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(Sali) We all know that one of the main functions of our skeleton is for support.

Thus, the human bodys skeletal system is brilliantly architected to coincide with such function. It is generally divided into two distinct partsthe axial skeleton and the appendicular skeleton. The axial skeleton forms the central or the longitudinal axis of the body, while the appendicular skeleton, which will be later discussed by Sir, is composed of bones that anchor the appendages to the axial skeleton. The axial skeleton is subdivided into the skull, the vertebral column and the thoracic cage.


The skull is composed of 22 bones which are grouped into two, the braincase or the cranium and the facial bones. The braincase consists of 8 bones that immediately surround and protect the brain. On the other hand, the 14 facial bones form the structure of our faces. 13 of which are rather solidly connected to form the bulk of the face. The mandible, however, forms a freely movable articulation with the rest of the skull. Three auditory ossicles, which transmit sound vibrations, are also found in each middle ear. The major features of the intact skull re described from four views, the lateral, frontal or anterior, superior (inferior view of the cranial cavity), and inferior (base of the skull seen from below) views. The bones of the skull are united by joints called sutures. LATERAL VIEW (Sajiran) The lateral view features the side of the head which is mainly composed of the parietal and temporal bones. These two bones are joined together at the side of the head by the squamous suture. Anteriorly, the parietal bone is joined to the frontal bone by the coronal suture. Posteriorly, the lambdoid suture connects the parietal bone to the occipital bone. The temporal bones lie inferior to the parietal bones. These temporal bones consists the following bone markings: The external acoustic meatus is a large opening, prominent at the temporal bone, which enables sound waves to reach the eardrum. The styloid process, a sharp, needlelike projection, is just inferior to the external auditory meatus. Many neck muscles use this as an attachment point. The sphenoid bone can be seen anterior to the temporal bone. It is a single bone that extends completely across the skull. Anterior to the sphenoid bone is the zygomatic bone or the cheek bone which can be easily felt. The zygomatic arch consists of joined processes of the temporal and zygomatic bones, forms a bridge across the sided of the face and provides a major attachment site for a muscle moving the mandible. The maxilla forms the upper jaw and contains the superior set of teeth. It articulates by sutures to the temporal bone. The mandible, on the other hand, forms the lower jaw and contains the inferior teeth. FRONTAL VIEW (Lim) The major structures seen from the frontal view are the frontal bone, the zygomatic bones, the maxillae and the mandible. The bones of the face and teeth are very visible in this view.

The orbits and the nasal cavity are the most prominent openings into the skull in this view. The orbits are cone-shaped fossae, so named because of the rotation of the eyes within them. The bones of the orbits provide both protection for the eyes and attachment points for the muscles that move the eyes. Each orbit has several openings through which structures communicate with other cavities. The largest of these are the superior and inferior orbital fissures, which provide opening through which nerves and blood vessels communicate with the orbit or pass to the face. The optic nerve, for the sense of vision, passes from the eye through the optic foramen and enters the cranial cavity. The nasolacrimal canal passes from the orbit into the nasal cavity. It contains a duct that carries tears from the eyes to the nasal cavity. A small lacrimal bone can be seen in the orbit just above the opening of this canal. The nasal cavity is divided into two by a nasal septum. The bony part of the nasal septum consists primarily of the vomer inferiorly and the perpendicular plate of the ethmoid bone superiorly. The anterior part of the nasal septum is formed by a cartilage. The external part of the nose is formed mostly of cartilage. The bridge of the nose is formed by the nasal bones. Each lateral walls of the nasal cavity has three bony shelves, the nasal conchae. The inferior nasal concha is a separate bone, and the middle and the superior conchae are projections from the ethmoid bone. The conchae function to increase the surface area of the nasal cavity. The increased surface area of the overlying epithelium facilitates moistening and warming of the air inhaled through the nose. Paranasal sinuses are large cavities which open into the nasal cavity. These decrease the weight of the skull and act as resonating chambers during voice production. They are named for the bones where they are located and include frontal, maxillary, ethmoidal and sphenoidal sinuses. The mastoid air cells are additional sinuses of the skull which are located inside the mastoid process of the temporal bone. These air cells open into the middle ear instead into the nasal cavity. An auditory tube connects the middle ear to the nasopharynx (upper part of throat). SUPERIOR VIEW (INFERIOR OF THE CRANIAL CAVITY (Sali) When the floor of the cranial cavity is viewed from above with the roof cut away, it can be divided into three cranial fossae (anterior, middle and posterior), which are formed as the developing skull conforms to the shape of the brain. The bones forming the floor of the cranial cavity from the anterior to posterior are the frontal, ethmoid, sphenoid, temporal and occipital. Several foramina can be seen in the floor of the middle fossa which allow passage of nerves and blood vessels through the skull. The large foramen magnum, through which the spinal cord joins the brain, is located in the posterior fossa. The seila turcica contains the pituitary gland and is in the central region of the sphenoid bone. INFERIOR VIEW (BASE OF SKULL SEEN FROM BELOW) (Enriquez) The foramen magnum is located in the occipital bone near the center of the skull base. Occipital condyles are smooth points of articulation between the skull and the vertebral column located near the foramen magnum. Two, long styloid processes project from the inferior surface of the temporal bone. Muscles involved in the movement of the tongue, the hyoid bone, and the pharynx originate from this process. The mandibular fossa is where the mandible articulates with the temporal bone and is anterior to the mastoid process. The hard palate forms the floor of the nasal cavity and the roof of the mouth. The anterior twothirds are formed by the maxilla and the posterior one-third by the palatine bones. The connective tissue and muscles that forms the soft palate extend posteriorly from the hard or bony plate. The hard and soft palates function to separate the nasal cavity and the nasopharynx from the mouth, enabling us to chew our food and breathe at the same time. HYOID (Enriquez) The hyoid bone is an unpaired u-shaped bone that is not part of the skull. Muscles and ligaments attach it to the skull. It provides attachment for some tongue muscles, and is also an important attachment point for neck muscles that elevate the larynx during speech and swallowing.


(Bumotad) The vertebral column is the central axis of the skeleton, extending from the base of the skull to slightly past the end of the pelvis. It usually consists of 26 individual bones grouped into five regions: 7 cervical, 12 thoracic, 5 lumbar, 1 sacral vertebrae and 1 coccygeal bone. (C1-C7, T1-T12, L1-L5, S and CO) The adult vertebral column has four major curvatures. The cervical region and the lumbar region curves anteriorly, while the thoracic, sacral and coccygeal regions curve posteriorly. Five major functions of the vertebral column: (1) supports the weight of the head and trunk; (2) protects the spinal cord; (3) allows spinal nerves to exit the spinal cord; (4) provides a site for muscle attachment; (5) permits movement of the head and trunk. GENERAL PLAN OF THE VERTEBRAE (Ledesma) Each vertebra consists of a body, an arch and various processes. The weight-bearing portion is the body. The vertebral bodies are separated by intervertebral disks which are formed by dense fibrous connective tissue. The vertebral arch surrounds a large opening called the vertebral foramen. The vertebral foramina of all the vertebrae form the vertebral canal, where the spinal cord is located and is protected from injury. Each vertebral arch consists of two pedicles, which extend from the body to the transverse process of each vertebra, and two laminae, which extend from the transverse process to the spinouts process. A transverse process extends laterally from each side of the arch, between the pedicle and lamina, and a single spinous process (series of lumps at the back) projects dorsally from where the two laminae meet. These processes provide attachment sites for muscles that move the vertebral column. Spinal nerves exit the spinal cord through the intervertebral foramina, which are formed by notches in the pedicles of adjacent vertebrae. Each vertebra has a superior and inferior articular process where the vertebrae articulate with each other. Each articular process has a smooth little face called an articular feet. REGIONAL DIFFERENCES IN VERTEBRAE (Ngo) The cervical vertebrae have very small bodies except for the atlas, which has no body. Each of the transverse processes has a transverse foramen through which the vertebral arteries pass toward the brain. Several of the cervical vertebrae also have split spinous processes. The first cervical vertebra is called the atlas because it holds up the head. Movement between the atlas and occipital bone is responsible for the yes motion. It also allows the slight tilting of the head from side to side. The second cervical vertebra is called the axis because rotation occurs at this vertebra (no motion). This rotation occurs around a process called dens, which extends superiorly from the axis. The thoracic vertebrae possess long thin spinous processes that are directed inferiorly. These also have extra articular facets on their lateral surfaces that articulate with the ribs. The lumbar vertebrae have large, thick bodies and heavy, rectangular transverse and spinous process. The superior articular facets of the lumbar vertebrae face medially, while the inferior ones face laterally. This arrangement tends to lock adjacent lumbar vertebrae together, giving the lumbar part of the vertebral column more strength. The articular facets in other regions of the vertebral column have a more open position, allowing more rotational movement but less stability than in the lumbar region. The five sacral vertebrae are fused into a single bone called sacrum. The spinous processes of the first four sacral vertebrae form the median sacral crest, whereas the spinous process of the fifth vertebra does not form, leaving a sacral hiatus at the inferior end of the sacrum, which is often the site of caudal anesthetic injections given just before childbirth. The anterior edge of the body of the first sacral vertebra

bulges to form the sacral promontory, a landmark that can be felt during vaginal examination. It is used as a reference point during measurement to determine if the pelvic openings are large enough to allow for normal vaginal delivery of a baby. The coccyx (tail-bone) consists of four more-or-less fused vertebrae. The vertebrae of the coccyx do not have the typical structure of most other vertebrae. They consist of extremely reduced vertebral bodies, without foramina or processes, fused into a single bone.

THORACIC CAGE (rib cage) (Bumotad, Glinada)

(Bumotad) The thoracic cage protects the vital organs within the thorax and prevents its collapse during respiration. It consists of the thoracic vertebrae, the ribs with the associated cartilages, and the sternum. RIBS AND COSTAL CARTILLAGES (Glinada) The 12 pairs of ribs can be divided into true and false ribs. The superior seven pairs are called true ribs, which are attached directly to the sternum by means of costal cartilages. The inferior five pairs are called false ribs, which are not attached directly to the sternum. Three pairs (8-10) are attached by common cartilage while two pairs (11-12) are called floating ribs, which do not attach to the sternum. STERNUM (breastbone) (Glinada) The sternum resembles a sword and is divided into three parts: the manubrium, the body and the xypoid process. At the superior end of the sternum, a depression, called the jugular notch, is located between the ends of the clavicles where they articulate with the sternum. A slight elevation, called the sternal angle, can be felt at the junction of the manubrium and the body of the sternum. This is an important land mark which identifies the location of the second rib. This identification allows the ribs to be counted. The xiphoid process is another important landmark of the sternum. It is very important to place the hands over the body of the sternum during CPR than over the xiphoid process. The pressure applied during CPR could break the xiphoid process and drive into an underlying abdominal organ, causing internal bleeding.