SKELETAL SYSTEM

q internal framework for the body

1. FUNCTIONS
1.Support formtheframeworkthat supportsthebodyandcradlessoft organs 2.Protection provideaprotectivecase forthebrain,spinalcord,andvital organs 3.Movement provideleversformuscles 4.Mineralstorage reservoirfor minerals,especiallycalciumand phosphorus e.g.Ca,P,Mg,Na Calciumisnecessaryfor: Transmissionofnerveimpulses Musclecontraction Bloodcoagulation Secretionbyglandsandnervecells Celldivision

5.Bloodcellformation hematopoiesis occurs withinthemarrowcavities ofbones e.g. Ininfants,foundin

the medullarycavity andallareasofspongy bone Inadults,foundin the diploofflatbones, andtheheadofthe femurandhumerus

Includesnotonlybones,butalsojoints,cartilages,and ligaments

SkeletalCartilages
Containsnobloodvesselsornerves Surroundedbythe perichondrium (dense irregularconnectivetissue)thatresistsoutward expansion Threetypes 1. Hyalinecartilage 2. elasticcartilage 3. fibrocartilage

Hyaline Cartilage
Providessupport,flexibility, andresilience Isthemostabundant skeletalcartilage Ispresentinthese cartilages:
Articular coverstheends oflongbones Costal connectstheribs tothesternum Respiratory makesupthe larynxandreinforcesair passages Nasal supportsthenose

ElasticCartilage
Similartohyalinecartilagebutcontainselastic fibers Foundintheexternalearandtheepiglottis

Fibrocartilage
Highlycompressedwithgreattensilestrength Containscollagenfibers Foundinmenisciofthekneeandin intervertebral discs

MicroanatomyoftheBone
RigidformofCTwithcell,fibers&groundsubstance/ matrix Groundsubstanceiscalcified becomeshardandbrittle Calcifiedmatrixmadeupoforganicelements(collagen, proteinpolysaccharideand chondroitin sulfate) Inorganicelements calcium,magnesium,andsodium; makesupthegreaterportionofthematrix

BoneCells 1.Osteoblasts 2. Osteocytes 3. Osteoclasts 4. Osteoprogenitorcells

Undifferentiatedcells Onfreebonysurfaces, endosteum, periosteum, liningofthe Haversian canal, epiphyseal plate Divide osteoblasts (bone formingcells) Unite osteoclasts (bone destroyingcells)

BoneTissues

Cancellous orSpongy bone(substancia spongiosa)

Compactbone (substanciacompacta)

SpongyBone
Irregularbranchingbony spicules forminganetwork ofinterconnectingspaces containingbonemarrow Withthin trabeculaemade upofirregularlamellaeof bonewithlacunae containing osteocytes Trabeculaelinedby endosteum containing osteoprogenitorcells, osteoblasts & osteoclasts Absenceof haversiansystem

CompactBone
Haversian system,or osteon thestructural unitofcompactbone
Lamella weight bearing,columnlike matrixtubescomposed mainlyofcollagen Haversian,orcentral canal centralchannel containingbloodvessels andnerves Volkmannscanals channelslyingatright anglestothecentral canal,connectingblood andnervesupplyofthe periosteum tothatof the Haversian canal

 Osteoblasts bone formingcells Osteocytes mature bonecells Osteoclasts largecells that resorb orbreak downbonematrix Osteoid unmineralized bonematrixcomposed of proteoglycans, glycoproteins,and collagen

OSTEOGENESIS/ OSSIFICATION q Beginsatweek8ofembryodevelopment

q Intramembranous ossification

q Intracartilaginous ossification

OSTEOGENESIS/ OSSIFICATION
1. Intramembranous Ossification

occursdirectlyinprimitive

CTw/ocartilageformation e.g.Commonlyseenintheflatbonesoftheface&skull
Stages:

StagesofIntramembranousOssification

2. Intracartilaginous / Endochondral Ossification Involvesthereplacementofacartilagemodelbybone

e.g. Involvesthebonesoftheentireskeletalsystemexceptthe bonesoftheface&skull Useshyalinecartilagebonesasmodelsforboneconstruction Requiresbreakdownofhyalinecartilagepriortoossification

Ectopicboneformation whenbonearisesintissues notbelongingtotheskeletalsystemorinCTw/o osteogenic properties

Steps:

Classificationof bonesasto shape

1.Longbones longerthanthey arewide mostlycompact bone haveashaftwith headsatboth ends functionaslevers e.g.limbbones suchas humerus

Epiphysealplate separatesthe epiphysisfromthe diaphysis Metaphysisa transitionalregion connectingthe epiphyseal plateto the diaphysis

Periosteum alayerof specializedCTw/ osteogenic potential

Endosteum athincellular layerw/ osteogenic propertiescoveringthe marrowcavity

2. Shortbones
Cubeshaped bones Containmostly spongybone Foundinconfined spaces,wherethey transferforcesof movement e.g.wristsandankle bones

3.flatbones
thin,flattened,andusually

curved have2thinlayersof compactbonesandwiching alayerofspongybone provideprotectionfor underlyingorgansand surfacesformuscle attachment e.g.ribs,sternum,andmost skullbones

4.Irregularbones
boneswith

complicatedshapes or elaboratedfor muscleattachment orarticulation e.g. vertebraeand hipbones, ethmoid

Diploe foundintheflatbonesofthefaceandskull;a layerofspongybonebetween2layersofcompactbone forminganouterandinnertable

5. Wormian bones accessorybones foundbetweenthe jointsoftheskull whentheiredges meet e.g.Suturesofthe skull 6. Sesamoid bones smallboneswhich developwithin tendonsinresponse tostress e.g.Kneecap

Main Division of the Skeleton 1. AxialDivisionbonesthatformtheaxisofthebodyandsupports

andprotecttheorgansofthehead,neck,andtrunk

2. Appendicular Divisionbonesofthegirdlesandtheextremities.
Thegirdlesanchortheappendagestotheaxialskeleton.

1. AXIAL SKELETON
A. Skull Cranium Facial Bones (including hyoid and ear ossicles)

B. Vertebral Column/ Spine

Cervical Thoracic Lumbar Sacrum Coccyx Manubrium Body Xiphoid True ribs False ribs(including floating ribs)

C. Bony Thorax

Sternum

Ribs

11.Appendicular Skeleton
A.PectoralgirdleClavicle Scapula B.UpperExtremitiesUpperArm Humerus LowerArmRadius Ulna HandCarpals Metacarpals Phalanges C.PelvicGirdleIlium Ischium Pubis D.LowerExtremitiesThighFemur LegTibia Fibula Foot Tarsals Metatarsals Phalanges

Thereare 206 bonesintypicalhumanskeleton.

1.AXIALSKELETON(80)3.Earossicles (6) A.SKULL(22) malleus (2) 1.Cranial(8) incus (2) frontal(1)stapes(2) parietal(2) temporal(2)4.Hyoid(1) occipital(1) ethmoid(1)B.Thorax(25) sphenoid(1) sternum(1) 2.Facial ribs(24) nasal(2) lacrimal(2) C.VertebralColumn(26) maxlla (2)cervical(7) inferiornasalconchae (2)thoracic(12) zygomatic (2) lumbar(5) palatine(2) sacrum(1)5fusedvertebrae vomer (1) coccyx(1)4fusedvertebrae mandible(1)

11. APPENDICULAR SKELETON (126)

A.PectoralGirdle(4) C.PelvicGirdle(2) scapula(2) os coxae (2)eachcontains clavicle(2)3fusedbones

B.UpperExtremities(60)D.LowerExtremities(60) humerus (2) femur(2) radius(2) tibia(2) ulna(2)fibula(2) carpals(16)patella(2) metacarpals(10) tarsals (14) phalanges(28) metatarsals(10) phalanges(28)

1.AXIALSKELETON

q dividedinto3parts: skull, vertebralcolumn and thorax q dividedinto3parts: skull, vertebralcolumn and thorax A.SKULL 1.Cranium protectsthebrain consistof8large,flatbones allaresingleexcepttheparietalsandthe temporals

1.1Frontal formstheforehead,thebony projectionsundertheeyebrowsand thesuperiorpartofeacheyesorbit Ifthefrontalsutureunitingtheleft andrightsidesofthefrontalbone persists,itisreferredtoasthe metopic suture

1.2Parietals formsthelateralandsuperiorwalls oftheskull theymeetinthemidlineofthe skullatthe sagittal suture meetthefrontalbonebya coronalsuture

Orbit
roofisformedbythe frontal lateralwallbythe zygomatic and sphenoid medialwallbythe nasals, lacrimals,and ethmoid floorbythe maxillaries

1.3 Temporals formthetemple lieinferiortotheparietalbones meettheparietalsatthe squamoussuture with5bonemarkings 1.externalacoustic(auditory) meatuscanalthatleadstothe eardrumandmiddleear 2.styloidprocess inferiortothe externalauditorymeatus needlelikeprojectionthatserves asattachmentpointforsomeneck muscles 3.zygomaticprocess joinsthe temporalprocessofthe zygomatic bonetoformthe zygomaticarch

4.mastoidprocess roughbreastlike projectionposteriorandinferiortothe external acoustic meatus attachmentsiteforsomeneckmuscle easilypalpatedasabonyknobbehindthe earlobe fullofaircavitiescalledmastoidsinuses high riskspotforinfectionbecauseofits proximitytothemiddleearandbrain 5.Jugularforamen atthejunctionofthe occipitalandtemporalbones allowspassageofjugularvein(largestvein ofthehead)thatdrainsthebrain Carotidcanalallowspassageofcarotid arterythatsuppliesbloodtothebrain 6.temporal fossaadepressiononthe inferiorsideofthe zygomaticprocessofthe temporal bone articulateswiththemandibletoformthe TMJ

1.4 Occipital formsthefloorandbackwallofthe skull joinsparietalbonesatthelambdoid suture. with3bonemarkings: 1.foramenmagnumlargeopening atthebasethatallowsthebrainto connectwiththespinalcord 2.occipitalcondylesround protrusions,lateraltotheforamen magnum,thatarticulatewiththeatlas ofthevertebralcolumn 3.externaloccipital protruberanceprominentmidline projectionontheposteriorsurfacejust posteriortotheforamenmagnumthat serveasattachmentpointforthe ligamentumnucha,alargefibrous elasticligamentwhichhelpssupport thehead

1.5Sphenoidbone butterflyshapedbonethat spansthewidthoftheskull keystoneofthecranium formsthefloorofthe skull with2bonemarkings: 1.sellaturcica(Turks saddle)adepressionatthe center thatholdsthe pituitaryglandinplace 2.foramenovalealarge openingattheposteriorend ofthesella turcicathat allowsthepassageofcranial nerveV(trigeminalnerve)

1.6 Ethmoidboneanirregularbonein frontofsphenoidandbehindfrontalbone formstheroofofthenasalcavityandpartof themedialwalloftheorbit with4bonemarkings: 1.cristagalli (literally, cockscomb) projectingfromitssuperiorsurface. servesasapointofattachmentforthe membranesthatcoverthebrain 2.superiorandmiddlenasalconchae (turbinates) scrollshapedbonesinthe lateralwallofthenasalcavity Turbinatesallowtheairtoswirlso foreignparticlesmaybecometrappedinthe mucusthatlinesthenasalpassageways. 3.perpendicularplateformsthesuperior portionofthenasalseptum 4.cribriformplatetheholeyareasoneach sideofthecrista gallithatallowfibers carryingimpulsesfromtheolfactory(smell) receptorsofthenosetoreachthebrain

2.FACIALBONES consistof14bones 12arepairedonlythemandibleand vomer aresingle 2.1Maxillae formtheupperjaw themain,orkeystonebonesofthe face becauseallfacialbonesexcept themandiblejointhemaxillae itsextensionscalled palatine processes formtheanteriorpartofthe hardplate carrytheupperteethinthesockets ofthealveolarmargin 2.2Palatinesformtheposterior partofthehardpalate Failureofthepalatinesorthe palatineprocessestofusemedially resultsincleftpalate

2.3 Zygomaticsthecheekbones withtemporalprocessesthatunite withthezygomaticprocessesofthe temporalbonestoformthe zygomatic arch 2.4 Lacrimalsformpartofthe medialwallsofeachorbit smallestfacialbonesaboutthe sizeofafingernail withgroovesthatserveasa passagewayfortears 2.5Nasalssmallrectangular bonesformingthebridgeofthe nose 2.6 Vomersingleboneinthe medianlineofthenasalcavity formsthebridgeofthe nose 2.7InferiorNasalConchae thincurvedbonesprojectingfrom thelateralwallsofthenasalcavity

TheSuturesoftheSkull Whichofthesuturesisnotshown?

2.8Mandible formsthelowerjaw thehorizontalpart(thebody)formsthechinthetwouprightbars(the rami) connectthemandiblewiththetemporalbone eachramus presents2processesthe condylarand coronoidprocesses largestandthestrongestboneoftheface theonlymovableboneoftheface

Sinuses areairfilledcavitiessuchas the paranasal sinuses(frontal, maxillary, ethmoid,sphenoid, sphenoid)andthemastoid sinuses.Functiontolightenthe weightoftheskullandgive resonancetothevoice

fontanels softspots/ unossified areasinthe skullof newlyborn littlefountainbecauserhythmofthe babyspulsecanbefeltinit allowthe fetal skulltobe compressedslightlyduringbirthand theinfantsbraintogrowduringthe latterpartofpregnancy

Hyoidbonehorseshoeshaped, withabodyand2pairsofhorns suspendedinthe midneck regionabovethelarynx anchoredbyligamentsto the styloidprocesses uniqueinthatitisthe onlyboneofthebodythatdoes not articulate directlywithanyother bone servesasmovablebase fortongueandattachmentpoint forneckmuscles Ear ossicles3 littlepaired bonesfoundinsidethemiddleear cavity 1.anvil/incus 2.hammer/ malleus 3.stapes/stirrups smallestbonesinthebody amplifythesound

Earossicles3 littlepairedbones foundinsidethe middleearcavity 1.anvil/incus 2.malleus/ hammer 3.stapes/ stirrups smallestbonesin thebody amplifythesound

B.Vertebralcolumn(Spine) theaxialsupportofthebody extendsfromtheskull,whichit supports,tothepelvis,whereit transmitstheweightofthebodyto thelowerlimbs formedfrom26irregularbones connectedandreinforcedby ligaments beforebirth,thespineconsistsof 33separate vertebarae but9of thesefusetoform2composite bones:the sacrum andcoccyx the24 singlevertebraeinclude7 cervical,12thoracic,and5lumbar vertebrae) thevertebraeareseparatedby padsoffibrocartilage (intervertebraldiscs)

The Vertebrae
Commonfeatures body(centrum)disclike, weightbearingpartofthevertebra Vertebralarchformedfrom joiningoflaminaandpedicle Vertebralforamencanal throughwhichspinalcordpasses Transverseprocess2lateral projectionsfromthevertebralarch Spinousprocesssingle projectionarisingfromthe posterioraspectofthevertebral arch Superiorandinferior articularprocessespaired projectionslateraltothevertebral foramenallowvertebratoform jointswithadjacentvertebrae

1. CervicalVertebrae

formstheneckregion first2aredifferent st 1 CV: atlascarriesthe skull ringlikebody(centrum)is absentwithlargeneuralcanal withlargedepressionthat articulateswiththeoccipital condyles oftheskullforming atlantooccipitaljointallowsyou tonodyes nd 2 CV: axis (epistropheus)actsasapivot fortherotationoftheatlasand skullwithodontoid processor dens whichactsasthepivotpoint thejointbetweenC1andC2 allowsyoutorotateyourhead fromsidetosidetoindicateno

2.Thoracicvertebrae 12thoracicvertebraeareall typical with heartshapedbody the spinous processislongand hookssharplydownward has2costal demifacets oneach sideforarticulatingwiththe ribs 3.Lumbarvertebrae withmassiveblocklikebodies andshort,hatchetshaped spinous processes strongbecausebearsmostof thebodyweight

4.Sacrum formedbyfusionof5sacralvertebrae formstheposteriorwallofthepelvis with winglikealae thatarticulatelaterally withthehipbones andamediansacralcrest

th The spinousprocessofthe5 vertebraof sacrum(postview)doesnotform,leaving a sacralhiatus whichisthesiteofcaudal anesthetic injectionsgivenjustbefore childbirth Theanterioredgeofthebodyofthefirst sacralvertebrabulgestoformthe sacral promontory,alandmarkfeltduringthe vaginalexaminationtodetermineifpelvic openingsarelargeenoughtoallowfor normalvaginaldelivery

5.Coccyx thehumantailbone formedbyfusionby3to5tinyvertebrae

AbnormalSpinalCurvatures
Abnormalitiesmaybecongenitalorresultfromdisease,poor posture,orunequalmusclepullonthespine

Scoliosis
lateralbendingofthe vertebralcolumn,usually inthethoracicregion

Kyphosis(hunchback)
anexaggeration ofthethoraciccurve ofthevertebralcolumn

Lordosis(swayback)
anexaggerationofthe lumbarcurve

OSTEOPOROSIS
q Osteoporosis,orporousbone,resultsfromreductionintheoverall quantityofbonematrix. q Acommonconsequenceofaging,particularlyinwomen q FactorsthatcontributetoosteoporosisareadietpoorinCa2+ and protein,lackof Vit D, smokin g,andinsufficientweightbearing exercise,tostressthebones

C.BONYTHORAX consistsofsternum,ribs,and thoracicvertebrae 1.Sternum commonlycalledbreastbone

attachedtotheclavicleby sternoclavicular joint itisaflatboneconsistingof3 segments: 1.manubrium(anteriormost), 2.body 3.Xiphoid process(sword like) animportantlandmarkin givingcardiopulmonaryresuscitation (CPR) Becausesternumislocatedclosetothe bodysurface,itiseasytoobtainsamples of bloodformingtissuefordiagnosisof blooddiseases.

Markings: 1. Sternal angle(angleofLewis)aslightelevationfeltat thejunctionofthe manubrium andbodyofthe nd nd sternum;correspondstothe2 ribortothe2 intercostal spaceortothepointofbifurcationof tracheaintobronchiortotherootofthearchofthe aorta

2. Suprasternal (jugular)notch adepressionfoundat thelevelof sternoclavicular joint;attachmentpointof neckmuscles

2.Ribs
itshead articulatesposteriorlytothevertebraandanteriorlytothesternumthru costalcartilages Types a.trueribs(vertebrosternalribs) thefirst7pairs attachdirectlytothesternumbycostalcartilages b.falseribs vertebrochondral indirectlyattachedtothesternumbecause th th th 8 ,9 ,and10 ribsattachtoeachother th andthentothe7 pairofribs floating(vertebralribs) lacksternalattachment

11. Appendicular Skeleton

qcomposedof126bonesofthelimbsandgirdles
A.PectoralgirdleClavicle Scapula B.UpperExtremitiesUpperArm Humerus LowerArmRadius Ulna HandCarpals Metacarpals Phalanges C.PelvicGirdleIlium Ischium Pubis D.LowerExtremitiesThighFemur LegTibia Fibula Foot Tarsals Metatarsals Phalanges

A. PectoralGirdle
light,poorlyreinforcedtoallowupperextremitiesagreaterdealoffree

movementhowever,shoulder jointisveryeasilydislocated consistsof2bones:clavicleandscapula

1.Clavicle (collarbone)
formsthebonyrootoftheneck slender,Sshapedbone attachestothemanubriumofthesternummedially(byits sternal end)andtothescapulalaterally(byitsacromialend) itactsasabracetoholdthearmawayfromthetopofthethoraxand help preventshoulderdislocationthewholeshoulderregioncavesin mediallywhentheclavicleisbroken

2.Scapula (shoulderblade)
commonlycalledwings triangular with2 impt processes:acromion and coracoid Acromion expanded processofthescapularspine whichcanbefeltasthehighpointof theshoulder connectswiththeclavicleformingthe acromioclavicularjoint Coracoid beaklikeprojectionofthesuperiorborderofthescapulaandtowhichthe tendonsofthemusclesattach has 3borders:superior,vertebral(medial),and axillary (lateral) has 3angles:superior,inferior,andlateral

A spinerunsdiagonallyacrossthe posteriorsurfaceofthe scapula. Abovethespineisthe supraspinousfossa andbelow,isthe infraspinousfossa. Bothserveassurfacesofattachmentforthetendonsof shouldermuscles. Onthe anteriorsurfaceisthe subscapularfossa,alsoa surfaceofattachmentforthetendonsof shouldermuscles.

Glenoidcavity
ashallowsocketthatreceivestheheadofthe humerus foundatthelateralangleofthe scapula

B.1.HUMERUS
thearmbone thelongestandlargestboneofupperextremity attheproximalendisaroundedheadthatarticulateswiththeglenoidcavityof thescapulaoppositetheheadare2bonyprojections the greater(lateral)and lesser(anterior)tubercles inthemidpoint,isaroughenedareacalledthedeltoidtuberosity whichisa pointofattachmentforthedeltoidmuscleoftheshoulder atthedistalend,arethemedialtrochlea(aspoolshapedsurfacethatarticulates withtheulna)andthelateral capitulum(aroundedknobthatarticulateswiththe headoftheradius) thecoronoidfossaisananteriordepressionthatreceivesthe coronoidprocessof theulnawhentheforearmisbenttheolecranonfossaisaposteriordepression thatreceivesthe olecranonoftheulnawhentheforearmisextended themedialandlateralepicondylesareroughprojectionsoneithersideofthe distalendtowhichmostmusclesoftheforearmareattached

2.1.RADIUS theshorter,morerobustbonelocatedonthelateral(thumb)side of theforearm thediscshapedhead articulateswiththecapitulumofthehumerus andthe radialnotchoftheulna servesasattachmentpointforthe tendonofbicepsmuscle 2.2.ULNA thelongerbonewithdistinctdepressionsandislocatedonthe medial (littlefinger)sideoftheforearm onitsproximalendareanteriorcoronoidprocess andposterior olecranonprocess,whichareseparated bytrochlearnotchtogether these2processesgripthe trochleaofthehumerusinaplierslikejoint attheproximalendoftheulnaisthe olecranon whichformsthe

prominenceoftheelbow

3.1CARPALS
8carpalbones,arrangedin2irregularrowsof4boneseach navicular(lateralside) Lunate proximalrow Triquetrum Pisiform distalrow Scaphoid Lunate Triquetrum Pisiform

greater Multangular (lateral)Trapezium

lesserMultangular Trapezoid Capitate (largest) Capitate Hamate Hamate scaphoid, lunate,andtriquetrum articulatewiththedistalendoftheradius 3.2.METACARPALS numbered1to5fromthethumbsidetowardthelittlefinger whenthefistisclenched,theheadsorknucklesofthemetacarpalsbecome prominent 3.3PHALANGES eachhandcontains14phalanges the5fingersarethepollexthumb),index,medius, medius,annularis, minimus thereare 3phalangesineachfingerexceptinthethumb,whichhasonly2

C.PelvicGirdle(2)

C. PELVICGIRDLE large,heavy,andsecurelyattachedtothesacrumbecauseofitsweight bearingfunction commonlycalledhipbones bracesthelowerextremities formedby2 coxalbonescalled ossa coxae each coxalboneisformedbyfusionof3bones:ilium,ischiumand pubis united anteriorlybythesymphysispubis hipbones,sacrum,andcoccyxformsthe bonypelviswhichsupports andprotectsthereproductiveorgans,urinarybladder,andpartofthe largeintestine

Ilium uppermost,large,flaringbone whenyouputyourhandsonyourhips,theyrestovertheilia articulateswiththesacrumatthesacroiliacjoint Iliaccrestprominentupperedgeofilium importantanatomiclandmarkbythosegivinginjectionsimportantin bonemarrowaspiration

Ischium sitdownbone formsthemostinferiorpartofthecoxal bone Ischialtuberosityroughenedarea,receivesbodyweightwhensitting Greatersciaticnotchfoundbelowposteriorinferioriliacspine allowsbloodvesselandlargesciaticnervetopassfromthepelvis posteriorly intothethighinjectioninthebuttocksshouldalwaysbe givenawayfromthisarea Ischialspinefoundsuperiortothetuberosityanimportant landmarkinpregnantwomanbecausenarrowsthepelvicoutlet

Pubis mostanteriorpartofa coxalbone fusedatthepubicsympysis obturator foramenformedbythefusionoframiofpubicand ischialbonesallowsbloodvesselsandnervestopassintothe anteriorpartofthethigh acetabulumvinegarcupadeepandheavilyreinforced socketthatreceivestheheadofthefemur ComparisonBetweenMaleandFemalePelvis Ingeneral,femalepelvisislighterandbroader;inletandoutletare larger;characteristicfeaturesarerelatedtothechildbearingfunctions

D.1.Femur
thighbone longest,heaviest,strongestboneofthebody Itsballlikeheadattheproxproximalend ofthebonearticulates withtheacetabulum theconstrictedneckisacommonfracturesiteinoldpeople thegreaterandlessertrochanterlocatedontheshaftallserve assitesformuscleattachment lineaasperaisaverticalridgeontheposteriorsurfaceofthe shaft thelateralandmedialcondyles whichareseparatedby intercondylarfossaarticulatewiththetibiaandformajointwith thepatella oneithersideabovecondylesarethelateralandmedial epicondyles

Tibia theshinbone largerandmoremedial medialandlateralcondyles articulatewiththedistalendofthe femurtoformthekneejoint tibialtuberosityroughenedareaontheanteriortibialsurfaceserves asattachmentpointfortheligamentofthepatella medialmalleousformstheinnerbulgeoftheankle anteriorcrestanteriorsurfaceofthetibia(easilyfeltbeneaththe skin) Fibula Nopartinformingthekneejoint Lateralmalleousformsthe the outerpartoftheankle

FOOT supportsbodyweightandservesasaleverthatallowsustopropel ourbodiesforwardwhenwewalkandrun composedof tarsals,metatarsals,andphalanges Tarsus composedof7tarsalbones,5metatarsalsand14phalanges the tarsalbonesinclude a.talus(anklebone) b. calcaneus(heelbone)) c. navicular(boatshaped) d. cuboid e.the3cuneiforms 6.themetatarsalsformthesole 7.phalangesformthetoeseachtoehas3phalangesexceptthe greattoewhichhasonly2