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Dr. Adelia Matanguhan || 08/04/2017


OUTLINE Other Case Studies:

I. Case C. Composition
II. Approaches to D. Bone Classifications A first year medical student enjoyed running for exercise and relief
Studying Anatomy E. Bone markings of tension. Near the end of a particularly long and strenuous run,
A. Regional Anatomy VII. Joints she suddenly developed a severe pain on the bottom of her foot.
B. Surface Anatomy A. Classification of She immediately stopped running and sat down to rest; the pain
C. Systemic Anatomy joints subsided somewhat, but persisted. Although she rested from
D. Clinical Anatomy B. Major types of running for several days, the pain did not go away and was
III. Anatomical Position synovial joints particularly apparent if she stood for long periods in the gross
IV. Anatomical Planes VIII. Muscular System anatomy lab. In frustration, she finally went to a Sports Medicine
A. Median Plane A. General anatomy of Clinic to seek relief. Clinical evaluation and radiological tests
B. Sagittal Plane muscles revealed no fracture or other bone or joint deformities.
C. Frontal Plane B. Types of muscles Neurological tests revealed no nerve involvement other than the
D. Horizontal Plane C. Shapes of skeletal pain, which appeared to be related entirely to the soft tissues on
V. Anatomical Terms muscles the bottom of her foot.
A. Location D. Functions of skeletal
B. Laterality muscles What are some possible diagnoses?
C. Position E. Intrinsic and extrinsic 1. One initial diagnosis might be a stress fracture of one of
D. Movement muscles the metatarsals.
VI. Skeletal System 2. Pain therefore appears to be related to the soft tissues
A. Function (muscles, ligaments, etc.) which is a common foot injury
B. Functional Parts in runners.


Regional Anatomy
At the end of the lecture, the student should be able to: • Human body divided segments: head, neck, trunk, upper limbs,
1. Enumerate and describe the functional parts of the and lower limbs.
skeletal system Surface Anatomy
2. Classify bones and give examples. • Layers of skin, subcutaneous tissue and deep fascia.
3. Enumerate bony markings and give examples. Systemic Anatomy
4. Describe the anatomical position. • Studies interaction of different organs.
5. Define anatomical planes in terms of relationship, Clinical Anatomy
laterality and movement. • Integration of systemic, regional, and clinical application
6. Classify joints and give examples of each.
7. Classify synovial joints and give examples of each.
8. Enumerate and describe the types of muscles.
9. Classify muscles based on shape and give examples
10. Describe the coordinated action of muscle group.


At the ER, the clinical clerk on duty is tasked to report his physical
examination findings on a 70 y/o male patient who came in with
lacerated wound on the arm associated pain on movement after a
motorcycle accident.

Structure Involved Movements Affected

Elbow Joint (Humeroradial • Movement affected may

Joint, Humeroulnar joint, vary depending on the
Figure 1. Anatomical Position
Proximal Radioulnar joint and activity.
• The anatomical position is the common visual reference
Annular Ligament) • The humeroulnar and
humeroradial joints are
 Subject stands erect facing with face (head level) and
responsible for flexion
eyes forward.
and extension.
 Feet flat on the floor parallel and slightly separated facing
• The proximal radioulnar
joint and the annular
ligament allow for  Arms hanging relaxed at the sides with palms facing
pronation and forward so the radius and ulna are parallel to each other
supination with rotation
of the head of the radius.

Trans 1 Group #3 : Agawin, Aguas, Aguilar, Aguilera, Al-Fawaz 1 of

between the skin
IV. ANATOMICAL PLANES and the humerus
Deep Away from the surface of the The humerus is
body deep to the arm

Superior Towards the head or nearer The heart is superior

/Cranial the vertex, the topmost point to the stomach
of the cranium
Inferior Towards the coccyx or nearer The stomach is
/Caudal to the sole of the foot inferior to the heart
Proximal Nearer to the trunk or point of The elbow is
origin proximal to the wrist
Distal Farther from the trunk or point The wrist is distal to
of origin the elbow
Medial Towards or nearer to the The 5th digit (little
median plane finger) is on the
medial side of the
Lateral Farther away from the median The 1st digit (thumb)
plane is on the lateral side
of the hand
Internal Nearer to the center of an The brain is internal
organ/cavity to the skull
External Farther from the center of an The ribs are external
Figure 2. Anatomical Planes organ/cavity to the lungs

Midsagittal/Median Plane Table 2. Terms of Laterality

• A vertical plane dividing the body into equal right and left Term Definition Example
halves (Snell, 2012) Bilateral Paired structures having Kidneys, lungs,
• In the hand and foot, the median plane is marked by the 3rd right and left members legs, arms, eyes
digit Unilateral On one side of the body Spleen, stomach
Sagittal Plane only
• Vertical plane parallel to the median plane, also divides Ipsilateral Occuring on the same Right arm and leg
the body into equal right and left portions side of the body relative to
• Flexion and extension movements usually occur in this another structure
plane. Contralateral Occuring on the opposite Right arm and left
• Axis of movement: Coronal or frontal side of the body relative to leg
another structure
Frontal or Coronal Plane
• Vertical planes at a right angle to the median plane
• Divides the body into anterior (front) and posterior (back)
• Abduction and adduction usually occur in this plane
• Axis of movement: Sagittal
Transverse or Horizontal Plane
• Planes at a right angle to both the median and coronal
planes. (Snell, 2012)
• Rotational movements usually occur in this plane
• Divides the upper and lower limb
• Axis of movement: Vertical
Figure 4. Terms of Laterality
• Are made up of: • Movement of body parts is defined:
 Roots (e.g. part of the body, condition)  In relationship to anatomical position
 Prefixes and/or Suffixes (which describe the root e.g.  Is along/aligned with planes
shape, size, location, function, etc.)  Around axes
• Terms in itself provide information about the structure:  Terms in pairs of opposing movements
e.g. The deltoid muscle, like the symbol for delta, the fourth
letter of the Greek alphabet. The suffix -oid means “like” therefore, Table 3. Ordinary Movements
deltoid means “like delta”. Plane and Term Description Example
Table 1. Terms of Location and Position (1) Along Flexion Decrease joint *see below
Term Definition Example
sagittal angle
Anterior Towards or nearer to the front The toes are anterior
/Ventral surface of the body to the ankle
plane Extension Increase joint
Posterior Towards or nearer to the back The heel is posterior (2) Around angle
/Dorsal surface of the body to the toes transvers
Superficial Towards the surface or nearer The muscles of the e axis
to the outer surface of the arm are superficial
body to its bone

Intermediate Between a superficial and The biceps muscle

deep structure is intermediate

ANATOMY Anatomy of Motion 2 of 10

forearm and
hand so that
the palm of the
hand faces
anteriorly (i.e.
moving into
n of digits

(1) Along Abduction Movement

frontal away from the
plane midline
Abduction of Spreading
(2) Around Adduction Movement
digits digits
AP axis toward the
t of digits away
Around Medial/ Brings the
from neutral
longitudinal internal anterior
position of the
axis rotation surface of a
3rd finger and
2nd toe
Adduction of Movement of
the median
digits digits
Lateral Brings the
to the neutral
/external anterior
position of the
rotation surface away
3rd finger or 2nd
from the
median plane
Around and Circumduc Combination of
along above tion flexion, • "SOUPination": Supination is to turn your arm palm up, as if you
mentioned abductions, are holding a bowl of soup.
actions extension, • "POUR-nation": Pronation is to turn your arm with the palm
adduction down, as if you are pouring out whatever is your bowl.

Table 6. Thumb movements and examples.

Table 4. Special Movements of the foot Term Description Example
Term Description Example Flexion/Extension Movements in
Flexion at the the frontal
Dorsiflexion ankle joint, heel plane from
on the ground and anatomical
toes lifted off the position
Plantar Bends foot and
Flexion toes towards the
ground Opposition Movement of
Eversion Moves the sole of 1st digit
the foot away from (thumb) to
the median plane another digit
as in pinching

Inversion Moves the sole of Reposition Thumb moves

the foot towards back to
the median plane anatomical

Table 5. Hand and Arm movements and examples.

Table 7. Other movements and examples.
Term Description Example
Term Description example
Pronation Rotational
Lateral Bending of the neck
movement of
Flexion and trunk to the left
the forearm and
and right
hand medially
so that the palm
of the hand
Supination Rotational
movement of

ANATOMY Anatomy of Motion 3 of 10

Elevation Raises or moves a
part superiorly (e.g.
shrugging, opening
of eyes)

Depression Lowers or moves a

part inferiorly (e.g.
slouching, closing
the eyes)

Retrusion Movement
(e.g. retruding the
mandible, lips, or
Protrusion Movement Figure 5. Axial (brown) and Appendicular (blue) Skeleton
(e.g. protruding the COMPOSITION
chin, lips, or tongue) • Cartilage
Protraction Anterior movement  Semi rigid, resilient, avascular
of the shoulder (e.g.  Connective tissue that forms part of the skeleton where more
moving to hug flexibility is required
someone, pushing
 Blood vessels do not enter cartilage; instead, its cells obtain
off the ground)
oxygen by diffusion
• Bone
Retraction Posterior movement  Supporting tissue of the body
of the shoulder (e.g.  Highly specialized living tissue
moving to elbow  Serves as clinical landmarks
someone from
• Body (Diaphysis)
• 2 terminal ends (Epiphysis)
• The total number of bones in a typical adult is 206.
 At birth, the total number of bones is close to 300 but will
later be reduced to 206 due to fusion of bones during growth.

Wormian bones, a.k.a. intrasutural bones, are small bones

that are often found within the sutures and fontanelles of the

• Provides the basic shape for the body
• Protect the vital organs such as the heart, lungs, and pelvic Figure 7. Parts of a Long Bone


Axial Skeleton (Central Supporting Axis)

• Total number of bones: 80
• Head: cranium (8), facial bone (14), auditory ossicles (6)
• Neck: hyoid bone (1)
• Trunk: ribs (24), sternum (1), vertebrae (24), sacrum (1)
and coccyx (1)
Appendicular Skeleton (Bones of Extremeties)
• Total number of bones: 126
• It consists of the bones of limbs including those forming the
pectoral and pelvic girdles

ANATOMY Anatomy of Motion 4 of 10

Sesamoid • Small nodules of bone pisiform, patella
BONE CLASSIFICATIONS Bones that are found in certain (the largest
tendons where they rub sesamoid bone
over bony surfaces. in the body.)
• Functions to reduce
friction on the tendon; it
can also alter the direction
of pull of a tendon

• Location of the bands of fascia, ligaments, tendons, or
• Arteries lie adjacent to them.
• Every bump, groove, and hole contains the name of the

Table 10. Extensions and Projections of Bones

(Projections that are the site of bones and ligaments)
Term Description Classification
Iliac crest of pelvis

A narrow ridge
Figure 8. Bone Classifications Crest
of the bone
Table 8. Based on solid matter and size of space
Compact Spongy Medial epicondyle of
• Tightly packed and • Consists of a branching network femur
appears as a solid of trabeculae which are arranged
mass in such a manner as to resist
• Strength for weight stresses and strains to which the A projection
bone is exposed (Snell, 2012) Epicondyle superior to a
e.g. Shafts of long • Usually short bones, e.g. carpals
bones and tarsals

Nuchal lines of skull

A slightly raised,
elongated ridge

Mastoid Process
Figure 9. Compact bone vs spongy bone
Any bone
Table 9. Based on Shape
Class Description Examples
Long • Usually found in the limb. Humerus,
Bones • Their length > breadth. femur, Mental Protuberance of
metacarpals, chin
A bony
Protuberance outgrowth or
protruding part
Short • Usually found in the hand Carpals and
Bones and foot. tarsals
• Cuboidal in shape. Spine of scapula
• Length < width A sharp, slender,
Flat • Found in the vault of the Frontal bone, Spine or narrow
Bones skull. parietal bone, process
2 layers; • Usually serve protective scapulae,
diploe in functions. Composed of sternum, ribs
between Greater and lesser
thin inner and outer layers
trochanter of the femur
of compact bone (tables)
with a layer of cancellous
bone at the middle (diploe) Trochanter A blunt elevation
Irregular • Various shapes including Vertebrae,
Bones those not assigned to the ossicles, facial
previous groups. bones, the
pelvic bones

ANATOMY Anatomy of Motion 5 of 10

Greater Tubercle of
A small, rounded

Tibial Tuberosity Intertubercular sulcus

of humerus

A groove for a tendon,

Tuberosity A rough surface nerve or blood vessel

Table 13. Bone Passages

Table 11. Surface Features of Bones (Markings) (Passage for blood flow and other bodily fluids)
(Projections that help to form joints) Term Description Example
Term Description Example Condylar canal of the skull
Occipital condyles of
the skull
A tubular passage or
Rounded knob that Canal
tunnel in a bone
Condyle articulates with another

Orbital fissure of eye

Articular facets of

Fissure A slit through a bone

Smooth, flat, slightly

Facet concave or convex
articular surface
Foramen magnum

A hole through a
bone, usually round
Head of the femur

Prominent expanded end

of a bone, sometimes Acoustic meatus of ear

Meatus An opening into a

Soleal line of tibia canal

Ramus Arm-like bar of bone

• Also known as articulations
Table 12. Bone Depressions • unions or junctions between two or more bones or rigid
(Depressions and Openings around blood vessels and nerves) parts of the skeleton
Term Description Example
Alveolus A pit or socket Tooth socket CLASSIFICATION OF JOINTS
Mandibular Fossa
Table 14. Classification of joints based on function
A shallow, broad, or Joint Description Example
elongated basin Synarthrosis Immovable joints Cranium
Amphiarthrosis Slightly movable Vertebral column

Fovea A small pit Fovea Capitis of femur

ANATOMY Anatomy of Motion 6 of 10
Diarthrosis Freely movable Joints in the Hinge -Uniaxial; Elbow Joint
joints upper and lower permit flexion-
limbs extension only

• Synovial Joints
 united by a joint capsule spanning and enclosing an articular
 separated by joint cavity filled with synovial fluid Saddle -Biaxial; Carpometacarpal
 permits a great degree freedom of movement permit flexion- joint at the base of
 Synovial Fluid extension and the 1st digit (thumb)
▪ viscous, slippery texture – “raw egg white” abduction-
▪ rich in albumin and hyaluronic acid adduction
▪ Functions: -
 nourishes articular cartilages Circumduction
 remove their wastes is also
 serves as lubricant for joint surfaces possible

Condyloid -Biaxial; Metacarpophalangeal

permit flexion- joints (knuckle joints)
extension and
is limited

Ball and Socket -Multiaxial: Hip joint

permit flexion-
medial and
Figure 10. Parts of a synovial joint. rotation, and
highly mobile
Pivot -Uniaxial; Median atlantoaxial
Table 15. Parts of a Synovial Joint Permit joint
Term Description rotation
Fibrous outer layer and lined internally by around a
Joint Capsule central axis
serous synovial membrane
Potential space containing synovial fluid from -Rounded
Joint Cavity process of
synovial membrane
Articular bone rotates
Cartilages within a
▪ fibrocartilaginous articular disc sleeve or ring
▪ absorbs shock and pressure Gliding -Very limited
▪ guides bones across each other movement
▪ lessens chances of dislocation
▪ distributes the force across the entire joint

Accessory ▪ Tendon, Ligament, Bursa, Tendon Sheaths


Table 16. Types of Synovial Joints • Fibrous Joints

Synovial Joint Description Example  united by fibrous tissue
Plane -Permit gliding Acromioclavicular  movement depends on the length of the fibers uniting the
and sliding in joint articulating bones
the plane of  permits very little movement
the articular

ANATOMY Anatomy of Motion 7 of 10

Table 17. Types of Fibrous Joints  Joints have rich nerve supply
Fibrous Joint Description Example ▪ fibrous capsule and ligament have abundant sensory
Syndesmosis -Unites the bones with a Distal articulation of nerves
sheet of fibrous tissue tibia and fibula ▪ stretch receptors – joint position sense
(ligament or fibrous ▪ few nerves at articular cartilage
1.Decreased collagen production VS mineral content – more
brittle bone
2. Decreased bone mass – fracture
3. Ligaments and tendons shorten and become less flexible –
decrease in range of motion
Gomphoses -Fit into a socket Articulations of teeth 4. Articular cartilages of joints can wear down and decline in
articulation between the in jaw bones production of the lubricating synovial fluid – Arthritis
rooth of the tooth and the
alveolar process of the VIII. MUSCULAR SYSTEM
- attachment site
Sutures -Bones are close either Sutures between the
- does not move during contraction
interlocking in a wavy skull bones
- less movement, proximal
line or overlapping
- usually a bone
- moves during contraction
- more movement, distal
- part where you cut in dissection
- attachments of muscle to bone
• Cartilaginous Joints - flat sheets formed by tendons of some muscles
 United by hyaline cartilage or fibrocartilage
 Freely movable
 Can be:
▪ Primary
o synchondroses
o united by a plate or a bar of hyaline catilage
o temporary unions
o union between the epiphysis and the diaphysis of a
growing bone
o found in epiphyseal plates in long bones
o no movement
• Secondary
o symphyses
o strong, slightly movable joints united by fibrocartilage
o found between the vertebrae (intervertebral discs)
and pubic symphysis of the pelvic girdle
Figure 12. Origin, Insertion, and belly of the gastrocnemius
o provide strength and shock absorption
o small amount of movement


1. Prime mover (Agonist)
- chief muscle
- muscle with major responsibility for certain movement
- contracts concentrically to produce the desired movement
2. Synergist
- muscle that aids and complements the action of the prime
- helps prevent rotation
- contracts and stabilizes the intermediate joints
3. Antagonist
- muscle that opposes or reverses a prime mover
- contracts eccentrically
- before a prime mover can contract, the antagonist muscle
must be equally relaxed
Figure 11. Cartilaginous joints 4. Fixator
- stabilizes the origin of the prime mover
BLOOD AND NERVE SUPPLY OF JOINTS - contracts isometrically
 Numerous articular branches from arteries and anastomosis
in synovial layer form a fine network of blood vessels

ANATOMY Anatomy of Motion 8 of 10

*Example: for elbow flexion NERVE SUPPLY OF SKELETAL MUSCLE
Prime mover: Brachialis  Nerve trunk to a muscle is a mixed nerve
Synergist: Biceps brachii ▪ 60% motor
Antagonist: Triceps brachii ▪ 40% sensory
Fixators: Shoulder and scapular stabilizers ▪ Some sympathetic autonomic fibers
 Motor Point
Table 18. Types of Synovial Joints  Place of entrance of nerve (midpoint on its deep surface, often
Muscle Description Example near the margin)
Flat -parallel fibers often with External oblique,
aponeurosis Sartorius
Pennate -feather-like in the a. Extensor digitorum 1. Decreased muscle mass (sarcopenia) – slower pace
arrangement of their longus 2. Increased fibrous connective tissue – body weakness
fascicles b. Rectus femoris 3. Decreased elasticity – less flexible
a. Unipennate c. Deltoid
b. Bipennate
c. Multipennate
Fusiform -Spindle-shaped with a Biceps brachii
round thick belly and
tapered ends
Convergent -form a broad area Pectoralis Major
-converge to form a
single tendon
Quadrate -four equal sides Rectus abdominis
Circular or -surrounds a body Orbicularis oculi
Sphincteral opening or orifice and
constricting it when
Multi-headed -more than one head or Biceps and triceps
or Multi- attachment or more than (three heads),
bellied one contractile belly Digastric and
Gastrocnemius (two

Figure 14. Architecture and shape of skeletal muscles. The

architecture and shape of a skeletal muscle depend on the
arrangement of its fibers.


1. Complete each statement using the everyday term for

the body part.
a. The distal femoral (thigh) area is immediately
superior to the ____.
b. The proximal brachial (upper arm) area is
immediately inferior to the ____.
c. The patellar (kneecap) area is directly proximal to
the ____.
d. The volar (palmar) area is directly distal to the ____.
Figure 13. Different forms of the internal structure of skeletal
muscle. A relaxed and a contracted muscle are also shown; note 2. Complete each statement using the everyday term for
how the muscle fibers, on contraction, shorten by one third to one the body part.
half of their resting length. Note also how the muscle swells. a. The distal femoral (thigh) area is immediately
superior to the ____.
b. The proximal brachial (upper arm) area is
NAMING OF MUSCLES immediately inferior to the ____.
1. Direction of muscle fibers – e.g. Rectus abdominis c. The patellar (kneecap) area is directly proximal to
2. Relative size of the muscle – e.g. Pectoralis minor the ____.
3. Location of the muscle – e.g. Subscapularis d. The volar (palmar) area is directly distal to the ____.
4. Number of origins – e.g. Triceps brachii
5. Location of muscle’s origin and insertion – e.g.
Sternocleidomastoid or SCM
6. Shape of the muscle – e.g. Deltoid
7. Action of the muscle – e.g. Flexor digitorum profundus

ANATOMY Anatomy of Motion 9 of 10


1. 2020 A,B,C Transes

2. Matanguihan-Quijano, A. n.d. Anatomy of Motion [PowerPoint
Slides]. Department of Anatomy, UERMMMCI.
3. Moore, K. L., Dalley, A. F., & Agur, A. M. (n.d.). Clinically
oriented anatomy (7th ed.). Baltimore: Lippincott Williams &
4. Scanlon, V.C. and Sanders, T. Essentials of Anatomy and
5. Snell, R. S. (2012). Clinical anatomy by regions (9th ed.).
Philadelphia: Lippincott Williams & Wilkins.

ANATOMY Anatomy of Motion 10 of 10