The Skeletal System

1. The Skeletal System Medical root word for the next two weeks “Osteo”

2. Objectives • Locate and describe the structures of the skeletal system • Recognize, pronounce, spell and build words related to the system • Describe pathology (disease) related to the system • You will have the opportunity to learn all 206 bones in the body!

3. Bones • Provide the framework for the body • What would happen if we didn’t have bones? • Blobs!! • Provide protection to all organs • Store Calcium • Produce blood cells within their cavities

4. Bone Cells • 3 main types • Osteoblasts • Create bone cells • Osteocytes • Mature bone cells • Osteoclasts • Destroy bone cells Osteocyte nucleus

5. Features of Bones • Epiphysis • Proximal/Distal Part of bone • Growth Plates • Diaphysis • Shaft • Medullary Cavity • Yellow Bone Marrow (Fluid) • Endosteum-inner layer of medullary cavity • Periosteum • Hard, outer layer of bone • “peri”=around + “oste” bone • Articular Cartilage • Smooth, white part at either end of bone that touches (articulates) the next bone • Think of chicken bone

6. Features of Bones (cont) • Compact bone • Surrounds medullary cavity • Yellow marrow • Looks hard, solid, like a “typical” bone. • Spongy bone • Cavernous, Swiss-cheese bone • Found in epiphysis • Full of red bone marrow • This is where blood cells are made-hematopoiesis

7. Surface Feature of Bone • Articulating (Touching) Surfaces-2 Types • 1. Condyle • Smooth part of bone that touches the next bone • Has articular cartilage covering it • 2. Head • Big, rounded articulating part of bone with cartilage on it. • Head of shoulder, femur

8. Types of Fractures • Compound (Open) • Exposed to surface • Comminuted • Fractured to pieces • Compression • Vertebrae squooshed • Impacted • Bone other than vertebrae is squooshed • Complete • Bone is completely broken • Buckle (Torus) • Forearm bone is cracked • Displaced • Part of bone moved completely out of position

9. Communited Open complete Displaced Buckle Impacted

10. Types of bones • Long • Almost all extremity bones • Short • Carpals (Wrist) and Tarsals (Ankle) • Flat • Skull, ribs, scapula, sternum • Irregular • Pelvis and vertebrae • Sesamoid • Strange bones that develop throughout lifetime • In tendons • Patella (kneecap), circular bones in hand and feet

11. Patella and Flabella Hand Sesamoid Foot sesamoid

12. Typical Bone Joint • Articular Cartilage • Silvery part where the bones actually touch • Synovial Fluid • Bathes the joints to prevent friction • Ligaments • Rubber-band-like connective tissue that connect bone to bone • Keeps all joints in place

13. Osteoarthritis • 1. Cartilage deteriorates • 2. Joint Space narrows • 3. Synovial Fluid lessens • 4. Bone spurs develop • 5. Cartilage and bone fragments float in synovial fluid • Pain follows. • Joint replacement is necessary • Arthroplasty.

14. Pathology Fractures, Diseases, and Other Bad Things

15. Spinal Curvature Disorders • Scoliosis • Abnormal lateral curvature • Think of middle school • Kyphosis • Abnormal anterior curvature • Hunchback

16. Spinal Curvature (Cont) • Lordosis • Swayback • Abnormal posterior curvature

17. Pathology Arthritis • Arthritis (Osteo and Rheumatoid) • “Arthro” = Joint • Inflammation of joints • Osteoporosis • Bones become brittle • Seen in geriatric people • Osteomyelitis • Infection of bone, chronic or acute • Paget Disease • Softening and bending of bones • Multiple Myeloma • Cancer of the bone marrow • Sarcoma • Cancer of the actual bone Paget

18. Other Skeletal Pathologies • Rickets • Deficiency of Vitamin D (typically due to lack of sun or poor diet) • Vitamin D needed for absorption of calcium • Leads to Osteomalacia, or softening of bones which leads to frequent fractures. • Paget’s Disease • Etiology unknown • Bone destruction occurs quickly (osteoclasts), but it is replaced with fibrous cartilage or abnormal bones. • Fractures occur easily. • Systemic problems ensue like heart failure

19. Other Skeletal Pathologies • Bone Cancer • Most bone cancers are malignant but relatively rare vis-à-vis others • Osteosarcoma • Most common primary cancer • Found in epiphysis of long bones in children • Excision of tumor in bone and chemo must be done quickly before metastasis occurs to lungs. • Bone cancer is a common secondary site • Spreads to breast and lung cancers. • Gout (Hyperuricemia) • Accumulation of uric acid in the joints causing acute inflammation. • Most common in men over 40 years of age • Hyperuricemia is ideopathic but eating rich, protein-laden foods or genetics likely play a role.

20. “Arthro”=joint “Costo”=rib Medical Terminology

21. Bones of the Body Upper Extremity Phalanges to Scapula

22. The Hand • Each hand has 27 bones • Each finger is a digit • Thumb is 1st digit • Pinky is 5th digit • Each hand is made up of 3 sections of bones • 14 phalanges • 5 Metacarpals • 8 Carpals

23. Phalanges (Fingers) • 1) Phalanges (Sing. Phalanx) • We call these the fingers. • There are 14 phalanges per hand • 2nd-5th digits have three phalanges. They are the: • The Proximal phalanx • (Closest to body) • The Middle Phalanx • The Distal Phalanx • (Farthest from body) • Fingernails are attached to these bones. • Thumb (1st Digit) only has 2 PHALANGES • Proximal and Distal phalanges.

24. Hand (cont) • 2) Metacarpals • Each digit has 1 metacarpal • These are the bones of the palm • 3) Carpals • These are the 8 small bones in each wrist • Scaphoid, lunate, triquetrum, pisiform, trepezium, trapezoid, capitate, hamate • Bonus!!!

25. Hand Joints • There are 3 main sets of joints in the hand • 1) Metacarpal-phalangeal Jt • Known as MCP Jt • It is the joint b/t the metacarpal and proximal phalanx • Otherwise known as the knuckle • There are 5 MCPs jts

26. Hand Joints • 2) Proximal Interphalangeal Jts • Known as PIP Joints • It is the joint b/t proximal and middle phalanges • There are 4 PIPs in the hand

27. Hand Joints • 3. Distal Interphalangeal Joints • Known as DIP Joint • It is the loint between middle and distal phalanges of 2nd-5th fingers (digits) • There are 4 DIPs jts in the hand

28. Thumb • Thumb is unique • Why? Look at pic • Thumb only has 2 phalanges • Since it only has two phalanges, the joint between the two bones is the “Interphalangeal Joint,” or IP Joint • This is the only IP joint in the hand

31. The Forearm (Antebrachial Region) • There are 2 bones in forearm • They stretch from the elbow to the wrist. • 1) The Ulna • The MEDIAL bone • It is the main bone of the elbow joint, but plays little role in the wrist joint • Prominent Features • Styloid Process of Ulna- Ball on side of wrist • Olecranon Process- The posterior, proximal part of ulna that forms the elbow joint

32. Forearm • 2) Radius • The LATERAL bone • Responsible for turning of arm • Pronate “Prone” turns palm toward the ground • Supinate “Supine” turns palm toward the air (which is anatomical position) • The radius plays minor role in elbow joint, but is the main supporting bone of wrist • Prominent Features • The radial head- Smooth round, circular part of proximal radius that allows your arm to turn

34. Elbow Joint (The Antecubital and Olecranal Regions) • The Joint is comprised mainly of Humerus and Ulna • The Olecranon Process (hook) of the Ulna “hooks into” the Olecranon Fossa (opening) of the Humerus • It is a Hinge Joint • Radial head most common elbow fx (fracture)

36. The Humerus (Brachial Region) • The bone of the arm. • Prominent Features • The Humeral head • Ball ‘N Socket joint of the shoulder • The Olecranon Fossa • It is the cavity in which the olecranon process of the ulna fits into to create the elbow joint. • The Surgical Neck • Skinny part distal to head • Most common fracture site

37. Shoulder Joint • Comprised of two bones • Humerus • Scapula • The official name of the shoulder joint is the The Gleno-Humeral Joint • The humeral head articulates with the Glenoid Fossa of the Scapula • Most common dislocation joint

38. Scapula • Scapula (Shoulder Blade) • DOES NOT ARTICULATE with the ribs; completely free floating bone • Prominent Features • The Scapular Spine • Large “mountain range” on the posterior aspect • The Acromium Process- • Arises from the scapular spine and rises superiorly to articulate with the clavicle • Body- the main part of scapula • The Borders • Medial border is the side closest to spine • Lateral border is the one closest to shoulder • Superior border is on the “top” side near clavicle

39. Scapula

40. Clavicle • The Collar Bone • Articulates with scapula at acromial-clavicular joint (AC) Joint and with the sternum (breastbone) at sterno-clavicular (SC) joint • IT IS THE ONLY UPPER EXTREMITY BONE TO ARTICULATE WITH THE BODY (THORAX) • Because of this fact and because it is thin, it is very easy to break

42. Lower Extremity Phalanges to Pelvis

43. The Foot • Digits numbered 1-5 like feet; Great Toe is #1 • The foot is identical to hand aside from the fact there are 7 tarsal bones, not 8.

44. The Foot • The foot has 14 phalanges (proximal, middle, and distal) • The foot has 5 metatarsals, not metacarpals

45. The Foot • The Tarsals • There are 7 bones • They are the equivalent to the carpal bones in the hand • Talus and Calcaneus are the most important • Talus is the distal (inferior) bone of the ankle joint • Calcaneus is the heel bone • Cuboid, Navicular, and the Medial, Middle, and Lateral Cuneiform round out the tarsals • Bonus!

46. Foot Joints • The foot has the same joints as the hand, only with slight change. • Metatarsal-phalangeal joint (MTP) • All 5 bones • PIP and DIP joints • 2nd-5th digits • Great Toe has IP Joint like thumb

47. Ankle Joint • Made up of: • Tibia and Fibula (proximal) • Talus (distal) • Medial and Lateral Malleoli • These are the balls on your ankles

48. Bimalleolar fracture • Fracture of both the lateral and medial malleoli

50. Ankle Sprain & Fractures • Sprain vs Fracture • Sprain is a stretching or tearing of ligaments over a joint • Fracture is a break in the bone • Most common sprain and fracture will be on the lateral side of ankle • On the Fibular side • It is a weaker bone