AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 1
The A to Z of Bones, Joints, Ligaments & the Back
Dr A. L. Neill BSc MSc MBBS PhD FACBS
[email protected] Front cover
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 3
The A to Z of Bones, Joints & Ligaments
Introduction
aN eill
This is the fourth major update of the A to Z books, after the updated version of the A to Z of Anatomical, Medical and Histological terms, and the A to Z of Skeletal Muscles.
The A to Z of the Bones of the Skull has been completely rewritten and is now wholey incoorperated in the A to Z of the Head & Neck, which discusses the bones and muscles of the Head and Neck. Although it is derived from the A to Z of the Bones, Joints & Ligaments its emphasis has changed, as with the Head and Neck book, due to large amount of feedback received and there is a separate section on the back and Vertebral Column - VC, clinical testing and assessment of this area.
rA ma nd
Please note there is now a supportive website: http://www.aspenpharma.com.au/atlas/student.htm, where images of all the A to Z books may be found. Feedback pages reside at the end of the book as does a boney quizz for all those interested (did you name all the gold teeth in the A to Z of the Head and Neck?). All feedback will be well received, particularly regarding future titles, and any other ideas!!! Note using this book and online quizzes it is possible to use this material for continuing education programs please write/email/contact me for further details.
Acknowledgement
©D
Thankyou ASPENpharmacare Australia for your support and assistance in this valuable project, particularly Mr Greg Lan CEO of Aspenpharmacare Australia, Rob Koster, Richard Clements and Ante Mihaljevic from TM graphic design.
Dedication
To structural & personal growth, maturation, improvement & success.
How to use this book The first section consists of the basic anatomical concepts, movement planes, classification and definitions of all tissues discussed in this book.
© A. L. Neill
3
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 4
The A to Z of Bones, Joints & Ligaments
rA ma nd
aN eill
Bones, Joints and Ligaments have been listed alphabetically and cross referenced as much as possible with their common names (e.g. the SHOULDER JOINT is the GLENOHUMERAL JOINT and the COLLAR BONE is the CLAVICLE) preference is made to list them as their proper anatomical names with cross referencing in the index to their common names, but each item may be looked up with either terminology. Each bone and joint is shown from at least 2 aspects, with numbered features on the diagram page and the key or index to these on the opposite page. Numbering is generally started anew with each diagram, except where it is obvious the diagrams are related and then the numbering is continued onto the second diagram and the key to the features is the same for both. Bones or groups of bones are also shown “in situ”, or as an “overview” to relate them to the whole body structure, in other words as they lay in body or cavity anatomically. For example the RIBS together form the RIB CAGE and anatomically this bony structure is the way most of the ribs function most of the time not as individual bones.
Capitalization is used to demonstrate the bones involved in several structures including joints of all kinds (e.g. sutures). In other words the parietomastoid suture is listed as Parieto-Mastoid suture to further remind the reader of the involved bones or bony features involved in the composition of the structure. This helps to further orientate the reader to the structural components of the feature. As a separate feature at the end of the book a consideration is given to the back its function clinical examination and testing.
©D
It is hoped that this will prove a valuable resource for those examining individual bones and their articulations and support structures to build up the complete joint as in the study of ANATOMY and its many uses such as: archeology, anthropology, chiropractic, dentistry, forensics, geology, medicine, orthopaedics, osteology, paleontology, paleobiology, physiotherapy, massage therapy and surgery and so on...
Note colour coding found on the base of each page is regional.
Thank you
Amanda Neill
BSc MSc MBBS PhD FACBS
4
ISBN 1 74138 167 5 © A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 5
The A to Z of Bones, Joints & Ligaments
Abbreviations actions /movements of a joint anastomosis or anastomoses adjective also known as anterior longitudinal ligament alternative anterior articulation (joint w/o the additional support structures) Alternative Spelling, generally referring to the diff. b/n British & American spelling between bone marrow blood supply carpal / carpo compared to central nervous system collateral Cerebrospinal fluid connective tissue example extracellular (outside the cell) extensor (as in muscle to extend across a joint) Greek intercarpal / intercarpo interphalangeal intertarsal / intertarso joints = articulations Left lower limb aka leg Latin ligament metacarpal / metacarpo medial metatarsal / metatarso nervous system / nerve supply nervous tissue phalangeal / phalanges / phalango plural posterior longitudinal ligament posterior Right singular spinal cord spinal nerve spinous process transverse process upper limb aka arm vertebral body vertebral column within without
aN eill
= = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = =
©D
rA ma nd
A aa adj. aka ALL alt. ant art AS b/n BM BS C c.f. CNS collat. CSF CT e.g. EC ext. Gk. IC IP IT jt(s) L LL Lt. lig MC med MT NS NT P pl. PLL post. R sing. SC SN SP TP UL VB VC w/n w/o
© A. L. Neill
5
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 6
The A to Z of Bones, Joints & Ligaments
Anatomical position and Anatomical planes This is the anatomical position.
©D
rA ma nd
aN eill
A = Anterior aspect from the front, Posterior Aspect from the back, used interchangeably with ventral and dorsal respectively. B= Lateral Aspect from either side C = Transverse / Horizontal plane D= Midsagittal plane = Median plane; trunk moving away from this plane = lateral flexion or lateral movement moving into this plane medial movement; limbs moving away from this direction = abduction; limbs moving closer to this plane = adduction E = Coronal plane F = Median
6
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 7
©D
rA ma nd
aN eill
The A to Z of Bones, Joints & Ligaments
© A. L. Neill
7
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 8
The A to Z of Bones, Joints & Ligaments
Hip extension
rA ma nd
Hip flexion
aN eill
Anatomical Movements
Hip abduction
©D
Hip lateral and medial rotation
Knee flexion
8
Hip adduction
Hip circumduction
Knee extension © A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 9
Foot dorsiflexion
Foot inversion
aN eill
The A to Z of Bones, Joints & Ligaments
Foot plantar flexion
Foot eversion
rA ma nd
Foot normal position
Fingers extension
©D
Forearm pronation
Fingers flexion
Forearm supination
Fingers abduction Fingers adduction
© A. L. Neill
Hand deviation radial/laterally ulna/medially
Thumb opposition 9
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 10
Order now (including radiology of the Skull)
(including pronunciation guide, anatomy word builder, abbrev. of medical qualifications and organ wgt.)
rA ma nd
(origins insertions actions BS & NS of each muscle listed alphabetically)
aN eill
to complete your ‘A to Z’ set so far!
©D
(each bone’s features and its articulation group relations, individual joints, movements, BS & NS, and joint classifications listed)
(including a clinical section with examination techniques for general nerve disorders and assessments)
Includes the bones, joints and individual muscles and other major structures including teeth, BS, NS & lymphatics
To order or if you have any enquiries re these or other educational tools and advice please contact Anatomy Update at:
[email protected] or 0410 018 681 or fax to 612 93651000 and remember to include email address or phone number or other details. We are always pleased to receive feedback comments or questions.
10
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 11
The A to Z of Bones, Joints & Ligaments
Table of contents
rA ma nd
aN eill
INTRODUCTION 5 ACKNOWLEDGEMENT 5 DEDICATION 5 HOW TO USE THIS BOOK 5 ABBREVIATIONS 7 Anatomical position and Anatomical planes 8 Anatomical movements 10 TABLE OF CONTENTS 12 COMMON TERMS USED IN OSTEOLOGY / SKELETAL ANATOMY 13 CLASSIFICATION AND SUMMARY OF BONES 21 Bone structure - LONG BONE 22 Bones Articulated anterior posterior regional colouring 23 Bones Disarticulated regional colouring 24 CLASSIFICATION AND SUMMARY OF JOINTS 25 Synovial joints 26 CLASSIFICATION AND SUMMARY OF LIGAMENTS 27 The Bones, Joints and Ligaments - order of illustrations 29 The Bones joints and Ligaments 33 The BACK 203 Excercises for joints 233
OVERVIEWS to be found in this book
©D
carpus / wrist overview chest overview foot overview hand and wrist overview pectoral girdle / overview of the shoulders pelvic girdle / overview of the hips skull overview including sinuses spine overview / vertebral column teeth overview Anatomical joint exercises Overview of all A to Z books Feedback page for A to Z books © A. L. Neill
43 49 79 85 137 139 163-178 206 185 233 241 241 11
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 12
The A to Z of Bones, Joints & Ligaments
aN eill
Common terms in Osteology and Skeletal Anatomy Ablation
The removal of part of the body, generally a boney part, most commonly the teeth.
Acral
in the extremities - bones at the apex or end of limbs.
Acromegaly
A continuation of growth of the ends of cartilage covered bone (after fusion of the long bones) hence a gross change in the features (most noticeable in the jaw and digits) without growth in height, due mainly to the over activity of the pituitary gland.
Ala
A wing, hence a wing-like process as in the Ethmoid bone pl. - alae.
Alveolus
Air filled bone - tooth socket adj - alveolar (as in air filled bone in the maxilla) - coalescence of alveoli helps in the formation of the sinuses. This device also lightens the weight of the bone particularly the skull.
Ankle
Bend = angle usually referring to the bend just above the foot, hence the ankle is the joint b/n the foot and the lower leg
Appendicular
Areola ArthArthritis Arthropathy Arthrosis Articulation
Attrition Auditory Avulsion
An opening or space between bones or within a bone. Refers to the appendices of the axial i.e. in the skeleton, the limbs upper and lower which hang from the axial skeleton, this also includes the pectoral and pelvic girdles but not the sacrum. Small, open spaces as in the areolar part of the Maxilla may lead or develop into sinuses.
To do with joints hence… Inflammation of a joint. Diseases of the joints. Joint types. Joint, description of the bone surfaces joining w/o the supporting structures = point of contact b/n 2 opposing bones hence the articulation of humerus and scapula is the articulation of the shoulder joint. Tooth wear and tear.
Pertaining to hearing, hence, pertaining to the ear. (Auditory exostosis = a bony growth on the walls of the External Auditory Meatus)
Forceable tearing away of a structure or part of a structure as in an avulsed fracture where a fragment bone is torn away from the main bone. Refers to the head and trunk (vertebrae, ribs and sternum) of the body.
©D
Axial
rA ma nd
Annulus fibrosis The peripheral fibrous ring around the intervertebral disc Aperture
Ball and Socket Generally referring to a joint which resembles a ball sitting tightly in a socket - very stable, limited range of movement e.g. hip joint.
Basilar
Relating to the base or bottom of structures.
Basiocranium
Bones of the base of the skull.
Boss
A smooth round broad eminence - mainly in the frontal bone female > male
Bregma
Refers to a junction of more than 2 bones in a joint as in the Bregma of the skull, junction between the coronal and sagittal sutures which in the infant is not closed and can be felt pulsating – site of the anterior fontanelle.
Buccal
Pertaining to the cheek.
12
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 13
Common terms in Osteology and Skeletal Anatomy Callus
Hard tissue formed in the osteogenic layer of the periosteum as a fracture repair tissue it is replaced over time with compact bone. The calotte consists of the calvaria from which the base has been removed
Calvaria
The calvaria refers to the cranium without the facial bones attached.
Canal
Tunnel / extended foramen as in the carotid canal at the base of the skull adj canular (canicular - small canal).
Cancellous bone = Trabecular bone
aN eill
Calotte
A spongy porous bone with spicules (trabeculae) of compact bone. It is found at the ends of long bones and in the bones of the axial skeleton. Red BM is found b/n the spicules. Caput / Kaput
The head or of a head, adj.- capitate = having a head (c.f. decapitate)
Carotid
To put to sleep; compression of the common or internal carotid artery causes coma. This refers to bony points related to the Carotid vessels. Wrist
Cavity
An open area or sinus within a bone or formed by two or more bones (adj. cavernous), may be used interchangeably with fossa. Cavity tends to be more enclosed fossa a shallower bowl like space (Orbital fossa-Orbital cavity).
rA ma nd
Carpo
Cavum
A cave.
Cephalic
Pertaining to the head
Cervico
Pertaining to the Neck
Clinoid
Like a bed-post, part of a four poster bed so that clinoid processes look like bed posts eg. in the Sphenoid bone.
Clivus
A slope hence in the anterior cranial fossa referring to a slope on the base of the cavity.
Cochlea
A snail, hence snail-like shape relating to the Organ of Corti in the ear.
Compact bone = Cortical bone = Dense bone Bone found in the shafts and on external bone surfaces. Highly structured in concentric circles or Haversian systems. It is constantly changing and remodeling depending upon the lines of force. Concha
A shell shaped bone as in the ear or nose (pl. conchae adj. chonchoid) old term for this turbinate.
A rounded enlargement or process possessing an articulating surface. A horn (as in the Hyoid)
Corona
A crown. adj.- coronary, coronoid or coronal; hence a coronal plane is parallel to the main arch of a crown which passes from ear to ear (c.f. coronal suture).
©D
Condyle Cornu
Costa / Costo
Pertaining to the ribs
Cranium
The cranium of the skull comprises all of the bones of the skull except for the mandible.
Crest
Prominent sharp thin ridge of bone formed by the attachment of muscles particularly powerful ones eg Temporalis/Sagittal crest
Cribiform A sieve or bone with small sieve-like holes. Ethmoid Cuneate /Cuneus A wedge / wedge-shaped.
Dens
© A. L. Neill
A tooth hence dentine and dental relating to teeth, denticulate having tooth-like projections adj dentate See also odontoid. 13
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 14
The A to Z of Bones, Joints & Ligaments Depression
A concavity on a surface. Wearing away of the tooth surfaces of OA.
Detritus
The material left after the wearing away or rubbing.
Diaphysis
The shaft or body of a long bone. In the young this is the region b/n the growth plates and is composed of compact bone. pl.= diaphyses adj.= diaphyseal
Diploë
The cancellous bone between the inner and outer tables of the skull, adj.- diploic.
aN eill
Detrition
Edentulous
Without teeth
Elbow
Any angular bend often in the arm, usually referring to the joint b/n the arm and the forearm
A smooth projection or elevation on a bone as in iliopubic eminence.
Endocranium
Refers to the interior of the “braincase” adj. endocranial divided into the 3 major fossae anterior (for the Frontal lobes) middle (containing Temporal lobes) and posterior (for the containment of the Cerebellum).
Endostium
A mesodermal CT which lines the inner surface of all bones and is the conduit for the NS and BS of the bone. Llifting of the endostium causes cancellous bone to be laid down to fill the gap b/n the bone and the cellular layer and this device may be used to encourage bone growth/repair. See periosteum.
Epiphysis = Metaphysis
Ethmoid =
rA ma nd
Eminence
The end of a long bone beyond the growth plate or epiphyseal plate. Generally develops as a secondary ossification centre. There are 2 epiphyses to each long bone. In a long bone the shafts are generally compact bone and the ends = epiphyses are trabecular bone pl.= epiphyses adj.= epiphyseal Cribiform
External Auditory Ear hole Meatus Exostosis
Facet Falciform Fissure
A face, a small bony surface (occlusal facet on the chewing surfaces of the teeth) seen in planar joints.
relating to shapes that are in a sickle shape so falciform ligaments curve around and end in a sharp point.
A narrow slit or gap from cleft.
A fountain, associated with the palpable pulsation of the brain as in the anterior fontanelle of an infant. These soft spots on the skull are cartilagenous connective tissue coverings “joints” which allow for skull cranial expansion and then become the mould for the bone development and shape joining long the sutural lines, later becoming the Bregma.
©D
Fontanelle
A bony outgrowth from a bony surface, often due to irritation (as in Swimmer’s ear) and may involve ossification of surrounding tissues such as muscles or ligaments.
Foramen
A natural hole in a bone usually for the transmission of blood vessels and/or nerves.(pl. foramina).
Fornix
An arch.
Fossa
A pit, depression, or concavity, on a bone, or formed from several bones as in temporomandibular fossa. Shallower and more like a “bowl” than a cavity. (pl. fossae)
14
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 15
Common terms in Osteology and Skeletal Anatomy Fovea
A small pit (usually smaller than a fossa)- as in the fovea of the occlusal surface of the molar tooth.
aN eill
Fracture = break hence … Avulsed fracture - bone break due to a tearing away of part of a bone under stress \ Complete fracture - complete break b/n in 1 or more bones Compound fracture - break of a bone where the bone is exposed to the air Incomplete = Greenstick fracture - where there is an incomplete break along with bending or changing of the bone shape it is generally seen in in young bones. Pathological fracture - a break which has to do with a disease, generally thinning of the bone for example in osteoporosis or weakening due to a tumour as in osteosarcoma or from other causes as in osteomalacia (Paget's disease) and causes the bone to break with little or no force A cock, hence, crista galli, the cock’s comb (i e possessive form of gallus).
Genu / genio
Knee adj referring to the knee.
Gigantism -
Overgrowth of the length of the long bones due to excess growth hormone before the fusion of the long bones (if this occurs after fusion it is acromegaly)
Gomphosis
Joint b/n the roots of the teeth and the jaw bones pl - gomphoses
rA ma nd
Gallus / Galli
Groove
Long pit or furrow.
Growth plate
A plate of cartilage b/n the diaphysis and epiphysis to allow growth of a long bone. The plate disappears, converting to bone, upon attainment of the full height/length of the bone.
Hallux
The big toe = the first toe.
Hamus
A hook hence the term used for bones which “hook around other bones or where other structures are able to attach by hooking hamulus = a small hook.
Harris lines
Lines of increased bone density due to assault. They may occur across the growth plate and arrest growth of the length of the long bone.
Haversian canals = secondary osteons = lamellar bone The system of concentric circles of bone matrix and osteocytes, which continually forms and reforms, during the life of the bone.
Hinge joint
Joint with movement in one plane e.g. elbow or knee.
Hydroxyapetite
A dense organic filling; the second component of bone.
Hyoid
U-shaped.
Hyperostosis
Abnormal bone growth generally overgrowth or ectopic growth.
A notch.
Between
Intra
Within.
©D
Incisura
Inter
Introitus
An orifice or point of entry to a cavity or space.
Joint =
Articulation + supporting structures.
Jugum
A bridge between 2 halves of a bone pl.( juga) as in Sphenoid.
Kyphosis
Collapse of vertebral body(ies) causing sharp convexity of the spine.
Lacerum
Something lacerated, mangled or torn eg foramen lacerum a small sharp hole at the base of the skull. This often tears tissues.
© A. L. Neill
15
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 16
The A to Z of Bones, Joints & Ligaments Related to tears and tear drops. (noun lacrima)
Lambda
From the Greek letter a capital ‘L’ and written as an inverted V. (adj. lambdoid) and used to name the point of connection b/n the 3 skull bones Occipital and Temporals.
Lamellar bone = Haversian system
aN eill
Lacrimal
Bone with sheets of concentric collagen fibres around Haversian canals in compact bone Lamina
A plate as in the lamina of the vertebra, a plate of bone connecting the vertical and transverse spines (pl. laminae)
Ligament
A band of tissue which connects bones (articular ligaments) or viscera - organs (visceral ligaments). A Ligament is a tie or a connection Originally sing. ligamentum pl ligamenta from ligate or to tie up is generally composed of collagen fibres. See classification of ligaments. A line as in the Nuchal lines of the Occiput/Occipital bone. Pertaining to the tongue.
Lipping
Bone projecting over the usual margin, excessive production generally pathological as in osteoarthritis, may interfere with joint movement
Locus
A place (c.f. location, locate, dislocate).
Lordosis Magnum Malleus Mandible Mastoid Maxilla Meatus Meniscus Mental Meta Metaphysis =
rA ma nd
Linea Lingual
Increased cervical and/ or lumbar curve also called ‘sway back’. Large pl magna
Hammer (as in the ear ossicle)
From the verb to chew, hence, the movable lower jaw; adj. mandibular.
A breast or teat shape - mastoid process of the Temporal bone. The jaw-bone; now used only for the upper jaw; adj.- maxillary.
A short passage; adj.- meatal as in external acoustic meatus connecting the outer ear with the middle ear. Gk. crescent.
Relating to the chin (mentum = chin, not mens = mind).
An extension of: cf. metacarpal = extension of the wrist.
Epiphysis The slightly expanded end of the shaft of a bone. (pl. metaphysis)
Neurocranium
The neurocranium refers only to the braincase of the skull.
Notch
An indentation in the margin of a structure.
Nucha
The nape or back of the neck adj.- nuchal.
The prominent convexity of the back of the head Occipitum = Occipital bone adj. occipital
©D
Occiput
Occulus
An eye
Odontoid
Relating to teeth, toothlike see Dens
Ontogeny
The development of an individual growth pattern
Orbit
A circle; the name given to the bony socket in which the eyeball rotates; adj.- orbital.
Orifice
An opening.
Os
A bone or pertaining to bones adj.- osseus
16
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 17
Common terms in Osteology and Skeletal Anatomy A small bone as in the ear ossicles: stapes (stirrup), incus (anvil) and malleus (hammer).
Ossification
The process of turning something into bone, i.e. from one tissue to another as in cartilagneous ossification from cartilage into bone
aN eill
Ossicle
Two other forms are primary ossification (in the shaft of the long bone where the bone forms from CT and secondary ossification where the bone has formed and secondary centeres devlop as at the ends of the long bones). Osteitis
Inflammation of the bone
Osteoblasts
Bone cells capable of dividing and laying down matrix - ‘baby’ osteocytes
Osteochondroma Bone and cartilaginous tumour benign often arising in the ephyseal plate or line and protrude at right angles, common and asymptomatic Osteoclasts
Multinuclear cells which resorb or phagocytose bone = resorption of bone = Giant cells.
Osteocytes
Bone cells incapable of dividing but maintain the extracelluar matrix of the bone
Osteogenesis
Formation and growth of bone Tumour of the bone tissue
rA ma nd
Osteoma Osteomalacia
Disease of softening of the bones / Paget’s disease
Osteomyelitis
Inflammatory disease of the bone due to infection
Osteoporosis
A thinning of the bones due to age and/or calcium deficiency
Osteosarcoma
Malignant tumor of bone tissue
Ostium
A door, an opening, an orifice.
Otic
Pertaining to the ear
Ovale
Oval shaped
Palate
A roof adj.- palatal or platatine.
Parietal
Pertaining to the outer wall of a cavity from paries, a wall.
Parotid
Pertaining to a region beside or near the ear (par - otic)
Pars
A part of / nearby (adj para)
Pecten
A comb.
Perikymata
Transverse ridges and the grooves on the surfaces of teeth
Periosteum
Layer of fascial tissue (connective tissue) on the outside of compact bone not present on articular (joint) surfaces see endostium Inflammation on the outer surface of the bone Abnormal growth of long bones on their outer surfaces
Petrous
Pertaining to a rock / rocky / stoney adj. petrosal
Phalanx
Pertaining to flanks of soldiers - phalanges a row of soldiers used for a row of fingers or toes
Planar joints
Joints which allow for sliding across the joint as in the wrist, foot and ribs movement in one plan.
©D
Periostitis
Periostosis
Pneumatic
Air filled see Classification of Bones.
Pollex
Thumb.
Process
A general term describing any marked projection or prominence as in the mandibular process.
© A. L. Neill
17
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 18
The A to Z of Bones, Joints & Ligaments Prominens
A projection.
Pseudoarthrosis False or new joint due to the nonhealing of a fracture. A wing; the region where the tip of the greater wing of the sphenoid meets or is close to the parietal, separating the frontal from the squamous region of the temporal bone. (TERY-on) Alternatively the region where these 4 bones meet.
Pterygoid
Wing shaped.
Pubis
Hairy, that part of the hip bone with hair over the surface adj pubic pl pubes.
Ramus
Branch as in the superior pubic ramus the superior or higher branch of the pubic bone (Pubis).
Recess
A secluded area or pocket; a small cavity set apart from a main cavity.
aN eill
Pterion
Rectus
Straight - erect.
Retinaculum
A device to hold structures in place - generally composed of CT - such as the flexor retinaculum see Classsification of Ligaments.
Rickets
Form of osteomalacia or bone softening due to Vitamen D deficiency.
Rotundum Sagittal Scoliosis Sella Sesamoid Sigmoid Sinus
Skull Spheno-
Round.
An arrow, the sagittal suture is notched posteriorly, making it look like lightening arrows. A deviation from the vertical plane of the Vertebral column laterally (as opposed to exaggeration of vertical curves in kyphosis and lordosis).
A saddle; adj.- sellar, sella turcica = Turkish saddle. Grainlike.
S-shaped, from the letter Sigma which is S in Greek.
A space usually within a bone, lined with mucous membrane, such as the frontal and maxillary sinuses in the head. A modified BV usually vein, with an enlarged lumen for blood storage and containing no or little muscle in its wall. Sinuses may contain air, venous or arterial blood, lymph or serous fluid depending upon location and health of the subject adj.- sinusoid. The skull refers to all of the bones that comprise the ‘head’. A wedge i.e. the Sphenoid is the bone which wedges in the base of the skull between the unpaired frontal and occipital bones adj.- sphenoid A thorn adj.- spinous descriptive of a sharp, slender process/protrusion.
©D
Spine
Elevated bony growth often roughened.
rA ma nd
Ridge
Splanchocranium The splanchocranium refers to the facial bones of the skull. Stylos
An instrument for writing hence adj.- styloid a pencil-like structure.
Sulcus
Long wide groove often due to a BV indentation.
Sustenaculum
A supportive structure as in the sustenaculum tali = a structure which supports the Talus in the foot.
Suture
The saw-like edge of a cranial bone that serves as joint b/n bones of the skull.
Symphysis
A cartilagenous joint or a growth with bone-cartilage-bone. See classification of joints.
18
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 19
Common terms in Osteology and Skeletal Anatomy Syn-
Together ie... the close proximity of or fusion of 2 structures.
Syndesmosis
Tight inflexible joints b/n 2 bones little to no movement. Many axial joints are of this type. Fusion of any joints.
Any moveable joint with synovial fluid b/n the 2 opposing bones - most moving jointd are synovial.
aN eill
Synostosis Synovial joints
Ankle (Gk. bend).
Pertaining to any bones joining the foot with the leg adj. - tarsal (Gk wickerwork referring to the basketlike structure of the os tarsus with its ligaments).
Tectum
A roof.
Tegmen
A covering.
Temporal
Refers to time and the fact that grey hair (marking the passage of time) often appears first at the site of the temporal bone.
Tendon
A tie or cord of collagen fibres connecting muscle with bone (as opposed to articular ligaments which connect bone with bone).
Tentorium
A tent.
Torus
rA ma nd
Talus Tarsus
Protruberance pl tori.
Trabecula
A “little” beam i.e. supporting structure or strut pl. trabeculae = spicule.
Trephination
The practice of making an artifical hole in the cranium practiced in many ancient religions used to relieve cranial pressure.
Trochanter
Pertaining to a small wheel or disc. In the femur it is a large disc shaped tuberosity.
Trochlea
A pulley that part of the bone or ligamantous attachment that pulls the bone in another direction as in the elbow or the ankle (adj Trochlear).
Tubercle
A small process or bump, an eminence.
Tuberculum
A very small prominence, process or bump.
Tuberosity
A large rounded process or eminence, a swelling or large rough prominence often associated with a tendon or ligament attachment.
Turbinate
A child’s spinning top, hence shaped like a top. An old term for the nasal conchae.
Tympanum
A drum pl. tympani
Ulna
= Elbow or arm (adj ulnar) A hook adj.- uncinate.
Vagina
A sheath; hence, invagination is the acquisition of a sheath by pushing inwards into a structure, and evagination is similar but produced by pushing outwards adj.- vaginal.
Volar
Pertaining to the palm (hand) or the sole (foot)
Wormian bone
Extrasutural bone in the skull
Zygoma
A yoke, hence, the bone joining the maxillary, frontal, temporal & sphenoid bones adj.- zygomatic.
©D
Uncus
For more terms and their origins and pronunciation see the A to Z of Anatomical, Medical and Histological terms.
© A. L. Neill
19
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 20
The A to Z of Bones, Joints & Ligaments
Classification and Summary of Bones Flat bones
aN eill
Thin flattened and usually curved bones: most Skull bones, Scapula, Manubrium generally surrounded by a layer of compact bone with cancellous or spongy bone in b/n.
Irregular bones Various shapes not easily classified Sphenoid, Vertebrae, Hip, Ear Bones irregular growth centres Long bone
Longer than wide 2 ends epiphysis and a central diaphysis. Growth mainly lengthwise: most limb bones: Femur, Fibula Humerus, Radius, Tibia, Ulna, and digits Phalanges see diagram
Pneumatic bone/Alveolar bone Bones filled with air to lighten their weight Maxilla, Frontal, Mandible, Ethmoid and bones with “sinuses”
Short bone
rA ma nd
Sesamoid bone Bones completely surrounded by soft tissue w/o joints Hyoid Roughly cubic in shape. Most wrist Carpal and ankle Tarsal bones; many of the bones at the base of the skull.
Sutural bone
“Wormian” bone small bones which occur within the skull sutures sometimes called extra-sutural if the main part of the bone is outside of the suture. Generally, they are unnamed although the Incus is given to the large extra-sutural bone when present.
There are:
There are between 600 and 620 bones in the body including the various sesamoid and Wormian bones and other areas where there may be separate or ossified joints. 22 paired skull bones including the ear ossicles / not including the teeth. 5 single bones mainly on the base of the skull 1 mandible 1 hyoid variable sutural and extra-sutural bones (generally between 3-5)
56 digit bones or Phalanges plus an additional 3 to 4 small sesamoid bones in the foot over the big toe and the thumb
©D
There are:
Each limb has a single long bone proximally (arm and thigh), a hinge joint and 2 bones distally (the forearm and shin) joined by an interosseous upper membrane ligament. Each pair of limbs is supported by a GIRDLE of supporting bones the PECTORAL GIRDLE and the lower PELVIC GIRDLE.
20
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:45 PM Page 21
Classification and Summary of Bones
Bone Structure
aN eill
Long Bone (Femur)
Spongy or Cancellous Bone with Red Marrow
rA ma nd
Yellow Marrow
Compact Bone
Haversian Systems
©D
Periosteum
© A. L. Neill
Endosteum
Blood Vessel
21
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 22
The A to Z of Bones, Joints & Ligaments
Posterior
©D
rA ma nd
Anterior
aN eill
Articulated Skeleton
22
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 23
The A to Z of Bones, Joints & Ligaments
©D
rA ma nd
aN eill
Disarticulated Bones
© A. L. Neill
23
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 24
The A to Z of Bones, Joints & Ligaments
Classification and Summary of Joints
STRUCTURE BONE FIBRES TOOTH SYNARTHROSES = BONE FIBROUS JOINT FIBRES BONE eg SUTURE BONE (short fibrous FIBRES connection b/n bones) BONE eg SYNDESMOSIS BONE (longer fibres more FIBRES cartilage) BONE SYNCHONDROSIS = BONE 1º CARTILAGENOUS HYALINEJOINT CARTILAGE (Amphiarthrosis) BONE SYMPHYSIS BONE (20 cartilagenous joint) FIBROCARTILAGE BONE SYNOVIAL (Diarthrosis)
eg PLANE
eg PIVOT
eg CONDYLOID
eg BALL & SOCKET
eg SADDLE
24
EXAMPLES teeth / jaw bone
little / nil
nil
little
due to the elasticity of the CARTILAGE
little in all directions may be influenced by HORMONES bones BONE Full movement HYALINE type depends CARTILAGE upon the shape SYNOVIAL FLUID of the boney HYALINE surfaces CARTILAGE BONE gliding / sliding
©D
eg HINGE
MOVEMENT nil
rA ma nd
TYPE OF JOINT GOMPHOSIS
aN eill
definition: joint = any BONE something BONE B+?+B i.e whenever 2 or more bones meet
one directional
joints in the Skull
joints b/n flat bones Tibiofibula joint Radioulna joint
1st costal cartilage to the Manubrium rib cartilage Manubriosternum MOST joints in axial skeleton eg b/n VERTEBRAL BODIES b/n Pubic MOST joints in the appendicular skeleton, upper limb, lower limb, feet and hand joints
costovertebral zygapophyseal elbow /knee /finger /toe atlanto-axial medial joint wrist /ankle
movement around an axis movement in 2 directions movement in many directions - common hip / shoulder centre movement in 2 planes thumb C-MC joint
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 25
Classification and Summary of Joints
Joint capsule
aN eill
Synovial Joint
Bone
©D
rA ma nd
Synovial cavity
© A. L. Neill
Synovial membrane
Hyaline cartilage
Periosteum (continuous with joint capsule - stops at articular surface)
25
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 26
The A to Z of Bones, Joints & Ligaments
Classification and Summary of Ligaments
aN eill
definition: a band of tissue connecting bones, viscera or other body structures, may be distinct fibrous bands or fascial folds or nonfunctional remnants of foetal structures
DESCRIPTION
EXAMPLES
SHOWN IN
any “helping” lig. supporting/strengthening the primary lig generally used where there are many short bones in a crowded area
the: palm (palmar), sole (plantar), phalanges (volar) temporomandibular joint (Henle), humerus and wrist
hand overview, foot overview, TMJ views, shoulder joint, wrist overview
annular also see retinaculum
any circular lig.
binding enclosing lig.
annulus fibrosis annular lig. of the Radius
vertebro-vertebral joints elbow
any curved lig.
arcuate pubic ligament pelvic girdle overview
description of any lig. in front of the named structure (also used to describe those fibres in front of a structure)
ANTERIOR LONGITUDINAL LIGAMENT = ALL
craniovertebral jts thoracic cage vertebro-vertebral jts
lig. with 2 insertions
calcaneocuboid + calcaneonavicular pisio-hamate + pisio-metacarpal
ankle joint-subtalar dorsum of the hand
any “helping” lig. supporting/strengthening the primary lig generally used with outer ligs over bigger joints
radial collat lig.
elbow, knee jts wrist
cruciform
ligaments which cross over
CRUCIATE LIGAMENTS knee jt (of the knee) cruciate ligs of the atlanto-axial jt odontoid jt craniovertebral jts
deltoid
ligs which fan out as a “D” DELTOID LIGAMENT
arcuate anterior
bifurcate
©D
collateral = accessory
rA ma nd
NAME accessory = collateral
26
ankle jt
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 27
Classification and Summary of Ligaments
aN eill
The ligaments included in this book are those associated with the musculoskeletal system, bones and skeletal muscles. Tendons which join muscle to bone are not discussed nor are other ligamentous structures such as the aponeuroses or ligaments of organs such as the Hepatic ligaments. NAME
DESCRIPTION
flava
ligs with large amounts of elastic fibres hence yellow in colour
inter-osseous
ligs which span across 2 bones for a considerable length - deep ligs acting as a surface for muscle attachment
inter-spinous
ligs which are b/n 2 spines INTERSPINOUS deep ligs acting as a LIGAMENTS surface for muscle attachment.
long ligs which attach 2 bones “interspinous” over long distances acting as an extended surface for muscle attachment - more supf than the inter- ligs
radiate
interosseous membrane forearm radioulna jts of the forearm lower leg tibiofibular jts interosseous membrane of the lower leg OBTURATOR LIG pelvic overview
SUPRASPINOUS LIGAMENTUM NUCHAE SACROSPINOUS SACROTUBEROUS INGUINAL LIG
vertebral column overview
vertebro-vertebral jts craniovertebral jts pelvic girdle overview sacrum pelvic girdle
description of any lig POSTERIOR behind the named structure LONGITUDINAL (also used to describe LIGAMENT = PLL those fibres of a lig behind a structure)
vertebro-vertebral jts
lig which fans out (smaller deltoid shape)
thoracic cage, costovertebral jts
©D
posterior
SHOWN IN
vertebra-vertebro jts
long head of Biceps shoulder jt cruciate ligs of the knee knee jts acetabular lig hip jt
rA ma nd
interarticular ligs which enter the (may also be synovium and are inside called synovial) the joint
EXAMPLES
LIGAMENTUM FLAVA
radiate lig of the rib
synovial = interarticular
© A. L. Neill
27
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 28
The A to Z of Bones, Joints & Ligaments
The Bones, Joints and Ligaments This is the order of the illustrations in the book.
aN eill
When beside the name of a structure there is a listing - (see XYZ)… it will be listed at the site XYZ, which may also refer to its alternative name; when beside a structure there is a listing - (also see XYZ)… further information about that structure will be at the site for XYZ, but it will be present in the order listed site as well; this includes structures listed in the BACK section.
Bones are listed in BLACK; Joints are listed in DARK YELLOW and ligaments when referred to separately are listed in ORANGE. Generally ligaments will be referred to in joint diagrams and not listed or demonstrated in separate diagrams. Overviews of regions are listed in MAROON (DARK RED).
©D
rA ma nd
Acetabular joint (see HIP JOINT) Acromioclavicular articulation & joint ANKLE BONE (see Talus - (biggest of the Tarsal bones aka Tarsus)) ANKLE JOINT = Talocrual joint = Talus + Tibia + Fibula = Subtalar joints = Talus + Calcaneus + Os Tarsus ARM = Upper limb = Humerus + Radius + Ulna (see Humerus) Atlas (C1 ) - (Vertebra - cervical) also see the Back Atlanto-Axial joints (C1/C2) Atlanto-Occipital joint (see Craniovertebral joint) Axial-Occipital joint (see Craniovertebral joint) Auditory Ossicles (aka EAR BONES) Axis (C2) - (Vertebra - cervical) also see the Back BACK See end of this section the Back = Vertabral Column. BREAST BONE (see Manubriosternum) Calcaneus (aka HEEL) Capitate (see Carpus disarticulated, also Hand & Wrist overview) Carpus - carpal bones wrist (Os Carpus = Wrist bones) articulated see Hand & Wrist overview individual bones 1st row - Trapezium, Scaphoid, Lunate, Triquetral, Pisiform, 2nd row - Trapezoid, Capitate, Hamate Carpus - disarticulated Carpo-Metacarpal joints (see HAND and WRIST joints) CHEEK BONES (see Zygoma) CHIN (see Mandible) CHEST OVERVIEW (Thoracic cavity) (also see Pectoral Girdle) 28
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 29
The A to Z of Bones, Joints & Ligaments
©D
rA ma nd
aN eill
Clavicle (aka COLLAR BONE) Coccyx -Os coccygis (also see Sacrum) Collar bone (see Clavicle) Costovertebral articulations & joints (RIB & SPINAL joints) Costovertebral articulations of atypical ribs 1 & 2 (see Ribs – Atypical) Cranial Fossae (see Skull internal views) Craniovertebral joints (HEAD/SPINE joints aka Atlanto-Occipital joints & Axial-Occipital joints) also see the Back Cuboid (ankle) Cuneiforms (foot) 1st - medial cuniform , 2nd intermediate cuniform , 3rd lateral cuniform ELBOW - articulation, joint (humero-ulnar) Ethmoid bone Femur (upper leg bone) aka THIGH bone aka LEG bone Fibula (lower leg lateral bone part of the SHIN) FINGERS articulation overview ((see Hand and Wrist bones overview) FINGER JOINTS = interphalangeal joints + MCP joints FOREARM (see Radius, Ulna) FOREHEAD (see Frontal bone) FOOT BONES (tarsal + metatarsal + phalanges) overview (see also Metatarsals) FOOT JOINTS - aka Intertarsal joints Frontal bone (aka FOREHEAD) Glenohumeral joint (see SHOULDER JOINT) Hamate (see Carpus disarticulated, also Hand, Wrist) HAND (and WRIST bones) overview Carpal, Metacarpal bones and Phalanges - articulations HAND BONES (see Metacarpals disaraticulated) HAND JOINTS intercarpal joints = IC joints Carpometacarpal intercarpal joints = C-MC, IC joints HANGING joint (see Atlanto-Axial median joint) also see the Back HEAD/SPINE JOINTS (see Craniovertebral joints) also see the Back HEEL (see Calcaneus) Hip (aka Os Coxae - Innominate) HIP ISCHIUM, ILEUM, PUBIS overview HIP joint (also see PELVIC GIRDLE Sacrum) Humeroulnar joint (see ELBOW JOINT) Humerus = ARM bone (upper arm bone) Hyoid Inferior Nasal Concha (see Nasal bones and cavity) Innominate (see HIP) Interphalangeal joints of the Foot = TOES © A. L. Neill
29
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 30
The A to Z of Bones, Joints & Ligaments
©D
rA ma nd
aN eill
Interphalangeal joints of the Hand (see FINGER joints) Interphalangeal joints = TOES (see FOOT joints) Ischium (see HIP) JAW (see Mandible) KNEE CAP (see Knee articulations) KNEE JOINTS (Tibiofemoral + [Tibiofibular]+ Femoropatellar + Tibiopatellar) Larynx overview (aka Voicebox) LEG = Lower limb = Femur + Patella +Tibia + Fibula Lunate (see Carpus disarticulated, also hand, wrist) Mandible (aka JAW aka CHIN) Mandibular joint (see Temporomandibular joint) Manubriocostal joints (see Sternocostal joints) Manubriosternum = Manubrium + Sternum + Xiphoid process aka BREAST BONE Manubrium (see Manubriosternum) Maxilla (aka UPPER JAW) Metacarpals aka HAND BONES (see hand & wrist overview) Metacarpal Individual views - disarticulated 1st - the thumb / 2nd - the index / 3rd - the middle 4th - the ring / 5th - to the little finger Metatarsals (bones b/n the ankle & the toes) aka FOOT BONES see overview Metatarsals (individual views) disarticulated 1st (bone to the big toe) / 2nd (bone to the second toe) 3rd / 4th / 5th (bone to the little toe) Nasal bones and cavity = NOSE Navicular (ankle) NOSE (see Nasal bones and cavity) Occipital bone / Occiput Odontoid Joint (see Atlanto-Axial median joint) Os Coxae (see HIP bone) Palantine bones / Palate Parietal bone Patella = aka KNEE CAP (see Knee articulations) Pectoral girdle = SHOULDERS overview PELVIS = HIPS (see Pelvic girdle) Pelvic girdle = HIPS (also see Hip) Phalanges = FINGERS / TOES (see Hand and Foot overviews) Pisiform (see Carpus disarticulated, also Hand & Wrist bones overview) Pubic Symphysis = Pubic joint (also see Pelvic girdle) Pubis (see HIP) 30
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 31
The A to Z of Bones, Joints & Ligaments
©D
rA ma nd
aN eill
Radiocarpal joint see WRIST JOINT Radioulnar joints (also see ELBOW) Radius (aka FOREARM) RIB CAGE overview (see Chest overview) RIB JOINT (see costo-vertebral joint) Rib atypical - ribs 1, 2 Ribs typical - ribs 3 - 10 Sacroiliac joint also see the Back Sacrum (lower BACK BONE) also see the Back Scaphoid (see Carpus disarticulated, also hand and wrist) Scapula (aka SHOULDER BLADE) SHIN (see Tibia) SHOULDER JOINT (aka Glenohumeral joint) Sinuses overview (see Skull Internal views - coronal) Skull External Views and Internal Views Sphenoid SPINE overiew see the Back SPINAL JOINTS see the Back Sternoclavicular joints Sterno-Costal joints Sternum (see Manubriosternum) Talus (aka Tarsus aka ANKLE) Teeth overview Temporal bone (aka TEMPLE) Temporomandibular joint (akaTMJ) Thoracic cavity (see CHEST overview) Tibia (aka lower leg bone aka SHIN - shin bone)) Tibiofemoral joint (see KNEE which includes this joint) Tibiofibula joints TOES = digits = phalanges (see Foot bones overview) Trapezium (see Carpus disarticulated, also Hand & Wrist overview) Trapezoid (see Carpus disarticulated, also Hand & Wrist overview) Triquetral (see Carpus disarticulated, also Hand & Wrist overview) Ulna (aka FOREARM - also funny bone) Vertebrae, Vertebral Column and Vertebral joints see the Back VOICE BOX (see Larynx) Vomer Wrist bones (see Carpal bones disarticulated also Hand & Wrist overview / Metacarpal bones) Wrist joint (aka radiocarpal joint) Xiphoid (see Manubriosternum) Zygapophyseal joints see the Back Zygoma (aka CHEEK BONES) see the Back © A. L. Neill
31
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 32
The A to Z of Bones, Joints & Ligaments
A Acromio-Clavicular articulation & joint =
part of the pectoral girdle
NS
aN eill
anterior (ribs cut away) BS suprascapular artery, thoracoacromial artery suprascapular, lat. pectoral Ns (C5-C6)
Movements associated with scapula: elevation / depression, protraction/retraction, rotation 1
Acromion
1A Aromio-Clavicular lig.
Coracoid process of Scapula
rA ma nd
2
2A Coraco-Acromial lig
2B Coraco-Clavicular lig.- Trapezoid part 2C Coraco-Clavicular lig. - conoid part 3
supra-scapula notch
3A supra-scapular lig
Clavicle - sternal end
5
Clavicle - acromial end
6
Acromio-Clavicular art.
©D
4
32
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 33
The A to Z of Bones, Joints & Ligaments
2
aN eill
A
3
1
4
5
rA ma nd
6
1A
2C 3A
©D
2A
2B
© A. L. Neill
33
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 34
The A to Z of Bones, Joints & Ligaments
A ANKLE JOINT = Talocrural joint
aN eill
medial / lateral / posterior BS ant. tibial & peroneal arteries
NS deep peroneal (=ant. tibial), tibial (L4-S2) A
dorsiflexion plantarflexion 1D Tibio-Calcaneal (deep) lig 2D Tibio-Navicular lig 3D Tibio-Calcaneal lig 4D Tibio-Talar (deep) lig ant. Talo-Fibular lig
6
Tibio-Talar lig
7
Tibio-fibular lig
8
post. Talo-Fibular lig
9
Talo-Fibular lig - tibial fibres
rA ma nd
5
10 Calcaneo-Fibular lig 11 Talonavicular lig
©D
*D = all parts of the DELTOID lig -from TIBIA to ankle bones in a “D” shape
34
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 35
The A to Z of Bones, Joints & Ligaments
A
aN eill
11 6
2D
3D
8
rA ma nd
5
2D
10
©D
7
© A. L. Neill
8 1D 2D 3D
9 10
4D
35
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 36
The A to Z of Bones, Joints & Ligaments
A ANKLE JOINTS lower = SUBTALAR joints
aN eill
lateral / medial BS* anastomotic network around jts from ant. post. tibial arteries, dorsalis pedis, peroneal arteries NS medial lateral plantar Ns (L4-S3) A
inversion eversion (foot) gliding and rotation (subtalar joints individually) interosseous Talo-Calcaneal lig
2
cervical lig
3
Talo-Navicular lig
rA ma nd
1
4B* lat. Calcaneo-Navicular lig
5B* med. Calcaneo-Cuboidal lig 6
long plantar lig
7
lat. Talo-Calcaneal lig
8
subtalar jt
9
med. Talo-Calcaneal lig
10 Talo-Calcaneo-Navicular jt
11 Spring lig / plantar Calcaneo-cuboidal lig 12 short plantar lig
©D
B* = BIFURCATED lig (2 heads) also called Bifurcate lig.
36
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:46 PM Page 37
The A to Z of Bones, Joints & Ligaments
1
rA ma nd 6
9
©D
8
2
3
8
7
aN eill
A
4B
5B
11 3
10
12
© A. L. Neill
6
37
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:47 PM Page 38
The A to Z of Bones, Joints & Ligaments
A Atlas = C1 = First Cervical Vertebra no vertebral body no spinous process no articular discs
special anterior facet for dens (odontoid process)
aN eill
Special features
Atlanto-Axial joint-median = ODONTOID JOINT
rA ma nd
AKA hanging joint Atlanto-Axial joints - lateral = zygapophyseal joints of C1/C2 BS anastomotic network around jts from ant. post. tibial arteries, dorsalis pedis, peroneal arteries NS medial lateral plantar Ns (L4-S3) A inversion eversion (foot) gliding and rotation (subtalar joints individually)
Axis = C2= Second Cervical Vertebra (Axis - pivot for movement of the head all movements but nodding)
Special features 1
no vertebral body Dens acts as an dens/odontoid process AXIS for rotation no articular discs at C1
facet for odontoid / Dens process
9
2
ant. tubercle
11 vertebral foramen
3
superior articular facet for Atlanto-Occipital jt
12 ant. arch
4
inferior articular facet
4A medial tubercle
13 Dens process = Odotontoid process
5
posterior tubercle
14/14A transverse lig of Axis (C2) and groove for the lig
6
posterior arch
15/15A spine of Axis (C2)
7
groove for vertebral BVs & suboccipital N
16 lamina of Axis (C2)
8
Foramen Transversarium = transverse foramen (transverse notch if open)
18 pedicle (C2)
©D 38
TP
10 lat. mass
17 attachment of Alar lig
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:47 PM Page 39
The A to Z of Bones, Joints & Ligaments
12
A
2
3
aN eill
1
11 10
4, 4A
5
12
6
7
12
2 13
14
rA ma nd
1
8
12
3
16
8 6
15
13A
©D
13
17
14A
3
18
8
© A. L. Neill
4A
11 15 9 4
16 39
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:47 PM Page 40
The A to Z of Bones, Joints & Ligaments
Calcaneus = Os Calcis = Heel bone lateral / medial / Inferior / Superior (Calcaneus - large quadrangular bone at the back of the Talus - largest of the Tarsal bones/Os Tarsus i.e. foot bones)
aN eill
C
Articulations: 3 articular surfaces Calcaneo-navicular for the Os Tarsus Calcaneo-talus (tarsal bones) Calcaneo-cuboid
rA ma nd
Sulcus Calcanei = Calcaneal sulcus middle articulation surface with foot bones / Os Talus anterior articulation surface with foot bones / Os Tarsus peroneal trochlea attachment for the calcaneofibular ligament posterior surface posterior part of the joint surface for the Talus groove for Flexor Hallicus Longus Sustenaculum Tali articular surface for Cuboid medial process Calcaneal tuberosity lateral process Peroneal tubercle
©D
1 2 3 4 5 6 7 8 9 10 11 12 13 14
40
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:47 PM Page 41
The A to Z of Bones, Joints & Ligaments
aN eill
6
7
3
1
4
9
2
1
2
7
C
3
rA ma nd
6
10
5
4
10
8
7
2 9
14
3
©D
9
6
© A. L. Neill
13
11
11 12
10
8
41
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:47 PM Page 42
The A to Z of Bones, Joints & Ligaments
C dorsal / palmar
aN eill
Carpus = Carpal Bones = WRIST BONES Overview - ARTICULATED (Carpus = Os Carpus = wrist bones = 2 rows of bones between the fingers and the forearm)
1st row 2nd row trapezium, scaphoid, lunate, trapezoid, capitate hamate triquetral, pisiform,
rA ma nd
Triquetral Capitate Lunate Trapezoid Scaphoid Trapezium Metacarpals = MC head of 5th MC shaft of 5th MC base of 5th MC Hamate Pisiform Hook of Hamate
©D
1 2 3 4 5 6 7 8 9 10 11 12 13
42
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:47 PM Page 43
aN eill
The A to Z of Bones, Joints & Ligaments
8
9
11
10
C
1
2
3
7
4
rA ma nd
5
6
8
9
©D
7
© A. L. Neill
10
13 11 12
1 2 3 4
6
5
43
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:47 PM Page 44
The A to Z of Bones, Joints & Ligaments
Carpus = Carpal Bones = WRIST BONES Overview - DISARTICULATED
aN eill
C Capitate / Hamate / Lunate / Pisiform / Scaphoid dorsal / palmar
These bones allow for small gliding movements in the hand in several directions to increase the mobility of the fingers
Capitate = Os Capitus
A
small cap-like bone in the wrist - consists mainly of articulating facets
Hamate
B
bone in the shape of a hammer with hook process which attaches to the flexor retinaculum
Lunate = Os Lunatus
C
rA ma nd
small moonshaped bone of the wrist consists mainly of articulating facets
Scaphoid
D
boat shaped bone, most lateral and proximal in the Carpus large pivotal bone similar to the Navicular in the foot - forms part of the attachment of the flexor retinaculum
Pisiform - smallest carpal bone - sesamoid bone
E
attaches to the flexor retinaculum
1 2 3 4 5
©D
6
articulation surface for Lunate palmar surface facet for 3rd MC facet for 4th MC articulation surface for Hamate articulation surface for Scaphoid facet for Trapezoid facet for 2nd MC dorsal surface
7 8 9
44
10 facet for Triquetral 11 Hamulus - hook of the Hamate 12 articulation surface for Capitate 13 facet for the 5th MC 14 facet for Radius 15 facet for Trapezium 16 tubercle
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:47 PM Page 45
The A to Z of Bones, Joints & Ligaments
dorsal
palmar
aN eill
6
1
9
5
2
A 4
3 12
1
10
1
2
2
C
14
5
10
12
9
9
2 6
14
9
9
©D
D
11
13
4
13
4
8
3
rA ma nd
B
7
9
11
C
12
12 16
16
15
10
E
© A. L. Neill
9 45
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:47 PM Page 46
The A to Z of Bones, Joints & Ligaments
Carpus = Carpal Bones = WRIST BONES Overview - DISARTICULATED dorsal / palmar
aN eill
C Trapezium / Trapezoid / Triquetral
These bones allow for small gliding movements in the hand in several directions to increase the mobility of the fingers
Trapezium = Os Trapezius (Lt - greater multi-angular) F medium-sized irregular bone with large saddleshape articulation for the thumb often broken in trauma
Trapezoid (Lt lesser multi-angular)
G
2nd smallest carpal bone-irregular bone
rA ma nd
Triquetral
H
irregular bone of the wrist articulates with the Pisiform
articulation surface for Lunate articulation surface for Pisiform articulation surface for Hamate tubercle facet for 1st MC articulation surface for Scaphoid articulation surface for Trapezoid facet for 2nd MC articulation surface for Capitate dorsal surface palmar surface
©D
1 2 3 4 5 6 7 8 9 10 11
46
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:47 PM Page 47
palmar
C
dorsal
6
4
aN eill
The A to Z of Bones, Joints & Ligaments
7
6
8
F 7
4
rA ma nd
5 8
9
G
8
10
10
6
H
2
©D
1
3
© A. L. Neill
1
3
47
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:48 PM Page 48
The A to Z of Bones, Joints & Ligaments
CHEST - OVERVIEW anterior synovial joints
aN eill
Thoracic cavity
C ARTICULATIONS
RIB 1 with Manubrium see STERNO-COSTAL jt RIB 2 with the Manubrium & Sternum see STERNO-COSTAL jt RIBS 3-6 (true ribs) with the Sternum directly
cartilaginous joints
RIBS 7-10 (false ribs) with Sternum via costocartilagenous ridge RIBS 11-12 (floating ribs) do not articulate anteriorly
20 fibrocartilagenous joints - ossify with age
rA ma nd
Manubrium with Sternum Sternum with Xiphisternum
posterior planar synovial joints
EACH RIB with the same VB and the one above medially + with the TP of the VB laterally
SPECIAL FEATURES
UPPER 6 ribs - pump movement -up & down LOWER 4 ribs - bucket handle movement -up and out & down and in LOWEST 2 ribs - DO NOT MOVE with respiration - anchor the DIAPHRAGM upper border = thoracic inlet = 1st rib + clavicle +manubrium + VB lower border = thoracic outlet = Xphisternum + 12th rib + VB
1st rib Clavicle acromion (Scapula) Humerus 5th rib
©D
1 2 3 4 5
6 7 8 9 10
Manubrium Sternum Xiphoid process 12th rib L1 VB
See also Pectoral Girdle
48
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:48 PM Page 49
The A to Z of Bones, Joints & Ligaments
6
aN eill
2
1
3 4
rA ma nd
5
9
8
7
©D
10
C
© A. L. Neill
49
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:48 PM Page 50
The A to Z of Bones, Joints & Ligaments
Clavicle = COLLAR BONE
aN eill
1 2 3 4 5 6 7 8 9
Sternal end of Clavicle facet for first costal cartilage groove for subclavian artery conoid tubercle acromial end of Clavicle trapezoid line (obliue ridge) impression for costoclavicular lig superior surface anterior surface
rA ma nd
C
inferior / anterior Articulations: with Manubrium with acromion proximally (Scapula) distally sterno-clavicular jt acromio-clavicular jt
Coccyx = Os Coccygis anterior / posterior
(Coccyx = Small tail bones at the base of the spine - functions as an anchor for many regional muscles and ligaments = the vestigial tail looks like a cuckoo's bill)
S1-3/5 average 4 sacro-coccygeal may fuse with sacrum late in life looks like the bill of the cuckoo
©D
Articulations: with each other 3-5 bones with the sacrum superiorly Special less features inferiorly after features: S1 no pedicles, laminae or spinous processes Variable Shape/Morphology 1 2 3 4
50
rudimentary superior articular surface = cornua body of coccyx (Co1) fused bodies (Co3-5) -± intervertabral discs TP
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:48 PM Page 51
The A to Z of Bones, Joints & Ligaments
8
5
aN eill
1
C
3
9
3
rA ma nd
2
5
4
6
7
1
1
©D
4
4
© A. L. Neill
2
3 1 2
3 51
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:48 PM Page 52
The A to Z of Bones, Joints & Ligaments
Costovertebral joints = RIB/SPINE joints articulations-superior / joints-superior (Costovertebral joints = 3 joints in each typical rib, 2 with the bodies of the vertebrae, 1 with the transverse process of the respective thoracic vertebra)
aN eill
C
BS posterior intercostals -spinal branches of the thoracic Aorta
NS posterior intercostals Ns spinal branches (C8,T1-12) A
gliding in inspiration upper 6 elevation (pump handle) lower 4 eversion (bucket handle) lowest 2 no movement
transverse costovertebral joint = costotransverse joint
articular facet for (TP) transverse process tubercle of rib articular part of rib neck of rib facet on the head of the rib superior demi-facet on the base of the VB articular capsule of the costotransverse joint costotransverse lig joint capsule intervertebral disc inner -nucleus pulposis intervetebral disc outer- annulus fibrosis intra-articular lig superior costotransverse lig lat costotransverse lig
©D
1 2 3 4 5 6 7 8 9 10 11 12 13 14
demifacets on the bodies of 2 adj vertebrae & their connecting disc
rA ma nd
Articulations: with VB 2 demi-joints eg RIB 3 articulates with T2,T3 VB with the TP of the equivalent vertebra eg RIB 3 with T3
52
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:48 PM Page 53
aN eill
The A to Z of Bones, Joints & Ligaments
1
2
3 4 5
C
rA ma nd
6
8
7
14
9
2 4
13
©D
5
12
10
11
© A. L. Neill
53
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:48 PM Page 54
The A to Z of Bones, Joints & Ligaments
Costovertebral joints = RIB/SPINE joints articulations, joints / lateral (Costovertebral joints = 3 joints in each typical rib, 2 with the bodies of the vertebrae, 1 with the transverse process of the respective thoracic vertebra)
aN eill
C
BS posterior intercostals -spinal branches of the thoracic Aorta
NS posterior intercostals Ns spinal branches (C8,T1-12) A gliding in inspiration upper 6 elevation (pump handle) lower 4 eversion (bucket handle) lowest 2 no movement
articular facet for TP superior demi-facet on the base of the VB VB = vertebral body radiate lig ALL = anterior longitudinal lig intervertebral disc intra-articular lig head of rib angle and shaft of rib paired synovial joints planar with demi-facets superior costotranverse lig spine of thoracic vertebra superior costo-demi-facet on inferior aspect of VB
©D
1 2 3 4 5 6 7 8 9 10 11 12 13
demifacets on the bodies of 2 adj vertebrae & their connecting disc transverse costovertebral joint = costotransverse joint
rA ma nd
Articulations: with VB 2 demi-joints eg RIB 3 articulates with T2,T3 VB with the TP of the equivalent vertebra eg RIB 3 with T3
Costovertebral joints - Atypical ribs see Ribs Atypical
54
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:48 PM Page 55
aN eill
The A to Z of Bones, Joints & Ligaments
2
1
rA ma nd
12
C
2
1
11
3 4 5 6
©D
10 9
© A. L. Neill
7 8
55
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:48 PM Page 56
The A to Z of Bones, Joints & Ligaments
Craniovertebral joints = HEAD/SPINE joints anterior - looking onto the anterior surface of the cervical spine
BS vertebral arteries
aN eill
C
(made up of median and lateral Atlanto-Occipital (C1/head) and AxialOccipital joints (C2/head) joints)
NS medial branches of dorsal rami, recurrent laryngeal spinal branches of ventral rami (C1-3) flexion/extension, lateral flexion, rotation
basilar of Occiput - cut through jugular foramen (TF of the base of the skull) mastoid process TP of C1 ALL = anterior longitudinal lig attached to tubercle of C1 intervertebral disc C2/C3 ALL C2/C3 zygapophyseal joint (L) capsule of the lat. atlanto-occiptal joint capsule of the lat. atlanto-axial joint ant. atlanto-occipital membrane
©D
1 2 3 4 5 6 7 8 9 10 11
rA ma nd
A
56
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:49 PM Page 57
11
aN eill
The A to Z of Bones, Joints & Ligaments
C
1
rA ma nd
2
3 4
9
5
10
6
8
©D
7
© A. L. Neill
57
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:49 PM Page 58
The A to Z of Bones, Joints & Ligaments
Craniovertebral joints = HEAD/SPINE joints lateral (made up of median and lateral Atlanto-Occipital (C1/head) and AxialOccipital joints (C2/head) joints)
BS vertebral arteries
aN eill
C
NS medial branches of dorsal rami, recurrent laryngeal spinal branches of ventral rami (C1-3) A
flexion/extension, lateral flexion, rotation
basilar of Occiput tectorial membrane ant atlanto-occipital membrane leads to … 3A ALL ALL apical lig. of Dens ant arch of Atlas C1 Dens of C2 longitudinal band of cruciform lig superior (becomes 7A) longitudinal band of cruciform lig inferior C2/C3 intervertebral disc body of C3 PLL lamina of C2 transverse lig of atlas (C1) post. atlanto-axial lig post. arch of C1
15 16 17 17A
vertebral artery post atlanto-occipital lig space which leads to foramen magnum and then … vertebral foramen
©D
rA ma nd
1 2 3 3A 4 5 6 7 7A 8 9 10 11 12 13 14
58
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:49 PM Page 59
17
aN eill
The A to Z of Bones, Joints & Ligaments
C
1 2
17A
16
15
rA ma nd
3
4
5 6 7
14 13 12
3A 7A 8
11
©D
10
© A. L. Neill
9
59
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:49 PM Page 60
The A to Z of Bones, Joints & Ligaments
Craniovertebral joints = HEAD/SPINE joints posterior internal - looking into the back of the vertebral canal (made up of median and lateral Atlanto-Occipital (C1/head) and AxialOccipital joints (C2/head) joints)
BS vertebral arteries
aN eill
C
NS medial branches of dorsal rami, recurrent laryngeal spinal branches of ventral rami (C1-3) A
flexion/extension, lateral flexion, rotation jugular foramen
2
transverse process of Atlas
3
tectoral membrane
rA ma nd
1
3A PLL 4
capsule of zygapophyseal joints
5
C2/C3 intervertebral disc
6
longitudinal band of cruciform lig inferior
7
capsule of lat joint of C1 C2
8
transverse band of cruciform lig over the deeper stronger transverse lig of the Atlas (C1)
9
alar lig*
10 capsule of lat atlanto-occipital jt
©D
11 longitudinal band of cruciform lig superior *broken in hanging
60
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:49 PM Page 61
11
aN eill
The A to Z of Bones, Joints & Ligaments
C
1
10
2
rA ma nd
9
8
3
7
4
6
3A
©D
5
© A. L. Neill
61
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:49 PM Page 62
The A to Z of Bones, Joints & Ligaments
C lateral / medial
aN eill
Cuboid = part of Os Tarsus / bones of the foot (Cuboid = large cubic bone of the tarsal bones b/n calcaneus and the 4th and 5th metatarsals, has a tuberosity and groove to support the passage of peroneus longus tendon of the foot)
cubo-metatarsal joints underneath and to the side
facet for lateral cuniform facet for Navicular facet for Calcaneus facet for 4th MT dorsal surface lateral surface facet for 5th MT groove for peroneus longus tendon facet on tuberosity for sesamoid bone in the tendon
©D
1 2 3 4 5 6 7 8 9
cubo-calcaneal
rA ma nd
Articulations: with Calcaneus posteriorly with 4th and 5th MTs anteriorly Special cuboid shape with features large tuberosity on the inferolateral surface
62
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:49 PM Page 63
aN eill
The A to Z of Bones, Joints & Ligaments
C
2
1
4
rA ma nd
3
5
6
4
9
7
©D
8
© A. L. Neill
63
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:49 PM Page 64
The A to Z of Bones, Joints & Ligaments
Cuneiform bones - wedgeshaped
aN eill
C
1 Medial Cuniform = 1st Cuneiform 2 Intermediate Cuniform = 2nd Cuneiform 3 Lateral Cuniform = 3rd Cuneiform part of Os Tarsus / bones of the foot Lateral / Medial
There are 3 + 1 bones in the middle layer of the foot, broadening the sole from the heel for better weightbearing and balance. The Cuboid is the biggest and most lateral of the Cuneiform bones and spans across 2 layers.
rA ma nd
Medial / 1st = the largest Cuneiform, kidney shaped at the base for the 1st MT
Intermediate / 2nd = the smallest Cuneiform - articulates with Cuneiforms on both sides
©D
Lateral / 3rd
64
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:49 PM Page 65
Lateral
Medial
C
rA ma nd
1
aN eill
The A to Z of Bones, Joints & Ligaments
2
©D
3
© A. L. Neill
65
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:50 PM Page 66
The A to Z of Bones, Joints & Ligaments
ELBOW joint / humero-ulnar articulation, anterior / posterior
aN eill
Extended (Elbow joint -hinge joint between the Ulna and the Humerus only one dimensional movement)
E BS anastomosies around joint from brachial, profunda brachii, radial and ulnar arteries
NS musculocutaneous, radial, ulnar and median Ns (C5-7) A
flexion and extension -elbow supination pronation proximal & distal radioulnar jts at the wrist
rA ma nd
Articulations: hinge jt Ulna hinge joint and Humerus inferior is the proximal pivot joint radio-ulnar joint 1 Humerus 2 Radius 3 Ulna 4 head of Radius 5 neck of Radius 6 Trochlea of Humerus 7 Olecranon of Ulna
©D
Ear bones - Auditory ossicles see the A to Z of the Head & Neck
66
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:50 PM Page 67
aN eill
The A to Z of Bones, Joints & Ligaments
rA ma nd
1
7
3
E
6 4 5 2
2
3
Right anterior
©D
Left posterior
© A. L. Neill
67
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:50 PM Page 68
The A to Z of Bones, Joints & Ligaments
ELBOW joint / humero-ulnar
aN eill
joint, lateral / medial Flexed (Elbow joint -hinge joint between the Ulna and the Humerus only one dimensional movement)
E BS anastomosies around joint from brachial, profunda brachii, radial and ulnar arteries
NS musculocutaneous, radial, ulnar and median Ns (C5-7) A
flexion and extension -elbow supination pronation proximal & distal radioulnar jts at the wrist
radial collateral lig annular lig (covering the head of the Radius) radial tuberosity interosseous membrane oblique cord supinator crest of Ulna articular capsule lat epicondyle of Humerus ant band of Ulnar collateral lig medial epicondyle post band of Ulnar collateral lig Olecranon of Ulna oblique band of Ulnar collateral lig
©D
1 2 3 4 5 6 7 8 9 10 11 12 13
rA ma nd
Articulations: hinge jt Ulna and Humerus hinge joint inferior is the proximal pivot joint radio-ulnar joint
68
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:50 PM Page 69
1
aN eill
The A to Z of Bones, Joints & Ligaments
E
2
3
8
rA ma nd
7
4
6
5
7
9
10
2 5
11
©D
12
4
13
© A. L. Neill
69
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:50 PM Page 70
The A to Z of Bones, Joints & Ligaments
Ethmoid bones anterior / lateral / medial / superior
1
Ethmoidal labyrinth containing air cells (part of the Ethmoid sinus) continuous with the Sphenoid sinus 2 Crista Galli 3 Orbital plate of Ethmoid bone (part of the Orbital cavity) 4 Middle Nasal concha 5 Jugum of Sphenoid - Jugum Sphenoidale (Bridge connecting the 2 wings of the Sphenoid bone) 6 Perpendicular plate of the Palatine bone 7 Uncinate process 8 Ala (of Crista Galli) 9 Anterior groove (on the Ethmoid) 10 Posterior groove (on the Ethmoid) 11 Cribiform plate (entrance for the Olfactory nerve) 12 Vomer
©D
rA ma nd
E
aN eill
(Ethmoid = sieve light spongy cubic bone sitting b/n the 2 orbital cavities).
70
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:50 PM Page 71
The A to Z of Bones, Joints & Ligaments
anterior 1
aN eill
2
3
7
4 6
5 1
8
3
rA ma nd
4
2
E
lateral
6
medial
3 10 9
7
1
11
1
2
8
6
©D
superior
© A. L. Neill
12
71
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:50 PM Page 72
The A to Z of Bones, Joints & Ligaments
Femur = Thigh bone aka LEG BONE anterior / posterior Articulations: with acetabulum with the hip superiorly / proximally with patella and tibia with the knee distally and only 1 bone of the lower leg greater trochanter fovea on the head Head of the femur neck of the femur intertrochanteric line lesser trochanter shaft of the femur adductor tubercle medial epicondyle medial condyle lateral condyle lateral epicondyle patella surface of the femur trochanteric fossa intertrochanteric crest spiral line linea aspera medial supracondylar line intertrochanteric fossa popliteal surface lateral supracondylar line quadrate tubercle gluteal tuberosity
©D
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
rA ma nd
F
aN eill
(Femur = is the longest heaviest and strongest bone in the body)
72
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:50 PM Page 73
aN eill
The A to Z of Bones, Joints & Ligaments
2
2 3 4
1
5
14 4
F
23
22
15 6
rA ma nd
6
1
3
16
17
7
18
21
13
12
©D
11
© A. L. Neill
8 9 10
20
19
12 11
73
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:50 PM Page 74
The A to Z of Bones, Joints & Ligaments
Fibula = lower leg bone aka SHIN BONE anterior / posterior
Articulations: with Tibia superiorly Tibiofibular jt not the knee with Talus distally Talofibular jt lateral lateral malleolus side 1 2 3 4 5 6 7 8 9 10 11 12
styloid process articular facet for Tibia head of Fibula lateral surface lateral border anterior border posterior surface interosseus border medial surface Tubercle between articulations fossa for lateral malleolus fossa for Tibia (distal)
rA ma nd
F
aN eill
(Fibula = is a long thin lateral bone of the lower leg incidental at the knee joint pivotal at the ankle)
©D
Fingers = Digits - see Hand and Wrist bones overview
74
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:51 PM Page 75
aN eill
The A to Z of Bones, Joints & Ligaments
1 2
F
3
4
9
rA ma nd
4
6
7
8
8
©D
5
© A. L. Neill
12
10
11
75
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:51 PM Page 76
The A to Z of Bones, Joints & Ligaments
aN eill
FINGER joints = Interphalangeal joints (IP jts) + metacarpophalangeal joints (MCP jts) Bones of the “Hand ” = Carpals (C), Metacarpals (MCs) & Fingers (Phalanges - P) + Sesamoid bones encased in tendons = 27 bones (foot 26).
F
The MCs are shorter than the foot Metatarsals (MTs) and the fingers much longer, as the functional emphasis is for gripping and fine motor skills rather than weightbearing. Each finger has a proximal, middle and distal phalanx, except the thumb (Pollux), which only has 2
rA ma nd
BS princes pollicis, radialis indicis, palmer & dorsal digital art. NO ANASTOMOSES ACROSS THE FINGERS hence blocking both sides of the finger will result in tissue death eg wearing a tight ring NS median N for medial nerve for the thumb, index and middle finger, ulnar N for the little and ring fingers (C7-T1) A
IP extension / flexion MCP flexion/extension, rotation, adduction/abduction circumduction
palmer lig of IP joints collat. ligs of IP joints collat. ligs of MCP joints capsule for MCP of the thumb deep transverse MC ligs palmer ligs grooved for flexor tendons
©D
1 2 3 4 5 6
76
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:51 PM Page 77
6
rA ma nd
1
aN eill
The A to Z of Bones, Joints & Ligaments
F
2
3
4
©D
5
© A. L. Neill
77
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:51 PM Page 78
The A to Z of Bones, Joints & Ligaments
FOOT BONES overview dorsal / plantar
aN eill
Articulations: ‘foot’ with Tibia - Talo-Fibular jt = lateral Malleoli ‘foot’ with Fibula - Talo-Fibular = medial malleoli w/n the foot T-MT jts + MT-P jts = the arch of the foot IP jts = ball of the foot lateral tubercle of Talus medial tubercle of Talus trochlea of Talus neck of Talus head of Talus Navicular lat. Cuneiform intermed. Cuneiform medial Cuneiform proximal P of Hallux (big toe) distal P of Hallux (big toe) middle P of 2nd toe distal P of 2nd toe proximal P of 2nd toe metatarsals = MTs Cuboid facet for medial malleolus Calcaneus middle P of 4th toe middle P of 3rd toe Sustenaculum Tali of Calcaneus
©D
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
rA ma nd
F
Bones of the “Foot” = Tarsal (T), Metatarsals (MTs) & Toes (Phalanges P) + Sesamoid bones encased in tendons = 26 bones (hand 27). The MTs are longer than the hand Metacarpals (MCs) and the toes are shorter than the fingers, as the functional emphasis goes from gripping to weightbearing & shock absorbing. Each toe has a proximal, middle and distal (terminal) phalanx, except the big toe (Hallux) which only has 2.
78
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:51 PM Page 79
The A to Z of Bones, Joints & Ligaments
12
14
aN eill
11 10
13
9
F
15
8 7 6
16
rA ma nd
5
17
4
3
2
1
13
11
18
20
19
10
15
©D
9
8
© A. L. Neill
16
7 6 4 21
18 79
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:51 PM Page 80
The A to Z of Bones, Joints & Ligaments
see also Phalanges dorsal / plantar
aN eill
FOOT joints = Intertarsal joints (IT jts) Bones of the “Foot” = Tarsal (T), Metatarsals (MTs) & Toes (Phalanges - P) + Sesamoid bones encased in tendons = 26 bones (hand 27).
F
The MTs are longer than the hand Metacarpals (MCs) and the toes are shorter than the fingers, as the functional emphasis goes from gripping to weightbearing & shock absorbing.
As with the Hand - IP joints hinge joints - flexion and extension only IT joints planar joints - slight gliding +rotation MT joints gliding and planar - slight gliding + rotation
rA ma nd
BS branches of dorsalis pedis, medial & lat. plantar arteries. NS deep peroneal medial & lat. plantar Ns (S1-2) A
the actions of the foot joints are much more limited than the hand and are primarily to assist with inversion / eversion of the foot and weight dispersal dorsal intercuneiform ligs dorsal cuneonavicular lig dorsal cuboidenonavicular lig dorsal cuneocuboid lig plantar intercuneiform ligs plantar cuneonavicular lig plantar cuboidenonavicular lig plantar cuneocuboid lig
©D
1 2 3 4 5 6 7 8
80
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:51 PM Page 81
aN eill
The A to Z of Bones, Joints & Ligaments
1
4
F
3
rA ma nd
2
©D
5
8
6
© A. L. Neill
7
81
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:51 PM Page 82
The A to Z of Bones, Joints & Ligaments
Frontal bones anterior / lateral / inferior
Frontal tuberosity -Frontal bossing Superciliary arch Supraorbital margin and notch Nasal spine Superior and inferior temporal lines Superior Orbital plate - pars orbitalis Frontal and Ethmoid air cells - Frontal sinus Posterior Ethmoidal foramen Anterior Ethmoidal foramen Zygomatic process Supra-Orbital notch or foramen Lacrimal fossa Metopic suture - frontal suture, Glabella Frontal squama Ethmoidal notch
rA ma nd
F
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
aN eill
Description - Unpaired largest and very robust anterior bone forming the forehead - horizontal section forming the roof of the orbit.
©D
Hammate see Carpus - disarticulated
82
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:51 PM Page 83
The A to Z of Bones, Joints & Ligaments
aN eill
14 1
2
13
3
F
4
rA ma nd
5
1
2
3
4
11
12
4 6
©D
10
9
© A. L. Neill
7 8
15
83
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:51 PM Page 84
The A to Z of Bones, Joints & Ligaments
HAND and WRIST bones overview
aN eill
dorsal Bones of the “Hand + Wrist ” = Carpals (C), Metacarpals (MCs) & Fingers (Phalanges - P) + Sesamoid bones encased in tendons = 27 bones (foot 26).
The MCs are shorter than the foot Metatarsals (MTs) and the fingers much longer, as the functional emphasis is for gripping and fine motor skills rather than weightbearing. Each finger has a proximal, middle and distal phalanx, except the thumb (Pollux), which only has 2.
distal ends of forearm bones carpus or wrist bones in 2 layers MCs phalanx / phalanges, P = finger bones Ulna, distal end Radius, distal end Scaphoid (part of os carpus/wrist) 1st MC proximal P of thumb (pollux) distal P of thumb middle P of 2nd finger (index finger) distal P of index finger distal P of 3rd finger (middle finger) distal P of 4th finger (ring finger)
rA ma nd
1 2 3 4 5 6 7 8 9 10 11 12 13 14
©D
H
84
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:52 PM Page 85
13 14
aN eill
The A to Z of Bones, Joints & Ligaments
12
11
4
rA ma nd
10
H
9
3
8
©D
2
7
1
© A. L. Neill
6 5 85
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:52 PM Page 86
The A to Z of Bones, Joints & Ligaments
HAND (and WRIST) bones overview
aN eill
palmar Bones of the “Hand + Wrist ” = Carpals (C), Metacarpals (MCs) & Fingers (Phalanges - P) + Sesamoid bones encased in tendons = 27 bones (foot 26).
The MCs are shorter than the foot Metatarsals (MTs) and the fingers much longer, as the functional emphasis is for gripping and fine motor skills rather than weightbearing. Each finger has a proximal, middle and distal phalanx, except the thumb (Pollux), which only has 2.
distal ends of forearm bones carpus or wrist bones in 2 layers MCs phalanx / phalanges, P = finger bones Ulna, distal end Radius, distal end Scaphoid (part of os carpus/wrist) 1st MC proximal P of thumb (pollux) distal P of thumb middle P of 2nd finger (index finger) distal P of index finger distal P of 3rd finger (middle finger) distal P of 4th finger (ring finger)
rA ma nd
1 2 3 4 5 6 7 8 9 10 11 12 13 14
©D
H
86
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:52 PM Page 87
The A to Z of Bones, Joints & Ligaments
12
aN eill
13 14
11
10
9
rA ma nd
4
H
7
3
8
©D
2
7
1
6
© A. L. Neill
5
87
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:52 PM Page 88
The A to Z of Bones, Joints & Ligaments
dorsal / palmar
Articulations: main levels forearm with wrist wrist with hand hand with fingers sublevel within the wrist along the fingers Special thumb/pollux only has features 2 phalanges proximal & distal all other fingers have 3 (middle)
radiocarpal / radioulnar C-MC MC- P
IC IP MC-P jt in the thumb = saddle jt - hence additional mobility
rA ma nd
H
aN eill
Hand - Intercarpal joints = IC joints b/n the wrist and the fingers
BS anterior interosseus C & MC branches of radial & ulnar art. and deep palmar arch rich aa NS ant post interosseus Ns (C6-8) A
sliding and gliding to allow increased wrist range of movement, radial and ulna deviation
©D
1 palmar C-MC ligs 2 radial collat ligs 3 palmer radiate C lig 4 proximal IC lig 5* pisiohamate lig 6* pisio-MC lig 7 distal dorsal IC ligs 8 radial collat ligs 9 dorsal radiate ligs 10 dorsal C-MC ligs * Bifurcate ligament
88
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:52 PM Page 89
aN eill
The A to Z of Bones, Joints & Ligaments
1
6
H
rA ma nd
2
5
4
3
7
©D
10
8
9
© A. L. Neill
4
89
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:52 PM Page 90
The A to Z of Bones, Joints & Ligaments
dorsal / palmar Articulations: main levels forearm with wrist wrist with hand hand with fingers sublevel within the wrist along the fingers Special thumb/pollux only has features 2 phalanges proximal & distal all other fingers have 3 (middle)
radiocarpal / radioulnar C-MC MC- P
IC IP MC-P jt in the thumb = saddle jt - hence additional mobility
rA ma nd
H
aN eill
HAND JOINTS - Carpo-metacarpaI and Intercarpal joints = C-MC IC joints b/n the forearm and the fingers
BS anterior interosseus, carpal and metacarpal branches of radial and ulnar arteries and deep palmar arch rich aa NS ant & post interosseus Ns (C6-8) A
sliding and gliding to allow for the fingers and thumb to increase range of movements interosseous MC lig dorsal lig of the thumb lateral lig of the thumb dorsal C-MC lig dorsal MC-MC ligs (inter MC) palmar MC-MC lig (interMC) palmar lig of the thumb palmar C-MC ligs
©D
1 2 3 4 5 6 7 8
90
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:52 PM Page 91
aN eill
The A to Z of Bones, Joints & Ligaments
1
5
H
rA ma nd
2
3
4
6
7
©D
1
© A. L. Neill
3 8
91
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:52 PM Page 92
The A to Z of Bones, Joints & Ligaments
Hip bone = Innominate bone (unnamed bone) = Os Coxae
aN eill
lateral
(Hip bone - unnamed because it does not resemble anything)
Articulations/Special features - see Pelvic Girdle
rA ma nd
ASIS = anterior superior iliac spine Iliac fossa Iliac crest Iliac tuberosity PSIS = posterior superior iliac spine Auricular surface / articular surface of Ilium with sacrum PIIS = posterior inferior iliac spine greater sciatic notch (enclosed with a ligament in life) ischial spine lesser sciatic notch ischial body ischial tuberosity ischiopubic junction ischiopubic ramus pubic symphysis pubic crest pubic tubercle superior ramus of Pubis iliopubic eminence AIIS = anterior inferior iliac spine
©D
H
1 2 3 4 5 6 7 8 9 10 11 12 13 13A 14 15 16 17 18 19
92
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:53 PM Page 93
1
3,4
2
rA ma nd
19
aN eill
The A to Z of Bones, Joints & Ligaments
5
H
6
18
7
17
16
8 10 9 12
15
©D
14
© A. L. Neill
13
11
13A
93
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:53 PM Page 94
The A to Z of Bones, Joints & Ligaments
Hip bone = Innominate bone (unnamed bone) = Os Coxae
aN eill
sagittal plane - (looking into the joint through the fumer) (Hip bone - unnamed because it does not resemble anything)
made up of 3 bones ILIUM, ISCHIUM, PUBIS which meet in the Acetabulum -lunate surface
©D
rA ma nd
H
1 ASIS = anterior superior iliac spine 2 iliac fossa 3, 4 iliac crest, iliac tuberosity 5 PSIS = posterior superior iliac spine 7 PIIS = posterior inferior iliac spine 8 greater sciatic notch (+ lig - greater sciatic foramen) 9 ischial spine 10 lesser sciatic notch (+ lig lesser sciatic foramen) 11 ischial body 12 ischial tuberosity 13/13A ischiopubic junction / ramus 15 pubic crest 18 iliopubic eminence 19 AIIS = anterior inferior iliac spine 20 post. gluteal line / superior gluteal line 21 ant. gluteal line 22 inf. gluteal line 23 Rim of Acetabulum n 24 Obturator groove 25 Obturator foramen
94
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:53 PM Page 95
aN eill
The A to Z of Bones, Joints & Ligaments
3,4 5
21
1
22
H
19
rA ma nd
20
23
7
18 15
8
9
10
11
©D
12
© A. L. Neill
13A
13 25
24
95
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:53 PM Page 96
The A to Z of Bones, Joints & Ligaments
Hip joint
aN eill
anterior / posterior BS articular branches of: obturator, medial circumflex femoral, superior and inferior gluteal arteries NS gluteal, obturator Ns (L2-4)
1 2 3 4 5 6
iliofemoral lig pubofemoral lig medial band of iliofemoral lig central band of iliofemoral lig lateral band of iliofemoral lig ischiofemoral lig
©D
H
flexion / extension, adduction / abduction / circumduction, rotation
rA ma nd
A
96
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:53 PM Page 97
aN eill
The A to Z of Bones, Joints & Ligaments
1
2
5
H
rA ma nd
4
3
©D
5
© A. L. Neill
6
97
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:53 PM Page 98
The A to Z of Bones, Joints & Ligaments
Hip joint
aN eill
sagittal plane - (looking into the joint from inside of the pelvis) BS articular branches of: obturator, medial circumflex femoral, superior and inferior gluteal arteries NS gluteal, obturator Ns (L2-4)
1 2 3 4 5 6 7 8 9 10
iliofemoral lig pubofemoral lig ischeal ramus pubic ramus femur acetebulum-edge ligament of femoral head ischeal spine transverse ligament head of femur in acetabulum-cavity
©D
H
flexion / extension, adduction / abduction / circumduction, rotation
rA ma nd
A
98
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:53 PM Page 99
10
aN eill
The A to Z of Bones, Joints & Ligaments
6
rA ma nd
8
H
7
3
4
©D
1
© A. L. Neill
9
5
99
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:53 PM Page 100
The A to Z of Bones, Joints & Ligaments
Humerus = ARM bone (upper arm bone) anterior / posterior Articulations proximal/upper end arm with scapula distal/lower end elbow Special ossifies from 8 features centres
head of Humerus / epiphysis anatomical neck surgical neck medial lip of intertubercular sulcus shaft of Humerus / diaphysis and nutrient foramen medial supracondylar ridge coronoid fossa medial epicondyle trochlea capitulum lateral epicondyle radial fossa lateral supracondylar ridge deltoid tuberosity lesser tubercle greater tubercle sulcus for radial N olecranon fossa
©D
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
glenohumeral joint = shoulder joint elbow = humerus + ulna + radius shaft, head, 2 tubercles, capitulum, trochlea, 2 epicondyles
rA ma nd
H
aN eill
(Humerus = largest bone in the upper limb)
100
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:53 PM Page 101
aN eill
The A to Z of Bones, Joints & Ligaments
1
16 15
16
1
2
2 4 3
rA ma nd
4
3
14
5
13
12
7 18 8 9
6
14
17
13 9 11
©D
11
6
H
10
© A. L. Neill
101
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:53 PM Page 102
The A to Z of Bones, Joints & Ligaments
Hyoid
Articulations: nil Special of interest in Forensic investigation rarely features broken unless specific pressure on this bone because of its site, acts to shape the jawline by supporting and bending the strap muscles body of hyoid greater horn (cornu) lesser horn (cornu) MUSCLE ATTACHMENTS 4 Genioglossus 5 Geniohyoid 6 Middle Phayngeal Constrictor 7 Hypoglossus 8 Stylohyoid 9 Thyrohyoid 10 Omohyoid 11 Sternohyoid 12 Mylohyoid
rA ma nd
1 2 3
©D
H
aN eill
Description - Small U-shaped bone. Attached to the styloid processes via ligaments. This bone has no articulations -the only bone in the body - and is not normally broken in trauma, protected by the mandible / CHIN. It may be broken in hanging and strangulation.
Incus see Auditory Ossicles in the A to Z of the Head & Neck
Inferior Nasal Concha see Nasal bones and cavity
102
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:54 PM Page 103
aN eill
The A to Z of Bones, Joints & Ligaments
2
3
1
rA ma nd
1
H
2 3
6
©D
4
12
© A. L. Neill
7 8 9
11
5
10
103
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:54 PM Page 104
The A to Z of Bones, Joints & Ligaments
KNEE articulation anterior / posterior
aN eill
(the knee is the most unstable peripheral joint in the body)
BS genicular branches of the following: femoral, ant. tibial and peroneal NS obturator, femoral, tibial, common peroneal Ns
hinge joint - flexion/extension slight lateral and medial rotation for “locking” and “unlocking 1 2 3 4 5 6 7 8
K
Femur Patella Tibia Fibula Tibial tuberosity styloid process of Fibula soleal line lateral condyle of Femur
rA ma nd
A
KNEE cap = Patella
©D
anterior / posterior 7 1 base 2 apex 3 femur articulation in flexion 4 femur articulation - lateral condyle 5 femur articulation in extension 6 area for infra-patella fat pad 7 femur articulation - medial condyle
104
1
2
5 4
3 6
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:54 PM Page 105
1 9 2 7
4 3
rA ma nd
5
aN eill
The A to Z of Bones, Joints & Ligaments
K
9
©D
7 6
© A. L. Neill
8
105
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:54 PM Page 106
The A to Z of Bones, Joints & Ligaments
KNEE JOINT (the knee is the most unstable peripheral joint in the body)
NS tibial, N (S1-2)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24
ant. cruciate lig post. meniscofemoral lig tibial collat lig medial meniscus tendon of semimembranosis oblique popliteal lig post. cruciate lig popliteal muscle arcuate lig fibular collat lig tendon of popliteal lateral meniscus suprapatellar bursa tendon of quadratus patella subcutaneous prepatella bursa infrapatella fat pad patella lig deep infrapatella bursa synovial cavity fibrous capsule transverse lig of the knee coronary lig ant ligs of the proximal tibiofibular joint
©D
K
hinge joint - flexion/extension slight lateral and medial rotation for “locking” and “unlocking”
rA ma nd
A
aN eill
BS genicular branches of the following: femoral, ant. tibial and peroneal
106
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:54 PM Page 107
The A to Z of Bones, Joints & Ligaments
aN eill
anterior flexed 22
7
1
23
rA ma nd
10
24
superior
1
K
4
3 22
12
4
10
©D
3
© A. L. Neill
2
7 5
107
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:54 PM Page 108
The A to Z of Bones, Joints & Ligaments
KNEE JOINT posterior / lateral
aN eill
(the knee is the most unstable peripheral joint in the body genu = knee)
BS genicular branches of the following: femoral, ant. tibial and peroneal NS tibial, Ns (S1-2) A
rA ma nd
intra-articular MENISCI, CRUCIATE LIGAMENTS, structures 1 ant. cruciate lig 2 post. meniscofemoral lig 3 tibial collat lig 4 medial meniscus 5 tendon of semimembranosis 6 oblique popliteal lig 7 post. cruciate lig 8 popliteal muscle 9 arcuate lig 10 fibular collat lig 11 tendon of popliteal 12 lateral meniscus 13 suprapatellar bursa 14 tendon of quadratus 15 patella 16 subcutaneous prepatella bursa 17 infrapatella fat pad 18 patella lig 19 deep infrapatella bursa 20 synovial cavity 21 fibrous capsule
©D
K
hinge joint - flexion/extension slight lateral and medial rotation for “locking” and “unlocking”
108
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:54 PM Page 109
1 12 11
rA ma nd
10
aN eill
The A to Z of Bones, Joints & Ligaments
2
3
4
5
8
K
6
9
7
13 14 15
1
16
©D
21
17
7
20
© A. L. Neill
18 19
109
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:54 PM Page 110
The A to Z of Bones, Joints & Ligaments
Larynx
L
5 6 7 8 9 10 11 12
Hyoid bone Epiglottis Thyroid membrane Thyroid cartilage Thyroid cartilage - superior horn - inferior horn Medial cricothyroid ligament Cricoid cartilage Arytenoid cartilages Tracheal “rings” Corniculate cartilages Attachment for Transverse Arytenoid Muscular process (for arytneoids) Attachment for vocal cords
rA ma nd
1 2 3 4 4A/B
aN eill
Cartilages articulated and disarticulated
©D
11
110
7
8
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:55 PM Page 111
aN eill
The A to Z of Bones, Joints & Ligaments
1
4A
rA ma nd
2
4
4B
3
L
4
4B
7
6
10
2
12
©D
4A
© A. L. Neill
4B
6
111
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:55 PM Page 112
The A to Z of Bones, Joints & Ligaments
Mandible = JAW lateral / posterior
aN eill
(Mandible - lower jaw bone joins the skull via the condyles and a cartilaginous articular plate in the Temporal fossa. Primary function - mastication, houses all the bottom teeth).
Articulations with the Temporal TMJ = temporofossa - this shallow mandibular joint fossa makes it easy to dislocate this joint
rA ma nd
mandibular notch pterygoid fovea head of Mandible - condylar process neck of Mandible post. border of ramus of Mandible ramus - vertical ramus angle of mandible oblique line inferior border body - horizontal ramus base mental foramen mental tubercle - Gnathion mental protuberance alveolar bone surrounding teeth anterior border of ramus coronoid process - endocoronial ridge mandibular foramen lingula superior and inferior mental spines digastric fossa mylohyoid line mylohyoid groove
©D
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
112
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:55 PM Page 113
The A to Z of Bones, Joints & Ligaments
1
2
aN eill
3
17
4
5
16
6
15
7
14
11
rA ma nd
13
10
5
12
8
9
M 18
21
22
20
©D
23
19
changes in the mandible from child <1yo to adult
© A. L. Neill
113
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:55 PM Page 114
The A to Z of Bones, Joints & Ligaments
Manubriosternum = BREAST BONE
aN eill
(Combination of 3 bones = Manubrium + Sternum + Xiphoid)
xiphisternal
Manubrium clavicular notch notch for 1st costal cartilage (rib) notch for 2nd costal cartilage (cartilaginous part of the rib) sternal angle / manubriosternal joint - fibrous notch for 3rd costal cartilage notch for 4th costal cartilage notch for 5th costal cartilage notch for 6th costal cartilage notch for 7th costal cartilage xiphoid process Xiphisternal joint Sternum Jugular notch
©D
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14
manubriosternal costomanubrial manubrioclavicular costosternal
rA ma nd
Articulations Manubrium + Sternum Manubrium + 1st rib; 2nd rib Manubrium + Clavicle Sternum with all costal cartilages except the 1st Xiphoid with Sternum Xiphoid with 7th rib Special 6 ossification centres features Xiphoid bone bizarre patterns of ossification
114
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:55 PM Page 115
2
aN eill
The A to Z of Bones, Joints & Ligaments
1
3
3
14
2
rA ma nd
4
5
M
6
13
7
8
©D
9
© A. L. Neill
12
10
11
115
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:55 PM Page 116
The A to Z of Bones, Joints & Ligaments
Maxilla / Maxillae Bones anterior / lateral / medial
premaxillary suture is here - fuses with completed jaw growth
Incisive canal supported by the canine jugun Greater Palatine canal - groove articulating surface – with Palatine bones maxillary hiatus continues with the sinus Nasal Lacrimal process alveolus -bone containing tooth root canine jugun inferior meatus
©D
19 20 21 22 23 24 25
frontal process medial orbital surface infra-orbital margin zygomatic process infra-orbital foramen nasal notch nasal crest anterior nasal spine alveolar bone around teeth tuberosity infra-temporal surface orbital surface palatine process ethmoid crest middle meatus conchal crest which tooth is this?
rA ma nd
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
aN eill
(The Maxillae are 2 paired bones which form the dominant portion of the face and hold the upper teeth. The “overgrowth” of the Maxilla is often the reason for orthodontic treatment.)
116
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:55 PM Page 117
The A to Z of Bones, Joints & Ligaments
1
aN eill
2
3
4
13
5
6 7
24
8
9
1
rA ma nd
12
3
11
4
5
M
6
7
8
24
9
1
22
©D
21
10 14
15 16 25 7
20
8 18 9
19
10
© A. L. Neill
17
23
13
24
117
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:55 PM Page 118
The A to Z of Bones, Joints & Ligaments
Metacarpals = HAND BONES Articulations
Special features
aN eill
(metacarpals = bones between the wrist and the fingers)
proximal - 2nd row of carpal bones (wrist bones) metacarpals either side distal - proximal end of the approp. proximal phalanx these are long bones
M
rA ma nd
View of the 1ST MC lateral / medial rounded articulation at the HEAD for the proximal phalanx of the THUMB indented facet at the BASE for TRAPEZIUM groove at the HEAD for tendons of FLEXOR POLLICUS BREVIS & LONGUS
©D
View of the 2ND MC lateral / medial rounded articulation at the HEAD for - proximal phalanx of the INDEX finger indented facet at the BASE for TRAPEZIUM + TRAPEZOID +CAPITATE lateral facets for articulations with 3rd MC
118
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:56 PM Page 119
lateral
rA ma nd
1
aN eill
The A to Z of Bones, Joints & Ligaments
Medial
M
©D
2
© A. L. Neill
119
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:56 PM Page 120
The A to Z of Bones, Joints & Ligaments
Metacarpals = HAND BONES Articulations
Special features
aN eill
(metacarpals = bones between the wrist and the fingers)
proximal - 2nd row of carpal bones (wrist bones) metacarpals either side distal - proximal end of the approp. proximal phalanx these are long bones
M
rA ma nd
View of the 3RD MC lateral / medial rounded articulation at the HEAD for proximal phalanx of the MIDDLE finger indented facet at the BASE for CAPITATE next to STYLOID process lateral facets for articulations with 2nd MC and 4th MC
View of the 4TH MC lateral / medial rounded articulation at the HEAD for proximal phalanx of the RING finger indented facet at the BASE for HAMATE lateral facets for articulations with 3rd MC and 5th MC
©D
View of the 5TH MC lateral / medial rounded articulation at the HEAD for proximal phalanx of the LITTLE finger indented facet at the BASE for HAMATE lateral facets for articulations with 4TH MC
120
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:56 PM Page 121
The A to Z of Bones, Joints & Ligaments
rA ma nd
3
Medial
aN eill
lateral
4
M
©D
5
© A. L. Neill
121
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:56 PM Page 122
The A to Z of Bones, Joints & Ligaments
Metatarsals = FOOT BONES (not ankle) disarticulated
aN eill
(metatarsals = bones between the ankle and the toes)
Articulations proximal - tarsal bones cuneiforms + cuboid lat/medial - adjacent metatarsals distal - proximal end of proximal phalanx Special these are long bones features
rA ma nd
View of the 1ST metatarsal lateral / medial rounded articulation at the HEAD for the proximal phalanx of the BIG TOE indented facet at the BASE for the MEDIAL CUNEIFORM lateral facet ± 2nd MT
M View of the 2ND metarsal
©D
lateral / medial rounded articulation at the HEAD for the proximal phalanx of the 2nd TOE indented facets at the BASE for the LATERAL & MEDIAL CUNEIFORMS lateral facet for 3rd MT
122
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:56 PM Page 123
rA ma nd
1
aN eill
The A to Z of Bones, Joints & Ligaments
M
©D
2
© A. L. Neill
123
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:56 PM Page 124
The A to Z of Bones, Joints & Ligaments
Metatarsals (MTs) = FOOT BONES disarticulated
aN eill
(metatarsals = bones between the ankle and the toes)
Articulations proximal - tarsal bones (ankle bones) metatarsals either side distal - proximal end of the appropriate proximal phalanx Special these are long bones features
M
rA ma nd
View of the 3RD metatarsal lateral / medial rounded articulation at the HEAD for the proximal phalanx of the MIDDLE TOE indented facets at the BASE for the LATERAL CUNEIFORMS lateral/medial facets for 2nd & 4th MT View of the 4TH metarsal lateral / medial rounded articulation at the HEAD for the proximal phalanx of the 4th TOE indented facets at the BASE for the LATERAL CUNEIFORMS & CUBOID lateral/medial facets for 3rd & 5th MT
©D
View of the 5TH metarsal lateral / medial rounded articulation at the HEAD for the proximal phalanx of the LITTLE TOE indented facets at the BASE for the CUBOID medial facet for 4th MT
124
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:56 PM Page 125
rA ma nd
3
aN eill
The A to Z of Bones, Joints & Ligaments
M
©D
4
5
© A. L. Neill
125
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:56 PM Page 126
The A to Z of Bones, Joints & Ligaments
Nasal Bones and Cavity = NOSE BONES external / internal / paired - posterior
aN eill
The NOSE consists of: - 2 small thin rectangular bones below the Glabella, the NASAL BONES; 2 lateral walls which house the 3 PAIRED TURBINATES or CONCHAE; the MEDIAL SEPTUM - made up of the VOMER and the ETHMOID bones and the many cartilages which determine the length and shape of the nose and nasal nares (nostrils). The cavity is surrounded by sinuses which open into it and superiorly by the Ethmoid plate allowing the OLFACTORY nerves to drop processes into the cavity.
Articulations
with Frontal superiorly with Lacrimal laterally with itself medially with Ethmoid inferiorly “articulates” with nasal cartilages anteriorly parts of the Ethmoid bone
All 2º fibrocartilagenous joints
frontal sinus Nasal spine of frontal bone articulation with frontal bone Nasal bone - external surface Nasal bone internal surface perpendicular plate of Ethmoid ant. nasal spine Maxilla articulation b/n Nasal bones and Maxilla Sphenoid bone - (pterygoid plates) Vomer Sphenoidal sinus Crista Galli foramen for Nasal vein notch for external nasal Nerve articulation with other Nasal bone Lacrimal bone Inferior concha and meatus Palantine bone - perpendicular plate and incisive fossa sphenopalantine meatus superior concha and meatus middle concha and meatus groove for Ethmoidal Ns articulation with lateral nasal cartilages
©D
N
1 2 2A 3 3A 4 5 6 6A 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
rA ma nd
SPECIAL BS in septum does FEATURES not extend to cartilage superior & middle nasal conchae inferior nasal 2 small snail like bones lying conchae on top of Palantine bones
126
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:56 PM Page 127
The A to Z of Bones, Joints & Ligaments
2 6A
2A
aN eill
2A
13
11
6A
12 1
3
1
10
3
rA ma nd
2
3A
21
9
3
9
4
N
15
8
5
7
6
1
19 19 18 18
1
9
©D
3A
14 6
15
7 17
16
© A. L. Neill
127
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:57 PM Page 128
The A to Z of Bones, Joints & Ligaments
distal / proximal
aN eill
Navicular = part of Os Tarsus / bones of the foot Articulations with all the cuneiforms distally with Talus proximally
©D
N
tuberosity facet for medial cuniform facet for intermediate cuniform facet for lateral cuniform facet for head of Talus
rA ma nd
1 2 3 4 5
128
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:57 PM Page 129
aN eill
The A to Z of Bones, Joints & Ligaments
4
1
©D
rA ma nd
2
© A. L. Neill
3
N
1
5
129
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:57 PM Page 130
The A to Z of Bones, Joints & Ligaments
Occipital bone
aN eill
external / internal Articulations with Sphenoid anteriorly with VC inferiorly with C1, C2 laterally Special large bowl like bone with a features hole at the infero-posterior portion of the skull
rA ma nd
superior angle highest nuchal line superior nuchal line inferior nuchal line Mastoid margin jugular process condylar fossa Occipital condyle foramen magnum hypoglossal canal condylar canal lateral surface lateral angle Occipital crest (external) squamous surface Occipital protuberance (internal) lamboid margin groove for superior sagittal sinus posterior cerebral fossa / occipital fossa groove for transverse sinus attachment for Tentorium Cerebelli groove for sigmoid sinus jugluar notch jugular tubercle attachments for Falx Cerebri opisthion basion Occipital sulcus - sagittal sinus
©D
O
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
130
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:57 PM Page 131
The A to Z of Bones, Joints & Ligaments
1
17
aN eill
2
16
3
15 14
4
13
5
12
rA ma nd
6
11
10
9
25
28
7 8 18 19
17
16 14 13
©D
12
21 5 22 23
11
27
24
26
© A. L. Neill
O
20
9
10
131
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:57 PM Page 132
The A to Z of Bones, Joints & Ligaments
Palatine bones (Left)
aN eill
lateral / medial / anterior / posterior Articulations mainly with the 2o upper jaw (Maxilla) fibrocartilagenous and the Sphenoid joints Special L-shaped bones features forms the floor of the Nasal cavity
P
perpendicular plate - vertical plate Palato-Maxillary suture Maxilla Orbital process Spheno-Papalatine notch Sphenoidal process Pterygo-Palatine canal horizontal plane
rA ma nd
1 2 3 4 5 6 6A 7
©D
inferior
132
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:57 PM Page 133
The A to Z of Bones, Joints & Ligaments
rA ma nd
aN eill
1
1
5
4
©D
6
1
3 2
P
5
1
6
6A
7
© A. L. Neill
8
2
7
133
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:57 PM Page 134
The A to Z of Bones, Joints & Ligaments
Parietal bone (Left)
aN eill
external / internal Articulations with the Frontal - anterior with the Temporal - inferiorly with the Occipital - posteriorly with itself medially Special large square bone - largest of features the cranial vault - even thickness all 4 corners made up the basis of the fontanelles in the infant
superior temporal line parietal eminence articulation with the Occipital bone (Lambdoid suture) articulation with the Temporal bone (Mastoid)
rA ma nd
1 2 3 4
All 2o fibrocartilagenous joints
Parieto-Mastoid suture
5
articulation with the Temporal (Squamous) Temporo-Parietal suture
6
articulation with the Sphenoid (Greater wing) Spheno-Parietal suture
P
articulation with the Frontal bone Coronal suture inferior Temporal line articulation between Parietal bones Sagittal suture frontal angle sphenoidal angle groove for frontal branch of Middle Meningeal vessels groove for parietal branch of Middle Meningeal vessels mastoid angle groove for sigmoid sinus occipital angle groove for superior sagittal sinus
©D
7 8 9 10 11 12 13 14 15 16 17
Patella = KNEE CAP see Knee articulation
134
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:57 PM Page 135
The A to Z of Bones, Joints & Ligaments
1
aN eill
9
8
2
7
rA ma nd
3
6
5
4
17
10
P
16
©D
15
11
14
© A. L. Neill
13
12
135
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:58 PM Page 136
The A to Z of Bones, Joints & Ligaments
PECTORAL GIRDLE = SHOULDERS
aN eill
anterior / superior / posterior SPECIAL FEATURES to support the upper limb to act as accessory structure in respiration
rA ma nd
first rib Clavicle Acromion of Scapula Humerus glenoid fossa of Scapula coracoid process of Scapula Manubrium (part of the Manubriosternum) Sternum (part of the Manubriosternum) Xphisternum vertebral body of T12 rib 11 rib 12 spine of Scapula medial border of Scapula transverse processes spine of vertebrae
©D
P
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
136
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:58 PM Page 137
The A to Z of Bones, Joints & Ligaments
7
2
aN eill
1
6 5 8
rA ma nd
9
12
3
10
16
1
P
7
4
©D
13
14
15
© A. L. Neill
137
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:58 PM Page 138
The A to Z of Bones, Joints & Ligaments
anterior Articulations Pubis to Pubis defining the mid-Sagittal plane
Pubic symphysis 2ocartilagenous
hip” joint synovial / diarthrosis ball and socket Ilium with Sacrum Iliosacral joint synarthrosis Sacrum with VB of L5 lumbosacral 2o cartilagenous fused segments of the Sacrum Intrasacral joints synarthroses partial fusion with fibrous inserts “vestigial discs”
rA ma nd
Femur with Acetabulum
aN eill
Pelvic Girdle articulations Articulariae Coxea
Sacrum with Coccyx may completely fuse later in life
Sacrococcygeal 2o cartilagenous synarthrosis
Special features
P
3 component bones of the HIP bone = PUBIS/pubic bone + ILIUM + ISCHIUM with separate ossification centres completely fuse in adolescence - ceases to be a “joint” highly modified for bipedal walking and increased weight bearing
©D
hip+sacrum+hip = pelvic girdle (PG) 1 2 3 4 5 6
138
Acetabulum intersection of the 3 component bones on the Lunate surface
ligaments extremely strong and designed to prevent forward pitch
PG longer wider
> <
intervertebral disc L5/S1 Iliosacral joint Femoro-acetabular joint - “hip”jt Pubic symphysis ala of the Ilium ala of the Sacrum © A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:58 PM Page 139
aN eill
The A to Z of Bones, Joints & Ligaments
1
2
rA ma nd
5
3
P
©D
4
© A. L. Neill
139
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:58 PM Page 140
The A to Z of Bones, Joints & Ligaments
PELVIC GIRDLE = HIPS antero-superior
aN eill
SPECIAL FEATURES to support the body weight to support the pelvic organs and contents to balance weight across the lower limbs
rA ma nd
©D
P
1 anterior longitudinal lig = ALL 2 iliolumbar lig superior band 3 iliolumbar lig inferior band 4 ant. sacroiliac lig 5 iliac fossa 6 iliac crest 7 greater sciatic foramen 8/8A spine of Ischium / Sacrospinal lig 9 lesser sciatic foramen 10 pectoneal lig = Cooper’s lig 11/11A tuberosity of Ischium / Sacrotuberous lig 12 superior pubic lig 13 interpubic disc 14 iliopectoneal eminence 15 ant inferior iliac spine = AIIS 16 ant superior iliac spine = ASIS 17 sacroiliac joint 18/18A base of Sacrum / sacral canal 19 inguinal lig 19A reflected inguinal lig (cut to demonstrate deeper lig) 20 aponeurosis of the external oblique muscle 21 lacuna lig 22 supf inguinal ring 22A/22B medial crus / lateral crus
140
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:58 PM Page 141
The A to Z of Bones, Joints & Ligaments
1
2
aN eill
3
1
4
rA ma nd
6
16
15
8 14 11
13 10 11A
12
18A
17
9
7 8A
18
P
©D
7
20
© A. L. Neill
22
19 22B
21 19A
22A
16
20
141
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:58 PM Page 142
The A to Z of Bones, Joints & Ligaments
PELVIC GIRDLE = HIPS posterior
aN eill
SPECIAL FEATURES to support the body weight to support the pelvic organs and contents to balance weight across the lower limbs
rA ma nd
©D
P
1 anterior longitudinal lig = ALL 2 iliolumbar lig superior band 3 iliolumbar lig inferior band 4 ant. sacroiliac lig 5 iliac fossa 6 iliac crest 7 greater sciatic foramen 8/8A spine of Ischium / Sacrospinal lig 9 lesser sciatic foramen 10 pectoneal lig = Cooper’s lig 11/11A tuberosity of Ischium / Sacrotuberous lig 12 superior pubic lig 13 interpubic disc 14 iliopectoneal eminence 15 ant inferior iliac spine = AIIS 16 ant superior iliac spine = ASIS 17 sacroiliac joint 18/18A base of Sacrum / sacral canal 19 inguinal lig 19A reflected inguinal lig (cut to demonstrate deeper lig) 20 aponeurosis of the external oblique muscle 21 lacuna lig 22 supf inguinal ring 22A/22B medial crus / lateral crus
142
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:58 PM Page 143
aN eill
The A to Z of Bones, Joints & Ligaments
6
rA ma nd
17
11
©D
2
© A. L. Neill
18A
18
16
3
P
7 15 8A 11A 11
143
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:58 PM Page 144
The A to Z of Bones, Joints & Ligaments
Pubic Symphysis = Pubic joint anterior BS internal pudendal
aN eill
(Pubic symphysis is a secondary fibrocartilagenous joint)
NS internal pudendal Ns perineal branch (S2-4)
nil - except under hormonal influence eg childbirth 1/1A 2 3 4 5 6 7 8 9
©D
P
inguinal lig / thickened central portion acetabular labrium pectineal lig transverse acetabular lig lacuna lig arcuate pubic lig interpubic disc of fibrocartilage superior pubic lig hyaline cartilage
rA ma nd
A
144
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:58 PM Page 145
rA ma nd
aN eill
The A to Z of Bones, Joints & Ligaments
1A
1
2
9 8
3
7
P
4
6
©D
5
© A. L. Neill
145
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:59 PM Page 146
The A to Z of Bones, Joints & Ligaments
anterior
aN eill
Radio-Ulnar joint proximal (below the elbow) distal (above the wrist) (pivot joint between the Ulna and the Radius allowing turning one bone over the other)
BS anastomosies around joint from brachial, profunda brachii, radial and ulna arteries NS radial and median Ns (C7-8) A
supination / pronation
1 2 3 4 5 6 7
annular lig oblique cord gap for the posterior interosseous vessels interosseous membrane gap for the posterior interosseous vessels styloid process sacciform recess of the capsule of distal radioulnar joint
©D
R
rA ma nd
Articulations superior is the elbow joint hinge joint inferior is the wrist joint
146
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:59 PM Page 147
1
2
rA ma nd
3
aN eill
The A to Z of Bones, Joints & Ligaments
4
5
7
R
©D
6
© A. L. Neill
147
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:59 PM Page 148
The A to Z of Bones, Joints & Ligaments
Radius
aN eill
anterior / posterior Articulations with Ulna proximally & distally with first row of carpal bones distally
scaphoid, lunate, triquetral
rA ma nd
head neck radial tuberosity shaft interosseous border ulnar notch styloid process dorsal tubercle posterior border grooves for the tendons crossing the Radius ext. digitorum ext. indicis ext. carpi radialis brevis ext. carpi radialis longus ext. pollicus brevis ext. pollicus longus
©D
R
1 2 3 4 5 6 7 8 9 a-f a b c d e f
mid radio-ulnar joint = interosseous
148
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:59 PM Page 149
aN eill
The A to Z of Bones, Joints & Ligaments
1
2
rA ma nd
3
4
9
5
©D
7
© A. L. Neill
8
R
6
a b c d e f
149
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:59 PM Page 150
The A to Z of Bones, Joints & Ligaments
Articulations superior Bones superior
T1 - RIB 1 T2 RIB 2 costovertebral joints demi-facets on head of Rib 2 b/n T1 and T2 crest in b/n single facet on head of Rib 1 for T1 4 spine of T1 + TP 5 costal tubercles 6 shafts 7A/7V groove for subclavian artery and N and vein 8 scalene tubercle 9 attachment of costovertebral lig 10 attachment of lig of Serratus Anterior
©D
R
rA ma nd
1/1A 2/2A 3 3A
aN eill
Ribs - atypical 1, 2
150
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:59 PM Page 151
aN eill
The A to Z of Bones, Joints & Ligaments
3
4
1
5
2
6
rA ma nd
1A
10
2A
5
3A
©D
6
© A. L. Neill
3A 3A
R 7A 8 7V 9
10
151
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:59 PM Page 152
The A to Z of Bones, Joints & Ligaments
Ribs - typical 3 -10
aN eill
inferior / posterior Articulations with VC -transverse process (TP) posteriolaterally with VB posteriorly synovial joints
head neck tubercle facet tubercle angle shaft / body costal groove costal end demi-facet for vertebra interarticular crest demi-facet for vertebra
©D
R
1 2 3 4 5 6 7 8 9 10 11
at the same level and above eg RIB 3 = T2/3 artic. with Sternum directly cartilaginous joints or through costal bone cartilage bone cartilage ridge each rib has a costal groove which protects the segmental BS & NS
rA ma nd
Special features
at the same level eg RIB 3 = T3 artic.
152
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:59 PM Page 153
2
4
aN eill
The A to Z of Bones, Joints & Ligaments
5
1
3
6
rA ma nd
7
8
1
2
11
4
©D
10 9
8
© A. L. Neill
5
R
3
6
7
153
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:59 PM Page 154
The A to Z of Bones, Joints & Ligaments
Sacroiliac joint (part of the Pelvic girdle)
aN eill
anterior / posterior BS anastomosies around joint: superior gluteal, iliolumbar and sacral arteries NS superior gluteal, sacral plexus (L4,5 S1)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
anterior longitudinal lig = ALL lubosacral lig iliolumbar lig ant. sacroiliac lig sacrospinous lig inguinal lig pectineal lig sacrotuberous lig ant. sacrococcygeal lig lateral sacrococygeal lig (ant. aspect) lumbosacral lig short dorsal sacroiliac lig long dorsal sacroiliac lig lateral sacrococygeal lig (post aspect) intercornu lig supf. dorsal sacrococygeal lig falciform process lesser sciatic foramen greater sciatic foramen superior pubic lig
©D
S
slight AP rotation
rA ma nd
A
154
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 25/05/09 1:59 PM Page 155
The A to Z of Bones, Joints & Ligaments
3 4
aN eill
anterior right 2
1
5
10
rA ma nd
9
6
8
7
20
3
11 12
19
5
13
S
©D
18
8
14
17
© A. L. Neill
16
15
posterior left 155
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:00 PM Page 156
The A to Z of Bones, Joints & Ligaments
Sacrum (+ Coccyx) = part of the PELVIC GIRDLE
superior articular process body ala articular surface fusion b/n 2 VB inferior lateral angle sacral canal hiatus sacral cornu dorsal sacral foramen lateral crest & tubercles lamina TP median sacral crest & spinous process(es) Coccyx Coccygeal Cornu
©D
S
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Iliosacral joint synarthrosis superiorly with VB of L5 lumbosacral 2o cartilagenous fusion of 5 sacral this may change and “vertebrae” deteriorate with age, disease or nutrition and contribute to lower back pathology
rA ma nd
Special features
aN eill
anterior / lateral / posterior Articulations laterally with Ilium
156
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:00 PM Page 157
The A to Z of Bones, Joints & Ligaments
1
aN eill
3 2 4 5 6
14
rA ma nd
3 11
10
4
4
13
6
9
8
14
15 1
S
3
©D
12
4
11
© A. L. Neill
9
10
7 13
8
15 14
157
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:00 PM Page 158
The A to Z of Bones, Joints & Ligaments
rA ma nd
anterior / posterior / lateral 1 superior angle 2 medial edge 3 superior border 4 suprascapula notch 5 acromion 6 coracoid process 7 glenoid fossa 8 subscapula fossa 9 lateral axillary border 10 inferior angle 11 body 12 acromial angle 13 infraspinous fossa 14 supraspinous fossa 15 spinoglenoid notch 16 spine of scapula
aN eill
Scapula = part of the PECTORAL GIRDLE
©D
S
Scaphoid see Carpus disarticulated
158
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:00 PM Page 159
aN eill
The A to Z of Bones, Joints & Ligaments
3
6
5
1
5
6
16
7
7
13
8
9
rA ma nd
2
9
10
10
12
6
5
4
8
3
1
14
15
S
16
©D
13
9
© A. L. Neill
10
159
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:00 PM Page 160
The A to Z of Bones, Joints & Ligaments
SHOULDER JOINT = Glenohumeral joint
aN eill
(Articulation b/n the Glenoid fossa of the Sacpula and the head of the Humerus - Ball and Socket joint of ill fitting boney surfaces great mobility inferior instability)
BS posterior circumflex, humeral and suprascapular arteries
NS posterior cord of the Brachial Plexus suprascapular, axillary & lateral pectoral Ns (C5-6)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
superior glenohumeral lig middle glenohumeral lig inferior glenohumeral lig Latissimus Dorsi tendon of long head of Biceps Pectoralis Major (cut) transverse lig of Humerus coracohumeral lig Supraspinatus tendon articular capsule Subscapularis bursa edge of the articular capsule glenoid labrium glenoid cavity Subscapularis tendon
©D
S
flexion/extension, abduction/adduction, lateral/medial rotation, circumduction
rA ma nd
A
160
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:00 PM Page 161
aN eill
The A to Z of Bones, Joints & Ligaments
1
8
2
7
3
rA ma nd
6 5
4
15
5
1 9 10
S
©D
14
11
13
2
12
© A. L. Neill
3
161
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:00 PM Page 162
The A to Z of Bones, Joints & Ligaments
Skull External Views
rA ma nd
Frontal bone Fronto-Nasal suture Inter-Nasal suture Nasal bone, Lacrimal bone Supra-Orbital foramen Spheno-Parietal suture Spheno-Frontal suture Spheno-Squamosal suture Zygoma Zygomatico-Maxillary suture Infra-orbital foramen Middle Nasal concha - turbinate (from Ethmoid bone) Inferior nasal concha - turbinate (from Ethmoid bone) Vomer Mandible Mental foramen Inter-Maxllary suture Maxilla Ethmoid bone (Orbital plate) Inferior Orbital fissure Temporo-Zygomatic suture Superior Orbital suture Fronto-Zygomatic suture Greater wing of the Sphenoid Coronal suture - Fronto-Parietal suture Lesser wing of the Sphenoid Optic foramen
©D
S
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27
aN eill
anterior
162
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:00 PM Page 163
27
aN eill
The A to Z of Bones, Joints & Ligaments
1
2
3
26
4
25
5
6
rA ma nd
24 23
7
22
8
21
9
20
10
19
11
18
S 12
©D
17
16
© A. L. Neill
15
14
13
163
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:00 PM Page 164
The A to Z of Bones, Joints & Ligaments
Skull External Views
©D
S
rA ma nd
aN eill
inferior base of skull 1 Incisive fossa - Alveolare 2 Medial Pterygoid plate and Hamulus (Ethmoid) 3 Posterior Nasal aperture 4 Pterygoid plate (ethmoid) 5 Lateral Pterygoid plate (Ethmoid) 6 Zygomatic arch 7 Mandibular fossa 8 External Auditory meatus 9 Styloid process 10 Mastoid process 11 Parieto-Mastoid suture 12 Occipito-Mastoid suture 13 Foramen magnum 14 External Occipital proturberance 15 Sagittal suture - Parieto-Parieto suture 16 Lambda 17 Lambda suture 18 Superior nuchal line (Occipital) 19 Inferior nuchal line (Occipital) 20 Occipital condyle 21 Jugular foramen (fossa) 22 Stylo-Mastoid foramen 23 Carotid foramen - Carotid canal 24 Foramen spinosum 25 Foramen lacerum - Basilar suture 26 Greater Palatine foramen 27 Horizontal plate of Palatine 28 Palatine process of the Maxilla
164
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:01 PM Page 165
aN eill
The A to Z of Bones, Joints & Ligaments
1
28
2
3
27
4
26
5
rA ma nd
25
6
24
7 8
23
22
9
21
10 11
20
12
19
13
18
16
15
14
©D
17
S
© A. L. Neill
165
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:01 PM Page 166
The A to Z of Bones, Joints & Ligaments
Skull External Views
©D
S
rA ma nd
aN eill
lateral 1 Frontal bone - Temporal ridges for attachment of Temporalis 2 Parietal bone 3 Occipital bone - Occipitum 4 external auditory meatus (Porion - upper margin) 5 Temporal bone 5A mastoid process (Temporal bone) 5B styloid process (Temporal bone) 5C zygomatic arch (Temporal bone) 6 medial pterygoid plate (Sphenoid) 7 Mandible 8 body of the Mandible 9 Maxilla 10 Zygoma 11 Nasal bone 12 Lacrimal bone 13 Ethmoid 14 Frontal bone 15 greater wing of the Sphenoid
166
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:01 PM Page 167
1 2
aN eill
The A to Z of Bones, Joints & Ligaments
14
rA ma nd
13
12 11 10
3
4
9
5
7
8
S
©D
6
© A. L. Neill
167
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:01 PM Page 168
The A to Z of Bones, Joints & Ligaments
Skull External Views
rA ma nd
aN eill
posterior 1 sagittal suture 2 Parietal foramen 3 lambda Pareito-Occipital suture 4 Occipital bone 5 lambdoid suture 6 inf. nuchal groove 7 Occiptal bone 7A external Occitipal protruberance 8 superior nuchal groove 9 sutural bones - Inca 10 Parietal bone
Skull External Views
©D
S
superior 3 lambda 5 lambdoid suture - Occipito-Parieto suture 7 Occipital bone 10 Parietal bone 11 Parietal eminence - Euryon 12 Frontal bone 13 Bregma 14 coronal suture
168
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:01 PM Page 169
The A to Z of Bones, Joints & Ligaments
1
aN eill
10
2
3
4
5
rA ma nd
9 8
7
6
7A
7
3
5
1
11
S
©D
10
14
© A. L. Neill
13
12 169
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:01 PM Page 170
The A to Z of Bones, Joints & Ligaments
Skull Internal Views
©D
S
rA ma nd
aN eill
inferior Skull cap 1 Lambda 2 Lambdoid suture 3 Parietal foramen 4 Diploe 5 Bregma 6 Coronal suture 7 Frontal crest 8 Frontal bone 9 Depressions for arachnoid granulations 10 Grooves for middle meningeal vessels 11 Parietal bone 12 Sagittal suture 13 Groove for superior sagittal sinus 14 Occipital bone
170
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:01 PM Page 171
14
aN eill
The A to Z of Bones, Joints & Ligaments
1
2
13
3
12
10
rA ma nd
11
4
5
6
S
9
©D
8
© A. L. Neill
7
171
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:01 PM Page 172
The A to Z of Bones, Joints & Ligaments
Skull Internal Views
©D
S
rA ma nd
aN eill
Lateral -looking out to the sides of the skull from the inside 1 groove for the middle meningeal artery 2 Frontal sinus 3 superior nasal concha 4 middle nasal concha 5 inferior nasal concha 6 hard palate 7 mandible 8 lateral pterygoid plate 9 medial pterygoid plate 10 styloid process 11 mastoid process 12 sphenoid sinus
172
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:01 PM Page 173
1
3 4 5
rA ma nd
2
aN eill
The A to Z of Bones, Joints & Ligaments
6
12 11
10
9
©D
8
© A. L. Neill
S
7
173
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:01 PM Page 174
The A to Z of Bones, Joints & Ligaments
Skull Internal Views
POSTERIOR FOSSA MIDDLE FOSSA ANTERIOR FOSSA
©D
S
A B C
rA ma nd
aN eill
superior internal base - cranial fossae 1 Cribiform plate 2 Frontal sinus 3 Crista Galli 4 Orbital plate of Frontal bone 5 Jugum of Sphenoid 6 Optic canal 7 Lesser wing of the Sphenoid bone 8 Anterior Clinoid process 9 Foramen rotundum 10 Foramen lacerum 11 Foramen ovale 12 Foramen spinosum 13 Dorsum sellae 14 Internal acoustic meatus 15 Jugular foramen 16 Foramen magnum
174
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:02 PM Page 175
1
aN eill
The A to Z of Bones, Joints & Ligaments
2
3
4
5
6
C
©D
B
rA ma nd
7
© A. L. Neill
8 9 10 11 12 13 14 15
S
16
A
175
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:02 PM Page 176
The A to Z of Bones, Joints & Ligaments
Skull Internal Views Sinus Overview
©D
S
Cranial Vault ethmoid air cells of Frontal bone and Maxilla Maxillary sinus nasal cavity boney palate inferior meatus 6A inferior concha middle meatus 7A middle concha superior meatus 8A superior concha orbit
rA ma nd
1 2 3 4 5 6 7 8 9
aN eill
Coronal
176
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:02 PM Page 177
aN eill
The A to Z of Bones, Joints & Ligaments
1
8
rA ma nd
9
8A 7 7A 6
2 2 3 4 5
S
©D
6A
2
© A. L. Neill
177
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:02 PM Page 178
The A to Z of Bones, Joints & Ligaments
Sphenoid anterior / posterior / schema - developement
rA ma nd
articulation with L Temporal bone orbital surface infratemporal crest body of the Sphenoid openings for sphenoidal sinuses lesser wing (come accross and meet to form jugum) squamosal suture - articulation with R Temporal bone superior orbital fissure foramen rotundum pterygoid canal rostrum vaginal process medial pterygoid plate pterygoid hamulus pterygoid notch lateral pterygoid plate pterygoid process sphenoid spine greater wing cerebral surface of the greater wing anterior clinoid process posterior clinoid process dorsum sellae articulation with occiput
©D
S
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 19A 20 21 22 23
aN eill
A single wedge-shaped bone consisting of four parts: the central body; the lateral greater wings, the medial lesser wings and the lower ptergoid plates. The bone looks like a bat in flight and is the centre piece of the skull.
178
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:02 PM Page 179
The A to Z of Bones, Joints & Ligaments
3 4
6
aN eill
1 2
5
7
8
18
9 10
17
11 12
16
13
15
rA ma nd
14
19A
6
20 21
22
23 8
19
9 7
18
10 12
16
15
13
14
©D
11
4
8
6
S 19A 19 9
17 15
© A. L. Neill
179
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:02 PM Page 180
The A to Z of Bones, Joints & Ligaments
anterior
aN eill
Sterno-Clavicular joints Sterno-Costal joints (joints b/n the Manubriosternum and the Clavicle = SYNOVIAL JOINTS and these joints have INTRA-ARTICULAR DISCs
joints b/n the Manubriosternum and RIBS 3-9 = planar SYNOVIAL JOINTS joints b/n Manubriosternum and RIBS 6-10 = 10 CARTILAGENOUS JOINTS - SYNCHONDROSIS - they have elasticity due to the cartilage but little to no actual mobility)
BS internal thoracic artery
A
elevation / depression, retraction / protraction, rotation 1 2 3 4 5 6 7 8 9 10 11 12 13
interclavicular lig fibrocartilage artic surface articular disc - the disc is inside the joint cavity costoclavicular lig double synovial joint cavity RIB 2 with intra-articular lig. sternocostal / manubriocostal joints manubriosternal symphysis (20 cartilagenous) ant. sternoclaviular lig costoclavicular lig sternocostal lig sternocostal joints (R3-9) PLANE synovial joints interchondral cavities (R6-10) synchondrosis interchondral ligs syndesmosis costochondral junction
©D
S
rA ma nd
NS ant supraclavicular & N to subclavius ant cutaneous branches of intercostal Ns (C8-T1-12)
180
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:02 PM Page 181
The A to Z of Bones, Joints & Ligaments
aN eill
1
2
8
7
3
rA ma nd
4
5
6
9
5 6
©D
13
© A. L. Neill
10
T
11 12
181
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:02 PM Page 182
The A to Z of Bones, Joints & Ligaments
anterior / posterior medial / lateral
aN eill
Talus = ANKLE BONE (Talus biggest of the Tarsal bones in the foot - irregular bone)
Articulations with Tibia superiomedially with Calcaneus inferiorly with Navicular anteriorly with Fibula laterally
rA ma nd
1 trochlea surface for Tibia facet for lateral Malleous neck groove for ant.lig of ankle artic surface for Navicular sulcus Tali lat. process post. calcaneal facet plantar surface facet for medial Malleous medial tubercle roughened surface for Deltoid lig groove for Hallucis longus medial tubercle ant. surface for Calcaneus middle calcaneal surface plantar calcaneonavicular lig
©D
T
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Tibiotalar joint Talocrural joint Subtalar joint Talofibular
182
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:02 PM Page 183
The A to Z of Bones, Joints & Ligaments
7
superior
2
12
aN eill
10
1
3
9
4 5 7
16
rA ma nd
inferior 5
14
lateral
6 12
1
2
3
4
15
5
6
©D
medial
© A. L. Neill
8
7
3
1
T
9
4 5 11
10
7 183
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:03 PM Page 184
The A to Z of Bones, Joints & Ligaments
Teeth Overview
Maxillary upper right quadrant - adult Maxillary upper left quadrant - adult Mandibular lower left quadrant - adult Mandibular lower right quarant - adult Maxillary upper right quadrant - child Maxillary upper left quadrant - child Mandibular lower left quadrant - child Mandibular lower right quarant - child
1 2 3 4 5 6 7 8
Central Incisor Lateral Incisor Canine First Pre-molar Second Pre-molar First Molar Second Molar Third Molar
A B C D E F
Palatal Buccal Mesial Distal Lingual Occlusal -
rA ma nd
1 2 3 4 5 6 7 8
upper tooth surface facing the inside of the mouth any tooth surface facing the cheek any tooth more anterior than the 1st molar all teeth behind the 1st molar lower tooth surface facing the tongue any tooth surface which abuts with another tooth-bite surface (shown surface) - any tooth surface facing the lips
©D
T
aN eill
There are many different methods used to name teeth, define their positions and dentitions and describe their surfaces. This overview shows the 1o & 2 o dentitions, describes their positions and tooth types using some of the better known methods. Teeth are labeled XY on the Left and Right - X is the quadrant of the teeth and dentition type - adult or child - Y is the tooth type (devised by the Federation Dentaire Internationale)
G Labial
184
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:03 PM Page 185
rA ma nd
aN eill
The A to Z of Bones, Joints & Ligaments
T
©D
Teeth are labeled by letters and subscripts on the Right letters I = incisors 2o dention (adult) i = incisors 1o dentition (child) C = canine c = canine M = molar m = molar P = premolar Teeth are labeled using roman numerals in the smaller circle to demonstrate this method - (not commonly used) Each tooth has several surfaces and lies in different oral regions
© A. L. Neill
185
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:03 PM Page 186
The A to Z of Bones, Joints & Ligaments
Temporal bone (Left) external / inferior / internal
aN eill
Temporal = TIME. This bone shows 1st signs of aging - grey hair. It is involved in both the wall and the base of the Skull. Temporal bones contain the Auditory ossicles/ear bones & form the only synovial joint in the Skull - the TEMPOROMANDIBULAR jt with the Mandible
rA ma nd
©D
T
1 suprameatal triangle / ridge 2 groove for middle Temporal artery 3 parietal notch 4 squamo-Mastoid suture 5/5A mastoid area / mastoid process 5B mastoid notch = groove for Digastricus 5C mastoid foramen 6/6A sheath of styloid process / styloid process 7 external acoustic meatus i 8 squamo-tympanic fissure 9 mandibular fossa 10 zygomatic process - forming the zygomatic arch 11 postglenoid tubercle 12 squamous part - Squama 13 stylomastoid foramen 14 occipital groove 15/15A jugular surface / jugular fossa 16 canaliculus (opening) for Tympanic nerve 17 petrous part containing auditory ossicles 18 carotid canal 19 edge of tegmen tympani 20 groove for the middle meningeal vessels 21 groove for the superior Petrosal sinus 22 articulation with the greater wing of the Sphenoid Spheno-Temporal suture 23 groove for the middle meningeal vessels 24 internal acoustic meatus 25 articulates with the Occipital bone 26 groove for sigmoid sinus - sigmoid sulcus 27 arcuate eminence 28 articulates with the Parietal bone Temporoparietal suture
186
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:03 PM Page 187
The A to Z of Bones, Joints & Ligaments
1
2
12 11
aN eill
3
4
10
5
9
5A
8
6
7
10
18
rA ma nd
6A
8
19
9
17
16
6A
15A
13
15
5
14
26
12
28
5B
21
©D
27
22
T 10
26
23
5,6
24 6A
25
© A. L. Neill
187
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:03 PM Page 188
The A to Z of Bones, Joints & Ligaments
Temporo-Mandibular joint = TMJ
(only SYNOVIAL joint in the skull)
aN eill
closed - lateral open / medial (looking from inside the mouth) a cut through the sagittal plane (enlarged view)
BS superficial temporal & maxillary arteries
NS auriculotemporal & masseteric branches of mandibular branch of Trigeminal N (CN V3 )
1 2 3 4 5 6 7 8 9 10 11 12 13 14
fibrous capsule lat. TMJ lig stylomandibular lig Mandible ant. Temporal attachment of Meniscus ant. extension post. band lateral wall of the capsule bilaminar region sphenomandibular lig post. temporal attachment medial wall of the capsule intermediate zone ant. band of the capsule
©D
T
depression/elevation, protrusion/retraction, lateral movements
rA ma nd
A
188
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:43 PM Page 189
15
1
3
rA ma nd
2
aN eill
The A to Z of Bones, Joints & Ligaments
1
10
3
6
14
4
©D
13
12 6
T
5
11
12
© A. L. Neill
9
7 8 189
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:03 PM Page 190
The A to Z of Bones, Joints & Ligaments
Tibia
aN eill
anterior / posterior Articulations with Fibula laterally syndesmosis distally and proximally with Talus inferiorly synovial- condyloid
©D
T
interosseous border medial malleolus tibial tuberosity posterior border anterior border fibular notch articular facet for Fibula lateral condyle soleal line medial condyle attachment of iliotibial tract tubercles of intercondylar eminence medial surface
rA ma nd
1 2 3 4 5 6 7 8 9 10 11 12 13
190
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:03 PM Page 191
aN eill
The A to Z of Bones, Joints & Ligaments
12
10
8
8
7
3
rA ma nd
11
1
9
13 5
1
4
T
©D
2
© A. L. Neill
2
6
191
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:03 PM Page 192
The A to Z of Bones, Joints & Ligaments
Tibio-Fibula joints posterior
aN eill
(3 joints distal, proximal and along the shafts via the interosseous membrane)
BS proximal - ant tibial artery distal - ant & post tibial arteries
NS proximal - tibal N (S2-3) distal - deep peroneal and tibial Ns (L5 S1-3)
proximal - lateral at. rotation with dorsiflexion of foot distal - as above 1 2 3 4 5
rA ma nd
A
proximal post. Tibiofibula lig opening for ant tibial vessels interosseous membrane opening for peroneal artery distal post Tibiofibula lig
TOES = digits = Phalanges see foot bones overview Trapezium , Trapezoid / Triquetral bones = Carpal bones see Carpus disarticulated, also hand and wrist.
©D
T
192
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:03 PM Page 193
aN eill
The A to Z of Bones, Joints & Ligaments
1
rA ma nd
2
3
4
T
©D
5
© A. L. Neill
193
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:04 PM Page 194
The A to Z of Bones, Joints & Ligaments
Ulna
aN eill
anterior / posterior Articulations with Radius proximally pivot joint and distally with Humerus proximally hinge jt ELBOW
©D
U
radial notch olecranon trochlea notch coronoid process interosseous border head styloid process subcutaneous area of olecranon crest for supinator medial surface posterior border / surface groove for ext. carpi ulnaris
rA ma nd
1 2 3 4 5 6 7 8 9 10 11 12
Vertebrae Vertebral Column and Vertebral joints including Zygapophyseal joints removed to BACK see index
194
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:04 PM Page 195
aN eill
The A to Z of Bones, Joints & Ligaments
2
8
3
4
1
2
9
rA ma nd
10
5
5
11
©D
6
© A. L. Neill
7
7
12 6
U
195
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:04 PM Page 196
The A to Z of Bones, Joints & Ligaments
Vomer lateral / posterior / in situ
©D
3 4 5 6 7 8 9 10 11 12 13 14
Ala (Alae) Articulation with Maxillae and Palatine Maxillovomer suture / palatinovomer suture Groove for the nasopalantine nerves and vessels articulation with nasal cartilages articulation with Sphenoid bone articulation with the Ethmoid plate Perpendicular plate of the Ethmoid Body of Vomer Maxillae areolar bone Medial pterygoid plate Frontal bone Sphenoid sinus anterior of nasal bones Frontal sinus
rA ma nd
1 2
aN eill
A single small narrow frail plough-shaped midline bone. It is the deviation of this bone which may obstruct the nasal airways.
V
196
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:04 PM Page 197
aN eill
The A to Z of Bones, Joints & Ligaments
6
4
5
3
1
8
1
rA ma nd
2
3
7
8
11
14
6
7
12
13
4
5
©D
8
© A. L. Neill
V 9
2
10
197
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:04 PM Page 198
The A to Z of Bones, Joints & Ligaments
WRIST JOINT = Radiocarpal joints
aN eill
palmar / dorsal BS anterior interosseous, ant post carpal branches of the radial and ulan art NS ant post interosseous Ns (C6-8) flexion / extension ulna and radial deviation circumduction, meniscus ulna collateral lig articular disc palmar ulnocarpal lig palmar radio carpal lig radial collateral lig dorsal radio carpal ligs
©D
1 2 3 4 5 6 7
rA ma nd
A
W
198
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:04 PM Page 199
aN eill
The A to Z of Bones, Joints & Ligaments
1
rA ma nd
6
2
5
6
©D
7
© A. L. Neill
3 4
2 1 3
W
199
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:04 PM Page 200
The A to Z of Bones, Joints & Ligaments
Zygoma = CHEEK BONES antero-lateral / postero-medial
aN eill
These bones form the prominent corners of the face under the orbital rim.
the palpable “cheek” bone is actually made up of the Temporal + Zygoma bones
frontal process Zygomatico-Facial formina articulation with the Frontal bone articulation with the Sphenoid Zygomatico-Orbital foramina articulation with Maxilla Zygomatico-Temporal foramina temporal process maxillary process orbital surface
©D
1 2 3 4 5 6 7 8 9 10
synarthrosis / suture synarthrosis synarthrosis
rA ma nd
Articulations with Frontal bone antero -superiorly with Maxilla infero-medially with Sphenoid medially with Temporal bone laterally Special these bones form the features prominent corners of the face under the orbital rim
Z
200
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:04 PM Page 201
3 4
rA ma nd
5
aN eill
The A to Z of Bones, Joints & Ligaments
7
8 6
2
1
8
10
©D
4
© A. L. Neill
9
Z 201
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:04 PM Page 202
The A to Z of Bones, Joints & Ligaments
The Back
aN eill
“The Back” generally defined as the lumbar region of the VC, includes here the VC of the cervical, thoracic and lumbar regions and associated boney structures. Its primary function is to house and protect the SC, allow exit and entrance of the SNs and act as an axis for the body’s boney skeleton – all things hang from the back. Pathology associated with this structure generally includes a consideration of what happens if there is an interruption of these SNs, which is also dealt with in A to Z of Peripheral Nerves and changes which may occur with malalignment or changes in the musculature of the VC – examined also in the A to Z of Skeletal Muscles
rA ma nd
The cervical VC, also dealt with in detail in the A to Z of the Head and Neck consists of the 7 cervical vertebrae. The special vertebrae - the Atlas (C1) and Axis (C2) and their associated joints – craniovertebral and atlanto-axial, which are listed in the main section of the bones, joints and ligaments (BJL).
The thoracic VC consists of the 12 thoracic vertebrae (T1-12). Costovertebral joints (rib joints) are also listed in the main section of the BJL and overviewed in Chest overview. The lumbar VC consists of the 5 lumbar vertebrae (L1-5). The Sacrum, Iliosacral joints and the Pelvic girdle, are also listed in the main section. Typical VB of each region, their joints and associated ligaments are listed in order in this section of the book.
©D
Anatomical movements of the back are listed along with other anatomical movements – in the front, but testing and examination of the component parts are in this section. Cross referencing b/n each section is maintained wherever possible.
202
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:04 PM Page 203
The Back
The Back
aN eill
This is the order of illustrations of this section of the book - note if beside the title there is a listing to see …it will be found at that site. The BJL means the main section where the bones joints and ligaments of the body are listed. The same colour coding is maintained here as in the main section. THE BACK overview
Development of the normal spinal curves
Common Postures and Abnormal Curves of the Spinal Column
rA ma nd
Movements of the Head & Neck and the Back see Anatomical movements (in the front) VERTEBRAE overview
Typical vertebrae: - cervical, thoracic & lumbar Typical vertebro-vertebral articulations : - cervical, thoracic & lumbar Typical vertebro-vertebral joints Typical vertebral BS and NS
CERVICAL SPINE:- Overview
Examination of the boney features and ligaments Examination of the vertebral artery and mobility THORACIC SPINE : - Overview
©D
see Chest overview, Costovertebral joints and Pectoral Girdle Overview in the BJL
LUMBAR SPINE : - Overview Boney features see also Sacrum and Sacroiliac joints in the BJL Examination of the boney features and ligaments Examination of mobility
© A. L. Neill
203
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:04 PM Page 204
The A to Z of Bones, Joints & Ligaments
Back - VC overview
II Lateral III Posterior / in situ
aN eill
B I Anterior AP
CERVICAL CURVE (7 cervical vertebrae) THORACIC CURVE (12 thoracic vertebrae) LUMBAR CURVE (5 lumbar vertebrae) SACRUM (5 fused sacral vertebrae)
©D
rA ma nd
Spinal curves develop with the adoption of the upright posture.
204
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:05 PM Page 205
The Back
II
aN eill
B
III
©D
rA ma nd
I
© A. L. Neill
205
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:05 PM Page 206
The A to Z of Bones, Joints & Ligaments
Common Postures and Abnormal Curves of the Spinal Column 1
aN eill
C 1 Normal Posture - note presence of
cephalic thoracic and lumbar curves (see image to the right)
2 poor posture Rounded Shoulders may lead to Dowager hump (4) or Thoracic Kyphosis (5)
rA ma nd
3 Forward Head posture -reducing thoracic curve by exaggerating head tilt may lead to flat back (6) associated with back pain
©D
Note awareness of these postures allows for corrections in the early stages, particularly the rounded shoulders and forward head postures. They should be first looked for in adolescence.
206
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:05 PM Page 207
C
3
©D
rA ma nd
2
aN eill
The Back
© A. L. Neill
207
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:05 PM Page 208
The A to Z of Bones, Joints & Ligaments
Common Postures and Abnormal Curves of the Spinal Column continued 1
aN eill
C 1 Normal Posture - note presence of
cephalic thoracic and lumbar curves (see image to the right)
4 Dowager’s hump - commonly seen in older women - permanent change in bones and maybe a sign of developing osteoporosis.
rA ma nd
5 exaggerated AP thoracic curve Thoracic Kyphosis may develop into the Dowager hump deformity with age 6 Flat back - commonly associated with back pain, reduced shock absorption also the result of poor lifetime posture
7 Sway Back - commonly seen in adolescent girls exaggerated AP lumbar curve - Lumbar Lordosis
©D
Note awareness of these postures allows for corrections in the early stages, particularly the rounded shoulders and forward head postures. They should be first looked for in adolescence.
208
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:05 PM Page 209
The Back
5
C
rA ma nd
aN eill
4
7
©D
6
© A. L. Neill
209
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:05 PM Page 210
The A to Z of Bones, Joints & Ligaments
Common Postures and Abnormal Curves of the Spinal Column continued
aN eill
C 8 Thoracic scoliosis abnormal lateral curve in thoracic region 9 Lumbar scoliosis abnormal lateral curve in lumbar region
©D
rA ma nd
Note awareness of these postures allows for corrections in the early stages. They should be first looked for in adolescence. If not detected changes may become permanent and exaggerated.
210
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:05 PM Page 211
The Back
C
rA ma nd
aN eill
8
©D
9
© A. L. Neill
211
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:05 PM Page 212
The Back
aN eill
Anatomical movements of the Head and Neck Cervical Spine
rA ma nd
neck flexion
neck extension/hyper-extension
©D
lateral flexion
lateral rotation
note: extension of the neck is in the normal anatomical position
212
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:05 PM Page 213
The Back
extension of the VC
©D
rA ma nd
flexion of the VC
aN eill
Anatomical movements of the Back Thoracic and Lumbar spine.
lateral flexion
© A. L. Neill
rotation of the VC 213
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:06 PM Page 214
The A to Z of Bones, Joints & Ligaments
Vertebrae Overview superior
superior facet articular pillar – zygapophysis 3 vertebral body 4 transverse foramen (cervical) 5 inferior facet 6 transverse process 7 anterior tubercle 8 posterior tubercle 9 uncinate process 10 lamina 11 zygapophysial joint 12 spinal canal –vertical 13 spinous process 13a superior border 13b lateral border 13c tip 14 inferior facet
©D
1 2
rA ma nd
aN eill
Typical Cervical Vertebrae - C3-7 atypical C1 - Atlas / C2 Axis see the BJL Typical Thoracic vertebrae - T2-9 atypical T1 attaches fixed first rib / T10-12 see the BJL ribs atypical Typical Lumbar Vertebrae - L1-5 Articulations with vertebrae above and below for typical VB-VB jts - symphysis single vertebrae SP-SP jts - syndesmosis via lig. single zygapophyseal jts planar synovial paired TP-TP jts syndesmosis via lig. paired Thoracic with rib + VB 2 demifacets on superior & inferior only lips of the VB and disc in b/n for artic with rib above and below -planar synovial paired with rib+TP costal facet on TP -planar synovial - paired
V
214
15 pedicle 16 intervertebral foramen (separate -notches) 16i inferior vertebal notch 16s superior vertebral notch 17 intervertebral disc 18i inferior demifacet (thoracic) 18s superior demifacet (thoracic) 19 costal facet (for rib tubercle - thoracic) 20 head of rib 21 neck of rib 22 costotransverse junction (thoracic) 23 body of rib 24 mammillary process (lumbar) © A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:06 PM Page 215
The Back
13 10
5
12 6
aN eill
8
4
4
1
13c
13 22
7
3
15
rA ma nd
13b
10
5
1
18s
6
15
18i
12
13
13c
13b
1 10 24
©D
6
V
10
15
9
© A. L. Neill
12
3 215
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:06 PM Page 216
The A to Z of Bones, Joints & Ligaments
A Vertebral - Vertebral articulations
CERVICAL, THORACIC, LUMBAR
aN eill
lateral / posterior / anterolateral view
©D
rA ma nd
1 superior facet 2 articular pillar – zygapophysis 3 vertebral body 4 transverse foramen (cervical) 5 inferior facet 6 transverse process 7 anterior tubercle 8 posterior tubercle 9 uncinate process 10 lamina 11 zygapophysial joint 12 spinal canal –vertical 13 spinous process 13a superior border 13b lateral border 13c tip 14 inferior facet 15 pedicle 16a intervertebral foramen (separate -notches) 16i inferior vertebal notch 16s superior vertebral notch 17 intervertebral disc 18i inferior demifacet (thoracic) 18s superior demifacet (thoracic) 19 costal facet (for rib tubercle - thoracic) 20 head of rib 21 neck of rib 22 costotransverse junction (thoracic) 23 body of rib 24 mammillary process (body) (lumbar)
V
216
1 2 3 4 5 6 7 8
9 1 2 10 5 11 12 13
9 3 12 1 2 14 11 6 7 8 10 13
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:06 PM Page 217
The Back
1,2 15 3 16a 17 11 13 24 6 14
rA ma nd
aN eill
1,2 15 3 16 17 11 18i,s 6 19 5 13 1,2 6 10 13a
11 13b 13c
©D
3 12
© A. L. Neill
20 21 22 23 13
1,2 6 10 13 14 11 24 8 1 12 24 6 17 14 11 1 10 13
V
217
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:06 PM Page 218
The A to Z of Bones, Joints & Ligaments
Vertebral - Vertebral joints - external views CERVICAL Occiput/C1/2
rA ma nd
aN eill
external posterior view* 1 external occipital protuberance 2 mastoid process 3 TP 4 posterior tubercle (C1) 5 TP outer edge 6 transverse foramina 7 spinous process (C2) 8 lamina 9 outer capsule of PLL supf to cruciate ligs deep to the ligamentum nuchae (not shown) 10 vertebral artery 11 capsule of lateral VV jts 12 capsule of lateral Head/Spine jts
LUMBAR
©D
posterior view 1 TP 2 inferior artic pillar of zygapophysis 3 supraspinous lig 4 lamina 5 intervertebral disc - deep to the vertebral foramen 6 intertransverse lig 7 capsular lig 8 intervertebral disc capsule
V
* see also Atlanto-Axial, Atlanto-Occipital, Axial-Occitpital jts
** see also Costovertebral jts
218
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:06 PM Page 219
aN eill
The Back
1
12
rA ma nd
8 11 10 9
8
3 4 5
2
6
7
8
1
7 6 5
2
©D
1 4 3
© A. L. Neill
V
219
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:07 PM Page 220
The A to Z of Bones, Joints & Ligaments
Typical vertebral BS
aN eill
superior arteries: supplied via segmental spinal branches from the aorta and iliacs
veins: supplied via segmental branches from the azygous vessels
medial venous plexi drain to the azygous vessels
note the vertebrae are richly innervated and vascularized with multiple aas allowing for movement and for repair. Branches travel in the pia-arachnoid mater to supply the SC.
SP TP vertebral foramen VB pedicle spinal artery intravertebral vein intercostal artery /vein segmental artery intervertebral vein basivertebral vein venous plexus of vertebral body anterior venous plexus posterior venous plexus
©D
1 2 3 4 5 6A 6V 7 8A 8V 9 10 11 12
rA ma nd
VBs have red BM and supply new blood elements in the adult
V
220
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:07 PM Page 221
aN eill
The Back
1
6V
12
3
2
6A
5
7
11
rA ma nd
12
©D
1
4
© A. L. Neill
10
8V
8A 4 9
11
5 6V
V 6V
221
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:07 PM Page 222
The A to Z of Bones, Joints & Ligaments
Typical vertebral NS
aN eill
superior nerves -thoracic region: the SP, TP and laminae supplied via segmental spinal branches from the dorsal rami VB supplied by segmental branches of the ventral rami
Note the sympathetic chain in this region and the solid SC
nerves - lumbar region: the SP, TP and laminae supplied via segmental spinal branches from the dorsal rami
VB supplied by segmental branches of the ventral rami – these bodies are very large in this region and require extensive innervations very sensitive to pain
SP TP vertebral foramen VB pedicle rib sympathetic ganglion N to vertebral body ad ALL grey and white rami doral ramus ventral ramus recurrent meningeal nerve parspinal sympathetic ganglion dorsal root ganglion cauda equina – lumbar sacral roots
©D
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
rA ma nd
Note the SC has finished in this region -the corda equina travels in the CSF fluid -
V
222
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:07 PM Page 223
The Back
aN eill
5 3
10
6
2
rA ma nd
11
9
7
4
14
1
15
©D
3
10
11
2
V
13
4
© A. L. Neill
10
8
12 223
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:07 PM Page 224
The A to Z of Bones, Joints & Ligaments
Cervical Spine - Overview
©D
rA ma nd
aN eill
note vertebra prominens - the most prominent SP on palpation is either on C7 or T1 1 Atlas = C1 2 Axis = C2 3 C3 4 C4 5 C5 6 C6 7 C7 8 T1 9 1st rib 10 clavicle 11 Occiput cut surface 12 Transverse foraminae -canal for the vertebral artery often misses C6-7 13 cervical curve - concave 14 intervertebral disc
V
224
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:07 PM Page 225
aN eill
The Back
11
1
13
2
3
rA ma nd
12
©D
14
© A. L. Neill
4
5 6 7
8
9
10
V
225
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 226
The A to Z of Bones, Joints & Ligaments
aN eill
Examination of the cervical spine
rA ma nd
examination of C1 / Atlas
examination of C2 / Axis
©D
examination of ligamentum nuchae
examination of the mastoid process
226
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 227
examination of the vertebral artery
©D
rA ma nd
distraction of the cervical spine
aN eill
The Back
examination for cervical irritability and mobility
© A. L. Neill
227
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 228
The A to Z of Bones, Joints & Ligaments
rA ma nd
aN eill
Examination of the lumbar spine - boney features and ligaments
©D
examination of SP
examination of mobility of SP
examination of TP
examination of mobility of the TP
note with any N irritability cease as compressing the intervertebral space will aggravate any N pathology
228
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 229
The A to Z of Bones, Joints & Ligaments
rA ma nd
aN eill
Examination of the lumbar spine - boney features and ligaments continued
©D
examination of the supraspinous lig
© A. L. Neill
examination of the vertebral artery 229
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 230
The A to Z of Bones, Joints & Ligaments
Examination of the lumbar spine - mobility
rA ma nd
aN eill
These examinations of the boney and ligaments of the cervical and lumbar spines and associated joints are not complete and do not cover any neurological considerations which are dealt with in the A to Z of the Head and Neck and the A to Z of the Peripheral Nerves will be further examined in the A to Z of clinical examination and assessment. These examinations of the boney and ligaments of the cervical and lumbar spines and associated joints are not complete and do not cover any neurological considerations which are dealt with in the A to Z of the Head and Neck and the A to Z of the Peripheral Nerves will be further examined in the A to Z of clinical examination and assessment.
©D
examination of back and hip extension lumbar and SI joint mobility
230
lumbar distraction and extension for lumbar and SI mobility
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 231
The A to Z of Bones, Joints & Ligaments
aN eill
Examination of the lumbar spine - mobility continued
rA ma nd
examination of lumbar mobility AP
©D
examination of lumbar mobility with hip and leg rotation and lateral flexion
© A. L. Neill
examination of lumbar mobility with hip and leg flexion 231
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 232
The A to Z of Bones, Joints & Ligaments
Anatomical Joint Excercises Exercises for the BACK mobility and strength
aN eill
lifting - deadweight bending with a straight back and extended arms lift the weight straight up along the calves. stand with the weight and extended arms in upright posture this stops any shoulder compression or reflex contraction distracting the shoulder joint and giving max weight bearing to the back
©D
rA ma nd
the back is made up of several layers of muscles the most superficial allow for gross changes but the deeper muscles adjust posture and vertebral alignment -this exercise slowly lifting in a vertical manner allows for the deep muscles to adjust and align the VC during the lift - Multifidis, Rotatores
232
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 233
©D
rA ma nd
aN eill
Anatomical Joint Excercises
© A. L. Neill
233
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 234
The A to Z of Bones, Joints & Ligaments
Anatomical Joint Excercises Exercises for the BACK mobility and strength
aN eill
extension UP - supporting the legs lift the body up with a straight back
then - DOWN drop down in a controlled manner in the end hanging down to distract the joints giving - max weight bearing to the neck head and upper back.
rA ma nd
The back is made up of several layers of muscles the most superficial allow for gross changes such as this - Erector Spinae and Trapezius - this exercise decompresses the joints and stretches all the supportive structures, particularly the back flexion – in this case the hanging down position.
©D
This exercise can be modified by lying on the floor and dropping over steps to extend the back.
234
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 235
©D
rA ma nd
aN eill
The Back
© A. L. Neill
235
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 236
The A to Z of Bones, Joints & Ligaments
Anatomical Joint Excercises Exercises for ANKLE JOINT mobility & strength
aN eill
toes up and down holding onto a support on the contralateral side and a balancing weight on the ipsilateral side stand up on the toes of the weightbearing leg and then dorsiflex the foot to stand on the heel. 10 times for each leg. Tibialis Anterior - dorsiflexion (standing on the heel) Tibialis Posterior, Gastrocnemius and Soleus - plantarflexion (standing on the toes)
rA ma nd
Exercises for SHOULDER JOINT rotation mobility
shoulder up and down lying on the side supporting the head with or w/o a weight flex the elbow and rotate the shoulder into and out of the body. 10 times for each side. This loosens and stretches the ligaments of the shoulder and surrounding muscles.
©D
Biceps, Triceps, Deltoid and Scapular muscles
236
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 237
©D
rA ma nd
aN eill
Anatomical Joint Excercises
© A. L. Neill
237
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 238
The A to Z of Bones, Joints & Ligaments
aN eill
Anatomical Joint Excercises Exercises for KNEE JOINT stability, mobility and strength knees up and down seated - extend the knees with or w/o a weight on the anterior surface of the lower leg then lift and lower the leg - stabilizes the knee jt by strengthening the muscles around the joint. prone - curl legs up and down with or w/o weights
Use supports to keep the back straight and the movement even. 10 times for each exercise.
©D
rA ma nd
4 groups of muscles act upon the knees -Quadraceps and Tibialis Anterior to extend - Hamstrings and Tibialis Posterior, Gastrocnemius and Soleus - to flex. Adductors and Tensor Fascia Lata stabilize this joint.
238
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 239
Anatomical Joint Excercises
Exercises for HIP JOINT mobility and strength
aN eill
leg abducting lying laterally - flexed knees, open and close legs with or w/o a weight on the lateral surface of the leg. lunge standing - extend one leg forward and move body over the leg by flexing at the knee while keeping the back straight Use supports to keep the back straight and the movement even. 10 times for each exercise.
Hip joint abduction is via the relatively small Tensor Fascia Lata which has a large fibrous component - flexion via the Adductors
rA ma nd
hip joint flexion is via the Psoas muscles - extension via the Hamstrings and Erector Spinae
©D
rotation via the Gluteals and Obturator muscles
© A. L. Neill
239
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:08 PM Page 240
(including radiology of the Skull)
(including pronunciation guide, anatomy word builder, abbrev. of medical qualifications and organ wgt.)
rA ma nd
(origins insertions actions BS & NS of each muscle listed alphabetically)
aN eill
Order now to complete your ‘A to Z’ set so far!
(each bone’s features and its articulation group relations, individual joints, movements, BS & NS, and joint classifications listed)
(including a clinical section with examination techniques for general nerve disorders and assessments)
Includes the bones, joints and individual muscles and other major structures including teeth, BS, NS & lymphatics
Website www.aspenatlas.com (www.aspenpharma.com.au/atlas/student.htm) email us for complete access to the many A to Z educational aids • The A to Z of Histological and Anatomical images • The A to Z of Skeletal Muscles • The A to Z of Medical quizzes
Coming soon!
list in order of priority
The A to Z of Brain and Cranial Nerves The A to Z of Surface Anatomy. The A to Z of Emergency Medicine The A to Z of Hair, Nails & Skin The A to Z of the Anatomical Excercising The A to Z of Radiology and other imaging
©D
• • • • • •
Research projects
The A to Z of Topographical anatomical mapping in conjunction with the Forensic Institute of NSW and Anatomy Update
please email any comments, or to order additional copies (special student rates)
[email protected] GPO 637 Sydney 2001 NSW Australia. fax 61 2 9365 1000 phone 0410 018 681 Name: E-mail: Other contact:
240
© A. L. Neill
AtoZ Bones,Joints,Ligaments™21 26/05/09 2:09 PM Page 244
The A to Z of Bones, Joints, Ligaments & the Back
Dr. A. L. NEILL BSc MSc MBBS PhD FACBS
[email protected] or www.amandasatoz.com mobile 0410 018 681 Contact www.aspenpharma.com.au for login and passwords for the complete A to Z and the AspenAtlas online. Aspen Pharmacare Australia Pty Ltd 34-36 Chandos Street, St Leonards NSW 2065 ABN 51 096 236 985 Back cover