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Evidence-based physiotherapy and rehabilitation resources
Editorial & review policyHuman Anatomy · General anatomy
Before you learn a single bone, you need the language that describes where things are and how they move. Get this chapter right and every later one becomes easier; skip it and you will spend three years guessing what a sentence means.
Anatomy is the study of the structure of the body and the relationships between its parts. That sounds dry until you realise what it buys you: if you know exactly what lies under your hand, you can work out what has gone wrong without seeing inside.
The subject is usually divided into several branches, and you will meet all of them during your course.
| Branch | What it studies | Where you meet it |
|---|---|---|
| Gross anatomy macroscopic |
Structures large enough to see with the naked eye. Usually taught either region by region, or system by system. | Most of this subject. The bones, muscles, vessels and nerves you will name and palpate. |
| Histology microscopic |
The structure of tissues and cells, seen under a microscope. | Why bone can remodel and cartilage struggles to heal. |
| Embryology developmental |
How the body forms from a single cell, and how that process can go wrong. | Congenital conditions such as spina bifida, and why a nerve supplies the muscles it does. |
| Surface anatomy living anatomy |
What can be seen and felt on a living person. | Every assessment you will ever perform. Arguably the most important branch for a physiotherapist. |
| Radiological anatomy | The body as it appears on X-ray, ultrasound, CT and MRI. | Reading the imaging report that arrives with your patient. |
| Applied or clinical anatomy | Anatomy interpreted for practice: what a structure means when it is injured. | Everywhere. It is the reason the rest is worth learning. |
Why this subject carries more weight for you than for most
A physician can order a scan. A physiotherapist works with hands, eyes and reasoning, on a living person, usually without imaging in the room. Your anatomy has to be good enough to build a picture of what is underneath from what you can see and feel. That is a higher standard than passing an examination, and it is the standard this subject is written to.
Here is a problem. If a patient is lying face down and you say a structure is "above" the knee, you have said nothing useful, because "above" depends entirely on how they happen to be lying. Anatomy solves this by agreeing on one reference posture and describing everything from it, no matter what position the person is actually in.
The anatomical position, in full
The body stands upright, with the head facing forward and the eyes looking to the horizon. The feet are together and flat on the ground, toes pointing forward.
The arms hang by the sides, and the palms face forward, so the thumbs point away from the body.
That last detail catches people out, so it is worth pausing on. Standing normally, your palms face your thighs and the radius crosses over the ulna. In the anatomical position the forearm is supinated, and the radius and ulna lie parallel and uncrossed. This is why the radius is described as lateral and the ulna as medial — a description that only makes sense in this position, and would be wrong for an arm hanging naturally by the side.
Everything that follows — every plane, every direction, every movement name — is defined from this position. When you read that a structure is anterior, it means anterior in the anatomical position, whatever the patient is doing at the time.
A plane is a flat surface cutting through the body. Three of them matter, and each one divides the body a different way.
Figure 1 · The three planes of the body
| Plane | Runs | Divides the body into | Also called |
|---|---|---|---|
| Sagittal | Front to back, vertically | Left and right parts | The one passing exactly through the midline is the median or midsagittal plane. Any sagittal plane parallel to it and off to one side is paramedian. |
| Coronal | Side to side, vertically | Front (anterior) and back (posterior) parts | Frontal plane |
| Transverse | Horizontally | Upper (superior) and lower (inferior) parts | Horizontal or axial plane. This is the plane most CT and MRI slices are cut in. |
| Oblique | At an angle to all three | — | Most real human movement happens in oblique planes. The three above are a simplification we use to describe it. |
A plane tells you the flat surface a movement travels along. An axis is the imaginary line the movement turns around, like the pin through a hinge. The two always come as a pair, and the axis is always at right angles to the plane.
This is the single idea that makes movement names logical rather than arbitrary, so it is worth learning properly now.
Figure 2 · Planes, axes and the movements that pair with them
Read that as a sentence each time: flexion happens in the sagittal plane, around a frontal axis. Bending your elbow moves the forearm along a front-to-back surface, turning around a side-to-side pin through the joint. Once the pairing is fixed in your head you can work out any movement name from first principles instead of memorising a list.
The exception that proves the rule
Movements of the thumb are named relative to the plane of the palm rather than the body, because the thumb sits rotated ninety degrees to the other digits. Thumb flexion and extension therefore happen in the coronal plane of the body, and abduction and adduction in the sagittal plane — the opposite way round to everywhere else. Expect this to be asked.
These are the words you will use in every set of notes you ever write. They always come in opposing pairs, and each pair answers one question.
Figure 3 · Terms of position and direction
| Term | Means | Example |
|---|---|---|
| Superior / inferior | Nearer the head / nearer the feet | The shoulder is superior to the elbow. |
| Anterior / posterior | Nearer the front / nearer the back | The sternum is anterior to the heart. |
| Medial / lateral | Nearer the midline / further from it | The ulna is medial to the radius. |
| Proximal / distal | Nearer the trunk or the origin of a limb / further away | The knee is proximal to the ankle. Used for limbs, not the trunk. |
| Superficial / deep | Nearer the surface / further from it | The skin is superficial to the muscles beneath it. |
| Internal / external | Nearer the inside of a cavity or organ / nearer the outside | The internal surface of the ribs faces the lungs. |
| Ipsilateral / contralateral | On the same side / on the opposite side | After a stroke, weakness is contralateral to the lesion. |
| Dorsal / ventral | Back / front. More common in embryology and neuroanatomy. | The dorsal root of a spinal nerve carries sensation. |
| Palmar / dorsal (hand) | The palm side / the back of the hand | The palmar surface of the fingers grips. |
| Plantar / dorsal (foot) | The sole / the upper surface of the foot | Plantar fasciitis affects the sole. |
| Cranial / caudal | Towards the head / towards the tail | Used mainly for the trunk and in embryology. |
| Prone / supine | Lying face down / lying face up | Position your patient prone for a lumbar examination. |
Two pairs that are relative, not absolute
Proximal and distal and superficial and deep only mean anything when you name the two things being compared. A structure is not "distal" on its own; it is distal to something else. Writing "pain in the distal thigh" is loose; "pain in the thigh, just proximal to the knee" is a description another clinician can act on.
Movement terms describe what a joint does. Most are paired opposites, and most follow the plane-and-axis logic above.
Figure 4 · The shape of the basic joint movements
| Movement | What happens | Plane and axis |
|---|---|---|
| Flexion | The angle at the joint decreases; the two parts approach each other | Sagittal plane, frontal axis |
| Extension | The angle increases, returning towards or beyond the straight position. Movement past straight is hyperextension. | Sagittal plane, frontal axis |
| Abduction | The part moves away from the midline of the body | Coronal plane, sagittal axis |
| Adduction | The part moves back towards the midline | Coronal plane, sagittal axis |
| Medial rotation | The front of the limb turns towards the midline | Transverse plane, vertical axis |
| Lateral rotation | The front of the limb turns away from the midline | Transverse plane, vertical axis |
| Circumduction | Flexion, abduction, extension and adduction performed in sequence, so the limb traces a cone. It is a combination, not a movement of its own. | All three |
Several regions have movement names of their own, because the general terms do not describe them well. These are the ones you must know:
| Region | Movement | What happens |
|---|---|---|
| Forearm | Pronation | The palm turns to face backwards or downwards; the radius crosses over the ulna. |
| Supination | The palm turns to face forwards or upwards; the two bones lie parallel. Remember it as carrying a bowl of soup. | |
| Ankle | Dorsiflexion | The foot lifts towards the shin. |
| Plantarflexion | The foot points downwards, as in standing on tiptoe. | |
| Foot | Inversion | The sole turns to face the midline. |
| Eversion | The sole turns away from the midline. | |
| Scapula and jaw | Protraction | Movement forwards, away from the midline of the back. |
| Retraction | Movement backwards, towards it. | |
| Scapula | Elevation | Lifting, as in shrugging. |
| Depression | Lowering again. | |
| Thumb | Opposition | The thumb pad turns to meet the pad of another finger. It is what makes the human hand what it is. |
| Reposition | Returning the thumb from opposition. | |
| Trunk and neck | Lateral flexion | Side bending, in the coronal plane. |
Bones are not smooth. Their bumps, ridges and hollows exist because something attaches there, passes over it, or sits in it — so the names are worth learning as a set of clues rather than a vocabulary list.
Figure 5 · The surface features of a long bone
Illustration to be added
A labelled illustration of a human femur, viewed from the front and from behind, with every surface-feature term in the table below marked on it: head, neck, greater and lesser trochanter, linea aspera, medial and lateral condyle, medial and lateral epicondyle, intercondylar fossa, nutrient foramen, and the shaft with its borders. A second smaller panel should show a scapula labelled with spine, acromion, coracoid process, glenoid fossa, supraspinous and infraspinous fossae, and the superior, medial and lateral borders. Style: clean line illustration on white, navy line work with gold leader lines, matching the site palette. Landscape, roughly 1600 by 900 pixels.
| Group | Term | What it is | Example |
|---|---|---|---|
| Raised usually where muscle, tendon or ligament pulls |
Process | Any bony projection | Spinous process of a vertebra |
| Tuberosity | A large, rounded, roughened elevation | Ischial tuberosity, the bone you sit on | |
| Tubercle | A small rounded elevation | Greater tubercle of the humerus | |
| Trochanter | A very large blunt elevation. The word is used only at the femur. | Greater trochanter | |
| Crest | A prominent ridge | Iliac crest | |
| Line | A less prominent ridge | Linea aspera of the femur | |
| Spine | A sharp, slender projection | Spine of the scapula | |
| Rounded and articular usually forming joints |
Head | A rounded articular end, often on a narrowed neck | Head of the femur |
| Condyle | A rounded articular knuckle | Femoral condyles at the knee | |
| Epicondyle | A raised area just above a condyle, for attachment | Medial epicondyle of the humerus | |
| Facet | A small, smooth, flat articular surface | Facet joints of the spine | |
| Hollows and openings things pass through or sit in them |
Fossa | A shallow depression | Olecranon fossa of the humerus |
| Groove or sulcus | A furrow, usually holding a tendon, vessel or nerve | Intertubercular groove | |
| Notch | An indentation in the edge of a bone | Greater sciatic notch | |
| Foramen | A hole through a bone | Foramen magnum of the skull | |
| Canal or meatus | A tunnel | External acoustic meatus | |
| Sinus | An air-filled cavity within a bone | Frontal sinus |
Read the bone, do not just name it
A roughened tuberosity means a powerful tendon pulls there. A smooth groove means something slides across. A large foramen means something important passes through, and that something can be compressed. Once you read bones this way, a dried skeleton starts telling you what it did in life.
Finally, the map. Clinical notes are written in regional terms, and using the correct one removes most ambiguity at a stroke.
| Main division | Regions within it |
|---|---|
| Head and neck | Cranial (skull), facial, orbital, nasal, oral, auricular, occipital (back of head), cervical (neck) |
| Trunk — front | Thoracic, sternal, pectoral (chest), mammary, axillary (armpit), abdominal, umbilical, inguinal (groin), pelvic, pubic |
| Trunk — back | Vertebral, scapular, lumbar, sacral, gluteal (buttock), perineal |
| Upper limb | Deltoid (shoulder), brachial (arm), cubital (elbow, with the antecubital fossa in front), antebrachial (forearm), carpal (wrist), palmar, dorsum of hand, digital |
| Lower limb | Coxal (hip), femoral (thigh), patellar (front of knee), popliteal (back of knee), crural (leg), sural (calf), tarsal (ankle), plantar (sole), dorsum of foot, digital |
"Arm" and "leg" mean less than you think
In careful anatomical use the arm is only shoulder to elbow, and the forearm is elbow to wrist. The thigh is hip to knee, and the leg is knee to ankle only. A patient saying "my leg hurts" may mean anywhere from hip to toes, so your notes should say which part you actually examined.
All of this exists for one purpose: so that a description you write can be reconstructed exactly by someone who was not there. Compare these two entries.
"Pain in the outer part of the arm, near the top. Worse when lifting the arm up to the side. Some tenderness on pressing."
"Pain over the lateral aspect of the proximal arm, referred distally. Reproduced on active abduction in the coronal plane between 60 and 120 degrees. Tender on palpation over the greater tubercle of the humerus."
The second entry names a plane, a movement, a range and a bony landmark. Another clinician can repeat that examination exactly and compare their findings with yours. That is what the vocabulary is for — not to sound impressive, but to be repeatable.
If your patient is lying prone, "the wound is above the scapula" is meaningless to whoever reads it next. Describe from the anatomical position always, and it will still be correct when the patient stands up.
It seems a trivial detail until you try to explain why the ulna is the medial forearm bone when your own arm is hanging by your side with the palm facing in. The position is the reference; your current posture is not.
They belong to limbs. On the trunk, use superior and inferior.
A useful anchor: a coronal plane is the plane a crown sits in as it goes across the head from ear to ear. The sagittal plane is the one an arrow would travel along if fired at your back.
It is four movements run together. If an examiner asks which muscles produce circumduction, the answer is all the muscles producing flexion, abduction, extension and adduction at that joint, in sequence.
A tuberosity is not simply a lump with a name. It is evidence that something pulls hard at that spot. Learn the reason and the name comes free.
Ten questions on this chapter. Tap one to see the answer and the reasoning.
Answer: (B) Palms face forwards, so the forearm is supinated and the radius and ulna lie parallel. This is why the ulna is described as the medial bone of the forearm.
Answer: (C) Sagittal plane, frontal axis. The movement travels along a front-to-back surface, turning around a side-to-side line through the joint.
Answer: (B) Any sagittal plane that does not pass exactly through the midline is paramedian. Only the one dividing the body into equal left and right halves is median or midsagittal.
Answer: (C) Proximal and distal describe position along a limb, relative to its attachment to the trunk. On the trunk itself, use superior and inferior.
Answer: (B) Inversion. Eversion is the opposite, turning the sole away from the midline. Both are distinct from plantarflexion, which points the foot downwards.
Answer: (C) Trochanter. The term is reserved for the greater and lesser trochanters of the femur. A tuberosity is large and roughened, a tubercle is small and rounded.
Answer: (C) It is a combination rather than a movement of its own. The limb traces a cone because four movements run one after another.
Answer: (B) The thumb sits rotated about ninety degrees to the other digits, so its movements are named from the plane of the palm. Thumb flexion therefore occurs in the coronal plane of the body.
Answer: (B) Grooves usually carry a tendon, vessel or nerve across the bone. Roughened elevations indicate strong attachment; foramina indicate something passing through.
Answer: (C) Knee to ankle only. Hip to knee is the thigh. Because patients use 'leg' loosely, your notes should name the region you actually examined.
Everything on this page, in one screen
These are standard texts held in most physiotherapy libraries in India. Details below are taken from the books themselves.
| Book | Why it is worth your time |
|---|---|
| Anatomy and Human Movement: Structure and Function Palastanga, Field and Soames |
Written for physiotherapists. Muscles are taught by what they do, not only by where they attach. If you buy one book for this subject, buy this one. |
| B D Chaurasia's Handbook of General Anatomy Chaurasia and Garg |
The standard Indian text for general anatomy, and closely matched to the material in this chapter and the ones that follow it. |
| Clinical Anatomy by Regions Snell |
Region by region, with the clinical meaning attached to each structure rather than bolted on at the end. |
| BRS Gross Anatomy Chung |
Condensed and question-driven. Best used for revision once you already understand the material. |
| Gray's Atlas of Anatomy Drake, Vogl and Mitchell |
An atlas rather than a textbook. Keep it open beside whatever else you are reading. |
Reviewed by the Physiotherapist India Team. · Human Anatomy contents