IMPROVEMENTS IN OSTEOLOGICAL PEDAGOGY: APPLICATION OF 3D

TECHNOLOGY & INTERDISCIPLINARY PRACTICE

_____________________

A University Thesis Presented to the Faculty

of

California State University, East Bay

_____________________

In Partial Fulfillment

of the Requirements for the Degree

Master of Art in Anthropology

_____________________

By

Christine Allison (DeNicola) Berlier

December 2018
 IMPROVEMENTS IN OSTEOLOGICAL PEDAGOGY: APPLICATION OF 3D

TECHNOLOGY & INTERDISCIPLINARY PRACTICE

By

Christine Allison (DeNicola) Berlier

Approved: Date:
D

f& 7
s
Albert Gonzalez, Ph.D.

ii
 Table of Contents

Part I: Teaching Philosophy ............................................................................................ 1

Chapter 1 – Target Students ........................................................................................ 2

Chapter 2 – Learning Objectives................................................................................. 5
Human or Nonhuman .................................................................................................. 5
Left or Right................................................................................................................. 6
Identification of Features ............................................................................................ 6
Limits of Knowledge .................................................................................................... 6
Student Study Methods ................................................................................................ 7
Chapter 3 – Measuring Student Abilities ................................................................. 11
Chapter 4 – Fundamental Components .................................................................... 11
PPE............................................................................................................................ 11
Respect & Ethics ....................................................................................................... 12
Part II: Setting Up an Osteological Course .................................................................. 13

Chapter 5 – Obtaining Osteological Specimens ....................................................... 13

Purchasing Human Bones ......................................................................................... 14
Borrowing Between Institutions ................................................................................ 16
Osteology & Technology: 3D Scanning & Printing ................................................. 16
Part III: Determining Class Structure & Organization .............................................. 18

Chapter 6 – Class Structure ....................................................................................... 18

Example Course Syllabi ............................................................................................ 19
Graduates as TAs ...................................................................................................... 19
Specialty Course ........................................................................................................ 20
Chapter 7 - Quiz & Test Design................................................................................. 23
Creating Questions .................................................................................................... 24
Test Organization ...................................................................................................... 25

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 Chapter 8 - Grading.................................................................................................... 26
Part IV: Teaching Osteology ......................................................................................... 27

Chapter 9 – Course Outline ....................................................................................... 27

Vocabulary ................................................................................................................ 27
Cranium ..................................................................................................................... 27
Hyoid & Vertebrae .................................................................................................... 28
Sternum & Ribs ......................................................................................................... 28
Shoulder, Arm, & HAND ........................................................................................... 29
Pelvis, Leg, & Foot.................................................................................................... 29
Chapter 10 – Biometrics ............................................................................................. 29
Bone Composition & Function .................................................................................. 29
Bone Growth.............................................................................................................. 30
Biomechanics: Strength, Fragility, & Adaptation..................................................... 32
Chapter 11 – Variable Determination....................................................................... 35
Sex ............................................................................................................................. 35
Age ............................................................................................................................. 41
Stature ....................................................................................................................... 48
Chapter 12 - Pathology ............................................................................................... 49
Joint Diseases ............................................................................................................ 50
Infections ................................................................................................................... 51
Congenital Disorders ................................................................................................ 52
Neoplasia ................................................................................................................... 54
Endocrine Disorders ................................................................................................. 56
Metabolic Disorders .................................................................................................. 57
Other Types of Pathologies ....................................................................................... 58
Dental Caries ............................................................................................................ 63
Chapter 13 – Taphonomy & Modification ............................................................... 66
Antemortem Trauma .................................................................................................. 67
Perimortem Trauma .................................................................................................. 74

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 Postmortem Changes ................................................................................................. 81
Chapter 14 – Application of Osteology in Criminal Justice ................................. 89
Part V: References .......................................................................................................... 91

References ................................................................................................................. 91
Appendix .................................................................................................................. 110

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 1

Part I: Teaching Philosophy

Osteology is the study of skeletal structures &, though that may seem vague, the

study of bones can be applied to a vast array of fields & careers. The primary challenge

of developing educational programs is determining who can or should benefit from the

intended curriculum. In this instance, we must decide which students, professionals,

and/or governmental agencies need human osteology.

In my own experience, the most common majors of students who enroll in

osteological courses include anthropology, criminal justice, & nursing/medicine. I have

also noticed that the students who enroll in human osteology are often undergraduates in

their junior or senior year &, as with many courses, the course is taken due to a specific

requirement or as a general credit fulfillment. The benefit of enrollment of

undergraduates in their final year(s), is that they have already decided on their major.

That means they have taken the time to choose a field of interest &, generally,

understanding the level of energy needed to fulfill their degree. Human osteology is not

an easy course & it requires time, dedication, & discipline. On average, there are only

biological anthropology majors enrolled, who are required to take the course before

graduating. However, although the status quo seems to place osteology in the hidden

realm of anthropology, I argue that the various courses outlined here can & should be

used to bridge boundaries between the criminal justice fields, anthropological osteology,

& forensic osteology. Beyond that I investigate the importance of human osteology,
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within both anthropological & forensic lenses, in, not just criminal justice curricula, but

also in police departments & crime scene investigation units.

To conclude, I will further explore target students & constructive study

methods, as well as the changing territory of how to obtain osteological teaching

specimens & I will offer syllabi examples to teach courses in five different learning

environments that include, at least, the basics on the foundational information of forensic

osteology.

Chapter 1 – Target Students

Before designing a course, the dominant hurdle is finding students. Students are,

in the simplest form, those who study. The focus often places “students” as those in

college or university. I argue that “students” is a much broader term, including any

individual that studies an area of interest. In this case, there is a large base of students

who would benefit from osteological training. As previously stated, those at college or

university, including graduate students, & professionals & those within governmental

agencies, are primary targets. However, the United States is not the only country that has

yet to bridge the distance between anthropological & osteological knowledge & the

popular fields of criminal justice & criminology. Jobs such as criminal investigators,

crime scene investigators, forensic technicians, police officers & detectives, as well as

lab analysts have become increasingly popular worldwide. Yet these jobs, which will

most likely encounter osteological remains, are, on a multinational average, not required

or occasionally even offered osteological and/or anthropological courses. As

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I’ve discussed, part of this is due to a large gap between the anthropology & criminal

justice departments. However, another part, as I will discuss later, is the growing

difficulty obtaining osteological specimens as well as how to use 3D technology to

potentially avoid future issues. Here I will further discuss who our target students should

be for osteological training.

Undergraduates who are declared biological anthropology majors at California

State University, East Bay, must take human osteology. However, as mentioned, this is

not the case at all schools. Schools such as the University of Maryland, the University of

Albany, & the University of Cincinnati are some of the top criminal justice schools in the

United States, yet none require osteology or anthropology. Even the top criminology

schools in the United Kingdom, such as the universities at Stirling, Leicester, & York, do

not include osteology courses for criminal justice majors, even if offered for forensic

anthropology or bioarchaeology, etc. Students that pursue human osteology on their own,

as opposed to course requirements, have career motives such as forensic anthropology,

criminal justice, & nursing. Thus, target students for undergraduate osteology should be

broadened to include, not just biological anthropological majors, but also those in majors

that can reach the careers of police officers, detectives, crime scene investigators, &

forensic lab technicians.

Graduate students should, & generally do, have some footing in osteology &

practice handling skeletal remains. Graduate students with osteological background may

help in guiding & leading the class as well as making time to study with students and/or
 4

provide access to study collection. Having graduate students with osteological

background, regardless of their major, is beneficial to both the graduate & undergraduate

students, as well as the professor. In this position, graduate students take on a mentor-like

role with the undergraduates; providing time to tutor, useful study methods, & most

importantly, challenging both the undergraduates & themselves by constantly “self-

testing”, as I will discuss later. The graduate course is also designed to teach graduates

osteological pedagogy in both theory & practice.

Professionals & government agencies, as mentioned previously, should also be

considered students. Regardless of the educational level of the individuals in police

departments, crime scene units, or forensic labs, these students should be targeted for

specialized osteological training. As discussed, it is not in the practice of universities &

colleges, on a worldwide scale, to include or even offer, osteological training to those

training outside of the fields of forensic anthropology or bioarchaeology. Let alone not

offering human osteology to those in criminology, the push from federal departments for

police to have college degrees is still nominal. Various studies on higher education

within police departments have shown that, on average, only 50% of individuals have

some college experience while only 30% have a bachelor’s degree. While many of these

studies also show the effects of higher education on issues such as authoritarian attitudes,

arrest frequencies, use of force, & predilection to perform searches, they also show the

correlation between college degrees & better social & ethical behavior as well as being

more progressive towards minority communities. Studies have begun to urge policy

changes to promote college education requirements in police departments. I will

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demonstrate that while promotion of college degrees is beneficial, we should be

progressively adopting comprehensive forensic osteology courses for criminal justice

majors as well as those with & without degrees in federal agencies (Rydberg & Terrill,

2010; Roberg & Bonn, 2004; Paoline, 2000; Henion & Terrill, 2015).

Chapter 2 – Learning Objectives

Undergraduate & graduate students should be able to identify the following from

a bone, whether complete or fragmentary, while still diagnostic: 1) Determine if it is

human or non-human 2) Determine the side of the body the fragment is from 3) identify

diagnostic features, & 4) Know when there is not enough evidence to give a definitive

answer.

Human or Nonhuman
The first & most important concept students should master is determining whether

a bone or bone fragment is human. In potential crime scenes it is always imperative that

the osteologist correctly identify any skeletal remains as human or nonhuman. There

have been countless incidents in which animal remains are incorrectly identified as

human. Teaching this concept often tests students on recalling specific shapes of human

osteological remains & fragments. Students should be taught to focus on a routine of

looking at the size, shape, texture, & diagnostic features of bones & fragments to

determine human versus non-human. As a teacher, this includes making sure students are

familiar with all ages of osteological specimens as well as deciduous dentition.

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Left or Right
The second consideration the students must make is determining what side of the

body the bone or fragment is from. For the complete axial components of the skeleton

such as the vertebrae or hyoid, siding is considered the midline of the body. However, for

appendicular bones, duplicate cranial bones, fragments, & the os coxae, the students

should be able to determine what side they are from. Again, this requires identification of

diagnostic features to come to an absolute answer, when possible.

Identification of Features
Thirdly, the students should be familiar enough with the features & craniometrics

of the skeleton to use as a diagnostic determining tool. Features can be used to determine

human versus non-human, element, & anatomical positioning. They should also be able

to name specific craniometrics & features on a bone-by-bone basis.

Limits of Knowledge
Lastly is knowing when to say, “I don’t know”. This can be one of the most

challenging concepts to grasp & master. There will be fragments that are nondiagnostic,

both in study & in the real world. Students should try to use the fragment’s features for

identification, but should be conscious of bias & assumptions. Students should be able to

effectively argue their position using diagnostic features to determine the element or

fragment while being open to discussion & alternative viewpoints.

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Student Study Methods

There are many ways to study osteology & it is our job as educators to guide the

students to the method of study that will be the most beneficial to them. Some

osteological learning methods I have witnessed or used myself in the course of study are:

Color-coded flashcards, drawings or sketches, charts of features, muscles, &

craniometrics, self-guided testing, mnemonic devices, & sensory cues.

The number one study method for mastering osteology is self-guided testing.

Students should use the teaching collection & their text resources to guide themselves

through the course objectives. During this time, the students can discuss their thoughts &

questions with the teacher or graduate students. As they move through the course, they

should be encouraged to look at smaller fragments as well as pushed to focus on their

weak points. This method is beneficial in the sense that it is both a way to acquaint

graduate students with teaching pedagogy, but also to have them continually refreshing

their knowledge of osteology &, potentially, associated subjects such as forensics,

archaeology, & anatomy. In a similar fashion, graduate student led studying is also

effective. By breaking the students into smaller groups, roughly five to six students, it is

much easier for graduate students to discuss specifics or pass around bones or fragments.

Color-coded flashcards are especially helpful for straight definitions as opposed

to descriptions of elemental features, soft tissues, or craniometrics. It is up to the

instructor to determine the most important definitions for the students. This is variable

depending on the structure of courses at your institution. For semester systems, it is

easier to ask more of the students in terms of definitions, craniometrics, & non-metric
 8

features than it is during a quarter system. In the Teaching Osteology section, I go into

more detail about minimum specifics. Even on a quarter system, it is possible to cover

the skeleton & the vast majority diagnostic features & soft tissues. Flashcards, however,

cannot replace hands-on interaction with the skeleton. I have noticed that the less time

students spend working hands-on with the bones, the less information they retain.

My first introduction to studying osteology was by sketching the bones &

labeling features on my own drawings. While this method is not always easy & not

effective for all students, it is especially helpful for muscle memory as well as becoming

intimate with the more complicated elements. For example, finding the jugular fossa on

the posterior angle of the temporal bone is often challenging for new students. For some

students, drawing the bone & labeling their own drawing is often all they need for it to

click in their mind. This method can also help with the shape memorization of elemental

fragments that is so important in osteological studying. Drawing is also helpful when

studying muscle attachments, by allowing students to color-code their own sketches.

Drawing is not for all students, however, so I often suggest creating charts. I often

list the features of each element & their corresponding soft tissues, craniometrics, or

other important information, such as non-metric features or articulation. I started my own

charts which eventually led to an abridged guide to human osteology. See Appendices for

an example laboratory guide for a quarter system.

Mnemonic devices can be used but this, generally, will be on an individual basis.

What makes sense to one person may or may not make sense to another. It is less helpful
 9

to force your preferred way of learning & more beneficial to use the student’s strengths

to their advantage. Sensory cues are often used by students without them realizing it. It is

useful to point out the varying textures of the human skeleton. This improves the

student’s retention of the information as well as strengthens their understanding of how

the human body works. For instance, I like to use the rugosities on the clavicle as an

example of muscle attachments on bone. The rough texture at the attachment point is

quite different from the smooth shaft. Each time they pick up a fragment, they should be

able to discern between different textures to help orientate the element within the body.

Without realizing it, they will have trained themselves to respond to these sensory cues.
Study Method Description Advantages Disadvantages

Color-coded Colored notecards Straight definition Lack of hands-on

flashcards memorization interaction with
categorized into elements

useful groups (i.e.

blue- cranium, green-

axial)

Drawing/sketching Free-handed or Creates muscle This method can

sketched study be difficult & is
guides for specific memory responses not for every
bones student
as well as a
greater familiarity
with elements
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Feature & muscle Charts designed to Creates a “quick Similar to color-

charts correlate guide” for coded flashcards,
craniometrics, students to use in these charts lack
features, & muscles the lab & in reality hands-on practice

Self-guided testing Use of whole & Allows for open Students will
fragmentary discussion using often lose

elements to test fragmentary bones motivation in this

oneself with the help & allows students method if not
of the professor to focus on their encouraged by the
and/or graduate own weak points instructor(s)
student(s)

Mnemonic devices Acronyms, phrases, Allows for This tends to be

etc. used to as individualization quite individual &
memory signals of methods of few can be used
memorization with the class as a
whole
 11

Sensory cues Involuntary signals Creates a stronger Since these

obtained from the reactions are
senses; here, touch understanding of involuntary, there
& sight are the two is no way to
most important the skeletal regulate the
outcome other than
system, individual
continued
bones, & osteological
practice
fragments as well

as differences in

textures/shapes

etc.

Chapter 3 – Measuring Student Abilities

As in most class settings, the general basis of measuring the student’s abilities is done

using quizzes & tests. Students are quizzed every other week & in addition have one

midterm & one final. The quizzes, midterm, & final each contain a combination of

element identification & short-answer questions. Students have one & a half minutes per

question to display that they have learned the four previously discussed points.

Chapter 4 – Fundamental Components

PPE
Prior to students handling bones, it is an instructor’s duty to ensure they have the

proper personal protective equipment (PPE) as well as understand the importance of

engaging with human remains, regardless of the discipline. First & foremost, it is

imperative that all students wear gloves while handling human remains. While many
 12

labs, including my own, have casts or resin models, it is easier to have students wear

gloves while handling these as well, although it is not ethically necessary. Some students

also choose to wear a lab coat, though it should not be made a requirement. Lastly,

students should not wear rings, bracelets, or other jewelry that could potentially damage

bones, even with gloves on.

Respect & Ethics

Secondly, it should be made clear to students the expectations regarding their

attitude while handling remains. These were once living, breathing humans. Students,

primarily undergraduates, tend to be slightly detached due to the arbitrary nature of the

skeleton for beginners. It is best to address this trend directly with the students, making it

clear that human remains should be: 1) handled with respect & 2) handled with care.

Handling remains with respect goes beyond the common sense understanding to not

deface or use any remains inappropriately. Respectful examination includes using bones

for learning & research purposes only. Often, students displace intense feelings that

emerge from handling human remains with humor, but this is not generally appropriate.

Social media & imagery could potentially lead to a legal situation if a student decides to

post a “selfie” with someone’s great-great grandfather. Skulls should be carefully

handled with two hands, & never by the orbits or foramen magnum. Students should

have ample lab space to sit down & examine bones over a flat, stable area covered in a

plastic, corrugated mat. Carpet or cloth mats can be detrimental to the elements & should

be avoided. Tables should be free & clear of debris; books & notebooks should be kept to

a minimum.
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Part II: Setting Up an Osteological Course

Chapter 5 – Obtaining Osteological Specimens

By far the most difficult part of teaching osteology is getting your hands on your own

teaching collection. To do this, you first must decide what you need. Learning osteology

requires the ability to, not only see examples of every bone, but to see multiple examples

of every bone to show variation as well. Students also need access to examples of

fragmented pieces as well as representation of trauma, healing, & pathology.

Aside from the elements used as teaching materials, one must also have a collection

for testing. This smaller collection should be separated from your teaching material to

provide fair grading standards by not allowing any student access to them prior to the

exam. The first tests should have fully intact or large fragments of bone. As the class

progresses, the testable fragments should get smaller. It is difficult to find a decent

number of specimens that are both diagnostic as well as challenging. Students need

testable materials that will force them to recognize patterns in shapes, textures, & breaks.

Common testable fragments include skull fragments, such as a single occipital condyle or

a sphenoidal greater wing, vertebral & pelvic fragments, individual teeth, proximal, distal

& shaft portions of long bones, & singular whole elements, such as a first metacarpal

(MC1) or an individual tarsal.

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Purchasing Human Bones

Purchasing human bones or casts is not necessarily difficult. There are various

companies that offer complete skeletons & individual bones, collections of different ages

& pathologies, & additionally, high-quality casts of these as well. Some of these

companies specialize in real human bones like The Bone Room, Osteology Warehouse,

& Skulls Unlimited International. While others focus on realistic & medical-grade

replicas like Carolina Biological, Anatomy Warehouse, & Vision Scientific.

Buying real or cast human bones can be extremely expensive. When trying to

create a collection or a teaching set, the totals can quickly add up to the tens of

thousands. For example, real standard human skulls run an average of $1,692 each while

casts of these cost $256 each on average. For real complete skeletons, the prices

skyrocket. The average price for a real, standard, complete human skeleton pushes

$3,500. Full cast skeletons are much more affordable, around $550 on average. Singular

bones & small sets of bones are typically economically priced & allow acquisition of

articulated & disarticulated joints. However, these are primarily real bones & it can be

difficult to find casts of small bones.

Additionally, bones & casts can be purchased from independent sellers as well as

public & private institutions. Buying from an independent seller can be problematic &

potentially risky. It is critical that you know & understand state & federal restrictions as

well as the guidelines of the Native American Graves Protection & Repatriation Act

(NAGPRA) & the Uniform Anatomical Gift Act (UAGA).

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NAGPRA

NAGPRA “was enacted on November 16, 1990, to address the rights of lineal

descendants, Indian tribes, & Native Hawaiian organizations to Native American cultural

items, including human remains, funerary objects, sacred objects, & objects of cultural

patrimony” (National Parks Service). Universities & colleges that receive federal funding

may have to return any remains or artifacts to the Most Likely

Descendants (MLDs) if they come under their institute’s possession.

UAGA

The UAGA, however, governs the sale & donation of tissue & organs on a state-

by-state basis. In 2015, Georgia enacted a bill entitled the “Georgia Revised Uniform

Anatomical Gift Act” which severely limits the sale or purchase of human remains. This

includes shipping remains, even those from reputable or medical sources, to Georgia.

Likewise, Washington, D.C. has made buying & selling human body parts completely

illegal, regardless of what they will be used for. This was done by strictly defining what

was included under the category of “human body parts” as well as prohibiting who could

purchase biological specimens, which includes for purchases medical purposes (Section

7–1501.01. “Human body parts” defined; prohibited acts).

Buying human bones is almost always legal on a state-by-state basis. However,

this is merely because the law does not explicitly state that it is illegal to do so. Because

this changes on a per state basis, it is crucial that you understand the laws where you

wish to purchase osteological remains from as well as the possessions laws in your own
 16

state. Questionable purchases may lead to an inquiry, which is a mess that can be easily

avoided. It is preferable to know that the source is reputable and/or to know the

provenience of any osteological specimens you wish to purchase.

Borrowing Between Institutions

Another option of obtaining, at least a temporary, collection is through your own

institutions. California State University, East Bay, in Hayward, California has its own

faunal & human osteological collection in the Anthropology department, as do most of

the other CSUs. Borrowing between state institutions like CSU is possible & encouraged.

However, as most researchers will find, most schools are unwilling to part with their

precious specimens.

Osteology & Technology: 3D Scanning & Printing

Over the past few years, the technology of 3D scanning & printing has become

more precise, less space-consuming, & much more affordable. This technology has been

applied to a multitude of fields due to its many applications. The process is structurally

simple. A 3D scanner is used to create a digital three-dimensional model of whatever

object you choose. The most common & useful 3D scanner is a structured light scanner.

This type of device uses a stand or turntable and a camera. The camera simultaneously

uses bands of light to determine the surface structure of the scanned item as well as

records the scan on the associated personal computer. Scanners that use a nonmoving

stand require the user to rotate the objects as needed. Although turntable structured-light

3D scanners may cost a little more, they are more effective at rotating the piece without

affecting the scan. It should be noted that the personal computer, mentioned above, must
 17

meet fairly rigorous specifications, particularly in regard to the graphics card &

processor.

3D scanning & printing could quickly become the most efficient & cost-effective

manner of obtaining an osteological collection. The benefits of owning the equipment to

replicate bones pays for itself quickly. Likewise, the scanning of a bone creates a file that

can be duplicated, shared, & printed numerous times over. The two most obvious

benefits being that the printing of exact scans could theoretically allow all students in one

room to hold & study the exact same bone or fragment at the same time &, the digital

copy protects a once unique element by allowing the owner to quickly & economically

create an exact laser model.

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Part III: Determining Class Structure & Organization

Chapter 6 – Class Structure

For the undergraduate students, the ideal class size is as small as the university

will allow. I have found in my experience that if there are any more than fifteen students

in the course, multiple problems come to light. Issues can arise with too large a class size

such as: a lack of one-on-one student-teacher interaction, practical assessments can

become overwhelming to set up, monitor, & grade, &, of course, with a larger class you

need a larger teaching collection as well as a larger testing collection. For small colleges

or new teachers, this can be a challenging feat.

In addition to teaching a small undergraduate class, it is helpful & necessary to

run a small graduate class concurrently. Graduate students can be led to direct & guide

the undergraduates. These students should also assist with the designing, set-up,

monitoring, & grading of undergraduate practicums.

The benefits of running a small class are more obvious. It is much easier to have

one-on-one interactions with students or lead discussions in small groups. With a smaller

class, less bones, fragments, & testable materials are needed to effectively run & teach

the class. However, there are some other benefits that are less obvious. Smaller class

sizes led to increased socialization between the students, including graduate students, &

the teacher. In my experience, students group up to study &, over the course of the class,

become friends & colleagues. This closeness between students creates quite a bit of
 19

competition. This also allows the teacher & any graduate student assistants to focus on

the students & their strengths & weaknesses. As the class is not designed around lectures,

it gives the class a free-study feel. Students can follow the course outline as well as

continuously work on their areas that need improvement.

Example Course Syllabi

See Appendix B for example course syllabi for undergraduate & graduate

students. Professional students should be encouraged to follow the one-week course,

discussed in Specialty Course.

Graduates as TAs
The graduate students, as discussed previously, should be given varying degrees

of responsibility in teaching the course based on experience, knowledge, ambition, &

involvement with the course. The graduate students should help design the quizzes,

again, by being tested themselves. They should, however, be required to take the midterm

& the final exams with the undergraduates. This allows the instructor to grade the

graduate students based on midterm & final grades, as well as attendance & participation.

Graduate students should have at least one human osteology course in their

transcript before assisting professors with work. Under supervision, graduate students

should direct student studying, design & write quizzes, as well as proctor & grade

quizzes. These students should also make themselves available outside of class time to

assist students with studying as well as making sure they have access to the study

collection.
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Specialty Course
At California State University, Criminal Justice majors are not required to take

human osteology, forensic osteology, general forensics, or anatomy & physiology. While

this is not the case at all institutions, there is a trend for future police officers, sheriffs, &

crime scene investigators to be educated in sociology, ethics, & psychology, but not

anthropology, osteology, anatomy, or forensics.

A specialty course could be designed to help combat this lack of knowledge. In a

week-long seminar, a basic introduction to the entire skeleton, determinations of age, sex,

& stature, different pathologies, taphonomic factors, types of modification, soft tissues,

& an outline of NAGPRA & the UAGA will be covered in a series of daily lectures.

The following week-long seminar could be taught to 10-15 students/professionals

using this thesis, the attached guide, & the associated 3D scans. While this will not make

the attendees experts, they will be able to gain a fundamental understanding of skeletal

structure as well as the appropriate forensic osteological methods of analysis.

Additionally, the 3D scans included allow for the printing of a study of skull bones for

each student. This is immensely important to retaining osteological & anatomical details.

One Week Forensic Osteology Course: An Introduction to Basic Concepts

Day One:

After a brief introduction by the instructor, the course should immediately begin

with an introduction to the basic directional, anatomical, & osteological terminology. The

next topic should be the cranium, bone-by-bone, including the most important features.
 21

The cranium should be following by the mandible, again, focusing on the important

features. This will conclude the skull as an element & time should be given for questions

& review.

After the analysis of the skull, details of dentition should be covered next.

Students in this specialty course will not need to know the minute details of each tooth

but should be able to discern between the different teeth. This encompasses deciduous

dentition as well. It is important that students can distinguish between immature & adult

teeth. Lastly, the day should end with an elementary review of biometrics. It is less

important that students understand the particular structures of bone, but rather the

observable health or weakness of bone. Before the end of each day, a question & answer

period should be allotted for clarification.

Day Two:

The second day of the seminar should begin with a short review of the previous

day’s topics. This should be done each day before presenting new information. After

reviewing the skull, dentition, & biometrics, the vertebral column should be covered next

followed by the sternum & the manubrium.

The last portion of the chest cavity is the ribs. Not much detail should be placed

on the ribs, with the exception of the first, second, eleventh, & twelfth ribs. To end the

day, a basic introduction to taphonomy should be covered next. The first & most

important aspect is to cover the definitions anti-, peri-, & post-mortem. Once these basic

descriptions have been discussed, it is useful to cover the differences between green &
 22

dry fractures, examine types of soil discoloration, & review burned bones. More relevant

however, is the inclusion of human bone modification versus animal or plant damage. A

significant priority should be placed on cut marks, crushing, projectile marks, gunshot

wounds, & peeling, while less emphasis should be placed on carnivore- & rodent-

gnawing. As mentioned prior, it is beneficial to wrap up with a question & answer

session.

Day Three:

After reviewing the two prior days, the focus shifts from the axial skeleton to the

appendicular skeleton. Before starting the arm, it is preferred to begin with the shoulder

girdle, including the clavicle. The rotator cuff muscles will naturally lead right into the

humerus. Continue distally down the arm to cover the radius & ulna. Very limited time

needs to be spent covering the carpals, metacarpals, & phalanges of the hand.

Though it may not be intuitive, it is best to discuss pathologies of both bone &

teeth at this point. As one would assume, it makes the most sense to only cover the more

common or important pathologies, such as osteoporosis, osteoarthritis, rickets,

osteomyelitis, achondroplasia, & osteosarcoma. Lastly, it is relevant to examine the place

of fractures in the frame of pathology as well as taphonomy.

Day Four:

This review should be structured as a discussion as the seminar comes to an end.

Day four moves back to the axial skeleton to cover the entire pelvis. The pelvis includes
 23

two os coxae, a sacrum, & the coccyx. Although the os coxae are the most important

structures of the pelvis, the sacrum & coccyx are important in the overall architecture.

More detailed focus can be placed on the features of the os coxa rather than the sacrum &

coccyx.

Shifting into the subject of variable determination is logical after covering the

pelvis. Sexing & aging can both be done with pelvis. Sexing the skull using Walker’s

field method is very easy for even the most inexperienced students to master. Routine

field techniques of objective age analysis using dentition & the os coxae are also useful

& important tools to cover. Stature & ancestry analysis are less important to cover.

Day Five:

The final review will be the lengthiest & again should allow the students to guide

the topics of focus. After the review, the final part of the appendicular skeleton can be

covered; this portion covers the femur, patella, tibia, fibula, tarsals, metatarsals, &

phalanges of the foot. Like the arm, the importance should be placed on the leg bones &

less on the tarsals. The final topics should cover modification & the application of these

tools in the fields of criminal justice & forensics. The seminar will end with a final

question & answer session.

Chapter 7 - Quiz & Test Design

In measuring student abilities, I discussed quizzes & tests. Here, I will go into

further detail regarding physically building the tests as well as simple grading

procedures. For the quizzes, you and/or the graduate students should determine how
 24

many questions you will need. It is beneficial to create a few extra questions than there

are students in the course. I will discuss this further in a bit.

Creating Questions
When creating questions, the teacher and/or the graduate students should choose

bones and/or fragments as well as short-answer questions that test the undergraduates up

to the teaching point in class. Elements should begin intact or largely intact for the first

quiz, getting progressively more fractured &, consequently, difficult as the course goes

on. As a teacher, it is imperative that you can in fact tell for sure anything asked of the

students. For instance, if you have an individual deciduous lower second molar but siding

is, for some reason, inconclusive, you cannot ask this of the students. In the section,

“Obtaining a Collection”, I explore further how to design a testable set of bones.

Once the bones or fragments are chosen, it is quite beneficial to have the graduate

students “take the reins”, so to speak. The graduate students should examine the

fragments, essentially testing themselves. After reviewing the fragments with the

graduate students, allow them to come up with potential questions. For general human

osteology, the question for each element is a standard three-part, three-point question that

asks, “Which element? What side? What feature?” So, within the allotted one minute &

thirty seconds, each student must pick up the bone at their station, examine it, & answer

which element it is, what side of the body it is from (left, right, or midline), & what

diagnostic feature led them to this conclusion. Although, to make questions more

difficult, you can use smaller fragments, and/or use non-toxic, removable, colored dots to

highlight specific features. For instance, a red dot with an arrow pointing into the nutrient
 25

foramen on the femur could be used to ask specifically which feature it is. In this

example, a shaft fragment of said femur with the highlighted nutrient foramen could be

used in more difficult questions to require students to understand how to side shaft

fragments using the highlighted feature & their osteological training.

Not all questions need to be structured this way; dentition & vocabulary questions

are also used & encouraged. Loose, individual teeth make great testing materials. While

dividing up points on dentition questions can be difficult, there is more than one way to

do it. However, for testing teeth, questions should reflect the student’s ability to

determine which type of tooth it is, the side, whether it is maxillary or mandibular, & the

number of the tooth. It is also a good chance to teach the proper annotation for dentition

in osteology. For instance, the answer on a test for a question on an upper right third

premolar would be RP3. Other questions can be centered around vocabulary, like

defining craniometrics or other specific definitions. For example, questions that asks that

students to define bregma, lambda, or apex using appropriate osteological vocabulary are

encouraged. Another one of my favorite questions is to ask the student to define, using

appropriate vocabulary, Frankfort Horizontal.

Test Organization
In terms of setting up the test, your first priority should be to protect the bones &

second to protect the students. To protect the bones, they should be on nice flat surfaces,

generally, within small, shallow boxes. This helps prevent them from rolling, sliding, or

being knocked off the table or desk. Anyone touching the bones should have gloves, as

per usual, including students throughout the test. To protect the students, there needs to
 26

be ample room between testing “stations” as well as between students to prevent

cheating. This also helps deter “ambitious” students from trying to work on the upcoming

bones, abusing the timed system. In my experience, it is best to create a ring of desks

and/or tables around the outer edge of the classroom. “Stations” should be spread out

evenly, skipping desks between “stations” whenever possible. If desks in the ring all face

the same way, students will generally sit at the desks blocking each other from seeing

their classmates’ stations.

Chapter 8 - Grading
As mentioned earlier, I generally use the standard three-part, three-point question

for elements. While dividing points on dentition can be tricky, short-answer questions

can easily be made three-points apiece as well. An example of grading percentages that

could be used is as follows: conduct/attendance is 15%, quizzes are 30% total, the

midterm exam is 25% & the final exam is 30%.

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Part IV: Teaching Osteology

Chapter 9 – Course Outline

Vocabulary
Students should be able to fluently use & understand superior, anterior, posterior,

inferior, medial, lateral, proximal, distal, endocranial, exocranial, sagittal, coronal,

transverse, palmar & plantar. For the entire skeleton, students should know appendicular,

axial, articulation, & foramen (foramina). Other important vocabulary includes skull,

mandible, cranium, calvaria, calotte, splanchnocranium, & neurocranium. When covering

dentition, be sure students can effectively use mesial, distal, lingual, labial, buccal,

interproximal, & occlusal to describe teeth. There are many, many more words within the

frame of the osteology but these are the most commonly used & should be mastered by

the completion of the course.

Cranium
Regardless of whether your course runs on quarter or a semester system, it is best

to start with the cranium, in the most literal sense. Before breaking the cranium down

bone-by-bone, familiarize the students with the most commonly used craniometrics &

Frankfort Horizontal. Proceed with the crania, going over all pertinent features, as

follows: frontal, parietals, temporals, occipital, maxillae, palatine, vomer, inferior nasal

conchae, ethmoid, lacrimals, nasals, zygomatics, & sphenoid. It is worth noting however,
 28

that the palatines, vomer, inferior nasal conchae, auditory ossicles (malleus, incus, &

stapes), & sometimes the ethmoid, are often difficult to show separate from the whole

cranium, aren’t generally recovered from archaeological sites intact, & aren’t generally

useful for determining anything useful within in the forensic field. While students should

be taught this small set of bones, less focus should be placed on siding & more on their

position within the entire skull. Once the cranium is covered, is it fair to move on to the

mandible & then the individual teeth. Features of the teeth should be covered as to

benefit the students in terms of categorizing & siding individual teeth.

Hyoid & Vertebrae

Following the axial skeleton from the skull, next cover the hyoid & the vertebral

column. It is useful to cover general features that apply to the entire vertebral column

before breaking down the vertebrae into their groups. Students should cover cervical

vertebrae one thru seven, paying special attention to the atlas & the axis, thoracic

vertebrae one thru twelve, & lumbar vertebrae one thru five. In terms of the special

diagnostic vertebrae, students should be able to specifically identify cervical vertebrae

one (atlas), two (axis), & seven, thoracic vertebrae one, ten, eleven, & twelve, & lumbar

vertebrae one & five. It is easier to save the sacrum until covering the os coxae.

Sternum & Ribs

The sternum should be covered next, followed by the ribs. Ribs tend to be

difficult to pick out individually, apart from ribs one, two, ten, eleven, & twelve.

Students should get practice, not just handling individual ribs, but also serrating a set of

ribs from at least one individual.

 29

Shoulder, Arm, & Hand

Although it may not be intuitive, from the ribs we move on to the arm & shoulder

socket. To set up the arm, it is best to start with the scapula & clavicle. This order is

especially useful when covering soft tissues. From there, move on to the humerus, radius,

ulna, & then cover the carpals, metacarpals, & hand phalanges.

Pelvis, Leg, & Foot

Next, the course can proceed to the sacrum, coccyx, & the os coxae. It is worth

mentioning to the students the variation in the number of coccygeal vertebrae. The os

coxae should be taught starting by covering the three individual bones that make up os

coxae: the illium, the ishium, & the pubis. This naturally leads to the femur, patella, tibia,

fibula, tarsals, metatarsals, & foot phalanges.

Chapter 10 – Biometrics
Bone Composition & Function
Bone tissue, which supports the entire body, protects vital organs, & anchors

muscles, is a composite material made up of the mineral, hydroxyapatite & the protein,

collagen. Hydroxyapatite is found in both the bones & the teeth, & is responsible for

giving healthy elements their rigidity. Collagen, the most common protein in the body,

gives bones their flexibility. Together, collagen & hydroxyapatite create a compound that

is as strong as steel but as light as wood. Bones are extremely strong but can react &

respond to stresses & pressures to change & adapt. Adult bone is comprised of nearly

65% hydroxyapatite, 10% collagen, 25% water, & small amounts of other elements, like

magnesium, sodium, silicon, & zinc.

 30

Bone falls into two categories, woven & lamellar. Woven bone is generally

considered immature bone. Juveniles, whose bones are still growing, contain a lot of

woven bone. Woven bone is also seen when a broken bone is attempting to repair itself.

Alternatively, lamellar bone is regarded as mature & makes up the adult skeleton.

Lamellar bone has two subcategories; cortical & trabecular. Cortical bone is what

everyone pictures when they think of “bones”. Cortical bone is solid & compact, &

makes up the exterior surface as well as the entirety of the shaft sections of the long

bones. Unlike cortical bone, which is smooth & dense, trabecular bone is porous &

netted. These two different types of lamellar bone serve two different purposes.

Trabecular bone is seen at the ends of long bones or where bones are under constant

pressure. The spongy matrix of trabecular bone allows it to support more weight than

cortical bone, although it looks less stable. However, cortical bone is constantly under

compression & tension, for instance in the femoral shaft. The dense but hollow frame of

the cortical shaft allows for leverage of movement with the maximum amount of strength

but the minimum amount of weight (Soluri & Agarwal, 2016; White, 2012).

Bone Growth
Bone growth, or ossification, can be broken down into two categories: primary &

secondary ossification centers. Primary ossification points are the areas where bone

growth starts in the prenatal development process. Ossification of the skull, which starts

in the fourth month of the embryonic stage, has 110 primary centers. By the time the

child becomes an adult, the skull will have 22 mature bones, after the fusion of the other

88 ossification points.
 31

Primary Ossification

Primary ossification is divided into two subcategories: endochondral &

intramembranous ossification. Endochondral ossification refers to the embryonic growth

of the skull bones, or the 110 primary ossification centers. Intramembranous ossification

refers to the fetal development of the long bones. The difference between endochondral

& intramembranous ossification is the calcification process of cartilage. Endochondral

ossification does not go through this process, whereas the intramembranous ossification

does.

Secondary Ossification

Secondary ossification points occur during an individual’s childhood &,

sometimes, through adulthood, as cartilage goes through the process of ossification. This

is most easily seen in the long bones. Long bones are divided into three sections: the

epiphysis, the diaphysis, & the metaphysis. The epiphyses of the long bones are at the

proximal & distal ends. The diaphysis is also known as the shaft; for example, the dense,

hollow, lamellar bone of the femoral shaft. The metaphyses are the meeting points of the

diaphysis & the epiphyses. Between the metaphysis & the epiphysis is the epiphyseal

plate, or the growth plate, where the addition of new bone lengthens the shaft.

The shaft also grows in width through appositional growth, as well as through

mechanotransduction, as I will explore in Bone Strength & Fragility. This happens

through a process known as modeling or remodeling, wherein old bone is resorbed &
 32

new bone cells create an outer layer of fresh bone (Soluri & Agarwal, 2016; White,

2012).

Biomechanics: Strength, Fragility, & Adaptation

The constant pressures on bone require them to be very metabolically active as

they adapt to their surroundings. In the 19th century, German doctor Julius Wolff

determined the mechanotransduction properties of bone & hypothesized that bone would

react & remodel in the face of external stresses. Today, we call this Wolff’s Law, which

states that as stress is applied to bone, the bone will remodel & rebuild to adapt to, &

eventually, resist against repetitive tension or compression.

In the 1960s, American doctor Harold Frost refined Wolff’s Law with a model

called the Mechanostat. He determined that “mechanical elastic deformation of bone” is

a lifelong process caused by muscles & other changes to bone, like breaks. The elastic

deformation of the bone is measured in strain in regard to disuse, overload, fracture, &

constant adaptation. This model, which was first displayed in the Utah Paradigm of

Skeletal Physiology, is primarily important in combating bone loss in such instances as

severe fracture, osteoarthritis, & osteoporosis. This has led others, such as Charles H.

Turner, to focus specifically on the mechanotransductor pathway method to use

pharmacotherapy to restore bone loss.

There are two basic models of biomechanics; the load-displacement curve & the

stress-strain curve. In the load-displacement model, the y-axis represents the force

applied to the bone & the x-axis represents the displacement, or dislocation, of the
 33

bone. The load-displacement curve provides a variety of information: bone integrity,

stiffness, brittleness, & the point of fracture. Likewise, this model can also show the

changes to the bone depending on varying circumstances. For instance, “osteopetrotic

bone is brittle & thus displays reduced work to failure” because the bone does not have

the capability to be displaced the same way a healthy bone would. Furthermore, the

pliable nature of juvenile elements raises the amount of displacement needed before the

bone will break, “resulting in increased work to failure” & potential deformation of the

bone. The stress-strain curve measures the rigidity of the bone & the amount of energy

necessary to cause the bone to fracture. The trajectory of the stress-strain curve is known

as Young’s modulus.

Together, these two models can tell the osteologist the durability & the stiffness

of the bone in question. Where an element falls within the load-displacement curve &

stress-strain curve determines how healthy the bone is. When placed together, Young’s

modulus & the ultimate strain are inversely correlated along the y-axis. The x-axis

displays the bone mineral density (BMD) which is displayed as a fraction of the mineral

volume of bone. As previously discussed in Bone Composition & Function, there are

average percentages of the different components of bone. Changes to this ratio could

have serious consequences in terms of the strength & fragility of the bone. The higher the

hydroxyapatite, or mineral content, the more brittle the bone becomes. Alternatively,

collagen, while less significant to the strength or fragility of the bone, improves the

durability of the bone.

 34

Many researchers, like Turner, set out to prove that, German physicist Dr. Claus

Mattheck’s theory on the biomechanics of trees, could also be applied to bone. If

Mattheck’s theory applied to bone biomechanics as well, then it is expected that stress on

bone will cause growth & adaptation in the area the stress is directly affecting.

Alternatively, lack of stress or disuse can cause bone to become less dense. In the early

2000s, it was determined in multiple experiments that bone does in fact react greater to

higher strains & in the specific area that it is needed. “The improvement in bone structure

is evidenced by a 64% increase in bone strength & a 100-fold increase in fatigue life, yet

the improvement in areal BMD was only a modest 5-8%”. This shows that stress greatly

increases the strength & life span of the bone while keeping the bone mineral density, or

heaviness, to a minimum.

Bone Adaptation

Bone adaptation follows three central rules: 1) It is stimulated by dynamic

loading, 2) it occurs during short intervals of time, & 3) it is more reactive to novel

loading. Firstly, bone adapts, as Wolff determined, when stress is applied. However,

stress loads fall into two different categories, & bones react differently between the two

types of loading. Dynamic loading is constantly varying in the force being applied to the

bone, whereas static loading applies a steady, constant pressure. Bone adapts more

readily to dynamic loading, as opposed to static. Secondly, bone responds quickly to

short intervals of loading. In fact, continued dynamic loading can hit a point of saturation

where the bone will begin to resist adaptation &, eventually, will decrease additional

remodeling. Thirdly, bone adaptation is more respondent to unique stress situations than
 35

habitual or methodical loading. This is because the bone cells react strongly to new &

uncommon stresses (Turner, 1998; Turner, 2002; Turner, 2006; Bonfield & Li, 1966).

Chapter 11 – Variable Determination

Sex
Determining sex of skeletal remains is one of the most important aspects of

forensic anthropology. The pelvis has been regarded as the most sexually dimorphic bone

in the body. However, the pelvis does not always survive. Many osteologists & forensic

anthropologists have historically considered the skull to be the second most useful

element in determining an individual’s sex. However, there is a growing trend to use

biometric or osteometric statistical measurements to analyze univariate & multivariate

qualities of postcranial elements. If multiple postcranial bones are available, it is more

effective to metrically evaluate the sex for a higher rate of accuracy than just cranial

analysis alone.

Pelvis

Estimating sex using the pelvis can be done visually, without the use of metrics,

& if done correctly, sex can be determined with high accuracy. The greater sciatic notch

of the ilium is one highly variable feature. Males tend to have narrow, deep notches,

while females have wide, broad notches. On the pubis, the most sexually diagnostic

element of the pelvis, three features can be visually evaluated to estimate sex using

Phenice’s Technique: 1) the ventral arc, 2) the subpubic concavity, & 3) the medial

aspect of the ischiopubic ramus. The ventral arc & subpubic concavity are almost never

seen in males. The anterior surface of the pubis in males is flat & generally smooth,
 36

whereas in females, the ventral arc creates a distinct lipped edge. On the posterior side of

the pubis, a concavity is seen on females on the inferior aspect of the ischiopubic ramus.

Again, this feature is absent in males, whose ishiopubic ramus has a straight, almost

linear inferior angle. Lastly, the medial inferior border of the ischiopubic tends to have a

sharp ridge in females, which is smooth & dull in males (Phenice, 1969; Lovell, 1989;

White, 2012).

The pelvis, which includes both os coxae, the sacrum, & the coccyx, has sexually

dimorphic characteristics that can be analyzed, when available. When viewing the pubic

cavity inferiorly, females tend to have a wide opening, free of potential obstructions of

the birth canal. Males, alternatively, have a heart shaped opening with protrusion of the

ischial tuberosities & the coccyx into the pubic cavity. When viewed anteriorly, the male

pubic concavity is narrow & the iliac fossae incline superiorly. In this same view, the

female pubic cavity is much wider than the males & the iliac fossae are much more

horizontally angled, creating wider hips & a shallow pelvic bowl.

Similar to the sciatic notch, the subpubic angle is acute in males & obtuse in

females. Inversely, males tend to have wider pubic angles than females. From the lateral

view, male obturator foramina look like vertically-orientated ovals. The female obturator

foramina look compressed & slightly triangular.

Cranium

The cranium, when present, is often considered the second-best indicator of sex

when the pelvis is unavailable. Although this is disputed by some, Dr. Phillip L.
 37

Walker’s qualitative grading method for skulls has an accuracy rate around 86%.

Walker’s system requires the osteologist to objectively classify each of five features of

the skull, while in Frankfort Horizontal, on a scale of one to five, where one is more

feminine & five is more masculine. A grade of three signifies an inability to discern

feminine or masculine aspects. However, assignments of two & four reflect an

uncertainty; two is a probable female & four is probable male. The five features analyzed

in this method are 1) the nuchal crest of the occipital, 2) the mastoid processes of the

temporals, 3) the supraorbital margins of the frontal, 4) the glabella of the frontal, & 5)

the mental eminence of the mandible. Once the osteologist has graded each feature

available, the mean total will give the sex estimation.

The nuchal crest, attachment site of many neck & upper back muscles, should be

viewed laterally. In females, the nuchal crest is less pronounced due to leaner muscle

structure. In males, the nuchal crest tends to protrude posteriorly. The mastoid processes

are also neck muscle attachment sites which tend to pull the bone posteriorly more in

males than in females. A good, if unofficial, method for grading the size of the mastoid

processes is to place the skull on a smooth, flat surface. If the mastoids are large enough

to lift the skull up off the table, it is most likely a male. However, if the mastoids are

small then the skull will rest on the occipital condyles around the foramen magnum; this

situation generally dictates a female skull. Next, determine the value for the supraorbital

margins. When viewed laterally, female supraorbital margins are sharp & point

posteriorly, while males tend to have blunt, rounded margins. In this same view, the

glabella of the frontal can be graded as well. In males, the glabella protrudes just anterior
 38

to the nasion of the nasal bones. This is nearly absent in females, as the glabella tends to

be almost smooth. Lastly, the mental eminence of the mandible, a triangular portion of

the jaw which defines the size of the chin in life, can be graded as the other features. As

assumed, females tend to have slight eminences & overall smaller mandibles. Male jaws

are often larger in comparison with more pronounced mental eminences. Although not

included in Walker’s qualification method, the gonial angles of the mandible are also fair

indicators of sex. Men tend to have large, flared, & generally 90° gonial angles. This

produces strong, square jaws in life. Inversely, females have slender angles that are fairly

rounded (White, 2012; Walker, 2008).

The skull and/or pelvis may not always be available for sex determination

analysis in all situations. It is possible to use postcranial elements to determine sex,

however, these techniques usually require laboratory metrics as opposed to the

qualitative style of field procedures. Naturally, the more postcranial elements & features

examined, the higher the accuracy percentage.

Scapula

The scapula may have as high as a “95% correct sex determination using only

three parameters” including the maximum distance between the acromion & coracoid

process, the maximum length of the coracoid process, & the anteroposterior length of the

glenoid fossa (Di Vella, 1994). Measurement of the anatomical height, or the maximum

length, of the scapula can also be used for sex determination, though this method has its

restrictions. Delimitation points of scapular height can determine sex with nearly 97%
 39

accuracy. Male scapulae have a minimum length of 14 cm & female scapulae have a

maximum height of 17 cm. However, scapular measurements that fall in between these

demarcation points can only be sexed with 29% accuracy (Dwight, 1894; Dabbs 2009).

Lastly, the scapular breadth can be used to gauge sex with roughly 85% accuracy.

Female scapulae average out at 9.5 cm wide & men at nearly 11 cm (Moore, 2016;

Spradley, 2011). Less exact visual assessments of the scapula can be made using the

suprascapular notch & the angle of the scapular spine. Male scapulae tend to have deep

notches while female notches are shallow. Furthermore, male & female scapulae vary in

the obvious aspects of overall size & shape, including the angle of the spine to the vertex

of the superior angle, which is larger in males than in females.

Humerus

The humerus is multivariate with an accuracy rate of over 85%. The two features

of the humerus with the highest accuracy are the vertical humeral head diameter & the

epicondylar breadth. The vertical humeral head is measured from the lateral-most to the

medial-most points along a true line. Males average at 4.7 cm & females at 4.1 cm. The

epicondylar breadth is measured from the lateral-most portion of the lateral epicondyle to

the medial-most part of the medial epicondyle. The average female epicondylar breadth

is 5.5 cm while the mean male breadth is almost a centimeter more at 6.4 cm. According

to numerous studies, the presence of a supratrochlear foramen just anterior to the trochlea

of the distal humerus could indicate a female. The average percentage of females with the

foramen is 23%, while only about 16% of males show presence of this trait (Ndou et al.

2012, Erdogmus et al. 2014).

 40

Femur

Like many of the other long bones, the average overall length of the bone can

sometimes be used in sex determination due to the correlation between height & long

bone length. Out of all the components of the radius, the maximal length is the most

accurate at 85%. Female radii generally average out at 24 cm while male radii have an

average length of nearly 27 cm. However, leg bones are much more accurate for sex

determination, with tibial & femoral features having accuracy greater than 86%. This is

not including the respective lengths of these elements, whose accuracy falls below 80%

for both the tibia & the femur. The best tibial feature for determining sex is the breadth of

the proximal epiphysis, which is measured from the lateral-most point of the tibial

plateau to the medial-most point of the plateau. Females have an average maximum

breadth of 7 cm & males average out at 8cm.

The femur, however, has two features that should be used concurrently when

establishing sex. The femoral epicondylar breadth, at 89% accuracy independently, & the

maximal diameter of the head, at 86% accuracy independently, are the most precise

femoral traits. It is worth noting though that other studies have shown these precision

rates to be lower in non-White populations. The femoral epicondylar breadth, measured

from the lateral epicondyle to the medial epicondyle, has a sectioning point of 7.7 cm,

with females at an average of 7.2 cm & males at an average of 8.2 cm. The vertical

diameter of the femoral head averages at 4.1 cm in females & 4.6 cm in males, with a

demarcation position at 4.3 cm. Lastly, the triangle formed by the lateral-most point of

the femoral head plate & the apices of the greater & lesser trochanters on the posterior
 41

proximal end has been found to be sexually dimorphic. The differences in size are

directly correlated to sex in most cases. Muscular insertion points, like those on the

proximal end of the femur & the distal end of the humerus, create greater variances

between the sexes. This method of measuring the proximal end of the femur is over 87%

accurate (Işcan, 2005; Purkait, 2005).

Age
Age estimation attempts to determine the age of the individual at death. There are

several methods for estimating age such as dental formation & eruption, dental attrition,

epiphyseal plate growth, long bone length, sternal rib ends, suture closures, & the pubic

symphysis & auricular surface of the os coxae. While each method has its own benefits

& disadvantages, it is most effective to use multiple techniques as well as comparing

dental & elemental development & growth (Bassed, 2012).

Tooth Formation

Tooth formation begins in utero & continues through the development of

permanent teeth. While eruption charts are useful, radiographs can allow a more

profound inspection of the predetermined structure of tooth formation. Demirjian, et. al

developed a system for classifying & scoring seven teeth from the left mandible in which

the use of comparative radiographic images, detailed illustrations, & exacting,

descriptive stages allows for chronological aging with over 90% accuracy. However, this

aging method is only useful for subadults (Demirjian, 1973; Maber, 2006).
 42

Tooth Eruption

If radiographic analysis is unavailable, tooth eruption patterns are also used to age

subadults. Eruption charts are available from multiple different reputable, reviewed

sources; most of these charts agree on the specific years of childhood & adolescence in

which teeth erupt. By the second year of life, the majority of the deciduous teeth will

have emerged. Around seven, permanent teeth begin to emerge, starting with the incisors.

By eleven, the permanent canines & premolars are emerging. & the permanent molars

come in at the intervals of six years, twelve years, & eighteen years.

Considering that not all individuals fall within these patterns, it is beneficial to compare

multiple methods of aging dentition as well as other available correlative data (Ubelaker,

1999; White, 2012).

Dental Wear

Once an individual has all of their permanent teeth fully formed & erupted, these

methods are no longer applicable for aging. However, dental wear patterns are one way

to age adults upon completion of eruption. Dental wear patterns or attrition charts, such

as Brothwell’s dental wear chart, attempt to estimate age based on the amount of dentine

exposed on the occlusal surface of the tooth. However, there are numerous issues with

systems such as this. The primary issue is that exact chronological age is not achievable.

Brothwell’s age ranges are 17-25, 25-35, 35-45, 45+. While an age estimation of 25-35

may be sufficient in some cases, the 45+ age range leads into the issue of aging elderly

individuals. The second concern, as just mentioned, is the uncertainty in aging during

senescence. As individuals age, especially as seen in archaeological sites, tooth loss is

 43

somewhat common; thus in combination with potentially severe wear, aging older

individuals with any sort of exactness is unfeasible. The third & final dilemma is the lack

of cultural or individual variety. Various diets, lifestyles, beliefs, & other behaviors can

impact dental wear & health. These variations cause differences in the way tooth loss

occurs, whether it is through attrition, erosion, or abrasion (Koçani, 2012; Scheuer, 2002;

Brothwell, 1965).

Epiphyseal Fusion

The epiphyseal plate is the area at the proximal & distal ends of long bones that

allows for growth during childhood. These plates contain a layer of cartilage that goes

through the process of ossification during development to continually add new layers of

bone. Mature bones that are no longer growing have fused epiphyseal plates in which

bone has replaced all the cartilage. The predictable rates at which these plates fuse can

help osteologists estimate individual age. Long bone fusion, which occurs between 18-25

years of age, is the most accurate for aging. The fusion rates of other elements, including

the scapula & the ischium, are much more variable & thus, provide less accuracy. Proper

aging using this technique requires appropriate differentiation between separate, fusing,

& fully fused epiphyses (Scheuer, 2002; Stevenson, 1924).

Long Bone Length

Long bone length used in age determination attempts to find chronological age

based on the interrelationship between the overall size of the element & the age of the

individual. However, these measurements, including the length of the diaphysis, the
 44

length of the entire long bone, & the maximal vertical diameter of the femoral head, are

generally only useful for subadults up to approximately 23 years of age. Nevertheless,

long bones are still useful in age determination, especially the femur. The use of

radiographs, or even more precise, microradiographs, for the study of the internal tissue

structure can predict adult & elderly ages as well as give more exact ranges. It has been

noted, however, that additional factors, such as illness, cultural influences, variation, &

population-specific data, skew analysis, even through the use of regression formulae. The

most common problem seen with most age estimation methods is a direct correlation

between old age & ambiguous categories. As bones age, the predictability of their

microbiology & architecture becomes less definite & thus, accuracy decreases as the

chronological age of the individual increases, regardless of the intensity of the element

destruction (Rissech, 2008; Watanabe, 1998; Jantz & Jantz, 1999; Schmeling, 2007;

Franklin, 2010).

Ribs

Analysis of the ribs has become increasingly popular for age estimation. This

method, developed by M. Y. Işcan, scores three multivariate factors of the sternal end of

the ribs allowing for increasingly accurate aging in senescence. Though, like many other

aging techniques, this method tends to overestimate ages. The benefit of this method is

that numerous rib analysis tends to support the same result as the singular analysis of the

right fourth rib, which is less work on the osteologist than other techniques & provides

up to 75% accuracy (Franklin, 2010; Işcan, 1984; Wolff, 2012; Meena & Rani, 2014).
 45

Cranial Suture Fusion

Just as epiphyseal plates fuse during development, the separate bony plates that

make up the cranium fuse at the suture lines as an individual ages. Young individuals

have space for growth between the plates. Once the skull matures, the sutures begin to

close in a very specifically timed pattern, beginning endocranially & moving to the

ectocranium. Generally, it is only vault sutures that are analyzed, with the exception of

the four palatine sutures, to estimate age. There are multiple different scoring techniques

used to age, & when possible, multiple variables & methods should be used & compared.

As with other biological estimations, variation exists across populations & time, & non-

specific data should be treated with apprehension. It should also be noted that suture

fusion or union can result in complete erasure of the suture; this will be discussed further

in the congenital disorder section of “Pathology”.

Comparing multiple methods of the cranial suture closure age estimation will lead

one to a basic set of structured limits. As previously noted, it is safe to say that sutures

close from the endocranium to the ectocranium in a constant, distinguishable pattern. The

“lapsed union” phenomena has been addressed by multiple authors, which states that

suture closure may decelerate with age, with endocranial activity terminating around

middle age, causing incomplete closure, even in completely healthy individuals. Sex can

also cause differences in suture closure times & should be taken into consideration. Due

to the potential of previously discussed variation, it is safest, & more prevalently

accepted, to use decade age ranges for age estimation. Lastly, correct age estimation

becomes more difficult as an individual ages, & as such, older estimation should be done
 46

so with greater conservation (Krogman, 1962; Bedford et al., 1993; Key, Aiello, &

Molleson, 1994; Meindl & Lovejoy, 1985; Todd & Lyon, 1925).

Pubic Symphysis

A common method of adult age estimation is the morphology & texture of the

pubic symphysis. The pubic symphysis is the meeting point of the left & right os coxae

of the pelvis. In life, the two sides have a layer of cartilage in between them & are held

together by the pubic ligaments. It is important to understand this because the two faces

of the pubic symphysis never actually touch. However, throughout the course of an

individual’s life, the faces change shape & texture. Young individuals have well defined

pubic symphyseal faces with deep ridges. As individuals age, the ridges erode & become

less visible. The overall outline of the face may also change shape.

In the 1920s, T. W. Todd developed a ten-phase chart for age estimation of the

pubic symphyseal face in adults. While many others have expanded on & improved upon

Todd’s method, the Suchey-Brooks method has since proved to have high accuracy from

18-30 years old, dropping exponentially as the individual’s true age increases. This is

partly due to the unpredictability of changes as an individual ages. Different factors can

contribute to more severe degradation such as childbirth or injury. The Suchey-Brooks

system encompasses six phases that include strict characterization for each, including

sketches. While Todd’s method was based solely on a moderately sized sample of White

males, Suchey-Brook’s method utilized a sample of over 1,000 males & females (Todd,
 47

1921; Brooks & Suchey, 1990; Gilbert & McKern, 1973; Cox, 2010; Brooks, 1955;

Franklin, 2010).

Auricular Surface

Similarly to the pubic symphysis, the auricular surface of the os coxae is also

used. The auricular surface, like the symphyseal plates, is separated from directly

articulating with the sacrum by cartilage & the joint is held together by large ligaments.

The erosion to this kidney bean-shaped portion of the ilium can be used to estimate age at

time of death. The auricular surface is considered a more reliable indicator of age than

the Suchey-Brooks method for the pubic symphysis. This method uses Lovejoy’s eight-

phase system to place individuals within an age range. As with multiple types of age

estimation, unpredictability often causes higher percentages of overestimation in

individuals over the age of sixty.

The surface of the iliosacral articulation is undulated with highly visible striae. As

the individual ages, the surface loses ridge detail, becomes more porous, & begins to lip

up around the perimeter of the joint. This method also uses features such as

microporosity, granularity, & transverse organization. It has been recently suggested

however, that some of the phase requirements for the Lovejoy method may occur

independently of each other & therefore, atypical of the model (Hens, 2008; Schmitt,

2004; Buckberry & Chamberlain, 2002; Lovejoy, 1985; Franklin, 2010; White, 2012;

Klepinger, 2006).
 48

Stature
Long Bone Length

When estimating stature, it is common to use long bones due to their direct

correlation to an individual’s living height. While height estimation began very

differently, most methods today rely on specific formulae to determine living stature

within a degree of error. As with all other estimations & calculations, populations &

genders vary in stature across the world. It is also important to note that stature may be

lost with age &, some have found, that taller individuals have a greater amount of soft

tissue to account for.

Various methods have been developed with the use of varying populations.

Trotter & Gleser’s 1952 version was used until Trotter spoke at a seminar in 1968 about

improvements to the system. Since then, more precision has been added to known

populations & genders.

FORDISC & Owsley’s Method

The debate about the difference between biological stature & forensic stature has

led to other methods of linear regression models being formulated as well as using

greater numbers of sources of osteological data. The most extensive, although far from

perfect, is FORDISC 3.0, a collective software used for establishing a probable biological

profile. Unlike the methods of Trotter & Gleser (1952), Trotter (1970), & Owsley

(1995), FORDISC establishes stature from cranial fragments only. The benefit of

FORDISC is the extensive inventory of collections used as reference within the software.
 49

FORDISC contains the cranial data of W. W. Howell’s lifelong work as well as the

Forensic Anthropology Data Bank (FDB), which is partnered with over 30 institutions,

including medical examiners’ offices, universities, & the C. A. Pound Human

Identification Laboratory. The FDB currently reports to having almost 3,400 total

individuals with the sex & ancestry known of over 2,400 of those.

Owsley’s regression model is often considered next best when lack of funding or

other issues prevent the use of FORDISC. To counter the errors in Trotter & Gleser’s

1952 measurements, Owsley’s method, using left elements only, measured the femur,

tibia, ulna, humerus, & radius of males & females in Black & White populations, when

available. Further expansions have focused on damaged, as opposed to intact, elements,

particularly in the use of the distal or proximal ends of long bones as well as foot

measurements. This is especially helpful in specific forensic cases as well as bombings &

mass killings (Trotter & Gleser, 1952; Trotter, 1970; Owsley, 1995; Özaslan, 2003;

Krishan, 2006; Brandt, 2009).

Chapter 12 - Pathology
While the vast majority of diseases do not leave their marks on bone, many

different types of congenital, metabolic, & infectious diseases are clearly visible on

affected elements. Archaeologically, this helps understand the population as a whole;

what diseases affected them & how they handled them within a socio-cultural

perspective. It is worth noting that fractures can be categorized as both a pathology as

well as a human modification depending on the cause & effect on the bone.
 50

Joint Diseases
The most common pathology among humans is arthritis. Arthritis can be broken

down into two different categories, rheumatoid arthritis (RA) & osteoarthritis (OA). It is

important to know their similarities & differences, though we do not currently have the

capability to macroscopically determine which arthritis an individual is exhibiting.

Further research in this area could help expand knowledge about archaeological

populations & the presence of RA, an autoimmune disorder. OA, while the same as RA

in the sense that both can cause severe joint inflammation & pain as well as constant

degradation of the joint cartilage, is caused by normal use during the aging process.

Historically & presently, knee joints are the most commonly effected.
The two most common pieces of osteological evidence of arthritis are very

specific & clear to determine. First, many arthritic specimens show signs of polishing,

also known as eburnation; this gives the bone surface a smooth & shiny appearance

which is caused by complete obliteration of cartilage in life. Secondly, & most

commonly, is the formation of osteophytes, also known as “bone spurs”, which causes

sharp, bony projections & deformation around the outer edges of the element. If

osteophyte growth is severe, total fusion of joints is possible, especially in the vertebral

column.

Additional joint diseases include TMD, Forestier’s Disease, Charcot’s Joint,

septic arthritis, & cysts. TMD, often misreferred to as TMJ, is a condition that affects the

temporomandibular joint of the mandibular fossa. Forestier’s Disease is a type of Diffuse

Idiopathic Skeletal Hyperostosis (DISH), which most often affects the spine by causing
 51

the spinal tendons to calcify. A multitude of factors can cause DISH, such as genetics,

environment, diet, & overuse. Neurotrophic arthropathy, also known as

Charcot’s Joint, is a degenerative, reabsorption of joint bones, often due to diabetes.

While OA & RA are incurable, septic arthritis is curable but also life-threatening. Septic

arthritis is not truly a type of arthritis, but instead an infection of the fluids within a joint.

Cysts can also form within joints, often leaving lesions easily visible macroscopically

(White, 2012; Ubelaker, 1999; Rogers, 1990; Soluri & Agarwal, 2016; Twigger, 2007;

Gray, 1977; Mayo Clinic, 2017; ABTA, 2014).

Infections
Various types of infections can lead to bone degeneration & deformation.

Bacterium, viruses, & fungi can enter the bloodstream, lymphatic system, respiratory

system, or immune system & effect the overall quality of the bone. Many infections

cause affected bones to show signs of localized swelling & inflammation as well as

porosity, apertures, anamorphosis, & overall enlargement of the entire bone.

Infections of the skeletal system are, in general, labelled osteomyelitis, or the

inflammation of bone. All types of infections that affect bones cause osteomyelitis. The

most common of these, however, are mycobacterium, which causes tuberculosis, &

pyogenic bacterium, such as staph infections & salmonella. Other types of infectious

diseases include Bechterew’s Disease, syphilis, & Hansen’s Disease. Bechterew’s

Disease, known medically as ankylosing spondylitis, causes spine deformation,

particularly in young men. Syphilis is a bacterium-caused STD which can be cured of,

but when left untreated, can cause soreness, rashes, &, eventually, deformation. When
 52

left untreated, syphilis can reach its tertiary state which can affect the central nervous

system, cause the growth of soft, gummatous tumors, & abdominal aortic aneurysms

(AAA).

White, Black, & Folkens also explain the effect of periostitis on bone. Periostitis

is different from osteomyelitis in the sense that, while the latter affects the entirety of the

bone, including the medullary cavity, periostitis only affects the external surface of the

bone. Periostitis is not itself an infectious disease, but instead, it is a common

manifestation of various infections when the periosteum (the tissue layer over bone)

incurs damage. Periostitis can cause localized erosion to the cortical bone such as in

cases of chronic shin splints in athletes (Ubelaker, 1999; White, 2012; Rosenberg &

Khurana, 2016; Twigger, 2007; Gray, 1977; Mayo Clinic, 2017; ABTA, 2014;

Brothwell, 1965).

Congenital Disorders
Congenital disorders occur either in utero or right around the time of birth. Many

congenital disorders are inherited, such as achondroplasia & mucopolysaccharidoses

disorders (most of which are also metabolic). Other congenital disorders occur due to a

combination of genetic & environmental factors, such as spina bifida & cleft palate.

Talipes equinovarus (CTEV) & femoral deficiency (CFD) are both congenital disorders

that may or may not have genetic factors; disorders like these still evade doctors as to

their cause. Polio is a congenital disorder that is caused by a virus & is therefore both

congenital & infectious.

 53

Achondroplasia, also known as dwarfism, is the most common type of skeletal

dysplasia. The most common skeletal symptom of achondroplasia is shortened long

bones. Mucopolysaccharidoses disorders are part of a unique set of inherited, congenital

metabolic syndromes. These include Hurler’s Syndrome, Hunter’s Syndrome, Sanfilippo

Syndrome, & Morquio Syndrome. This group of syndromes is characterized by the

body’s inability to create skin, tissues, cartilage, tendons, &, of course, bone.

Osteogenesis imperfecta & osteopetrosis are also genetic congenital disorders but are

rather rare. Osteogenesis imperfecta, also known as Brittle Bone Disease or OI, manifests

in one of four types & affects the collagen structure of bone. Conversely, osteopetrosis,

also called Marble Bone Disease or osteosclerosis fragilis generalisata, has three different

forms that affect the overall density of bone. Both cases, however, increase the risk of

fracture & deformation.

While some congenital disorders have known causes, others, such as spina bifida

& cleft palate, are still not fully understood. Spina bifida is often used as an umbrella

term for each of the three different types. Spina bifida occulta is the least severe form of

the disorder which causes slight spaces between the vertebrae. It is possible that spina

bifida occulta may not actually have any osteological signs. Meningocele &

myelomeningocele are the other two types of spina bifida, which are rarer & more

severe, respectively. Meningocele, like spina bifida occulta, may not have any

osteological signs due to the relative mildness & its focus on soft tissues.

Myelomeningocele is the most severe form of the disorder & is often called spina bifida

in everyday speech. Myelomeningocele causes an opening along the lower vertebrae,

 54

causing them to protrude outwardly. This often causes deformation of the spine & feet, as

well as the appearance of Wolff’s Law in the pelvis. Like spina bifida, the cause of cleft

palates are not completely known. It is accepted that environmental & dietary factors

play a large role, as the majority of cases are seen in undeveloped or developing

countries. Cleft palates are separated into two parts, cleft lip (CL) & cleft palate (CP), &

are recognizable as moderate to severe deformation of the maxillae and/or the palates.

Talipes equinovarus, also known as club foot, & congenital femoral deficiency

(CFD) are both congenital disorders that are not considered to have heritable factors.

Club foot can cause a shortening of the femur as well as contortion of the foot. CFD

causes deformation to the knee and/or hip joints causing weakness & imbalance. Lastly,

polio or poliomyelitis, caused by the poliovirus, often causes coxa valga, or the widening

of the femoral-acetabular joint. Coxa valga creates an angle of greater than 135° from the

shaft to the apex of the femoral head (Gray, 1977; White, 2012; Ubelaker, 1999; Mayo

Clinic, 2017; ABTA, 2014).

Neoplasia
Quite simply, neoplasia is the abnormal growth of tissue. Neoplastic conditions

are those in which the individual suffers from malignant and/or benign tumors, which

can leave their mark on the skeleton. Malignant neoplasia, commonly referred to as

cancer, are tumors that grow rapidly, can infect other parts of the body, & effectively

cause damage to nearby soft tissues as well as osseous tissue. Malignant sarcomas

commonly affect bone or the surrounding tissues & thus are easily visible on both green
 55

& dry bone. Many of the sarcomas look the same in the sense that they can form lytic

lesions, blastic lesions, or, sometimes, a combination of both.

The most common type of bone-affecting cancer is osteosarcoma, which begins in

the metaphyses of the long bones during the early years of growth. This can look very

similar to chondrosarcoma, which are tumors that invade the cartilage present in the

pelvis & joints of older individuals. Paget’s Disease, commonly misidentified as late

onset osteosarcoma or chondrosarcoma, is specifically characterized by an expedited rate

of bone destruction & regrowth affecting the pelvis & legs, but it is also known to affect

the skull & spine. Similarly, Ewing’s Sarcoma is a rare form of bone disease that affects

the appendages & pelvis of young children. Lastly, fibrosarcoma & rhabdomyosarcoma,

which can be fairly difficult to identify in skeletal remains, affect the fibrous tissues &

the muscles, respectively, leaving their marks on bone.

Other non-sarcoma cancers can still affect the bone, specifically the quality of the

bone. Multiple myeloma, or Kahler’s Disease, is one such cancer that attacks the bone

marrow via the white blood cells & results in an overall weakening of the bones.

Alternatively, leontiasis ossea, sometimes called “lion face”, is marked by severe bony

overgrowth in the skull & mandible. Lastly, nasopharyngeal carcinoma, a type of skin or

organ-lining tissue cancer, can mimic leprosy. This type of carcinoma eats away at the

nasal & sphenoid bones (Ubelaker, 1999; Brothwell, 1965; White, 2012; Mayo Clinic,

2017; ABTA, 2014; Krygler & Lewis, 2009; Chowdhuri, 1969; PRO, 2014; NCI, 2016)
 56

Endocrine Disorders
The endocrine system of the human body is responsible for releasing hormones

into the bloodstream via the different glands. Disorders that affect the hormone levels in

the body can cause issues with growth & development as well as mineral metabolism of

bone. All endocrine disorders can also be congenital as well. Conditions such as

hyperparathyroidism & hypothyroidism can affect the overall quality of the bone

whereas disorders such as pituitary dwarfism & acromegaly tend to only affect the

growth & development of the bone.

Conditions such as these tend to cause the release of either too much or too little

of the necessary growth hormones. Hypothyroidism, which is caused by an underactive

thyroid, can lead to delayed skeletal development in children as well as the

discontinuation of bone reabsorption & remodeling in older age, if left untreated.

Comparatively, hyperparathyroidism affects the smaller parathyroid glands, just

posterior to the thyroid, causing an overproduction of hormones. However, similar to

hypothyroidism, bones can become weak & brittle in those with hyperparathyroidism.

Both conditions have also been associated with joint pain & the onset of OA.

Whereas hyperparathyroidism & hypothyroidism can affect bone mass & quality,

pituitary dwarfism & acromegaly tend to affect the overall rate of development. Both

pituitary dwarfism & acromegaly are caused by issues with the pituitary gland, however

the latter is caused by an underactive gland & the former by an overproduction of

hormones during childhood. Pituitary dwarfs have shortened limbs & a disproportionally
 57

large cranium. Conversely, acromegaly causes the hands, feet, & cranium of those

affected to grow abnormally large. Acromegaly is often referred to as gigantism due to

the proportionally acute growth of the limbs & torso (Mayo Clinic,

2017; White, 2012; Brothwell, 1965; Ubelaker, 1999; Gray, 1977; Harvey, 2002;

Potluková, 2013).

Metabolic Disorders
Various metabolic conditions can leave macroscopically visible traces. Metabolic

disorders can either arise independently, such as when an individual is missing essential

vitamins, or in response to other factors, such as endocrine disorders, liver or pancreatic

disease, or eating disorders. Conditions such as these generally lower the individual’s

BMD or bone mineral density. For the vast majority of these conditions, the bones

become weak & brittle from a lack of healthy bone growth. This leads to deformation &

fracture of bone in life.

Many of the metabolic issues revolve around various deficiencies. Some of these

disorders include calcium, vitamin D, & vitamin C deficiencies. Other conditions come

about due to overall poor nutrition, such as in cases of anorexia or in undeveloped

countries. Many of the deficiency conditions can be congenital if the mother has poor

nutrition during pregnancy.

Hyper- & hypocalcemia are conditions that are related to too much calcium & too

little calcium, respectively. As the calcium levels in the bloodstream become unstable,

the new bone growth is weak & characterized by lytic lesions. It has been noted that
 58

hypercalcemia can come about due to childhood leukemia. Rickets & osteomalacia both

result from a lack of vitamin D. Rickets is associated with soft, deformed bones in

children, & while osteomalacia also creates weak bones, it only occurs in adults as a

consequence of the aging process & poor nutrition.

Osteopenia is a classic disorder associated with anorexia. This disease creates

bones with an overall lowered BMD by resorbing old bone faster than the new bone is

formed. This gives the bone a porous appearance with a brittle structure subject to

frequent breaks. Paget’s Disease also causes issues with the regeneration of healthy bone.

As previously mentioned, Paget’s Disease is often confused with osteosarcoma, due to

the similarities in bone degradation. Due to the bone cell’s inability to regenerate

properly, the new bone is soft & pliable. This commonly leads to deformities, especially

in the skull, pelvis, & spine. Lastly, scurvy, sometimes called scorbus, is a nearly

eradicated disease caused by a lack of vitamin C. Many undeveloped & developing

countries have issues providing proper nutrition to their people; conditions like these

often affect children the worst. Scurvy prevents the bone from developing properly. This

often results in distinctive blastic cysts on the frontal squama & on the frontal bone

portion of the orbits (Mayo Clinic, 2017; White, 2012; Ubelaker, 1999; Brothwell, 1965;

Lee, 2007; Walters & De Swiet, 2002; Viswanathan, 2014; Selby, 2013).

Other Types of Pathologies

There are various other types of pathologies that can cause damage to the skeletal

system. As mentioned before, fractures can be considered a pathology due to the changes

to structure of the bone during fracture & any subsequent healing. Other pathologic
 59

conditions that are skeletally visible include suture closure issues, chromosomal

syndromes, various anemias, & other genetic disorders.

Healed Fractures

As previously discussed, osteomyelitis is any inflammation of bone. This

inflammation initiates the response of bone growth. Bone fractures, when improperly set

or provoke infections, fall within the realm of pathologies. However, even when properly

set, fractures are often easy to spot & will be discussed further in modification & trauma.

Nonetheless, fractures that heal improperly still go through the normal bone healing

process, infections & disorders notwithstanding. The normal healing process begins with

osteomyelitis at the fracture site. Like any other injury to the body, the reactionary

response is inflammatory. However, at a fracture site, this inflammation is necessary to

begin the healing process. New osteoblasts continue to form & cartilage begins to bridge

the gap. Once this process begins, cartilage will advance in the path of least resistance to

connect the two (or potentially more) ends of the improperly set bones.

The cartilage continues through the normal ossification process, culminating in deformed

bones in severe fractures &, as states, fractures that are either set improperly or left to

heal naturally. The injury site is clearly visible by a “knotted” appearance due to irregular

remodeling (Agarwal & Soluri, 2016; White, 2012; Väänänen, 1996; Brothwell, 1965;

Klepinger, 2006; Ubelaker, 1999).

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Suture Closure

The closure pattern of sutures generally follows a normal, patterned course. Issues

with the timing and/or pattern of the suture closures falls into two categories:

craniosynostosis or delayed closure. Craniosynostosis refers to any condition that causes

premature suture closing. In 1851, H.R. Virchow postulated the ways in which premature

suture closure happens & the consequences of such instances. All forms of

craniosynostosis cause microcephaly, in which the brain cause is significantly smaller

than average. Microcephalic individuals have impeded brain development & thus suffer

from learning disabilities. Virchow observed five types of craniosynostosis, depending

on which sutures fused prematurely: trigonocephaly, scaphocephaly, brachycephaly, &

anterior & posterior plagiocephaly. Delayed suture closure, unlike craniosynostosis, is

not necessarily abnormal & generally does not cause developmental issues. The most

common result of these delayed closures is the appearance of Wormian bones. While

Wormian bones are also associated with types I & IV of osteogenesis imperfect, they are

more commonly a benign sign (Soluri & Agarwal, 2016; Cohen, 1988; Key, 1994;

White, 2012; Meindl & Lovejoy, 1985; Todd & Lyon, 1925; Alden, 1999; Gray,

1977; Brothwell, 1965).

Chromosomal Disorders

While there are many types of chromosomal disorders, few have such an extreme

impact on the skeleton as Turner’s Syndrome. This syndrome begins with a

chromosomal disorder. Turner’s Syndrome only affects biological females, causing them

to be born with only one X chromosome. While this does not directly affect the skeletal
 61

system, Turner’s Syndrome causes delayed puberty as well as cardiovascular &

endocrine system issues. Because of this delayed growth, those with Turner’s Syndrome

tend to maintain a childlike appearance, even into adulthood. This includes stunted

growth & shortened limbs (Soluri & Agarwal, 2016; Mayo Clinic, 2017).

Anemic Diseases

Anemic disorders are those that are defined by affecting the body’s red blood

cells. However, anemia in which the individual has nutritional lack of iron is specifically

known as iron deficiency anemia. This lack of iron stops the body from making healthy

red blood cells that can effectively carry oxygen throughout the body. Iron deficient

anemia is common, both presently as well as historically, due to its connection to

malnutrition & parasitic activity. Various authors have attributed this type of anemia to

the archaeological presence of porotic hyperostosis. Porotic hyperostosis (PH) is

characterized by destructive lesion growth “that usually presents in the cranial bones as

porous & spongy bone surfaces” (Soluri & Agarwal, 2016). Porotic hyperostosis that

occurs specifically in the orbits is known as cribra orbitalia, while lesions of the

endocranium are known as cribra cranii. More recently, biological anthropologists have

been questioning the assumed attribution of anemia in cases of porotic hyperostosis. It

should also be noted that while sickle cell anemia & thalassemia are potentially more

likely causes of porotic hyperostosis, they are both quite rare in comparison to iron

deficiency anemia (Walker, 2009; Mayo Clinic, 2017; Mushrif, 2000; Ortner, 2003;

Soluri & Agarwal, 2016; Brothwell, 1965; Ubelaker, 1999).

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Genetic Disorders

Many types of heritable genetic disorders, while generally rare, can leave severe

evidence on an individual’s bones. Two of these rare genetic disorders cause heterotopic

ossification, or growth of bone tissue in abnormal areas of the body. This generally leads

to ossification of the connective, muscle, nervous, & epithelial tissues implicating

organs, tendons, & ligaments. These two diseases are fibrodysplasia ossificans

progressive (FOP) & progressive heterotopic ossification (HO). FOP’s most common

sign is the congenital appearance of deformation of the bones attached to the first

metatarsal. As the disease progresses, the ossification moves to the cervical vertebrae,

scapulae, & the appendicular skeleton. Alternatively, HO begins in the skin & fat tissues.

The primary stages of the disease only affect the outer skin layers. As the disease

progresses, muscle tissue & joints are commonly ossified. In both FOP & HO, the

disease may cause total immobility; hyperostosis cranialis interna, though also a genetic

ossification disease, does not affect mobility. Hyperostosis cranialis interna is a genetic

disease that causes thickening of the calvaria, particularly near the basilar region & the

occipital condyles. This expansion of the bones often causes cochleovestibular nerve

compression syndrome (CNCS), which results in palsy of the facial nerves &, regularly,

the sense of smell. Similarly, hyperostosis frontalias interna, causes an accumulation of

bone on the vertical & horizontal endocranial portions of the frontal bone (NLM, 2017;

White, 2012; Kaplan, 2013; Kaplan, 1994; Kaplan, 2008; Manni, 1990; Waterval, 2010;

Waterval, 2012; Schwaber & Hall, 1992; Klepinger, 2006).

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Dental Disease
Dental diseases are commonly seen historically as well as in current populations.

White, Black, & Folkens discuss the categories of dental disease determined by J. R.

Lukacs in 2006; the four categories are developmental, degenerative, genetic, &

infectious, though there is a distinction drawn at dental wear. Dental wear is only viewed

as pathological if it causes symptoms that fall into one of Lukacs’ four categories.

Common dental diseases include dental caries, periodontal disease, enamel hypoplasia,

dental fluorosis, hypodontia, severe attrition, as well as dental calculus.

Dental Caries

Dental caries, more commonly known as cavities, are areas of the teeth that are

going through demineralization & deterioration due to an overproduction of acid in the

mouth. This overproduction of acid correlates to what types of food are ingested. It has

been noted that populations with diets higher in carbohydrates are more likely to incur

dental caries. If left untreated, dental caries can cause permanent damage to, not just the

enamel, but to the dentin as well (White, 2012; Soluri & Agarwal, 2016; Brothwell,

1965).

Periodontal Disease

Periodontal disease, a leading cause of tooth loss, is an infection of both the soft

tissues of the mouth as well as the alveolar bone. As this disease progresses, the bone

surrounding the teeth is resorbed & fails to properly remodel. In the severity of the

disease, the bone resorbs until the teeth fall out. This degenerative disease is caused by a

variety of factors such as calculus build-up, severe attrition, & genetic predisposition, as
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well as reduced tissue resistance caused by malnutrition and/or eating disorders (White,

2012; Brothwell, 1965).

Hypoplasia

Enamel hypoplasia creates horizontal lines on the teeth which “indicate [that] the

individual suffered stress (nutritional or health problems) while the tooth was being

formed in early childhood” (Soluri & Agarwal, 2016). The lines are areas of the tooth

that have incurred demineralization & thus have less enamel than the surrounding areas.

Hypoplasia is an interesting developmental disease that affects amelogenesis, the crown-

to-root formation of enamel. This creates many clues to, not just recognizing hypoplasia,

but also to help also ascertain when the individual experienced the cause of the disease.

Because enamel formation begins at the crown, tooth eruption ages can help gauge ages

affected. Teeth that have already been formed, regardless of eruption, are not affected.

However, if the enamel is still being constructed, the development of the remainder of

the tooth may be affected. Enamel hypoplasia can also be an indication of the length of

time the individual was affected for (White, 2012; Soluri & Agarwal, 2016; Brothwell,

1965).

Dental Fluorosis

One of the most commonly misidentified & still somewhat misunderstood

diseases is dental fluorosis. Fluoride, a mineral found in ground & natural water, has

been shown to help reduce dental caries by protecting the teeth against acid. However,

various studies have noted the effects of excess fluoride in drinking water. Long term
 65

exposure to, even low levels of, fluoride cause enamel hypomineralization, which

weakens enamel during development. These weakened areas of enamel create a blotchy,

irregular surface. In mild circumstances, the teeth seem to have white patches. As the

exposure continues, the teeth become increasingly weak as the body is unable to maintain

a healthy tooth exterior. This eventually leads to excessive dental caries, tooth decay, &

tooth loss. Early stages of dental fluorosis have been notably mistaken for hypoplasia

(Pendrys, 1990; Pendrys, 1996; Breslow, 2002; Aoba & Fejerskov, 2002).

Hypodontia

Hypodontia is a rare developmental disease in which one or more of the teeth fail

to form. This can occur in the deciduous or permanent tooth formation stages. There are

two other forms of hypodontia, anodontia & microdontia. Anodontia, which is the rarest

form, refers to a total lack of tooth formation, in either or both types of dentition.

Microdontia, which causes incomplete formation of teeth, often results in small, pointed

or rounded lateral incisors. Microdontia often occurs in addition to general hypodontia.

This developmental disease has genetic & environmental factors that are still not

completely understood. The prevalence of some form of hypodontia is roughly 5% in

permanent dentition & some studies have noted higher instances in females than males.

Hypodontia is associated with other conditions such as malocclusion, misplacement on

teeth, & slowed dental growth (Daugaard-Jensen, 1997; Jeong, 2015; Gill, 2011).
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Dental Attrition

Dental attrition, within normal, non-pathological circumstances, is the wear that

occurs between the two surfaces of the maxillary & mandibular teeth during regular

chewing. However, should the wear become severe enough, it may cause damage to the

dentin, dental caries, & other inflammatory conditions, such as abscesses. Severe wear is

seen more in prehistoric populations in which teeth were commonly used as tools, dental

health was non-existent, &, as many studies have suggested, grit/sand in food was more

prevalent & is likely a contributing factor to intense dental erosion (White, 2012;

Ubelaker, 1999).

Dental Calculus

Lastly, dental calculus is the most common pathology. Calculus occurs when

plaque becomes mineralized on the tooth’s exterior. However, dental calculus build-up

leads to other issues such as calcification &, as previously mentioned, periodontal

disease. Calcification occurs when the calculus growth becomes severe enough to cause

permanent damage. Often, severe calcification will gradually push the gums away as the

build-up continues down the root. Historically, dental calculus & associated dental caries

occur more often in agricultural societies as opposed to hunter gatherers (White, 2012;

Brothwell, 1965).

Chapter 13 – Taphonomy & Modification

Taphonomy is specifically the “study of the processes that operate between the

time of death of the organism” & when the remains are collected & analyzed (White,

2012). The time frame for these changes can be broken down into three categories:
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antemortem, perimortem, & postmortem. Antemortem changes happen while the

individual is still alive. These are not technically taphonomic changes because they occur

prior to death. Antemortem pathologies, including fractures, generally show some to

complete healing. Perimortem changes, however, occur just around the time of death &

could be potentially related to the cause. Because these occur so close to the time of

death, there are generally no signs of healing, but the bones still react as fresh bones.

Postmortem changes occur after the individual is already deceased.

Modifications to the human skeleton can be divided into the different taphonomic

groups: antemortem, perimortem, & postmortem. Antemortem changes, as previously

mentioned, generally show complete healing. Bone fractures, cultural modifications,

amputations, & other pathologies are included in the antemortem time frame. Perimortem

alterations are nearly always related to trauma & are therefore extremely useful to the

forensic osteologist. Postmortem changes, often referred to as psuedopathologies,

encompass animal marks, dry bone fractures, physical/biological alterations, & human

modifications.

Antemortem Trauma
Antemortem pathology is any trauma that occurred during the individual’s life &

shows some signs of healing. While this trauma generally is not the cause of death,

antemortem pathologies can help identify individuals as well as determine more about an

individual’s life. Common antemortem alterations seen archaeologically as well as

forensically are cranial deformations, amputations, & dislocations. As discussed in

Pathologies, cranial deformation can be caused by disorders such as craniosynostosis.

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However, cultural deformations such as cranium wrapping & trephination can cause

antemortem damage that the individual may survive with their entire life.

Cranial Deformation

Artificial cranial deformation has been reported in various parts of the world over

the span of many cultures. There are five different types of cranial deformation: 1)

vertico-occipital, 2) lambdoid, 3) frontal, 4) fronto-occipital, & 5) circular (Ubelaker,

1999; Stewart, 1973). Vertico-occipital flattening is the easiest & most common type of

cranial deformation, which produces a depression on the occipital bone.

Archaeologically, this is seen in infants that have been strapped to a cradleboard.

However, in recent times, vertico-occipital deformation is common in infants left on their

backs for extended periods of time. Lambdoid deformation, though less common, is a

less extensive form of vertico-occipital flattening. This type of deformation occurs

anterior to the occipital planum, just along the intersection of the sagittal & lambdoid

sutures. Frontal deformation occurs when pressure is applied to the frontal squama. The

use of tumplines, both archaeologically & currently, can produce this type of

deformation. Fronto-occipital flattening is often seen archaeologically as a cultural norm

in some civilizations. This combines either types 1 & 3 or 2 & 3 of the types of

deformation (Ubelaker, 1999). Lastly, circular deformation produces flattening around

the circumference of the skull producing a cone shape. This is occasionally caused by the

force applied to the infant’s cranium during passage through the birth canal. This type of

deformation can be fixed if altered during the child’s early years (White, 2012; Ubelaker,

1999; Stewart, 1973; Brothwell, 1965).

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Trephination

Trephination is the cultural & medical practice of cutting or drilling into in the

cranial vault bones. The most common reasons behind this practice was to leave pain

caused by brain swelling or attempting to perform a biopsy. Antemortem trephination

scars are healing or completely healed. However, in the cases where trephination leads to

death, it is categorized as perimortem trauma. Nonetheless, many individuals survived

trephination procedures & show distinct marks of the procedure as well as various levels

of regrowth (White, 2012; Ubelaker, 1999; Brothwell, 1965).

Amputation

Amputation, or the complete or partial removal of the appendicular body,

produces hypervascularity in the affected area. The most common effect of amputation is

a reduction in bone density, otherwise known as atrophy. The severity of atrophy is

dependent on where the amputation occurred, what type of tool was used, additional

factors, such as sclerosis or infection, & the amount of healing between procedure & the

individual’s death (Krogman, 1962; Sevastikoglou, 1969).

Whereas a fracture causes a break in the actual bone, dislocations affect the joint.

If the dislocation is reset properly, there will likely be no osteological evidence of the

trauma. However, in some instances, the joint is not properly repositioned & degradation

of bones begins. Changes in morphology & articulation points occur the longer the bone

is out of the joint socket (Lovell, 1997; Ubelaker, 1999; White, 2012).
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Fractures

Fractures can be caused by four different factors, according to Nancy C. Lovell’s

1997 article. Fractures can be caused by direct trauma, indirect trauma, stress, or

pathology (Lovell, 1997). Within these causal categories, force applications can be

divided into three subcategories: shearing, compression, & tension (Johnson, 1985).

Shearing results in a shifting motion that slides the parts in opposite directions.

Compression, as will be discussed further in crush fractures, is force applied to both sides

of the element. Lastly, tension is any motion that pulls in opposite directions (Lovell,

1997; Johnson, 1985).

Direct trauma occurs at the site of impact whereas indirect trauma occurs adjacent

to the impact site. Stress fractures, sometimes referred to as fatigue fractures, are caused

by repetitive force. As discussed previously, shin splints suffered by athletes can

commonly result in a tibial stress fracture due to repeated pressures. Lastly, certain

pathologies may create an environment more open to bone fracture. Pathologies such as

osteogenesis imperfecta & metabolic conditions weaken elemental chemical make-up

leading to increased risks of fracture (Johnson, 1985; Lovell, 1997).

Direct trauma fractures occur due to exact force in a specific location. Fractures

that often occur during direct trauma are crush, transverse, comminuted, & penetrating

(Lovell, 1997). Crush fractures occur frequently in trabecular bone. This type of fracture

can be broken down into three categories: compression, depression, or pressure (Lovell,

1997; Johnson, 1985).

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Compression fractures, within crush fractures as well as in the broader sense of

the term, occur when both sides of the bone are subjected to tension until the point of

break. Alternatively, depression fractures only occur on one side of the bone & may

cause indentations or led to complete rupture. Pressure crush fractures occur in bone that

is still developing. This is often seen in conjunction with cultural alterations such as in

cranial deformation or “the alteration of the normal contour of the skull by applying

external forces” (Ubelaker, 1999) & foot binding practices (Ubelaker, 1999; White,

2012; Johnson, 1985; Lovell, 1997).

Transverse fractures resulting from direct force are commonly referred to as a

“clean break”. These fractures occur when “force [is] applied in a line perpendicular to

[the] long axis of the bone” (Lovell, 1997). Transverse fractures occur in one single

break perpendicular to the longest axis of the bone. Transverse fractures are always

complete, meaning that they always break the bone through & can often lead to

displacement (Lovell, 1997; Radiopaedia, 2017).

Comminuted fractures result from crushing force in long bone diaphysis. These

fractures differ from crush fractures to trabecular bone in that they cause the cortical

bone to break into at least two pieces. Commonly, “high velocity bullets & blunt force

trauma to the cranium […] cause comminuted fractures” (Lovell, 1997).

Lastly, penetrating fractures can cause complete or impartial break of the bone by

a severe piercing force in one specific area. Penetrating fractures have an extremely large

base of causes. In archaeological sites, penetrating fractures are often produced by

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projectiles, such as arrowheads, or cutting tools, such as knives or axes. In current

forensic cases, penetrating fractures are often seen in sharp force trauma to the skull as

well as stab wounds. Penetrating fractures also include puncture wounds such as gun

shots (Brothwell, 1965; Lovell, 1997; Johnson, 1985; Glaister, 1921).

Indirect trauma, which occurs away from the point of impact, can result in spiral,

oblique, greenstick, impaction, burst, & avulsion fractures. Spiral, oblique, & greenstick

fractures occur more frequently than impaction, burst, or avulsion fractures, due to their

causes (Lovell, 1997).

Spiral fractures are caused by high intensity, “rotational & downward loading

stress on the longitudinal axis” of the bone (Lovell, 1997). Spiral fractures occur when

one end of the bone is in a fixed or immoveable & the other end is forcefully twisted.

“Accidental spiral fractures of the tibia are common in preschool children who fall short

distances onto an extended leg & are often called "toddler's fractures" (Lukefahr, 2008).

However, instances of spiral fractures in individuals younger than two years of age may

represent abuse due to the amount of force needed to force a fracture (Lovell, 1997;

Klepinger, 2006; Lukefahr, 2008).

Similar to & often confused with spiral fractures are oblique fractures. Transverse

fractures split the bone perpendicularly to the longest axis, whereas oblique breaks

fracture the bone at an angle. Like transverse fractures, oblique fractures are fairly

common but oblique breaks require rotational force as well as direct impact to the site. It
 73

has been noted that, when “well healed, this break is easily confused with a spiral line”

(Lovell, 1997).

The last of the most common types of indirect trauma are greenstick fractures. As

discussed in Chapter 4, fresh bone is a living organism that is constantly regenerating

cells & remodeling. Fractures to fresh bone occur when the energy needed to break the

bone reaches the “work to failure” limit (Turner, 2006). As discussed, fresh bones will

bend with some ductility until the force of displacement causes fracture. Greenstick

fractures are those that are specific to fresh bone. Lovell identified two common causes

of greenstick fractures: angular force & compression. Greenstick fracture caused by

angular force could result from a variety of reasons, such as overly ductile bone or failure

to reach the minimum point of fracture. This angular force causes deformation &

incomplete fracture. The bone will bend until the point of fracture is reached. In

greenstick fractures, the bone will bow & may potentially create an incomplete fracture

on the convex edge. Compressive greenstick fractures, as the name implies, incur

compression force as opposed to angular force. Like angular greenstick fractures,

compressive greenstick fractures may occur is excessively flexible bone or when there is

not enough force applied to fracture the bone. In most instances, this causes a “localized

bulging on the bone” (Lovell, 1997) & is often seen in infant bones during childbirth as

well as the limb bones of the elderly (Lovell, 1997; Turner, 2006).

Impaction fractures, though less common than compressive greenstick fractures,

occur due to the same type of force. Impaction fractures result from severe compression
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on both ends of the bone & causes one or both ends to break. Impaction fractures are

often jagged, unlike the “clean break” of a transverse fracture & are “often seen in the

proximal humerus as the result of a fall onto an outstretched hand” (Lovell, 1997).

Burst fractures also occur due to compression. However, unlike greenstick &

impaction fractures, burst fractures are only seen in the vertebrae & result in the

deterioration of the trabecular bone of the vertebral body. It is uncommon to see burst

fractures in the general population, & it is even more rare when burst fractures occur for

reasons other than senescence. As individuals age, constant compression & degeneration

of the vertebrae cause “the intervertebral disc [to rupture] through the vertebral end

plate” (Lovell, 1997).

Lastly, “an avulsion fracture is caused when a joint capsule, ligament, or tendon is

strained & pulls away from its attachment to the bone, tearing a piece of the bone with it”

(Lovell, 1997). This often results in a transverse fracture to the bone but is specifically

connected to the spraining of a muscle, tendon, or ligament. While this is a common

injury in athletes, due to overextension of the joints, occurrence in younger individuals

may be a sign of abuse. While uncommon, there are numerous sites where avulsion

fractures may occur such as the rotator cuff, the patellar tendon, or any of the attachment

sites of the hip rotator cuff muscles (Lovell, 1997; Radiopaedia, 2017; Klepinger, 2006).

Perimortem Trauma
Perimortem changes to the skeleton are the most useful to the forensic osteologist.

These pathologies, which occur near the time of death, are almost always related to the
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cause of death. Trauma analysis of recovered skeletons attempts to determine the type of

injury present as well the device used to cause damage.

Forensic Trauma: Blunt Force, Sharp Force, Gunshot, Dismemberment, & Hyoid

Fracture

While fractures often occur due to falls, pathologies, or other injuries, they may

often point to signs of homicide, suicide, or interpersonal violence. Blunt force trauma,

particularly to the cranium, sharp force trauma, gunshot wounds (GSW),

dismemberment, & hyoid fractures are the most common sources of forensic osteological

evidence.

Blunt Force Trauma

Blunt force trauma, while potentially mild to the skeleton, can cause severe

internal damage to the soft tissues leading to death. Blunt force trauma results in a

depression caused by compression force & perpendicular fracture lines “radiating toward

the point of impact, & oppositely to the point of distension” (Glaister, 1921). Depending

on the amount of force used, “concentric extocranially directed heaving fractures [may]

develop perpendicular to the radiating fractures” (Klepinger, 2006).

Using the biomechanics of bone, LeFort & Moritz “identified areas of buttressing in the

face” & vault, respectively (Berryman & Haun, 1996). Facial & cranial buttress systems

surround fragile bones by thick, solid bones. This allows the thicker bones to absorb the

force from blows, sparing the delicate bones of the face. Various instruments are used to

inflict blunt force trauma such as baseball bats, hammers, pipes, or clubs. This type of
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trauma can cause internal or external beveling, depending on the amount of force applied

to the blow. In rare cases, trauma from a blunt instrument can imitate a gunshot wound

(Quatrehomme, 2015).

One rule used in studies of blows to the head is the Hat Brim Line Rule. Ehrlich

& Maxeiner determined the hat brim line to be about a three-centimeter-wide ring that

runs above the eyebrows & ears & across the occipital protuberance (Ehrlich &

Maxeiner, 2002; Kremer, 2008). These studies have shown that it is possible to use the

Hat Brim Line (HBL) to determine if an individual suffered an accidental fall or a violent

blow. Accidental falls tend to occur at or below the HBL & generally affect the right side

of the cranium. Alternatively, blows to the head or purposeful pushes frequently occur

above the HBL, affect the left side of the cranium, & are more likely to have associated

wounds to the soft tissues of the scalp. Various studies have also used CT scans to

determine homicidal trauma from a fall (Gruspier, 1999; Glaister, 1921; Soluri &

Agarwal, 2016; Klepinger, 2006; White, 2012; Brothwell, 1965; Kremer, 2008;

Ehrlich & Maxeiner, 2002; Fleming-Farrell, 2013; Jordana, 2013; Lovell, 1997;

Berryman & Haun, 1996; Quatrehomme, 2015).

Sharp Force Trauma

Sharp force trauma is caused by acute damage to the soft tissue that may impact

the skeleton. In archaeological specimens, this may include sword or axe cuts; in more

recent forensic cases, knives or blades generally cause sharp force trauma. It is easy to

overlook stab wounds as they often look like a small notch, however, “absence of sharp
 77

instrument stigmata on the skeleton does not mean that sharp injury was not the cause of

death” (Klepinger, 2006). The most common sharp trauma injuries are seen in the chest,

including the ribs, sternum, & clavicles. Sharp force injuries are also seen in the cranium,

though the blade used is generally wider & longer than used in chest trauma.

While cuts can be seen with standard macroscopic analysis, “scanning electron

microscopy (SEM) has become the method of choice for analyzing such cut marks”

because it produces “a high-resolution magnified image of the surface of the element of

interest” (Thompson & Inglis, 2009). Such advances in technology, including 3D

scanning, can answer specific questions such as “the position of the victim in relation to

the attacker, the handedness of the attacker”, the specific weapon used, & whether the

wounds are self-inflicted or homicidal (Thompson & Inglis, 2009). Due to the pliable

nature of fresh bone in relation to dry bone, cut marks may cause a sliver of bone to bend

away from the element, particularly in the ribs (Soluri & Agarwal, 2016; Klepinger,

2006; Ubelaker, 1999; Thompson & Inglis, 2009).

Penetrating Gunshot Wounds

Gunshot wounds (GSW), particularly to the skull, have similar attributes to blunt

force trauma. Like blunt force trauma to the skull, GSWs generally create radiating &

concentric fractures around the area of impact. This occurs in both types of trauma by

compressing the convex side of the skull. Simple macroscopic analysis is enough to

differentiate a GSW from blunt force trauma. GSWs leave a circular aperture & are much

more forceful than when hit with a blunt object. Because of this difference in force,
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GSWs cause internal beveling. Internal beveling, which occurs at the entrance wound,

causes the bone to fracture outwardly in the inner table of the bone. This causes the

endocranial plate to have a wider opening than the initial GSW to the ectocranial table.

There may or may not be an exit wound, however when present, they are generally much

larger than the entrance wound & “the external table of [the cranial] bone [will exhibit] a

ragged, cone-shaped external bevel” (Smith, 2003). Not all GSWs follow the same

patterns, however. Variations in gun type, bullet category, & range of fire can, not only

be mistaken for blunt trauma, but often require radiographic imaging to determine cause

of death. More importantly, understanding differences between “acute angle & tangential

shots”, which “can produce very irregular patterns, such as the “keyhole” wound”, may

lead to determining if the death was suicide or homicide (Klepinger, 2006).

Understanding bone biomechanics & effects of trauma is useful both archaeologically as

well as forensically (Berryman & Haun, 1996; Klepinger, 2006; Gruspier, 1999;

Ubelaker, 1999; Soluri & Agarwal, 2016; Glaister, 1921; Smith, 2003; Denton, 2006).

Dismemberment

Signs of dismemberment can often tell the forensic anthropologist if the trauma

occurred peri- or postmortem, what type of weapon was used, &, in some cases, the

reason behind why the crime occurred. “Soft tissues will show vital reactions, &

demonstrable hemorrhages will be present if the person was alive when the

dismemberment took place”, however, this evidence will be missing in instances of

postmortem trauma (Gruspier, 1999). Rainwater developed a three-type classification

system for dismemberment based on the earlier works of Reichs (1998) & Häkkänen-
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Nyholm (2009). The three different types of dismemberment trauma are: “disarticulation

around the joints, transection of bone via chopping, & transection of bone via sawing”

(Rainwater, 2015). The use of sharp instruments show signs similar to sharp force

trauma, such as stabbing. How & where the body was dissected can help infer the movie

behind the crime and/or potential information about the perpetrator. Klepinger defines

the three most common motives of dismemberment as attempts to obstruct forensic

analysis, efforts to fit remains into certain storage containers, & mutilation for lustful or

impassioned reasons (Klepinger, 2006). A common feature associated with

dismemberment are false start kerfs. These notches are incomplete cuts to the bone, often

adjacent to complete transection points, caused by a deliberate change in the position of

the cutting implement or, more frequently, the “jump” of power saws &, sometimes,

hand saws. False start kerfs & complete kerfs of dismembered bodies can be

microscopically & macroscopically analyzed to “broadly characterize the tool used”,

whether it be a straight or serrated knife, axe, or saw (Klepinger, 2006). In multiple

cases, this has been imperative to determining the murder weapon (Gruspier, 1999;

Klepinger, 2006; Rainwater, 2015).

Hyoid Fracture

While still under the general category of fractures, hyoid breaks are particularly

interesting to forensic osteologists. This fragile bone is “suspended from the tip of the

styloid processes of the temporal bone by ligamentous bands, the stylo-hyoid ligaments”

& can easily be deformed, broken, or separated from the attachment points (Gray,
 80

1977). Deformation is more common in children due to the pliability of their bones.

However, damage to the cricoid and/or thyroid cartilages is also possible by not visible

osteologically. Hyoid fractures & associated cartilage damage is generally indicative of

hanging, ligature & manual strangulation, or throttling. Various studies have reported

that actual fracture of the hyoid bone is partially dependent on the type of trauma to the

throat. Ubelaker (1992) reported that the hyoid bone fractured in 34% of manual

strangulation cases. However, ligature strangulation caused fracture in only 11% of cases

& in hanging cases, the fracture only occurred in 8% of instances. Pollanen (1999)

determined that fracture of the hyoid bone is directly connected to “age & status of

fusion […] of the hyoid synchondroses”. While absence of a fracture may not rule out

strangulation or throttling, presence of a fracture should be thoroughly evaluated for

potential interpersonal violence (Gray, 1977; Ubelaker, 1992; Klepinger, 2006; Pollanen,

1999; Lovell, 1997; Soluri & Agarwal, 2016).

Blast Trauma

In the last 70 years, mass killings via explosion have become increasingly

common. Terrorism & the use of improvised devices & car bombs has led to an

increasing number of forensic anthropologists called to separate individuals in these mass

murders. Explosions cause damage in a radius known the blast wave. The burst begins at

the site of ignition & explodes through the materials of the bomb “at speeds often as high

as 6-8 km/sec” (Christensen, 2012). Damage to the skeleton is caused by two different

factors in blast trauma: 1) the force of the explosion and/or 2) impact from blast

projectiles. It goes without saying that the extent of the damage is directly correlated to
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the size of the explosive. Most explosions apply a variety of forces to the body

“including compression, shearing, & bending; these patterns appear to be more r&om in

appearance than those typically associated with projectile or blunt force injury events”

(Christensen, 2012). In instances of mass fatalities, forensic anthropologists may not

have skeletonized remains but are necessary to develop biological profiles & a minimum

number of individuals. Micro- & macroscopic analysis as well as the appearance of

butterfly fractures, particularly in the ribs, can be used to determine blast trauma as

opposed to low-speed forces (Saul & Saul, 2003; Christensen, 2012; Christensen &

Smith, 2013; Pechníková, 2015).

Postmortem Changes
The postmortem interval includes any changes that occur after the death of the

individual. Taphonomic changes incur no healing & are caused by obvious &

distinguishable marks. The time since death & the burial environment(s) are important to

the forensic anthropologist for a number of reasons. Stephen Nawrocki explains that the

burial location is part of an ecosystem that requires “a holistic approach that blends

biology, geology, & environmental science” in order to produce the most complete

picture of the individual’s life, death, & subsequent burial (Nawrocki, 2016). Proper

analysis of human remains can help determine if the individual is within the

archaeological or forensic time frame, the presence of human modification, number of

burial sites, animal or plant damage, environmental effects, & postmortem fracturing.

Forensically, remains older than 50 years are of little importance due to the presumed
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death of the criminal (Sorg, 2012; Knight & Lauder, 1969; White, 2012; Klepinger,

2006; Gruspier, 1999; Nawrocki, 2016).

Determining time since death can be a complicated & difficult process. Multiple

factors must be taken into account before making any analysis. The first & primary

consideration is that taphonomic process occur more slowly when the individual is

buried as opposed to exposed to the elements. Thus, skeletonization occurs more quickly

& there is a greater likelihood of scavenging when remains are left unburied. This

requires the forensic anthropologist to consider “information about ecological processes

of decomposition, consumption, dispersal, & assimilation involving plants, animals, &

microorganisms that become associated with the decomposing body” for the most

thorough analysis (Sorg, 2012).

Stages of Death

As soon as the body enters the postmortem interval, the skin will lose its blush &

the internal temperature begins to drop; these are the stages of pallor & algor mortis,

respectively. While pallor mortis sets in regardless, algor mortis is much more dependent

on the temperature of the environment. Colder temperatures slow decomposition & will

delay the onset of the consecutive stages if kept at or below 32° Fahrenheit. Rigor mortis,

also called cadaveric rigidity, refers to the third stage of death in which “a limited

contraction of the muscle takes place”, forcing the remains into a stiff, immoveable body

due to the loss of adenosine triphosphate (ATP) (Glaister, 1921; Klepinger, 2006). The

onset & duration of rigor mortis is dependent on four factors at the time of death: 1) the
 83

age of the individual, 2) the muscular condition of the individual, 3) the temperature of

the environment prior to algor mortis, & 4) the manner of death (Glaister, 1921). Young

individuals, whose muscles have yet to fully mature, are less susceptible to & generally

sustain a shorter period of time of rigor mortis. Muscular condition at death also impacts

the severity & duration of rigor mortis. The more muscular the individual, the slower the

onset of rigor mortis & the longer the duration of the stage. These rules are true unless

the remains are exposed to temperatures above 160° Fahrenheit. In high temperatures, the

body goes through a phenomenon known as “heat stiffening” in which the muscles

become stiffer than normal rigor mortis. However, as previously mentioned, cold

temperatures can delay the start of rigor mortis if kept frozen. Regardless, once the

remains reach temperatures above 50° Fahrenheit, rigor mortis will begin quickly & pass

quickly. Lastly, the way in which the individual died or was killed will have an impact on

the period of rigor mortis. If the individual exerted muscular energy prior to death, such

as during a struggle, convulsion, or due to a pathology, the rigor mortis stage will have an

early onset & a short duration period.

After rigor mortis, the body enters lavor mortis. Once the heart ceases to pump

blood throughout the body, it begins to pool at the body’s lowest point. The remains take

on a dark blue or purple color with “bruising” characteristics where the coagulated blood

has settled. From this stage on, the remains begin to decay in the putrefaction process

which continues into decomposition, & then to skeletonization.

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Decay of the remains follow a five-stage process: 1) fresh, 2) bloat, 3) active

decay, 4) advanced decay, & 5) dry (Klepinger, 2006). The duration & severity is

dependent on how or if the remains were buried. Depending on environment temperature

& element exposure, insect activity will begin within the first couple of hours & may

need the expertise of a forensic entomologist (Klepinger, 2006). Insect development is

dependent on the ecosystem in which the remains are left. While most insects have

patterned stages of development, the presence of some drugs can alter their maturation

times (Klepinger, 2006; Glaister, 1921).

Human Modification

Alterations made to the skeleton after death can sometimes point to the presence

of human involvement. There is a wide variety of ways that humans modify bones which

can describe both the individual & the modifier. Cut marks, fractures, burial placement,

cremation, & ritual practices can be distinguished from modifications made by alternate

processes.

As previously discussed, disarticulation of the body after death can lead to small,

unintentional cuts to the bone. However, dismemberment is not the only cause of cut

marks. Defleshing often leads to slight, parallel lines in the bone in attempts to remove

soft tissues (White, 2012). Fractures can be difficult to determine if the time frame of

their occurrence was perimortem or postmortem. GSWs, sharp force trauma, & blunt

force trauma are all fairly recognizable within the realm of perimortem damage. In some

instances, fracture & tension on fresh bones can cause peeling on the ends of the affected
 85

element. Where & how the body was buried can also cause fracture. This can occur

during forceful positioning or dropping the remains from a height (White, 2012;

Klepinger, 2006).

Cremation of human remains is a practice that dates back as far 40,000 BP,

according to the most recent dating of the Mungo Lady of Australia, discovered in 1969

(Bowler, 2003; Snoeck & Schulting, 2013). The analysis of the cremation & burial of

remains requires a trained forensic anthropologist. Sites of cremation can be evidence of

archaeological burial practices. However, the cremation of remains is common in

homicide cases in an attempt to destroy potential evidence as well as prevent the

identification of the victim (Skinner, 1999). The primary change caused to the bone

during cremation is shrinkage. Studies have shown that, when subjected to temperatures

greater than 1,400° Fahrenheit, total shrinkage can reach 25% (Klepinger, 2006).

Similarly, calcined bone will begin to occur in temperatures over 1,300° Fahrenheit

(Alunni, 2014). Death and/or cremation by pyre is uncommon in modern forensic studies

& in these cases, it is difficult to determine the cause of death. It is rare for cremation to

completely destroy the skeleton & severe burning requires adding fuel, manual breakage,

& long duration period (Fairgrieve, 2008; Skinner, 1999; Alunni, 2014). Crematoriums

run at an average of 1,700°, requiring the calcined remains to be pulverized afterwards

(Skinner, 1999; Alunni, 2014; Klepinger, 2006; Fairgrieve, 2008; Van Deest, 2012).

Fairgrieve suggests that all fatal fires are of forensic importance until fully

investigated. Modern cases of homicide may occasionally include covert bonfires;

 86

however, intentional arson is more common. Instances of house fires should be

investigated for cause as well as the circumstances of the fire. In 2007, arson accounted

for 9% of fire deaths in Canada & 25% of all of British Columbia’s fires were considered

incendiary (Wijayasinghe, 2011). In some instances, such as when the perpetrator has

time to properly dispose of the body, Fairgrieve argues that burial is likely to follow

cremation. This method of disposal can be done in a number of ways. The body may be

burned in one location, moved, & buried in another location. However, some cases

involve shallow fire pits in which the remains are burned & subsequently buried in the

same place (Fairgrieve, 2008; Skinner, 1999; White, 2012; Klepinger, 2006; Van

Deest, 2012).
Ritual practices & desecration of burials often taken place months to years after

death. Historically, burials & human remains have been pillaged for a variety of reasons.

Trophy gathering, or the practice by the perpetrator of removing parts of the body to

keep, is a practice still seen today (Klepinger, 2006). Other ritual practices are cult or

religion related & involve painting certain elements or using crania as bowls (Klepinger,

2006). Burials are desecrated worldwide to sell mortuary items as well as in order to

move the body to a new location (Ubelaker, 1999; Klepinger, 2006).

Plant, Soil, & Animal Modification

Whether remains have been buried or left exposed to the elements, plant & animal

activity begins soon after decomposition begins. Scavengers, such as dogs, wolves,

coyotes, vultures, cats, raccoons, & various rodents, greatly affect bone assemblages by

removing portions to other areas, damaging bones, & creating pseudopathological signs.
 87

Large carnivores often remove portions of the body to other locations & crush the

trabecular areas of bone in order to obtain marrow (White, 2012). Carnivore’s create four

types of bone trauma: 1) punctures, 2) pits, 3) furrows, & 4) scores (Blumenschine,

1996). Carnivore puncture marks are created by teeth penetrating the bone, whereas pits

do not fully pierce the affected element. While scores may be singular, they are generally

shallow cut marks. However, furrows are much deeper & occur “from attempts to access

the marrow” (Klepinger, 2006). These types of trauma can be differentiated from

intentional cut marks or other pathologies by their patterns & more irregular profile (Bell,

1996; Blumenschine, 1996; Klepinger, 2006; White, 2012).

Rodent gnawing can mimic large carnivore damage by relocating remains as well

as producing parallel scoring marks (Klepinger, 2006). However, the repetitive gnawing

produces a “distinctive, fan-shaped pattern of regular, shallow, parallel or subparallel,

flat-bottomed grooves” that can conclude the damage as rodent as opposed to human or

carnivore inflicted (White, 2012). The movement & burrowing of rodents can also cause

bioturbation, disrupting the original burial placement. Insects, such as dermestid &

tenebrionid beetles, can create burrow patterns & furrows in bones (Rajendran &

Parveen, 2005; Ubelaker, 1999). However, the presence of certain animal or insect

activity can give more information about the environment(s) in which the individual’s

body was during the postmortem interval (Ubelaker, 1999; Rajendran & Pareveen, 2005;

Klepinger, 2006; White, 2012).

Plants & soils can also greatly impact the preservation & subsequent recovery of

human remains. When left untouched, plant roots can destroy bones & produce a vast
 88

network of grooves on the skeleton. As the roots move into the ground in search of

water, they produce acids which crave the bones with shallow, white grooves (Nawrocki,

1995). Soil taphonomy is broken into two categories: macro- & micro-alterations.

Macroalterations of soil taphonomy include ground freeze/thaw cycles, or cryoturbation,

as well as large-scale ground movement (Jaggers & Rogers, 2009). High moisture

environments can also be connected to chemical leaching from remains which increases

“dissolution & the loss of bone material” & fractures (Jaggers & Rogers, 2009).

Earthquakes & ground shifting can also alter the placement of burials or, in some

instances, completely destroy the remains & any potential evidence. Soil pH, whether

acidic or alkaline, can completely alter how bones are preserved or destroyed. More

acidic environments can erode the outer layer of bone; however, more alkaline

environment may lead to better preservation of the skeleton (White, 2012). Factors such

as these should be thoroughly investigated to preserve as much of the remains as

possible, as well as any pertinent evidence (White, 2012; Klepinger, 2006; Jaggers &

Rogers, 2009; Nawrocki, 1995).

Fractures

Postmortem fractures are common for the variety of reasons discussed above as

well as during excavation & recovery. It is imperative to know & understand the

morphological differences between peri- & postmortem fractures. Though the length of

time remains stay in the perimortem interval after death vary depending on environment,

burial, & animal & insect activity, it is possible to determine if fractures occurred while

in the green or dry state. Forensic taphonomic studies have shown that fresh bones are
 89

much more resistant to fracture by having a higher moisture content & being more

pliable than dry bones. Trauma to dry bones causes severe fragmentation, the presence of

bone flakes, & 90° fracture angles (Jordana, 2013). Likewise, fresh bones, with higher

moisture content, absorb energy more readily than dry bones, creating radiating &

concentric fractures Jordana, 2013). While fractures can be separated into peri- or

postmortem, proper crime scene investigation, excavation, & recovery of remains can

avoid unnecessary damage & potential loss of evidence (White, 2012; Jordana, 2013).

Chapter 14 – Application of Osteology in Criminal Justice

The idea of including anthropological perspectives in criminology is not a new

one. Cesare Lombroso, often called the father of criminal anthropology, attempted to use

the physical human body to explain & profile criminals (Lombroso, 1895). Lombroso

used the theory of social evolution derived from Charles Darwin’s Origin of Species.

Lombroso resisted the theory that criminal actions were part of general human nature &

instead concluded that criminals were inherently lawless with distinguishable physical

defects (Lombroso, 1895). Similar areas of study, such as phrenology, incorrectly

attempt to connect the physical body to the psychological nature of humans. While

psychology is immensely important to understanding the criminal mind, I argue

biological anthropology should be just as important. Most criminal justice or criminology

schools require sociology and/or psychology courses. However, as previously mentioned,

forensic anthropology is either not required or omitted entirely, despite the important

skills included. Forensic osteologists have to be able to distinguish human from non-

human, biological characteristics, & trauma. These same skills should be taught in the
 90

fields of criminology & criminal justice. Forensic osteological training provides law

enforcement with the skills needed to appropriately identify potential burials, determine

human vs. nonhuman, & recognized signs of trauma. Competence in this field can

prevent scene contamination, assist in biological identification, & promote recognition &

understanding of the types of trauma. Despite the advantages, anthropology & its

associated fields are underutilized in current criminal justice education (Lombroso,

1895).
 91

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 110

Appendix
Osteological Guidebook

To be used concurrently with this thesis, the scans, & the

associated teaching materials.

PART ONE: Necessary Vocabulary

Skeleton

• Axial – Consisting of the skull with the hyoid,

vertebral column to the coccyx, & the ribs

• Appendicular – Consisting of the shoulder

(includes clavicle & scapula), arms to fingers,

pelvis, & legs to toes

• Articulation – Where bones meet via a joint at

articulation points

• Foramen – Opening in bone for passage of soft

tissues

Skull

• Skull – Entire head & jaw

• Mandible – Lower jaw

• Cranium – Skull without the mandible

• Calvaria (calvarium) – Cranium without the face

or skull without the face or mandible

 111

• Calotte – Calvaria without the base or skull

without the face, mandible, or base

• Splanchnocranium – Facial skeleton

• Neurocranium - Braincase

Directions & Planes of Reference

• Superior – Towards the head, upwards (faunal:

cranial)

• Inferior – Away from the head, downwards,

opposite of superior (faunal: caudal)

• Anterior – Towards the front, forward (faunal:

ventral)

• Posterior – Towards the rear, backward (faunal:

dorsal)

• Medial – Towards the midline, middle

• Lateral – Away from the midline, outside,

opposite of medial

• Proximal – Towards the axial skeleton, opposite

of distal

• Distal – Away from the axial skeleton, opposite

of proximal

• Endocranial – Inside cranial vault

• Ectocranial – Outside cranial vault

• Sagittal – Midline plane along the

anterior/posterior line, line of symmetry
 112

• Coronal – Perpendicular plane to sagittal plane

along lateral (side to side) line

• Transverse – Horizontal plane along the

superior/inferior line

• Palmar – Palm side of hand

• Plantar – Sole side of foot

• Volar – Same as palmar & plantar

• Dorsal – Opposite palmar & plantar
• Mesial – Teeth, towards midline of body
• Distal – Teeth, away from midline, opposite of
mesial

• Lingual – Teeth, side the tongue touches

• Labial – Teeth, side the lips touch, opposite of

lingual (incisors, canines)

• Buccal – Teeth, side the cheeks touch, opposite

of lingual (premolars, molars)

• Interproximal – Teeth, where teeth touch each

other

• Occlusal – Teeth, biting surface

Motions

• Flexion - Bending movement that decreases the

angle between body parts

• Extension – Straightening movement that

increases the angle between body parts

 113

• Abduction – Movement of a body part away

from the sagittal plane

• Adduction – Movement of a body part towards

the sagittal plane

• Rotation – Movement of a body part around an

axis

• Opposition – Movement of body parts coming

together

• Pronation – Movement of the forearm that

rotates the palm from anterior facing to posterior

facing

• Supination – Movement of the forearm that

rotates the palm from posterior facing to anterior

facing

• Eversion – Pronation of the foot

• Inversion – Supination of the foot

Craniometrics Associated Landmarks

Prosthion Alveolar process
Nasospinale Nasal aperture
Rhinion Internasal suture
Nasion Nasal & frontal intersection
Glabella Frontonasal suture
Metopian Metopic midline
Bregma Coronal & sagittal intersection
Apex Poria plane
Vertex Frankfurt horizontal
Obelion Parietal foramina
Lambda Sagittal & lambdoidal suture
 114

Opisthocranion Occipital midline

Opisthion Posterior foramen magnum
Basion Anterior foramen magnum
Sphenobasion Basilar midline
Orbitale Orbital margin
Pterion Frontal, parietal, temporal, sphenoid
Porion External acoustic meatus

PART TWO: Osteological Chart

Area Landmarks Veins/ Arteries/ Muscle Craniometri

Nerves/ Vessels Attachments/ cs/ features
Ligaments/
Tendons
Crania

Frontal
Frontal
eminences

Temporal Temporalis
lines

Zygomatic
processes

Superciliary
arches
Supraorbital
margins
Supraorbital Supraorbital
notches or vessels
foramina
 115

Metopic
suture
Meningeal Middle
grooves meningeal
arteries
Sagittal Superior sagittal
sulcus sinus
Frontal crest
Foramen
cecum
Arachnoid Arachnoid
foveae
Pars orbitalis
Lacrimal Lacrimal
fossae glands
Ethmoidal
notch
Frontal
sinuses
Parietals
Frontal angle Bregma
Sphenoidal Pterion
angle
Occipital Lambda
angle
Mastoid angle Asterion
Parietal
eminence
Superior Temporal fascia
temporal lines
Inferior Temporalis
temporal lines
Parietal
foramen
Parietal striae
Meningeal Middle
grooves meningeal
arteries
 116

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Sagittal sulcus Superior
sagittal sinus
Arachnoid Arachnoid
foveae
Sigmoid Sigmoid
(transverse) (transverse)
sulcus sinus
Temporal
Petrous Temporal &
pyramid occipital
lobes*
External Ear canal
acoustic
meatus
Zygomatic Masseter
process
Suprameatal
crest
Supramastoid Temporalis
crest
Parietal notch
Mastoid Sternocleidomastoid
process eus, splenius capitis,
& longissimus
capitis
Mastoid Occipital
foramen artery
Mastoid notch Digastric
or digastric
groove
Occipital Occipital
sulcus (groove) artery
Temporomadib
ular articular
surface
 117

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Vessels Ligaments/
Tendons
Mandibular
fossa
Postglenoid
process
Entoglenoid
process
Styloid Stylohyoid
process ligament
Stylomastoid Facial nerve &
foramen stylomastoid
artery
Vaginal
process
Jugular fossa Internal jugular
vein
Carotid canal Internal carotid
artery
Middle
meningeal
grooves
Internal Facial &
acoustic acoustic nerves
meatus & internal
auditory artery
Sigmoid Sigmoid sinus
sulcus
Occipital
Foramen Brainstem
magnum
External
occipital
protuberance
Superior Nuchal
nuchal line
 118

Inferior Nuchal
nuchal line
External Nuchal ligament
occipital crest
Occipital Atlas
condyles articulation
Condylar Emissary vein
foramina
(canals)
Hypoglossal Hypoglossal
canals nerves
Jugular
processes
Jugular notch

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Cruciform Cerebral (2)
eminence &
cerebellar
(2) fossae
Cerebral fossae Occipital
lobes*
Cerebellar Cerebellar
fossae lobes*
Internal
occipital
protuberance
Sagittal Sagittal sulcus
(occipital)
sulcus
Internal
occipital crest
Occipitomargin *Is not
al sulcus* always
present
 119

Transverse sulci Transverse

sinuses
Groove for the
medulla
oblongata
Maxillae
Alveolar
process
Alveoli
Canine jugum
Zygomatic
process
Infraorbital Infraorbital
foramen nerve & vessels
Canine fossa
Anterior nasal
spine
Infraorbital
sulcus (groove)
Infraorbital
canal

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Vessels Ligaments/
Tendons
Maxillary sinus
Frontal process
Anterior
lacrimal crest
Lacrimal
groove
Lacrimal canal Nasolacrimal
duct
Palatine
process
Incisive
foramen
 120

Incisive canal Greater palatine

artery &
nasopalatine
nerve
Premaxillary
suture
Greater palatine Greater palatine
groove vessels & nerve
Maxillary tuber
Nasoalveolar
clivus
Palatine
Greater palatine Greater palatine
foramen vessels & nerve
Pterygopalatine
canal
Posterior nasal
spine
Lesser palatine Lesser palatine
foramina nerves
Perpendicular
plate
Pyramidal
process
Conchal crest
Vomer
Wings (alae)
Perpendicular
plate
Posterior
border

Area Landmarks Veins/ Arteries/ Muscle Craniometri

Nerves/ Vessels Attachments/ cs/ features
Ligaments/
Tendons
Nasopalatine Nasopalatine
groove nerves & vessels
 121

Inferior
Nasal
Conchae
Maxillary
process
Lamina
Lacrimal fossa
Ethmoidal
process
Ethmoid
Cribiform plate Olfactory nerves
Cristagalli Olfactory bulbs
& falx cerebri (of
the dura mater)
Labyrinths
(lateral masses)
Perpendicular
plate
Lacrimals
Posterior
lacrimal crest
Lacrimal
groove (sulcus)
Nasals
Nasal foramen
Zygomatics
Frontal process
Temporal
process
Maxillary
process
Zygomaticofaci Zygomaticofacial
al foramen nerve & vessels
Masseteric Masseter
origin
Zygomaticoorbi
tal foramina
 122

Area Landmarks Veins/ Arteries/ Muscle Craniometri

Nerves/ Vessels Attachments/ cs/ features
Ligaments/
Tendons
Zygomaticotem Zygomaticotempor
poral foramen al nerve
Sphenoid
Optic canals Ophthalmic artery
& optic nerve
Sella turcica
Hypophyseal Pituitary gland
fossa
Dorsum sellae
Posterior
clinoid
processes
Clivus
Sphenoidal
crest
Sphenoidal
rostrum
Sphenoidal
sinuses
Greater wings
Superior orbital
fissures
Foramen Maxillary nerves
rotundum
Foramen ovale Mandibular nerves
& accessory
meningeal arteries
Foramen Middle meningeal
spinosum vessels
Infratemporal
crests
Orbital
surfaces
Lesser wings
 123

Anterior Tentorium
clinoid cerebelli
processes
Angular spine Pterygospinous
ligament
Pterygoid
processes

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Vessels Ligaments/
Tendons
Lateral
pterygoid plate
Medial Medial
pterygoid plate pterygoideus
Pterygoid
fossae
Pterygoid
Hamulus
Pterygoid
canals
Mandible
Alveolar Alveoli
portion
Mental Mental vessels
foramen & nerve
Oblique line
Extramolar Buccinator
sulcus
Mylohyoid Mylohyoid
line
Submandibular Submandibular
fossa gland
Sublingual Sublingual
fossa gland
Mandibular
torus
 124

Mandibular
symphysis
Mental spines Genioglossus &
geniohyoid
Digastric Digastric
fossae
Mental
protuberance
Ramus
Mandibular
condyle
Condylar neck Lateral
pterygoideus
Coronoid Temporalis
process

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Mandibular
notch
Gonial angle Masseter
Masseteric Masseter
tuberosity
Masseteric
fossa
Endocoronoid
ridge
Mandibular Alveolar Mandibular
foramen vessels & canal
inferior
alveolar nerve
Lingula Sphenomandibular
ligament
Mylohyoid Mylohyoid
groove vessels &
nerve
 125

Pterygoid Medial
tuberosities pterygoideus
Hyoid &
Vertebrae
Hyoid
Greater horns Lateral thyrohyoid
ligament
Lesser horns Stylohyoid
ligament
Vertebral
anatomy
Vertebral Spinal cord
foramen
Vertebral Basivertebral
body vein
Vertebral Spinal cord
arch
Pedicle
Lamina
Spinous Interspinatous &
process suprapinatous
ligaments
Transverse
process
Superior
articular facet

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Inferior
articular facet
Cervical
vertebrae
(N=7)
Uncinate
processes
 126

Vertebral
foramina
Transverse
processes
Transverse Vertebral
foramina arteries
Lateral
portion
(3)
Posterior
tubercle of the
transverse
process
Anterior
tubercle of the
transverse
process
Intertubercular
lamina
Spinous
processes
Articular
facets
(2)
Superior
Inferior
Special
Cervical
Vertebrae
Atlas C1
Axis C2 Dens or
odontoid
process

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
 127

Seventh
cervical
vertebra C7
Thoracic
Vertebrae
(N=12)
Costal facets
(4)
Transverse T1-T10
costal facets
Superior costal T2-T9
demi facets
Inferior costal T1-T8
demi facets
Costal facets T1, T10-T12
Vertebral
foramina
Transverse
processes
Aortic T5-T10
impression
Spinous
processes
Articular
facets
(2)
Superior
Inferior
Intervertebral Spinal nerves
notches (2)
Superior
Inferior
Intervertebral
foramina
Special
Thoracic
Vertebrae
First thoracic
vertebra T1
 128

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Tenth thoracic
vertebra T10
Eleventh
thoracic
vertebra T11
Twelfth
thoracic
vertebra T12
Lumbar
Vertebrae
(N=5)
Vertebral
foramina
Spinous
processes
Transverse
processes
Articular
facets
(2)
Superior
Inferior
Mammillary
process
Accessory
process
Sternum &
Ribs
Sternum
Manubrium
Clavicular
notches
Jugular notch
 129

Costal
notches
Corpus sterni
Sternal angle
Lines of
fusion
Xiphoid
process
Ribs
Head

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Crest for rib
head
Neck
Crest for rib
neck
Tubercle
Costal angle
Shaft
Coastal groove Intercostal
artery, vein, &
nerve
Sternal end
Cranial end
Caudal end
Special
Ribs
First rib Subclavian Anterior scalene
vein,
subclavian
artery, &
brachial plexus
Second rib Serratus anterior
 130

Tenth rib Single

articular
surface
Eleventh rib “floating”
Twelfth rib “floating”
Clavicle &
Scapula
Clavicle
Sternal end
Acromial end
Costoclavicular Costoclavicular
tuberosity ligament
Subclavian Subclavius
sulcus
Conoid tubercle Conoid ligament
Trapezoid line Trapezoid
ligament
Nutrient
foramen
Superior
surface
Rugosity for Trapezius
Rugosity for Deltoideus

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Vessels Ligaments/
Tendons
Rugosity for Pectoralis major
Scapula
Superior
border
Scapular Suprascapular
notch nerve
Coracoid Biceps brachii,
process pectoralis minor,
coracobrachialis,
& coracoid
tendon
 131

Subscapular Subscapularis
fossa
Oblique
ridges
Lateral Teres minor &
border teres major
Glenoid fossa
Supraglenoid Biceps brachii
tubercle
Infraglenoid Triceps brachii
tubercle
Scapular
neck
Medial Serratus anterior,
border rhomboid major,
& rhomboid
minor
Scapular Deltoid &
spine trapezius
Acromion Deltoid & Clavicular
process trapezius facet
Supraspinous Supraspinatus
fossa
Infraspinous Infraspinatus
fossa
Superior Levator scapulae
angle
Inferior angle Latissimus dorsi
Humerus,
Radius, &
Ulna
Humerus
Humeral
head

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
 132

Anatomical Joint capsule

neck
Surgical neck
Lesser tubercle Subscapularis
Greater Supraspinatus,
tubercle infraspinatus, &
teres minor
Intertubercular Biceps brachii &
groove transverse
humeral ligament
Crest of the Pectoralis major
greater tubercle
Crest of the Teres major,
lesser tubercle latissimus dorsi,
&
medial rotators &
abductors
Humeral shaft
Anteromedial
surface
Anterolateral
surface
Posterior
surface
Medial border
Lateral border
Deltoid Deltoideus
tuberosity
Crest for Triceps brachii
Radial sulcus Radial nerve
Nutrient Nutrient
foramen arteries
Olecranon
fossa
Coronoid fossa
Radial fossa
Capitulum
Trochlea
 133

Lateral Radial collateral

epicondyle ligament,
supinator, &
extensors

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Medial Ulnar collateral
epicondyle ligament, pronator
teres, & flexors
Medial
supracondylar
crest
Lateral Brachioradialis
supracondylar
crest
Radius
Radial head
Radial neck
Radial Biceps brachii
tuberosity
Anterior Pronator
surface quadrutus
Posterior
surface
Lateral
surface
Interosseous Interosseous
border membrane
Anterior
border
Posterior
border
Nutrient
foramen
Anterior
oblique line
 134

Posterior
oblique line
Pronator Pronator teres
tuberosity
Ulnar notch
Carpal
articular
surface
Styloid
process
Suprastyloid Brachioradialis
crest
Dorsal Extrinsic extensor
tubercle muscles

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Groove for Extensor muscle
tendons
Groove for Extensor pollicis
longus
Groove for Extensor carpi
radialis
Ulna
Olecranon Triceps brachii
Trochlear
notch
Guiding ridge
Coronoid
process
Ulnar Brachialis
tuberosity
Radial notch
Ulnar shaft
Anterior
surface
 135

Posterior
surface
Medial
surface
Interosseous
border
Anterior
border
Posterior
border
Longitudinal
crest
Nutrient
foramen
Supinator Supinator
crest
Pronator ridge Pronator
quadrutus
Ulnar head
Ulnar styloid Ulnar collateral
process ligament
Groove for Extensor carpi
ulnaris
Articular
circumference
Carpals

Scaphoid

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Scaphoid Flexor
tubercle retinaculum
Facet for Capitate
Facet for Lunate
Radial facet
Facet for Trapezoid
 136

Facet for Trapezium

The scaphoid is shaped like a snail. Hold the scaphoid in your hand with the
convex side of the “shell” pointing towards yourself. The “head” of the snail will
point in the direction of its side. E.g. the “head” points to the left, therefore it is a
left scaphoid.
Lunate
Facet for Radius
Facet for Scaphoid
Facet for Capitate
Facet for Triquetral
Facet for Hamate
Hold the lunate so that the side in which the articulating groove is the deepest is
facing you. The groove leans in the direction of its side. E.g. the groove leans to
the right, therefore it is a right lunate.
Triquetral
Facet for Hamate
Facet for Lunate
Facet for Pisiform
Place your index finger on the pisiform facet & place your thumb on the lunate
facet. The direction in which the hamate facet is facing gives you the side. E.g.
the hamate facet is facing right, therefore it is a right triquetral.
Pisiform
Pisiform body Flexor
retinaculum
Facet for Triquetral
Pisiform
groove
No siding method
Trapezium
Trapezial Flexor
ridge retinaculum
Trapezial Tendon of the
groove flexor
Facet for Carpi radialis MC1
Facet for MC2
Facet for Trapezoid
 137

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Facet for
scaphoid
Hold with the MC1 facet facing away from yourself & down. Put your thumb
over your curved fingers. The direction of the ridge between the facets will tell
the side it’s from. E.g. the ridge is pointing left, therefore it is a left trapezium.
Trapezoid
Double facet MC2
for
Facet for Capitate
Non-articular
palmer surface
Facet for Trapezium
Facet for Scaphoid
Non-articular
dorsal surface
Hold the trapezoid so that the bone resembles a boot or a shoe. The “zipper” on
the side of the bone always faces laterally towards the sign that it’s from.
Capitate
Head
Base
Facet for Scaphoid
Facet for Lunate
Facet for MC3
Facet for MC2
Facet for Trapezoid
Non-articular
palmer surface
Non-articular
dorsal surface
Facet for Hamate
Face the head up & away while facing the hamate facet(s) toward yourself. The
side of the bone the facet(s) are on gives the side.
Hamate
Facet for MC4
 138

Facet for MC5

Facet for Triquetral
Facet for Capitate
Facet for Lunate
“Hook” Flexor
retinaculum

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
With the hook pointing upwards, the hamate resembles a thumbs-up. The
thumbs-up always lines up with the second knuckles & the hamate looks like the
side it is from.
Ribs
See Rib
Chart
Sacrum,
Coccyx, &
Os Coxae
Sacrum
Base
Sacral plateau L5
Sacral
promontory
Alae or
“wings”
Sacral canal
Pelvic surface
Transverse
ridges
Auricular
surface
Sacral Sacroiliac
tuberosity ligaments
Lateral part
 139

Anterior Anterior
(pelvic) sacral divisions of
foramina the sacral
nerves
& lateral
sacral arteries
Superior
articular facets
Superior
articular
processes
Dorsal surface
Dorsal wall
Posterior Posterior
(dorsal) sacral divisions of
foramina the sacral
nerves
Intervertebral
foramina
Sacral spine

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Intermediate
sacral crest
Lateral sacral
crest
Sacral hiatus
Sacral cornua
Apex of the
sacrum
Facet for Coccyx
Coccyx
Coccygeal
cornua
Transverse
processes
 140

Os Coxae
Ilium (2)
Body
Ala
Ischium (2)
Body
Rami
Pubis (2)
Body
Rami
Acetabulum
Acetabular
margin
Acetabular Ligamentum teres
fossa
Acetabular
notch
Lunate surface
Supraacetabular
groove

Gluteal surface
Gluteal lines (3) Gluteus minimus,
gluteus medius,
& gluteus
maximus

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Inferior gluteal
line
Anterior
gluteal line
Posterior
gluteal line
Sacropelvic
surface (2)
 141

Auricular Cranial &

surface caudal limbs
Iliac Sacroiliac ligaments
tuberosity
Spina limitans
Iliac pillar
Tuberculum of Iliac crest
Iliac crest (3) Abdominal muscles
Outer lip External oblique
Inner lip Transversus
abdominis
Intermediate Internal oblique
zone
Anterior Saratorius muscle &
superior iliac inguinal ligament
spine
Anterior Rectus femoris
inferior iliac muscle & iliofemoral
spine ligament
Posterior Gluteus maximus
superior iliac
spine
Posterior Sacrotuberous
inferior iliac ligament
spine
Preauricular
sulcus
Greater sciatic Piriformis
notch
Ischial spine Sacrospinous
ligament

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Lesser sciatic Obturator internus
notch
 142

Ischial Semitendinosus,
tuberosity semimembranosus,
biceps femoris, &
quadratus femoris
Iliac fossa
Arcuate line
Pectineal line Pectineus
Iliopubic
eminence
Pubic crest Rectus abdominis
Superior pubic
ramus
Ischiopubic
ramus
Pubic tubercle Inguinal ligament
Symphyseal Pubic ligaments Pubic
surface symphysis
Obturator Obturator
foramen membrane
Obturator crest Pubofemoral
ligament
Anterior
obturator
tubercle
Posterior
obturator
tubercle
Obturator Obturator Obturator
groove vessels & canal
nerve
Pelvis
Pelvic surface
Pelvic cavity
Pubic arch
Greater pelvis
Lesser pelvis
Linea terminalis Separates
greater &
 143

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
lesser
pelvises
Iliopectineal
line
Pelvic inlet
Pelvic outlet
Leg
Femur
Femoral head Articulates
with
acetabulum
Fovea capitis Ligamentus teres
Femoral neck
Greater Gluteus minimus
trochanter & gluteus medius
Intertrochanteri Joint capsule Iliofemoral
c line ligament
Trochanteric Tendon of
fossa obturator
externus, superior
gemelli, inferior
gemelli, obturator
internus, &
piriformis
Obturator Tendon of
externus groove obturator
externus
Lesser Iliopsoas tendon
trochanter
Intertrochanteri Quadratus Quadrate
c crest femoris tubercle
Gluteal Gluteus maximus
tuberosity
Spiral line Vastus medialis
Pectineal line Pectineus
 144

Femoral shaft
Linea aspera Vastus, longus,
brevis, & magnus
Medial lip of Adductor magnus
the linea aspera & adductor
longus

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Lateral lip of Vastus lateralis &
the linea biceps femoris
aspera
Nutrient
foramen
Medial
supracondylar
line
Lateral
supracondylar
line
Popliteal
surface
Lateral condyle
Lateral Lateral
epicondyle collateral
ligament &
gastrocnemius
Popliteal Tendon of the
groove popliteus muscle
Medial condyle
Medial Medial collateral
epicondyle ligament
Adductor Adductor magnus
tubercle
Impression for
the lateral head
 145

of the
gastrocnemius

Impression for
the popliteus
Intercondylar Anterior &
fossa posterior cruciate
ligaments
Intercondylar
line
Patellar surface
Patellar lip
Siding a femur: The trochanters & the linea aspera are posterior. The patellar lip
will be higher on the lateral side. The fovea capitis is posterior inferior.
Patella

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Apex
Lateral
articular facet
Medial
articular facet
Base
Siding a patella: The medial facet is the largest. Hold the patella so that the apex
(pointed end)
is away from you. The bone will “lean” towards the side it is from.
Tibia
Tibial plateau Medial &
lateral menisci
Medial
condyle
Lateral
condyle
Intercondylar
eminence
 146

Medial
intercondylar
tubercle
Lateral Anterior &
intercondylar posterior cruciate
tubercle ligaments
Anterior Anterior cruciate
intercondylar ligament
area
Superior
fibular
articular facet
Groove for Semimembra
nosus
Tibial Patellar ligament
tuberosity & quadriceps
femoris
Shaft
Medial surface
Posterior Popliteal
surface surface
Lateral surface Interosseous
Medial border Deep transverse
fascia
Anterior
border

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Vessels Ligaments/
Tendons
Interosseous Interosseous
border membrane
Soleal Popliteus muscle,
(popliteal) line popliteus fascia,
& soleus muscle
Nutrient
foramen
 147

Vertical line Tibialis posterior

& flexor
digitorum longus
Medial Anterior &
malleolus posterior
colliculus
Intercollicular Deltoid ligament
groove
Anterior
groove
Fibular notch Tibiofibular
ligament
Distal fibular
articular
surface
Posterior Tendons of the
(malleolar) tibialis posterior
groove & flexor
digitorum longus
muscle
Groove for Flexor
halluces
longus
Talar articular
surface

Fibula
Fibular head Biceps femoris
muscle & lateral
collateral
ligament
Styloid process
Proximal
fibular articular
surface
Fibular neck
Shaft
 148

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Anterior
border
Lateral surface
Posterior
border
Posterior
surface
Medial crest Tibialis posterior
& flexor halluces
longus
Posteromedial Tibialis posterior,
border soleus, & flexor
halluces longus
Medial surface
Interosseous Interosseous
border membrane
Surface for Interosseous
membrane
Nutrient
foramen
Triangular
subcutaneous
area
Lateral
malleolus
Malleolar
articular
surface
Malleolar fossa Transverse
tibiofibular &
posterior
talofibular
ligaments
 149

Fibular groove Tendons of the

fibularis
(peroneus) longus
& fibularis
(peroneus) brevis

Foot
Tarsals
Head
Body
Trochlea

Area Landmarks Veins/ Muscle Craniometri

Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Neck
Groove for Flexor halluces
longus
Subtalar
facets
(3)
Anterior
subtalar
Medial
subtalar
Posterior
subtalar
Sulcus tali
Calcaneus
Calcaneal Calcaneal
tuberosity tendon
(Achilles)
Lateral & Intrinsic
medial
processes
Sustentacular
tali
 150

Sustentacular Tendon of the

sulcus flexor halucis
longus
Fibular Tendons of the
tubercle fibularis
(peroneus)
longus & brevis
Groove for Fibularis
(peroneus)
longus
Facet for Talus
Facet for Cuboid
Cuboid
Cuboid
tuberosity
Groove for Tendon for the
fibularis longus
Facet for Calcaneus
Facet for Lateral
cuneiform
Facet for MT4
Facet for MT5
Navicular
Area Landmarks Veins/ Muscle Craniometri
Arteries/ Attachments/ cs/ features
Nerves/ Ligaments/
Vessels Tendons
Tubercle Tibialis
posterior
Facet for Talus
Facet for Medial
cuneiform
Facet for Lateral
cuneiform
Facet for Intermediate
cuneiform
Medial
Cuneiform
Facet for Navicular
 151

Facet for Intermediate

cuneiform
Facet for MT1
Facet for MT2
Intermediate
Cuneiform
Facet for Navicular
Facet for Medial
cuneiform
Facet for Lateral
cuneiform
Facet for MT2
Lateral
Cuneiform
Facet for Navicular
Facet for Cuboid
Facet for Intermediate
cuneiform
Facet for MT2
Facet for MT3
Facet for MT4

Rib Chart
Rib Facets Shaft Features General
Appearance
1 Unifaceted Scalene
tubercle,
subclavian
vein,
subclavian
artery
2 Tuberosity for
serratus
anterior
 152

3 Thicker,
rounded
4 Thicker, Tighter
rounded curve, flatter
superior
5 Thicker, Inferior costal Tighter
rounded groove curve, flatter
superior
6 Thicker, Inferior costal Gradual
rounded groove shallow
curve,
rounded
superior
7 Inferior costal Gradual
groove shallow
curve,
rounded
superior
8 Gradual
shallow
curve,
rounded
superior
9 Superior crest Gradual
shallow
curve
10 Unifaceted Superior crest Gradual
shallow
curve
11 Unifaceted Sharp superior Pointed
crest sternal end
12 Unifaceted Sharp superior Pointed
crest sternal end
 153

PART THREE: Dentition Chart

Dentition chart & associated legends.
Maxillary Legend:

• Pr = Protocone (Mesiolingual)
• Pa = Paracone (Mesiobuccal)
• Me = Metacone (Distobuccal)
• Hy = Hypocone (Distolingual) Mandibular
Legend:

• Me = Metaconid (Mesiolingual)
• Pr = Protoconid (Mesiobuccal)
• Hy = Hypoconid (Distobuccal)
• Hyd = Hypoconulid (Disto)
• En = Entoconid (Distolingual)
 141

Dentition - Upper teeth angle up lateromedially, bottom teeth angle down mediolaterally

Maxillary - Buccal & lingual cusps of Ps are nearly equal; buccal side of Ms tends to wear

slower lending to more height over the lingual side

 155

142

Mandibular – Buccal cusps of Ps dominates the lingual side in size & height; Lingual side of the
Ms tends to wear slower lending to more height over the buccal side
156
 157

PART FOUR: Example Syllabi

Human Osteology Syllabus (Graduate Quarter Class)

Course Overview
Human osteology is, very simply, the study of human bones. While this may seem

short-sighted, human osteology actually encompasses a wide range of techniques,

methods, & disciplines. Osteology, & the associated fields, are useful in many areas of

study, including criminal justice, forensic anthropology, nursing & medicine,

paleoarchaeology, & epidemiology.

Bones can tell us a lot, including information about human biological variation &

human populations, as well as precise forensic evidence. Osteologists may use their

training in forensic crime labs, archaeological sites, & centers for pathological disease

research, as well as many other settings.

Learning Outcomes

• Students will learn the appropriate anatomical & directional terminology

required to discuss osteology.
• Students will learn each element in the adult human skeleton.
• Students will learn craniometrics and/or features for each element in the adult
skeleton.
• Students will learn how to properly discern between human & non-human
bones.
• Students will learn how to appropriately handle human remains with respect &
care.
• Students will learn how to critically analyze diagnostic features of intact &
fragmented bones to determine vital information.
• Students will learn peer-reviewed methods of age, sex, & stature determinations.
 158

• Students will learn how to identify osteological pathologies and/or

pathological conditions that affect bones.
• Students will learn the differences between anti-, peri-, & post-
mortem changes to the human skeleton, & how to recognize them.
• Students will learn about bone modifications by bioturbation,
humans, & physical factors.
• Students will learn fields & careers that use real world applications
of human osteology.
• Students will learn osteological teaching pedagogy.
• Students will contribute to teaching & instructing the classes.
• Students will act as mentors & guides to the undergraduates.
• Students will learn how to design, set-up, proctor, & grade practical
exams.

Required Text
Human Osteology, Third Edition, White, Black, & Folkens: 2012 The
Human Bone Manual, First Edition, White & Folkens: 2005

Course Schedule
Week Subject Areas of Focus

One Overview, Terminology, & WBF 1, 2, 4 MT 1, 2, 3

Skull OG P1

Two Skull & Intro to Biometrics WBF 3, 4 MT 3, 4 OG

P1, P2

Three WBF 4, 5, 19 MT 3, 6
Skull, Dentition, & Pathology
OG P1, P2, P3

Four Hyoid, Vertebrae, Ribs, & WBF 6, 7, 20 MT 3, 8

Modification OG P1-3

Five Review & Midterm

Six Shoulder Girdle, Humerus, WBF 8, 9 MT 3 OG P1-

Radius, & Ulna 3
 159

Seven Carpals, Metacarpals, & WBF 10, 20 MT 3, 7, 8

Taphonomy OG P1-3
Eight Pelvis & Variable WBF 11, 18 MT 3, 5 OG
Determination P1-3
Nine Femur, Tibia, Fibula, Tarsals, WBF 12, 13, 23, 24 MT
Metatarsals, & Forensic Case 3, 9 OG P1-
3 Studies

Ten Review & Final

Exam Schedule *Design

& Grade Only

Week Subject Type

Two Skeleton overview, terminology, & the skull* Quiz

Four Through ribs* Quiz

Five Through ribs Midterm

Seven Through the hand* Quiz

Nine Through the foot* Quiz

Ten Cumulative Final

Human Osteology Syllabus (Graduate Semester Class)

Course Overview
 160

Human osteology is, very simply, the study of human bones. While this may seem

short-sighted, human osteology actually encompasses a wide range of techniques,

methods, & disciplines. Osteology, & the associated fields, are useful in many areas

of study, including criminal justice, forensic anthropology, nursing & medicine,

paleoarchaeology, & epidemiology.

Bones can tell us a lot, including information about human biological variation &

human populations, as well as precise forensic evidence. Osteologists may use their

training in forensic crime labs, archaeological sites, & centers for pathological

disease research, as well as many other settings.

Learning Outcomes

• Students will learn the appropriate anatomical & directional terminology

required to discuss osteology.
• Students will learn each element in the adult human skeleton.
• Students will learn craniometrics and/or features for each element in the
adult skeleton.
• Students will learn how to properly discern between human & non-human
bones.
• Students will learn how to appropriately handle human remains with respect
& care.
• Students will learn how to critically analyze diagnostic features of intact &
fragmented bones to determine vital information.
• Students will learn peer-reviewed methods of age, sex, & stature
determinations.
• Students will learn how to identify osteological pathologies and/or
pathological conditions that affect bones.
• Students will learn the differences between anti-, peri-, & post-mortem
changes to the human skeleton, & how to recognize them.
• Students will learn about bone modifications by bioturbation, humans, &
physical factors.
 161

• Students will learn fields & careers that use real world applications of human
osteology.
• Students will learn osteological teaching pedagogy.
• Students will contribute to teaching & instructing the classes.
• Students will act as mentors & guides to the undergraduates.
• Students will learn how to design, set-up, proctor, & grade practical exams.

Required Text
Human Osteology, Third Edition, White, Black, & Folkens: 2012
The Human Bone Manual, First Edition, White & Folkens: 2005

Course Schedule
Week Subject Areas of Focus

One Overview & terminology WBF 1, 2 MT 1, 2, 3 OG

P1

Two Skull & Intro to Biometrics WBF 3, 4 MT 3, 4 OG

P1, P2

Three WBF 3, 4, 5 MT 3, 4 OG
Skull, Dentition, & Biometrics
P1, P2, P3

Four Dentition & Pathology WBF 5, 19 MT 3, 6 OG

P1-3

Five WBF 6, 19 MT 3, 6 OG
Hyoid, Vertebrae, & Pathology
P1-3

Six Vertebrae & Ribs WBF 6, 7 MT 3 OG P1-

3

Seven Review & Midterm

Eight Clavicle, Scapula, & WBF 8, 20 MT 3, 8 OG

Modification P1-3
 162

Nine Humerus, Radius, Ulna, WBF 9, 20 MT 3, 7, 8

Modification, & Taphonomy OG P1-3

Ten Carpals, Metacarpals, & WBF 10, 20 MT 3, 7 OG

Taphonomy P1-3

Eleven WBF 11, 18 MT 3, 5 OG

Pelvis & Variable Determination
P1-3

Twelve WBF 11, 18 MT 3, 5 OG

Pelvis & Variable Determination
P1-3

Thirteen Femur, Tibia, Fibula, & Forensic WBF 12, 15 MT 3, 9 OG

Application P1-3

Fourteen Tarsals, Metatarsals, & Forensic WBF 13, 23, 24 MT 3, 9

Case Studies OG P1-3
Fifteen Review & Final

Exam Schedule *Design

& Grade Only

Week Subject Type

Two Skeleton overview, terminology, & the skull* Quiz

Four Through dentition* Quiz

Seven Through ribs Midterm

Nine Through the arm* Quiz

Eleven Through the pelvis* Quiz

Thirteen Through the leg* Quiz

 163

Fifteen Cumulative Final

Human Osteology Syllabus (Undergraduate Quarter Class)

Course Overview
Human osteology is, very simply, the study of human bones. While this may seem

short-sighted, human osteology actually encompasses a wide range of techniques,

methods, & disciplines. Osteology, & the associated fields, are useful in many areas

of study, including criminal justice, forensic anthropology, nursing & medicine,

paleoarchaeology, & epidemiology.

Bones can tell us a lot, including information about human biological variation &

human populations, as well as precise forensic evidence. Osteologists may use their

training in forensic crime labs, archaeological sites, & centers for pathological

disease research, as well as many other settings.

Learning Outcomes
• Students will learn the appropriate anatomical & directional terminology
required to discuss osteology.
• Students will learn each element in the adult human skeleton.
• Students will learn craniometrics and/or features for each element in the
adult skeleton.
• Students will learn how to properly discern between human & non-human
bones.
• Students will learn how to appropriately handle human remains with respect
& care.
 164

• Students will learn how to critically analyze diagnostic features of intact &
fragmented bones to determine vital information.
• Students will learn peer-reviewed methods of age, sex, & stature
determinations.
• Students will learn how to identify osteological pathologies and/or
pathological conditions that affect bones.
• Students will learn the differences between anti-, peri-, & post-mortem
changes to the human skeleton, & how to recognize them.
• Students will learn about bone modifications by bioturbation, humans, &
physical factors.
• Students will learn fields & careers that use real world applications of human
osteology.

Required Text
Human Osteology, Third Edition, White, Black, & Folkens: 2012
The Human Bone Manual, First Edition, White & Folkens: 2005

Course Schedule
Week Subject Areas of Focus

One Overview, Terminology, & WBF 1, 2, 4 MT 1, 2, 3

Skull OG P1
Two Skull & Intro to Biometrics WBF 3, 4 MT 3, 4 OG
P1, P2
Three WBF 4, 5, 19 MT 3, 6
Skull, Dentition, & Pathology
OG P1, P2, P3
Four Hyoid, Vertebrae, Ribs, & WBF 6, 7, 20 MT 3, 8
Modification OG P1-3

Five Review & Midterm

Six Shoulder Girdle, Humerus, WBF 8, 9 MT 3 OG P1-

Radius, & Ulna 3
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Seven Carpals, Metacarpals, & WBF 10, 20 MT 3, 7, 8

Taphonomy OG P1-3
Eight WBF 11, 18 MT 3, 5 OG
Pelvis & Variable Determination
P1-3
Nine Femur, Tibia, Fibula, Tarsals, WBF 12, 13, 23, 24 MT
Metatarsals, & Forensic Case 3, 9 OG P1-3
Studies

Ten Review & Final

Exam Schedule
Week Subject Type

Two Skeleton overview, terminology, & the skull Quiz

Four Through ribs Quiz

Five Through ribs Midterm

Seven Through the hand Quiz

Nine Through the foot Quiz

Ten Cumulative Final

Human Osteology Syllabus (Undergraduate Semester Course)

Course Overview
Human osteology is, very simply, the study of human bones. While this may seem

short-sighted, human osteology actually encompasses a wide range of techniques,

methods, & disciplines. Osteology, & the associated fields, are useful in many areas

of study, including criminal justice, forensic anthropology, nursing & medicine,

paleoarchaeology, & epidemiology.

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Bones can tell us a lot, including information about human biological variation &

human populations, as well as precise forensic evidence. Osteologists may use their

training in forensic crime labs, archaeological sites, & centers for pathological

disease research, as well as many other settings.

Learning Outcomes

• Students will learn the appropriate anatomical & directional terminology

required to discuss osteology.
• Students will learn each element in the adult human skeleton.
• Students will learn craniometrics and/or features for each element in the
adult skeleton.
• Students will learn how to properly discern between human & non-human
bones.
• Students will learn how to appropriately handle human remains with respect
& care.
• Students will learn how to critically analyze diagnostic features of intact &
fragmented bones to determine vital information.
• Students will learn peer-reviewed methods of age, sex, & stature
determinations.
• Students will learn how to identify osteological pathologies and/or
pathological conditions that affect bones.
• Students will learn the differences between anti-, peri-, & post-mortem
changes to the human skeleton, & how to recognize them.
• Students will learn about bone modifications by bioturbation, humans, &
physical factors.
• Students will learn fields & careers that use real world applications of human
osteology.

Required Text
Human Osteology, Third Edition, White, Black, & Folkens: 2012 The
Human Bone Manual, First Edition, White & Folkens: 2005

Course Schedule
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Week Subject Areas of Focus

One Overview & terminology WBF 1, 2 MT 1, 2, 3 OG
P1
Two Skull & Intro to Biometrics WBF 3, 4 MT 3, 4 OG
P1, P2
Three WBF 3, 4, 5 MT 3, 4 OG
Skull, Dentition, & Biometrics
P1, P2, P3
Four Dentition & Pathology WBF 5, 19 MT 3, 6 OG
P1-3
Five WBF 6, 19 MT 3, 6 OG
Hyoid, Vertebrae, & Pathology
P1-3
Six Vertebrae & Ribs WBF 6, 7 MT 3 OG P1-
3

Seven Review & Midterm

Eight Clavicle, Scapula, & WBF 8, 20 MT 3, 8 OG
Modification P1-3
Nine Humerus, Radius, Ulna, WBF 9, 20 MT 3, 7, 8
Modification, & Taphonomy OG P1-3
Ten Carpals, Metacarpals, & WBF 10, 20 MT 3, 7 OG
Taphonomy P1-3
Eleven WBF 11, 18 MT 3, 5 OG
Pelvis & Variable Determination
P1-3
Twelve WBF 11, 18 MT 3, 5 OG
Pelvis & Variable Determination
P1-3
Thirteen Femur, Tibia, Fibula, & Forensic WBF 12, 15 MT 3, 9 OG
Application P1-3
Fourteen Tarsals, Metatarsals, & Forensic WBF 13, 23, 24 MT 3, 9
Case Studies OG P1-3

Fifteen Review & Final

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Exam Schedule
Week Subject Type

Two Skeleton overview, terminology, & the skull Quiz

Four Through dentition Quiz

Seven Through ribs Midterm

Nine Through the arm Quiz

Eleven Through the pelvis Quiz

Thirteen Through the leg Quiz

Fifteen Cumulative Final