anterior aspect of vertebral bodies and IVD axis to first sacral segment Posterior Longitudinal Ligament attaches axis (continuous with the Tectorial membrane) to the first sacral segment inside of the neural canal attaches body to body and IVD’s Interspinous Ligament connects adjacent spinous processes
Supraspinous Ligament N 146
attach the tips of the spinous processes, C7 to S1
Ligamentum Nuchae N14/16
superior continuation of the supraspinous ligament
triangular in shape
attaches to the EOP and the median nuchal line, posterior tubercle of the atlas, and spinous processes of the cervical vertebrae
Ligamentum Flavum
connects adjacent lamina, one on each side, elastic ligament
Supraspinous Ligament
attach the tips of the spinous processes, C7 to S1
Ligamentum Nuchae
superior continuation of the supraspinous ligament
triangular in shape, attaches to the EOP and the median nuchal line, posterior tubercle of the atlas, and spinous processes of the cervical vertebrae
Ligamentum Flavum
connects adjacent lamina, one on each side, elastic ligament
The Rib Cage
Sternum – “dagger” N 171
Manubrium – superior portion
Jugular notch
clavicular notch – where the clavicle articulates
costal notch
manubriosternal joint - sternal angle, Angle of Louis ( can see it when you look laterally )- heart just deep to this
Body of the Sternum
6 Costal notches
Xiphoid Process – starts out cartilaginous
7 ribs total attach to the sternum
Sternum has articulations ribs
Manubrium 7 4
Body 14 12
Xiphoid 1 0
Costal Margin - fusion of cartilage of ribs 8,9,10 ( vertebrochondral ribs )
Costal Angle - formed by the 2 costal margins
Ribs N 170
12 pairs of ribs
Ribs 1 thru 7 - Vertebrosternal ( True ) ribs
Ribs 8 thru 10 - Vertebrochondral ( False ) ribs – these do not attach directly to the sternum, but through a cartilaginous attachment.
Ribs 11 and 12 - Floating ribs – no attachment on one side
NOTE: all 12 ribs articulate directly with the body of the sternum ( via their costal cartilage )
Components of a typical rib
Head
Body – main portion
Tubercle
Costal groove – posterior inferior surface of rib, distinguishes L from R rib , houses intercostal vein, artery, and nerve.
Neck
Intercostal space
Angle
Costochondral joint
The Appendicular Skeleton
CH. 7, p. 169 - 188
The Pectoral Girdle
p. 169 - 172
The Clavicle - Collar Bone – superior surface is smooth
Acromial Extremity - lateral end – articulates with the acromion of the scapula
Coronoid Tubercle - coracoclavicular ligament
Sternal Extremity – medial end, large round, knob like
Costal Tuberosity - costoclavicular ligament
Groove for the Subclavius muscle N 391
The Scapula
Spine of the scapula
acromion - lateral end of spine is enlarged – separates the 2 fossa below
Fossae of the Scapula
supraspinous fossa - supraspinatus m.
infraspinous fossa - infraspinatus m.
subscapular fossa – anterior surface – subscapularis muscle originates here
Glenoid cavity N 392
Articulates with head of humerus to make the shoulder joint
supraglenoid tubercle - long head of biceps brachii m.
infraglenoid tubercle - long head of triceps brachii m.
Coracoid process - 3 muscles attach here N 393
Margins (borders) of the scapula
lateral border (axillary margin)
medial border (vertebral margin)
superior border
suprascapular notch - scapular notch - suprascapular nerve
Angles of the Scapula
inferior angle
medial angle
superior angle
Neck
The Humerus
Head
Anatomic neck ( where the joint capsule attaches ) vs. surgical neck ( humerus would be removed here )
Greater tubercle
Lesser Tubercle
Intertubercular groove – bicipital groove
Deltoid Tuberosity – midshaft on the anterior surface – deltoid muscle inserts here.
Radial groove - spiral groove - musculospiral groove - radial nerve – located below the deltoid tuberosity. A midshaft break of the humerus oftentimes is along this groove, and the radial nerve can be damaged.
Medial epicondyle - flexors of carpus and digits
Lateral epicondyle - extensor muscles of the carpus and digits originate here
Medial and lateral supracondylar crests
Trochlea – “pulley” – articulates with the ulna
Capitulum –articulates with the radius – trochlea and capitulum together make up the
distal condyle
Coronoid fossa – anterior distal aspect of the trochlea
Olecranon fossa – posterior aspect of the trochlea.
To tell a L bone from a R, orient it in 3 planes, proximal/distal; medial/lateral; anterior/ posterior.
The Ulna
Olecranon process - elbow
Semilunar notch - trochlear notch – hinge joint
Coronoid process – sits in olecranon fossa when arm is extended
Ulnar tuberosity – distal to coronoid process on the anterior surface.
Radial notch - on lateral surface, where the head articulates with the radius (L/R distinguishing factor!)
Styloid process
Interosseous margin – membrane or ligament attaches here.
Posterior border of ulna - separates forearm into flexor and extensor compartment N 409
The Radius
Head
Radial tuberosity
Styloid process - distal
Ulnar notch – distal – where the ulna articulates
Grooves on the posterior surface
groove for ECRL (Extensor carpi radius longus ) and ECRB mm.
dorsal tubercle
groove for the Ex Pollicis Longus m.
groove for the Ex Dig. And Ex. Indicis mm
The Carpus N 422
Proximal Row of Carpal Bones - medial to lateral
Pisiform - sesamoid bone in the tendon of Flexor Carpi Ulnaris m.
Triquetral - triangular bone
Lunate - articulates with radius
Scaphoid bone - navicular bone, articulates with radius
Distal Row - medial to lateral
Hamate bone - hamulus – “hammer” – has a hook on it
Capitate - Os Magnum – largest bone of the carpi
Trapezoid - Lesser multangular
Trapezium - Greater multangular
Mnemonic how to remember the carpal bones from proximal medial to distal lateral
Please Take Larry Shopping – He Came To Town
Pisiform Triquetral Lunate Scaphoid – Hamate Capitate Trapezoid Trapezium
X-rays of carpals are difficult to interpret
Metacarpal Bones and Phalanges
Metacarpal bones
Base
Body
Head
Phalanges
Proximal, middle and distal phalanx on 4 digits, but not the thumb.
Digits are numbers form lateral to medial, 1-5
The Pelvic Girdle
Formed by two Ossa Coxae - hip bones
Greater pelvis (false) - superior to pelvic brim
Lesser (true) pelvis - inferior to brim of pelvis
Pelvic Brim - sink
Pelvic Inlet – hole through the brim
Bones of the Pelvis
p. 177 - 180
Ilium
External surface
Iliac crest - ( holds up the bikini! )
anterior superior iliac spine and anterior inferior iliac spine
posterior superior iliac spine ( locate dimples!) and posterior inferior iliac spine
Gluteal Lines - lateral aspect of ilium, “glutes” attaches here.
Iliac Fossa - medial
Greater Sciatic Notch - posterior
Auricular Surface for the sacrum – medial articulation with auricular surface of sacrum
Iliac tuberosity
Inguinal ligament - pubic tubercle to ASIS
Ischium N 453
Spine of the Ischium
Ischiatic tuberosity – sitting on it! Hamstring muscle originates here.
Lesser Sciatic Notch
Body
Ramus (“bridge ) of the Ischium – connects body to pubic bone
Pubis
Superior Pubic Ramus
pubic tubercle
pecten pubis – line
obturator groove
Inferior Pubic Ramus
Symphysis
Obturator Foramen –in life, this hole is covered by membrane
Acetabulum – “cup of vinegar” N 453
acetabular notch – inferior surface
acetabular fossa
lunate surface – moon like rim around the surface
Sex related differences in the pelvis
Page 332 – pelvic differences
Male pelvis female pelvis
Narrow, straight broad, flared out
Heavy light
Rough smooth
Heart shaped oval to round
Deep relatively shallow
Pubic symph angle <=90 >90 degrees
Larger pelvic outlet
Wider inlet
The Femur N 455
Head –large, prominent
fovea capitis
Neck
Greater and lesser trochanter
Shaft – diaphysis, bows anteriorly
Linea aspera – pectineal line
Gluteal tuberosity - third trochanter
Epicondyles
Adductor tubercle – adductor m. attaches here
Condyles – point posteriorly
Intercondylar fossa
Popliteal fossa
The Tibia – shin bone N 478
Medial Condyle - proximal
Lateral Condyle
Gerdy’s tubercle – on the anterior lateral aspect of tibia - insertion of the iliotibial tract
Tibial Plateau
Intercondylar eminence
Medial and lateral intercondylar tubercle – menisci attach here
Tibial Tuberosity – Quadriceps femoris attaches here
Shaft
Interosseous crest - lateral
Medial Malleolus – distal medial aspect – ankle bone
Inferior Articular surface – articulates with tarsus
Fibular notch
The Fibula
Head
Interosseous border - medially
Lateral Malleolus – distally, little fossa on it, posterior medial aspect (L/R distinguishing factor!)
The Tarsal Bones ( 7 )
Talus - pulley shaped, articulates with distal tibia and fibula
posterior process
groove for the FHL m.
medial and lateral tubercles
Calcaneus - heel bone
tuberosity
sustentaculum tali – “balcony”, supportive to talus, points medially (L/R distinguishing factor!)
groove for the FHL m.
Navicular
Cuboid - groove for the peroneus longus m.
Cuneiform bones – 3 – they make an arch
Metatarsals and Phalanges N 488
Metatarsals - numbered from medial to lateral [ carpals lateral to medial!!!]
base, body, head
Mt 5 has a tuberosity on its base
Phalanges
proximal, middle and distal
Hallux has only two phalanges
Arches of the Foot
Longitudinal Arch – toes to heel
medial portion is more elevated than lateral portion. The talus is the keystone of the medial portion and the cuboid is keystone for the lateral portion.
Transverse Arch –from medial to lateral
extends across the width of the foot. Formed by the calcaneus, navicular, cuboid and all 5 Metatarsal’s.
Terms for 1-28-99
Tracheostomy – Formation of an opening into the trachea
Tracheotomy – The operation of opening into the trachea
Cystocenthesis – puncture of a cyst, or bladder
Pneumoconiosis – inflammation commonly leading to fibrosis of the lungs caused by the inhalation of dust
Apnea – absence of breath
Rhinoplasty – nose job
Atelectasis –Absence of gas from a part or the whole of the lungs, due to failure of expansion or resorption of gas from the alveoli.
Epistaxis – nose bleed
Embolism – Obstruction or occlusion of a vessel by an embolus
Aphonia – loss of the voice as a result of disease or injury of the organ of speech
Arthrology
CH. 8, p. 192 – 225
Terms for this section
Symphysis – grown together, fused
Synostosis - osseous union between the bones forming a joint.
Synchondrosis - a union between two bones formed either by hyaline cartilage or fibrocartilage.
Synarthrosis – a joint that does not permit movement between the articulating elements
Amphiarthrosis – symphysis
Diarthrotic – relating to 2 joints
Arthrology – study of joints
Joints ( SAVE THESE NOTES FOR BOARDS IN UPPER TRIs!)
Definition of a joint – AKA articulation, arthrosis: a place where two or more bones come together. There may or may not be movement there. A joint’s primary purpose is movement, but it doesn’t have to be.
Kinesiology - the study of the mechanics of motion, biomechanics, study of the movement of joints. The motion present is largely determined by the structure of the articular surfaces.
Classification of Joints
According to the type of material that holds the bones together and the method used to unite the boney components. What holds the bones together, what method is used to hold them together?
Synarthrosis – ( “to join”)
Fibrous joints - joined by fibrous connective tissue – no joint cavity
suture - found only in the skull – there are over 30 in the skull – they are classified by how they overlap {bone-fibrous tissue-bone}
serrate suture - most common - sawlike interlocking articulations
squamous - edges overlap – pterion/asterion
plane - edges are smooth and do not overlap – maxilla/palatine – often disappear later in life by fusing bony fusion = synostosis
syndesmosis – “joined by a ligament”
a ligament is a CT structure that connects bone to bone
single ligament or interosseous ligament - FCT sheet between two bones
( tympanostapedial )
between the radius and ulna
interspinous ligament – between the spines of the vertebrae
between tibia and fibula
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