The Skeletal System Wk5 PDF

TOPIC 5: THE SKELETAL SYSTEM BY: HESTON SIAL  SKELETAL SYSTEM OVERVIEW 1. FUNCTIONS OF THE SKELETAL SYSTEM 2. BONE STRUCTURE AND ITS HISTOLOGY 3. DEVELOPMENT AND GROWTH OF BONE a. INTRAMEMBRANOUS b. ENDOCHONDRAL 4. AX...

TOPIC 5: THE SKELETAL SYSTEM BY: HESTON SIAL  SKELETAL SYSTEM OVERVIEW 1. FUNCTIONS OF THE SKELETAL SYSTEM 2. BONE STRUCTURE AND ITS HISTOLOGY 3. DEVELOPMENT AND GROWTH OF BONE a. INTRAMEMBRANOUS b. ENDOCHONDRAL 4. AXIAL AND APPENDICULAR SKELETONS a. AXIAL SKELETON AND ITS COMPONENTS b. APPENDICULAR SKELETON AND ITS COMPONENTS c. DIFFERENTIATE BETWEEN THE MALE AND FEMALE PELVIS 5. ARTICULAR SYSTEM (JOINTS) a. TYPES OF JOINTS b. TYPES OF JOINT MOVEMENTS 6. CLINICAL INTERESTS a. CLINICAL TERMS RELATED TO THE SKELETAL SYSTEM b. TYPES OF FRACTURE c. BONE DISEASES 7. EFFECTS OF AGING RELATED TO THE SKELETAL SYSTEM (ASSIGNMENT)  OVERVIEW PARTS OF THE SKELETAL SYSTEM SKELETON – 20% OF BODY MASS 1. BONES 206 BONES IN THE ADULT HUMAN 270 BONES IN HUMAN INFANTS, WHICH FUSE TO BECOME 206 BONES IN HUMAN ADULT 2. LIGAMENTS CONNECTS BONE TO BONE 3. CARTILAGE COVERS END OF BONE REDUCES FRICTION 4. JOINTS PLACES WHERE BONE MEETS  OVERVIEW TWO MAIN TYPES OF BONE TISSUE 1. COMPACT BONE CAN WITHSTAND FORCE PROVIDES SUPPORT AND PROTECTION 2. SPONGY BONE OR CANCELLOUS BONE TO BONE NETWORK OF BONY RODS WITH SPACES MAKES SKELETON LIGHTER  OVERVIEW SINUSES HOLLOW PORTIONS OF BONES SURROUND NASAL CAVITY FUNCTIONS: LIGHTEN THE SKULL AMPLIFY THE VOICE ADD RESONANCE TO VOICE (INTENSIFY/QUALITY OF TONE)  1. FUNCTIONS OF THE SKELETAL SYSTEM 1. SUPPORT STRUCTURAL SUPPORT FOR THE BODY FRAMEWORK FOR ATTACHMENT TISSUES  1. FUNCTIONS OF THE SKELETAL SYSTEM 2. STORAGE RESERVE OF CALCIUM SALTS LIPIDS STORED IN YELLOW MARROW  1. FUNCTIONS OF THE SKELETAL SYSTEM 3. BLOOD CELL PRODUCTION AKA “HEMATOPOIESIS” FORMED IN RED MARROW PRODUCES FORMED ELEMENTS OF BLOOD RED BLOOD CELLS WHITE BLOOD CELLS PLATELETS  1. FUNCTIONS OF THE SKELETAL SYSTEM 3. PROTECTION PELVIS DIGESTIVE AND REPRODUCTIVE ORGANS RIBS HEART AND LUNGS SKULL BRAIN VERTEBRAE SPINAL CORD  1. FUNCTIONS OF THE SKELETAL SYSTEM 5. LEVERAGE CHANGE MAGNITUDE AND DIRECTION OF FORCES GENERATED BY MUSCLES  2. BONE STRUCTURE AND HISTOLOGY DIAPHYSIS EPIPHYSIS DI-A-FUH-SIS UP-PI-FUH-SIS COMPACT BONE SPONGY BONE STRONGER, MORE SOLID HAS SPACES, MAKES BONE TIGHTER  2. BONE STRUCTURE AND HISTOLOGY EPIPHYSEAL PLATE EP-I-PHYS-EE-UHL GROWTH PLATE THIN PLAN OF CARTILAGE BETWEEN DIAPHYSIS AND EPIPHYSIS BECOMES EPIPHYSEAL LINE (AFTER BONE FINISHES GROWING -ADULT) GROWTH RATE CONTROLLED BY HORMONES WEAKEST PART OF BONE  2. BONE STRUCTURE AND HISTOLOGY CARTILAGE COVERS EPIPHYSIS DECREASES FRICTION AT JOINTS  2. BONE STRUCTURE AND HISTOLOGY PERIOSTEUM COVERS OUTER SURFACE OF BONE PROVIDES FOR ATTACHMENT OF LIGAMENTS AND TENDONS ISOLATES THE BONE FROM THE SURROUNDING TISSUE ALLOWS CIRCULATORY AND NERVE SUPPLIES PARTICIPATES IN BONE GROWTH AND REPAIR  2. BONE STRUCTURE AND HISTOLOGY ENDOSTEUM LINES THE MARROW CAVITY ACTIVE DURING BONE GROWTH, REPAIR, REMODELING  2. BONE STRUCTURE AND HISTOLOGY MEDULLARY CAVITY CONTAINS BONE MARROW (LOOSE CONNECTIVE TISSUE) CAVITY IN DIAPHYSIS (SHAFT) CONTAINS: YELLOW MARROW (ADULTS) RED MARROW (BABIES/CHILDREN)  2. BONE STRUCTURE AND HISTOLOGY BONE MARROW RED MARROW YELLOW MARROW SITE OF HEMATOPOIESIS STORES FAT BABIES BORN WITH ALL RED MARROW CONVERTED TO RED MARROW IN TIME OF BLOOD LOSS  2. BONE STRUCTURE AND HISTOLOGY CELLS IN BONE (3) OSTEOBLASTS OSTEOCLASTS OSTEOCYTES  2. BONE STRUCTURE AND HISTOLOGY OSTEOBLASTS “BUILDERS” PRODUCE NEW BONE (OSTEOGENESIS) PRODUCE NEW BONY MATRIX PROMOTE DEPOSITION OF CALCIUM SALTS BECOME OSTEOCYTES WHEN SURROUNDED BY CALCIFIED MATRIX (LAMELLA)  2. BONE STRUCTURE AND HISTOLOGY OSTEOCLASTS GIANT CELLS (50+ NUCLEI) “CLEANERS” SECRETE ACIDS AND ENZYMES DISSOLVE BONY MATRIX (OSTEOLYSIS) RELEASE STORED MINERALS (RESORPTION)  2. BONE STRUCTURE AND HISTOLOGY OSTEOCYTES MOST ABUNDANT CELLS IN BONE MATURE BONE CELLS RECYCLING CALCIUM SALTS ASSISTING REPAIRS  3. DEVELOPMENT AND GROWTH OF BONE OSSOFICATION THE NATURAL PROCESS OF BONE FORMATION DETERMINES SIZE AND PROPORTIONS OF THE BODY BEGINS ABOUT 6 WEEKS AFTER FERTILIZATION ENDS AROUND AGE 25 OSSOFICATION REPLACING OTHER TISSUE WITH BONE CALCIFICATION DEPOSITION OF CALCIUM SALTS  3. DEVELOPMENT AND GROWTH OF BONE REQUIREMENTS FOR BONE GROWTH MINERALS (ESPECIALLY CALCIUM SALTS AND PHOSPHATE) DURING PREGNANCY, A PERSON LOSES BONE MASS VITAMIN D (VITAL FOR CALCIUM METABOLISM) VITAMIN A AND VITAMIN C HORMONES (GROWTH HORMONES, THYROID HORMONES, SEX HORMONES)  3. DEVELOPMENT AND GROWTH OF BONE REMODELING OF BONE IN ADULTS, ABOUT 18% OF BONE IS REMODELED EVERY YEAR PROTEIN AND MINERAL COMPONENTS ARE REMOVED AND REPLACED IMPORTANT SO BONES CAN ADAPT TO STRESS BONES RESPOND TO STRESS (REGULAR EXERCISE IS IMPORTANT) HEAVILY STRESSED BONE BECOME THICKER AND STRONGER BONES WITHOUT STRESS BECOME THIN AND BRITTLE AFTER A FEW WEEKS ON CRUTCHES, A BONE CAN LOSE UP TO 1/3 OF BONE MASS  3. DEVELOPMENT AND GROWTH OF BONE 2 TYPES OF OSSIFICATION 1. INTRAMEMBRANOUS OSSIFICATION BONE DEVELOPS FROM FIBROUS MEMBRANE FORMS: FLAT BONES OF SKULL, MANDIBLE, CLAVICLE OSSIFICATION CENTER (WHERE OSSIFICATION FIRST BEGINS) STEM CELLS FORM A TEMPLATE STEM CELLS BECOME OSTEOBLASTS OSTEOBLASTS SECRETE EXTRACELLULAR MATRIX & DEPOSIT CALCIUM TO HARDEN THE MATRIX (FIBROUS TEMPLATE > BONE)  3. DEVELOPMENT AND GROWTH OF BONE 2 TYPES OF OSSIFICATION 2. ENDOCHONDRAL OSSIFICATION BONE REPLACES HYALINE CARTILAGE HOW MOST BONES ARE FORMED  3. DEVELOPMENT AND GROWTH OF BONE 2. ENDOCHONDRAL OSSIFICATION 1. CHONDROCYTES FOR A TEMPLATE 2. MATRIX BEGINS TO CALCIFY AND CHONDROCYTES DIE BLOOD VESSELS INVADE SPACES 3. SECONDARY CENTERS OF OSSIFICATION FORM AT EPIPHYSIS (FOLLOWING SAME PATTERN) 4. ENDS OF THE BONE REMAIN COVERED IN CARTILAGE 5. THIN LAYER OF EPIPHYSEAL CARTILAGE REMAINS SEPARATING EPIPHYSIS AND DIAPHYSIS GROWTH PLATE / EPIPHYSEAL PLATE 6. GROWTH RATE CONTROLLED BY HORMONES 7. BECOMES EPIPHYSEAL LINE IN ADULTS  3. DEVELOPMENT AND GROWTH OF BONE APPOSITIONAL GROWTH 1. BONES GROW IN WIDTH 2. CELLS OF PERIOSTEUM DEVELOP INTO OSTEOBLASTS PRODUCE ADDITIONAL BONY MATRIX NEW BONE IS DEPOSITED OUTSIDE 3. OSTEOCLASTS ERODE SOME OF THE INNER SURFACE MEDULLARY CAVITY INCREASE IN SIZE  4. AXIAL AND APPENDICULAR SKELETONS a. AXIAL SKELETON AND ITS COMPONENTS b. APPENDICULAR SKELETON AND ITS COMPONENTS c. DIFFERENTIATE BETWEEN THE MALE AND FEMALE PELVIS  4. AXIAL AND APPENDICULAR SKELETONS A. AXIAL SKELETON FORMS LONGITUDINAL AXIS OF BODY CONTAINS 80 BONES BONES OF SKULL OSSICLES (INNER EAR) VERTEBRAE RIB CAGE AND STERNUM  4. AXIAL AND APPENDICULAR SKELETONS A. AXIAL SKELETON CREATES A FRAMEWORK SUPPORTS AND PROTECTS ORGANS IN DORSAL AND VENTRAL CAVITIES PROVIDES AREAS FOR MUSCLES (TO ATTACH): ADJUST POSITION OF HEAD, NECK, TRUNK PERFORM RESPIRATORY MOVEMENT STABILIZE AND POSITION APPENDICULAR SKELETON  4. AXIAL AND APPENDICULAR SKELETONS B. APPENDICULAR SKELETON FORMS LIMBS FORMS ATTACHMENT SITES CONTAINS 126 BONES UPPER LIMBS LOWER LIMBS PECTORAL GIRDLE PELVIC GIRDLE  4. AXIAL AND APPENDICULAR SKELETONS THE CLAVICLE IS PART OF WHICH SKELETON? AXIAL SKELETON APPENDICULAR SKELETON ANSWER: APPENDICULAR SKELETON  4. AXIAL AND APPENDICULAR SKELETONS C. MALE AND FEMALE PELVIS  4. AXIAL AND APPENDICULAR SKELETONS C. MALE AND FEMALE PELVIS MALE PELVIS NARROWER AND LESS FLARED, EXHIBITING AN OVAL OR HEART-SHAPED PELVIC INLET, THE ANGLE OF THE PUBIC ARCH IS LESS THAN 90 DEGREES. ADULT FEMALE PELVIS IS USUALLY BROADER AND EXHIBITS A ROUND PELVIC INLET, THE ANGLE OF THE PUBIC ARCH IS GREATER THAN 90 DEGREES  5. ARTICULAR SYSTEM (JOINTS) a. TYPES OF JOINTS b. TYPES OF JOINT MOVEMENTS  5. ARTICULAR SYSTEM (JOINTS) JOINTS: ARTICULATIONS OCCUR WHERE TWO BONES MEET  5. ARTICULAR SYSTEM (JOINTS) FUNCTIONS OF JOINTS HOLD BONES TOGETHER BEAR WEIGHT ALLOW FOR MOBILITY  5. ARTICULAR SYSTEM (JOINTS) A. CLASSIFICATION OF JOINTS  SYNARTHROSIS – FIBROUS – IMMOVABLE BONES JOINED BY FIBROUS TISSUE BONES VERY CLOSE TOGETHER, EVEN INTERLOCKING EX. SUTURES OF THE SKULL  SYNARTHROSIS – FIBROUS – IMMOVABLE FEATURES OF FIBROUS JOINTS FONTANELLES AND SKULL SUTURES SKULL AT BIRTH, THE BONES OF THE SKULL ARE NOT FULLY FORMED LARGE ANTERIOR FONTANELLE SMALLER POSTERIOR FONTANELLE  SYNARTHROSIS – FIBROUS – IMMOVABLE BE CAREFUL HOLDING BABIES ▪ ANTERIOR FONTANELLE ▪ CLOSES BY 1.5-2 YEARS OF AGE ▪ POSTERIOR FONTANELLE ▪ USUALLY CLOSED BY 2 MONTHS  SYNARTHROSIS – FIBROUS – IMMOVABLE WHY ARE BABIES BORN WITH FONTANELLES? ANSWER: TO ALLOW FOR MOVEMENT THROUGH THE BIRTH CANAL SYNARTHROSIS – FIBROUS – IMMOVABLE SKULL SUTURES ▪ AS FONTANELLES CLOSE, SUTURE FORM 3 TYPES ▪ FIBROUS / SYNARTHROTIC JOINT  AMPHIARTHROSIS – CARTINAGINOUS – SLIGHTLY MOVABLE BONES CONNECTED BY CARTILAGE BONES FURTHER APART EX. DISTAL ARTICULATION OF TIBIA AND FIBULA TWO PUBIC BONES (PUBIC SYMPHYSIS) INTERVERTEBRAL DISCS  DIARTHROSIS – SYNOVIAL – FREELY MOVABLE BONES SEPARATED BY JOINT ACTIVITY FILLED WITH SYNOVIAL FLUID ENCLOSED BY JOINT CAPSULE SOME HAVE ADDITIONAL PADDING FAT PADS MENISCI (FIBROCARTILAGE PADS)  DIARTHROSIS – SYNOVIAL – FREELY MOVABLE SPORTS APPLICATION SYNOVIAL FLUID BECOMES LESS VISCOUS (THICK) WHEN IT IS WARM. THIS ALLOWS THE JOINT TO MOVE MORE FREELY (JUST LIKE OIL IN CARS) WARM UP BEFORE YOU STRETCH AND DO OTHER ACTIVITIES  DIARTHROSIS – SYNOVIAL – FREELY MOVABLE B. TYPES OF JOINT MOVEMENTS SYNOVIAL JOINTS 6 TYPES OF SYNOVIAL JOINTS  DIARTHROSIS – SYNOVIAL – FREELY MOVABLE 1. GLIDING/PLANE JOINT SOME MOVEMENT IN ALL DIRECTIONS CARPALS TARSALS ENDS OF VERTEBRAE  DIARTHROSIS – SYNOVIAL – FREELY MOVABLE 2. HINGE JOINT BACK AND FORTH MOVEMENT ELBOW KNEE PHALANGES  DIARTHROSIS – SYNOVIAL – FREELY MOVABLE 3. PIVOT JOINT ROTATION ONLY BETWEEN ATLAS (C1) AND AXIS (C2) BETWEEN RADIUS AND ULNA ALLOWS PRONATION / SUPINATION  DIARTHROSIS – SYNOVIAL – FREELY MOVABLE 4. ELLIPSOIDAL/CONDOLOID JOINT MOVEMENT BACK AND FORTH + SIDE TO SIDE BETWEEN METACARPALS AND PHALANGES METATARSALS AND PHALANGES  DIARTHROSIS – SYNOVIAL – FREELY MOVABLE 5. SADDLE JOINT ANGULAR MOTION (INCLUDING CIRCUMDUCTION) BUT NOT ROTATION POLLEX (CARPOMETACARPAL JOINT)  DIARTHROSIS – SYNOVIAL – FREELY MOVABLE 6. BALL AND SOCKET JOINT SHOULDER HIP  6. CLINICAL INTERESTS BONE FRACTURES FRACTURE – BREAK IN A BONE TYPES OF BONE FRACTURE CLOSED (SIMPLE) FRACTURE – DOES NOT BREAK THE SKIN OPEN (COMPOUND) FRACTURE - BREAK THE SKIN  FRACTURES MOST COMMONLY BROKEN BONES CLAVICLE ARM BONES CARPAL BONES FOOT BONES HIPS (ESPECIALLY IF OVER 65 YEARS OLD)  FRACTURES WHY DO BONES BREAK? ENERGY APPLIED GREATER THAN BONE STRENGTH DUE TO: TOO MUCH ENERGY (EX. FALL) TOO MUCH REPETITIVE STRESS (EX. MARATHON RUNNERS) BONE WEAKENING (EX. OSTEOPOROSIS, INFECTION, TUMORS) TOO MUCH TORSION  FRACTURES FIRST AID FOR FRACTURES  FRACTURES TREATMENT OF FRACTURES MOVE BACK BONE INTO PROPER ALIGNMENT IF DISPLACED  FRACTURES IMMOBILIZE – SPLINT, SLING OR CAST  FRACTURES SURGERY – PINS, PLATES, SCREWS, RODS TO HOLD BONE IN PLACE  FRACTURES KINDS OF FRACTURE SIMPLE (CLOSED) – ONLY INVOLVES THE BREAKAGE OF BONES COMPOUND (OPEN) – INVOLVES THE BREAKAGE OF BONES AS WELL AS THE SKIN NON-DISPLACED – NORMAL ALIGNMENT DISPLACED – PULLED OUT OF NORMAL ALIGNMENT  FRACTURES KINDS OF FRACTURE TRANSVERSE FRACTURE RIGHT ANGLE ACROSS BONE OBLIQUE FRACTURE DIAGONAL TO BONE’S LONG AXIS GREENSTICK BONE BREAKS INCOMPLETELY ONE SIDE BREAKS, OTHER SIDE BENDS COMMON IN YOUNG CHILDREN SPIRAL FRACTURE RAGGED BREAK CAUSE: EXCESSIVE TWISTING FORCE  FRACTURES KINDS OF FRACTURE COMMINUTED FRACTURE BONE BREAKS INTO 3+ PIECES CAUSE: GREAT DEAL OF FORCE COMPRESSION FRACTURE PART OF VERTEBRAE COLLAPSE CAUSE: TRAUMA, TUMOR, INFECTION COMMON IN ELDERLY, OSTEOPOSORIS  FRACTURES KINDS OF FRACTURE DEPRESSION FRACURE BREAK IN SKULL WITH DEPRESSION OF BONE TOWARD BRAIN AVULSION FRACTURE FRAGMENT OF BONE TEARS AWAY FROM MAIN MASS OF BONDE CAUSE: SEVERE PHYSICAL TRAUMA  FRACTURES HEALING AFTER FRACTURE: WHILE CASTED, A BONE LOSES MASS (NO WEIGHT BEARING) 60+ YEARS OLD = AT RISK FOR FRACTURES  FRACTURES 4 STAGES TO REPAIR A FRACTURED OR BROKEN BONE STAGE 1 BLOOD VESSELS IN THE BROKEN BONE TEAR CLOTTED BLOOD, OR HEMATOMA FORMS SEALING OF BLOOD VESSELS BONE CELLS DEPRIVED OF NUTRIENTS BEGIN TO DIE  FRACTURES 4 STAGES TO REPAIR A FRACTURED OR BROKEN BONE STAGE 2 SOFT CALLUS PHAGOCYTES CLEAR AWAY DEAD CELLS FIBROBLASTS MAKE COLLAGEN FIBERS TO CONNECT BONE CHONDROBLASTS BUILD CARTILAGE OSTEOBLASTS START TO BUILD BONE  FRACTURES 4 STAGES TO REPAIR A FRACTURED OR BROKEN BONE STAGE 3 BONY CALLUS OSTEOBLASTS CONTINUE TO BUILD BONE TAKES ABOUT TWO MONTHS FOR ENDS TO BE FIRMLY JOINED TOGETHER  FRACTURES 4 STAGES TO REPAIR A FRACTURED OR BROKEN BONE STAGE 3 REMODELLING MAY TAKE MANY MONTHS, BONE MAY REMAIN UNEVEN FOR YEARS COORDINATED WORK OF OSTEOCLASTS AND OSTEOBLASTS  FRACTURES 4 STAGES TO REPAIR A FRACTURED OR BROKEN BONE BONE DISEASE/DISORDERS BONE DISEASE/DISORDERS THANK YOU!