1. Skeletal System
Dr. Nichols Coronado HS

2. Foot
phalangies
metatarsals
tarsals
tarsals
metatarsals
phalangies

5. Bone cells that aid in remodeling
Osteoblast
Builds new bone
Mature bone cell
Osteocyte
OsteoblastsOsteoblasts are responsible for building new bone and lie at the centre of bone physiology. Their functions include the synthesis of collagen and the control of mineralisation.
OsteoclastsOsteoclasts are specialised cells that resorb bone. They work by sealing off an area of bone surface then, when activated, they pump out hydrogen ions to produce a very acid environment, which dissolves the hydroxyapatite.
OsteocytesBone adapts to applied forces by growing stronger in order to withstand them; it is known that exercise can help to improve bone strength. Osteocytes are thought to be part of the cellular feed-back mechanism which directs bone to form in the places where it is most needed. They lie within mineralised bone and it is thought that they may detect mechanical deformation and mediate the response of the osteoblasts.
Osteoclast
Eats bone

6. Osteoporosis 29 40 84 92

7. Fetal Skull

8. Immovable Joints (synarthrosis)
Fibrous Joints
Immovable Joints (synarthrosis)
suture
pubis symphisis

9. Slightly Movable Joint (ampharthrosis)
Cartilagenous Joints
Slightly Movable Joint (ampharthrosis)

10. (diarthrosis)- freely moveable
Synovial Joints
(diarthrosis)- freely moveable
pelvis
ligaments
femur

11. Synovial Joints joint capsule pelvis hyaline cartilage synovial cavity
femur

12. Knee Joint

13. Synovial Joint Movement
Extension
Rotation
Flexion
Adduction
Abduction

14. 275 bones 12 weeks (6-9 inches long)
Fetal Skeleton
275 bones 12 weeks (6-9 inches long)

15. Fetal Skull

16. bone cartilage calcified cartilage epiphyseal line epiphyseal plate
Fetus: 1st 2 months
Endochondral Ossification
2o ossification center
bone
cartilage
calcified cartilage
Just before birth
epiphyseal line
epiphyseal plate
Childhood
Adult

17. Bone cells that aid in remodeling
Osteoblast
Builds new bone
Mature bone cell
Osteocyte
OsteoblastsOsteoblasts are responsible for building new bone and lie at the centre of bone physiology. Their functions include the synthesis of collagen and the control of mineralisation.
OsteoclastsOsteoclasts are specialised cells that resorb bone. They work by sealing off an area of bone surface then, when activated, they pump out hydrogen ions to produce a very acid environment, which dissolves the hydroxyapatite.
OsteocytesBone adapts to applied forces by growing stronger in order to withstand them; it is known that exercise can help to improve bone strength. Osteocytes are thought to be part of the cellular feed-back mechanism which directs bone to form in the places where it is most needed. They lie within mineralised bone and it is thought that they may detect mechanical deformation and mediate the response of the osteoblasts.
Osteoclast
Eats bone

18. Bone Repair: Electrical stimulation of the fracture site:
Increases speed and completeness of healing
The e- stimulation inhibits PTH and slow osteoclasts down from reabsorbing bone
2. Ultrasound treatment:
Daily treatments reduce healing time of broken bones by 25-35%
3. Free vascular fibular graft technique:
Transplant fibula in arm
Gives good blood supply not available in other treatments
4. Bone substitutes:
Crushed bone from cadaver- but risk of HIV and hepatitis
Sea bone- coral
Artificial bone- ceramic

20. Repair of Fractures
hematoma
callus
bony callus
bone
remodeling

21. Osteoporosis 29 40 84 92

22. Diseases of the Skeletal System:
Rickets- vitamin D deficiency
Osteomalacia- soft bones, inadequate mineralization in bones, lack of vitamin D
Pagets Disease- spotty weakening in the bones, excessive and abnormal bone remodeling
Rheumatoid arthritis- autoimmune reaction

24. Types of Bones
Long Bones- metacarples, metatarsals, phelangies, humerus, ulna, radius, tibia, fibula
Short Bones- carpals, tarsals
Flat Bones- rib, scapula, skull, sternum
Irregular Bones- vertebrae, some facial bones
Sesamoid- patella

25. Bone Classification

26. Anatomy of a Long Bone spongy bone Proximal compact bone epiphysis
Endosteum
diaphysis
epiphyseal line
yellow marrow
Sharpey’s fibers
Distal
epiphysis
periosteum
hyaline cartilage

27. Axial Skeleton

28. Appendicular Skeleton

29. Axial Skeleton

30. Axial Skeleton

31. Axial Skeleton
Posterior View

32. Sinal Cavities Frontal Sinus Ethmoid Sinus Sphenoid Sinus
Maxillary Sinus
Warm and moisten air
Lighten the skull
Enhance voice resonance

33. The Vertebral Column Cervical Vertebrae (7) Thoracic Vertebrae (12)
Axial Skeleton
The Vertebral Column
Cervical Vertebrae (7)
Thoracic Vertebrae (12)
Lumbar Vertberae (5)
Sacrum
Coccyx

34. Cervical Vertebrae

37. The Thoracic Cage Sternum True Ribs (7) False Ribs (3)
Axial Skeleton
The Thoracic Cage
Sternum
True Ribs (7)
False Ribs (3)
Floating Ribs (2)

38. Axial Skeleton
Sacrum & Coccyx

39. Bones of the Pectoral Girdle
Appendicular Skeleton
Bones of the Pectoral Girdle

40. Appendicular Skeleton
Humerus
Ulna
Radius
8 Carpals
5 Metacarpals
14 Phalanges

41. Humorus

42. Ulna & Radius

43. Hand Bones

44. Appendicular Skeleton
Pelvis

45. Appendicular Skeleton
Pelvis (lateral view)
Ilium
Acetabulum
Obturator
foramen
Pubis
Ischium
Ischium

46. Male vs Female Pelvis
                                         
        Female Pelvic Girdle
Male Pelvic Girdle

48. Appendicular Skeleton
The Lower Limb (Legs)
Femur
Patella
Tibia
Fibula
7 Tarsals
5 Metatarsals
14 Phalanges

49. Femur

50. Patella

51. Tibia & Fibula

52. Disorder of the Day
Paget’s Disease:
Is a chronic disorder that can result in enlarged and misshapen bones. The excessive breakdown and formation of bone tissue causes affected bone to weaken, resulting in pain, misshapen bones, fractures, and arthritis in the joints near the affected bones.

53. Causes
Paget’s Disease:
Paget's disease may be caused by a slow virus infection (measles association, Canine distemper virus) present for many years before symptoms appear.

54. Symptoms
Paget’s Disease:
Many patients do not know they have Paget's disease because they have a mild case and have no symptoms, characterized by ‘spotty bone pain.’

55. Bisphosphonates: Didronel (200-400mg), Fosamax (40mg once daily)
Treatments
Paget’s Disease:
Goal of treatment is to relieve bone pain and prevent progression of disease.
Bisphosphonates: Didronel ( mg), Fosamax (40mg once daily)

56. Cases

57. Disorder of the Day! Avascular Necrosis
Is a disease that results from the temporary or permanent loss of blood supply to the bone.
When blood supply is cut off, the bone tissue dies and the bone collapses. If avascular necrosis occurs near a joint, collapse of the joint surface may occur.

58. Symptoms Minimal early joint pain
Increased joint pain as bone and joint begin to collapse
Limited range of motion due to pain

59. Treatments Medications: Ibuprofen, Aleve to relieve pain.
Osteotomy - a surgical procedure to reshape the bone and reduce stress on the affected area.
Bone graft - a surgical procedure in which healthy bone is transplanted from another part of the patient's body into the affected area.
Arthroplasty (total joint replacement) - a surgical procedure to remove and replace an arthritic or damaged joint with an artificial; may be considered only after other treatment options have failed to provide adequate relief from pain and/or disability

60. Up Close

61. Rare Disorder of the Day: Von Hippel-Lindau (VHL)
Von Hippel-Lindau disease (VHL) is said to affect one in 35,000 people. It is an extremely rare genetic condition that is characterized by the growth of tumors in different parts of the body.

62. More Info
Many of the tumors will grow within the central nervous system and are often benign. Different tumors are also known to grow on the pancreas, adrenal glands, and kidneys.
If left untreated, the disease can cause strokes, heart attacks, and cardiovascular disease.

63. Symptoms Chronic Headaches.
Problems with balance and walking, dizziness.
Weakness of the limbs.
Vision problems (retinal detachment common)
High blood pressure.

64. Treatment Laser coagulation of retinal occlusions.
Cryotherapy to reduce swelling, inflammation, also aids in removal of tumor.

65. Symptoms

66. Looks like:

67. Disorder of the Day Chondrosarcoma
Is a type of cancer that develops in cartilage cells. Cartilage is the specialized, connective tissue that is present in adults and the tissue from which most bones develop. Cartilage plays an important role in the growth process.

68. Disorder of the Day
Chondrosarcoma is the second most common type of primary bone cancer. A primary bone cancer is one that originates from bone, as opposed to starting in another organ and then spreading to the bone.
This type of cancer rarely affects individuals under age 20 and continues to rise until age 75. The incidence between males and females is equal.

69. Symptoms -Large mass on the affected bone (tumor)
-Feeling of pressure around the mass
-Pain that is usually worse at night and may be relieved by taking anti-inflammatory medications such as ibuprofen
-Pain that is not usually relieved through rest
-Pain that may be present for years but increases gradually over time

70. Treatments -Surgery to remove the tumor
-Physical therapy to regain strength and use of the affected area after surgery
-Chemotherapy, although not the primary treatment, may be required if the cancer has spread to other areas of the body.
Key Chemo (drug)- Doxorubicin, Ifosfamide. Methotrexate, cisplatin.

71. Disorder of the Day
Fibrous dysplasia is a chronic disorder in which bone expands due to abnormal development of fibrous.
Any bone in the body can be affected but more commonly affects, the femur, tibia, ribs, skull, humerus, pelvis, vertebrae.

72. Causes
The exact cause of fibrous dysplasia is not known, but it is believed to be due to a chemical irregularity in a specific bone protein.
This bone protein abnormality may be due to a gene mutation present at birth, but it is not known to be an inherited disorder.

73. Symptoms -a waddling walk
-bone pain (as a consequence of the expanding fibrous tissue in the bone)
-bone deformity
-bone fractures
-scoliosis - a lateral, or sideways, curvature and rotation of the back bones.
-uneven growth of bones
-pain
-brittle bones

74. Symptoms -a waddling walk
-bone pain (as a consequence of the expanding fibrous tissue in the bone)
-bone deformity
-bone fractures
-scoliosis - a lateral, or sideways, curvature and rotation of the back bones.
-uneven growth of bones
-pain
-brittle bones

75. Treatment Surgery, including the following:
-removal of affected bone, followed by bone grafting
-removal of bone wedge
-placement of a rod down the shaft of the bone
-Medication: (bisphosphonates) Aredia, Fosamax, preserve bone mass and even increase bone density reducing the risk of fractures.
-Pain management
-Physical therapy

76. Disorder of the Day!
Osteomyelitis
Is an inflammation or swelling of bone tissue that is usually the result of an infection. Osteomyelitis, or bone infection, may occur for many different reasons and can affect children or adults.

77. Symptoms fever pain and tenderness in the affected area irritability
swelling of the affected area
redness in the affected area
warmth in the affected area
difficulty moving joints near affected area
difficulty bearing weight or walking

78. Treatment
Medications: Intravenous or oral antibiotic treatment for osteomyelitis may be very extensive, lasting for many weeks. I.E (Ancef, Ceftin, Azactam)
monitoring of successive x-rays and blood tests
pain management
bed rest or restricted movement of the affected area
Surgery In some cases, surgical intervention may be necessary to drain infectious fluid, or to remove damaged tissue and bone.

79. Osteomyelitis