Musculoskeletal System: Functions, Structure, and Importance

1. Chapter Three Musculoskeletal System And Connective Tissue

2. Functions of the Musculoskeletal System • Acts as a framework for the organ systems • Protects many of the body’s organs • Provides the organism with the ability to move • Storage of minerals • Hematopoiesis (formation of blood cells) Word Parts hemat/o = blood -poiesis = formation

3. Musculoskeletal System • Bones-inflexible • Cortical- 2 types compact bone and cancellous (spongy) bone • Muscles- smooth and striated • Joints/articulations- shock absorbers • Ligaments/Tendons- connective tissue • Fascia • Cartilage- collagen fibers and cartilage cells. • Elastic- stretchy and forms parts of the ears and nose. Fibrocartilage- bundled collagen found in discs between vertebrae. • Hyaline cartilage-covers ends of long bones and acts as a cushion. Word Parts oste/o, oss/i, osse/o = bone muscul/o, my/o, myos/o = muscle arthr/o, articul/o = joint ligament/o, syndesm/o = ligament tendin/o, tend/o, ten/o = tendon cartilag/o, chondr/o = cartilage

4. The Importance of the MS System • Bones are used to name structures throughout the body • Examples: femur (thigh) • Femoral artery • Femoral vein • Femoral nerves

5. Skeletal Divisions • Axial skeleton • Skull • Spine (Vertebrae) • Rib cage • Appendicular skeleton • Shoulder girdle • Upper extremities • Pelvic girdle • Lower extremities

6. ICD-10-PCS Divisions • Head and facial bones • Upper bones • Lower bones

7. Shapes of Human Bones • Long bones- named for length (humerus, femur) • Short bones- length (carpal, and tarsal) • Flat bones- shape (sternum, scapula) • Irregular bones vertebra, stapes (ear) • Sesamoid bones- patella

8. Bone Structure • Osteocytes- mature bone cells • Matrix- substance between osteocytes formed by a fibrous protein substance a framework for mineral salts called hydroxyapatitte. This gives bone its lattice-like structure. • Osteoblasts- immature cells responsible for building bone. • Osteoclasts- breaks down bone to release calcium salts. Bone requires a blood source to remain healthy, therefore passageways are created to allow blood supply. Word Parts oste/o = bone -cyte = cell -blast = embryonic -clast = breaking down myel/o = bone marrow, spinal cord

9. Bone Structure • Osteons -cylindrical units within the • harder outer bone (Haversian system)- • Lamellae- layers surrounding osteons • Vascular pathways – provide a system for blood to travel in for nourishment • Haversian • Volkman’s • Trabeculae – allows space for storage of fat cells and formation of blood.

10. Bone Structure • Trabeculae • Lamellae- there are different types Word Parts perioste/o = periosteum trabecul/o = trabecula

11. Long Bones and Bone Structure • Diaphysis-shaft • Epiphysis-ends • Epiphyseal plate-where growth occurs • Metaphysis- area where both the ephipysis and epihiseal plate meet. • Endosteum-inner lining • Periosteum – tissue surrounding bone • Bone marrow- stores fat cells and produces blood • cells Word Parts dia- = through -physis = growth, nature epi-= above peri- = surrounding oste/o = bone endo- = within myel/o = bone marrow

12. Bone Depressions • Fissure- deep cleft or groove • Foramen (pl. foramina)- opening or hole • Fossa (pl. fossae)- hollow or depression, usually at the end • Sinus (pl. sinuses)- cavity or channel that has membrane lining • Synonym: antrum • Sulcus (pl. sulci)- refers to groove or depression in a structure that is more shallow than a fissure. Word Parts fissur/o = fissure foramin/o = foramen foss/o = fossa sin/o = sinus antr/o = antrum sulc/o = sulcus

13. Bone Processes • Ramus- extension resembling a branch • (bone) Head- rounded proxmimal portion of some long bones • Spine- thornlike projection • Trochanter- 1 of 2 bony projections on the proximal ends of the femurs that serve as points of attachment for muscle • Tubercle- nodule or small raised area • Tuberosity- elevation or protuberance larger than a tubercle. Word Parts capit/o = head spirn/o = spine trochanter/o = trocanter tubercul/o = tubercle

14. Bone Processes • Condyle- rounded projection found at the end of a bone • Crest- narrow elongated elevation • Epicondyle- projection on surface above a condyle • Facet- smooth flat articular surface • Neck- narrow area away from a bone head. Word Parts condyl/o = condyle epicondyl/o = epicondyle

15. Bone Depressions

16. Review Question • If you see the combining form chondr/o in a report, you know that the term has to do with the: A. cartilage B. fascia C. bone D. ligaments

17. PCS Guideline Alert! B4.6 If a procedure is performed on the skin, subcutaneous tissue, or fascia overlying a joint, the procedure is coded to the following body part: • shoulder is coded to upper arm • elbow is coded to lower arm • wrist is coded to lower arm • hip is coded to upper leg • knee is coded to lower leg • ankle is coded to foot

18. PCS Guideline Alert! • B4.5 Procedures performed on tendons, ligaments, bursae, and fascia supporting a joint are coded to the body part in the respective body system that is the focus of the procedure. Procedures performed on joint structures themselves are coded to the body part in the joint body systems. • Example: Repair of the anterior cruciate ligament of the knee is coded to the knee bursae and ligament body part in the Bursae and Ligaments body system. Knee arthroscopy with shaving of articular cartilage is coded to the knee joint body part in the Lower Joints body system.

19. Bones of the Axial Skeleton • Skull (cranium and facial bones) • Rib cage • Spine (vertebrae)

20. Cranium and Facial Bones • Cranium • Frontal bone- front part of skull and forehead • Parietal bone- sides of the skull • Occipital bone- back of the skull Word Parts crani/o = cranium front/o = frontal pariet/o = parietal occipit/o = occipital

21. Cranium and Facial Bones • Cranium • Temporal bone- lower sides of the skull • Mastoid process-back part of the temporal bone behind the ear • Petrous bone-hard bone in the temporal bone that houses auditory canal, and middle and inner ear. • Tympanic portion- lower area that encircles eardrum. • Zygomatic process-front porjection that forms inferior portion of the cheek. • Styloid process- thin pointed projection at the base of temporal bone that allows for attachment for ligaments and muscles. Word Parts tempor/o = temporal petr/o, petros/o = stone tympan/o = eardrum styl/o = styloid

22. Cranium and Facial Bones • Cranium • Ethmoid bone- seiveline bone that forms roof and walls of nasal cavity. • Cribiform plate- contains holes for the olfactory nerves (for smell) • Sphenoid bone- forms internal base of the skull. • Optic foramina- openings for optic nerves • Alisphenoid- wings of the triangular projections of the temporal bone • Orbitosphenoid- small prjections that form the back of the orbit and support part of the frontal lobe. • Paranasal sinuses- air filled cavities named for bones where they are located. • Hyoid bone- u shape bone at the back of neck that is attached to styloid process. Word Parts ethmoid/o = ethmoid crib/i = sieve -form = shape sphenoid/o = sphenoid opt/o = eye al/i = wing para-= near nas/o = nose hy/o = u-shaped, hyoid bone

23. Cranium and Facial Bones • Facial Bones • Zygomatic- cheekbones • Lacrimal bones- forner of each eye that cradle tear ducts • Maxilla- upper jaw bone Word Parts zygomat/o, zygom/o = zygoma lacrim/o = lacrimal bone maxill/o = maxilla =

24. Cranium and Facial Bones • Facial Bones • Mandible- jaw • Mental foramina- holes in the central part of the mandible • Ramus-back part of the verticle projections • Condyloid process/Coronoid process- front projections of the ramus that articulates with the jaw. • Mandibular notch- space between condyloid/coronoid processes. • Nasal bones • Vomer- bone that forms front and back part of the septum • Nasal septum- divider between nostrils • Palatine bones-roof of the mouth • Orbit –bony socket of eyeball. Word Parts mandibul/o = mandible ment/o = chin condyl/o = condyle coron/o = crown vomer/o = vomer palat/o = palatine bone

25. Rib Cage • True/false/floating ribs- 12 pairs of thin, flat bones • 7 pairs of true attached at sternum • Five pairs of false, attached by cartilage • Two floating that are not attached at the front at all • Sternum- breastbonee • Manubrium, suprasternal notch, corporis, xiphoid process • Costochondral cartilage- cartilage that attaches ribs Word Parts cost/o = rib stern/o = sternum supra- = above corpor/o = body xiph/o = xiphoid

26. View of the breastone

27. Spine (vertebrae) • Cervical C1-C7 • Atlas (C-1) • Axis (C-2) • Odontoid process/dens • Thoracic T1-T12 • Lumbar L1-L5 • Sacral S1-S5 • Coccygeal Word Parts cervic/o = neck axi/o = axis odont/o = tooth thorac/o = chest lumb/o = loin sacr/o = sacrum coccyg/o = coccyx (tailbone)

28. Spine (vertebrae) • Vertebra • Body • Foramen • Arch • Pedicle • Spinous process • Lamina • Transverse process • Facet/articular process Word Parts spin/o = spine lamin/o = lamina

29. Review Question • What is the combining form for the neck? A. cephal/o B. thorac/o C. cervic/o D. coccyg/o

30. Bones of the Appendicular Skeleton • Shoulder girdle and upper extremity • Pelvic girdle and lower extremity

31. Shoulder Girdle and Upper Extremity • Scapula shoulder • Acromion process • Glenoid cavity • Coracoid process • Clavicle • Humerus • Caput • Anatomical neck • Medial and lateral epicondyles Word Parts scapul/o = scapula glen/o = glenoid clavicul/o, cleid/o = clavicle humer/o = humerus

32. The scapulae (s. scapula) are the shoulder blades, which are flat bones on the dorsal aspect of the body. • The acromion process is the lateral protrusion of the scapula that forms the highest point of the shoulder. • The glenoid cavity (its orgins meaning a cavity) is the socket in the scapula where the head (caput) of the humerus sits. • The coracoid process is the beaklike process (corac/o comes from the term meaning a crow) that serves as a point of attachment for muscles and ligaments in the shoulder. • The clavicles are the collarbones. These are long, curved horizontal bones that attach to the upper sternum at one end and to the acromion process of the scapula at the other. These bones help stabilize the shoulder in the front of the body. It’s interesting to note that the “wishbone” of a chicken is composed of its clavicles fused together. • The humerus is the upper arm bone.

33. Shoulder Girdle and Upper Extremity • Radius • Ulnar notch • Ulna • Radial notch • Olecranon Word Parts radi/o = radius uln/o = ulna olecran/o = elbow, olecranon • The radius is the lower lateral arm bone (remember to position the body in anatomical position to determine which bone is medial and which is lateral). • The ulna is the lower medial arm bone. The olecranon is a proximal projection of the ulna that forms the tip of the elbow. This “funny bone” is actually a process, not a separate bone. • Note that the notches (ulnar and radial) appear on the opposite bone, because they are the locations where those bones articulate. The radial notch is at the proximal end, while the ulnar notch is at the distal end.

34. Shoulder Girdle and Upper Extremity • Carpals • First row • Second row • Capitate, hamate, lunate, pisiform, scaphoid, trapezium, trapezoid, triquetral Word Parts carp/o = carpus, wristbone capit/o = head ham/o =hooked, hamate lun/o = moon, lunate pis/i = pea, pisiform -form = shape scaph/o = boat, scaphoid trapezi/o =table, trapezium triquetr/o = three corner, triquestral

35. Named for their shape • Capitate (head) • Hamate (hooked) • Lunate (moon) • Pisiform (pea) • Scaphoid (boat) • Trapezium (table) • Trapezoid (table) • Triquetrum (three corner) Wrist Bones(Carpus)

36. Shoulder Girdle and Upper Extremity • Metacarpals- hand bones • Phalanges-bones of fingers/toes • Interphalangeal joints • DIP • PIP • Digitus, finger • Pollex thumb Word Parts metacarp/o = hand bone metacarpus, phalang/o = phalanx, finger/toe bone inter- = between dist/o = far proxim/o = near digit/o = digit, finger/toe pollic/o = thumb

37. PCS Guideline Alert! • B4.7 If a body system does not contain a separate body part value for fingers, procedures performed on the fingers are coded to the body part value of the hand. If a body system does not contain a separate body part value for toes, procedures performed on the toes are coded to the body part value for the foot.

38. Pelvic Girdle and Lower Extremity • Pelvic Girdle • Bony pelvis • Ilium- upper hip • Ischium- lower hip • Pubis-lower front pelvis • Acetabulum- hip socket • Sacrum • Coccyx Be Careful! Don’t confuse ilium with ileum (part of the digestive system). Word Parts pelv/i = pelvis cox/o = hip ili/o = ilium ischi/o = ischium pub/o = pubis acetabul/o = acetabulum

39. Did You Know? • Archeologists can often tell a male from a female skeleton by examining the pelvic outlets. The female pelvis is wider.

40. Pelvic Girdle and Lower Extremity • Femur • Femoral head • Femoral neck • Trochanters • Greater • Lesser • Condyles • Medial • Lateral • Epicondyles • Medial • Lateral • Patella Word Parts femor/o = femur patell/a = patella Femoral head- connects the head to the shaft where the two protuberances (greater and lesser trochanter) allow for attached muscles. Distal end of the shaft are medial and lateral condyles that articulate with tibial condyles. Avoe those are the medial and lateral epicondyles.

41. Pelvic Girdle and Lower Extremity • Tibia- shinbone. • Condyles (proximal end) • Medial • Lateral • Medial malleolus • Fibula (lower lateral leg bone) • Shaft • Lateral malleolus-process that extends outward at the distal end of the bone Be Careful! Don’t confuse perone/o for fibula with peritone/o, meaning the lining of the abdomen. Word Parts tibi/o = tibia fibul/o, perone/o = fibula malleol/o = malleolus

42. Pelvic Girdle and Lower Extremity • Tarsus, tarsal bones (ankle, foot) • Calcaneus- (heel) • Cuboid-(box shaped) • Cuneiform(wedge-shaped) • Navicular- (boat shaped) • Talus (dice) Word Parts tars/o = tarsus calcane/o = calcaneus cuboid/o = cuboid cun/e = cuneiform navicul/o = navicular tal/o = talus

43. Pelvic Girdle and Lower Extremity • Metatarsus, metatarsal bone • Phalanges • Hallux- great (big) toe Word Parts metatars/o = metatarsal, metatarsus, foot bone phalang/o = phalanx, finger/toe bone halluc/o = great toe

44. Review Question • One of your patient’s records documents a fracture of her upper arm bone. The healthcare term for it is the: A. femur B. radius C. sternum D. humerus

45. Muscles (Anterior View) Anterior view

46. Muscles (Posterior View) Posterior view

47. Did You Know? • The word muscle comes from the Latin musculus, the diminutive of mus, meaning a mouse; hence, literally, little mouse, usually explained by the allusion to rippling of muscles under the skin as the scurrying of little mice. Muscle

48. Muscle Actions • Extension-stretch • Flexion-bend at joint Word Parts ex- = out tens/o = stretching -ion = process of flex/o = bending Extension/flexion

49. Muscle Actions • Adduction-toward midline • Abduction-away from midline Word Parts ad- = toward duct/o = carry -ion = process of ab- = away duct/o = carry Adduction Abduction

50. Muscle Actions • Supination-palm up • Pronation-palm down Supination/pronation