The Skeletal system

Prepared by: Arthur Christian B.

Mangio, PTRP
 Functions:
• Support. The skeleton serves as the structural
framework for the body by supporting soft
tissues and providing attachment point for the
tendons of most skeletal muscles.
• Protection. The skeleton protects the most
important internal organs from injury. For
example, cranial bones protect the brain, and the
rib cage protects the heart and lungs
• Assistance in movement. Most skeletal muscles
attach to bones; when they contract, they pull on
bones to produce movement
• Mineral homeostasis (storage and release). Bone tissue
makes up about 18% of the weight of the human body.
– It stores several minerals, especially calcium and phosphorus,
which contribute to the strength of bone. Bone tissue stores
about 99% of the body’s calcium. On demand, bone releases
minerals into the blood to maintain critical mineral balances
(homeostasis) and to distribute the minerals to other parts of
the body.
• Blood cell production
• Triglyceride storage. Yellow bone marrow consists mainly
of adipose cells, which store triglycerides. The stored
triglycerides are a potential chemical energy reserve
 Classification
• Long bones : longer than wide
– Mostly compact bones
– They act as lever that are pulled by contracting muscles
– This lever makes it possible for the body to move
• Short bones: equal in length., width and thickness and
shaped irregulary
– Occurs only in wrist and ankle
• Flat bones: actually thin or more curved than flat
• Sesamoid bones: small bones embedded within
certain tendons
– Usually occur where tendons pass over the joint of the
long bone
•
• Accessory bone: most commonly found in the
feet
• Occurs when developing bones do not fuse
completely
• Sutural bones
• Irregular bones: bones that do not fit into any
category
 ANATOMY OF A TYPICAL LONG BONE
• Diaphysis – tubular shaft, hollow cylinder with walls of compact bone
tissue
• Epiphyses - are the proximal and distal ends of the bone.
• Metaphyses - are the regions between the diaphysis and the epiphyses.
– In a growing bone, each metaphysis contains an epiphyseal (growth) plate a
layer of hyaline cartilage that allows the diaphysis of the bone to grow in
length in length.
– When a bone ceases to grow in length at about ages 14–24, the cartilage in
the epiphyseal plate is replaced by bone; the resulting bony structure is
known as the epiphyseal line.
• Articular cartilage is a thin layer of hyaline cartilage covering the part of
the epiphysis where the bone forms an articulation (joint) with another
bone.
– Articular cartilage reduces friction and absorbs shock at freely movable joints.
Because articular cartilage lacks a perichondrium and lacks blood vessels,
repair of damage is limited.
• Medullary cavity – center of the cylinder
– Contains yellow marrow (fat or adipose tissue)
– The porous latticework of the spongy epiphyses is filled with red
bone marrow or myeloid tissue
• Endosteum: lines the internal cavities of bones
• Periosteum: covers the outer surface of the bone
– Attached to the bones by the collagenous fibers called periosteal
perforating fibers
– Contains nerves, lymphatic vessels an d capillaries
• Bone markings
– Projections of processes: grows out of the bone surface
– Depressions or cavities: indentations in the bone

– Nutrient foramen:
Bone Markings
Projections that are site of muscle and
ligament attachment
• Tuberosity – large rounded projection; may be
roughened
• Crest – Narrow ridge of bone; usually prominent
• Trochanter – very large, blunt, irregularly shaped
process. The only example is in the femur
• Line – narrow ridge of bone; less prominent than
a crest
• Tubercle – small rounded projection or a process
• Epicondyle – raised area on or above a condyle
• Spine – sharp, slender often pointed projection
 Projections that helps form joints
• Head – bony expansion carried on a narrow
neck
• Facet – smooth, nearly flat articular surface
• Condyle – rounded articular projection
• Ramus - armlike bar of bone
 Depressions and openings allowing
blood vessels and nerves to pass
• Meatus – canal like passageway
• Sinus – cavity within a bone, filled and lined with
mucous membrane
• Fossa – shallow, basin like depression in a bone,
often serving as an articular surface
• Groove - furrow
• Fissure – narrow slit like opening
• Foramen – round or oval opening through a bone
 Microscopic Anatomy Of Bone
• Compact Bone Tissue – forms the outer shell
of a bone is very hard and dense, ivory like
and appears to the naked eye to be solid
• It contains cylinders of calcified bone known
as osteons or haversian system
• The basic unit of a compact bone is an osteon
or the harvesian system and each osteon has
four parts
• The lamellae - concentric rings of extracellular
matrix that consist of mineral salts (mostly
calcium and phosphates), which give bone its
hardness and compressive strength, and collagen
fibers, which give bone its tensile strength.
– The lamellae are responsible for the compact nature
of this type of bone tissue.
• Central canal or haversian canal contains blood
vessels and nerves
– Central canal usually have branches called perforating
canals or Volkmann’s canals that run at right angles
and extend the system or nerves and vessels to the
periosteum and endosteum
– Perforating canals are not enclosed by concentric
lamellae
• Lacunae: are small spaces between lamellae
that contain mature bone cells called
osteocytes
• Projecting from the lacunae are canaliculi
(little canals), networks of minute canals
containing the processes of osteocytes.
– Canaliculi provide routes for nutrients to reach
osteocytes and for wastes to leave them.
• Spongy or Cancellous Bone – bone tissue is
formed in an interlaced pattern that
withstands maximum stress and support shifts
in weight distribution
• Trabeculae – tiny spikes of bone tissue
sorrounded by matrix that has calcified or
become hardened by the deposition of
calcium salts
 Bone cells
• Osteogenic (osteoprogenitor)
– are unspecialized bone stem cells derived from
mesenchyme, the tissue from which almost all
connective tissues are formed. They are the only
bone cells to undergo cell division; the resulting
cells develop into osteoblasts. Osteoprogenitor
cells are found along the inner portion of the
periosteum, in the endosteum, and in the canals
within bone that contain blood vessels.
• Osteoblast
– bone-building cells. They synthesize and secrete
collagen fibers and other organic components needed
to build the extracellular matrix of bone tissue, and
they initiate calcification (described shortly). As
osteoblasts surround themselves with extracellular
matrix, they become trapped in their secretions and
become osteocytes.
– (Note: The ending -blast in the name of a bone cell or
any other connective tissue cell means that the cell
secretes extracellular matrix.)
• Osteocyte
– mature bone cells, are the main cells in bone
tissue and maintain its daily metabolism, such as
the exchange of nutrients and wastes with the
blood. Like osteoblasts, osteocytes do not
undergo cell division.
– (Note: The ending -cyte in the name of a bone cell
or any other tissue cell means that the cell
maintains and monitors the tissue.)
• Osteoclast
– are huge cells derived from the fusion of as many as 50
monocytes (a type of white blood cell) and are
concentrated in the endosteum. On the side of the cell
that faces the bone surface, the osteoclast’s plasma
membrane is deeply folded into a ruffled border. Here the
cell releases powerful lysosomal enzymes and acids that
digest the protein and mineral components of the
underlying extracellular bone matrix.
– This breakdown of bone extracellular matrix, termed bone
resorption (rē-SORPshun) is part of the normal
development, maintenance, and repair of bone.
– (Note: The ending -clast means that the cell breaks down
extracellular matrix.)
• Bone lining cells
– Found in the surface of most bones in the adult
skeleton
– Derived from osteoblast that cease their function and
flattened out on the bone surface
– They can be osteogenic cells that can divide and
differentiate into osteoblasts
– Iron barrier around bone tissue
– Contributes to mineral homeostasis by regulatong the
movement of calcium and phosphate into and out of
the bone matrix
 Bone tissue
• 20% water
• Stronger, more durable, lighter and flexible
• They are composed of cells embedded in a marix
of ground substance and fibers
• They are rigid because it also contains inorganic
salts(mainly calcium phosphate and calcium
carbonate) -> hydroxyapatite crystals
• When the body needs the calcium or phosphate
that is stored within the bones, the
hydroxyapatite crystals ionize and releases the
required amount
 Bone Growth
• Ossification or osteogenesis
• Bone growth happens in 4 situations
– (1) the initial formation of bones in an embryo and
fetus,
– (2) the growth of bones during infancy, childhood, and
adolescence until their adult sizes are reached,
– (3) the remodeling of bone (replacement of old bone
by new bone tissue throughout life),
– (4) the repair of fractures (breaks in bones)
throughout life.
 Bone Remodelling
• Bone remodelling is the ongoing replacement of old bone tissue by
new bone tissue.
• It involves bone resorption, the removal of minerals and collagen
fibers from bone by osteoclasts, and bone deposition
• 5 % of total bone mass is being remodeled at any given time
• The distal portion of the femur is replaced about every four
months.
• By contrast, bone in certain areas of the shaft of the femur will not
be replaced completely during an individual’s life. Even aft er bones
have reached their adult shapes and sizes, old bone is continually
destroyed and new bone is formed in its place.
• Remodeling also removes injured bone, replacing it with new bone
tissue. Remodeling may be triggered by factors such as exercise,
sedentary lifestyle, and changes in diet
 Factors Affecting Bone Growth and
Bone Remodelling
• 1. Minerals. Large amounts of calcium and phosphorus
are needed while bones are growing, as are smaller
amounts of magnesium, fluoride, and manganese.
– These minerals are also necessary during bone
remodeling.
• 2. Vitamins. Vitamin A stimulates activity of
osteoblasts. Vitamin C is needed for synthesis of
collagen, the main bone protein. vitamin D helps build
bone by increasing the absorption of calcium from
foods in the gastrointestinal tract into the blood.
• Vitamins K and B12 are also needed for synthesis of
bone proteins.
• 3. Hormones. During childhood, the hormones most important to
bone growth are the insulin-like growth factors (IGFs), which are
produced by the liver and bone tissue.
• IGFs stimulate osteoblasts, promote cell division at the epiphyseal
plate and in the periosteum, and enhance synthesis of the proteins
needed to build new bone. IGFs are produced in response to the
secretion of growth hormone (GH) from the anterior lobe of the
pituitary gland
• Thyroid hormones (T3 and T4) from the thyroid gland also promote
bone growth by stimulating osteoblasts.
• In addition, the hormone insulin from the pancreas promotes bone
growth by increasing the synthesis of bone proteins.
 Fracture and Bone Repair
• A fracture (FRAK-choor) is any break in a bone.
Fractures are named according to their severity,
the shape or position of the fracture line, or even
the physician who first described them.
• Stress fracture is a series of microscopic fissures
in bone that forms without any evidence of injury
to other tissues. In healthy adults, stress fractures
result from repeated, strenuous activities such as
running, jumping, or aerobic dancing.
 Phases of Bone Healing
• Reactive phase. This phase is an early inflammatory phase.
• Blood vessels crossing the fracture line are broken.
• As blood leaks from the torn ends of the vessels, a mass of blood
(usually clotted) forms around the site of the fracture.
• This mass of blood, called a fracture hematoma (hē′-ma-TO - -ma;
hemat- = blood; -oma = tumor), usually forms 6 to 8 hours after the
injury.
• Because the circulation of blood stops at the site where the fracture
hematoma forms, nearby bone cells die.
• Swelling and inflammation occur in response to dead bone cells,
producing additional cellular debris.
• Phagocytes (neutrophils and macrophages) and osteoclasts begin to
remove the dead or damaged tissue in and around the fracture
hematoma.
• This stage may last up to several weeks.
• Reparative phase: Fibrocartilaginous callus formation. The
reparative phase is characterized by two events: the formation of a
fibrocartilaginous callus, and a bony callus to bridge the gap
between the broken ends of the bones.
• Blood vessels grow into the fracture hematoma and phagocytes
begin to clean up dead bone cells.
• Fibroblasts from the periosteum invade the fracture site and
produce collagen fibers. In addition, cells from the periosteum
develop into chondroblasts and begin to produce fibrocartilage in
this region.
• These events lead to the development of a fibrocartilaginous
(soft) callus (fibrō- kar-ti-LAJ-i-nus), a mass of repair tissue
consisting of collagen fibers and cartilage that bridges the broken
ends of the bone. Formation of the fibrocartilaginous callus takes
about 3 weeks.
• Reparative phase: Bony callus formation. In areas
closer to well-vascularized healthy bone tissue,
osteoprogenitor cells develop into osteoblasts,
which begin to produce spongy bone trabeculae.
• The trabeculae join living and dead portions of
the original bone fragments. In time, the
fibrocartilage is converted to spongy bone, and
the callus is then referred to as a bony (hard)
callus.
• The bony callus lasts about 3 to 4 months
• Bone remodeling phase. The final phase of
fracture repair is bone remodeling of the callus.
Dead portions of the original fragments of broken
bone are gradually resorbed by osteoclasts.
• Compact bone replaces spongy bone around the
periphery of the fracture. Sometimes, the repair
process is so thorough that the fracture line is
undetectable, even in a radiograph (x-ray).
However, a thickened area on the surface of the
bone remains as evidence of a healed fracture.
• Although bone has a generous blood supply,
healing sometimes takes months.
• The calcium and phosphorus needed to
strengthen and harden new bone are
deposited only gradually, and bone cells
generally grow and reproduce slowly.
• The temporary disruption in their blood
supply also helps explain the slowness of
healing of severely fractured bones.
 Joints
• Attachment or articulation of bones
• Classification by 2 methods:
– Based on their anatomical structures
– The degree of movement
• The structural classification of joints is based on
two criteria: (1) the presence or absence of a
space between the articulating bones, called a
synovial cavity, and (2) the type of connective
tissue that binds the bones together.
 Structurally:
• Fibrous joints
– There is no synovial cavity, and the bones are held
together by dense irregular connective tissue that is
rich in collagen fibers.
• Cartilaginous joints
– There is no synovial cavity, and the bones are held
together by cartilage.
• Synovial joints
– The bones forming the joint have a synovial cavity and
are united by the dense irregular connective tissue of
an articular capsule, and often by accessory ligaments.
 Movement
• Synarthrosis
– An immovable joint. The plural is synarthroses.
• Amphiarthrosis
– A slightly movable joint. The plural is amphiarthroses.
• Diarthrosis
– A freely movable joint.
– The plural is diarthroses.
– All diarthroses are synovial joints. They have a variety
of shapes and permit several different types of
movements.
 3 types of fibrous joints
• Suture –
– a fibrous joint composed of a thin layer of dense
irregular connective tissue; sutures occur only
between bones of the skull.
– In older individuals, sutures are immovable
(synarthroses), but in infants and children they are
slightly movable (amphiarthroses) .
– Sutures play important roles in shock absorption
in the skull.
• Syndesmoses
– a fibrous joint in which there is a greater distance between
the articulating surfaces and more dense irregular
connective tissue than in a suture
– Ex: distal tibiofibular joint, where the anterior tibiofibular
ligament connects the tibia and fibula
• Gomphosis (gom-FO￣ -sis; gompbo- = bolt or nail) or
dentoalveolar joint, in which a cone-shaped peg fits
into a socket.
– The only examples of gomphoses in the human body are
the articulations between the roots of the teeth (cone-
shaped pegs) and their sockets (dental alveoli) in the
alveolar processes in the maxillae and mandible
• Interosseous Membrane-
– a substantial sheet of dense irregular connective tissue
that binds neighboring long bones and permits slight
movement (amphiarthrosis)
– One occurs between the radius and ulna in the forearm
and the other occurs between the tibia and fibula in the
leg
– These strong connective tissue sheets not only help hold
these adjacent long bones together, they also play an
important role in defining the range of motion between
the neighboring bones and provide an increased
attachment surface for muscles that produce movements
of the digits of the hand and foot.
 Cartilaginous joints
• Synchondrosis –
– a cartilaginous joint in which the connecting material is hyaline
cartilage and is slightly movable (amphiarthrosis) to immovable
(synarthrosis)
• Ex: joint between the manubrium and the first rib
– in an x-ray of a young person’s skeleton, the synchondroses are easily
seen as thin dark areas between the white-appearing bone tissue
– This is how a medical professional can view an x-ray and determine
that a person still has some degree of growth remaining.
– Breaks in a bone that extend into the epiphyseal plate and damage the
cartilage of the synchondrosis can aff ect further growth of the bone,
leading to abbreviated development and a bone of shortened length.
• Symphyses - (SIM-fi-sis = growing together;
plural is symphyses)
– a cartilaginous joint in which the ends of the
articulating bones are covered with hyaline
cartilage, but a broad, flat disc of fibrocartilage
connects the bones
– All symphyses occur in the midline of the body
– A symphysis is a slightly movable joint
(amphiarthrosis).
• Epiphyseal Cartilages - are actually hyaline cartilage
growth centers during endochondral bone formation,
not joints associated with movements
• An example of epiphyseal cartilage is the epiphyseal
(growth) plate that connects the epiphysis and
diaphysis of a growing bone
• Functionally, epiphyseal cartilage is an immovable joint
(synarthrosis).
• When bone elongation ceases, bone replaces the
hyaline cartilage, and becomes a synostosis, a bony
joint.
 Synovial Joints
• Structure
– Synovial cavity or joint cavity between the articulating
bones.
• Because the synovial cavity allows considerable movement at a
joint, all synovial joints are classified functionally as freely movable
(diarthroses).
• The bones at a synovial joint are covered by a layer of
hyaline cartilage called articular cartilage
• The cartilage covers the articulating surfaces of the
bones with a smooth, slippery surface but does not
bind them together.
• Articular cartilage reduces friction between bones in
the joint during movement and helps to absorb shock.
• Articular Capsule - sleevelike articular capsule or
joint capsule surrounds a synovial joint, encloses
the synovial cavity, and unites the articulating
bones.
• The articular capsule is composed of two layers,
an outer fibrous membrane and an inner synovial
membrane
– Fibrous membrane – consists of of dense irregular
connective tissue (mostly collagen fibers) that
attaches to the periosteum of the articulating bones.
In fact, the fibrous membrane is literally a thickened
continuation of the periosteum between the bones
• The inner layer of the articular capsule, the
synovial membrane, is composed of areolar
connective tissue with elastic fibers. At many
synovial joints the synovial membrane
includes accumulations of adipose tissue,
called articular fat pads.
• An example is the infrapatellar fat pad in the
knee
– Double jointed person
• Synovia Fluid - The synovial membrane secretes
synovial fluid (ov- = egg), a viscous, clear or pale
yellow fluid named for its similarity in appearance
and consistency to uncooked egg white
• Its functions include reducing friction by
lubricating the joint, absorbing shocks, and
supplying oxygen and nutrients to and removing
carbon dioxide and metabolic wastes from the
chondrocytes within articular cartilage
 Accessory Ligaments, Articular Discs,
•
and Labra
Extracapsular ligaments lie outside the articular
capsule. Examples are the fibular and tibial collateral
ligaments of the knee joint
• Intracapsular ligaments occur within the articular
capsule but are excluded from the synovial cavity by
folds of the synovial membrane. Examples are the
anterior and posterior cruciate ligaments of the knee
joint
• Inside some synovial joints, such as the knee, crescent-
shaped pads of fibrocartilage lie between the articular
surfaces of the bones and are attached to the fibrous
capsule. These pads are called articular discs or menisci
• A labrum (LA￣-brum; plural is labra),
prominent in the ball-andsocket joints of the
shoulder and hip is the fibrocartilaginous lip
that extends from the edge of the joint socket.
• The labrum helps deepen the joint socket and
increases the area of contact between the
socket and the ball-like surface of the head of
the humerus or femur.
• The various movements of the body create friction
between moving parts. Saclike structures called bursae
(BER-sē = purses; singular is bursa) are strategically
situated to alleviate friction in some joints, such as the
shoulder and knee joints
• Structures called tendon sheaths also reduce friction at
joints. Tendon sheaths or synovial sheaths are tubelike
bursae; they wrap around certain tendons that
experience considerable friction as they pass through
tunnels formed by connective tissue and bone
– A tendon sheath protects all sides of a tendon from friction
as the tendon slides back and forth.
• Uniaxial
• Bi axial
• Multi axial
 Types of synovial joint
• Hinge joint : resembles the hinges on the lid of a
box
– Ex: elbow, finger, knee and ankle
• Pivot joint – only able to rotate around a central
axis
– Composed of a central bone pivot sorrounded by a
collar made partly of a bone and partly of a ligament
– Ex: neck
• Condyloid joint: modifications of the multiaxial ball and socket
joints
– Because of the ligaments and muscle surrounding the joints it is limited
to two axes of rotation
– Ex: MCP,
• Gliding joints: almost always small and formed by essentially flat
articular surface, minimal axis of rotation if there is any movement
– Ex: articular process of vertebra and joints between some carpal and
tarsal bones
• Saddle joints : both the opposing articular surfaces are shaped like
saddles, they have both concave and convex areas at aright angle
to each other
– Multiaxial
– Ex: thumb
• Ball and Socket joint: composed of globelike
head of one bone that fits into the concavity
of another bone
• Most freely movable joints
• 3 degrees of freedom
• Hip and shoulder
Bones
• The adult human skeleton consists of 206
named bones, most of which are paired, with
one member of each pair on the right and left
sides of the body.
• The skeletons of infants and children have
more than 206 bones because some of their
bones fuse later in life.
• Bones of the adult skeleton are grouped into
two principal divisions:
– the axial skeleton (80) and the appendicular
skeleton(126)
Divisions Of The Adult Skeletal System
 THE SKULL
AND FACIAL BONES
• The skeleton of the head is the skull
• It can be divided into two: 1. cranial skull
(cranium) which supports and protects the
brain 2. facial skull which form the framework
for the nasal and oral cavity
• The skull is lightened by small cavities called
paranasal sinuses
 Bones of the Cranium
• Frontal Bone
– Forms the forehead (the anterior part of the cranium), the roofs of the orbits
(eye sockets), and most of the anterior part of the cranial floor
– Soon after birth, the left and right sides of the frontal bone are united by the
metopic suture, which usually disappears between the ages of six and eight
• Parietal Bones
– The two parietal bones (pa-RĪ-e-tal; pariet- = wall) form the greater portion of
the sides and roof of the cranial cavity
– The internal surfaces of the parietal bones contain many protrusions and
depressions that accommodate the blood vessels supplying the dura mater,
the superficial connective tissue (meninx) covering of the brain
• Temporal Bone
– The paired temporal bones (tempor- = temple) form the inferior lateral
aspects of the cranium and part of the cranial floor
– Each temporal bone has 4 parts: squamous, tympanic portions, petrous and
mastoid
• Occipital Bone
– (ok-SIP-i-tal; occipit- = back of head) forms the posterior part and most of the
base of the cranium
– Forms the floor and back of the skull
– The foramen magnum (= large hole) is in the inferior part of the bone. The
medulla oblongata (inferior part of the brain) connects with the spinal cord
within this foramen, and the vertebral and spinal arteries also pass through it
along with the accessory (XI) nerve
– The occipital condyles, oval processes with convex surfaces on either side of
the foramen magnum, articulate with depressions on the first cervical
vertebra (atlas) to form the atlanto-occipital joint, which allows you to nod
your head “yes.” Superior to each occipital condyle on the inferior surface of
the skull is the hypoglossal canal (hypo- = under; -glossal = tongue).
– The external occipital protuberance is the most prominent midline projection
on the posterior surface of the bone just above the foramen magnum. You
may be able to feel this structure as a bump on the back of your head, just
above your neck
• Sphenoid Bone
– The sphenoid bone (SFE--noyd = wedge-shaped) lies at the middle part of the
base of the skull
– The keystone of the cranial floor because it articulates with all the other
cranial bones, holding them together
– The shape of the sphenoid resembles a butterfly with outstretched wings
– The body of the sphenoid is the hollowed cubelike medial portion between
the ethmoid and occipital bones.
– The Sella Turcica is a bony saddle-shaped structure on the superior surface of
the body of the sphenoid
– Openings located in this bone: 1. optic foramen – through which optic nerve
and ophthalmic artery pass 2. superior orbital fissure – through which 3
cranial nerve for eye muscle and sensory nerve to the orbital and forehead
region pass 3. foramen rotundum and foramen ovale – passage for the
different division of trigeminal nerve 4. foramen spinosum – passage of
meningeal artery to the side and roof of the skull
• Ethmoid Bone
– The ethmoid bone (ETH-moyd = like a sieve) is a
delicate bone located in the anterior part of the
cranial floor medial to the orbits and is spongelike
in appearance
– Forms the roof of the nasal cavity
• Sutural Bones
– Also called wormian bones
– Found most often in the lamdoidal suture
 Sutures
• An immovable joint (in most cases in an adult
skull) that holds most skull bones together
• Sutures in the skulls of infants and children,
however, often are movable and function as
important growth centers in the developing
skull.
• The names of many sutures reflect the bones
they unite.
• The coronal suture (KO-rō-nal; coron- = relating
to the frontal or coronal plane) unites the frontal
bone and both parietal bones
• The sagittal suture (SAJ-i-tal; sagitt- = arrow)
unites the two parietal bones on the superior
midline of the skull
• The lambdoid suture (LAM-doyd) unites the two
parietal bones to the occipital bone. This suture is
so named because of its resemblance to the
capital Greek letter lambda (Λ)
• The two squamous sutures (SKWA- -mus; squam-
= flat, like the flat overlapping scales of a snake)
unite the parietal and temporal bones on the
lateral aspects of the skull
• The paranasal sinuses (par′-a-NA- -zal SI--nus-ez;
para- = beside) are cavities within certain cranial
and facial bones near the nasal cavity.
• They are most evident in a sagittal section of the
skull
• The paranasal sinuses are lined with mucous
membranes that are continuous with the lining of
the nasal cavity.
• Secretions produced by the mucous membranes
of the paranasal sinuses drain into the lateral wall
of the nasal cavity
 Facial Bones
• Nasal Bones
– The paired nasal bones are small, flattened, rectangular-shaped
bones that form the bridge of the nose
– These small bones protect the upper entry to the nasal cavity
and provide attachment for a couple of thin muscles of facial
expression.
• Lacrimal Bones
– The paired lacrimal bones (LAK-ri-mal; lacrim- = teardrops) are
thin and roughly resemble a fingernail in size and shape
– These bones, the smallest bones of the face, are posterior and
lateral to the nasal bones and form a part of the medial wall of
each orbit.
– The lacrimal bones each contain a lacrimal fossa, a vertical
tunnel formed with the maxilla, that houses the lacrimal sac, a
structure that gathers tears and passes them into the nasal
cavity
• Palatine Bone
– The two L-shaped palatine bones (PAL-a-tīn) form the posterior
portion of the hard palate, part of the floor and lateral wall of
the nasal cavity, and a small portion of the floors of the orbits
– The posterior portion of the hard palate is formed by the
horizontal plates of the palatine bones
• Inferior Nasal Conchae
– The two inferior nasal conchae (turbinates), which are inferior
to the middle nasal conchae of the ethmoid bone, are separate
bones, not part of the ethmoid bone
– These scroll-like bones form a part of the inferior lateral wall of
the nasal cavity and project into the nasal cavity.
– All three pairs of nasal conchae (superior, middle, and inferior)
increase the surface area of the nasal cavity and help swirl and
filter air before it passes into the lungs.
– However, only the superior nasal conchae of the ethmoid bone
are involved in the sense of smell
• Vomer
– The vomer (VŌ-mer = plowshare) is a roughly
triangular bone on the floor of the nasal cavity
that articulates superiorly with the perpendicular
plate of the ethmoid bone and sphenoid bone and
inferiorly with both the maxillae and palatine
bones along the midline
– It forms the inferior portion of the bony nasal
septum, the partition that divides the nasal cavity
into right and left sides.
• Maxilla
– The paired maxillae (mak-SIL-ē = jawbones;
singular is maxilla) unite to form the upper
jawbone.
– They articulate with every bone of the face except
the mandible (lower jawbone)
– Each maxilla has a hollow body contatining a large
maxillary sinus and four process. The zygomatic
process, frontal process, and alveolar process
• Zygomatic Bone
– The two zygomatic bones (zygo- = yokelike),
commonly called cheekbones, form the
prominences of the cheeks and part of the
– Lateral wall and floor of each orbit They articulate
with the frontal, maxilla, sphenoid, and temporal
bones.
– The temporal process of the zygomatic bone
projects posteriorly and articulates with the
zygomatic process of the temporal bone to form
the zygomatic arch
• Mandible
– The mandible (mand- = to chew), or lower
jawbone, is the largest, strongest facial bone
– It is the only movable skull bone (other than the
auditory ossicles, the small bones of the ear).
– The horizontal part of the mandible, the body
forms the chin
– Two upright bar bone, the rami extend the body
to connect the mandible with the temporal bone
 Fontanels
• At birth, bone ossification is incomplete, and the
mesenchyme-filled spaces become dense connective
tissue regions between incompletely developed cranial
bones called fontanels (fon-ta-NELZ = little fountains),
commonly called “soft spots”
• Functionally, the fontanels serve as spacers for the
growth of neighboring skull bones and provide some
flexibility to the fetal skull, allowing the skull to change
shape as it passes through the birth canal and later
permitting rapid growth of the brain during infancy.
Although an infant may have many fontanels at birth,
the form and location of six are fairly constant
• The unpaired anterior fontanel, the largest fontanel, is
located at the midline among the two parietal bones
and the frontal bone, and is roughly diamond-shaped.
It usually closes 18 to 24 months aft er birth.
• The unpaired posterior fontanel is located at the
midline among the two parietal bones and the occipital
bone. Because it is much smaller than the anterior
fontanel, it generally closes about 2 months after birth.
• The paired anterolateral fontanels, located laterally
among the frontal, parietal, temporal, and sphenoid
bones, are small and irregular in shape. Normally, they
close about 3 months after birth.
• The paired posterolateral fontanels, located laterally
among the parietal, occipital, and temporal bones, are
irregularly shaped. They begin to close 1 to 2 months
after birth, but closure is generally not complete until
12 months
 Hyoid Bone
• The single hyoid bone (= U-shaped) is a unique
component of the axial skeleton because it does not
articulate with any other bone.
• Rather, it is suspended from the styloid processes of
the temporal bones by ligaments and muscles
• Supports the tongue, providing attachment sites for
some tongue muscles and for muscles of the neck and
pharynx
• The hyoid bone and the cartilages of the larynx and
trachea are often fractured during strangulation. As a
result, they are carefully examined at autopsy when
manual strangulation is a suspected cause of death.
 Vertebral Column
• Also called the spine, backbone, or spinal column,
makes up about two-fifths of your total height and is
composed of a series of bones called vertebrae
• Consists of bone and connective tissue; the spinal cord
that it surrounds and protects consists of nervous and
connective tissues.
• The total number of vertebrae during early
development is 33. As a child grows, several vertebrae
in the sacral and coccygeal regions fuse. As a result, the
adult vertebral column typically contains 26 vertebrae
• 7 cervical vertebrae (cervic- = neck) in the
neck region.
• 12 thoracic vertebrae (thorax = chest)
posterior to the thoracic cavity.
• 5 lumbar vertebrae (lumb- = loin) supporting
the lower back.
• 1 sacrum (SA- -krum = sacred bone) consisting
of five fused sacral vertebrae.
• 1 coccyx (KOK-siks = cuckoo, because the
shape resembles the bill of a cuckoo bird)
usually consisting of four fused coccygeal
vertebrae (kok-SIJ-ē-al).
• When viewed from the side
– A convex forward cervical curve
– Convex backward thoracic curve
– Convex forward lumbar curve
– Convex backward sacral curve
• Thoracic and sacral curves are the primary
curves
• Cervical and lumbar are the secondary curves
 Intervertebral Discs
• Found between the bodies of adjacent
vertebrae from the second cervical vertebra to
the sacrum and account for about 25% of the
height of the vertebral column.
 Parts of a Typical Vertebra
• Vertebra typically consists vertebral body, a
vertebral arch, and several processes.
• Vertebral Body
– The vertebral body, the thick, disc-shaped anterior portion, is
the weight-bearing part of a vertebra. Its superior and inferior
surfaces are roughened for the attachment of cartilaginous
intervertebral discs.
• Vertebral Arch
– Two short, thick processes, the pedicles (PEDi- kuls = little feet),
project posteriorly from the vertebral body and then unite with
the flat laminae (LAM-i-nē = thin layers) to form the vertebral
arch.
– The vertebral arch extends posteriorly from the body of the
vertebra; together, the vertebral body and the vertebral arch
surround the spinal cord by forming the vertebral foramen
– The vertebral foramen contains the spinal cord, adipose tissue,
areolar connective tissue, and blood vessels. Collectively, the
vertebral foramina of all vertebrae form the vertebral (spinal)
canal.
– Formed from the joining of all posterior extensions
• Processess
• Seven processes arise from the vertebral arch.
– At the point where a lamina and pedicle join, a transverse process
extends laterally on each side.
– A single spinous process (spine) projects posteriorly from the junction
of the laminae.
– These three processes serve as points of attachment for muscles.
• The remaining four processes form joints with other vertebrae
above or below.
– The two superior articular processes of a vertebra articulate (form
joints) with the two inferior articular processes of the vertebra
immediately above them.
– The two inferior articular processes of that vertebra articulate with the
two superior articular processes of the vertebra immediately below
them, and so on.
• The articulating surfaces of the articular processes, which are
referred to as facets (FAS-ets or fa-SETS = little faces), are covered
with hyaline cartilage.
 Regions of the Vertebral Column
• Cervical
• The bodies of the cervical vertebrae (C1–C7) are smaller
than all other vertebrae except those that form the coccyx
• Their vertebral arches, however, are larger
• All cervical vertebrae have three foramina: one vertebral
foramen and two transverse foramina
– The vertebral foramina of cervical vertebrae are the largest in
the spinal column because they house the cervical enlargement
of the spinal cord
– Each cervical transverse process contains a transverse foramen
through which the vertebral artery and its accompanying vein
and nerve fibers pass
• The spinous processes of C2 through C6 are often bifid—
that is, they branch into two small projections at the tips
• The first two cervical vertebrae differ considerably from the
others.
• The atlas (C1), named after the mythological Atlas who
supported the world on his shoulders, is the first cervical
vertebra inferior to the skull
– With anterior and posterior arches and large lateral masses.
– It lacks a body and a spinous process.
– The superior surfaces of the lateral masses, called superior
articular facets, are concave. They articulate with the occipital
condyles of the occipital bone to form the paired
atlantooccipital joints
– These articulations permit you to move your head to signify
“yes.”
– The inferior surfaces of the lateral masses, the inferior articular
facets, articulate with the second cervical vertebra.
– The transverse processes and transverse foramina of the atlas
are quite large.
• The second cervical vertebra (C2), the axis does
have a vertebral body
– A peglike process called the dens (= tooth) or odontoid
process projects superiorly through the anterior
portion of the vertebral foramen of the atlas
– The dens makes a pivot on which the atlas and head
rotate.
– This arrangement permits side-to-side movement of
the head, as when you move your head to signify
“no.”
– The articulation formed between the anterior arch of
the atlas and dens of the axis, and between their
articular facets, is called the atlanto-axial joint
• The third through sixth cervical vertebrae (C3–
C6), represented by the vertebra in
correspond to the structural pattern of the
typical cervical vertebra previously described.
• The seventh cervical vertebra (C7), called the
vertebra prominens, is somewhat different
– It has a large, nonbifid spinous process that may
be seen and felt at the base of the neck, but
otherwise is typical.
 Thoracic Region
• T1 – T12
• Larger and stronger than cervical vertebrae
• The spinous processes on T1 through T10 are long, laterally
flattened, and directed inferiorly
• The spinous processes on T11 and T12 are shorter, broader,
and directed more posteriorly
• Thoracic vertebrae also have longer and larger transverse
processes.
• They are easily identified by their costal facets (cost- = rib),
which are articular surfaces for the ribs.
• The feature of the thoracic vertebrae that distinguishes
them from other vertebrae is that they articulate with the
ribs.
• T11 and T12, the transverse processes of
thoracic vertebrae have costal facets that
articulate with the tubercles of the ribs
• The vertebral bodies of thoracic vertebrae
have articular surfaces that form articulations
with the heads of the ribs
• The articular surfaces on the vertebral bodies
are called either facets or demifacets
– A facet is formed when the head of a rib
articulates with the body of one vertebra.
– A demifacet is formed when the head of a rib
articulates with two adjacent vertebral bodies
• These articulations between the thoracic
vertebrae and ribs, called vertebrocostal
joints, are distinguishing features of thoracic
vertebrae.
• Movements of the thoracic region are limited
by the attachment of the ribs to the sternum.
 Lumbar Vertebrae
• The lumbar vertebrae (L1–L5) are the largest and strongest
of the unfused bones in the vertebral column because then
amount of body weight supported by the vertebrae
increases toward he inferior end of the backbone.
• Their various projections are short and thick.
• The superior articular processes are directed medially
instead of superiorly, and the inferior articular processes
are directed laterally instead of inferiorly
• The spinous processes are quadrilateral in shape, are thick
and broad, and project nearly straight posteriorly.
• The spinous processes are well adapted for the attachment
of the large back muscles.
 Sacral and Coccygeal Vertebrae
• Sacrum
– The sacrum (SA- -krum) is a triangular bone formed by
the union of five sacral vertebrae (S1–S5)
– The sacral vertebrae begin to fuse in individuals
between 16 and 18 years of age, a process usually
completed by age 30.
– Positioned at the posterior portion of the pelvic cavity
medial to the two hip bones, the sacrum serves as a
strong foundation for the pelvic girdle.
– The female sacrum is shorter, wider, and more curved
between S2 and S3 than the male sacrum
• Coccyx
– Like the sacrum, is triangular in shape.
– It is formed by the fusion of usually four coccygeal
vertebrae
– The coccygeal vertebrae fuse somewhat later than
the sacral vertebrae, between the ages of 20 and
30
– Tailbone
 Thorax
• The entire chest region
• The skeletal part of the thorax, the thoracic cage, is a
bony enclosure formed by the sternum, ribs and their
costal cartilages, and the bodies of the thoracic
vertebrae.
• The thoracic cage is narrower at its superior end and
broader at its inferior end and is flattened from front to
back.
• It encloses and protects the organs in the thoracic and
superior abdominal cavities, provides support for the
bones of the upper limbs, and, plays a role in
breathing.
• Sternum
• or breastbone, is a flat, narrow bone located in the
center of the anterior thoracic wall that measures
about 15 cm (6 in.) in length and consists of three parts
• The superior part is the manubrium (ma-NOO-brē- =
handlelike); the middle and largest part is the body;
and the inferior, smallest part is the xiphoid process
(ZI--foyd = sword-shaped).
• The segments of the sternum typically fuse by age 25,
and the points of fusion are marked by transverse
ridges.
• The manubrium also articulates with the costal
cartilages of the first and second ribs.
• The body of the sternum articulates directly or
indirectly with the costal cartilages of the second
through tenth ribs.
• The xiphoid process consists of hyaline cartilage
during infancy and childhood and does not
completely ossify until about age 40.
• No ribs are attached to it, but the xiphoid process
provides attachment for some abdominal
muscles.
 Ribs
• Twelve pairs of ribs, numbered 1–12 from
superior to inferior, give structural support to
the sides of the thoracic cavity
• The ribs increase in length from the first
through seventh, and then decrease in length
to rib 12.
• Each rib articulates posteriorly with its
corresponding thoracic vertebra.
• The first through seventh pairs of ribs have a
direct anterior attachment to the sternum by a
strip of hyaline cartilage called costal cartilage
• The remaining five pairs of ribs are termed false
ribs because their costal cartilages either attach
indirectly to the sternum or do not attach to the
sternum at all.
• The eleventh and twelft h pairs of ribs are false
ribs designated as floating (vertebral) ribs
because the costal cartilages at their anterior
ends do not attach to the sternum at all
• The ribs that have costal cartilages and attach
directly to the sternum are called true
(vertebrosternal) ribs.
• The cartilages of the eighth, ninth, and tenth
pairs of ribs attach to one another and then to
the cartilages of the seventh pair of ribs. These
false ribs are called vertebrochondral ribs

 1- 7 = true ribs
 8-11 = false ribs
 12 = floating rib
Appendicular Skeleton
 Pectoral Girdle or Shoulder Girdle
• The human body has two pectoral (shoulder)
girdles (PEK-tō-ral) that attach the bones of
the upper limbs to the axial skeleton
• Each of the two pectoral girdles consists of a
clavicle and a scapula
• Clavicle
• The clavicle is the anterior bone and articulates with the
manubrium of the sternum at the sternoclavicular joint
• Each slender, S-shaped clavicle (KLAV-i-kul = key), or collarbone, lies
horizontally across the anterior part of the thorax superior to the
first rib
• The bone is S-shaped because the medial half is convex anteriorly
(curves toward you when viewed in the anatomical position), and
the lateral half is concave anteriorly (curves away from you). It is
rougher and more curved in males.
• The medial end, called the sternal end, is rounded and articulates
with the manubrium of the sternum to form the sternoclavicular
joint.
• The broad, flat, lateral end, the acromial end articulates with the
acromion of the scapula to form the acromioclavicular joint
• Scapula
• Each scapula (SCAP-ū-la; plural is scapulae), or shoulder
blade, is a large, triangular, flat bone situated in the
superior part of the posterior thorax between the levels of
the second and seventh ribs
• A prominent ridge called the spine runs diagonally across
the posterior surface of the scapula
• The lateral end of the spine projects as a flattened,
expanded process called the acromion, easily felt as the
high point of the shoulder
• Inferior to the acromion is a shallow depression, the
glenoid cavity, that accepts the head of the humerus (arm
bone) to form the glenohumeral (shoulder) joint
 Upper Extremity / Limb
• Each upper limb (upper extremity) has 30
bones in three locations—
• (1) the humerus in the arm; (2) the ulna and
radius in the forearm; and (3) the 8 carpals in
the carpus (wrist), the 5 metacarpals in the
metacarpus (palm), and the 14 phalanges
(bones of the digits) in the hand
• Humerus
• Or arm bone, is the longest and largest bone
of the upper limb
• It articulates proximally with the scapula and
distally with two bones, the ulna and the
radius, to form the elbow joint.
• Ulna and Radius
• The ulna is located on the medial aspect (the
little-finger side) of the forearm and is longer
than the radius
• The radius is the smaller bone of the forearm
and is located on the lateral aspect (thumb
side) of the forearm
• In contrast to the ulna, the radius is narrow at
its proximal end and widens at its distal end
-----------------------
• Carpals
• The carpus (wrist) is the proximal region of the hand and consists of eight small
bones, the carpals, joined to one another by ligaments
• Articulations among carpal bones are called intercarpal joints.
• The carpals are arranged in two transverse rows of four bones each.
• Their names reflect their shapes.
• The carpals in the proximal row, from lateral to medial, are the
– scaphoid (SKAF-oyd = boatlike)
– lunate (LOO-nāt = moon-shaped
– triquetrum (trī-KWE- -trum = three-cornered)
– pisiform (PĪS-i-form = pea-shaped).
• The proximal row of carpals articulates with the distal ends of the ulna and radius
to form the wrist joint.
• The carpals in the distal row, from lateral to medial, are the
– trapezium (tra-PE- -zē-um = four-sided figure with no two sides parallel)
– trapezoid (TRAP-e-zoyd = four-sided figure with two sides parallel)
– capitate (KAP-i-tāt = head-shaped)
– hamate (HAM-āt = hooked).
• Metacarpals
• The metacarpus (meta- = beyond), or palm, is the
intermediate region of the hand and consists of five bones
called metacarpals
• Phalanges
• The phalanges (fa-LAN-jēz; phalan- = a battle line), or
bones of the digits, make up the distal part of the hand.
There are 14 phalanges in the five digits of each hand and,
like the metacarpals, the digits are numbered I to V (or 1–
5), beginning with the thumb, from lateral to medial.
• A single bone of a digit is referred to as a phalanx (FA - -
lanks).
 Pelvic Girdle
• The pelvic (hip) girdle consists of the two hip bones,
also called coxal (KOK-sal; cox- = hip) or pelvic bones or
os coxa
• The hip bones unite anteriorly at a joint called the
pubic symphysis
• They unite posteriorly with the sacrum at the sacroiliac
joints
• The complete ring composed of the hip bones, pubic
symphysis, sacrum, and coccyx forms a deep, basinlike
structure called the bony pelvis
• The pelvic girdle of the bony pelvis also connects the
bones of the lower limbs to the axial skeleton.
• 3 bones of the hip bone
• Ilium
• The ilium (IL-ē-um = flank), the largest of the
three components of the hip bone, composed
of a superior ala (= wing) and an inferior body
• The body is one of the components of the
acetabulum, the socket for the head of the
femur
• Ischium - sit down bone
• The ischium (IS-kē-um = hip), the inferior, posterior portion of the
hip bone comprises a superior body and an inferior ramus (ram- =
branch; plural is rami).
• The ramus is the portion of the ischium that fuses with the pubis.
• Important landmarks:
– Ischial tuberosity – roughened area that receives body weight
– Ischial spine – superior to tuberosity, an important landmark
particularly to pregnant women, because it narrows the outlet of the
pelvis through which the baby must pass during the birth process
– Greater sciatic notch – allows blood vessels and the large sciatic nerve
to pass from the pelvis posteriorly to the thigh
• Pubis – the most anterior part
• The pubis (PŪ-bis; plural is pubes), meaning
pubic bone, is the anterior and inferior part of
the hip
• A superior ramus, an inferior ramus, and a
body between the rami make up the pubis.
• The portion of the bony pelvis inferior to the pelvic brim is
the true (lesser) pelvis.
• It has an inlet, an outlet, and a cavity.
• It is bounded by the sacrum and coccyx posteriorly, inferior
portions of the ilium and ischium laterally, and the pubic
bones anteriorly.
• The true pelvis contains the rectum and urinary bladder in
both genders, the vagina and cervix of the uterus in
females, and the prostate in males
• The superior opening of the true pelvis, bordered by the
pelvic brim, is called the pelvic inlet; the inferior opening of
the true pelvis is the pelvic outlet, which is covered by the
muscle at the floor of the pelvis
• True and false pelvis are separated by the
pelvic brim
 Male and Female Pelves
• The female usually shows the following difference
from the male pelvis
– Lighter and thinner bones. Bone markings are less
prominent because of smaller muslces
– Sacrum is less curved and set more horizontally. This
increases the discance between the coccyx and the
symphysis pubis and makes the sacrum broader
– The pelvis has larger openings. The true pelvis and
these openings surround and define the size of the
birth canal
 Lower Limb / Extremity
• Each lower limb (lower extremity) has 30
bones in four locations—
• (1) the femur in the thigh; (2) the patella
(kneecap); (3) the tibia and fibula in the leg;
and (4) the 7 tarsals in the tarsus (ankle), the 5
metatarsals in the metatarsus, and the 14
phalanges (bones of the digits) in the foot
• Femur
• The femur, or thigh bone, is the longest, heaviest, and strongest bone in the body
• Its proximal end articulates with the acetabulum of the hip bone.
• Its distal end articulates with the tibia and patella
• The proximal end consists of:
– Head – forms slightly more than half a sphere, articulates with the acetabulum
of the hipbone
– Neck – connects the head to the shaft; most common site of fracture
– Greater and lesser trochanters – sites of attachment for some large muscles
and buttock muslces
– The body (shaft) of the femur angles medially and, as a result, the knee joints
are closer to the midline than the hip joints.
• This angle of the femoral shaft (angle of convergence) is greater in
females because the female pelvis is broader
• Patella
• The patella (= little dish), or kneecap, is a
small, triangular bone located anterior to the
knee joint
• Largest sesamoid bone in the body
• Leg
• Tibia – second longest and heaviest bone in the body
• The tibia, or shin bone, is the larger, medial, weight-
bearing bone of the leg
• The term tibia means flute, because the tibial bones of
birds were used in ancient times to make musical
instruments.
• The tibia articulates at its proximal end with the femur
and fibula, and at its distal end with the fibula and the
talus bone of the ankle.
• The tibia and fibula, like the ulna and radius, are
connected by an interosseous membrane.
• At the proximal end of the tibia the medial
and lateral condyles articulate with the
condyles of the femur at the knee joint
• Tibial tuberosity – prominence found on the
proximal anterior surface
• The distal end of the tibia is the medial
malleolus that articulates medially with the
head of the talus
• Fibula
• The fibula is parallel and lateral to the tibia, but it is
considerably smaller. Unlike the tibia, the fibula does not
articulate with the femur, but it does help stabilize the
ankle joint.
• The distal end is more arrowhead shaped and has a
projection called the lateral malleolus that articulates with
the talus of the ankle.
• This forms the prominence on the lateral surface of the
ankle
• The head at its proximal end articulates with the lateral
condyle of the tibia not the femur
• It articulates distally with the talus
 Tarsals, Metatarsals,
and Phalanges
• The tarsus (ankle) is the proximal region of the foot
and consists of seven tarsal bones
• They include the talus Cankle bone) and calcaneus
(heel), located in the posterior part of the foot.
• The calcaneus is the largest and strongest tarsal bone.
• The anterior tarsal bones are the navicular (na-VIK-ū-
lar = like a little boat), three cuneiform bones (KŪ-nē-i-
form = wedge-shaped) called the third (lateral), second
(intermediate), and first (medial) cuneiforms, and the
cuboid (KŪ-boyd = cube-shaped).
• The metatarsus, the intermediate region of the foot,
consists of five metatarsal bones numbered I to V (or 1–5)
from the medial to lateral position
• Like the metacarpals of the palm of the hand, each
metatarsal consists of a proximal base, an intermediate
shaft, and a distal head.
• The metatarsals articulate proximally with the first, second,
and third cuneiform bones and with the cuboid to form the
tarsometatarsal joints.
• Distally, they articulate with the proximal row of phalanges
to form the metatarsophalangeal joints.
• The first metatarsal is thicker than the others because it
bears more weight
• The phalanges comprise the distal component of
the foot and resemble those of the hand both in
number and arrangement.
• The toes are numbered I to V (or 1–5) beginning
with the great toe, from medial to lateral
• Each phalanx (singular) consists of a proximal
base, an intermediate shaft, and a distal head.
• The great or big toe (hallux; HAL-eks) has two
large, heavy phalanges called proximal and distal
phalanges.
• References:
– Chanco, C. R. (2002). Human Anatomy and
Physiology. Pasay City, Manila: Christine R. Chanco
– Tortora, G. J., & Derrickson, B. H., (2017).
Principles of Anatomy and Physiology (15th ed.).
Hoboken: John Wiley & Sons.
– Netter, F.H., (2011). Atlas Of Human Anatomy (5th
ed.). Philapdelphia: Saunders/Elsevier