Skeletal System Review

206 bones in the body Cranium- 29 bones Spine- 26 bones Thorax- 25 bones Upper limbs- 64 bones Lower limbs- 62 bones

Function Provides structure and support Protects internal organs Provides leverage for lifting and allows movement (through the muscles that attach to the bones) Produces blood cells Stores calcium from the body

Types of bones Long bones Short bones Flat bones Irregular bones Sesamoid bones

Long bones Length of bones is greater than the width Femur Humerus Tibia Radius

Short Bones “blocky”, no relation between width and length Carpals Tarsals

Flat bones Parallel “plates” with layer of spongy bone Scapula Skull

Irregular Bones Complex shape and structure Facial bones Vertebrae

Sesamoid bones Small bones found in tendons Patella Sesamoid of the big toe

Structure of the long bone Diaphysis Long shaft of the bone Epiphysis Growth plate Production of RBCs Medullary Canal Cavity in the diaphysis Filled with yellow marrow Fat cells

Structure of the long bone Endosteum Lining of the medullary canal Keeps yellow marrow intact Periosteum Outside layer of the bone

2 Parts of Skeleton system Axial Skeleton Skull, spinal column, ribs, sternum Appendicular Skeleton Arms and legs, shoulder girdle, pelvic girdle

Fractures A crack or break in the bone 2 types Closed Open, compound

Avulsion Fracture Bone fragment is torn away  occurs on the body where a ligament attaches to the bone Can occur with an ankle sprain

Greenstick Fracture Incomplete break in the long bone shaft, bone is partially bent Usually occurs in children and adolescents

Stress Fracture Caused by repeated stress Ex. Marathon running Indicator is usually persistent pain Bone scan  small fx

Impacted Fracture One bone fragment becomes embedded in another Ex: rodeo sports and contact sports

Longitudinal (linear) Fracture Bone splits or cracks lengthwise Caused by a hard impact Long jumpers

Oblique Fracture One end receives torsion, the other end Is fixed

Spiral Fracture S- shaped fracture Caused by having the foot planted and the upper part of the bone is violently twisted basketball

Transverse Fracture Occurs along the bone shaft at a right angle along the axis Usually caused by a direct blow Contact sports

Commmminuted Fracture Break with 3 or more fragments Contact sports

Standard Treatment- Compound Fracture Apply sterile dressing Stop bleed with pressure point…carefully! Activate EMS

Standard Treatment- Any Fracture Patient comfort Activate EMS Splint

HOW CAN FRACTURES BE CAUSED? Direct Impact Compression Torsion Indirect impact Disease process (cancer) Stress (running) Sudden muscle contraction (seizure)

Splinting A rigid device that holds parts of the body together and limits motion Cardboard SAM Splint Magazinnes Air splint Vacuum splint When splinting, be sure to continuously check the pulse to ensure proper circulation

Joints

Articulations A joint; the point at which two or more bones meet

3 types of joints 1. Fibrous Immovable Includes the bones of the cranium, or skull

3 types of joints 2. Cartilaginous Slightly movable Includes the vertebrae of the spine

3 types of joints 3. Synovial freely movable Includes the elbow, knee, fingers, etc

How do joints stay connected? Tendons- fibrous connective tissue around a joint that connects muscle to bone Ligament- a band of white, fibrous, connective tissue that helps hold bone to bone

Other Parts of the Joint Synovial Fluid- shock absorber, cushions ends of bones to reduce irritation Bursa- sac filled with synovial fluid, reduces friction between tendons, bones, and ligaments Meniscus- cartilaginous disc that reduces friction during movement and adds stability

Ball and Socket joint A round end of the bone fits into a cup-like end of another bone, allowing for a wide range of movement Hip, shoulder https://www.youtube.com/watch?v=RsNFDMyUU3g

Pivot joint A projection fits through a ring made up of bone and ligament, allowing only pivoting movement 1st and 2nd vertebral joints, wrist https://www.youtube.com/watch?v=oPdsRmuI5nk

Hinge joint A joint in which the two surfaces are molded together closely, allowing a wide range of flexion and extension along a single plane. Elbow, knee https://www.youtube.com/watch?v=GFy6GrjtwOM

Saddle joint A joint in which two surfaces, one convex and the other concave, fit together. Thumb https://www.youtube.com/watch?v=xVmvBrOoaP8

Condyloid (Ellipsoid) joint A round or oval end of a bone fits into an oval cavity, allowing all types of movement except pivoting. Wrist, metacarpals https://www.youtube.com/watch?v=8suMd2VXac8

Gliding joint Two facing bone surfaces meet, allowing only gliding movement. Motion is limited by surrounding structures. Wrist, ankle, vertebrae https://www.youtube.com/watch?v=c-rsjPin6v0

Tissue Injury Compression Tension Shear Causes a crush to the tissue Can result in a contusion Tension Force that pulls and stretches tissue Can result in ligament or capsular sprains, muscle strains Shear Force that moves against the parallel organization of collagen fibers

Sprains Overstretching or tearing of ligaments or other connective tissues caused by traumatic twisting of a joint Sx: deformity, crepitation, point tenderness, and immediate swelling

Grade 1/ 1° sprain Minor tearing of the ligament(s) or capsule + mild point tenderness + mild loss of strength - joint laxity - decrease in ROM

Grade 2/ 2° sprain Partial tearing of the ligament(s) or capsule + swelling + point tenderness + decrease in ROM + some laxity, endpoint present Moderate loss of function

Grade 3/ 3° sprain Complete tearing of the ligament(s) or capsule + swelling + point tenderness + laxity, endpoint not present Complete loss of function Abnormal motion Possible deformity

Immediate Treatment Protect Rest Ice Compression Elevate

Follow-up treatment Strengthening exercises Flexibility exercises to increase ROM Braces?

Dislocation An injury resulting from a force that causes a joint to go beyond its normal anatomical limits S&S + point tenderness + loss of strength +loss of motion +swelling +deformity

Subluxation Joint “feels” like it will slip out or dislocate but immediately will go back in

Immediate Treatment Check for pulse and sensation Why? Splint Recheck pulse and sensation Ice Refer to physician

Follow up treatment Same as with a sprain

Synovitis and Bursitis Inflammation of the synovial membrane in a joint, characterized by pain, localized tension and increased pain with movement Bursitis Inflammation of a bursa