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Cell and Tissues

The organisation of the body

The human body is organised into various levels that begin at the very small and basic and come
together to form the complete body whose different parts work in unison. This can be seen as a kind
of ladder going from the basic to the very complex.
At the simplest level, the body is comprised of atoms.

Cells, tissues, organs and systems

The cell
The basic unit of body structure is the cell. All cells need food, water, and oxygen to live and function.
As cells use or metabolise food and oxygen they give off carbon dioxide and other wastes. The cell is
comprised of the cell membrane, which is the outer covering; it encloses the cell and helps it hold its
The nucleus is the control centre; it directs the cells activities. Cytoplasm surrounds the nucleus.
Organelles are structures that are suspended in the cytoplasm. The protoplasm refers to all structures,
substances and water within the cell.
Chromosomes are threadlike structures within the nucleus. Each cell has 46 chromosomes.
Chromosomes contain genes, which determine our physical and chemical makeup.

Cell qualities

The cell is the most basic unit of life.

There are cells that are organisms themselves, such as bacteria cells.
There are cells that only function when part of a larger organism.
In the body, there are brain cells, skin cells, liver cells, blood cells and many more.
All of these cells have unique functions and features.
Although cells may be very different and highly specialised, they all have the same basic structure.
They all have:
an outer covering called the membrane
a main substance called the cytoplasm
a control centre known as the nucleus
organelles dispersed within their cytoplasm.
The cell membrane protects the cell and regulates the passage of materials into and out of the cell.
The nucleus is the control centre of the cell. DNA, which makes up the genes, is found within the
chromatin granules and within the nucleolus is the RNA.
Organelles, which are structures found in the cytoplasm, are the:
mitochondria, the powerhouse of the cell, function in cellular metabolism and
endoplasmic reticulum produces proteins and lipids and transports these substances
within the cell
lysosomes function in intracellular digestion and form the self-destruct system of the
golgi complex concentrates some secretions, adds carbohydrates to some secretions and
packages secretions for export from the cell
vacuoles are small cavities within the cell used to store secretions or waste products
centrioles, cilia and flagella are composed of microtubules
o centrioles are contained in the centrosome and are involved in mitosis
(cell division)
o cilia aid in the movement of materials outside the cell. For example,
trapping of dust particles in the respiratory tract.
o flagella are important in the locomotion of sperm cells.

Functions of the cell

1. Respiration all cells require oxygen to metabolise food.
2. Ingestion and assimilation cells are able to select chemicals from the surrounding fluid
for their structure.
3. Growth and repair cells can synthesise new cytoplasm so that growth can occur and
repair worn out parts.
4. Excretion waste products are eliminated into surrounding tissue to be transported by
the blood for elimination via organs.
5. Irritability and activity cells are able to respond to stimuli. For example a stimulus
causes a muscle to contract or relax.
6. Metabolism cells are able to break down and use substances from food as fuel.
7. Reproduction cells reproduce by simple division but some cells can never be replaced
once destroyed. For example, central nervous system cells.

Cytology - the study of cells

Cells vary greatly in SIZE and STRUCTURE

Cells have two main parts - NUCLEUS & CYTOPLASM,
Enclosed in a CELL MEMBRANE (also called PLASMA MEMBRANE)

Extremely thin
Outpouchings and infoldings
Selectively Permeable = controls what enters and leaves the cell, it allows some things to pass but not others, this is
the MAIN FUNCTION of the cell membrane

CYTOPLASM - the area between the plasma membrane and nucleus. Where most metabolic reactions/activities take
place. Filled with a clear fluid called CYTOSOL. Contains many structures called ORGANELLES


1. ENDOPLASMIC RETICULUM (E.R.) - complex system or network of interconnected

membranes, canals, or channels. Connected to cell membrane, nuclear membrane, and

A. Rough ER - where ribosomes are located. Ribosomes manufacture (synthesize)

B. Smooth ER - no ribosomes, where lipid synthesis takes place

2. GOLGI APPARATUS (BODIES) - series of flattened, membranous sacs near the

Function = "Refining", "Packaging", Delivery of proteins

3. MITOCHONDRIA (-ion = sing.) - Usually numerous, double layer membrane - inner layer folded to form CRISTAE.
Function = where chemical energy (food substances) is transformed into a useable form - molecules of ATP
(adenosine triphosphate) that are like "packets" of energy. The process of releasing/transforming the energy from
food involves OXYGEN and is called CELLULAR RESPIRATION

4. LYSOSOMES - quite variable in size and shape. Contain powerful digesting enzymes - breakdown and destroy
foreign particles, microorganisms, damaged or worn out cells and cell parts

5. CENTROSOME (central body) - Usually near the G.A. and nucleus. Composed of 2 "cylinders" called
CENTRIOLES (each composed of numerous microtubules), which always lie perpendicular to each other. Active
involved in cell reproduction - SPINDLE forms from the centrioles

6. VESICLES - tiny sacs in which substances are transported

7. MICROFILAMENTS & MICROTUBULES - threadlike structures

MICROFILAMENTS - involved in cellular movement, as in muscle cells
MICROTUBULES - larger than filaments, maintain shape ("skeleton" of the cell)

The NUCLEUS - directs the activities of a cell. Contains GENETIC materials. Surrounded by a selectively permeable
membrane called the NUCLEAR MEMBRANE or ENVELOPE. Filled with fluid called NUCLEOPLASM
1. NUCLEOLUS - small, dense structures within nucleus, made of proteins and RNA. No membrane
FUNCTION = produces ribosomes

2. CHROMATIN - loosely coiled "fibers" in nucleoplasm. Forms CHROMOSOMES during cell reproduction.
Composed mainly of DNA (deoxyribonucleic acid) and PROTEIN. Contains coded information that directs protein
synthesis in the cell

Movement of Substances Through the Cell Membrane

DIFFUSION - molecules move spontaneously (no cellular energy used) from an area of higher concentration to an
area of lower concentration

FACILITATED DIFFUSION - molecules diffuse through a membrane by means of a carrier molecule transports
(requires no energy = PASSIVE TRANSPORT)

OSMOSIS - the diffusion of water through a selectively permeable membrane.

OSMOTIC PRESSURE = pressure to stop osmosis


Solute = Substance dissolved

Solvent = Substance in which a solute is dissolved (usually water)
Hypertonic Solution = conc. of solute particles is greater outside the cell
Hypotonic Solution = conc. of solute particles is lower outside the cell
Isotonic Solution = conc of solute particles is the same inside and outside the cell

FILTRATION - molecules are forced through a membrane by hydrostatic pressure

ACTIVE TRANSPORT - molecules are moved against the concentration gradient. This requires the use of cellular
energy, also usually involves a carrier molecule.

Exocytosis = transport of particles out of the cell

Endocytosis = transport of particles into th cell
Pinocytosis - liquids taken in, cell engulfs a droplet of water
Phagocytosis -solids taken in. a vesicle forms.

The Life Cycle of a Cell

A. Mitosis (nuclear division)

B. Cytoplasmic Division (cytokinesis)
C. Interphase (growth)
D. Differentiation - cells become specialized, developing characteristics in structure and function

1. INTERPHASE - cell is in a resting state,

growth occurs and DNA makes a copy of itself



Chromatin condenses and

becomes visible as
Spindle forms and centrioles
migrate to the poles
Nuclear membrane dissolves


Chromosomes line up along the



Individual chromatids separate


Nuclear membrane reforms

Spindle disappears


The cytoplasm (and hence the whole cell) separates

Activity 2
In this activity you will learn about the structure and function of cells. Click here

Groups of cells form tissues and there are four main types. The structure of tissues reflects their

Types Function Example

Epithelial Protection Skin

Connective Support Bones

Muscular Movement Skeletal

Nervous Communication Brain

Epithelial tissue

This tissue covers the body surfaces and lines its cavities. Some specialise to form glands.
The functions of epithelial tissue include:
surface transport
reception of sensory information.
A gland is one or more epithelial cells specialised to produce and discharge substances.
Endocrine glands secrete have no ducts and secrete hormones directly into the bloodstream, for
example pituitary gland.
Exocrine glands release their secretions through ducts, for example salivary and sweat glands.

Connective tissue

This tissue joins other tissues of the body together, supports the body and protects underlying organs.
Some main types are:
ordinary connective tissue - subcutaneous tissue and collagen
adipose tissue - stores fat
cartilage - protects joints and supports soft tissues
bone - rigid supporting tissue of the skeleton
blood - lymph and lymphoid tissue - produce blood cells

Muscular tissue

Muscle is composed of cells specialised to contract.

Skeletal muscle is striated (striped) and is under voluntary control.
Cardiac muscle is present only in the walls of the heart, is striated and is controlled by involuntary
nerve messages from the brain.
Smooth muscle, also involuntary, is responsible for movement of food through the digestive tract, and
changing the diameter of blood vessels.
Nervous tissue

Nervous tissue forms the brain, spinal cord and the nerves. The basic cell is called the neuron.
Specialised to receive stimuli and send impulses from one part of the body to another.

Groups of tissues come together to form organs. For example the heart is made up of cardiac muscle
and nervous tissues, held together with connective tissues and lined with epithelium. Each organ has a
specific function.

Organ Function

Heart Circulation

Stomach Digestion

Brain Communication/coordination

Uterus Reproduction

Several organs working together form a system. For example the urinary system is made up of the
kidneys, bladder and ureters.

System Organs

Cardiovascular Heart, blood, vessels

Respiratory Nose, pharynx, trachea, bronchus, bronchiole, lungs, alveoli

Musculoskeletal Muscles, joints, bones

Integumentary Skin

Nervous Brain, spinal chord, nerves

Digestive Tongue, esophagus, stomach, liver, pancreas, gall bladder, small

intestine, large intestine, rectum, anus

Urinary Kidneys, ureters, bladder, urethra

Reproductive Male: Testes, scrotum, vas deferens, seminal vesicle, prostate,

ejaculatory duct, urethra, penis, glans, perineum
Female: Ovaries, fallopian tubes, uterus, cervix, vagina, labia, urethra,
clitoris, perineum

Endocrine Glands: pituitary, hypothalamus, pineal, parathyroid, thyroid, adrenals,

pancreas, gonads: ovaries ; testes , and their hormones.

Lymphatic/Immune Lymph glands and vessels, lymph, lymphocytes, T and B cells.

Tissue - a group or mass of similar cells working together to perform certain common functions

There are 4 major types of tissue


1. Epithelial Tissue

General Characteristics:
- Found throughout the body, covers all body surfaces both inside and out.
- Main glandular tissue.
- Attached to underlying connective tissue by noncellular nonliving basement membrane.
- Usually has no vascular tissue - blood supply
- Cells reproduce rapidly (rapid healing).
- Cells tightly packed together

Functions: Protection, secretion, absorption, excretion, sensory perception

Six Specific types of epithelial tissue - categorized based on the shape of the cells and the layers of cells. ( * We
won't distinguish glandular epithelium because it is of the cuboidal or columnar type.)

A. SIMPLE SQUAMOUS - single layer (simple) of very thin, flattened cells (squamous). Function: diffusion and
filtration. Found in air sacs of lungs, walls of capillaries.

B. SIMPLE CUBOIDAL - single layer, cube-shaped cells. Function: Secretion and absorption. Found: Lining of kidney
tubules, ducts of glands, covering surface of ovaries

C. SIMPLE COLUMNAR - single layer, elongated cells with their nuclei in about the same position in each cell
(usually near the basement membrane). Protection, secretion, absorption. Found in the lining of digestive tract and
- contains scatter goblet cells functioning in the secretion of mucus
- some columnar cells (involved in absorption) have tiny finger-like processes from their free surface called microvilli
(increases surface area)

D. STRATIFIED SQUAMOUS - muli-layered, squamous cells. Thicker tisse.

Functions in protection. Found lining body cavities like the mouth and outer layer of skin
E. PSEUDOSTRATIFIED COLUMNAR - appear "stratified" but really a single layer with nuclei at various levels giving
the appearance of layered cells. Usually ciliated (tiny, hair-like projections for sweeping materials along a surface).
Contains goblet cells.
- Function: secretion and cilia-aided movement
- Location: lining air passages like the trachea and tubes of the reproductive system

F. TRANSITIONAL EPITHELIUM - thick, layered cuboidal cells. "Stretchable" tissue, also forms barrier to block
diffusion. Found: lining of urinary bladder.

2. Connective Tissue

General Characteristics:
-Most abundant tissue in your body, found throughout
-Binds structures together
-Provides support, protection, framework, fills space, stores fat, produces blood cells, fights infection, and helps repair
-Composed of more scattered cells with abundant intercellular material ' matrix
-Made up of a ground substance (fluid, semi-solid) and fibers
-Most has a good blood supply
-Cells can reproduce
-Three Common types of cells:
1. mast cells (prevents blood clots)
2. macrophages (phagocytic) and
3. fibroblasts (most abundant, produce fibers)

main types of fibers:

-collagenous fibers - thick, made of protein collagen, major structural protein in the body, appear in long parallel
bundles. Strong, flexible, but not very elastic, also known as white fibers. (bones, ligaments, tendons)
- elastic fibers - microfibrils in protein elastin, yellow fibers. Not as strong, but very elastic (respiratory and vocal

A. LOOSE C.T. or AREOLAR TISSUE - binds skin to underlying organs and organs to organs, space between
muscles, throughout body

B. ADIPOSE TISSUE - aka FAT, beneath skin, around kidneys and eyeballs, abdominal membranes. Function:
Protective cushion, insulation to preserve body heat, stores energy, cells are called adipocytes

C. FIBROUS C.T. - dense tissue, closely packed, thick collagenous fibers and fine network of elastic fibers. Few
cells, poor blood supply, thus slow healing.
Tendons - connect muscles to bones
Ligaments - connect bones to bones

CARTILAGE (all cartilage cells are called chondrocytes)

D. HYALINE CARTILAGE - very fine white (collagenous) fibers. Most common cartilage. Covers ends of bones and
joints, noise, respiratory passages.

E. ELASTIC CARTILAGE - more flexible and elastic, external ear and larynx

F. FIBROCARTILAGE - very tough, large numerous collagenous fibers. Intervertebral disks, menisci
G. BONE TISSUE - Osseus tissue. Rigid due to mineral salts.
Layers - lamellae, haversian canals, osteocytes

H. BLOOD TISSUE - circulates throughout the body

I. RETICULOENDOTHELIAL - found scattered throughout the body

3. Muscle Tissue

A. Skeletal - skeletal muscles

- voluntary (striated)
B. Smooth - in hollow organs, stomach
- involuntary
C. Cardiac - wall of the heart

4. Nerve Tissue

Found in brain, spinal cord, nerves

A. Neurons - transmit signals

B. Neuroglia - protection, support

Epithelial Tissues



Epithelia are tissues consisting of closely

apposed cells without intervening intercellular
substances. Epithelia are avascular, but all
epithelia "grow" on an underlying layer of
vascular connective tissue. The connective
tissue and the epithelium are separated by a
basement membrane. Epithelium covers all
free surfaces of the body. Epithelium also lines
the large internal body cavities, where it is
termed mesothelium. Furthermore, the internal
surfaces of blood and lymph vessels are lined by epithelium, here called endothelium.

Epithelia are classified on the basis of the number of cell layers and the shape of the cells in the surface layer.

* If there is only one layer of cells in the epithelium, it is designated simple.

* If there are two or more layers of cells, it is termed stratified.

* Cells in the surface layer are, as a rule, described according to their height as squamous (scale- or plate-like),
cuboidal or columnar.

Psuedostratified epithelia appears to be layered (stratified) because the cell nuclei occur in two or more levels in a
row of aligned cells

View Slides

Type of Tissue Function Location

Pseudostratified columnar removing dust and particles from airways, has cilia lines the respiratory passageways
lines the uterus and most organs of the
Simple Columnar Absorption
digestive tract
Simple Cuboidal Secretion and Absorption glands, kidney tubules, ovaries
Simple Squamous Diffusion and Filtration lungs, walls of capillaries and vessels
skin(keratinized) and the throat, vagina,
Stratified Squamous Protects underlying cells
mouth (soft)
lines ducts of the mammary glands, sweat
Stratified Cuboidal Protection
glands, pancreas
male urethra and vas deferens, parts of the
Stratified Columnar Protection, secretion
Transitional (unstretched) Specialized to become distended urinary tract

Medical professionals often refer to sections of the body in terms of anatomical planes (flat surfaces). These planes
are imaginary lines vertical or horizontal drawn through an upright body. The terms are used to describe a specific
body part.

Listed below are general anatomical terms and their meanings.

Anatomical Planes
Coronal Plane or Frontal Plane
Sagittal Plane or Lateral Plane
Axial Plane or Transverse Plane

Anatomical Terms Direction

Medial Toward the midline of the body
Lateral Away from the midline of the body
Proximal Toward a reference point (extremity)
Distal Away from a reference point (extremity)
Inferior Lower or below
Superior Upper or above
Cephalad or Cranial Head
Caudal or Caudad Tail, tail end
Anterior Toward the front
Posterior Toward the back
Dorsal Posterior
Ventral Anterior
Synovial joints allow the body a tremendous range of movements. Each movement at a synovial joint results from the
contraction or relaxation of the muscles that are attached to the bones on either side of the articulation. The type of
movement that can be produced at a synovial joint is determined by its structural type. While the ball-and-socket
joint gives the greatest range of movement at an individual joint, in other regions of the body, several joints may work
together to produce a particular movement. Overall, each type of synovial joint is necessary to provide the body with
its great flexibility and mobility. There are many types of movement that can occur at synovial joints (Table 1).
Movement types are generally paired, with one being the opposite of the other. Body movements are always described
in relation to the anatomical position of the body: upright stance, with upper limbs to the side of body and palms
facing forward. Refer
Figure 1. Movements of the Body, Part 1. Synovial joints give the body many ways in which to move. (a)(b) Flexion
and extension motions are in the sagittal (anteriorposterior) plane of motion. These movements take place at the
shoulder, hip, elbow, knee, wrist, metacarpophalangeal, metatarsophalangeal, and interphalangeal joints. (c)(d)
Anterior bending of the head or vertebral column is flexion, while any posterior-going movement is extension. (e)
Abduction and adduction are motions of the limbs, hand, fingers, or toes in the coronal (mediallateral) plane of
movement. Moving the limb or hand laterally away from the body, or spreading the fingers or toes, is abduction.
Adduction brings the limb or hand toward or across the midline of the body, or brings the fingers or toes together.
Circumduction is the movement of the limb, hand, or fingers in a circular pattern, using the sequential combination of
flexion, adduction, extension, and abduction motions. Adduction/abduction and circumduction take place at the
shoulder, hip, wrist, metacarpophalangeal, and metatarsophalangeal joints. (f) Turning of the head side to side or
twisting of the body is rotation. Medial and lateral rotation of the upper limb at the shoulder or lower limb at the hip
involves turning the anterior surface of the limb toward the midline of the body (medial or internal rotation) or away
from the midline (lateral or external rotation).

Figure 2. Movements of the Body, Part 2. (g) Supination of the forearm turns the hand to the palm forward position in
which the radius and ulna are parallel, while forearm pronation turns the hand to the palm backward position in
which the radius crosses over the ulna to form an X. (h) Dorsiflexion of the foot at the ankle joint moves the top of
the foot toward the leg, while plantar flexion lifts the heel and points the toes. (i) Eversion of the foot moves the
bottom (sole) of the foot away from the midline of the body, while foot inversion faces the sole toward the midline. (j)
Protraction of the mandible pushes the chin forward, and retraction pulls the chin back. (k) Depression of the
mandible opens the mouth, while elevation closes it. (l) Opposition of the thumb brings the tip of the thumb into
contact with the tip of the fingers of the same hand and reposition brings the thumb back next to the index finger.

Flexion and Extension

Flexion and extension are movements that take place within the sagittal plane and involve anterior or posterior movements of the
body or limbs. For the vertebral column, flexion (anterior flexion) is an anterior (forward) bending of the neck or body, while
extension involves a posterior-directed motion, such as straightening from a flexed position or bending backward. Lateral
flexion is the bending of the neck or body toward the right or left side. These movements of the vertebral column involve both
the symphysis joint formed by each intervertebral disc, as well as the plane type of synovial joint formed between the inferior
articular processes of one vertebra and the superior articular processes of the next lower vertebra.
In the limbs, flexion decreases the angle between the bones (bending of the joint), while extension increases the angle and
straightens the joint. For the upper limb, all anterior-going motions are flexion and all posterior-going motions are extension.
These include anterior-posterior movements of the arm at the shoulder, the forearm at the elbow, the hand at the wrist, and the
fingers at the metacarpophalangeal and interphalangeal joints. For the thumb, extension moves the thumb away from the palm of
the hand, within the same plane as the palm, while flexion brings the thumb back against the index finger or into the palm. These
motions take place at the first carpometacarpal joint. In the lower limb, bringing the thigh forward and upward is flexion at the
hip joint, while any posterior-going motion of the thigh is extension. Note that extension of the thigh beyond the anatomical
(standing) position is greatly limited by the ligaments that support the hip joint. Knee flexion is the bending of the knee to bring
the foot toward the posterior thigh, and extension is the straightening of the knee. Flexion and extension movements are seen at
the hinge, condyloid, saddle, and ball-and-socket joints of the limbs (see Figure 1a-d).
Hyperextension is the abnormal or excessive extension of a joint beyond its normal range of motion, thus resulting in injury.
Similarly, hyperflexion is excessive flexion at a joint. Hyperextension injuries are common at hinge joints such as the knee or
elbow. In cases of whiplash in which the head is suddenly moved backward and then forward, a patient may experience both
hyperextension and hyperflexion of the cervical region.

Abduction and Adduction

Abduction and adduction motions occur within the coronal plane and involve medial-lateral motions of the limbs, fingers, toes,
or thumb. Abduction moves the limb laterally away from the midline of the body, while adduction is the opposing movement that
brings the limb toward the body or across the midline. For example, abduction is raising the arm at the shoulder joint, moving it
laterally away from the body, while adduction brings the arm down to the side of the body. Similarly, abduction and adduction at
the wrist moves the hand away from or toward the midline of the body. Spreading the fingers or toes apart is also abduction,
while bringing the fingers or toes together is adduction. For the thumb, abduction is the anterior movement that brings the thumb
to a 90 perpendicular position, pointing straight out from the palm. Adduction moves the thumb back to the anatomical position,
next to the index finger. Abduction and adduction movements are seen at condyloid, saddle, and ball-and-socket joints
(see Figure 1e).


Circumduction is the movement of a body region in a circular manner, in which one end of the body region being moved stays
relatively stationary while the other end describes a circle. It involves the sequential combination of flexion, adduction,
extension, and abduction at a joint. This type of motion is found at biaxial condyloid and saddle joints, and at multiaxial ball-and-
sockets joints (see Figure 1e).


Rotation can occur within the vertebral column, at a pivot joint, or at a ball-and-socket joint. Rotation of the neck or body is the
twisting movement produced by the summation of the small rotational movements available between adjacent vertebrae. At a
pivot joint, one bone rotates in relation to another bone. This is a uniaxial joint, and thus rotation is the only motion allowed at a
pivot joint. For example, at the atlantoaxial joint, the first cervical (C1) vertebra (atlas) rotates around the dens, the upward
projection from the second cervical (C2) vertebra (axis). This allows the head to rotate from side to side as when shaking the
head no. The proximal radioulnar joint is a pivot joint formed by the head of the radius and its articulation with the ulna. This
joint allows for the radius to rotate along its length during pronation and supination movements of the forearm.
Rotation can also occur at the ball-and-socket joints of the shoulder and hip. Here, the humerus and femur rotate around their
long axis, which moves the anterior surface of the arm or thigh either toward or away from the midline of the body. Movement
that brings the anterior surface of the limb toward the midline of the body is called medial (internal) rotation. Conversely,
rotation of the limb so that the anterior surface moves away from the midline is lateral (external) rotation (see Figure 1f). Be
sure to distinguish medial and lateral rotation, which can only occur at the multiaxial shoulder and hip joints, from
circumduction, which can occur at either biaxial or multiaxial joints.

Supination and Pronation

Supination and pronation are movements of the forearm. In the anatomical position, the upper limb is held next to the body with
the palm facing forward. This is the supinated position of the forearm. In this position, the radius and ulna are parallel to each
other. When the palm of the hand faces backward, the forearm is in the pronated position, and the radius and ulna form an X-
Supination and pronation are the movements of the forearm that go between these two positions. Pronation is the motion that
moves the forearm from the supinated (anatomical) position to the pronated (palm backward) position. This motion is produced
by rotation of the radius at the proximal radioulnar joint, accompanied by movement of the radius at the distal radioulnar joint.
The proximal radioulnar joint is a pivot joint that allows for rotation of the head of the radius. Because of the slight curvature of
the shaft of the radius, this rotation causes the distal end of the radius to cross over the distal ulna at the distal radioulnar joint.
This crossing over brings the radius and ulna into an X-shape position. Supination is the opposite motion, in which rotation of
the radius returns the bones to their parallel positions and moves the palm to the anterior facing (supinated) position. It helps to
remember that supination is the motion you use when scooping up soup with a spoon (see Figure 2g).
Dorsiflexion and Plantar Flexion

Dorsiflexion and plantar flexion are movements at the ankle joint, which is a hinge joint. Lifting the front of the foot, so that the
top of the foot moves toward the anterior leg is dorsiflexion, while lifting the heel of the foot from the ground or pointing the toes
downward is plantar flexion. These are the only movements available at the ankle joint (see Figure 2h).

Inversion and Eversion

Inversion and eversion are complex movements that involve the multiple plane joints among the tarsal bones of the posterior foot
(intertarsal joints) and thus are not motions that take place at the ankle joint. Inversion is the turning of the foot to angle the
bottom of the foot toward the midline, while eversion turns the bottom of the foot away from the midline. The foot has a greater
range of inversion than eversion motion. These are important motions that help to stabilize the foot when walking or running on
an uneven surface and aid in the quick side-to-side changes in direction used during active sports such as basketball, racquetball,
or soccer (see Figure 2i).

Protraction and Retraction

Protraction and retraction are anterior-posterior movements of the scapula or mandible. Protraction of the scapula occurs when
the shoulder is moved forward, as when pushing against something or throwing a ball. Retraction is the opposite motion, with the
scapula being pulled posteriorly and medially, toward the vertebral column. For the mandible, protraction occurs when the lower
jaw is pushed forward, to stick out the chin, while retraction pulls the lower jaw backward. (See Figure 2j.)

Depression and Elevation

Depression and elevation are downward and upward movements of the scapula or mandible. The upward movement of the
scapula and shoulder is elevation, while a downward movement is depression. These movements are used to shrug your
shoulders. Similarly, elevation of the mandible is the upward movement of the lower jaw used to close the mouth or bite on
something, and depression is the downward movement that produces opening of the mouth (see Figure 2k).


Excursion is the side to side movement of the mandible. Lateral excursion moves the mandible away from the midline, toward
either the right or left side. Medial excursion returns the mandible to its resting position at the midline.

Superior Rotation and Inferior Rotation

Superior and inferior rotation are movements of the scapula and are defined by the direction of movement of the glenoid cavity.
These motions involve rotation of the scapula around a point inferior to the scapular spine and are produced by combinations of
muscles acting on the scapula. During superior rotation, the glenoid cavity moves upward as the medial end of the scapular
spine moves downward. This is a very important motion that contributes to upper limb abduction. Without superior rotation of
the scapula, the greater tubercle of the humerus would hit the acromion of the scapula, thus preventing any abduction of the arm
above shoulder height. Superior rotation of the scapula is thus required for full abduction of the upper limb. Superior rotation is
also used without arm abduction when carrying a heavy load with your hand or on your shoulder. You can feel this rotation when
you pick up a load, such as a heavy book bag and carry it on only one shoulder. To increase its weight-bearing support for the
bag, the shoulder lifts as the scapula superiorly rotates. Inferior rotation occurs during limb adduction and involves the
downward motion of the glenoid cavity with upward movement of the medial end of the scapular spine.

Opposition and Reposition

Opposition is the thumb movement that brings the tip of the thumb in contact with the tip of a finger. This movement is
produced at the first carpometacarpal joint, which is a saddle joint formed between the trapezium carpal bone and the first
metacarpal bone. Thumb opposition is produced by a combination of flexion and abduction of the thumb at this joint. Returning
the thumb to its anatomical position next to the index finger is called reposition (see Figure 2l).

Movements of the Joints (Table 1)

Type of
Joint Movement Example

Atlantoaxial joint (C1C2 vertebrae

Pivot Uniaxial joint; allows rotational movement
articulation); proximal radioulnar joint

Knee; elbow; ankle; interphalangeal joints of

Hinge Uniaxial joint; allows flexion/extension movements
fingers and toes

Biaxial joint; allows flexion/extension, Metacarpophalangeal (knuckle) joints of fingers;

Condyloid abduction/adduction, and circumduction radiocarpal joint of wrist; metatarsophalangeal
movements joints for toes

Biaxial joint; allows flexion/extension,

First carpometacarpal joint of the thumb;
Saddle abduction/adduction, and circumduction
sternoclavicular joint

Multiaxial joint; allows inversion and eversion of

Intertarsal joints of foot; superior-inferior
Plane foot, or flexion, extension, and lateral flexion of the
articular process articulations between vertebrae
vertebral column

Multiaxial joint; allows flexion/extension,

abduction/adduction, circumduction, and Shoulder and hip joints
medial/lateral rotation movements
movement in the coronal plane that moves a limb laterally away from the body; spreading of the fingers
movement in the coronal plane that moves a limb medially toward or across the midline of the body; bringing fingers
circular motion of the arm, thigh, hand, thumb, or finger that is produced by the sequential combination of flexion,
abduction, extension, and adduction
downward (inferior) motion of the scapula or mandible
movement at the ankle that brings the top of the foot toward the anterior leg
upward (superior) motion of the scapula or mandible
foot movement involving the intertarsal joints of the foot in which the bottom of the foot is turned laterally, away from
the midline
movement in the sagittal plane that increases the angle of a joint (straightens the joint); motion involving posterior
bending of the vertebral column or returning to the upright position from a flexed position
movement in the sagittal plane that decreases the angle of a joint (bends the joint); motion involving anterior bending
of the vertebral column
excessive extension of joint, beyond the normal range of movement
excessive flexion of joint, beyond the normal range of movement
inferior rotation
movement of the scapula during upper limb adduction in which the glenoid cavity of the scapula moves in a downward
direction as the medial end of the scapular spine moves in an upward direction
foot movement involving the intertarsal joints of the foot in which the bottom of the foot is turned toward the midline
lateral excursion
side-to-side movement of the mandible away from the midline, toward either the right or left side
lateral flexion
bending of the neck or body toward the right or left side
lateral (external) rotation
movement of the arm at the shoulder joint or the thigh at the hip joint that moves the anterior surface of the limb away
from the midline of the body
medial excursion
side-to-side movement that returns the mandible to the midline
medial (internal) rotation
movement of the arm at the shoulder joint or the thigh at the hip joint that brings the anterior surface of the limb
toward the midline of the body
thumb movement that brings the tip of the thumb in contact with the tip of a finger
plantar flexion
foot movement at the ankle in which the heel is lifted off of the ground
pronated position
forearm position in which the palm faces backward
forearm motion that moves the palm of the hand from the palm forward to the palm backward position
anterior motion of the scapula or mandible
movement of the thumb from opposition back to the anatomical position (next to index finger)
posterior motion of the scapula or mandible
movement of a bone around a central axis (atlantoaxial joint) or around its long axis (proximal radioulnar joint;
shoulder or hip joint); twisting of the vertebral column resulting from the summation of small motions between
adjacent vertebrae
superior rotation
movement of the scapula during upper limb abduction in which the glenoid cavity of the scapula moves in an upward
direction as the medial end of the scapular spine moves in a downward direction
supinated position
forearm position in which the palm faces anteriorly (anatomical position)
forearm motion that moves the palm of the hand from the palm backward to the palm forward position