BonesMiss Ulrich

Cartilage

Connective tissue

Most of the skeleton is initially formed by fast-growing cartilage. This is replaced by bone tissue in the fetal and childhood periods

Consists primarily of water (60-80%) and is very resilient --> has the ability to spring back to original shape after being compressed

Types of Cartilage Hyaline: most common

form of cartilage

Provides support through flexibility and resilience.

Makes up articular cartilage (covers the ends of adjoining bones in movable joints

Also forms the cartilaginous attachments of the ribs to sternum.

Most of the cartilage found in the respiratory structures and the embryonic skeleton

Types of Cartilage

Elastic: similar to hyaline but more elastic

Better to tolerate repeated bending

Epiglottis is made up of elastic cartilage

Fibrocartilage: unusual tissue that resist both strong compression and strong tension (pulling) forces.

In certain ligaments (i.e., discs between vertebrae and menisci of the knee)

Classification of Bones

Bone are classified by their shape:

1.Long bones: most bones in the limbs are long bones

2.Short bones: roughly cubed shaped. Occur in wrist and ankle

3.Flat bones: thin, flattened, and usually somewhat curved. Most cranial bones, ribs, sternum, scapula

4.Irregular bones: various shapes and do not fit into other categories . Hip bones, vertebrae.

The Skull

a bony structure Support the structure of the face and creates a

cavity for the brain provides attachments for the head and neck

muscles At birth, the skull is large in comparison to the

rest of the body, and a baby's skull is compressible. The "soft spots" in a baby's head harden and grow together until the bones meet and mesh like a jigsaw puzzle.

The largest of the six main soft spots is a diamond-shaped area near the middle of the top of the skull. This is the last area to harden and close, usually at about the age of eighteen months.

The Mandible

Largest, strongest bone of the face

Our Jaw

Serves for the reception of the lower teeth

Temporomandibular Joint (TMJ) is the joint that acts as a hinge as well as gliding mechanism

The Spine The three types of vertebra

Cervical vertebrae contain three holes Located in the neck

Thoracic vertebrae have a long, thin spinous process that is angled downward (it looks like a giraffe)

The lumbar vertebrae have a short spinous process that is flat and sticks straight out (it looks like a moose)

The sacrum and coccyx bones

The sacrum is a triangular shaped bone with many openings for nerves It is located in the back of

the pelvis

Between the red brackets

The coccyx bone is the tailbone that hangs down from the sacrum The blue arrows point to

the coccyx

Where are the back bones located on the body?

The cervical is in the neck Fracture often leads to paralysis or

death The thoracic is in the upper back

Most common fracture of the spine along with lumbar

The lumbar is in the lower back Most common fracture of the spine

along with thoracic Severe back pain, if spinal cord

involved: numbness, tingling, weakness, bowel/bladder dystfunction

The sacrum is below the lumbar vertebra Low back pain, buttock, or hip pain,

pain in the groin and front portion of thigh. Weakness is lower limbs, bladder control

The coccyx hangs off the sacrum Common from falls. More common in

females due to wider pelvis

cervical

thoracic

lumbar

sacrum

coccyx

The clavicle

The clavicle is the only ‘s’ shaped bone in the body…it is our collar bone

Acts as braces (hold scapulae and arms out laterally from thorax)

Commonly fractured. Usually by a fall

Signs and Symptoms: Sharp pain with movement Swelling Referred pain Possible nausea, dizziness

Treatment: rest and sling

clavicle

The Scapula

The scapula is your shoulder blade The scapula contains a large

ridge on the posterior side that is referred to as the scapular spine (the red arrow points to the scapular spine)

Fracture is caused by blunt trauma

Symptoms: Extreme pain when moving arm Swelling around back of

shoulder Skin abrasions

Treatment: sling works for most fractures. Sometimes hospitalized

The Sternum

The sternum is the breastbone The sternum is composed of three

bones (specifically) The manubrium is the enlarged

upper section The body is the blade-like center

section The xiphoid process is the

downward projection from the body of the sternum

Fracture caused by blunt trauma Symptoms:

Pain, tenderness, bruising, swelling, may be bent or deformed

Treatment: reducing pain and limiting movement. Fractures often come with internal injuries

The Ribs A thin curved bone The body has 12 pairs of ribs All attach to the thoracic

vertebrae posteriorly and run to the front of the chest

The top 7 pairs attach directly to the sternum and are called true ribs

The bottom 5 pairs attach to the sternum either indirectly or not at all and are called false ribs

Middle ribs are most commonly fractured, usually from direct blows. The 7th and 10th rib are most commonly fractured.

Symptoms: pain/ grating sound while breathing or with movement

The Humerus

The humerus is the upper arm bone It has a large round

knob at the proximal end which fits into the cavity of the scapula

This creates a “ball and socket joint”

Fracture symptoms: severe bone pain, swelling, bruising, tenderness

Treatment: hanging cast, surgery

The Ulna

The ulna is a forearm bone that has a ‘u’ shape at the proximal end Red arrow indicates the

bone Slightly longer than the

radius Main bone forming the

elbow joint with the humerus

Looks like a monkey wrench

Causes of fractures: sporting accident, repetitive stress

Symptoms: pain, swelling, arm deformity tenderness

The Radius

The radius is the forearm bone that has a ‘golf tee’ like dip in the proximal endRotates over the ulna

when pronating

Most common fracture in the arm

Casting, surgery

Carpals, metacarpals and phalanges of the hand (general)

The carpals are the wrist bones

The metacarpals are the bones of the palm of the hand

The phalanges of the hand are the finger bones

These bones will be asked on articulated hands (assembled together)

Most injuries result from direct trauma

Treatment: casting, splints, pins, metal plates/screws

carpals

metacarpals

phalanges

The Coxal bone The coxal bone is the hip

bone. Three bones make up the

coxal Ischium is the rough thick

section, it is what you sit on (green color)

Ilium is the large, flat upper section (cream color)

Pubis is the thin, curved anterior, inferior section of the coxal bone (orange color)

Fractures are difficult to heal. 90% are in patients 65 or over.

The Femur The femur is the thigh

bone Largest, longest, and

strongest bone of the body and highly vascular

The femur has a round knob on the proximal end on the medial side

The main shaft of the bone bows forward

Most fractures are treated surgically

Up to 40% require blood transfusion

The PatellaKnee cap (looks like

a little rock)Protects the anterior

articular surface of the knee joint

Functional role: knee extensionIncreases the

leverage that the tendon can exert on the femur by increasing the angle at which it acts

Dislocations occur with significant regularity, particularly in young female athletes-Patella slides out of position, with intense pain and swelling-Can be tracked back into place with extension of the knee

The Tibia

The large bone of the lower leg, the proximal end is more enlargedWeight baring

Medial malleolus is the medial projection at the distal end

Shaft fractures are most common

Cast is most common treatment, rodding may also take place

The Fibula

Smaller, thinner bone of the lower leg

The lateral malleolus is the lateral projection at the distal end of the bone

Most common fracture comes from an rolling your ankle inwards

The FootTarsals, metatarsals, and phalanges (general)

Tarsals are the ‘ankle bones’

Metatarsals are the bones of the flat part of the food

Phalanges of the foot are the bones of the toes

Fractures in the foot are very common

tarsals

metatarsals

phalanges

Disorders of Bones

OsteoporosisThe most common type of bone disease. (1 out of 5 women over the age of 50)

Occurs when the body fails to form enough new bone, when too much old bone is reabsorbed by the body, or both.

Calcium and Phosphate are two minerals that are essential for normal bone formation

Disorders of Bones (cont’d)

As you age, calcium and phosphate may be reabsorbed back into the body from the bones, which makes tissue weaker. Results in: brittle, fragile

bones that are prone to fractures. Even without injury

Loss usually occurs gradually over the years.

Leading cause are a drop in estrogen in women at the time of menopause and a drop in testosterone in men

Higher risk in women over the age of 50 and men over the age of 70

Testing: bone mineral density test, spine CT, spine or hip x-ray

Disorders of Bones (cont’d)

OsteosarcomaCancerous bone tumor

Develops during the period of rapid growth that occurs in adolescence.

Average age at diagnosis is 15 (between the age of 10-25)

Males and females have similar incidence until late adolescence, when males are more commonly affected.

Disorders of Bones (cont’d)

Cause is unknown.

Commonly occurs in the bones of the:

Shin (near the knee)

Thigh (near the near)

Upper arm (near the shoulder)

In large bones and in the area of bone with fastest growth rate

Complications:

Limb removal

Spread of cancer to the lungs

Side effects of chemotherapy

Testing: biopsy, blood tests, bone scan, CT scan, x-ray)

Disorders of Bones (cont’d)

Scoliosis The “twisted disease”

3 general causes:

Congenital (present at birth)- due to a problem with the formation of the vertebrae or fused ribs during development in the womb or in early life

Neuromuscular: poor muscle control or muscle weakness, or paralysis due to diseases such as cerebral palsy, muscular dystrophy, etc.

Idiopathic scoliosis- unknown cause. Most common in adolescents

Most cases occur is girls

Disorders of Bones (cont’d)

Scoliosis Symptoms:

One shoulder appears to be higher than the other

Pelvis appears to be tilted

Backache or low-back pain

Fatigue

Shoulders or hips appear uneven

Spine curves abnormally to the side (laterally)

Testing: Scoliometer screening (measure curvature of the spine), spine X-rays, MRI)