Anatomical Terms

ANATOMICAL TERMS
Anatomical Positions
1. Erect anatomical position:
For descriptive purposes:
Human body is regarded as standing erect.
Eyes are looking forwards.
Upper limbs are hanging by the sides.
Palms are facing forwards.
Thumbs are directed laterally.
This position is used as a reference in describing the anatomy of the
body.

Anatomical Position
1

Anatomical Terms

2. Supine position: The body lies on its back.

3. Prone position: The body lies on its face.
4. Lateral decubitus position: The body lies on its side (right or left).
5. Lithotomy position: The body lies on its back with flexion of hip and
knee and abduction of hip joints.

Anatomical Planes
1. Median plane (Sagittal):
It is the vertical plane which passes in the middle line of the body
dividing it longitudinally into equal halves, right and left.
2. Paramedian plane: It is a plane parallel to and nearby the median
plane.
3. Coronal (Frontal) plane:
It is the plane which cuts the body vertically into an anterior part
towards the front of the body and a posterior part towards the back.
4. Horizontal plane:
It is the transverse plane which runs horizontally cutting the body into
an upper (superior) and lower (inferior) parts.

Planes of the Body

Anatomical Terms

Terms of Position
1. Anterior (Ventral) = In front of
= Nearer to the front of the body
2. Posterior (Dorsal)= Behind
= Nearer to the back of the body
3. Superior (upper or cranial): = Nearer to the upper end of the body.
4. Inferior (lower or caudal):
= Nearer to the lower end of the body.
5. Median

= exactly in the middle line or median plane.

6. Medial

= nearer to the median plane.

7. Lateral

= away from the median plane.

8. Proximal

= nearer to the root of the limb.

9. Distal

= away from the root of the limb.

10. Superficial

= towards the skin or the surface of the body.

11. Deep

= further away from the skin or the surface of the body.

12. Internal (inner) = inside the organ or the body.

13. External (outer) = near or on the surface of the organ, or body.

Skin

SKIN

Skin

The skin is thick in palms and soles and thin allover the body.
The skin consists of:
I. Epidermis: Keratinized stratified squamous epithelium.
The epidermis is covered by a keratin layer making it waterproof.
Epidermal ridges are seen on the palmar aspect of hands and fingers
(prints).
II. Dermis: Consists of collagen and elastic fibers through which run blood
vessels, lymphatics and nerves. A tiny bundle of muscle fibers (arrector
pili muscle) connect the side of the hair follicle to the junction between
the dermis and epidermis.

Structure of the
Skin
Skin appendages:
1. Hairs: There are two types:
a- Primary (lanugo hair): It is the first hair that appears and covers the
whole skin of the fetus inside the uterus.
b- Permanent hair: It is the hair found in the adult.
2. Nails: Develop from epidermis. It is formed of a root, body, and free
border.
3. Sebaceous glands: Their ducts open in the hair follicles.
4. Sweat glands: Simple coiled tubular glands which open on the surface
of the skin.
Skin pigments: The skin tint is modified by five pigments:

Skin

1. Melanin.

2. Melanoid.

3. Carotenes.

4. Oxyhaemoglobin.

5. Reduced haemoglobin.

Fascia

FASCIA
It is a collection of connective tissue under the skin. It covers the body wall
and limbs; it is divided into two layers: Superficial and Deep.
A-

Superficial

Fascia:

A layer of loose connective tissue lies

immediately deep to the skin. The superficial fascia contains a variable

quantity of fat which is more in females than in males.
Functions of the superficial fascia:
1. It prevents heat loss from the body, so it acts as thermal insulator (due
to the presence of fat).
2. It acts as a medium conducting the cutaneous nerves, blood vessels
and lymphatics which supply the skin.
3. It contains skin muscles, as in face (muscles of expression), in the neck
(platysma) and in the scrotum (dartos muscle).
4. It contains special types of glands as mammary glands, sweat glands,
and superficial lymph nodes.
5. It softens and smoothens the surface of the body.
6. It facilitates the movement of skin over the underlying structures.
B- Deep Fascia:
A membrane composed of compact and regular collagen fibers; it is
inelastic. It is well defined in the limbs and very strong and thick in the
palm and sole. It is absent in the face and in the anterior wall of abdomen.
Parts and Functions:
1. Formation of broad sheets:
They surround the muscles of the different parts of the upper and lower
limbs. They give attachment to some muscles, keep the underlying
structures in position.
2. Formation of intermuscular septa and interosseous membranes:
They separate different groups of muscles which have different actions
and nerve supply.
7

Fascia

3. Formation of retinacula: They are localized transverse thickened

bands of deep fascia present at wrist and ankle joints. They keep the
tendons in position during movements of joints.
4. Formation

of

palmar

aponeurosis

(in

palm)

and

plantar

aponeurosis (in sole): They are very thick, strong and protective
layers of deep fascia. They protect blood vessels, nerves and tendons.
5. Formation of sheaths around big blood vessels, e.g.:
Femoral sheath around the femoral blood vessels in lower limb.
Carotid sheath around the carotid arteries and internal jugular vein in
the neck.

Fibrous sheath

Palmar aponeurosis

Parts of Deep Fascia

Interosseous
membrane

Cartilage

CARTILAGE

Cartilage

Properties:
1. It is a rubbery type of connective tissue, it is tough and resilient.
2. It has no blood vessels, nerves or lymphatics. It gets its nutrition by
diffusion from the blood vessels of the perichondrium.
3. It consists of mature cartilage cells (chondrocytes), fibers and matrix.
4. Its function to resist compress forces and friction.

Types of Cartilage
A- Hyaline Cartilage: (Glass like):
Structure:
1. Matrix: Homogenous and translucent.
2. Cartilage cells: Numerous, small rounded cells, present as single
separate cells or 2-3 cells present in one capsule (cell nest).
3. Fibers: Collagen fibres which are very thin and few.
4. This cartilage is covered with perichondrium.
5. It is present in the following sites:
a- In the developing bones in the fetus.
b- In the epiphyseal plates of the long bones in children.
c- The articular cartilage in joints.
d- The costal cartilage and xiphoid process (sternum).
e- The larynx (except the epiglottis) and tracheal rings.
6. In certain sites it is replaced by bone in old age e.g. in larynx and
epiphyseal cartilages.
B- White Fibrocartilage:
1. Matrix: It is obaque and not translucent because it is rich in collagen
bundles.
2. Cells: They are few in number.

10

Cartilage

3. Fibers: It contains large amount of collagen fibres.

4. This cartilage is tough and has a great tensile strength.
5. It is present in the following structures: Intervertebral discs and
symphysis pubis.
6. It does not show ossification in old age.
C- Yellow Elastic Fibrocartilage:
1. Matrix: Its yellow in appearance because it is rich in yellow elastic
fibers.
2. Cells: They are abundant.
3. Fibers: Very rich elastic fibers.
4. It is present in tip of nose, auricle of ear, epiglottis (larynx) and
eustachian tube.
5. It does not show ossification in old age.

11

Cartilage
Perichondrium

Cartilage cell

Matrix
Cell nest

Hyaline cartilage

Perichondrium

Cartilage cell

Collagen
fibers

White fibrocartilage

Types of Cartilage

12

Bones

BONES
Functions of Skeleton:
Gives a specific shape to the body and provides it with a central axis.
Protects the vital organs, the skull protects the brain, and thoracic cage
protects the heart and lungs.
Provides surface area for muscular attachment.
Forms the joints which make the important part of the locomotor
system.
Transmits and supports the body weight. The vertebral column
transmits the weight of the head and trunk to the bony pelvis then
through the bones of lower limbs to the feet and lastly to the ground.
Forms the blood elements in the bone marrow.
Stores calcium salts.
Classification of Bones (Skeleton):
I. According to their position in the body:
a. Axial skeleton: Skull, mandible, hyoid bone, sternum, ribs and vertebral
column.
b. Appendicular (peripheral) skeleton: Bones of upper and lower limbs.
II. According to the process of ossification:
The process of bone formation is called ossification. It is of two types:
a. Intra-membranous ossification: Occurs in some bones, e.g. clavicle,
roof of skull (cap). The bones are developed directly from connective
tissue membrane (mesenchyme).
b. Intra-cartilaginous ossification: It occurs in long bones, vertebrae,
ribs and base of skull. The connective tissue membrane (mesenchyme)
is changed at first into a cartilage model.

13

Bones

The Human Skeleton

14

Bones

III. According to their shape: They are:

15

Bones

A- Long bones: Present in upper and lower limbs e.g. femur and
humerus.
Structure: Each bone consists of two ends called epiphysis and a shaft in
between called diaphysis.
Epiphysis: The expanded upper and lower ends of the long bone. In living
subjects, the epiphysis is used for articulation and its articular surface is
covered with a layer of hyaline cartilage called articular cartilage.
Diaphysis (Shaft):
A tube of compact bone with a central medullary cavity which is lined
by endosteum and filled with soft vascular tissue called bone marrow.
The shaft is covered with fibrous sheath called periosteum.
The long bones increase in width from periosteum.
In the growing long bones, the epiphysis and the diaphysis are
separated by a disc of hyaline cartilage called epiphyseal plate of
cartilage which is responsible for the growth of long bones in length.
Metaphysis: It lies in the upper and lower parts of the diaphysis long
bone just beneath the epiphyseal cartilage. (It is the most active part of
the long bone).
B- Short Bones: e.g. carpal bones (in hand) and tarsal bones (in foot).
C- Flat Bones: e.g. bones forming roof of skull, scapula and ribs.
D- Pneumatic Bones: They are bones containing air sinuses. They are
present in skull bones surrounding the nose, so the air sinuses are called
paranasal sinuses, e.g. maxillary and frontal sinuses.
Functions:
1. They decrease the weight of skull.
2. Resonance of voice.
E- Irregular Bones: Bones of irregular shape with projecting processes
e.g. vertebrae.
F- Sesamoid Bones: Small nodules of bones which are embedded in
some muscle tendons near their insertion or origin.

16

Bones

Function: They diminish friction between tendons and underlying bones

e.g. patella which is the largest sesamoid bone, embedded in the tendon
of the quadriceps femoris muscle in front of knee joint.

17

Bones

18

Bones

The Bones of the Upper Limb

1. The Clavicle
The clavicle has:
I. Two ends:
1- Lateral or acromial end: flattened.
2- Sternal or medial end: Thick and rounded.
II. Two borders:
1- Anterior border: The medial 2/3 are convex anteriorly and the lateral
1/3 is concave anteriorly.
2- Posterior border: The reverse of anterior border.
III. Two surfaces:
1- Superior: Smooth.
2- Inferior: Rough.
Articulations (joints):
1- Acromioclavicular joint: plane synovial joint between the lateral end of
the clavicle and the acromial process of the scapula.
2- Sternoclavicular joint: saddle synovial joint between the medial end of
the clavicle and the manubrium of the sternum.

Medial
Lateral

(Sterna

(Acromi

l End)

al End)

Upper
surface

19

Bones

2. Scapula
It is a triangular bone, it has the following features:
1. Three borders:
a- Medial border: Thin, more or less vertical.
b- Lateral borer: Thick and oblique.
c- Superior border: more or less horizontal and has suprascapular
notch.

Suprascapul
ar notch

SCAPULA: Anterior (ventral) Surface

20

Bones

2. Three angles:
a- Superior angle: right angle lies opposite the 2nd rib.
b- Inferior angle: acute angle lies opposite the 7th rib.
c- Lateral angle: is the glenoid cavity.
3. Two surfaces:
a- Ventral (Costal) surface forming the subscapular fossa.
b- Dorsal surface: contains the spine which separates supraspinous
fossa above it and infraspinous fossa below it.
4. Two processes:
a- Acromial process: lies at the lateral end of the spine.
b- Coracoid process: lies above the glenoid cavity.
Articulations of the scapula (joints):
1. Shoulder joint: Ball and socket synovial joint between the glenoid cavity
and the head of humerus.
2. Acromio-claviuclar joint: plane synovial joint between the acromial
process and the lateral end of the clavicle.

21

Bones

SCAPULA: Posterior (dorsal)

Surface

22

Bones

The Humerus
It is the skeleton of the upper arm, it has: I. Upper end.

II. Shaft.

Lower end.
I. Upper end: It has:
1. Head: Less than half a sphere. It is directed medially and articulates
with the glenoid cavity forming shoulder joint.
2. Two tuberosities:
a- Greater: directed laterally.
b- Lesser: directed anteriorly.
3. Bicipital groove: It lies anteriorly between the 2 tuberosities.
4. Two necks:
a- Anatomical neck: below the head.
b- Surgical neck: below the 2 tuberosities.
II. Shaft: It shows the deltoid tuberosity in its middle part.
III. Lower end: It has:
1. Two epicondyles: large medial epicondyle and small lateral
epicondyle.
2. Two articular surfaces:
a- Trochlea: medially.
b- Capitulum: laterally.
3. Three fossae:
a- Coronoid fossa anteriorly.
b- Radial fossa anteriorly.
c- Olecranon fossa posteriorly.
Articulations (joints of humerus):

23

III.

Bones

1. Shoulder joint: Ball and socket synovial joint between head of

humerus and glenoid cavity of scapula).
2. Elbow joint: Hinge synovial joint between:
a- Trochlea articulating with trochlear notch of ulna.
b- Capitulum articulating with the superior surface of head of radius.

24

Bones

Surgical
neck

Bicipital groove

Deltoid
tuberosity

Cronoid
fossa

Trochlea
HUMERUS
25

Bones

The Radius
It is the lateral of the 2 bones forming the skeleton of the forearm. It has:
I. Upper end.

II. Shaft.

III. Lower end.

I. Upper end: It has:

1. Head: articulates with the radial notch of ulna medially and with
capitulum of the humerus superiorly.
2. Neck: Below the head.
3. Tuberosity: Below the neck.
II. Shaft.
III. Lower end: It has 5 surfaces:
1. Lateral: Continues as the styloid process.
2. Medial: "Ulnar notch": articulates with the head of the ulna.
3. Anterior: Smooth and concave.
4. Posterior: It shows the dorsal tubercle of radius.
5. Inferior: articulates with the carpal bones of hand forming the wrist
joint.
Joints (Articulations) of radius:
1. Elbow joint: Mentioned before.
2. Superior radioulnar joint: It is pivot synovial joint between the
circumference of head of radius with annular ligament and the radial
notch of ulna.
3. Wrist joint: It is ellipsoid synovial joint between the inferior surface of
the lower end of radius and carpal bones (scaphoid and lunate).
4. Inferior radioulnar: It is formed by head of ulna articulating with the
ulnar notch of radius.

26

Bones

Radius and Ulna (Anterior View)

27

Bones

The Ulna
It is the medial of the 2 bones forming the skeleton of the forearm. It has:
I. Upper end: It has:
1. Two processes:
a- Olecranon process: above.
b- Coronoid process: below.
2. Two articular surfaces:
a- Trochlear fossa: lies between the olecranon and coronoid processes.
It articulates with the trochlea of the humerus.
b- Radial notch: for articulation with 1/5 of the circumference of the
head of the radius.
II. Shaft.
III. Lower end: It has:
1. Head: rounded and directed laterally.
2. Styloid process: lies medially.
Joints (Articulations) of ulna:
1. Elbow joint: Mentioned before.
2. Superior radioulnar joint: Mentioned before.
3. Inferior radioulnar joint: Mentioned before.

28

Bones

Bones of Hand
1. The Carpus (Bones of Wrist) = (8 bones)
It is the skeleton of the wrist, it is formed of 8 bones arranged in 2 rows
proximal and distal.
1. Proximal row: (4) from lateral to medial are scaphoid, lunate,
triquetral and pisiform.
2. Distal row: (4) from lateral to medial are trapezium, trapezoid,
capitate and hamate.

2. The Metacarpus (Bones of Palm) = (5 bones)

It is the skeleton of the palm, it is formed of 5 bones each one has base,
shaft and head.

3. The Phalanges (Bones of Fingers) = (14 bones)

They are 3 phalanges for each finger (proximal, middle and distal) except
the thumb which has 2 phalanges (proximal and distal).

1. Scaphoid
2. Lunate
3. Triquetral
4. Pisoform
5.
Trapezium
6.
Trapezoid
7. Capitate
8. Hamate

Bones of the Hand (Anterior View)

29

Bones

Bones of the Lower Limb

The Hip Bone
It is the skeleton of the pelvic girdle. It is formed of 3 parts: ilium, ischium
and pubis. The 3 parts meet at a cup-shaped depression called
acetabulum, they are separated by triradiate cartilage at the center of the
acetabulum before puberty, but they fuse together at puberty. Below the
acetabulum, there is a large foramen called obturator foramen.

Parts of Hip Bone

I. The Ilium: It forms the upper part of the hip bone. It has
A- Three borders:
1. Upper border: Iliac crest.
2. Anterior border: Extends from the anterior superior iliac spine till the
anterior inferior iliac spine.
3. Posterior border: It extends from the posterior superior iliac spine, to
the posterior inferior iliac spine and forms the greater sciatic notch.
B- Two surfaces:
1. Outer "gluteal" surface: Rough.
2. Inner "pelvic" surface: Smooth and has a depression called iliac
fossa.

II. The Ischium:

It forms the lower and posterior part of the hip bone.
It is formed of:
A- Body: It forms the ischial spine and lesser sciatic notch.
B- Ramus: is continuous with the inferior pubic ramus to form the pubic
arch.
C- Ischial tuberosity: It supports the body during sitting.
30

Bones

31

Bones

32

Bones

III. The Pubis:

It forms the lower and anterior part of the hip bone.
It is formed of:
A- Body.
B- Superior pubic ramus.
C- Inferior pubic ramus: It joins the ischial ramus, to form lower border
of obturator foramen and pubic arch.
(Joints) articulations of the hip bone:
1. Sacro-iliac joint between the articular surfaces of the ilium and sacrum.
2. Symphysis pubis between the bodies of the 2 pubic bones.
3. Hip joint between the acetabulum and the head of the femur.

The Femur
It is the skeleton of the thigh, it is the longest and strongest bone in the
body. It has:
I. Upper end: has:
1. Head: more than 1/2 of a sphere, directed upwards forwards and
medially.
2. Neck: about 5 cm long, below the head.
3. Greater trochanter: directed laterally.
4. Lesser trochanter: directed postero-medially.
II. Shaft: It is cylindrical in the middle part but expands as it is traced up
and down.
III. Lower end: It is formed of:
Two condyles: The lateral condyle is larger than the medial. The 2
condyles articulate with the condyles of the tibia forming knee joint.
The anterior surface of the two condyles show the patellar surface for
the patella.
Articulations of the femur:
1. Hip joint: Ball and socket synovial joint between the head of femur and
the acetabulum.
33

Bones

2. Knee joint: Bicondylar synovial joint between the condyles of femur

above and the condyles of tibia below and patella infront.

34

Bones

35

Bones

The Patella
It is the largest sesamoid bone in the body, it is triangular in shape and it
has:
I. Base "upper border": directed upwards.
II. Apex: directed downwards.
III. Two borders: Medial and lateral.
IV. Two surfaces:
A- Anterior surface: Rough.
B- Posterior surface: of which
1- The lower 1/3 is rough and non-articular.
2- The upper 2/3 is smooth and articular. It is divided by vertical
ridge into large lateral part and small medial part which
articulate with the femoral condyles.

The Tibia
It is the medial of the 2 bones forming the skeleton of the leg. It has:
I. Upper end: has:
1. Two condyles: Medial and lateral. A facet present on the lateral
condyle for the articulation of the head of fibula.
2. Tibial tuberosity: It has a smooth upper part and a rough lower part.
II. Shaft: It has a sharp marked anterior border called shin.
III. Lower end: Has 5 surfaces:
A- Anterior.
B- Posterior.
B- Lateral: Has a fibular notch for the articulation of the lower end of
fibula.
C- Medial: Continues as medial malleolus.
D- Inferior: Concave surface articulates with the talus.
(Joints) articulations of the tibia:
1. The upper surfaces of tibial condyles articulate with lower end
of femur to form knee joint.
2. A facet on the lateral condyle of tibia articulates with head of
fibula to form superior tibiofibular joint.
3. Fibular notch of the lower end of tibia articulates with the
lower end of fibula to form the inferior tibiofibular joint.
36

Bones

4. The inferior surface of the lower end of tibia and the medial
malleolus articulate with the talus of the foot to form ankle
joint.

37

Bones

A
Left Patella: (A) Anterior aspect (B) Posterior
aspect

Anterior
(shin)

border

Shaft

Left tibia
fibula (B)
view)

(A) and
(anterior

38

Bones

The Fibula
It is the lateral of the 2 bones forming the skeleton of the leg. It has:
I. Upper end: which is formed of:
A- Head: Bulky and has 2 main features:
1- Styloid process: directed upwards.
2- Articular facet: directed medially, for articulation with the lateral
condyle of the tibia to form the superior tibio-fibular joint.
B- Neck: The constriction below the head.
II. Shaft.
III. Lower end "lateral malleolus: flat, longer than the medial malleolus
& it has:
A- Lateral surface: subcutaneous.
B- Medial surface: It shows 2 parts:
1- Smooth facet for the articulations with the talus.
2- Rough area above the smooth facet for the articulation of lower end
of tibia.
Joints (Articulations):
1- Superior tibiofibular joint: between the head and lateral condyle of
tibia. It is plane synovial joint.
2- Inferior tibiofibular joint: between the lateral malleolus and lower
end of tibia. It is fibrous joint (syndesmosis).
3- Ankle joint: between the lateral malleolus and talus of foot. It is hinge
synovial joint.

The Bones of the Foot

The Tarsus
7 bones arranged into 2 rows, they are:
I. Proximal row 2 bones: calcaneous and talus.
II. Distal row: 5 bones:
a- Three cuniform bones: Medial, intermediate and lateral.
b- Cuboid: lies between calcaneous and lateral 2 metatarsals.
c- Navicular: lies between head of talus and the 3 cuniform bones.

The Metatarsus
It is the skeleton of the middle part of the foot, it is formed of 5 bones,
each one is formed of base, shaft and head.

The Phalanges
39

Bones

They are the skeleton of the toes, each toe has 3 phalanges except the big
toe which has 2 phalanges.

The Arches of the Foot

The bones of tarsus and metatarsus are arranged to form 2 longitudinal
arches and one transverse arch.

Functions of the Arches of the Foot

1. It supports the body weight in standing position.
2. Movable spring-like structure in walking and running.
3. They protect the blood vessels and nerves in the sole of foot.

Bones of the Right Foot (A)

40Dorsal view. (B) Lateral
view

Bones

Thoracic Cage
Boundaries:
1. Anteriorly: Sternum.

2. Posteriorly: 12 thoracic vertebrae.

3. On both sides: 12 pairs of ribs with their costal cartilages.

Parts of the thoracic cage:
1. Thoracic inlet.

2. Thoracic cavity.

3. Thoracic

outlet.
Thoracic inlet: It lies above:
Boundaries:
1. Anteriorly: Upper border of the manubrium sterni "suprasternal
notch".
2. On each side: First rib and its costal cartilage.
3. Posteriorly: Body of the 1st thoracic vertebra.
Thoracic outlet: It lies below and is closed by the diaphragm which
separates the thoracic and the abdominal cavities.
Thoracic cavity: It contains the lungs and pleurae, pericardium and the
heart with big vessels and nerves.

The Sternum
It has 3 parts:
A- Manubrium:
It is 2 inches long, lies opposite T3 and T4 vertebra. It articulates with
the body to form Manubriosternal angle (sternal angle).
B- Body (4 inches, lies opposite T5,6,7 and T8 vertebrae).
C- Xiphoid process: One inch, lies opposite T9 vertebra.

41

Bones

Thoracic Cage

42

Bones

The Ribs
They are 12 pairs of ribs.
Classification:
A- According to sternal attachment:
1. True ribs: The upper 7 ribs are attached to the sternum by costal
cartilages.
2. False ribs: The lower 5 ribs are not attached to the sternum.
3. Floating: Ribs: The last 2 ribs "No. 11 and 12". They have free anterior
ends (not attached anteriorly).
B- According to vertebral attachment and shape:
1. Typical ribs: from 3rd to 9th ribs (each rib articulates with two vertebrae).
2. Atypical ribs: No. 1, 2, 10, 11 and 12 (each rib articulates with the
corresponding vertebra only).

Typical rib: It has:

A- Posterior end: It has 3 parts:
1. Head: Articulates with the sides of the bodies of 2 vertebrae (the
corresponding vertebra and the vertebra above).
2. Neck.
3. Tubercle.
B- Shaft: It is curved at the junction of the anterior 3/4 and the posterior
1/4 to form the angel of rib.
It has:
1- Two borders: upper thick and lower thin and sharp border.
2- Two surfaces: outer convex and inner concave border.
C- Anterior end: Cup-shaped to receive its costal cartilage.

43

Bones

Anterior end

Parts of a Typical Rib

44

Bones

The Skull
The skull is the skeleton of head, it is formed of 21 bones (5 single and 8
paired) articulating together, by fibrous joints called sutures. To
understand the skull we look to it from different views, each view is called
norma.
I. Normal verticalis (top or vertical view):
It shows the following features:
1. Four bones: Frontal, 2 parietal and occipital.
2. Three sutures:
a- Sagittal suture: Between the 2 parietal bones.
b- Coronal suture: Between the frontal and the 2 parietal bones.
c- Lambdoid suture: Between the occipital and the 2 parietal bones.
3. Two points:
a- Bregma: Between the coronal and sagittal suture, it the site of the
anterior fontanelle in the foetus which ossifies at 18 months after
birth.
b- Lambda: Between the lambdoid suture and the sagittal suture, it the
site of the posterior fontanelle in the foetus which ossifies at the 3
months after birth.

45

Bones

II. Norma frontalis (anterior view): The following bones are seen.
1. Frontal bone (above).
2. Two maxillary bones (below).
3. Nasal bones and anterior nasal opening in the middle part.
4. The two orbits and 2 zygomatic bones, present between the frontal
bone and maxillary bones laterally.

46

Bones

47

Bones

III. Norma lateralis: The side view of the skull.

It contains the following bones:
A- Many bony parts belong to the temporal bones, they are:
1- Zygomatic arch.

2- Squamous part of temporal bone.

3- Mastoid process. 4- Styloid process.

5- External auditory

meatus.
B- Other bones which are seen in norma frontalis and verticalis,
they are:
1- Frontal bone.

2- Parietal bone.

3- Occipital bone.

4-

Zygomatic bone.
C- Greater wing of sphenoid.
D- Pterion: The area of meeting of 4 bones: parietal, frontal, greater wing
of sphenoid and squamous part of temporal bone.

Z.A = Zygomatic
arch

48

Bones

IV. Norma occipitalis: Posterior view of skull.

The following bones are seen:
1. Occipital bone showing external occipital protuberance.
2. Lambdoid suture.
3. Mastoid processes.
4. Posterior parts of the two parietal bones.

Parietal
bone

Norma Occipitalis

49

Bones

V. Norma basalis externa: The base of the skull from outside.

The following structures can be seen:
1. Teeth and hard palate.
2. Posterior nasal openings with vomer (V) inbetween.
3. Petrous part of temporal bone.
4. Mandibular fossa for the articulation with the mandible.
5. Foramen magnum.
6. Occipital condyles for articulation with the 1st cervical vertebra (Atlas).

50

Bones

VI. Norma basalis interna: The base of the skull from inside.
It is divided into 3 fossae:
A- Anterior cranial fossa: contains the frontal lobe of the brain and its floor
forms the roof of the orbits and nasal cavity.
B- Middle cranial fossa: Houses the temporal lobe of the brain on each
side, and the pituitary gland in the pituitary fossa in the middle.
C- Posterior cranial fossa: contains the occipital lobes of the brain and the
cerebellum.
N.B.: The petrous part of temporal bone separates the middle from the
posterior cranial fossa.

51

Bones

The Mandible
It is the skeleton of the lower jaw which is formed of a body and 2 rami.

The Body
It is horse shoe shaped which is convex forwards, it has:
I. Two Borders:
A- Upper border: Carriers the teeth and is called alveolar margin.
B- Lower border "Base".
II. Two Surfaces:
A- Outer surface which has mental foramen.
B- Inner surface shows mylohyoid line.

The Ramus
The ramus has:
1. Two borders: Anterior and Posterior border which meets the lower
border of the body to form the angle of the mandible.
2. Two surfaces:
a- Outer surface.
b- Inner surface: Shows mandibular foramen.
3. Two ends:
a- Upper end: Which has:
1- Coronoid process: in front.
2- Condyloid process: behind and consists of head and neck.
3- Mandibular notch separates these 2 processes.
b- Lower end: Continuous with the body.
N.B.: The point of meeting of the 2 halves of the mandible is a bony ridge
in the middle line anteriorly called symphysis menti.

52

Bones

Oblique line

Outer Surface

Mylohyo
id
line
Inner
Surface
Mandible

53

The Vertebral Column

THE VERTEBRAL COLUMN

Average adult length:
A- In male: about 70 cms.
B- In female: about 65 cms.

Vertebral Column (Regions and Crvatures)

54

The Vertebral Column

Curvatures:
A- Primary curvature:
C-shaped; its concavity is directed anteriorly due to the general attitude
of flexion of the fetus inside the uterus.
B- Secondary curvatures:
1. Antero-posterior curvature: two anterior convexities appear:
a- Cervical convexity: appears about the age of 3rd to 4th month when
the baby starts to raise and support his head.
b- Lumbar convexity: appears at the age of 12 th to 18th month when
the baby starts to walk.
So, the vertebral column is concave anteriorly in thoracic and
sacral region and convex anteriorly in cervical and lumbar regions.
2. Side to side curvature: The vertebral column is slightly convex on
the right side, in the right- handed people.

Curvatures of the Vertebral Column

Components of the vertebral column:

1. Vertebrae: comprise about 3/4 of its length. They are divided into:
a- Separate vertebrae: 7 cervical, 12 thoracic and 5 lumbar.
b- Fused vertebrae: 5 sacral vertebrae (sacrum) and 3(1) coccygeal
vertebrae (coccyx).
55

The Vertebral Column

2. Intervertebral discs: comprise about 1/4 of its length, each disc is

formed of 2 parts:
a- Anulus fibrosus: a fibrous ring forming the periphery of the disc.
b- Nucleus pulposus: a gelatinous material occupying the center of
the disc. It acts as a buffer to absorb shocks applied to the vertebral
column.

Intervertebral Disc

Parts of a typical vertebra:

1. Body (centrum): variable in size; its shape may be either heart or
kidney-shaped with flat superior and inferior surfaces.
2. Two vertebral arches: each arch is formed of 2 parts:
a- Pedicle: lies anteriorly, it is notched above and below to form the
intervertebral foramen, which is present between the notches of the
pedicles of the vertebra above and the vertebra below, and through
which the spinal nerve leaves the vertebral column.
b- Lamina: lies posteriorly, the two laminae fuse together to form the
spine.
3. Seven processes:
a- Two superior articular processes: each carries a facet for articulation
with the facet present on the inferior articular process of the
vertebra above. They are directed upwards.

56

The Vertebral Column

b- Two inferior articular processes: each carries a facet for articulation

with the facet present on the superior articular process of the
vertebra below. They are directed downwards.
c- Two transverse processes: they are directed laterally.
d- A spinous process (dorsal spine): it is directed posteriorly.
4. Neural (vertebral) foramen or canal: it lies between the 2 vertebral
arches and the body. It accommodates the spinal cord and the
meninges.

Typical Thoracic Vertebra

Joints between the vertebrae (intervertebral joints):

1. Secondary cartilaginous joint: between 2 vertebral bodies and the
intervertebral disc inbetween.
57

The Vertebral Column

2. Synovial joints: between the superior and inferior articular processes

of the vertebrae.
Movements of the vertebral column:
1. Flexion and extension.
2. Lateral flexion.
3. Rotation.
Identification of the vertebra:
A- If it has a foramen in the transverse process (foramen
transversarium): it is a cervical vertebra:
1- If it has a short bifid dorsal spine, it is a typical cervical vertebra (3,
4, 5 & 6).
2- If it is ring-shaped with no body, it is the first cervical vertebra
(atlas).
3- If it has an odontoid process and short thick strong dorsal spine, it is
the second cervical vertebra (axis).
4- If it has a long non bifid dorsal spine, it is the 7th cervical vertebra.
B- If it has no foramen transversarium but it has: a facet or a
demifacet on the side of the body of the vertebra (for articulation with
the head of the rib) it is typical thoracic vertebra.
C- If it has no foramen transversarium and the body is large with
no facet or demifacet, it is a lumbar vertebra.
Short bifid
spine
A-1
Odontoid
process

A-2

Long nonbifid spine

A-3

A-4
Demifacet

58
B

Joints

JOINTS
The joint is the contact between two bones or more together:

Classification of Joints
There are 3 types of joints.
I. Fibrous Joints:
Fixed joints in which the surfaces of bones are connected together by
fibrous tissue.
There are 3 types:
Syndesmosis
Gomphosis
Sutures
Present in inferior
Present in teeth.
Present in skull.
tibio fibular joint.
The roots of teeth
The bones of skull are
The lower end of
are connected to
connected together by
tibia and fibula are
their sockets in
a thin layer of fibrous
connected together
mandible and
tissue called sutural
by fibrous tissue
maxilla by fibrous
ligament.
called interosseous
tissue called
They obliterated in old
ligament
periodontal
age
ligament.

Fibul
a

Fibrous Joints

The Skull, Norma

Verticalis

59

Joints

II. The Cartilaginous Joints: In these joints the surfaces of the

articulating bones are connected together by cartilagenous tissue.
They are 2 types:
a. Primary cartilaginous joint: It is a temporary joint formed of plate of
hyaline (epiphyseal) cartilage between the articulating bones (epiphysis
and diaphysis).
Site: At the ends of the growing long bones between the epiphysis and
diaphysis. It is immobile joint which disappears in adulthood by
ossification.
b- Secondary cartilaginous joint: The articulating bones are separated
by a disc of white fibrocartilage which is permanent. The surface of the
articulating bones are covered by a thin layer of hyaline cartilage. It is
slightly mobile joint.
Sites: Intervertebral discs and symphysis pubis.
They are present in midline.
They have limited movement which is facilitated by the elasticity of
the fibrocartilaginous disc.
The joint is strengthened by fibrous ligaments which extend from one
bone to the other fusing with the cartilagenous disc.

Cartilaginous Joints
III. Synovial Joints:
They are freely mobile joints present mostly in the limbs
Characters (structure) of synovial joints:
A- Fibrous capsule:
60

Joints

The synovial joint is surrounded completely by a strong fibrous capsule

which is lined by synovial membrane. This capsule is supported and
strengthened by strong ligaments and pierced by blood vessels and
nerves which supply the joint.
B- Articular cartilage:
Hyaline cartilage covers the articular surfaces of bones. It is very
smooth and is lubricated by the synovial fluid. It has no blood and nerve
supply.
C- Joint cavity:
It is a potential cavity which becomes manifest if fluid, blood or pus
collect into it. It contains a very thin film of synovial fluid.
D- Synovial membrane:
Thin, moist and glistening membrane that covers all structures inside
the joint except the articular surfaces, it also lines the fibrous capsule. It
secretes and absorbs the synovial fluid.
E- Synovial fluid:
Pale yellow viscous fluid similar to egg-albumin.
Functions:
1- Lubricates the articular cartilage.
2- Reduces erosion of articular cartilage.
3- Helps nutrition of articular cartilage.
F- Ligaments:
Extracapsular and intracapsular ligaments which support and strength
the joint.

61

Structure of Synovial Joints

Joints

G- Structures which may be present inside the cavity of synovial

joints:
1- Articular disc: Disc of fibrocartilage which divides the joint cavity
into two compartments (upper and lower) e.g. temporomandibular
joint.
2- Menisci (semilunar cartilages): e.g. the two semilunar plates of
fibrocartilage present inside the knee joint.
3- Ligament: e.g. cruciate ligament inside the knee joint.
4- Tendon: e. g. the tendon of long head of biceps muscle inside the
shoulder joint.

Intra-Articular Structures

Factors affecting the stability of the joint:

1- Shape and fitting of articulating surfaces.
2- Thickness and elasticity of the capsule.
3- Position and strength of ligaments.
4- Strength of muscles surrounding the joint.
62

Joints

63

Joints

Types (varieties) of Synovial Joints

A- According to the number of articulating bones:
1. Simple joints: Between two bones e.g. shoulder.
2. Compound joints: Between more than two bones e.g. elbow.
3. Complex joints: Contain intra-articular structures e.g. knee joint.
B- According to the axis of movement:
I.

Uni-axial joints: In this type of joints the movements take place

around a single axis. According to the direction of axis: there are 2
types:
a- One transverse axis: e.g. elbow joint.
b- One longitudinal axis: e.g. superior radio ulnar joint.
According to the shape of the articular surfaces there are 2
types:
a- Hinge joint: The convex articular surface is trochlea-like. The joint is
uni-axial with one transverse axis. The movement is flexion and
extension only due to strong collateral ligaments, e.g. elbow.
b- Pivot joint: The articulating surface consist of a central bony pivot
(axis) surrounded by a fibro-osseous ring, e.g. superior radio-ulnar
joint.
The movement of this joint is rotation around longitudinal axis passing
through the center of the pivot.

II. Bi-axial joints: In this type of joints the movements take place around
2 axes perpendicular to each other.
According to the shape of the articular surface there are 3
types:
1- Condylar (Bicondylar) joint:
It consists of either 2 separate convex surfaces (condyles) which
articulate with 2 concave surfaces, e.g. knee joint or one condyle
articulating with one concave surface e.g. temporomandibular joint.
2- Ellipsoid joint:

64

Joints

It is formed by the articulation of an oval convex surface (carpal

bones) with an elliptical concave surface (inferior surface of radius
and the articular disc of ulna) e.g. wrist joint.
3- Saddle joint:
The articulating surfaces of this joint are concavoconvex. e.g.
carpometacarpal joint of thumb and sternoclavicular joint.
III. Multi-axial joints:
In this type of joints, the movements occur around 3 axes. The
artiuclar surface consists of globular rounded bone articulates with
concave socket. They are the most freely mobile joints in the body.
According to the shape of the articular surfaces, they are called ball
and socket joints, e.g. shoulder and hip joints.
IV. Non-axial (plane) joints:
The articular surfaces of these joints are flat and the movement is
gliding without any axis of movement e.g., the superior tibio-fibular
joint and intervertebral joints.

Uni-axial synovial joints

65

Bi-axial Synovial Joint

Joints

Bi-axial synovial joint

Non-axial synovial
joint

Multi-axial synovial
joint

Types of synovial joints

According to the

According to shape of the articular surface

axis of movement.
I. Uni-axial joints

1- Hinge e.g. elbow joint

2- Pivot e.g. superior R.U. joint
1- Condylar e.g. knee-T.M. joint

II. Bi-axial joints

2- Ellipsoid e.g. wrist joint

3- Saddle e.g. caropmetacarpal joint of thumb

Multi-axial

Ball and socket e.g. Hip-shoulder

IV. Non-axial joints

Plane joints e.g. superior tibio-fibular joint.

III.
joints

66

Joints

Movements of the Joints

1. Flexion: Approximation of two ventral aspects (bending).
2. Extension: Straightening; the two ventral surfaces move away from
each other.
3. Abduction: Movement away from the middle line. In the fingers
moving away from the middle finger, in the toes moving away from the
second toe.
4. Adduction: Movement towards the middle line. In the fingers moving
towards the middle finger, in the toes moving towards the second toe.

(1)

(2)

(3)
(4)

67
Flexion, Extension, Abduction and Adduction

Joints

5. Circumduction: Combination of all above movements.

6. Rotation: Medial or lateral rotation of the limb around a vertical axis.

Rotation and 68
Circumduction

Joints

7. Gliding: Non-axial movement.

8. Supination: The lateral rotation of the forearm.
9. Pronation: The medial rotation of the forearm.
10.

Inversion: The sole of foot is directed inwards.

11.

Eversion: The sole of foot is directed outwards.

12.

Opposition: The thumb is opposing (come in contact) the other 4

fingers.

69
Pronation, Supination, Inversion, Eversion and
Opposition

Joints

70

Joints

Joints of Upper Limb

Shoulder Joint
Type: Ball and socket synovial joint.

Articulating bones are:

1. Head of humerus.
2. Gelnoid cavity of scapula.
It is not a stable joint and its dislocation is common.
Movements:
1. Flexion and extension. 2- Abduction and adduction. 3- Medial rotation
and lateral rotation. 4- Circumduction.
Important muscles acting on it:
Pectoralis major, teres major, subscapularis, teres minor and latissimus
dorsi and deltoid muscle.

Tendon of long head of

biceps brachii muscle
Joint
capsule

Shoulder Joint

71

Joints

Elbow Joint
Type: Hinge synovial joint.

Articulating bones:
1. Lower end of humerus: trochlea and capitulum.
2. Superior surface of the head of radius articulating with capitulum.
3. Trochlear notch of ulna articulating with trochlea.
Movements: Flexion and extension.
Important muscle acting on it: Biceps, brachialis and triceps.

Superior
radioulnar joint

Elbow Joint

72

Joints

Wrist Joint
Type: Ellipsoid synovial joint.

Articulating bones:
1. Lower end of radius (inferior surface) articulating with scaphoid and
lunate (carpal bones).
2. Articular disc below head of ulna articulating with triquetral (carpal
bone).
Movements:
1. Flexion & Extension. 2- Abduction & Adduction.

3-

Circumduction.
Important muscles acting on it:
Anterior "flexors", and posterior "extensor" muscles of forearm.

Wrist Joint

73

Joints

Joints of Lower Limb

Hip Joint
Type: Ball and socket synovial joint.

Articulating bones:
1. Head of femur.
2. Acetabulum of hip bone.
Movements:
1. Flexion & Extension. 2. Abduction & Adduction. 3. Medial rotation &
Lateral rotation. 4. Circumduction.
Important muscles acting on it:
Gluteus maximus, gluteus medius, gluteus minimus, iliopsoas, sartorius,
hamstrings and the adductor group.

Hip Joint.
74

Joints

Knee Joint
Type: Bicondylar synovial joint.
Articulating bones:
Lower end of femur: (The 2 condyles) with patella and upper end of tibia
(superior surface of the 2 tibial condyles).
Structures inside the knee joint:
(intracapsular structures), they are:
1. Two menisci "semilunar cartilages": on the superior surfaces of the 2
tibial condyles.
2. Two cruciate ligaments "anterior and posterior": They connect the upper
end of tibia with the lower end of femur. They prevent the anterior and
posterior dislocation of the
tibia.
Movements:
1. Flexion & Extension.
2. Medial and lateral rotations
of the flexed knee.

Knee Joint

75

Joints

Ankle Joint
Type: Hing synovial joint.

Articulating bones:
Lower ends of both tibia and fibula with the talus (tarsal bone).

Movements:
1. Flexion (plantar flexion).
2. Extension (Dorsiflexion).
Muscles acting on it: Anterior "extensor" and posterior "flexor" muscles
of leg.

Ankle Joint

76