Skeletal System PDF - LSMU Anatomy Past Paper

Skeletal system  Welcome! LSMU SIS SCHEDULE OF THE CLASSES IN HUMAN ANATOMY FOR FOREIGH STUDENTS OF NURSING FACULTY LSMU MOODLE TEAMS SLEN24 Institute of Anatomy...

Skeletal system  Welcome! LSMU SIS SCHEDULE OF THE CLASSES IN HUMAN ANATOMY FOR FOREIGH STUDENTS OF NURSING FACULTY LSMU MOODLE TEAMS SLEN24 Institute of Anatomy [email protected] Tel. +370 37 32 72 40 Attendance at lectures and practical works is mandatory!!! Retake of practical works- students arrange themselves with responsible teacher! Retake of failed colloquiums – look in schedule! Retake of failed exam- on last week of the semester! Institute of anatomy Formula of the Anatomy subject final grade for first year student of Nursing program 50 % Cumulative part + 50 % Final exam = 100 % Final grade [K1 + K2]/2 x 0,5 + [(ET x 0,5) + (EP x 0,5)] x 0,5 = Final grade K-cumulative colloquiums (2 colloquiums): E-final exam: E= (Tx 0,5 + P x 0,5) x 0,5 ET – exam test; EP – exam practical part Notes: 1. It is obligatory to take the colloquiums. Only student‘s who attended all the classes are allowed to take colloquiums. Missed classes must be accomplished before the colloquiums. 2. To take final exam are allowed students who passed all colloquiums. 3. If during the course of studies, the student succeeds to cumulate the required minimum amount of points >=5, she/he can take no final examination. The only requirement is to have all colloquiums passed successfully. 4. The final exam is passed only when the grades from test and practical part are not less than 5. If one part of exam is failed – the whole exam is failed and student must retake both parts. Head of Anatomy Institute prof. Dainius H. Pauža  Human Anatomy Latin (L.)- anatomia Greek (Gr.)- anatome Cutting up, dissection is a science which deal with the structural (morphological) organization of the body, its parts, organs, and tissue together with function, individual, age, and gender peculiarities The Anatomy Lesson of Dr. Nicolaes Tulp (1632) by Rembrandt 1452-1519  Giedrė Deveikytė STAFF Second floor, Fourth floor 217 Museum of Anatomy Third floor  RESEARCH Preparation and presentation of chosen research work Laboratory of Neuroanatomy Laboratory of Embalming Laboratory of Ultramicrotome Laboratory of Electron Microscopy Laboratory of Immunochemistry Laboratory of Neuromorphology Laboratory of Microscopy Locker room- only for handbags, backpacs, books Overcoats, jackets – in ground floor – Rūbinė- cloakroom  NOTE! Prosectorium Dissection room- ground floor DURING PRACTICE IN PROSECTORIUM/DISSECTION ROOM STUDENTS MUST WEAR WHITE COATS, CAPS (TO COVER HAIR), GLOVES AND FACE MASK! 024 First floor: 130,131 121 027  RULES OF STUDENTS’ BEHAVIOUR AND ORDER IN PROSECTORIUM AND DISSECTION ROOM InA Anatomy Institute meetings, held on 4th of November, 2009 and 9th of December, 2009, decision was taken to accept the following rules of students’ behaviour and order in prosectorium and dissection room: 1. Prosectorium and Dissection room are premises designed to study human anatomy for KUM students and it is forbidden for outsiders to visit these premises without written permission of head of Anatomy Institute. 2. Human corpses are kept in Prosectorium and Dissection room; consequently the students must behave respectfully and keep silence, allowing everybody without hindrance to study human anatomy during laboratory work. 3. Students must have a card (ID card) not less than 4 cm X 8 cm, on which faculty, course, group and name and surname (in capital letters) should be indicated. 4. Students must wear hooked up clean white (medical) coats, clean footwear with special shoe covers and have special gloves to tuck wrists into while working with corpses. Long hair must be hided under special head cap. Personal accessories (rings, bracelets, earring, watches, etc.) should not obstruct the work. 5. With human bones, organs, organ complexes, models and corpses students must behave respectfully and very carefully. 6. Students must keep anatomical preparations against desiccation: to cover with polyethylene wrap the parts of corpses that are not used for studies. When laboratory work is over, corpses must be enclosed in polyethylene wrap and with the help of worker of Anatomy Institute placed into refrigerator. 7. Lecturers present these rules to students during the lecture time. During laboratory work, the lecturer of the group or other responsible persons of Anatomy Institute controls how the students keep to the rules.  Text books https://www- clinicalkey- com.ezproxy.db azes.lsmuni.lt/#!/ browse/book/3- s2.0- https://www- C20160041931 clinicalkey- com.ezproxy.dbazes.l smuni.lt/#!/browse/b ook/3-s2.0- C20150000041 Anatomy databases. Acland Anatomy- https://login.ezproxy.dbazes.lsmuni.lt/login STAT1Ref (Anatomy.tv)- https://login.ezproxy.dbazes.lsmuni.lt/login Visible Body- https://login.ezproxy.dbazes.lsmuni.lt/login  Anatomy is the descriptive science! Anatomy requires names for structures! Learn Medical Terminology: spelling and pronunciation Approximately 75% of Medical Terms are based on either Greek or Latin An accurate use of anatomicAL terms in anatomy and medicine is essential to avoid confusions! Anatomijos vardynas, 2020 https://www.lsmuni.lt/cris/bitstream/20.500.12512/9 9817/2/ISBN9789955156390.pdf  Regional anatomy Anatomy Macroscopic anatomy- gross anatomy Microscopic anatomy- histology Systemic a. Systemic Anatomy Regional a.  The integumentary system Surface anatomy  The skeletal system  The muscular system Functional a.  The nervous system Clinical anatomy  The circulatory system  the cardiovascular s. Comparative a.  the lymphatic s. Radiological a.  The digestive (alimentary) system Developmental anatomy, embriology  The respiratory system Pathological anatomy …  The urinary system  The genital (reproductive) system  the endocrine system  Methods for studies   OBSERVATION!, inspectio Conversation Mortui vivos docent- the dead teaches the living  PALPATION, palpatio  AUSCULTATION, auscultation  TAP, percussion  Dissection! ANTHROPOMETRY, anthropometrio Praeparatio! Diagnostic imaging techniques  ENDOSCOPY  ULTRASOUND  RADIOGRAPHY  SUBTRACTION ANGIOGRAPHY  DOPPLER ULTRASOUND  COMPUTED TOMOGRAPHY  MAGNETIC RESONANCE IMAGING  NUCLEAR MEDICINE IMAGING  POSITRON EMISSION TOMOGRPAHY...  Periods of human life Prenatal period (280 days before birth) Ontogenesis Intrauterine development is a stage of first manifestations of human motor skills. Childhood 1) Newborn child (6 weeks) period of innate reflex movements 2) Suckling (6 weeks to 1 year) period of body straightening, grabbing and locomotion 3) Early childhood (1 to 3 years) period of developing walk, run and handling objects 4) Pre-school childhood (3 to 7 years) period of developing new, mainly overall, movements 5) School childhood (7 to 11 years) period of enhanced motor learning Adolescence 1) Puberty (11 to 15 years) period of differentiation and redevelopment of motor skills 2) Adolescence (15 to 20 years) period of integration and completing motor development Adulthood 1) Early adulthood (20 to 30 years) period of the climax of motor efficiency 2) Middle adulthood (30 to 45 years) period of stabilized motor efficiency 3) Late adulthood (45 to 60 years) period of decline in motor efficiency Old age 1) Early old age (60 to 75 years) period of initial involution of human motor skills 2) Middle old age (75 to 90 years) period of involution of human motor skills 3) Late old age (over 90 years) period of decline in human motor skills  Description of the human body is based on the Anatomical position!  the body is upright  head, gaze (eyes), and toes directed forward  arms adjacent to the sides with palms facing anteriorly and  lower limbs together with the feet parallel Positions: t Principal axes 1. Vertical axis 2. Transverse axis 3. Sagittal axis Position of organs or their parts in space is determined by ANATOMICAL PLANES  TRANSVERSE, HORIZONTAL, AXIAL  CORONAL, FRONTAL  SAGITTAL, MEDIAN  Terms of relationship and comparison Superior – inferior Cranial (L. cranium- skeleton of the head) Caudal (L. cauda, tail) Ventral (L.venter-abdomen)- Dorsal (L.dorsum-back) Proximal- Distal Superficial- Deep (profundus) External- Internal Medial- Lateral Terms of laterality: Abbreviations!  Bilateral Muscle- m.  Unilateral Artery- a.  Ipsilateral Vein- v.  Contralateral Nerve- n. PRINCIPLES of the body composition: 1. POLARITY (superior, inferior pole) 2. SYMMETRY- bilateral 3. METAMERISM- metameric segmentation- linear series of body segments  Anatomical variations- are common! Variability is the law of life," Sir William Osler. It is important to understand that no two living organisms are structurally or functionally identical! Anomaly- a deviation from the common rule, type, arrangement, or form- is almost always incompatible with an infant’s survival. (Anencephalus) About 1 in 10000 people have their organs arranged in a mirror image (situs viscerum inversus)- the liver is on the left, the heart on the right, and so on. Body (constitutional) types  Astenic (dolichomorph, leptosomic, ectomorph)  Normostenic (mesomorph, atletic)  Hyperstenic (brachimorph, pyknic, endomorph) ORGANIZATION OF THE HUMAN BODY HEAD, CAPUT NECK, COLLUM seu CERVIX TRUNK, TRUNCUS: THORAX, DORSUM, ABDOMEN, PELVIS UPPER LIMB, MEMBRUM SUPERIUS LOWER LIMB, MEMBRUM INFERIUS UPPER LIMB, MEMBRUM SUPERIUS  PECTORAL (SHOULDER) GIRDLE - CINGULUM MEMBRI SUPERIORIS  Free part of upper limb: -ARM- BRACHIUM -FOREARM- ANTEBRACHIUM -HAND- MANUS:  wrist, CARPUS  metacarpus- METACARPUS  fingers, DIGITI: (thumb- pollex(I), index(II), middle(III), ring(IV), little(V) finger -phalanges: phalanx proximalis, media, distalis  Pelvic girdle LOWER LIMB- MEMBRUM INFERIUS Thigh  PELVIC GIRDLE (PELVIS)  Free part of lower limb: -THIGH- FEMUR Leg -LEG- CRUS -FOOT- PES: -tarsus-TARSUS Foot -metatarsus-METATARSUS -toes- DIGITI, great toe- hallux(I) -phalanges: phalanx proximalis, media et distalis Body cavities  Thoracic cavity  Abdominopelvic cavity  Cranial cavity  Vertebral canal  4 types of tissue Lines inner and outer surfaces Coordinates response to stimuli of Movement is a consequence of contraction of these cells  Provide structure and connection.  Characterized by cells and non- cellular matrix:  E.g. cartilage, bone, blood, fat tissue  Locomotor system The musculoskeletal system system of bones, joints, ligaments, muscles, tendons, and associated tissues that move the body and maintain form Passive part Skeletal system Joints Active part Muscular system Nervous, cardiovascular system, sensory organs, endocrine system – are playing important role in activities of locomotor system!  Skeletal system Composition of the bone  Minerals give bone its Non- characteristic hardness organic and ability to resist compression! component These- particularly- collagen- provide the Organic bone with resilience to component stretching and twisting!  Shine bone, fibula Demineralized (decalcified) bone Non-organic component is removed when bone is placed in a mineral acid and calcium salts dissolve away:  bone becomes soft, elastic and pliable  organic substances preserve only its basic shape  such bones can be easily bent or twisted!  Types of the bone tissue Compact bone Spongy, Strongest and cancellous, densest tissue in trabecular bone diaphysis of long Mainly in axial bones skeleton! Vertebrae, diploë of flat bones, epiphyses of long bones Compact, cortical bone dense, external layer of bone! Osteon- Haversian system  long, cylindrical structures run parallel to long axis of bone!  within each osteon is group of concentric lamellas 4-20 Lamella (lamina): layer of bone matrix- All the collagen fibers in a particular lamella run in a single direction, while collagen fibers in adjacent lamella will run in the opposite direction- allows the bone to better withstand twisting forces!  Haversian canal- runs through center of osteon, containing blood vessels and nerves  Osteons are connected by Volkmann’s canals  Cancellous (spongy, trabecular) bone  appears poorly organized compared to compact bone! Lacks osteons!  trabeculae are made up of a number of lamellas between which there are lacunas containing osteocytes  In spaces between trabeculae is red bone marrow  trabeculae arranged in very real pattern best adapted to resist the local strains and stress!  Membranes Periosteum is thick fibrous membrane with thin cellular layer  covers outer surface of the bones, except articular surfaces!  contains generative layer with osteoblasts!-  during growth the width of the bone increases as osteoblasts produce new bony tissue (bony repair after fracture!)  rich with nerve terminals!- very sensitive structure! Endosteum is thin connective membrane-  lines the inner surfaces of the medullary cavity of the long bones  it also is osteogenic and contributes to new bone formation! To prevent the bone from becoming unnecessarily thick, osteoclasts resorb the bone Functions of the membranes: bone growth, repair, modeling, remodeling, ca homeostasis, nutrition, attachment site, limiting membrane  Principles of blood supply  1-3 nutrient arteries supply the bone’s shaft  epiphyses have own blood supply and is richer than nutrition of diaphyses  arteries are accompanied by the veins and innervation of the bone Fine myelinated and unmyelinated axons accompany blood vessels in Haversian canals!  Sensory innervation by nerves that enter at the same site as arteries, nerve fibers travel together with branches of arteries  Sympathetic nerves provide vasomotor innervation, regulates blood flow  Epiphyseal line (hyaline cartilage) Growth in the length and diameter! Remodulation of the bone Bone is dynamic structure! Age related changes of bone  Mineral density is significantly reduced!- loss of calcium  Protein synthesis slows- no formation of new collagen  Decrease of bone mass  Gradual loss of cells and water  Trabeculae become thin, less, larger cavities  Cartilage becomes thinner  Changes of posture and gait Pathological bone development in children may causes Ricket- soft, weak bones, deformities of bones. In adult-osteomalacia.  Cartilage  is connective tissue  compound of chondrocytes and extracellular matrix, with collagen type II  does not contain blood vessels and nerves! Functions- provide the flexibility, important for bone modeling, other functions similar to skeleton Three types of cartilage!: 1. Hyaline, with age tends to become calcified and sometimes may ossified  most abundant  support via flexibility/resilience  e.g. at limb joints- articular cartilage, ribs, nose 2. Elastic  many elastic fibers in matrix too  great flexibility  e.g. external ear, epiglottis, external nose 3. Fibrocartilage, may calcify and ossify!  resists both compression and tension  e.g. meniscus, intervertebral disc  Skeleton Ancient Gr.- sceletós- dried up Average number of bones in  adult skeleton is 206 bones,  in newborn skeleton- 270 Axial Appendicular Skeleton of upper and Skeleton of head and lower limbs trunk (80 bones) 126 bones (64;62)  Functions of the skeletal system 1.Support chief supporting tissue of the body! the bones of the lower limbs, and vertebral column support the weight of the upright posture the mandible, and maxilla support the teeth other bones support various organs and tissue 2. Protection of the vital structures of the body: the skull protects the brain 3. Movement thoracic cage- protect the lungs and skeletal muscles use the heart bones as levers (mechanical vertebral canal- protects the spinal basis) to move the body’s parts cord pelvis protects the reproductive organs 4. Storage for mineral salts and adipose tissue 5. Hematopoiesis- 95% of the body’s calcium is blood cell formation- all blood cells stored in skeleton are produced in the red bone 90% of the body’s phosphorous is marrow stored in skeleton adipose tissue is found in the yellow bone marrow Variety of bones  Bone, os, ossis, ossa Types of the bones Long Short Irregular Flat Have peculiar shapes that cannot grouped as the 3 Longer than they are Roughly cube previous types: vertebrae, wide shaped: ethmoid, sphenoid, Bones of the limbs, Thin, flattened, temporal, pelvic bones except, scapula, Carpal and tarsal bones and usually a bit Pneumatic bones- patella, carpal and tarsal bones curved: scapula, containing cavities: sternum, ribs, and maxilla, frontal, sphenoid, most of the skull ethmoid bones bone, pelvic bone Sesamoid bones- small bony tissue structures, that develop in the tendons at points where great forces are applied to the tendons. Patella. Short bones, ossa brevia  wrist bones - 8  tarsal bones - 7  Flat bones, ossa plana  ilium  sternum  scapula  skull bones: parietal bone, squama of frontal, temporal, and occipital bones... Irregular bones, ossa irregularia Sphenoid bone  Pneumatic bones, ossa pneumatica Bones are containing cavity- sinus: 4 paranasal sinuses Maxilla Ethmoid bone- labyrinthus- sinus  Sesamoid bones, ossa sesamoideae Sutural bones, os incae Inca bones in the skull sutures Kneecap- patella (in Inca civilization) Common structures of the long bones! Expanded ends are epiphyses: proximal and distal; spongy bone is lined by thin layer of compact 1. bone. Articular surfaces are covered by hyaline cartilage. Shaft, diaphysis, body Consists of a thick layer of compact bone surrounding a medullary (marrow) cavity 2. In adults, the cavity contains fat - yellow bone marrow. Metaphysis, small portion between epiphysis and diaphysis. In childhood it contains growth epiphyseal plate- for growth in length!!! 3. In adulthood (18-25years) it ossifies became as epiphyseal line- to permit loads from joint to shaft.  Bone marrow, medulla ossium rubra et flava 1.6 - 3.7 kg Red bone marrow- produces all types of Head of femur blood cells (haematopoesis!) Yellow bone marrow (fat cells- energy) is in adult long bone medullar cavity In adult skeleton Red bone marrow with stem cells is located in:  the proximal spongy ends of humerus and femur;  the ribs, sternum, vertebrae, pelvic bones, and flat bones of the skull General guidelines for osteology studies: 1. recognize the bone, name, explain location in the skeleton! 2. give short characteristic: e.g.: a) humerus- belongs to the skeleton of the arm b) humerus is the typical long bone 3. name it’s main parts: e.g. humerus has proximal end, shaft, and distal end 4. describe the each part: e.g. - on shaft of humerus is groove for radial nerve …. …………….  Anatomical terms for bone markings Structures of the bone Structures for attachment ligaments, tendons, and muscles: process, spina, tuberosity, crest, condyle, tubercle, trochanter, eminence Structures for joints: articular surfaces Structures for blood vessels, nerves, organs, and air: sulcus, fissure, hiatus, foramina, aperture, canalis, cavity, sinus  Axial skeleton  Bones of the skull  Hyoid bone  Vertebral column  Bones of the thorax Hyoid bone Skeleton of the head- Skull, cranium consists of 28 bones:  bones of cerebral part-neurocranium - 7  bones of facial skeleton - 15  auditory ossicles - 6  Cerebral part:  calvaria  base Facial part Bones of the cerebral part- neurocranium  Frontal bone, os frontale -1  Sphenoid bone, os sphenoidale -1  Parietal bone, os parietale -2  Temporal bone, os temporale -2  Occipital bone, os occipitale -1  Features of bones of neurocranium  Calvaria (skull cap) bones are flat bones!  external plate- very resilience!  diploë- spongy bone with bone marrow  internal plate, s. lamina vitrea, more brittle!  Base- many foramina- fractures! Only external plate is covered with periosteum (pericranium)!- Internal plate- lamina vitrea is high mineralized part, very fragile, and isn’t lined by periosteum- there is periosteal layer of dura mater!  Facial skeleton, viscerocranium Flat bones: thin and very fragile! Except- mandible!  Mandible, mandibula -1  Maxilla, maxilla -2  Palatine bone, os palatinum -2  Zygomatic bone, os zygomaticum -2  Ethmoidal bone, os ethmoidale-1  Inferior nasal concha, concha nasalis inferior -2  Lacrimal bone, os lacrimale -2  Nasal bone, os nasale -2  Vomer, vomer -1 Auditory ossicles are located in tympanic cavity of the temporal bone:  malleus - 2  stapes - 2  incus - 2 Whole skull Anterior view Posterior view Lateral view Lateral view Inferior view Superior view  Inferior view External cranial base (without mandible)- 3 parts Bony thickness of cranial base varies: thicker bones are in regions for support in other regions bones are thin, covered with muscles distinct feature- there are many foramina! Axial CT scan Internal base of the neurocranium There are 3 fossae: anterior, middle, and posterior Roots of the cranial nerves  Facial skull, viscerocranium Anterior view  Forehead  Orbits  Bony nasal cavity  Upper jaw  Lower jaw  Lateral view There are 3 fossae: temporal, infratemporal, and pterygopalatine Bones of the trunk Vertebral column, columna vertebralis Vertebra, vertebrae 24; 33- 34  Cervical part- vertebrae cervicales-7  Thoracic part- vertebrae thoracicae-12  Lumbar part- vertebrae lumbales-5  Sacral part- vertebrae sacrales-5; os sacrum  Coccygeal part- vertebrae coccygeae-4-5, os coccygis Typical features of the vertebra! Structural components  Body, corpus  Arch, arcus  Foramen  Processes, processus  Distinct features of the vertebrae Cervical vertebra Thoracic vertebra Lumbar vertebra Foramen transversarium Costal facets Costal process Sacrum and coccyx Sacral canal Sacral foramina: ventral and dorsal Thoracic skeleton- bones of the thorax  sternum Sternum:  ribs (12 pairs) Rib, costa,  manubrium (C) consists of:  body (D)  bony part  xiphoid process (E)  cartilage Ribs:  True ribs, I-VII  False ribs, VIII-XII  Floating ribs, XI-XII Appendicular skeleton Bones of the upper limb 1. Bones of the pectoral (shoulder) girdle  Clavicle, scapula 2. Bones of the free part  Bone of arm: humerus  Bones of forearm: radius, ulna  Bones of hand:  carpal bones  metatarpal bones  phalanges Bones of the pectoral (shoulder) girdle  clavicle, clavicula  scapula HUMERUS Bone of the arm Humerus Proximal epiphysis- head Diaphysis, body, shaft Distal epiphysis- condyle Head and condyles- with articular surfaces! and hyaline cartilage! Bones of the forearm  Radius  Ulna Proximal epiphysis Diaphysis (body/shaft) Distal epiphysis Bones of the hand  carpal bones - 8  metacarpal bones - 5  bones of the fingers- phalanges -14  Lumbar vertebrae Pelvic Sacrum bone Coccyx Bones of the lower limb 1. Bones of the pelvic girdle: pelvic bone 2. Bones of the free part:  Bones of thigh: femur  Bones of leg: tibia, fibula  Bones of foot: tarsal bones metatarsal bones phalanges Pelvic bone (hip, coxal bone), os coxae acetabulum obturator foramen Parts: !  ilium  pubis  ischium Pelvic brim Bone of the thigh Bones of the leg  femur  tibia  fibula  Femur proximal end: head, neck, trochanters  Diaphysis, shaft, body  Distal epiphysis: condyles On distal end of:  Tibia- medial malleolus  Fibula- lateral malleolus Bones of the foot middle  tarsal bones - 7  metatarsal bones- 5  finger (toes)bones: phalanges - 14