Chapter 3 Medical Terminology and Chapter 6 Body Structures THE SKELETAL SYSTEM Med Term book chapter 4, pages 94 – 113. Exercises: 1 – 100 Body structures text book chapter 6, pages 83 – 105. Exercise: Review questions, labeling Body structures text book chapter 6, pages 58 – 76. Exercises: D, F, G, J, K, M, N2, O, Q2, S. Delmar video “The Musculoskeletal System” , tape 4

Structures of the Skeletal System INCLUDES: Bones Cartilage Ligaments Joints Bursa

Functions of the Skeletal System Bones – act as framework of body, support and protect the internal organs – stores calcium required for normal nerve and muscle function Joints/Muscles/Ligaments, and tendons – make variety of body movements possible Red Bone Marrow – located in spongy bone, has important function in the formation of blood

The Structure of Bones Tissues of Bone: Bone is a form of connective tissue and is almost the hardest tissue in the human body (dental enamel is harder) Tissues of Bone: Although it is very hard and dense, bone is a living structure that changes and is capable of healing itself

Bone Marrow Located w/in spongy bone, is hematopoietic and manufactures red blood cells, hemoglobin, white blood cells, thrombocytes CAUTION: the word part myel/o means either bone marrow or spinal cord Hematopoietic/hemopoietic: pertaining to formation of blood cells Hemato/Hemo = blood Poietic = pertaining to formation Yellow Bone Marrow: found in medullary cavity, composed chiefly of fat cells and functions as a fat storage area

Joints - aka articulations – connections btwn. Bones Articulate: to join or to come together in a manner that allows motion between parts Types of Joints Sutures Symphyses Synovial Joints

Sutures The jagged line where bones join and form an immovable joint Fontanel/fontanell: AKA soft spot – where the sutures btwn. the frontal/parietal bones have not yet closed on a baby’s head disappears as the child grows and the sutures close

Symphyses Symphysis: where 2 bones join and are held firmly together so they function as one bone (ie: pubic symphysis)

Synovial Joints Movable joints of body Ball and Socket Joints: synovial joints that allow a wide range of movement in many directions (ie: hips and shoulders) Hinge Joints: synovial joints that allow movement primarily in one direction or plane (ie: knees and elbows)

The Skeleton 206 bones total in adult human body divided into 2 systems Axial: (80 bones) protects the major organs of the nervous, respiratory, and circulatory systems – axial refers to an imaginary line or axis thru the center of the body – includes skull, spinal column, ribs, and sternum Appendicular: (126 bones) makes body mvmt. Possible, also protects the organs of digestion, excretion, and reproduction – appendicular refers to an appendage, which is anything attached to a major part of the body Organized into: Upper extremities: shoulders, arms, forearms, wrists and hands Lower Extremities: hips, thighs, legs, ankles, and feet

Cranium - portion of the skull that encloses the brain CONSISTS OF: Frontal bone: forms the forehead Parietal bones: form most of the roof and upper sides of the Cranium Occipital bone: forms the posterior floor and walls of the cranium foramen magnum: opening in occipital bone thru which spinal cord passes Temporal bones: form the sides and base of the cranium Sphenoid bone: forms part of the base of the skull and parts of the floor and sides of the bony socket surrounding and protecting the eyeball Ethmoid bone: forms part of the nose, the orbit, and the floor of the cranium

Auditory Ossicles bones of the middle ear EAM: external auditory meatus – external opening of the ear, is located in the temporal bone

Thoracic Cavity, Ribs, and Sternum Thoracic Cavity: AKA rib cage – made up of the ribs, sternum, and thoracic vertebrae Ribs: 12 pair (costals) attach to thoracic vertebrae posteriorly First 7 pair – true ribs – attach anteriorly to the sternum (FIG 3.11) Next 3 pair – false ribs – attach anteriorly to cartilage that joins with the sternum Last 2 pair – floating ribs – are not attached anteriorly Sternum: forms middle of the front of the rib cage – divided into 3 parts Manubrium: bone, upper portion of the sternum Body: bone, middle portion Xiphoid process: cartilage, lower portion

Shoulders Pectoral girdle: AKA shoulder girdle – supports arms and hands Clavicle: slender bone that connects the sternum to scapula Scapula: shoulder blade Acromion: an extension of the scapula that form highest point of the shoulder

Arms humerus: bone of upper arm radius: smaller bone in the forearm, runs up the thumb (lateral) side of arm ulna: larger bone of the forearm, articulates with the humerus to form the elbow joint olecranon process: large projection on the proximal end of the ulna that forms the point of the elbow

Wrists and Hands carpals: bones of the wrist metacarpals: form the palm of the hand phalanges: bones of the fingers (and toes) each finger has 3 bones: distal, middle, proximal phalanges thumb: only distal and proximal phalanges

Spinal Column consists of 26 vertebrae – functions to support head and body and protect spinal cord

Types of Vertebrae Cervical: first set of 7 – form neck C1 – C7 Thoracic vertebrae: second set of 12 vertebrae – form outward curvature of spine T1 – T12 Lumbar vertebrae: third set of vertebrae L1 – L5 – largest and strongest of the vertebrae – form the inward curvature of spine Intervertebral Disks made of cartilage, separate and cushion the vertebrae from each other, act as shock absorbers and allow for movement of the spinal column

Sacrum/ Coccyx Sacrum Coccyx triangular shaped bone near the base of the spine (FIG 3.15) at birth = 5 separate sacral bones = fuse to form one in young child Coccyx tailbone, forms end of spine and is made up of four small bones fused together

Pelvic Girdle - Protects internal organs and supports lower extremities 3 BONES FUSED TOGETHER – posteriorly w/ sacrum ilium: upper, blade shaped part of hip on each side of the pelvic girdle sacroiliac: slightly moveable articulation btwn. Sacrum and ilium ischium: lower and posterior portion of the pelvic girdle pubis: anterior portion of the pelvic girdle 2 pubic bones join at anterior midline to form pubic symphysis – cartilaginous joint that holds the bones firmly together acetabulum: large socket in pelvic bones, forms hip socket for head of femur

Legs and Knees Femur upper leg bone – largest bone in body Knees head: articulated with the acetabulum femoral neck: narrow area just below the head of the femur trochanter: one of the two large bony projections of the proximal end of the femur just below the femoral neck Knees patella: bony anterior portion of the kneecap popliteal: refers to the posterior surface of the knee – used to describe the structures in this area anterior cruciate ligament (ACL)/posterior cruciate ligament (PCL): make the movements of the knee possible – shaped like a cross Lower Leg Tibia: larger weight-bearing bone in the anterior of the lower leg fibula: smaller of the 2 bones of the lower leg

Medical Specialties Related to the Skeletal System chiropractor orthopedic surgeon orthotics osteopathic physicians podiatrist rheumatologist

Curvatures of the spine kyphosis: abnormal increase in the outward curvature of thoracic spine (dowager’s hump) lordosis: abnormal increase in forward curvature of the lumbar spine (swayback) scoliosis: lateral curvature of the spine

Scoliosis Lordosis Kyphosis

Fractures - broken bone greenstick fx: bone is partially bent and only partially broken usually longitudinal and occurs primarily in children closed fx: complete fx – bone is broken but there is no open wound in the skin transverse fx: straight across the bone oblique fx: at an angle open fx: compound fx – bone is broken and there is an open wound in the skin comminuted fx: the bone is splintered or crushed compression fx: bone is pressed together on itself spiral fx: bone has been twisted apart – occurs as a result of a severe twisting motion as in a sports injury stress fx: small crack in bones that often develop from chronic, excessive impact – usually due to a sports injury

Diagnostic Procedures of the Skeletal System arthrocentesis: surgical puncture of joint to remove synovial fluid for analysis arthroscopy: visual exam of internal structure of joints, using an arthroscope Bone density testing: densitometry, use of radiation tests to determine bone density Bone marrow biopsy: insertion of a sharp needle into the hipbone or sternum and removing bone marrow cells, used to determine why blood cells are abnormal, also to find a donor match Bone scan: use of nuclear medicine to detect bone cancer and osteomyelitis Dual X-ray absorptiometry MRI Radiographs

Bone marrow biopsy and tools arthroscopy arthrocentesis Bone marrow biopsy and tools Bone density testing X-rays

Treatment procedures for Joints arthroscopic surgery: use of an arthroscope and other instruments to treat the interior of a joint, ie: removal of torn cartilage bursectomy: surgical removal of a bursa chondroplasty: surgical repair of cartilage synovectomy: surgical removal of a synovial membrane from a joint, used to repair a joint damaged by rheumatoid arthritis arthrodesis: fusion, surgical procedure to stiffen a joint to join spinal vertebrae arthrolysis: surgical loosening of an ankylosed joint periosteotomy: incision thru the periosteum

chondroplasty arthroscopy bursectomy synovectomy arthrodesis Arthroplasty And prosthesis

Joint Replacement arthroplasty: surgical repair of a damaged joint – surgical replacement of a joint prosthesis: implant or substitute for diseased or missing part of the body total knee replacement partial knee replacement total hip replacement revision surgery

Spinal Column diskectomy: surgical removal of an intervertebral disk percutanious diskectomy: thin tube is inserted thru skin of the back – suction is used to remove ruptured disk or vaporize it with a laser laminectomy: surgical removal of the lamina from vertebrae spinal fusion: immobilize part of the spine by fusing 2 or more vertebrae

Bones craniectomy: surgical removal of a portion of the skull craniotomy: bone flap – surgical incision or opening into the skull that is performed to gain access to part of the brain cranioplasty: surgical repair of the skull osteoclasis: surgical fx of bone to correct a deformity ostectomy: surgical removal of bone osteoplasty: surgical repair of bones osteorrhaphy: suturing or wiring together of bones osteotomy: surgical incision or sectioning of a bone

Treatment of Fractures manipulation: attempted realignment of the bone (closed reduction) traction: pulling force exerted on a limb in a distal direction in an effort to return the bone or joint to normal alignment immobilization: holding or suturing or fastening the bone in a fixed position (ie casting) External Fixation fx treatment where pins are place thru the soft tissues and bone for the use of external appliance to hold pieces of bone firmly in place during healing ex fix removed after healing Internal Fixation open reduction – fx in treated with pins or a plate placed directly into bone to hold broken pieces in place not usually removed after healing occurs