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Chapter 8, Bones, PartChapter 8, Bones, Part 2: 2: The Appendicular SkeletonThe Appendicular Skeleton
Appendicular Skeleton =Appendicular Skeleton =
Everything that is not the Everything that is not the Axial Skeleton, i.e., pelvis Axial Skeleton, i.e., pelvis and limbsand limbs
Goal: Learn and locate the bones and Goal: Learn and locate the bones and markings of the appendicular skeletonmarkings of the appendicular skeleton
The GirdlesThe Girdles
Pectoral GirdlePectoral Girdle Supports the ArmsSupports the Arms Clavicle and ScapulaClavicle and Scapula
Pelvic GirdlePelvic Girdle Supports the LegsSupports the Legs PelvisPelvis
Ilium, ischium, pubic boneIlium, ischium, pubic bone
Clavicle Clavicle (collarbone)(collarbone)
Manubrium to Acromion
Frequently fractured
Scapula Scapula (shoulder blade)(shoulder blade)
Origin of biceps brachii muscle:Origin of biceps brachii muscle:Coracoid ProcessCoracoid ProcessSupraglenoid tubercleSupraglenoid tubercle
GlenoidGlenoid SpineSpine AcromionAcromion Acromioclavicular Acromioclavicular
jointjoint Inferior and Superior Inferior and Superior
AnglesAngles
The ArmThe Arm
Synonym: Upper limbSynonym: Upper limb Upper Arm = BrachiumUpper Arm = Brachium Forearm = Forearm =
AntebrachiumAntebrachium
Humerus, Radius and Humerus, Radius and UlnaUlnaCarpus (wrist)Carpus (wrist)Hand (manus)Hand (manus)
HumerusHumerusHeadHeadGreater and Lesser Greater and Lesser TuberclesTuberclesIntertubercular SulcusIntertubercular Sulcus
Biceps tendonBiceps tendon
Coronoid FossaCoronoid FossaOlecranon FossaOlecranon FossaTrochleaTrochleaMedial and Lateral Medial and Lateral EpicondylesEpicondyles
Radius UlnaRadius UlnaHead, neck, shaftHead, neck, shaftInsertion of biceps Insertion of biceps brachii:brachii: Radial TuberosityRadial TuberosityRadial Styloid Radial Styloid ProcessProcess
OlecranonOlecranonTrochlear notchTrochlear notchCoronoid ProcessCoronoid ProcessUlnar Styloid ProcessUlnar Styloid Process
Interosseous Membrane (between Interosseous Membrane (between radius and ulna)radius and ulna)
Note how the two bones can Note how the two bones can crosscross
““Funny bone”Funny bone”
Carpus = WristCarpus = WristFour ProximalFour Proximal Scaphoid, Scaphoid,
lunate, lunate, triquetrum, triquetrum, pisiformpisiform
Four DistalFour Distal Trapezium, Trapezium,
trapezoid, trapezoid, capitate, hamatecapitate, hamate
Scaphoid is frequently fractured
Hand = ManusHand = Manus
Five metacarpal bones (1-5)Five metacarpal bones (1-5)Five fingers Five fingers Labeled 1-5Labeled 1-5 Thumb = Pollex = digit 1Thumb = Pollex = digit 1
Two phalangeal bonesTwo phalangeal bones Fingers = phalanges = digits 2-5Fingers = phalanges = digits 2-5
Three phalangeal bonesThree phalangeal bones Proximal, middle, distalProximal, middle, distal
The GirdlesThe Girdles
Pectoral GirdlePectoral Girdle Supports the ArmsSupports the Arms Clavicle and ScapulaClavicle and Scapula
Pelvic GirdlePelvic Girdle Supports the LegsSupports the Legs Pelvis (os coxae)Pelvis (os coxae)
Pelvis = Pelvis = os coxae = hip bone = os coxae = hip bone = (innominate bone)(innominate bone)
Three bones: Ilium, Ischium, Three bones: Ilium, Ischium, PubisPubisAnterior and posterior iliac Anterior and posterior iliac spines meet to form the iliac spines meet to form the iliac crestcrestGreater and Lesser Sciatic Greater and Lesser Sciatic NotchesNotchesIschial TuberosityIschial TuberosityAcetabulumAcetabulum
Acetabular fossaAcetabular fossa
Obturator ForamenObturator Foramen
More PelvisMore Pelvis
Articular Surface for Articular Surface for Articulation with SacrumArticulation with SacrumDifference between male Difference between male and femaleand femalePelvic (or pubic) Pelvic (or pubic) symphysissymphysis
FibrocartilageFibrocartilage Stretches at childbirth Stretches at childbirth
(Relaxin)(Relaxin)
The legThe leg
AKA Lower LimbAKA Lower Limb
FemurFemurPatellaPatellaTibia/fibulaTibia/fibulaTarsusTarsusFootFoot
FemurFemurHead and fovea capitusHead and fovea capitus Articulate with pelvis Articulate with pelvis
Neck (“fx pelvis”)Neck (“fx pelvis”)Greater and Lesser Greater and Lesser TrochantersTrochantersShaftShaftLateral and medial Lateral and medial condyles and condyles and epicondylesepicondylesIntercondylar fossaIntercondylar fossaPatellar SurfacePatellar Surface
Patella Patella = knee cap= knee cap
Sesamoid BoneSesamoid BoneEnclosed in the Enclosed in the tendon of the tendon of the quadriceps group of quadriceps group of musclesmuscles
“Skyline” MRI of patella
Tibia Tibia = shin bone= shin bone
Lateral and medial Lateral and medial condylescondyles Intercondylar eminenceIntercondylar eminence
Tibial tuberosityTibial tuberosityInferior articular surfaceInferior articular surfaceMedial malleolusMedial malleolus (= ankle bone)(= ankle bone)
Interosseous MembraneInterosseous Membrane
FibulaFibula
HeadHeadShaftShaftLateral malleolusLateral malleolus (= ankle bone)(= ankle bone)
Not weight bearingNot weight bearing Frequent fxFrequent fx
Interosseous MembraneInterosseous Membrane
Tarsus (7 bones)Tarsus (7 bones) Cute Tillie Never Could Cooperate Cute Tillie Never Could Cooperate
NavicularNavicularCuboidCuboidCunieform (3)Cunieform (3) CalcaneusCalcaneus
TalusTalus
FootFoot
Metatarsals (1-5)Metatarsals (1-5)Phalanges (3 per toe Phalanges (3 per toe except big toe)except big toe)Longitudinal ArchesLongitudinal Arches
Medial and lateralMedial and lateral
Transverse ArchTransverse Arch
Dancer’s fx
Cute Tillie Never Could Cooperate
Fractures Fractures (a review)(a review)
BleedingBleeding Then clotThen clot
Periosteal reactionPeriosteal reaction FibroblastsFibroblasts OsteoblastsOsteoblasts
CallusCallus New bone “collar”New bone “collar”
RemodelingRemodeling
““Hip” fractureHip” fracture““Grandma fell and broke her hip.”Grandma fell and broke her hip.”
More accurately, “Grandma broke More accurately, “Grandma broke her femoral neck and then fell.”her femoral neck and then fell.”
Sometimes the fx is at the Sometimes the fx is at the intertrochanteric lineintertrochanteric line
Diabetes, hypertension, Diabetes, hypertension, osteoporosisosteoporosis25% die from complications in first 25% die from complications in first year mostly related to immobility:year mostly related to immobility:
AnesthesiaAnesthesia Muscle AtrophyMuscle Atrophy PneumoniaPneumonia Decubitus ulcersDecubitus ulcers Depression and disorientationDepression and disorientation
Douglas IrisDouglas Iris