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Online Anatomy

Module 1

INTRO & TERMS CELL EPITHELIUM CONNECTIVE TISSUE MUSCLE NERVOUS SYSTEM AXIAL SKELETON APPENDICULAR SKELETON MUSCLES EMBRYOLOGY

SKULL VERTEBRAL COLUMN RIBS

SKELETON: Divisions

PECTORAL GIRDLE LIMB BONES PELVIC GIRDLE LIMB BONES Marieb Fig 5.6, p 121

2 SKELETONS

APPENDICULAR SKELETON PECTORAL GIRDLE CLAVICLE (Collar bone) omitted LIMB BONES

upper

PELVIC GIRDLE LIMB BONES

lower

appendicular skeleton hangs on the axial

PECTORAL GIRDLE

The pectoral girdle is not a 19th century corset for the upper chest On each side, it is a pair of bones that allows the arm to be fastened to the body, but to have an amazing range of movements & uses The arm is used for: swinging, crawling, reaching, pulling, throwing, twisting; & for positioning, orienting, stabilizing & controlling all that the hand does The bones of the pectoral girdle are the shoulder-blades & the collar-bones

PECTORAL GIRDLE

The bones of the pectoral girdle are the shoulder-blades & the collar bones SCAPULA or SHOULDER-BLADE CLAVICLE or COLLAR-BONE

SCAPULA

The SCAPULA is a peculiarly-shaped bone, with many surfaces, edges and protuberances for muscles (& ligaments) to attach. These are needed to control the arm directly, but also to position and stabilize the scapula for whatever the arm is doing The scapula is a highly mobile bone The arm is used for: swinging, crawling, reaching, pulling, throwing, twisting, etc; & for positioning, orienting, stabilizing & controlling all that the hand does

PECTORAL GIRDLE

SCAPULA Shoulder-blade

The scapula is the major part of the pectoral girdle & lies posteriorly The scapula is a shallow dish, with the concave side facing anteriorly, as it fits over the muscles & ribs of the back

SCAPULA: Terminology

Acromion process Coracoid process Spine Vertebral margin Glenoid fossa Inferior angle Needless to say, each side and angle has a name. Here are enough to be going on with.

SCAPULA: Parts I

The SPINE rises and thickens from the medial edge going laterally, forming a triangular ridge ending in a protuberance termed the ACROMION Spine The spine defines territories above & below it, into which muscles fit Acromion = Acromion process

SCAPULA: Parts II

ACROMION PROCESS improves the angle of action of the deltoid muscle pulling the arm away from the body, & anchors the lateral end of the clavicle Medial/Vertebral margin Spine Lies by the spines of vertebrae from which muscles attach to it

Coracoid process Glenoid fossa

SCAPULA: Parts III

Acromion process

CORACOID PROCESS Anterior beak to improve angle of biceps muscle Spine h u m e r u s GLENOID FOSSA Shallow socket for head of the humerus

Medial/Vertebral margin

SCAPULA: Parts IV

Viewed from side Acromion process Spine Coracoid process Anterior beak to improve Glenoid fossa u m e r u s

SCAPULA & CLAVICLE

The SCAPULA is a peculiarly-shaped bone, with many surfaces, edges and protuberances for muscles (& ligaments) to attach. These are need to control the arm, but also to position and stabilize the scapula for whatever the arm is doing The scapula is a highly mobile bone The arm is used for: swinging, reaching, pulling, throwing, twisting; & for positioning, orienting, stabilizing & controlling all that the hand does The CLAVICLE is the strut that: holds the shoulder out away from the trunk; absorbs shock; fastens appendicular to axial skeleton ; & anchors several muscles & ligaments

CLAVICLE

The arm is used for: swinging, crawling, reaching, pulling, throwing, twisting; & for positioning, orienting, stabilizing & controlling all that the hand does The CLAVICLE is the strut/brace that: holds the shoulder out, away from the trunk; absorbs shock; & fastens appendicular to axial skeleton

(at the sterno-clavicular joint)

& anchors several muscles & ligaments

Connections between axial & appendicular skeletons I Sterno-clavicular joint

Sterno-clavicular joint CLAVICLE Sternum S T E R N U M SCAPULA rotated unnaturally

Connections between axial & appendicular skeletons I Sterno-clavicular joint

Jugular notch Manubrium Sternum body CLAVICLE S T E R N U M Acromio-clavicular joint Scapula has no other joints, Hence NO joint with axial skeleton.

SCAPULA rotated unnaturally Sterno-clavicular joint Marieb Fig 5.20, p 133

CLAVICLE Left versus Right I

The clavicle has a lumpy sternal end & a blade-like acromial end The upper surface is smoother* than the inferior one, because ligaments etc come from below to attach to tuberosities The clavicle is a pulled-out S-shape Use these three features to ID left from right thus: “Smooth” - feel on yourself

CLAVICLE Left versus Right II

1 Place the clavicle on your chest with the lumpy end at your breast-bone 2 Try on right & left sides to make the first curvature going outward from the breast-bone face forward

Front Back

3 If the upper surface is not the smoother one, move the clavicle (keeping orientations 1 & 2) to the other side It should now be identifiable as Rt or Lft

Connections between axial & appendicular skeletons II Sacro-iliac joint

SACRUM of axial is wedged into the hip bones of the appendicular pelvic girdle For stability & the transmission of load via the hip bones to the legs

Sacro-iliac joint

Marieb Fig 5.18, p 132

Tuberosity

small bump

COMMON BONE TERMS

PROCESS

Protuberance

Spine Spine FOSSA

Shallow depression

Angle Margin Border Edge Head

COMMON BONE TERMS

PROCESS has become an overused word In anatomy, as noun, it means something that sticks out or protrudes from a cell, from a bone, or from a soft organ In anatomy, as noun, process still also means the way in which something occurs - the process of cell division, the process of shrinking, of winking To give slow-witted politicians more time to think, the last example has been horribly extended by their speech-writers for example, ‘deciding’ is a noun and does not need to be the ‘decision-making process’. Thus, “deciding that won’t be easy” , “wine-making is fun” are natural & correct English

HUMERUS

Viewed from behind Is the single bone of the ARM Proximally, it articulates with the scapula at the shoulder Distally, it articulates with two bones of the forearm at elbow joint It has specially shaped surfaces at the elbow to allow the ulna & radius their movements At the elbow, it has depressions engaging processes of the ulna to limit its movement It has several tuberosities and much surface , including epicondyles, for the attachment of muscles

HUMERUS I

Viewed from front Deltoid tuberosity Lateral Epicondyle Capitulum HEAD Coronoid Fossa Medial Epicondyle Trochlea

HUMERUS II

Viewed from behind HEAD Deltoid tuberosity Olecranon Fossa Medial Epicondyle Trochlea Lateral Epicondyle

HUMERUS Right versus Left

1 On yourself, place the rounded head of the humerus at either shoulder 2 Turn the head so that it faces medially (inward) at that shoulder At the elbow end, look for the shallow coronoid fossa on one side & the deeper olecranon fossa on the other 3 Keeping orientations 1 & 2, move the humerus to the side that has the deep olecranon fossa facing posteriorly As one extends the elbow, the olecranon process of the ulna locks into the fossa on the humerus, preventing hyperextension

DISTAL HUMERUS

Viewed from front The Capitulum is a little sphere-like structure: a surface for rotation The Capitulum matches a dimple in the symmetrical head of the radius bone Trochlear is a noun, not an adjective The Trochlear is a spool-like rolling surface for the ulna For the name, remember that capital punishment used often to include beheading

Head Neck

RADIUS I

Viewed from in front Radial tuberosity Styloid process Articular surface for wrist/carpal bones

Head Neck Styloid process

RADIUS II

Viewed from in front

Radial tuberosity

Sharp edge - Interosseous border/margin Concave surface -

space for muscles

Feel for yourself: the back of the forearm is bony, the front, squishy

Articular surface for wrist/carpal bones

RADIUS: Right versus Left

Head lies at elbow end

Radius lies laterally to ulna

Sharp edge faces medially towards ulna Concave surface space for muscles faces forward Styloid process sort-of points laterally

Head

RADIUS & ULNA: Cautions

The head of the ulna is at the wrist end Styloid process The ulna also has a styloid process. The two help hold the carpal bones in place.

ULNA I

Viewed from in front Radial notch Caution - on the ulna !

Olecranon Palpable at the back of the elbow, when you flex & extend it Coronoid process Ulnar head Styloid process

ULNA II

Viewed from in front Radial notch Caution - on the ulna !

Olecranon Palpable at the back of the elbow, when you flex & extend it Coronoid process Head of ulna Ulnar head The bump lying laterally on the back of your wrist, when it is pronated (palm down) Styloid process

ULNA III

Olecranon Coronoid process Radial notch allows the radius to rotate against the ulna for supination-pronation movements Interosseous margin for strong fibrous attachment to the radius Head Concave surface -

space for muscles

Styloid process

ULNA IV

Viewed from lateral side Radial notch allows the radius to rotate against the ulna for supination pronation movements a ligament holds the radius in place Olecranon Coronoid process The elbow end of the ulna is distinctive, with its hook-like olecranon process for raking in the chips at the neolithic gaming table

HUMERUS

Viewed from behind It has specially shaped surfaces at the elbow to allow the ulna & radius their movements At the elbow, it has depressions engaging processes of the ulna to limit its movement - behind, the Olecranon fossa takes olecranon of ulna to limit extension of the elbow

Back to the forearm Right FOREARM BONES RADIUS on thumb side RADIUS ULNA on little- finger side A relation kept during pronation ULNA

ANTERIOR Right FOREARM: Radius & Ulna SUPINATED Thumb lateral Radius rotates on two radio ulnar joints PRONATED Two bones are held together by ligaments & the interosseous membrane Thumb medial

ULNA: Right versus Left

Olecranon is at elbow end

Ulna lies medially to radius

Radial notch faces laterally toward radius Sharp edge faces laterally towards radius Concave surface - space for muscles - faces forward Styloid process sort-of points medially

Anterior surfaces

Rt U LIMB

Head

RE-ASSEMBLY

HUMERUS Capitulum RADIUS ULNA Thumb

WRIST & HAND III This is a view of the DORSUM (back) of the hand. The other is the PALMAR (palm) side

Little finger/

Pinky

Head of ulna Ring finger Thumb Index finger/

Forefinger

Middle finger

WRIST & HAND I

Digits

CAUTION One thinks of the wrist as what one grips on someone, using one’s whole hand

Knuckles

However, the wrist bones carpals - are only those that lie under two fingers’ width just distal to the end of the ulna Head of ulna

HAND II: BONES

Phalangeal bones

Metacarpal bones 8 Carpal (wrist) bones

HAND II: BONES

Terminal Distal Middle Proximal

Phalanges (Phalangeal bones) 3 per finger 2 for the thumb

Proximal Terminal V IV III II I Metacarpal bones 8 Carpal (wrist) bones

WRIST & HAND II

Knuckles of the fist are the heads of the metacarpals However, the wrist bones - carpals - are only those that lie under two fingers’ width just distal to the end of the ulna Carpal bones Head of ulna But the carpal bones articulate with the radius: wrist is the radio-carpal joint

BROKEN ‘WRIST’

is a term to arouse caution The carpal bones articulate with the radius: wrist is the radio-carpal joint, so falling on the hand may break the distal radius However, the wrist bones - carpals - are only those that lie under two fingers’ width just distal to the end of the ulna Carpal bones And one bone in particular of these true wrist ones is sometimes fractured

MAINLY SPONGY BONE LOSS causes fractures in 1 Bones that are mostly spongy, e.g. vertebra

compression fracture

2 Spongy part of long bones where leverage concentrates loading “Wrist” end of radius “Hip” fracture at neck of femur

from falling on the hand

WRIST FOR COMMUNICATION Passing through the wrist are:

Arteries Veins Nerves Tendons to flex Tendons to extend All critical & vunerable, & with little muscle or fat to protect them Some protection comes from running many structures on the palmar side Some of the carpal bones create a tunnel for more protection

LEFT CARPAL TUNNEL

Schematic cross-section Ulnar artery Flexor retinaculum - sheet of fibrous tissue roofing in the tunnel Median nerve Ulnar nerve Tendons to flex CARPAL BONES Tendons to extend outside tunnel, on dorsal side of wrist lubricated spaces/compartments for structures to glide in Discomfort of C-T syndrome from compromised median nerve

RADIAL ARTERY: Pulse

Concave surface - space for muscles - faces forward & Radius lies laterally to ulna also protects vessels, e.g., radial artery Close to the wrist, where the muscles thin & give way to tendons, the pulse can be felt by pressing the artery against the bone with the finger tips

BRACHIAL ARTERY: Pulse

Brachial refers to the arm The brachial artery lies protected on the medial side of the humerus Humerus Close to the elbow, where the muscles thin, the pulse can be felt by pressing the brachial artery against the humerus, or listened for with a stethoscope

LOWER APPENDICULAR SKELETON

Lower appendicular skeleton supports the axial skeleton and upper body & provides locomotion & other activities It comprises the lower LIMB BONES & the PELVIC GIRDLE stabilizing them & connecting with the axial skeleton The connection is secured by wedging the axial sacrum between the hip bones to create the bony pelvis SACRUM ILIUM

LOWER APPENDICULAR SKELETON

Lower appendicular skeleton supports the axial skeleton upper body & provides locomotion & other activities It comprises the lower LIMB BONES & the PELVIC GIRDLE stabilizing them & connecting with the axial skeleton The connection is secured by wedging the axial sacrum between the hip bones to create the bony pelvis PELVIC GIRDLE HIP BONES Ilium Ischium Pubic bone

Connections between axial & appendicular skeletons II Sacro-iliac joint

SACRUM of axial is wedged into the hip bones of the appendicular pelvic girdle For stability & the transmission of load via the hip bones to the legs Marieb Fig 5.18, p 132

PELVIS

Viewed from in front Is an assembly of the axial sacrum & two threesomes - hip bones SACRUM ILIUM The three bones are fused together, but there are three pelvic joints: two sacro-iliac & one pubic symphysis The pelvis protects the pelvic organs, but has four openings, two large The pelvis is a stable device for transferring axial load to the legs at the hip joints The hip joints allow the legs freedom of movement

think gymnasts & ballet

Hip has much surface , including crests, for the attachment of muscles

Anterior view

HIP JOINT

SACRUM

ILIUM

Acetabulum - socket for ball like head of femur/ thigh bone This is a deep dislocation resistant ball-&-socket joint, unlike the shoulder joint

ILIUM

PELVIS: Lines of sight

In general, some of the views of bones used here are a little different from those in the textbook in order to add to your ideas on the pieces of the skeleton View from above - Superior View from in front & above Most of Marieb’s Figs View from in front - Anterior

PELVIC GIRDLE + SACRUM

Anterior view Two hip bones are fused assemblages of three bones each.

They have the sacrum wedged between them behind & fasten at the front by a fibrocartilaginous joint - symphysis Sacroiliac joint SACRUM

ILIUM

Pubic symphysis Pubic bone Ischium

ILIUM is the major bone

PELVIC GIRDLE + SACRUM II

Anterior view SACRUM

ILIUM

Obturator foramen - hole defined by Ischium below Pubic bone above Acetabulum

Anterior view

OBTURATOR FORAMEN

SACRUM ILIUM Acetabulum Inferior pubic ramus Superior pubic ramus Obturator foramen Ischial tuberosity Ischial ramus

Ramus

(L)

-

a branch, bough

Anterior view

OBTURATOR FORAMEN II

SACRUM Inferior pubic ramus

NOTE on 1 SIDE Two pubic rami, one ischial ramus Lower ramus has a join halfway along Unseen that the ischium is larger than the pubic bone

Superior pubic ramus Obturator foramen Ischial tuberosity Ischial ramus

Lateral view

HIP/COXAL BONES = ONE OS COXA

HIP BONES Ilium Ischium Pubic bone

ILIUM

Ilium Ischium Acetabulum Lines of fusion of 3 bones during childhood Pubic bone Obturator foramen

Ilium Ischium

HIP/COXAL BONES = ONE OS COXA

ILIUM

CAUTION - Ask When the term ‘hip bones’ is used, is the reference to: the two composite hip bones of each side?

the three bones making up one hip bone?

the six bones making up both hip bones?

Ask Pubic bone

SUB-PUBIC ANGLE

SACRUM

ILIUM

Obturator-foramen shape Sub-pubic angle

(Pubic arch)

is one of many variables between female & male pelves, aimed at having the female pelvis suited for childbirth, as well as the other pelvic functions

Lateral view

ISCHIUM I

Anterior view

ILIUM

SACRUM

ILIUM

Sciatic notch Ischial ramus Ischial tuberosity

what one sits on

Ischial tuberosity

PELVIS & ISCHIUM II

Superior view SACRUM Mid-pelvic diameter Ischial spines create a hazardous constriction in the pelvic (birth) canal

Please don’t squeeze my head

Superior view Before reaching the ischial tuberosities, etc, of the pelvic outlet , the baby’s head has to enter the pelvic inlet Sacral promontory One of its critical dimensions is the INLET between the sacral promontory & the upper margin of the pubis SACRUM The sacral promontory & the lower edge of the pubis can be felt via the vagina for prior warning of trouble

WORKING PELVIS

Despite the number of views of the pelvis that we have seen already, one more - the medial is needed to understand a working pelvis SACRUM ILIUM ILIUM from the midline looking laterally The empty-appearing black spaces shown within the contours of the pelvis are occupied by many muscles & ligaments Sciatic notch Ischial spine Some holes also let nerves & vessels pass out Although, for diagrams, the pelvis is presented aligned with the screen or page margins, in life it is tilted in the body in the sagittal plane

SACRUM

HIP/COXAL BONE

Medial view from the midline looking laterally Iliac crest

(felt at the ‘hip’)

Sciatic notch Ischial spine Ischial tuberosity Pubic symphisis Obturator foramen

PELVIS IN POSITION

The pelvis protects the pelvic organs, but has four openings, two large Pelvic inlet

boundary between cavities

Pelvic cavity ILIUM Abdominal cavity At the top, it is freely open to the abdominal cavity Pubic symphysis Underneath, the narrower opening is covered in by the muscles of the pelvic floor

Pelvic inlet Pelvic cavity

ILIUM

PELVIS IN POSITION

Note the axis curves going through the pelvis The upper direction is taken as the fetus grows into abdominal territory At birth, the head must make several turns & twists to follow the axis down

Abdominal cavity Pubic symphysis

Pelvic axis

PELVIS: Female versus Male

We have seen just about enough views to list some of the differences. So far, the pelvis shown has not SACRU M really been sexually differentiated.

FEMALE

More lightly built Pelvis wider & more shallow Obturator foramen oval Unseen here: pelvic inlet, oval; Sub-pubic angle wide

(greater than 80 0 )

Shorter, more curved sacrum outlet, relatively large

PELVIS: Female versus Male

FEMALE

Anterior view More lightly built Pelvis wider & more shallow Obturator foramen oval Unseen here: pelvic inlet, oval; Sub-pubic angle wide

(greater than 80 0 )

Shorter, more curved sacrum outlet, relatively large Marieb Fig 5.23, p.137

PELVIS: Male versus Female

MALE Anterior view More heavily built Pelvis deep Obturator foramen round Sub-pubic angle narrow

(less than 80 0 )

Longer, straighter sacrum Unseen: pelvic inlet, heart-shaped; outlet, relatively small

PELVIS: Female versus Male

FEMALE

More lightly built Pelvis wider & more shallow MALE Obturator foramen round Sub-pubic angle wide

(greater than 80 0 )

Longer, straighter sacrum

COXAL BONE: Right versus Left I

Iliac crest

(felt at the ‘hip’)

Acetabulum (on lateral side) SACRUM will be absent Pubic symphisis

For lab ID of one hip bone

Place the bone on yourself with: the iliac crest superior , the acetabulum facing outward , and bone tilted so that the rough pubic symphysis faces a little down, and is right at the midline to meet its fellow of the other side

COXAL BONE: Right versus Left II

ILIUM Place the bone on yourself with: the iliac crest superior, the acetabulum facing outward, and bone tilted so that the rough pubic symphysis faces a little down, and is right at the midline to meet its fellow of the other side

The pelvis protects the pelvic organs, but has four openings, two large Pelvic inlet

boundary between cavities

Pelvic cavity ILIUM

PELVIC ORGANS

Pelvic cavity: contents Genital/ reproductive Urinary bladder Ends of ureters Rectum Vessels & nerves

Abdominal cavity Pubic symphysis

Muscular pelvic floor holds contents up.

Pelvic cavity ILIUM

PELVIC ORGANS: Prolapse

Pelvic cavity: contents Genital/ reproductive Urinary bladder Ends of ureters Rectum Vessels & nerves Muscular pelvic floor holds contents up. If the floor is weakened by trauma, giving birth, nerve damage, organs can drop - prolapse; sometimes to the point of hanging out of orifices

FEMUR I

Viewed from behind Is the single bone of the thigh Proximally, it articulates with the pelvic girdle at the hip At the hip , it has a prominent head Distally, it articulates at the knee with one of the two leg bones It has specially shaped surfaces - condyles - at the knee to roll on the plateau of the tibia It has several tuberosities and much surface , including epicondyles, for the attachment of muscles

Greater trochanter

FEMUR II

Viewed from front Femoral head Femoral neck Minor trochanter Lateral epicondyle Medial epicondyle

Femoral head

FEMUR III

Viewed from behind Greater trochanter Femoral neck Minor trochanter Linea aspera Lateral epicondyle Medial condyle Intercondylar fossa Medial epicondyle Lateral condyle

FEMUR IV: ID left from right

Viewed from behind Femoral head facing in to the hip Gluteal tuberosity Linea aspera facing posteriorly Concavity for hamstring muscles & popliteal region to the back

TIBIA & FIBULA I

Lateral condyle Fibular HEAD TIBIA Rt viewed from front Medial condyle Tibial tuberosity Anterior crest

Sharp edge to be felt down the front of the shin bone

Lateral Malleolus Medial Malleolus

Patella

FEMUR IV Patella

Viewed from front The quadriceps muscles in the front of the thigh send their tendon across the knee joint to insert into the front of the tibia. As the tendon passes the knee, it includes a bone - the patella or knee-cap.

The patella, on its posterior side, has cartilage-covered surfaces to articulate with the anterior femur

(they feel smooth)

Patella does not articulate with the tibia The tendon continues on to anchor in the tibial tuberosity

Posterior

KNEE I

FEMUR Lateral view Anterior Quadriceps muscle Quadriceps tendon Patella Popliteal space for nerves vessels, muscles, etc TIBIA Cruciate Ligament One of many robust ones stabilizing the knee The fibula does not participate

Patella F E M U R TIBIA

KNEE II

Anterior view The femoral condyles roll on the flatter condyles of the tibial plateau The motion is mostly in one plane for flexion & extension of the knee because of the many ligaments restraining motion However, some rotation is necessary Wedge-shaped semicircular pieces of fibrocartilage lie medially & laterally, partially to cushion the opposing condyles. Each is a meniscus. The medial meniscus is held in place and often gets torn a “torn knee cartilage”, with the piece(s) causing inflammation & interfering with motion

Fibular HEAD

FIBULA

In the lab, the fibula is a slender bone distinguished by its lack of distinction at either end Lateral Malleolus

TIBIA

TIBIA & FIBULA II

Rt. viewed from front Lateral Malleolus TALUS Interosseous membrane

fastening fibula to tibia , along with ligaments, e.g.,

Anterior tibiofibular ligament Medial Malleolus

TIBIA Right versus Left

TIBIA Rt viewed from front Tibial tuberosity Anterior crest

Sharp edge to be felt down the front of the shin bone

Like the femur, more muscle is at the back, so the concavity should face rearwards Medial Malleolus

other Malleolus is on the fibula

Big toe

FOOT I: BONES

Rt foot from above

Phalangeal bones

Metatarsal bones Tarsal / ankle bones TALUS CALCANEUS heel-bone

Big toe

FOOT II: TARSAL BONES

Phalangeal bones

Metatarsal bones from above

Note contrasts with the wrist bones

Two much larger bones Only one bone - talus articulates with the tibia & fibula Tarsal/ankle bones TALUS CALCANEUS heel-bone Bones held together with strong ligaments Bones participate in constructing flexible arches for walking Marieb Fig 5.26, p. 139 7 bones instead of 8

TIBIA

FOOT III: ANKLE JOINT

Rt. viewed from front Lateral Malleolus TALUS Interosseous membrane

fastening fibula to tibia , along with ligaments, e.g.,

Anterior tibiofibular ligament Medial Malleolus

FOOT IV: Loading

Rt. viewed from medial side The Talus spreads the load to the heel-bone and the heads of the metatarsals to transfer to the ground, tree, floor, mud, or wherever you live TALUS CALCANEUS Medial longitudinal arch of the foot.

There are also lateral longitudinal, and transverse arches

WHERE AM I?

Online Anatomy

Module 1

INTRO & TERMS CELL EPITHELIUM

You are at the End

CONNECTIVE TISSUE MUSCLE NERVOUS SYSTEM AXIAL SKELETON APPENDICULAR SKELETON MUSCLES EMBRYOLOGY Caution how you exit.

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