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A Personal Anthropology of Driving

12 Mar

As I shift the gear stick I can feel the muscles tensing and releasing in my left arm; I can also imagine the tendons moving smoothly under the flesh, like steel lift cables, as the contracting muscles react to the electric jolts shooting down the nervous pathways spread across the body.  Both of my legs work in tandem with my left arm to leverage the accelerator and clutch pedals in a fluid series of movements to change the engines gear, whilst the right arm keeps the steering wheel stable.  My eyes keep a steady lookout at the road ahead, alert to the changes around me and the weather before me as the grey clouds break and heavy raindrops start to splatter the windscreen.  A quick flick of my index finger switches the front wipers on.  My ears are primed to the sounds of passing engines or the screaming sirens of emergency vehicles.  Perceptibly, but just, I can feel my heart beat that much faster as my right foot presses down on the accelerator.  At a stretch I’d say it was beating in time to the song playing, but that may be poetic licence and an exaggeration…

~~~

Broken Bones: Convoluted as a Medical History

It has been just over  a year since I first started driving in a daily capacity after passing my driving test a few years ago.  It has been a long and somewhat patient journey to get to this stage.  I had passed the theory and practical tests almost two years beforehand, but a well-timed pathological fracture to the right tibia and fibula bones of the lower leg (as, when a tibia breaks, the fibula, acting not unlike a supporting lateral strut to the larger and more robust tibia bone and connected to it by a tough fibrous tissue, also often fractures) kept me off the road for a good while after having just ordered a car for the first time.  After healing from this fracture, the third such transverse fracture for these two bones, I was again ready to hop in the car and onto the road but this time as a fully legit legal driver no longer in his training vehicle.  My body, however, had different ideas as I went on instead to fracture the right humerus bone of the upper arm in an accident shortly before receiving the said car, delaying once again my time to drive. and time on the tarmac.

As a direct result of these two separate fracture incidents I gained two new titanium plates as permanent (and palpable) bodily additions and welcomed, though somewhat initially delayed, doses of entinox and morphine to subdue the immediate pain from the fractures themselves.  After the initial throbbing pain of a fractured bone, which is enhanced by the muscle spasms and contractions that often accompany a break of a major limb bone, the pain starts to wear off to a gentle ache once the limb has been stabilized, protected and padded from any further movement or injury.  Where necessary the bone is reduced to the correct alignment.  The reduction of the bone can, without anesthetic, be as painful as initially fracturing the bone itself.  As indicated above my fractures were treated surgically to correct long-standing problems using metallic alloys fashioned into a sturdy plated screwed onto the bone, which help prevent stress shielding and allow the natural responsive dynamics of bone modelling to continue.  It should be stated here that fractures can also be treated conservatively, with limb immobilization and pain relief given whilst the bone heals itself if a good enough reduction and union can be carried out without the need for surgical intervention.

right humerus fracture 2014 july

Humerous triptych. Pre-surgical and post-surgical fixation with the use of a permanent titanium plate on the right humerus (upper arm) following the pathological fracture I sustained in an accident in July 2014. As a result of having McCune Albright Syndrome, and the associated Polyostotic Fibrous Dysplasia disorder where bone tissue is replaced with a fibrous tissues, my skeletal system is weaker than normal with a higher bone cell turner rate. Pathological lesions in the bone, which can already be naturally deformed in size and shape, can lead to fractures (so-called ‘ground glass’ visual which can be found on x-rays of PFD bone). If reproduced elsewhere please credit as appropriate and inform the author of this blog.

I said it was a long and patient journey because the majority of the time spent waiting to drive was spent silently healing, my head often buried in an article or a book whilst devouring coffee.  It took a long time for the two pieces of the bone shafts to become one again as the callus formed and bridged the fracture site, the woven bone that is initially laid down changing over time to lamellar, or mature, bone.  So much so that in some cases bone fracture sites can be completely remodeled with little noticeable sign of a historic break ever having taken place.  During this time I was shuttled from appointment to appointment as a passenger in my assigned vehicle, wondering what it was like to dictate the journey and the destination, what it was like to take control.

On Starting

You may think that I would be wary of driving due to the above described frailties that my body imposed on my life, but I was ready to go and ready to face the roads of my country.  I was, and remain, eager to explore the freedom of the road alongside the exploration of the idea that that freedom represents in itself .  Many of my friends had started driving at 17 or 18 years old, had passed their tests and then drove aimlessly to gain experience on the roads around the regional towns, only to abandon their cars as they themselves started undergraduate courses at universities in other towns and other cities across the country.  Running a car, and having the money to fund the fuel bill, insurance, road tax and other associated costs, was an expense that many didn’t have and didn’t need at that time in their lives.

I too had started to learn to drive at that age but I soon gave it up, frustrated at the confusing methods used by the teacher and wary of the upcoming femoral fixation surgeries that I faced at that time to limit what appeared to be regular interruptions of forced stillness in my life.  I was happy to ignore the need to drive for another decade or so, not needing to do it for my undergraduate and postgraduate university courses and happy to use the trains and other methods of public transport for work and pleasure.  Indeed I came to love the numerous hours spent commuting to volunteer placements, work, and journeys to see friends and old companions.  It was time to relax, to speak to other passengers, to sit and to read or simply to sit and to stare at the county unfolding before me.

As every driver informs every non-driver, the convenience of the car is the epitome of freedom over the strict timetable of public transport.  As an ardent user and lover of the train (the misery of the delay is trumped by the friends made in the carriage and by the regulars who recognize you in turn), I remained somewhat skeptical of this claim.  I had no counted on, however, how it actually felt to have that freedom when I drove myself, both for my own pleasure and as a matter of commuting to and from my workplace.  There have been times when, as I’m driving down an empty flyover at 1 am with the twinkle of the industrial north to my right and the disappearance of the work office behind me, the song I’m listening to reaches its crescendo and I feel at peace with the world around me.  This is of course the thrill of riding an empty road listening to your favorite music and soaking in every last note sounded and vocal moaned.  But driving with a crowd is different, but it is different for me in particular.

To Drive, To Think

The car, for me, and the act of driving the car, means that I can merge in with the public body at large in a seemingly innocuous manner.  When I walk I use crutches for short distances and, for longer distances, I use a manual wheelchair.  As such it is an obvious difference that is noticed immediately on sight, that I am different in some significant way from the majority.  I have had, and continue to have, people treat me differently in ways that they would not my friends or family, say by speaking to someone other than me even when it is I who have raised the question or query or by treating me in such a way which invokes past experiences of relatives or loved ones in states of profound impairment despite the fact that my experiences and needs are different; that in such cases my personal agency as an actor with their own views, worries and questions, is abated.  I am viewed as a representative therefore I am not an individual.  There is no such differentiation between specialized, or adapted, vehicles for the physically impaired, or disabled, individuals on the road compared with ‘normal’ cars – we all flow into the same lane or road.  (The caveat here is, of course, parking bays where disabled bays, alongside mother and child bays, are given proximity priority but I am strictly talking of when the car is in motion).  As such I am intrigued by the possibility of me in the car being treated in a similar manner as to everyone else who is present on the road.  That our actions speak for themselves, rather than the prejudices present on seeing the physical self as a first judgement.

I’ve briefly touched on my own experiences here and a few ideas above, but I want to more forward to acknowledge a few thoughts that have swirled around my mind over the past year or so on the road.  I have become somewhat intrigued by the notion of driving, and the path of the road, as a cultural symbol and as a personal experience.  As such the following are thoughts, somewhat vague in nature, of driving.

A Marker By The Side

During the first six months of my experience as a driver I passed a personal marker on the road to work, a curve in the dual carriageway where a silent, single fluttering jersey indicated a geographical spot where a young life had been cut short, the car skidding from the road late at night, killing one of its two occupants.  The jersey by the side of the road aptly demonstrated both the family’s pain and the danger of driving without due regard for the road conditions, a memento of the often tumult path of life.  It acted as a constant reminder for me then, when I saw it throughout the different seasons of the year, and I remember it clearly now in my mind’s eye.  It is easy to be self-contained in a car if you are driving alone, thinking only of yourself and not of the actions that you yourself have on others and those around you.  That the road is open and easy to see.  Yet drivers, especially of cars, can be subdued too easily by the sheltering in the cage of metal and glass.  Too easy it is to shut out both the weather and the sound of the road, too easy to become disconnected from what is in front, to the side, and behind.  Death is the ultimate outcome of driving dangerously or incorrectly, each person who drives should understand that they are both responsible for themselves, any passengers, and for the safety of those of who the car comes near, be it other vehicle drivers or pedestrians.

A friend who rides a motorcycle near year-round has spoken of their wish that each person who learns to drive does so first on a motorbike, where every second must be concerned, and concentrated with, the movement of your bike and your body, where the dangers in the driving blind spot become that much more pronounced as there is no clear boundary or distinction between the body and the tarmac.  It is an interesting idea, I think, and it shows that although the majority of the road users in most countries are car and truck drivers there are different experiences of using the road out there.  That even though we may be all drivers, we do not each experience the same sense of driving or the same security from the vehicles we choose to use to get from A to B.  It is my suggestion that this is the experience of the other in this environment, the one that car and truck drivers must take extra special care for motorcyclists (as well as cyclists) due to the physical differences in the size of the vehicle and the position of the body on top of the vehicle, rather than the notion of what it feels like to be on the inside of it.

Thoughts on Interior vs Exterior

However, within the confines of my personal anthropology of driving, there is also a need to define the personal space within the interior of the car and the exterior public face of the vehicle, i.e. the personalization of the interior as a representation of the identity versus the need to drive responsibly and react accordingly to the changes in weather, traffic density and normal, or exceptional, road hazards.

We have all, for instance, seen the personalized number plates or stickers attached to the exterior surface of cars, or the use of rosary beads dangling from the rear view mirror, possibly signifying a religious connection to Catholicism or perhaps simply a physical item in which to grab and to hold, to reassure and to connect.  These are markers of expressed individual and group identity through the modified material culture of the car, which could be symbolic of the beliefs of the individual and, possibly, an indicator of the nature of their personality, although there must also be a distinction between these leaps and not infer beyond the unreasonable.  These do of course differ dependent on the circumstances.  The cliché of a boy impressing a girl by driving fast is indicative of the use of the vehicle to express dominance or perceived masculinity and not the expression of the material culture of the individual within the car.  There are, as such, different signifiers at work when we consider the expression of identity with regards to vehicle ownership and use (see photograph below).

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‘Warning: if you value your life as much as I value this truck don’t mess with it!’. Seen in San Francisco in April 2015. Photograph, taken with a digital camera, by the author. If used elsewhere please credit as appropriate.

So what is in my car?  You can expect to find the odd physio stretching band, placed in the car from before I started to drive so I could exercise the muscles of the right arm on the way to and from work, to regain the majority of the extension of the antebrachium back.  (I have permanently lost the ability to fully extend my arm due to the somewhat intimidating and unnerving bend of the right humerus – it isn’t immediately noticeable, the bend, but when I point it out in person you may be surprised and somewhat horrified at what once was and now what is).  Look into the main storage box and you’ll find a whole heap of CD’s covering a fairly wide range of genres and musical styles, from the cut and thrust of Fugazi‘s 13 Songs to the emotional tape loops of Steve Reich‘s Different Trains and Guitar Counterpoint.  You could probably tell that the CD medium is the one in which I invest the most in for music listening just via the car haul of discs themselves.  I’m forever rotating my classic selection of favoured CD’s with new albums I’ve purchased more recently, such as Joanna Newsom‘s Divers, Godspeed You! Black Emperor‘s Asunder, Sweet and Other Distress, or Sufjan Steven‘s hauntingly beautiful Carrie and Lowell album.  The car, now, has become one of my prime personal music venues, enhanced by the visuals on the road and the acuity of speaker-to-body distance.  The drive to and from work allows for the almost total immersion of sound to radiate around me, to envelope the body and invigorate the mind as I drive.

The expression of music is carried on in the material contents of the car by three or four worn drumsticks perched precariously in the front chair’s backseat pocket.  The drum sticks head and necks are pretty worn away, indicative of their active life beating the various tom toms, snares, and high hats of drum kits across the rehearsal and practice rooms my home town.  If you dig a bit deeper it is quite possible you may find a roll of film (now I’m really harking back to pre-digital technology!), indicative of the ownership of my beloved cheap Pentax camera, which sometimes finds a temporary home in the car for when I am out and about and is sometimes paired with my cheaper-still digital camera.  Nestled in the front passenger seat is a battered copy of Will Self’s experimental novel Shark, a copy of which I convince myself I will finish one day.  (Regardless of the growing stack of novels and non-fiction books that mount beside my bed.  Karl Ove Knausgård’s Min Kamp circle of books has taken my recent fancy as well as Janine Di Giovanni‘s more somber documentation of Syria’s ongoing destruction in her book The Morning They Came For Us: Dispatches from Syria).  It is, I think, also an expression of the need to read in down times, where I find myself waiting for one reason or another.

So these are the two big things you may notice in my car – music and books, but what does the car and the road say about us from a non-individual status?  What laws do we follow and why, what are the roads laid out before us and why do we subscribe to a set of nationally, and internationally, prescribed laws?

State Expression

As such it could be highlighted here that the need to observe the rules of the road are, essentially, laid in law by whichever, or whoever, is in control of the land itself.  That is, the road, and the population who drive on that road, are obeying the rules in a manner prescribed by the ruling power and as such act in that way.  This could be a potentially reductionist approach to understanding how countries or cultures approach driving and the road network, however it is also an intriguing area of interest.  Allow me to expound briefly on the above point.  The expression of the state is manifested by the obligation of the driver to obey the rule of the law on the road, whilst the interior environment of the car allows for a personal reflection of the identity via its material culture.  Aligned to this are group identities expressed in this way – they can be cultural, religious, personal, or idiosyncratic in nature.  We’ll take a very quick global tour to explore some of this expressions of individuality within group expression.  I’ll also highlight some of the cultural restrictions placed on car drivers in different countries as it can be easy to think that each country’s laws are similar to one another, but cultural restrictions play an important part in this as a projection of the country’s laws and beliefs.

Road Changes & Cultural Restrictions

Road space rationing is the term used to describe the strategy to limit road users using particular methods of restriction.  These can include methods such as no-drive days, alternate day travel, and general restrictions on road access.  The strategies are used globally as temporary or permanent measures to decrease vehicle use and environmental impact, largely in major cities but also with increasing use in major industrial countries such as China and India.  A similar method to this is the use of car-sharing lanes where privileged road, or lane, access is given to cars containing more than one person as an incentive to cut single person travelling.

In London, England, the permanent Congestion Charge Zone was introduced in 2003 to combat the growing number of vehicles entering the center of the capital city, as a means of cutting down environmental damage and of limiting the sheer volume of traffic.  Bikes, and notorious Boris Bikes, have been particularly targeted as the green and safe way to travel within the city center alongside the extensive public transportation routes.  Transport for London (TfL) have stated that there has been a 10% reduction in vehicle traffic in the decade since the introduction of the congestion charge, which has found favor with a number of residents of the city.  In the capital of France, Paris, a temporary scheme whereby owners of cars with odd or even number plates were not allowed into the city on that particular day or days was in place during a particularly polluted period in 2014.  Temporary measures such as this are largely aimed at immediately cutting smog that threatens, or has, blanketed the city in question.

Other methods include closing down particular routes or roads during particular days.  In São Paulo, Brasil’s biggest city, a normally packed 3.5 km section of the Minhocão highway (nicknamed ‘the Big Worm’) is returned for the use of pedestrians and cyclists only each weekday evening, Saturday afternoons and full Sundays during the summer period.  Whilst Minhocão has been partially closed to vehicles for 26 years, there has been a new movement to close down Avenida Paulista in the city on Sundays as well.  The schemes in São Paulo is used as an urban reclamation of roads, or transportation routes, as a matter to regain urban walkways and increase the use of public transportation and finds similarities with a number of schemes across the globe.  For instance in New York City, USA, the reclamation of the 1.45 km long High Line, an old railroad renovated as an elevated walkway festooned with shrubbery, has seen it become a major attraction within the city itself in its own right.

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The car can become symbolic as in this case where it is the icon of a city forever on the move. The New York taxi is one such symbol and if encountered on its home turf is often accompanied by an incessant honking of the horn and the permanent background noise of a thousand ticking engines running over, forever stopping and starting. Photograph, on a digital camera, by the author. If used elsewhere please credit the author as appropriate.

New York City is both famous and infamous for its classic yellow cabs that litter the city.  To any driver from Europe, the roads of American cities can present a challenge as American cities are often built on the grid pattern, much like the ‘new city’ of Milton Keynes in the United Kingdom.  In such a busy and compacted city as New York this invariably means that the traffic never truly gets a chance to flow due to the traffic lights at each and every corner dictating who goes where when.  On a visit to the city that I was lucky enough to have last year I couldn’t help but notice the truly gigantic sounding board that the multi-storied buildings of Manhattan presented as the taxi drivers and drivers throughout the city incessantly honked their horn.  It surprised me, but also moved me in a way I had not expected – I was in the city of the movies, arguably the heart of the country itself in all of its architectural splendor and Freudian intimidation alongside the metaphorical American Dream representations.

As I come to the conclusion of this post I have presented a quick introduction to some of my thoughts, rounding down to international approaches to do with the increase in the number of the drivers and the damage wrought by diesel and petrol hungry engines in city centers, not to mention the natural environment.  Yet there is much more that I feel I ought to write, I haven’t touched on the interesting subculture of young male drivers in the kingdom of Saudi Arabia in which steam is let off by drifting (or Tafheet) and other associated vehicular activities, not the mention the incredibly strict restrictions placed on females in the country (females are forbidden from driving, although this is not illegal per se, it is heavily policed with punishments handed out for females caught driving).  Nor have I mentioned the fascinating subculture of bōsōzoku in Japan, which centers around the customization of cars and motorcycles.

The post describing these subcultures can perhaps wait for another day as this post has reached a fairly substantial length already.

Disengaging the Engine

So those are my brief thoughts on a personal anthropology of driving with a few nods to international views and explorations.  Nothing substantial, just a brief overlay of ideas that percolate through my brain as I slip on my seat belt, engage the engine and accelerate away onto the tarmac before me and into the night.

Influences & Further Reading

BBC & British Library Sound Archive. 2015. Noise: A Human History. An Ever Noisier World. Episode 29 of 30. BBC Radio 4.

Martin, D. L., Harrod, R. P. & Pérez, V. R. 2014. Bioarchaeology: An Integrated Approach to Working with Human Remains. New York: Springer.

Robb, P. 2005. A Death In Brazil: A Book of Omissions. London: Bloomsbury Publishing.

A Right To Bear Arms: A Traumatically Introduced Ursus Phalanx

31 May

Whilst browsing a recent edition of the International Journal of Palaeopathology I came across this article by Richards et al. (2013) titled ‘Bear Phalanx Traumatically Introduced Into A Living Human: Prehistoric Evidence‘; it is an eye-catching title I am sure you will agree!  Although it is common for skeletal remains to display traumatically introduced pathologies (see Roberts & Manchester 2010 and Waldron 2009), it is rare for palaeopathological case studies to document traumatically inserted foreign objects into a human skeleton, much less so to find a bear claw crushed into a human arm.  Yet this is exactly the case that Richards et al. (2013) document in a female skeleton dating from a Middle Period (500BC-300AD) Prehistoric Californian shellmound site called Ellis Island.

The individual, PHMA 12-2387, was found during archaeological excavations conducted in1906-1907 of the shellmounds that formerly lined the San Francisco Bay area, and the excavation recovered a total of 160 burials from the highly stratified shellmound middens (Richards et al. 2013: 48).  The shellmounds along the San Francisco Bay were inhabited by hunter-gatherers during the Middle Period, who focused their efforts on the near shore marine rich resources.  Interestingly the habitation period of the area at and around Ellis Island reflects occupation, abandonment and re-occupation over a 2000 year long span.  Following the osteological analysis of the nearly complete skeletal remains of PHMA 12-2387, it was concluded that the skeleton likely represented an adult female (biological sex based on pelvic features) aged between 30-40 years old (based on dental eruption and wear stage, epiphyseal and sutural closure, pubic symphysis and joint  surface morphology) at the time of death, who was buried supine with both her upper and lower limbs flexed (Richards et al. 2013: 49).

Now here is the interesting part.  Following the qualitative analysis of the normal ranges of joint and bone surface morphology of other shellmound individuals (N=159) and the comparison of the careful analysis of CT scans taken of the arms of PHMA 12-2387, it was concluded that the upper limbs bones of PHMA 12-2387 were large and strongly muscled, which were representative of a middle aged female who had suffered ‘traumatic injury that involved the left cubital fossa region, both forearms, and the right shoulder girdle’ (Richards et al. 2013: 50).  The right upper limb displays a bending fracture in the mid shaft of the ulna, which was complicated by the non-union of the break during the healing process.  Found within the left humerus cubital fossa was a Ursus (bear) phalanx, which had been driven in by a likely crushing trauma to a depth of 5 to 7mm into the dense cortex of the humeral shaft (See Figure 1).

Beartraumarichardsetal20133333

The CT scans of the upper limbs of PHMA 12-2387, where A represents varying views of both remaining limbs, and B shows the traumatically fractured right ulna and crushing injury of left cubital fossa of the humerus (See Richards et al. 2013: 50 for further information).

The injuries to this individual undoubtedly affected her movement.  The right upper limb would have suffered from problems with restricted range of the elbow joint, and restricted pronation and supination of the forearm due to the non-union fracture, whilst the trauma of the phalanx fractured through olecranon process and likely severed the m. triceps brachii, a major forearm extensor.  This likely resulted ‘in unopposed forearm flexion’, although pronation and supination of the forearm was ‘less affected’, with the bone material adapting to, and reflecting, the changes (Richards et al. 2013: 51).  The Ursus phalanx became fused within the injury of PHMA 12-2387’s left arm, and remained there until her death.

Although hypothetical situations are documented by Richards et al. in a  trauma reconstruction, it is likely thought that the upper limb injuries occurred at the same time as each other, and that the Ursus phalanx represented a part of a decoration (possibly a necklace) worn by the individual in question.  The mechanism of the introduction of the phalanx is likely to have been a devastating crushing injury which rammed the phalanx into the bone, as documented by the surrounding tissue damage.  Richards et al. 2013 (52-53) suggest that the individual was wearing a possible necklace of ‘claws’, with the phalanx having a shamanic connotation or reflecting a high status within the Middle Period horizon cultures.  Ethnographic accounts of Central Californian tribes indicate that shamans were ‘an integral part of the political, economic and legal institutions’ (Richards et al. 2013: 52).  A number of scenarios regarding her possible role within a society are postulated, and although no firm conclusion can be made, the case calls for a unique perspective for a personal osteobiography during the Californian prehistoric period.

Importantly this case study of this unfortunate individual highlights the coming together of the historical, the ethnographic, the osteological and the anatomical.  Whilst the hypothetical situation of the cause of the trauma can be discussed and postulated, it nevertheless stimulates a worthwhile discussion on the role of shamanistic behaviour in prehistoric California and it adds to the importance of understanding the injuries on the living individual, a living osteobiography.  It is an important article and well worth the full read.

Bibliography:

Richards, G., Ojeda, H., Jabbour, R., Ibarra, C., & Horton, C. (2013). Bear phalanx traumatically introduced into a living human: Prehistoric evidence International Journal of Paleopathology, 3 (1), 48-53 DOI: 10.1016/j.ijpp.2013.01.001

Roberts, C. & Manchester, K. 2010.  The Archaeology of Disease. Stroud: The History Press.

Waldron, T. 2009. Palaeopathology. Cambridge: Cambridge University Press.

ResearchBlogging.org

Skeletal Series Part 7: The Human Arm

30 May

In this post we shall focus on the main bones located in the arm.  They are the Humerus, Radius & Ulna.  The previous post on the shoulder elements (Scapula & Clavicle) can be found here.  It should be noted that the bones discussed  in this post, known as the forelimb, are the homologs to the bones in the leg, the hind limb.

The Human Arm, And The Bones Under Discussion

Articulation of arm with the distal humerus and proximal radius and ulna making the elbow joint (Image credit: Wikipedia 2011).

Excavation

As noted in previous Skeletal Series posts care should be taken with excavating human remains, and the maxim that ‘context is everything’ should be well noted with detailed plans of the in-situ remains made.  It is likely that some damage will have occurred to the smaller ulna and radius as they are more fragile then the larger and denser humerus bone.  A record of the condition of the bones should be made, alongside what contextual information is available (Mays 1999, White & Folkens 2005).

Arm Anatomy & Function

The humerus articulates proximally with the scapula and clavicle, as discussed in the last entry (See diagram below).  The distal humerus articulates with the proximal radius and ulna head.  This articulation makes up the elbow, which will be discussed in detail below.  At the distal end of the radius and ulna the carpals are located, which make up the wrist.  These, alongside the other elements in the hand, will be discussed in the next Skeletal Series post.

The individual brachium and antebrachium skeletal elements and major skeletal landmarks, as seen in articulation with the full limb (image credit: Wikipedia 2011).

The function of the forelimb is to provide a rigid limb to help hold, grab and move surfaces and objects.  The shoulder girdle and arm bones have moved away from our evolutionary history of weight-bearing limbs, and have become essential in helping humans to manipulate and move objects with astounding dexterity (Jurmain et al 2011).

Elbow Joint

The elbow joint (image credit: CK-12).

This joint in particular is important to understand as it is a key hinge joint.  The diagram below helps to mark out the distal humerus with the proximal radius and ulna in articulation.  The elbow is one of the strongest points of the body in terms of bone hitting strength.  The two main movements of the elbow are flexion and extension of the humerus and ulna, alongside the pronation of the radius and ulna in turning the arm over (White & Folkens 2005).  The joint itself has a large synovial membrane that protects the articulation points of the bone, whilst the main muscles involved are the Brachialis & Brachiaoradialus (at the anterior side) and the Triceps Brachii & Aconaeus towards the posterior side.  The lateral and medial muscles are the Supinator and Extensor muscles, alongside the Flexor muscles and Flexor Carpi Ulnaris muscles (White & Folkens 2005, but also here).

Anterior elbow joint in articulation, highlighting the major skeletal landmarks of the three bones that make up the joint. Image credit: here.

The Humerus

The humerus is the largest bone in the upper body, and ‘compromises of a proximal end with a round articular head, a shaft, an irregular distal end’ (White & Folkens 2005: 203).  It articulates with the Glenoid cavity (or fossa) of the scapula, and as mentioned, the proximal radius and ulna at the distal end.  The humerus head faces medially, whilst the surgical (or anatomical) neck is the groove that encircles the head for the attachment of the joint capsule (White & Folkens: 203-4).  Both the Greater and Lesser Tubercle are muscle attachment eminences that help move and rotate the upper arm.  On the Greater tubercle (the more posterior and large of the tubercles) rugosities for the insertion of the rotator cuff muscles are round, which help in rotation and adduction and abduction of the arm (White & Folkens 2005).

Main skeletal landmarks of the humerus (click to enlarge). Image credit: Google 2011.

The Shaft of the humerus is variably triangular in section, going from more cylindrical at its proximal end to more triangular in shape towards the distal end (Larsen 1997).  The Deltoid tuberosity is an important feature located on the lateral side of the shaft.  It is the insertion site of the deltoideus muscle, and is recognised by its roughened appearance.  Towards the distal end of the humerus we have several key features that are easily identifiable in recognising this as an upper limb element.

The Olecrannon Fossa is the largest of three hollows located posteriorly at the distal end, and accommodates the olecrannon process of the ulna during forearm extension.  The Capitulum is the rounded eminence that forms the lateral portion of the distal humeral surface, and it articulates with the head of the radius (White & Folkens 2005: 211).  The Lateral and Medial Epicondyle are the non articulating projections of bone, the medial is more prominent than the lateral epicondyle.

The humerus is relatively easy to recognise by the certain features picked out above, but parts can be confused with the tibia and femur.  With the femur, the head has a distinct depression called the Fovea Capitis whilst the humerus lacks this feature (Mays 1999).  The humeral shaft is smaller and less triangular than the tibial shaft.  When siding remember that the olecrannon fossa is posterior and the medial epicondyle is larger, and the humeral head faces medially.  The deltoid tuberosity is found laterally (White & Folkens 2005: 214).

The Ulna

The Ulna is the longest and thinnest bone of the forearm, and articulates proximally with trochlea of the humerus and head of the radius.  Distally, it articulates with the ulnar notch of the radius and an articular disk that separates it from the carpals.  The Olecrannon of the ulna is located on the most proximal part of the ulna; it is the insertion point for triceps brachii muscle.  The Trochlea Notch articulates with the trochlea articular surface of the humerus.  The Coronoid Process is the ‘anterior beak shaped projection at the base of the semilunar notch’ (White & Fokens 2005: 219).  The Radial Notch  is the small articular surface for the radius, and is located along the lateral side of the coronoid process.  The Radial Articulation (Ulna Head)  is the distal, lateral round articulation that conforms to the ulna notch on the radius.  The distal and proximal ends of the ulna are fairly distinctive and indicative of the element, however as White & Folkens (2005) and May (1999) point out, the shafts could be mistaken for radial or fibular shafts.

The ulna and the radius and their associated skeletal landmarks, click to enlarge. Image credit: Wikipedia 2011.

The Radius

The radius is a relatively small bone and shortest of the three in the forelimb.  Its name was gained for the action it goes through as the ‘turning movement about the capitulum of the humerus’ (White & Folkens 2005: 214).  At the proximal end it articulates with the humerus and medially with the ulna on both proximal and distal ends, whilst also distally it articulates with two carpal bones of the wrist.

The Head is a round articular structure at the proximal end of the radius, and as stated above articulates with both the humerus and ulna.  The Neck is a slender segment between the head and the radial tuberosity.  The Radial Tuberosity is a blunt rugged structure on the anteromedial site of the proximal radius that marks the insertion for the biceps brachii muscle (Mays 1999).  The  Styloid Process is a sharp projection located on the lateral side of the distal radius whilst the Ulnar Notch is a concave articular hollow on the medial corner of the distal radius.

Discussion: Wrist Fracture

Colle’s fracture is a break at the distal end of the radius and ulna that results in a ‘dinner fork deformity‘ with dorsal angulation, and displacement of the fracture with radial angulation.  The counterpart to this is Smith’s fracture which is the same but the fracture is displaced in the opposite direction, ie palmar (Marsland & Kapoor 2008: 96).

Smiths fracture highlighting the displacement of the distal radius. Image credit: Wikipedia 2011.

These type of fractures often occur because of trips or falls onto outstretched hands, as an automatic safety device by the body.  In modern contexts they also happen in a variety of sport environments.  These types of breaks are often easy to treat with splints and plaster casts, although they sometimes require surgery to correct the breaks and/or angles.  The patients can often be left with a visible deformity, but likely without any pain whatsoever (Marsland & Kapoor 2008: 96).  In archaeological examples these type of fractures can be found in any number of contexts or cultures.  It is important to note that, as Larsen (1997) says, many human cultures’ skeletal series often exhibit these breaks, and it can shed light into pathways of differing lifestyles.  Larsen also notes that whilst there is a large osteological literature on injuries in comparison to more population based studies which would help to highlight inferences on accidents and conflict in both historic and prehistoric societies (1997: 109).

Further Information

Bibliography

Jurmain, R. Kilgore, L. & Trevathan, W.  2011. Essentials of Physical Anthropology International Edition. London: Wadworth.

Larsen, C. 1997. Bioarchaeology: Interpreting Behaviour From The Human Skeleton. Cambridge: Cambridge University Press.

Marsland, D. & Kapoor, S. 2008. Rheumatology and Orthopaedics. London: Mosby Elsevier.

Mays, S. 1999. The Archaeology of Human Bones. Glasgow: Bell & Bain Ltd.

Roberts, C. & Manchester, K. 2010. The Archaeology of Disease Third Edition. Stroud: The History Press.

Waldron, T. 2009. Palaeopathology: Cambridge Manuals in Archaeology. Cambridge: Cambridge University Press.

White, T. & Folkens, P. 2005. The Human Bone Manual. London: Elsevier Academic Press.

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