Skeletal System

Functions
• Protects our organs (brain, intestines, etc.)
• Provides a framework for the movement of
our body through our muscles
• Stores minerals that our body needs to
function properly
• Produces blood cells
 Divisions of Skeleton
• Axial Skeleton: consists of
the 80 bones that make up
the trunk of our body.
• Appendicular Skeleton:
consists of the other 126
bones in the human body
and make up our limbs.
 Shapes of Bones:
• Long bones
• Short bones
• Flat bones
• Irregular bones
• (Sesamoid bones)
 L o n g Bones
• Longer than wide
• Carry most the load of our daily activities
• Crucial for skeletal mobility
• Examples: thigh bone (femur),
tibia, and fibula
 L o n g Bones
• Structure:
– Diaphysis: main shaft composed of compact bone
• Periosteum: membrane of living cells in diaphysis that
allow tendons and muscles to attach themselves to
bones
• Medullary cavity: hole that contains bone marrow
– Bone marrow: stores fat, produces blood cells, and plays an
important part in the body’s immune system
– Epiphysis (2 portions): part that is composed of
cancellous bone and articular cartilage
 Diaphysis

Epiphysis

Medullary cavity

Epiphysis Bone marrow

 Short Bones
• Approximately about as wide as long
• Provide support and stability at vital joint
areas of the skeletal system
• Examples: wrist/carpal bones and ankle/tarsal
bones
 Flat Bones
• Protect vital softer tissues
• Provide a surface for muscle attachments
 Ir r egul a r Bones
• Bones which, from their peculiar form, cannot
be grouped/defined like the other types of
bones
• Protect nervous tissue
 Sesamoid Bones
• Found in locations where a tendon passes
over a joint, such as the hand, knee, and foot.
• Functionally, they act to protect the tendon
and to increase its mechanical effect.
Sesamoid Bones
 Bones
Bones have two inside parts:

• Compact bone

• Cancellous, or spongy, bone

So named because of its
holey appearance.
Types of tissue that form bones
• Compact bone:
– Supports the whole body
– Protects organs
– Provides levers for movement
– Stores and releases chemical elements (calcium)
– Dense, smooth and very strong
– Contains living cells which help make repairs if a
bone is injured or broken.
Types of tissue that form bones
• Cancellous/spongy bone:
– Typically occurs at the ends of long bones,
proximal to joints and within the interior of
vertebrae
– Spongy and light weight
– Also, like compact bone, contains living cells which
help make repairs if a bone is injured or broken.
Compact Bone

Cancellous Bone
 Ligaments
• The tissue that connects bones to other bones
 Joints
• Joint: location where two
or more bones make
contact.
• Joints allow movement
and provide mechanical
support.
• There is a cartilage cushion
in between the bones to
keep them from touching
directly – which would
hurt!
 Joints
Examples of Joints
 Tendons
Muscle
Tendons: attach muscles
to bone.

They are made out of a

tough connective tissue Tendon

and are capable of

stretching to allow for
movement.
Bone
 Diaphysis

Epiphysis

Medullary cavity

Epiphysis Bone marrow

Compact Bone

Cancellous Bone
Ligaments
Joints
 Axial Skeleton
Sections:
• Skull

• Spine
(vertebral column)

• Ribcage
 Appendicular Skeleton
Sections:
• Arms and hands
(upper extremities)
• Legs and feet
(lower extremities)
• Shoulders
• Hips (pelvis)
SKELETAL TISSUE
AND PHYSIOLOGY
 CARTILAGE
• Connective tissue
• Fibers embedded in firm gel
• Avascular
• Chondrocytes lie in lacunae
• Nutrients delivered by diffusion
 3 TYPES
• Fibrocartilage – menesci of knee
and between vertebrae
• Elastic – external ear and epiglottis
• Hyaline – articular, chondral,
laryngeal, tracheal and bronchial
FUNCTIONS OF SKELETON
1. Support
2. Protection
3. Movement –bones and joints –
levers
4. Mineral reservoir – Ca++,
Phosphorus
5. Hemopoiesis – blood cell
formation
 TYPES OF BONES
1. Long – humerus, femur, ulna,
radius, tibia, fibula
2. Short – carpals and tarsals
3. Flat – skull, ribs, patella, scapula
4. Irregular – vertebrae, facial
bones, hyoid
 MACROSCOPIC
STRUCTURE OF LONG
BONES
1. Diaphysis – main shaft like
portion; hollow, cylindrical, thick
compact bone
2. Epiphysis(-es) – end of long bones
– bulbous shape provides
generous space for muscle
attachments – spongy
(cancellous) bone filled with
yellow marrow except in proximal
3. Articular cartilage – thin layer of
hyaline cartilage that covers joint
surfaces of epiphyses – shock
absorber
4. Periosteum –dense, white fibrous
membrane that covers bone
everywhere but joint surfaces –
Sharpey’s fibers penetrate bone –
muscle fibers interlace with these
providing a firm anchor – BVs
from periosteum nourish bone –
- OSTEOBLASTS (bone building cells)
compose inner periosteum

5. Medullary cavity – marrow

containing cavity in diaphysis
6. Endosteum – membrane lining
medullary cavity
 SHORT, FLAT AND
IRREGULAR BONES
• Cancellous bone covered
w/compact bone
• Red marrow fills spaces in
cancellous bone inside a few
irregular and flat bones (vertebrae
and sternum)
• Needle aspiration – diagnostic tool
 BONE TISSUE
• Connective tissue – cells, fibers
(collagen) and calcified matrix
• More matrix than cells; lots of
collagen
• Strength of cast iron, 1/3 the mass
 BONE MATRIX
1. Inorganic salts – APATITE (crystals
of calcium and phosphate) gives
bone its hardness – oriented to
resist stress
2. Organic matrix – collagen and
ground substance – amorphous
mixture of protein and
polysaccharides
MICROSCOPIC STRUCTURE
OF BONE
Compact bone composed of Haversian
system
1. Lamellae – concentric cylinders of
calcified matrix
2. Lacunae – small spaces containing
tissue fluid in which osteocytes lie
between lamellae
3. Canaliculi – small canals radiating from
lacunae, connecting them to each
other and the Haversian canal
4. Haversian canal – extends
through center of each Haversian
system – blood and lymph
transport O2 and nutrients to
bone cells
- BVs from periosteum penetrate
bone via Volkmann’s canals;
arteries supply marrow
Cancellous bone – NO Haversian
systems; weblike arrangement of
marrow filled spaces separated
by trabeculae (thin processes of
bone)
 BONE MARKINGS
A. DEPRESSIONS AND OPENINGS
1. Fossa
2. Sinus
3. Foramen
4. Meatus
5. Sulcus
B. PROJECTIONS AND PROCESSES

1. Condyle
2. Head
3. Trochanter
4. Crest
5. Spinous process
6. Tuberosity
7. Tubercle
DEVELOPMENT OF BONE -
OSTEOGENESIS
1. Intramembranous ossification
a. happens in connective tissue
membrane
b. Includes broad flat bones of the skull
c. Membrane like layers of primitive
connective tissue appear at the site of
future bone
d. Layers supplied with blood –
connective tissue cells arrange
themselves around the blood vessel
• These cells differentiate into
osteoblasts
• Osteoblasts deposit bony matrix –
produce spongy bone
• Osteoblasts become surrounded
by bony matrix – in lacunae,
osteocytes
• Osteoblasts on inside of
periosteum give rise to compact
bone
2. Endochondral
a. Formed from hyaline cartilage
model
b. Periosteum develops, enlarges,
and forms subperiosteal collar
c. 1o ossification center develops as
cartilage begins to calcify and
BVs enter rapidly changing
cartilage model at midpoint of
diaphysis
d. Ossification proceeds from
diaphysis to epiphysis
e. Bone grows in length
f. 2o ossification center appears at
epiphyses and growth proceeds from
epiphysis to diaphysis
g. Until bone length growth is complete,
a layer of cartilage (epiphyseal
cartilage) remains between diaphysis
and epiphysis
h. Epiphyseal cartilage thickens during
growth periods
i. This cartilage ossifies – osteoblasts
make organic bone matrix, matrix
calcifies – bone grows longer
 BONE GROWTH AND
RESORPTION
Bone growth – diameter
1. Osteoclasts
2. Osteoblasts
 Ossification and resorption occur
concurrently
 In adult years, rate =
 Childhood and adolescence,
ossification > resorption
 35- 40 years, resorption > ossification
 BONE FRACTURES AND
REPAIRS
Fracture – break in bone’s continuity
1. Simple – skin unbroken
2. Compound – skin broken
• Alignment = reduction
• Closed reduction = fracture set
without opening skin
• Open reduction – requires surgical
incision
• Osteomyelitis
• Kids – greenstick fractures – bone
cracked
 HEALING OF FRACTURES
• Dead bone – removed by
osteoclasts or serves as framework
for CALLUS (repair tissue)
• Callus – periosteal and endosteal
cells differentiate into
chondroblasts and osteoblasts
• Callus binds broken ends – callus
tissue is eventually replaced by
normal bone
Bones, cartilage,
and the special
structures that
connect them
make up your
 Major Organs of the
Skeletal System
Skull Clavicle
Ribs Humerus
Radius Ulna
Patella Femur
Tibia Fibula
Pelvic Vertebral
girdle column
• Protection
• Storage
• Movement
• Blood Cell Formation
 Protection
• Your heart and lungs are shielded
by your ribs

• Your spinal cord is protected by

your vertebrae

Your brain is protected

 Storage
• Bones store minerals that help
the nerves and muscles function
properly

• Your arm and leg bones also

store fat that can be used for
energy
 Movement
• Skeletal muscles pull on the
bones to produce movement

• Without bones, you

would not be able to
sit, stand, walk, or run
 Blood Cell
Formation
• Some of your bones
are filled with a
special material
that makes blood
cells
• A bone may seem lifeless, but it
is a living organ made of several
different tissues.
• Bone is composed of connective
tissue and minerals that are
deposited by living cells called
osteoblasts.
 Different Kinds
of
Compact Bone
Bone Tissue
Bone tissue that does not have any visible open spaces
Spongy Bone
Bone tissue that has many open spaces
Spongy bone provides most of the strength and
support for a bone. It acts like the trusses of a
bridge.
Bone Marrow
Red marrow, found in spongy bone, produces red
blood cells
Yellow marrow, found in the central cavity of long
bones, stores fat
 Growing
Bones
• Most bones start out as a soft, flexible
tissue called cartilage
• When you were born, you had little
true bone
• As you grow, the cartilage is replaced
by bone
• During childhood, growth plated of
cartilage remain in most bones,
providing a place for those bones to
continue to grow.
• The place where two or more bones
connect is called a joint
• Some joints allow a lot of movement,
while other joints are fixed.
• Joints that have a wide range of
movement tend to be more susceptible
to injury that those that are less
flexible.
 Three Types of
• Sliding Joint Joints
– Sliding joints allow bones in the hand to glide
over one another, giving some flexibility to the
area.
• Ball-and-Socket Joint
– Like a joystick on a computer game, the
shoulder enables your arm to move freely in all
directions.
• Hinge Joint
– Like a hinge on a door, the knee enables you to
flex and extend your lower leg.
Slidin
g
Joint
 Ball-and-
Socket Joint
Hinge Joint
• Joints are kept together with strong elastic
bands of connective tissue called ligaments.
• A strained ligament will usually heal with
time, but a torn ligament will not.
• A torn ligament must be repaired surgically
• Cartilage helps cushion the area where two
bones meet
• If cartilage wears away, the joint becomes
arthritic.
 Chapter 08
Lecture Outline
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Copyright © McGraw-Hill Education. Permission required for reproduction or display. 1

 Introduction
• Many organs are named for their relationships to
nearby bones
• Understanding muscle movements also depends on
knowledge of skeletal anatomy
• Positions, shapes, and processes of bones can
serve as landmarks for clinicians

8-2
 Overview of the Skeleton
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Frontal bone Parietal bone • Axial skeleton is

Skull Maxilla
Occipital bone
colored beige
Mandible

Clavicle
Mandible

Clavicle
– Forms central
Pectoral
girdle Scapula Scapula supporting axis of
Sternum
Thoracic Ribs Humerus
body
cage
Costal cartilages
– Skull, vertebrae,
Vertebral column
sternum, ribs,
Hip bone
sacrum, and hyoid
Pelvis
Sacrum
Ulna
Coccyx Radius

Carpus
Metacarpal
• Appendicular
bones
Phalanges
skeleton is colored
green
–
Femur
Pectoral girdle
–
Patella
Upper extremity
Fibula – Pelvic girdle
Tibia
– Lower extremity
Tarsus
Metatarsal bones

Phalanges
Figure 8.1
8-3
(a) Anterior view (b) Posterior view
 Bones of the Skeletal System

• Number of bones
– 206 in typical adult skeleton
• Varies with development of sesamoid bones
– Bones that form within tendons (e.g., patella)
• Varies with presence of sutural (wormian) bones in
skull
– Extra bones that develop in skull suture lines
– 270 bones at birth, but number decreases with fusion

8-4
 Anatomical Features of Bones
• Bone markings—ridges, spines, bumps,
depressions, canals, pores, slits, cavities, and
articular surfaces

• Ways to study bones

– Articulated skeleton: held together by wire
and rods, shows spatial relationships between
bones
– Disarticulated bones: taken apart so their
surface features can be studied in detail
8-5
Anatomical Features of Bones

8-6
 Anatomical Features of Bones
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Lines
Crest

Sinuses
Fovea
Head
Foramen
Meatus Crest Head
Trochanters Tubercle
Process
Condyle Alveolus
Spine Foramen

Tuberosity
(a) Skull (lateral view)
Line

Process
Spine Fossae

Epicondyles Fossae

Condyles

Figure 8.2 (c) Femur (d) Humerus 8-7

(b) Scapula (posterior view) (posterior view) (anterior view)
 The Skull
• Expected Learning Outcomes
– Distinguish between cranial and facial bones.
– Name the bones of the skull and the anatomical
features.
– Identify the cavities in the skull and in some of its
individual bones.
– Name the principal sutures that join the bones of the
skull.
– Describe some bones that are closely associated with
the skull.
– Describe the development of the skull from infancy
through childhood.

8-8
 The Skull

• Skull—most complex part of skeleton

• 22 bones joined together by sutures (immovable
joints)
• Several cavities—cranial cavity (brain case),
orbits (eye sockets), nasal cavity, oral (buccal)
cavity, middle- and inner-ear cavities, and
paranasal sinuses

8-9
 The Skull
• Foramina—holes that allow passage for nerves and blood
vessels
• Paranasal sinuses—frontal, sphenoid, ethmoid, maxillary
– Lined by mucous membrane and are air-filled
– Act as chambers that add resonance to the voice; lighten the skull

8-10
 The Skull
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Cranial cavity

Ethmoid
Frontal bone air cells

Ethmoid bone
Orbit
Superior Zygomatic
Nasal Middle bone
conchae
Inferior Maxilla

Maxillary
Vomer sinus

Nasal cavity
Oral
cavity
Mandible
Figure 8.7 8-11
 Cranial Bones
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Anterior cranial Frontal lobe

fossa

Temporal lobe

Middle cranial
fossa
Cerebellum

Posterior cranial Posterior cranial fossa

fossa
Middle cranial fossa

Anterior cranial fossa

(a) Superior view (b) Lateral view

Figure 8.9
• Cranium (braincase)
– Meninges (membranes) separate brain from bones
• Dura mater is thickest membrane
– Consists of two parts: calvaria (skullcap) and cranial base

8-12
 Cranial Bones
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Anterior cranial Frontal lobe

fossa

Temporal lobe

Middle cranial
fossa
Cerebellum

Posterior cranial Posterior cranial fossa

fossa
Middle cranial fossa

Anterior cranial fossa

(a) Superior view

Figure 8.9 (b) Lateral view

• Base is divided into three basins that comprise the cranial floor
– 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
• 8 cranial bones: 1 frontal, 2 parietal, 2 temporal, 1 occipital,
1 sphenoid, 1 ethmoid 8-13
 The Frontal Bone
• Forms forehead and part of
the roof of the cranium
• Coronal suture—posterior
boundary of frontal bone
• Supraorbital margin—ridge
of bone deep to eyebrow
• Supraorbital foramen
provides passage for nerve,
artery, and vein
• Glabella—smooth area Figure 8.3
above root of the nose
• Contains frontal sinus

8-14
 The Parietal Bones
• Form most of cranial roof and
part of its lateral walls

• Bordered by four sutures

– Sagittal: between parietal bones
– Coronal: at anterior margin
Figure 8.4a – Lambdoid: at posterior margin
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Anterior
– Squamous: at lateral border

• Two temporal lines for

Frontal bone

Coronal suture

attachment of the temporalis

Parietal bone
muscle
Sagittal suture

Sutural bone

Parietal foramen

Lambdoid suture

Occipital bone
Figure 8.6 8-15
Posterior
 The Temporal Bones
• Temporal bone: lateral wall and
part of floor of cranial cavity
• Four parts: squamous, tympanic,
mastoid, and petrous
• Squamous part
– Encircled by squamous suture
– Zygomatic process
– Mandibular fossa
• Tympanic part
– External auditory meatus
– Styloid process
• Mastoid part
Figure 8.4a
– Mastoid process
– Mastoid notch
– Mastoid foramen
– Stylomastoid foramen
8-16
 The Temporal Bones
(Continued)
• Petrous part
– Part of cranial floor
– Separates middle from posterior
cranial fossa
– Houses middle- and inner-ear
cavities
– Receptors for hearing and
balance
– Internal auditory meatus—
opening for CN VIII
(vestibulocochlear nerve)
Figure 8.5b
– Carotid canal
– Jugular foramen
8-17
 The Temporal Bones
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Squamous suture

Squamous part

Mastoid part
Zygomatic process
Mandibular fossa
Mastoid notch External acoustic
Mastoid process meatus
Styloid process Tympanic part

(a) Lateral surface

Squamous suture

Squamous part

Zygomatic Petrous part

process
Internal acoustic
meatus

Mastoid process
Styloid process
8-18
(b) Medial surface Figure 8.10
 The Occipital Bone
• Rear and base of skull
• Foramen magnum opening for
spinal cord
• Basilar part—thick median plate
• Occipital condyles—knobs
resting on spinal column
– Condylar canal, posterior to
occipital condyle (only present in
some people)
• Hypoglossal canal transmits
hypoglossal nerve (CN XII)
• External occipital protuberance
for nuchal ligament
• Superior and inferior nuchal
lines for neck muscle attachment Figure 8.5a

8-19
 The Sphenoid Bone
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Lesser wing
Dorsum sellae
Greater wing
Superior orbital
Body fissure
Foramen
• Body
Foramen ovale rotundum

Lateral pterygoid plate • Greater wing

Medial pterygoid plate Pterygoid processes
(b) Posterior view
• Lesser wing
Figure 8.11b
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. • Optic canal
Diploe (spongy bone)

Crista galli
Cribriform foramina
Frontal bone
Cribriform plate
of ethmoid bone
• Anterior
Optic foramen
Sphenoid bone
clinoid
Foramen rotundum
Foramen ovale
Sella turcica
processes
Foramen spinosum Temporal bone
Internal acoustic
Petrous part of
meatus
Jugular foramen
temporal bone
Parietal bone
Foramen magnum
• Superior
Groove for
venous sinus
Hypoglossal canal
Occipital bone orbital fissure
• Sella turcica
(b) Superior view of cranial floor
8-20
Figure 8.5b
 The Sphenoid Bone

• Foramen
rotundum
• Foramen ovale
Figure 8.11a • Foramen
lacerum
• Posterior nasal
apertures or
choanae
• Medial and
lateral pterygoid
plates
• Sphenoid sinus

8-21
Figure 8.5b
The Sphenoid Bone

Figure 8.4b

8-22
The Sphenoid Bone

Figure 8.5a
8-23
 The Ethmoid Bone
• Located between eyes
• Contributes to medial
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
wall of orbit, walls and
Cribriform
plate roof of nasal cavity, and
Cribriform Crista galli
foramina
nasal septum
Orbital plate
Superior
• Perpendicular plate
Ethmoidal
nasal concha forms superior two-thirds
cells
Middle of nasal septum
Perpendicular
nasal concha
• Cribriform plate forms
plate
roof of nasal cavity
• Crista galli: blade,
attachment for dura
• Cribriform (olfactory)
foramina
Figure 8.12 • Labyrinth forms lateral
masses
- Ethmoidal cells
- Orbital plate
8-24
The Ethmoid Bone

Figure 8.14

8-25
 The Ethmoid Bone

Figure 8.4b

• Superior and middle nasal conchae—scroll-like plates that

project into the nasal fossa
• Along with an inferior concha (a separate bone), these
plates occupy most of the nasal cavity, create turbulence
of airflow, and help humidify air
8-26
The Ethmoid Bone

Figure 8.13

8-27
 Facial Bones
• Facial bones (14)—skull bones anterior to the cranial
cavity (do not enclose brain)
– Support teeth
– Give shape to face
– Form part of orbital and nasal cavities
– Provide attachments for muscles of facial expression and
mastication

2 maxillae 2 nasal bones

2 palatine bones 2 inferior nasal conchae
2 zygomatic bones 1 vomer
2 lacrimal bones 1 mandible

8-28
 The Maxillae

• Largest facial bones

• Forms upper jaw and meets at
median intermaxillary suture
– Alveolar processes: bony points
between teeth
– Alveolus: sockets that hold teeth
– Cleft palate and cleft lip occur
when the two maxillae fail to join
at the suture

Figure 8.3

8-29
The Maxillae

Figure 8.5a
8-30
 The Maxillae
(Continued)
• Forms inferomedial wall of orbit
– Infraorbital foramen
– Inferior orbital fissure

• Forms most of the hard palate

– Forms roof of mouth and floor of nasal cavity
– Palate allows us to chew while breathing
– Palatine process
– Incisive foramen

8-31
 The Maxillae
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Sphenoid
sinus
Frontal
sinus
Ethmoid
sinus
Maxillary
sinus

Figure 8.8 Figure 8.8

• Maxillary sinus fills maxillae bone

• Larger in volume than frontal, sphenoid, and
ethmoid sinuses
8-32
 The Palatine Bones
• L-shaped bones
• Form posterior
portion of the hard
palate
• Part of lateral nasal
cavity wall
• Part of the orbital
floor
Figure 8.13
• Greater palatine
foramina

8-33
The Palatine Bones

Figure 8.5a
8-34
 The Zygomatic Bones
• Form angles of
cheekbones and part
of each lateral orbital
wall
• Zygomaticofacial
foramen
• Zygomatic arch is
formed from temporal
Figure 8.4a
process of zygomatic
bone and zygomatic
process of temporal
bone
8-35
 The Lacrimal Bones

• Form part of medial

wall of each orbit
• Smallest bone of
skull
• Lacrimal fossa
houses lacrimal sac
– Tears collect in sac
Figure 8.4a
and drain into nasal
cavity

8-36
 The Nasal Bones

• Form bridge of nose

• Support cartilages
that shape lower
portion of the nose
• Often fractured

Figure 8.3

8-37
 The Inferior Nasal Conchae

• Inferior nasal concha

is largest of three
conchae in the nasal
cavity
– It is separate from the
other conchae that are
parts of the ethmoid
bone Figure 8.13

8-38
 The Vomer

• Inferior half of the

nasal septum
– Inferior to perpendicular
plate of ethmoid
• Supports cartilage
that forms anterior
part of nasal septum
Figure 8.4b

8-39
 The Mandible
• Strongest bone of skull
– Only one to noticeably move
• Supports lower teeth
– Alveolar processes between teeth
• Provides attachments for muscles
of expression and mastication
• Mental symphysis—joint at midline
– Ossifies in early childhood
– Mental protuberance—point of chin
• Mental foramen on anterolateral
Figure 8.15
surface
– For nerves and vessels of chin
• Mandibular foramen on medial
surface
– For nerves and vessels of lower teeth 8-40
 The Mandible
• Major parts
– Body: supports teeth
– Ramus: articulates with cranium
– Angle—where body meets ramus
• Features of ramus
– Condylar process with
mandibular condyle that articulates
with temporal bone forming TMJ
Figure 8.15 (temporomandibular joint)
– Coronoid process for temporalis
muscle
– Mandibular notch between
processes

8-41
 Bones Associated with the Skull
• Auditory ossicles
– Three in each middle-ear cavity Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

– Malleus, incus, and stapes

• Hyoid bone
– Slender U-shaped bone
between chin and larynx Styloid process

– Does not articulate with any Stylohyoid muscle

other bone Hyoid

– Suspended from styloid Larynx Lesser horn
Greater horn
process of skull
– Body and greater and lesser
horns (cornua) Body
Figure 8.16
– Fractured hyoid bone is
evidence of strangulation

8-42
 The Skull in Infancy and Childhood
• Fontanels—spaces between
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Coronal
suture
Frontal
unfused cranial bones
– Contain fibrous membrane
Parietal bone bone
Sphenoid
Lambdoid
fontanel

– Allow shifting of bones during

suture
Nasal
Squamous bone
suture

Occipital bone
Maxilla birth and growth of brain
Zygomatic
Mastoid
bone
Mandible
– Anterior, posterior,
fontanel

Temporal bone
Sphenoid sphenoid (anterolateral), and
bone
(a) Lateral view mastoid (posterolateral)
fontanels
Frontal bone

Anterior fontanel
• Two frontal bones fuse by age
Sagittal suture
6 (metopic suture)
Parietal
bone
• Skull approaches adult size
Posterior fontanel
by 8 or 9 years of age
(b) Superior view
Figure 8.17 8-43
 The Vertebral Column and
Thoracic Cage
• Expected Learning Outcomes
– Describe the general features of the vertebral column
and those of a typical vertebra.
– Describe the structure of the intervertebral discs and
their relationship to the vertebrae.
– Describe the special features of vertebrae in different
regions of the vertebral column, and discuss the
functional significance of the regional differences.
– Describe the anatomy of the sternum and ribs and
how the ribs articulate with the thoracic vertebrae.

8-44
 General Features of the
Vertebral Column Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• Functions of spine
Anterior view Posterior view

Atlas (C1)

– Supports skull and trunk and allows

Axis (C2)
Cervical vertebrae

for their movement C7

– Protects spinal cord T1

– Absorbs stresses of movements

– Provides attachments for limbs, Thoracic vertebrae

thoracic cage, and postural muscles

• 33 vertebrae with intervertebral T12

discs between most of them L1

– Discs account for about one-quarter Lumbar vertebrae

of spine’s 71 cm length (on average)

– Discs compress a bit during the day L5

due to pressure of body weight S1

Sacrum

S5
Coccyx Coccyx

Figure 8.18 8-45

 General Features of the
Vertebral Column Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Anterior view Posterior view

• Five vertebral groups Atlas (C1)

Axis (C2)
Cervical vertebrae

– 7 cervical in the neck C7

– 12 thoracic in the chest T1

– 5 lumbar in lower back

– 5 fused sacral at base Thoracic vertebrae

of spine
– 4 fused coccygeal T12

• Variations in number
L1

Lumbar vertebrae
of vertebrae occur in 1
in 20 people L5

– Generally in the number S1

of fused vertebrae in Sacrum

inferior part of spine S5

Coccyx Coccyx

Figure 8.18 8-46

 General Features of the
Vertebral Column
• Primary curvature: spine
exhibits one continuous C-
shaped curve at birth (convex)
– This persists as the curvature of
the thoracic and pelvic spine
• With crawling and walking,
secondary curvatures
develop in cervical and lumbar
areas (concave)
– Vertebral column is S-shaped
beyond the age of 3 years

Figure 8.20
8-47
 General Features of the
Vertebral Column
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

C1
Cervical curvature • S-shaped vertebral column
C7
T1
with four normal
curvatures
– Cervical
Thoracic curvature
– Thoracic
– Lumbar
T12
L1
– Pelvic
Lumbar curvature

L5
S1

Pelvic curvature

Figure 8.19 8-48

 Abnormal Spinal Curvatures
• Abnormalities result from
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
disease, paralysis of trunk
muscles, poor posture,
pregnancy, or congenital
defects

• Scoliosis—abnormal lateral
curvature
– Most common
– Usually in thoracic region
(a) Scoliosis (b) Kyphosis
(“hunchback”)
(c) Lordosis
(“swayback”) – Particularly of adolescent girls
Key
Normal
Pathological – Developmental abnormality in
Figure 8.21 which the body and arch fail to
develop on one side of the
vertebrae
8-49
 Abnormal Spinal Curvatures
• Kyphosis (hunchback)—exaggerated thoracic
curvature
– Usually from osteoporosis, also osteomalacia or spinal
tuberculosis, wrestling or weight lifting in young boys

• Lordosis (swayback)—exaggerated lumbar

curvature
– From pregnancy or obesity

8-50
 General Structure of Vertebra
• Body (centrum)
– Spongy bone (with red Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Posterior
marrow) covered with a shell Spinous process
of compact bone Superior articular Lamina
– Weight-bearing portion facet

– Rough surfaces enhance

Vertebral
Transverse arch
process
attachment of intervertebral Vertebral foramen Pedicle

discs
• Vertebral foramina Body

– Collectively form vertebral

canal for spinal cord Anterior

• Vertebral arch Figure 8.22a

– Pedicle: pillar-like
– Lamina: plate-like
• Spinous process
– Projects from arch
– Bump that is visible under
skin 8-51
 General Structure of Vertebra
• Transverse process
– Extends laterally from point
where pedicel and lamina
meet
• Superior articular
processes
– Project upward from one
vertebra and meets
inferior articular
processes from the
vertebra above
• Facets
– Flat articular surfaces Figure 8.23a
covered with hyaline
cartilage

8-52
 General Structure of Vertebra
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Superior articular
process of L1 • Intervertebral foramen
Inferior vertebral – Opening between pedicles
notch of L1
L1
of two adjoining vertebrae
– Passageway for spinal
Intervertebral
foramen

Superior vertebral
notch of L2 nerves
L2

Spinous process
– Inferior vertebral notch in
the pedicle of the upper
Intervertebral disc vertebra
– Superior vertebral notch
L3

Inferior articular
process of L3
in the pedicle of the lower
(b) Left lateral view vertebra
Figure 8.23b

8-53
 Intervertebral Discs
• Intervertebral discs (23)
– Pad consisting of:
• Nucleus pulposus—inner
gelatinous mass
• Anulus fibrosus—outer ring of
fibrocartilage
– Bind vertebrae together
– Support weight of the body
– Absorb shock
– Herniated disc (“ruptured” or
“slipped” disc) puts painful
pressure on spinal nerve or Figure 8.22b,c
spinal cord

8-54
 Regional Characteristics of Vertebrae
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Superior views Lateral views

Spinous process

Lamina Superior articular facet

Transverse foramen Body

Transverse process
Spinous process
(a) Cervical vertebrae
Inferior articular process
Figure 8.25a

• Cervical vertebrae (C1-C7) are small and light

• Bifid or forked spinous processes in C2 to C6
• Small body and large vertebral foramen
• Transverse foramen in each short transverse process
– Provides passage for vertebral artery and vertebral vein
• C1 = atlas; C2 = axis
• C7 = vertebra prominens—prominent spinous process
8-55
 Cervical Vertebrae
• Atlas (C1)
– Supports the head
– Has no body; consists of
delicate ring around large
vertebral foramen
– Lateral masses
• Superior articular facets
articulate with occipital
condyles forming atlanto–
occipital joint; allows
nodding “yes”
Figure 8.24a
• Inferior articular facets
articulate with C2
– Anterior and posterior arches
• Anterior and posterior
tubercles

8-56
 Cervical Vertebrae
• Axis (C2)
– Allows head rotation gesturing
“no”
– Dens or odontoid process—
prominent knob on its
anterosuperior side
• Fuses with axis by age 3 to 6
years
• Projects into vertebral
foramen of the atlas
• Held in place by a
transverse ligament
– Atlantoaxial joint: between
Figure 8.24b
atlas and axis

8-57
 Atlas and Axis Articulation
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Axis of rotation

Dens
Atlas

Transverse
ligament
Axis

Figure 8.24c
8-58
(c) Atlantoaxial joint
 The Thoracic Vertebrae
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Spinous process Superior articular facet

Lamina
Transverse process

Transverse costal facet Superior costal facet Transverse costal facet

Inferior costal facet
Body
Inferior articular facet
(b) Thoracic vertebrae
Spinous process
Figure 8.25b

• 12 thoracic vertebrae (T1–T12)

– Correspond to the 12 pairs of ribs attached to them
• Spinous processes pointed and angled sharply downward
• Have larger body than cervical, but smaller than lumbar
• Superior and inferior costal facets for attachment of ribs
– On body as small, smooth, slightly concave spots
• Transverse costal facets at end of each transverse process T1–T10
– Provide second point of articulation for ribs 1–10
8-59
 The Lumbar Vertebrae
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Spinous process

Superior articular facet Superior articular process

Transverse process
Pedicle

Body Spinous process

(c) Lumbar vertebrae

Figure 8.25c Inferior articular facet

• Five lumbar vertebrae (L1–L5)

• Thick, stout body
• Blunt, squarish spinous process
• Superior articular processes face medially
– Lumbar region resistant to twisting movements
8-60
 The Sacrum • Sacrum—bony plate that forms
posterior wall of pelvic cavity
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
• Five separate sacral vertebrae
Superior articular
process (S1–S5) begin fusing around
Sacral
age 16 and complete fusion by
Ala
promontory age 26
S1
• Anterior surface
S2
– Smooth and concave
Transverse lines – Four transverse lines indicate
Anterior sacral
S3
regions of fusion
foramina S4 – Four pairs of large anterior
S5
sacral (pelvic) foramina
Co2 Co1
Coccyx
Co3
Co4
• Allow passage of nerves and
arteries to pelvic organs
(a) Anterior view
– Sacral promontory—ridge
Figure 8.26a jutting from front of S1

8-61
The Sacrum
(Continued)
• Posterior surface very rough
– Median sacral crest—fusion of
spinous processes
– Lateral sacral crests—fusion of
transverse processes
– Posterior sacral foramina—four
pairs of openings for nerves to
gluteal region and lower limbs
• Sacral canal runs vertically through
sacrum and ends as sacral hiatus
– Contains spinal nerve roots
• Auricular surface is part of sacroiliac
(SI) joint formed with hip bone
• Superior articular processes on S1;
Figure 8.26b articulates with L5
• Alae—pair of large, wing-like extensions
lateral to the superior articular
processes
8-62
 The Coccyx
• Coccyx—usually consists
of four small vertebrae
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. (Co1–Co4); sometimes five
Superior articular Sacral canal
process
• Fuse into single,
triangular bone by age 20
Median
sacral crest to 30
Auricular
surface • Horns (cornua) on Co1
Lateral sacral – Serve as attachment points
crest
for ligaments that bind
Posterior sacral
foramina coccyx to sacrum
Horn
Sacral hiatus • Fractured during difficult
Transverse
childbirth or by hard fall
• Provides attachment for
process Coccyx

(b) Posterior view

muscles of the pelvic
floor
Figure 8.26b
8-63
 The Thoracic Cage • Thoracic cage consists
of thoracic vertebrae,
sternum, and ribs
• Encloses lungs and heart
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Sternoclavicular joint – Also provides some
Acromioclavicular joint
T1
Sternum:
Suprasternal notch
protection of spleen, liver
Pectoral girdle:
1 Clavicular notch kidneys
• Provides attachment for
Clavicle Manubrium
Scapula 2 Angle

3 pectoral girdle and upper

True ribs (1–7)
4
Body
limbs
5
Xiphoid process
• Broad base, narrower
6 Costal cartilages apex
8
7 11
• Rhythmically expanded
False ribs (8–12)
Floating ribs
(11–12)
9
12 T12
by respiratory muscles
10 L1
Costal margin
to draw air into lungs
Figure 8.27 • Costal margin—inferior
border of thoracic cage
formed by arc of lower ribs
8-64
 The Sternum
• Sternum (breastbone)—bony plate anterior to the heart
• Divided into three regions
– Manubrium
• Broad superior portion
• Suprasternal (jugular) notch
• Clavicular notches—articulate with clavicle
– Body (gladiolus)
• Longest part of sternum
• Sternal angle—point where body joins manubrium
• Ribs attach along scalloped lateral margins
– Xiphoid
• Inferior point of sternum
• Attachment for some abdominal muscles
• CPR (cardiopulmonary resuscitation) should avoid pressure against
the xiphoid to avoid internal bleeding
8-65
 The Ribs

• 12 pairs of ribs
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Sternoclavicular joint

Acromioclavicular joint
T1
Sternum:
Suprasternal notch - Posterior (proximal)
Pectoral girdle:
Clavicle
1 Clavicular notch

Manubrium
ends attached to
Scapula 2 Angle
vertebral column
3
Body
- Most ribs’ anterior
4
True ribs (1–7)
(distal) ends attached
5
Xiphoid process
to sternum
• Costal cartilages
6 Costal cartilages

7 11
8 (made of hyaline
12 T12
False ribs (8–12)
Floating ribs
(11–12)
9
10 L1
cartilage) attach rib
Costal margin to sternum
Figure 8.27

8-66
 The Ribs
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Tubercle Neck Head

• Head—portion of rib that

articulates with bodies of
Articular facet
Superior Inferior
thoracic vertebrae
Angle for transverse Articular facets
process for vertebral bodies – Superior and inferior articular
facets
• Neck—narrow portion distal
Costal groove
Shaft

(b) Ribs 2–10 Figure 8.28b to the head

• Tubercle—wider, rough
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
area distal to the neck
Superior Transverse
articular
facet
costal facet
for rib 6
– Articulates with transverse
costal facet of vertebra
Tubercle
Superior Rib 6
Neck
costal
facet Head
T6
for rib 6

8-67
(b) Superior view
Figure 8.29b
 The Ribs
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Tubercle Neck Head

• Angle—lateral curve of
rib
Superior Inferior • Shaft—long, gentle
Articular facet
Angle for transverse
process
Articular facets
for vertebral bodies
sloping, blade-like portion
of rib
Costal groove – Costal groove on inferior
Shaft
margin of shaft
(b) Ribs 2–10
Figure 8.28b

8-68
 The Ribs
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Inferior costal
facet of T5
Vertebral Superior articular
body T5 facet of rib 6
Rib 6

Inferior articular
Vertebral facet of rib 6
body T6 Superior costal
facet of T6
(a) Anterior view

Superior Transverse
articular costal facet
facet for rib 6

Tubercle

Superior Neck Rib 6

costal
Head
facet T6
for rib 6 Figure 8.29
8-69
(b) Superior view
 The Ribs
• True ribs (ribs 1–7)
– Each is directly connected to
sternum
• False ribs (ribs 8–12)
– Lack independent
connections to sternum
– Floating ribs (ribs 11–12)
• Do not have cartilaginous
connection to sternum or
higher costal cartilages
Figure 8.27
• Do not have tubercles or
attachments to transverse
processes of vertebra

8-70
 The Pectoral Girdle and
Upper Limb
• Expected Learning Outcome
– Identify and describe the features of the clavicle,
scapula, humerus, radius, ulna, and bones of the
wrist and hand.

8-71
 The Pectoral Girdle
• Pectoral girdle (shoulder girdle) supports the arm

• Consists of two bones on each side of the body

– Clavicle (collarbone) and scapula (shoulder blade)

• Clavicle articulates medially to the sternum and

laterally to the scapula
– Sternoclavicular joint
– Acromioclavicular joint

• Scapula articulates with the clavicle and the humerus

– Glenohumeral joint: shoulder joint
– Easily dislocated due to loose attachment
8-72
 The Clavicle
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Sternal
Acromial
end
end
Conoid tubercle

(a) Superior view

Conoid tubercle
Sternal
end Acromial
end
(b) Inferior view Figure 8.30

• Clavicle—S-shaped, somewhat flattened bone

• Sternal end—hammer-like head
• Acromial end—flattened
• Conoid tubercle—rough bump near acromial end
• Braces shoulder, keeps arm away from midline
• Frequently fractured 8-73
 The Scapula
• Scapula—named for resemblance to a shovel
• Triangular plate that posteriorly overlies ribs 2
to 7
– Three sides: superior, medial, and lateral borders
– Three angles: superior, inferior, and lateral angles
• Suprascapular notch—conspicuous notch on
superior border
– Provides passage for a nerve
• Spine—transverse ridge on posterior surface
– Supraspinous fossa: indentation superior to the spine
– Infraspinous fossa: broad surface inferior to the spine
8-74
 The Scapula
• Subscapular fossa—concave, anterior surface of
scapula
• Lateral angle of scapula has three main features
– Acromion: plate-like extension of the spine
• Forms apex of the shoulder
• Articulates with clavicle—sole point of attachment of
scapula and upper limb to the rest of the skeleton
– Coracoid process: shaped like a bent finger
• Provides attachment for tendons of biceps brachii and
other arm muscles
– Glenoid cavity: shallow socket that articulates with the
head of the humerus
• Helps form glenohumeral joint

8-75
 The Scapula
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Superior
Suprascapular border Superior angle
Acromion
notch

Acromion
Supraspinous
Coracoid fossa
process Lateral
angle
Glenoid Spine
cavity

Subscapular Infraspinous
fossa fossa

Lateral Medial
border border

Inferior angle

(a) Anterior view (b) Posterior view

Figure 8.31
8-76
 The Upper Limb
• Upper limb is divided into four regions containing
a total of 30 bones per limb
– Brachium (arm proper): extends from shoulder to elbow
• Contains only 1 bone—humerus
– Antebrachium (forearm): extends from elbow to wrist
• Contains 2 bones—radius and ulna
– Carpus (wrist)
• Contains 8 small bones arranged in two rows
– Manus (hand)
• 19 bones in two groups
– 5 metacarpals in palm
– 14 phalanges in fingers
8-77
The Humerus

• Proximal end
– Hemispherical head
that articulates with
the glenoid cavity of
scapula
– Anatomical neck
– Greater and lesser
tubercles and deltoid
tuberosity
– Intertubercular
sulcus holds biceps
tendon
– Surgical neck

8-78
Figure 8.32
The Humerus
• Distal end
– Rounded capitulum
articulates with head of
radius
– Trochlea articulates
with ulna
– Lateral and medial
epicondyles
– Lateral and medial
supracondylar ridges
– Olecranon fossa holds
olecranon process of
ulna
– Coronoid fossa
– Radial fossa
8-79
Figure 8.32
 The Radius
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Olecranon Olecranon

Radial notch
Trochlear notch
• Radius
of ulna
Head of
Head of
radius
– Head: disc-shaped, allows
Coronoid process
radius
Neck of
for rotation during pronation
Neck of
radius Ulnar tuberosity
radius and supination
Radial
tuberosity
• Superior surface
articulates with
Ulna capitulum on humerus
Radius
• Side of disc spins on
radial notch on ulna
Interosseous – Neck
borders
– Radial tuberosity for
Interosseous
biceps muscle
membrane
– Styloid process can be
palpated near thumb
Ulnar notch
of radius
– Ulnar notch
Head of ulna accommodates head of
Styloid
Styloid process
Articular facets Styloid
ulna
process process
(a) Anterior view (b) Posterior view

Figure 8.33 8-80

 The Ulna
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Olecranon Olecranon

Radial notch
Trochlear notch
• Ulna
of ulna
Head of Coronoid process
Head of
radius – Trochlear notch articulates
radius
Neck of
Neck of with trochlea of humerus
radius
radius Ulnar tuberosity
– Olecranon: bony point at
Radial
tuberosity back of elbow
Ulna
– Coronoid process
Radius
– Radial notch holds head of
radius
Interosseous
borders
– Styloid process

Interosseous
membrane • Interosseous membrane
– Ligament attaches radius to
Ulnar notch ulna along interosseous
of radius
Head of ulna margin of each bone
Styloid process
Styloid Articular facets Styloid
process process
(a) Anterior view (b) Posterior view
8-81
Figure 8.33
 The Carpal Bones

• Eight bones form wrist

– Allow movements of flexion, extension, abduction,
and adduction
• Two rows (four bones each)
– Proximal row: scaphoid, lunate, triquetrum, and
pisiform
• Pisiform is a sesamoid developed by age 9 to12 in
tendon of flexor carpi ulnaris muscle
– Distal row: trapezium, trapezoid, capitate, and
hamate

8-82
The Right Wrist and Hand
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Distal phalanx II

Key to carpal bones

Middle phalanx II Distal row

Proximal row
Proximal phalanx II

III II Distal
Head IV phalanx I

Phalanges Body V
Proximal
Base phalanx I
I
Head

Metacarpal Body First

bones metacarpal
Base
Hamulus of hamate
Trapezoid
Hamate Trapezium
Carpal Pisiform Carpal
Capitate bones
bones Triquetrum
Scaphoid
Lunate

(a) Anterior view

Figure 8.34a

8-83
 The Metacarpal Bones and the
Phalanges
• Metacarpals—bones of the palm
– Metacarpal I proximal to base of thumb
– Metacarpal V proximal to base of little finger
– Proximal base, body, and distal head

• Phalanges—bones of the fingers

– Thumb or pollex has two phalanges
• Proximal, distal phalanx
– Fingers have three phalanges
• Proximal, middle, distal phalanx

8-84
The Right Wrist and Hand
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Distal phalanx II

Key to carpal bones

Middle phalanx II Distal row

Proximal row
Proximal phalanx II

III II Distal
Head IV phalanx I

Phalanges Body V
Proximal
Base phalanx I
I
Head

Metacarpal Body First

bones metacarpal
Base
Hamulus of hamate
Trapezoid
Hamate Trapezium
Carpal Pisiform Carpal
Capitate bones
bones Triquetrum
Scaphoid
Lunate

(a) Anterior view

Figure 8.34a

8-85
 The Pelvic Girdle and
Lower Limb
• Expected Learning Outcomes
– Identify and describe the features of the pelvic girdle,
femur, patella, tibia, fibula, and bones of the foot.
– Compare the anatomy of the male and female pelvic
girdles and explain the functional significance of the
differences.

8-86
 The Pelvic Girdle
• Pelvic girdle—a ring
composed of three
bones Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

– Two hip (coxal) bones,

Iliac
crest

also called ossa coxae or

Iliac
fossa
Base of
Ilium sacrum

innominate bones Anterior

superior
iliac spine
Sacroiliac joint
Pelvic surface
of sacrum

– One sacrum (also part of Anterior inferior

iliac spine
Spine
Pelvic inlet

Coccyx

vertebral column) Ischium

Body
Acetabulum
Interpubic
disc
Ramus

• Pelvis—the pelvic girdle Pubis

Superior ramus
Inferior ramus
Body
Obturator
foramen

plus ligaments and

Pubic symphysis

(a) Anterosuperior view

Figure 8.35a
muscles that line the
pelvic cavity and form its
floor
8-87
 The Pelvic Girdle
• Sacroiliac joint—joins
coxal bone to vertebral Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

column Iliac
crest

– Auricular surface of
Iliac
fossa
Base of
Ilium sacrum
Sacroiliac joint

ileum to auricular Anterior

superior
iliac spine
Pelvic surface
of sacrum

surface of sacrum Anterior inferior

iliac spine
Spine
Pelvic inlet

Coccyx

Ischium Acetabulum
Body
Interpubic

• Pubic symphysis—the
disc
Ramus

Superior ramus Obturator

Pubis Inferior ramus foramen
Body

interpubic disc (of Pubic symphysis

(a) Anterosuperior view

Figure 8.35a
fibrocartilage) joins
pubic bones anteriorly

8-88
 The Pelvic Girdle
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
Iliac
crest

Iliac
fossa
Base of
Ilium sacrum

Anterior Sacroiliac joint

superior Pelvic surface
iliac spine of sacrum

Anterior inferior
Pelvic inlet
iliac spine
Spine
Coccyx

Ischium Acetabulum
Body
Interpubic
disc
Ramus

Superior ramus Obturator

Pubis Inferior ramus foramen
Body
Pubic symphysis

(a) Anterosuperior view

Figure 8.35a
Figure 8.35b

• Greater (false) pelvis—between flare of the hips

• Lesser (true) pelvis—narrower and below
• Pelvic brim—round margin that separates the two
• Pelvic inlet—opening circumscribed by brim that infant’s
head must pass during birth
• Pelvic outlet—lower margin of the lesser pelvis 8-89
 The Pelvic Girdle
• Three distinct features
of hip bone
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

– Iliac crest: superior crest

of hip Ilium Ischium Pubis Iliac crest

– Acetabulum: hip socket Anterior gluteal

line
Inferior gluteal

– Obturator foramen:
line
Anterior superior
Posterior gluteal iliac spine
line

large hole below Posterior superior

Iliac spine

acetabulum Posterior inferior

Iliac spine
Anterior
r inferior
iliac spine
Greater sciatic notch
Body of ilium

• Each adult hip bone is Acetabulum

Ischial spine
Superior ramus
of pubis

Body of pubis

formed by the fusion Lesser sciatic notch

Body of ischium
Inferior ramus
of pubis

of three childhood Ischial tuberosity Obturator foramen

Ramus of ischium

bones: ilium, (a) Lateral view

ishchium, pubis Figure 8.36a 8-90

 The Pelvic Girdle
• Ilium
– Largest bone in hip
– Extends from iliac crest to center of the acetabulum
– Anterior and posterior superior spine
– Anterior and posterior inferior spines
– Greater sciatic notch and iliac fossa
• Ischium
– Inferioposterior portion of hip
– Heavy body with prominent spine
– Lesser sciatic notch
– Ischial tuberosity
– Ramus
• Pubis (pubic bone)
– Most anterior portion of the hip bone
– Body, superior, and inferior ramus
8-91
 The Pelvic Girdle

Figure 8.37

• Male—heavier and thicker

• Female—wider and shallower, and adapted to the needs
of pregnancy and childbirth, larger pelvic inlet and outlet
for passage of infant’s head
8-92
The Pelvic Girdle

8-93
 The Lower Limb
• Lower limb divided into four regions containing 30
bones per limb
– Femoral region (thigh): extends from hip to knee region
• Contains femur and patella

– Crural region (leg proper): extends from knee to ankle

• Contains medial tibia and lateral fibula

– Tarsal region (tarsus): ankle—the union of the crural

region with the foot
• Tarsal bones are considered part of the foot

– Pedal region (pes): foot

• Composed of 7 tarsal bones, 5 metatarsals, and 14 phalanges in
the toes

8-94
 The Femur
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
• Longest and strongest bone
Greater trochanter
Fovea capitis

Head
Greater trochanter
of the body
Neck
Intertrochanteric crest
• Hemispherical head articulates
Intertrochanteric line
Lesser trochanter

Spiral line
with acetabulum of pelvis
Gluteal tuberosity

– Fovea capitis: pit in head of

femur for attachment of a
Linea aspera
ligament
Shaft • Greater and lesser
trochanters for muscle
attachment
• Intertrochanteric crest—thick
Medial supracondylar line

Popliteal surface
Lateral supracondylar
line ridge on posterior surface that
Lateral epicondyle
Patellar surface
Medial epicondyle Lateral epicondyle
Lateral condyle
connects the trochanters
Base of patella
Medial condyle Intercondylar fossa
• Intertrochanteric line—more
Apex of patella
Articular facets
delicate ridge on anterior
(a) Anterior view (b) Posterior view
surface that connects
Figure 8.38 trochanters
8-95
 The Femur
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Fovea capitis
Greater trochanter Greater trochanter
Head

Neck

Intertrochanteric line
Lesser trochanter
Intertrochanteric crest
• Linea aspera—ridge on
Spiral line Gluteal tuberosity posterior of the shaft

Linea aspera
• Spiral (pectineal) line and
Shaft
gluteal tuberosity
• Medial and lateral condyles
and epicondyles found
distally
Medial supracondylar line Lateral supracondylar

• Intercondylar fossa
line
Popliteal surface
Lateral epicondyle Medial epicondyle Lateral epicondyle
Patellar surface Lateral condyle

• Patellar and popliteal

Medial condyle Intercondylar fossa

Base of patella

Apex of patella
Articular facets
surface
(a) Anterior view (b) Posterior view

Figure 8.38
8-96
 The Patella • Patella—triangular
sesamoid bone embedded
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. in tendon of knee
Fovea capitis
Greater trochanter
Head
Greater trochanter
• Cartilaginous at birth
Neck

Intertrochanteric line
Lesser trochanter
Intertrochanteric crest
– Ossifies at age 3 to 6 years
• Base—broad, superior
Spiral line Gluteal tuberosity

Linea aspera
portion
Shaft
• Apex—pointed, inferior
portion
• Articular facets—shallow,
posterior portion
Medial supracondylar line Lateral supracondylar

• Quadriceps tendon
line
Popliteal surface
Lateral epicondyle Medial epicondyle Lateral epicondyle
Patellar surface Lateral condyle
Medial condyle Intercondylar fossa
extends from front of thigh
Base of patella

Apex of patella
Articular facets
to patella
(a) Anterior view (b) Posterior view – Continues as the patellar
Figure 8.38 ligament from patella to tibia
8-97
 Tibia
• Tibia—thick, medial, leg bone
– Only weight-bearing bone of
the crural region
– Medial and lateral condyles
• Flat surfaces that articulate
with condyles of femur
– Intercondylar eminence—
ridge separating condyles
– Tibial tuberosity—
attachment of patellar
ligament, a continuation of
quadriceps tendon
– Anterior border—sharp,
angular
– Medial malleolus—bony
knob on inside of ankle

Figure 8.39
8-98
 The Fibula
• Fibula—slender, lateral strut
that helps stabilize ankle
• Does not bear any body
weight
• Head—proximal end
– Apex—point of the head

• Lateral malleolus—distal
expansion, bony knob on
lateral side of ankle
• Joined to tibia by
interosseous membrane

Figure 8.39
8-99
 The Ankle and Foot • Tarsal bones—in ankle
– Differ from carpal bones due to
load-bearing role of the ankle
• Calcaneus—largest tarsal bone
– Forms heel
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Distal phalanx I
– Distal portion is point of
Distal
attachment for calcaneal
Proximal phalanx I phalanx V
(Achilles) tendon
• Talus is most superior tarsal bone
Middle
phalanx V

Proximal

– Forms ankle joint with tibia and

Metatarsal
II phalanx V
I III
IV
V
fibula
Medial cuneiform
Intermediate cuneiform
Lateral cuneiform
– Sits upon calcaneus and
Navicular Cuboid
articulates with navicular
• Proximal row of tarsal bones
Talus
Calcaneus

Trochlear surface

– Talus, calcaneus, navicular

Key to tarsal bones
of talus
Distal
group

(a) Superior (dorsal) view

Tuberosity of calcaneus Proximal group
• Distal row of tarsal bones
– Medial, intermediate, lateral
Figure 8.40a cuneiforms and cuboid

8-100
 The Ankle and Foot
• The rest of the foot bones
resemble the hand bones
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. in name and arrangement
• Metatarsals
Distal phalanx I

Distal
Proximal phalanx I

– Metatarsal I is proximal to the

phalanx V

Middle
phalanx V

Proximal
great toe (hallux)
– Metatarsal V is proximal to the
Metatarsal
II phalanx V
I III
IV
V
little toe
– Proximal base, intermediate
Medial cuneiform
Intermediate cuneiform
Lateral cuneiform
Navicular Cuboid shaft, and distal head
Talus

• Phalanges
Calcaneus

Trochlear surface
Key to tarsal bones

– Two in great toe

of talus
Distal
group

(a) Superior (dorsal) view

Tuberosity of calcaneus Proximal group
• Proximal and distal phalanx
– Three in all other toes
Figure 8.40a
• Proximal, middle, distal
phalanx
8-101
 The Ankle and Foot
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Thumb
Future
thumb Elbow

Future Knee
great toe
Great toe

(a) Seven weeks (b) Eight weeks

Figure 8.41

• Rotation of upper and lower limbs in opposite directions

– Starts seventh week of embryonic development
– Largest digit medial in foot and lateral in hand
– Each limb rotates about 90° in opposite directions
– Rotation also explains why elbow flexes posteriorly and knee flexes
anteriorly 8-102
 The Ankle and Foot
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
• Sole of foot is not flat on
ground
• Three springy arches absorb
stress
– Medial longitudinal arch
• From heel to hallux
• Formed from the
Medial
longitudinal arch calcaneus, talus, navicular,
Transverse cuneiforms, and
arch metatarsals I and III
Lateral • Lateral longitudinal arch
longitudinal
arch
– From heel to little toe
– Includes calcaneus, cuboid,
and metatarsals IV and V
Figure 8.42a

(a) Inferior (plantar) view 8-103

 The Ankle and Foot
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• Transverse arch
– Across middle of foot
– Includes the cuboid,
cuneiforms, and proximal
heads of metatarsals
– Arches held together by
Medial
longitudinal arch
short, strong ligaments
Transverse
arch
• Pes planus (flat feet)—
Lateral
longitudinal
excessive weight,
arch repetitious stress, or
congenital weakness
Figure 8.42a

(a) Inferior (plantar) view 8-104

Skeletal Adaptations for Bipedalism

• Humans are only animals habitually bipedal

– 3.6-million-year-old human footprints indicate upright
walking
• Adaptations
– Strong, springy foot arches
– Great toe not opposable
– Femurs angle inward so knees are closer together—
erect posture requires less muscular effort
– Viscera supported in bowl-shaped pelvis
– Insertions of gluteal muscles differ from other
primates
8-105
Skeletal Adaptations for Bipedalism

8-106
Figure 8.43a,b
Skeletal Adaptations for Bipedalism

Figure 8.43c,d,e 8-107

Skeletal Adaptations for Bipedalism

Figure 8.43f
8-108
 Fracture healing

MSK Physiotherapy Support Worker

Development Group
Becky Dunphy May 2018
Review date May 2020
 What is a fracture?
A medical condition in which there
is a partial or complete break in
the bone.

Often documented as ‘#’ in notes.

 What causes a fracture?
 Usually the result of a high force impact or
stress.
 May be secondary to underlying medical
conditions that weaken the bones such as
osteoporosis, osteopenia, bone cancer or
osteogenesis imperfecta.
 In the case of the fracture being due to a
weakening of the bony structure, the
fracture is termed a pathological fracture.
What is bone made from?
 Bone is made from
collagen which is a
connective tissue.
The protein collagen
provides a soft
malleable framework
and the mineral
calcium phosphate is
added to provide
strength and harden
the bone.
 Bone structure
 The outer layer of
bone is called the
cortical bone and
is a hard and
compact layer.
 The inner layer of
bone is called
trabecular bone
and has a
honeycomb
structure and is
more malleable.
https://commons.wikimedia.org/wiki/File:Illu_compact_spongy_bone.jpg
 Bone remodelling
 Throughout our lives, our bones are
undergoing a process called remodelling.
This process involves the constant
breakdown (resorption) and renewal of old
bone (formation).
 In early life the bone formation outstrips
the process of resorption and so the bones
get stronger.
 In osteoporosis, the process of resporption
outstrips the process of formation and so
the bones get less dense.
 Fracture
 There are several
different types of
fracture based on
the way that the
bone has broken.
 Common fracture sites
 The most common fragility fractures are at
the neck of femur, wrist and spine.

 Themost common fractures treated in

MSK physiotherapy are neck of humerus,
ankle, wrist.
 Healing process

https://www.orthobullets.com/basic-science/9009/fracture-healing
 Haematoma formation
 After a fracture, the blood vessels bleed
into the injury site.
 Soon afterwards the blood vessels
constrict, preventing further bleeding and
within a few hours of the injury the blood
cells form a clot called a haematoma.
 The haematoma acts as the template or
matrix for the formation of callus which is
the next stage of healing.
 Granulation
 The haematoma then causes the release
of inflammatory mediators, with the
inflammatory response peaking at around
24 hours and being completed by about 7
days.
 Within 7-14 days there has formed at the
injury site, a loose bundle of cells,
interspersed with blood vessels which is
known as granulation tissue.
 It is at this stage that the dead bone ends
and other necrotic tissue is removed.
 Callus formation
 From 7-9 days post fracture, the cells on
either side of the fracture gap begin to
transform into the stronger hyaline
cartilage.
 Cells within the granulation tissue also
begin to transform into hyaline cartilage
 The two ends grow across the gap until
the join together in what is known as
callus.
 This peaks at around day 14 post fracture
 Trabecular bone formation
 The next stage is the replacement of
hyaline cartilage with lamellar bone.
 The bone is more mineralised, stronger
and less flexible than the hyaline cartilage.
 Eventually all of the callus is reformed as
lamellar bone which takes the form of
trabecular bone, giving the bone most of
its original strength.
 Remodelling
 This process begins 3-4 weeks after
fracture and has been documented to last
3-5 years to complete.
 This substitutes the trabecular bone with
compact bone. This compact bone more
closely resembles the shape and size of
the original bone.
 Wolff’s law
 Wolff’s law states that a bone in a healthy
mammal will adapt to the load under which
it is placed.
 This is true for healing too. Loading helps
the bone to heal stronger and a gradual
increase in loading will allow the bone to
gradually adapt to the increased stresses
and become stronger.
 Factors that influence healing
 These can be split into two groups –
systemic factors or local factors
 Systemic factors include – age, nutrition,
general health, co-morbidities,
atherosclerosis, hormonal factors, anti-
inflammatory medication, smoking.
 Local factors include- degree of trauma,
area of bone affected, abnormal bone,
degree of immobilisation of #, disruption of
vascular supply.
 References
 5 stages of fracture healing. Medic Guide. [online] Accessed 10/05/18. Available at:
http://medicguide.blogspot.co.uk/2008/05/what-are-5-stages-of-fracture-healing.html
 Basic Bone structure. Spine Universe. Accessed 14/05/18. Available at:
https://www.spineuniverse.com/anatomy/basic-bone-structure
 Fracture Healing. Ortho Bullets. [online]. Accessed 10/05/18. Available at:
https://www.orthobullets.com/basic-science/9009/fracture-healing
 Fractures. Ortho Info. [online]. Accessed 10/05/18. Available at:
https://orthoinfo.aaos.org/en/diseases--conditions/fractures-broken-bones/
 Factors affecting bone healing. Queens University. [online] Accessed 10/05/18. Available at:
https://meds.queensu.ca/central/assets/modules/msk_bonemorph_agg/3f793c529c8c46ed8e93/3f793c529c8c46
ed8e93.htm
 Fracture healing.The royal children’s hospital, Melbourne. [online]. Accessed 24/05/18. Available at:
https://www.rch.org.au/fracture-education/fracture_healing/
 Stages of bone healing. Orthopaedic trauma program. [online] Accessed 10/05/18. Available at:
https://cnx.org/resources/862629253ae694e355c028c9af0d67233bbfb277/20-Reading%20-%20Calgary.pdf
 Chapter 26

Second Edition

Ramutkowski  Booth  Pugh  Thompson  Whicker

Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1
The Muscular System
Objectives
26-1 List the functions of muscle.
26-2 Explain how muscle tissue generates energy.
26-3 List the three types of muscle tissue and describe
the locations and characteristics of each.
26-4 Describe how smooth muscle produces peristalsis.
26-5 Describe the structure of a skeletal muscle.

2
The Muscular System
Objectives (cont.)
26-7 List and define the various types of body
movements produced by skeletal muscles.
26-8 Define the terms origin and insertion.
26-9 List the major skeletal muscles of the body and
give the action of each.
26-10 Describe various disorders and diseases of the
muscular system.

3
Introduction
 Bones and joints do  By alternating between
not themselves contraction and
produce movement. relaxation, muscles
 The human body has cause bones and
more than 600 supported structures to
individual muscles move.

You will focus on the differences among three muscle tissue

types, the structure of skeletal muscles, muscle actions, and
the names of skeletal muscles.
4
Functions of Muscle
Muscle has the ability Functions:
to contract, and this  Movement
contraction allows  Stability
muscles to perform  Control of body
various functions.
openings and
passages
 Heat production
Click for
Larger View 5
Skeletal Muscle

6
Functions of Muscle
 Movement:
 Skeletal muscles are attached to bones which
allow you to walk or wave your hand.
 Smooth muscle is found on organ walls such as
the intestine. Contractions produces movement
of food through the intestine.
 Cardiac muscle produces the pumping of the
blood in the heart.

7
Functions of Muscle
 Stability:
 Muscles hold your bones together to
stabilize joints.
 Small muscles hold your vertebrae
together to stabilize your spinal column.

8
Functions of Muscle
 Controlling of openings and passages:
 Muscles form valve like structures called
sphincters
 Sphincters control movement of substances in
and out of passages.
 A urethral sphincter prevents or allows
urination

9
Functions of Muscle
 Heat production:
 When muscles contract heat is released
 This helps the body maintain a normal
temperature
 Moving your body can make you warmer if
you are cold.

10
3 Types of Muscle Tissue
Muscle Major Location Major Function Mode of
Group Control

Skeletal Attached to bones Produces body Voluntary

Muscle and skin of the movements and
face facial expressions

Smooth Walls of hollow Moves contents Involuntary

Muscle organs, blood through organs;
vessels, and iris vasoconstriction

Cardiac Wall of the heart Pumps blood Involuntary

Muscle through heart

11
Peristalsis
 Rhythmic contraction that pushes substances
through tubes of the body.
 Muscle fibers in visceral smooth muscle respond
to neurotransmitters but they also stimulate each
other to contract.
 The muscle fibers tend to contract and relax
together.
 This type of muscle produces an action called
peristalsis.
12
Production of Energy
for Muscle
ATP (adenosine Muscle cells must have
triphosphate), a type of
chemical energy, is
three ways to store or
needed for sustained or make this substance:
repeated muscle  Creatine phosphate
contractions.  Aerobic respiration
of glucose
 Lactic acid production

13
Oxygen Debt
 Oxygen debt develops when skeletal
muscles are used strenuously for a minute
or two and:
 supplies in the muscle are low
 the aerobic respiration of glucose can no
longer be used to produce ATP.
 This process accounts for why you still burn
energy after you exercise.
14
Muscle Fatigue
 Condition in which a muscle has lost its ability to
contract
 Develops due to an accumulation of lactic acid
 Occurs when the blood supply to a muscle is
interrupted
 A motor neuron loses its ability to release
acetylcholine onto muscle fibers
 Cramps or painful involuntary contractions of
muscles, can accompany muscle fatigue

15
Apply Your Knowledge
What causes bones to move?

16
Apply Your Knowledge -Answer
What causes bones to move?

Bones move by alternating between contraction

and relaxation; muscles cause bones and
supported structures to move.

17
Structure of Skeletal Muscles
 Skeletal muscles are the
major organs that make up
the muscular system
 Consists of connective
tissues, skeletal muscle
tissue, blood vessels, and
nerves
 When body movements are
produced, not just one
muscle is involved, but a
group of muscles contract
18
Connective Tissue Coverings
 Fascia - covers entire skeletal muscles and separates them
from each other.
 Tendon - a tough, cord-like structure made of fibrous
connective tissue that connects muscles to bones.
 Aponeurosis - a tough, sheet-like structure made of fibrous
connective tissue that attaches muscles to other muscles.
 Epimysium - a thin covering that is just deep (underneath)
to the fascia of a muscle that surrounds the entire muscle.
 Perimysium - connective tissue divides a muscle into
sections called fascicles.
 Endomysium - covering of connective tissue surrounds
individual muscle cells.
19
Attachments and Actions of
Skeletal Muscles
 Actions of skeletal
muscles depend largely
on what the skeletal
muscles are attached
 Insertion - an attachment
site that moves when a
muscle contracts.
 Origin - an attachment
site that does not move
when a muscle contracts
20
Body Movements
Flexion – Bending a Plantar flexion –
body part Pointing the toes down
Extension – Abduction – Moving a
Straightening a body body part away from
part its position in the
Hyperextension – anatomical position
Extending a body part
past the normal Adduction – Moving a
anatomical position body part toward its
Dorsiflexion – Pointing position in the
the toes up anatomical position
21
Body Movements (cont.)
Circumduction- Inversion – Turning the
Moving a body part in sole of the foot
a circle; for example, medially
moving your arm in a
Eversion – Turning the
circular motion
sole of the foot
Pronation – Turning the laterally
palm of the hand
down Retraction – Moving a
Supination – Turning body part posteriorly
the palm of the hand Protraction – Moving a
up body part anteriorly
22
Body Movements (cont.)
Elevation – Lifting a body part; for example, elevating
the shoulders as in a shrugging expression
Depression – Lowering a body part; for example,
lowering the shoulders

23
Apply Your Knowledge
The doctor has asked you to abduct the
patient’s leg, so he can see the patient’s
wound. In order to position the patient
correctly what will you have to do?

24
Apply Your Knowledge - Answer
The doctor has asked you to abduct the
patient’s leg, so he can see the patients
wound. In order to position the patient
correctly what will you have to do?
Moving the patient’s leg away from its
position in the anatomical position.

25
Major Skeletal Muscles
 The muscle name indicates the
location, size, action, shape, or
number of attachments of the muscle.
 As you study muscles, you will find it
easier to remember them if you think
about what the name describes.

26
Muscles of the Head
 Sternocleidomastoid - pulls the head to one side
and also pulls the head to the chest
 Splenius capitis - rotates the head and allows it to
bend to the side
 Frontalis - raises the eyebrows
 Orbicularis oris - allows the lips to pucker
 Orbicularis oculi - allows the eyes to close
 Zygomaticus - pulls the corners of the mouth up
 Platysma - pulls the corners of the mouth down
 Masseter and temporalis - close the jaw
27
Arm Muscles
 Pectoralis major - pulls the arm across the
chest; it also rotates and adducts the arms
 Latissimus dorsi - acts to extend, adduct,
and rotate the arm inwardly
 Deltoid - acts to abduct and extend the arm
at the shoulder
 Subscapularis - rotates the arm medially
 Infraspinatus - rotates the arm laterally
28
Forearm Muscles
 Biceps brachii - flexes the arm at the elbow
and rotates the hand laterally
 Brachialis - flexes the arm at the elbow
 Brachioradialis - flexes the forearm at the
elbow
 Triceps brachii - extends the arm at the elbow
 Supinator - rotates the forearm laterally
(supination)
 Pronator teres - rotates the forearm medially
(pronation) 29
Muscles of the Wrist,
Hand and Fingers
 Flexor carpi radialis and flexor carpi ulnaris - act
to flex and abduct the wrist.
 Palmaris longus - acts to flex the wrist.
 Flexor digitorum profundus - acts to flex the distal
joints of the fingers but not the thumb.
 Extensor carpi radialis longus and brevis - act to
extend the wrist and abduct the hand.
 Extensor carpi ulnaris - acts to extend the wrist.
 Extensor digitorum - acts to extend the fingers but
not the thumb.
30
Respiratory Muscles
 Diaphragm - separates
the thoracic cavity from
the abdominal cavity; its
contraction causes
inspiration.
 External and internal
intercostals - muscles
expand and lower the ribs
during breathing. 31
Apply Your Knowledge
A patient has arrived in the office
complaining of pain when she raises her
arm. What muscle would be involved in
this action?

32
Apply Your Knowledge -Answer
A patient has arrived in the office
complaining of pain when she raises her
arm. What muscle would be involved in
this action?

The deltoid muscle acts to abduct and

extend the arm at the shoulder.

33
Abdominal Muscles
 External and internal
obliques - compress
the abdominal wall.
 Transverse abdominis
- also compresses the
abdominal wall.
 Rectus abdominis -
acts to flex the
vertebral column and
compress the
abdominal wall. Click for Larger View
34
Abdominal Muscles (cont.)

35
Muscles of the Pectoral Girdle
 Trapezius - muscle raises the
arms and pulls the shoulders
downward.
 Pectoralis minor - muscle
pulls the scapula downward
and raises the ribs.

36
Leg Muscles
 Psoas major & iliacus - flexes the thigh.
 Gluteus maximus - extends the thigh.
 Gluteus medius and minimus - abduct the
thighs and rotate them medially.
 Adductor longus and magnus - muscles adduct
the thighs and rotate them laterally.
 Biceps femoris, semitendinosus, and
semimembranosus - three muscles are known as
the hamstring group. They act to flex the leg at
the knee and extend the leg at the thigh. 37
Leg Muscles (cont.)
 Rectus femoris, vastus
lateralis, vastus medialis, and
vastus intermedius - act to
extend the leg at the knee.
 Sartorius - flexes the leg at the
knee and thigh and abducts the
thigh, rotating the thigh laterally
but rotating the lower leg
medially.
38
Muscles of the Ankle,
Foot, and Toes
 Tibialis anterior - acts to invert the foot and point
the foot up (dorsiflexion).
 Extensor digitorum longus - acts to extend the
toes and point the foot up.
 Gastrocnemius - acts to flex the foot and flex the
leg at the knee.
 Soleus - also acts to flex the foot.
 Flexor digitorum longus - acts to flex the foot and
toes.

39
Apply Your Knowledge
Your patient complains of hurting his
hamstring when running today. You
would look at what part of the leg, and
what muscles would be involved?

40
Apply Your Knowledge -Answer
Your patient complains of hurting his
hamstring when running today. You
would look at what part of the leg, and
what muscles would be involved?
You would look at the back of his leg, and the
muscles involved would be the biceps femoris,
semitendinosus, and semimembranosus. These three
muscles are known as the hamstring group.
41
Muscle Strains and Sprains
 Warm Up – Warming up muscles for just a few
minutes before an intense activity raises muscle
temperature.

 Stretch – Stretching improves muscle performance

and should always be done after the warm up or
after exercising.

 Cool Down – Slowing down the exercise before

completely stopping prevents dizziness and
fainting.
42
Diseases and Disorders
of the Muscular System
 Botulism - affects the  Muscular Dystrophy -
gastrointestinal tract inherited disorder
and various muscle characterized by
groups muscle weakness and a
 Fibromyalgia - fairly loss of muscle tissue
common condition that  Myasthenia gravis -
causes chronic pain patients experience
primarily in joints, muscle weakness
muscles, and tendons
43
Diseases and Disorders
of the Muscular System
 Rhabdomyolysis -  Trichinosis - an
a condition in which infection caused by
the kidneys have parasites (worms)
been damaged
related to serious
muscle injuries
 Tetanus -
commonly called
lockjaw
44
Apply Your Knowledge
The doctor has told your patient that his
son has muscular dystrophy disorder.
What is muscular dystrophy?

45
Apply Your Knowledge -Answer
The doctor has told your patient that his
son has muscular dystrophy disorder.
What is Muscular dystrophy?

Muscular dystrophy is an inherited disorder

characterized by muscle weakness and a loss
of muscle tissue.

46
Summary
Medical Assistant
Skeletal muscle works in conjunction with the
skeletal system to produce movement.

You must understand the muscular system in order to

give muscular injections, prepare patients for massage
therapy, demonstrate ambulatory techniques, and
assist in the care of sprains and strains.
47
End of Chapter

48
 FRONTALIS - A: (Action) Elevates
eyebrows in glancing upward and
Name the muscle,
expressions of surprise or fright; draws
A: (Action), O:
scalp forward and wrinkles skin of
(Origin), and I:
forehead; O: (Origin) Galea aponeurotica;
(Insertion)
I: (Insertion) Subcutaneous tissue of
eyebrows

OCCIPITALIS - A: (Action) Retracts

Name the muscle,
scalp; fixes galea aponerotica so frantalis
A: (Action), O:
can act on eyebrows; O: (Origin) Superior
(Origin), and I:
nuchal line and temporal bone; I:
(Insertion)
(Insertion) Galea aponeurotica

ORBICULARIS OCULI - A: (Action)

Sphincter of eyelids; closes eye in blinking,
Name the muscle, squinting, and sleep; aids in flow of tears
A: (Action), O: across eye; O: (Origin) Lacrimal bone;
(Origin), and I: adjacent regions of frontal bone and
(Insertion) maxilla; medial angle of eyelids; I:
(Insertion) Upper and lower eyelids; skin
around margin of orbit

ORBICULARIS ORIS - A: (Action)

Name the muscle, Encircles mouth, closes lips, protrudes lips
A: (Action), O: as in kissing; uniquely developed in
(Origin), and I: humans for speech; O: (Origin) Modiolus
(Insertion) of mouth; I: (Insertion) Submucosa and
dermis of lips

BUCCINATOR - A: (Action) Compresses

cheek against teeth and gums; directs food
between molars; retracts cheek from teeth
Name the muscle,
when mouth is closing to prevent biting
A: (Action), O:
cheek; expels air and liquid; O: (Origin)
(Origin), and I:
Alveolar processes on lateral surfaces of
(Insertion)
mandible and maxilla; I: (Insertion)
Orbicularis oris; submucosa of cheek and
lips
 PLATYSMA - A: (Action) Draws lower lip
and angle of mouth downward in
Name the muscle,
expressions of horror or surprise; may aid
A: (Action), O:
in opening mouth widely; O: (Origin)
(Origin), and I:
Fascia of deltoid and pectoralis major; I:
(Insertion)
(Insertion) Mandible; skin and
subcutaneous tissue of lower face

Name the muscle, HYOGLOSSUS - A: (Action) Depresses

A: (Action), O: tongue; O: (Origin) Body and greater horn
(Origin), and I: of hyoid bone; I: (Insertion) Lateral and
(Insertion) inferior surfaces of tongue

TEMPORALIS - A: (Action) Elevation,

Name the muscle, retraction, and lateral and medial excursion
A: (Action), O: of the mandible; O: (Origin) Temporal
(Origin), and I: lines and temporal fossa of cranium; I:
(Insertion) (Insertion) Coronoid process and anterior
border of mandibular ramus

MASSETER - Elevation of mandible, with

Name the muscle,
smaller roles in protraction, retraction, and
A: (Action), O:
lateral and medial excursion; O: (Origin)
(Origin), and I:
Zygomatic arch; I: (Insertion) Lateral
(Insertion)
surface of mandibular ramus and angle

MEDIL PTERYGOID - A: (Action)

Elevation, protraction, and lateral and
Name the muscle, medial excursion of the mandible; O:
A: (Action), O: (Origin) Medial surface of lateral pterygoid
(Origin), and I: plate; palatine bone; lateral surface of
(Insertion) maxilla near molar teeth; I: (Insertion)
Medial surface of mandibular ramus and
angle
 LATERAL PTERYGOID - A: (Action)
Depression (In wide opening of the mouth),
protraction, and lateral and medial
Name the muscle,
excursion of the mandible; O: (Origin)
A: (Action), O:
Lateral surfaces of lateral pterygoid plate;
(Origin), and I:
greater wing of sphenoid; I: (Insertion)
(Insertion)
Neck of mandible (just below condyle);
STERNOCLEIDOMASTOID - A:
articular disc and capsule of
(Action) Unilateral action tilts head slightly
upward and temporomandibular
toward the opposite jointside, as in
looking over one's contralateral shoulder.
The most common action is probably
Name the muscle,
rotating the head to the left or right.
A: (Action), O:
Bilateral action draws the head straight
(Origin), and I:
forward and down, as when eating or
(Insertion)
reading. Aids in deep breathing when head
is fixed.; O: (Origin) Manubrium of
sternum; medial one third of clavicle; I:
(Insertion)
TRAPEZIUS Mastoid process; lateral
- A: (Action) Extends half
andof
superior
laterally flexes neck.;nuchal line External
O: (Origin)
Name the muscle,
occipital protuberance; medial one-third of
A: (Action), O:
superior nuchal line; nuchal ligament;
(Origin), and I:
spinous processor of vertebrae C7-T3 or
(Insertion)
T4; I: (Insertion) Acromion and spine of
scapula; lateral
DIAPHRAGM - A:one-third
(Action)of clavicle
Prime mover
of inspiration (responsible for about
two-thirds of air intake); contracts in
preparation for sneezing, coughing, crying,
Name the muscle,
laughing, and weight lifting; contraction
A: (Action), O:
compresses abdominal viscera and aids in
(Origin), and I:
childbirth and expulsion of urine and feces;
(Insertion)
O: (Origin) Xiphoid process of sternum;
ribs and costal cartilages 7-12; lumbar
EXTERNAL
vertebrae; INTERCOSTALS
I: (Insertion) - A: of
Central tendon
(Action) When diaphragm
scalenes fix rib 1, external
intercostals elevate and protract ribs 2-12,
Name the muscle, expanding the thoracic cavity and creating
A: (Action), O: a partial vacuum causing inflow of air;
(Origin), and I: exercise a braking action during expiration
(Insertion) so that expiration is not overly abrupt.; O:
(Origin) Inferior margins of ribs 1-11; I:
(Insertion) Superior margin of next lower
rib
 INTERNAL INTERCOSTALS - A:
(Action) In inspiration, the intercartilagous
part aids in elevating the ribs and
expanding the thoracic cavity; in
Name the muscle, expiration, the interosseous part depresses
A: (Action), O: and retracts the ribs, compressing the
(Origin), and I: thoracic cavity and expelling air; the latter
(Insertion) occurs only in forceful expiration, not in
EXTERNAL ABDOMINAL
relaxed breathing.; OBLIQUE
O: (Origin) Superior -
A: (Action)
margins Supports
and costal abdominal
cartilages viscera
of ribs 2-12;
against pull of gravity; stabilizes vertebral
margin of sternum; I: (Insertion) Inferior
columnmargin
duringofheavy
next lifting; maintains
higher rib
posture; compresses abdominal organs,
Name the muscle,
thus aiding in forceful expiration of breath
A: (Action), O:
and in expulsion of abdominopelvic
(Origin), and I:
contents during childbirth, urination,
(Insertion)
defecation, and vomiting; unilateral
contraction causes contralateral rotation of
waist; O: (Origin) Ribs 5-12; I: (Insertion)
Anterior
INTERNAL half ABDOMINAL
of iliac crest; symphysis
OBLIQUE and-
superior
A: (Action) margin
Same of pubisoblique
as external
Name the muscle,
except that unilateral contraction causes
A: (Action), O:
ipsilateral rotation of waist; O: (Origin)
(Origin), and I:
Inguinal ligament; iliac crest;
(Insertion)
thoracolumbar fascia; I: (Insertion) Ribs
10-12; costal cartilages 7-10; pubis

RECTUS ABDOMINIS - A: (Action)

Name the muscle, Flexes lumbar region of vertebral column,
A: (Action), O: producing forward bending at the waist; O:
(Origin), and I: (Origin) Pubic symphysis and superior
(Insertion) margin of pubis; I: (Insertion) Xiphoid
process; costal cartilages 5-7

ERECTOR SPINAE - A: (Action)

Extension and lateral flexion of vertebral
column; the longissimus capitis also
Name the muscle,
produces ipsilateral rotation of the head; O:
A: (Action), O:
(Origin) Nuchal ligament; ribs 3-12;
(Origin), and I:
thoracic and lumbar vertebrae; median and
(Insertion)
lateral sacral crests; thoracolumbar fascia;
I: (Insertion) Mastoid process; cervical and
thoracic vertebrae; all ribs
 ERECTOR SPINAE: ILIOCOSTALIS - A:
(Action) Extension and lateral flexion of
vertebral column; the longissimus capitis
Name the muscle, also produces ipsilateral rotation of the
A: (Action), O: head; O: (Origin) Nuchal ligament; ribs
(Origin), and I: 3-12; thoracic and lumbar vertebrae;
(Insertion) median and lateral sacral crests;
thoracolumbar fascia; I: (Insertion) Mastoid
process; cervical
ERECTOR and thoracic
SPINAE: vertebrae;- all
LONGISSIMUS A:
ribs
(Action) Extension and lateral flexion of
vertebral column; the longissimus capitis
Name the muscle, also produces ipsilateral rotation of the
A: (Action), O: head; O: (Origin) Nuchal ligament; ribs
(Origin), and I: 3-12; thoracic and lumbar vertebrae;
(Insertion) median and lateral sacral crests;
thoracolumbar fascia; I: (Insertion) Mastoid
process;
ERECTORcervical and thoracic
SPINAE: vertebrae;
SPINALIS - A: all
(Action) Extensionribsand lateral flexion of
vertebral column; the longissimus capitis
Name the muscle, also produces ipsilateral rotation of the
A: (Action), O: head; O: (Origin) Nuchal ligament; ribs
(Origin), and I: 3-12; thoracic and lumbar vertebrae;
(Insertion) median and lateral sacral crests;
thoracolumbar fascia; I: (Insertion) Mastoid
process; cervical and thoracic vertebrae; all
QUADRATUS ribs LUMBORUM - A:
(Action) Aids respiration by fixing rib 12
and stabilizing inferior attachments of
Name the muscle,
diaphragm. Unilateral contraction causes
A: (Action), O:
ipsilateral flexion of lumbar vertebral
(Origin), and I:
column; bilateral contraction extends
(Insertion)
lumbar vertebral column.; O: (Origin) Iliac
crest; iliolumbarligament; I: (Insertion) Rib
12, vertebrae L1-L4

EXTERNAL URETHRAL SPHINCTER -

Name the muscle,
A: (Action) Retains urine in bladder until
A: (Action), O:
voluntarily voided; O: (Origin) Ischiopubic
(Origin), and I:
rami; I: (Insertion) Encircles urethral
(Insertion)
orifice
 COMPRESSOR URETHRAE - A:
Name the muscle, (Action) Aids in urine retention; found in
A: (Action), O: females only; O: (Origin) Ischiopubic rami;
(Origin), and I: I: (Insertion) Right and left compressor
(Insertion) urethrae meet as muscular sheet inferior to
external urethral sphincter

EXTERNAL ANAL SPHINCTER - A:

Name the muscle,
(Action) Retains feces in rectum until
A: (Action), O:
voluntarily voided; O: (Origin) Coccyx;
(Origin), and I:
perineal body; I: (Insertion) Encircles anal
(Insertion)
canal and orifice

PECTORALIS MINOR - A: (Action) With

serratus anterior, draws scapula laterally
Name the muscle, and forward around chest wall; with other
A: (Action), O: muscles, rotates scapula and depresses apex
(Origin), and I: of shoulder, as in reaching down to pick up
(Insertion) a suitcase; O: (Origin) Ribs 3-5 and
overlying fascia; I: (Insertion) Coracoid
process of scapula
LEVATOR SCAPULAE - A: (Action)
Elevates scapula if cervical vertebrae are
Name the muscle, fixed; flexes neck laterally if scapula is
A: (Action), O: fixed; retracts scapula and braces shoulder;
(Origin), and I: rotates scapula and depresses apex of
(Insertion) shoulder; O: (Origin) Transverse processes
of vertebrae C1-C4; I: (Insertion) Superior
angle to medial border of scapula

RHOMBOIDEUS MINOR - A: (Action)

Name the muscle, Retracts scapula and braces shoulder; fixes
A: (Action), O: scapula during arm movements; O:
(Origin), and I: (Origin) Spinous processes of vertebrae
(Insertion) C7-T1; nuchal ligament; I: (Insertion)
Medial border of scapula
Name the muscle, RHOMBOIDEUS MAJOR - A: (Action)
A: (Action), O: Same as rhomboideus minor; O: (Origin)
(Origin), and I: Spinous processes of vertebrae T2-T5; I:
(Insertion) (Insertion) Medial border of scapula

PECTORALIS MAJOR - A: (Action)

Flexes, adducts, and medially rotates
Name the muscle, humerus, as in climbing or hugging; aids in
A: (Action), O: deep inspiration; O: (Origin) Medial half of
(Origin), and I: clavicle; lateral margin
LATISSIMUS DORSI of -sternum;
A: (Action)costal
(Insertion) cartilagesand
Adducts 1-7; aponeurosis
medially rotatesofhumerus;
external
oblique;
extends I: (Insertion)
the shoulder jointLateral lip of on
as in pulling
intertubercular
the oars of a rowboat;sulcus of humerus
produces backward
swing of arm in such actions as walking
and bowling; with hands grasping overhead
Name the muscle, objects, pulls body forward and upward, as
A: (Action), O: in climbing; aids in deep inspiration,
(Origin), and I: sudden expiration such as sneezing and
(Insertion) coughing, and prolonged forceful
expiration as in singing or blowing a
sustained note on a wind instrument; O:
DELTOID
(Origin) - A: (Action)
Vertebrae T7-L5;Anterior fibers
lower three or
flex and medially rotate arm; lateral
four ribs; iliac crest; thoracolumbar fascia;fibers
abduct arm;Floor
I: (Insertion) posterior fibers extend sulcus
of intertubercular and
Name the muscle,
laterally rotate
of arm; involved in arm
humerus
A: (Action), O:
swinging during such actions as walking or
(Origin), and I:
bowling, and in adjustment of hand height
(Insertion)
for various manual tasks; O: (Origin)
Acromion and spone of scapula; clavicle; I:
(Insertion) Deltoid tuberosity of humerus

SUPRASPINATUS - A: (Action) Aids

Name the muscle, deltoid in abductions of arm; resists
A: (Action), O: downward slippage of humeral head when
(Origin), and I: arm is relaxed or when carrying weight; O:
(Insertion) (Origin) Supraspinous fossa of scapula; I:
(Insertion) Greater tubercle of humerous
 INFRASPINATUS - A: (Action)
Name the muscle, Modulates action of deltoid, preventing
A: (Action), O: humeral head from sliding upward; rotates
(Origin), and I: humerous laterally; O: (Origin)
(Insertion) Infraspinous fossa of scapula; I: (Insertion)
Greater tuberclue of humerus

TERES MINOR - A: (Action) Modulates

action of deltoid, preventing humeral head
Name the muscle, from sliding upward as arm is abducted;
A: (Action), O: rotates humerous laterally; O: (Origin)
(Origin), and I: Lateral border and adjacent posterior
(Insertion) surface of scapula; I: (Insertion) Greater
tubercle of humerus; posterior surface of
joint capsule

SUBSCAPULARIS - A: (Action)
Modulates action of deltoid, preventing
Name the muscle,
humeral head from sliding upward as arm
A: (Action), O:
is abducted; rotates humerus medially; O:
(Origin), and I:
(Origin) Subscapular fossa of scapula; I:
(Insertion)
(Insertion) Lesser tubercle of humerus;
anterior surface of joint capsule

BRACHIALIS - A: (Action) Prime mover

Name the muscle,
of elbow flexion; O: (Origin) Anterior
A: (Action), O:
surface of distal half of humerus; I:
(Origin), and I:
(Insertion) Coronoid process and tuberosity
(Insertion)
of ulna

BICEPS BRACHII - A: (Action) Rapid or

forceful supination of forearm; synergist in
elbow flexion; slight shoulder flexion;
Name the muscle,
tendon of long head stabilizes shoulder by
A: (Action), O:
holding humeral head against glenoid
(Origin), and I:
cavity; O: (Origin) Long head-superior
(Insertion)
margin of glenoid cavity; Short
head-coracoid process; I: (Insertion)
Tuberosity of radius; fascia of forearm
 TRICEPS BRACHII - A: (Action) Extends
elbow; long head extends and adducts
Name the muscle, humerus; O: (Origin) Long head-inferior
A: (Action), O: margin of glenoid cavity and joint capsule;
(Origin), and I: Lateral head-posterior surface of proximal
(Insertion) end of humerus; Medial head-posterior
surface of entire humeral shaft; I:
(Insertion) Olecranon; fascia of forearm

Name the muscle, BRACHIORADIALIS - A: (Action) Flexes

A: (Action), O: elbow; O: (Origin) Lateral supracondylar
(Origin), and I: ridge of humerus; I: (Insertion) Lateral
(Insertion) surface of radius near styloid process

ANCONEUS - A: (Action) Extends elbow;

Name the muscle,
may help to control ulnar movement during
A: (Action), O:
pronation; O: (Origin) Lateral epicondyle
(Origin), and I:
of humerus; I: (Insertion) Olecranon and
(Insertion)
posterior surface of ulna

PRONATOR QUADRATUS - A: (Action)

Prime mover of forearm pronation; also
Name the muscle,
resists separation of radius and ulna when
A: (Action), O:
force is applied to forearm through wrist, as
(Origin), and I:
in doing push-ups; O: (Origin) Anterior
(Insertion)
surface of distal ulna; I: (Insertion)
Anterior surface of distal radius

PRONATOR TERES - A: (Action) Assists

pronator quadratus in pronation, but only in
Name the muscle,
rapid or forceful action; weakly flexes
A: (Action), O:
elbow; O: (Origin) Humeral shaft near
(Origin), and I:
medial epicondyle; coronoid process of
(Insertion)
ulna; I: (Insertion) Lateral surface of radial
shaft
 SUPINATOR - A: (Action) Supinates
Name the muscle, forearm; O: (Origin) Lateral epicondyle of
A: (Action), O: humerus; supinator crest and fossa of ulna
(Origin), and I: just distal to radial notch; anular and radial
(Insertion) collateral ligaments of elbow; I: (Insertion)
Proximal one-third of radius

FLEXOR CARPI RADIALIS - A: (Action)

Name the muscle,
Flexes wrist anteriorly; aids in radial
A: (Action), O:
flexion of wrist; O: (Origin) Medial
(Origin), and I:
epicondyle of humerus; I: (Insertion) Base
(Insertion)
of metacarpals II-II

FLEXOR CARPI ULNARIS - A: (Action)

Name the muscle, Flexes wrist anteriorly; aids in ulnar flexion
A: (Action), O: of wrist; O: (Origin) Medial epicondyle of
(Origin), and I: humerus; medial margin of olecranon;
(Insertion) posterior surface of ulna; I: (Insertion)
Pisiform; hamate; metacarpal V

Name the muscle, FLEXOR POLLICIS LONGUS - A:

A: (Action), O: (Action) Flexes phalanges of thumb; O:
(Origin), and I: (Origin) Radius; interosseous membrane; I:
(Insertion) (Insertion) Distal phalanx I

EXTENSOR CARPI RADIALIS

Name the muscle,
LONGUS - A: (Action) Extends wrist; aids
A: (Action), O:
in radial flexion of wrist; O: (Origin)
(Origin), and I:
Lateral supracondylar ridge of humerus; I:
(Insertion)
(Insertion) Base of metacarpal II
 EXTENSOR CARPI ULNARIS - A:
(Action) Extends and fixes wrist when fist
Name the muscle,
is clenched or hand grips an object; aids in
A: (Action), O:
ulnar flexion of wrist; O: (Origin) Lateral
(Origin), and I:
epicondyle of humerus; posterior; I:
(Insertion)
(Insertion) Base of metacarpal V surface of
ulnar shaft

EXTENSOR POLLICIS BREVIS - A:

Name the muscle,
(Action) Extends metacarpal I and
A: (Action), O:
proximal phalanx of thumb; O: (Origin)
(Origin), and I:
Shaft of radius; interosseous membrane; I:
(Insertion)
(Insertion) proximal phalanx I

EXTENSOR POLLICIS LONGUS - A:

(Action) Extends distal phalanx I; aids in
Name the muscle,
extending proximal phalanx I and
A: (Action), O:
metacarpal I; adducts and laterally rotates
(Origin), and I:
thumb; O: (Origin) Posterior surface of
(Insertion)
ulna; interosseous membrane; I: (Insertion)
Distal phalanx I
ILIACUS - A: (Action) Flexes thigh at hip
when trunk is fixed; flexes trunk at hip
when thigh is fixed, as in bending forward
Name the muscle,
in a chair or setting up in bed; balances
A: (Action), O:
trunk during sitting; O: (Origin) Iliac crest
(Origin), and I:
and fossa; superolateral region of sacrum;
(Insertion)
anterior sacroiliac and iliolumbar
ligaments; I: (Insertion) Lesser trochanter
and nearby shaft of femur

PSOAS MAJOR - A: (Action) Same as

Name the muscle, iliacus; O: (Origin) Bodies and
A: (Action), O: intervertebral discs of vertebrae T12-L5;
(Origin), and I: transverse processes of lumbar vertebrae; I:
(Insertion) (Insertion) Lesser trochanter and nearby
shaft of femur.
 TENSOR FASCIAE LATAE - A: (Action)
Extends knee, laterally rotates tibia, aids in
abduction and medial rotation of femur;
Name the muscle,
during standing, steadies pelvis on femoral
A: (Action), O:
head and steadies femoral condyles on
(Origin), and I:
tibia; O: (Origin) Iliac crest; anterior
(Insertion)
superior spine;MAXIMUS
GLUTEUS deep surface- A: (Action)
of fascia lata;
Extends thigh at hip as in stair climbing
I: (Insertion) Lateral condyle of tibia via
(rising to next step) or running
iliotibial band and walking
(backswing of limb); abducts thigh;
elevates trunk after stooping; prevents
Name the muscle, trunk from pitching forward during
A: (Action), O: walking and running; helps stabilize femur
(Origin), and I: on tibia; O: (Origin) Posterior gluteal line
(Insertion) of ilium, on posterior surface from iliac
crest to posterior superior spine; coccyx;
posterior surface of lower sacrum;
aponeurosis of erector spinae; I: (Insertion)
GLUTEUS MEDIUS
Gluteal tuberosity - A: (Action)
of femur; Abduct
lateral condyle
and medially rotate
of tibia thigh; during
via iliotibial bandwalking,
Name the muscle,
shift weight of trunk toward limb with foot
A: (Action), O:
on the ground as other foot is lifted; O:
(Origin), and I:
(Origin) Most of lateral surface of ilium
(Insertion)
between crest and acetabulum; I:
(Insertion) Greater trochanter of femur

PIRIFORMIS - A: (Action) Laterally

Name the muscle, rotates extended thigh; abducts flexed
A: (Action), O: thigh; O: (Origin) Anterior surface of
(Origin), and I: sacrum; gluteal surface of ilium; capsule of
(Insertion) sacroiliac joint; I: (Insertion) Greater
trochanter of femur

Name the muscle, QUADRATUS FEMORIS - A: (Action)

A: (Action), O: Laterally rotates thigh; O: (Origin) Ischial
(Origin), and I: tuberosity; I: (Insertion) Intertrochanteric
(Insertion) crest of femur
 RECTUS FEMORIS - A: (Action) Extends
Name the muscle, knee; flexes thigh at hip; flexes trunk on
A: (Action), O: hip if thigh is fixed; O: (Origin) Ilium at
(Origin), and I: anterior inferior spine and superior margin
(Insertion) of acetabulum; capsule of hip joint; I:
(Insertion) See quadriceps femoris above

BICEPS FEMORIS - A: (Action) Flexes

knee; extends hip; elevates trunk from
stooping posture; laterally rotates tibia on
Name the muscle,
femur when knee is flexed; laterally rotates
A: (Action), O:
femur when hip is extended; counteracts
(Origin), and I:
forward bending at hips; O: (Origin) Long
(Insertion)
head-ischial tuberosity; Short head-linea
aspera and lateral supracondylar line of
femur; I: (Insertion) Head of fibula
SEMITENDINOSUS - A: (Action) Flexes
knee; medially rotates tibia on femur when
Name the muscle,
knee is flexed; medially rotates femur when
A: (Action), O:
hip is extended; counteracts forward
(Origin), and I:
bending at hips; O: (Origin) Ischial
(Insertion)
tuberosity; I: (Insertion) Medial surface of
upper tibia

SEMIMEMBRANOSUS - A: (Action)
Name the muscle, Same as semitendinosus, O: (Origin)
A: (Action), O: Ischial tuberosity; I: (Insertion) Medial
(Origin), and I: condyle and nearby margin of tibia;
(Insertion) intercondylar line and lateral condyle of
femur; ligament of popliteal region

POPLITEUS - A: (Action) Rotates tibia

medially on femur if femur is fixed (as in
sitting down), or rotates femur laterally on
Name the muscle,
tibia if tibia is fixed (as in standing up);
A: (Action), O:
unlocks knee to allow flexion; may prevent
(Origin), and I:
forward dislocation of femur during
(Insertion)
crouching; O: (Origin) Lateral condyle of
femur; lateral meniscus and joint capsule; I:
(Insertion) Posterior surface of upper tibia
 TIBIALIS ANTERIOR - A: (Action)
Dorsiflexes and inverts foot; resists
backward tipping of body (as when
Name the muscle,
standing on a moving boat deck); helps
A: (Action), O:
support medial longitudinal arch of foot; O:
(Origin), and I:
(Origin) Lateral condyle and lateral margin
(Insertion)
of proximal half of tibia; interosseous
membrane; I: (Insertion) Medial cuneiform,
metatarsal I

GASTROCNEMIUS - Plantar flexes foot,

Name the muscle, flexes knee; active in walking, running and
A: (Action), O: jumping; O: (Origin) Condyles, popliteal
(Origin), and I: surface, and lateral supracondylar line of
(Insertion) femur; capsule of knee joint; I: (Insertion)
Calcaneus

SOLEUS - A: (Action) Plantar flexes foot;

Name the muscle, steadies leg on ankle during standing; O:
A: (Action), O: (Origin) Posterior surface of head and
(Origin), and I: proximal one-fourth of fibula; middle
(Insertion) one-third of tibia; interosseous membrane;
I: (Insertion) Calcaneus

GLUTEUS MINIMUS - A: (Action)

Abduct and medially rotate thigh; during
Name the muscle,
walking, shift weight of trunk toward limb
A: (Action), O:
with foot on the ground as other foot is
(Origin), and I:
lifted; O: (Origin) Most of lateral surface of
(Insertion)
ilium between crest and acetabulum; I:
(Insertion) Greater trochanter of femur
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NERVOUS SYSTEM PPT

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NERVOUS SYSTEM

MR. SUHAS AGEY

Assistant Professor,
Department of Pharmacology
NMIMS, Shirpur
 Introduction
• With a mass of only 2 kg, about 3% of the total
body weight, the nervous system is one of the
smallest and yet the most complex of the 11
body systems.
• Nervous system controls and coordinates all
essential functions of the body including all
other body systems allowing the body to
maintain homeostasis or its delicate balance.
• The brain is the control center for registering
sensations, correlating them with one another
and with stored information, making decisions,
and taking actions. It also is the center for
intellect, emotions, behavior, and memory.
 Introduction
About 85 billion neurons and 10
trillion to 50 trillion neuroglia make
up the brain, which has a mass of
about 1300 g (almost 3 lb) in adults.
On average, each neuron forms 1000
synapses with other neurons. Thus, the
total number of synapses, about a
thousand trillion or 1015, is larger than
the number of stars in our galaxy.
 Functions of Nervous system
1. The Sensory Function- Gathers information from both inside and outside the
body through sensory neurons

2. Integrative function- Transmits and processes the information in the brain.

3. Motor Function- Sends information from the brain to the muscles, glands, and
organs so they can respond appropriately through the motor neurons

4. Complex functions- The nervous system is also responsible for our perceptions,
emotions, behaviors, memories etc.
Classification
 CENTRAL
NERVOUS SYSTEM
•The central nervous system (CNS) consists of the brain &
spinal cord.
•The brain is the part of the CNS that is located in the skull
and contains about 85 billion neurons.
•The brain is connected to the spinal cord.
•The spinal cord is connected to the Communication to the
peripheral nervous system (PNS) and transmits the
information from the body to the brain and vice versa.
Nervous Tissues
There are 2 types of nervous tissues
1. Excitatory – Neurons
2. Non-excitatory- Neuroglia

Neurons have the potential the excite in response to specific stimuli

Neuroglia are smaller cells but they greatly outnumber neurons,

perhaps by as much as 25 times

Neuroglia support, nourish, and protect neurons, and maintain the

interstitial fluid that bathes them.
Neurons- Parts
• Dendrite – receive stimulus and carries its impulses
toward the cell body
• Cell Body with the nucleus
• Axon – fiber which carries impulses away from the cell body
• Schwann Cells- cells which produce the myelin sheath
• Myelin sheath – dense lipid layer which insulates the axon
• Node of Ranvier – gaps or nodes in the myelin sheath
• Impulses travel from dendrite to cell body to axon
Neurons
A. Glial cell in CNS
1. Astrocytes:-
• These are star-shaped cells and are the
largest and most numerous of the neuroglia.
• astrocytes wrapped around blood capillaries
within CNS and forms blood-brain barrier
between capillaries and neurons
• Maintain the chemical
environment of the brain (CNS)
2. Microglia
• They are tissue macrophages
• Spider-shaped
• Phagocytosis- dispose of debris
3. Ependymal cells
• Line cavities of the brain and spinal cord
• Synthesize and circulate
cerebrospinal fluid
• Form the blood–CSF barrier
• Oligodendrocytes
Produce myelin
sheath around nerve
fibers in the CNS.
B. Glial Cell in PNS
1. Schwann Cells-These cells encircle PNS
axons. Like oligodendrocytes, they form the
myelin sheath around axons.

2. Satellite Cells- Besides providing

structural support, satellite cells regulate
the exchanges of materials between
neuronal cell bodies and interstitial fluid.
• The meninges
• Membranes covering brain &
spinal cord
• Protect the CNS
Three (3) layers of tissue:-
• Dura mater ( outer layer)
• Arachnoid mater ( middle
layer)
•Space contains
cerebrospinal fluid
(CSF)
• Pia mater ( inner layer)
 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• There are four (4) ventricles

• It is interconnected cavities within cerebral
hemispheres and brain stem Lateral ventricle
Interventricular
foramen

•The ventricles are continuous with the Third ventricle

Cerebral
central canal of the spinal cord aqueduct
Fourth ventricle

• They are filled with CSF To central canal

of spinal cord
(a)

• The four (4) ventricles are: Interventricular

• Lateral ventricles (2)

foramen

Lateral
•Known as the first and second ventricle

Third ventricle
ventricles
• Third ventricle (1) Cerebral
aqueduct
• Fourth ventricle (1) Fourth

• Interventricular foramen
ventricle
11
• Cerebral aqueduct (b)
To central canal
of spinal cord
• Cerebrospinal fluid (CSF) is a clear, colorless liquid composed
primarily of water that protects the brain and spinal cord from
chemical and physical injuries.
• The majority of CSF production is from the choroid plexuses,
networks of blood capillaries in the walls of the ventricles
• It also carries small amounts of oxygen, glucose, and other
needed chemicals from the blood to neurons and neuroglia
• CSF continuously circulates through cavities in the brain and
spinal cord and around the brain and spinal cord in the
subarachnoid space
• The total volume of CSF is 80 to 150 mL (3 to 5 oz) in an adult.
 Composition of CSF:-

•Water
•Glucose
•Protein
•Nitrogen substance
•Electrolytes Na,K,Cal,Chloride etc.
•Cell (few)
 Process of CSF
•CSF secreted by choroid plexus with in the cerebral ventricles (rt & lt) by ultra-
filtration o& active secretion.
•From Rt & Lt lateral ventricle

•Third ventricle

•Fourth ventricle

•Sub arachnoid space

•Absorbe in the sinus

 Function of CSF:-

1.Support the brain & spinal cord

2.Protect the brain & spinal cord

3. Maintain pressure around the structure

4. Keep brain & spinal cord moist

5. Conveys nutrition to brain & spinal cord

6. Remove waste product of brain & spinal cord

 Epidural space
Space is superior to dura matter.

Subdural space
Space between dura and arachnoid mater.

Subarachnoid space
Space between arachnoid & pia mater
Filled with CSF
Contains the blood vessels supplying brain.
BRAIN
 Major Parts of the Brain
1. Telencephalon – Cerebrum (Cerebral hemispheres)
2. Diencephalon - Thalamus,
-Hypothalamus
-Epithalamus,
3. Brain stem - Medulla Oblangata
- Pons
- Midbrain (mesencephalon)
4. Cerebellum
 Cerebral Hemispheres (Cerebrum/Cerebral cortex)

A. Folds of the cerebrum

B. Lobes of Cerebrum

C. Layers of the cerebrum

D. Functional area of the cerebral

cortex
Figure 7.13a

Slide
 Cerebral Hemispheres (Cerebrum)
A. Folds of the cerebrum
i. Larger folds- Sulci (single- Sulcus)
It divides the cerebrum into various lobes
a. Central sulcus- Frontal & parietal lobe
b. Lateral sulcus- Frontal & temporal lobe
c. Parieto-occipital sulcus- parietal lobe &
occipital lobe.
ii. Smaller folds- Gyri- Single (Gyrus)
Figure 7.13a

It increases the surface area of the brain

 B. Lobes of Cerebrum
• Sulcus divides the cerebrum into lobes
• Surface lobes of the cerebrum
• Frontal lobe
• Parietal lobe
• Occipital lobe
• Temporal lobe
 C. Layers of the Cerebrum

i. Gray matter
• Outer layer
• Composed
mostly of neuron
cell bodies

Figure 7.13a
 C. Layers of the Cerebrum

ii. White matter

• Nerve fiber tracts inside
the gray matter
• Deep within the brain, the
hemispheres are connected
by a mass of white matter
(nerve fibers) called the
corpus callosum.
Figure 7.13a

Slide
 D. Functional Areas of the Cerebrum

I. Sensory area
• Somatic sensory area – receives impulses from the body’s sensory
receptors of skin.
• Visual area- Located in the occipital lobe, receives impulses from eyes
• Auditory area- Near lateral sulcus, receive impulses from ear.
• Olfactory area- In the temporal lobe, receives impulses from the nose.
• Taste area- Near parietal lobe, receives impulses from the tongue.
II. Motor Area
• Primary motor area – sends impulses to skeletal muscles
• Broca’s area – involved in our ability to speak.
 D. Functional Areas of the Cerebrum
iii. Interpretation areas of the cerebrum
• Wernicke’s Area- Speech/language region- interprets the
meaning of speech by recognizing spoken words
• The prefrontal cortex- concerned with the makeup of a person’s
personality, intellect, complex learning abilities, recall of
information, initiative, judgment, foresight, reasoning,
conscience, intuition, mood, planning for the future
• General interpretation area- Receive impulses from all the above
areas
Functional Area of the Cerebrum
 2. Diencephalon

• The diencephalon forms a central core of brain tissue

completely surrounded by the cerebral hemispheres.
Enclosed by the cerebral hemispheres
• Made of three parts
• Thalamus
• Hypothalamus
• Epithalamus
Diencephalon
 Thalamus
• The thalamus makes up 80% of the diencephalon, consists of
paired oval masses of gray matter.
• The relay station for sensory impulses that reaches the sensory
area of the cerebrum.
• The thalamus is the major relay station for most sensory
impulses that reach the primary sensory areas of the cerebral
cortex from the spinal cord and brain stem
• The thalamus also relays nerve impulses between different
areas of the cerebrum and plays a role in the maintenance of
consciousness
 Hypothalamus

• small part of the diencephalon located inferior to the

thalamus
• The hypothalamus controls many body activities and is
one of the major regulators of homeostasis.
 Functions of Hypothalamus

• Control of the ANS. The hypothalamus controls and integrates

activities of the autonomic nervous system, which regulates the
contraction of smooth muscle and cardiac muscle and glands.
• Production of hormones- releasing hormones and inhibiting
hormones that control anterior pituitary hormones and
synthesized oxytocin and antidiuretic hormones produced in
the paraventricular and supraoptic nuclei respectively.
• Regulation of emotional and behavioral patterns-
participates in expressions of rage, aggression, pain and
pleasure, and sexual arousal
 Functions of Hypothalamus

• Regulation of eating and drinking.- the presence of feeding

center and Thirst center
• Control of body temperature- senses body temperature from
the blood flowing through the hypothalamus.
• Regulation of circadian rhythms and states of
consciousness- sleep-wake cycle) that occur on a circadian
schedule (cycle of about 24 hours).
 Epithalamus

• a small region superior and posterior to the thalamus,

consists of the pineal gland
• The pineal gland is part of the endocrine system because
it secretes the hormone melatonin.
• As more melatonin is liberated during darkness than in
light, this hormone is thought to promote sleepiness.
 3. Brain Stem

• It is the part of the brain between the spinal cord and the
diencephalon.
Parts of the brain stem
• Midbrain
• Pons
• Medulla oblongata
Brain Stem

Figure 7.15a

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

 Midbrain
The midbrain or mesencephalon extends from the diencephalon to the pons.
The midbrain contains 2 imp nuclei,
• Substantia nigra- large and darkly pigmented nuclei. Neurons, extending
from the substantia nigra to the basal nuclei release dopamine, which
helps control subconscious muscle activities. Loss of these neurons is
associated with Parkinson’s disease
• Red nuclei- look reddish due to their rich blood supply and an iron-
containing pigment in their neuronal cell bodies. Axons from the
cerebellum and cerebral cortex form synapses in the red nuclei, which
help control muscular movements.
 Pons

The pons is a bridge that connects parts of the brain such

as the cerebrum, diencephalon, and cerebellum.
Various ascending sensory tracts and descending motor
tracts pass through the pons.
There are nuclei within the pons that act as relay
stations.
pneumotaxic and apnoustic centers (nuclei) in pons
operate in conjunction with the respiratory center in the
medulla oblongata to control respiration
 Medulla Oblongata

• The lowest part of the brain stem

• Merges into the spinal cord
• The medulla matter contains all sensory
(ascending) tracts and motor (descending)
tracts that extend between the spinal cord and
other parts of the brain.
• 90% of the axons in the right pyramid cross to
the left side. This crossing is called the
decussation of pyramids
 Medulla Oblongata- Functions
The medulla also contains several nuclei that act as control centers
• The cardiovascular center- regulates the rate and force of the
heartbeat and the diameter of the blood vessel.
• The medullary respiratory center- adjusts the basic rhythm of
breathing.
• The vomiting center of the medulla causes vomiting.
• The deglutition center of the medulla promotes deglutition
(swallowing) of a mass of food.
• Sneezing and coughing center involves spasmodic contraction of
breathing muscles that forcefully expel air through the nose and
mouth.
 4. Cerebellum

• The cerebellum, the second largest

part of the brain located in the
posterior and inferior part of the
cranial cavity.
• It is ovoid in shape and has two
hemispheres, separated by a narrow
median strip called the vermis.
• Grey matter forms the surface of the
cerebellum, and the white matter lies
deeply.
Cerebellum
 Cerebellum- Functions
• The cerebellum smooths and coordinates the complex sequence
of contractions of skeletal muscles that help in learning the
skilled muscular movements.
• It coordinates activities associated with the maintenance of
posture, balance and equilibrium. The sensory input for these
functions is derived from the muscles and joints, the eyes and
the ears.
• impulses from the eyes and the semicircular canals in the ears
provide information about the position of the head in space.
• The cerebellum may also have a role in learning and language
processing.
 Spinal Cord
• The spinal cord is the elongated, cylindrical part of
the CNS, suspended in the vertebral canal
surrounded by the meninges and CSF.

• Extends from the medulla oblongata to the region

of the 1st lumbar vertebra. 45 cm long

• Below the lumbar vertebra is the cauda equina (a

collection of spinal nerves).

• Link between brain and rest of the body.

• Spinal nerves are the paths of communication

between the spinal cord and specific regions of the
body. The spinal cord appears to be segmented
because the 31 pairs of spinal nerves emerge at
regular intervals from intervertebral foramina
 Spinal Cord Internal Anatomy
• A cross-section of the spinal cord
shows that it is composed of grey
matter in the center surrounded by
white matter supported by
neuroglia.
• A. Grey matter- H shaped. They
are clusters of neuronal cell bodies
(sensory and motor nuclei), having
two posterior, two anterior and two
lateral columns.
 Spinal Cord Anatomy

• The posterior gray horns contain cell bodies

and axons of interneurons as well as axons
of incoming sensory neurons
• The anterior gray horns contain somatic
motor nuclei, which are clusters of cell
bodies of somatic motor neurons that
provide nerve impulses for the contraction of
skeletal muscles.
• The lateral gray horns contain autonomic
motor nuclei, which are clusters of cell
bodies of autonomic motor neurons that
regulate the activity of cardiac muscle,
smooth muscle, and glands
 Spinal Cord Anatomy

The white matter - is organized into the

following regions
(1) Anterior white column,
(2) Posterior white columns, and
(3) Lateral white columns
Each column in turn contains distinct
bundles of axons having a common origin
or destination and carrying similar
information.
 Spinal Cord- Physiology

The spinal cord has two principal functions

1. Sensory and Motor Tracts- Nerve impulses from sensory receptors
propagate up the spinal cord to the brain and motor output from the
brain travels down the to body parts

2. Reflexes and Reflex Arcs- A reflex is a fast, involuntary, unplanned

sequence of actions that occurs in response to a particular stimulus.
Some reflexes are inborn, such as pulling your hand away from a hot
surface before you even feel that it is hot. Other reflexes are learned or
acquired.
 Reflex arc and reflex action
Nerve impulses propagating into, through, and out of the CNS follow specific pathways.
The pathway followed by nerve impulses that produce a reflex is a reflex arc. A reflex
arc includes the following five functional components.
1. Sensory receptor- present in sensory neurons of sense organs, It responds to a
specific stimulus.
2. Sensory neuron- The nerve impulses propagate from the sensory neuron to the
gray matter of the spinal cord.
3. Integrating center- a. Monosynaptic reflex- single synapse between a sensory
neuron and a motor neuron. b. Polysynaptic reflex- the integrating center consists of
one or more interneurons.
4. Motor neuron- Impulses triggered by the integrating center propagate out of the
spinal cord along a motor neuron to the part of the body
5. Effector- The part of the body that responds to the motor nerve impulse, such as a
muscle or gland, is the effector. Its action is called a reflex.
Reflex arc and reflex action
 Spinal Nerves
• They are parallel bundles of axons and
their associated neuroglial cells
wrapped in several layers of
connective tissue. Spinal nerves
connect the CNS to sensory receptors,
muscles, and glands in all parts of the
body.
• The 31 pairs of spinal nerves are
named and numbered according to the
region and level of the vertebral
column from which they emerge.
 Spinal Nerves

Types of Spinal Nerves

1. Cervical Nerves (8)
2. Thoracic Nerves (12)
3. Lumbar Nerves (5)
4. Sacral Nerves (5)
5. Coccygeal Nerves (1)
 Cranial Nerves
The 12 pairs of cranial nerves as they pass through the bones of the cranium
and arise from the brain inside the cranial cavity.
Types of cranial nerves-
1. sensory nerves- Three cranial nerves (I, II, and VIII) carry sensory
neurons and thus are called special sensory nerves.
2. motor nerves- Five cranial nerves (III, IV, VI, XI, and XII) are
classified as motor nerves because they contain only motor neurons as
they leave the brain stem.
3. The remaining four cranial nerves (V, VII, IX, and X) are mixed
nerves—they contain both sensory neurons entering the brain stem and
motor neurons leaving the brain stem.
Cranial Nerves
Cranial Nerves
References
1. Tortora, G. J., & Grabowski, S. R. (2012). 15th edition, Principles of
anatomy and physiology. New York.
2. Ross and Wilson Anatomy and Physiology in Health and Illness
International Edition, 13th Edition.
 There is a solution to all your problems/doubts, the
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