The Bone Book: A Photographic Lab Manual for Identifying and Siding Human Bones 9780398091637, 9780398091644, 2017005163, 2017016710, 0398091633

Table of contents :
FOREWORD
PREFACE
ACKNOWLEDGMENTS
CONTENTS
Chapter 1 HEAD AND NECK Skull, Hyoid, Thyroid, and Cricoid
Chapter 2 CHEST AND PELVIS
Chapter 3 UPPER LIMB
Chapter 4 LOWER LIMB
Chapter 5 SUBADULT SKELETON
Chapter 6 ANALYZING SKELETAL REMAINS
Appendix 1 SKELETAL DIAGRAM
Appendix 2 SKELETAL LAYOUT PHOTOGRAPH
Appendix 3 SIX VIEWS OF SKULL
Appendix 4 MAKING AND USING A SPINE TRAY
Appendix 5 COLLECTIONS USED IN THIS BOOK
BIOGRAPHY

Citation preview

THE BONE BOOK

THE BONE BOOK THE BONE BOOK A Photographic Lab Manual for Identifying A Photographic Lab Human ManualBones for Identifying and Siding

and Siding Human Bones By

ROBERT W. MANN, PH.D., D-ABFA, FCPP By

ROBERT W. MANN, Ph.D., D-ABFA, FCPP

CHARLES C THOMAS • PUBLISHER, LTD.

Springfield • Illinois U.S.A.

Published and Distributed Throughout the World by CHARLES C THOMAS • PUBLISHER, LTD. 2600 South First Street Springfield, Illinois 62704 This book is protected by copyright. No part of it may be reproduced in any manner without written permission from the publisher. All rights reserved. © 2017 by CHARLES C THOMAS • PUBLISHER, LTD. ISBN 978-0-398-09163-7 (comb) ISBN 978-0-398-09164-4 (ebook) With THOMAS BOOKS careful attention is given to all details of manufacturing and design. It is the Publisher’s desire to present books that are satisfactory as to their physical qualities and artistic possibilities and appropriate for their particular use. THOMAS BOOKS will be true to those laws of quality that assure a good name and good will. Printed in the United States of America UB-S-2 Library of Congress Cataloging-in-Publication Data Names: Mann, Robert W., 1949- author. Title: The bone book : a photographic lab manual for identifying and siding human bones / by Robert W. Mann, Ph.D., D-ABFA, FCPP. Description: Springfield, Illinois : Charles C Thomas, Publisher, LTD., [2017] | Includes bibliographical references. Identifiers: LCCN 2017005163 (print) | LCCN 2017016710 (ebook) | ISBN 9780398091644 (ebook) | ISBN 9780398091637 (comb) Subjects: LCSH: Human skeleton--Analysis. | Human remains (Archaeology)--Analysis. | Bones--Analysis. | Forensic anthropology. Classification: LCC GN70 (ebook) | LCC GN70 .M36 2017 (print) | DDC 930.1--dc23 LC record available at https://lccn.loc.gov/2017005163

FOREWORD

D

uring half a century as a professor, I taught tens of thousands of students, including more than a thousand graduate students. I’ve long since forgotten most of them. But I’ll always remember the brightest and best. Bob Mann is one of those. Bob came to the University of Tennessee with a few more years of life and experience under his belt than most students possessed. By the time he enrolled in our master’s degree program, Bob already had an excellent grasp of osteology. He quickly became a valuable addition to our Forensic Response Team, which helped law enforcement agencies recover, identify, and analyze human remains. Bob quickly proved himself to be good at forensic fieldwork — so good that if I couldn’t go with the team on a case call, I put Bob in charge. If Bob was on the case, I knew the fieldwork would be done right. One such case made for sensational headlines. In 1986 a burned human torso — with no arms, no legs, no head, but three bullets embedded in it — was found at a quarry outside Knoxville. A few hours later, a fisherman found a severed head in a silver trash bag floating down the Tennessee River. Other body parts, including intestines and severed genitals, began turning up all over Knoxville. The story behind the case was as lurid as the disposal of the remains: A love triangle — two men and a woman — had gone sour, and one man turned against the other, stabbing him in the temple with an ice pick, then putting a plastic bag over his head, then bashing his skull with a hammer, and finally — just to be sure — shooting him three times. The case came to trial, and the surviving man and the woman were sent to prison, thanks in part to Bob’s excellent work on recovering and analyzing the victim’s remains. In the thirty years since that case, Bob has had a stellar career as a forensic anthropologist. For almost a quarter century, he worked to identify the remains of American military personnel. Among those were two Civil War sailors who drowned when the Union ironclad USS Monitor sank, eight Confederates who died in the CSS Hunley (the first submarine to sink a ship in battle), and military personnel who died in the September 11 terrorist attack on the Pentagon. The lion’s share of Bob’s work, though, has involved identifying the skeletonized remains of service personnel killed in Southeast Asia during the 1960s and ’70s — pilots and ground troops and commandos killed in Vietnam, Cambodia, Laos, and Thailand. Many of those cases have hinged on partial, fragmentary skeletal material from plane crashes or decades-old burials. That’s extremely difficult material, often requiring excavation in rough field conditions. Such work is challenging both scientifically and physically; it v

vi

The Bone Book requires skill, toughness, and dedication. Bob possesses all these in abundance. (He also plays a mean guitar, but that’s a topic for another time, another book, and maybe a CD . . .) Meanwhile, this book — The Bone Book — is the culmination of Bob’s three decades of skeletal analysis, teaching, and research on the human skeleton. Designed for use in either the lab or the field, the book covers the material from top to bottom — from cranium to metatarsals and phalanges — with the help of more than 400 vivid, full-color photographs, clearly annotated to highlight key features. Complex bones, such as the cranium, are shown in multiple photos (including several “exploded” or disarticulated skulls showing how the complex bones fit together). In addition to the photos, the book offers easy-to-follow instructions and mnemonic tips that guide the reader, step by step, through the process of identifying every individual bone and which side of the body it came from. The Bone Book can be used as a stand-alone reference or as a companion to other sources (such as my own time-tested Human Osteology: A Laboratory and Field Manual ). Bob’s book is useful not just to anthropology students but also to anatomists, surgeons, medical examiners, and others working with the human skeleton. Although most of the photos show adult bones, the book also includes helpful photos of subadult bones and even fetal bones, which some forensic cases involve. Bones tell stories, as every forensic anthropologist knows. Collectively, the bones in these pages tell me the story of Bob Mann and the experience and expertise he has amassed during a long and distinguished career. In The Bone Book, Bob is now sharing his experience and expertise with others, just as I shared mine with him many years ago. It’s an honor to be included in these pages, and this story of a former student whose career makes me very proud. WILLIAM M. BASS, Ph.D. Founder of the Anthropology Research Facility — the “Body Farm” — at the University of Tennessee

PREFACE

T

his book or manual is the culmination of more than 35 years of skeletal analysis, teaching forensic anthropology and conducting skeletal research at universities and museums in the U.S., Asia, Pacific, Africa, and Europe. While there are many illustrated human osteology and anatomy books available to students and professionals, there is none that approaches the topic of identifying and siding human bones quite like The Bone Book with its large, annotated color photographs and easy-to-follow steps, “ID and siding tricks,” as some of my students have put it. This book was written at the suggestion of my colleagues and at the urging of my students. Both encouraged me to capture and share my unique experiences in identifying, siding, and sequencing bones. I had previously relied on handouts, journal articles, textbooks, and “lab guides” when teaching classes and workshops. In 2014, I finally decided to compile a book that would provide students and professionals with an explicit, but easy-to-use photographic reference book that includes helpful tips and techniques that I’d been taught as a student at the College of William and Mary and the University of Tennessee, that I had picked up along the way, or that I came up with after examining more than 8,000 complete and partial human skeletons from around the world. Not every method or technique for identifying, siding or sequencing bones is mentioned herein, only those that I have either found most useful, or that I tend to rely on most are included in The Bone Book. I will, however, continue to seek out, and when possible, refine new methods and techniques for siding, sequencing and numbering bones and include them in future editions of The Bone Book. Being a visual learner, I have always tried to devise and use simple and easy-to-remember methods for identifying and siding bones. I appreciate reference materials with good photographs, descriptions, and accurate illustrations. I also appreciate having a photographic resource that uses pointers, like arrows, circles, squares, and lines to indicate exactly what I’m looking at so I don’t have to “Find Waldo,” as one of my students once put it. Therefore, I have used large, color photographs, many with hand-drawn arrows to give the book a more relaxed and personalized feel, to show the reader exactly what I’m referring to, and to let the reader rely on the photos without lengthy and sometimes confusing descriptions. I have done my best to provide readers with a useful laboratory and reference book that I hope is comprehensive and accurately depicted. On a technical note for those interested, the photographs in this manual were taken with a Nikon D300 camera and a 60 mm Micro Nikkor lens, mounted on a tripod, and using a manual shutter release cable to minimize camera movement. vii

viii

The Bone Book It is my desire that The Bone Book will find its place on the shelves of laboratories, libraries, and offices around the world, and that experts and novices alike will deem it useful, helpful, and, on occasion, perhaps even illuminating. I trust that The Bone Book will contribute to filling a gap in identifying and siding bones more easily and, in that sense, add to the body of anthropological, anatomical, and medical literature. It is with these intentions that I offer The Bone Book. ROBERT W. MANN, Ph.D., D-ABFA, FCPP Adjunct Professor in Anatomy and Pathology John A. Burns School of Medicine of the University of Hawaii

ACKNOWLEDGMENTS

I

would like to thank Dr. Thomas D. Holland, Dr. John E. Byrd, Dr. William Belcher, the scientists and staff of the Central Identification Laboratory (CIL), and the many dedicated men and women of the Defense POW/MIA Accounting Agency (DPAA, previously JPAC, Joint POW/MIA Accounting Command) for their untiring efforts to find, recover, and identify America’s missing servicemen and servicewomen from all past wars. America’s heroes are in great part brought home because of your unflagging efforts. I also thank the families, friends, and comrades-in-arms for their ever present hope, dedication, and promise to bring home their loved ones. For those soldiers, sailors, airmen, Marines, and civilians who have yet to come home . . . “You are not forgotten.” I also thank Cortland Sciotto of the CIL for his encouraging discussions and insightful comments during the early stages of this book. Special thanks to Dr. Scott Lozanoff, Chair of Anatomy, John A. Burns School of Anatomy of the University of Hawaii; Beth Lozanoff; Steven LaBrash; Lee LaBrash; Michael Andrews-Newman; and Jesse Thompson of the JABSOM Department of Anatomy for their dedication, vision, and expertise in human anatomy, research, and the Willed Body Program. Thanks also to Dr. Alan Schiller, Chair of the Department of Pathology ( JABSOM), for his wisdom and guidance in this and other areas of research. Special thanks to the staff and Pontestura residents and friends, particularly Mayor Franco Berra, and Giorgio Merati, Gianni Pasino, and Alessandra Pasino for their dedication and support in hosting the Campo Estivo di Osteologia e Antropologia (Summer School in Osteology and Anthropology) in Pontestura (AL), Italy. I am especially grateful to the 46 attendees comprised of forensic medicine specialists (pathologists) and anthropology and archaeology students for “field testing” a draft version of this book at the Summer School in June 2016. Roberto Cighetti read and provided useful comments on a draft of this book. I also thank my students in Introductory Forensic Anthropology at Chaminade University and Advanced Forensic Anthropology at the University of Hawaii at West Oahu for “test driving” a draft version of this book and providing useful comments in 2016. Special thanks to Professor John R. DeFreytas, LtCol, USMC (ret.) for his in-depth editing, comments, and careful attention to detail during preparation of this book manuscript. I also thank Professor and Dr. Cristina Cattaneo of the Laboratorio Di Antropologia E Odontologia Forense (LABANOF) dell'Università degli Studi di Milano (University of Milan, Italy) for her kindness and friendship, and for hosting the author’s visits and research, and the faculty and students of LABANOF for sharing their laboratory space and cases (and many lunches). ix

x

The Bone Book Thanks also to Dr. Annalisa Cappella, Dr. Daniel Gaudio, Dr. Daniele Gibelli, Dr. Danilo De Angelis, Davide Porta, Debora Mazzarelli, Dr. Emanuela Sguazza, Francesca Magli, Lara Olivieri, Marco Commaudo, Mirko Mattia, Dr. Pasquale Poppa, Zuzana Cˇ aplová, and Dr. Zuzana Obertová. Ciao and grazie mille! Thanks to Professor and Dr. Pasuk Mahakkanukrauh, Assistant Professor Apichat Sinthubua, and the staff, faculty, and students in the Forensic Osteology Program at Chiang Mai University School of Medicine, Thailand, for the CMU Osteology Collection; Neu Sittiporn for reading a draft manuscript of this book; Sumon Thitiorul, Phuwadon Duangto, Hathaichanok Chompoopuen, Natthamon Pureepatpong Kongkasuriyachai, Nadthaganya Suwanlikhid, Sithee Praneatpolgrang, Dr. Pongpon Traithepchanapai, Dr. Tawachai Monum, Phruksachat Singsuwan, and the staff, faculty, and students in the Forensic Osteology Program at Chiang Mai University School of Medicine, Thailand. Thanks to Dr. D. Troy Case (whom I first met at Chiang Mai University) of North Carolina State University for providing comments on the hands. I also thank Dr. Kamoltip Brown and Dr. Panya Tuamsuk of Khon Kaen University School of Medicine, Thailand. Special thanks also to Dr. Sakda Sathirareuangchai and the faculty and staff of Siriraj Hospital, Bangkok, Thailand. I thank Dr. Khunying Porntip Rojanasunand (Retired Director), Deputy Director General Tiyarith Temahivong, and Police Captain Rachadaporn Mornmoung of the Central Institute of Forensic Science, Ministry of Justice and the Missing Person Identification Section (MPIS), formerly the MPIC of the Central Institute of Forensic Science (CIFS), Laksi, Bangkok, Thailand for allowing me to examine some of the unidentified remains in their institute. Special thanks to the staff and identification analysts of the MPIS, including Narumol Parasompong, Onuma Tangsomsuk, Sujitra Boonma, Sulawan Limburanasmbat, Nunto Sartprasit, Malisa Lamsila, Wissarut Thanomsub, Paweena Puangsri, and Nattida Srinak for their dedicated work over the years. I have been privileged to have received comments and assistance from a number of esteemed international colleagues. I would be remiss if I did not acknowledge their invaluable input, contribution, and support over the years and I thank them all: Professor and Dr. Katerina Harvati, Dr. Michael Francken, and Judith Beier for allowing access to the osteological collection in the Department of Anthropology, Tübingen University, Germany; Professor and Dr. Dr. Michael Schultz of Göttingen University, Göttingen, Germany; Dr. Gerhard Hotz of the Natural History Museum, Basel, Switzerland; Professor Dr. Maria Teschler-Nicola, Professor Dr. Christian Koeberl, Director General of the Natural History Museum, Vienna, Austria, and Dr. Karin Wiltschke-Schrotta for hosting my visits to their museums and departments; Barbara Teßmann, Freie Universität Berlin, Institut für Prähistorische Archäologie Department for hosting my visit to Berlin and my workshop at the Charlottenburg Schloss (Charlottenburg Palace); Eduard Winter, Curator and Collection Manager of Vienna’s Pathological-Anatomical Museum Narrenturm (“Fools’ Tower”), Austria; and Dr. Sylva Kaupová, Dr. Petr Velemínský, and the staff of the National Museum in Prague (Národní Muzeum), Czech Republic. I have learned from all of you.

Acknowledgments Special thanks to my friends, colleagues, and mentors in anthropology at the College of William and Mary in Virginia, the University of Tennessee, Knoxville, and the University of Hawaii, Manoa. My sincerest thanks to Dr. William M. Bass III at the University of Tennessee for encouraging and inspiring me to pursue a career in forensic anthropology, for allowing me to be his forensic anthropology graduate assistant, and for teaching me more about the human skeleton than I thought was possible. Special thanks to my friends and colleagues Anna Dhody at the Mütter Museum and Dr. Janet Monge of the University of Pennsylvania, Philadelphia; and to Dr. Douglas Owsley, Dr. Douglas Ubelaker, and Dr. David Hunt at the Smithsonian Institution, Washington, DC for their friendship, inspiration, support, and wisdom over the years. My personal thanks to Mr. Michael Thomas of Charles C Thomas Publishers for his unwavering support and help in the publication of this and other books that I have been involved with over the years. Lastly, I thank my wife Vara as this book could not have been started nor finished without her unwavering love, dedication, and support. Mistakes, omissions, or misinterpretations in this book are exclusively mine.

“Simplicity is the ultimate sophistication.” — Leonardo da Vinci

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CONTENTS

Page Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

v

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

vii

Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

ix

Chapter 1. Head and Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3

2. Chest and Pelvis . . . . . . . . . . . . . . . . . . . . . . . . . . . .

71

3. Upper Limb . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

129

4. Lower Limb . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

189

5. Subadult Skeleton . . . . . . . . . . . . . . . . . . . . . . . . . . .

283

6. Analyzing Skeletal Remains . . . . . . . . . . . . . . . . . . . . .

349

Appendix 1. Skeletal Diagram . . . . . . . . . . . . . . . . . . . . . .

363

Appendix 2. Skeletal Layout Photograph. . . . . . . . . . . . . . . . .

365

Appendix 3. Six Views of Skull . . . . . . . . . . . . . . . . . . . . . .

367

Appendix 4. Making and Using a Spine Tray. . . . . . . . . . . . . . .

369

Appendix 5. Collections Used in this Book . . . . . . . . . . . . . . . .

371

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

373

Biography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

375

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THE BONE BOOK

From Bernhard Siegfried Albinus’ Tabulae sceleti et musculorum corporis humani (London, 1749).

Chapter 1 HEAD AND NECK Skull, Hyoid, Thyroid, and Cricoid

INTRODUCTION

B

ones are arranged in this manual using a regional approach starting with the skull and working down to the feet. The major bones and many features of the skull are identified, as are the other bones in the human skeleton. Most of this book utilizes adult bones, but it also includes some children and adolescent bones. Also included are an articulated Beauchene “exploded” skull of a subadult and a rare disarticulated (“pre-drilled”) Beauchene skull of a late adolescent or young adult, likely prepared in the 1950s or 1960s. The majority of the bones depicted in this book are from three sources: the Forensic Science Academy (FSA) of the Central Identification Laboratory (CIL) in Hawaii, the John A. Burns School of Medicine ( JABSOM) of the University of Hawaii, and the Laboratorio Di Antropologia E Odontologia Forense (LABANOF) in Milan. Also shown are bones from other institutions, including Chiang Mai University (CMU), Thailand; National Museum of Natural History of the Smithsonian Institution, Washington, DC; Tübingen University, Tübingen, Germany; Natural History Museum of Vienna, Austria, National Museum in Prague, Národní Muzeum, Czech Republic; the Mütter Museum of the College of Physicians of Philadelphia; and the Missing Person Identification Section (MPIS), Thailand. When compiling this book, I took care to cover the majority of complete and partial skeletal elements of males and females from fetal to old age. Examples of some bones and bone fragments are represented once, while others are represented several times to provide a more diverse representation of a bone, variation of a feature or trait, and additional information for those bones that are unusually difficult to identify, side, or sequence. Simply put, some bones deserve multiple images. Judging from my own experience and what students have told me over the years, I think it’s safe to say that the hands and feet have some of the most difficult bones to identify and side. Of course identifying, siding, and sequencing fetal bones can also be very difficult. Siding the tiny ear ossicles, in comparison, is usually not attempted, although there are 3

4

The Bone Book

practitioners who can easily accomplish this task. Identifying and siding adult hand and foot bones are given added attention because these bones comprise more than half the bones in the human skeleton, possess many complex articular facets, and often are not taught in the classroom. One always learns from teaching. One thing that I have learned is that a consistent approach to describing and recalling a siding feature is always simpler and easier for students to remember. For example, learning that “If the hook (or crest, or whatever) curves to the right, the bone is a right,” is simpler than “If the hook (or crest, or whatever) curves to the right, the bone is a left.” For me, the former is easy, the latter is confusing, and consistency is the key. Consequently, I have striven for consistency in all siding tips of this nature. Most non-metric traits and anatomical variants are not presented in this book. This is not the book’s intended purpose, and there are other sources and resources covering this topic. A few of the more commonly encountered pathological lesions, such as osteoarthritis and periapical abscesses of the teeth, are described to alert the viewer that these conditions can alter the appearance of bones, thereby producing artifacts that are not part of their “normal” or typical anatomy. Also included in this book are a few examples of prosthetic devices in the event the analyst encounters one of the many thousands that are put into the human skeleton (body) each year. Not all bones, epiphyses, or developmental ages are represented in this book due to extensive size and shape differences of bones at various developmental and growth stages throughout one’s lifetime. In some examples to help the reader orient or identify a bone, I have included views and perspectives not often presented in osteology textbooks or manuals.

Head and Neck

a

5

b

c

d Figure 1a-d. (a-b) Frontal and right oblique views of a known-identity, adult Caucasoid male skull ( JABSOM). (c-d) Left oblique and inferior (basilar) views of the same skull.

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The Bone Book

Figure 2. Frontal view of adult male skull (FSA DS035) (* indicates the paired nasal bones and + the nasal septum).

Head and Neck

7

Figure 3. Using back lighting to reveal a moderately developed brow ridge (resembling bird’s wings, rectangle) in an adult male ( JABSOM). Males typically have raised (convex) brow ridges and sloping frontal bones and females have small or flat brow ridge areas and vertical frontal bones when viewed from the side (laterally).

8

The Bone Book

Figure 4. Endocranial (inner surface) view of the skull “cap” (vault, calotte) showing the numerous pits housing Pacchionian bodies, also known as arachnoid granulations (circle); the metopic suture (anatomical variant if it persists into adulthood) separating the frontal bone in two pieces; the coronal and sagittal sutures; and the grooves for the meningeal arteries in both parietal bones (LABANOF). The ectocranium is the outer surface of the skull and the endocranium is the inner portion/surface that houses and surrounds the brain.

Head and Neck

Figure 5. Superior view of the hollow frontal sinuses (rectangle), nasal bones (yellow oval), and diploë (arrows) (LABANOF).

Figure 6. Endocranial view of the cranium with large frontal sinuses (rectangle) (LABANOF).

9

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Figure 7. Frontal view of a Beauchene (“exploded,” or disarticulated skull, pronounced “Boo-shin”) showing some of the major bones in a subadult skull ( JABSOM). Beauchene skulls, named after French anatomist and surgeon Edmé Chauvot de Beauchêne (ca. 1780–1830) (Spinner et al. 2011), who perfected the technique of separating the skull along its sutures, can usually only be created from the skulls of subadults and young adults before their sutures have permanently fused (synostosed).

Head and Neck

11

Figure 8. Morphology of the frontonasal (frontomaxillary) suture. Removal of the two nasal bones reveals a vertically-oriented suture resembling stalactites (rectangle) for articulation with the nasal bones (LABANOF). Note the vertical, fragile, nasal conchae inferior to this suture.

a

b

Figure 9a-b. (a) Anterior/facial and (b) posterior/internal views of left nasal bone ( JABSOM). (a) Anatomy shows the frontonasal suture for articulation with the frontal bone, the margin (>) that articulates in the midline with the right nasal bone, and the jagged lateral margin (arrow) for articulation with the vertical part of the maxilla. Note that the anterior portion of the nasal bone is convex and has several vessel foramina ( 90° angle formed by the junction of the sagittal and lambdoidal sutures (posterior-medial portion of the parietal bones).

The Bone Book

48

a

b Figure 51a-b. (a) Internal surface of the left and (b) right parietal bones showing the grooves for the middle meningeal artery () in two of the hyoids in the bottom row ( JABSOM).

a

b Figure 77a-b. (a) Anterior and (b) oblique magnified views of the lesser horns (< and >) in the same individual ( JABSOM). Note that the left lesser horn (rectangle), unlike the right lesser horn, is loosely attached to the hyoid.

Head and Neck

a

b Figure 78a-b. Two views of calcified thyroid and cricoid cartilages (CMU). (a) Thyroid (TC) and cricoid (CC) cartilages in an adult Mongoloid male showing articular facets (circle and oval) on the right side. (b) Anterior view of the calcified thyroid cartilage (TC) and cricoid cartilage (CC) showing the ring-like morphology of the cricoid.

69

Chapter 2 CHEST AND PELVIS Rib, Sternum, Vertebra, Innominate, Sacrum, Coccyx

Figure 79. Anterior view of plastinated (impregnated with silicone) rib cage showing right and left 1st ribs, costal cartilage (CC), thoracic vertebrae T11 and T12, lumbar vertebrae L1 and L2, 11th and 12th ribs, calcifications (red arrows), transverse processes of L1 and L2 (white arrows), and xiphoid process (*) in an elderly individual ( JABSOM). The sternum is comprised of three segments — the manubrium, body, and xiphoid process (Specimen prepared by Steven Labrash). Ribs 1–7 are known as true ribs and attach directly to the sternum, 8–10 as false ribs and attach to the sternum via the ribs above them, and 11–12 as floating ribs because their ventral ends are free.

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The Bone Book

72

a

b Figure 80a-b. (a) Superior and (b) inferior views of articulated rib cage (plastinated). Shown are (a) ribs 1–3, the size and shape of the opening at the base of the neck between the 1st ribs, first thoracic vertebra (T1), and manubrium showing the site of articulation (*) for the right and left clavicles. (b) Note the position of the ribs (1–8 numbered), costal cartilage (CC), vertebrae (T12 is the 12th thoracic vertebra), and the size and shape of the chest cavity/rib cage when viewed from below in an elderly individual ( JABSOM).

Chest and Pelvis

73

Figure 81. Manubrium (**), body of sternum (+), and fused first ribs (squares) in an elderly male. Note that the xiphoid process that joins along the inferior margin is missing ( JABSOM). When articulated, these bones often resemble the shape of a scorpion. When orientating the body to the manubrium (+), note that the proximal end has three angled sides (white line and arrow) and the distal end is curved or “V”-shaped (yellow line). The distal end often resembles the head of an alligator with eyes (* costal facets) along either side and a “V”-shaped “snout” (distal tip).

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The Bone Book

a

b Figure 82a-b. (a) Anterior and (b) posterior views of manubrium and sternum (CIL). (The manubrium and body of the sternum in the right photo are held together with clear tape.)

Chest and Pelvis

75

Figure 83. Right and left ribs of an adult male and paired sixth ribs (“standing”) compared by size and shape (FSA DS035).

Figure 84. Sixth and fifth ribs from the same individual comparing their size (length) and shape (FSA DS035). This is a good method to use when trying to match left and right ribs (antimeres) to see if they are the same size and shape.

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The Bone Book

a

b Figure 85a-b. Right ribs 1–11 “spooned” based on their curvature (rib 12 is missing in this specimen) ( JABSOM). (a) To put ribs in their correct anatomical order (arrows indicate the cupped sternal end), begin with rib 1 (the smallest and most C-shaped of the ribs) and put the next most curved beside it, and so forth. The ribs will not “spoon” (fit next to one another) or “stack” except in their proper order. (b) Note that the vertebral ends rise in height (red curved line) from rib 1 to rib 7 (arrow) and descend in height in ribs 8–11 (including rib 12, which is not shown in these images). Rib 7 is usually the tallest rib. The blue arrow points to rib 1, which is difficult to see in this view.

Chest and Pelvis

77

Figure 86. Stack the ribs on top of each other (possibly using tape or clear wax) and line up their vertebral ends (in this example using right ribs 2–5). The position of the round, raised costal facets will gradually “move closer” (anteriorly, blue line) towards the sternal end as you move down the ribs. The red arrow indicates the vertebral end of the rib, and the yellow arrow the sternal end.

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The Bone Book

Figure 87. Right rib showing the sharp “knife edge” (>) and groove (*) along the inferior border ( JABSOM). When siding and orienting ribs, hold the faceted vertebral end toward your spine, the cup-shaped sternal end toward the middle of your chest, and the sharp “knife edge” down or toward the table top as if you were cutting/chopping something. This will allow you to side most of the ribs, with the exception of 1, 2, 11, and 12. Remember that the “knife edge” always goes down as in a chopping motion.

Chest and Pelvis

79

a

b Figure 88a-b. (a) Right and left first ribs posterior view showing that in this position a finger can be slipped beneath the ends of the ribs. In this incorrect position the rib heads and necks are pointing upward and if pushed with a finger can be “rocked” up and down ( JABSOM). (b) Right and left first ribs oriented correctly (posterior view) with the vertebral ends (heads and necks) pointed down such that a finger cannot slide beneath them.

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a

b Figure 89a-b. Left and right first ribs showing (a) the downward curvature of the vertebral end of the first rib and (b) that curvature annotated with arrows ( JABSOM).

Chest and Pelvis

Figure 90. Right and left first ribs resembling human legs and feet ( JABSOM). When held in this position, the right “heel” (*) is medial/inside and the foot points outward (arrow) much like a person’s foot when standing ( JABSOM). The left “heel” (*) is medial and the “foot” points (arrow) lateral as well. The right foot points to the right and the left foot points to the left indicating the sides that the bones come from.

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a

b Figure 91a-b. Superior and inferior views of right first rib ( JABSOM). (a) Superior view showing the irregular surface of the rib with depression for the subclavian vein (square). (b) Inferior view showing the smooth surface of the rib (rectangle).

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Figure 92. Right ribs viewed from the inner surface (top in photo), inferior (middle), and superior (bottom) surfaces. Note the rounded superior body (inverted  and +); groove (*) for a vein, artery, and nerve; sharp “knife edge” () along the inferior edge of the rib; and “figure-8” shaped articular facets (**) for attachment to the vertebrae (FSA DS035). When held properly, the upper portion of the rib is rounded/blunt, and the inferior portion/edge is sharp. Also note the sternal end of the rib for attachment to the sternum and vertebral end for attachment to the vertebrae.

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Figure 93. Eleventh and twelfth “floating” ribs showing that the 11th is typically longer than the 12th and that both taper downward and towards their distal ends (LABANOF). Note the smoother superior margin (white arrow) and the “wavy” inferior surface (red line) in the 12th ribs.

Figure 94. Right and left 12th ribs showing their morphology when oriented incorrectly. The 11th and 12th ribs are often incorrectly sided (LABANOF). Note the concave (red wavy lines) and convex (white lines) margins of these ribs (see Figure 93). When held on the correct side (left and right), the concave “wavy” side of the 12th rib should be inferior (down), and the smoother convex margin should be superior (up). This photo shows an easy way to hold the ribs to determine right and left — note that when held on the wrong side (upside down) the pointed ends of the ribs point slightly upward (should point downward).

Figure 95. Features of the seven cervical vertebrae as seen from posterior-superior (FSA DS035). The C1 is also known as the atlas, C2 as the axis, and C7 as vertebra prominens due to the long, slender, and nearly horizontal orientation of the spinous process. The spinous processes of C2–C5, and sometimes C6, are usually bifid (divided near their tips). Cervical vertebrae also have two foramen transversaria (transverse foramen).

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a

b Figure 96a-b. (a) Anterior and (b) posterior views of the cervical spine with C1 (atlas) at the top and C7 at the bottom (FSA DS035).

Figure 97. First (C1, atlas) and second (C2, axis) cervical vertebrae viewed posteriorly ( JABSOM).

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Figure 98. First (C1, atlas) cervical vertebrae in two adults showing variation in the size, shape, and number of superior articular facets ( JABSOM). On the left is a C1 with single articular facets (*), and on the right is a C1 with divided/double superior articular facets (+). Both represent typical/normal variation.

Figure 99 Anterior view of first (C1) cervical vertebra, articulated (but not fused/synostosed) with the cranial base (occiptial condyles), in an adult male to show its position relative to the cranial base ( JABSOM).

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a

b

c

d Figure 100a-d. (a-b) Base of skull with first (C1) and second (C2) cervical vertebrae showing the morphology (size and shape) features of their articulating facets ( JABSOM). It can be very difficult to match/articulate the correct C1 and C2 to the appropriate cranial base (occipital condyles) in commingled skeletal remains. Often the opposing articulating facets of these two vertebrae are not always the same size and shape and often do not “match” or fit the occipital condyles of the cranial base. (c-d) Additionally, some C1 and C2 vertebrae from the same individual do not appear to match, when in fact they do. (c) Note that the C1 is in anatomical position and the C2 is upside down to show the opposing articulating facets (facets marked with + and *). The dens and articular facet for the dens (double-headed arrow) in this specimen articulate well with one another. (d) The inferior facets of C1 do not exactly match the superior articular facets of C2, even though they are from the same individual.

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a

b Figure 101a-b. C1 and C2 vertebrae from an adult male viewed (a) posteriorly and (b) anteriorly ( JABSOM). When trying to reassociate a C1 and C2 vertebrae, check to see if the articular facets (arrows) appear to be a good “fit” in all dimensions and that opposing facets are not noticably wider than one another. Be aware that matching a C1 with the appropriate C2 and the C1 with the cranial base (occipital condyles) can be very difficult to do in some individuals. Features to look for are facets similar in size and shape, and that any degenerative changes such as osteophytes or fused areas of bone align and are similar in morphology, but not necessarily exact.

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Figure 102. Articulated atlas (C1) and axis (C2) viewed posteriorly and from the right lateral side showing the dens (white arrow) and position of the right articular facets (red arrow) such that they meet along the edge of both facets and are neither too wide nor too short for one another (adult male, JABSOM). The size and shape of these facets indicate they articulate properly and are from the same individual (which they are). Note that in this individual the superior articular facets of C1 are divided/double, a feature not always present in the corresponding occipital condyles.

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Figure 103. Anterior view of the fifth, sixth, and seventh cervical vertebrae (sawed horizontally through the centrum) showing their morphology and small bony projections (*), known as osteophytes, in an adult male ( JABSOM). They represent degenerative joint disease. Some osteophytes on vertebral bodies (centra) may form bony bridges that align and articulate.

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Figure 104a-b. (a) Anterior and (b) posterior views of thoracic vertebrae T1 through T12 (FSA DS035).

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b Figure 105a-b. Facet morphology of a T12 (12th thoracic) vertebra ( JABSOM). (a) Left posterior-oblique view showing the flat orientation (red line) of the two superior articular facets and the curved/angled morphology of the two inferior facets (curved blue line). Note the single articular rib facet (red circle) on the left and right side that are only present in 11th and 12th thoracic vertebrae. (b) Inferior view of morphology of the “V”-shaped/angled inferior facets of the 12th thoracic verebra (inverted red “V”) and small transverse processes (arrow). The 12th thoracic vertebra is also known as the “transitional” vertebra because of its thoracic-like flat superior articular facets and lumbar-like angled inferior articular facets. These facets allow the spine to transition from thoracic vertebrae to lumbar vertebrae.

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c

Figure 106a-c. Thoracic vertebrae and right rib (FSA DS035) (see Figure 107) showing two articular facets () on the side that the bone comes from. The concave side is along the left side of the auricular surface in this left innominate.

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Figure 134. Auricular surface (rectangle) of the left innominate showing the horizontal pattern of valleys and peaks consistent with a subadult or young adult (Tübingen). Note the boomerang shape of this area with its convex anterior margin and concave posterior margin indicating it is a left bone. Another way to side the innominate using the auricular surface is to think of the two ends of the “>” as arrowheads (black arrows) or fingers that point to the side it comes from.

a

b Figure 135a-b. Medial/internal view of adult male right innominate showing (a) the shape of the auricular surface (arrow) and (b) the “V” formed with the index and middle fingers overlaying the auricular surface that points to and opens to the right, indicating this is a right hip/innominate (FSA).

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a

b Figure 136a-b. Medial/internal view of adult female left innominate showing (a) the shape of the auricular surface (arrow) and (b) the “V” formed with the index and middle fingers overlaying the auricular surface that points to and opens to the left, indicating this is a left hip/innominate (FSA).

Figure 137. Right innominate and sacrum showing an accessory articular facet (circles) where the posterior portion of the innominate abuts/articulates with an area of bone posterior to the auricular surface of the sacrum ( JABSOM). The twoheaded arrow indicates that these two joint surfaces articulate/join one another.

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Figure 138. The same right innominate and sacrum as in Figure 137 showing the accessory articular facet (circle) formed by contact with the sacrum and innominate ( JABSOM). Note the degenerative joint disease/osteoarthritis (pitting and irregular bone growths  and ) (CIL). The medial epiphyseal cap of the clavicle is the last epiphysis in the human skeleton to fully unite/fuse, usually by about 30 years of age.

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a

b Figure 149a-b. Sawed adult clavicle (CMU). (a) Anterior view showing the morphology of the sternal and acromial ends. (b) Medial view showing the internal structure of the trabeculae (blue arrow) and thin outer cortex (red arrow). Some might think that the entire length of the clavicle is occupied by the “hollow” (tubular) medulla. As this illustration shows, the sternal and acromial ends of clavicles are filled with trabeculae.

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Figure 150. Variation in the size and shape of nine, adult right clavicles (superior view) (CMU).

Upper Limb

Figure 151. Left and right inferior views of clavicles from an adult Thai male (CMU). Note the location of foramina (rectangle and square) along the concave, or inferior, surface of the clavicle. Also note that clavicles have an “S”-shape. With the clavicle laid flat and the large, round, medial/sternal end toward you, rotate the clavicle so the conoid tubercle (circle) points up. Now the flattened, lateral, scapular end points to the appropriate side; i.e., it points right in a right clavicle and left in a left clavicle.

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a

b Figure 152a-b. (a) Posterior and (b) anterior views of scapulas in an elderly male ( JABSOM). (b) Note the bilateral suprascapular foramina (red squares) as a result of calcification of the suprascapular ligament, angled/diagonal pleating () of the body for muscle attachments, and the translucent (paper-thin) areas of the body, likely due to osteoporosis. Young and healthy individuals, however, often have thin/ translucent scapular bodies.

Upper Limb

Figure 153. Magnified view of the anterior/ventral surface of left scapula ( JABSOM) showing the suprascapular foramen (red square) and paper-thin body (CP = coracoid process; AP = acromial process).

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Figure 154. Dorsal/posterior view of a left scapula showing the translucent body such that the fingers can be seen through the bone when backlit as in this image ( JABSOM).

Upper Limb

Figure 155. Anterior view showing the morphology of a left scapula in an adult (FSA DS035).

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Figure 156. Left scapula with osteophytes (*) due to osteoarthritis, surgical removal of the lateral portion of the coracoid process (square), and a glenoid cavity prosthesis (arrow) ( JABSOM).

Upper Limb

Figure 157. Posterior/dorsal view of a left scapula showing its morphology (FSA DS035).

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Figure 158. Medial view of left scapula (FSA DS035). When held in this position, there is a small notch (>) along the glenoid cavity that, if on the left side of the glenoid, indicates it is a left scapula, and along the right side of the glenoid cavity, that it is a right scapula. Note that the inferior portion of the scapula, when held in this position, curves down and to the left (white curved arrow), indicating that the bone is a left scapula. Also note that the acromion and coracoid processes both point to the side the bone comes from, in this case to the left.

Upper Limb

Figure 159. Anterior/ventral view of right scapula (FSA).

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Figure 160. Posterior/dorsal view of right scapula (FSA DS035).

Upper Limb

Figure 161. Lateral view of right scapula (FSA DS035). Note the small notch () as depicted here, note the location of the nutrient foramen (square). (b) Hold the radius with the large distal end up and the interosseous crest toward you. The concave side (red arrows) at the distal end will go up and to the left in a left radius, and up and to the right in a right radius. (c) To side the proximal end, draw a line along the interosseous crest (blue). The radial tuberosity (*) will be to the left side of the line in a left radius and to the right of the line in a right radius.

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b

Figure 172a-b. Right radius showing a typical position of nutrient foramen and typical position of the radial tubercle in an Asian adult (CMU). (a) Nutrient foramen (rectangle) is positioned along the left side of the interosseous crest (arrow), with the typical position of the radial tuberosity along the right half and lateral to the interosseous crest (oval), and normal anatomy and curvature (curved arrow) of the concave distal end in a right radius. The radial nutrient foramen is usually positioned along the right half of the interosseous crest in a right radius, and along the left half of this crest in a left radius. (b) Red probe inserted into the nutrient foramen (black circle) showing its orientation entering the bone towards the elbow and the typical position of the radial tuberosity (oval).

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b Figure 173a-b. Left and right distal radii (FSA). (a) When positioned as seen here, one of the sides is straighter than the other sides and it angles down (arrows) and to the side the bone comes from. (b) In addition to the downward angle of one of the sides (arrows), the outline of the articular surface typically resembles a capital “B.” The two loops that form the “B” point to the side the bone comes from. When oriented as a “B”, the bone is a right radius, and when the “B” is left facing, or reversed, it is a left radius.

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b

Figure 174a-b. Right and left ulnae (FSA). (a) Ventral view of the ulnae showing its morphology. (b) Hold the ulnae with the proximal end up, the interosseous crest (+) and radial notch (*) facing toward you. The trochlear opening (“mouth” or “Pac-Man” as some like to remember it) of the ulna opens (red arrows) to the side the bone comes from. To side the distal end of an ulna, hold the bone in this position and note that the distal end curves down and toward (white arrows) the side the bone comes from.

Figure 175. Distal right and left ulnae (FSA). Hold the ulna with the styloid process (*), a finger-like projection, at the top. There will be a slight ridge (red arrows) of bone that extends and curves from below to above toward the styloid process. This curved line will travel up and to the right in a right ulna, and up and to the left in a left ulna. Note the interosseous crest and concavity (+) along the bottom of the ulna when held in this position.

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a

b Figure 176a-b. Dorsal and palmar views of right and left hands ( JABSOM). (a) Dorsal view of the right and left hands, showing the radius (R) and ulna (U) in pronation (medial rotation). (b) Palmar view of the right and left hands, showing the radius (R) and ulna (U) in supination (lateral rotation).

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Figure 177. Right hand dorsal view (MPC). Not shown are the sesamoid bones that may be present in the 1st, 2nd, and 5th fingers. (Note: This hand is presented to demonstrate the articulation of the carpals and metacarpals. A few of the middle phalanges appear to have been incorrectly sided when reconstructed/articulated and are not in their proper sequence.) Popular mnemonic: Some Lovers Try Positions That They Can’t Handle Scaphoid Lunate Triquetral Pisiform Trapezium Trapezoid Capitate Hamate

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Figure 178. Right hand palmar view (MPC). Not shown are the sesamoid bones. (Note: This hand is presented to demonstrate the articulation of the carpals and metacarpals. A few of the middle phalanges appear to have been incorrectly sided when articulated at a biological supply house and are not in their proper sequence.) One way to remember which of the “3 Ts” (triquetral, trapezium and trapezoid) comes first as you say the mnemonic is “Tri Trapping a Trapezoid.” Popular mnemonic: Some Lovers Try Positions That They Can’t Handle Scaphoid Lunate Triquetral Pisiform Trapezium Trapezoid Capitate Hamate

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Figure 179. The first step in laying out (left) hand bones (in five regions) (FSA DS035). From left to right are the 5 distal phalanges, the 4 middle phalanges (only 4, as the thumb doesn’t have a middle phalanx), the 5 proximal phalanges, the 5 metacarpals, and the 8 carpals (wrist bones).

Figure 180. Dorsal view (pronated/medial rotation) of right hand of a late teen or young adult showing some of the hardware used to articulate the hand bones ( JABSOM). Hardware such as this is consistent with a commercially prepared anatomical specimen.

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Figure 181. Dorsal view of right hand ( JABSOM) without the carpals. The metacarpals and phalanges in this specimen were dissected and kept separate to ensure the proper sequence of each bone (from left to right: 1st (thumb), 2nd (index), 3rd (middle), 4th (ring), and 5th (little) fingers. Note that the first finger has only two phalanges (proximal and distal), unlike the other four fingers, each of which has three phalanges. The formula for hand phalanges starting with the first finger is 2-3-3-3-3.

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Figure 182. Palmar view of right hand ( JABSOM) without the carpals. The metacarpals and phalanges in this specimen were dissected and kept separate to ensure the proper sequence of each bone. Not shown are the small sesamoid bones that may be present in the 1st, 2nd, and 5th fingers. Note that the first finger has only two phalanges (proximal and distal), unlike the other four fingers, each of which has three phalanges. The formula for hand phalanges starting with the first finger is 2-3-3-3-3.

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Figure 183. Dorsal view of right hand showing the approximate articulation of the metacarpals and phalanges in this dissected hand. DP = distal phalanx, MP = middle phalanx, and PP = proximal phalanx ( JABSOM). (This individual has osteoarthritis of some of the bones in this hand and shows some features/variation due to degenerative joint disease.)

Upper Limb

Figure 184. Dorsal view of the proximal facets of right 2, 3, 4, and 5 metacarpals articulated ( JABSOM).

Figure 185. Palmar view of right 2, 3, 4, and 5 metacarpals showing the morphology of their facets ( JABSOM).

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a

b Figure 186a-b. (a) Medial and (b) lateral views of right 2, 3, 4, and 5 metacarpals showing their overall morphology ( JABSOM). Note the base (proximal end), shaft (diaphysis), and head (distal end or knuckle).

Figure 187. Dorsal view of left and right distal hand phalanges (dissected) when aligned by their proximal joints showing their morphology ( JABSOM). Note that the first distal phalanges are the largest, the fifth phalanges are the smallest and narrowest, and, in this specimen, the third phalanges are wider than the second and fourth phalanges.

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Figure 188. Dorsal view of partially disarticulated left hand (left in photo; JABSOM) and dorsal view of articulated right hand (right in photo; MPC). Note the pattern (curved arrow) for the mnemonic, “Some Lovers Try Positions That They Can’t Handle,” that begins in the row of carpal bones nearest to the radius and moves toward the ulna (S-L-T-P), and then comes back to the thumb side and goes laterally again toward the ulna (T-T-C-H). (Note: The hand in the right half of the photo is presented to demonstrate the articulation of the carpals and metacarpals. Some of the middle phalanges appear to have been improperly sided and sequenced when articulated at a biological supply house and are not in their proper sequence.)

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b

c Figure 189a-c. (a) Dorsal view of left metacarpals showing their morphology and “V”-shaped flattened surface that helps distinguish right from left metacarpals (FSA). (b) Metacarsals 5, 4, 3 and 2 (left to right) showing a curved line that is part of the “V” that originates (>) along the lateral/outer side of the bone and curves proximally. Another method is to follow the curve (red line) from its proximal end such that the red line curves up and to the left in a left bone, and up and to the right in a right metacarpal. When in doubt always examine/rely on the proximal facets, as the curved lines may be altered by acidic soil. (c) The same metacarpals showing the “V” and flat dorsal area (blue); the “V” is present in metacarpals, but not present in metatarsals.

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b Figure 190a-b. (a) Palmar and (b) dorsal views of left 2, 3, 4, and 5 metacarpals showing the morphology of their proximal articular facets ( JABSOM).

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Figure 191. Comparison of a right metatarsal (foot) and metacarpal (hand) ( JABSOM). Note that the diaphysis/shaft of the metatarsal typically is longer, narrower, and tapers distally, and that the distal joint for articulation with the phalanges is smaller in comparison to that in the metacarpal. Close examination, using shadows, will reveal that the metacarpal has a “V”-shaped flat area along the dorsal surface.

Upper Limb

Figure 192. Dorsal (pronated) view of left hand showing approximate position and articulation of the bones for better viewing of the features used to side them (FSA). Note that in many textbooks and articles the hand scaphoid is referred to as the navicular. The scaphoid, however, can be easily distinguished from the navicular. The scaphoid is “S”-shaped and about the size of a cashew nut. The scaphoid is about half the size of the navicular and will fit inside the concave facet of the navicular (see Figure 285b).

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Figure 193. Loosely articulated metacarpals and phalanges in a dissected left hand ( JABSOM). These bones/fingers are in their correct rays (sequence from 1–5), compared to a fleshed left hand. The formula for hand phalanges starting with the 1st finger is 2-3-3-3-3.

Figure 194. A comparison of the proximal phalanges of the left hand and left foot in an adult. The foot phalanx, unlike the hand phalanx, constricts and narrows at mid-shaft (red line) (FSA).

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Figure 195. Left hand 2nd and 3rd middle (M) and distal (D) phalanges (dissected, known finger numbers) showing their comparative size and shape. Note the “V”-shaped/projection (*) along the superior margin of the proximal (base) articular surfaces ( JABSOM). This “V”-shaped projection is present in the middle phalanges and fits into a “V”-shaped depression along the distal end of the proximal phalanx.

a

b Figure 196a-b. (a) Dorsal and (b) proximal views of right and left distal 1st phalanges, the largest of the distal hand phalanges, showing their similar morphology ( JABSOM). (a) Note the relative distance (double-headed arrow) from the tuft to the proximal extensions. Note that the shorter distance/shorter arrow (yellow) is usually on the side the bone comes from, although activities and osteoarthritis can result in considerable variation of these features.

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Figure 197. Right carpal (wrist) bones (see the next figure for ways to side these bones) in a dissected hand ( JABSOM). Note there are several spellings and names (synonyms) for the carpals and tarsals. For example, the “triquetrum” (pronounced “tri-kwee-trum”) is often called the “triquetral” (pronounced “tri-kway-tral”); the “trapezium” is called the “greater multangular,” and the “trapezoid” is called the “lesser multangular.”

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Figure 198. Showing how to side the right carpal (wrist) bones ( JABSOM). For quick reference: trapezium is shaped like a saddle with an elongated saddle horn (*) and a groove () indicate the lateral supracondylar line, an extension of the linea aspera along the posterior surface of the femur that extends down and to the right indicating this is a right femur.

Lower Limb

Figure 227. Sawed right and left femurs showing their internal morphology (CMU). Note the fovea capitis (FC) for attachment of the ligamentum teres that helps hold the femur head in the acetabulum, the greater trochanter (GT), lesser trochanter (LT, green arrow), cortex, and medullary cavity. Also note the varying thickness of the cortex (blue arrow) and the dense pattern of latticework-trabeculae (circles) providing internal support to the femur.

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b

Figure 228a-b. (a) Anterior and (b) posterior views of a right femur (FSA DS035).

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b Figure 229a-b. Right femoral head and fovea capitis ( JABSOM). (a) The oval, round, or tri-cornered fovea capitis (central depression) showing that the longest distance (black arrow) of the fovea capitis to the circumference of the femoral head is always superior, the “corner” of the fovea capitis closest to the circumference (red arrow) is apparent in the lower the right corner in this right femur, and the intermediate corner (yellow arrow) is on the left. (b) When viewed medially and regardless of the shape of the fovea capitis, the lowest point (red arrow) indicates the side the bone comes from. The shortest distance can be obtained metrically or visually. (See Mann 1990 for more on this method.)

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Figure 230. Posterior view of paired left and right distal femurs showing the prominent and raised lateral supracondylar line (< and >) that slopes downward and to the side that the bone comes from (FSA).

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b Figure 231a-b. Prominent supracondylar line/crest, an extension of the linea aspera, along the posterior surface of the femur that extends down and to the right, indicating this is a right femur (CMU). (a) Posterior surface of a right femur and (b) posterior close-up of the same right femur.

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Figure 232a-b. (a) Anterior and (b) posterior views of articulated left femur, tibia, and fibula (FSA DS035). (b) The soleal line (long arrow) on the posteiror surface of the tibia is angled such that it runs up and toward the side that the bone comes from, in this case up and to the left. Note that the articular facet (circle) near the top of the left soleal line is always posterior and lateral (same side that the bone comes from) and articulates with the large oval facet at the proximal end of the fibula (double-headed arrow). Also note that the large foramen (rectangle) enters the tibia from above to below (small black arrow). Remember the saying known to many medical students and physical anthropologists that the nutrient foramen in the arm and leg bones typically “seeks the elbows and flees the knees.” This mnemonic can usually be used to orient these bones.

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b

Figure 233a-b. (a) Anterior and (b) posterior views of articulated right femur, tibia, and fibula (FSA DS035).

Figure 234. Right distal femur, with the posterior surface facing up, showing the articular surface consisting of two large and rounded condyles that articulate with the proximal tibia, the intercondylar line shaped like a “U” (>, , and ) and medial toward the side that the bone comes from. In this example, the border travels down and to the right, indicating it is a right tibia (FSA). Note that when looking at the tibia from this perspective (anteriorly), the medial malleolus (red rectangle) is on the side of the tibia that the bone comes from, in this example the right side. The fibula shows its approximate orientation lateral to the tibia.

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c

d Figure 250a-d. Siding a right distal tibia. (a) Right tibia placed on a flat surface with its anterior (A) surface up (L = lateral, P = posterior, M = medial surfaces; * = medial malleolus) (LABANOF). (a-d) The four images show the features of the distal right tibia as it is rotated clockwise one-quarter turn in each image.

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Figure 251a-b. (a) Lateral view of right and left fibulae (FSA DS035). The small finger-like projection of bone (>) on the right fibula is an osteophyte, likely resulting from localized trauma. (b) Superior view of proximal end of left fibula showing the position and orientation of the large oval-shaped articular facet that articulates with an oval-shaped facet on the proximal end of the tibia.

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Figure 252a-c. Right and left fibulae ( JABSOM). (a) Right and left fibulae showing the roughly triangular facet (*) for articulation with the talus and the internal/medial surface of the length/diaphysis of the fibulae, and the apex (+) at the proximal end in an adult male. (b) Raised ridge (< and >) that forms a “V” as it travels towards the foot. Note the concave area (*) along the anterior ridge. (c) Right and left fibulae turned upside down showing the curved “V” ridge (< and >) that, in this orientation (upside down), goes up and toward the side that the bone comes from. In this photo, the curved “V” goes up and toward the left in the left fibula, and up and toward the right in the right fibula. The diaphyses of fibulae are extremely variable, not only between individuals, but often within the same individual. Siding the diaphysis of a fibula when the proximal and distal ends are missing is very difficult, but in most cases can be accomplished following this method that relies on features of the midshaft of the diaphysis.

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Figure 253. Siding a right fibula (diaphysis) by putting the proximal end down (hold the bone upside down) and looking for the “V” along the diaphysis ( JABSOM). The “V” will be widest at the true proximal end and tapers to a point (wedge shaped) toward the true distal end. When held in this position, the point of the “V” will go up and off toward the side (arrow) that the bone comes from, in this example, the right side indicating that this is a right fibula.

Lower Limb

Figure 254. Pilot study (October 2015) for siding a fibular diaphysis missing the proximal and distal ends and without the landmarks and features to identify, or side, the bone ( JABSOM). In the diagram the internal surface and morphology of a left fibula, as well as the external surface and morphology, are being examined, looking for “siding” features. (The drawing is not to scale.)

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Figure 255a-b. Right fibula turned upside-down (note that the anatomical distal end is up and the anatomical proximal end is down). Use the elongated and “V”-shaped feature of the diaphysis to side the bone (CMU). (a) The right fibula without the “V”-shaped feature highlighted and (b) the same illustration with the “V”-shaped feature outlined in red. The “V” goes up and to the right (arrow) in a right fibula and up and to the left in a left fibula (not shown). The dark brown staining at the proximal end of the bone is due to grease that leeches out of bone if it has not been thoroughly degreased.

Lower Limb

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b Figure 256a-b. (a-b) Medial view of orienting a left fibula with the large, rounded proximal end (circle) up and large vertical/ triangular facet (arrow) for articulation with the talus facing you (FSA). (b) When held in this position, the small “ear lobelike” indentation (the thumb is grasping) will be on the side that the bone comes from. This small indentation is like an ear lobe that can be grabbed and held between the thumb and index finger (without crossing over and hiding the large triangular facet).

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Figure 257. When held in this position (medial view), you can cover the large oval-shaped proximal articular facet with the thumb on the side that the bone comes from (in this case the left fibula) (FSA). Note that in this orientation the large triangular facet (arrow) for articulation with the talus will be facing you. The diaphysis/shaft of fibulae is extremely difficult to side if both the proximal and distal ends of the bone are missing.

Lower Limb

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b Figure 258a-b. (a) Left proximal fibula with its flat margin down (horizontal red line), large oval-shaped facet (*) with its longest dimension top to bottom, smallest dimension left to right, and the widest lateral margin (red double-headed arrow) and narrower medial margin (blue double-headed arrow) (FSA). (b) Left proximal fibula such that the (left) thumb can grasp and cover the facet on the side the bone comes from (without “crossing over” the bone with the right thumb), leaving a large non-articular portion of the fibula visible.

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b Figure 259a-b. (a) Proximal end of left and right fibulae showing the morphology and large oval facet that articulates with the proximal tibia. (b) In this position, the oval facet is oriented with its maximum length top to bottom (white double-headed arrow) and narrowest left to right and resting on the flattest side of the proximal fibula (horizontal red line). Note that the outlines of the ovals (slightly tear-drop shaped) are narrowest at the bottom and widest at the top and that there is a wide area of bone medial to the oval (b; double-headed red arrow).

Lower Limb

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b Figure 260a-b. (a) Morphology of the proximal end of the left and right fibulae (FSA). (b) When held in this position, the oval facet slopes down (red arrow) and to the side the bone comes from. The other side of the proximal end slopes down (black line) in the opposite direction forming an inverted “V.”

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Figure 261a-b. Lateral view/surface of distal left fibula (FSA). (a) Holding the proximal end of the fibula superiorly (up) and with the flat, triangular distal facet away from you, look for a narrow, vertically oriented triangle that goes up and toward the side that the bone comes from. (b) In this example the triangle (known as the subcutaneous surface [Dixon 1937] or subcutaneous triangle), goes up and to the left (arrow) indicating this is a left fibula. This triangle is positioned along the anterolateral surface of the distal tibia. Look for this triangle when trying to side even small distal fragments of a fibula.

Lower Limb

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c Figure 262a-c. Right and left patellas (FSA). (a) Anterior view of patellas showing their striated and pitted surfaces. (b) Posterior view of patellas showing the large (lateral) and small (medial) articular surfaces and pointed inferior portion (red arrows). (b) The left patella exhibits a vertical line/crease (