Chapter 9 Joints Lecture Presentation by Lee Ann

An Introduction to Joints • Learning Outcomes • 9 -1 Contrast the major categories of joints, and explain the relationship between structure and function for each category. • 9 -2 Describe the basic structure of a synovial joint, and describe common synovial joint accessory structures and their functions. • 9 -3 Describe how the anatomical and functional properties of synovial joints permit movements of the skeleton. • 9 -4 Describe the joints between the vertebrae of © 2015 Pearson Education, Inc.

An Introduction to Joints • Learning Outcomes • 9 -5 Describe the structure and function of the shoulder joint and the elbow joint. • 9 -6 Describe the structure and function of the hip joint and the knee joint. • 9 -7 Describe the effects of aging on joints, and discuss the most common age-related clinical problems for joints. • 9 -8 Explain the functional relationships between the skeletal system and other body systems. © 2015 Pearson Education, Inc.

An Introduction to Joints • Articulations • Body movement occurs at joints (articulations) where two bones connect • Joint Structure • Determines direction and distance of movement (range of motion or ROM) • Joint strength decreases as mobility increases © 2015 Pearson Education, Inc.

9 -1 Classification of Joints • Two Methods of Classification 1. Functional classification is based on range of motion of the joint 2. Structural classification relies on the anatomical organization of the joint © 2015 Pearson Education, Inc.

9 -1 Classification of Joints • Functional Classifications • Synarthrosis (immovable joint) • Amphiarthrosis (slightly movable joint) • Diarthrosis (freely movable joint) © 2015 Pearson Education, Inc.

9 -1 Classification of Joints • Structural Classifications • • Bony Fibrous Cartilaginous Synovial

Table 9 -1 Functional and Structural Classifications of Joints (Part 1 of 3). ©

Table 9 -1 Functional and Structural Classifications of Joints (Part 2 of 3). ©

Table 9 -1 Functional and Structural Classifications of Joints (Part 3 of 3). ©

9 -1 Classification of Joints • Synarthroses (Immovable Joints) • Are very strong • Edges of bones may touch or interlock • Four types of synarthrotic joints 1. 2. 3. 4. © 2015 Pearson Education, Inc. Suture Gomphosis Synchondrosis Synostosis

9 -1 Classification of Joints • Suture • Bones interlocked • Are bound by dense fibrous connective tissue • Are found only in skull • Gomphosis • Fibrous connection (periodontal ligament) • Binds teeth to sockets © 2015 Pearson Education, Inc.

9 -1 Classification of Joints • Synchondrosis • Is a rigid cartilaginous bridge between two bones • Epiphyseal cartilage of long bones • Between vertebrosternal ribs and sternum • Synostosis • Fused bones, immovable • Metopic suture of skull • Epiphyseal lines of long bones © 2015 Pearson Education, Inc.

9 -1 Classification of Joints • Amphiarthroses • More movable than synarthrosis • Stronger than freely movable joint • Two types of amphiarthroses 1. Syndesmosis • Bones connected by ligaments 2. Symphysis • Bones separated by fibrocartilage © 2015 Pearson Education, Inc.

9 -1 Classification of Joints • Synovial Joints (Diarthroses) • • Also called movable

9 -2 Synovial Joints • Articular Cartilages • Pad articulating surfaces within articular capsules • Prevent bones from touching • Smooth surfaces lubricated by synovial fluid • Reduce friction © 2015 Pearson Education, Inc.

9 -2 Synovial Joints • Synovial Fluid • Contains slippery proteoglycans secreted by fibroblasts • Functions of synovial fluid 1. Lubrication 2. Nutrient distribution 3. Shock absorption © 2015 Pearson Education, Inc.

9 -2 Synovial Joints • Accessory Structures • • • Cartilages Fat pads Ligaments

9 -2 Synovial Joints • Cartilages • Cushion the joint • Fibrocartilage pad called a meniscus (or articular disc; plural, menisci) • Fat Pads • Superficial to the joint capsule • Protect articular cartilages • Ligaments • Support, strengthen joints • Sprain – ligaments with torn collagen fibers © 2015 Pearson Education, Inc.

9 -2 Synovial Joints • Tendons • Attach to muscles around joint • Help support joint • Bursae • Singular, bursa, a pouch • Pockets of synovial fluid • Cushion areas where tendons or ligaments rub © 2015 Pearson Education, Inc.

9 -2 Synovial Joints • Factors That Stabilize Synovial Joints • Prevent injury by limiting range of motion • • Collagen fibers (joint capsule, ligaments) Articulating surfaces and menisci Other bones, muscles, or fat pads Tendons of articulating bones © 2015 Pearson Education, Inc.

Figure 9 -1 a The Structure of a Synovial Joint. Medullary cavity Spongy bone Periosteum Components of Synovial Joints Joint capsule Synovial membrane Articular cartilages Joint cavity containing synovial fluid Metaphysis Compact bone a Synovial joint, sagittal section © 2015 Pearson Education, Inc.

Figure 9 -1 b The Structure of a Synovial Joint. Quadriceps tendon Patella Joint capsule Femur Synovial membrane Accessory Structures of a Knee Joint Bursa Fat pad Joint cavity Articular cartilage Meniscus Tibia Ligaments Extracapsular ligament (patellar) Intracapsular ligament (cruciate) b Knee joint, sagittal section © 2015 Pearson Education, Inc.

9 -2 Synovial Joints • Injuries • Dislocation (luxation) • Articulating surfaces forced out of position • Damages articular cartilage, ligaments, joint capsule • Subluxation • A partial dislocation © 2015 Pearson Education, Inc.

9 -3 Movements • Three Types of Dynamic Motion 1. Linear movement (gliding) 2. Angular movement 3. Rotation • Planes (Axes) of Dynamic Motion • Monaxial (1 axis) • Biaxial (2 axes) • Triaxial (3 axes) © 2015 Pearson Education, Inc.

Figure 9 -2 Joint Movement. © 2015 Pearson Education, Inc.

Figure 9 -2 Joint Movement (Part 1 of 12). SIMPLE MODEL OF ARTICULAR MOTION Take a pencil as your model and stand it upright on the surface of a desk. The pencil represents a bone, and the desk is an articular surface. A lot of twisting, pushing, and pulling will demonstrate that there are only three ways to move the pencil. © 2015 Pearson Education, Inc.

Figure 9 -2 Joint Movement (Part 2 of 12). Moving the Point Linear motion Possible movement 1 shows the pencil can move. If you hold the pencil upright, without securing the point, you can push the pencil across the surface. This kind of motion is called gliding. You could slide the point forward or backward, from side to side, or diagonally. © 2015 Pearson Education, Inc.

Figure 9 -2 Joint Movement (Part 3 of 12). Changing the Shaft Angle Angular motion Possible movement 2 shows the pencil shaft can change its angle with the surface. With the tip held in position, you can move the eraser end of the pencil forward and backward, from side to side, or at some intermediate angle. © 2015 Pearson Education, Inc.

Figure 9 -2 Joint Movement (Part 4 of 12). Changing the Shaft Angle Circumduction Possible movement 3 shows a complex angular movement. Grasp the pencil eraser and move the pencil in any direction until it is no longer vertical. Now, swing the eraser through a complete circle in a movement called circumduction. © 2015 Pearson Education, Inc.

Figure 9 -2 Joint Movement (Part 5 of 12). Rotating the Shaft Rotation Possible movement 4 shows that the pencil shaft can rotate. If you keep the shaft vertical and the point at one location, you can still spin the pencil around its longitudinal axis in a movement called rotation. No joint can freely rotate because this would tangle blood vessels, nerves, and muscles as they crossed the joint. © 2015 Pearson Education, Inc.

9 -3 Movements • Types of Movement at Synovial Joints • Terms describe: •

9 -3 Movements • Types of Movement at Synovial Joints • Gliding movement •

9 -3 Movements • Angular Movement • Flexion • Angular motion • Anterior–posterior plane • Reduces angle between elements • Extension • Angular motion • Anterior–posterior plane • Increases angle between elements © 2015 Pearson Education, Inc.

9 -3 Movements • Angular Movement • Hyperextension • Angular motion • Extension past

Figure 9 -3 a Angular Movements. Extension Flexion Hyperextension Flexion Extension Flexion Hyperextension Extension

9 -3 Movements • Angular Movement • Abduction • Angular motion • Frontal plane • Moves away from longitudinal axis • Adduction • Angular motion • Frontal plane • Moves toward longitudinal axis © 2015 Pearson Education, Inc.

Figure 9 -3 b Angular Movements. Abduction Adduction b © 2015 Pearson Education, Inc.

Figure 9 -3 c Angular Movements. Adduction c © 2015 Pearson Education, Inc. Abduction

9 -3 Movements • Angular Movement • Circumduction • Circular motion without rotation •

Figure 9 -3 d Angular Movements. d Circumduction © 2015 Pearson Education, Inc.

9 -3 Movements • Types of Movement at Synovial Joints • Rotation • • Direction of rotation from anatomical position Relative to longitudinal axis of body Left or right rotation Medial rotation (inward rotation) • Rotates toward axis • Lateral rotation (outward rotation) • Rotates away from axis © 2015 Pearson Education, Inc.

Figure 9 -4 a Rotational Movements. Head rotation Right rotation Lateral (external) rotation Left

9 -3 Movements • Types of Movements at Synovial Joints • Rotation • Pronation

Figure 9 -4 b Rotational Movements. Pronation Supination b Supination Pronation © 2015 Pearson

9 -3 Movements • Special Movements • Inversion • Twists sole of foot medially • Eversion • Twists sole of foot laterally • Dorsiflexion • Flexion at ankle (lifting toes) • Plantar flexion • Extension at ankle (pointing toes) © 2015 Pearson Education, Inc.

Figure 9 -5 Special Movements (Part 1 of 6). Eversion © 2015 Pearson Education,

Figure 9 -5 Special Movements (Part 2 of 6). Dorsiflexion (ankle flexion) Plantar flexion

9 -3 Movements • Special Movements • Opposition • Thumb movement toward fingers or palm (grasping) • Reposition • Opposite of opposition • Protraction • Moves anteriorly • In the horizontal plane (pushing forward) • Retraction • Opposite of protraction • Moving anteriorly (pulling back) © 2015 Pearson Education, Inc.

Figure 9 -5 Special Movements (Part 3 of 6). Opposition © 2015 Pearson Education,

Figure 9 -5 Special Movements (Part 4 of 6). Retraction © 2015 Pearson Education,

9 -3 Movements • Special Movements • Elevation • Moves in superior direction (up) • Depression • Moves in inferior direction (down) • Lateral flexion • Bends vertebral column from side to side © 2015 Pearson Education, Inc.

Figure 9 -5 Special Movements (Part 5 of 6). Depression © 2015 Pearson Education,

Figure 9 -5 Special Movements (Part 6 of 6). Lateral flexion © 2015 Pearson

9 -3 Movements • Functional Classification of Synovial Joints • • • Gliding Hinge

9 -3 Movements • Gliding Joints • Flattened or slightly curved faces • Limited motion (nonaxial) • Hinge Joints • Angular motion in a single plane (monaxial) • Condylar Joints • Oval articular face within a depression • Motion in two planes (biaxial) © 2015 Pearson Education, Inc.

Figure 9 -2 Joint Movement (Part 7 of 12). Gliding joints, or plane joints, have flattened or slightly curved surfaces that slide across one another, but the amount of movement is very slight. © 2015 Pearson Education, Inc. Movement: Gliding. Slight nonaxial or multiaxial icle Clav Manubrium

Figure 9 -2 Joint Movement (Part 8 of 12). Hinge joints permit angular motion in a single plane, like the opening and closing of a door. © 2015 Pearson Education, Inc. Movement: Angular. Monaxial Humerus Ulna Examples: • Elbow joint • Knee joint • Ankle joint • Interphalangeal joint

Figure 9 -2 Joint Movement (Part 9 of 12). Condylar joints, or ellipsoidal joints, have an oval articular face nestled within a depression on the opposing surface. © 2015 Pearson Education, Inc. Movement: Angular. Biaxial Scaphoid bone Radius Ulna Examples: • Radiocarpal joint • Metacarpophalangeal joints 2– 5 • Metatarsophalangeal joint

9 -3 Movements • Saddle Joints • Two concave, straddled (biaxial) • Pivot Joints • Rotation only (monaxial) • Ball-and-Socket Joints • Round articular face in a depression (triaxial) © 2015 Pearson Education, Inc.

Figure 9 -2 Joint Movement (Part 10 of 12). Saddle joints have complex articular faces and fit together like a rider in a saddle. Each face is concave along one axis and convex along the other. Examples: • First carpometacarpal joint Movement: Angular. Biaxial III II Metacarpal bone of thumb Trapezium © 2015 Pearson Education, Inc.

Figure 9 -2 Joint Movement (Part 11 of 12). Pivot joints only permit rotation. Movement: Rotation. Monaxial Atlas Axis © 2015 Pearson Education, Inc. Examples: • Atlantoaxial joint • Proximal radioulnar joint

Figure 9 -2 Joint Movement (Part 12 of 12). Ball-and-socket joint In a ball-and-socket joint, the round head of one bone rests within a cup-shaped depression in another. © 2015 Pearson Education, Inc. Movement: Angular, circumduction, and rotation. Triaxial Scapula Humerus Examples: • Shoulder joint • Hip joint

9 -3 Movements • Joints • A joint cannot be both mobile and strong • The greater the mobility, the weaker the joint • Mobile joints are supported by muscles and ligaments, not bone-to-bone connections © 2015 Pearson Education, Inc.

9 -4 Intervertebral Joints • C 2 to L 5 spinal vertebrae articulate: • At inferior and superior articular processes (gliding joints) • Between adjacent vertebral bodies (symphyseal joints) © 2015 Pearson Education, Inc.

9 -4 Intervertebral Joints • Intervertebral Discs • Pads of fibrocartilage • Separate vertebral bodies • Anulus fibrosus • Tough outer layer • Attaches disc to vertebrae • Nucleus pulposus • Elastic, gelatinous core • Absorbs shocks © 2015 Pearson Education, Inc.

Figure 9 -6 a Intervertebral joints. Superior articular process Intervertebral Ligaments Ligamentum flavum Posterior longitudinal ligament Anterior longitudinal ligament a Anterior view © 2015 Pearson Education, Inc.

Figure 9 -6 b Intervertebral joints. Superior articular facet Intervertebral Disc Intervertebral foramen Vertebral end plate Intervertebral Ligaments Anulus fibrosus Ligamentum flavum Nucleus pulposus Spinal cord Posterior longitudinal ligament Spinal nerve Interspinous ligament Supraspinous ligament Anterior longitudinal ligament b Lateral and sectional view © 2015 Pearson Education, Inc.

9 -4 Intervertebral Joints • Vertebral Joints • Also called symphyseal joints • As vertebral column moves: • Nucleus pulposus shifts • Disc shape conforms to motion • Intervertebral Ligaments • Bind vertebrae together • Stabilize the vertebral column © 2015 Pearson Education, Inc.

9 -4 Intervertebral Joints • Six Intervertebral Ligaments 1. Anterior longitudinal ligament • Connects anterior bodies 2. Posterior longitudinal ligament • Connects posterior bodies 3. Ligamentum flavum • Connects laminae © 2015 Pearson Education, Inc.

9 -4 Intervertebral Joints • Six Intervertebral Ligaments 4. Interspinous ligament • Connects spinous processes 5. Supraspinous ligament • Connects tips of spinous processes (C 7 to sacrum) 6. Ligamentum nuchae • Continues supraspinous ligament (C 7 to skull) © 2015 Pearson Education, Inc.

9 -4 Intervertebral Joints • Damage to Intervertebral Discs • Slipped disc • Bulge in anulus fibrosus • Invades vertebral canal • Herniated disc • Nucleus pulposus breaks through anulus fibrosus • Presses on spinal cord or nerves © 2015 Pearson Education, Inc.

Clinical Note 9 -1 a Damage to Intervertebral Discs. T 12 Normal intervertebral disc L 1 Bulging disc L 2 a A lateral view of the lumbar region of the spinal column, showing a bulging intervertebral disc © 2015 Pearson Education, Inc.

Clinical Note 9 -1 b Damage to Intervertebral Discs. Compressed area of spinal nerve Spinal cord Nucleus pulposus of herniated disc Anulus fibrosus b A sectional view through a herniated disc, showing the release of the nucleus pulposus and its effect on the spinal cord and adjacent spinal nerves © 2015 Pearson Education, Inc.

9 -4 Intervertebral Joints • Movements of the Vertebral Column 1. 2. 3. 4.

Table 9 -2 Joints of the Axial Skeleton (Part 1 of 3). © 2015

Table 9 -2 Joints of the Axial Skeleton (Part 2 of 3). © 2015

Table 9 -2 Joints of the Axial Skeleton (Part 3 of 3). © 2015

9 -5 The Shoulder Joint • • Also called the glenohumeral joint Allows more motion than any other joint Is the least stable Supported by skeletal muscles, tendons, ligaments Ball-and-socket diarthrosis Between head of humerus and glenoid cavity of scapula © 2015 Pearson Education, Inc.

9 -5 The Shoulder Joint • Socket of the Shoulder Joint • Glenoid labrum

9 -5 The Shoulder Joint • Processes of the Shoulder Joint • Acromion (clavicle) and coracoid process (scapula) • Project laterally, superior to the humerus • Help stabilize the joint © 2015 Pearson Education, Inc.

9 -5 The Shoulder Joint • Shoulder Ligaments • • • Glenohumeral Coracoacromial Coracoclavicular Acromioclavicular • Shoulder Separation • Dislocation of the shoulder joint © 2015 Pearson Education, Inc.

9 -5 The Shoulder Joint • Shoulder Muscles (Rotator Cuff) • • Supraspinatus Infraspinatus

9 -5 The Shoulder Joint • Shoulder Bursae • • Subacromial Subcoracoid Subdeltoid Subscapular

Figure 9 -7 a The Shoulder Joint. Acromioclavicular Coracoacromial Coracoclavicular ligaments ligament Tendon of supraspinatus muscle Acromion Clavicle Articular capsule Subdeltoid bursa Coracoid process Scapula Synovial membrane Articular cartilages Humerus Joint cavity Glenoid labrum Articular capsule a Anterior view, frontal section © 2015 Pearson Education, Inc.

Figure 9 -7 b The Shoulder Joint. Ligaments Stabilizing the Shoulder Joint Subcoracoid bursa Clavicle Tendon of biceps brachii muscle Acromioclavicular ligament Subacromial bursa Muscles and Tendons of the Rotator Cuff Coracoclavicular ligaments n io m ro c A Coracoacromial ligament Coracohumeral ligament (cut) Tendon of supraspinatus muscle Glenohumeral ligaments Tendon of infraspinatus muscle Subscapular bursa Glenoid cavity Teres minor muscle Glenoid labrum Subscapularis muscle Articular capsule Scapula b Lateral view of pectoral girdle © 2015 Pearson Education, Inc.

9 -5 The Elbow Joint • A stable hinge joint • With articulations involving

9 -5 The Elbow Joint • Joints of the Elbow • Humeroulnar joint •

9 -5 The Elbow Joint • Joints of the Elbow • Humeroradial joint •

Figure 9 -8 a The Right Elbow Joint Showing Stabilizing Ligaments. Humerus Radial collateral ligament Radial tuberosity Antebrachial interosseous membrane Radius Ulna Capitulum Annular ligament (covering head and neck of radius) a © 2015 Pearson Education, Inc. Lateral view

9 -5 The Elbow Joint • Supporting Structures of the Elbow • Biceps brachii muscle • Attached to radial tuberosity • Controls elbow motion • Elbow ligaments • Radial collateral • Annular • Ulnar collateral © 2015 Pearson Education, Inc.

Figure 9 -8 b The Right Elbow Joint Showing Stabilizing Ligaments. Tendon of biceps brachii muscle Annular ligament Articular capsule Antebrachial interosseous membrane Medial epicondyle Ulnar collateral ligament Radius Ulna Olecranon of ulna b © 2015 Pearson Education, Inc. Humerus Medial view

9 -6 The Hip Joint • Also called coxal joint • Strong ball-and-socket diarthrosis

9 -6 The Hip Joint • Structures of the Hip Joint • Head of

9 -6 The Hip Joint • Ligaments of the Hip Joint • • •

Figure 9 -9 a The Right Hip Joint. Iliofemoral ligament Articular cartilage Acetabular labrum Ligament of the femoral head Acetabulum Transverse acetabular ligament (spanning acetabular notch) Fat pad in acetabular fossa a A lateral view with the femur removed © 2015 Pearson Education, Inc.

Figure 9 -9 b The Right Hip Joint. Pubofemoral ligament Greater trochanter Iliofemoral ligament

Figure 9 -9 c The Right Hip Joint. Iliofemoral ligament Ischiofemoral ligament Greater trochanter Lesser trochanter Ischial tuberosity c A posterior view, showing additional ligaments that add strength to the capsule © 2015 Pearson Education, Inc.

9 -6 The Knee Joint • A complicated hinge joint • Transfers weight from femur to tibia • Articulations of the knee joint • Two femur–tibia articulations • At medial and lateral condyles • One between patella and patellar surface of femur © 2015 Pearson Education, Inc.

9 -6 The Knee Joint • The Articular Capsule and Joint Cavity • Medial and lateral menisci • • Fibrocartilage pads At femur–tibia articulations Cushion and stabilize joint Give lateral support © 2015 Pearson Education, Inc.

9 -6 The Knee Joint • Seven Major Supporting Ligaments 1. Patellar ligament (anterior) 2. & 3. Two popliteal ligaments (posterior) 4. & 5. Anterior and posterior cruciate ligaments (inside joint capsule) 6. Tibial collateral ligament (medial) 7. Fibular collateral ligament (lateral) © 2015 Pearson Education, Inc.

Figure 9 -10 a The Right Knee Joint. Quadriceps tendon Joint capsule Patellar retinaculae Tibial collateral ligament Patellar ligament Fibula Tibia a Anterior view, superficial layer © 2015 Pearson Education, Inc. Ligaments that Stabilize the Knee Joint Fibular collateral ligament

Figure 9 -10 b The Right Knee Joint. Patellar surface Ligaments that Stabilize the Knee Joint Posterior cruciate ligament Anterior cruciate ligament Lateral condyle Medial condyle Tibial collateral ligament Menisci Medial Fibular collateral ligament Tibia Cut tendon of biceps femoris muscle Fibula b Deep anterior view, flexed © 2015 Pearson Education, Inc. Lateral

Figure 9 -10 c The Right Knee Joint. Plantaris muscle Gastrocnemius muscle, lateral head Gastrocnemius muscle, medial head Femur Ligaments that Stabilize the Knee Joint Bursa Tibial collateral ligament Joint capsule Fibular collateral ligament Popliteal ligaments Popliteus muscle Cut tendon of biceps femoris muscle Tibia Fibula c Posterior view, superficial layer © 2015 Pearson Education, Inc.

Figure 9 -10 d The Right Knee Joint. Femur Ligaments that Stabilize the Knee Joint Anterior cruciate ligament Fibular collateral ligament Posterior cruciate ligament Medial condyle Lateral condyle Menisci Lateral Medial Cut tendon Tibia Fibula d Deep posterior view, extended © 2015 Pearson Education, Inc.

Table 9 -3 Joints of the Appendicular Skeleton (Part 1 of 2). © 2015

Table 9 -3 Joints of the Appendicular Skeleton (Part 2 of 2). © 2015

9 -7 Effects of Aging on Joints • Degenerative Changes • Rheumatism • A pain and stiffness of skeletal and muscular systems • Arthritis • All forms of rheumatism that damage articular cartilages of synovial joints • Osteoarthritis • Caused by wear and tear of joint surfaces, or genetic factors affecting collagen formation • Generally in people over age 60 © 2015 Pearson Education, Inc.

9 -7 Effects of Aging on Joints • Rheumatoid Arthritis • An inflammatory condition • Caused by infection, allergy, or autoimmune disease • Involves the immune system • Gouty Arthritis • Occurs when crystals (uric acid or calcium salts) • Form within synovial fluid • Due to metabolic disorders © 2015 Pearson Education, Inc.

9 -7 Effects of Aging on Joints • Joint Immobilization • Reduces flow of synovial fluid • Can cause arthritis symptoms • Treated by continuous passive motion or CPM (therapy) • Bones and Aging • Bone mass decreases • Bones weaken • Increases risk of hip fracture, hip dislocation, or pelvic fracture © 2015 Pearson Education, Inc.

9 -8 Integration with Other Systems • Bone Recycling • Living bones maintain equilibrium

9 -8 Integration with Other Systems • Factors Affecting Bone Strength 1. 2. 3. 4. 5. Age Physical stress Hormone levels Calcium and phosphorus uptake and excretion Genetic and environmental factors © 2015 Pearson Education, Inc.

9 -8 Integration with Other Systems • Bones Support Body Systems • Support and protect other systems • Store fat, calcium, and phosphorus • Manufacture cells for immune system © 2015 Pearson Education, Inc.

9 -8 Integration with Other Systems • Bones Support Body Systems • Disorders in other body systems can cause: • • Bone tumors Osteoporosis Arthritis Rickets (vitamin D deficiency) © 2015 Pearson Education, Inc.