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Anatomy and Physiology 1 (AP1)

Foundations

STUDENT MANUAL

This Manual is part of the Delivery (Training) for the Nationally Recognised Health Training Package Qualification:

Certificate IV in Massage Therapy Practice (HLT40312)

Anatomy and Physiology 1 (AP1) – Student Manual AP1 STD MAN Rev. 002

Copyright © 2014 Melbourne College of Professional Therapists of 84

Training Package Information

Qualification Certificate IV in Massage Therapy Practice HLT40312

The following Health Training Package Unit(s) are Aligned with this Subject:

Unit Description HLTCOM406C Make referrals to other health care professionals when appropriate

This unit of competency describes the skills and knowledge required to arrange referrals to other health care professionals when required

HLTCOM408D Use specific health terminology to communicate effectively

This unit covers the skills required to understand and respond to instructions, carry out routine tasks and communicate with a range of internal and external clients in a health care practice, using appropriate practice-specific health terminology

HLTAP401B Confirm physical health status

This unit of competency describes a detailed level of knowledge of anatomy and physiology required to confirm physical health status

HLTREM406C Provide massage treatment

This unit of competency describes the skills and knowledge required to administer client basic massage treatment according to the philosophy and practices of a massage therapy framework

HLTREM407C Plan massage treatment

This unit of competency describes the skills and knowledge required to prepare clients for basic massage and negotiate treatment with them

HLTREM408C Apply massage assessment framework

This unit of competency describes the skills and knowledge required to interpret information gathered in the health assessment and make and review accurate assessment for basic massage treatment

HLTREM409C Perform massage health assessment

This unit of competency describes the skills and knowledge required to observe the condition of the client and gather information relevant to the case in order to provide a basic massage

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Contents

# Topic Page

1 Introduction 5

2 Fundamentals 6

2.1 Levels of Organisation 7

2.2 Organ Systems 9

2.3 Characteristics of Life (Necessary Life Functions) 12

2.4 Survival Needs (Life Maintenance) 13

2.5 Homoeostasis 14

3 Anatomical Terminology 15

3.1 Positional and Directional Terms 16

3.2 Body Cavities 17

3.3 Axial Body Areas 19

3.4 Appendicular Body Areas 20

3.5 Other Body Areas 21

4 Cells 22

5 Tissues 23

5.1 Muscle and Nervous Tissue 24

5.2 Epithelial Tissue 25

5.3 Connective Tissue 27

5.4 Membranes 29

6 Integumentary System 30

6.1 Skin Derivatives and Functions 31

6.2 Skin Colouration 33

7 Skeletal System 34

7.1 Bone Structure 35

7.2 Whole Skeleton 36

7.3 Vertebral Column 37

8 Bony Markings 38

8.1 Skull 39

8.2 Vertebrae 40

8.3 Atlas and Axis 41

8.4 Sternum, Rib and Clavicle 42

8.5 Scapula 43

8.6 Humerus 44

8.7 Ulna and Radius 45

8.8 Pelvis 46

8.9 Sacrum and Coccyx 47

8.10 Femur 48

8.11 Tibia and Fibula 49



# Topic Page

9 Study Questions 50

9.1 Anatomy and Physiology 51

9.2 Cells 54

9.3 Tissues 55

9.4 Integumentary System 58

9.5 Skeletal System 60

9.6 Bony Markings 64

10 Suggested Answers 71

10.1 Anatomy and Physiology 72

10.2 Cells 74

10.3 Tissues 75

10.4 Integumentary System 76

10.5 Skeletal System 77

10.6 Bony Markings 80

11 Appendices 82

11.1 Bone Locations Summary 82



1 Introduction

Anatomy and Physiology 1 covers the basics of Anatomy (and

some Physiology). Also included are the Integumentary and Skeletal Organ Systems (including Bony Markings). On the right column you will see an area for you to include your own notes from Class/Tutorial or other Study. Near the end of the manual there are Study Questions which may be completed. Answers are provided at the end of this Manual. As well, there are exercises from the Anatomy Coloring book that are spread throughout these notes. It is suggested that you complete these exercises to consolidate your knowledge. Reference Texts References are made to the following resource:

The notes and diagrams on this side of each page are extra references or information relating to the subject under discussion on the left side of the vertical dividing line. This side area can also be useful for adding your own information during class or study.

The Learning Pyramid below (Fig. 1b) shows the different strata of knowledge and how the “higher” level (closer to treatment) is built upon a “lower” level.

The Anatomy Coloring Book, 3rd Edition – Kapit and Elson

Figure 1a – References

Therapy(Treatment)

Pathology(Dysfunction)

Physiology(Function)

Anatomy(Structure)

Figure 1b – Learning Pyramid

Note: There may be Coloring Book pages to complete in a Box like this.



2 Fundamentals

Anatomy is the study of the structure of a living organism. It is

helpful to understand that Anatomy is a static thing. This means it is only 3 Dimensional, ie. involves space (length, width and height) but not time. 1. Anatomy: Fields of Study

The overall study of Anatomy can be broken up into specific areas of study: a. Surface

The study of structures that give form to the body and provide landmarks on its surface.

b. Macroscopic (Gross) The study of structures of the body that can be seen with the naked eye.

c. Microscopic The study of structures that can only be seen with the aid of a microscope.

d. Regional Anatomy studied by regions such as the head, neck, thorax, abdomen, pelvis, limbs (Gross anatomy can be studied this way).

e. Systemic The body is studied by their systems.

f. Developmental Focuses on the development of the body from the fertilised ovum to the adult form.

g. Radiographic Is valuable in diagnosis. X-Rays pass through the structure under examination and the image is exposed for study eg. X-Rays, CT scan, CAT scan, MRI (Ultrasound at lower frequencies).

In contrast, Physiology is the study of the function of an organism. This is dynamic – it is 4 Dimensional (space and time). 2. Physiology: Fields of Study

Similarly, the study of Physiology can be broken up into many areas: a. Neuro-

Nervous System function.

b. Cardiovascular Function of Heart and Blood Vessels.

c. Renal Kidney function and Urine production.

The Human Body: The order and plan of creation have challenged Man/woman throughout history. His/her world is organized into a solar system, the solar system into a galaxy, and the galaxy into a universe. In the opposite direction, his world is divided into civilizations, civilizations into societies, societies into men/women, and men/women into chemical elements. The Complex Organism: Man as a living organism may be viewed as an assemblage of microscopic units called cells which are marvellously integrated both structurally and functionally. Cells eventually specialize or differentiate to a greater or lesser extent. An aggregate of similarly differentiated cells comprises a tissue, such as the fat cells of adipose tissue. Tissues, in turn, form organs; organs form systems. Ultimately, systems combine in an intricate manner to create thinking and acting human. When viewing the human body in this fashion, one stands in awe at the complexity of the organization of the body and the fine balance and interdependence of the various parts.

Anatomy and physiology describe this interdependence of structure and function.



2.1 Levels of Organisation Fundamentals

The human body incorporates many levels of structural

complexity. Simply put:

Many Chemicals make up Cells Many Cells make up Tissues Many Tissues make up Organs Many Organs make up Systems Many Systems make up Organisms

These Levels are: 1. Chemical

The entire body is made up of chemicals. Chemical reactions underlie all body processes, movement, digestion, heartbeats, nerve impulses etc. The body is composed of 4 basic elements (atoms) Carbon, Hydrogen, Oxygen and Nitrogen. In turn these can combine to form 4 basic compounds (molecules) Proteins, Carbohydrates, Lipids (fats) and Nucleic Acids (DNA & RNA).

2. Cellular Cells are the smallest structural unit that can function independently (ie. it’s “alive”). The cell is composed of chemicals. Different chemical compositions and chemical reactions in cells are the basis for cell specialization.

3. Tissue Groups of similar cells join together to perform common or related functions. There are 4 Basic Tissue Types (described in detail later): a. Epithelial

Epithelium covers the surface of the body and lines body cavities, ducts and vessels.

b. Connective Connective Tissue (CT) is used for support.

c. Muscle Muscle Tissue consists of specialised cells which contract thereby causing movement and assisting circulation.

d. Nervous Tissue Nervous Tissue in the brain, spinal column and nerves generate and transmit messages throughout the body.

The Scientific Study: Physiology is the study of function in the living organism, at both the biochemical and gross levels. The student is usually startled to learn that living things are composed of the same atoms and substances found on shelves in chemistry laboratories, and that these substances are governed by the same laws and principles that govern those reactions occurring in test tubes and flasks. When the substances are individually considered, each is obviously inanimate. What, then, is different about living substances composed of ordinarily inanimate materials? The answer seems simple, but is complex-it is organization. Living tissue is composed of molecules which would never assume the proper configuration, structure, and relationship if energy were not supplied to maintain this level of organization. An un-mended wall gradually falls to pieces, a deserted house disintegrates, and oriented cell molecules become chaotic unless energy is expended to maintain them in high energy configuration. This is called ENTROPY.



4. Organ Two or more tissues combine to form an organ. They function to perform complex physiological processes. Eg. the stomach is lined with epithelium and walls of muscle.

5. Organ System Certain organs work together as a system to perform a specific set of bodily functions For example, the Digestive System is comprised of the following organs:

Mouth

Oesophagus

Stomach

Intestine

Rectum

This Level will be discussed in the next Section.

6. Organism The living human being. The sum total of all other structural levels working in unison.

Figure 2.1 – Levels of Organisation



2.2 Organ Systems Fundamentals

In the human body, there are numerous organ systems.

Each system can be considered to have its own specific function. Usually they are divided into 12 as below: 1. Integumentary

PROTECTS internal body structures.

Consists of skin, hair, nails, sweat and oil glands (Fig. 2.2a).

2. Skeletal SUPPORTS and protects soft tissues and organs.

Consists of bone and cartilages (Fig. 2.2c).

3. Muscular MOVES body and its parts.

Consists of Skeletal muscles (Fig. 2.2d).

4. Nervous CONTROLS and integrates body activities and is responsible for thought and reason.

Consists of Brain, Spinal Cord and Nerves (Fig. 2.2e).

5. Cardiovascular TRANSPORTS materials between the internal and external environments and also between the different cells and tissues of the body.

Consists of Heart and blood vessels (Figs. 2.2f, g).

6. Lymphatic DRAINS fluid from body tissues and transports it to the cardiovascular system via a network of vessels and collecting points.

Consists of Lymph vessels, Lymph Nodes and accessory organs (Fig. 2.2b).

Figure 2.2a – Integumentary System

Figure 2.2b – Lymphatic System

Figure 2.2c – Skeletal System

Figure 2.2g – Veins

Figure 2.2f – Arteries

Figure 2.2e – Nervous System

Figure 2.2d – Muscular System

Cardiovascular System



7. Digestive DIGESTS food and ABSORBS nutrients.

Consists of mouth, oesophagus, stomach, intestines, bowel, colon and accessory organs: salivary glands, pancreas, liver and gall bladder (Fig. 2.2h).

8. Urinary ELIMINATES a variety of metabolic waste products and FILTERS body fluids.

Consists of kidneys, ureters, bladder, urethra (Fig. 2.2i).

9. Reproductive REPRODUCES the organism.

Consists of: a. Male organs (testes, seminal vesicles, prostate &

penis) produce sperm for fertilization of the ovum (Fig. 2.2m).

b. Female organs (ovaries, uterus, vagina, mammary glands etc.) produce the ova and provide environment for the fertilized ovum (Fig. 2.2n).

10. Endocrine REGULATES body activities by producing hormones.

Consists of pineal gland, pituitary gland, thyroid, thymus, adrenal glands, pancreas & gonads (Figs. 2.2k, l).

11. Respiratory RESPIRATES ie. transfers oxygen from the atmosphere to the blood and carbon dioxide from blood to the atmosphere by breathing.

Consists of nose, pharynx, larynx, trachea, bronchi and lungs (Fig. 2.2j).

12. Immune DEFENDS. A functional system that protects the body against bacteria, virus, hazardous chemicals.

Includes skin, mucus membranes, lymphatic system and other organs in the body.

Figure 2.2h – Digestive System

Figure 2.2i – Urinary System

Figure 2.2j – Respiratory System

Figure 2.2k – Pancreas

Figure 2.2n – Male

Figure 2.2m – Female

Figure 2.2l – Adrenal Glands

Reproductive System

Endocrine System



Sometimes these Systems are organised slightly differently: a. Circulatory

The Circulatory System is a combination of the Cardiovascular and Lymphatic Systems.

b. Immune/Lymphoid This is a combination of Lymphatic and Immune Systems.

c. Musculoskeletal The Musculoskeletal System is a combination of the Muscular and Skeletal Systems.

d. Articular This is (usually) a subdivision of the Skeletal System (consists of the Joints and their structures).

It is recommended that students learn the names of these 12 systems and their primary function. A Mnemonic may be useful in recalling the Systems themselves. Using the first letter of each System to make a phrase could be:

CRUEL MIND SIR

Or you might create your own.

A MNEMONIC is a memory/recall device. Mnemnos = “mindful”, as in Amnesia = “not mindful”. Eg. the colours in the rainbow can be remembered by transposing the first letters of each colour and making a phrase: Red Rip

Orange Out

Yellow Your

Green Guts

Blue Before

Indigo I

Violet Vomit

Rip out your guts before I vomit! You will never forget now!

# System Primary Function(s) Organs

1 Integumentary Protection Skin Oil Glands

Hair Sweat Glands

Finger/Toe Nails

2 Skeletal Support Bone Cartilage

3 Muscular Movement Muscles

4 Nervous Control Brain Nerves

Spinal Cord Sensors (Receptors)

5 Cardiovascular Transport Heart Blood Vessels

6 Lymphatic Drainage Lymph Vessels Accessory Organs

Lymph Nodes

7 Digestive Digestion Mouth Stomach

Absorption Oesophagus Large/Small Intestines

8 Urinary Elimination Kidney Ureters

Filtration Bladder Urethra

9 Reproductive Reproduction Genitals

Male: Testes

Female: Ovaries and Mammary Glands

10 Endocrine Regulation Pineal Gland Thymus

Pituitary Gland Adrenal Glands

Thyroid pancreas

11 Respiratory Respiration (Breathing) Nose Trachea

Pharynx Bronchi

Larynx Lungs

12 Immune Defence Skin Lymph Vessels

Mucus Membranes Lymph Nodes

Table 2.2 – Organ Systems Summary

Complete: Anatomy Coloring Book Page 3 Page 4



2.3 Characteristics of Life Fundamentals

Also called Necessary Life Functions

The following characteristics are necessary for any organism to

be classified as living: 1. Maintenance of Boundaries

The internal environment remains distinct from the external environment and the organism level environment. ie. the inside isn’t leaking to the outside and vice versa.

2. Movement Movement includes motion of the whole body, individual organs, single cells or even structures inside cells.

3. Responsiveness Being sensitive to the environment (able to detect stimuli) and having the ability to respond, eg. light, temperature. Can be voluntary or involuntary. Drinking when thirsty is an example.

4. Digestion The process of breaking down and ingesting food stuffs for absorption. Ingestion (eating, drinking) is usually a conscious process, digestion is not.

5. Absorption Absorption is the passage of substances (such as digested food) through certain membranes.

6. Assimilation Assimilation is the changing of absorbed substances into forms that are chemically different from those that entered body fluids.

7. Metabolism A broad term that includes all chemical reactions that occur within the cells of the body.

8. Excretion

Elimination of wastes from digestion and metabolism.

9. Reproduction Refers to either the formation of new cells for Growth, Repair or Replacement or to the making of a New Individual.

10. Growth Increase in overall size of the body part or the organism. Body materials are produced faster than they are removed. Growth can involve increases in :

Cell size

Numbers of Cells

Extra cellular substances

Many of these processes occur at a macroscopic level and at a microscopic level. There are many mechanisms of movement – muscle contraction is one of them. 2 Phases of Metabolism are:

Catabolism This phase provides the energy needed to sustain life by breaking down substances such as food molecules.

Anabolism This phase uses the energy from catabolism to make various substances that form body structures and enable them to function.



2.4 Survival Needs Fundamentals

Also called Life Maintenance

The ultimate goal of nearly all body systems is to maintain life.

Life requires several factors, or survival needs, acting together for its persistence: 1. Nutrients

For energy, growth and reproduction.

2. Oxygen For respiration at the cellular level. This is the most critical factor for survival. O2 is required in energy production.

3. Water Water is on average 60-80 % of total body weight. It is required for many Metabolic Processes and provides the environment in which Most of them take place. Water also transports substances within the organism and is important in regulating body temperature.

4. Body Temperature Heat is a form of energy arising as a product of Metabolic Reactions. Body Temperature remains stable within limits, regardless of activity and surroundings. Human Body Temperature is approximately 37.8°C.

5. Atmospheric Pressure To permit gaseous exchange in the Alveoli of the Lungs.

Fig. 2.4 below is a graphical representation to assist with remembering the above information.

Figure 2.4 – Survival Needs

O2

37°C

1atm



2.5 Homoeostasis Fundamentals

Homoeostasis is the ability to maintain a relatively stable internal

environment (inside the body), even in the face of continuous external changes.

homoeo = alike, the same stasis = condition (status)

The body is said to be in homoeostasis when its cells needs are adequately met. There are many variables which can affect this equilibrium:

Temperature

Heart rate

Blood pressure

Breathing rate and depth

Nutrients, oxygen and carbon dioxide

Hydration, ie. water balance

Sugar level

If any of these variables are out of balance (equilibrium) for any period of time then homoeostasis has not been attained. There are two systems that control/regulate homoeostasis: 1. Nervous

This system produces electrical impulses via nerves which increase or decrease activity in a gland or organ.

2. Endocrine This system produces hormones which are transported via blood.

All of the above systems function together to help the Human Body to Maintain HOMOEOSTASIS. A person who is in good health is in a state of Homoeostasis. Homoeostasis reflects the ability of the body to maintain relative Stability and to Function Normally despite constant Changes. Changes may be External or Internal, and the body must Respond Appropriately. As we continue to study the Human Body, keep in mind that the Proper Functioning of each Organ and Organ System has a role to perform in maintaining HOMOEOSTASIS. The Human Body uses Homoeostasis Mechanisms to maintain its stable internal environment. Homoeostatic Mechanisms work much like a Thermostat (NEGATIVE FEEDBACK) that is sensitive to temperature and maintains a relative constant room temperature whether the room gets to Hot or Cold.

Figure 2.5 – A Homoeostatic Process



3 Anatomical Terminology

To prevent misunderstanding, anatomists have a universally

accepted terminology that allows body structures to be located and identified with a minimum of words and a high degree of precision. The use of such precise terminology precludes ambiguity and ensures accuracy in descriptions. IT IS ESSENTIAL TO BE CONVERSANT WITH THESE TERMS. 1. Anatomical Position

The anatomical position is the standard position from which any part may be related to others by the use of descriptive terms. It is used throughout clinical medicine.

2. Body Planes In a similar vein, the study of Anatomy often involves dissection, in which the body or its organs are sectioned (cut) along an imaginary line called a plane. These planes relate to the anatomical position: a. Median (Mid-Sagittal)

The body is divided into equal right and left halves.

b. Sagittal The body is divided into right and left. Not necessarily equal portions.

c. Frontal (Coronal) The body is divided into front and back sections.

d. Transverse (Horizontal) The body is divided into upper and lower portions.

Organisation of the Body Anatomic reference systems have been adopted to facilitate uniformity of description of the body. Four basic reference systems of organisation are considered:

Direction

Planes

Cavities

Structural Units

Stand erect with your hands by your side, palms facing forward, heels together and feet pointing forward. You are now in the Anatomical Position. The Sagittal, Frontal and Transverse Planes divide the body into portions that are not necessarily equal.

Figure 3 – Body Planes

Complete: Anatomy Coloring Book Page 1



3.1 Positional and Directional Terms Anatomical Terminology

There are specific terms that describe positions and directions as

they relate to the anatomical position.

Direction Description

Superior Towards upper body

Inferior Towards lower body

Anterior Towards front of body

Posterior Towards back of body

Medial Inner portion, towards the mid-line

Lateral Outer portion, away from the mid-line

Proximal Closer to trunk

Distal Further from trunk

Superficial Closer to surface

Deep Further from surface

Ventral Towards the belly side

Dorsal Towards the back side

Central Towards the centre

Peripheral Towards the perimeter

Table 3.1 – Anatomical Directions

There are often interchangeable terms or those that seem to be interchangeable but arise from different approaches. Orthogonal Directions: Superior/Inferior, Anterior/Posterior and Medial/Lateral all relate to the Planes. Appendicular Directions: Proximal/Distal replaces Superior/Inferior for the appendages. Vertebral Directions: In creatures with a horizontal spine, Anatomical terms may be slightly different. Ventral = front of spine Dorsal = back of spine Cranial = towards head Caudal = towards tail Organs/Cavities: External/Internal are used mostly in reference to the body wall, body cavities and hollow organs Left and Right: Ipsilateral = the side being referenced Contralateral = the side opposite that being referenced

Figure 3.1 – Directions




3.2 Body Cavities Anatomical Terminology

Internal organs are located within cavities of the body that are

lined by smooth membranes. There are 2 Major Cavities: 1. Dorsal (Posterior)

The posterior cavity is divided into two smaller regions: a. Cranial

Contains the Brain.

b. Vertebral (Spinal) Contains the Spinal Cord.

2. Ventral (Anterior) The most anterior cavity contains Viscera (organs) and is divided into smaller regions: a. Thoracic

The Thorax (Thoracic Spine, Rib Cage and Sternum) is the skeletal structure that makes the walls of the Thoracic Cavity. The floor is the Diaphragm. It is divided into 3 smaller cavities:

i. Right Pleural Viscera: Right Lung and Bronchi.

ii. Mediastinum Viscera: trachea, oesophagus, thymus gland, aorta and vena cava. It has a cavity at the bottom:

Pericardium Viscera: Heart

iii. Left Pleural Viscera: Left Lung and Bronchi.

b. Abdominopelvic This is actually 1 cavity divided by the Urogenital Diaphragm into:

i. Abdominal Viscera: Liver, Gall Bladder, Stomach, Pancreas, Intestines, Spleen, Kidneys and Ureters.

ii. Pelvic Viscera: Bladder, Female and Male Sex Organs and part of the Large Intestine.

There are other Body Cavities:

Oral (Mouth)

Nasal (Nose)

Orbital (Eye Socket)

Middle Ear (Ear Drums)

Synovial (Joints)

The Ventral and Dorsal Body Cavities are separated by the Bodies of the Vertebrae in the Spinal Column and the Intervertebral Discs. The Thoracic and Abdominopelvic Cavities are separated by the Diaphragm.



The Axial Body also houses Open Visceral Cavities called Tracts:

Respiratory

Urinary (Urogenital Tract)

Digestive (Alimentary Canal)

Each Cavity has a membranous covering (Serosa) around the organs inside the Cavity and lining the cavity itself. Eg: The Parietal Peritoneum lines the Abdominal Cavity walls and the Visceral Peritoneum covers the Abdominal Organs.

Figure 3.2 – Body Cavities

Table 3.2 shows a summary of the Body Cavities.

Cavity Defined By Contains

Dorsal (Posterior) Most of the Central Nervous System

Cranial Inside Skull (not Mandible) Brain

Vertebral (Spinal) From Foramen Magnum (Occipital Bone) along Vertebral Canal of Spine to Sacral Hiatus (Sacrum)

Spinal Cord

Ventral (Anterior) Anterior to Vertebral Column Viscera involved in maintaining Homeostasis

Thoracic Thorax

Pleural Left and Right Pleura Lungs, Bronchi, Bronchioles

Mediastinum Between Pleurae Thymus, Great Blood Vessels, Lymph vessels, Oesophagus, Trachea

Pericardium Inferior part of Mediastinum Heart

Abdominopelvic Is divided into 2 sections

Abdominal Surrounded by Muscles and Lumbar Spine

Kidneys, Stomach, Large/Small Intestines, Spleen, Liver, Gallbladder

Pelvic Within Pelvis Reproductive (Ovaries, Testes and Prostate) and excretory organs

Table 3.2 – Body Cavities Summary



3.3 Axial Body Areas Anatomical Terminology

The human body is divided into different areas, all identifiable on the surface. These areas

are the best first step in learning how to differentiate Body Areas. The diagram on this page (Fig. 3.3) shows the Axial Body Areas (axial = center, core). Diagram Notes 1. The Shoulder and Hip areas shown here are part of the Appendicular Surfaces (see next

page). This means that there is some overlap between Axial and Appendicular areas. 2. The overlapping Joint Surfaces (eg. Shoulder, Hip, etc.) can be used to refine the limits of

any expression of areas (eg. Chest and Shoulder is not the same as Chest and Arm). 3. The abbreviations of body areas are for report writing. 4. Directional Terms (eg. Posterior, Medial, etc.) and Left/Right should be used in conjunction

with these areas when expressing various types of information.

Anterior Left Lateral Posterior

Head

Neck

Chest

Abdomen Groin

ShoulderUpper Back

Lower Back

He

Ne

Ch

Ab

UB

LB Gr

Hip

Sh

Hi

*Back (Ba) = Upper Back (UB) + Lower Back (LB)

Back*

Ba

†

Figure 3.3 – Body Areas (Axial)



3.4 Appendicular Body Areas Anatomical Terminology

This diagram (Fig. 5.5b) shows the Appendicular Body Areas (appendage = add-on).

Left Lateral Anterior Right Lateral Posterior

Arm

Forearm

Ar

F/a

Ha

Shoulder

Elbow

Sh

El

Wr

Hand Wrist Ankle

Knee

Hip

Hi

Kn

An

Thigh

Leg

Foot

Th

Le

Fo

Upper Limb (UL)or Upper Extremity (UE)

Lower Limb (LL)or Lower Extremity (LE)

UL = Shoulder (Sh) to Hand (Ha) LL = Hip (Hi) to Foot (Fo)

Figure 3.4 – Body Areas (Appendicular)



3.5 Other Body Areas Anatomical Terminology

There are also terms used to describe regions that are based on more technical origins.

These expressions are also useful to learn as they relate to other anatomical features. For example, the muscle Biceps Brachii has in its name an indication of where it is found (brachi = arm).

Figure 3.5 – Body Regions (Anatomical Terms)




4 Cells

A cell is a microscopic living organism. Cells are capable of

mitosis (division) and are specialised for specific functions. The study of cells is called CYTOLOGY. There are 3 main components of cells and a wide range of others: 1. Major

A generalised human cell consists of these three major parts: a. Nucleus

The nucleus controls cell activities and is usually centrally located within the cell.

b. Cytoplasm Cytoplasm surrounds the nucleus and contains ORGANELLES. The organelles are small structures that perform specific functions within the cell.

c. Plasma Membrane A membrane forms the outer cell boundary and therefore surrounds and contains the cytoplasm and nucleus.

2. Other (Organelles) These cell parts are located in various places: a. Nuclear Membrane divides Cytoplasm from Nucleoplasm

b. Nucleoplasm is the contents of the Nucleus

c. Nucleolus is the centre of the Nucleus

d. Smooth Endoplasmic Reticulum (ER) has special functions

e. Rough Endoplasmic Reticulum (ER) transports proteins

f. Ribosomes are where proteins are made

g. Golgi Complex collects and packages secretory products

h. Mitochondrion is the power supply for cell functions

i. Vacuoles are transporters

j. Lysosomes break down substances

k. Centrioles are important in cell division

l. Microtubules are the “skeleton” of the cell

m. Microfilaments are another structural element

n. Cell Inclusion are technically an organelle (functional part) of the cell

Loss of cellular Homoeostasis leads to nearly every disease. The Plasma Membrane is composed of a bilipid (2 fat molecules thick) layer.




5 Tissues

A tissue is a group of closely associated cells that are similar in

structure and perform a common function. 1. Types

As mentioned previously, there are 4 main types of Tissue: a. Muscle b. Nervous c. Epithelial d. Connective

2. Components

All tissues have 2 main components: a. Parenchyma

This is the functional component and is usually a type of cell. These cells perform the main function(s) of the tissue they invest. Eg.:

Nervous Tissue: Neurons receive, process and transmit nerve impulses.

Muscle Tissue (Skeletal): Muscle cells contract to generate forces as required.

b. Stroma This is the structural component and is made from cells and other elements to support the Parenchymal cells in their function. Eg.:

Nervous Tissue: Neuroglia support and protect axons, dendrites and cell bodies of neurons.

Muscle Tissue (Skeletal): Connective tissue (endomysium, perimysium and epimysium) supports muscle cells and transmits forces to attachments.

The study of tissues is called HISTOLOGY.

Figure 5 – Tissue Types




5.1 Muscle and Nervous Tissue Tissues

Muscle and Nervous Tissue are introduced here but are

explained in greater detail under the Muscular and Nervous Systems in other Manuals. 1. Muscle Tissue

There are different types of muscle: a. Skeletal

Like the tissue found in Biceps Brachii (anterior arm muscle).

b. Cardiac Found in the walls of the heart.

c. Smooth Found in many structures such as:

Muscles that make your body hair “stand up” (arrector pili)

Pupils of the eyes (adaptation to light)

Arteries

Digestive tracts

The main function of muscle tissue is MOVEMENT. Muscle tissue can also be classified according to whether it is a VOLUNTARY muscle (you have control of the movement), or INVOLUNTARY muscle (like the smooth muscle of the digestive tract). Muscle Tissue is further discussed in Anatomy and Physiology 2 (Student Manual).

2. Nervous Tissue Nervous Tissue includes the brain and spinal cord as well as motor/sensory nerves. The functions of nerve tissues are CONTROL and CONDUCTION of electrical impulses. Nerve tissue consists of NEURONS and NEUROGLIA. Nervous Tissue is further discussed in Anatomy and Physiology 3 (Student Manual).




5.2 Epithelial Tissue Tissues

Epithelial Tissue forms the working surface of skin and all body

cavities. 1. Functions

The general functions of epithelial tissue are ABSORPTION, PROTECTION and SECRETION.

2. Structure Epithelial tissue can be classified according to the SHAPE of its cells and the number of LAYERS of these cells: a. Shape

Squamous Squamous cells are thin flat cells, like fish scales

Cuboidal Cuboidal cells are boxlike, about as tall as they are wide

Columnar Columnar cells are tall, column shaped cells

b. Layers

Simple One layer of cells is known as SIMPLE EPITHELIA

Stratified More than one layer of cells is known as STRATIFIED EPITHELIA

Examples: i. Simple Squamous Epithelium

Can be found in the lining of the heart.

ii. Stratified Squamous Epithelium Can be found in the outer layers of skin.

3. Glandular Epithelium Most glands are epithelial cells that produce specific secretions. Eg. perspiration, hormones. There are 2 types of Glands: a. Exocrine

Those glands that are usually external. Eg. sebaceous (for hair follicle), sweat (sudoriferous) and mammary. Secretion is via ducts.

b. Endocrine Glands that are more internal, and secrete straight into the blood stream, ie. no ducts. Eg. Pineal, Thyroid, etc.

Epithelium has 6 Special Characteristics that distinguish them from other tissue types: Cellularity: Composed almost entirely of close-packed cells. Specialised contacts – fit close together to form continuous sheets. Polarity: The cells on the free (exposed) surface differ in form and function to those cells at the basal surface. Connective Tissue Support: All epithelial tissue rests upon and is supported by connective tissue. Innervated but Avascular: Contains nerves but no blood supply. Regenerability: Has a high regeneration capacity.




4. Specialised Epithelium There are various types of epithelium that are specialised and found in various membranes/linings: a. Mesothelium

Derived from embryonic mesoderm it is a SIMPLE SQUAMOUS EPITHELIUM and is present in:

Body cavity membranes

Internal reproductive organs

In body cavity membranes, the cells in this tissue produce lubricating fluids to allow ease of movement between adjacent surfaces as well as protection of organs.

b. Endothelium Also deriving from embryonic mesoderm, this epithelium is found in the internal linings of:

Heart and Blood Vessels (Vascular Endothelial cells)

Lymphatic Vessels (Lymphatic Endothelial cells)

These cells perform specialised functions relating to Filtration (in Kidneys), Haemostasis (stopping blood flow) and others.

c. Urothelium (Uroepithelium) This epithelium is specific to the urinary system as it lines the Urinary Tract (Ureters, Bladder and Urethra). It is a type of TRANSITIONAL Epithelium and can expand or contract depending on fluid (urine) volumes.

Pathologists do not consider Mesothelium and Endothelium as TRUE Epithelium due to their differing pathologies.



5.3 Connective Tissue Tissues

Connective tissue is the most abundant tissue type in the body

and includes:

blood

bones

tendons

ligaments

adipose (fat)

cartilage

fascia

1. Functions The main functions of connective tissue are BINDING and SUPPORT, PROTECTION, INSULATION and TRANSPORTATION (of nutrients and waste).

2. Structure All connective tissue is made up of 3 elements: a. Ground Substance

This can range from a fluid to a gel consistency, which holds nutrients and proteins.

b. Fibres There are 3 types of Fibres in connective tissue:

Collagen fibres for STRENGTH

Elastin fibres for MOVEMENT

Reticular fibres for SUPPORT

c. Cells Connective tissue can also include these Specialised Cells:

fibroblasts – create fibres

chondroblast – create cartilage

osteoblast – create bone

macrophage – destroys foreign material

3. Vascularity Some connective tissue (TENDONS and to some extent BONES) have a regular blood supply (VASCULARITY) which helps with healing. Other connective tissue (CARTILAGE and LIGAMENTS) have little or no blood supply (AVASCULARITY), and cannot be easily (and/or quickly) repaired when damaged.

4. Types Connective Tissue (CT) comes in a variety of forms: a. Ligaments

Tough band of white fibrous connective tissue linking 2 bones together. It strengthens the joint and limits movement in certain directions.

Bone and Blood are both classified as CT but their properties are best studied independently – see later in this and other AP Student Manuals.




b. Tendons Cord of dense fibrous connective tissue linking muscle to bone. Assists in concentrating the pull of the muscles on a small area of bone. Also provides "shock absorber" role because of its ability to stretch, albeit very slightly.

c. Tendon sheath Elongated bursa that wraps completely around a tendon. This helps reduce friction.

d. Aponeurosis A thin, strong, fibrous sheath of tissue that replaces a tendon in a muscle. It is flat and sheet-like as it has a wide area of attachment.

e. Fascia Forms membranous layers in the body surrounding delicate organs. Deep fascia forms sheaths for muscles.

f. Collagen Protein which is the principal constituent of white fibrous connective tissue.

g. Scar Tissue Damaged tissue is replaced by connective tissue as scar tissue. Compared with the original tissue it has reduced elasticity.

h. Joint capsule Covers all the internal joint surfaces not covered by hyaline cartilage. Table 5.3 below describes the main CT types.

The Golgi Tendon Organ is found in the tendon. It responds to changes in tension within the tendon.

CT Type Subtype Function Distribution

Loose Areolar wraps/cushions organs, holds fluid

Lamina propria, capillaries

Adipose energy storage, insulation, shock absorption

Subcutaneous (Hypodermis), Organs

Reticular supports other cells Lymphoid organs

Dense Regular tensile strength Tendons, Aponeuroses, Ligaments

(Fibrous) Elastic elastic

Ligamentum Nuchae, Ligamentum Flava

Irregular omnidirectional tensile strength

Dermis (Skin), Joint Capsules, Submucosa

Cartilage Hyaline compression strength, pliability

Articular (Joints), Costal (Ribs), Nose, Trachea, Larynx

Elastic strength, flexibility Pinna (Ears), Epiglottis (Throat)

Fibrocartilage strength, flexibility Intervertebral discs (Spine), Menisci (Knee)

Bone (Osseus) strength Skeleton

Blood transport medium Within: Heart, Blood vessels

Table 5.3 – Connective Tissue Types



5.4 Membranes Tissues

When Epithelium is bound to Connective Tissue, it forms a

continuous multicellular sheet called a Membrane. These membranes cover the outside or line the inside of various body parts and are therefore simple organs. They are: 1. Cutaneous

This covering is a dry membrane (exposed to air) of the skin composed of 2 layers: 1 Keratinised Stratified Squamous Epithelium (Epidermis)

2 Dense Irregular Connective Tissue (Dermis)

2. Mucous Mucosae are moist (“wet”) membranes which are exposed to moisture and sometimes air. Some produce a viscous, sticky fluid called mucus. Depending on their location they are composed of 2 or 3 layers:

1 Stratified Squamous Epithelium Or

Simple Columnar Epithelium

Usually

2 Loose Connective Tissue (Lamina Propria)

3 Smooth Muscle Cells Sometimes

3. Serous

Serosae are thin, smooth membranes that line and enclose several body cavities. They secrete a Serous fluid which lubricates between body structures for frictionless movement. There are 2 layers:

1 Simple Squamous Epithelium (Mesothelium)

2 Loose Connective Tissue (Areolar CT)

They are present in body cavities:

Thoracic Pericardium (Heart) Pleurae (left and right Lungs)

Abdominopelvic Peritoneum

4. Synovial

The Synovium of Synovial Joints is a special case and not readily grouped with the above types. A simplified Articular (Joint) Capsule can be made from:

1 Thin sheet of cells (Intima) Synovium

2 Fibrous, Adipose or Areolar CT (Subintima)

3 Dense Irregular Connective Tissue Fibrous Capsule

More information is provided in Anatomy and Physiology 2 (Student Manual).

Cutis = “skin”. Mucosae are found in many places such as:

Orifices o Nostrils o Mouth Lips o Eyelids o Ears o Anus

Tracts o Respiratory o Urinary o Digestive

Genital Area o Clitoris o Penis (Head, Foreskin)

Each Serosa has 2 parts:

Parietal Lines the cavity which each serous membrane is situated.

Visceral Covers the organs inside the cavity.

These can be listed:

Pericardium o Parietal Pericardium o Visceral Pericardium

Pleura o Parietal Pleura o Visceral Pleura

Peritoneum o Parietal Peritoneum o Visceral Peritoneum

Synovium = Synovial Membrane. Synovia = Synovial Fluid secreted by Synovium.



6 Integumentary System

The skin receives very little respect from all of us. As the largest,

and probably the most complex organ in the body it probably deserves our respect. There are a few specialised derivatives (nails, hair etc.) which all come under the mantle of the INTEGUMENTARY SYSTEM. Of all the cells that make up this system, KERATIN CELLS (Keratinocytes) contribute most to the barrier effect of the skin. The skin is divided into Skin Layers: 1. Epidermis

This is the upper 4 or 5 layers of tissue. It is STRATIFIED SQUAMOUS, AVASCULAR and INNERVATED.

2. Dermis This lies below the epidermis and is split into two major layers: a. Papillary b. Reticular

The dermis is dense connective tissue, VASCULAR and INNERVATED.

3. Hypodermis Though not strictly speaking skin, the hypodermis is the deepest layer. Here, adipose tissue is stored, as well as anchoring the layers above it to the underlying tissue (mostly skeletal muscle).

Figure 6a – Skin Layers

Figure 6b – Section of Skin




6.1 Skin Derivatives and Functions Integumentary System

The Integumentary System of a Human Being consists of more

than just skin. 1. Derivatives (Appendages)

a. Hair These derivatives extend from the epidermal surface into the dermis. They are AVASCULAR and whilst the hair root is INNERVATED, the shaft is not. Hair (of different types) is found in most places except the palms, soles (feet), lips, nipples and parts of external genitalia. There are 2 main types of hair:

Vellus Vellus hair is fine, short and pale. It is found on body surfaces where hair exists but cannot be easily seen.

Terminal Terminal hair is coarse, long and darker. It is found on the scalp, eyebrows, armpits and pubic areas. In males it is also found on the chest, face, arms and legs.

Skin without any hair is called GLABROUS (eg. palms and soles of feet).

b. Nails The nail is a scale-like adaptation of the epidermis.

c. Glands i. Sudoriferous (sweat)

These glands extend from the LOWER RETICULAR LAYER of the dermis. Sweat is produced from ducts, so this gland is therefore an EXOCRINE gland. There are 2 main types of Sweat Gland:

Eccrine Eccrine sweat glands are most numerous in the palms, foot soles and forehead.

Apocrine Apocrine sweat glands are clustered in the pubic/perineal area and armpits.

ii. Sebaceous (oil) glands are in the UPPER RETICULAR LAYER of the dermis. They usually secrete their oil onto the hair follicle. Once again, this is an EXOCRINE gland.

More notes about hair: Eyelashes protect the eyes from irritants. Nose hair filters the air of small particles. Hair can insulate against cold in some places (head, face, armpit, groin). It is arguable whether hair which “stands on end” (goose bumps) has any insulating effect against cold. In prehistory, hairy, ape-like mammals probably benefited from this feature. Hair also acts as a touch receptor (eg. for insects).



2. Functions There are a variety of functions performed by the Integumentary System: a. Protection

CHEMICAL: from UV rays and bacteria

PHYSICAL: from injury etc; Waterproof

BIOLOGICAL: as part of the immune system’s defence (eg. dermicidin is antimicrobial)

b. Excretion Through sweating, amounts of ammonia, urea and uric acid can be excreted.

c. Body Temperature Regulation When we are too hot, the dermal blood vessels dilate, and the sweat glands switch on. The evaporating sweat cools the body. When we are too cold, the dermal blood vessels constrict, and blood is bypassed from the dermis which conserves heat in the core of the body.

d. Sensory Reception Via CUTANEOUS SENSORY RECEPTORS in the skin.

e. Vitamin D Synthesis Vitamin D is produced from UV light from the sun, and is necessary for the absorption of calcium.

f. Blood Reservoir The vascular supply to the skin is extensive and can hold large volumes (5% of Body’s blood volume).



6.2 Skin Colouration Integumentary System

Skin colour can be an uneasy topic for some people as historical

prejudices and ignorance can take the place of proper information. Depending on genetic background and environmental influences, “normal” skin colouration can vary widely between and even within populations. The main colouration of skin comes from the Pigments generated within. Other colours result from emotional reactions or disease: 1. Pigments

There are three pigments that contribute to skin pigmentation: a. Melanin

Melanin ranges in colour from yellow to black. Prolonged sun exposure causes a substantial build-up of melanin, resulting in a visible darkening of the skin (or a tan). Melanin is the only pigment produce by the skin.

b. Carotene Carotene is a yellow to orange pigment, usually most obvious in the palms and soles.

c. Haemoglobin Haemoglobin comes from the reddish tinge from red blood cells circulating through the dermal blood vessels.

2. Affects There are other reasons for skin colour to vary: a. Erythaema (redness)

Blushing

Fever

Hypertension

Inflammation (Hyperaemia)

Allergy

b. Pallor (blanching)

Emotional stress (Emotional Shock)

Anaemia

Hypotension (low blood pressure – eg. fainting)

c. Jaundice (yellow cast) Liver disorder (yellow bile)

d. Bronzing (metallic) Hypofunction of adrenal cortex (Addison’s Disease)

e. Haematoma (black/blue/yellow) From blood clotting under skin

Do not confuse Melanin with Melatonin which is a hormone involved with preparing the body for sleep.



7 Skeletal System

Bone is the supporting structure of the body and consists

primarily of a network of connective tissue fibres interspersed with cells and lying in a substance which is impregnated with Calcium salts to produce rigidity. 1. Bone Groups

There are 206 bones in the Adult Human Body. These can be divided into two groups: a. Axial

The Axial Skeleton consists of 80 bones made up of the skull, vertebral column, sternum and ribs (thorax).

b. Appendicular The Appendicular Skeleton consists of 126 bones made up of the shoulder girdle, upper extremity (arm, wrist and hand), pelvic girdle and lower extremity (leg, ankle and feet).

2. Skeletal Cartilages The Human skeleton is initially composed of cartilages and fibrous membranes. As we mature, cartilage is replaced with bone except in some places:

Costochondral cartilage (Ribs near Sternum)

Trachea, External Nose

External Ear (Pinna), Epiglottis

3. Functions a. Support

This is the Primary Function. Bones are the hard framework for soft organs, eg. the ribcage supports the thorax wall.

b. Protection Sensitive organs need protection, eg. the skull protects the brain.

c. Movement Skeletal muscles attach to the bones by tendons and act as levers with the joints acting as pulleys. The arrangement and type of joint influences the type of movement possible.

d. Storage Fat and minerals (such as calcium which is important in muscle contraction) are stored in the bones.

e. Blood Cell Formation Blood cells are produced for the cardiovascular system in the marrow of the skeletal muscle, eg. skull, pelvis, ribs and sternum. The process of Red Blood Cell (Erythrocyte) formation is called Haematopoiesis.

Coordinated movement is only possible because of the way bones are joined to one another in joints and the way that muscles are attached to the bones. The Axial Skeleton protects the soft organs and is the framework supporting the muscles. The Appendicular Skeleton forms the appendages to the axial skeleton to provide movement and manipulation. Hyaline cartilage and the joint extensions such as the Menisci (Knee), Acetabulum (Hip) and Glenoid Labrum (Shoulder) are fibrocartilages and also do not normally ossify.



7.1 Bone Structure Skeletal System

Bone is living tissue, capable of growth and repair. Since it is

alive, it requires a blood supply which is provided by nutrient arteries entering the bone. These arteries leave foramina (natural openings) in the bones, many of which are readily identifiable in skeletal material. 1. Bone Shapes

Bones can be classified according to shape: a. Long

Long bones are tubular with a shaft and two extremities, eg. humerus and femur.

b. Short Short bones are cuboidal in shape, eg. carpals (wrist) and tarsals (ankle). There is also a subset of short bones:

Sesamoid Sesamoid bones are a type of Short Bone, usually round or oval and are found within tendons, eg. patella.

c. Flat Flat bones consist of two plates of compact bone with cancellous bone between, eg. Ilium.

d. Irregular Irregular bones have various shapes, eg. bones of the face.

2. Typical Long Bone Structure a. Diaphysis (Shaft)

The shaft of a long bone is where the bone first forms.

b. Epiphysis The epiphysis is the end of a long bone. The epiphysis is usually wider than the shaft and can be made entirely of cartilage or separated from the shaft by a disc of cartilage.

c. Epiphyseal Line/Plate This is a plate of cartilage between Diaphysis and Epiphysis that has growth on both sides.

d. Periosteum/Perichondrium The Periosteum is a Dense Irregular CT membrane surrounding most bony surfaces. The Perichondrium is the equivalent fibrous membrane for Skeletal Cartilage.

e. Cartilage Cartilage is fibrous, connective tissue which covers the articular surfaces of the bone and serves as the skeletal tissue in certain regions such as the tip of the nose and the external ear.

Bone Density: Bones can also be classified in terms of density: a. Compact (Cortical)

This hard, dense material is found in the outer layer of all bones and a most of the shafts of long bones.

b. Spongy (Cancellous or Trabecular) Although composed of the same mineralised Calcium for reinforcement, it forms an interweaving network of Trabeculae. This allows strength with reduced weight.

Tendons attach to the Periosteum, not to the bone itself. There is also Endosteum which is a delicate CT that covers trabeculae (spongy bone) and canals (compact bone).




7.2 Whole Skeleton Skeletal System

These diagrams show the whole skeleton.

Figure 7.2a – Anterior: Entire Human

Figure 7.2b – Posterior: Entire Human




7.3 Vertebral Column Skeletal System

This diagram shows the Vertebral Column (Spine).

Figure 7.3 – Left Lateral: Vertebral Column




8 Bony Markings

Bones have various lumps and bumps on them, which helps the

tendons of muscles attach more securely. Anatomists have devised various names for these markings, which enables precision when describing where muscles are attached. They may also be used with respect to other structures such as nerves and blood vessels. Each bony marking has a distinctive name such as:

ISCHIAL TUBEROSITY This name incorporates the name of a bone (ISCHIUM) and the marking (TUBEROSITY). These markings can be divided into:

Projections Where excess bone protrudes in some way from the surface to form a distinctive feature.

Depressions/Openings Other markings involve the absence of bone.

Bony Landmarks are usually Bony Markings that are palpable from the surface. Depressions and Openings often relate to Blood/Lymphatic Vessel or Nerve penetration.

Marking Description

Pro

jec

tio

ns

Tuberosity Broad process, larger than a tubercle

Crest Sharp, prominent bony ridge

Trochanter Large, somewhat blunt process

Line Slight bony ridge

Tubercle Nodule or small rounded process

Epicondyle Small projection located on or above a condyle

Spine Slender pointed projection

Process Prominence or projection

Ramus Projecting part or elongated process

Head Generally, the larger end of a long bone

Facet Smooth, nearly flat articular surface

Condyle Rounded lump that articulates with another bone

Dep

res

sio

ns

/Op

en

ing

s

Meatus Canal-like passageway

Sinus Cavity, air-filled and lined with mucous membrane

Fossa Depression

Groove Furrow

Fissure Narrow, cleft like passage

Foramen Hole

Notch Looks like a chunk of bone has been removed near the edge

Table 8 – Bony Markings



8.1 Skull Bony Markings

This diagram shows the Bones and Bony Markings of the Skull.

Figure 8.1a – Right Lateral: Skull

Figure 8.1b – Anterior: Skull

1. Frontal bone 2. Temporal bone 3. Parietal bone 4. Occipital bone 5. Nasal bone 6. Maxilla 7. Mandible 8. Sphenoid bone 9. Zygomatic bone and arch 10. Mastoid process 11. External auditory meatus 12. External occipital protuberance 13. Coronal suture 14. Squamous suture 15. Lambdoidal suture 16. Foramen magnum 17. Styloid process 18. Sagittal suture 19. Orbit 20. Occipital condyle 21. Palatine process of maxilla 22. Nasal aperture (choana) 23. Lateral pterygoid plate

Figure 8.1c – Inferior: Skull




8.2 Vertebrae Bony Markings

These diagrams show the Vertebral Column (Spine) and the 3 main types of Vertebra.

Figure 8.2 – Right Lateral: Vertebral Column and Right Lateral/Superior: Vertebrae

1. Spinous process 2. Lamina 3. Transverse process 4. Pedicle 5. Body 6. Vertebral foramen (canal) 7. Superior articular facet 8. Inferior articular facet

9. Intervertebral disc




8.3 Atlas and Axis Bony Markings

These diagrams show the first 2 Vertebrae of the Spine.

Figure 8.3a – Superior: Atlas (C1)

Figure 8.3b – Inferior: Atlas (C1)

Figure 8.3c – Superior: Axis (C2)



8.4 Sternum, Rib and Clavicle Bony Markings

This diagram shows the Sternum, Clavicle, Scapula and first 2 Ribs.

Figure 8.5 – Anterior: Ribs 1 and 2, Sternum, Scapula (Right) and Clavicle (Right)

Sternum Rib Clavicle 1. Manubrium 2. Clavicular notch 3. Body (Gladiolus) 4. Xiphoid process

5. Head 6. Body 7. Costal cartilage

8. Sternal end 9. Acromial end




8.5 Scapula Bony Markings

These diagrams show the Scapula.

Figure 8.4 – Posterior/Right Lateral/Anterior: Scapula (Right)




8.6 Humerus Bony Markings

These diagrams show the Right Humerus.

Figure 8.6a – Anterior: Humerus (Right)

Figure 8.6b – Posterior: Humerus (Right)

1. Head 2. Anatomical Neck 3. Surgical Neck 4. Greater tubercle 5. Lesser tubercle 6. Intertubercular (bicipital) groove 7. Deltoid tuberosity 8. Spiral groove (for radial nerve) 9. Lateral supracondylar ridge 10. Lateral epicondyle 11. Medial epicondyle 12. Medial supracondylar ridge 13. Radial fossa 14. Capitulum 15. Coronoid fossa 16. Trochlea

17. Olecranon fossa



8.7 Ulna and Radius Bony Markings

These diagrams show the Right Ulna and Radius.

Radius

1. Head 2. Neck 3. Tuberosity 4. Anterior oblique line 5. Posterior oblique line 6. Interosseous border 7. Styloid process 8. Dorsal tubercle

Ulna 9. Olecranon process 10. Trochlear notch

(semilunar notch) 11. Coronoid process 12. Radial notch 13. Tuberosity 14. Interosseous border 15. Styloid process 16. Head 17. Supinator crest

Figure 8.7a – Anterior: Ulna and Radius (Right)

Figure 8.7b – Posterior: Ulna and Radius (Right)




8.8 Pelvis Bony Markings

These diagrams show the Pelvis.

Figure 8.8a – Anterior: Pelvis

Figure 8.8b – Posterior: Pelvis

The 3 Bones of the Pelvis (Innominate Bone) are: A. Ilium B. Ischium C. Pubis 1. Iliac crest 2. Superior (posterior) gluteal line 3. Middle (anterior) gluteal line 4. Inferior gluteal line 5. Anterior superior iliac spine 6. Anterior inferior iliac spine 7. Posterior superior iliac spine 8. Posterior inferior iliac spine 9. Greater sciatic notch

10. Ischial tuberosity 11. Ischial spine 12. Lesser sciatic notch 13. Ramus of ischium

14. Pubic symphysis 15. Body of pubis 16. Superior ramus of pubis 17. Inferior ramus of pubis

The pelvis can be said to include these structures: D. Acetabulum

E. Obturator foramen F. Sacrum G. Coccyx




8.9 Sacrum and Coccyx Bony Markings

These diagrams show the Sacrum and Coccyx.

Figure 8.9a – Anterior: Sacrum and Coccyx

Figure 8.9b – Posterior: Sacrum and Coccyx



8.10 Femur Bony Markings

These diagrams show the Femur.

Figure 8.10a – Anterior: Femur (Right)

Figure 8.10b – Posterior: Femur (Right)

1. Head 2. Neck 3. Greater trochanter 4. Lesser trochanter 5. Intertrochanteric line 6. Intertrochanteric crest 7. Trochanteric fossa 8. Quadrate tubercle 9. Gluteal tuberosity 10. Linea aspera 11. Adductor tubercle 12. Medial epicondyle 13. Lateral epicondyle 14. Patellar surface 15. Medial supracondylar line 16. Lateral supracondylar line 17. Medial condyle 18. Lateral condyle 19. Popliteal surface

20. Intercondylar notch




8.11 Tibia and Fibula Bony Markings

These diagrams show the Tibia and Fibula.

Fibula

1. Styloid process 2. Head 3. Neck 4. Interosseous border 5. Lateral malleolus 6. Shaft

Tibia 7. Medial condoyle 8. Lateral condoyle 9. Tibial tuberosity 10. Soleal line 11. Shaft 12. Interosseous border 13. Medial malleolus

Figure 8.11a – Anterior: Tibia and Fibula (Right)

Figure 8.11b – Posterior: Tibia and Fibula (Right)



9 Study Questions

The following pages contain Questions based on the material presented in this manual.

These questions are included for Students to test themselves after studying the material and/or attending a Class/Tutorial related to this Subject.



9.1 Fundamentals Study Questions

1. Name the fields of study of Anatomy being used in the following situation:

a) Looking at the Lymphatic System involving examination of the lymph nodes and

lymphatic vessels of the entire body.

b) Looking at a certain skeletal problem of the spine using a CAT scan.

c) Studying the structural changes during adolescence.

d) Viewing collagen fibres in cartilage under a microscope.

e) Observing the body shape and muscle definition of the upper back during a massage.

2. Explain using the diagram below the levels of organisation in the body. Use the Digestive System as the example in your explanation.



3. List five environmental factors upon which life is totally dependent.

1

2

3

4

5

4. Using the table below list the 12 organ systems of the body, naming two organs of each

system, and describe the overall or major function of the system.

Organ System Organs Major Function

a)

b)

c)

d)

e)

f)

g)

h)

i)

j)

k)

l)



5. One body system is directly responsible for one characteristic of life. Match them up: Life Characteristic Body System

Movement

Endocrine System

Responsiveness

Nervous System

Metabolism & Growth

Reproductive System

Maintenance of Boundaries

Integumentary System

Excretion

Muscular and Skeletal System

Reproduction

Digestive System

Nutrition

Urinary and Digestive System

6. Regarding Homoeostasis:

a) Define Homoeostasis.

b) Using the variable Blood Pressure (acceptable range 110/70 to 130/90), explain the process of homoeostasis.

7. Regarding Anatomical Terminology: a) Describe the Anatomical Position.

b) Why is an understanding of this position important?

c) What is the importance of directional terms?



9.2 Cells Study Questions

1. The smallest unit capable of life by itself is:

a. organ b. organelle c. tissue d. cell e. nucleus

2. Define Cytology.

3. Explain why mitosis can be thought of as cellular immortality.

4. If a cell loses or ejects its nucleus, what is its fate and why?

5. Draw and label a diagram of a typical cell here:



9.3 Tissues Study Questions

1. Define "Tissues".

2. Define "Histology".

a) List the four primary tissue types that interweave to form the "fabric" of the body.

1

2

b) Write down a single term next to each type that would best describe its overall role.

3

4

3. List the three general areas in the body where Epithelium is located.

4. Explain the following characteristics of Epithelium: a) Cellularity

b) Polarity

c) Avascularity

d) Regeneration



5. The gland type that secretes products such as milk, saliva, bile, or sweat through a duct is: a. an endocrine gland b. an excitable gland c. an exocrine gland

6. Match the important functions of epithelial tissues with the examples of tissues

exemplifying these functions.

Function Examples

Protection

Lining of the stomach

Secretion

Air sacs of the lungs

Filtration

Epidermis of the skin

Absorption

Lining of the trachea

7. Give two areas in the body where simple squamous epithelium (the most basic

epithelium tissue structure) is located.

1

2

8. Why is blood considered a connective tissue?

9. List the following connective tissues in order of vascularity:

cartilage 1

tendon 2

bone 3

10. The connective tissue is the most abundant of the 4 primary tissues in the body.

True or False?

11. List the types of muscle under the headings below

Voluntary Involuntary



12. What are the two structures that nervous tissue is composed of and what roles do they perform?



9.4 Integumentary System Study Questions

1. The barrier nature of the epidermis is largely due to the presence of:

a. Melanin b. Carotene c. Collagen d. Keratin

2. Skin colour is determined by:

a. The amount of blood b. Pigments c. Oxygenation level of the blood d. All of these

3. Which of the following is not an epidermal derivative?

a. Hair b. Sweat gland c. Sensory receptor d. Sebaceous gland

4. You can cut your hair without feeling pain because:

a. There are no nerves associated with hair. b. The shaft of the hair consists of dead cells. c. Hair follicles develop from epidermal cells and the epidermis lacks a nerve supply. d. Hair follicles have no source of nourishment and therefore cannot respond.

5. Complete the table below:

Region Cutaneous or

Subcutaneous? Number of

Layers Types of Tissues

Types of Cells/Fibres

Epidermis 4 or 5

Collagen, Elastin,

Reticular

Subcutaneous Connective



6. The skin and its derivatives perform a variety of functions that prevent external factors such as bacteria, abrasion, heat, cold and chemicals from upsetting body homoeostasis. Match the functions of the skin with the method given: Function Method

Body temperature regulation

Extensive vascular supply

Cutaneous sensation

Removing waste products through sweat

Vitamin D Synthesis

Controlling heat loss via blood flow and sweating

Body Reservoir

Cholesterol molecules being irradiated with ultra-violet radiation

Protection

Activation of sensory receptors which transmit nerve impulse

Excretion

Chemical, physical and biological barriers

7. Write T (true) of F (false) next to each of the following statements:

a) Melanin is the only pigment that contributes to skin colour.

b) Melanin ranges in colour from yellow to orange to brown.

c) Melanin helps protect skin cells from ultra-violet radiation.

d) Dark skinned people have much more and darker melanin that fair skinned people.

e) Freckles and pigmented moles reflect local accumulations of melanin.

f) Prolonged sun exposure causes a substantial reduction in melanin build up.



9.5 Skeletal System Study Questions

1. Besides contributing to body shape and form, our bones perform five functions for the

body. List them.

1

2

3

4

5

2. The human skeleton is made up of how many bones?

3. What is the main function of the: a) Axial skeleton?

b) Appendicular skeleton?

4. Bones are classified according to size, not shape. True or False?

5. Name the four types of bone found in the body and give examples of each:

1

2

3

4

6. Name the two basic types of bone tissue found in bones:

1

2



7. Draw the structure of a long bone and label the following: epiphysis diaphysis periosteum spongy bone compact bone epiphyseal plate nutrient artery articular cartilage marrow

8. Give the Skeletal (ie. Anatomical) name for each of the following body parts: Common Skeletal Common Skeletal

fingers “upper” arm ankle jaw shin heel hand head hip forearm (thumb side) spine collar bone foot tail bone thigh breastbone shoulder blade wrist



9. Label the Skeleton:

Figure 9.5a – Anterior: Entire Human



10. Label the Spinal (Vertebral) Column:

Figure 9.5b – Right Lateral: Vertebral Column



9.6 Bony Markings Study Questions

1. Label the Atlas and the Axis:

An

terio

r

Figure 9.5c – Superior: Atlas (C1)

Po

ste

rio

r

Figure 9.5d – Superior: Axis (C2)

2. Label this Cervical Vertebra:

Po

ste

rio

r

An

terio

r

Figure 9.5e – Superior: Cx

Figure 9.5f – Left Lateral: Cx



3. Label this Thoracic Vertebra:

Po

ste

rio

r

An

terio

r

Figure 9.5g – Superior: Tx

Figure 9.5h – Left Lateral: Tx

4. Label this Lumbar Vertebra:

Po

ste

rio

r

An

terio

r

Figure 9.5i – Superior: Lx

Figure 9.5j – Left Lateral: Lx



5. Label the Sacrum and Coccyx:

Figure 9.5k – Anterior: Sacrum and Coccyx

Figure 9.5l – Posterior: Sacrum and Coccyx



6. Label the Right Scapula:

Figure 9.5m – Anterior: Scapula (Right)

Figure 9.5n – Posterior: Scapula (Right)



7. Label the Right Humerus, Ulna and Radius:

Figure 9.5o – Anterior: Humerus, Ulna and Radius (Right)

Figure 9.5p – Posterior: Humerus, Ulna and Radius (Right)



8. Label the Pelvis:

Figure 9.5q – Anterior: Pelvis

Figure 9.5r – Posterior: Pelvis



9. Label the Right Femur, Tibia and Fibula:

Figure 9.5s – Figure Anterior: Femur, Tibia and Fibula (Right)

Figure 9.5t – Posterior: Femur, Tibia and Fibula (Right)



10 Suggested Answers

The following pages contain suggested answers to the previous questions.

Try to answer the questions before finding an answer here.



10.1 Fundamentals Suggested Answers

1.

a) Systemic

b) Radiographic

c) Developmental

d) Microscopic

e) Surface

2. Chemicals – Cells – Tissues – Organs – Systems – Organisms.

3. Nutrients, Oxygen, Water, Body Temperature, Atmospheric pressure.

4.

Organ System Organs Major Function

a) Integumentary Skin, hair, oil and sweat glands PROTECTION

b) Skeletal Bone, cartilage SUPPORT

c) Muscular Muscle MOVEMENT

d) Nervous Brain, spinal cord, nerves CONTROL

e) Lymphatic Lymph vessels and nodes, accessory

organs DRAINAGE

f) Digestive Mouth, oesophagus, stomach DIGESTION and

ABSORPTION

g) Urinary Kidney, bladder, urethra ELIMINATION and

FILTRATION

h) Reproductive Male and Female organs REPRODUCTION

i) Endocrine Pineal, pituitary, thyroid, thymus,

adrenal, pancreas REGULATION

j) Respiratory Nose, pharynx, larynx, Trachea,

bronchi, lungs RESPIRATION

k) Cardiovascular Heart, blood vessels TRANSPORT

l) Immune Skin, mucus membranes, Lymphatic DEFENCE



5. Life Characteristic Body System

Movement

Endocrine System

Responsiveness

Nervous System

Metabolism & Growth

Reproductive System

Maintenance of Boundaries

Integumentary System

Excretion

Muscular and Skeletal System

Reproduction

Digestive System

Nutrition

Urinary and Digestive System

6.

a) The ability to maintain a relatively stable internal environment despite external

changes. A constant process of stimulation and response.

b) If BP rises above normal, baroceptors (sometimes chemoreceptors) signal control

centres which in turn command the heart rate to decline/reduce force and vasodilation

of arterioles/veins. This means less blood flow to wider veins and results in a drop of

BP. 7.

a) Standing, head facing forward, arms by side with palms turned to the front, feet

together pointing forward.

b) Creates a Universal Standard – facilitates accurate/concise communication/study of

the Body between everyone involved in technical use of Anatomy.

c) To indicate positions/relationships of different parts of the Body.



10.2 Cells Suggested Answers

1. d (cell).

2. The study of cells.

3. The division of the nucleus/cells ensures that that the original pattern is maintained, even

after the original cell has died.

4. It will die because the nucleus controls all cell activities. Some useful examples are:

Erythrocytes (Red Blood Cells) transport O2 and CO2.

Keratinocytes (Skin Cells) die as they become more superficial (protection).

5.



10.3 Tissues Suggested Answers

1. A group of closely associated cells that are similar in structure and perform a common

function.

2. The study of tissues.

a) Epithelial, Nerve, Muscle, Connective.

b) Protection, Control, Movement, Support.

3. Skin, Visceral Lining of organs, Glands.

4.

a) Composed almost entirely of close packed cells.

b) The cells at the exposed surface are different in form and function to those cells at

the basal level.

c) No blood supply.

d) High regeneration capacity.

5. a (an endocrine gland).

6. Function Examples

Protection

Lining of the stomach

Secretion

Air sacs of the lungs

Filtration

Epidermis of the skin

Absorption

Lining of the trachea

7. Linings of heart, lungs and abdominal organs (serosae), blood vessels, air sacs of lungs,

lymphatic vessels, kidney glomeruli.

8. It has most of the recognized characteristics of Connective tissue (ie. mostly extracellular

fluid with organelles and cells).

9. Tendon (poorly), bone (poorly), cartilage (avascular).

10. True.

11. Voluntary Involuntary

Skeletal Smooth

Cardiac

12. Neurons generate and conduct electrical impulses. Neuroglia are non-generating/non-

conducting and support neurons.



10.4 Integumentary System Suggested Answers

1. d (Keratin).

2. d (All of these).

3. c (Sensory receptor).

4. a (There are no nerves associated with hair).

5.

Region Cutaneous or

Subcutaneous? Number of

Layers Types of Tissues

Types of Cells/Fibres

Epidermis Cutaneous 4 or 5 Epithelial Keratin

Dermis Cutaneous 2 Connective Collagen, Elastin,

Reticular

Hypodermis Subcutaneous 1 Connective Adipose

6.

Function Method

Body temperature regulation

Extensive vascular supply

Cutaneous sensation

Removing waste products through sweat

Vitamin D Synthesis

Controlling heat loss via blood flow and sweating

Body Reservoir

Cholesterol molecules being irradiated with ultra-violet radiation

Protection

Activation of sensory receptors which transmit nerve impulse

Excretion

Chemical, physical and biological barriers

7.

a) False

b) False

c) True

d) True

e) True

f) False



10.5 Skeletal System Suggested Answers

1. Support, Protection, Movement, Storage, Production.

2. 206 (in an adult).

3.

a) Protection.

b) Movement.

4. False.

5. 1 Long eg. Humerus, Femur, Metacarpals, Metatarsals, Phalanges,

Clavicle, Tibia, Fibula, Radius, Ulna

2 Short eg. Tarsals, Carpals, Patella (sesamoid) 3 Flat eg. Cranium, Ribs, Sternum, Ilium, Ischium, Pubis, Scapula

4 Irregular eg. Vertebrae, Facial bones

6. Lamellar (compact), trabecular (spongy).



7.



8. Common Skeletal Common Skeletal

fingers Phalanges upper arm Humerus

ankle Tarsals jaw Mandible

shin Tibia heel Calcaneus

hand Metacarpals head Skull

hip Ilium forearm (thumb side) Radius

spine Vertebral column collar bone Clavicle

foot Metatarsals tail bone Coccyx

thigh Femur breastbone Sternum

shoulder blade Scapula wrist Carpals

9. Skeleton (Fig. 9.5a) – Clockwise from top right:

Frontal, Maxillary, Mandible, Sternum, Ribs, Radius, Sacrum, Ulna, Carpals, Metacarpals,

Phalanges, Tibia, Fibula, Tarsals, Phalanges, Metatarsals, Calcaneus, Patella, Femur,

Pelvis/Ilium/Coxal, Vertebral column/vertebrae, Humerus, Scapula, Clavicle, Occiput,

Parietal.

10. Spine (Fig. 9.5b) – Clockwise from top right:

Atlas, Axis, Coccyx, Sacrum, Lumbar (L1-L5), Thoracic (T1-T12), Cervical (C1-C7).



10.6 Bony Markings Suggested Answers

1. Atlas (Fig. 9.5c) – Clockwise from top right:

Transverse process/foramen, Vertebral foramen, Left lateral mass. Axis (Fig. 9.5d) – Clockwise from top right:

Dens (odontoid process), Superior articular surface, Vertebral foramen.

2. Cervical Superior (Fig. 9.5e) – Clockwise from top:

Spinous process, Vertebral foramen, Body (centrum), Transverse foramen, Superior

articular surface. Cervical Lateral (Fig. 9.5f) – Clockwise from top:

Spinous process, Inferior articular surface, Superior articular surface.

3. Thoracic Superior (Fig. 9.5g) – Clockwise from top:

Spinous process, Lamina, Pedicle, Vertebral foramen , Body (centrum), Transverse process,

Costotransverse articular surface. Thoracic Lateral (Fig. 9.5h) – Clockwise from top right:

Spinous process, Inferior articular surface, Superior articular surface.

4. Lumbar Superior (Fig. 9.5i) – Clockwise from top right:

Spinous process, Superior articular surface, Lamina, Transverse process, Pedicle, Body

(centrum), Vertebral foramen. Lumbar Lateral (Fig. 9.5j) – Clockwise from top right:

Spinous process, Inferior articular surface, Transverse process, Body (centrum), Superior

articular surface.

5. Sacrum/Coccyx Anterior (Fig. 9.5k) – Clockwise from right:

Transverse lines of fusion, Coccyx, Anterior sacral foramina, S1 Body, Sacral promontory,

Ala. Sacrum/Coccyx Posterior (Fig. 9.5l) – Clockwise from top right:

Superior articular process, Posterior sacral foramina, Sacral hiatus, Coccyx, Median sacral

crest, Auricular surface.

6. Scapula Anterior (Fig. 9.5m) – Clockwise from top:

Coracoid process, Vertebral (medial) border, Inferior angle, Axillary (lateral) border,

Subscapular fossa.



Scapula Posterior (Fig. 9.5n) – Clockwise from top right:

Coracoid process, Acromion (process), Glenoid fossa, Infraglenoid tubercle, Axillary

(lateral) border, Inferior angle, Vertebral (medial) border, Infraspinous fossa, Spine,

Supraspinous fossa, Superior border.

7. Humerus/Ulna/Radius Anterior (Fig. 9.5o):

Humerus: (Clockwise from top right) Head, Lesser tubercle, Trochlea, Capitulum, Deltoid

tuberosity, Intertubercular (bicipital) groove, Greater tubercle.

Ulna: Coronoid process.

Between Ulna and Radius: Proximal radio ulnar Joint.

Radius: (Clockwise from bottom) Radiocarpal articular surface, Radial tuberosity. Humerus/Ulna/Radius Posterior (Fig. 9.5p):

Humerus: (Clockwise from top right) Greater tubercle, Lateral epicondyle, Olecranon fossa,

Medial epicondyle, Surgical neck, Anatomical neck.

Ulna: (Clockwise from bottom) Medial styloid process, Coronoid process.

Between Ulna and Radius: Distal radio ulnar Joint.

Radius: (Clockwise from bottom) Head, Lateral styloid process.

8. Pelvis Anterior (Fig. 9.5q) – Clockwise from top left:

Sacroiliac joint, Iliac crest, Iliac fossa, Acetabulum, Obturator foramen, Pubic angle, Pubic

crest. Pelvis Posterior (Fig. 9.5r) – Clockwise from top left:

Iliac crest, Posterior superior iliac spine (PSIS), Sacrum: Superior articular process, Lesser

sciatic notch, Ischial tuberosity, Greater sciatic notch, (Superior (posterior), Middle

(anterior) and inferior) Gluteal lines.

9. Femur/Tibia/Fibula Anterior (Fig. 9.5s):

Femur: (Clockwise from top left) Greater trochanter, Lesser trochanter, Patella, Trochlea.

Tibia: (Clockwise from top right) Tibial plateau, Tibial tuberosity, Medial malleolus.

Between Tibia and Fibula: Proximal tibiofibular joint.

Fibula: Lateral malleolus. Femur / Tibia/Fibula Posterior (Fig. 9.5t) – Clockwise from top right:

Femur: (Clockwise from top left) Head, Greater trochanter, Gluteal tuberosity, Linea

aspera, Lateral condyle, Popliteal surface, Medial condyle, Medial epicondyle, Lesser

trochanter, Neck, Head.

Tibia: (Clockwise from bottom left) Medial malleolus, Soleal line.

Between Tibia and Fibula: Distal tibiofibular joint, Proximal tibiofibular joint.

Fibula: Lateral malleolus.



11.1 Bone Location Summary Appendix 1

The following tables summarise the Locations of the Bones described previously.

Background Colour Level Note

White Massage 1 Learn these items All these items are to be learnt for the whole Course (as shown in the tables in Massage 3)

Grey Massage 2 Learn these new items

Dark Grey Massage 3 Learn these new items

Bones Listed by Area These Bones are relatively easily Located at a Body Area.

Area Bone(s) Abbreviation Area Aspect Lev Fig

Head Skull Skull Entire M1 8.1a-c

Mandible Mand Anterior, Inferior M2 8.1a, b

Neck Cervical Vertebrae Cx: C1-7 Posterior M1 7.3, 8.2 8.3a-c

Chest Sternum Ster Medial M1 8.5

Upper Back Thoracic Vertebrae Tx: T1-7 Medial M1 7.3, 8.2

Lower Back Lumbar Vertebrae Lx: L1-5 Medial M1 7.3, 8.2

Arm Humerus Hum Entire M1 8.6a, b

Forearm Ulna Uln Medial M1 8.7b

Radius Rad Lateral M1 8.7a

Wrist Carpals Carp Entire M2 7.2a, b

Hand Metacarpals 1-5 Metacarp Proximal M2 7.2a, b

Proximal Phalanges 1-5 Prox Phal 1-5 Distal M3 7.2a, b

Middle Phalanges 2-5 Mid Phal 2-5 Distal M3 7.2a, b

Distal Phalanges 1-5 Dist Phal 1-5 Distal M3 7.2a, b

Thigh Femur Fem Entire M1 8.10a, b

Leg Tibia Tib Medial M1 8.11a, b

Fibula Fib Lateral M1 8.11a, b

Foot Tarsals Tars Proximal M2 7.2a, b

Metatarsals Metatars Middle M2 7.2a, b

Proximal Phalanges 1-5 Prox Phal 1-5 Distal M3 7.2a, b

Middle Phalanges 2-5 Mid Phal 2-5 Distal M3 7.2a, b

Distal Phalanges 1-5 Dist Phal 1-5 Distal M3 7.2a, b

Table 11.1a – Bones Listed by Area



Bones Listed Alphabetically These Bones are less easily Located at multiple Body Areas or Inconvenient Locations.

Area Abbreviation Bone(s) Area Aspect Lev Fig

Clavicle Clav Neck Inferior M1 8.5

Shoulder Superior, Medial

Chest Superior

Pelvis Pelv Hips Superior M1 8.8a, b

Abdomen Inferior

Groin Occluded

Ribs 1-6 Rib 1-6 Chest Entire M2 8.5

Upper Back Entire 7.2a, b

Ribs 7-12 Rib 7-12 Chest Entire M2 7.2a, b

Upper Back Inferior

Abdomen Lateral

Lower Back Superior

Sacrum Sac Hips Medial M1 8.8a, b

Lower Back Inferior 8.9a, b

Scapula Scap Upper Back Lateral M1 8.4

Shoulder Medial 8.5

Table 11.1b – Bones Listed Alphabetically



This Manual contains some images from: Spence, A P: Basic Human Anatomy, the Benjamin/Cummings Publishing Co, Redwood City 1990. Travell JG, Simons DG: Myofascial Pain and Dysfunction: The Trigger Point Manual Volumes 1 and 2. Williams and Wilkins, Baltimore 1992 CorelDraw version 12 Clip Art

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