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The A to Z of Bones, Joints, Ligaments & the Back

© A. L. Neill

Table of contentsINTRODUCTION 1

ACKNOWLEDGEMENT 1

DEDICATION 1

HOW TO USE THIS BOOK 1

ABBREVIATIONS 5

COMMON TERMS USED IN OSTEOLOGY / SKELETAL ANATOMY 6

ANATOMY

Anatomical planes & relations

Joint movements

Neck 18

Back 19

Shoulder & Upper Limb 20

Hips & Lower Limb 22

Structure of bone tissue 24

BONES in situ UPPER 26

BONES in situ LOWER 28

Classification of bones 30

Structure of a Long Bone 32

Regional Skeletons & Disarticulated Bones 34Classification and Summary of Joints 36

Synovial joint 37

Classification and Summary of Ligaments 38Bones, Joints & Ligaments index 40

alphabetical listing Common pathologies of Bones 44

benign bone lesions malignant bone lesions

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OVERVIEWS to be found in this book carpus / wrist overview (including hand bones) 60

chest overview 66

ear bones overview 84

fingers overview 96foot, toes overview 98

hand, wrist, fingers overview 104

pectoral girdle / overview of the shoulders 158

pelvic girdle / overview of the hips 160

sinuses overview 200

skull overviews 184

teeth overview 208

vertebral column overview 228

vertebrae overview 236

cervical spine overview 246


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A = actions /movements of a joint aa = anastomosis or anastomosesadj. = adjectiveaka = also known as ALL = anterior longitudinal ligament alt. = alternative ant. = anteriorart. = articulation (joint w/o the additional support structures)AS = Alternative Spelling, generally referring to the diff. b/n British & American spellingb/n = between BM = bone marrowBS = blood supplyBV = blood vesselC = carpal / carpo co = cortexc.f. = compared toCNS = central nervous system collat. = collateral CSF = Cerebrospinal fluidCT = connective tissueD = diaphysisE = epiphysise.g. = exampleEC = extracellular (outside the cell) ext. = extensor (as in muscle to extend across a joint)GC = giant cellsGk. = Greek IC = intercarpal / intercarpo IP = interphalangeal IT = intertarsal / intertarso jt(s) = joints = articulations L = Left / LumbarLB = long bonesLL = lower limb aka legLt. = Latinlig. = ligament M = metaphysisMC = metacarpal / metacarpo med = medial / medulaMet = metastasisMT = metatarsal / metatarsoNS = nervous system / nerve supplyNT = nervous tissueOC = osteoclastP = phalangeal / phalanges / phalango

pl. = pluralPLL = posterior longitudinal ligament post. = posteriorproc = processprox = proximinal PS = public symphysis R = Right ROM = range of movement sing. = singular SC = spinal cord SN = spinal nerve SP = spinous process TP = transverse process UL = upper limb aka armV = vertebra(e) / vein VB = vertebral bodyVC = vertebral column w/n = within w/o = without& = and

Abbreviations


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Common terms in Osteology and Skeletal AnatomyAblation The removal of part of the body, generally a bony part, most commonly the teeth.

Acral in the extremities - bones at the apex or end of limbs.

Acromegaly A continuation of growth of the ends of cartilage covered bone (after fusion of the long bones) hence a gross change in the features (most noticeable in the jaw and digits) without growth in height, due mainly to the over activity of the pituitary gland.

Ala A wing, hence a wing-like process as in the Ethmoid bone pl. - alae.

Alveolus Air filled bone - tooth socket adj. - alveolar (as in air filled bone in the maxilla) - coalescence of alveoli helps in the formation of the sinuses. This device also lightens the weight of the bone particularly the skull.

Ankle Bend = angle usually referring to the bend just above the foot, hence the ankle is the joint b/n the foot and the lower leg.

Annulus fibrosis The peripheral fibrous ring around the intervertebral disc.

Aperture An opening or space between bones or within a bone.

Appendicular Refers to the appendices of the axial i.e. in the skeleton, the limbs upper and lower which hang from the axial skeleton, this also includes the pectoral and pelvic girdles but not the sacrum.

Areola Small, open spaces as in the areolar part of the Maxilla may lead or develop into sinuses.

Arth- To do with joints hence… Arthritis Inflammation of a joint.

Arthropathy Diseases of the joints.Arthrosis Joint types. Articulation Joint, description of the bone surfaces joining w/o the supporting structures = point of contact b/n 2 opposing bones hence the articulation of humerus and scapula is the articulation of the shoulder joint.

Attrition Tooth wear and tear.

Auditory Pertaining to hearing, hence, pertaining to the ear. (Auditory exostosis = a bony growth on the walls of the External Auditory Meatus).

Avulsion Forceable tearing away of a structure or part of a structure as in an avulsed fracture where a fragment bone is torn away from the main bone.

Axial Refers to the head and trunk (vertebrae, ribs and sternum) of the body.

Ball and Socket Generally referring to a joint which resembles a ball sitting tightly in a socket - very stable, limited range of movement e.g. hip joint.

Basilar Relating to the base or bottom of structures.

Basiocranium Bones of the base of the skull.

Boss A smooth round broad eminence - mainly in the frontal bone female > male.

early disease loss of cartilage inflammation of jt laxity of lig & permanent damage


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arm/shoulder movements in the coronal plane commencingfrom adduction abduction to extension

shoulder/scapula movements inthe horizontal plane


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Joint movements of the Shoulder


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Joint Movements of the Upper Limb & Shoulder

arm extension in sagittalplane / shoulder movement

shoulder extension inthe sagittal plane

shoulder abduction in the coronalplane (with elbow flexion)

shoulder elevation - reversemovement shoulder depression

shoulder movement

wrist extension wrist flexion

arm abduction - away from medianplane / adduction - towards the median

plane -shoulder movement

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NAME DESCRIPTION EXAMPLES SHOWN IN

flava ligs with large amounts of LIGAMENTUM FLAVA vertebra-vertebro jts elastic fibres hence yellow in colour

interarticular ligs which enter the long head of Biceps shoulder jt (may also be synovium and are inside cruciate ligs of the knee knee jtscalled synovial) the joint acetabular lig. hip jt

inter-osseous ligs which span across 2 interosseous membrane forearm radioulna jts bones for a considerable of the forearm lower leg tibiofibular jts length - deep ligs acting interosseous membrane as a surface for muscle of the lower leg attachment OBTURATOR LIG. pelvic overview

inter-spinous ligs which are b/n 2 spines INTERSPINOUS vertebral column deep ligs acting as a LIGAMENTS overview surface for muscle attachment.

long ligs which attach 2 bones SUPRASPINOUS vertebro-vertebral jts “interspinous” over long distances acting LIGAMENTUM NUCHAE craniovertebral jts as an extended surface for SACROSPINOUS pelvic girdle overview muscle attachment - more SACROTUBEROUS sacrum supf than the inter- ligs INGUINAL LIG pelvic girdle

posterior description of any lig. POSTERIOR vertebro-vertebral jts behind the named structure LONGITUDINAL (also used to describe LIGAMENT = PLL those fibres of a lig. behind a structure)

radiate lig. which fans out (smaller radiate lig. of the rib thoracic cage, deltoid shape) costovertebral jts

synovial = interarticular

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Classification and Summary of Ligaments

© A. L. Neill

The ligaments included in this book are those associated withthe musculoskeletal system, bones and skeletal muscles.Tendons which join muscle to bone are not discussed nor areother ligamentous structures such as the aponeuroses orligaments of organs such as the Hepatic ligaments.


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The Bones, Joints and LigamentsThis is the order of the illustrations in the book.

When beside the name of a structure there is a listing - (see XYZ)…it will be listed at the site XYZ, which may also refer to its alternativename; when beside a structure there is a listing - (also see XYZ)…further information about that structure will be at the site for XYZ, butit will be present in the order listed site as well; this includesstructures listed in the BACK section.

Bones are listed in BLACK; Joints are listed in DARK YELLOW & ligamentswhen referred to separately are listed in ORANGE. Generally ligaments willbe referred to in joint diagrams and not listed or demonstrated in separatediagrams. Overviews of regions are listed in MAROON (DARK RED).

Acetabular joint (see HIP JOINT) Acromioclavicular articulation & joint ANKLE BONE (see Talus - (biggest of the Tarsal bones aka Tarsus))ANKLE JOINT = Talocrural joint = Talus + Tibia + Fibula

= Subtalar joints = Talus + Calcaneus + Os TarsusARM = Upper limb = Humerus + Radius + Ulna (see Humerus) Atlas (C1 ) - (Vertebra - cervical) also see the BackAtlanto-Axial joints (C1/C2)Atlanto-Occipital joint (see Craniovertebral joint)Axial-Occipital joint (see Craniovertebral joint)Auditory Ossicles (see EAR BONES overview)Axis (C2) - (Vertebra - cervical) also see the BackBACK See end of this section the Back = Vertebral Column.BREAST BONE (see Manubriosternum)Calcaneus (aka HEEL)Capitate (see Carpus disarticulated, also Hand & Wrist overview)Carpus - carpal bones wrist (Os Carpus = Wrist bones)articulated see Hand & Wrist overview individual bones1st row - Trapezium, Scaphoid, Lunate, Triquetral, Pisiform, 2nd row - Trapezoid, Capitate, Hamate Carpus - disarticulated Carpo-Metacarpal joints (see HAND and WRIST joints)CHEEK BONES (see Zygoma) CHIN (see Mandible)CHEST OVERVIEW (Thoracic cavity) (also see Pectoral Girdle)Clavicle (aka COLLAR BONE) Coccyx -Os coccygis (also see Sacrum) Collar bone (see Clavicle)


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Costovertebral articulations & joints (RIB & SPINAL joints)Costovertebral articulations of atypical ribs 1 & 2 (see Ribs – Atypical)Cranial Fossae (see Skull internal views)Craniovertebral joints (HEAD/SPINE joints aka Atlanto-Occipitaljoints & Axial-Occipital joints) also see the BackCuboid (ankle) Cuneiforms (foot) 1st - medial cuniform, 2nd intermediate cuniform, 3rd lateral cuniformEAR BONES overviewELBOW - articulation, joint (humero-ulnar) Ethmoid bone Femur (upper leg bone) aka THIGH bone aka LEG bone Fibula (lower leg lateral bone part of the SHIN) FINGERS articulation overview ((see Hand and Wrist bones overview)FINGER JOINTS = interphalangeal joints + MCP jointsFOREARM (see Radius, Ulna)FOREHEAD (see Frontal bone)FOOT BONES (tarsal + metatarsal + phalanges) overview (see also Metatarsals)FOOT JOINTS - aka Intertarsal jointsFrontal bone (aka FOREHEAD)Glenohumeral joint (see SHOULDER JOINT) Hamate (see Carpus disarticulated, also Hand & Wrist) HAND (and WRIST bones) overview Carpal, Metacarpal bones and Phalanges - articulations HAND BONES (see Metacarpals disarticulated) HAND JOINTS intercarpal joints = IC joints Carpometacarpal, intercarpal joints = C-MC, IC joints HANGING joint (see Atlanto-Axial median joint) also see the BackHEAD/SPINE JOINTS (see Craniovertebral joints) also see the BackHEEL (see Calcaneus)Hip (aka Os Coxae - Innominate)HIP ISCHIUM, ILIUM, PUBIS overview HIP joint (also see PELVIC GIRDLE Sacrum) HIPS (also see PELVIC GIRDLE)Humeroulnar joint (see ELBOW joint) Humerus = ARM bone (upper arm bone)HyoidInferior Nasal Concha (also see Nasal Bones & Cavity)Innominate (see HIP)Interphalangeal joints of the Foot = TOES Interphalangeal joints of the Hand (see FINGER joints)Interphalangeal joints = TOES (see FOOT joints)


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Ischium (see HIP)JAW (see Mandible)Knee articulationsKNEE CAP (see Knee articulations) aka PatellaKNEE JOINTS (Tibiofemoral + [Tibiofibular]+ Femoropatellar +Tibiopatellar)Lacrimal (see inf Nasal Concha)Larynx overview (aka VOICEBOX)LEG = Lower limb = Femur + Patella +Tibia + Fibula Lunate (see Carpus disarticulated, also hand & wrist)Mandible (aka JAW aka CHIN) Mandibular joint (see Temporomandibular joint) Manubriocostal joints (see Sternocostal joints)Manubriosternum = Manubrium + Sternum + Xiphoid process akaBREAST BONE Manubrium (see Manubriosternum)Maxilla (aka UPPER JAW)Metacarpals aka HAND BONES (see Hand & Wrist overview)Metacarpal Individual views - disarticulated 1st - the thumb / 2nd - the index / 3rd - the middle 4th - the ring / 5th - to the little finger Metatarsals (bones b/n the ankle & the toes) aka FOOT BONESsee overview Metatarsals (individual views) disarticulated1st (bone to the big toe) / 2nd (bone to the second toe) 3rd / 4th / 5th (bone to the little toe)Nasal bones and cavity = NOSE Navicular (ankle) NOSE (see Nasal Bones & Cavity)Occipital bone / OcciputOdontoid Joint (see Atlanto-Axial median joint) Os Coxae (see HIP bone)Palantine bones / PalateParietal bonePatella = aka KNEE CAP (see Knee articulations)Pectoral girdle = articulations PELVIS = HIPS (see Pelvic girdle) Pelvic girdle = HIPS (also see Hip)Phalanges = FINGERS / TOES (see Hand and Foot overviews)Pisiform (see Carpus disarticulated, also Hand & Wrist bones overview)Pubic Symphysis = Pubic joint (also see Pelvic girdle) Pubis (see HIP)Radiocarpal joint see WRIST JOINT


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Hip joint anterior / posterior

BS articular branches of: obturator, medial circumflex femoral, superior and inferior gluteal arteries

NS gluteal, obturator Ns (L2-4)

A flexion / extension, adduction / abduction / circumduction, rotation

1 iliofemoral lig.

2 pubofemoral lig.

3 medial band of iliofemoral lig.

4 central band of iliofemoral lig

5 lateral band of iliofemoral lig

6 ischiofemoral lig

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Hip joint sagittal plane - (looking into the joint from inside of the pelvis)

BS articular branches of: obturator, medial circumflex femoral, superior and inferior gluteal arteries

NS gluteal, obturator Ns (L2-4)

A flexion / extension, adduction / abduction / circumduction, rotation

1 iliofemoral lig.

2 pubofemoral lig.

3 ischeal ramus

4 pubic ramus

5 femur

6 acetebulum - edge

7 ligament of femoral head

8 ischeal spine

9 transverse ligament

10 head of femur in acetabulum - cavity

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Pelvic Girdle - articulationsArticulariae CoxeaanteriorArticulations

Special features

1 intervertebral disc L5/S1 2 Iliosacral joint 3 Femoro-acetabular joint - “hip” jt4 Pubic symphysis 5 ala of the Ilium 6 ala of the Sacrum

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Pubis to Pubis defining themid-Sagittal plane

Pubic symphysis 2ocartilagenous

Femur with Acetabulum “hip” joint synovial / diarthrosisball and socket

Ilium with Sacrum Iliosacral joint synarthrosisSacrum with VB of L5 lumbosacral 2o cartilagenous fused segments of the Sacrumpartial fusion with fibrousinserts “vestigial discs”

Intrasacral joints synarthroses

Sacrum with Coccyx maycompletely fuse later in life

Sacrococcygeal 2ocartilagenous synarthrosis

3 component bones of theHIP bone = PUBIS/pubicbone + ILIUM + ISCHIUMwith separate ossificationcentres completely fuse inadolescence - ceases to bea “joint” highly modified forbipedal walking and weightbearing

Acetabulum–intersection ofthe 3 component bones onthe Lunate surface

ligaments extremely strongand designed to preventforward pitch

hip+sacrum+hip = pelvicgirdle (PG)

PG longer >wider <


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PELVIC GIRDLE = HIPS LIGAMENTSantero-superior SPECIAL FEATURES to support the body weight to support the pelvic organs and contents to balance weight across the lower limbs

1 anterior longitudinal lig. = ALL 2 iliolumbar lig. superior band 3 iliolumbar lig. inferior band 4 ant. sacroiliac lig. 5 iliac fossa 6 iliac crest 7 greater sciatic foramen 8/8A spine of Ischium / Sacrospinal lig. 9 lesser sciatic foramen 10 pectoneal lig. = Cooper’s lig. 11/11A tuberosity of Ischium / Sacrotuberous lig. 12 superior pubic lig. 13 interpubic disc 14 iliopectoneal eminence 15 ant. inferior iliac spine = AIIS 16 ant. superior iliac spine = ASIS17 sacroiliac joint 18/18A base of Sacrum / sacral canal 19 inguinal lig. 19A reflected inguinal lig. (cut to demonstrate deeper lig.) 20 aponeurosis of the external oblique muscle 21 lacuna lig. 22 supf. inguinal ring 22A/22B medial crus / lateral crus

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PELVIC GIRDLE = HIPS ARTICULATION & LIGAMENTS Posterior SPECIAL FEATURES to support the body weight to support the pelvic organs and contents to balance weight across the lower limbs

1 anterior longitudinal lig. = ALL 2 iliolumbar lig. superior band 3 iliolumbar lig. inferior band 4 ant. sacroiliac lig. 5 iliac fossa 6 iliac crest 7 greater sciatic foramen 8/8A spine of Ischium / Sacrospinal lig. 9 lesser sciatic foramen 10 pectoneal lig. = Cooper’s lig. 11/11A tuberosity of Ischium / Sacrotuberous lig. 12 superior pubic lig. 13 interpubic disc 14 iliopectoneal eminence 15 ant. inferior iliac spine = AIIS 16 ant. superior iliac spine = ASIS17 sacroiliac joint 18/18A base of Sacrum / sacral canal 19 inguinal lig. 19A reflected inguinal lig. (cut to demonstrate deeper lig.) 20 aponeurosis of the external oblique muscle 21 lacuna lig. 22 supf. inguinal ring 22A/22B medial crus / lateral crus

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Skull Internal Views inferior Skull cap

1 Lambda

2 Lambdoid suture

3 Parietal foramen

4 Diploe

5 Bregma

6 Coronal suture

7 Frontal crest

8 Frontal bone

9 Depressions for arachnoid granulations

10 Grooves for middle meningeal vessels

11 Parietal bone

12 Sagittal suture

13 Groove for superior sagittal sinus

14 Occipital bone

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Skull Internal Views lateral - looking out to the sides of the skull from the inside

1 groove for the middle meningeal artery

2 Frontal sinus

3 superior nasal concha

4 middle nasal concha

5 inferior nasal concha

6 hard palate

7 mandible

8 lateral pterygoid plate

9 medial pterygoid plate

10 styloid process

11 mastoid process

12 sphenoid sinus

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Skull Internal Views superior internal base - cranial fossae

1 Cribiform plate

2 Frontal sinus

3 Crista Galli

4 Orbital plate of Frontal bone

5 Jugum of Sphenoid

6 Optic canal

7 Lesser wing of the Sphenoid bone

8 Anterior Clinoid process

9 Foramen rotundum

10 Foramen lacerum

11 Foramen ovale

12 Foramen spinosum

13 Dorsum sellae

14 Internal acoustic meatus

15 Jugular foramen

16 Foramen magnum

A ANTERIOR FOSSA

B MIDDLE FOSSA

C POSTERIOR FOSSAS


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Common Postures and Abnormal Curves ofthe Spinal Column continued8 Thoracic scoliosis abnormal lateral curve in thoracic region

9 Lumbar scoliosis abnormal lateral curve in lumbar region

Note awareness of these postures allows for corrections in theearly stages. They should be first looked for in adolescence.If not detected changes may become permanent andexaggerated.

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Vertebrae Overview superiorTypical Cervical Vertebrae - C3-7 atypical C1 - Atlas / C2 Axis see the BJL

Typical Thoracic vertebrae - T2-9 atypical T1 attaches fixed first rib / T10-12 see the BJL ribs atypical

Typical Lumbar Vertebrae - L1-5

Articulations with vertebrae above and below for typical VB-VB jts - symphysis single vertebrae SP-SP jts - syndesmosis via lig. single zygapophyseal jts planar synovial paired TP-TP jts syndesmosis via lig. paired Thoracic with rib + VB 2 demifacets on superior & inferioronly lips of the VB and disc in b/n for artic. with rib above and below - planar synovial paired with rib+TP costal facet on TP - planar synovial - paired

1 superior facet 2 articular pillar –

zygapophysis 3 vertebral body 4 transverse foramen

(cervical) 5 inferior facet 6 transverse process 7 anterior tubercle 8 posterior tubercle 9 uncinate process 10 lamina 11 zygapophyseal joint 12 spinal canal – vertical13 spinous process 13a superior border 13b lateral border 13c tip 14 inferior facet

15 pedicle 16 intervertebral foramen

(separate - notches)16i inferior vertebal notch16s superior vertebral notch 17 intervertebral disc 18i inferior demifacet

(thoracic)18s superior demifacet

(thoracic) 19 costal facet (for rib

tubercle - thoracic) 20 head of rib 21 neck of rib 22 costotransverse junction

(thoracic) 23 body of rib 24 mammillary process

(lumbar)


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Examination of the lumbar spine - mobility continued

examination of lumbar mobility AP

Lumbarverterbra +

disc

examination of lumbar mobility with hipand leg rotation and lateral flexion

examination of lumbar mobility with hip and leg flexion


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