Fundamentals Anatomy and Physiology Exam 2 Notes

A+P Exam II Notes LOOK AT BONES LIST!

Chapter 7: The Axial Skeleto

Axial skeleton forms longitudinal axis of bodyo Adjust position of head, neck & trunko Perform respiratory movementso Stabilize or position parts of appendicular skeleton (limbs)o 80 bones

Skull Bones associated with skull Vertebral column (26, 24 vertebrae + sacrum and coccyx) Thoracic cage (25, 24 ribs and 1 sternum)

Skullo 22 boneso 8 form cranium that enclose cranial cavity

Supports braino 14 bones associated with faceo 7 additional bones associated with skull

6 auditory ossicles Hyoid bone

Joint are articulations form where 2 bones connect 9 superficial bones serve as attachment site for muscles that control facial expressions and eat

food 5 deeper bones separate oral and nasal cavities, help form nasal septum

o Divides nasal cavity into left and right halves Sinuses are air filled chambers

o Lessen weight of boneo Mucus membrane lining them produces mucus that moistens and cleans air in and

adjacent to sinuseso Serve as resonating chambers in speech production

Connection between skull bones of adults are immovable joints called sutureso Bones tied firmly together with dense fibrous connective tissueo Lambdoid suture

Connects occipital with 2 parietalo Coronal suture

Attaches frontal to parietal on both sideso Sagittal suture

Attaches between parietal from lambdoid to coronalo Squamous suture

On each side of skull, joins temporal and parietal

SKULL BONES Occipital

o Forms posterior and inferior surfaces of craniumo Articulates with parietal, temporal, sphenoid and atlaso External occipital cresto Occipital condyleso Foramen magnumo Jugular forameno Hypoglossal canals

Parietalo Forms part of superior and lateral surfaces of cranium

Frontalo Forms anterior portion of cranium and roof of orbitso Frons (forehead)o Supraorbital margin/supraorbital foramen/supraorbital notcho Glabellao Lacrimal fossao Frontal sinuses

Temporalo Form part of lateral walls of cranium and zygomatic archeso Form only articulations with mandibleo Surround and protect sense organs of inner earo Are attachment sites for muscles that close the jaws and move the heado Zygomatic processes/zygomatic archo Mastoid processo Styloid processo Mandibular fossao Auditory ossicleso Carotid canal, foramen lacerum, internal/external acoustic meatus, stylomastoid

foramen Sphenoid

o Formal part of floor of craniumo Unites cranial and facial boneso Cross brace that strengthens sides of skullo Body forms central axis of sphenoido Sella turcica is bony saddle shaped enclosure on superior surfaceo Hypophyseal fossa contains pituitary glando Sphenoidnal sinuses, lesser wings, greater wings

Ethmoido Forms anteromedial floor of cranium, roof of nasal cavity & part of nasal septum

o Cribiform plate Crista galli

o Paired lateral masses Ethmoidal labyrinth, ethmoid air cells, superior nasal conchae, middle nasal

conchaeo Perpendicular plate

FACIAL BONES Maxillae

o Upper jawboneso Support upper teeth, form inferior orbital rim, upper jaw & most of hard palateo Orbital rimo Hard palateo Infraorbital foramen

Palatine boneso Form posterior portion of hard palateo Contribute to floor of each orbit

Nasal boneso Support superior portion of bridge of nose

Vomero Forms inferior portion of the bony nasal septum

Inferior nasal conchae o creates turbulence in air passing through nasal cavity

Zygomatic bones o contribute to rim and lateral wall of orbit and form part of zygomatic archo Temporal process

Lacrimal bones o form part of medial wall of orbit (smallest facial bones)

Mandible forms lower jawo Body is horizontal portiono Alveolar process supports lower teetho Ramus is ascending part that begins at mandibular angle on each side

Condylar process Coronoid process Mandibular notch

o Mental foraminao Mandibular foramen

Hyoid oneso Supports larynx, pharynx, and tongueo Bodyo Greater & lesser horns

Certain cranial and facial bones form orbital complex and nasal complexo Surrounds eye, surround nasal cavities

Orbits are bony recesses that contain the eye Seven bones of orbital complex form each orbit

o Frontal bone, maxilla, lacrimal, ethmoid, sphenoid, palatine, zygomatic Nasal complex includes bones that enclose nasal cavities and paranasal sinuses

o Nasal complex = Frontal bone, sphenoid, ethmoid, macillae, lacrimal, inferior nasal conchae, nasal bones

o Pranasal sinuses = sphenoid, ethmoid, frontal, palantine, maxillae Lighten skull bones and provide extensive area of mucuous epithelium, which

releases mucus into nasal cavities Fontanelles are non-ossified areas between cranial bones that allow for brain growth in infants

and small childreno 2 frontal bones, four occipital bones, several sphenoid and temporal elementso Anterior fontanelle

Largest, intersection of frontal, sagittal, coronal sutureso Posterior/Occipital fontanelle

Junction between lambdoid and sagittal sutureso Sphenoidal fontanelle

Junction between squamous and coronal sutureso Mastoid fontanelle

Junction between squamous and lambdoid suture Vertebral column has four spinal curves

o 26 bones (24 vertebral, sacrum, coccyx)o Four spinal curves

1. Cervical 2. Thoracic 3. Lumbar 4. Sacral Primary (accommodation) curves = thoracic and sacral curves (present at birth) Secondary curves (compensation) = cervical and lumbar

Help shift weight to permit upright posture Fully developed by age 10

Vertebrae consist of:o Vertebral body: part of vertebrae that transfers weight along axis of vertebral column

Bodies of adjacent vertebrae separated by intervertebral discso Vertebral arch

Forms posterior margin of each vertebral foramen Walls called pedicles, flat laminae layers Vertebrae form vertebral canal which enclose spinal column

o Articular processes (Spinous process projects posteriorly) (Transverse process projects laterally)

Articular processes arise at junction between pedicles and laminae Superior/inferior articular process on each side

o Articulate with each other of successive vertebrae Each has smooth concave surface = articular facet

Gaps between pedicles of successive vertebrae called intervertebral foramina Permit passage of nerves running to or from enclosed spinal cord

7 cervical, 12 thoracic, 5 lumbar, sacrum, coccyx Kyphosis

o Normal thoracic curvature becomes exaggeratedo Produces round back appearanceo Can be caused by osteoporosis, chronic contractions of muscles that insert on vertebrae,

abnormal vertebral growth Lordosis

o Swayback, both abdomen and buttocks protrude abnormally, anterior exaggeration of lumbar curvature

o Occur during pregnancy or result from abdominal obesity or weakness in ab muscles Scoliosis

o Abnormal lateral curvature of spine in one or more of movable vertebraeo May result from development problems from damage to vertebral bodies, muscular

paralysis on one side of back, often impossible to determine Unknown cause generally appears in girls during adolescence Small curves may stabilize after growth, may need braces for bigger curves Implanted metal rods or cables also used

Cervical vertebrae smallest in columno Occipital bone to thoraxo Body is small compared to vertebral formaen

Support only weight of heado Spinous processes have prominent notch (bifid)o Transverse processes fused to costal processes

Transverse foramina Protect vertebral arteries and vertebral veins

o Whiplash = dislocation of cervical vertebrae by rapid acceleration or decelerationo Atlas = C1

Holds up the head Articulates with occipital condyles Distinguished by lack of body and spinous processes & presence of large, round

vertebral foramen bounded by anterior and posterior archeso Axis = C2

Prominent dens process Allows us to shake heads in no motion Atlas = yes motion

Thoracic vertebrae has heart shaped body, more massive than cervical bodyo Costal facets articulate with heads of the ribso Transverse process relatively thick, contain transverse costal facets

o Spinous process generally point downwards Lumbar vertebrae

o Large bodies, superior and inferior surfaces are oval rather than heart shapedo Transverse process project laterallyo Vertebral foramen is triangularo Stumpy spinous processes project laterallyo Superior articular processes face mediallyo Inferior articular processes face laterallyo Withstand the most weight

Sacrumo Consists of fused components of five sacral vertebraeo Fused at age 25-30o Protects reproductive, digestive and urinary organso Attaches axial skeleton to pelvic girdle of appendicular skeletono Sacral canal = extends length of sacrumo Median sacral crest = posterior ridge

Coccyxo 3-5 coccygeal vertebrae begun fusing by age 26o Attachment site for muscles that constrict anal openingo Very old people, coccyx may fuse with sacrum

Thoracic cage provides bony support to walls of thoracic cavityo Thoracic vertebrae, ribs, sternumo Ribs and sternum form rib cage

protects heart, lungs, thymus, and other structures in thoracic cavity serves as attachment point for muscles involved in respiration, maintenance of

position of vertebral column, movements of pectoral girdle (both clavicle and scapulae) and upper limbs

Ribs, also called costae are long, curved, flattened bones that originate on or between thoracic vertebrae and end in wall of thoracic cavity

o 12 sets of ribso Frist 7 = true ribs, connected to sternum by costal cartilages gradually increase in

length and in radius of curvatureo 8-12 = false ribs, do not attach directly to sternumo 11, 12 = floating ribs = no attachment to sternumo 1-10 originate at costal facets on vertebrae T1 through T10

Sternum = breastbone, flat bone that forms in anterior midline of thoracic wallo Manubrium articulates with clavicle, ribs 1 attacheso Body, tongue shaped, attaches to ribs 2-7o Xiphoid smallest process. Diaphragm and rectus abdominis attach

Used as landmark for CPR, proper hand positioning to reduces chances of breaking ribs or xiphoid process

o Ossification begins age 6-10, fuses at least age 25

Chapter 8: Appendicular Skeleton

Includes bones of limbs and supporting bone (pelvic and pectoral) girdles that connect them to the trunk

Appendicular skeleton lets you manipulate objects and move from place to place Dominated by long bones

o Head, shaft, neck Pectoral girdle

2 s-shaped clavicles, two flat scapulaeo Articulation are the only direct connections between pectoral girdles and axial

skeletono Makes shoulder extremely mobile, but not very strong

Movements of clavicles and scapulae position on shoulder joints and provide base for arm movement

o Surfaces of each are extremely important for muscle attachment Clavicles

S-shaped bones originate at superior lateral border of manubrium of sternum, lateral to jugular notch

Sternal end is medial (flat) Acromial end is lateral Small and fragile

o However, easy to repair Scapulae

Body, superior border, medial border (straight), lateral border, glenoid cavityo Glenoid cavity articulates with humeruso Subscapular fossa (anterior), infra/supraspinous fossa (posteriror)o Scapulae and clavicle join at acromion

Upper limb = arms, forearms, wrists, hands Arm/brachium contains humerus

Scapula to elbow Head, greater tubercle, lesser tubercle, intertubercular groove, anatomical neck, surgical

neck, deltoid tuberosity (anterior) radial groove (posterior), medial & lateral epicondyleso Humerus articulates with raidius and ulna at condyle

Ulna and Radius make up forearm/antebrachium Ulna lies medial to radius

o Olecranon is proximal end of ulnao Trochlear notch of ulna articulates with trochlea of humerus at the elbow joint

o Coronoid process, radial notch, interosseous membrane, ulnar head, styloid process (pillar)

Radius is lateral bone of forearmo Radial heado Radial tuberosityo Ulnar notcho Styloid process

There are eight carpal bones in the wrist/carpus Four proximal carpal bones

o Scaphoid (lateral), lunate, triquetrum, pisiform Four distal carpal bones

o Trapezium, trapezoid, capitate, hamate Five metacarpal bones

o I-V beginning with lateral Phalanges have proximal middle and distal

o Thumb = pollex Only two phalanges (proximal and distal)

Pelvic girdle attaches to lower limbs Pelvic girdle = two hip bones (appendicular) & sacrum and coccyx (axial)

Pelvic girdle = paired hip bones/coxal/pelvic bones Hip bone forms by fusion of ilium, ischium & pubis

o Medial surfaces of hip bones are connected by fibrocartilage at joint called pubic symphysis

Hip bones have acetabulum, acetabular notch, lunate surface Ischium have ischial spine, ischial tuberosity, ischial ramus, inferior ramus, obturator

foramen Ilium have arcuate line, iliac creast, iliac fossa, iliac tuberosity

Pelvis consists of two hip bones, sacrum, coccyx Ligaments connect lateral borders of sacrum with iliac crest, ischial tuberosity, ischial spine

and arcuate line True (lesser) pelvis encloses pelvic cavity, line extends from other side of the sacrum

o Bony edge of true pelvis is pelvic grid False pelvis is greater pelvis Females have smoother, lighter and less-prominent markings on pelvis

o Coccyx points inferiorlyo Hormone relaxin loosens pubic symphysiso Allows for child birth

Lower limbs are adapted for movement and support Include femur, patella, tibia, fibula, tarsal bones, metatarsal, phalanges of foot Femur is longest and heaviest bone in the body

o Femoral head, fovea capitis, neck, shaft, greater and lesser trochaners, interochanteric crest, linea aspera, medial and lateral epicondyles, intercodylar fossa, patellar surface

Patella is large sesamoid bone forms within tendon of quadriceps femoriso Rough convex surfaceo Broad baseo Patellar ligament connects apex of patella to tibiao Start to ossify when a person begins walkingo Patella glides up and down, not side to side

Tibia is shinboneo Large medial bone of lego Medial & lateral tibial condyles, tibial tuberosityo Medial malleolus

Fibula is slender bone that parallels lateral border of tibiao Interosseous membraneo Lateral malleolus

Ankle consists of seven tarsal boneso Large talus transmits weight of body from tibia towards the toes

Articulation between talus and tibia occurs across superior and medial surfaces of trochlea

Chapter 9: Joints

Joints are articulations Joints have varying range of motion

o Synarthrosis is immovable joints Fibrous or cartilaginous

o Amphiarthrosis is slightly movable Fibrous or cartilaginous

o Diarthorsis Synovial

Synovial joints are diarthrotico 2 layered joint capsule, called articular capsule surrounds synovial joint

Joint capsule contains inner synovial membrane and outer fibrous capsuleo Bony surfaces cannot contact each other because of articular cartilage

Synovial joints cannot function normally without working articular cartilageo Synovial fluid is viscous solution that lubricates, distributes nutrients, and absorbs shocko Meniscus is articular disc that lies between opposing bones within a synovial join

Pad of fibrocartilage Subdivide synovial cavity, channel flow of synovial fluid or allow for variations in

shapes of articular surfaces

o Accessory ligaments support, strengthen and reinforce synovial joints Ligaments are very strong

In a sprain, ligament is stretched so collagen fibers tear, ligament a a whole survives and joint is not damaged

Bones often break before ligaments Heals slowly because avascular, diffusion instead

o Tendons not a part of joints but may limit joint range of motiono Bursae are small, thin, fluid filled pockets in connective tissue

Contain synovial fluid and lined by synovial membrane Form when tendon or ligament rubs against other tissues

Reduce friction and act as shock absorbers Adventitious bursae develop in abnormal locations or because of abnormal

stresso Joints are either highly mobile and weak, or not very mobile and strong

Synarthrotic = strongest Movement beyond normal range will damage any mobile diarthrosis Range of motion can be limited by:

Collagen fibers Shapes of articulating surfaces Presence of other bones or fat pads around joint Tension in tendons

o Dislocation = luxation Subluxation is a partial dislocation

Less severe than dislocation = double jointedness

Structure and function of synovial joints enable various skeletal movementso Gliding

Two opposing surfaces slide past one another Occurs in carpal, tarsal, and between clavicle and sternum

o Flexion is movement that decreases angle of articulating boneo Extension is movement that increases angle of articulating bone

Can be continued past anatomical position Called hyperextension

o Abduction is movement away from longitudinal axis of bodyo Adduction is movement towards longitudinal axis of bodyo Circumduction is moving arm in a loopo Rotation

Left/right rotation Lateral rotation is anterior surface moving away from body Medial rotation is anterior surface moving towards body Pronation is turning wrist down Supination is turning wrist up

o Special movements Inversion is twisting sole of foot inward

Eversion is twisting sole of foot outward Dorsiflexion is flexion at ankle joint and elevation of sole by digging in heel Plantar flexion is elevating heel, digging in sole

Tip-toes Opposition is thumb towards surface of palm

Reposition is movement that returns thumb and fingers from opposition Protraction is moving body part anteriorly in horizontal plane

Retraction is moving body part posteriorly in h-plane Think protract and retract jaw

Elevation and depression is when a structure moves in superior or inferior depression

Think mandible Lateral flexion occurs when vertebral column bends side to side

Intervertebral discs and ligaments are structural components of intervertebral jointso Articulations between superior and inferior articular processes of adjacent vertebrae are

called intervertebral joints Gliding joints that permit small movements associated with flexion and rotation

of vertebral columno Vertebrae are separated and cushioned by pad of fibrocartilage called intervertebral

discs Not found in sacrum or coccyx

b/c fusedo annulus fibrous = tough outerlayer of intervertebral disco annulus fibrous surround nucleus pulpous

soft, elastic, gelatinous core gives resiliency and enables it to absorb shock

o superior and inferior surfaces of disc are covered by thin vertebral end plates composed of hyaline cartilage and fibrocartilage

o movement of vertebral column compresses nucleus an displaces it in opposite direction this displacement permits smooth gliding movements between vertebrae while

maintaining alignment o as we grow older water content of nucleus pulposus decreases, become less effective,

increase risk of injury numerous ligaments are attached to bodies and processes of all vertebrae

o anterior longitudinal ligament connects anterior surface of adjacent vertebral bodies

o posterior longitudinal ligament parallels anterior longitudinal ligament if weakened (often occurs with age)

nucleus pulposus breaks through annulus fibrous may protrude into vertebral canal

o known as herniated disc compresses spinal nerves and may cause paion

o ligamentum flavum

connects laminae of adjacent vertebraeo interspinous ligament

connects spinous processes of adjacent vertebraeo supraspinous ligament

interconnects tips of spinous processes from C7 to sacrum ligamentum nuchae extends from vertebrae C7 to base of skull

continuous with supraspinous ligament vertebral movements

o flexion, bending anteriorly o extension, bending posteriorlyo lateral flexion, bending laterallyo rotation

shoulder Is ball and socket joint, elbow is hinge jointo shoulder joint = glenohumeral joint

permits greatest range of motion of any joint most frequently dislocated ball and socket diarthrosis

formed by articulation of head of humerus with glenoid cavity of scapula

area of glenoid cavity is increased with fibrocartilaginous glenoid labrum continues beyond bony rim and deepens socket articular capsule permits extensive range of motion bones of pectoral girdle provide some stability

o acromion and coracoid process project laterally superior to head of humerus

surrounding skeletal muscles provide most of stability major ligaments are glenohumeral, corcohumeral, coracoacromial,

coracoclavicular, acromioclavicular ligraments shoulder separation is partial or complete dislocation of

acromiocclavicular jointo can result from hit to superior surface of shoulder

acromion suppressed, clavicle held back muscles that move humerus stabilize shoulder joint more so than do all

ligaments and capsular fibers combined rotator cuff = SITS

o supraspinatus, infraspinatus, teres minor, subscapularis muscles severe strain on shoulder can cause rotator cuff injury

baseball, white-water raftin, etc. inferior capsule of shoulder poorly reinforced = easier to disclocate inflammation of bursae can restrict motion

o elbow is complex hinge joint involves humerus, radius and ulna

largest and strongest articulation at elbow is humeroulnar jointo trochlea of humerus articulates with trochlear notch of ulna

joint works like door hinge humeroradial joint

o capitulum of humerus articulates with head of radius radial nerve

o muscles extend elbow to attach rough surface of olecranon biceps brachialis

o covers anterior surface of arm extremely stable because:

bony surfaces of humerus and ulna interlock single, thick articular capsule surrounds both humeroulnar and proximal

radioulnar joints, strong ligaments reinforce articular capsule radial collateral ligament stabilizes lateral surface of elbow joint annular ligament binds head of radius to ulna ulnar collateral ligament stabilizes medial surface of elbow joint elbow can be damaged by severe impacts or unusual stresses

if fall on hand with partially flexed elbow, contractions of muscles that extend elbow may break ulna at center of trochlear notch

o less violent stresses can produce dislocations or other injuries to elbow

o nursemaid’s elbow occurs when parents drag toddler, twisting pull on elbow joint that can result from partial dislocation of radial head

Hip joint is ball and socket joint, knee is hinge jointo Hip joint is diarthrotic

Permits flexion, extension, adduction, abduction, circumduction, rotation Acetabulum, deep fossa, accommodates head of femur

Articular cartilage extends like horseshoe on either sideo Acetabular labrum increases depth of joint cavity and helps seal

synovial fluido Articular capsule extremely dense and strong

Extends from lateral and inferior surfaces of pelvic girdle to intertrochanteric line and crest of femur enclosing head and neck of femur

Keeps femoral head from moving too far Iliofemoral, pubofemoral, ischiofemoral are regional thickening of capsule

Transverse acetabular ligament crosses acetabular notch filling in gap in inferior border of acetabulum

o Ligamentum teres orginates along transverse acetabular ligament

Attaches to fovea capitis Tenses only when hip is flexed and thigh undergoing

lateral motiono Knee joint transfers weight to tibia

Knee is ‘complicated’

Functions as hinge Joint more complex than elbow or ankle

Rounded condyles of femur roll across superior surface of tibia, so points of contact are constantly changing

Permits flexion, extension and limited rotation Contains three separate articulations

Medial condyle to medial condyle Lateral condyle to later condyle Between patella and patellar surface of femur

Articular capsule at knee joint is thin and incomplete in some areas Various ligaments, tendons of associated muscles strengthen it

o Pair of fibrocartilage pads, medial and lateral menisci lie between femoral and tibial structures

Menisci acts as cushion Conforms shape of articulating surfaces as

femur changes position Provides lateral stability to joint

Fat pads cushion margins of joint Also assist many bursae in reducing friction

between patella and other tissues Supporting ligaments

Complete dislocation of knee is rare because seven major ligaments stabilize knee joint

o Patellar ligament, 2 politeal ligaments, ACL, PCL, MCL, LCL Can lock the knee with ACL

Prevents one from using muscles and tiringo Knee can be unlocked by medially rotating and contracting

muscleso If locked knee is truck from side, supporting ligaments can be

seriously damagedo Joints are subjected to heavy wear and tear throughout life

Rheumatism is general term for pain and stiffness affecting musculoskeletal system

Arthritis (joint inflammation) encompasses all rheumatic diseases that affect synovial joints

Involves damage to articular cartilageso From bacterial or viral infection, injury to joint, decreased

viscosity or lack of synovial fluid, metabolic problems, severe physical stress

Most common arthritis is osteoarthritiso Degenerative joint disease

People 60 or older Cumulative wear and tear at joint surfaces or from

genetic factors affecting collagen formation

o Regular exercise can prevent this Rheumatoid arthritis is inflammatory condition affecting less than 1% of

adults generally between 40 and 60, often womeno Occurs when immune response mistakenly attacks own tissues

Autoimmune disease Allergies, bacteria, viruses, genetic factors all

proposed to contribute to destructive inflammation

Gouty arthritis or crystal arthritiso Crystals of uric acid form within synovial fluid of joints

Accumulation of interferes with normal movements Named after gout

o 30-60% percent of adults over 85 Joint immobilization may cause degenerative changes like arthritis

When motion ceases so does circulation of synovial fluid, cartilage begins to degenerate

Continuous passive motion (CPM) of any injured joint appears to encourage repair by improving circulation of synovial fluid

o PT or machine can perform thiso Skeletal system supports and stores energy and minerals for other body systems

Living skeleton is dynamic and undergoes continuous remodeling Osteoblast to osteoclast activity

o More osteoblasts = thickeningo More osteoclasts = thinning

Balance between varies with age, physical stresses, circulating hormone levels, rates of calcium and phosphorous absorption and excretion and genetic and environmental factors