THE BONES OF THE TRUNK

- The vertebrae

- Ribs

- Sternum

THE VERTEBRAE

- they are 33-34 in number

- they are rings placed one above another which form a single column called
vertebral or spinal column
- vertebral column has the following parts:
- cervical part noted C1 C7
- thoracic part noted T1 T12
- lumbar part noted L1 L5
- sacral part
- coccygeal part
- the first three parts form true vertebrae called in this way because they are
independent and mobile
- the last two parts form false vertebrae called in this way because the
vertebrae fused to form the sacrum bone and the coccyx bone

I. GENERAL CHARACTERISTICS OF VERTEBRAE

- the vertebra presents a body

- an arch
- processes
- the body is situated anterior
- it has - an upper surface

- a lower surface

- in the posterior part, the body presents many nutrient foramina

which serve for the passage of vessels and nerves into the bone
substance

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 - the bodies of the vertebrae are joined by means of intervertebral
discs ( cartilages) so that it results a very flexible column

- the arch it forms the posterior and lateral boundaries of the vertebral
foramen; between the vertebral body and arch there is the pedicle of
vertebral arch ( one on the left side and one on the right side)

- processes are 7 in number

- one of them is unpaired it extends from the middle of the arch

and it goes backward; it is called spinous process
- the other processes are paired:
- articular processes which are 2 superior and 2 inferior, they
serve to the articulation with suprayacent and subyacent
vertebra ( suprayacent = proximally upper vertebra; subyacent
= proximally lower vertebra)
- transverse processes extend from the lateral surfaces of the
vertebral arch

!!! Between the body and the arch there is the vertebral foramen. The foramina
are placed one above another and form the vertebral canal.

!!! Between two neighbors vertebrae there is the intervertebral foramen for the
spinal nerves and vessels.

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II. PARTICULAR CHARACTERISTICS OF VERTEBRAE

1. CERVICAL VERTEBRAE
- they are 7 in number
- they are characterized by:
- small low bodies exception the first two vertebrae
- the spinous process is bifid
- the transverse processes are short and project laterally
- the upper surface of each process carries a deep groove for the spinal
nerve it separates an anterior tubercle from the posterior tubercle
the transverse process has foramen transversarium for vessels ( artery
and veins)
- the articular processes are short, extended obliquely

!!! exception C1, C2, C6, C7

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 !

C1 = ATLAS

- it has neither a body, but it is a ring formed by two arches ( anterior and
posterior) joined one to another by two more developed lateral masses; each
of these masses carries:
- an oval concave superior articular facet for articulation with
occipital bone
- an almost flat inferior articular facet for articulation with the second
cervical vertebra
- the anterior arch has an anterior tubercle on the anterior surface and a small
facet for odontoid process on the posterior surface which articulates with the
dens of axis
- the posterior arch has a posterior tubercle and a groove for the vertebral
artery

C2 = AXIS - it carries an odontoid process projected upward from the body

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C6 it has an anterior tubercle on the transverse processes called carotidian
tubercle or Chaissaignac tubercle

C7 vertebra prominens it has a long and nonbifid spinous process which is

easily palpated under the skin

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2. THORACIC VERTEBRAE

- They are 12 in number

- Their bodies are much higher and thicker than the cervical vertebrae; their
bodies gradually increase in size downward toward the lumbar vertebrae
- Posterior part of lateral surface of the body carries two facets:
- The upper costal facet
- The lower costal facet
- The lower facet of one vertebra joins the upper facet of the adyacent
distal vertebra to form a complete articular facet = the site of
articulation with the head of the rib (exception the first T1)
- The spinous processes are long, three-sided, pointed and slope downward.
Those of the middle thoracic vertebrae fit one over the other like tiles
- The transverse process extends laterally, and a little to the back and carries a
small costal facet for articulation with the tubercle of the rib.
- The articular processes are vertically in frontal plane.

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 !

3. LUMBAR VERTEBRAE

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 - They are 5 in number
- They are distinguished from other vertebrae by their large size
- The body is bean-shaped
- The vertebral foramen is larger than in thoracic part
- The arches are strongly developed
- The spinous process is short and wide, thickened and rounded at the end
- The transverse process is in front of the articular process; it is compressed
from front to back and projects laterally; its greater part is a rudiment of the
rib and is therefore called the costal process
- The articular processes arise from the arch, project to the back of the
transverse process almost vertically, in sagital plane

THE SACRUM

- The sacral vertebrae, 5 in number are fused to form a single bone =

SACRUM

- It is located below to the last lumbar vertebra and contributes to the

formation of the posterior wall of the pelvis

- It present an anterior surface

- a posterior surface

- 2 lateral borders

- a base

- an apex

- sacral canal runs through the bone from the base to the apex

ANTERIOR SURFACE
- it is smooth and concave

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 - it is called the pelvic surface
- it has 4 parallel transverse ridges which are the traces of fusion of the bodies
of the five sacral vertebrae
- laterally to these ridges on each side are 4 anterior sacral foramina for the
anterior branches of the sacral spinal nerves

!
DORSAL SURFACE
- it is convex longitudinally and rough
- it carries 5 bony tubercles descending one after another, which form crest
median. It is formed by fusion of the spinous processes of the sacral
vertebrae; laterally, on both sides there is an intermediate crest formed by the
articular processes of the sacral vertebrae; still laterally, on both sides there
is lateral crest formed by the transverse processes
- on each side between the articular and transverse tubercles there are 4 dorsal
sacral foramina

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 !

THE SACRAL CANAL

- It is a direct downward continuation of the spinal canal
- It communicates with the sacral foramina anteriorly and posteriorly via
intervertebral foramina

THE BASE OF THE SACRUM

- It carries a transverse oval depression for articulation with the inferior
surface of the body of the fifth lumbar vertebra
- Between the base of the sacrum and the last lumbar vertebra there is the
promontory ( it is an angle)
- Behind of this oval surface there is the entry into the sacral canal
- Laterally, there are 2 processes for articulation with L5

THE APEX
- It is narrow
- It has a small oval surface for articulation with coccyx
- Behind the apex there are the sacral cornua

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 - Between the apex and sacral cornua there is the sacral hiatus; it looks like
V but turned with the apex upward

LATERAL BORDERS
- In the upper part each of them presents a lateral surface = auricular surface
which articulates with the ilium (a part of coxal bone); back of this surface
there is sacral tuberosity

THE COCCYX

- The coccigeal vertebrae, 4-5 in number fuse to form the the coccyx
- It has a curved pyramid shape
- The base is articulated with the sacrum; it has coccigeal cornua (2 in
number) extending upward
- The apex has a small tubercle
- The anterior and posterior surfaces have 3-4 transverse ridges ( the fusion of
the bodies 4 or 5 )

VERTEBRAL COLUMN

- It has 73 cm at male and 63 cm at female

- It represents 40% from the body

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 !

EXTERNAL CONFIGURATION
- Vertebral column present: - an anterior surface
- a posterior surface
- 2 lateral surfaces
ANTERIOR SURFACE
- It is represented by the bodies of the vertebrae
POSTERIOR SURFACE
- It presents on the median line the spinous processes
- Laterally, on each side there are vertebral grooves for muscles
- Still laterally, there are articular processes
LATERAL SURFACE
- Transverse process
- Vertebral pedicle
- Intervertebral foramina which is formed by the juxtaposition of the vertebra
VERTEBRAL CANAL

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 - The vertebral foramina are placed one above another to form the vertebral
canal which lodges the spinal cord
- The vertebral canal follows the different curves of the column: it is large and
triangular in cervical and lumbar regions and it is small and rounded in the
thoracic region, where the motion is more limited.

THE CURVES OF VERTEBRAL COLUMN

1. IN SAGITAL PLANE
- Cervical curve it is convex forward
- Thoracic curve it is concave forward
- Lumbar curve it is convex forward
- Sacrococcigeal curve - it is concave forward
!!! newborns vertebral column is straight in antero-posterior direction. Later,
as the result of a number of factors, the curves form in it.
- Cervical curve appears in the first 3 months of life
- Thoracic curve appears at 6-7 months
- Lumbar curve appears in the first years of life

2. IN FRONTAL PLANE
- Cervical curve convex to the left
- Thoracic curve convex to the right
- Lumbar curve convex to the left

PATOLOGICAL CURVES

- Kyphosis it is an exaggerated posterior curvature of the thoracic region

- Lordosis it is an exaggerated anterior curvature of the lumbar region
- Scoliosis lateral curvature it is the most common abnormal curvature

THE FUNCTIONS OF VERTEBRAL COLUMN

- Protection of the spinal cord and spinal nerves
- Maintain the body (the trunk and the head)
- Locomotion
STERNUM

- It is a median, anterior and unpaired bone

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 - It is a long bone
- It presents: - manubrium
- Sternum body
- Xiphoidian process

CONFIGURATION
- It has an anterior surface
- A posterior surface
- 2 lateral borders
- A base
- An apex

ANTERIOR SURFACE
- It is convex forward
- Between manubrium and the sterna body there is Louis angle= it is a very
important to know about it because it serve to recognize the second rib
- It presents 3-4 transversal ridges which are the traces of fusion of some bone
pieces which are called sternebrae.
POSTERIOR SURFACE
- It is concave
- It has the same ridges (3-4 transversal ridges)

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LATERAL BORDERS
- On each side there are 7 costal incisura for articulation with the head of costal
cartilages

BASE
- It is represented by manubrium
- It has jugularis incisura it is median- can be palpated under the skin
- clavicular incisura it is situated laterally, on each side, for
articulation with clavicle

THE APEX
- It is represented by the xiphoidian process, which is a cartilage. This
cartilage become bone at old man.

THE RIBS

- They are bony arches which extend from the vertebral column to the
sternum
- They are 12 pairs of ribs and there are 2 groups of ribs:
- True ribs the first seven pairs of ribs; they are called like this
because the ribs are joined to the sternum
- False ribs the last five pairs of ribs; for all that, the ribs 8,9,10 are
joined with the cartilage of the seventh rib; the ribs 11 and 12 are lost
in the muscle plane
The rib presents:
- a bony part
- a costal cartilage
- 3 curvatures along of their faces lateral face is convex and medial face
is concave
- along of their borders the head of the rib is upper than the
end of the rib which is situated below
(the ribs are obliquely)
- along of their axle the head of the rib and the end of the rib
are in the same sagital plane

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CONFIGURATION

THE BONY PART OF THE RIB it presents:

- a head which is joined with the vertebrae
- a neck
- a tubercle - which is articulated with the transverse process of vertebra
- a body with 2 faces lateral, convex and medial, concave
!!!! on the inferior border of the rib there is a groove = costal groove for
vessels and nerves
- an anterior end which is united with costal cartilage

THE COSTAL CARTILAGE

- it continuous the costal bone
- The first 7 pairs are for the first 7 costal bones and they join the ribs with
sternum
- The next 3 pairs of cartilages are joined by the proximal adjacent cartilage
(number 7)
- The last 2 pairs are lost in muscular plane

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 CLAVICLE

- It is a long bone and paired

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- It is situated between the thorax and neck

- It is horizontally, between sternal manubrium and acromion

- It has 2 faces
- 2 borders
- 2 ends

Superior surface
- it is thin in the middle part and rough in lateral parts
- it can be palpated under the skin
- sternocleidomastoidian muscle is inserted here

Inferior surface
- It has a nutrient foramina
- It has a groove;
- medially there is costoclavicular ligament;
- laterally there is conoidian tubercle

Anterior border

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- it is concave in lateral part and convex in medial part

Posterior border
- it is concave-convex inverse than the anterior border

Medial end
- is named sternal end
- it is bigger and it has a sternal face for articulation with the sternum

Lateral end
- it is named acromial end
- it has an acromial face for articulation with the acromion of scapula

HUMERUS

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- it is a long tubular bone
- it has a body or shaft
- 2 ends upper and lower end

ORIENTATION
- head must be superior
- articular surface of the head is medially
- intertubercular groove - anteriorlly

THE BODY
- it is rounded superiorly and trihedral in the lower part; here, in this part it
has 3 surfaces and 3 borders
- posterior surface it has a spiral groove for radial nerve. This groove runs
downwards and laterally
- antero-lateral surface it carries the deltoid tuberosity for deltoid muscles
insertion
!!! above this tuberosity there is axillary nerve
Below this tuberosity there is radial nerve
- antero-medial surface it has a nutrient foramina and intertubercular
groove

THE UPPER END = PROXIMAL EPIPHYSIS

- It is thickened and carries a semispherical prominence = head of the
humerus whose surface is orientated medially, upward and slightly backward
- The head is separated from the rest of the bone by a shallow annular
constriction called the anatomical neck of the humerus
- This anatomical neck presents antero-laterally a prominence = the greater
tuberosity and medially and a little to the front there is the lesser tuberosity
- Between the greater and the lesser tuberosity there is intertubercular groove
or bicipital groove
- The junction of the upper end and the body is represented by a small
constriction called surgical neck

THE LOWER END = DISTAL EPIPHYSIS

- It is flattened in the antero-posterior direction
- It presents a condyle ( capitulum and trochlea) and two epicondyles

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- In its lateral part there is a rounded eminence called the capitulum of the
humerus (for articulation with the head of the radius)
- Next to this eminence there is trochlea of the humerus (for articulation with
ulna)
- Above the trochlea there is coronoid fossa
- Above the capitulum there is radial fossa
- Olecranon fossa is situated on the posterior surface of the lower end
- The lower end of the humerus has 2 epicondyles one lateral and one
medial; the medial epicondyle is more prominent and its posterior surface
carries the groove for ulnar nerve
- These epicondyles are easily palpated under the skin

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 RADIUS

- It is situated at the external side of the forearm

- Its upper end is small and forms the slight part of the elbow joint

- Its lower end is large and forms the chief part of the wrist

- It is a long bone, prismatic and a little curved

ORIENTATION

- The biggest end inferiorly

- The styloid process laterally

- The rough surface of this extremity posteriorly

- It has 3 surfaces

- 3 borders

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 !

THE BODY it has anterior, posterior and lateral surface

ANTERIOR SURFACE
- It is concave

- It has a nutrient foramina

- In its upper part there is the origin of the flexor longus policis muscle

- In its lower part there is the origin of the pronator quadrates muscle

POSTERIOR SURFACE
- It is rounded, convex, smooth and covered by the supinator muscle

- In its middle part it is inserted the extensor policis brevis

LATERAL SURFACE
- It is rounded and convex in the middle
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 - In its upper third it presents the supinator muscle
- In the lower part it is covered by tendons of the extensor metacarpal and
policis brevis

THE BORDERS
- Anterior border extends from the lower part of the tuberosity to the base
of the styloid process
- Posterior border it exist only in the middle part of the bone
- Medial border it inserts the interosseus membrane

THE UPPER END

- It presents a head
- A neck
- A tuberosity
- The head is articulated with the capitulum of the humerus
- The neck is situated between the head and the body
- The tuberosity inserts the biceps muscle

THE LOWER END

- It is large and presents 4 surfaces
- Anterior is rough and irregular
- Posterior is convex and it carries 3 grooves for muscles
- Lateral it has the styloidian process
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 - Medial it has a groove for articulation with the head of the ulna
- The base has 2 articular surfaces for articulation with the scaphoid bone
and lunate bone

ULNA

- It is a long bone
- It is situated in the inner side of the forearm, parallel to the smaller radius

ORIENTATION

- The biggest end superiorly

- The openin of this end anteriorly
- The thinnest border laterally

- It has a body
- 2 ends the lower end is smaller than the large upper end

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 !

THE BODY
- It is a little concave
- It has - 3 surfaces
- 3 borders

Anterior surface
it presents a nutrient foramina
- in its upper part it inserts the flexor profundus digitorum muscle
- in its lower part it inserts the pronator quadrates muscle

Posterior surface
- it is flat
- above it is concave and presents a ridge for insertion of anconeus muscle
- in the middle it is convex and inserts the extensor carpi ulnaris muscle
- below it is rounded
Medial surface
- it is flat, concave above and convex below and it presents the origin of the
tendons of the flexor digitorum profundus muscle
The borders
- anterior it leads from the coronoid process to the styloid process
- posterior it leads from the olecranon to the styloid process
- lateral it inserts interosseus membrane

The upper end = proximal epiphysis

- it has 2 large, curved processes
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 - olecranon it is large, thick and curved eminence at the upper
back part; its anterior surface is smooth, concave
- coronoid process it is horizontally to the front part of ulna; in its
lateral surface it carries a radial notch for articulation with the
radius
- between olecranon and coronoid process there is trochlear notch

The lower end = distal epiphysis

- it presents 2 eminences:
- the head of the ulna it is articulated laterally with the radius
- styloid process which is medially and it can be palpated under
the skin

HAND

- The skeleton of the hand is subdivided into 3 segments:

- Carpus or the wrist bones

- Metacarpal bones

- Phalanges or digities

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 I.CARPUS
-There are 8
carpus bones
arranged into
2 rows:
- Proximal row or the upper row scaphoid bone
- Lunate bone
- Triquetral bone
- Pisiform bone
- Distal row or the lower row trapezium bone
- Trapezoid bone
- Capitate or magnum bone
- Hamate bone
- They have 6 surfaces in common: superior, inferior, anterior, posterior,
lateral and medial
SCAPHOID
- It is the largest bone of the first row
- it articulates with the radius above and trapezoid, trapezium below
- Medial it is articulated with lunate bone

LUNATE
- It is articulated with - the radius above
- Capitate below
- Scaphoid laterally

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 - Triquetral medially

TRIQUETRAL
- It is articulated with the head of the ulna above
- Hamate below
- Lunate laterally
- Pisiform medially

PISIFORM
- It is small and articulates with triquetral

TRAPEZIUM
- It is articulated with scaphoid above
- The first metacarpal below
- Trapezoid and the second metacarpal medially

TRAPEZOID
- It is small and articulates with scaphoid above
- The second metacarpal below
- Trapezoid laterally
- Capitate medially

CAPITATE
- It is the largest bone and it occupies the centre of the wrist
- it has - a head
- a neck
- a body
- it is articulated with scaphoid and lunate above
- the third and fourth metacarpal below
- trapezoid laterally
- hamate medially

HAMATE
- it is pyramidal formed
- it is articulated with lunate above
- the fourth and the fifth metacarpal below
- capitate laterally

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 - triquetral medially

II. METACARPAL BONES

- They are long, cylindrical with a prismatic shaft which has 3 surfaces:
dorsal, lateral and medial
- Their base articulates with the carpal bones
- Their head articulates with the proximal phalanx

- The first metacarpal is the shortest and the thickest; it is articulated with
trapezium
- The second metacarpal is articulated with the third and its base is articulated
with trapezium, trapezoid and capitate

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- The third metacarpal is articulated with the second laterally and the fourth
medially; its base is articulated with capitate
- The fourth metacarpal is articulated with the third laterally and the fifth
metacarpal medially; its base is articulated with capitates and hamate
- The fifth metacarpal is articulated with the fourth and its base with the
hamate

III. PHALANGES
- They form the five digities which are named:
- The thumb
- The Index
- The middle
- The ring
- The little finger

- The thumb has a proximal and a distal phalanx, but the others fingers have

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 - A proximal phalanx

- A middle phalanx

- A distal phalanx

- The phalanges have a base

- A body

- A head

COXAL
BONE

- It is a large, flattened and irregular shaped bone

- It is constricted in the center and expanded above and below

- It has 3 parts ilium

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 - Ischium

- Pubis

- These parts are distinct at the young subjects, but they are fused at the
adults; together with the sacrum they form a ring which is called the bony
pelvis

ORIENTATION
- Backward the border which has a big notch
- Laterally the surface which has a hemispheric cavity
- Downward the notch of this cavity

THE ILIUM
- It is divided into 2 parts:
- The body which limits the acetabul superior
- The ala = wing
- Between the body and the ala there is arcuate line which is visible only on
the internal surface of the bone

THE ISCHIUM
- It is divided into 2 parts:
- The body it limits the acetabul posterior and inferior
- The ramus it is joined with the inferior ramus of pubis

THE PUBIS
- It id divided into 3 parts:
- The body it limits the acetabul anterior
- Superior ramus
- Inferior ramus
- The limit between superior and inferior ramus is called the pubis angle

CONFIGURATION
- The coxal bone presents:
- 2 surfaces lateral or external and medial or internal
- 4 borders superior, inferior, anterior and posterior
- 4 angles
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I. LATERAL SURFACE

- This surface presents the acetabulum

ACETABULUM = It is a deep, hemispherical depression, limitated by:
- Superior by the ilium
- Posterior by the ischium
- Inferior and anterior by the pubis
- It is articulated with the head of the femur
- It is limitated by a prominent brow
- It presents a deep notch below = the acetabular notch, which is
continuous with a circular depression = acetabular fossa
- It has a lunate surface inside

THE OBTURATOR FORAMEN

- It is a large aperture situated between the ischium and pubis

- It is bounded by a thin margin

- A strong membrane is attached on this margin
- On the superior part, this margin is substituted by the obturator groove

THE ALA OR WING

- It is called gluteal surface
- It is a large superior expanded part
- It is crossed by 3 lines
- Anterior gluteal line the longest; it begins at the greater sciatic notch
and it is over at the antero-superior iliac spine
- Posterior gluteal line it begins at the greater sciatic notch and it is
over at the superior border of the coxal bone (it is vertically)
- Inferior gluteal line it begins at the greater sciatic notch and goes
horizontally to the anterior border

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!

II. MEDIAL SURFACE

- It is crossed by an arcuate line which divide the medial surface into 2 parts
- Iliac fossa above the arcuate line
- Under the arcuate line there are:
- Sacro-pelvic surface formed by the tuberosity of illium
and auricular surface
- A plane surface correspond with acetabul
- The obturator foramen

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 !

SUPERIOR BORDER
- It is called iliac crest
- It is thinner at the center than the extremities
- It presents anterior superior iliac spine
- Posterior superior iliac spine
- It can be palpated under the skin
- It inserts fascia lata
- The tensor of fascia lata
- Iliac muscle
- Gluteal muscle

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INFERIOR BORDER
- It begins at the ischiatic tuberosity and ends at the pubic angle
- It is formed by the inferior ramus of pubis and the inferior ramus of ischion
and it is called ischio-pubian branch

ANTERIOR BORDER
- It is concave
- It has 2 parts one vertically = ilium part
- One horizontally = pubis part
- It has: - antero-superior spine
- A little notch for passage of the femoral cutaneos lateral nerve
- Antero-inferior iliac spine
- Below this spine there is a notch for iliopsoas muscle
- From here, the anterior border changes its direction
- Below there is iliopectineal eminence
- Pectineal surface for pectineal muscle; this surface is limitated by
pubic crest which ends in pubic tubercle
POSTERIOR BORDER
- It presents postero-superior iliac spine
- Postero-inferior iliac spine
- Below there is a deep notch = the greater sciatic notch
- Below the ischiatic spine
- The lesser sciatic notch
- The ischial tuberosity

THE ANGLES
- Antero-superior represented by the antero-superior spine
- Antero-inferior represented by the pubis angle
- Postero-superior represented by the postero-superior iliac spine
- Postero-inferior represented by the ischiatic tuberosity

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 FEMUR

- It is a long paired bone

- It has a body and two extremities

ORIENTATION

- Superior extremity with an angle

- Medial hemispherical surface of this extremity

- Posterior the rough border of the body

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THE UPPER EXTREMITY= PROXIMAL EPIPHYSIS
- It presents a head

- A neck

- A greater trochanter

- A lesser trochanter

The head
it is spherical and directed upward, inward and a little forward
- It has a depression called fovea capitis situated a little behind the center for
insertion of the teres ligamentum or round ligament
The neck
- It connects the head with the body and it presents 2 surfaces anterior and
posterior
- Anterior surface presents intertrochanteric line

- Posterior surface presents - intertrochanteric crest

The greater trochanter
- It is a large irregular eminence situated in the lateral part of the neck and a
little backward
- It has 2 surfaces external rough and convex
- Internal with intertrochanteric fossa
- It inserts gluteus muscle, gemellus muscle, piriform muscle
- It can be palpated
The lesser trochanter

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 - It is a conical eminence which lies at the lower back part of the neck
- It inserts iliopsoas muscle
THE BODY = diaphysis
- It is cylindrical, convex in front and concave behind
- It presents 3 surfaces
- 3 borders
Anterior surface
- It is convex, thin and covered by vastus intermedius muscle
Lateral surface
- It Inserts vastus intermedius muscle
Medial surface
- It is covered by vastus intermedius muscle
The borders
- The most important border is posterior border which is called linea aspera
- This line presents 2 lips: lateral lip and medial lip; between the lips
there are inserted vastus medial, vastus lateral, the adductor
muscles, femoral biceps
- Above , linea aspera is prolonged into 3 ridges:
- The external ridge or lateral is very rough, called
gluteal ridge
- The internal or medial ridge continues the
intertrochanteric line
- The middle ridge inserts pectineus muscle
- Below , linea aspera is divided into 2 ridges:
- Between these 2 ridges there is a triangular space
called popliteal space crossed by the popliteal artery

THE LOWER EXTREMITY = DISTAL EPIPHYSIS

- It is divided into 2 eminences called condyles; the medial condyle is smaller
and lower situated
- Anterior this extremity presents a smooth depression for patella
- Posterior it presents intercondilar fossa

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 PATELLA = THE KNEE CAP

- It is a circular triangular bone

- It is articulated with the femur

- It protects the knee joint

- It is situated inside of the tendon of cquadriceps femoral muscle

- It can be palpated under the skin

- It has a base

- An anterior surface

- A posterior surface

- An apex

- 2 borders

ORIENTATION
- The base is superior

- The articular face of base is posterior

- Laterally the biggest part of this face

THE BASE
- It is superior

POSTERIOR SURFACE
- It is oval
- It has a crest and 2 eminences
- It presents a nutrient foramina

40
ANTERIOR SURFACE
- It is convex

THE BORDERS
- One is lateral border and one is medial border

THE APEX
- It is downward
FIBULA

- It is situated at the outer side of the leg

- It is smaller than the tibia
- It is articulated with tibia above and below
- It has a body
- 2 extremities upper and lower

41
THE BODY
- It is triangular; it has 3 surfaces and 3 borders
- Posterior surface it has a nutrient foramina
- Lateral surface it inserts - the extensor digitorum longus
- Extensor hallucis
- Peronier the third
- Medial surface it has a crest
- Borders anterior
- Lateral in the lower part it becomes posterior
- Medial interosseus

THE UPPER EXTREMITY

- It is small
- It presents a flattened articular face above directed upward, forward and
inward for articulation with the tibia; this articular face is the head of fibula
- The head of the fibula has an apex, which inserts the tendon of the femoral
biceps muscle
- Below the head, there is the neck which is surrounded by the fibular nerve

THE LOWER EXTREMITY

- It is formed by the external malleolus which presents :
- A base
- An apex
- A lateral surface
- A medial surface which has an articular facet for tibia and
talus
- A malleolus fossa
- A groove for tendons of peroneus
muscles.

THE FOOT

- The bones of the foot are divided in 3 parts:

42
 -Tarsus 7 bones
-Metatarsus 5 bones
-Phalanges 14 bones

I.TARSUS
- The bones of the tarsus are: calcaneus, talus,
cuboid, navicular and 3 cuneiforms

1. THE TALUS
- It is the largest tarsal bone and it occupies the middle upper part
- It is articulated superior with tibia
- Inferior with calcaneus
- Anterior with navicular
- It has a head
- A neck
- A body

The body has 6 surfaces:

43
- Anterior surface presents the head which is articulated with navicular
bone
- Posterior surface is prominent, convex and presents the posterior process
of talus and 2 tubercles one lateral and one medial
- Superior surface presents trochlea which is articulated with tibia
- Inferior surfaces has 3 faces for articulation with calcaneus and these 3
faces are named: anterior, middle and posterior calcaneus surfaces. The
middle and posterior surfaces are separated by a groove called sulcus tali
- Lateral surface it has a process and inserts ligaments external lateral
ligament and talocalcanean ligament
- Medial surface is irregular

2. CALCANEUS

- It is the

strongest tarsal bone

- It has 6 surfaces:
- Anterior surface or articular surface is articulated with cuboid bone
- Posterior surface it has a prominent eminence and it is divided into 2
parts; the inferior part inserts the Achillis tendon
- Superior part it is divided into 3 parts anterior, middle and posterior for
articulation with talus

44
- Inferior part is irregular and presents 3 prominences one anterior and 2
posterior (medial and lateral)
- Lateral surface is under the skin; it has fibular trochlea
- Medial surface presents an eminence namely sustentaculum tali

3. NAVICULAR
- It is situated in front of the talus, in the inner side, behind the 3 cuneiforms
- It has 6 surfaces:
- Anterior surface it has 2 ridges which divide this surface into 3 faces for
articulation with the cuneiform bones
- Posterior surface is concave, it articulates with talus
- Superior surface convex, rough and inserts ligaments like the inferior
surface
- Lateral surface is articulated with cuboid bone
- Medial surface has a tubercle

45
! !

4. CUBOID
- It is situated on the outer side of the foot, in front of the calcaneus and
behind the fourth and the fifth tarsal bones
- It has 6 surfaces:
- Anterior surface it has a vertical ridge which divides this surface in 2
faces for articulation with metatarsal 4,5;
- Posterior surface is articulated with calcaneus
- Superior surface inserts ligaments
- Inferior surface has a deep groove for the peroneus longus muscle and it
has tuberosity of the cuboid
- Lateral surface it can be palpated
- Medial surface it is articulated with the third cuneiform

46
5. CUNEIFORMS
- They are 3 in number situated in front of the navicular
- Medial cuneiform (I) is the largest, situated between the navicular, the
base of the first and second metatarsal bones and the middle cuneiform
- Middle cuneiform (II) it is the smallest situated between the navicular
bone, the second metatarsal and the internal and medial cuneiform
- Lateral cuneiform (III) is articulated with the navicular, third metatarsal,
middle cuneiform and cuboid.

47
 THE FRONTAL BONE

- It is situated at the anterior part of the skull, median

- It has a vertical part = squamous part
- An horizontal part formed by 2 orbital plates
- 1 nasal part

I. THE FRONTAL SQUAMA

- It is convex forward, and it has an external surface
- an internal surface
- a border

External surface

48
 - It is smooth, convex forward
- It has 2 eminences = frontal eminences, one on each side of median line
- Below are 2 ridges called supraciliary arches ( they are produced by the
projection outward of the air sinuses )
- Between these ridges there is a smooth surface = glabella
- Below the ridges there is an inferior border = supraorbital border , in fact
this border is the limit between vertical part and horizontal part of the bone

- This border presents:

- Supraorbital foramen for artery, vein and nerves
- Laterally temporal line for insertion of the temporal fascia
- Still laterally - there is zygomatic process

Internal surface
- It presents along of the middle line:
- The small foramen caecum
- The crest of the frontal bone
- Sagital superior groove
- Laterally, on each side, there are:
- Mamillary eminences
- Artery grooves
- Impressions for the gyri

49
The border
- It is called parietal border and it is an arcuate and irregular border
- It forms the coronal suture

II. THE HORIZONTAL PART

Orbital plate 2 in number

- It contributes to the formation of the superior wall of the orbit
- It presents
- a superior or cerebral surface it has impressions for gyri,
cerebral ridges
- an inferior or orbital surface - has in its lateral part a small fossa for
lacrimal gland
- The anterior border is supraorbital border

- The posterior border is articulated with the small wing of the

sphenoid bone

- Lateral border - is articulated with the greater wing of the sphenoid

bone

- Medial border it limits ethmoidal notch

- Orbital plates are separated one from another by the ethmoidal notch; this
notch contains the cribriform plate ( a part from ethmoidal bone )

Nasal part
- It closes the ethmoidal notch in front

- In the middle part it has the nasal spine

- Laterally there are on each side the aperture of the frontal sinus

Frontal sinus
- It is a paired cavity situated between the both plates of the frontal bone in its
antero-inferior part

50
- These cavities contain air
- They are separated by a vertical septum

THE OCCIPITAL BONE

- It is unpaired bone

- It forms the posterior and inferior part of the skull

- It has an oval foramen in its lower part, which connects the cranial cavity
with the spinal canal
- It presents: - 2 surfaces external and internal

- 4 angles

- 4 borders

- It is divided in basilar part

- Squamous part

- Lateral parts

I. THE EXTERNAL SURFACE

1. Basilar part
- It is situated in front of the foramen magnum
- It presents the basilar process
- In the median line the pharyngeal tubercle

2. Squamous part
- It is convex
51
- It is situated above and behind foramen magnum
- It presents a prominent tubercle called external occipital protuberance
- The external occipital crest
- Laterally, on each side there are 3 lines the nuchal lines
suprema, superior and inferior ( these lines insert sterno-cleido-
mastoidian muscle)

3. Lateral parts
- Each of them presents - a condyle for articulation with the atlas
- Hypoglossal canal for hypoglossal nerve
- Occipital fossa

II.
III.

II. INTERNAL SURFACE

1. Basilar part
- It presents the clivus, which supports the medulla oblongata and a part of the
Varolli pons
52
 2. Squamous part
- It is concave
- It is divided in 4 cavities by a crucial ridge; the superior cavities 2 in
number, receive the occipital laps of the brain, while the inferior cavities
receive the hemispheres of the cerebellum
- At the point where the 4 divisions unite lies the internal occipital
protuberance
- Superior there is a groove for the superior sagital sinus
- Laterally - 2 transverse grooves for lateral sinuses
- Inferior there is the internal occipital crest

3. Lateral parts
- Each of them presents a supracondilian eminence

THE BORDERS
53
- 2 Superior borders = lambdoid borders which articulate with the parietal
bones and form the lambdoid suture
- 2 inferior borders = mastoid borders which articulate with the temporal
bone; these borders present jugular notch
THE ANGLES
- Superior angle it is formed by the lambdoid borders
- Inferior angle formed by the basal part
- Lateral angles between lambdoid border and mastoid border

THE TEMPORAL BONE

- It is a paired bone
- It is situated between the parietal bone
- Occipital bone
- Sphenoid bone
- It has squamous part
- Tympanic part
- Petrous part
- Mastoidian part

ORIENTATION
- Squamous part superior
- Zigomatic process on lateral surface
- The end of the zigomatic process - anterior

I. SQUAMOUS PART

- It is circular and it has - 2 surfaces lateral or temporal

- Medial or cerebral
- 4 borders

Temporal surface

54
 - It inserts temporal muscle
- This surface presents zygomatic process ; this process has an apex and 2
roots; between the roots there is the mandibular fossa ; the transversal root is
called articular tubercle
- The apex is articulated with the zygomatic bone
- Above the external acoustic foramen there is spina suprameatum

Cerebral surface
- It presents artery grooves
- Mamilary eminences
- Impressions for gyri
Borders
- 2 superior free borders sphenoidal part and parietal part
- 2 postero-inferior borders one between the squamous part and
mastoidian part, and one between the squamous part and petrous part

II. THE TYMPANIC PART

55
 - It is like a canal with concavity orientated above and forms the big part of
the external acoustic meatus
- This part presents a vagina for the styloidian process which is situated on the
inferior surface of the petrous part
- This part presents a fissure between tympanic part and petrous part called
petro-tympanic fissure

III. THE PETROUS PART

- It is endocranian
- It is pyramidal with the base at the mastoidian process

- It has 3 surfaces
- 3 borders
- A base
- An apex
-
Anterior surface presents:
- A groove for trigeminal nerve
- Laterally arcuate eminence; Between this eminence and the trigeminal
groove there are 2 foramens;
- The first is the hiatus for the greater petrosal canal which
contains the greater petrous nerve
- The second is the hiatus for the lesser petrosal canal which
contains the lesser petrous nerve
- Above a surface called tegmen tympani

Posterior surface presents:

- the internal auditory foramen
- Laterally there is subarcuate fossa
- Still laterally there is the external foramen for the aqueduct of the vestibule

Inferior surface presents:

- Lateral part with stylo-mastoidian foramen and styloidian process
- Middle part with jugular fossa
- Midial part with external foramen of carotidian canal ; between this
foramen and the jugular fossa there is a crest with a depression called

56
 fosula petrosa; deep in this fossa there is a foramen for the tympanic
canaliculus, which contains tympanic nerve

THE BORDERS
- Superior separates the anterior surface from the posterior surface; it has
the superior petrous sulcus
- Anterior it is united with the squamos part
- Posterior it is articulated with the occipital bone

THE APEX
- It presents the internal foramen for the carotidian canal of carotid artery

IV. THE MASTOIDIAN PART

- It is situated behind the external acoustic meatus
- It has 2 surfaces and a circumference

The external surface

- it is convex
- it presents - the mastoidian process
- the mastoidian incisura
- the mastoidian foramen is above the mastoidian process
- medial from the mastoidian incisura there is an arterial groove
for the occipital artery

The internal surface

- it presents a groove for sigmoid sinus
- the circumference is articulated before with the parietal bone and behind
with the occipital bone

THE ETHMOID BONE

- It is a single bone situated median, in the frontals groove

57
- It
is complex and participates at the formation of nasal cavities, orbital cavities
and the base of the skull

- It has a vertical plate median and thin

- Horizontal plate = cribriform lamina

- 2 lateral masses = the labyrinths; they contain air, so the ethmoid

bone is a pneumatic bone

58
VERTICAL PLATE
- It is divided by horizontal plate in 2 parts
- Superior part = crista galli, small and triangular
- Inferior part = the perpendicular lamina, thin and it forms with the
vomer and nasal cartilage the nasal septum

HORIZONTAL PLATE
- It is divided by crista galli in 2 antero-posterior canals
-It has 25 orifices passes by
the branches of olfactory
nerves

THE LABYRINTHS
-They are 2 cubic masses
situated at the lateral borders
of the horizontal plate (one
on each side)
-They contain ethmoid cells
with air
-Each ethmoidal labyrinth
has 6 surfaces:

59
 - Lateral surface or orbital surface because it forms the medial wall of
the orbit
- Medial surface it forms the lateral wall of the nasal cavity; this wall
presents 2 prominences called superior nasal concha and middle nasal
concha which determine 2 spaces = superior and middle meatus; middle
meatus contains: ethmoidal bula, uncinate process and semilunaris hiatus
- Superior surface presents many cells which are united with the cells of
the frontal bone; this surface presents anterior and posterior ethmoidal
orifices
- Inferior surface it is formed by the middle concha
- Anterior surface it presents cells which are united with the cells of
lacrimal bone
- Posterior surface presents cells which are united with the cells of
sphenoid bone

INTERNAL CONFORMATION
- The labyrinths cells form the ethmoid sinus; these cells are grouped:
- Anterior group and the middle group are opened into the middle
meatus
- Posterior group is opened into the upper meatus

THE SPHENOID BONE

- It is unpaired bone
- It forms the central part of the skulls base
- It has a body
- 2 pairs of wings-laterally
- Pterigoid processes inferiorly

ORIENTATION lesser wings - superior

- Sinouses in front

60
THE BODY
- It is cubic and it has 6 surfaces:

Superior surface presents:

- Anterior a plane surface between the small wings
- Behind this surface there is chiasmatic groove
- Behind the hypophysis fossa / sella turchica, which contains the
hypophysis or pituitary gland inside; this fossa is limited in front by a
tubercle and behind by a transverse ridge called dorsum sellae; in its lateral
ends, there are the posterior clinoid processes

Inferior surface presents:

- It presents a median spine called sphenoidal rostrum
- Laterally it presents the sphenoidal concha ( on each side )

Anterior surface presents:

- A medial spenoidal crest
- Laterally on each side sphenoid sinus which is a large concavity

Posterior surface :
- It is united with the basilar part of the occipital bone

Lateral surfaces:
- They are united with the greater wings

61
62
THE LESSER WINGS
- Extend laterally from the upper part of the body
- They are 2 triangular plates projected laterally
- Each of them presents:
- A superior surface smooth
- An inferior surface which forms the upper part of the orbital roof
- Between the lesser and the greater wing there is orbital fissure
- The base of the lesser wing presents the optic canal for the optic nerve and
ophthalmic artery
- The borders anterior is dentate and it is articulated with the frontal bone
- Posterior is concave and presents anterior clinoid process

THE GREATER WINGS

- Extend from the lower part of the body, laterally and each of them presents:
- A base
- An apex
- 5 surfaces
- 6 borders

The base
- It is united with the body
- Superior presents a round foramen for maxillary nerve
- Laterally presents an oval foramen for the mandible nerve
- posterior a spinous foramen for the middle cerebral artery

The apex
- it is laterally and it is articulated with the parietal bone

Surfaces
- cerebral is endocranian and has artery grooves, mamillary eminences and
impressions
- temporal it is a part of the temporal fossa and inserts temporal muscle

63
 - infratemporal is situated below to the temporal surface and it forms the
upper wall of the infratemporal fossa
- orbital it forms the lateral wall of the orbit
- maxillary situated below the orbital surface

The borders
- 3 are exocranian parietal
- Orbital
- Zygomatic
- 3 are endocranian frontal
- Squamous
- petrous

PTERIGOIDIAN PROCESSES
- extend vertically and inferiorly, where the greater wings unite with the body
- each of them has 2 plates medial and lateral; in front they are united, but
posterior they are separated by pterigoid fossa

64
 THE MANDIBLE

- It is median and unpaired

- It has a body
- 2 rami

ORIENTATION
- Anterior convex surface
- Superior border with teeth

THE BODY
- It is formed by 2 halves of the bone which fuse on the first year of life and
form a single bone
- It has a base and an alveolar part
- It presents 2 surfaces

External surface
- It is convex forward and presents on the median line the mental
protuberance and mental simphys
- Laterally, on each side there is the mental foramen for vessels and nerves
- In the upper part there are many prominences called juga alveolaria

65
 !

Internal surface
- It presents on median line 4 processes 2 superior and 2 inferior; they form
the mental spine
- Laterally, on each side there is an oblique line called mylohyoidian line
which divides this surface into 2 parts:
- the upper part is sublingual fossa for sublingual salivary gland
- the lower part is submandibular fossa for homonym gland
- the borders are 2 in number
- superior border formed by alveolar part; alveolar part is determined by the
teeth which it carries. This border bears 16 tooth sockets = dental alveolas
separated one from another by interalveolar septum; for the teeth with 2 or 3
roots there are interradicular septum
- inferior border with digastrics fossa for digastrics muscle and a groove for
facial artery

66
 !

THE RAMI
- each of them presents 2 surfaces
- 4 borders
- 2 processes

- Lateral surface is covered by masseter muscle and it presents the

tuberosity of mandible
- Medial surface presents a foramen for mandibular nerve and a
prominence = lingual, which is important in anestesy
- Anterior border is thin
- Posterior border is thick, rounded and covered by parotid gland
- Superior border presents the coronoid process and the condyloid
process; between them there is a notch = mandibular notch; condyloid
process presents the head of mandible and the neck
- Inferior border forms an angle with the posterior border of rami

67
INTERNAL CONFIGURATION
- Each half of mandible is crossed by mandibular canal which contains
mandibular vessels and nerves; it starts from the mandible foramen, goes
downward and it is divided into 2 parts lateral part is finished in mental
foramen and medial part is divided in small canals for the roots of the teeth

THE MAXILLA

- It is paired bone, situated in the centre of the face

- It participates to the formation of the nasal cavity
- orbital cavity
- mouth cavity
- infratemporal fossa
- pterigopalatine fossa
- it has a body
- 4 processes

ORIENTATION
- Inferior surface with teeth
- Medial surface with a big orifice (sinous)
- Behind the most voluminous border

THE BODY

68
 - It is pyramidal and it has a base
- An apex
- 3 surfaces
- 3 borders
The base
- It is orientated medial and it forms the lateral wall of the nasal cavity, so that
is called nasal surface
- It presents a lacrimal groove which is substitute by naso-lacrimal canal
- Behind the lacrimal groove there is maxillary hiatus

Anterior surface
- It presents suborbital foramen
- Below there is fossa canina and nasal incisure

Posterior surface
- It presents the maxillary tuberosity with 2-3 small foramina for dental canals

Superior surface
- It is orbital surface because it forms the inferior wall of the orbit
- It presents suborbital canal for vessels and nerves

The apex
- It presents zygomatic process

The borders
- They are 3 in number anterior, posterior and inferior
PROCESSES
- They are 4 in number:

Palatine process
- It is horizontal and it has 2 surfaces and 4 borders
- Superior surface is a part of the noses floor
- Inferior surface forms the roof of the mouth
- Medial border articulates with the opposite and forms the median palatine
suture; it presents incisor canal in front
- Lateral border is the same with the nasal surface of the body
- Anterior border presents the anterior nasal spine

69
 - Posterior border unites with the horizontal plate of the palatine bone

Frontal process
- It is projected upward and backward and it has 2 surfaces and 4 borders
- Lateral surface inserts muscles
- Medial surface is a part of the nasal cavity
- Anterior border it is articulated with the nasal bone
- Posterior border it is articulated with lacrimal bone
- Superior border with frontal bone
- Inferior border with the maxillas body

Alveolar process
- It is thickest part of the bone, deeply concaved for the reception of the teeth
- Between the teeth there are interalveolar septum; in case of the teeth which
have more roots, between them there are interradicular septum
- On the anterior surface of the alveolar process there are some prominences
called juga alveolaria determined by the alveolas

Zygomatic process
- It is articulated with the zygomatic bone

INTERNAL CONFIGURATION
- It has a sinus which is opened on the bases surface
- It is crossed by suborbital canal and many small alveolar canals

70
PALATINE BONE

- It is a paired bone
- It is situated at the
back part of the
nasal cavities.
- I t presents - an
horizontal
plate
- a vertical
plate
- 3 processes.

71
The horizontal plate
- it presents 2 surfaces and 4 borders.
- Superior surface forms the floor of the nose.
- Inferior surface forms the back part of the roof of the mouth.
- Anterior border is articulated with the palatine process of the maxillary
bone.
- Posterior border is concave.
- Medial border is articulated with the medial border of the opposite bone.
- Lateral border is between vertical and horizontal plate.

The vertical plate

- It presents 2 surfaces and 4 borders.
- Lateral surface is articulated with the inner surface of the maxillary
bone.
- Medial surface forms the wall of nasal meatus.
- Anterior border is articulated with the maxillary bone.
- Posterior border is articulated with the pterigoid process.
- Superior border presents 2 processes : - Orbital
- Sphenoidal
- Inferior border is the same with the lateral border of the horizontal
plate, and presents the pyramidal process.

ZYGOMATIC BONE

- It is a paired bone
- It is situated on the lateral part of the face.
- It has - 2 surfaces
- 4 borders
- 3 processes.

Surfaces

- Lateral surface - is convex and presents the zygomatico-facial foramen.

- Medial surface - is concave and forms the temporal fossa.
- It presents the zygomatico-temporal foramen
72
Borders

- Antero-superior or orbital border.

- Postero-superior border has one vertical part and one small horizontal part.
- Antero-inferior border is articulated with the maxillary bone.
- Postero-inferior border is free.

Processes

- Frontal for articulation with the zygomatic process of the frontal bone.
- Temporal is articulated with the zygomatic process of the temporal bone.
- Orbital is articulated with the greater wing of the sphenoid and with the
maxillary bone.

NASAL BONE

- It is little and paired, quadrilateral

- it participates to the formation of the nasal cavity.
- It has 2 surfaces and 4 borders.

Surfaces

- Anterior surface is concave and directed vertically.

- Posterior surface forms the wall of the nasal cavity.

Borders

- Superior border is articulated with the frontal bone.

- Inferior border is articulated with the nasal cartilage.
- Lateral border is articulated with the frontal process of the maxillary
bone.
- Medial border is articulated with the opposite side.

VOMER

73
- it is a median, unpaired bone
- it participates to the formation of the nasal septum.
- It presents
- 2 lateral surfaces which form the medial wall of the nasal
cavity.
- 4 borders - Superior border it has a groove delimitated by the
Wings
- Inferior border is articulated with the nasal crest.
- Anterior border is oblique forward and downward
- posterior borders thin and free

LACRIMAL BONE

- It is a paired bone, quadrilateral

- it participates to the formation of the medial wall of the orbit and lateral
wall of the nasal cavity.
- It presents 2 surfaces - lateral and medial
- 4 borders

- Lateral surface presents a crest which delimitates sulcus (groove)

lacrimalis.
- Medial surface forms the lateral wall of the nasal cavity.
- Superior border is articulated with the frontal bone.
- Inferior border is articulated with the maxillary bone.
- Anterior border is articulated with the frontal process of maxillary bone.
- Posterior border is articulated with the ethmoid bone.

INFERIOR CONCHA

- It is a paired bone
74
 - It is situated in the nasal cavity below the middle ethmoidal concha.
- It presents:

- Lateral surface is concave and forms, with the lateral wall of the nasal
cavity, the inferior meatus.
- Medial surface is convex.
- Superior border presents 3 processes : - Lacrimal
- Maxillar
- Ethmoidal

- Inferior border is free.

HYOID BONE

- It is unpaired bone
- It is situated below the tung.
- it is shaped like a horse shoe
- It can be palpated under the skin.
- It presents a body which forms the central part of the bone; It is convex
and presents a transverse crest and a vertically crest.
- The greater horns are situated in the laterally part.
- The lesser horns arise at the junction part of the greater horns of the
body.

NASAL CAVITY

- It is situated in the centre of face

- There are 2 nasal cavities
- It presents 4 walls
- 2 orifices

THE INFERIOR WALL

- It is formed by the palatine process of maxilla and horizontal plate of the
palatine bone
75
 - Between them there is transversal palatine suture
- In front it presents incisor orifice

THE SUPERIOR WALL

- It is formed by - nasal bone
- nasal spine of frontal bone
- cribriforme lamina
- sphenoid bone (anterior and inferior surfaces)

THE LATERAL WALL

- it is formed by maxilla
- Lacrimal bone
- Ethmoid bone
- Vertical plate of the palatine bone
- Inferior concha
- It presents - superior and middle conchas
- Inferior concha
- Meatus superior, middle and inferior

THE MEDIAL WALL

- It separates the nasal cavities
It is formed by perpendicular lamina of the ethmoid bone
- Vomer

ORIFICES
- One anterior and one posterior

Nasal cavity communicates :

- With cranium through the orifices of the cribriforme lamina
- Orbit through naso-lacrimal canal
- Oral cavity through incisor canal
- Paranasal sinuses
- Pharynx posterior
- Exterior in front

76
 INFRATEMPORAL FOSSA

- It is situated below to temporal fossa

- It contains - pterygoid muscles
- Mandible nerve
- Maxillary artery

- Superior wall the greater wing of the sphenoid bone

- Inferior wall is absent
- Anterior wall maxilla
- Posterior wall is absent
- Lateral wall zygomatic bone and mandibles ramus
- Medial wall pterygoid process of the sphenoid bone and maxilla

- It communicates with cranium through oval and spinous foramina

- Temporal fossa through the space which is
delimitated by the zygomatic bone

- Pterygo-palatine fossa

- Orbit through the inferior orbital fissure

- Mandibles canal through mandible foramen

PTERYGO-PALATINE FOSSA

- It is formed by maxilla in front

- Sphenoid bone - behind
- Palatine bone - medially
- It is connected with infratemporal fossa through the pterygo-maxillary
fissure
- It communicates with orbit through the inferior orbital fissure
77
- Nasal cavity through spheno-palatine foramen
- Cranium through the round foramen of sphenoid
- Dental alveolas through maxillas tuberosity
- Infratemporal fossa

78