The Skeletal System

Regions of the skeleton axial skeleton forms the central axis skull, vertebral column, ribs, sternum and sacrum appendicular skeleton includes the limbs & girdles
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Axial & Appendicular Skeleton

Axial skeleton in yellow
skull, vertebrae, sternum, ribs, sacrum & hyoid

Appendicular skeleton in blue

pectoral girdle upper extremity pelvic girdle lower extremity

SKELETAL SYSTEM 206

Cranium Skull Skull and associated 29 bones Associated bones Face Auditory ossicles Hyoid

8 14 6 1

APPENDICULAR SKELETON 126 (see Section 2)

AXIAL 80 SKELETON
Thoracic 25 cage

Sternum Ribs

1 24

Costal cartilages (cartilages of ribs)

Intervertebral discs (cartilage) Vertebrae 24 Vertebral column 26 Sacrum Coccyx 1 1

The bones of the axial skeleton:

provides attachment for muscles involved in respiration provides attachment for muscles of the axial skeleton provides attachment for muscles that move the head, neck, and trunk

The 22 bones that form the skull, plus the seven bones associated with the skull
SKULL FACE Maxillary bones Palatine bones Nasal bones Inferior nasal conchae Zygomatic bones Lacrimal bones Vomer Mandible 14 2 2 2 2 2 2 1 1 CRANIUM Occipital bone Parietel bones Frontal bone Temporal bones Sphenoid Ethmoid 8 1 2 1 2 1 1 Hyoid bone 1 Auditory ossicles enclosed in temporal bones ASSOCIATED BONES (see Module 7.7) 7

Many skull bones are connected by sutures

Immovable Bones tied together with dense fibrous connective tissue Four major sutures 1. Coronal (frontal to parietal bones) Calvaria (skullcap formed by frontal, parietal, and occipital bones) 2. Squamous (temporal to parietal bones) 3. Sagittal (between parietal bones) 4. Lambdoid (occipital to parietal bones)

The major sutures of the skull

Frontal bone Parietal bone

Coronal suture

Temporal bone

Squamous suture
Occipital bone

Lambdoid suture

Lateral view of skull Sagittal suture

Parietal bone Parietal bone

Sutural bone Lambdoid suture

Occipital bone

Posterior view of skull

The Skull
22 bones joined together by sutures
Cranial bones surround cranial cavity 8 bones are in contact with meninges frontal (1), parietal (2), temporal (2), occipital (1), sphenoid (1) and ethmoid (1) calvaria (skullcap) forms roof & walls Facial bones support teeth & form nasal cavity & orbit 14 bones with no direct contact with brain or meninges attachment of facial & jaw muscles

Cranial Fossa

3 basins that comprise the cranial floor or base

Anterior cranial fossa holds the frontal lobe of the brain Middle cranial fossa holds the temporal lobes of the brain Posterior cranial fossa contains the cerebellum

Swelling of the brain may force tissue through foramen magnum resulting in death
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Frontal Bone
Forms forehead and part of the roof of the cranium Forms roof of the orbit Contains the frontal sinus

Parietal Bone
Pterion

Forms cranial roof and part of its lateral walls Bordered by 4 sutures
coronal, sagittal, lambdoid and squamous

Marked by temporal lines of the temporalis muscle

Temporal lines
Pterion is the the weakest part of the skull. Middle meningeal artery is below it.

A blow to the pterion (e.g. in boxing) may rupture the artery causing an extradural hematoma!

Temporal Bone

Fractures of the temporal bone may cause facial paralysis, affect hearing and balance.

Forms lateral wall & part of floor of cranial cavity 1. squamous part zygomatic process mandibular fossa & TMJ 2. tympanic part external acoustic meatus styloid process for muscle attachment 3. mastoid part mastoid process Does not develop until after 2 years mastoiditis results from ear infection 4. Petrous part 1. Houses middle & inner ear Seen from inside

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Petrous Portion of Temporal Bone

Forms part of cranial floor
separates middle fossa from the posterior cranial fossa

Houses middle and inner ear cavities

receptors for hearing and sense of balance internal auditory meatus is entrance for CN VIII (vestibulocochlear nerve) and facial nerve (CN VII)
! Fractures of this bone may have very serious consequences as not only does it protect the inner ear mechanisms of balance (vestibular apparatus), and hearing (cochlea), but also contains the VIIth cranial nerve (facial paralysis).

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Openings in Temporal Bone

Carotid canal
passage for internal carotid artery supplying the brain

Jugular foramen
irregular opening between temporal & occipital bones passageway for drainage of blood from brain to internal jugular vein

Stylomastoid foramen
Facial nerve exits

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Openings in Temporal Bone

Stylomastoid foramen
Facial nerve exits

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Occipital Bone
Rear & much of base of skull Foramen magnum holds spinal cord Skull rests on atlas at occipital condyles Hypoglossal canal transmits hypoglossal nerve (CN XII) supplying tongue muscles External occipital protuberance for nuchal ligament attachment Nuchal lines for attachment of neck muscles

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Sphenoid Bone

Lesser wing Greater wing Body of sphenoid Medial and lateral pterygoid processes

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Sphenoid Bone
Body of the sphenoid houses the pituitary gland Lesser wing Greater wing -has 3 foramina
foramina rotundum & ovale for brs. of trigeminal nerve & foramen spinosum for meningeal artery sella turcica contains deep pit (hypophyseal fossa)

optic foramen contains optic nerve & ophthalmic a.

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Sphenoid Bone

Hypophyseal fossa

Sphenoid sinus
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Ethmoid Bone
Between the orbital cavities Forms lateral walls and roof of nasal cavity Cribriform plate & crista galli Ethmoid air cells form ethmoid sinus Perpendicular plate of ethmoid forms part of nasal septum Nasal Concha or turbinates on lateral wall creates air turbulence and warms up the air in the nasal passage

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Ethmoid Bone

Superior & middle nasal concha

Cribriform plate, foramina & crista galli

Perpendicular plate forms the nasal septum Fracture of the ethmoid bone in car accidents or being punched in the nose can cause leakage of cerebrospinal fluid (CSF) and anosmia. With loss of smell the danger comes because patients cannot smell smoke, gas, or spoiled food.

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Maxillary Bones
Forms upper jaw
alveolar processes are bony points between teeth alveolar sockets hold teeth

Forms inferomedial wall of orbit

infraorbital foramen

Palatine processes form anterior 2/3s of hard palate

incisive foramen cleft palate

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Skull bones contain cavities and paranasal sinuses

Frontal bone

Cranial cavity Ethmoidal air cells (sinus) Orbit Zygomatic bone Maxillary sinus

Maxilla

Frontal section

Mandible

Nasal cavities

Paranasal sinuses decreases the weight of the skull Therefore, neck muscles dont have to work hard to hold the head up Mucus membrane lining the sinuses traps dusts and pathogens

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Locations of Paranasal Sinuses

Frontal Ethmoid Maxillary Sphenoid Maxillary sinus fills maxillae bone Other bones containing sinuses are frontal, ethmoid & sphenoid.

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Locations of Paranasal Sinuses

Maxillary sinusitis is a common condition as the drainage system for this bone's sinus is poorly designed for upright humans. Best way to drain this sinus is to stand on your head!

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Palatine Bones
L-shaped bone Posterior 1/3 of the hard palate Part of lateral nasal wall Part of the orbital floor

N M

Never Make Lily Eat Spinach Nasal, maxillary, lacrimal, ethmoid and Sphenoid

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Zygomatic Bones
Forms angles of the cheekbones and part of lateral orbital wall Zygomatic arch is formed from zygomatic bone and zygomatic process of the temporal bone

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Lacrimal Bones
Form part of medial wall of each orbit Lacrimal fossa houses lacrimal sac in life
tears collect in lacrimal sac and drain into nasal cavity

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Nasal Bones
Forms bridge of nose and supports the cartilages of nose Often fractured by blow to the nose In certain congenital syndromes and infectious diseases, such as leprosy, there may be an "eating" away of this bony structure resulting in a sunken nose and characteristic faces
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Loss of Nasal Bones in Leprosy

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Inferior Nasal Conchae

A separate bone Not part of ethmoid like the superior & middle concha or turbinates The nasolacrimal duct opens below the inferior concha

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Vomer

Inferior half of the nasal septum Supports cartilage of nasal septum

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Mandible
Only bone of the skull that can move jaw joint formed between mandibular fossa of temporal bone & condyloid process Both endochondral and membranous ossification Holds the lower teeth Attachment of muscles of mastication
temporalis muscle onto coronoid process masseter muscle onto angle of mandible

Mandibular foramen Mental foramen

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The mandible in lateral view

Coronoid process

Teeth (molars)

Condylar process

Alveolar process

Mental foramen Mandibular notch Body of the mandible Ramus of the mandible

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The mandible in medial view

Coronoid Condylar process process Mylohyoid line Head

Mandibular foramen Alveolar part

Position of the submandibular salivary gland

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SKULL

FACE
Maxillary bones Palatine bones Nasal bones Inferior nasal conchae Lacrimal bones Vomer Mandible

14 2 2 2 2

CRANIUM
Occipital bone Parietal bones Frontal bone Sphenoid Ethmoid

8 1 2

ASSOCIATED BONES 7

1 Temporal bones 2 1 1

Hyoid bone 1

Auditory ossicles enclosed in temporal bones 6 (see Chapter 15)

Zygomatic bones 2 2 1 1

The auditory ossicles, bones associated with the skull

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Hyoid Bone
Suspended from styloid process of skull by stylohyoid muscle and ligament @ the level of cervical vertebrae C2 and C3 Greater & lesser horns

Greater horn

Lesser horn Body of the hyoid

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The Skull in Infancy & Childhood

Spaces between unfused skull bones called fontanels
filled with fibrous membrane allow shifting of bones during birth & growth of brain in infancy fuse by 2 years of age

2 frontal bones fuse by age six

metopic suture Visible in many Eskimos and Bedouins

Skull reaches adult size by 8 or 9 causing heads of children to be larger in proportion to trunk Premature fusion is prevented by an inhibitory protein called Noggin

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Scaphocephaly

Left parietal bone

Right parietal bone

Sagittal suture

Occipital fontanelle Lambdoid suture Occipital bone

Due to premature closure of the sagittal suture. 1 in 2000

children may have premature fusion.

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Plagiocephaly: premature closure of the coronal suture.

Sagittal suture Anterior fontanelle

Right parietal bone

Left parietal bone

(soft spot)
Coronal suture
Frontal suture

Frontal bone

Frontal suture

Posterior fontanelle normally fuses by the 2-3 months Anterior fontanelle fuses around the second year (~18 months).

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Metopic suture persists in some adults

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Encephalocele in a 10-year old Kenyan girl

The skull is not fully closed and the brain protrudes through a hole in the skull!

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General Features of the Vertebral Column

33 vertebrae & discs of fibrocartilage between them Five vertebral groups
7 cervical in the neck 12 thoracic in the chest 5 lumbar in lower back 5 sacral fused into the sacrum 4 coccygeal fused into coccyx

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Newborn Spinal Curvature

Spine exhibits one continuous C-shaped curve Known as primary curvature
Thoracic Pelvic

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Adult Spinal Curvatures

S-shaped vertebral column with 4 curvatures Secondary curvatures develop after birth lifting head as it begins to crawl develops cervical curvature walking upright develops lumbar curvature
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Primary

Primary

Abnormal Spinal Curvatures

Result from disease, posture, paralysis or congenital defect Scoliosis from lack of proper development of one vertebrae Kyphosis is from osteoporosis Lordosis is from weak abdominal muscles
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The parts of a typical vertebra

Parts of a Vertebra
Articular processes

The parts of the vertebral arch

Vertebral Arch
Spinous process Vertebral foramen Laminae

Vertebral arch

Vertebral body

Superior view
Transverse process

Pedicles

Inferior view

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Disc in young person

A semigelatinous nucleus pulposus surrounded peripherally by an anulus brosus. Each disc is separated from the bone above and below by two growth plates of hyaline cartilage
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Vertebral Canal, Intervertebral Foramen & Discs

Vertebral canal Intervertebral foramen
Vertebral canal

formed from vertebral notches of adjacent vertebrae passageway for spinal nerves

Intervertebral discs
bind vertebrae together absorb shock inner gelatinous nucleus pulposus surrounded by annulus fibrosus (ring of fibrocartilage) herniated disc puts pressure on spinal nerve or spinal cord

Nucleus pulposus consists of collagen and proteoglycans. Annulus fibrosus collagen IX. Mutation in collagen IX predisposus the disc for herniation and back pain.

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Back-Pain

Women are more likely to have neck, lumbar or pelvic pain & tendency for injury at specific times in their menstrual cycle (days 12-14 & days 24-26)
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Herniated Disc

Nicotine in cigarettes contributes to low back pain in two ways. First, nicotine hampers the flow of blood to the vertebrae and disks. This impairs their function and may trigger a bout of back pain. Second, smokers tend to lose bone faster than nonsmokers, putting them at greater risk for osteoporosis, another common cause of back pain

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Force on Disc At Various Positions

Lying on your back with your legs up on a stool produces least pressure on the lumbar spine Sitting position produces more pressure than standing position on the lumbar spine In standing position, the center of gravity is 5 cm anterior to the L3 vertebra. The force acting on the intervertebral disc is 800 N (~180 pounds) to prevent the body from falling forwards In sitting position, the center of gravity is 15 cm anterior to the L3 vertebra. The force acting on the intervertebral disc is 1600 N (~360 pounds) to prevent the body from falling forwards
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Sit Properly?

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Typical Cervical Vertebrae

Bifid spinous process

Transverse foramen

Vertebral foramen Vertebral body

Transverse process

Costal process

Smaller body and larger vertebral foramen Transverse process short with transverse foramen for protection of vertebral arteries Bifid or forked spinous process in C2 to C6 The 7th cervical vertebra is known as the vertebra prominens

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The Unique Atlas and Axis

Atlas (C1) supports the skull
concave superior articular facet
nod your head in yes movement

ring surrounding large vertebral foramen

anterior & posterior arches

Axis (C2)
dens or odontoid process is held in place inside the vertebral foramen of the atlas by ligaments allows rotation of head -- no

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Atlas & Axis Articulation

Anterior arch of atlas Dens (odontoid process) Atlas

Atlanto-occipital joint that permits nodding (as in indicating yes)

Axis

Posterior arch of atlas

Ligament that enables rotation (as in shaking the head to indicate no)

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Location of Cervical Vertebrae

7th cervical vertebra (C7) is known as the vertebra prominens

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Typical Thoracic Vertebrae

Spinous process Transverse process
Superior costal facet Transverse costal facet

Vertebral foramen

Superior articular facet Superior costal facet

Vertebral body

Vertebral body

Inferior costal facet Transverse process Spinous process

More massive body (heart-shaped) than cervical but smaller than lumbar Spinous processes pointed and angled downward Superior articular facets face posteriorly permitting some rotation between adjacent vertebrae Rib attachment facets & demifacets on vertebral body and costal facets at ends of transverse processes for articulation of tubercle of ribs 1 to 10

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Typical Lumbar Vertebrae

Thick, stout kidney shaped body and blunt, squarish spinous process Superior articular processes face medially
lumbar region resistant to twisting movements

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Is Your Sacrum Fused?

Sacral promontory Once thought to be location of soul!

5 separate sacral vertebrae fuse by age 26 Anterior surface

smooth & concave sacral foramina were intervertebral foramen
nerves & blood vessels

Anterior View

4 transverse lines indicate line of fusion of vertebrae

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Sacral promontory

Sacral promontory is the anatomical term for the anterior most portion of the sacrum. It marks the border of the pelvic inlet. 59

Sacrum (Posterior View)

Rough surface of sacrum Spinous processes have fused into median sacral crest Transverse processes fuse into lateral sacral crest Posterior sacral foramina Sacral canal ends as sacral hiatus Auricular surface is part of sacroiliac joint
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Is Your Coccyx Fused?

Single, small, triangular bone
4 small vertebrae fused by age of 30 Co1 to Co 4

Provides attachment site for muscles of pelvic floor Cornua

hornlike projections on Co1: ligaments attach coccyx to sacrum

Fractured by fall or during childbirth

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Thoracic Cage
Consists of thoracic vertebrae, sternum & ribs Attachment site for pectoral girdle and many limb muscles Protects many organs Rhythmically expanded by respiratory muscles to draw air into the lungs
Sternal angle or Angle of Louis Sternal puncture On either side of the sternal angle is the second intercostal space Anterior thoracotomy for coronary artery bypass surgery

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Anatomy of the Sternum

Sternal angle is formed between the manubrium and the body M a n u b r i u m articulates with the clavicles on either side During CPR it is important to position the hand on the sternum properly so that the xiphoid process and the ribs are not damaged.

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Male Nipple is in the 4th Intercostal Space

Sternum

Ribs

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True and False Ribs

True ribs (1 to 7) attach to sternum via hyaline cartilage

False ribs (8-12)

11-12 are floating and not attached to sternum

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Posterior view of a representative rib (ribs 29)

Articular facets on head Capitulum

Tubercle

Shaft

Angle of the rib

Superficial surface

Costal groove

Flat blade called a shaft

inferior margin has costal groove for nerves & blood vessels

Proximal head & tubercle are connected by neck

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Superior view of a representative rib

Transverse process Tubercular facet

Superior costal facet Transverse costal facet Inferior costal facet

Articulation
head articulates with the body of vertebrae tubercle articulates with the transverse process

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