The Skeletal System: The Framework

CHAPTER

ESSENTIALS OF A&PFOR EMERGENCY CARE

Copyright ©2011 by Pearson Education, Inc.All rights reserved.

Essentials of A&P for Emergency CareBruce J. Colbert • Jeff Ankney • Karen T. Lee • Bryan E. Bledsoe

The Skeletal System: The Framework

6



Multimedia Asset Directory

Slide 30Hip Displacement AnimationSlide 45Bone Healing AnimationSlide 54Knee Displacement AnimationSlide 58Classification of Joints AnimationSlide 64Movement of the Joints AnimationSlide 65Ankle Dorsiflexion/Extension AnimationSlide 66Ankle Inflexion/Eversion AnimationSlide 67Elbow Pronation/Supination AnimationSlide 68Elbow Flexion/Extension AnimationSlide 69Hand Opposition AnimationSlide 70Humerus Adduction/Abduction AnimationSlide 71Humerus Circumduction AnimationSlide 72Humerus Rotation Animation



Multimedia Asset Directory

Slide 73Wrist Circumduction AnimationSlide 74Wrist Flexion/Extension AnimationSlide 97Osteoporosis VideoSlide 98 Arthritis VideoSlide 112 Fractures AnimationSlide 113 Radiologic Technology Video



Introduction

• The skeletal system provides support and allows us to move.

• The bones (also known as osseous tissue) that make up the skeleton also protect the soft body parts, produce blood cells, and act as a storage unit for minerals and fat.

• There are 206 bones in the adult skeleton, along with cartilage, ligaments, and joints.



Learning Objectives

• Describe the functions of the skeletal system.• Identify and describe the anatomy and

physiology of bone.• Locate and describe the various bones within

the body.• Differentiate between bone, cartilage,

ligaments, and tendons.• Locate and describe the various joints and

types of movement of the body.



Pronunciation GuideClick on the megaphone icon before each item to hear the pronunciation.

appendicular skeleton (app en DIK yoo lahr)arthritis (ahr THRYE tis)articulation (ahr TICK you LAY shun)axial skeleton (AK see al)callus (KAL us)diaphysis (dye AFF ih sis)epiphyseal plate (EP ih FEEZ ee al)epiphysis (eh PIFF ih sis)haversian (haah VER shun)




hemopoiesis (HEE moh poy EE sus)ischium (IS kee um)medullary cavity (MED uh lair ee)osseous tissue (OSS see us)ossification (OSS ih fih KAY shun)osteoarthritis (OSS tee oh ahr THRYE tis)osteocyte (OSS tee oh site)osteons (OSS tee ons)periosteum (pair ee OSS tee um)




synovial fluid (sin OH vee al)trabeculae (tra BECK you lay)vertebrae (VER teh bray)



Bones

• The primary components of the skeleton are bones.

• Although bones are composed of non-living minerals such as calcium and phosphorous, they are very much alive, constantly building and repairing themselves.

• The word ‘skeleton’ comes from the Greek meaning “dried up body.”



General Bone Classifications

• Bones are classified according to their shape.

• Long bones– these bones are longer than they are wide

and can be found in the arms and legs.

• Short bones– these bones are fairly equal in width and

length and are found mostly in the wrists and ankles.



General Bone Classifications

• Bones are classified according to their shape.

• Flat bones– these bones are thinner and can be either flat

or curved. They can be plate-like in nature and would include the skull, ribs, and sternum (breast bone).

• Irregular bones– these bones are like parts of a jigsaw puzzle,

odd in shape, and include the hip bone and vertebrae.



Figure 6-1 Various bone shapes.



Basic Bone Anatomy

• Periosteum is a tough and fibrous connective tissue.

• The periosteum contains blood vessels which transport blood and nutrients to nurture bone cells.

• It also contains lymph vessels and nerves.• The periosteum acts as an anchor point

for ligaments and tendons.



Basic Bone Anatomy

• Epiphysis is the expanded end of the long bone.

• Diaphysis is the region running between the two epiphyses.– The diaphysis is hollow. This hollow area is

called the medullary cavity, and acts as a storage area for the yellow marrow.

– Yellow marrow has a high fat content and can convert to red marrow, which makes red blood cells, in an emergency.



Figure 6-2 Basic bone anatomy.



Bone Tissue

• Bone can be composed of two types of tissue– Compact – Spongy



Compact Bone

• Compact bone is a dense, hard tissue normally found in the shafts of long bones and the outer layer of other bones.

• The tightly-packed material that composes this type of bone tissue makes for a dense and strong structure.

• The material forms microscopic, cylindrical-shaped units called osteons, or haversian systems.



Compact Bone

• Each of these units has mature bone cells (osteocytes) forming concentric circles around a central (haversian) canal, containing blood vessels.

• The area around the osteocyte is filled with protein fibers, calcium, and other minerals.

• The osteons run parallel to each other with perforating canals (blood vessel passages) literally connecting with them to ensure sufficient oxygen and nutrients for the bone cells.



Spongy Bone

• Spongy, or cancellous, bone is arranged in bars and plates called trabeculae.

• There are irregular holes between the trabeculae making the bone lighter in weight and providing space for red bone marrow, which produces red blood cells.

• The holes give the bone a spongy appearance.



Figure 6-3 Comparison of compact and spongy bone.



Surface Structure of Bones

• Bone is not perfectly smooth.• There are a variety of projections, bumps,

and depressions. – Projections act as points of attachment for

muscles, ligaments, or tendons.– Grooves and depressions act as pathways for

nerves and blood vessels.• Projecting structures and depressions can

work together as joining or articulation points to form joints such as the ball and socket joint in your hip.



From the Streets:Intraosseous (IO) Needle Placement

• Large bones are highly vascular, allowing large volumes of fluid to be transferred to the central circulation.

• Specially designed IO needles pierce the cortex of the bone

• IO route viable route for critically ill or injured patients.



From the Streets:Intraosseous (IO) Needle Placement

• Current trauma practices call for limited fluid administration in trauma, so the expanding role of IO therapy appears to be in cardiac arrest when an IV cannot be placed.



Figure 6-4 Intraosseous needle properly placed in marrow cavityand medullary sinusoids.



Figure 6-5 Special intraosseous needle for emergency intraosseous access.



Figure 6-6 Bone injection gun (BIG) IO device. (a) adult; (b) pediatric.



Figure 6-7 F.A.S.T. 1 Sternal IO.



Figure 6-8 EZ-IO device.



Click here to view an animation on the topic of hip displacement.

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Table 6-1 Bone Features.



Bone Growth and Repair

• Ossification is the term used to describe the formation of bone in the body.

• Bones grow longitudinally in order to develop height and they grow horizontally (wider and thicker) so they can more efficiently support our body weight and any other weight we support.



Types of Cells Involved in Formation and Growth

• Osteoprogenitor cells• Osteoblasts• Osteocytes• Osteoclasts



Osteoprogenitor Cells

• Osteoprogenitor cells are non-specialized cells found in the periosteum, endosteum, and central canal of compact bones.

• Non-specialized cells can turn into other types of cells as needed.



Osteoblasts

• Osteoblasts are the cells that actually form bones.

• They arise from the non-specialized osteoprogenitor cells and are the cells that secrete the matrix of calcium with other minerals that give bone its typical characteristics.



Osteocytes

• Osteocytes are considered mature bone cells and started as osteoblasts.

• Osteoblasts surround themselves with a matrix to then become the mature osteocytes.



Osteoclasts

• It is believed that osteoclasts originate from a type of white blood cell called a monocyte that is found in red bone marrow.

• The osteoclasts’ job is to tear down bone material and help move calcium and phosphate into the blood.



Bone Development and Growth

• Bone development begins when you are an embryo.

• Intramembranous ossification – Occurs when bone develops between two sheets

composed of fibrous connective tissue.– Cells from connective tissue turn into osteoblasts and

form a matrix while other osteoblasts create compact bone over the surface of the spongy bone.

– Once the matrix surrounds the osteoblasts they become osteocytes.

– This is how the bones of the skull develop.




• Endochondral ossification– The majority of bones form through

endochondral ossification.– Shaped cartilage is replaced by bone.– Periosteum surrounds the diaphysis of the

cartilage model as the cartilage begins to break down.




• Endochondral ossification– Osteoblasts come into the diaphysis and

create spongy bone in an area that is then referred to as the primary ossification center.

– Other osteoblasts begin to form compact bone under the periosteum. The osteoclasts break down the spongy bone of the diaphysis to create the medullary cavity.



Epiphyseal Plate

• After you are born, the epiphysis on your long bones continues to grow.

• A thin band of cartilage forms an epiphyseal plate (growth plate) between the primary and secondary ossification centers.

• This plate exists as long as bones need to lengthen. Controlled by hormones, the plate will eventually ossify and stop the growth process.



Figure 6-9 Endochondral ossification of long bone.



Bone Repair

• When a bone is fractured, it must be repaired. • Bone repair is accomplished by the same

process as bone growth, endochondral ossification.

• Bone tissue is very good at repairing itself, but for a bone fracture to heal, the ends of broken bone must be touching. If they are not, then a medical procedure called reduction (setting) must be performed. Then the bone must be immobilized so the ends will stay touching.



Bone Repair

• Stage 1 is hematoma formation and inflammation.

• Stage 2 is soft (fibrocartilage) callus formation. Cartilage fills in the space between the bones.

• Stage 3 is hard (bony) callus formation. Bone replaces the cartilage via endochondral ossification.

• In stage 4, the bone is remodeled via the activity of osteoblasts and osteoclasts until the fracture is nearly undetectable.



Click here to view an animation on the topic of Bone Healing.

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Cartilage

• Cartilage is a special form of dense connective tissue that can withstand a fair amount of flexing, tension, and pressure.

• The flexible parts of your nose and ears are cartilage.

• Cartilage also makes a flexible connection between bones, as between the ribs and sternum, allowing chest flexion during deep breathing.



Cartilage

• Cartilage acts as a cushion between bones. Articular cartilage is located on the ends of bones and acts as a shock absorber, preventing the ends from grinding together when you move.

• In this location, a small sac, called a bursa, secretes a lubricant called synovial fluid.

• Joints can still wear out and become inflamed despite all this protection, resulting in arthritis or osteoarthritis.



Figure 6-10 Articular cartilage and synovial joint.



Joints and Ligaments

• When two or more bones join together it forms a joint or articulation.

• Articulating joints are held together, yet are still movable. This is accomplished by special connective tissue called ligaments. – Ligaments are very tough, whitish bands that

connect from bone to bone and can withstand heavy stress.

• Tendons are cord-like structures that attach muscle to bone.



Types of Joints

• Classified by function – Joints can be immobile, can move a little, or

can move freely. For example, skull sutures are immobile, the pubic symphysis between your pelvic bones moves a little, and your elbow moves freely.



Types of Joints

• Classified by structure– Based on the type of connective tissue that

links the bones together– Fibrous joints are held together by short

connective tissue strands. They are either immobile or slightly movable. The sutures in your skull are fibrous joints.

– Cartilaginous joints are held together by cartilage. The pubic symphysis and the joints between your ribs and sternum are cartilaginous joints. Cartilaginous joints are either immobile or slightly movable.



Types of Joints

• Classified by structure– Synovial joints are joined by a joint cavity

lined with a synovial membrane and filled with synovial fluid. All synovial joints are freely moving.



Types of Synovial Joints

• Gliding joints are the flat, or slightly curved, plate-like bones found in your wrists and ankles. Gliding joints slide back and forth.

• Hinge joints are found in your knees and elbows. Typically one bone is in the shape of a cylinder and the other a trough. They can either open or close.



Click here to view an animation on the topic of knee displacement.

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• Saddle joints have a bone shaped just like a saddle and another bone similar to a horse’s back. This joint type is found in the base of your thumb. Saddle joints rock up and down and side to side.

• Ellipsoidal joints (also called condyloid joints) provide two axes of movement through the same bone, like the joint formed at the wrist with both the radius and ulna. The knuckles of your fingers are ellipsoidal joints.




• Pivot joints (which act like a turnstile) have a circular portion of one bone that spins inside a ring-shaped portion of the other. Pivot joints are the type of joint found in your neck and forearm. They can only rotate.

• Ball-and-socket joints consist of a spherical articulation with a cup-shaped socket on the other bone. Ball-and-socket joints are located in your hips and shoulders and can perform all types of movement, including rotation.



Figure 6-11 Types of joints.



Click here to view an animation showing Classifications of the Joints.

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Movement Classifications

• Flexion– bending a joint and decreasing the angle

between involved bones

• Extension– straightening a joint

• Plantar flexion– pointing toes down




• Dorsiflexion– bending the foot up toward the body

• Abduction– moving away from the body’s midline

• Adduction– moving toward the midline of the body




• Inversion– turning a foot inward toward the other foot

• Eversion– turning a foot outward away from the

opposing foot

• Supination– turning a hand palm up

• Pronation– turning a hand palm down




• Protraction– drawing a part forward

• Retraction– drawing backward

• Circumduction– circular arm movement of a pitcher

• Rotation– spinning on axis



Figure 6-12 Classification of joint movements.



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Click here to view a video showing skeletal movement: Ankle Dorsiflexion/Extension

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Click here to view a video showing skeletal movement: Ankle Inversion/Eversion.

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Click here to view a video showing skeletal movement: Elbow Pronation/Supination

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Click here to view a video showing skeletal movement: Elbow Flexion/Extension.

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Click here to view a video showing skeletal movement: Hand Opposition.

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Click here to view a video showing skeletal movement: Humerus Adduction/Abduction.

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Click here to view a video showing skeletal movement: Humerus Circumduction.

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Click here to view a video showing skeletal movement: Humerus Rotation

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Click here to view a video showing skeletal movement: Wrist Circumduction.

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Click here to view a video showing skeletal movement: Wrist Flexion/Extension.

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The Skeleton

• Two main sections of the skeleton– Axial skeleton – Bones of the bony thorax,

spinal column, hyoid bone, bones of the middle ear, and skull; they protect the body organs and total 80 bones

– Appendicular skeleton – Bones of your arms, legs, hips, and shoulders and total 126 bones

– Half of the bones in your body are found in the hands and feet.



Figure 6-13 The anterior and posterior human skeleton.



The Human Skull

• The skull protects and houses the brain and has the openings needed for our sensory organs such as the eyes, nose, and ears.

• It also forms the mouth which is a common passageway for both the respiratory and digestive systems.

• Fibrous connective tissue allows for some flexibility of the bones surrounding the brain.



Figure 6-14 Bones of the skull.



Figure 6-14 (continued) Bones of the skull.



The Thorax

• The bones of the chest form a thoracic cage that provides support and protection for the heart, lungs, and great blood vessels.

• The cage is flexible due to cartilaginous connections that allow for movement during breathing.

• The sternum is the location for conducting chest compressions during CPR, compressing the heart between the sternum and the bones of the vertebrae.



The Thorax

• The sternum– The manubrium is the superior portion, and

the body is the largest, central portion. The xiphoid process is the final and inferior portion.



The Thorax

• The ribs – Attached by cartilage to allow for their

movement when we breathe True ribs – pairs 1 to 7 called vertebrosternal

because they connect anteriorly to the sternum and posteriorly to the thoracic vertebrae

False ribs – pairs 8 to 10 are called vertebrocostal, because they connect to the costal cartilage of the superior rib and to the thoracic vertebrae.

Floating – pairs 11 and 12: no anterior attachment.



Figure 6-15 The bony thorax.



The Spinal Column

• The spinal or vertebral column protects the spinal cord, the superhighway for information traveling to and from the central nervous system.

• The individual bones, or vertebrae, are numbered and classified according to the body region in which they are located.– 7 cervical vertebrae, 12 thoracic, 5 lumbar, 5

sacral (mid-buttocks), and 3 to 5 coccygeal (tailbone).



Figure 6-16 The spinal column.



Curvature of the Spine

• The initial curvature of the back begins in the newborn period. It is concave, like a fetal position.

• This curvature changes as the infant learns to hold its head up and then again as it begins to walk, curving in the opposite direction.

• From about age 2 onward, the vertebral column will present with a secondary curvature in the neck, primary in the upper back, secondary in the lower back, and primary in the mid buttocks and tail bone region.



Figure 6-17 Spinal disfigurements. (A) Spinal disfigurements compared to healthy spinal curves.



Figure 6-17 (continued) Spinal disfigurements. (B) Kyphosis. (Source: Phototake NYC.)



Figure 6-17 (continued) Spinal disfigurements. (C) Scoliosis. (Source: Photo Researchers, Inc.)



Learning Hint

• To remember the number of vertebrae in each region, think of 7 days in a week for cervical, 12 months in a year for thoracic, and 5 vertebrae in the lumbar area – the same as the number of digits on your hand.

• Another way of remembering is you have breakfast at 7 (cervical), lunch at 12 (thoracic), and dinner at 5 (lumbar).



Upper and Lower Extremities

• The appendicular region consists of the arms and legs.

• These areas perform most of the body’s movement.

• The arms and legs are of similar construction– One large bone (humerus in the arm; femur in the

legs), two smaller bones in the forelimb (radius and ulna in the arms; tibia and fibula in the legs), multiple bones (carpals in the wrist; tarsals in the ankle), five single bones (metacarpals in the hand; metatarsals in the foot) and digits made of multiple bones (phalanges).



Upper/Lower Extremities

• Both the arms and legs are attached to the axial skeleton via the pectoral and pelvic girdles, respectively. The pectoral girdle consists of the clavicle and scapula, whereas the pelvic girdle consists of the pelvic bones (ischium, ilium, and pubis).

• The pelvic girdle is different for women than men. Women have a greater pubic angle that facilitates childbirth and a broad girdle to support the weight of the growing fetus.



Figure 6-18 Bones of the upper and lower extremities.



Common Disorders of the Skeletal System

• Aging affects the cartilage and bones. While this is a natural process, in some cases we can slow things down.

• The chemical composition of cartilage changes as we age, becoming more brittle and yellow due to calcification. This can lead to arthritis, an inflammatory process of the joints, reducing flexibility and decreasing range of motion.



Common Disorders of the Skeletal System

• Bone mass decreases with age. In our 50s the breakdown of bone is greater. Osteoclasts are tearing down more bone than the osteoblasts are forming. A microscopic exam reveals holes, and the bone is lighter in weight, weaker, and more prone to breakage. This condition is called osteoporosis and affects more women than men.

• Proper calcium intake, vitamin D, weight bearing exercise and quitting smoking and cutting down on caffeine can decrease risk of osteoporosis.



Click here to view a video on the topic of Osteoporosis.

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Click here to view a video on the topic of Arthritis.

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Table 6-2 Bone Disorders



Table 6-3 Joint Disorders



From the Streets:Orthopedic Injuries

• There are four general types of skeletal and joint injuries.– Sprains

injuries that stretch or tear one or ligaments within a joint

– Subluxations a partial displacement of a bone end from its

position within a joint capsule. Also called a partial dislocation.




• There are four general types of skeletal and joint injuries.– Dislocations

a complete displacement of bone ends from their normal position within a joint.

– Fractures injuries that interrupt the structural integrity of a

bone.




• Sprains result in acute pain at the site, followed by inflammation and swelling. Sprains are classified to their severity, using the following criteria– Grade I. Minor and incomplete tear.– Grade II. Significant but incomplete tear.– Grade III. Complete tear and total failure of

the ligament or ligaments involved.




• Types of fractures– A simple or closed fracture is a break with

minimal displacement and no tear in the skin– In an open fracture, the skin is broken and a

communication exists between the fracture site and the environment.



Figure 6-23 Open and closed fractures. Open fractures, also called compound fractures, have a direct communication with the environment. Closed fractures, also called simple

fractures, do not have any communication with the environment.




• A greenstick fracture is an incomplete break and is often found in children.

• A spiral fracture is caused by a twisting motion to the bone.

• A comminuted fracture occurs when the bone fragments or splinters.




• In a torus fracture, there is localized buckling or swelling of the cortex, with little or no displacement of the bone itself. Occurs almost exclusively in children.



Figure 6-25 Colles’ fracture is a common forearm fracture where the injury resembles a dinner fork.



Figure 6-26 Supracondylar fracture. These fractures have a high incidence of associated nerve and vascular trauma. In children, these fractures can involve the growth plate and can

lead to permanent disability.



Figure 6-27 Types of hip fractures.



Figure 6-28 LeFort system of classifying facial fractures.



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Click here to view a video on the topic of Radiologic Technology.

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Snapshots from the Journey

• In addition to providing support and protection for the body, the skeleton also produces blood cells and acts as a storage unit for minerals and fat.

• The 206 bones of the skeleton can be classified according to their shape: long bones, short bones, flat bones, and irregular bones, and are covered with periosteum, a tough fibrous connective tissue.




• In long bones, each bone end is called an epiphysis, and the shaft is called the diaphysis. The hollow region within the diaphysis is called the medullary cavity and stores yellow marrow.




• Compact bone is a dense, hard tissue that is normally found in the shafts of long bones or is found as the outer layer of the other bone types. Spongy bone is different in that it contains irregular holes that make it lighter in weight and provides a space for red bone marrow, which produces red blood.




• Ossification is the formation of bone in the body. Osteoprogenitor cells are nonspecialized bone cells that can turn into osteoblasts, which are the cells that actually form bones. Osteocytes are considered mature bone cells that were originally osteoblasts.




• Osteoclasts originate from a type of white blood cell called a monocyte, found in red bone marrow. Osteoclasts break down bone material and help move calcium and phosphate into the blood.




• A thin band of cartilage forms an epiphyseal plate (often referred to as the growth plate), and as long as it exists, the length of the bone will increase.

• Cartilage is a form of connective tissue that can withstand a fair amount of flexing, tension, and pressure and makes a flexible connection between bones, as between the breastbone and ribs. It also acts as a cushion between bones.




• Various types of joints join two or more bones and provide various types of movement. The point at which they join is called an articulation. Ligaments are very tough, whitish bands that connect from bone to bone to hold the joint together and can withstand heavy stress.




• The skeleton can be divided into two main sections. The axial skeleton includes bones of the bony thorax, spinal column, hyoid bone, bones of the middle ear, and skull. The appendicular skeleton is the region of your appendages (arms and legs) as well as the connecting bone structures of the hip and shoulder girdles.




• As we age, the chemical composition of cartilage changes, causing it to become more brittle. Articular cartilage that ages or becomes injured can lead to arthritis, an inflammatory process of a joint or joints. Bone mass also gradually decreases with age, beginning in a person’s 50s. Even though this is a natural process of aging, it can be slowed by a healthy lifestyle.



Case Study

A somewhat frail 76-year-old female visits her physician’s office for an annual check-up. Her social history shows she smokes a pack a day and is a heavy coffee drinker. She has had several fractured bones in the last five years that required medical attention.



Case Study

During the initial examination, measurements show that the she has lost approximately an inch of height over the past year. She has also lost several pounds but states she still wears the same size clothes.



Case Study Questions

• What bone disease does she have?• Describe the bone changes in this

condition on a macro and cellular level.• What treatments/lifestyle changes would

you suggest?



From the Streets

You are called to a 56-year-old female restrained driver in a motor vehicle collision (MVC). Her car was rear-ended. She is alert and complaints of neck and back pain. Before you implement spinal immobilization you perform a physical exam. While placing resistance on her feet you ask her to “raise your toes toward your nose” and “press down like you are pressing on the gas pedal”. She is able to perform both.



From the Streets Questions

• With appropriate terms, describe the two movements you instructed your patient to perform during your physical exam.

• With appropriate terms, describe the movement that caused her neck pain.




• With appropriate terms, describe the two movements you instructed your patient to perform during your physical exam.

“Toes towards the nose”= dorsiflexion“Press down on the gas”= plantar flexion• With appropriate terms, describe the

movement that caused her neck pain.Hyperflexion



From the Streets

• You are performing cardiopulmonary resuscitation on a 79-year-old male patient. You frequently confirm proper hand placement and rate and depth of compression during CPR.




• What structure do you place your hands on to perform chest compressions?

• By ensuring proper hand placement you avoid damaging what structure?

• During chest compressions the heart is squeezed between what two structures?




• What structure do you place your hands on to perform chest compressions? The body of the sternum

• By ensuring proper hand placement you avoid damaging what structure? The xiphoid process

• During chest compressions the heart is squeezed between what two structures? The sternum and the thoracic spine



End of ChapterReview Questions

1. Your elbow is an example of what type of joint?a. Hinge jointb. Ball-and-socket jointc. Gliding jointd. Fibrous joint




2. The sternum is the correct medical term for which bone?a. Shin boneb. Breast bone c. Shoulder bladed. Collarbone




3. The end of a long bone is the:a. Diplodicusb. Epiphysisc. Condylcornd. Perla




4. The presence of a(n) ___________ in skeletal remains indicates the skeleton is a teenager or child.a. Torquer centerb. Ossifier c. Mantoux membraned. Epiphyseal plate




5. The aging process, excessive caffeine, and cigarette smoking can each contribute to this bone disease:a. Ligamental stenosisb. Osteoporosisc. Cartilentious dementiad. Ossification




6. Joe injured his elbow as a child and now, as an adult, his injured arm is much shorter than the other arm. Why?a. Fractured bone is always shorterb. His epiphyseal plate was damaged and the

bone didn’t growc. He has arthritis in the joint, which decreases

bone growthd. He has a congenital problem that caused

both the injury and the shorter bone




1. Name three large appendicular bones ______, _______ and _______.

2. List three places where cartilage is found in the body. ___________, ________, and _________.

3. ________ is a liquid found in joints that keeps them lubricated.

4. The specialized cells that constantly rebuild bone are called ___________.




5. These specialized cells are needed to tear down bone: ______________ .

6. Bone must be ________ to heal the fracture.




1. Describe the difference between tendons and ligaments.

2. Explain the process of endochondral ossification.

3. Explain the structural and functional classification of joints.

4. List and define the types of movements possible in freely moving joints.




5. Skeletons have a number of characteristics that allow forensic professionals to tell age, sex, health, and other characteristics of a person’s life or lifestyle. List them.

The Skeletal System: The Framework

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