ANATOMY OF BONE

Muliani
 CAUSES OF BONE DISEASES
• Trauma and Injury
• Infection
• Degenerative conditions
• Metabolic disorders
• Neoplastic disorders
• Autoimmune disorders
• Congenital disorders
 The Skeletal System

• Skeletal Function
• Bone Surface Markings
• Divisions of the Skeletal System
• Appendicular Skeleton

Copyright 2009, John Wiley & Sons, Inc.

 SKELETAL FUNCTION

• 1. SUPPORT
• 2. PROTECTION
• 3. MOVEMENT
• 4. MINERAL STORAGE
• 5. BLOOD CELL FORMATION
 Common Bone Categories
The adult skeleton has 206 bones.
Common Bone Categories
•Long bones •Irregular bones
(Femur) (Vertebrae)

•Short bones •Sesamoid bones

(Wrist bones) (Kneecap)

•Flat bones • Pneumatic bones

(Skull) (Frontal) 5
 Articular Spongy bone
Epiphyseal disks
Parts of Long Bones Part 2
cartilage

Proximal
Space containing epiphysis
Parts of a long bone
red marrow

Compact
•Articular cartilage is a thin bone
flexible substance that provides Medullary
protection at movable points. cavity
Yellow Diaphysis
marrow
•Medullary cavity contains yellow Periosteum
bone marrow.

•Red bone marrow is found in

infant bones and the flat bones of
adults. Distal epiphysis

Femur 6
 Bone Surface Markings
• Bones have characteristic surface markings
– Structural features adapted for specific functions
• There are two major types of surface markings:
– 1) Depressions and openings
• Allow the passage of blood vessels and nerves or form joints
– 2) Processes
• Projections or outgrowths that form joints or serve as
attachment points for ligaments and tendons

Copyright 2009, John Wiley & Sons, Inc.

Depression & Openings: Processes:
• Fissure • Condyle
• Foramen • Facet
• Fossa • Head
• Sulcus • Crest
• Meatus • Epicondyle
• Line
• Spinous process
• Trochanter
• Tubercle
• Tuberocity
 Divisions of the Skeletal System

• Axial skeleton
– Skull
– Auditory ossicles and hyoid bone
– Vertebral column
– Thoracic cage
• Appendicular skeleton
– Pectoral and pelvic girdles
– Upper and lower limbs
 Axial skeleton

Appendicular skeleton

Tampak depan Tampak belakang

The Appendicular Skeleton
 THE SKELETAL SYSTEM
The Appendicular Skeleton
• 2 pairs of limbs and 2 girdles
• Pectoral (shoulder) girdle attaches
upper limbs
• Pelvic (hip) girdle secures lower
limbs
• 3-Segmented limbs
– Upper = arm
• Arm
• Forearm
• Hand
– Lower = leg
• Thigh
• Leg
• Foot
UPPER LIMB
 Pectoral
Girdle
(Shoulder Girdle)

• Clavicle – anterior: collar bone

– Sternal end attaches to the manubrium medially
– Acromial end articulates with the scapula laterally
• Scapula – posterior: shoulder blade
Scapulae: triangular, paired, but don’t connect
in back (adds thoracic flexibility)
 capula
• Glenoid cavity
articulates with
the humerus
• Acromion
articulates with
clavicle
• Coracoid process
projects anteriorly
 Upper extremity
• Arm or Brachium =
upper arm
– Between shoulder and
elbow (humerus)
• Forearm or
Antebrachium
– Radius & ulna
• Hand includes:
– Wrist (carpus)
– Palm (metacarpus)
– Fingers (phalanges)
 Arm
ARM

– Humerus is the only

bone
– Head of humerus fits
into glenoid cavity of
scapula
– Distal & medially,
trochlea articulates with
the ulna
– Distal & laterally
capitulum articulates
with the radius
– Medial & lateral
epicondyles
 Right
humerus,
anterior view
Right humerus,
posterior view
 Radius is thinner proximally, like a spool of
Forearm thread, and wide distally; ulna is slightly
longer and looks like a monkey wrench
(supposedly!)

• 2 bones: articulate with each

other proximally and distally
• Interosseous membrane
between them
• Ulna
– Olecranon hinges with the
humerus forming elbow
– Styloid process distally
• Radius
– Contributes to wrist joint
– Styloid process anchors a ligament
to wrist (thumb side)
Right forearm bones, anterior
view
Right forearm bones, posterior
view
 In the anatomical position,
the radius is lateral
Left forearm (thumb side); with
pronation the palm faces
posteriorly and the bones
cross

prone Anatomical Prone: body lying face down

position Suppine: body lying face up

pronation moves the forearm into the prone

position and supination moves it back to the (you can remember prone if you think
anatomical position about how you would fall forward onto
your face if you passed out)
 Hand
• Proximal is “wrist” – 8 carpal bones
• Palm of hand - 5 metacarpals
• Fingers (or digits) consist of miniature long bones called
phalanges: thumb (“pollex”) has 2; fingers have 3: proximal,
middle, distal
Right hand, 2 views:
 Lower limb

• Thigh: femur

• Leg (lower
leg)
– Tibia
– Fibula

• Foot
 Pelvic Girdle
(Hip Girdle)

• Strongly attached to axial

skeleton (sacrum)
• Deep sockets
• More stable than pectoral
(shoulder) girdle
• Less freedom of movement
• Made up of the paired hip bones
– “Bony pelvis” is basin-like
structure: hip bones plus the
axial sacrum and coccyx
 Hip bone (os coxae): 3 separate bones
in childhood which fuse

• Ilium

• Ischium

• Pubis
 Ilium
ilium

• Iliac crest
• Anterior superior
iliac spine
• Greater sciatic
notch
• Forms part of
“acetabulum”
(hip socket)
which receives ilium
ball-shaped head
of femur
 Ischium

• Body
• Ramus
• Ischial spine ischium
• Ischial
tuberosity
• Part of socket

ischium
 Pubis

• Joins medially
in pubic
symphysis
• Forms pubis
“obturator
foramen”
(large hole)
with ischium
• Part of socket
pubis
Hip bones with labels
 False (greater) and
true (lesser) pelvis
Ligaments
 Pelvis and childbearing

• Male/female differences
– Large & heavy vs light & delicate
– Heart shaped pelvic inlet vs oval
– Narrow deep true pelvis vs wide & shallow
– Narrow outlet vs wide
– Less than 90 degree pubic arch vs more than 90 degree
• Birth canal changes shape as baby descends: head turns ¼
– Higher: pelvic inlet (brim) - side to side largest
– Lower: pelvic outlet - largest in AP direction
 Thigh

• Femur is largest, longest

and strongest bone in the
body
• Head fits in socket
(acetabulum) of pelvis
• Neck is weakest
• Greater trochanter
• Distal: lateral & medial
condyles and epicondyles
• Patella: sesamoid bone
Right femur, anterior
view
 Right femur,
posterior view
Coxa valga

Coxa vara
 Leg

• Tibia: shin bone

– Medial and lateral
condyles
– Tibial tuberosity
– Distal medial malleolus
(medial ankle)
• Fibula
– Distal lateral malleolus
(lateral ankle)
• Interosseous membrane
 Right lower
leg, anterior
view
 Foot
• Tarsus: 7 tarsal bones
– Talus: articulates with tibia
and fibula anteriorly and
calcaneus posteriorly
– Calcaneus: heel bone
– Smaller cuboid, navicular,
and 3 cuneiforms (medial,
intermediate and lateral)
• 5 metatarsals
• 14 phalanges
– Great toe is hallux
Right foot, superior (dorsal) view and inferior (plantar) view
Right foot, lateral
and medial views
Arches
 What is

• Fascia
• Tendon
• Ligament
• Bursae
SKIN
 OUR BODY IS COVERED BY
• Skin
• Fascia superficialis (subcutaneous tissue)
• Fascia profundus = fascia=fibrous membrane
between more specialized tissue such as
muscles
– More or less continues over the entire body and
commonly named according to region eg. Fascia
pectoralis, fascia lata etc.
 Epidermis

Dermis
 Function of the fascia
• Provide muscles origins and insertions
• Serving as an elastic sheath for muscles
• Forming specialized retaining band (retinacula) and
fibrous sheaths for tendons
• Provides pathways for the passage of vessels and
nerves (neurovascular sheath)
• Aided the venous return in lower limb by muscular
action
• May limit or control the spread of pus
• Strips of fascia are sometimes used for the repair of
the tendinous or aponeurotic defects
Tendons are
structures that connect
bone to muscle and are
made up of tendon tissue

Can have various shapes

Typical is cord-like tendon
of biceps

Sheeths are common--

”aponeuroses” e.g.
acromiotrapezius origin
from thoracic vertebral
spines,
Aponeurosis of
abdominal wall muscles
 LIGAMENT
Ligaments connect
bone-to-bone or
reinforce joints--they
are made up of
tendinous tissue as
well

E.g. knee ligaments

Serous Cavities of the Human Body
• serous = watery-
type fluid.
• Serous cavities = sacs
lined with serous
membranes.
• serve as lubricating
devices, reduce the
friction during the
motion between
organs
• Exp: bursa, pleural,
pericardial,
peritoneal cavities
Bursae
• Bursae: saclike
structures that reduce
friction. Located in
the shoulder and knee
joints. Found
between skin and
bone, tendons and
bones, muscles and
bones, ligaments and
bones.
Bursae vs Synovial Tendon Sheath
•Tendon Sheaths: tubelike bursae that wrap
around tendons. Found at the wrist, ankle, fingers and
toes.
 Tendons and Ligaments
Tendons and Ligaments

Tendons are bands of fibrous tissue that connect muscles to

bone.
Ligaments connect bones to other bones.

A joint lubricator (synovial fluid) helps synovial

joints move easier.

Movement occurs at joints with the assistance of muscles,

tendons and ligaments.
76
 Joints (Articulations)
• Weakest parts of the skeleton
• Articulation – site where two or more bones
meet
• Functions of joints
– Give the skeleton mobility
– Hold the skeleton together

77
 Classification of Joints: Structural
• Structural classification focuses on the
material binding bones together and whether
or not a joint cavity is present
• The three structural classifications are:
– Fibrous
– Cartilaginous
– Synovial

78
 Classification of Joints: Functional
• Functional classification is based on the
amount of movement allowed by the joint
• The three functional classes of joints are:
– Synarthroses – immovable
– Amphiarthroses – slightly movable
– Diarthroses – freely movable

79
 Fibrous Joints
• The bones are joined by fibrous tissues
• There is no joint cavity
• Most are immovable
• There are three types – sutures, syndesmoses,
and gomphoses

80
 Fibrous joints

• Suture
– Bones tightly bound by
minimal fiber
– Only found in skull
• Syndemoses
– Bones connected by
ligaments
– E.g. tibiofibular ligament,
interosseous membrane of
radius/ulna
• Gomphoses
– Peg in socket joint Fig. 9.1 a, M&M
– Only found in teeth/alveoli
 Fontanela anterior

Fontanela posterior
SUTURE

83
 Fibrous joints
• Suture
– Bones tightly bound by minimal fiber
– Only found in skull
• Syndemoses
– Bones connected by ligaments
Fig. 9.1 b, M&M
– E.g. tibiofibular ligament,
interosseous membrane of
radius/ulna
– Immovable to slightly variable
• Gomphoses
– Peg in socket joint
– Only found in teeth/alveoli

Fig. 8.4, M&M

 Fibrous joints
• Suture
– Bones tightly bound by
minimal fiber
– Only found in skull
• Syndemoses
– Bones connected by
ligaments
– E.g. tibiofibular ligament,
interosseous membrane of
radius/ulna
• Gomphoses
– Peg in socket joint
– Only found in Fig. 9.1 c, M&M
teeth/alveoli
 Cartilaginous Joints
• Synchondrosis
– Hyaline cartilage unites bones
– Epiphyseal growth plates
– Costal cartilage-sternum

Fig. 9.2, M&M

• Symphyses
– Fibrocartilage unites bones
– Pubic symphysis
– Intervertebral disc
• Most common joints in
body
• Most mobile joints
Synovial Joints
• Have
– Articular surfaces on
bone with hyaline
cartilage
– Completely enclosed by
joint capsule which is
formed from
ligamentous connective
tissue
– Synovial fluid within
capsule lubricates joint
– Some have meniscus or
articular disc(e.g. knee,
jaw joint)
 Synovial Joint Shape Types
• Plane joints--intercarpal joints
• Hinge joints--elbow,ankle, inter-phalangeal
• Pivot joints--radio-ulnar joint, atlas-dens joint
• Condyloid joints (egg into oval)--metacarpo-
phalangeal
• Saddle joints--carpo-metacarpal joint of thumb
• Ball-and-socket--hip, shoulder

The type of joint, in part, determines the range

and direction of movement
 Types of Synovial Joints Based on Shape

Figure 5.29a–c

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide

5.52a
Gliding- 
In a gliding or plane joint bones slide
past each other. Mid-carpal and mid-tarsal
joints are gliding joints. (Hands, Feet)
 Types of Joints
Hinge- 
A hinge joint allows extension and
flexion of an appendage. (Elbow, Knee)
PIVOT JOINT
BETWEEN C1
AND C2
 Types of Synovial Joints Based on Shape

Figure 5.29d–f

Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide

5.52b
 4. Condyloid, or Ellipsoidal, Joints
• Both articular surfaces
are oval
• Biaxial joints permit all
angular motions
• Examples: radiocarpal
(wrist) joints, and
metacarpophalangeal
(knuckle) joints

96
Saddle- This type of joint occurs when the
touching surfaces of two bones have both
concave and convex regions with the
shapes of the two bones complementing
one other and allowing a wide range of
movement. (Thumb)
Ball and Socket- 
A ball and socket joint
allows for radial movement in almost any
direction. They are found in the hips and
shoulders. (Hip, Shoulder)
Types of movement and examples (with muscles)
flexion- move lower leg toward upper
extension- straightening the leg

abduction- moving leg away from body

adduction- movong leg toward the body

rotation- around its axis

supination- rotation of arm to palm-up position
pronation- palm down

circumduction- swinging arms in circles

inversion- turning foot so sole is inward

eversion- sole is out
Joint Diseases
Arthritis
 Gout
• Gout is a disease that results from an
overload of uric acid in the body. This
overload of uric acid leads to the
formation of tiny crystals of urate that
deposit in tissues of the body, especially
the joints. When crystals form in the joints
it causes recurring attacks of joint
inflammation (arthritis). Chronic gout can
also lead to deposits of hard lumps of uric
acid in and around the joints and may
cause joint destruction, decreased kidney
function, and kidney stones.
X-ray of hand affected by arthritis
 Bursitis
• Inflammation of the Bursa (fluid
filled sac surrounding the joint).
• A bursa can become inflamed from
injury, infection (rare in the
shoulder), or due to an underlying
rheumatic condition.
• Bursitis is typically identified by
localized pain or swelling,
tenderness, and pain with motion of
the tissues in the affected area.
 Pathology Part 3
•Injury or trauma to the joints or muscle
may cause a sprain.
•Overuse of a muscle may cause a strain.
Other conditions:

•Tendinitis •Subluxation

•Dislocation •Osteoporosis
111
 Tendonitis
• Sometimes the tendons become inflamed
for a variety of reasons, and the action of
pulling the muscle becomes irritating. If
the normal smooth gliding motion of your
tendon is impaired, the tendon will
become inflamed and movement will
become painful. This is called tendonitis,
and literally means inflammation of the
tendon.
• The most common cause of tendonitis is
overuse.
Artificial Hip Joint
TRAUMA !!!
R. I. C. E. :
• REST

• ICE

• COMPRESS

• ELEVATE
124