ANATOMY AND PHYSIOLOGY

CHAPTER 6: Skeletal System: o If mineral in a long bone is reduced,

collagen becomes the primary
Bones and Joints constituent and the bone is overly
6.1 FUNCTIONS OF THE SKELETAL flexible. On the other hand, if the
SYSTEM amount of collagen is reduced in the
bone, the mineral component becomes
The skeletal system consists of bones as well as the primary constituent and the bone is
their associated connective tissues, including very brittle.
cartilage, tendons, and ligaments. - Brittle bone disease, or osteogenesis imperfecta,
Functions of Skeletal System imperfect bone formation, is a rare disorder
caused by any one of a number of faulty genes
1. Body support. that results in either too little collagen
- CARTILAGE provides firm yet flexible support formation, or poor-quality collagen. As a result,
within certain structures, such as the nose and the bone matrix has decreased flexibility and is
external ear. more easily broken than normal bone.
- LIGAMENTS, strong bands of fibrous
connective tissue, hold bones together.
2. Organ protection. Bone Cells
- BONE is hard and protects the organs it
surrounds. There are three types of bone cells
3. Body movement. 1. Osteoblasts
- Skeletal muscles attach to bones by TENDONS,
- are bone-building cells.
which are strong bands of connective tissue.
- Contraction of the skeletal muscles moves the
- cells have an extensive endoplasmic reticulum
and numerous ribosomes.
bones, producing body movement.
- JOINTS, which are formed where two or more - produce collagen and proteoglycans, which are
bones come together, allow movement between packaged into vesicles by the Golgi apparatus
bones. and secreted by exocytosis.
4. Mineral storage. - The formation of new bone by osteoblasts is
- If blood levels of these minerals decrease, the called ossification
minerals are released from bone into the blood. 2. Osteocytes
- If needed, the lipids are released into the blood - Osteoblasts become osteocytes
and used by other tissues as a source of energy. - Osteocytes account for 90–95% of bone cells
5. Blood cell production. and are very long-lived, with a life span of up to
- Many bones contain cavities filled with red bone 25 years.
marrow, which produces blood cells and - Osteocyte cell bodies are housed within the
platelets bone matrix in spaces called LACUNAE
- Osteocyte cell extensions are housed in narrow,
long spaces called CANALICULI
6.2 BONE HISTOLOGY - Nutrients and gases can pass through the small
• the fibrous protein collagen provides flexibility amount of fluid surrounding the cells in the
but resists pulling or compression. canaliculi and lacunae or pass from cell to cell.
3. Osteoclasts
• the matrix ground substance consists of
molecules called proteoglycans, water-trapping
- are bone-destroying cells
proteins, which helps cartilage be smooth and - Breakdown of bone is called bone reabsorption
resilient. - As bone is broken down, the Ca 2+ goes “back”
into the blood.
Bone Matrix
- multinucleated cells and develop from the red
- By weight, mature bone matrix is normally bone marrow cells that also differentiate into
about 35% organic and 65% inorganic material. specialized white blood cells.
- The organic material consists primarily of - The RUFFLED BORDER is a specialized
collagen and proteoglycans. reabsorption-specific area of the membrane.
- The inorganic material consists primarily of a (review this part)
calcium phosphate crystal called
hydroxyapatite Ca10 (PO4 )6 (OH)2.
- COLLAGEN
o collagen fibers lend flexible strength to
the matrix
 ANATOMY AND PHYSIOLOGY
Spongy and Compact Bone - Within joints, the end of a long bone is covered
with hyaline cartilage called articular cartilage
- Mature bone is called lamellar bone. It is
organized into thin, concentric sheets or layers, - epiphyseal plate
called lamellae (the collagen fibers of one o growth plate, is located between the
lamella lie parallel to one another, epiphysis and the diaphysis
- Spongy bone, which appears porous, has less
bone matrix and more space than compact bone.
- epiphyseal line
- Spongy bone o when bone stops growing in length, the
o consists of interconnecting rods or plates epiphyseal plate becomes ossified
of bone called trabeculae
o The surfaces of trabeculae are covered
with a single layer of cells consisting The cavities of spongy bone and the medullary
mostly of osteoblasts with a few cavity are filled with marrow
osteoclasts.
- Compact bone, or cortical bone RED MARROW - is the site of blood cell
o the solid, outer layer surrounding each formation
bone. YELLOW MARROW - is mostly adipose tissue.
o more matrix and is denser with fewer
pores than spongy bone
o The functional unit of compact bone is
an osteon or haversian system. An Layer of Bone
osteon is composed of concentric rings PERIOSTEUM - is a connective tissue membrane
of matrix, which surround a central covering the outer surface of a bone
tunnel and contain osteocytes
o the bull’s-eye of the target is the central ENDOSTEUM - is a single cell layer of connective
canal. tissue that lines the internal surfaces of all cavities
o Central canals are lined with endosteum within bones.
and contain blood vessels, nerves, and
loose connective tissue. Blood vessels
are contained within the central canals 6.4 BONE DEVELOPMENT
o Osteocytes are located in lacunae Bone formation in the fetus follows two processes:
between the lamellar rings.
1. INTRAMEMBRANOUS OSSIFICATION
o Nutrients in the blood vessels are
delivered to the osteocytes. Because the - Starts with embryonic connective tissue
osteocytes are in contact with each other membranes
through the canaliculi, nutrients are - approximately the fifth week of development in
passed from one osteocyte to another an embryo
osteocyte within each osteon. Waste
products are removed in the reverse - Centers of ossification - he locations in the
direction. membrane where intramembranous ossification
begins.
- Fontanels, or soft spots, are the larger,
membrane-covered spaces between the
6.3 BONE ANATOMY
developing skull bones that have not yet been
Structure of a Long Bone ossified.
- PROCESS
DIAPHYSIS 1) Osteoblast activity
2) Spongy bone formation
- is the center portion of the bone 3) Compact bone formation
- composed primarily of compact bone tissue,
surrounding a hollow center called the
2. ENDOCHONDRAL OSSIFICATION
medullary cavity.
- starts with a cartilage model.
EPIPHYSES - The formation of cartilage begins at
- ends of a long bone approximately the end of the fourth week of
embryonic development.
- mostly spongy bone, with an outer layer of
compact bone. - PROCESS
1) Cartilage model formation
 ANATOMY AND PHYSIOLOGY
2) Bone collar formation 6.7 BONE REPAIR
3) Primary ossification center formation Process
4) Secondary ossification center formation
5) Adult bone 1. Hematoma formation
2. Callus formation
o Callus - a mass of bone tissue that forms
6.5 BONE GROWTH
at a fracture site.
Bone Growth in Width 3. Callus ossification
- Bone growth occurs by the deposition of new 4. Bone remodeling
bone lamellae onto existing bone or other Classification of Bone Fractures
connective tissue.
- As osteoblasts deposit new bone matrix on the
surface of bones between the periosteum and the
existing bone matrix, the bone increases in
width, or diameter.
- This process is called appositional growth.

Bone Growth in Length

- Growth in the length of a bone, which is the
major source of increased height in an 6.8 CALCIUM HOMEOSTASIS
individual, occurs in the epiphyseal plate. - Bone is a major storage site for calcium
- This type of bone growth occurs through - Movement of calcium in and out of bone helps
endochondral ossification. determine blood levels of calcium
- PROCESS - Calcium moves into bone as osteoblasts build
1) The zone of resting cartilage is nearest new bone
the epiphysis and contains slowly - Calcium move out of bone as osteoclasts break
dividing chondrocytes. down bone
2) The chondrocytes in the zone of - Calcium homeostasis is maintained by
proliferation produce new cartilage by parathyroid hormone (PTH) and calcitonin
dividing and forming columns
resembling stacks of plates or coins. Calcium is a critical physiological regulator of
3) In the zone of hypertrophy, the many processes required to achieve and maintain
chondrocytes produced in the zone of homeostasis. The processes include:
proliferation mature and enlarge.
1. stimulation of skeletal muscle contraction
4) The zone of calcification is very thin and
2. stimulation and regulation of cardiac muscle
contains hypertrophied chondrocytes and
contraction
calcified cartilage matrix. The
3. exocytosis of cellular molecules, including
hypertrophied chondrocytes die, and
those important for neural signaling
blood vessels from the diaphysis grow
into the area. The connective tissue Calcium homeostasis is regulated by three
surrounding the blood vessels contains hormones (chemical messengers delivered via the
osteoblasts from the endosteum. blood):
5) The osteoblasts line up on the surface of
1. parathyroid hormone (PTH)
the calcified cartilage and deposit new
2. calcitriol, a biologically active form of
bone matrix, which is later remodeled.
vitamin D3
3. calcitonin.
6.6 BONE REMODELING Regulation of Blood Ca 2+ Levels
Bone remodeling involves: 1. Blood Ca 2+ levels are in the norm al range.
2. Blood Ca 2+ levels increase outside their
• removal of existing bone by osteoclasts and norm al range, which causes homeostasis to
• deposition of new bone by osteoblasts be disturbed.
• occurs in all bones 3. The control centers respond to the change in
• responsible for changes in bone shape, bone blood levels.
• repair, adjustment of bone to stress, and 4. The control center releases calcitonin, which
• calcium ion regulation inhibits osteoclasts.
 ANATOMY AND PHYSIOLOGY
5. Reduced osteoclast activity causes blood Ca which reduces the amount of Ca 2+
2+ levels to decrease. excreted in the urine.
6. Ca 2+ levels return to their norm al range
and homeostasis is restored. Observe the
Indirect Effects of PTH in the Small
responses to a decrease in blood Ca 2+
levels outside the norm al range by - The intestine regulates blood calcium via
following the red arrows in the bottom Parathyroid Hormone (PTH). PTH prompts
panel. kidney-triggered calcitriol release, enhancing
small intestine calcium absorption, elevating
blood calcium. PTH indirectly manages blood
calcium by influencing small intestine calcium
absorption through calcitriol.

Calcitriol
- Calcium ions (Ca2+) in blood are regulated by
calcitriol, a steroid hormone derived from
vitamin D3. Vitamin D3 synthesis begins in skin
and progresses in liver and kidney, where
calcitriol activates. Parathyroid hormone (PTH)
stimulates calcitriol activation in the kidney,
aiding PTH-induced blood calcium increase.
Calcitriol and PTH cooperate to boost osteoclast
activity, breaking down bone (bone resorption).
Calcitriol and PTH also collaborate in kidney
tubules to prevent calcium ion removal through
urine. These actions elevate blood calcium
levels.
Parathyroid Hormone
Calcitonin
- Parathyroid hormone is secreted by cells in the - Calcitonin is a hormone released by thyroid
parathyroid gland and is essential for the gland cells when there's too much calcium in the
maintenance of blood Ca 2+ levels within the blood. It quickly reduces blood calcium by
homeostatic limits. slowing down bone-dissolving cells called
- The key signal for PTH secretion is a reduction osteoclasts. We're still figuring out its exact role
in blood Ca 2+ levels. PTH works through two in adult bone maintenance. You can learn more
general mechanisms: about it in chapters 10 and 18.
1. direct effects on bone cells and in the kidney
and
2. indirect effects on the small intestine. 6.9 SKELETAL ANATOMY OVERVIEW
Direct Effects of PTH AXIAL SKELETON
- Bone Cells - consists of the bones of the skull, the auditory
o PTH regulates blood calcium levels by ossicles, the hyoid bone, the vertebral column,
controlling bone-related cells. It and the thoracic cage (rib cage).
stimulates osteoclasts that break down - Axial Skeleton
bone tissue, binding to osteoblasts and
• Skull (Cranium)
osteocytes. PTH promotes active
o Cranial bones
osteoclasts, prevents suppression of
o Paired (left and right)
osteoclast formation, and even
▪ Parietal 2
encourages new bone tissue formation,
▪ Temporal 2
despite its bone breakdown role.
o Unpaired (single)
Intermittent PTH use prevents
▪ Frontal 1
osteoporosis by maintaining bone
▪ Sphenoid 1
density. The exact mechanism of PTH's
▪ Occipital 1
bone formation stimulation is not
▪ Ethmoid 1
completely known.
• Facial bones
o Paired
- Kidney Tubules
▪ Maxilla 2
o PTH stimulates the reabsorption of Ca
▪ Zygomatic 2
2+ from urine in the kidney tubules,
▪ Palatine 2
 ANATOMY AND PHYSIOLOGY
▪ Lacrimal 2 Total appendicular skeleton bones 126
▪ Nasal 2 Total bones 206
▪ Inferior nasal concha 2
o Unpaired
▪ Mandible 1
▪ Vomer 1
Total skull bones 22
• Bones Associated with the Skull
o Auditory ossicles
▪ Malleus 2
▪ Incus 2
▪ Stapes 2
▪ Hyoid 1
Total associated bones 7
• Vertebral Column
o Cervical vertebrae 7
o Thoracic vertebrae 12
o Lumbar vertebrae 5
o Sacrum 1
o Coccyx 1 BONE SHAPES
Total vertebral column bones 26 There are four categories of bone, based on their
• Thoracic Cage shape:
o Ribs 24 1. LONG
o Sternum 1 - Long bones are longer than they are wide. This
Total thoracic cage bones 25 shape enhances their function in movement of
Total axial skeleton bones 80 appendages. Most of the bones of the upper and
lower limbs are long bones.
APPENDICULAR SKELETON
2. SHORT
- The appendicular skeleton consists of the bones - Short bones are approximately as wide as they
of the upper limbs, the lower limbs, and the two are long; examples are the bones of the wrist
girdles. The term girdle, which means “belt” or and ankle. Short bones help transfer force
“zone,” refers to the two zones where the limbs between long bones
are attached to the body. These two zones are 3. FLAT
the pectoral girdle and the pelvic girdle. - Flat bones have a relatively thin, flattened
- Appendicular Skeleton shape. Flat bones are well-suited to providing a
• Pectoral Girdle strong barrier around soft organs such as the
o Scapula 2 brain and heart. Examples of flat bones are
o Clavicle 2 certain skull bones, the ribs, the scapulae
o Upper Limb (shoulder blades), and the sternum.
▪ Humerus 2 4. IRREGULAR
▪ Ulna 2 - Irregular bones like vertebrae and facial bones
▪ Radius 2 don't fit into other bone categories. They have
▪ Carpal bones 16 unique shapes and serve specialized functions,
▪ Metacarpal bones 10 like protecting and allowing flexibility, such as
▪ Phalanges 28 in the spine.
Total girdle and upper limb bones 64
SKELETAL TERMINOLOGY
• Pelvic Girdle
o Hip bone 2
o Lower Limb
▪ Femur 2
▪ Tibia 2
▪ Fibula 2
▪ Patella 2
▪ Tarsal bones 14
▪ Metatarsal bones 10
▪ Phalanges 28
Total girdle and lower limb bones
62
Total appendicular skeleton bones 126
Total axial skeleton bones 80
 ANATOMY AND PHYSIOLOGY
6.10 AXIAL SKELETON - cribriform plates
SKULL - Olfactory foramina
There are four main sutures: - Perpendicular plate
1. Coronal - Septum
2. Sagittal - Conchae
3. Lambdoid - Inferior nasal concha
-
4. Squamous
Specialized Regions
Cranial Bones
The sinuses have two major functions:
The 8 bones of the cranium include:
1. they decrease the weight of the skull and
1. FRONTAL BONE
2. they act as a resonating chamber when
- The superior border of each eye orbit has a
speaking
supraorbital foramen for blood vessels and
nerves. The space between the orbits is called
Orbits
the glabella. The frontal bone also contains the
• nasolacrimal canal - carrying tears from the
frontal sinus one of the paranasal sinus. It
eyes to the nasal cavity
contributes to the anterior cranial fossa,
supporting brain lobes. Nasal Cavity
2. PARIETAL BONES (PAIR)
3. TEMPORAL BONES (PAIR) The only visible portions of the external nose in a
- The temporal bone is subdivided into three main dried skull are
regions: 1. the two nasal bones and
1) the squamous part 2. the maxilla
o The zygomatic process
o zygomatic arch
o mandibular fossa - is the attachment site Facial Bones
of the mandible (lower jaw).
2) the tympanic part The 14 facial bones of the skull include
o external auditory canal (external acoustic 1. Zygomatic bones
meatus) 2. Maxilla bones
3) the petrous part. 3. Palatine bones
o internal auditory canal 4. Lacrimal bones
o mastoid process 5. Nasal bones
o mastoid air cells 6. mandible
o mastoiditis 7. Vomer bone
o styloid process 8. Inferior nasal conchae
o stylomastoid foramen
o jugular Hyoid Bone
o foramina
The hyoid bone, which is not attached to other
o carotid canals
bones, is the attachment site for the throat and
o foramen lacerum
tongue muscles.
4. OCCIPITAL BONE
- foramen magnum
- posterior cranial fossae
- occipital condyles
- nuchal lines
5. SPHENOID BONE
- sella turcica
Three additional paired foramina are located on
either side of the sella turcica:
1. the foramen rotundum
2. the foramen ovale
3. the foramen
- optic canal
- middle cranial fossa
- superior orbital fissure
6. ETHMOID BONE.
- nasal septum (wall)
- ethmoidal sinuses
 ANATOMY AND PHYSIOLOGY
General Features of the Vertebrae
Each vertebra consists of:
1. a body
2. a vertebral arch
3. various processes
- The vertebral arch and body shield the spinal
cord. The arch extends backward from the body,
creating a circular bony frame with the vertebral
foramen, housing the spinal cord. Adjacent
vertebrae's foramina make up the vertebral
canal, holding the spinal cord and cauda equina.
The arch consists of left/right halves, each with
a pedicle (attached to the body) and a lamina
(back of foramen). Transverse processes extend
sideways, and a single spinous process is at the
laminae junction, felt as midline projections on
the back. Skeletal muscles attached to these
processes facilitate movement. Intervertebral
foramina, formed by notches in pedicles, allow
spinal nerves to exit.
Vertebral Column
- Vertebral column movement and support rely on
The vertebral column performs five major vertebral processes. Each vertebra has two
functions: superior and two inferior articular processes,
overlapping for increased rigidity. These
1. It supports the weight of the head and trunk
processes create smooth articular facets where
2. it protects the spinal cord,
they articulate. Intervertebral disks separate
3. it allows spinal nerves to exit the spinal cord
vertebrae.
4. it provides a site for muscle attachment
5. it permits movement of the head and trunk. Regional Differences in Vertebrae
The vertebral column usually consists of 26 bones,
called vertebrae, which can be divided into five
regions:
• 7 cervical vertebrae
• 12 thoracic vertebrae
• 5 lumbar vertebrae
• 1 sacral bone
• 1 coccygeal bone

• CERVICAL VERTEBRAE: Found in the neck,

cervical vertebrae allow head movement but are
prone to fractures due to small size. They
possess transverse foramina for vertebral
arteries. The first two, atlas and axis, enable
nodding and rotation.
• THORACIC VERTEBRAE: These support the
rib cage, protecting the heart and lungs. Least
mobile due to rib articulation, they have long
spinous processes and transverse processes with
rib facets.
• LUMBAR VERTEBRAE: Bear most body
weight, with large bodies, robust processes, and
thicker disks. Can experience intervertebral disk
issues. Fusion anomalies can affect lumbar-
sacral structure.
• SACRUM: Fused from sacral vertebrae,
supports hips, and stabilizes the lower limbs.
Forms a solid plate, integral to the pelvic
 ANATOMY AND PHYSIOLOGY
girdle's stability. The fused spinous processes manubrium has a jugular notch and connects to the
create the median sacral crest on the sacrum's first rib and clavicle. The point where the
back. The sacral hiatus, an opening, marks the manubrium meets the body forms the sternal angle,
end of the vertebral canal and is an anesthesia noticeable on the chest. The second rib's cartilage
injection point. The first sacral vertebra's attaches at the sternal angle, while ribs 3-7 attach to
anterior bulge, the sacral promontory, is a the sternum's body. The xiphoid process lacks rib
landmark for separating abdominal and pelvic attachments.
cavities.

6.11 APPENDICULAR SKELETON

Pectoral Girdle and Upper Limb

• COCCYX: The coccyx, or tailbone, is the end

of the vertebral column. Comprising 3-5 semi-
fused vertebrae, it's smaller with no vertebral
foramina or developed processes. In females, it
often projects downward. Prone to fractures
from hard seated falls.

Thoracic Cage
It consists of Pectoral Girdle: Scapula and Clavicle
1. the thoracic vertebrae,
2. the ribs with their associated costal (rib)
cartilages
3. the sternum

The pectoral girdle connects the upper limbs to the

body. It consists of two pairs of bones: the scapula
(shoulder blade) and the clavicle (collarbone). The
scapula is a flat, triangular bone with processes like
the acromion and coracoid, and a glenoid cavity that
Ribs and Costal Cartilages
connects with the humerus. The clavicle is a slightly
The rib cage has 12 pairs of ribs. Ribs 1-7 are true curved bone connecting the scapula and sternum,
ribs, attaching directly to the sternum via costal aiding upper limb mobility by keeping it away from
cartilage. Ribs 8-12 are false ribs, with ribs 8-10 the body.
attaching indirectly through a common cartilage to
rib 7, which connects to the sternum. Ribs 11 and 12
are floating ribs, not attached to the sternum. Costal Arm: Humerus
cartilages are flexible, allowing the thoracic cage to
expand during breathing.

Sternum
The sternum, or breastbone, resembles a sword with
three parts: the manubrium (handle), the body
(blade), and the xiphoid process (tip). The
 ANATOMY AND PHYSIOLOGY
Wrist: Carpals
The wrist consists of eight carpal bones in two
rows. The proximal row includes scaphoid, lunate,
triquetrum, and pisiform. The distal row includes
hamate, capitate, trapezoid, and trapezium. A
mnemonic "Straight Line To Pinky, Here Comes
The Thumb" helps remember their order.

Hand: Metacarpals and Phalanges

The arm, from shoulder to elbow, has one bone - the The hand has five metacarpal bones forming a
humerus. Its head connects with the scapula's curved structure with concave palms. Metacarpals
glenoid cavity. The surgical neck, prone to fractures, connect to carpal bones and form knuckles at their
lies just below the head. The proximal end holds distal ends. Each hand has five digits with
two attachment sites: the greater tubercle on the phalanges: the thumb has two (proximal and distal),
side, and the lesser tubercle upfront. while each finger has three (proximal, middle, and
distal).
The diaphysis shows the deltoid tuberosity for
deltoid muscle. The elbow's distal end has unique
features: the capitulum for radius articulation, and
Pelvic Girdle and Lower Limb
the trochlea for ulna. Forearm muscles attach just
above at the epicondyles. On the back, the
olecranon fossa accommodates the ulna's elbow
point.

Forearm: Ulna and Radius

Pelvic Girdle: Hip Bones and Sacrum

Hip Bones
ULNA: The ulna, a forearm bone, has a trochlear
notch that interacts with the humerus, allowing - The pelvic girdle consists of hip bones and the
elbow movement. Its coronoid process connects to sacrum, forming a circular bone structure. It
the humerus during bending, while the olecranon includes the coccyx, forming the pelvis. Each
process fits into the humeral olecranon fossa during hip bone is a fusion of the ilium, ischium, and
straightening. The ulna's head connects to the radius pubis. They converge at the acetabulum, where
and wrist bones, and its distal end has a styloid lower limbs attach. The pelvis supports body
process for wrist ligament attachment. weight, houses organs, and in women, aids
childbirth.
RADIUS: The radius articulates with the humerus - The ilium's crest, anterior and posterior spines,
via its head, rotating during elbow bending. The sciatic notch, and iliac fossa are key features.
radial tuberosity below the head connects to the - The ischium has the ischial tuberosity and spine,
biceps brachii muscle. The distal end features a while
lateral styloid process, aiding wrist ligament
attachment.
 ANATOMY AND PHYSIOLOGY
- the pubis forms the anterior pelvis and
surrounds the obturator foramen.
- The pelvis has a true and false part, with inlets
and outlets defined by bony and muscular
structures.

Leg: Tibia and Fibula

The leg, between knee and ankle, has two bones:
tibia (shinbone) and fibula. Tibia is larger and
weight-bearing, with condyles for femur connection
Comparison of the Male Pelvis and the Female
and a tuberosity for muscle attachment. Fibula's
Pelvis
head articulates with tibia's proximal end but doesn't
• Male pelvis = heavier due to bigger male body. connect to femur.
• Female pelvis = wider, rounder inlet/outlet for
childbirth.
• Wide inlet & spaced spines = easy baby Ankle
delivery. The ankle comprises the lower tibia and fibula
connecting with the talus bone in the foot. There are
visible prominences on each side: the medial
malleolus from the tibia and the lateral malleolus
from the fibula.

Thigh: Femur
The thigh's main bone is the femur, with a rounded
head connecting to the acetabulum, and a neck at an
angle to the shaft. Proximally, it has trochanters for
muscle attachment. The greater trochanter forms the
hip's widest point. The femur meets the tibia to form
the knee, with two smooth projections aiding knee
bending. The patella, a sesamoid bone in the
quadriceps femoris tendon, articulates with the
femur to smooth the knee's front end and keep the
tendon separated. Foot: Tarsals, Metatarsals, and Phalanges
The foot includes 7 tarsal bones:
1. talus,
2. calcaneus,
3. navicular,
4. medial cuneiforms
5. intermediate cuneiforms
6. lateral cuneiforms
 ANATOMY AND PHYSIOLOGY
7. cuboid. Cartilaginous Joints
Metatarsals and phalanges are like hand bones, with - Cartilaginous joints consist of bones united by
the great toe comparable to the thumb. Sesamoid cartilage, and they exhibit slight movement.
bones form in toe tendons. The foot has 3 arches—
longitudinal and transverse—formed by tarsals and Synovial Joints
metatarsals, aiding in upright support and walking. 1. Synovial joints are capable of considerable
These arches work like springs, supporting movement. They consist of the following:
movement and absorbing shock. o Articular cartilage on the ends of
The arches serve as an adjustable lever to assist in bones that provides a smooth surface
the two main functions of the foot: for articulation.
1. to support the body in its upright position o Articular disks can provide
both while standing and in forward additional support. A joint cavity is
movement during walking and surrounded by a joint capsule of
2. to push the body forward during walking fibrous connective tissue, which
and to absorb shock when the foot contacts holds the bones together while
the ground. permitting flexibility. A synovial
membrane produces synovial fluid,
which lubricates the joint.
6.12 JOINTS 2. Bursae are extensions of synovial joint
cavities that protect skin, tendons, or bone
A joint is a place where bones come together. from structures that could rub against them.
Fibrous Joints 3. Synovial joints are classified according to
Fibrous Joints the shape of the adjoining articular surfaces:
1. plane (two flat surfaces),
- consist of bones united by fibrous connective 2. saddle (two saddle-shaped surfaces),
tissue. They allow little or no movement. 3. hinge (concave and convex surfaces),
- Syndesmoses are fibrous joints with bones 4. pivot (cylindrical projection inside a
separated, connected by ligaments. Example: ring),
fibrous membrane between distal radius and 5. ball-and-socket (rounded surface into
ulna. a socket),
- Gomphoses are joints with pegs in sockets, 6. ellipsoid (ellipsoid concave and
secured by ligaments. Example: tooth-to-socket convex surfaces).
joint (dental gomphosis).
4. Movements at synovial joints are described
as uniaxial, occurring around one axis;
biaxial, occurring around two axes situated
at right angles to each other; or multiaxial,
occurring around several axes.
 ANATOMY AND PHYSIOLOGY
Types of Movement • Dislocations stretch joint capsule,
The major types of movement are: increasing future dislocation risk.
• FLEXION decreases joint angle, while • "Loose" joints can lead to hereditary
extension increases it (e.g., elbow, knee). predisposition for dislocations.
• HYPEREXTENSION goes beyond 180
degrees (caution: injury risk). SKELETAL DISORDERS:
• FOOT MOVEMENT: Plantar flexion • Gigantism: Excessive body size from
(pointing toes down), dorsiflexion (lifting
toes).
epiphyseal plate overgrowth.
• ABDUCTION moves away from midline; • Dwarfism: Abnormally small size due to
adduction moves toward (e.g., jumping improper epiphyseal plate growth.
jacks). • Rickets: Soft, weak bones from
• PRONATION (palm down) and supination nutritional deficiencies (Ca²⁺, vitamin D).
(palm up) for forearm rotation.
• Osteomalacia: Softening of adult bones
• EVERSION turns foot outward; inversion
turns foot inward.
due to calcium depletion.
• ROTATION turns a structure along its axis JOINT DISORDERS:
(e.g., arm shaking "no").
• CIRCUMDUCTION occurs in freely • Arthritis: Joint inflammation from
movable joints (e.g., shoulder). infection, metabolic, trauma, or immune
• PROTRACTION glides structure forward; causes.
retraction glides it backward
• Rheumatoid arthritis: Autoimmune
• ELEVATION moves structure upward;
depression moves it downward.
disease affecting connective tissues.
• EXCURSION moves structure to the side • Gout: Accumulation of uric acid crystals
(e.g., moving mandible side to side). causing joint and tissue inflammation.
• OPPOSITION (thumb to little finger) and • Bursitis: Inflammation of bursa (fluid-
reposition explained. filled sac) near joints.
• COMPLEX MOVEMENTS are
• Bunion: Deformation of first metatarsal
combinations of individual movements.
joint, often with bursitis.

OSTEOPOROSIS
• In women, low estrogen can lead to bone
loss, especially in vertebrae and forearm
bones.
• Menopause, ovary removal, extreme
exercise, anorexia, smoking can reduce
estrogen.
• In men, lower testosterone levels can
cause bone tissue loss, but less common
due to denser bones.
• Inadequate calcium intake, poor
absorption, medications, age-related
reduced absorption.
• Lack of exercise or disuse from injury
can contribute, with significant bone loss
Joint Injuries: in just 8 weeks.
• SPRAIN: ligaments torn when joint bones • Early diagnosis aids prevention. Dual-
pulled apart. energy x-ray absorptiometry (DEXA)
• SEPARATION: bones remain apart after measures bone density.
joint injury. • Prevention: dietary calcium, vitamin D,
• DISLOCATION: bone pulled from socket
exercise. Medications like calcitonin and
in ball-and-socket, ellipsoid, or pivot joint.
alendronate.
 ANATOMY AND PHYSIOLOGY
• Estrogen therapy side effects, not
recommended for treatment due to risks
like breast cancer.