St. Luke’s College of Medicine – William H.

Quasha Memorial
ANATOMY BLOCK 1

Lecture:1 - Introduction to Anatomy Date: 28/07/2015

Lecturer: Dr. Arturo Decano Trans Team: Advincula, Agapito, Agregado, Alilaen

Topic Outline II. Anatomicomedical Terminology

I. Introduction to Anatomy
A. Anatomical Position
II. Anatomicomedical Terminology
A. Anatomical Position  Stands erect
B. Anatomical Planes  Feet flat on the floor
C. Terms of Relationship and Comparison  Palms and face facing forward
D. Terms of Laterality  Arms at the sides
E. Terms of Movement
III. Levels of Structural Organization B. Anatomical Planes - divide body into two, either equally or
IV. Skeletal System unequally
A. Cartilage  Median - vertical plane dividing body into two equal halves,
B. Bone the left and the right
C. Joint  Sagittal - vertical plane parallel to median dividing body into
V. Muscular System two unequal left and right halves
o Mid-sagittal plane of the hand - pass through 3rd digit
A. Types of muscles o Mid-sagittal plane of the foot - located in between 2nd
B. Muscle Cells and 3rd digits
C. Organization from Outer to Inner  Coronal (frontal) - perpendicular to the sagittal and divides
D. Attachment of Skeletal Muscles the body into two unequal anterior and posterior halves
E. Naming of Skeletal Muscle  Transverse (longitudinal, axial, horizontal) - divides body
VI. Anatomy of a Neuron horizontally to produce two unequal superior and inferior
A. Neuron
halves
 Parts
 Planes are used to describe sections:
 Configuration
o Longitudinal – lengthwise
VII. Spinal Cord
o Transverse - cross section
o Oblique – diagonal
I. Introduction to Anatomy
 Study of the structure of the human body and how it relates to
function
 “Anatomê” - to cut

A. Types
o Gross Anatomy (Macroanatomy)
o Histology (Microanatomy)
o Embryology (Developmental anatomy)
o Radiological anatomy (X-ray, CT, MRI)
o Surgery

B. Approaches to Studying Anatomy

o Regional Anatomy
 Topographical anatomy
 Study of all structures in an area of the body
 Recognizes body organization by layers
 Skin
 Subcutaneous tissues Figure 1. Anatomical planes
 Deep fascia
 Surface anatomy C. Terms of Relationship and Comparison
 Provides knowledge on what lies beneath the skin
and what structures are palpable when body is at Table 1. Location and their descriptions.
rest or in motion Location Description
 Aim - to visualize and to distinguish abnormal Anterior (ventral) toward the front
findings Posterior (dorsal) toward the back
 Clinical application -> Physical Examination Superior toward the head (cranial)
 Palpation - used with observing and listening for Inferior toward the feet (caudal)
examining the body Medial nearer than another part to an
imaginary midline of the body
o Systemic Anatomy Lateral farther away from the midline
 Organized by systems Dorsum superior aspect of any part that
 Integumentary protrudes anteriorly from the body
 Skeletal Palm anterior of hand
 Articular Sole inferior of foot
 Muscular Proximal closer to pt. of attachment
 Nervous Distal located near surface
 Circulatory Superficial (external) near surface
 Digestive Intermediate halfway through surface
 Respiratory Deep (internal) Away from surface
 Urinary Central center of body/organ
 Reproductive Peripheral away from center of body/organ
 Endocrine
D. Terms of Laterality
o Clinical Anatomy  Bilateral - paired structures with right and left members (ex.
 Emphasizes application of anatomical knowledge to kidneys)
medical practice
 Unilateral - structures occurring at one side (ex. spleen)
 Ipsilateral - occurring on the same side of body as another
structure (ex. right thumb & right big toe)
 Contralateral - opposite side of body relative to another
structure (ex. right & left hand)

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E. Terms of Movement B. Bone

Table 2. Movement of body structures.  Calcified connective tissue, consisting of cells, fibers, and
Movement Description ground substance
Gliding bony surfaces of bone slide or glide  Presence of collagen (protein that gives bone a flexible
over each other framework)
Flexion bending movement that decreases the  Deposition of inorganic calcium phosphate salts as
angle of the joint hydroxyapatite crystals within its matrix renders the bone
Extension movement that increases angle of the structurally rigid
joint  Living bone cells - make bones metabolically active
Abduction moving away from the longitudinal axis o Osteocytes
Adduction moving toward from the longitudinal  Maintains bone tissue
axis  Mature bone cell trapped in collagen matrix
Rotation turning the bone or limb around its long o Osteoblast
axis  Forms bone matrix
Supination rotating the forearm laterally such that  Immature cells that produce collagen
the palm faces superiorly  Secrete hormones (alkaline phosphatase) to harden the
Pronation rotating the forearm medially such that bone
the palm faces inferiorly o Osteogenic cell
Inversion sole of foot faces or turns medially  Stem cell
Eversion sole of foot faces or turns laterally o Osteoclast
Protraction antero-lateral movement of the scapula  Resorbs bone
Protrusion jutting out of jaw  Destroys bone cell
Elevation raise or move a part superiorly  Produce acid phosphatase (destroy bones)
Depression lowering of limb or body inferiorly
Opposition to bring the thumb and index fingertips Two types of bone
a. Compact (lamellar) - dense and used for support
together
 Characterized by regularity of collagen fibers
Circumduction combination of all movement
 Contain osteons which are composed of:
 Central or Haversian canal: contains blood supply for
the bone
 Concentric lamellae: surround the canal help with
bone strength by resisting bending
 Lacunae: lie between or within the lamellae, contain
osteocytes
o Each lacunae are connected by canals called
canaliculi (canal for cytoplasmic extensions of
osteocytes, necessary for gas and nutrient exchange
between osteocytes and blood supply in the central
canal)
 Perforating (Volkmann's canals): run perpendicular
to the central canals and connect two central canals

b. Spongy (trabecular or cancellous), see Moore Fig 1.12, pp.

19-20.
 In the interior of some bones and resists compression
 Consists of a lattice of branching bony spicules
(trabeculae)
 Some regions, surrounded by bone marrow (site of
hematopoesis--blood cell differentiation)

Figure 2. Flexion and extension of different body parts

III. Levels of Structural Organization

 Chemical - atoms combine to form molecules
 Cellular - cells are made up of molecules
 Tissue - tissue consist of similar types of cells
 Organ - organs are made up of different types of tissue
(epithelial, muscular, nervous and connective)
 System - consists of different organs that work together
closely
 Body (Organismal) - the human organism is made up of
many organ system Figure 3. Parts of bone cell

IV. Skeletal System Periosteum

 206 bones in adult  Dense membrane of fibrous connective tissue that covers
 Divided into axial and appendicular all bones except articulating surfaces of bones
 Outer layer: protective, fibrous dense irregular connective
 Functions:
tissue
o To give the body its structural form
 Inner layer: osteogenic stem cells that differentiate
o Protect vital organs
(specialize) into bone cells like osteoblasts (bone forming)
o Store salts and other materials needed for metabolism
or osteoclasts (bone dissolving) cells
o Produce red blood cells (bone marrow of flat bones)
 connected to bone marrow via Sharpey's fibers
Endosteum
A. Cartilage
 Lines internal spaces, similar to inner layer of periosteum
 Resilient & semi-rigid
 Avascular
 Forms part of skeleton where more flexibility is required
 Articular cartilage - provides smooth, low-friction, gliding
surface for free movement

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Classification of bones
 Long bones (characterized by a long shaft called a
diaphysis, with epiphyses at the ends. connecting zone
between diaphysis and each epiphysis is called the
metaphysis)
 Ex: humerus, phalanges, femur
 Short bones (cuboidal, or cube-shaped)
 Ex: carpals, tarsals, talus
 Flat bones (thick and flat, but can be curved, like the bones
of the skull. Many flat bones serve a protective function)
 Ex: rib, temporal, parietal
 Irregular bones
 Ex: vertebrae, ischium, maxilla
 Sesamoid bones (bone developing from a ligament)
 Ex: patella

Figure 5. Intramembranous ossification

Figure 4. Types of bones

Axial vs Appendicular Skeleton: see picture (NOTE THAT

AXIAL INCLUDES THE SACRUM AND COCCYX, and the
appendicular includes the girdles)
Figure 6. Endochondral ossification
Bone markings
Table 3. Types of bone markings. ADDITIONAL INFO: BONES (from the blue boxes in the book)
Markings Description
Capitulum small, round, articular head 1. Accessory Bones (Supernumery Bones)
Condyle rounded, knuckle-like articular area,
- Development of additional ossification centers
often occurring in pairs
Crest ridge of bone appear and form extra bones
Epicondyle eminence superior or adjacent to a - Sutural bones: small, irregular, worm-like bones
condyle - Common to foot
Facet smooth flat area, usually covered with 2. Heterotropic Bones
cartilage, where a bone articulates with - Bones formed in soft tissues
another bone - Common in horse riders caused by chronic muscle
Foramen passage through a bone strain => bone hemorrhagic areas that undergo
Fossa hollow or depressed area classification and ossification
Groove elongated depression or furrow
3. Trauma to Bone and Bone Changes
Head large, round articular end
Line linear elevation - may cause bone breakage
Malleolus rounded process - reduction of fracture through bringing of bones
Notch indentation at the edge of a bone together
Protuberance projection of bone - green stick fractures: incomplete breaks caused by
Spine thorn-like process bone bending
Spinous Process projecting spine-like part 4. Osteoporosis
Trochanter large blunt elevation - bone quantity reduction
Trochlea spool-like articular process or process - assessed through bone scanning
that acts as a pulley 5. Sternal Puncture
Tubercle small raised eminence
- Wide-bore needle is inserted through thin cortical
Tuberosity large rounded
bone into spongy bone
Bone Development - Bone marrow transplant
a. Intramembranous Ossification 6. Bone Growth and Assessment of Bone Age
 Replacement of thin connective tissue membrane with - Criteria:
bone, developed directly from mesenchyme o Appearance of calcified material in diaphysis
 in flat bones and/or epiphysis
o Disappearance of radiolucent line
b.Endochondral Ossification
 Replacement of fetal cartilage skeleton with bone, representing the epiphyseal plate
developed from cartilage derived from mesenchyme 7. Effects of Diseases and Diet on Bone Growth
 in long, irregular, and short bones - Production of early epiphyseal fusion
- Delayed fusion
- Slowing of cartilage proliferation at metaphyses
- Lines of arrested growth

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ADDITIONAL INFO: BONES (cont.) ADDITIONAL INFO: JOINTS (from the blue boxes in the book)

8. Displacement and Separation of Epiphyses 1. Joints of Newborn Cranium

- Displaced epiphyseal plate: mistaken for a fracture
- Separation of epiphysis: mistaken for displaced
fractured bone
9. Avascular Necrosis
- Loss of arterial supply to epiphysis or other bone
parts = death of bone tissue
- Disorder ~ osteochondrosis
C. Joint
 Joint where two or more bones articulate
 Types of joint:
o Fibrous joints (Synarthroses)
 Adjacent bones are joined by collagen fibers
 No movement produced
 Ex. sutures of the skull
o Cartilaginous joints (Amphiarthroses)
 Two bones joined by a cartilage
 Minimal movement
 Ex. synchondroses and symphyses
o Synovial joints (Diarthroses)
 Freely movable and most common joint in the body
 Presence of joint cavity filled with fluid called synovial
fluid
 Any kind of movement can be done
 Ex. knee joint, elbow joint, shoulder, hip joint, and
phalanges of hands and feet.
 Joint capsule = fibrous capsule & synovial membrane
 Types:
 Plane - produces gliding or sliding movement
 Hinge - permits flexion and extension movement
 Saddle - permit movement in two different planes
 Ball and Socket - permit all types of movement
(prone to dislocation)
 Pivot - permits rotational movement
o Condyloid/Ellipsoid
 Permits flexion, extension, abduction, adduction, and
circumduction movements
- Bones of calvaria: do not connect with each other;
sutures form fontanelles (ant. part is most
prominent) (bulges during crying) (depressed when
baby is dehydrated) (pulsations reflect that of
cerebral arteries)
2. Degenerative Joint Disease
- Caused by heavy use over the years
- a.k.a. osteoarthritis
- accompanied by stiffness, discomfort, and pain
- common in older people
- traumatic infection of joint = followed by arthritis,
joint inflammation, and septicaemia (blood
poisoning)
3. Arthroscopy
- Enable orthopaedic surgeons to examine joints for
abnormalities
- Rapid healing
V. Muscular System
 Functions:
o Permits movement of the body
o Maintain posture
o Circulates blood throughout the body.
A. Types of muscles
 Skeletal - usually attached to bones, under conscious control,
somatic nervous control; striated.
 Cardiac - found in walls of heart, not under conscious control,
autonomic nervous control; striated and has the presence of
intercalated discs.
 Smooth - found in walls of most visceral organs, not under
conscious control, autonomic nervous control; not striated.
B. Muscle Cells
 Myocytes - also known as muscle fibers/ muscle cells
 Sarcolemma - cell membrane
 Sarcoplasm - cytoplasm of cell
 Sarcoplasmic reticulum - endoplasmic reticulum
 Myofibrils - long structures in sarcoplasm which contains
actin (thin filaments) and myosin (thick filaments).
Arrangement of filaments in myofibrils produces striations.
 Sarcomere - basic unit of muscle

C. Organization from outer to lower

 Fascia  Endomysium
 Epimysium  Sarcolemma
 Muscle  Myocyte
 Perimysium  Sarcomere
 Fascicle  Myofibril

Figure 8. Organization of muscles

D. Attachment of Skeletal Muscles

 Ligaments - join bones to bones. Made up of dense regular
connective tissue
 Tendons - join muscles to bones. Made up of dense regular
Figure 7. Joint movements connective tissue
 Aponeurosis - like a fascia that attaches muscle to another
muscle; flat
 Origin - an attachment site for a less movable bone
 Insertion - an attachment site for a more movable bone,
moves toward origin
*Actions depend largely on where muscles are attached to
attachment sites.

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E. Naming Skeletal Muscles - things to consider in naming

skeletal muscles:
 Location
 Size
 Action
 Shape
 Number of attachments of the muscle

ADDITIONAL INFO: MUSCLES (from the blue boxes in

the book)

1. Muscle Dysfunction and Paralysis

- note both the normal function/action of a muscle
- consider the consequences of its loss of function
(paralysis).

2. Absence of Muscle Tone

- without a normal muscle tone (a gentle, constant
pressure), opposing antagonist muscle(s) can cause a
limb to assume an abnormal resting position.
- denervated muscle that has lost muscle tone will
become fibrotic and lose its elasticity (contribute to the
abnormal position at rest)

3. Muscle Soreness and “Pulled” Muscles

- caused by eccentric contractions that are either
excessive or associated with a novel task
Figure 9. Parts of Neuron
- muscles cannot elongate beyond one third of their
resting length without sustaining damage B. Configuration
o Exception: hamstring can reach max length, which
 Unipolar (often called pseudounipolar): one axon that divides
is why hamstring muscles can be pulled (have
into two long processes:
more tears) than other muscles.
o Peripheral process: conducting impulses from the receptor
organ (touch, pain, or temperature sensors in the skin, for
4. Growth and Regeneration of Skeletal Muscle
example) toward the cell body
- skeletal striated muscles replaced by new muscle fibers
o Central process: continues from the cell body into the CNS.
- new skeletal muscles composed of disorganized
 Bipolar: possesses one axon and one dendrite (rare but
mixture of muscle fibers and fibrous scar tissues
found in the retina and olfactory epithelium)
- growing muscle results from hypertrophy of existing
fiber  Multipolar: possesses one axon and two or more dendrites
(most common type)
5. Muscle Testing
- diagnose nerve injuries.
- person performs movements that resist those of the
examiner and vice versa
- Electromyography(EMG): analyze the activity of an
individual muscle during different movements

6. Hypertrophy of the Myocardium and Myocardial

Infarction
- Compensatory hypertrophy cause myocardium to
increase size of fibers
- Tissue becomes necrotic due to loss of blood; fibrous
scar tissue develops into a myocardial infarct (area of
necrosis of cardiac tissue).
7. Hypertrophy and Hyperplasia if Smooth Muscle
- Compensatory hypertrophy caused by inc. in demands
- Smooth muscle in uterine wall during pregnancy
increase not only in size but also in number
(hyperplasia) (because these cells retain the capacity
for cell division)
- New smooth muscle cells develop from incompletely
differentiated cells (pericytes).
VI. Anatomy of Neuron
 Structural and functional units of the nervous system
A. Parts
 Cell body or soma
 Dendrites: small processes which carry impulses TO the cell
body
 Axon: small processes which carry impulses AWAY from the
cell body
 Myelin sheath
o Composed of Schwann cells (provide trophic support,
facilitate regrowth of PNS axons, and clean away cellular
debris)
o Gaps are called Nodes of Ranvier
 Ganglion
o A collection of neuron cell bodies outside the CNS
o Motor (autonomic) and sensory ganglia.
Figure 10. Types of neuron configuration
VII. Spinal Cord
 Composed of gray matter and white matter.
 The nerve cell bodies lie within and constitute the gray
matter; the interconnecting fiber tract systems form the white
matter
 In transverse sections of the spinal cord, the gray matter
appears roughly as an H-shaped area embedded in a matrix
of white matter.
 The struts (supports) of the H are horns; hence there are
right and left posterior (dorsal) and anterior (ventral) gray
horns.
 Consists of:
o A bundle of nerve fibers outside the CNS (or a “bundle of
bundled fibers,” or fascicles, in the case of a larger nerve)
o The connective tissue coverings that surround and bind
the nerve fibers and fascicles together
o The blood vessels (vasa nervosum) that nourish the
nerve fibers and their coverings
 Nerves are fairly strong and resilient because the nerve fibers
are supported and protected by three connective tissue
coverings:
o Endoneurium: delicate connective tissue immediately
surrounding the Schwann cells and axons.
o Perineurium: a layer of dense connective tissue that
encloses a fascicle of nerve fibers, providing an effective
barrier against penetration of the nerve fibers by foreign
substances.
o Epineurium: a thick connective tissue sheath that
surrounds and encloses a bundle of fascicles, forming the

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outermost covering of the nerve; it includes fatty tissue,

blood vessels, and lymphatics.

Figure 11. Organization of Nerve Figure 12. Spinal Nerve

 Spinal (segmental) nerves

o Exit the vertebral column (spine) through intervertebral VIII: REFERENCES
foramina).  Moore, K.L., Dalley, A.F., & Agur, A.M.R. (2014). Clinically
o Arise in bilateral pairs from a specific segment of the spinal th
oriented anatomy (7 ed.). Philadelphia: Lippincott Willias &
cord. Wilkins.
o The 31 spinal cord segments and the 31 pairs of nerves  Dr. Decano’s ppt.
arising from them are identified by a letter and number
(e.g., “T4”) designating the region of the spinal cord and QUIZ
their superior-to-inferior order (C, cervical;T, thoracic; L,
lumbar; S, sacral; Co, coccygeal). 1. True or False. Digits are considered as short bones.
o Initially arise from the spinal cord as rootlets which 2. Delicate connective tissue immediately surrounding the
converge to form two nerve roots: neurolemma, cells, and axons?
 Anterior (ventral) nerve root: consisting of motor 3. What type of configuration of neuron will you be able to
(efferent) fibers passing from nerve cell bodies in the find at the dorsal root ganglion? And what is its function
anterior horn of spinal cord gray matter to effector organs in neural transmission?
located peripherally. 4. The flat attachment of muscle to another muscle is
 Posterior (dorsal) nerve root: consisting of sensory called?
(afferent) fibers from cell bodies in the spinal sensory or 5. At what parts of the bones are tendons, ligaments, and
posterior (dorsal) root ganglionthat extend peripherally to fascias attached to?
sensory endings and centrally to the posterior horn of 6. Give an example of a sesamoid bone.
spinal cord gray matter. 7. Communicating system of _____ is essential for
o The posterior and anterior nerve roots unite, within or just exchange of gases and metabolites between the
proximal to the intervertebral foramen osteocytes.
 Form a mixed (both motor and sensory) spinal nerve
 Immediately divides into two rami (L., branches): a
posterior (dorsal) ramus and an anterior (ventral)
ramus.
o Posterior (primary) rami of spinal nerves:
 Supply nerve fibers to the synovial joints of the
vertebral column, deep muscles of the back, and
the overlying skin in a segmental pattern.
 Remain separate from each other (do not merge
to form major somatic nerve plexuses).
o Anterior (primary) rami of spinal nerves
 Supply nerve fibers to the much larger remaining
area, consisting of the anterior and lateral regions
of the trunk and the upper and lower limbs.

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