Health Sciences & Occupations Anatomy, Physiology and Disease Chapter 6 The Skeletal System.

Health Sciences & OccupationsHealth Sciences & Occupations

Anatomy, Physiology and Disease Anatomy, Physiology and Disease

Chapter 6Chapter 6The Skeletal SystemThe Skeletal System

IntroductionIntroduction Skeletal systemSkeletal system

- provides - provides supportsupport and allows us to and allows us to movemove BonesBones ( (osseous tissueosseous tissue) )

- - protectsprotects soft body parts soft body parts

- - producesproduces blood cells blood cells

- - actsacts as storage unit for minerals & fat as storage unit for minerals & fat 206 bones in adult skeleton206 bones in adult skeleton

- along with cartilage, ligaments, and joints- along with cartilage, ligaments, and joints

BonesBones

Word ‘bone’Word ‘bone’ comes from Greek meaning “ comes from Greek meaning “dried dried up body.up body.””

Composed ofComposed of non-living minerals such as non-living minerals such as calciumcalcium and and phosphorousphosphorous, bones are very much , bones are very much alivealive, constantly , constantly buildingbuilding and and repairingrepairing themselves.themselves.

Bone ClassificationsBone Classifications

Long BonesLong Bones: found in : found in armsarms and and legslegs Short BonesShort Bones: equal in width and length & found : equal in width and length & found

mostly in mostly in wristswrists and and anklesankles Flat BonesFlat Bones: thinner, flat or curved; can be plate-: thinner, flat or curved; can be plate-

like & would include like & would include skullskull, , ribsribs, and , and sternumsternum (breast bone)(breast bone)

Irregular BonesIrregular Bones: odd in shape, and include : odd in shape, and include hiphip bone and bone and vertebraevertebrae

Bone AnatomyBone Anatomy

PeriosteumPeriosteum:: Tough and fibrous Tough and fibrous

connective tissueconnective tissue

covering bone.covering bone. Contains lymph vessels & Contains lymph vessels &

nerves & nerves & blood vesselsblood vessels which transport blood & which transport blood & nutrients to nurture bone nutrients to nurture bone cells.cells.

Acts as Acts as anchor pointanchor point for for ligaments and tendons.ligaments and tendons.

Bone Anatomy Con’tBone Anatomy Con’t

Epiphysis & DiaphysisEpiphysis & Diaphysis EpiphysisEpiphysis: formed by increase in size of both ends of long : formed by increase in size of both ends of long

bone.bone. DiaphysisDiaphysis: region between two epiphyses: region between two epiphyses Medullary CavityMedullary Cavity: hollow area acts as storage area for : hollow area acts as storage area for

bone marrow.bone marrow. Bone MarrowBone Marrow: :

Yellow marrowYellow marrow: : - has high fat content- has high fat content - can convert to red marrow - can convert to red marrow in an emergency.in an emergency. Red marrowRed marrow:: - produces red blood cells - produces red blood cells

Bone AnatomyBone Anatomy

Bone TissueBone Tissue

Dense, hard tissueDense, hard tissue that composes shafts of long that composes shafts of long bones.bones.

Forms microscopicForms microscopic, cylindrical shaped , cylindrical shaped units called osteons, or Haversian units called osteons, or Haversian systemssystems

Bone Tissue Con’tBone Tissue Con’t

OsteocytesOsteocytes: mature bone cells forming : mature bone cells forming concentric concentric circlescircles around around blood vesselsblood vessels

Area around osteocyteArea around osteocyte is filled with is filled with proteinprotein fibersfibers, , calciumcalcium, and other , and other mineralsminerals

OsteonsOsteons run run parallelparallel to each other with blood to each other with blood vessels literally connecting with them to ensure vessels literally connecting with them to ensure sufficient sufficient oxygenoxygen and and nutrientsnutrients for bone cell for bone cell

Bone Tissue Con’tBone Tissue Con’t

Spongy (cancellous) bone Spongy (cancellous) bone Arranged in bars and platesArranged in bars and plates called called trabeculaetrabeculae Irregular holesIrregular holes between trabeculae make bone between trabeculae make bone

lighter in weight and provide space for lighter in weight and provide space for red bone red bone marrowmarrow, which produces , which produces red blood cellsred blood cells

HolesHoles give bone spongy appearancegive bone spongy appearance

Surface Structure of BonesSurface Structure of Bones

Bone is not perfectly smoothBone is not perfectly smooth ProjectionsProjections act as points of attachment for act as points of attachment for

muscles, ligaments, or tendonsmuscles, ligaments, or tendons GroovesGrooves and and depressionsdepressions act as pathways for act as pathways for

nerves and blood vesselsnerves and blood vessels

Bone FeaturesBone Features

Bone Growth and RepairBone Growth and Repair

Epiphyseal plateEpiphyseal plate (growth plate) (growth plate) After birth epiphysisAfter birth epiphysis on long bones continues to on long bones continues to

grow.grow. Plate is thin band of cartilagePlate is thin band of cartilage formed between formed between

primary and secondary ossification centersprimary and secondary ossification centers.. Plate exists as long asPlate exists as long as bones need to lengthen and bones need to lengthen and

widen; controlled by hormones, plate will eventually widen; controlled by hormones, plate will eventually ossify and stop growth process.ossify and stop growth process.

How bones develop over timeHow bones develop over time

OsteoporosisOsteoporosis

As we ageAs we age breakdown of bone becomes greater breakdown of bone becomes greater than formation of new bone (causing bone mass than formation of new bone (causing bone mass to gradually decrease).to gradually decrease).

Bones becomeBones become lighter & weaker lighter & weaker holes in spongy boneholes in spongy bone becoming more prominent becoming more prominent weakened bonesweakened bones more prone to breakage more prone to breakage decreasing bone densitydecreasing bone density called called osteoporosisosteoporosis

Increase calciumIncrease calcium: forms matrix of bone: forms matrix of bone Increase fluoride, & Increase fluoride, & vitamin Dvitamin D: helps body absorb : helps body absorb

ingested calcium from digestive tract.ingested calcium from digestive tract. Stop smokingStop smoking and decreasing and decreasing caffeinecaffeine consumption: consumption:

both aid in calcium depletion.both aid in calcium depletion. Do weight-bearingDo weight-bearing exercise exercise Take medicationsTake medications to increase bone mass such as to increase bone mass such as

alendronate/Fosamax.alendronate/Fosamax.

Rx for OsteoporosisRx for Osteoporosis

CartilageCartilage

Connective tissueConnective tissue that can withstand fair amount of that can withstand fair amount of flexing, tension, and pressure: flexing, tension, and pressure: Nose & EarsNose & Ears..

Flexible connectionFlexible connection between bones, as between between bones, as between ribsribs and and sternumsternum, allowing chest flexion during , allowing chest flexion during deep breathing & deep breathing & CPRCPR..

Cartilage ContCartilage Cont

Acts as cushionActs as cushion between bones; “ between bones; “articulararticular” ” cartilage located on ends of bones and acts as cartilage located on ends of bones and acts as shock absorber/anti-grinding.shock absorber/anti-grinding.

BursaBursa: small sacs secrete lubricant called : small sacs secrete lubricant called synovial fluidsynovial fluid..

OsteoarthritisOsteoarthritis: Inflammation of joints: Inflammation of joints

Figure 6-5 Articular cartilage and synovial joint.

Joints and LigamentsJoints and Ligaments

Joint or ArticulationJoint or Articulation: When two or more bones join : When two or more bones join together. together.

LigamentsLigaments: Tough, whitish bands that connect : Tough, whitish bands that connect bonebone to to bonebone..

TendonsTendons: cord-like structures that attach : cord-like structures that attach musclemuscle to to bonebone..

Types of Synovial JointsTypes of Synovial Joints Pivot JointPivot Joint: turnstile movement in : turnstile movement in neckneck and and forearmforearm Ball and socket jointBall and socket joint: : hip hip and and shouldershoulder mvt rotation mvt rotation Hinge jointHinge joint: allow opening and closing movement in : allow opening and closing movement in

kneesknees and and elbowselbows.. Gliding jointGliding joint: : wristswrists and and anklesankles; provides sliding ; provides sliding

back and forth movementback and forth movement

Movement ClassificationsMovement Classifications

FlexionFlexion: bending a joint : bending a joint ExtensionExtension: straightening a joint : straightening a joint Plantar flexionPlantar flexion: pointing toes down : pointing toes down DorsiflexionDorsiflexion: bending foot up toward body: bending foot up toward body AbductionAbduction: moving away from body’s midline: moving away from body’s midline AdductionAdduction: moving toward midline of body: moving toward midline of body

Movement Classifications con’tMovement Classifications con’t

InversionInversion: turning foot : turning foot medialmedial EversionEversion: turning foot : turning foot laterallateral SupinationSupination: turning hand palm : turning hand palm upup PronationPronation: turning hand palm : turning hand palm downdown CircumductionCircumduction: : circularcircular arm movement of a pitcher arm movement of a pitcher

Movement ClassificationsMovement Classifications

Common Skeletal DisordersCommon Skeletal Disorders

OsteoarthritisOsteoarthritis Etiology:Etiology: joint cartilage “wears out” joint cartilage “wears out” S/SS/S: painful inflammation: painful inflammation DxDx: visual exam; X-ray: visual exam; X-ray RxRx: rest, analgesics, anti-inflammatory meds, : rest, analgesics, anti-inflammatory meds,

steroid injections (into affected joint), surgical steroid injections (into affected joint), surgical intervention joint replacement.intervention joint replacement.

Common Skeletal Disorders contCommon Skeletal Disorders cont

Rheumatoid arthritisRheumatoid arthritis: : EtiologyEtiology: autoimmune disease that attacks connective : autoimmune disease that attacks connective

tissue; especially joints.tissue; especially joints. S/SS/S: stiffness, swelling and pain joints; inflammation of : stiffness, swelling and pain joints; inflammation of

synovial membrane; pronounced joint deformities.synovial membrane; pronounced joint deformities. DxDx: visual exam; X-ray; antibody screening (rheumatoid : visual exam; X-ray; antibody screening (rheumatoid

factor).factor). RxRx: aspirin; NSAID; corticosteroid meds; methotrexate; : aspirin; NSAID; corticosteroid meds; methotrexate;

rest & range of motion exercises; surgical intervention (in rest & range of motion exercises; surgical intervention (in extreme cases)extreme cases)


Septic arthritisSeptic arthritis EtiologyEtiology: infection inside joint, usually preceded by : infection inside joint, usually preceded by

penetrating joint wound, or pathogen carried in blood.penetrating joint wound, or pathogen carried in blood. S/SS/S: pain & edema; filling of joint with inflammatory : pain & edema; filling of joint with inflammatory

exudates; destruction of joint & replacement with fibrous exudates; destruction of joint & replacement with fibrous tissue & eventually bone.tissue & eventually bone.

DxDx: visual exam; X-ray; fluid culture for infection: visual exam; X-ray; fluid culture for infection RxRx: antibiotics; prevent septic arthritis with good “aseptic : antibiotics; prevent septic arthritis with good “aseptic

techniques.” techniques.”


BursitisBursitis: : Inflammation of a bursaInflammation of a bursa EtiologyEtiology: repetitive movement; strain; congenital defect; : repetitive movement; strain; congenital defect;

rheumatic diseasesrheumatic diseases S/SS/S: pain on movement; limited range of motion; : pain on movement; limited range of motion;

inflammation and swelling at affected siteinflammation and swelling at affected site DxDx: visual exam; X-ray: visual exam; X-ray RxRx: rest; moist heat/cold therapy; analgesics; NSAID; : rest; moist heat/cold therapy; analgesics; NSAID;

corticosteroid injection at affected site; draining (of fluid).corticosteroid injection at affected site; draining (of fluid).


Cruciate ligament tearsCruciate ligament tears: : Tear in one or more of ligaments of kneeTear in one or more of ligaments of knee EtiologyEtiology: trauma induced when leg is twisted, planted : trauma induced when leg is twisted, planted

(weight bearing) leg receives anterior or posterior blow.(weight bearing) leg receives anterior or posterior blow. S/SS/S: pain in knee; instability of knee; limited mobility: pain in knee; instability of knee; limited mobility DxDx: physical exam (especially joint stability tests); radiologic : physical exam (especially joint stability tests); radiologic

exam (especially MRI).exam (especially MRI). RxRx: NSAID, rest, immobilization, surgical repair: NSAID, rest, immobilization, surgical repair


GoutGout:: EtiologyEtiology: metabolic disease where uric acid levels become : metabolic disease where uric acid levels become

too high; causes uric acid crystals to deposit in joints too high; causes uric acid crystals to deposit in joints S/SS/S: pain in affected joint with inflammation & palpable : pain in affected joint with inflammation & palpable

heat tenderness with edema.heat tenderness with edema. DxDx: visual examination; blood testing for excessive uric : visual examination; blood testing for excessive uric

acid.acid. RxRx: low fat & low protein diet, rest & immobilization, Meds: : low fat & low protein diet, rest & immobilization, Meds:

anti-inflammatory medications & allopurinol. Monitor blood anti-inflammatory medications & allopurinol. Monitor blood uric acid levels.uric acid levels.


KyphosisKyphosis:: EtiologyEtiology: : osteoporosisosteoporosis S/SS/S: exaggerated curve of upper back (“: exaggerated curve of upper back (“humpbackhumpback”); ”);

may lead to backache, dyspnea/pulmonary insufficiencymay lead to backache, dyspnea/pulmonary insufficiency DxDx: visual exam, X-ray: visual exam, X-ray RxRx: depends on age and severity; may include: exercise; : depends on age and severity; may include: exercise;

bracing; surgery; electrical stimulation; weight controlbracing; surgery; electrical stimulation; weight control


Osteomalacia/RicketsOsteomalacia/Rickets: : softening of bonesoftening of bone EtiologyEtiology: decreased mineralization of bone due to : decreased mineralization of bone due to

insufficient insufficient vitamin Dvitamin D, lack of sufficient sunlight, , lack of sufficient sunlight, malmalabsorption conditions.absorption conditions.

S/SS/S: bone pain & deformity; loss of height: bone pain & deformity; loss of height DxDx: visual examination; bone scan: visual examination; bone scan RxRx: correct nutritional deficiency: : correct nutritional deficiency: increase vitamin Dincrease vitamin D


Plantar fasciitisPlantar fasciitis: (runner’s heel): (runner’s heel) EtiologyEtiology: repetitive impact on heel, resulting in inflammation : repetitive impact on heel, resulting in inflammation

of connective tissue on plantar surface of footof connective tissue on plantar surface of foot Predisposing FactorsPredisposing Factors: high arches, flat feet, shoes with poor : high arches, flat feet, shoes with poor

support, increased body weight, & sudden increase in activitysupport, increased body weight, & sudden increase in activity S/SS/S: intermittent pain: intermittent pain DxDx: X-ray: X-ray RxRx: rest, ice; NSAID; padding heel; possible surgery: rest, ice; NSAID; padding heel; possible surgery


TendonitisTendonitis: inflammation of tendon: inflammation of tendon EtiologyEtiology: repetitive movement: repetitive movement S/SS/S: pain on movement with inflammation of involved area: pain on movement with inflammation of involved area DxDx: visual exam; x-ray: visual exam; x-ray RxRx: rest; application of moist heat/cold; NSAID; injection of : rest; application of moist heat/cold; NSAID; injection of

affected site with corticosteroids.affected site with corticosteroids.


OsteomyelitisOsteomyelitis: : EtiologyEtiology: infection in bone, often preceded from wound in : infection in bone, often preceded from wound in

skin; staphylococcus aureus a common pathogen.skin; staphylococcus aureus a common pathogen. S/SS/S: sudden pain, swelling, heat, & tenderness of affected : sudden pain, swelling, heat, & tenderness of affected

site; high fever & chills, nausea & malaise.site; high fever & chills, nausea & malaise. DxDx: visual exam, culture wound for pathogen: visual exam, culture wound for pathogen RxRx: antibiotics; surgical debridement: antibiotics; surgical debridement

Types of Bone FracturesTypes of Bone Fractures SimpleSimple: (: (closedclosed): break without puncture to skin): break without puncture to skin CompoundCompound: (: (openopen): bone has been pushed through skin): bone has been pushed through skin HairlineHairline: does not completely break or displace bone: does not completely break or displace bone SpiralSpiral: caused by severe twisting of bone: caused by severe twisting of bone GreenstickGreenstick: incomplete breaks, more common in children: incomplete breaks, more common in children ComminutedComminuted: when bone has been : when bone has been fragmentedfragmented or or splinteredsplintered

SimpleSimple: (: (closedclosed): break without puncture to skin): break without puncture to skin

CompoundCompound: (: (openopen): bone has been pushed ): bone has been pushed through skinthrough skin

HairlineHairline: does not completely break or displace : does not completely break or displace bonebone

SpiralSpiral: caused by severe twisting of bone: caused by severe twisting of bone

GreenstickGreenstick: incomplete breaks, more common in : incomplete breaks, more common in childrenchildren

ComminutedComminuted: when bone has been : when bone has been fragmentedfragmented or or splinteredsplintered

Health Sciences & Occupations Anatomy, Physiology and Disease Chapter 6 The Skeletal System.

Documents

Transcript of Health Sciences & Occupations Anatomy, Physiology and Disease Chapter 6 The Skeletal System.