Chapter 8 - Appendicular Skeleton
the axial skeleton includes __1__ while the appendicular skeleton includes _2_
1. skull, vertebral column, rib cage 2. pectoral girdle, upper limbs, pelvic girdle, lower limbs
How many total phalanges of the foot are there? All toes except the ___ has a proximal, middle, and distal phalanges know how to name/number them
14 Hallus or great toe; it only has the proximal and distal phalanges
how bones form each upper limb?
30
the metatarsus consist of ___ small long bones called the metatarsals. Which of them supports body weight?
5 the FIRST metatarsal supports body weight
___ is the extension of the scapula, which forms the highest point of the shoulder. Be able to identify
acromion process
what connects the tibia and fibula, similar to the radius and ulna bone connection
an interosseous membrane
what do the following stand for? Locate them too ASIS AIIS PSIS PIIS
anterior superior iliac spine anterior inferior iliac spine posterior superior iliac spine posterior inferior iliac spine
the coxal bones unite ____ with each other and articulate ____ with the sacrum
anteriorly (at the pubic symphysis) posteriorly (at the sacroiliac joint)
what proximal region of the hand forms the true wrist?
carpus
The hand includes what 3 major category of bones?
carpus (wrist) metacarpals (palm) phalanges (fingers)
Which bone is an important landmark for central venous access, specifically for the subclavian vein?
clavicle
The pectoral girdle consists of what 2 major structures? They provides attachment for many muscles that join the _____ limb
clavicle scapula upper
only the ____ articulates with the axial skeleton while the ____ move freely
clavicle scapula
the ____ extend horizontally across the superior thorax
clavicles
which part of the appendicular skeleton hold the scapulae and arms laterally?
clavicles
what disorder of the appendicular skeleton is described: a congenital disorder often repaired surgically where the soles of the feet turn medially
club foot
____ _____ is a sight of muscle attachment on the scapulae. Be able to identify
coracoid notch
the pelvic girdle consists of paired hip bones aka ____(2 names)____ and the sacrum
coxal bones / pelvic bone
the scapulae lie on the ___ surface of the rib cage
dorsal surface
T/F: clavicles transmit compression forces from the upper limbs to the appendicular skeleton
false; they transmit it to axial skeleton
what is the single bone of the thigh? Also the longest and ___ bone of the body
femur, strongest
Name the sticklike lateral bone of the leg
fibula
the socket of the shoulder is called the ____ cavity and it is shallow.
glenoid cavity aka glenoid fossa
the glenohumeral joint is the point of articulation for scapula and shoulder where the ___ ___ and ____ meet
glenoid fossa/cavity and head of humerus
what type of movement occurs between the carpals that allows for wrist motion? How many carpal bones?
gliding; 8 marble sized bones
the ___ ____is palpable on the lateral thigh; locate it
greater trochanter
the tarsus makes up how much of the posterior foot? How many tarsal bones are located there?
half of the posterior foot 7 tarsal bones
unlike the hand, numbering in the foot begins medially (not laterally) at the ____ or great toe
hallux
the distal radius articulates with the carpal bones so when it moves the ___ moves with it
hand
if anesthetists are not careful when positioning a patient, the ___ of the fibula where superficial fibular nerve (aka peroneal nerve) is located can get injured, it is very superficial and palpatable
head of the fibula
the elbow joint is a ___ joint that allows the forearm to bend better known as flexion and extension of the elbow
hinge
what disorder of the appendicular skeleton is described: Head of the femur slips out of acetabulum
hip dysplasia
what is known as the large flaring bone of the pelvis that forms the superior region of the coxal bone?
ilium
Name and locate the 3 regions of the coxal bone
ilum, ischium, pubis
find the ulnar styloid process, it is ___ to the head of the ulna
inferior
what interconnects the radius and ulna?
interosseous membrane
what groove in the upper arm does the biceps tendon pass through? What letter correctly labels it in the photo?
intertubercular groove aka bicipital groove; C
___ ____ are the strongest part of the hip bone and is the attachment site of hamstrings, also "used when sitting"
ischial tuberosities
___ forms the posteroinferior region of the coxal bone and anteriorly jones the pubis
ischium
The foot supports body weight and acts as a _____ to propel the body forward in walking and running
lever
the medial end of each clavicle articulates with the ______ and first rib
manubrium of the sternum
what important bony structures of the distal humerus are often fractured in elbow fractures? Find them in the photo
medial and lateral epicondyles N and S
5 ____ radiate distally from the wrist and form the palm (aka metacarpus)
metacarpals
an unfixed scapula allows for a larger degree of freedom of _____ in the pectoral girdle as compared to the pelvic girdle and hips
movement
the *suprascapular ____* serves as a nerve passageway for the *surprascapular nerve*
notch
there are few changes that occur in the adult skeleton until middle age when: the skeleton loses mass while ____ and limb fractures become more common
osteoporosis (a systemic skeletal disorder characterized by low bone mass, micro-architectural deterioration of bone tissue leading to bone fragility, and consequent increase in fracture risk)
name the triangular sesamoid bone that's inferior to the femur; it is ___ in the tendon that secures the quadricep muscles and protects the knee anteriorly
patella embedded
___ ___ is where the patella articulates/slides across
patellar space
Appendicular skeleton includes
pectoral girdle, upper limbs, pelvic girdle, lower limbs
the ___ girdle attaches the upper limbs to the trunk, while the ___ girdle attaches the lower limbs to the trunk
pectoral; pelvic
what attaches the lower limbs to the spine?
pelvic girdle
except for the thumb (pollex), each finger has 3_____
phalanges (proximal, medial, distal). Thumb doesn't have medial phalanges.
"Phalanges" is the plural form of ____
phalanx
the phalanges and metacarpals are named by number 1-5 starting with the ____
pollex (thumb)
Where are head and neck of the radius are located: at the distal or proximal end of radius? Locate them
proximal end
bases of metacarpals articulate (proximally OR distally) with the carpals, while the heads articulate (proximally OR distally) with phalanges.
proximally; distally
Fibrocartilage joins the two pubic bones at the midline of the body and that region is called the ___ ___
pubic symphysis
the ___ forms the anterior region of the coxal bone
pubis
What 2 fossa of the distal humerus are sites of articulation for the elbow joint? Find them in the photo
radial and coronoid fossa F and L
Medially, the head of the radius articulates with the ___ ____ of the ulna; locate it.
radial notch
what tuberosity is the insertion site of the biceps tendon?
radial tuberosity they were in the notes section of the PPT but he said dont worry too much about it
at the proximal and distal radioulnar joints what bones articulate? And that allows for the spinning motion of the the ____ Find both joints
radias and ulna forearm and wrist for the spinning motion during pronation (palm up) *AND* supination (palm down)
the superior surface of what bone articulates with the capitulum-lateral distal aspect of humerus
radius
the forearm consists of what 2 paired bones? The proximal end of the forearm articulates with the _1_ and the distal end articulates with the _2_
radius and ulna 1 humerus 2 carpals
____ do not join each other or the axial skeleton
scapulae
anatomically the arm consists of bones from the ____ to ____ and the forearm includes bones from the ___ to ___
shoulder to elbow elbow to wrist
distally the ulna is (smaller/bigger) than the distal radius, while proximally the ulna is (smaller/bigger) than the proximal radius
smaller bigger this is why the ulna is a major player in elbow motion and the radius is the major player in wrist motion
the ___ of the scapula separates out different fossa and depressions. Be able to identify
spine (spinous process)
the fibula does NOT contribute to the knee joint but it ____ the ankle joint
stabilizes
lower limbs have less freedom of movement but are more ___ than the arm
stable
what are the 3 borders and 3 angles of the of scapula? Be able to identify them in a photo.
superior, medial (vertebral), lateral (axillary) borders superior, inferior, lateral angles
the foot is composed of 3 types of bones, what are they?
tarsus, metatarsus, phalanges
the ___ end of the clavicles articulate with the scapula
the *acromial (lateral)* end of the clavicles articulates with the scapula
the ___ end of the clavicles articulate with the manubrium
the *sternal (medial)* end of the clavicles articulate with the manubrium
The acromion clavicular joint joins what two structures?
the clavicle and the acromion on the scapula
what carries the weight of the erect body
the lower limbs
the (more/less) mobile a joint is the (more/less) the stabile it is.
the more mobile a joint is the less stabile. Vice versa. They are inversely proportional.
What is the weakest part of the femur and often the site of "hip" fractures Locate this
the neck of the femur find the head and neck
which are more mobile: the proximal and distal tibiofibular joints or the proximal and distal radioulnar joints?
the radioulnar joints are more mobile as they allow for supination and pronation; the tibiofibular joints are "barely mobile"
name the massive medial bone that receives the weight of the body from the femur. It's superior articulation with the femur forms the knee joint
the tibia
the patella improves leverage of the ___ muscles across the knee
thigh
What are the 3 segments of the lower limb divided into?
thigh, leg, foot
What 2 bones of the leg are analogous to the forearm?
tibia and fibula
the ___ tuberosity is the attachment site of the quadriceps tendon
tibial tuberosity
identify the iliac crest and the anterior superior iliac spine (ASIS) Mr. Lewis called them important landmarks for palpation.
top right of photo
the ___ of the talus is the site of articulation with the tibia. Identify it
trochlea
The ___ articulates with the ulna, point it out in the photo
trochlea; O
the __ notch is space where the olecranon articulates with the trochlea at the distal end of the humerus
trochlear
T/F the upper and lower limbs differ in function but share the same structural plan
true
which bone in the forearm is most responsible for forming the elbow joint with the humerus?
ulna
the ____ ____ of the radius is where the ulna articulates with the radius at the distal radioulnar joint. Find it on the pic
ulnar notch
the humerus is the longest and strongest bone of the ____ ____. It articulates with the ___ at the shoulder and the ___ and ___ at the elbow
upper limb glenoid cavity of scapula radius and ulna (know specific articulation parts)
the pelvic girdle supports ____ organs and attaches to the ___ skeleton by strong ligaments
visceral axial
___ articulates with the radius, point it out in the photo
capitulum, G
the shallowness of the Glenoid Cavity is good for ____ and bad for ___
good for flexibility bad for stability
the tibia articulates with ___ at the inferior end of the leg
talus
the ___ girdle encircle the body completely while the ____ girdle does not
*pelvic* girdle encircles the body completely while the *pectoral* girdle does not
the _1_ bone in the forearm has no role in hand/wrist movement while the _2_ bone has some role in the elbow movement and a big role in hand/wrist movement
1 ulna 2 radius
Among the 2 important landmarks of the ilium, the __ __ ___ is where the sciatic nerve passes through and the __ __ ___ is where nerves and vessels to the perineum pass through
1. Greater Sciatic Notch 2. Lesser Sciatic Notch
How many bones are in the arm? Name(s)?
1; the humerus
On humerus, what are the 2 sites attachments for muscles that move the arm and shoulder (proximal end). Identify them in the picture
A - greater tubercles B - lesser tubercles
laterally the ends of the clavicles join with the _____
Acromion process of the scapulae
What is the anesthetic significance of the anterior border of the tibia?
Because of its lack of padding, IO access (interosseous access) is easy to gain there. Administered medication can reach the bloodstream quickly.
which are bigger? Lateral and medial condyles or lateral and medial epicondyles Find all 4 located on the femur
Condyles are bigger than epicondyles
Is the radial styloid process located at the distal or proximal end of the radius? Locate it
Distal end
case study: A 6 year old male presents to the ED with lethargy and mental status changes. Pt. suddenly decompensates, prior to obtaining vascular access. Unable to place a PIV after two attempts. Patient is crashing.....what do we do? *a short term solution
IO Access = interosseous access drill into a bone to gain interosseous access since the bones have a rich blood supply, that will facilitate drugs to reach the desired target once they're circulated into the bloodstream pictured is the lumen of an IO needle inside the medullary cavity, where there's rich blood supply
find the 3rd proximal phalanx of the hand
Middle finger, a part of the finger, not palm
what is the opening between the ischium and pubis called?
Obturator Foramen
case study: among the 5 IO access sites, discussed in class, which is the go to site because of its easy palpation and access?
Proximal/distal tibia the others were: proximal humerus, femoral, iliac crest, and the sternum
in anesthesia, it is important to know where the radial groove is for what type of nerve block? Find it in the photo
Radial nerve block; J; if you cant find the nerve with an ultrasound at the distal end, you can usually find it posteriolaterally along the humerus at the radial groove
in anatomical position, the radius is ___ to the body while the ulna is ___ to the body
Radius - lateral (on side of thumb - thumb can make r shape when curled) Ulna - medial
the ilium's articulation with the sacrum forms what joint? The thin blue line in the photo
Sacroiliac joint = SI joint
What makes the foot pliable and adaptable to uneven ground?
Segmentation
body weight is borne primarily by the ___ and ___ bones of the foot. Locate them.
Talus Calcaneus
Among the important landmarks of the ilium, what 2 notches on the ilium were discussed in class? Identify them. The sciatic nerve passes through __1___. __2__ is a passageway for various nerves and vessels to the perineum.
The greater and lesser sciatic notches
Identify the lateral malleolus and medial malleolus; the posterior ____ nerve and artery is located posterior&inferior to the medial malleolus
Tibial
Find the 4th metacarpal; is it a part of your palm?
a part of palm, not finger
the ___ is a deep cup/socket that holds the head of the femur and is analogous to the ___ of the pectoral girdle Find it anteriorly and laterally in the pic
acetabulum (point of articulation for femur and pelvic girdle); Glenoid cavity (where humerus articulates with the scapulae at shoulder)
the scapulae are located between ribs ___ and ___
b/w ribs 2 and 7
very little padding to the anterior ___ of the tibia. Find this bony part of the tibia aka your shin
border
the olecranon fossa articulates with the ___ ____ of the ulna. What is being identified in the photo?
olecranon process of the ulna olecranon fossa