall. The process is also called Xiphisternum. The ribs
join the sternum by strips of cartilage.
• Ribs: There are twelve pairs of ribs which form bony lateral walls of
the thoracic cage. The first seven are described as true ribs; the
eighth, ninth and tenth are called false ribs and the last two are
called floating ribs. All the pairs articulate posteriorly with thoracic
vertebrae. Anteriorly, the first seven ribs are directly attached to the
sternum; the latter three are only indirectly attached to the sternum
and the last two pairs have no anterior attachment.

• Each rib is a flat curved bone having a head, neck, tubercle, angle, sternal end, anterior and posterior
surface and a superior and inferior border. The head articulates posteriorly with bodies of two adjacent
vertebrae. The neck is a constricted portion next to head and between the head and the tubercle. The
tubercle articulates with the transverse process of thoracic vertebra. The angle is the point at which
the bone bends. The sternal end is attached to the sternum by a costal cartilage. The superior border is
rounded and smooth while the inferior border exhibits a marked groove occupied by blood vessels and
nerves. The first rib does not move during respiration.
• Spaces between the ribs are occupied by intercostal muscles. During respiration, when these muscles
contract, the ribs and sternum are lifted upwards and downwards increasing the capacity of thoracic
cavity. The ribs increase in size from above to downwards so that the thoracic cavity is roughly cone-
shaped.
Appendicular System
• It consists of shoulder girdles with
upper limbs and pelvic girdle with
lower limbs.
• Each shoulder girdle consists of one
clavicle and one scapula. On each
side of the shoulder girdle following
bones are attached: one humerus,
one radius, one ulna, eight carpal
bones; five metacarpal bones and
fourteen phalanges.
• The clavicle is a long bone which is roughly S-shaped. On one end it
articulates with the manubrium of the sternum and on the other end it
forms joint with ‘acromion process’ of scapula. This clavicle is the only
bony link between the upper extremity and the axial skeleton. It lies
close under the skin and is easily felt. It keeps the scapula in position.
• Scapula or shoulder blade is a flat triangular bone lying on the posterior
chest wall, superficial to the ribs. It is held in place by muscles which
attach it to the ribs and the vertebral column. It has three borders called
medial, superior and lateral and three angles named as superior, inferior
and lateral. Superior and medial borders meet at superior angle and
lateral and medial borders meet at inferior angle. The point at which
superior, and lateral borders meet at lateral angles represents a shallow
articular surface called glenoid cavity which together with the head of
the humerus forms the shoulder joint. It has two processes, one of them
is coracoid process which projects forward from the superior border of
the bone. The posterior surface of the scapula is divided by a spine.
The spinous process projects beyond the lateral angle as the acromion
process and overhangs the shoulder joint. Both these processes give
attachment to muscles and keeps the head of humerus in place preventing
upward dislocation.
• Humerus: It is a long bone and is the largest in the upper limb. It
consists of a proximal end or head, neck, shaft and distal end.
The head is smooth and rounded and fits into glenoid cavity of
the scapula forming the shoulder joint. The neck is a slightly
constricted part next to the head. Between the neck and the
shaft there are two tubercles called greater and lesser tubercles.
These are divided by a deep groove which is occupied by one of
the tendons of the biceps muscle. At the proximal end the shaft
is cylindrical in shape but is flattened at its anterior and posterior
surfaces towards the distal end. The distal end of the bone
presents two articular surfaces, the capitulum and the trochlea.
Immediately above the articular surface, the anterior side of the
bone contains coronoid fossa and the posterior surface contains
olecranon fossa. The lower end of the bone also contains two
condyles for articulation with the radius and ulna respectively.
Above the condyles on either side are median and lateral
epicondyles
• Ulna and radius are the two bones of the forearm. There is an
interosseous membrane between the bones.

• Ulna: This is a long bone consisting of proximal end, shaft and distal
end or head. It is located on the inner side of the forearm and is
slightly bigger than radius. The proximal end contains a semilunar
notch called trochlear notch, which articulates with the trochlea of the
humerus. At its proximal end, there is the olecranon process which
forms the point of an elbow and fits into the olecranon fossa of the
humerus when the arm is straight. At its distal end of the trochlear
notch lies the coronoid process which fits into the coronoid fossa of
the humerus when the arm is bent. A smaller joint cavity, the radial
notch, faces outwards and forms a pivot joint with the head of the
radius which rotates against it. This joint produces turning movements
of a hand.
Shaft of the bone is triangular in shape and carries a sharp ridge for its
attachment to the sheet of fibrous tissue. The lower extremity is much
smaller and is joined to a wrist joint by a pad of white fibrous tissue. It
also carries a styloid process from the posterior end which gives
attachment to ligaments.
• Radius: It is a long bone and is the outer bone of a forearm. It consists
of head, neck, tuberosity, shaft and distal extremity. The head is disc-
shaped and flat on the top and articulates with the capitulum of the
humerus.
• The circumference of head articulates with the radial notch of ulna. At
the upper end of the shaft, there is a radial tuberosity which gives
attachment to muscles.
• The shaft carries a sharp ridge facing ulna. The distal end of the bone
is expanded. It articulates with the carpal bones to form a wrist joint
and with the ulna to form a radiolunar joint.
• It also carries a styloid process which is felt at the base of the thumb.
It gives attachment to ligaments and muscles.
• The carpal bones are eight in number and are arranged
in two rows each consisting of four bonds. The bones
are as follows:
• Proximal row: Scaphoid, lunate, triquetrum, pisiform.
• Distal row: Trapezium, trapezoid, capitate, hamate.

 The upper row forms the wrist joint, articulating with the radius, and the lower row
articulates with the metacarpus. These bones are closely fitted together and held in
position by ligaments which allow of movements between them.
 The metacarpal bones or the bones of hand are five in number and form a structure of
palm of a hand. Their upper extremities articulate with carpus and the lower extremities
with phalanges.
 Phalanges or bones of the fingers are fourteen in number and are so arranged that there
are three in each finger and two in the thumb. The upper end of these bones is the largest
and articulates with the corresponding metacarpal bone at one end and with the middle
phalanges at the other end. The lower phalanges are the smallest and form tips of fingers.
• Pelvic Girdle and Lower Limb: Bones of
pelvic girdle are two innominate bones
and one sacrum. The bones of the lower
extremity are as follows: One femur;
one tibia; one fibula; one patella; seven
tarsal bones; five metatarsal bones and
fourteen phalanges.
Innominate Bone: Each of the innominate or
the hip bones consists of three bones: ilium,
ischium and pubis, fused together to form
one large irregular bone. On its outer
surface, it has a deep depression called
acetabulum with which the head of femur
forms the hip joint. Ilium is the upper
flattened part of the bone and contains the
iliac crest.
• Pubis is an anterior part of the bone and articulates with the pubis of the other
hip bone at a cartilagenous joint called symphysis pubis. It also contains a large
opening called obturator foramen. Ischium is an inferior and posterior part of
the bone which contains ischial tuberosity. The external surfaces of the
innominate bones are markedly ridged for the attachment of muscles.
 Pelvis is formed by innominate bones
which articulate anteriorly with
symphysis pubis and posteriorly with
sacrum. The two pubic bones join one
another in the middle line. It is divided
into greater or false pelvis above and
lesser or true pelvis below. The ridge of
the bone called the brim of the pelvis is
a separating line for these two parts.
There are distinct differences between pelvis of male
and female. They are as follows:

Sr. No. Female Male

1. Bones Lighter and smaller Heavier and longer
2. Cavity Shallow and round Deep and funnel-shaped
3. Sacrum More concave anteriorly, Less concave, making the true
making the true pelvis pelvis narrower at the outlet
broader
4. Pubic- The angle made at the The angle of the pubic arch is
arch symphysis pubis is wider. narrower.
The bones are movable for The bones are immovable.
convenience in delivery.
• Femur: Femur or a thigh bone is the longest and strongest of
all the bones of the body.
• Proximal extremity consists of head, neck and greater and
lesser trochanters.
• The head is almost spherical and fits into acetabulum of the hip
bone.
• Two trochanters and intertrochanteric line give attachment to
muscles which move hip joint.
• The shaft of the bone is slightly convex anteriorly and is
broader towards its distal end.
• Posterior surface forms a flat triangular area called popliteal
surface.
• Distal extremity presents two condyles which take part in the
formation of a knee joint.
• Between the condyles, there is a depression called
intercondylar fossa.
• Tibia: Tibia is a long bone running on the inner side of a leg. Its
upper extremity is broad and thick and has two shallow condyles
which receive the condyles of the femur, forming a knee joint.
Between these condyles is the intercondylar eminence. On the front
side, there is a tuberosity of tibia which gives attachment to
muscles. The lateral condyle has a facet which articulates with the
head of the fibula. The shaft of the bone is roughly triangular and
the surfaces are called medial, lateral and posterior surfaces. The
crest of tibia is a ridge which can be felt very close to the surface on
anterior aspect of leg. Distal extremity of tibia forms an ankle joint
with talus. Tibia carries a process which projects downwards
forming the prominence on the inner side of the ankle joint called
the medial malleolus.

• Fibula: Fibula is a long slender bone which is lateral to tibia. The

head articulates with the lateral condyle of tibia and the lower
extremity articulates with its lower extremity and projects further to
form lateral malleolus, and takes part in the formation of the ankle
joint. The shaft of the bone is ridged for the attachment of muscles.
• Patella: Patella or knee cap is a sesamoid (developed in a muscle tendon) bone associated with
knee joint. It is roughly triangular and lies with the apex pointing downwards. Its anterior
surface is in the patellar tendon and the posterior surface articulates with patellar surface of
the femur in the knee joint.
• Tarsals: Tarsal or ankle bones are seven in number
and form the posterior part of the foot. The bones
are one talus; one calcaneous; one navicular; three
cuneiform and one cuboid.
 Talus articulates with tibia and fibula at the ankle joint. Calcaneous or heel bone is roughened
for the attachment of muscles. Navicular is situated on the medial side of the foot distal to talus.
The medial, intermediate and lateral cuneiform and cuboid form a row of bones which articulate
with the other three tarsal bones proximally and with the five metatarsal bones distally. The
metatarsal bones are five in number. Their proximal ends articulate with the tarsal bones and
the distal ends with phalanges. There are fourteen phalanges in each foot, two in the great toe
and three each in other toes.
 The arrangement of bones of a foot is such that it is not a rigid structure. The bones have a
bridge-like arrangement and are supported by muscles and ligaments so that four arches such as
medial longitudinal, lateral longitudinal and two transverse arches are formed.
Joints
• A joint is the site at which any two or more bones come together.
• The joints are classified as fibrous, cartilagenous and synovial. In fibrous
or fixed joint, there is no movement between the bones concerned.
• There is a fibrous tissue between their ends e.g., the joints between the
bones of the skull and the joints between the teeth and the maxilla and
mandible.
• In cartilagenous joints, there is a pad of white fibrocartilage between the
ends of the bones. Movement is possible because of the compression of
the pad of cartilage, e.g. symphysis pubis and joints between the bodies
of the vertebrae.
• Synovial joints are characterized by the presence of synovial membrane. A considerable amount of
movement is possible. Limitations on movement is mainly due to the shape of the bony surface which
forms the joint. They are subdivided according to the movements possible.
i. Ball and Socket Joint: A hemispherical head fits into a cup-shaped socket. e.g., shoulder and hip.
ii. Hinge Joints: These joints allow movement in one direction only, e.g. elbow, knee and ankle.
iii. Double Hinge Joints (Condyloid): These allow movement like a hinge in two directions, e.g. the wrist
joints and the joints between metacarpus or metatarsus and the phalanges.
iv. Gliding joints: The bones glide on one another, e.g. between various carpal and tarsal bones.
v. Pivot joints: One bone turns on another e.g., the radius on the ulna at the elbow and the atlas on
the axis.

 Some of the joints are capable of the following types of movements:

1. Flexion or bending, usually forward but occasionally backward.
2. Extension means strengthening or bending backward.
3. Abduction is the movement away from midline of the body.
4. Adduction is the movement towards midline of the body.
5. Rotation is the movement round the long axis of a bone.
6. Pronation means turning the palm of the hand down.
7. Supination means turning the palm of the hand up.
8. Circumduction is the combination of flexion, extension, abduction, and adduction. It involves
movements of the limbs through a circle.
9. Inversion is the turning the sole of the foot inwards.
10. Exversion is turning the sole of the foot outward.

Different types of joints help to make different kinds of movements. The ball-and-socket joints
are freely movable allowing flexion and extension, abduction, adduction, circumduction and
external and internal rotation. The hinge joints allow flexion and extension only. Double hinge
joints allow flexion, extension, adduction, abduction and circumduction. In the gliding joints,
there is only a slight movement increasing the range of movement in all directions. The pivot
joints permit rotation around the point where they are pivoted.
The joints are movable, but the movements are carried out by the various muscles. The
muscles also run from bone to bone and help to hold the bones in position and give support
to the joint capsule, as long as the normal tone is sustained.
• Disorders of joints: Any or all of the structures of joints may be damaged by disease.
• Inflammation of the joints is called arthritis. Arthritis is of two types; acute and chronic.
(a) Acute Arthritis: In Rheumatic arthritis, there is an acute synovitis with the excess of turbid fluid
in the joint. Extreme tenderness is the characteristics of a swollen and acutely inflammed joint.
In the case of traumatic synovitis, the inflammation is confined to the synovial membrane
without any destruction of tissue.
(b) Chronic Arthritis: There are various types of chronic arthritis. Tuberculous arthritis is a disease
very common in children. When it occurs in an adult, it is more likely to be primary in the
synovial membrane. The synovial fluid is usually scanty but highly fibrous so that it contains
flakes of fibrin which may develop into foreign bodies. Rheumatoid arthritis is a common, tragic
and crippling disease particularly affecting small joints of hands and feet; the larger joints may
affect later. It causes pains and swelling of the joints together with increasing stiffness and
disability. In the later stages, the joints become distorted and deformed. During this condition,
the patient may suffer from mild fever, anaemia, sweating etc. Osteoarthritis involves
degeneration of articular cartilage and bone. This is a disease which normally occurs in the old
age. Large joints are commonly affected, very often only one joint, i.e. particularly the hip joint.
Gout is yet another disease involving joints. The disease involves over-production of uric acid
which is deposited in the joint and the surrounding soft tissues. The deposits occur in the
synovial membrane and capsule. Kidneys may also suffer from the deposits.
The intervertebral disc also can be a site of disorder. The disc may be
protruded or herniated into the vertebral canal and press the spinal cord
or stretch the nerves. The disorder causes low back pain and sciatica or
pain passing down the back of the leg along the course of the sciatica
nerve.

A few other dysfunctions related to the joint may occur. If the bone from
a joint is displaced, the condition is called dislocation. Individuals
especially women past middle age, are frequently depleted of calcium.
Bones of such individuals lack in calcium and therefore become relatively
more fragile. This condition is called osteoporosis.