Anatomy Physiology Overview Skeletal System Skeletal System n

Anatomy / Physiology Overview Skeletal System

Skeletal System n Composed of organs called bones that give form to the body and, with the joints, allow body motion. The human adult has 206 bones

Skeletal System n Bones must be rigid and unyielding to fulfill their function, but they must also be able to grow and adapt as the human body grows (bone growth is usually complete by late teens) n Bones are just as much living tissue as muscle and skin, a rich blood supply constantly provides the oxygen and nutrients that bones require, each bone also has an extensive nerve supply

BONE FUNCTION v FRAMEWORK: support the body’s muscle, fat & skin v PROTECTION: surround vital organs to protect them v LEVERS: attach to muscles to help give movement v BLOOD PRODUCTION: makes red & white blood cells & platelets v STORAGE: stores most of calcium

Functions n Framework n Bones are as strong or stronger than reinforced concrete. The skeletal system provides structural support for the entire body. n Protection n Delicate tissues and organs are surrounded by skeletal elements. n n The skull protects the brain The vertebral column protects the spinal cord The ribs and sternum protects the heart and lungs The pelvis protects the digestive and reproductive organs

Functions n Levers n Bones work together with muscles to produce controlled, precise movements. The bones serves as points of attachment for muscle tendons. Bones act as levers that convert muscle action to movement. n Storage n Bones store minerals that can be distributed to other parts of the body upon demand. Calcium and phosphorus are the main minerals that are stored in bones. In addition, lipids are stored as energy reserves in the yellow bone marrow.

Functions n Hemopoiesis/Blood Production n Red bone marrow produces red blood cells, white blood cells, and platelets.

Classification of Bones n The bones of the human skeleton have four general shapes Long n Short n Flat n Irregular n n There is also one other category n Sesamoid

Classification of Bones Long Are longer than they are wide. Long bones are bones of the extremities. Short Equal in length & width, cube shaped- wrist, ankle

Flat Thin & broad as scapula, cranial, sternum, ribs Irregular Complex shapes as face & vertebrae

Sesamoid Small bones that are held in place by tendons as patella. Also called floating bones

Structure of Bones n Diaphysis – the long shaft of bone -Contains yellow bone marrow -Made of compact (dense) bone. n Epiphysis – two extremities or ends of bone -Contains the red bone marrow -Made of spongy (lighter) bone. n Epiphyseal line – known as the growth plate -this is the area where the diaphysis and epiphysis meet. In growing bone, it is where cartilage is reinforced and then replaced by bone.

MEDULLARY CAVITY a) Cavity in diaphysis b) Filled with Yellow Marrow YELLOW MARROW a) Inside the medullary cavity b) Mainly fat cells ENDOSTEUM a) Membrane that lines the medullary cavity b) Keeps yellow marrow intact c) Produces some bone growth

RED MARROW a) Found in certain bones such as vertebrae, ribs, sternum, cranium, and proximal ends of humerus and femur b) Produces red blood cells platelets, and some white blood cells c)Bone marrow is important in the manufacture of blood and is involved with the body’s immune systems. § Used in diagnosing blood diseases § Given as transplants to people with defective immune systems n

PERIOSTIUM a) Tough membrane covering on outside of the bone b)Contains blood and lymph cells c)Contains osteoblasts: special cells that form new bone tissue d)Necessary for bone growth, repair, and nutrition ARTICULAR CARTILAGE a)Thin layer covers the epiphysis b)Acts as a shock absorber when two bones meet to form a joint

Skeletal Terminology n Each of the bones in the human skeleton not only has a distinctive shape but also has distinctive external features. Theses landmarks are called bone markings or surface features. Foramen –a tunnel or hole for blood vessels and/or nerves (examples: pelvis, skull). n Fossa – a shallow depression (example: shoulder). n

Skeletal Terminology n Condyle – a smooth, rounded articular process; Knuckle like projection (example: femur, humerus). n Tuberosity – a small, rough projection (example: tibia, pelvis). n Crest- a prominent ridge (example: pelvis). n Sinus – a chamber within a bone, normally filled with air (example: skull).

Skeletal Divisions n The skeletal system consists of 206 separate bones and is divided into 2 DIVISIONS AXIAL- forms main trunk of the body -composed of skull, spinal column, ribs & sternum APPENDICULAR – forms extremities -composed of shoulder, arms, hip & leg bones

The 5 functions of the skeletal system are, support, protection, movement, storage & hemopoesis A. ) true B. ) false

Yellow marrow is used to diagnose blood diseases and is sometimes transplanted A. ) true B. ) false

The long shaft of the bone is the epiphysis A. ) true B. ) false

Where is the "growth plate" located? A. ) proximal end of a bone B. ) distal end of a bone C. ) where diaphysis & ephipysis meet D. ) center of bone

Axial Skeleton n Forms the long axis of the body. n The 80 bones of the axial skeleton can be subdivided into: n n n The 22 bones of the skull plus associated ones (6 auditory bones and the hyoid bone). The 26 bones of the vertebral column. The 24 ribs and the sternum.

Appendicular Skeleton n Forms the limbs and the pectoral and pelvis girdles. n Altogethere are 126 appendicular bones. 32 are associated with each upper limb. n 31 are associated with each lower limb. n

SKULL 1. Composed of cranial & facial bones 2. Cranium a) Rounded structured that surround & protect b) I. III. IV. V. the head Made of 8 bones Frontal Two parietal Two temporal Occipital Ethmoid VI Sphenoid

At birth the Cranium is not a solid bone Spaces called FONTANELS or “soft spots” allow for the enlargement of the skull as the brain grows They turn into solid bone by about 18 months of age

FACIAL BONES a) 14 Facial bones b) Main bones Mandible Maxilla- 2 bones Zygomatic- 2 bones Nasal- 5 bones Palatine- 2 bones SUTURES : AREA WHERE CRANIAL BONES HAVE JOINED TOGETHER

Sinuses : Air Spaces in the bones of the skull Provide strength with less weight Act as chambers for voice Lined with a mucous membrane Foramina: Opening in bones Allow for passage of nerves & blood vessels

VERTREBRAE Spinal Column has 26 bones Protects the spinal cord Provides support for head & trunk Main divisions: Cervical- 7 neck Thoracic -12 attach to ribs Lumbar- 5 at the waist Sacrum 5 fused bones posterior side of pelvis Coccyx- 1 fused tailbone

n Intervertebral disks § Pads of cartilage tissue that separate vertebrae n § Act as shock absorber § Permit bending and twisting movements of vertebral column n

RIBS (cost) n n 12 pairs of long slender bones Attach to thoracic vertebrae on dorsal surface of body n True Ribs § First 7 pairs of ribs § Attach directly to sternum on front of body n False Ribs § Next pairs of ribs § First 3 pairs attach to cartilage of ribs above § Floating ribs § Last two pairs of false ribs § No attachment on front of body

STERNUM n Breastbone Consist of three parts n Manubrium Body or center area Xiphoid process n Two Clavicles attach to the manubrium by ligaments Ribs attach to sternum with costal cartilage to form a cage that protects the heart and lungs

SHOULDER n Shoulder or pectoral girdle n Two CLAVICALS or collarbone Two SCAPULA or shoulder bones n n Scapula provides for attachment of upper arm bone

BONES OF THE ARM HUMERUS: upper arm bone RADIUS: lower arm bone on thumb side ULNA : larger bone of lower that joins olecranon process at proximal end forming the elbow CARPELS- 8 wrist bones on each hand METACARPELS: 5 bones on each hand to form palm PHALANGES: 14 bones on each hand to form thumb fingers n

BONES of PELVIS n 1. Made of two os coxae (coxal or hip bone) n 2. Join with sacrum on dorsal part of body n 3. Join together at a joint called the symphysis pubis on ventral part of body n 4. Each os coax made of three bones that are fused or joined n n n ILIUM ISHIUM PUBIS

5. Contains two recessed areas or sockets called acetabulums that provide for attachment of bones of the legs 6. Obturator foramen- Opening between the ischium and pubis Allows for passage of nerves & blood vessels that go to the legs

Bones of the legs Femur: Thigh bone Patella: Kneecap (floating) Tibia : Long supporting bone of the lower leg medial surface Fibula: smaller bone of lower leg, lateral surface Tarsals: 7 bones of ankles, calcaneous is heel. bone Metarsals: 5 bones forming instep of foot Phalanges: 14 bones on each foot, form toes n

Joints n Joints or articulations exist wherever two bones meet. The function of each joint depends on its anatomy. Each joint reflects a workable compromise between the need for strength and the need for mobility. Ligaments – connect bone to bone. n Bursa – fluid filled sac the reduces friction between soft tissue and bones, also act as shock absorbers. n Meniscus – a cartilage disc between some complex joints for shock absorption, cushioning, and stability. n

Types of Movement n Flexion n Inversion n Extension n Eversion n Abduction n Dorsiflexion n Adduction n Plantar Flexion n Circumduction n Opposition n Rotation (IR /ER) n Protraction n Pronation n Retraction n Supination n Elevation n Depression

Joint Classification n Joints can be classified according to the range of motion they permit. Synathrotic n Amphiarthrotic n Diarthrotic n

Synarthrotic Joints n Immovable joints. n Bones are connected by fibrous tissue or cartilage. n Examples: sutures – found between bones in the skull.

Amphiarthrotic Joints n Slightly movable joints. n Examples: joints between tibia and fibula, joints between vertebrae.

Diarthrotic Joints n Freely moveable joints permitting a wide range of motion. n Ends of the bones are covered by cartilage and held together by synovial capsules filled with synovial fluid. This fluid helps to lubricate the joint and permits smooth movement. n Examples are hips, shoulder, knee, wrist, ankle

Areas where the cranial bones have joined together are called A. ) fontenels B. ) foramina C. ) sutures D. ) sinuses

Spaces or soft spots in the cranium that allow for enlargement of the skull as brain growth occurs are A. ) fontanels B. ) foramina C. ) sutures D. ) sinuses

Exercise and the Skeletal System n Bone is dynamic and changes with the stress put on it. Bone has the ability to alter its strength in response to stress placed on it. n Bones that are positively stressed will increase their density and become stronger over a period of time. Conversely, bones that are adversely stressed will become weakened over time.

Exercise and the Skeletal System n Exercise enables bone to n Increase its deposition of mineral salts and collagen fibers n Become considerably stronger than bones of sedentary individuals n Maintain its strength and integrity

Diseases of skeletal system n ARTHRITIS: Osteoarthritis/ DJD § Group if diseases involving an inflammation of the joints § Two main types: osteoarthritis and rheumatoid arthritis § Osteoarthiritis § Chronic disease that occurs with aging § Symptoms: joint pain, stiffness, aching limited range of motion § Treatment: rest, heat/cold applications, aspirin, antiinflammatory medications, steroid injections, special exercises

RHEUMATOID ARTHRITIS § Rheumatoid arthritis § Chronic inflammatory disease of connective tissues and joints § Three times more common in women § Often begins between ages of 35 and 45 § Progressive attacks cause scars tissue formation and atrophy of bones and muscle tissue, which results in permanent deformity and immobility § Treatment: n Rest and prescribe exercise n Anti-inflammatory medications: n Surgery, or arthroplasty, to replace damaged joints such as hip or knees

OSTEOMYELITIS Inflammation of bone usually caused by pathogenic organism Pathogens causes formation of abscess within bone and accumulation of pus in medullary canal § Symptoms: pain at site, swelling, chills, fever § Treatment is antibiotics for infection § Can result in amputation

Common Disorders of the Skeletal System n Osteoporosis n A condition that produces a reduction in bone mass great enough to compromise normal function. Because bones are more fragile, they break easily and do not repair well.

Osteoporosis n Causes include n n n Decreased estrogen levels (postmenopausal women at greater risk) Poor Nutrition (Vitamin D and Calcium deficiency) Low activity levels Smoking (decreases estrogen levels) Race (Caucasians are at greater risk) Heredity

Fractures n A fracture is a break in a bone. n Fractures are classified according to their external appearance, the sit of the fracture, and the nature of the break in the bone. Some fractures fall into more than one category.

Types of Fractures q n n n Types of fractures § Greenstick: bone is bent and splits causing a crack or incomplete break; common in children § Simple: complete break with no damage to the skin Compound: break in bones that ruptures through skin; increased chance of infection Comminuted: bone fragment or splinters into more than two pieces § Spiral: severe twisting of the bone causes one or more breaks; coming in skiing and skating accidents Depressed: broken piece of skull bone moves inward: common with severe head injuries

Types of Fractures n Comminuted – n Greenstick – a fracture in which one side of the bone is broken and the other side bends; this usually occurs in children whose bones have yet to fully ossify

Types of Fractures Stress fracture – hairline cracks resulting from repeated stress to a bone, and can lead to other fractures Non-Displaced fracture – the bones remain in normal anatomical alignment Displaced fracture – the bones are no longer in anatomical alignment

Fracture Signs and Symptoms n Any athlete who complains of musculoskeletal pain must be suspected of having a fracture. n Deformity – use the opposite limb to provide a mirror image for comparison. n Tenderness – usually sharply localized at the site of the break. n Guarding – inability or refusal to use the extremity because motion increases pain.

Fracture Signs and Symptoms n Swelling and Ecchymosis – fractures are virtually always associated with swelling and bruising of surrounding soft tissues, however these signs are present following almost any injury and are not specific to fractures. n Exposed fragments – in open fractures, bone ends may protrude through the skin or be seen in the open wound.

Fracture Treatment n If a fracture is suspected, appropriate splinting and referral for an x-ray should be accomplished.

REDUCTION Process by which bone is put back into proper alignment n Closed reduction; position bone in alignment, usually with traction, and apply cast or splint to maintain position n Open reduction; surgical repair of bone, and times, insertion of pins, plates and other devices n n

Dislocations n Disruption of a joint so that the bone ends are no longer in contact or in normal anatomical alignment. Joint surfaces are completely displaced from one another. The bone ends are locked in the displaced position, making any attempted joint motion very difficult and very painful. n Frequently, the ligaments at the joint are torn at the time the joint dislocates. Bones is forcibly displaced from joint/ usually in shoulders, fingers, knees & hips

Dislocation Signs and Symptoms n Marked deformity of the joint n Swelling of the joint n Pain at the joint, aggravated by any attempt at movement. n Marked loss of normal joint motion (a “locked” joint)

Dislocation Treatment n All dislocations should be splinted before the athlete is moved. n Immediate transportation to a medical facility. A physician is required to reduce a dislocation.