Chapter 8/9

1. Chapter 8/9 The Skeletal System: Appendicular Skeleton Joints Lecture Outline

2. INTRODUCTION • The appendicular skeleton includes the bones of the upper and lower extremities and the shoulder and hip girdles. • The appendicular skeleton functions primarily to facilitate movement.

3. Chapter 8 The Skeletal System: Appendicular Skeleton • Pectoral girdle • Pelvic girdle • Upper limbs • Lower limbs

4. Clavicle • The clavicle or collar bone lies horizontally in the superior and anterior part of thorax superior to the first rib and articulates with the sternum and the scapula (Figure 8.2). • The clavicle, one of the most frequently broken bones in the body, transmits mechanical force from the upper limb to the trunk.

5. Scapula • The scapula or shoulder blade articulates with the clavicle and the humerus (Figure 8.3). • The scapulae articulate with other bones anteriorly, but are held in place posteriorly only by complex shoulder and back musculature.

6. Upper Extremity • Each upper limb = 30 bones • humerus within the arm • ulna & radius within the forearm • carpal bones within the wrist • metacarpal bones within the palm • phalanges in the fingers • Joints • shoulder (glenohumeral), elbow, wrist, metacarpophalangeal, interphalangeal

7. Ulna & Radius --- Proximal End • Ulna (on little finger side) • trochlear notch articulates withhumerus & radial notch with radius • olecranon process forms point of elbow • Radius (on thumb side) • head articulates with capitulum of humerus & radial notch of ulna • tuberosity for muscle attachment

8. Carpals, Metacarpal, and Phalanges • The eight carpal bones, bound together by ligaments, comprise the wrist (Figure. 8.8). • Five metacarpal bones are contained in the palm of each hand (Figure 8.8). • Each hand contains 14 phalanges, three in each finger and two in each thumb (Figure 8.8).

9. Metacarpals and Phalanges • Metacarpals • 5 total----#1 proximal to thumb • base, shaft, head • knuckles (metacarpophalangeal joints) • Phalanges • 14 total: each is called phalanx • proximal, middle, distal on each finger, except thumb • base, shaft, head

10. PELVIC (HIP) GIRDLE • The pelvic (hip) girdle consists of two hipbones (coxal bones) and provides a strong and stable support for the lower extremities, on which the weight of the body is carried (Figure 8.9). • Each hipbone (coxal bone) is composed of three separate bones at birth: the ilium, pubis, and ischium. • These bones eventually fuse at a depression called the acetabulum, which forms the socket for the hip joint (Figure 8.10a).

11. The Ilium • The larger of the three components of the hip bone and articulates (fuses) with the ischium and pubis (Figure 8.10b,c). • Bone marrow aspiration or bone marrow biopsy are frequently performed on the iliac crest in adults. • The ischium is the inferior, posterior portion of the hip bone (Figure 8.10b,c). • The pubis is the anterior and inferior part of the hip bone (Figure 8.10b,c).

12. Pelvis • Pelvis = sacrum, coccyx & 2 hip bones • Pelvic brim • sacral promontory to symphysis pubis • separates false from true pelvis • false pelvis holds only abdominal organs • Inlet & outlet • Pelvic axis = path of babies head

13. Female and Male Skeletons • Male skeleton • larger and heavier • larger articular surfaces • larger muscle attachments • Female pelvis • wider & shallower • larger pelvic inlet & outlet • more space in true pelvis • pubic arch >90 degrees

14. COMPARISON OF FEMALE AND MALE PELVES • Male bones are generally larger and heavier than those of the female; the male’s joint surfaces also tend to be larger. • Muscle attachment points are more well-defined in the bones of a male than of a female due to the larger size of the muscles in males. • A number of anatomical differences exist between the pelvic girdles of females and those of males, primarily related to the need for a larger pelvic outlet in females to facilitate childbirth (Table 8.1).

15. COMPARISON OF PECTORAL AND PELVIC GIRDLES • The pectoral girdle does not directly articulate with the vertebral column; the pelvic girdle does. • The pectoral girdle sockets are shallow and maximize movement; those of the pelvic girdle are deeper and allow less movement. • The structure of the pectoral girdle offers more movement than strength; the pelvic girdle, more strength than movement.

16. Patella • The patella or kneecap is a sesamoid bone located anterior to the knee joint (Figure 8.14). • It functions to increase the leverage of the tendon of the quadriceps femoris muscle, to maintain the position of the tendon when the knee is bent, and to protect the knee joint. • Patellofemoral stress syndrome is a common knee problem in runners.

17. Tarsals, Metatarsals, and Phalanges • Seven tarsal bones constitute the ankle and share the weight associated with walking (Figure 8.16). • Five metatarsal bones are contained in the foot (Figure 8.16). • Fractures of the metatarsals are common among dancers, especially ballet dancers. • The arrangement of phalanges in the toes is the same as that described for the fingers and thumb above - fourteen bones in each foot (Figure 8.16).

18. Arches of the Foot • The bones of the foot are arranged in two non-rigid arches that enable the foot to support the weight of the body; provide an ideal distribution of body weight over the hard and soft tissues, and provide leverage while walking (Figure 8.17). • Flatfoot, clawfoot, and clubfoot are caused by decline, elevation, or rotation of the medial longitudinal arches.

19. INTRODUCTION • A joint (articulation or arthrosis) is a point of contact between two or more bones, between cartilage and bones, or between teeth and bones. • The scientific study of joints is called arthrology.

20. Chapter 9Joints • Joints hold bones together but permit movement • Point of contact • between 2 bones • between cartilage and bone • between teeth and bones • Arthrology = study of joints • Kinesiology = study of motion

21. Classification of Joints • Structural classification is based on the presence or absence of a synovial (joint) cavity and type of connecting tissue. Structurally, joints are classified as • fibrous, cartilaginous, or synovial. • Functional classification based upon movement: • immovable = synarthrosis • slightly movable = amphiarthrosis • freely movable = diarthrosis

22. Fibrous Joints • Lack a synovial cavity • Bones held closely together by fibrous connective tissue • Little or no movement (synarthroses or amphiarthroses) • 3 structural types • sutures • syndesmoses • gomphoses

23. Articular Capsule • The articular capsule surrounds a diarthrosis, encloses the synovial cavity, and unites the articulating bones. • The articular capsule is composed of two layers - the outer fibrouscapsule (which may contain ligaments) and the inner synovial membrane (which secretes a lubricating and joint-nourishing synovial fluid) (Figure 9.3). • The flexibility of the fibrous capsule permits considerable movement at a joint, whereas its great tensile strength helps prevent bones from dislocating. • Other capsule features include ligaments and articular fat pads (Figure 9.3).

24. Special Features • Synovial Membrane • secretes synovial fluid containing slippery hyaluronic acid • brings nutrients to articular cartilage • Accessory ligaments • extracapsular ligaments • outside joint capsule • intracapsular ligaments • within capsule • Articular discs or menisci • attached around edges to capsule • allow 2 bones of different shape to fit tightly • increase stability of knee - torn cartilage • Bursae = saclike structures between structures • skin/bone or tendon/bone or ligament/bone

25. Angular Movements • In angular movements there is an increase or a decrease in the angle between articulating bones. • Flexion results in a decrease in the angle between articulating bones (Figure 9.5). • Lateral flexion involves the movement of the trunk sideways to the right or left at the waist. The movement occurs in the frontal plane and involves the intervertebral joints (Figure 9.5g). • Extension results in an increase in the angle between articulating bones (Figure 9.5). • Hyperextension is a continuation of extension beyond the anatomical position and is usually prevented by the arrangement of ligaments and the anatomical alignment of bones (Figures 9.5a, b, d, e).

26. Abduction, Adduction, and Circumduction • Abduction refers to the movement of a bone away from the midline (Figure 9.6a-c). • Adduction refers to the movement of a bone toward the midline (Figure 9.6d). • Circumduction refers to movement of the distal end of a part of the body in a circle (Figure 9.7). • Circumduction occurs as a result of a continuous sequence of flexion, abduction, extension, and adduction. • Condyloid, saddle, and ball-and-socket joints allow circumduction. • In rotation, a bone revolves around its own longitudinal axis (Figure 9.8a).

27. Special Movements • Elevation is an upward movement of a part of the body (Figure 9.9a). • Depression is a downward movement of a part of the body (Figure 9.9b). • Protraction is a movement of a part of the body anteriorly in the transverse plane (Figure 9.9c). • Retraction is a movement of a protracted part back to the anatomical position (Figure 9.9d).

28. Special Movements • Inversion is movement of the soles medially at the intertarsal joints so that they face away from each other (Figure 9.9e). • Eversion is a movement of the soles laterally at the intertarsal joints so that they face away from each other (Figure 9.9f). • Dorsiflexion refers to bending of the foot at the ankle in the direction of the superior surface (Figure 9.9g). • Plantar flexion involves bending of the foot at the ankle joint in the direction of the plantar surface (Figure 9.9g).

29. Special Movements • Supination is a movement of the forearm at the proximal and distal radioulnar joints in which the palm is turned anteriorly or superiorly (Figure 9.9h). • Pronation is a movement of the forearm at the proximal and distal radioulnar joints in which the distal end of the radius crosses over the distal end of the ulna and the palm is turned posteriorly or inferiorly (Figure 9.9h).

30. Special Movements • Opposition is the movement of the thumb at the carpometacarpal joint in which the thumb moves across the palm to touch the tips of the finger on the same hand. • Review • A summary of the movements that occur at synovial joints is presented in Table 9.1. • A dislocation or luxation is a displacement of a bone from a joint.