Skeletal system Pearson Education, Inc.

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1 NURS1004 Week 6 Part I Prepared by Didy Button Skeletal system

2 An Introduction to the Skeletal System The Skeletal System Includes: Bones of the skeleton Cartilages, ligaments, and connective tissues

3 6-1 Functions of the Skeletal System Five Primary Functions of the Skeletal System 1. Support 2. Storage of Minerals (calcium) and Lipids (yellow marrow) 3. Blood Cell Production (red marrow) 4. Protection 5. Leverage (force of motion)

4 7-1 The Axial Skeleton The Axial Skeleton Forms the longitudinal axis of the body Has 80 bones The skull 8 cranial bones 14 facial bones Bones associated with the skull 6 auditory ossicles The hyoid bone

5 7-1 The Axial Skeleton The Axial Skeleton The vertebral column 24 vertebrae (singular = vertebra) The sacrum The coccyx The thoracic cage 24 ribs The sternum

6 Figure 7-1b The Axial Skeleton Skull Cervical vertebrae Sternum Ribs Thoracic vertebrae Costal cartilages Lumbar vertebrae Sacrum Coccyx Anterior (left) and posterior (right) views of the axial skeleton. The individual bones associated with the skull are not visible.

7 An Introduction to the Appendicular Skeleton The Appendicular Skeleton 126 bones Allows us to move and manipulate objects Includes all bones besides axial skeleton The limbs The supportive girdles

8 Figure 8-1 The Appendicular Skeleton SKELETAL SYSTEM 206 AXIAL SKELETON 80 APPENDICULAR SKELETON 126 (see Figure 7 1) Pectoral girdle 4 Clavicle Scapula 2 2 Humerus 2 Upper limbs 60 Radius 2 Ulna 2 Carpal bones 16 Metacarpal bones 10 Phalanges 28 Pelvic girdle 2 Hip bone 2

9 8-3 The Pelvic Girdle The Pelvic Girdle Made up of two hip bones (coxal bones) Strong to bear body weight, stress of movement Part of the pelvis Coxal bones Made up of three fused bones 1. Ilium (articulates with sacrum) 2. Ischium 3. Pubis

10 Figure 8-1 The Appendicular Skeleton (Part 2 of 2) Femur 2 Lower limbs 60 Patella 2 Tibia 2 Fibula 2 Tarsal bones 14 Metatarsal bones 10 Phalanges 28

11 6-2 Classification of Bones Bones Are classified by: Shape Internal tissue organization Bone markings (surface features; marks)

12 6-2 Classification of Bones Six Bone Shapes 1. Sutural bones 2. Irregular bones 3. Short bones 4. Flat bones 5. Long bones 6. Sesamoid bones

13 Figure 6-1 A Classification of Bones by Shape Sutural Bones Flat Bones Sutural bone Sutures Parietal bone External table Internal table Diploë (spongy bone) Irregular Bones Long Bones Vertebra Humerus Short Bones Sesamoid Bones Carpal bones Patella

14 An Introduction to the Axial Skeleton Structures of Bones Articulations Contacts with other bones Landmarks (bone markings; marks) Areas of muscle and ligament attachment Foramina Openings for nerves and blood vessels

15 6-2 Classification of Bones Bone Markings Depressions or grooves Along bone surface Elevations or projections Where tendons and ligaments attach At articulations with other bones Tunnels Where blood and nerves enter bone

16 Table 6-1 An Introduction to Bone Markings Trochanter Head Sinus Neck Tubercle Foramen Head Sulcus Neck Crest Fossa Fissure Process Tuberosity Spine Ramus Line Facet Tubercle Skull Fossa Trochlea Foramen Ramus Pelvis Femur Condyle Condyle Humerus

17 6-2 Classification of Bones Structure of a Long Bone Diaphysis The shaft A heavy wall of compact bone, or dense bone A central space called medullary (marrow) cavity Epiphysis Wide part at each end Articulation with other bones Mostly spongy (cancellous) bone Covered with compact bone (cortex) Metaphysis Where diaphysis and epiphysis meet

18 Figure 6-2a Bone Structure Spongy bone Epiphysis Metaphysis Compact bone Diaphysis (shaft) Medullary cavity Metaphysis Epiphysis The structure of a representative long bone (the femur) in longitudinal section

19 6-3 Bone (Osseous) Tissue Bone (Osseous) Tissue Dense, supportive connective tissue Contains specialized cells Produces solid matrix of calcium salt deposits Around collagen fibers

20 6-3 Bone (Osseous) Tissue Characteristics of Bone Tissue Dense matrix, containing: Deposits of calcium salts Osteocytes (bone cells) within lacunae organized around blood vessels Canaliculi Form pathways for blood vessels Exchange nutrients and wastes

21 6-3 Bone (Osseous) Tissue Characteristics of Bone Tissue Periosteum Covers outer surfaces of bones Consists of outer fibrous and inner cellular layers

22 6-3 Bone (Osseous) Tissue Bone Matrix Matrix Proteins One third of bone matrix is protein fibers (collagen)

23 6-4 Compact Bone and Spongy Bone The Structure of Compact Bone Osteon is the basic unit Osteocytes are arranged in concentric lamellae Around a central canal containing blood vessels Perforating canals Perpendicular to the central canal Carry blood vessels into bone and marrow

24 Figure 6-13 The Blood Supply to a Mature Bone Periosteum Branches of nutrient artery and vein Articular cartilage Epiphyseal artery and vein Metaphyseal artery and vein Periosteal arteries and veins Connections to superficial osteons Periosteum Compact bone Medullary cavity Nutrient artery and vein Nutrient foramen Metaphyseal artery and vein Metaphysis Epiphyseal line

25 Figure 6-5a The Structure of Compact Bone Circumferential lamellae Osteons Venule Capillary Periosteum Perforating fibers Interstitial lamellae Concentric lamellae Trabeculae of spongy bone (see Fig.6 6) Vein Artery Arteriole Central canal Perforating canal The organization of osteons and lamellae in compact bone

26 6-3 Bone (Osseous) Tissue Bone Matrix Minerals Two thirds of bone matrix is calcium phosphate, Ca 3 (PO 4 ) 2 Reacts with calcium hydroxide, Ca(OH) 2 To form crystals of hydroxyapatite, Ca 10 (PO 4 ) 6 (OH) 2 Which incorporates other calcium salts and ions

27 6-3 Bone Landmarks for Physical examinaiotn Most prominent spinous process is C7/T1. Inferior points of scapulae are at interspace between T7 & T8. Superior margin of each iliac crest crosses L4. Two symmetric dimples overlying posterior superior iliac spine are at level of S2. Coccyx.

28 Figure 8-1 The Appendicular Skeleton SKELETAL SYSTEM 206 AXIAL SKELETON 80 APPENDICULAR SKELETON 126 (see Figure 7 1) Pectoral girdle 4 Clavicle Scapula 2 2 Humerus 2 Upper limbs 60 Radius 2 Ulna 2 Carpal bones 16 Metacarpal bones 10 Phalanges 28 Pelvic girdle 2 Hip bone 2

29 Physical Examination Landmarks You should be able to palpate these: Elbow (lateral and medial epicondyles of humerus, olecranon process of ulna) Wrist (styloid process of radius thumb side, & of ulna) Shoulder (acromian process of scapula) Hip (iliac crest, greater trochanter of femur) Knee (patella) Shin (anterior crest of tibia) Ankle (lateral malleolus of fibula & medial malleolus of tibia) Heel (calcaneus).

30 NURS1004 Week 6 Lecture Part II Articulations Prepared by Didy Button

31 An Introduction to Articulations Articulations Body movement occurs at joints (articulations) where two bones connect Joint Structure Determines direction and distance of movement (range of motion or ROM) Joint strength decreases as mobility increases

32 9-1 Classification of Joints Functional Classifications Synarthrosis (immovable joint) Amphiarthrosis (slightly movable joint) Diarthrosis (freely movable joint)

33 9-1 Classification of Joints Structural Classifications Fibrous joints. Articulating bones bound tightly together by fibrous connective tissue (sutures, syndesmosis between tibia & fibula, gomphoses). b) Cartilaginous joints. Articulating bones held tightly together by cartilage (synchondroses between rib & sternum, pubic symphysis). c) Synovial joints. Articulating bones have a fluid-filled space between them (gliding, hinge, pivot, ellipsoidal, saddle, ball & socket).

34 9-2 Synovial Joints Synovial Fluid (e.g. knee, hip, elbow, shoulder, fingers, toes, jaw) Contains slippery proteoglycans secreted by fibroblasts Functions of synovial fluid 1. Lubrication 2. Nutrient distribution 3. Shock absorption

35 Figure 9-1a The Structure of a Synovial Joint Medullary cavity Spongy bone Periosteum Fibrous joint capsule Synovial membrane Articular cartilages Joint cavity (containing synovial fluid) Compact bone Synovial joint, sagittal section

36 9-2 Synovial Joints Accessory Structures Cartilages Fat pads Ligaments Tendons Bursae

37 9-2 Synovial Joints Factors That Stabilize Synovial Joints Prevent injury by limiting range of motion Collagen fibers (joint capsule, ligaments) Articulating surfaces and menisci Other bones, muscles, or fat pads Tendons of articulating bones

38 Figure 9-1b The Structure of a Synovial Joint Bursa Joint capsule Synovial membrane Meniscus Intracapsular ligament Femur Tibia Quadriceps tendon Patella Articular cartilage Fat pad Patellar ligament Joint cavity Meniscus Knee joint, sagittal section

39 Inflammation of the synovial joint Osteoarthritis bony growths (osteophytes) at joints Rheumatoid arthritis is an autoimmune disease characterised by chronic inflammation of the synovial membrane leading to deformity, loss of function, pain, swelling, ultimately to joint destruction. Psoriatic arthritis associated with the skin condition psoriasis.

40 Figure 9-3a Angular Movements Extension Flexion Hyperextension Flexion Flexion Hyperextension Extension Flexion Extension Hyperextension Extension Flexion/extension

41 Figure 9-3b Angular Movements Abduction Abduction Adduction Adduction Abduction Abduction Adduction Adduction Abduction/adduction

42 Figure 9-3c Angular Movements Adduction Adduction/abduction Abduction

43 Figure 9-3d Angular Movements Circumduction

44 Figure 9-4a Rotational Movements Head rotation Right rotation Left rotation Lateral (external) rotation Medial (internal) rotation

45 Figure 9-4b Rotational Movements Supination Pronation Supination Pronation

46 Figure 9-5 Synovial Joints Eversion Inversion

47 Figure 9-5 Synovial Joints Dorsiflexion (ankle flexion) Plantar flexion (ankle extension)

48 9-6 The Knee Joint Seven Major Supporting Ligaments 1. Patellar ligament (anterior) 2. & 3. Two popliteal ligaments (posterior) 4. & 5. Anterior and posterior cruciate ligaments (inside joint capsule) 6. Tibial collateral ligament (medial) 7. Fibular collateral ligament (lateral)

49 Figure 9-12a The Right Knee Joint Quadriceps tendon Patellar retinaculae Fibular collateral ligament Patella Patellar ligament Joint capsule Tibial collateral ligament Tibia Anterior view, superficial layer

50 Figure 9-12b The Right Knee Joint Femur Joint capsule Gastrocnemius muscle, medial head Bursa Tibial collateral ligament Popliteal ligaments Popliteus muscle Tibia Plantaris muscle Gastrocnemius muscle, lateral head Fibular collateral ligament Cut tendon of biceps femoris muscle Fibula Posterior view, superficial layer

51 Figure 9-12c The Right Knee Joint Patellar surface Fibular collateral ligament Lateral condyle Posterior cruciate ligament Medial condyle Lateral meniscus Cut tendon Tibia Tibial collateral ligament Medial meniscus Anterior cruciate ligament Fibula Deep anterior view, flexed

52 Figure 9-12d The Right Knee Joint Femur Posterior cruciate ligament Medial condyle Tibial collateral ligament Medial meniscus Fibular collateral ligament Lateral condyle Lateral meniscus Cut tendon Anterior cruciate ligament Fibula Tibia Deep posterior view, extended

53 9-7 Effects of Aging on Articulations Joint Immobilization Reduces flow of synovial fluid Can cause arthritis symptoms Treated by continuous passive motion or CPM (therapy) Bones and Aging Bone mass decreases Bones weaken Increases risk of hip fracture, hip dislocation, or pelvic fracture

54 9-8 Integration with Other Systems Factors Affecting Bone Strength 1. Age 2. Physical stress 3. Hormone levels 4. Calcium and phosphorus uptake and excretion 5. Genetic and environmental factors

55 9-8 Integration with Other Systems Bones Support Body Systems Support and protect other systems Store fat, calcium, and phosphorus Manufacture cells for immune system

56 The End Knee joint