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CHAPTER 6 SKELETAL SYSTEM - BONES & JOINTS SKELETAL SYSTEM COMPONENTS • BONES • OTHER CONNECTIVE TISSUE • JOINTS FUNCTIONS OF THE SKELETAL SYSTEM • SUPPORT • PROTECTION • MOVEMENT • STORAGE • BLOOD CELL PRODUCTION EXTRACELLULAR MATRIX REVIEW • DETERMINES FUNCTION OF CONNECTIVE TISSUES • COLLAGEN • PROTEOGLYCANS • MINERALS EXTRACELLULAR MATRIX • TENDONS AND LIGAMENTS • LARGE AMOUNTS OF COLLAGEN FIBERS • CREATES TOUGH STRUCTURES, LIKE ROPE OR CABLE EXTRACELLULAR MATRIX • CARTILAGE • CONTAINS COLLAGEN AND PROTEOGLYCANS • COLLAGEN MAKES TOUGH • PROTEOGLYCANS MAKE SMOOTH AND RESILIENT EXTRACELLULAR MATRIX • BONES • CONTAINS COLLAGEN AND MINERALS (CALCIUM/PHOSPHATE) • COLLAGEN GIVES FLEXIBLE STRENGTH • MINERAL GIVES COMPRESSION OR WEIGHT BEARING STRENGTH SHAPE CATEGORIES OF BONE • LONG • SHORT • IRREGULAR • FLAT STRUCTURE OF A LONG BONE • DIAPHYSIS • EPIPHYSIS • ARTICULAR CARTILAGE • EPIPHYSEAL PLATE • EPIPHYSEAL LINE STRUCTURE OF LONG BONE STRUCTURE OF LONG BONE STRUCTURE OF LONG BONE • MEDULLARY CAVITY • YELLOW MARROW VS RED MARROW • PERIOSTEUM • ENDOSTEUM STRUCTURE OF LONG BONE GENERAL HISTOLOGY OF BONE • OSTEOBLASTS VS OSTEOCYTE • FORMED AS LAMELLAE • LACUNAE BETWEEN LAMELLAE • CANALICULI TYPES OF BONE – HISTOLOGY • COMPACT • SPONGY • ONE SINGLE BONE MAY HAVE BOTH TYPES WITHIN IT COMPACT BONE • FOUND IN DIAPHYSIS ON LONG BONES & THIN SURFACES OF OTHER BONES • MOST LAMELLAE ARE IN RINGS AROUND A HAVERSIAN CANAL (OR CENTRAL CANAL) COMPACT BONE • HAVERSIAN SYSTEM (OR OSTEON) • CANALICULI ALLOW FOR CONNECTIONS BETWEEN OSTEOCYTES, AND PATHWAY FOR DIFFUSION AND WASTE MOLECULES COMPACT BONE PICTURE SPONGY BONE • FOUND IN EPIPHYSES OF LONG BONES & INTERIOR OF OTHER BONES • TRABECULAE • MARROW IN SPACES SPONGY BONE • NO BLOOD VESSELS OR CENTRAL CANAL IN TRABECULAE • NUTRIENTS LEAVE MARROW AND DIFFUSE THROUGH CANALICULI TO REACH OSTEOCYTES THERE BONE OSSIFICATION • FORMATION OF BONE BY OSTEOBLASTS • AFTER AN OSTEOBLAST BECOMES SURROUNDED BY BONE MATRIX, IT BECOMES AND OSTEOCYTE INTRAMEMBRANOUS OSSIFICATION • OSTEOBLASTS BEGIN TO PRODUCE BONE IN CONNECTIVE TISSUE MEMBRANES • BEGINS IN OSSIFICATION CENTERS ENDOCHONDRAL OSSIFICATION • BONE STARTS AS CARTILAGE • CHONDROCYTES INCREASE IN NUMBER, ENLARGE AND DIE • CARTILAGE MATRIX BECOMES CALCIFIED • BLOOD VESSELS ACCUMULATE IN PERICHONDRIUM ENDOCHONDRAL OSSIFICATION • PRESENCE OF BLOOD VESSELS CAUSES SOME CONNECTIVE TISSUE CELLS TO BECOME OSTEOBLASTS • OSTEOBLASTS THEN START TO FORM BONE AROUND THE OUTSIDE OF DIAPHYSIS • PERICHONDRIUM BECOMES PERIOSTEUM ENDOCHONDRAL OSSIFICATION • BLOOD VESSELS GROW INTO DEEP PARTS OF DIAPHYSIS BRINGING IN OSTEOBLASTS AND STIMULATING OSSIFICATION • OSTEOCLASTS DESTROY CALCIFIED CARTILAGE MATRIX THAT IS NO LONGER NEEDED • OSTEOBLASTS LINE UP ON REST OF CALCIFIED CARTILAGE MATRIX TO START FORMING TRABECULAE ENDOCHONDRAL OSSIFICATION • MEDULLARY CAVITY FORMS IN CENTER OF DIAPHYSIS • BONE MARROW REPLACES SOME OF CALCIFIED CARTILAGE MATRIX IN MEDULLARY CAVITY • SECONDARY OSSIFICATION CENTERS FORM THE EPIPHYSES ENDOCHONDRAL OSSIFICATION BONE GROWTH • NEW BONE LAMELLAE IS PUT ON EXISTING BONE/CONNECTIVE TISSUE • APPOSITIONAL GROWTH • INCREASES WIDTH • INCREASE IN LENGTH OF BONE • ENDOCHONDRAL OSSIFICATION AT EPIPHYSEAL PLATE BONE REMODELING • EXISTING BONE IS REMOVED AND NEW BONE IS MADE • CAUSES BONE TO CHANGE SHAPE, REPAIR, ADJUST TO STRESS, AND REGULATE CALCIUM IONS IN BODY FLUIDS • INVOLVED IN NEW SPONGY BONE BEING CONVERTED TO COMPACT BONE BONE REMODELING BONE REMODELING BONE REPAIR • BONE BREAKS • BLOOD VESSELS ARE DAMAGED • CLOT FORMS • BLOOD VESSELS & CELLS FROM SURROUNDING TISSUE INVADE THE CLOT • CALLUS FORMS BONE REPAIR • OSTEOBLASTS FORM SPONGY BONE IN CALLUS • BONE REMODELING • IMMOBILIZATION? BONE REPAIR BONE & CALCIUM HOMEOSTASIS • CALCIUM IS STORED IN BONE • BODY MAINTAINS HOMEOSTASIS OF CALCIUM IN BLOOD HYPOCALCEMIA • LOW BLOOD CA LEVELS CAUSES ↑ PARATHYROID HORMONE (PTH) SECRETION • CAUSES ↑ OSTEOCLAST ACTIVITY TO ↑ BLOOD CA LEVELS • CAUSES ↑ VITAMIN D FORMATION BY KIDNEYS • VITAMIN D ↑ CA ABSORPTION FROM INTESTINES • CAUSES ↑ CA ABSORPTION FROM URINE IN KIDNEY HYPOCALCEMIA • HYPOPARATHYROIDISM • VITAMIN D DEFICIENCY • CHRONIC RENAL DISEASE HYPERCALCEMIA • HIGH BLOOD CA LEVELS CAUSES ↑ CALCITONIN SECRETION • CAUSES ↓ OSTEOCLAST ACTIVITY • ↓ VITAMIN D PRODUCTION BY KIDNEYS • ↓ ABSORPTION FROM THE INTESTINES • ↑ CA EXCRETION VIA THE KIDNEYS/URINE HYPERCALCEMIA • KIDNEY FAILURE • VITAMIN D DISORDERS • PARATHYROID DISORDERS • CANCER • HIGH BONE TURN-OVER RATES CALCIUM HOMEOSTASIS OSTEOPOROSIS • POROUS BONE • LESS BONE MATRIX • MORE COMMON IN ELDERLY & WOMEN • DUE TO DECREASES IN ESTROGEN • DUE TO DECREASES IN CALCIUM ABSORPTION • DUE TO LACK OF EXERCISE • DECREASES IN TESTOSTERONE DO NOT HAVE SAME EFFECT IN MALES • CAN CAUSE VERTEBRAE TO COLLAPSE • TREATMENTS GENERAL CONSIDERATIONS OF BONE ANATOMY • FORAMEN • CANAL/MEATUS • FOSSA • TUBERCLE/TUBEROSITY • PROCESS • CONDYLE AXIAL SKELETON COMPONENTS • SKULL • VERTEBRAL COLUMN • THORACIC CAGE SKULL • 22 BONES • BRAINCASE • 8 BONES • FACIAL BONES • 14 BONES • AUDITORY OSSICLES • 3 PER EAR SKULL – LATERAL VIEW • PARIETAL BONE • EXTERNAL AUDITORY CANAL • TEMPORAL BONE • MASTOID PROCESS • SQUAMOUS SUTURE • SPHENOID BONE • FRONTAL BONE • ZYGOMATIC BONE • CORONAL SUTURE • ZYGOMATIC ARCH • OCCIPITAL BONE • MAXILLA • LAMBDOID SUTURE • MANDIBLE SKULL – LATERAL VIEW PICTURE SPHENOID BONE PICTURE SKULL – FRONTAL VIEW • FRONTAL BONE • NASAL CAVITY • ZYGOMATIC BONES • NASAL SEPTUM • MAXILLAE • NASAL BONES • MANDIBLE • ORBITS • SUPERIOR & INFERIOR ORBITAL FISSURES • OPTIC FORAMEN • NASOLACRIMAL CANAL • LACRIMAL BONE • NASAL CONCHAE • PARANASAL SINUSES • MASTOID AIR CELLS SKULL - FRONTAL VIEW PICTURE PARANASAL SINUS PICTURE SUPERIOR VIEW OF THE CRANIAL CAVITY • DIVIDED INTO 3 CRANIAL FOSSAE • ANTERIOR, MIDDLE, & POSTERIOR • FORAMINA IN MIDDLE FOSSA ALLOW NERVES & BLOOD VESSELS INTO SKULL • FORAMEN MAGNUM IN POSTERIOR FOSSA ALLOWS SPINAL CORD TO CONNECT TO BRAIN • SELLA TURCICA CONTAINS THE PITUITARY GLAND SUPERIOR VIEW OF THE CRANIAL CAVITY HYOID BONE • U-SHAPED • NOT PART OF SKULL • MUSCLES & LIGAMENTS ATTACH IT TO SKULL • PROVIDES ATTACHMENT FOR SOME TONGUE MUSCLES & SOME NECK MUSCLES VERTEBRAL COLUMN • 7 CERVICAL VERTEBRAE • 12 THORACIC VERTEBRAE • 5 LUMBAR VERTEBRAE • 1 SACRAL BONE • 1 COCCYGEAL BONE VERTEBRAL COLUMN ABNORMALITIES Kyphosis Lordosis Scoliosis VERTEBRAL COLUMN FUNCTIONS • SUPPORT WEIGHT OF HEAD AND TRUNK • PROTECT SPINAL CORD • ALLOW SPINAL NERVES TO EXIT THE SPINAL CORD • PROVIDE SITES OF MUSCLE ATTACHMENT • PERMIT MOVEMENT OF HEAD AND TRUNK VERTEBRAL BODY ANATOMY • 3 PARTS • BODY • ARCH • PROCESSES • VERTEBRAL FORAMEN • INTERVERTEBRAL FORAMINA • INTERVERTEBRAL DISKS CERVICAL VERTEBRAE • SMALL (OR NO BODY) • TRANSVERSE PROCESS HAS TRANSVERSE FORAMEN FOR VERTEBRAL ARTERIES TO REACH BRAIN • ATLAS • AXIS THORACIC VERTEBRAE • LONG, THIN SPINOUS PROCESS THAT POINT INFERIORLY • EXTRA ARTICULAR FACETS ON SIDE FOR JOINT WITH RIBS LUMBAR VERTEBRAE • LARGE, THICK BODY • RECTANGULAR TRANSVERSE & SPINOUS PROCESS • SUPERIOR ARTICULAR FACETS FACE MEDIALLY & INFERIOR ARTICULAR FACETS FACE LATERALLY SACRUM • FORMED BY 5 FUSED VERTEBRAE • MEDIAN SACRAL CREST • SACRAL HIATUS • SACRAL PROMONTORY COCCYX • COCCYX • ABOUT 4 FUSED VERTEBRAE • REDUCED BODIES • NO FORAMEN OR PROCESS THORACIC CAGE • THORACIC VERTEBRAE • RIBS • CARTILAGE • STERNUM RIBS & COSTAL CARTILAGES • COSTAL CARTILAGE • TRUE RIBS • FALSE RIBS • FLOATING RIBS STERNUM • MANUBRIUM • BODY • XIPHOID PROCESS • JUGULAR NOTCH • STERNAL ANGLE APPENDICULAR SKELETON • UPPER LIMB • LOWER LIMB • GIRDLES PECTORAL GIRDLE • 2 SCAPULAE • FLAT, TRIANGULAR BONE • 3 FOSSA FOR ARM MUSCLES TO ATTACH • GLENOID • SPINE • ACROMION PROCESS • CORACOID PROCESS PECTORAL GIRDLE • 2 CLAVICLES • ARTICULATES WITH SCAPULA AT ACROMION PROCESS • PROXIMAL END ATTACHES TO STERNUM UPPER LIMB • ARM • FOREARM • WRIST • HAND ARM - HUMERUS • HEAD • ANATOMICAL NECK • GREATER & LESSER TUBERCLES • DELTIOD TUBEROSITY • CONDYLES • EPICONDYLES FOREARM • ULNA • TROCHLEAR NOTCH • OLECRANON PROCESS • CORONOID PROCESS • STYLOID PROCESS • RADIUS • HEAD • RADIAL TUBEROSITY • STYLOID PROCESS WRIST • 8 CARPEL BONES • SCAPHOID • LUNATE • TRIQUETRUM • PISIFORM • TRAPEZIUM • TRAPEZOID • CAPITATE • HAMATE HAND • 5 METACARPAL BONES • 14 PHALANGES • MAKE UP THE DIGITS PELVIC GIRDLE • PLACE WHERE LOWER LIMBS ATTACH TO BODY • PELVIC GIRDLE • RIGHT AND LEFT COXAL BONES (HIP BONES) JOIN TO FORM ANTERIOR PORTION • SACRUM JOINS POSTERIORLY • FORMS A RING PELVIC GIRDLE GENDER DIFFERENCES • MALES – LARGER • FEMALES – BROADER & SHORTER • WIDER INLET & OUTLET • SACRUM POINTS MORE POSTERIORLY IN FEMALES • SUBPUBIC ANGLE • LESS THAN 90° IN MALES, 90° OR MORE IN FEMALES PELVIC GIRDLE GENDER DIFFERENCES PELVIS • INCLUDES PELVIC GIRDLE AND COCCYX • ILIUM • ISCHIUM • PUBIS • ILIAC CREST • ANTERIOR SUPERIOR ILIAC SPINE • PUBIC SYMPHYSIS • SACROILIAC JOINTS • ACETABULUM • OBTURATOR FORAMEN PELVIS LOWER LIMB • THIGH • LEG • ANKLE • FOOT THIGH • BETWEEN HIP & KNEE • FEMUR • HEAD ARTICULATES WITH ACETABULUM OF COXAL BONE • CONDYLES ARTICULATE WITH TIBIA • EPICONDYLES ARE FOR LIGAMENT ATTACHMENT • TROCHANTERS ARE FOR MUSCLE ATTACHMENT • PATELLA • KNEECAP LEG • BETWEEN KNEE & ANKLE • TIBIA • FLAT CONDYLES ARTICULATE WITH FEMUR • TIBIAL TUBEROSITY – MUSCLES OF ANTERIOR THIGH ATTACH • ARTICULATES WITH TALUS OF ANKLE • MEDIAL MALLEOLUS • FIBULA • HEAD IS ATTACHED TO TIBIA • ARTICULATES WITH TALUS OF ANKLE • LATERAL MALLEOLUS ANKLE • 7 TARSAL BONES • TALUS • CALCANEUS • CUBOID • NAVICULAR • MEDIAL CUNEIFORMS • INTERMEDIATE CUNEIFORMS • LATERAL CUNEIFORMS FOOT • METATARSAL BONES • PHALANGES • 3 ARCHES • 2 GO FROM HEEL TO BALL OF FOOT • 1 GOES TRANSVERSELY JOINTS • ALSO CALLED ARTICULATION • A PLACE WHERE TWO BONES COME TOGETHER • MAY OR MAY NOT BE MOVEABLE • FUNCTIONAL CLASSIFICATION – BASED ON DEGREE OF MOVEMENT • STRUCTURAL CLASSIFICATION – BASED ON TYPE OF CONNECTIVE TISSUE THAT BINDS THE BONES TOGETHER AND WHETHER THERE IS A FLUID-FILLED JOINT CAPSULE FIBROUS JOINTS • BONES HELD TOGETHER BY FIBROUS TISSUE • USUALLY NO MOVEMENT BETWEEN BONES • 3 TYPES • SUTURES • FONTANELS • SYNDESMOSES • GOMPHOSES CARTILAGINOUS JOINTS • TWO BONES ARE JOINED BY CARTILAGE • ONLY SLIGHT MOVEMENT CAN OCCUR • EXAMPLES • BETWEEN RIBS & STERNUM • EPIPHYSEAL PLATES • INTERVERTEBRAL DISKS • FIBROCARTILAGE SYNOVIAL JOINTS • FLUID WILL BE IN A CAVITY THAT SURROUNDS THE ENDS OF THE BONES • FREELY MOVEABLE • GENERAL PARTS • ARTICULAR CARTILAGE • JOINT CAVITY • JOINT CAPSULE • SYNOVIAL MEMBRANE • SYNOVIAL FLUID • BURSA • TENDON SHEATH TYPES OF SYNOVIAL JOINTS • GROUPED BASED ON SHAPE OF ADJOINING BONES • PLANE JOINTS • SADDLE JOINTS • HINGE JOINTS • PIVOT JOINTS • BALL-AND-SOCKET JOINTS • ELLIPSOID JOINTS TYPES OF MOVEMENT • FLEXION & EXTENSION • PLANTAR FLEXION & DORSIFLEXION • • • • • • • • • ABDUCTION & ADDUCTION PRONATION & SUPINATION EVERSION & INVERSION ROTATION CIRCUMDUCTION PROTRACTION & RETRACTION ELEVATION & DEPRESSION EXCURSION OPPOSITION & REPOSITION DOUBLE DREAM FEET REVIEW • WHEN THE CLIP IS PAUSED, TELL ME THE TYPE OF MOVEMENT, BONES, & JOINT INVOLVED EFFECTS OF AGING ON THE SKELETAL SYSTEM AND JOINTS • BONE MATRIX • BECOMES MORE BRITTLE DUE TO LESS COLLAGEN • BECOMES LESS DENSE • OSTEOPOROSIS • JOINTS • LESS ARTICULAR CARTILAGE • LESS SYNOVIAL FLUID • ARTHRITIS • LIGAMENTS & TENDONS SHORTEN TYPES OF BONE FRACTURES • DISPLACED VS NON-DISPLACED • COMMINUTED • CLOSED VS OPEN • GREENSTICK • TRANSVERSE • OBLIQUE • IMPACTED PICTURES OF BONE FRACTURES
