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Musculoskeletal System in Brief………
Dr Gurjant Singh, MPT, (Ph.D), Assistant Professor, MMIPR
Anatomy of Skeletal Elements
The Musculoskeletal system
• 206 bones
• grouped into the axial and appendicular
skeletons
• 650 muscles
– approximately 40% of your body weight
– also divided into an axial and an appendicular
division
Classification of Bones
• 6 types - based on anatomical
classification
– Long bones = greater length than width
– Short bones = cube-shaped, spongy
bone except at surface
– Flat bones = two parallel plates of
compact bone sandwiching spongy bone
layer
– Irregular bones = cannot be grouped
– Sesamoid bones = develop in tendons
where there is considerable friction,
tension and stress
– Sutural bones = located within joints
between cranial bones
Bone Markings (surface features)
• Used to identify specific
elevations, depressions,
and openings of bones
• Bone markings provide
distinct and
characteristic landmarks
for orientation and
identification of bones
and associated
structures.
Bony Processes
• Depressions and openings
– Fissure – narrow slit
– Foramen – hole for nerves, blood vessels
– Fossa – cuplike depression
– Sulcus – furrow on a bone surface, contains a nerve or blood vessel
– Meatus – tubelike opening
• Processes – projection or outgrowth on bone for attachment
– Condyle – smoothened process at end of bone, forms a joint
– Facet – smooth flat surface, forms a joint
– Head – rounded condyle on a neck, forms a joint
– Crest – prominent ridge or projection, for attachment of connective tissues
– Epicondyle – projection above a condyle, for attachment of connective tissues
– Line – long, narrow ridge (less prominent than a crest), for attachment of
connective tissues
– Spinous process – sharp, slender projection, for attachment of connective tissues
– Trochanter – process of the femur, for attachment of connective tissues
– Tubercle – process of the humerus, for attachment of connective tissues
– Tuberosity – roughening on a bone surface, for attachment of connective tissues
Skeletal system includes
• Axial division
– Skull and associated bones
• Auditory ossicles
• Hyoid bones
– Vertebral column
– Thoracic cage
• Ribs & sternum
• Appendicular division
-Pectoral girdle
-Pelvic girdle
THE SKELETAL SYSTEM:
AXIAL DIVISION
Part A
The Axial Skeleton
• Axial division
– Skull and
associated bones
• Auditory ossicles
• Hyoid bone
– Vertebral column
– Thoracic cage
• Ribs & Sternum
The Skull and Associated Bones
The Adult Skull
• skull = 22 bones
• cranium = 8 bones: 1 frontal, 1 occipital, 2 temporals, 2 parietals, 1 sphenoid
and 1 ethmoid
• facial bones = 14 bones: 2 nasals, 2 maxillae, 2 zygomatics ,1 mandible, 2
lacrimals, 2 palatines, 2 inferior nasal conchae, 1 vomer
• mandible and auditory ossicles are the only movable skull bones
The Adult Skull
• skull is made up of several cavities
– 1. cranial cavity
– 2. nasal cavity
– 3. the orbits
– 4. paranasal sinuses
• skull contains many holes for the passage of nerves and vessels =
foramen/foramina
• cranial bones also attach to membranes called meninges
• outer surface provides large areas for muscle attachment that move
the head or provide facial expressions
Sutures
• Immovable joints
• form boundaries between skull bones
• four main sutures
– Coronal
– Sagittal
– Lambdoid
– Squamous
– PLUS lots of smaller sutures
• e.g. Frontonasal
• e.g.Temperozygomatic
• part of the base of the
skull
• surrounds the foramen
magnum
• forms part of the
jugular foramen
• hypoglossal foramen
found under the occipital
condyles
Mastoid notch
Occipital Bone
•Part of the superior and lateral
surfaces of the cranium
•united by a sagittal suture
•connects to frontal bone by coronal
suture
•connects to occipital bone by
lambdoid suture
Parietal Bone
•forms wall of jugular foramen
•three portions: squamous, petrous and tympanic
•petrous part houses tympanic membrane and middle and
inner ears
•auditory ossicles of middle ear transmit sound to inner ear
Temporal Bone
Petrous
portion
Tympanic
portion
Temporal Bone
Articular
Tubercle
Squamous
portion
Petrous
portion
Tympanic
portion
Frontal process of zygomatic bone
Maxillary process
of zygomatic bone
Temporal surface of greater wing of sphenoid
Lacrimal bone
glabella Internasal suture
Zygomatic process
of maxilla
Frontal process of maxilla
Supraorbital ridge
or margin
Frontal Bone
– Forms the forehead &
roof of the orbit
glabella
• Contributes to floor of cranium
• Bridges cranial and facial bones
• Optic canal allows passage of optic nerve
• Pterygoid processes sites of muscle attachment
Sphenoid Bone
• Irregularly shaped bone
• forms part of orbit & forms roof of nasal cavity
• Cribriform plate with olfactory foramina for olfactory nerves
• Perpendicular plate forms part of nasal septum
Ethmoid Bone
Facial Bones: Maxilla
• Paired bone
– Largest of the facial
bones
– Forms upper jaw
• entire lower jaw
• articulates with
temporal bone at the
Temporomandibular
joint
• moveable part of skull
Facial Bones: Mandible
• Nasal bones
– Paired bones
– Articulate with frontal bone
– Extend to superior border of external
nares
• Vomer
– Forms inferior (bottom) portion of
nasal septum
– Articulates with maxillae and
palatine bones
Facial bones
Nasal bones
• Inferior nasal concha
– Located on each side of nasal septum
– Increase epithelial surface
– Create turbulence in inspired air
• Zygomatic bone
– Temporal process articulates with zygomatic process of temporal bone
– Forms zygomatic arch
Facial bones
• Palatine bones
– Small
– L-shaped
– Form posterior portion of
hard palate
– Contribute to floor of orbit
•Lacrimal bones
–Smallest bones in skull
–Delivers tears to nasal cavity via
nasolacrimal canal
Facial bones
The Orbit
• Orbital complex
– Bony recess that holds the eye
– Seven bones
• Frontal bone
• Lacrimal bone
• Palatine bone
• Zygomatic bone
• Ethmoid
• Sphenoid
• Maxilla
Skull: Inferior View
Petrous
portion
Condylar foramen
may be present
Condylar fossa
Basilar
Portion
Figure 6.4 Sectional Anatomy of
the Skull, Part I
Lesser wing of sphenoid
Skull: Interior View
Cerebral surface of
Greater wing of sphenoid
Foramen
Rotundum
Hypophyseal fossa
Dorsum sella
Tuberculum sellae Sella
Turcica
Cranial Fossae
• Depressions in cranial
floor
• for the lobes of the
brain
• Anterior cranial fossa
– Frontal bone, ethmoid,
lesser wings of sphenoid
• Middle cranial fossa
– Sphenoid, temporal
bones, parietal bones
• Posterior cranial fossa
– Occipital bone, temporal
bones, parietal bones
Skull: Sagittal View
Skull: Sagittal View
• Bones and cartilage that
enclose the nasal cavity
• lined with a nasal mucosa
• associated with the 4
paranasal sinuses
– hollow airways
– lined with mucosa – like nasal
mucosa
– found in the frontal bones,
sphenoid, ethmoid and maxillae
The Nasal Complex
The Paranasal Sinuses
Infant Skull: The Fontanels
• the flat bones in the infant
skull are separated by
fontanels
• fibrous connections
between skull bones
• permit infant skulls to pass
through birth canal
• permit the skulls of infants
and children to continue
growing
• will be replaced by sutures
in the adult skull
The Hyoid Bone
• Consists of a body, greater horns and lesser horns
• Base for muscles of the tongue and larynx
Adult Vertebral Column
• strong, flexible rod
– average male = 71 cm (28 inches)
– average female – 61 cm (24 inches)
• capable of moving
– anteriorly
– posteriorly
– laterally
– also rotation
• supports the head
• encloses and protects the spinal cord
• allows for the exit of 31 pairs of spinal
nerves – through intervertebral
foramina
Adult Vertebral Column
• 26 vertebrae
– 24 individual vertebrae
– Sacrum
– Coccyx
• Seven cervical vertebrae
• Twelve thoracic vertebrae
• Five lumbar vertebrae
• Sacrum – 5 fused vertebrae
• Coccyx – 4 fused vertebrae
Adult Vertebral Column
• vertebrae separated by
intervertebral discs
– discs of fibrocartilage made up of an
outer ring and a softer inner region
– found between C1 and C2 and all the
way down to between L5 and the
sacrum
– form the joints of the vertebral
column
Adult Vertebral Column
• absorb shock – flatten,
broaden and bulge outward
• weakening in the outer ring
can allow the herniation of
the inner material
Spinal Curvature
• Four curvatures: increase the strength of the column
– Thoracic (primary) – forms fetally and retain the curve of the
fetus
– Sacral (primary) – forms fetally and retain the curve of the fetus
– Cervical (secondary) – forms when the baby holds its head erect
– Lumbar (secondary) – forms upon walking
• Every vertebrae has the
following:
– 1. body – weight bearing part of the
vertebra
• separated by the discs
– 2. vertebral arch – surrounds the
spinal cord
• surrounds a hole called a vertebral
foramen
– 3. processes – seven of them
• 1. Spinous (1) – muscle attachment
• 2. Transverse (2) – muscle
attachment
• 3. Superior articular (2) – forms
joint with upper vertebra
• 4. Inferior articular (2) – forms
joint with lower vertebra
Vertebrae
Vertebrae
Cervical Vertebra
• cervical vertebrae =
transverse foramina in the
transverse processes
• bifid spinous process
• 1st two cervical vertebrae
(atlas and axis) look
different but have all aspects
of a vertebrae
Thoracic Vertebrae Lumbar
Vertebrae
Fused Vertebrae: The sacrum & coccyx
• Sacrum - Union of 5 vertebrae (S1 - S5) – completely fused by age 30
– median sacral crest = fused spinous processes
– sacral ala = fused transverse processes
– sacral canal ends at sacral hiatus
• Coccyx = Union of 4 vertebrae (Co1 - Co4) – completely fused by age 30
Rib Cage
• 12 pairs of ribs
• vertebral end for articulation with the facets of the 12 thoracic
vertebrae – both body and the transverse process
• sternal end for articulation with the sternum
Rib Cage
-three kinds of ribs:
1. True – separate &
direct connection to
the sternum via
costal cartilage
2. False – no direct
connection to the
sternum – joined via
a composite piece of
costal cartilage
3. Floating – no
connection to the
sternum
Sternum
• comprised of the:
• 1. Manubrium – with
two clavicular
notches and a jugular
notch
• 2. Body – connects to
manubrium via a
sternal angle
• 3. Xiphoid process
Sternum & Rib Cage
• several muscles and muscle groups either originate from the
sternum and/or ribcage (or costal cartilages) or insert onto these
structures
– sternum:
• sternocleidomastoid
• sternohyoid & sternothryoid – depresses hyoid bone and larynx
– ribcage:
• intercostals – external and internal
• serratus anterior & posterior
• numerous muscles of the vertebral column
• pectoralis major & minor
• 4 muscles of the abdominal wall
THE SKELETAL SYSTEM:
APPENDICULAR DIVISION
Part A
Appendicular Skeleton
• Bones of upper and lower limbs
• Pectoral and pelvic girdles
– Connect limbs to trunk
Shoulder Girdle
• Includes
– Scapula (shoulder blade)
– Clavicle (collarbone)
• Squares shoulders
• Helps move the upper
limb
• Provides a base for
muscle attachment
Clavicle
• S-shaped bone
• Connects manubrium of sternum to the acromion process of scapula
• Only direct connection between pectoral girdle and axial skeleton
The Scapula
• Medial or vertebral border is the insertion point for the rhomboids, levator scapulae & serratus
anterior
• Two processes attach to ligaments and tendons
– Coracoid process – e.g insertion for pectoralis minor, origin of biceps
– Acromion process – e.g. origin of the deltoid
• continues on to become the scapular spine
• Articulates at the round head of the humerus to form the glenohumoral joint
• Articulates with clavicle at the acromioclavicular joint
Figure 7.5a, b The Scapula
The Humerus
• articulates with glenoid cavity of
scapula
• possesses an anatomical neck for
capsule attachment and a surgical neck
• trochlea and capitulum form joints
with the ulna and radius = elbow joint
• numerous muscles insert at greater and
lesser tubercle
– greater tubercle – insertion of 3 rotator
cuff muscles + pectoralis major
– lesser tubercle – insertion for the other
rotator cuff
• intertubercular groove – insertion for
latissimus dorsi
• deltoid tuberosity
– insertion of deltoid muscle
The Radius and Ulna
• Parallel bones of the forearm
• radial tuberosity – insertion
point for the biceps brachii
• Olecranon process of ulna
articulates with olecranon
fossa of humerus
– olecranon process is a major
point of muscle attachment for
the triceps
• Coronoid fossa of humerus
accommodates coronoid
process of ulna
– insertion for the major forearm
flexor = brachialis
Carpal Bones
• 8 wrist bones
• Two rows, proximal and distal
– scaphoid bone, lunate bone, triquetrum, pisiform
– trapezium, trapezoid bone, capitate bone, hamate bone
– scaphoid = most commonly injured carpal bone
• fall on the outstretched hand – fracture into two separate pieces (tears blood vessels)
“Some
lovers try
positions
that they
can’t
handle”
Metacarpal Bones
• Articulate with distal
carpals
• Distally articulate with
phalanges
– Fingers have three
phalanges
– Pollex/thumb has two
phalanges
The Pelvic Girdle
• ossum coxa
– Ilium
– Ischium
– Pubis
• the pelvic girdle consists of the two ossa coxae.
• union between pelvis and
sacrum = sacroiliac joint
The Pelvic Girdle
• Ilium
– Largest hip bone
– accommodates the head
of the femur
– Fused to ischium
posteriorly
– Fused to pubis anteriorly
via the superior ramus
• Pubis
– “pubic bone”
– superior & inferior ramus
• rami connect to the ilium and ischium
• surrounds the obturator foramen
– pubic symphysis is pad of
fibrocartilage between 2 pubic bones
• known as an amphithrotic (slightly
movable) joint
• Ischium
– “sit bones”
– ischial spine & tuberosity
• ischial tuberosity – site of origin
for hamstrings and adductor
magnus
– lesser sciatic notch
– ramus unites with the pubis
– inferior pubic ramus for origin of iliacus
(hip flexor), gracilis, adductor brevis and
magnus (hip adductors)
– superior pubic ramus for origin of the hip
adductor pectineus
– pubic crest/tubercle for origin of adductor
longus
– iliac fossa for origin of iliacus
– iliac crest for origin of gluteus maximus and
medius
– anterior gluteal line for origin of gluteus medius
– anterior superior iliac spine for origin of
sartorius
– anterior inferior iliac spine for origin of rectus
femoris
– greater sciatic notch for passage of sciatic nerve
Figure 7.12a-c Divisions of the
Pelvis
Female vs. Male Pelvis
• Smoother
• Lighter
• Less prominent markings
• Enlarged pelvic outlet
• Less sacral curvature
• Wider more circular pelvic
inlet
• Broader pubic angle
The Femur
• Longest bone in body
– takes 4-5 months to completely replace
• Rounded head on an anatomical
neck
– fits into the acetabulum of the pelvis to
form the hip joint
• proximal trochanters for muscle
attachment
• Distal medial and lateral condyles
articulate with tibia – to form the
knee joint
– knee joint is a hinge joint capable of one
plane of motion
• Large tendon attachments to
the trochanters and the linea
aspera
• Linea aspera
– roughened line on the back of the
femur
– origin for the hamstring biceps
femoris (short head) & the knee
extensor vastus medialis
– also the insertion point for
adductor longus, brevis and
magnus
• Greater and lesser
trochanters
– greater trochanter – origin
of vastus lateralis (knee
extensor) & the insertion
point for the hip abductors:
gluteus medius and minimus
and piriformis
– lesser trochanter – insertion
for iliopsoas (hip flexor)
The Patella
• Large sesmoid bone - forms within the tendon of the
quadriceps femoris.
• Forms within tendon of quadriceps femoris muscle group
• Patellar ligament attaches to tibial tuberosity
The Tibia
• Largest bone of leg
• Tibial tuberosity
– site of insertion for the quadriceps
femoris
• Anterior margin
– known as the “shin bone”
• Intercondylar eminence
between the condyles
– condyles of the tibia form the knee
joint with the condyles of the
femur
• Medial malleolus
– Medial support for talocrural joint
The Tibia & Fibula
The Tarsus
• Seven tarsal bones
– calcaneus = heel
• weight of body transferred
through this bone!
– talus – forms the ankle joint
with the tibia and fibula
• ligaments from the two
malleolus processes reinforce
this joint
– navicular
– cuboid
– 3 cuneiform bones
• weight passing through the calcaneus then passes along to 5 metatarsal
bones that form 2 arches:
-Longitudinal arch
-Transverse arch
Joints
1. Cartilage: functions in support, attachment, protection
-cells = chondrocytes
-matrix = collagen II fibers embedded in a gel-
like ground-substance
-ground substance - water + proteoglycans
-proteoglycans – core protein (aggrecan) + sugars
(e.g. chondroitin sulfate, glucosamine)
-in developing child - model for future bone
(endochondral bone formation)
-avascular tissue - produces anti-angiogenic
chemicals (inhibits growth of blood vessels)
-therefore diffusion is the main mode of
transport
Supportive Connective tissue: Cartilage
Proteoglycan
-3 types: 1) Hyaline - most common
- “glass”
- ends of bones, within joints (synovial, articular),
- end of nose, supports respiratory passages
2. Elastic - flexible cartilage
- external ears and parts of larynx
3. Fibrocartilage - very tough -> more collagen fibers
- shock absorber
e.g. intervertebral discs of the knee
Classification of Joints
Articulation (A Joint)
• Wherever two bones interact
• Function depends on structure
• can classify according to:
A. structure – i.e. what they are made of
A. fibrous
B. cartilagenous
C. synovial
B. function - movement
– No movement = synarthrotic
– Slight movement = amphithrotic
– Extensive movement = diathrotic
•lack a synovial cavity
•articulating surfaces are held very closely by fibrous connective tissue
•three types:
1. Sutures: composed a thin layer of fibrous connective tissue
-unites the bones of the skull
e.g. coronal suture
-interlocking edges of the suture gives them strength
-immovable joint
2. Syndesmoses: greater distance between articular edges
-more fibrous connective tissue
-connective tissue arranged as a sheet (interosseous membrane)
or bundle (ligament)
-slightly movable
e.g. tibiofibular ligament connecting the tibiofibular joint
e.g. interosseous membranes between the radius and ulna, tibia and fibula
3. Gomphoses: cone shaped peg fits into a socket
e.g articulations of the roots of the teeth with the jaw
-held by the periodontal ligament
-immovable
Fibrous Joints
•lacks a synovial cavity
•allows little or no movement
•articulating bones are connected by hyaline cartilage or fibrocartilage
1. Synchondroses: connecting material is hyaline cartilage
e.g. epiphyseal/growth plate of a growing bone
-immovable
2. Symphyses: ends of bones are covered with
hyaline cartilage but are connected by a flat disc of
fibrocartilage
-all symphyses occur at the midline of the body
e.g. pubic symphysis - connects two ends of the pubis
bones
e.g. intervertebral joints between the bodies of 2
vertebrae
-slightly movable
Cartilagenous Joints
Synovial joints
•presence of a synovial cavity between the articulating bone surfaces
•freely movable joints
•lined with hyaline cartilage called articular cartilage
•filled with a fluid called synovial fluid
•surrounded by a fibrous capsule – inside is lined with a synovial membrane
•movement is along three possible axes:
Monaxial
Biaxial
Triaxial or Multiaxial
Synovial Joints
9-87
• Articular/Joint capsule encloses joint cavity
– continuous with periosteum of the bones of the
joint
– lined by a synovial membrane that produces
synovial fluid
• Synovial fluid = slippery fluid; feeds cartilages
• Articular cartilage = hyaline cartilage
covering the joint surfaces
• Articular discs and menisci
– found in the jaw, wrist, sternoclavicular and
knee joints
– absorbs shock, guides bone movements and
distributes forces
• Tendon attaches muscle to bone
• Ligament attaches bone to bone
Synovial Joints: General Anatomy
Synovial joints
•synovial joint movement is along three possible axes:
Monaxial or uniaxial – e.g. knee joint, elbow joint
Biaxial – e.g interphalangeal joint
Triaxial or Multiaxial – e.g. shoulder & hip joint
Synovial Joints
Synovial joints
•6 subtypes:
1. planar/gliding
2. hinge
3. pivot
4. condyloid
5. saddle
6. ball and socket
Synovial Joints Types
1. Planar/Gliding joints : articulating surfaces are flat or slightly
curved
-permit side to side or back and forth gliding
motions
-non-axial - no motions around an axis
-some books say they are limited monaxial joints
e.g. intercarpal joints of the wrist bones
e.g. intertarsal joints of the ankle bones
2. Hinge joints: convex surface of one bone fits into a concave
surface
-produces an angular, open and close movement
-movement is in one plane of motion = monaxial
3. Pivot joints: rounded or pointed end of one bone fits into a ring of
another
-also monaxial
-rotates around a longitudinal axis
e.g. atlas-axis joint - first 2 vertebrae
4. Condyloid joints: or ellipsoid joints
-convex oval shaped projection of one bone fits into the
oval-shaped depression of another bone
-biaxial = two planes of motion
e.g. metacarpals and proximal phalanges
e.g. metatarsals and proximal phalanges
e.g. atlanto-occipital joint
5. Saddle joints: articular surface of one bone is saddle shaped
-modified condyloid joint
-biaxial – but more moveable than condyloid joints
e.g. thumb metacarpal and trapezium carpal bone
= trapeziometacarpal joint
6. Ball and socket joints: ball-like end of one bone fits into a
cuplike depression of another
-mult-iaxial - several planes of motion
e.g. hip joint, shoulder joint
Three categories based on range of
motion
• Synarthroses
– Immovable joints
• Amphiarthroses
– Slightly movable joints
• Diarthroses
– Freely movable joints
Synarthroses
• Bony edges may interlock
• Sutures
– Between skull bones
• Gomphosis
– Between teeth and jaw
• Synchondrosis
– Epiphyseal plate
• Synostosis
– Fused bones
Amphiarthroses
• Limited movements
• Syndesmosis
– Collagen fibers connect bones
• e.g. tibiofibular joint
• Symphysis
– Bones are separated by cartilage pad
• e.g. pubic symphysis
Diarthroses (synovial joints)
• Wide range of movement
• Bony surfaces covered by articular cartilage
• Lubricated by synovial fluid
• Enclosed with joint capsule
• Accessory structures
– Menisci
– Fat pads
– Ligaments
– Tendons
– Bursae
– Tendon sheaths
9-96
• Degrees through which a joint can move
• Determined by
– structure of the articular surfaces
– strength and tautness of ligaments, tendons and
capsule
• stretching of ligaments increases range of motion
• double-jointed people have long or slack ligaments
– action of the muscles and tendons
• nervous system monitors joint position and muscle tone
Joints: Range of Motion
9-97
• Abduction/Adduction
• Flexion/Extension/Hyperextension
Joints: Range of Motion
9-98
Movements of Head and Trunk
• Flexion, hyperextension and lateral flexion of vertebral
column
Joints: Range of Motion
9-99
• Movement on
longitudinal axis
– rotation of trunk,
thigh, head or arm
• Medial rotation turns
the bone inwards
• Lateral rotation turns
the bone outwards
Special movement terms: Rotation
• Medial and lateral
rotation of the hand –
called Pronation &
Supination
Special movements of the hand: Pronation & Supination
9-101
• Radial and ulnar
flexion
• Abduction of fingers
and thumb
• Opposition is
movement of the
thumb to approach or
touch the fingertips
• Reposition is
movement back to the
anatomical position
Special movements of the hand
• Dorsiflexion is raising of the toes as when you swing the foot
forward to take a step (heel strike)
• Plantarflexion is extension of the foot so that the toes point
downward as in standing on tiptoe
• Inversion is a movement in which the soles are turned medially
• Eversion is a turning of the soles to face laterally
Special movement of the foot
9-103
• Protraction & Retraction of mandible
• Lateral excursion = sideways movement
• Medial excursion = movement back to the midline
– side-to-side grinding during chewing
Special movement of the Mandible: Protraction & Retraction
Representative Articulations
The Temporomandibular Joint
• TMJ = mandibular fossa of temporal bone &
condylar processes of mandible
• Thick articular disc between the bones
• Supporting structures
– Dense capsule
– Temporomandibular ligament
– Stylomandibular ligament
– Sphenomandibular ligament
• Loose hinge joint
Intervertebral Articulations
• Articular processes of
adjacent vertebrae
• Symphyseal joints at
bodies
• Ligaments bind
vertebrae
• Permits flexion,
extension, lateral
flexion, rotation
The Sternoclavicular Joint
• Gliding joint
• between the sternal end of
clavicle and manubruim of
sternum
•Articular disc
•Supports include
-Anterior and posterior sternoclavicular ligaments
-Interclavicular ligaments
-Costoclavicular ligaments
The Shoulder Joint
• known as the
glenohumoral joint
– between the glenoid fossa
and head of humerus
• Loose shallow joint
• Greatest range of motion
Strength and stability are
sacrificed for motion
• Supported by ligaments
and muscles
• Many bursae to decrease
friction between ligaments
The Elbow Joint
• Hinge joint
• Flexion and extension
• Includes humeroulnar joint and humeroradial
joint
• Supported by
– Radial and ulnar collateral ligaments
– Annular ligaments
The joints & ligaments of the Wrist
• Three joints
– Distal radioulnar joint
• Pivot diarthrosis
• Pronation / supination
– Radiocarpal joint
• Ellipsoidal articulation
• Flexion/extension
• Adduction/ abduction
• circumduction
– Intercarpal joints
• Gliding joints
Joints of the Hand
• Intercarpal joints
– Gliding
• Carpometacarpal joint of thumb
– Saddle
• Carpometacarpal joints
– Gliding
• Metacarpophalangeal joints
– Ellipsoidal
• Interphalangeal joints
– Hinge
The Hip Joint
• Ball and socket diarthrosis
• Acetabulum of os coxae and head of femur
• Flexion / extension
• Adduction / abduction
• Circumduction
• Rotation
• Iliofemoral ligament
• Pubofemoral ligament
• Ischiofemoral ligament
• Transverse acetabular ligaments
• Ligament of femoral head
The Knee Joint
• Complex hinge joint
• Resembles three separate joints
– Medial condyles of femur and tibia
– Lateral condyles of femur and tibia
– Patella and patellar surface of femur
• Flexion / extension
• Limited rotation
• Support is not a single unified capsule
– Not a single fluid cavity
• Fibrocartilage pads
• Medial and lateral menisci
• Fat pads
• Seven major ligaments bind knee joint
– Popliteals
– Patellar
– Anterior and posterior cruciates
– Tibial and fibular collaterals
The Joints of the Ankle and Foot
• Hinge joint
• Inferior surface of tibia, lateral malleolus of fibula, trochlea of talus
– Primary joint is tibiotalar
• Stabilizing ligaments
• Dorsiflexion / plantar flexion
• Intertarsal joints
– Gliding
• Tarsometatarsal joints
– Gliding
• Metatarsophalangeal
– Gliding
• Interphanageal
– Hinge
QUICK guide to Skeletal System- Dr Gurjant Singh (PT)

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QUICK guide to Skeletal System- Dr Gurjant Singh (PT)

  • 1. Musculoskeletal System in Brief……… Dr Gurjant Singh, MPT, (Ph.D), Assistant Professor, MMIPR
  • 3. The Musculoskeletal system • 206 bones • grouped into the axial and appendicular skeletons • 650 muscles – approximately 40% of your body weight – also divided into an axial and an appendicular division
  • 4. Classification of Bones • 6 types - based on anatomical classification – Long bones = greater length than width – Short bones = cube-shaped, spongy bone except at surface – Flat bones = two parallel plates of compact bone sandwiching spongy bone layer
  • 5. – Irregular bones = cannot be grouped – Sesamoid bones = develop in tendons where there is considerable friction, tension and stress – Sutural bones = located within joints between cranial bones
  • 6. Bone Markings (surface features) • Used to identify specific elevations, depressions, and openings of bones • Bone markings provide distinct and characteristic landmarks for orientation and identification of bones and associated structures.
  • 7. Bony Processes • Depressions and openings – Fissure – narrow slit – Foramen – hole for nerves, blood vessels – Fossa – cuplike depression – Sulcus – furrow on a bone surface, contains a nerve or blood vessel – Meatus – tubelike opening • Processes – projection or outgrowth on bone for attachment – Condyle – smoothened process at end of bone, forms a joint – Facet – smooth flat surface, forms a joint – Head – rounded condyle on a neck, forms a joint – Crest – prominent ridge or projection, for attachment of connective tissues – Epicondyle – projection above a condyle, for attachment of connective tissues – Line – long, narrow ridge (less prominent than a crest), for attachment of connective tissues – Spinous process – sharp, slender projection, for attachment of connective tissues – Trochanter – process of the femur, for attachment of connective tissues – Tubercle – process of the humerus, for attachment of connective tissues – Tuberosity – roughening on a bone surface, for attachment of connective tissues
  • 8. Skeletal system includes • Axial division – Skull and associated bones • Auditory ossicles • Hyoid bones – Vertebral column – Thoracic cage • Ribs & sternum • Appendicular division -Pectoral girdle -Pelvic girdle
  • 9. THE SKELETAL SYSTEM: AXIAL DIVISION Part A
  • 10. The Axial Skeleton • Axial division – Skull and associated bones • Auditory ossicles • Hyoid bone – Vertebral column – Thoracic cage • Ribs & Sternum
  • 11. The Skull and Associated Bones
  • 12. The Adult Skull • skull = 22 bones • cranium = 8 bones: 1 frontal, 1 occipital, 2 temporals, 2 parietals, 1 sphenoid and 1 ethmoid • facial bones = 14 bones: 2 nasals, 2 maxillae, 2 zygomatics ,1 mandible, 2 lacrimals, 2 palatines, 2 inferior nasal conchae, 1 vomer • mandible and auditory ossicles are the only movable skull bones
  • 13. The Adult Skull • skull is made up of several cavities – 1. cranial cavity – 2. nasal cavity – 3. the orbits – 4. paranasal sinuses • skull contains many holes for the passage of nerves and vessels = foramen/foramina • cranial bones also attach to membranes called meninges • outer surface provides large areas for muscle attachment that move the head or provide facial expressions
  • 14. Sutures • Immovable joints • form boundaries between skull bones • four main sutures – Coronal – Sagittal – Lambdoid – Squamous – PLUS lots of smaller sutures • e.g. Frontonasal • e.g.Temperozygomatic
  • 15. • part of the base of the skull • surrounds the foramen magnum • forms part of the jugular foramen • hypoglossal foramen found under the occipital condyles Mastoid notch Occipital Bone
  • 16.
  • 17. •Part of the superior and lateral surfaces of the cranium •united by a sagittal suture •connects to frontal bone by coronal suture •connects to occipital bone by lambdoid suture Parietal Bone
  • 18. •forms wall of jugular foramen •three portions: squamous, petrous and tympanic •petrous part houses tympanic membrane and middle and inner ears •auditory ossicles of middle ear transmit sound to inner ear Temporal Bone Petrous portion Tympanic portion
  • 19. Temporal Bone Articular Tubercle Squamous portion Petrous portion Tympanic portion Frontal process of zygomatic bone Maxillary process of zygomatic bone Temporal surface of greater wing of sphenoid Lacrimal bone
  • 20. glabella Internasal suture Zygomatic process of maxilla Frontal process of maxilla Supraorbital ridge or margin Frontal Bone – Forms the forehead & roof of the orbit
  • 22. • Contributes to floor of cranium • Bridges cranial and facial bones • Optic canal allows passage of optic nerve • Pterygoid processes sites of muscle attachment Sphenoid Bone
  • 23. • Irregularly shaped bone • forms part of orbit & forms roof of nasal cavity • Cribriform plate with olfactory foramina for olfactory nerves • Perpendicular plate forms part of nasal septum Ethmoid Bone
  • 24. Facial Bones: Maxilla • Paired bone – Largest of the facial bones – Forms upper jaw
  • 25. • entire lower jaw • articulates with temporal bone at the Temporomandibular joint • moveable part of skull Facial Bones: Mandible
  • 26. • Nasal bones – Paired bones – Articulate with frontal bone – Extend to superior border of external nares • Vomer – Forms inferior (bottom) portion of nasal septum – Articulates with maxillae and palatine bones Facial bones Nasal bones
  • 27. • Inferior nasal concha – Located on each side of nasal septum – Increase epithelial surface – Create turbulence in inspired air • Zygomatic bone – Temporal process articulates with zygomatic process of temporal bone – Forms zygomatic arch Facial bones
  • 28. • Palatine bones – Small – L-shaped – Form posterior portion of hard palate – Contribute to floor of orbit •Lacrimal bones –Smallest bones in skull –Delivers tears to nasal cavity via nasolacrimal canal Facial bones
  • 29. The Orbit • Orbital complex – Bony recess that holds the eye – Seven bones • Frontal bone • Lacrimal bone • Palatine bone • Zygomatic bone • Ethmoid • Sphenoid • Maxilla
  • 30. Skull: Inferior View Petrous portion Condylar foramen may be present Condylar fossa Basilar Portion
  • 31. Figure 6.4 Sectional Anatomy of the Skull, Part I Lesser wing of sphenoid Skull: Interior View Cerebral surface of Greater wing of sphenoid Foramen Rotundum Hypophyseal fossa Dorsum sella Tuberculum sellae Sella Turcica
  • 32. Cranial Fossae • Depressions in cranial floor • for the lobes of the brain • Anterior cranial fossa – Frontal bone, ethmoid, lesser wings of sphenoid • Middle cranial fossa – Sphenoid, temporal bones, parietal bones • Posterior cranial fossa – Occipital bone, temporal bones, parietal bones
  • 35. • Bones and cartilage that enclose the nasal cavity • lined with a nasal mucosa • associated with the 4 paranasal sinuses – hollow airways – lined with mucosa – like nasal mucosa – found in the frontal bones, sphenoid, ethmoid and maxillae The Nasal Complex
  • 37. Infant Skull: The Fontanels • the flat bones in the infant skull are separated by fontanels • fibrous connections between skull bones • permit infant skulls to pass through birth canal • permit the skulls of infants and children to continue growing • will be replaced by sutures in the adult skull
  • 38. The Hyoid Bone • Consists of a body, greater horns and lesser horns • Base for muscles of the tongue and larynx
  • 39. Adult Vertebral Column • strong, flexible rod – average male = 71 cm (28 inches) – average female – 61 cm (24 inches) • capable of moving – anteriorly – posteriorly – laterally – also rotation • supports the head • encloses and protects the spinal cord • allows for the exit of 31 pairs of spinal nerves – through intervertebral foramina
  • 40. Adult Vertebral Column • 26 vertebrae – 24 individual vertebrae – Sacrum – Coccyx • Seven cervical vertebrae • Twelve thoracic vertebrae • Five lumbar vertebrae • Sacrum – 5 fused vertebrae • Coccyx – 4 fused vertebrae
  • 41. Adult Vertebral Column • vertebrae separated by intervertebral discs – discs of fibrocartilage made up of an outer ring and a softer inner region – found between C1 and C2 and all the way down to between L5 and the sacrum – form the joints of the vertebral column
  • 42. Adult Vertebral Column • absorb shock – flatten, broaden and bulge outward • weakening in the outer ring can allow the herniation of the inner material
  • 43. Spinal Curvature • Four curvatures: increase the strength of the column – Thoracic (primary) – forms fetally and retain the curve of the fetus – Sacral (primary) – forms fetally and retain the curve of the fetus – Cervical (secondary) – forms when the baby holds its head erect – Lumbar (secondary) – forms upon walking
  • 44. • Every vertebrae has the following: – 1. body – weight bearing part of the vertebra • separated by the discs – 2. vertebral arch – surrounds the spinal cord • surrounds a hole called a vertebral foramen – 3. processes – seven of them • 1. Spinous (1) – muscle attachment • 2. Transverse (2) – muscle attachment • 3. Superior articular (2) – forms joint with upper vertebra • 4. Inferior articular (2) – forms joint with lower vertebra Vertebrae
  • 45. Vertebrae Cervical Vertebra • cervical vertebrae = transverse foramina in the transverse processes • bifid spinous process • 1st two cervical vertebrae (atlas and axis) look different but have all aspects of a vertebrae
  • 47. Fused Vertebrae: The sacrum & coccyx • Sacrum - Union of 5 vertebrae (S1 - S5) – completely fused by age 30 – median sacral crest = fused spinous processes – sacral ala = fused transverse processes – sacral canal ends at sacral hiatus • Coccyx = Union of 4 vertebrae (Co1 - Co4) – completely fused by age 30
  • 48. Rib Cage • 12 pairs of ribs • vertebral end for articulation with the facets of the 12 thoracic vertebrae – both body and the transverse process • sternal end for articulation with the sternum
  • 49. Rib Cage -three kinds of ribs: 1. True – separate & direct connection to the sternum via costal cartilage 2. False – no direct connection to the sternum – joined via a composite piece of costal cartilage 3. Floating – no connection to the sternum
  • 50. Sternum • comprised of the: • 1. Manubrium – with two clavicular notches and a jugular notch • 2. Body – connects to manubrium via a sternal angle • 3. Xiphoid process
  • 51. Sternum & Rib Cage • several muscles and muscle groups either originate from the sternum and/or ribcage (or costal cartilages) or insert onto these structures – sternum: • sternocleidomastoid • sternohyoid & sternothryoid – depresses hyoid bone and larynx – ribcage: • intercostals – external and internal • serratus anterior & posterior • numerous muscles of the vertebral column • pectoralis major & minor • 4 muscles of the abdominal wall
  • 53. Appendicular Skeleton • Bones of upper and lower limbs • Pectoral and pelvic girdles – Connect limbs to trunk
  • 54. Shoulder Girdle • Includes – Scapula (shoulder blade) – Clavicle (collarbone) • Squares shoulders • Helps move the upper limb • Provides a base for muscle attachment
  • 55. Clavicle • S-shaped bone • Connects manubrium of sternum to the acromion process of scapula • Only direct connection between pectoral girdle and axial skeleton
  • 56. The Scapula • Medial or vertebral border is the insertion point for the rhomboids, levator scapulae & serratus anterior • Two processes attach to ligaments and tendons – Coracoid process – e.g insertion for pectoralis minor, origin of biceps – Acromion process – e.g. origin of the deltoid • continues on to become the scapular spine • Articulates at the round head of the humerus to form the glenohumoral joint • Articulates with clavicle at the acromioclavicular joint
  • 57. Figure 7.5a, b The Scapula
  • 58. The Humerus • articulates with glenoid cavity of scapula • possesses an anatomical neck for capsule attachment and a surgical neck • trochlea and capitulum form joints with the ulna and radius = elbow joint • numerous muscles insert at greater and lesser tubercle – greater tubercle – insertion of 3 rotator cuff muscles + pectoralis major – lesser tubercle – insertion for the other rotator cuff • intertubercular groove – insertion for latissimus dorsi • deltoid tuberosity – insertion of deltoid muscle
  • 59. The Radius and Ulna • Parallel bones of the forearm • radial tuberosity – insertion point for the biceps brachii • Olecranon process of ulna articulates with olecranon fossa of humerus – olecranon process is a major point of muscle attachment for the triceps • Coronoid fossa of humerus accommodates coronoid process of ulna – insertion for the major forearm flexor = brachialis
  • 60. Carpal Bones • 8 wrist bones • Two rows, proximal and distal – scaphoid bone, lunate bone, triquetrum, pisiform – trapezium, trapezoid bone, capitate bone, hamate bone – scaphoid = most commonly injured carpal bone • fall on the outstretched hand – fracture into two separate pieces (tears blood vessels) “Some lovers try positions that they can’t handle”
  • 61. Metacarpal Bones • Articulate with distal carpals • Distally articulate with phalanges – Fingers have three phalanges – Pollex/thumb has two phalanges
  • 62. The Pelvic Girdle • ossum coxa – Ilium – Ischium – Pubis • the pelvic girdle consists of the two ossa coxae. • union between pelvis and sacrum = sacroiliac joint
  • 63. The Pelvic Girdle • Ilium – Largest hip bone – accommodates the head of the femur – Fused to ischium posteriorly – Fused to pubis anteriorly via the superior ramus • Pubis – “pubic bone” – superior & inferior ramus • rami connect to the ilium and ischium • surrounds the obturator foramen – pubic symphysis is pad of fibrocartilage between 2 pubic bones • known as an amphithrotic (slightly movable) joint • Ischium – “sit bones” – ischial spine & tuberosity • ischial tuberosity – site of origin for hamstrings and adductor magnus – lesser sciatic notch – ramus unites with the pubis
  • 64. – inferior pubic ramus for origin of iliacus (hip flexor), gracilis, adductor brevis and magnus (hip adductors) – superior pubic ramus for origin of the hip adductor pectineus – pubic crest/tubercle for origin of adductor longus
  • 65. – iliac fossa for origin of iliacus – iliac crest for origin of gluteus maximus and medius – anterior gluteal line for origin of gluteus medius – anterior superior iliac spine for origin of sartorius – anterior inferior iliac spine for origin of rectus femoris – greater sciatic notch for passage of sciatic nerve
  • 66.
  • 67. Figure 7.12a-c Divisions of the Pelvis
  • 68. Female vs. Male Pelvis • Smoother • Lighter • Less prominent markings • Enlarged pelvic outlet • Less sacral curvature • Wider more circular pelvic inlet • Broader pubic angle
  • 69. The Femur • Longest bone in body – takes 4-5 months to completely replace • Rounded head on an anatomical neck – fits into the acetabulum of the pelvis to form the hip joint • proximal trochanters for muscle attachment • Distal medial and lateral condyles articulate with tibia – to form the knee joint – knee joint is a hinge joint capable of one plane of motion
  • 70. • Large tendon attachments to the trochanters and the linea aspera • Linea aspera – roughened line on the back of the femur – origin for the hamstring biceps femoris (short head) & the knee extensor vastus medialis – also the insertion point for adductor longus, brevis and magnus • Greater and lesser trochanters – greater trochanter – origin of vastus lateralis (knee extensor) & the insertion point for the hip abductors: gluteus medius and minimus and piriformis – lesser trochanter – insertion for iliopsoas (hip flexor)
  • 71. The Patella • Large sesmoid bone - forms within the tendon of the quadriceps femoris. • Forms within tendon of quadriceps femoris muscle group • Patellar ligament attaches to tibial tuberosity
  • 72. The Tibia • Largest bone of leg • Tibial tuberosity – site of insertion for the quadriceps femoris • Anterior margin – known as the “shin bone” • Intercondylar eminence between the condyles – condyles of the tibia form the knee joint with the condyles of the femur • Medial malleolus – Medial support for talocrural joint
  • 73. The Tibia & Fibula
  • 74.
  • 75. The Tarsus • Seven tarsal bones – calcaneus = heel • weight of body transferred through this bone! – talus – forms the ankle joint with the tibia and fibula • ligaments from the two malleolus processes reinforce this joint – navicular – cuboid – 3 cuneiform bones
  • 76. • weight passing through the calcaneus then passes along to 5 metatarsal bones that form 2 arches: -Longitudinal arch -Transverse arch
  • 78. 1. Cartilage: functions in support, attachment, protection -cells = chondrocytes -matrix = collagen II fibers embedded in a gel- like ground-substance -ground substance - water + proteoglycans -proteoglycans – core protein (aggrecan) + sugars (e.g. chondroitin sulfate, glucosamine) -in developing child - model for future bone (endochondral bone formation) -avascular tissue - produces anti-angiogenic chemicals (inhibits growth of blood vessels) -therefore diffusion is the main mode of transport Supportive Connective tissue: Cartilage Proteoglycan
  • 79. -3 types: 1) Hyaline - most common - “glass” - ends of bones, within joints (synovial, articular), - end of nose, supports respiratory passages
  • 80. 2. Elastic - flexible cartilage - external ears and parts of larynx
  • 81. 3. Fibrocartilage - very tough -> more collagen fibers - shock absorber e.g. intervertebral discs of the knee
  • 83. Articulation (A Joint) • Wherever two bones interact • Function depends on structure • can classify according to: A. structure – i.e. what they are made of A. fibrous B. cartilagenous C. synovial B. function - movement – No movement = synarthrotic – Slight movement = amphithrotic – Extensive movement = diathrotic
  • 84. •lack a synovial cavity •articulating surfaces are held very closely by fibrous connective tissue •three types: 1. Sutures: composed a thin layer of fibrous connective tissue -unites the bones of the skull e.g. coronal suture -interlocking edges of the suture gives them strength -immovable joint 2. Syndesmoses: greater distance between articular edges -more fibrous connective tissue -connective tissue arranged as a sheet (interosseous membrane) or bundle (ligament) -slightly movable e.g. tibiofibular ligament connecting the tibiofibular joint e.g. interosseous membranes between the radius and ulna, tibia and fibula 3. Gomphoses: cone shaped peg fits into a socket e.g articulations of the roots of the teeth with the jaw -held by the periodontal ligament -immovable Fibrous Joints
  • 85. •lacks a synovial cavity •allows little or no movement •articulating bones are connected by hyaline cartilage or fibrocartilage 1. Synchondroses: connecting material is hyaline cartilage e.g. epiphyseal/growth plate of a growing bone -immovable 2. Symphyses: ends of bones are covered with hyaline cartilage but are connected by a flat disc of fibrocartilage -all symphyses occur at the midline of the body e.g. pubic symphysis - connects two ends of the pubis bones e.g. intervertebral joints between the bodies of 2 vertebrae -slightly movable Cartilagenous Joints
  • 86. Synovial joints •presence of a synovial cavity between the articulating bone surfaces •freely movable joints •lined with hyaline cartilage called articular cartilage •filled with a fluid called synovial fluid •surrounded by a fibrous capsule – inside is lined with a synovial membrane •movement is along three possible axes: Monaxial Biaxial Triaxial or Multiaxial Synovial Joints
  • 87. 9-87 • Articular/Joint capsule encloses joint cavity – continuous with periosteum of the bones of the joint – lined by a synovial membrane that produces synovial fluid • Synovial fluid = slippery fluid; feeds cartilages • Articular cartilage = hyaline cartilage covering the joint surfaces • Articular discs and menisci – found in the jaw, wrist, sternoclavicular and knee joints – absorbs shock, guides bone movements and distributes forces • Tendon attaches muscle to bone • Ligament attaches bone to bone Synovial Joints: General Anatomy
  • 88. Synovial joints •synovial joint movement is along three possible axes: Monaxial or uniaxial – e.g. knee joint, elbow joint Biaxial – e.g interphalangeal joint Triaxial or Multiaxial – e.g. shoulder & hip joint Synovial Joints
  • 89. Synovial joints •6 subtypes: 1. planar/gliding 2. hinge 3. pivot 4. condyloid 5. saddle 6. ball and socket Synovial Joints Types
  • 90. 1. Planar/Gliding joints : articulating surfaces are flat or slightly curved -permit side to side or back and forth gliding motions -non-axial - no motions around an axis -some books say they are limited monaxial joints e.g. intercarpal joints of the wrist bones e.g. intertarsal joints of the ankle bones 2. Hinge joints: convex surface of one bone fits into a concave surface -produces an angular, open and close movement -movement is in one plane of motion = monaxial 3. Pivot joints: rounded or pointed end of one bone fits into a ring of another -also monaxial -rotates around a longitudinal axis e.g. atlas-axis joint - first 2 vertebrae
  • 91. 4. Condyloid joints: or ellipsoid joints -convex oval shaped projection of one bone fits into the oval-shaped depression of another bone -biaxial = two planes of motion e.g. metacarpals and proximal phalanges e.g. metatarsals and proximal phalanges e.g. atlanto-occipital joint 5. Saddle joints: articular surface of one bone is saddle shaped -modified condyloid joint -biaxial – but more moveable than condyloid joints e.g. thumb metacarpal and trapezium carpal bone = trapeziometacarpal joint 6. Ball and socket joints: ball-like end of one bone fits into a cuplike depression of another -mult-iaxial - several planes of motion e.g. hip joint, shoulder joint
  • 92. Three categories based on range of motion • Synarthroses – Immovable joints • Amphiarthroses – Slightly movable joints • Diarthroses – Freely movable joints
  • 93. Synarthroses • Bony edges may interlock • Sutures – Between skull bones • Gomphosis – Between teeth and jaw • Synchondrosis – Epiphyseal plate • Synostosis – Fused bones
  • 94. Amphiarthroses • Limited movements • Syndesmosis – Collagen fibers connect bones • e.g. tibiofibular joint • Symphysis – Bones are separated by cartilage pad • e.g. pubic symphysis
  • 95. Diarthroses (synovial joints) • Wide range of movement • Bony surfaces covered by articular cartilage • Lubricated by synovial fluid • Enclosed with joint capsule • Accessory structures – Menisci – Fat pads – Ligaments – Tendons – Bursae – Tendon sheaths
  • 96. 9-96 • Degrees through which a joint can move • Determined by – structure of the articular surfaces – strength and tautness of ligaments, tendons and capsule • stretching of ligaments increases range of motion • double-jointed people have long or slack ligaments – action of the muscles and tendons • nervous system monitors joint position and muscle tone Joints: Range of Motion
  • 98. 9-98 Movements of Head and Trunk • Flexion, hyperextension and lateral flexion of vertebral column Joints: Range of Motion
  • 99. 9-99 • Movement on longitudinal axis – rotation of trunk, thigh, head or arm • Medial rotation turns the bone inwards • Lateral rotation turns the bone outwards Special movement terms: Rotation
  • 100. • Medial and lateral rotation of the hand – called Pronation & Supination Special movements of the hand: Pronation & Supination
  • 101. 9-101 • Radial and ulnar flexion • Abduction of fingers and thumb • Opposition is movement of the thumb to approach or touch the fingertips • Reposition is movement back to the anatomical position Special movements of the hand
  • 102. • Dorsiflexion is raising of the toes as when you swing the foot forward to take a step (heel strike) • Plantarflexion is extension of the foot so that the toes point downward as in standing on tiptoe • Inversion is a movement in which the soles are turned medially • Eversion is a turning of the soles to face laterally Special movement of the foot
  • 103. 9-103 • Protraction & Retraction of mandible • Lateral excursion = sideways movement • Medial excursion = movement back to the midline – side-to-side grinding during chewing Special movement of the Mandible: Protraction & Retraction
  • 105. The Temporomandibular Joint • TMJ = mandibular fossa of temporal bone & condylar processes of mandible • Thick articular disc between the bones • Supporting structures – Dense capsule – Temporomandibular ligament – Stylomandibular ligament – Sphenomandibular ligament • Loose hinge joint
  • 106. Intervertebral Articulations • Articular processes of adjacent vertebrae • Symphyseal joints at bodies • Ligaments bind vertebrae • Permits flexion, extension, lateral flexion, rotation
  • 107. The Sternoclavicular Joint • Gliding joint • between the sternal end of clavicle and manubruim of sternum •Articular disc •Supports include -Anterior and posterior sternoclavicular ligaments -Interclavicular ligaments -Costoclavicular ligaments
  • 108. The Shoulder Joint • known as the glenohumoral joint – between the glenoid fossa and head of humerus • Loose shallow joint • Greatest range of motion Strength and stability are sacrificed for motion • Supported by ligaments and muscles • Many bursae to decrease friction between ligaments
  • 109. The Elbow Joint • Hinge joint • Flexion and extension • Includes humeroulnar joint and humeroradial joint • Supported by – Radial and ulnar collateral ligaments – Annular ligaments
  • 110. The joints & ligaments of the Wrist • Three joints – Distal radioulnar joint • Pivot diarthrosis • Pronation / supination – Radiocarpal joint • Ellipsoidal articulation • Flexion/extension • Adduction/ abduction • circumduction – Intercarpal joints • Gliding joints
  • 111. Joints of the Hand • Intercarpal joints – Gliding • Carpometacarpal joint of thumb – Saddle • Carpometacarpal joints – Gliding • Metacarpophalangeal joints – Ellipsoidal • Interphalangeal joints – Hinge
  • 112. The Hip Joint • Ball and socket diarthrosis • Acetabulum of os coxae and head of femur • Flexion / extension • Adduction / abduction • Circumduction • Rotation • Iliofemoral ligament • Pubofemoral ligament • Ischiofemoral ligament • Transverse acetabular ligaments • Ligament of femoral head
  • 113.
  • 114. The Knee Joint • Complex hinge joint • Resembles three separate joints – Medial condyles of femur and tibia – Lateral condyles of femur and tibia – Patella and patellar surface of femur • Flexion / extension • Limited rotation • Support is not a single unified capsule – Not a single fluid cavity • Fibrocartilage pads • Medial and lateral menisci • Fat pads • Seven major ligaments bind knee joint – Popliteals – Patellar – Anterior and posterior cruciates – Tibial and fibular collaterals
  • 115.
  • 116.
  • 117. The Joints of the Ankle and Foot • Hinge joint • Inferior surface of tibia, lateral malleolus of fibula, trochlea of talus – Primary joint is tibiotalar • Stabilizing ligaments • Dorsiflexion / plantar flexion • Intertarsal joints – Gliding • Tarsometatarsal joints – Gliding • Metatarsophalangeal – Gliding • Interphanageal – Hinge