skeletal system ch. 23 - florida technical...

Skeletal System

Ch. 23

Dr. Ken Thorson

Lesson Objectives

Upon completion of this lesson, students should be able to:

1.Define and spell the terms to learn for this chapter.

2.List the various types of bones in the body.

3.Identify specific bones for each bone classification.

Lesson Objectives

Upon completion of this lesson, students should be able to:

4.Discuss the functions of the bones of the human skeleton.

5.Explain various types of joints and body movements.

6.Describe the axial skeleton.

7.Describe the appendicular skeleton.

Skeletal System

• Makes up framework of the human body

• Responsible for:

• Providing shape and support

• Protecting internal organs

• Serving as a storage place for mineral salts, calcium, and phosphorus

Skeletal System

• Responsible for:

• Plays important role in formation of blood cells

• Providing an area for attachment of skeletal muscles

Skeletal System

• Two divisions compose skeletal system

• 206 bones

• Axial skeleton made of 80 bones

• Appendicular skeleton consists of remaining 126 bones

FIGURE 23-1 Anterior and posterior human skeleton.

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Bones and Their Classification

• Bones consist of 50 percent water

• Remaining 50 percent is a rigid, calcified substance known as osseous tissue

FIGURE 23-2 Microscopic components of osseous tissue.

TABLE 23-1 Microscopic Components of Osseous

Tissue

TABLE 23-1 (continued) Microscopic Components of Osseous

Tissue


• Bones classified according to shape

• Six common shapes of bones are:

• Long

• Short

• Flat

• Irregular

• Sesamoid

• Sutural (wormian)

FIGURE 23-3 Classification of bones by shape.


• Six Main Functions of Bones

• Provide shape, support, framework of body

• Provide protection for body’s internal organs

• Serve as a storage place for mineral salts, calcium, and phosphorus


• Six Main Functions of Bones

• Play important role in formation of blood cells as hemopoiesis takes place in bone marrow

• Provide area for attachment of skeletal muscle

• Help to make movement possible through articulation

Structure of a Long Bone

• Epiphysis

• Ends of a developing bone

• Diaphysis

• Shaft of the long bone

• Periosteum

• Membrane that forms the covering of bones, except at their articular surfaces


• Compact bone

• Dense, hard layer of bone tissue

• Medullary canal

• Narrow space or cavity throughout the length of the diaphysis that contains yellow bone marrow, which is made of fat cells


• Endosteum

• Tough, connective tissue membrane lining the medullary canal and containing the bone marrow

• Cancellous or spongy bone

• Reticular tissue that makes up most of the volume of bone

FIGURE 23-4 The features found in a long bone.

Bone Markings

• Condyle

• Crest

• Epicondyle

• Line

• Process

• Trochanter

• Tubercle

• Tuberosity

Joints and Movement

• A joint, called an articulation, is located at the place where two bones connect

Joints and Movement

• Joints classified according to the type of movement they provide

• Synarthrotic joint

• Produces no movement (Sutures- connect bones of the skull)

• Amphiarthrotic joint

• Permits very slight movement (intervertebral joints of spinal column)

• Diarthrotic joint

• Allows for free movement in a variety of directions (knee,elbow,shoulder)

FIGURE 23-5 A typical joint.

Joints and Movement

• Movements of the Body

• Abduction

• Moving a body part away from the midline

• Adduction

• Moving body part toward midline

• Circumduction

• Moving a body part in a circular motion

Joints and Movement


• Dorsiflexion

• Bending a body part backward

• Eversion

• Turning outward

• Extension

• Straightening a flexed limb

• Flexion

• Bending (or curving) the spine

Joints and Movement


• Inversion

• Turning inward

• Pronation

• Lying prone or face down; turning the hand so that the palm points downward

• Protraction

• Moving a body part forward

Joints and Movement


• Retraction

• Moving a body part backward

• Rotation

• Moving body part around central axis

• Supination

• Lying supine or face upward; process of turning the palm or foot upward

TABLE 23-3 Movements of the Body

TABLE 23-3 (continued) Movements of the Body

FIGURE 23-7 A contrasting comparison of the axial and

appendicular skeleton.

The Axial Skeleton

• Central portion of the skeleton

• Skull

• Sternum

• Ribs

• Vertebrae

• Sacrum

• Coccyx

• Head composed of 22 bones; skull has 8 bones, and bones of the face

The Axial Skeleton

• Vertebral column, which houses the spinal cord, consists of a series of vertebrae

• Vertebrae divided into five regions

• Cervical

• Thoracic

• Lumbar

• Sacral

• Coccyx, or tailbone

The Axial Skeleton

• Ribs

• Form protective cage that houses heart, lungs, other vital components of body

• Rib cage consists of 12 pairs of ribs divided into three categories: true, false, floating ribs

The Appendicular Skeleton

• Responsible for movement

• Upper extremities

• Lower extremities

• Clavicles

• Scapula

• Pectoral girdle

The appendicular skeleton.


• Upper extremity bones

• Humerus

• Radius

• Ulna

• Carpals

• Metacarpals

• Phalanges


• Lower extremity bones

• Femur

• Patella

• Tibia

• Fibula

• Tarsals

• Metatarsals

• Phalanges

FIGURE 23-13A The male pelvis

FIGURE 23-13B The female pelvis

Critical Thinking Questions

1.How can you remember the difference between the ulna and the radius?

2.How can you remember the difference between the carpals and metacarpals?

Common Disorders Associatedwith the Skeletal System

• Scoliosis

• Abnormal lateral curvature of the spine

• Often diagnosed early in toddlers, children, and adolescents

• Appears to have an S or C shape

• May often appear as if either their shoulders or their legs are uneven

• Treatment: orthopedic braces, physical therapy, and in severe cases, surgery


• Lordosis

• Often called swayback

• Exaggerated curvature of lumbar spine

• When diagnosed in adults, may be commonly found in those who are overweight and in pregnant women

• When diagnosed in children, most common symptom is prominently protruding abdomen and/or buttocks


• Lordosis

• Treatment depends on patient’s overall health, age, and severity of condition

• Overall goal of treatment is to stop the curvature and prevent spinal deformity


• Kyphosis

• Sometimes known as humpback

• Exaggeration of thoracic curvature


• Kyphosis

• May be result of:

• Congenital defect

• Disease process

• Compression fracture

• Faulty posture, osteoarthritis

• Rheumatoid arthritis, rickets, osteoporosis, or other conditions


• Kyphosis

• Rounded appearance of upper back

• Fatigue, mild back pain, either tender or stiff feeling within the spine

• In severe cases, shortness of breath


• Kyphosis

• Treatment depends on overall health and age of patient as well as cause or source of disease

• Physical therapy or bone-strengthening medications

Kyphosis.

Lordosis.

Scoliosis.


• Arthritis

• Inflammation of one or more joints

• Causes include:

• Joint injury

• Autoimmune disorders

• Normal to excessive wear and tear on joints

• Can occur at any age

• Most commonly develops in older adults


• Arthritis

• Signs and symptoms vary with every patient

• Joint pain and swelling

• Morning stiffness

• Warmth and redness around a joint

• Decreased ability to move the joint


• Arthritis

• Treatment depends on age, occupation, other activities of patient, cause and severity, joint affected

• Modification to daily activities and low-impact aerobic exercise


• Arthritis

• Medications to reduce joint pain and swelling

• Application of heat or cold

• Joint protection

• Surgery


• Osteoarthritis

• Most common type of arthritis resulting from years of wear and tear on joints

• Most frequently occurs in hips, knees, and finger joints of elderly patients

• Obesity, history of trauma, various genetic and metabolic diseases increase the risk of osteoarthritis

• Referred to as degenerative joint disease (DJD)


• Osteoarthritis

• Swelling and fluid accumulation around joints

• Aching pain associated with changes in the weather

• Permanent joint deformity may occur


• Osteoarthritis

• Treatment

• Nonsteroidal antiinflammatory drugs (NSAIDs)

• Steroid injections to affected joint

• In severe cases, joint replacement

osteoarthritis


• Rheumatoid Arthritis

• Autoimmune disorder in which inflammation causes joints to become deformed

• Increased growth of both cartilage and bone

• Marked by inflammation, joint swelling, and joint deformity



• Morning joint stiffness very common

• Fatigue and loss of appetite

• Smaller joints of body are affected along with the surrounding tissue



• There is no cure

• Early detection, diagnosis, and treatment may deter pain and joint decay



• Medications

• Antirheumatic drugs

• Nonsteroidal antiinflammatory drugs

• Corticosteroids

• Heat and cold treatments

• Low impact exercises

rheumatoid arthritis.


• Gouty Arthritis

• Also called gout

• Caused by formation and accumulation of uric acid crystals in the joints that result from high levels of uric acid in bloodstream

• Accumulation of these crystals leads to inflammation

• Gouty joint often very warm and very sore to the touch


• Gouty Arthritis

• After joints have been persistently affected by gout, they may become disfigured

• Medications available to reduce uric acid

• Diet rich in colorful fruits and vegetables

• Dietary restrictions include avoiding caffeine, alcohol, liver, and other purine-rich foods

Gouty arthritis of the finger joint.


• Bursitis

• Bursa is small sac of fluid that cushions and lubricates an area where joint-related tissues rub against one another

• Bursitis is inflammation of the bursa

• Joint pain

• Limited joint mobility

• Swelling

• Tenderness surrounding the joint


• Bursitis

• Rest

• Pain medication

• Steroid injections

• Aspiration of excess fluid from the bursa

• Antibiotics

• Physical therapy may be utilized to increase and promote joint movement


• Carpal Tunnel Syndrome

• Carpal tunnel narrow passageway in wrist

• Occurs when pressure placed on median nerve

• Repetitive movements involving the wrist may contribute to the condition



• Risk factors include obesity, diabetes, and rheumatoid arthritis

• Pain with numbness and hand weakness

• Hands and fingers may feel tingly, itchy, and swollen, even if swelling is not visibly present



• Wrist splints at night for several weeks

• Hot and cold compresses

• Resting the hand and wrist

• Proper ergonomics



• NSAIDs such as ibuprofen or naproxen to relieve pain and reduce inflammation

• Diuretics

• Injections of corticosteroids

• Surgical procedure

tendons and nerves involved in carpal tunnel syndrome.


• Fractures

• Bone cracks or breaks

• Classified based on:

• Site of fracture

• Nature of crack or break

• Whether or not fracture has caused a break in skin

• Diagnosed based on X-ray of the broken bone


• Types of Fractures

• Closed (simple)

• Does not involve a break in the skin and is completely internal.

• Open (compound)

• More dangerous fractures because fracture has broken through the skin. Risk of infection or hemorrhage is greater than with a closed fracture.



• Comminuted

• Part of the bone is shattered into a multitude of bony fragments.

• Transverse

• Break the shaft of bone across its longitudinal access.



• Greenstick

• Usually occurs in young children. Only one side of shaft is broken; the other side is bent, similar to breaking a green plant stick.

• Spiral

• Spread along length of a bone and produced by twisting stresses.



• Pott

• Occur in the ankle and affect both bones of the lower leg (tibia and fibula).

• Compression

• Occur in vertebrae after severe stress, such as when someone falls and lands with significant amount of force.



• Epiphyseal

• Commonly seen in children in areas of bone where growth plate is undergoing calcification and the chondrocytes are dying.

Various types of fractures.


• Fractures

• Generally casted by a physician

• At times, in severe fractures, surgical intervention must be performed

• Common that both pins and metal plating used to stabilize joints and bones during surgery

• Pain and antiinflammatory medications often prescribed for patient comfort


• Dislocations

• Occurs when a bone slips out of the joint

• Usually follows a blow, a fall, or other trauma

• Usually joint capsule and ligaments tear when a dislocation occurs

• Often the nerves are injured


• Dislocations

• May be visibly out of place

• Discolored

• Misshapen

• Limited in movement

• Bruised or swollen

• Intensely painful

• Very difficult to move the affected joint


• Dislocations

• Patients should seek emergency treatment in hospital or urgent care setting

• Many physicians’ offices not equipped to handle this injury

• Procedure known as reduction used to align and reposition the joint

• Pain relievers and antiinflammatory medications


• Osteoporosis

• Characterized by progression of loss of bone density and thinning of bone tissue

• Affects more than 25 million Americans, mostly women ages 50 to 70 years old

• Subject to increased fracture potential, especially in the hips, vertebrae, wrists

Critical Thinking Question

1.Why might an individual be more at risk for developing osteoporosis?


• Higher Risk of Developing Osteoporosis

• Family history of osteoporosis

• Those who do not engage in weight-bearing exercise as part of their lifestyle

• Caucasian women who have never been pregnant and experience early menopause

• Individuals with history of frequent corticosteroid use


• Higher Risk of Developing Osteoporosis

• Individuals who excessively smoke, drink alcohol, and consume diets high in salt, fat, and caffeine

• Individuals who have insufficient intake of calcium or vitamin D


• Osteoporosis

• Decreased height and stooped posture

• Back pain and frequent fractures

• Treatment includes:

• Calcium and vitamin D supplementation

• Medications to help preserve calcium and decrease bone loss

• Exercise


• Hallux Valgus

• Also called a bunion

• Enlargement of inner portion of metatarsophalangeal joint at base of big toe

• Reddened skin surrounds the inflamed joint of the big toe

• Joint may be filled with fluid and feel tender to the touch


• Hallux Valgus

• Properly fitting shoes should be worn

• Proper padding and cushioning of the joint

• Pain medications and antiinflammatory medications


• Hallux Valgus

• Foot surgery may be required for severe cases

• Patient may need to be fitted with special adaptive shoes made by orthopedic shoe specialist


• Hammer Toe

• Toe bends into hammer shape or claw shape because of abnormal flexion of proximal interphalangeal joint

• Frequently caused by wearing shoes that are too narrow or too short or wearing extremely high heels that force the toe to bend

• Pain and visible joint deformation


• Rickets

• Early childhood disease caused by deficiency in calcium, vitamin D, and phosphate

• Results in bone deformities, especially bowed legs

• Genetics may increase risk of developing rickets


• Rickets

• Pain and tenderness of the bones

• Increased likelihood of bone breakage

• Impaired growth and decreased height

• Muscle cramps

• Treatment: increasing vitamin and mineral intake and comfort measures, including rest and heat and ice applications


• Osteomalacia

• Adult onset of rickets

• Causes: deficiencies in calcium and vitamin D

• Additional causes: cancers, liver disease, kidney failure, side effects associated with antiseizure medications


• Osteomalacia

• Bone pain, bowing legs, frequent fractures

• Treatment similar to rickets: increasing vitamin and mineral intake and comfort measures to relieve symptoms

skeletal system ch. 23 - florida technical...

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