Chapter 8 Skeletal System.doc

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					Chapter 8. Skeletal System: Appendicular skeleton

1. Pectoral girdle/ Shoulder girdle (Fig.8.1)
      Attaches bones of upper limbs to axial skeleton
      Consisted with clavicle and scapula
   1) Clavicle/ Collar bone (Fig.8.2)
        -Sternal end
           :Articulates with manubrium of sternum (Sternoclavicular joint)
        -Conoid tubercle
        -Acromial end
           :Articulates with acromion of scapula (acromioclavicular joint)
        -Impression for the costoclavicular ligament
   2) Scapula/ Shoulder blade (Fig.8.3)
      Positioned between 2nd and 7th ribs
           :Articulates with acromial end of clavicle
        -Coracoid process
        -Glenoid cavity
           :Articulates with head of humerus (Glenohumeral joint)
        -Medial (vertebral) border: Thin edge
        -Lateral (axillary) border: Thick
        -Superior border
        -Superior and inferior angle
        -Scapular notch
        -Supra and infra spinous fossa
        -Subscapular fossa (anterior)
2. Upper Limb (Fig.8.4)
      Total 30 bones
        Humerus (1)
        Ulna and radius (2)
        Carpals (8)
        Metacarpals (5)
        Phalanges (14)
   1) Humerus (Fig.8.5)
        Articulates with
           -Scapula (head -'glenohumeral joint')
           -Ulna (Trochlea) and radius (Capitulum)
           -Anatomical and surgical neck
           -Greater and lesser tubercle
           -Intertubercular sulcus
           -Deltoid tuberosity

        -Radial fossa and coronoid fossa
        -Olecranon fossa
        -Trochlea and capitulum
        -Lateral and medial (*larger, coronoid process of ulna) epicondyle
        -Radial and coronoid fossa
2) Ulna and radius (Fig.8.6)
   (1) Ulna
        Medial aspect of forearm
        Longer than radius
           -Olecranon and coronoid process
           -Trochlear notch (Articulates with trochlea of humerus)
           -Ulnar tuberosity
           -Head of ulna (*distal position)
           -Styoid process of ulna
   (2) Radius
        Lateral aspect of forearm
        Colle's fracture
           -Head of radius
             :*Proximal position
             : Articulates with capitulum of humerus
           -Radial tuberosity
           -Styloid process of radius (Articulates with carpal bones)
             :*Scaphoid and lunate
   (3) Articulations (Fig.8.7)
        Between ulna and radius
           *Interosseous membrane
        Radius and humerus
        Ulna and humerus
3) Carpals, metacarpal, and phalanges
   (1) Carpals (Fig.8.8)
        8 bones
           -Connected by ligaments: intercarpal joints
           Trapezoid: four sided, two sides parallel
           Capitate: largest
           Pisiform: smallest
   (2) Metacarpals (5 bones)
           Form palm
           Carpometacarpal joints
           Proximal base and distal head

     (3) Phalanges (14 bones)
              Metacarpophalangeal joints
              Interphalangeal joints
              Proximal, middle, and distal
              Pollex (thumb) has only proximal and distal phalanx
3. Pelvic girdle (Fig.8.9)
        Consists with hip bone, pubic symphysis, sacrum
        Provides support for vertebral column and pelvic organs
     1) Components of hip bone (Fig.8.10)
        (1) Ilium
              Largest bone
              Iliac crest
              Anterior superior iliac spine
              Arcuate line
              Auricular surface: articulate with sacrum
        (2) Ischium
              Joints body to ilium, and ramus to pubis
              Obturator foramen: Largest foramen in skeleton
                 *Obturator membrane
        (3) Pubis
              Pubic Tubercle
              Pubic crest
              Iliopectineal line
              Pubic symphysis
                 Joints two hip bones through fibrocartilage
                 Relaxin (from ovary and placenta) increases flexibility of pubic symphysis
              Acetabulum (Vinegar cup)
                 Formed by fusion of three bones (ilium, ischium, and pubis)
                 Articulates with head of femur
              Acetabular notch
     2) False and true pelvis
        (1) Pelvic brim (Fig.8.11a,b)
              Divides superior and inferior portion of pelvis
              Circumference of connected line through,
                  :Sacral promontory - arcuate line (ilium) - liopectineal line (pubis) - pubic symphysis
        (2) False pelvis
              Space between pelvic brim and lumbar-iliac crest-abdominal wall
              No pelvic organs are included except urinary bladder
                      (when expended) and uterus (pregnant)
        (3) True pelvis
              Inferior to pelvic brim (pelvic cavity)
              Pelvic inlet: Pelvic brim
              Pelvic outlet: Inferior opening
              Pelvic axis: Imaginary curved line that goes through center of pelvic inlet and outlet
     3) Comparison of female and male pelvis (Table8.1) :female is....
        (1) Anterior views (Fig.8.1a)

           General structure: light/thin
           False pelvis: Shallow
           Pelvic brim: Larger/oval
           Acetabulum: Small/anteriorly
           Obturator foramen: Oval
           Pubic arch: Greater than 90 degree
     (2) Lateral views (Fig.8.1b)
           Iliac crest: Less curved
           Ilium: Less vertical
           Greater sciatic notch: Wide
           Coccyx: More movable/inferiorly
           Sacrum: Short/wide/inferiorly
     (3) Inferior views (Fig.8.1c)
           Pelvic outlet: Wider
           Ischial tuberosity: shorter/more lateral
  *Comparisons between pectoral vs. pelvic girdle

                                Pectoral girdle                     Pelvic girdle
   Articulation with
                            No direct articulation      Direct articulation (sacroiliac joint)
   vertebral column
                           Glenoid fossa is shallow             Acetabulum is deep
Articulation with limb
                           (Maximize movement)                  (Maximize strength)

4. Lower limb (Fig.8.12)
      Total 30 bones
        Femur (1)
        Patella (1)
        Tibia and fibula (2)
        Tarsals (7)
        Metatarsals (5)
        Phalanges (14)
   1) Femur (Fig.8.13a,b)
        Longest, heaviest, and strongest bone in body
             Proximal end: Head to acetabulum (coxal joint)
             Distal end: Tibia and Patella
           -Fovea capitis
           -Greater and lesser trochanter
           -Gluteal tuberosity
           -Linea aspera
           -Medial and lateral condyle: articulate with tibia
           -Medial and lateral epicondyle
           -Patellar surface

        -Intercondylar fossa
2) Patella (Fig.8.14)
      Developed in the tendon of quadriceps femoris muscle
        -Provides leverage of the tendon of quadriceps femoris muscle
        -Maintain position of the tendon when bent the knee
        -Protect knee joint
        -Base and apex
        -Articular facets: patellofemoral joint
3) Tibia and Fibula (Fig.8.15a,b)
      -Tibia and fibula connected by three points
        Proximal and distal end, interosseous membrane
   (1) Tibia
        Weight-bearing bone of leg
        Most frequently fractured bone
           -Medial and lateral condyle: articulate with femur
              *Lateral codyle articulates with fibula
           -Intercondylar eminence
           -Tibial tuberosity
           -Anterior crest/border
           -Medial malleolus: articulate with talus
           -Fibular notch (lateral): articulates with fibula
   (2) Fibula
        Positioned lateral to tibia
        Proximal end: Head
         Lateral malleolus: articulates with talus
4) Tarsals, metatarsals, and phalanges (Fig.8.16)
   (1) Tarsals
        7 bones
           -Talus: articulates with tibia and fibula
           -1st through 3rd cuneiform
   (2) Metatarsals
        5 metatarsal bones
   (3) Phalanges
        *Ballux- Big toe
5) Arches of foot (Fig.8.17)
      Distribution of body weight
      60% to heel, 40% to ball (bases of metatarsal)
      Provides leverage when walking
      Absorb shocks
      Clawfoot or flatfoot

(1) Longitudinal arch
     From calcaneus to metatarsals
     Rise at talus and cuboid
(2) Transverse arch
     From navicular to bases of metatarsals


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