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Anatomy: Skeletal System

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Lower arm. radius. ulna. Bones of the wrist and hand. Label: phalanges ... managed conservatively with rehabilitation exercises, but a small percentage may ... – PowerPoint PPT presentation

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Title: Anatomy: Skeletal System


1
Anatomy Skeletal System
  • functions, names and numbers of bones, problems

2
Skeletal System Functions
  • Bones are living structures with 5 functions
  • protect internal organs
  • support the body
  • make blood cells
  • store minerals
  • provide for muscle attachment

3
Classification of bones
  • Long bones
  • Short bones
  • Flat bones
  • Irregular bones
  • Sesamoid bones

4
Classification of bones
  • The femur is an example of a long bone

5
Classification of bones
  • These are short bones

6
Classification of bones
  • These are considered flat bones

7
Classification of bones
  • Vertebrae are irregular bones

8
Classification of bones
  • kneecap (patella) is a sesamoid bone

9
Review of bone tissue
  • Osteocyte
  • Canaliculi
  • Matrix
  • Haversian (central) canal
  • Lamella
  • 6. Haversian system (osteon)

10
Parts of a bone
  • Diaphysis - shaft of bone
  • Epiphyses - ends of bone
  • Articular cartilage - covers epiphysis at a joint
  • Periosteum - membrane covers outer bone surface
  • Endosteum - lines medullary cavity
  •  
  •  www.bmb.psu.edu/courses/ bisci004a/bone/bone.htm
  •                            

11
Parts of a bone
  • 1.
  • 2.
  • 3.
  • 4.
  • 5.

12
WHY WE NEED CALCIUM
  • You may know that calcium plays an important
    role in building healthy teeth and bones. What
    you may not know is that calcium is vital to
    every cell of the body for muscle function, nerve
    transmission, blood clotting and many other uses.
    When you don't get enough calcium in your diet,
    the calcium stored in your bones is "stolen" to
    supply the rest of your body. Hence, your bones
    suffer the consequences of a low-calcium diet.
    This is why the bones become more susceptible to
    fractures.

13
Where bones meet
  • A point where two or more bones connect is
    called a joint. There are two different types of
    joints in the body
  • Movable joints (like ball-and-socket, hinge,
    gliding and pivot joints)
  • Immovable joints (like the bones of the skull and
    pelvis) which allow little or no movement

14
There are approximately 206 bones in the body.
How many of them can you identify on this
skeleton?
15
Account for 206
  • 8 cranium (1 Occipital, 2 Parietal, 1Frontal, 2
    Temporal, 1 Sphenoid, 1 Ethmoid)
  • 14 face (2 Nasal, 2 Maxillæ, 2 Lacrimal, 2
    Zygomatic, 2 Palatine, 2 Inferior Nasal Conchæ, 1
    Vomer, 1 Mandible)
  • 6 ears
  • 1 hyoid
  • 26 Vertebral column-7 cervical, 12 thoracic, 5
    lumbar, (1)5 sacral, (1) 4 coccygeal
  • 25 Sternum and ribs
  • 64 Upper extremities
  • 62 Lower extremities

16
Skull
  • The skull is made up of 22 bones (8 paired and
    6 unpaired) joined by tight sutures
  • 8 bones to cranium
  • 14 bones in the face
  • Other bones in the area
  • 6 bones (3 each) ears
  • 1 hyoid

17
In the lateral view above label the following
bones
  • Cranium
  • Frontal 1
  • Parietal 2
  • Temporal 2
  • Occipital 1
  • Sphenoid 1
  • Ethmoid 1

18
In the lateral view above label the following
bones
Face Maxilla 2 Zygomatic 2 Lacrimal 2 Nasal
2 Vomer 1 NS Palatine 2 NS Inferior nasal concha
2 NS Mandible 1
19
Hyoid bone
20
Bones of the ear
  • each ear
  • malleus
  • incus
  • stapes

21
Vertebral column
  • Your back is made up of a series of bones
    called vertebrae." Together they form a flexible
    column. (left)  There are a total of thirty-three
    vertebrae and they are grouped under the names
    cervical, thoracic, lumbar, sacral, and
    coccygeal.  There are 7 cervical region, 12
    thoracic, 5 lumbar, 5 sacral, and 4 coccygeal

22
Lumbar vertebrae
  • fibrocartilage intervertebral disc

23
Name the vertebrae
  • 1.
  • 2.
  • 3.
  • 4.
  • 5.

24
Scapula
  • Compare the shoulder joint (glenoid) with the hip
    joint (acetabulum)
  • Note the spine, acromion process coracoid
    process.

25
Scapula and clavicle
26
Clavicle
  • Pectoral girdle for the humerus

27
Sternum and ribs
  • Notice the parts manubrium, blade (gladiolus)
    and xiphoid process
  • The ribs enclose the thoracic cavity. What are
    true ribs, false ribs floating ribs?

28
Upper limb
  • scapula
  • clavicle
  • humerus
  • radius
  • ulna

29
Shoulder joint
  • The shoulder joint is the joint with greatest
    ROM (range of motion) of any joint. But the wide
    range of motion is at the expense of stability. A
    lack of stability results in a joint that is
    loose with a tendency to dislocate (come out of
    its socket). The joint and the tendons about the
    joint are subjected to considerable wear and tear
    leading to degeneration of the joint surface
    giving rise to arthritis and tears in the
    supporting tendons .

30
Anatomy of shoulder
  • The shoulder is made up of three bones, the
    scapula, clavicle and humerus.

31
Torn rotator cuff
  • MRI of a torn rotator cuff. The supraspinatus
    tendon normally extends over the head of the
    humerus. Courtesy S. Sadiq, M.D.

32
x-ray of elbow
33
Lower arm
  • radius
  • ulna

34
Bones of the wrist and hand
  • Label
  • phalanges
  • metacarpals
  • carpals
  • Hamate
  • Capitate
  • Trapezoid
  • Trapezium
  • Triangular
  • Lunate
  • Scaphoid
  • Pisiform (not shown in this posterior view)

35
Male pelvis, hip, os coxa
  • ilium
  • ischium
  • pubis

36
Female pelvis
  • The pelvic girdle is formed from 2 pelvic
    bones joined to the sacrum (base of spinal cord).
    In front the pelvic bones are held together by
    the pubic symphysis joint. This joint allows only
    slight bending movement, but it softens and
    becomes more flexible in a female giving birth.

37
Acetabulum
  • This is a view of the right pelvic bone. It
    is formed from 3 fused bones the ilium (green),
    ischium (yellow) and pubis (red). The 3 bones
    meet in the acetabulum (hip socket) at point A.

38
Leg bones
  • Femur
  • Tibia
  • Fibula
  • Patella

39
X-ray of knee
40
knee surgery post-op 48 hours
  • Basically, the ACL runs in a left to right
    direction and provides support for pivoting
    motions. In most cases people can live with an
    ACL tear they just have to be careful and
    potentially limit certain activities

41
Bones of the foot
  • phalanges
  • metatarsals
  • tarsals Talus, Calcaneus, Navicular, Cuboid,
    Lateral cuneiform, Intermediate cuneiform, Medial
    cuneiform

42
Trauma
  • Fracture Definition - a break in the continuity
    of a bone or cartilage.
  • Classification
  • Closed fracture (simple) - no communication with
    the outside environment.
  • Open fracture (compound) - communication with the
    outside environment.

43
Bone fractures
  • Comminuted Fracture
  • This is a plain film of the left forearm and
    wrist which has at least five fragments of bone.

44
Bone fractures
  • A skeletally immature person suffered an ankle
    injury, resulting in a Salter-Harris Type III
    fracture. Note that the lateral aspect of the
    distal physis of the left tibia is separated with
    extension of the fracture line into the
    epiphyseal component of the distal tibia.

45
Bone fractures
  • Open fractures have contacted the
    environment. They are most commonly seen in
    vehicular or motorcycle accients and they are at
    high risk for infection or osteomyelitis.

46
Bone fractures
  • This is an image of a spiral fracture. Note
    the wavy appearance of the fracture due to torque
    through the bone. You often see spiral fractures
    in children when they twist an ankle or knee.
    This can be extremely alarming because a spiral
    fracture in children who are not yet walking can
    be due to child abuse.

47
Bone fractures
  • This is an image of a greenstick fracture. Due
    to the pliability of pediatric bone, the bone
    does not completely fracture. The medial side of
    the radius is open where as the lateral cortex
    has simply buckled.

48
Bone fractures
  • This is an example of a stress fracture of
    the tibia (arrows). Stress fractures are a common
    result of overuse or stress on the bone. It is
    desirable to catch them before they become
    complete fractures because they are non-displaced
    and in perfect anatomic alignment so they tend to
    heal well with appropriate treatment.

49
Bone fractures
  • This is a radiograph of the anterior superior
    illiac spine of the pelvis of a high school
    sprinter. Note the bony fragment that has
    dissociated from the pelvis (arrow). The patient
    pulled the bone fragment off the pelvis at the
    point of the Sartorious muscle attachment and
    subject to possible fracture at times of intense
    stress.

50
Bone fractures
  • This is an image of a both bone forearm
    fracture. The callus or fracture fragments have
    caused the bone to ossify between the radius and
    ulna fusing the forearm and preventing pronation
    or supination.

51
Dislocation of the elbow

52
Osteomyelitis (bone infection)
  • This is an advanced case of osteomyelitis that
    had been developing for approximately 3 to 4
    months at the time of the plain film. Note the
    mixed lytic and sclerotic processes that are
    occurring in the bone.

53
Degenerative Joint Disease (DJD or
osteoarthritis)
  • Primary osteoarthritis - most common in the older
    age group as the result of wear and tear on
    articular cartilage over time.
  • Secondary osteoarthritis - results from a
    previous process that damaged cartilage such as
    trauma, inflammatory arthritis.
  • The most commonly involved joints in primary
    osteoarthritis are
  • Distal interphalangeal joints
  • First carpometacarpal joint
  • Weight bearing joints spine, hips, knees

54
Inflammatory Arthritis
  • An inflammatory process with the target organ
    being the synovial membrane leading to pannus
    formation (inflammatory exudate in the lining of
    the synovial cells).

55
Rheumatoid arthritis
  • Diagnosis usually made by plain film
  • Osteopenia - a demineralization of the bone -
    is the result of increased blood flow, due to
    inflammation, which washes out the calcium.

56
Rheumatoid arthritis
  • Rheumatoid arthritis affecting the hands

57
Tumor involving bone
  • Primary tumors
  • Benign
  • Osteoid (e.g., osteoid osteoma, osteoblastoma)
  • Chondroid (e.g., enchondroma)
  • Fibrous (e.g., non-ossifying fibroma)
  • Mixed (e.g., osteochondroma)
  • Malignant
  • Osteoid (e.g., osteosarcoma)
  • Chondroid (e.g., chondrosarcoma)
  • Fibrous (e.g., fibrosarcoma)
  • Mixed (e.g. dedifferenciated chondrosarcoma)
  • Metastatic tumors

58
Benign Versus Malignant Tumor
  • Left image is an enchondroma in a metacarpal
    bone. It is a sharply marginated, lucent
    structure. It is a slow growing tumor.
  • The right image, however, is an osteosarcoma
    in the femur. The tumor is growing beyond the
    margins of the bone and it is difficult to
    discern the full extent of the tumor. These
    features suggest it is an aggressively growing
    tumor.

59
Ankle sprain
  • A sprain is a stretched or torn ligament.
    Ligaments connect one bone to another bone at a
    joint and help keep the bones from moving out of
    place. The most common site of sprains is the
    ankle

60
Ankle sprain
  • Although ligament damage frequently occurs
    during athletics or exercise, ankles are just as
    often injured stepping off a curb, into a
    pothole, or onto uneven ground.

61
Ankle sprain
  • Upon physical examination, the ankle will
    exhibit swelling and discoloration (black and
    blue) over the outside part of the joint.
    Touching of the area will result in a variable
    amount of discomfort. Frequently, there is
    instability notes on the drawer test as the heel
    structures are moved forward and back as the leg
    is stabilized. Range of motion (ROM) in the ankle
    can be limited due to pain and swelling, but
    strength is not usually affected. X-rays are
    essential, as the possibility of a fracture must
    be ruled out.

62
Ankle sprain-Grade I
  • Mild sprain, mild pain, little swelling, and
    joint stiffness may be apparent
  • Stretch and/or minor tear of the ligament without
    laxity (loosening)
  • Usually affects the anterior talofibular ligament
  • Minimum or no loss of function
  • Can return to activity within a few days of the
    injury (with a brace or taping)

63
Ankle sprain-Grade II
64
Ankle sprain-Grade II
  • Moderate to severe pain, swelling, and joint
    stiffness are present
  • Partial tear of the lateral ligament(s)
  • Moderate loss of function with difficulty on toe
    raises and walking
  • Takes up to 2-3 months before regaining close to
    full strength and stability in the joint

65
Ankle sprain-Grade III
  • Severe pain may be present initially, followed by
    little or no pain due to total disruption of the
    nerve fibers
  • Swelling may be profuse and joint becomes stiff
    some hours after the injury
  • Complete rupture of the ligaments of the lateral
    complex Usually requires some form of
    immobilization lasting several weeks
  • Complete loss of function and necessity for
    crutches
  • Usually managed conservatively with
    rehabilitation exercises, but a small percentage
    may require surgery
  • Recovery can be as long as 4 months

66
How can ankle sprains be treated?
  • Many doctors suggest using the RICE approach
  • Rest
  • Ice
  • Compression
  • Elevation

67
RICE approach Rest
  • Rest--You may need to rest your ankle, either
    completely or partly, depending on how serious
    your sprain is. Use crutches for as long as it
    hurts you to stand on your foot.
  • Ice--Using ice packs, ice slush baths or ice
    massages can decrease the swelling, pain,
    bruising and muscle spasms. Keep using ice for up
    to 3 days after the injury.
  • Compression--Wrapping your ankle may be the best
    way to avoid swelling and bruising. You'll
    probably need to keep your ankle wrapped for 1 or
    2 days after the injury and perhaps for up to a
    week or more.
  • Elevation--Raising your ankle to or above the
    level of your heart will help prevent the
    swelling from getting worse and will help reduce
    bruising. Try to keep your ankle elevated for
    about 2 to 3 hours a day if possible.

68
References
  • The Sourcebook of Medical Illustration, edited by
    Peter Cull (Park Ridge, NJ Parthenon, 1989)
    members.aol.com/Attic21/Anatomy/skullans.html
  • Virtual Hospital is the Apprentice's Assistant
    www.vh.org/.../Lectures/icmrad/
    skeletal/Parts/Compound.html
  • The Nicholas Institute of Sports Medicine and
    Athletic Trauma www.nismat.org/ptcor/
    ankle_sprain/
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