APPENDICULAR SKELETON SYSTEM :APPENDICULAR SKELETON SYSTEM ANATOMY & PHYSIOLOGY MR. MULLINS


WHAT IS THE APPENDICULAR SYSTEM? :WHAT IS THE APPENDICULAR SYSTEM? CONSIST OF THE: LOWER EXTREMITIES. PELVIC GIRDLES FEMUR TIBIA/FIBIA CARPALS PHLANGES UPPER EXTREMITIES: PECTORAL GIRDLES HUMURS ULNA/RADIUS CARPALS PHLANGES COMPOSED OF 126 BONES


BONES OF THE PELVIC GIRDLE AND LOWER LIMBS :BONES OF THE PELVIC GIRDLE AND LOWER LIMBS


THE PELVICE (HIP) GIRDLE :THE PELVICE (HIP) GIRDLE PAY PARTICULAR ATTENTION TO BONE MARKINGS NEEDED TO IDENTIFY RIGHT AND LEFT BONES THE PELVIC GIRDLE (HIP GIRDLE) IS FORMED BY THE FOLLOWING: TWO COXAL BONES (COXA SINGULAR FOR HIP) THE TWO COXAL BONES TOGETHER WITH THE SACRUM AND COCCYX FOR THE BONY PELVIS ARE HEAVY AND MASSIVE AND ATTACH SECURELY TO THE AXIAL SKELETON


PARTS OF THE COXAL BONE :PARTS OF THE COXAL BONE EACH COXAL BONE IS A RESULT OF THE FUSION OF THREE BONES: ILIUM: LARGEST PORTION ISCHIUM (COMMONLY REFERRED TO AS THE “SET-DOWN” BONE) PUBIS THESE ARE CLEARLY DISTINGUISHED IN A YOUNG PERSON THE PUBIC BONES OF EACH HIP BONE MEET ANTERIORLY AT THE PUBIC CREST TO FORM A CARTILAGINOUS JOINT CALLED THE PUBIC SYMPHYSIS (THIS STRETCHES DURING CHILDBIRTH)


THE ILIUM :THE ILIUM ILIUM: IS A LARGE FLARING BONE FORMS THE MAJOR PORTION OF THE COXAL BONE CONNECTS POSTERIORLY WITH THE SACRUM AT THE SACROILIAC JOINT ILIAC CREST IS THE SUPERIOR MARGIN OF THE ILIAC BONE (FEEL YOUR HIPS AND YOU ARE NOW TOUCHING THE ILIAC CREST) (ALSO THIS IS A GREAT PLACE TO OBTAIN EXTRA BONE FOR “BONE GRAFTS”)


THE ISCHIUM “SET-DOWN” BONE :THE ISCHIUM “SET-DOWN” BONE ISCHIUM (COMMONLY REFERRED TO AS THE “SET-DOWN” BONE) LESSER AND GREATER SCIATIC NOTCHES ALLOWS NERVES AND BLOOD VESSELS TO PASS TO AND FROM THE THIGH HINT!! THE SCIATIC NERVE PASSES THROUGH THE GREATER SCIATIC NOTCH (INFLAMATION OF THIS AREA CAUSES SHOOTING PAIN DOWN THE LEG)


THE PUBIS :THE PUBIS PUBIS IS THE MOST ANTERIOR PORTION OF THE COXAL BONE FUSION OF THE RAMI AND THE ISCHIUM FORMS A BAR OF BONE ENCLOSING THE OBTURATOR FORAMEN THROUGH WHICH BLOOD VESSELS AND NERVES RUN FROM THE PELVIC CAVITY INTO THE THIGH


COMPARISON OF THE MALE AND FEMALE PELVES :COMPARISON OF THE MALE AND FEMALE PELVES ALTHOUGH BONES OF MALES ARE USUALLY LARGER, HEAVIER, AND HAVE MORE PROMINENT BONE MARKINGS. THE MALE AND FEMALE SKELETONS ARE SIMILAR. THE OUTSTANDING EXCEPTION TO THIS IS THE PELVIC STRUCTURE WHY??????


LETS EXAMINE WHY!! :LETS EXAMINE WHY!! THE FEMALE PELVIS REFLECTS MODIFICATIONS FOR CHILDBEARING GENERALLY THE FEMALE PELVIS IS WIDER, SHALLOWER, LIGHTER, AND ROUNDER NOT ONLY MUST HER PELVIS SUPPORT THE INCREASING SIZE OF A FETUS, BUT IT MUST ALSO BE LARGE ENOUGH TO ALLOW THE INFANT’S HEAD TO DESCEND THROUGH THE BIRTH CANAL WHAT IS THE BIRTH CANAL??????


COMPARING PELVIC SEX DIFFERENCES :COMPARING PELVIC SEX DIFFERENCES ANATOMICALLY THE PELVIS IS DESCRIBED IN TERMES OF FALSE AND TRUE PELVIS: FALSE PELVIS SUPPORTS THE ABDOMINAL VISCERA IT DOES NOT RESTRICT CHILDBIRTH IN ANY WAY TRUE PELVIS (IMPORTANT IN CHILDBEARING) THE DIMENSIONS OF THE TRUE PELVIS PARTICULARLY ITS INLET AND OUTLET ARE CRITICAL IF DELIVERY OF A BABY IS TO BE UNCOMPLICATED AND THEY ARE CAREFULLY MEASURED BY THE OBSTETRICIAN.


GERNAL COMPARISON OF THE FEMALE AND MALE PELVES :GERNAL COMPARISON OF THE FEMALE AND MALE PELVES FEMALE INLET IS LARGER AND MORE CIRCULAR THE FEMALE PELVIS AS A WHOLE IS SHALLOWER AND THE BONES ARE LIGHTER AND THINNER THE FEMALE SACRUM IS BROADER AND LESS CURVED AND THE PUBIC ARRCH IS MORE ROUNDED THE FEMALE ACETABULAR ARE SMALLER AND FARTHER APART AND THE ILIS FLARE MORE LATERALLY THE FEMALE ISCHIAL SPINES ARE SHORTER, FARTHER APART AND EVERTED, THUS ENLARGING THE PELVIC OUTLET.


X-RAY OF PELVIS :X-RAY OF PELVIS


THE THIGH :THE THIGH


THE THIGH: SUPERIOR PORTION OF FEMUR :THE THIGH: SUPERIOR PORTION OF FEMUR SCIENTIFIC NAME FOR THIGH IS “FEMUR BONES” IS THE HEAVIEST, STRONGEST BONE IN THE BODY THE BALL-LIKE HEAD OF THE FEMUR ARTICULATES WITH THE HIP BONE VIA THE DEEP, SECURE SOCKET OF THE ACETABULUM THE HEAD OF THE FEMUR IS CARRIED ON A SHORT, CONSTRICTED NECK, WHICH ANGLES LATERALLY TO JOIN THE SHAFT THE NECK IS THE WEAKEST PART OF THE FEMUR AND IS A COMMON FRACTURE SITE (BROKEN HIP) PARTICULARLY IN THE ELDERLY AT THE JUNCTION OF THE SHAFT AND NECK ARE THE GREATER AND LESSER TROCHANTERS THESE ARE SITES FOR MUSCLE ATTACHMENT


THE THIGH: SHAFT AND TERMINAL ENDING (KNEE) :THE THIGH: SHAFT AND TERMINAL ENDING (KNEE) THE FEMUR INCLINES MEDIALLY AS IT RUNS DOWNWARD TO THE LEGE BONES; THIS BRINGS THE KNEES IN LINE WITH THE BODY’S CENTER OF GRAVITY THE MEDIAL COURSE OF THE FEMUR IS MORE NOTICEABLE IN FEMALES BECAUSE OF THE WIDER FEMALE PELVIS THE FEMUR TERMINATES IN THE LATERAL AND MEDIAL CONDYLES, WHICH ARTICULATE WITH THE TIBIA BELOW AND THE PATELLAR SURFACE, WHICH FORMS A JOINT WITH THE PATELLA (KNEECAP) ANTERIORLY


FEMUR ARTICULATION WITH PELVIC GIRDLE :FEMUR ARTICULATION WITH PELVIC GIRDLE


FEMUR ARTICULATION WITH PELVIC GIRDLE :FEMUR ARTICULATION WITH PELVIC GIRDLE


PATELLA (KNEECAP) :PATELLA (KNEECAP) IS TRAIANGULAR SESAMOID BONE ENCLOSED IN THE QUADRICEPS TENDON THAT SECURES THE ANTERIOR THIGH MUSCLES TO THE TIBIA IT GUARDS THE KNEE JOINT ANTERIORLY AND IMPROVES THE LEVERAGE OF THE THIGH MUSCLES ACTING ACROSS THE KNEE JOINT


CADAVER KNEE :CADAVER KNEE


X-RAY OF KNEE :X-RAY OF KNEE


THE LEG: TIBIA & FIBULA :THE LEG: TIBIA & FIBULA


TIBIA (SHINBONE) :TIBIA (SHINBONE) IS THE LARGER AND MORE MEDIAL OF THE TWO LEG BONES AT THE PROXIMAL END, THE MEDIAL AND LATERAL CONDYLES (SEPARATED IN THE MIDDLE BY THE INTERCONDYLAR EMINENCE) RECEIVE THE DISTAL END OF THE FEMUR TO FORM THE KNEE JOINT MEDIAL MALLEOLUS FORMS THE INNER BULGE OF THE ANKLE (INSIDE ANKLE…RUN YOUR FINGER AROUND THE INSIDE OF THE ANKEL TO FEEL THE MALLEOULUS) ANTERIOR CREST IS THE ANTERIOR SURFACE OF THE TIBIA THAT BEARS A SHARPENED RIDGE THAT IS RELATIVELY UNPROTECTED BY MUSCLES (RUN YOU FINGERS DOWN YOU LEG TO FEEL THIS!!!!)


THE FIBULA :THE FIBULA LIES PARALLEL TO THE TIBIA IT PLAYS NO PART IN FORMING THE KNEE JOINT, IT ARTICULATES WITH THE TIBIA, JUST BELOW THE KNEE JOINT THE FIBULA IS THIN AND STICKLIKE WITH A SHARP ANTERIOR CREST IT TERMINATES DISTALLY IN THE LATERAL MALLEOLUS, WHICH FORMS THE OUTER PART, OR LATERAL BULGE OF THE ANKLE. (RUN YOU FINGERS DOWN THE OUTSIDE OF YOUR ANKLE TO FEEL THE MALLEOLUS.


THE FOOT :THE FOOT


THE FOOT :THE FOOT BODY WEIGHT IS CONCENTRATED ON THE TWO LARGES TARSALS WHICH FORM THE POSTERIOR ASPECT OF THE FOOT: CALCANEUS (HEEL BONE) COMMON SITES OF BONE SPURS AND FRACTURES) TALUS, WHICH LIES BETWEEN THE TIBIA AND THE CALCANEUS THE BONES OF THE FOOT INCLUDE (26 BONES): 7 TARSAL 5 METATARSALS (WHICH FORM YOUR INSTEP) 14 PHALANGES (WHICH FORM THE TOES) EACH TOE HAS THREE PHALANGES EXCEPT THE GREAT TOE, WHICH HAS ONLY TWO PHALANGES


THE FOOT :THE FOOT THE BONES IN THE FOOT ARE ARRANGED TO PRODUCE THREE STRONG ARCHES TWO LONGITUDINAL ARCHES (MEDIAL AND LATERAL) ONE TRANSVERSE ARCH


X-RAY OF THE FOOT :X-RAY OF THE FOOT


SUMMARY :SUMMARY WE HAVE DISCUSSED THE NATURE OF THE PELVIC GIRDLE WE HAVE DISCUSSED THE DIFFERENCES BETWEEN THE MALE AND FEMALE PELVIS WE HAVE IDENTIFIED THE MAJOR PORTIONS OF THE PEVIC GIRDLE WE HAVE DISCUSSED ABNORMALITIES AND SURGICAL REPAIRS OF PARTICULAR ORTHOPEADIC CONDITIONS WE HAVE REVIEWED PARTICULAR X-RAYS, CADAVERS, AND SURGICAL PROCEDURES OF THE PELVIC GIRDLE


HOMEWORK :HOMEWORK DIRECTIONS: COMPLETE THE FOLLOWING TO BE TURNED IN AFTER WARM-UP? GOOD LUCK!!!! DRAW AND LABLE THE PELVIC GIRDLE DRAW AND LABLE THE FEMUR DRAW AND LABLE THE TIBIA AND FIBULA DRAW THE FOOT BONES READ AND PREPARE FOR THE UPPER EXTREMITIES.


Hip Arthroplasty Procedure :Hip Arthroplasty Procedure


Knee Arthroplasty Procedure :Knee Arthroplasty Procedure


Shoulder Girdle and limbs :Shoulder Girdle and limbs


WARM-UP :WARM-UP DIRCTIONS: WITH YOU LAB GROUP DISCUSS AND ANSWER THE FOLLOWING QUESTIONS. YOU WILL HAVE 5 MINUTES TO COMPLETE. PLEASE IF YOU COMPLETE YOUR WARM-UP, RESPECT OTHERS STILL WORKING AND PREPARE FOR TODAY’S LECTURE. WHAT ARE THE TWO APPENDICULAR PORTIONS OF THE SKELETAL SYSTEM? WHAT IS THE WEAKEST PORTION OF THE FEMUR BONE? WHICH BONE ACTUALLY ARTICULATES WITH THE FEMUR AT THE “KNEE”? IN RELATIONS TO “TRUE/FALSE PELVIS,” WHICH IS OF MORE IMPORTANCE TO THE DOCTOR WHEN CONSIDERING CHILDBIRTH? WHAT ARE SOME OF THE CONCERNS THAT A DOCTOR MAY WHAT TO CONSIDER WITH RELATIONS TO A FETUS PASSING THROUGH THE BIRTHCANNAL? “It's not that some people have willpower and some don't. It's that some people are ready to change and others are not.” ASK YOUR SELF...Have you made the change YET…if not you may want to seriously rethink your goals and future… James Gordon, M.D.


BONES OF THE PECTORAL GIRDLE AND UPPER EXTREMITY :BONES OF THE PECTORAL GIRDLE AND UPPER EXTREMITY


TODAY WE WILL… :TODAY WE WILL… DISCUSS THE PECTORAL GIRDLE DISCUSS THE UPPER EXTREMITY REVIEW NORMAL AND POST-OP X-RAYS VIEW SOME ACTUAL SURGICAL PICTURES. HOMEWORK COMPLETE DRAWING


THE PECTORAL (SHOULDER) GIRDLE :THE PECTORAL (SHOULDER) GIRDLE THE PAIRED PECTORAL, OR SHOULDER GIRLDES CONSIST OF TWO BONES THE ANTERIOR CLAVICLE (COLLAR BONE) POSTERIOR SCAPULA (SHOULDER BLADE) FUNCTIONS TO ATTACH THE UPPER LIMBS TO THE AXIAL SKELETON AS WELL AS TO SERVE AS ATTACHMENT POINTS FOR MANY TRUNK AND NECK MUSCLES


THE CLAVICLE (COLLAR BONE) :THE CLAVICLE (COLLAR BONE) SLENDER DOUBLY CURVED BONE (CONVEX FORWARD ON ITS MEDIAL 2/3 AND CONCAVE LATERALLY STERNAL (MEDIAL) END ATTACHES TO THE STERNAL MANUBRIUM. THE STERNAL END PROJECTS ABOVE THE MANUBRIUM (FEEL YOU COLLAR BONE NEAR THE MANUBRIUM, NEAR THE JUGULAR NOTCH) THE ACROMIAL (LATERAL) END OF THE CLAVICLE IS FLATTENED AND ARTICULATES WITH THE SCAPULA TO FORM PART OF THE SHOULDER JOINT THE CLAVICAL SERVES AS AN ANTERIOR BRACE TO HOLD THE ARM AWAY FROM THE TOP OF THE THORAX CAGE.


THE SCAPULAE :THE SCAPULAE Commonly name: Shoulder blade Has no direct attachment to the axial skeleton, it is held loosely in place by truck muscles Generally triangular and are commonly called the “wings” of humans Each scapula has a flattened body and two important processes: acromion: Is the enlarged end of the spine of the scapula Connects with the clavicle coracoid process Is beaklike Serves as an attachment point for some of the upper limb muscles. suprascapular notch Located at the base of the coracoid process Allows nerves to pass


Three angles of the scapula :Three angles of the scapula Three angles: Superior angle Top portion of the scapula Inferior angle Provides a landmark for auscultating lung sounds Bottom of the scapula Lateral angle Glenoid cavity Is a shallow socket that receives the head of the humerus Side view of the scapula


Shoulder Girdle Unlike Any Other System :Shoulder Girdle Unlike Any Other System It is exceptionally light Allows the upper limb a degree of mobility not seen anywhere else in the body and is due to: Sternoclavicular joints Are the only site of attachment of the shoulder girdles to the axial skeleton The looseness of the scapular attachment allows it to slide back and forth against the thorax with muscular activity Glenoid cavity is shallow and does little to stabilize the shoulder joint However!!! The flexibility comes at a price…the humerus is very susceptible to dislocation, and fracture of the clavicle disables the entire upper limb.


THE ARM AND FOREARM :THE ARM AND FOREARM


THE ARM :THE ARM CONSIST OF A SINGLE BONE KNOWN AS THE HUMERUS PROXIMALLY ITS ROUNDED HEAD FITS INTO THE SHALLOW GLENOID CAVITY OF THE SCAPULA. THE HEAD IS SEPARATED FROM THE SHAFT BY: FORMING A FREE FLOATING BALL-AND-SOCKET JOINT THE ANATOMICAL NECK AND SURGICAL NECK THE SURGICAL NECK IS THE MOST COMMON PLACE FOR FRACTURES OPPOSITE OF THE HEAD ARE TWO PROMINENCES: THE GREATER TUBERCLE THE LESSER TUBERCLE SHAFT IS THE MIDPOINT OF THE HUMERUS HAS A ROUGHENED AREA TERMED THE DELTOID TUBEROSITY WHERE THE LARGE SHOULDER MUSCLE (DELTOID) ATTACHES JUST INFERIOR TO THE DELTOID TUBEROSITY IS THE RADIAL GROOVE WHICH INDICATES THE PATHWAY OF THE RADIAL NERVE


Humerus :Humerus AT THE DISTAL END OF THE HUMERUS ARE TWO CONDYLES MEDIAL TROCHLEA (LOOKING LIKE A SPOOL) WHICH ARTICULATES WITH THE ULNA LATERAL CAPITULUM WHICH ARTICULATES WITH THE RADIUS THE CONDYLE PAIR IS FLANKED MEDIALLY BY THE: MEDIAL EPICONDYLE COMMONLY TERMED “FUNNY BONE” BECAUSE THE LARGE ULNAR NERVE RUNS IN A GROOVE BENEATH IT AND WHEN BUMPED, CAUSES PAINFUL, TINGLING SENSATION “HITTING THE FUNNY BONE” LATERAL EPICONDYLE


THE FOREARM :THE FOREARM ALSO TERMED ANTEBRACHIUM RADUS AND ULNA JOIN TOGETHER VIA A PIVOT JOINT TWO BONES: RADIUS SMALL PROXIMAL END AT THE ELBOW ARTICULATES WITH THE CAPITULUM OF THE HUMERUS HAS RADIAL TUBEROSITY, WHICH IS THE POINT OF ARTICULATION FOR THE TENDON OF THE BICEPS MUSCLES OF THE ARM LARGE DISTAL END AT THE WRIST THUMB SIDE ULNA CONNECTS TO THE HUMERUS VIA A HINGE JOINT LARGE PROXIMAL END AT THE ELBOW THE POSTERIOR SIDE OF THIS BONE IS KNOWN AS THE OLECRANON PROCESS, WHICH GRIP THE TROCHLEA OF THE HUMERUS LIKE A PLIERSLIKE JOINT. SMALL DISTAL END AT THE WRIST ON THE “PINKY” FINGER SIDE ALSO SEEN AS A “LUMP” KNOWN AS THE STYLOID PROCESS AT YOUR WRIST (CAN YOU FIND YOUR ULNA?) THE STYLOID PROCESS SERVES AS AN ATTACHMENT POINT FOR THE LIGAMENTS OF THE WRIST.


Cadaver Elbow :Cadaver Elbow


X-Ray of Elbow :X-Ray of Elbow


THE HAND :THE HAND INCLUEDS THREE GROUPS OF BONES: CARPUS (WRIST) 8 BONES ARRANGED IN TWO IRREGULAR ROLES OF 4 BONES EACH ARE ALL BOUND CLOSELY TOGETHER BY LIGAMENTS KNOWN AS PLANE JOINTS METACARPALS (BONES OF THE PALMS) NUMBERED 1-5 FROM THE THUMB TOWARD THE LITTLE FINGER WHEN THE FIST IS CLENCHED, THE HEADS OF THE METACARPALS BECOME PROMINENT AS THE “KNUCKLES” (TRY TO MAKE A FIST AND NOTICE YOUR KNUCKLES) MOST COMMON FRACTURE FOR FIGHTERS IS THE “BOXER FRACTURE,” WHICH IS THE FIFTH METACARPAL BONE. CONDYLOID JOINTS THE JOININ OF THE METACARPALS SADDLE JOINTS METACARPALS JOINING THE CARPAL BONE PHALANGES (BONES OF THE FINGERS) CONNECTED TO EACH OTHER AS HINGE JOINTS NUMBERS 1-5 BEGINNING FROM THE THUMB THERE ARE 14 BONES OF THE FINGERS (OR DIGITS) THEY ARE MINIATURE LONG BONES TERMED PHALANGES (EXCPET FOR THE THUMB {JUST LIKE THE GREAT TOE}) EACH FINGER CONTAINS THREE PHALANGES PROXIMAL MIDDLE DISTAL


Childs/Adult X-Ray :Childs/Adult X-Ray


Summary :Summary We have discussed the particular bones and their specific landmarks. Such as how the scapula has no articulation to the skeletal system We have discussed where each bone articulates with the following bones We have shown differences between children and adult skeletal systems We have viewed various X-rays of normal and abnormal structures. We have seen surgical implants We have viewed structure in cadaver bodies that relate to our topic for the day in order to see how structures really look like. Any questions or misunderstandings should be addressed now if there are none then we will proceed with our review tomorrow for the upcoming exam. We will be moving into the muscular system next and planning for dissecting a chicken wing to observe its muscular system; building a hand; and viewing muscle cells under the microscope


Shoulder Fusion (glenoidhumeral arthrodisis) :Shoulder Fusion (glenoidhumeral arthrodisis)


Repair of Ulna :Repair of Ulna


Open discussion and viewing of X-rays :Open discussion and viewing of X-rays


homework :homework Complete drawing of homework Review notes and work on your review Tomorrow we will have test review Open discussion on any concerns with the test.