The Skeletal System

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The Skeletal System
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How many bones are in the body?

• 206

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There are 5 main functions of bones

1. Framework- support muscles
2. Protection- surrounds vital organs, etc.
3. Levers- attach to muscles to provide movement
4. Produce blood cells- red, white, and platelets
5. Storage- calcium

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Parts of long bones

• Long bones are bones of extremities
• Periosteum-tough membrane covering outside of
  bones
• Contains osteoblasts which are special cells that
  form new bone tissue

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Spongy Bone

• Located at the ends of long bones
• Has many small, open spaces that make bones
  lightweight
• Filled with a substance called marrow
• yellow composed of fat cells
• red produces red blood cells

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Cartilage

• Smooth, slippery, thick layer of tissue
• Covers the ends of bones
• Does not contain blood vessels or minerals
• Flexible and acts as a shock absorber
• Makes movement easier by reducing friction

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Two sections of a skeleton

• Axial Skeleton
• 2. Appendicular Skeleton

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Axial Skeleton

• Forms main trunk of the body
• Composed of the skull, spinal column, ribs, and
  sternum

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Appendicular Skeleton

• Forms extremities (arms and legs)
• Composed of shoulder girdle, arm bones, pelvic
  girdle, and leg bones

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Skull

• Composed of cranial and facial bones

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Cranium

• Spherical structure that surrounds and protects
  the brain
• At birth, the cranium is not solid bone
• Spaces are called fontanels soft spots that
  allow for brain growth
• Turns into solid bone by 18 months

• Composed of 8 bones
• Frontal
• Two parietal
• Two temporal
• Occipital
• Ethmoid
• Sphenoid

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Facial bones

• Fourteen facial bones
• Main bones of the face
• Mandible lower jaw
• Maxilla two bones forming upper jaw
• Zygomatic two cheek bones
• Nasal five bones in upper part of nose
• Lacrimal two bones at inner aspect of eyes
• Palatine two bones of hard palate or roof of
  mouth

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Sutures

• Areas where cranial bones have joined together

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Sinuses

• Air spaces in the bones of the skull
• Act as a resonating chamber for the voice
• Lined with mucous membranes

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Foramina (Foramen)

• Openings in the bones
• Allow nerves and blood vessels to enter or leave
  bone

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Vertebrae

• Spinal column is composed of 26 bones called
  vertebrae
• Protects the spinal cord
• Provides support for head and trunk

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Main sections of vertebral column

• Cervical 7 neck vertebrae
• Thoracic 12 vertebrae in back of chest,
  attached to ribs
• Lumbar 5 vertebrae by waist
• Sacrum 1 large vertebra on back of pelvic girdle
• Coccyx 1 fused vertebra called tailbone

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Intervertebral disks

• Pads of cartilage tissue that separate vertebrae
• Act as shock absorbers
• Permit bending and twisting movements of
  vertebral column

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Ribs (costae)

• 12 pairs of long, slender bones
• Attach to thoracic vertebrae on dorsal surface of
  body

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• True ribs
• First 7 pairs of ribs
• Attach directly to sternum on front of body
• False ribs
• Next 5 pairs of ribs
• First three pairs attach to cartilage of rib
  above
• Floating ribs
• Last 2 pairs of false ribs
• No attachment on front of body

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Sternum

• Breastbone
• Consists of three parts
• Manubrium or upper region
• Gladiolus body or center area
• Xiphoid process small piece of cartilage at
  bottom (landmark for chest compressions)
• Two clavicles attach to the manubrium by
  ligaments
• Ribs attach to sternum with cartilage

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Shoulder or pectoral girdle

• Two clavicles or collarbones
• Two scapulas or shoulder bones
• Scapula provides for attachment of upper arm bone

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Bones of the arm

• Humerus upper arm bone
• Radius lower arm bone on thumb side that rotates
  around ulna to allow the hand to turn freely
• Ulna larger bone of lower arm that contains a
  projection called the olecranon process at upper
  end, forming elbow

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Wrist and hands

• Carpals 8 wrist bones on each hand
• Metacarpals 5 bones on each hand to form palm
• Phalanges
• 14 bones on each hand to form a thumb and fingers
• 3 on each finger
• 2 on each thumb

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Pelvic Girdle

• Made of two os coxae or hip bones
• Join with sacrum on dorsal part of body
• Join together at a joint called the symphysis
  pubis on ventral part of body

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• Each os coxae is made of three bones that are
  fused or joined
• Ilium
• Ischium
• Pubis
• Contains 2 recessed areas or sockets called
  acetabulum that provide for attachment of smooth
  rounded head of the femur
• Obturator foramen
• Opening between the ischium and pubis
• Allows for passage of nerves and blood vessels to
  and from the legs

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Bones of the legs

• Femur Thigh bone
• Patella Knee cap
• Tibia Larger weight bearing bone of lower
  leg. Commonly called the shin bone
• Fibula slender smaller bone of the lower
  leg that attaches to the proximal end of
  the tibia

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Ankles and Feet

• Tarsals 7 bones of ankles
• Calcaneous- Heel bone
• Metatarsals 5 bones forming instep of foot
• Phalanges
• 14 bones on each foot
• Form the toes
• 2 on each great toe
• 3 on each of other toes

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Joints
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• Joints
• areas where 2 or more bones join together
• Ligaments
• connective tissue bands that hold long bones
  together

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3 Main Types of Joints

• Diarthrosis or synovial
• Freely movable
• Ex Ball-and-socket joints of the shoulder and
  hip
• Ex Hinge joints of the elbow and knee

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• 2. Amphiarthrosis
• Slightly movable
• Ex is the attachment of the ribs to the thoracic
  vertebrae
• Ex symphysis pubis or joint between two pelvic
  bones
• 3. Synarthrosis
• Immovable
• Examples are the suture joints of the cranium

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Diseases and Abnormal Conditions
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Arthritis
Group of diseases involving an inflammation of
the joints
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• Two main types
• Osteoarthritis
• Chronic disease that occurs with aging
• Symptoms Joint pain, stiffness, aching, limited
  range of motion
• Treatment rest, heat/cold applications, ASA,
  anti-inflammatory medications, steroid
  injections, special exercises

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• 2. Rheumatoid
• Chronic inflammatory disease of joints
• Three times more common in women
• Often begins between age 35-45
• Scar tissue forms and atrophy of bone and muscle
  occurs
• Permanent deformity and immobility
• Treatment
• Rest and prescribed exercise
• Anti-inflammatory medications ASA and steroids
• Surgery, or arthroplasty to replace damaged
  joints such as hips or knees

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Bursitis
Inflammation of bursae, (small fluid-filled sacs
surrounding joints)
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• Bursitis frequently affects shoulders, elbows,
  hips, or knees
• Symptoms
• Severe pain, limited movement, accumulation of
  fluid in joint
• Treatment
• Pain medications and rest
• Injections of steroids and anesthetics into joint
• Aspiration of joint
• Physical therapy to preserve joint motion

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Fractures
A crack or break in a bone
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Types of fractures

• Greenstick bone is bent and splits, causing a
  crack or an incomplete break common in children
• Simple complete break with no damage to skin
• Compound break in bone that ruptures through
  skin increased chance of infection

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Types of fractures, cont

• Impacted broken fragments or splinters into
  more than two pieces
• Spiral severe twisting of a bone causing one or
  more breaks common in skiing and skating
  accidents
• Depressed broken piece of skull bone moves
  inward
• Colles breaking and dislocation of the distal
  radius that causes a characteristic bulge at the
  wrist, caused by falling with outstretched hand.

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Compound Fracture
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Greenstick
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Simple Fracture
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Spiral Fracture
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Impacted Fracture
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Depressed
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Reduction

• Process by which bone is put back into proper
  alignment
• Closed reduction position bone in alignment,
  usually with traction, and apply cast or splint
  to maintain position
• Open reduction surgical repair of bone and, at
  times, insertion of pins, plates, and other
  devices.

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ORIF (Open Reduction Internal Fixation)
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Disclocation

• Bone is forcibly displaced from a joint
• Frequently occurs in shoulders, fingers, knees,
  and hips
• Reduced and immobilized with splint, cast or
  traction

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Sprain

• Twisting action tears ligaments at a joint
• Common sites are wrists and ankles
• Symptoms pain, swelling, discoloration,
  limited movement
• Treatment rest and elevations,
  immobilization with elastic
  bandage or splint, cold applications.

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Osteomyelitis

• Inflammation of bone usually caused by pathogenic
  organism
• Pathogen causes formation of abscess within bone
  and accumulation of pus in medullary canal
• Symptoms pain at site, swelling, chills, fever
• Treatment antibiotics for infection

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Osteoporosis

• Metabolic disorder with increased porosity or
  softening of bones
• Causes
• Deficiency of hormones, especially estrogen in
  females
• Prolonged lack of calcium in diet
• Sedentary lifestyle
• Tx Increased intake of Ca and Vit D, exercise,
  medications such as Fosamax and Citracel,
  Estrogen replacement

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Ruptured disk (herniated)

• Interbertebral disk ruptures or protrudes out of
  place and causes pressure on the spinal nerve
• Most common site is lumbrosacral area can occur
  anywhere on spinal column

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• Symptoms severe pain, muscle spasm, impaired
  movement, and/or numbness
• Treatment
• Pain, anti-inflammatory, and muscle relaxant
  medications
• Rest and traction
• Physical and Massage therapy
• Chiropractic treatment
• Heat or cold applications
• Laminectomy surgical removal of the protruding
  disk for severe cases
• Severe cases, spinal fusion can be performed to
  insert a screw/rod

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Abnormal curvatures of spinal column

• Kyphosis hunchback bowing of thoracic area
• Scoliosis side to side, or lateral curvature of
  spine
• Lordosis swayback, inward curvature of lumbar
  spine

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Kyphosis
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Scoliosis
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Lordosis
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• Causes of abnormal curvatures of spine
• Poor posture
• Congenital defects
• Structural defects
• Malnutrition
• Treatment
• Therapeutic exercises, firm mattresses, and
  braces
• Surgical repair for severe deformities