Skeletal System Chapter 7 PDF

Chapter 7 Skeletal System Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 1 Learning Expectations for Exam Name the tissues and organs that compose the skeletal s...

Chapter 7 Skeletal System Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 1 Learning Expectations for Exam Name the tissues and organs that compose the skeletal system. State several functions of the skeletal system. Describe the general features of a long bone and a flat bone Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 2   Skeletal system—composed of bones, cartilages, and ligaments Cartilage—forerunner of most bones Covers many joint surfaces of mature bone Ligaments—hold bones together at joints Tendons—attach muscle to bone Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Functions of the Skeleton  Support—limb bones and vertebrae support body; jaw bones support teeth; some bones support viscera Protection—of brain, spinal cord, heart, lungs, and more Movement—limb movements, breathing, and other movements depend on bone Electrolyte balance—calcium and phosphate levels Acid–base balance—buffers blood against large pH changes by altering phosphate & carbonate salt levels Blood formation—red bone marrow is the chief producer of blood cells Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Hematopoiesis: Blood cell formation Blood cell production occurs in red bone marrow Red blood cells, white blood cells, and platelets are produced in red bone marrow With age, some red bone marrow is replaced by yellow bone marrow, which stores fat, but does not produce blood cells Red marrow remains in adult in skull, ribs, sternum, clavicles, vertebrae, hip bones Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 5 Bone Classification by Shape: Long Bones: Long and narrow Have expanded ends Short Bones: Cube-like, length = width Include sesamoid (round) bones, which are embedded in tendons Flat Bones: Plate-like, with broad surfaces Irregular Bones: Variety of shapes Most are connected to several other bones Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 6  Epiphysis: expanded end Diaphysis: bone shaft Parts of a Long Bone  Metaphysis: between diaphysis and epiphysis, widening part Articular cartilage: covers epiphysis Periosteum: encloses bone; dense connective tissue Compact (cortical) bone: wall of diaphysis Spongy (cancellous) bone: makes up epiphyses Trabeculae: branching bony plates, make up spongy bone Medullary cavity: hollow chamber in diaphysis; contains marrow Endosteum: Lines spaces, cavity Bone marrow: Red or yellow marrow, lines medullary cavity, spongy bone spaces Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 7   Microscopic Structure of Bone Osteocytes: Mature bone cells Lacunae: Chambers occupied by osteocytes Canaliculi: Tiny passageways through which the cell processes of osteocytes exchange nutrients and wastes The extracellular matrix of bone is largely collagen fibers and inorganic salts: Collagen gives bone resilience Inorganic salts make bone hard Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 8 Compact (dense or General Features of Bones 2  cortical) bone—dense outer shell of bone Spongy (cancellous) bone—loosely organized bone tissue Found in center of ends and center of shafts of long bones and in middle of nearly all others Covered by more durable compact bone Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Articular cartilage—layer of hyaline cartilage that covers joint surface; allows joint to move more freely Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Nutrient foramina—minute holes  in bone surface that allows blood vessels to penetrate Periosteum— external sheath covering most of bone Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Epiphysial plate (growth plate)—area of hyaline cartilage that separates epiphyses and diaphyses of children’s bones Enables growth in length Epiphysial line—in adults, a bony scar that marks where growth plate used to be Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Bone Growth and Repair Parts of the skeletal system begin to develop in first few weeks of prenatal development Bony structures continue to grow and develop into adulthood Bones form when bone tissue replaces existing connective tissue in one of two ways: Intramembranous Ossification: Flat skull bones, clavicles, sternum and some facial bones Bones form between sheets of primitive connective tissue Endochondral Ossification: Long bones and most of skeleton Bones form from hyaline cartilage models Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 14 Homeostasis of Bone Tissue During development of intramembranous and endochondral bones, osteoblasts and osteoclasts re-shape, or remodel, them Bone remodeling occurs throughout life Opposing processes of deposition and resorption occur on surfaces of endosteum and periosteum Bone Resorption: Removal of bone by osteoclasts Bone Deposition: Formation of bone by osteoblasts 10% to 20% of skeleton is replaced each year Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 15 Bone remodeling (absorption and deposition) occurs throughout life—10% of skeleton per year Repairs microfractures, releases minerals into blood, reshapes bones in response to use and disuse Wolff’s law of bone: architecture of bone determined by mechanical stresses placed on it Remodeling is a collaborative and precise action of osteoblasts and osteoclasts Bony processes grow larger in response to mechanical stress Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Bone Remodeling https://www.youtube.com/watch?v=0dV1Bwe2v6c Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Matrix of osseous tissue averages, by dry weight, about one-third organic and two-thirds inorganic matter Organic matter—synthesized by osteoblasts Collagen, carbohydrate–protein complexes, such as glycosaminoglycans, proteoglycans, and glycoproteins Inorganic matter 85% hydroxyapatite (crystallized calcium phosphate salt) 10% calcium carbonate Other minerals (fluoride, sodium, potassium, magnesium) Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Bone is a composite material—a combination of a ceramic and a polymer Hydroxyapatite and other minerals are the ceramic and collagen (protein) is the polymer Ceramic portion allows the bone to support body weight without sagging Rickets is a disease caused by mineral deficiency and resulting in soft, deformed bones Polymer (protein) gives some flexibility Osteogenesis imperfecta (brittle bone disease) results from a defect in collagen deposition Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Histology of compact bone reveals osteons (haversian systems). Concentric lamellae surround a central (haversian) canal running longitudinally Collagen in calcium-phosphate matrix is similar to re-enforced concrete Figure 6.5 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Perforating canals— transverse or diagonal passages Interstitial lamellae fill irregular regions between osteons Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw HillReschke/Getty d: © Ed LLC. Images   Spongy bone consists of: Structure in Relation to Mechanical Stress Lattice of bone covered with endosteum Thin plates or beams of bone called trabeculae Few osteons and no central canals All osteocytes close to bone marrow Provides strength with minimal weight Trabeculae develop along bone’s lines of stress Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Note that Trabeculae have no direct blood supply The structure of spongy bone, as shown in the head of the femur Trabeculae of Canaliculi Endosteum Lamellae spongy bone opening on surface Figure 6.4 3 – 4 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Bone marrow—soft tissue occupying marrow cavities of long bones & small spaces of spongy bone  Red marrow (myeloid tissue) Contains hematopoietic tissue—produces blood cells In nearly every bone in a child In adults, found in skull, vertebrae, ribs, sternum, part of pelvic girdle, and proximal heads of humerus and femur Yellow marrow found in adults Fatty marrow that does not produce blood Can transform back to red marrow in the event of chronic anemia Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Bone Elongation  Epiphysial plate—cartilage transitions to bone Functions as growth zone where bone elongates Has typical hyaline cartilage in the middle with transition zones on each side where cartilage is replaced by bone Metaphysis is zone of transition facing marrow cavity This is interstitial growth—growth from within Bone elongation is a result of cartilage growth within the epiphysial plate Epiphyses close when cartilage is gone—epiphysial line of spongy bone marks site of former epiphysial plate Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Bone Growth Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Bone Widening and Thickening Appositional growth—occurs at bone surface Continual growth in diameter and thickness Intramembranous ossification Osteoblasts of inner periosteum deposit osteoid tissue Become trapped as tissue calcifies Lay down matrix in layers parallel to surface Forms circumferential lamellae Osteoclasts of endosteum enlarge marrow cavity Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Figure 6.10 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Ages of Epiphyseal Fusion in Humans Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Factors Affecting Bone Development, Growth, and Repair 1 Nutrition, sunlight exposure, hormone levels, and physical exercise all affect bone development, growth, and repair: Vitamin D: calcium absorption; deficiency causes rickets, osteomalacia Vitamin A: osteoblast and osteoclast activity; deficiency retards bone development Vitamin C: collagen synthesis; deficiency results in slender, fragile bones Growth Hormone: stimulates cartilage cell division Insufficiency in a child can result in pituitary dwarfism Excess causes gigantism in child, acromegaly in adult Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 36 Factors Affecting Bone Development, Growth, and Repair 2 Thyroid Hormone: Causes replacement of cartilage with bone in epiphyseal plate, osteoblast activity Parathyroid Hormone (PTH): Stimulates osteoclasts, bone breakdown Sex Hormones (estrogen, testosterone): Promote bone formation; stimulate ossification of epiphyseal plates Physical Stress: Stimulates bone growth Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 37 Clinical Application 7.2 Preventing Fragility Fractures Fragility Fracture: Fracture that occurs after a fall from less than standing height; a sign of low bone density Bone remodeling occurs throughout life With age, osteoclasts remove more bone than osteoblasts deposit Can result in osteopenia (bone loss) or progress to osteoporosis (severe bone loss that leaves spaces and canals in bone, weakens them) Estimated that 50% women and 25% men over 50 have one of the bone loss conditions Most common in postmenopausal women, due to hormone changes To prevent fragility fractures: Get 30 minutes of exercise per day; include weight-bearing exercise Get enough calcium and vitamin D Do not smoke Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 38 Osteoporosis—the most common bone disease Severe loss of bone density Bones lose mass and become brittle due to loss of organic matrix and minerals Affects spongy bone the most since it is the most metabolically active Subject to pathological fractures of hip, wrist, and vertebral column Kyphosis (widow’s hump)—deformity of spine due to vertebral bone loss Complications of loss of mobility are pneumonia and thrombosis Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Estrogen maintains bone density in both sexes; inhibits resorption by osteoclasts Postmenopausal white women at greatest risk Ovaries cease to secrete estrogen White women begin to lose bone mass as early as age 35; by age 70, average loss is 30% of bone mass Risk factors: race, age, gender, smoking, diabetes mellitus, diets poor which are poor in: calcium, protein, vitamins C and D Osteoporosis also seen in young female athletes with low body fat causing them to stop ovulating and decrease estrogen secretion Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Treatments Estrogen replacement therapy (ERT) slows bone resorption, but increases risk of breast cancer, stroke, and heart disease Drugs Fosamax, Actonel destroy osteoclasts PTH slows bone loss if given as daily injection Forteo (PTH derivative) increases density by 10% in 1 year May promote bone cancer so use is limited to 2 years Best treatment is prevention: exercise and a good bone-building diet between ages 25 and 40 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Clinical Application 7.2 Figure 7C Normal Bone and Bone with Osteoporosis Michael Klein/ Photolibrary/Getty Images Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 42 7.5 Skeletal Organization Number of bones in the adult skeleton is about 206 Some people have extra bones, while others lack certain bones Examples of extra bones that some people have: Sutural (wormian) bones in sutures between major skull bones Small sesamoid bones in tendons; reduce friction A vertebra Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 43 Skeletal Organization Axial Skeleton (80 Bones) The appendicular skeleton includes The axial skeleton the bones of the consists of the limbs and the bones of the skull, pectoral and pelvic thorax, and vertebral girdles that attach column. These the limbs to the elements form the axial skeleton. longitudinal axis of the body. Appendicular Skeleton (126 Bones) Figure 6 Section 1 1 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Divisions of the Skeleton Axial Skeleton (80 bones): Skull: Cranium and facial bones Middle ear bones: Move sound to receptors in inner ear Hyoid bone: Supports tongue and is muscle attachment site Vertebral column: Forms central axis of skeleton Thoracic cage: Ribs and sternum; protects organs Appendicular Skeleton (126 bones): Pectoral girdle: Scapula and clavicle; upper limb movement Upper limbs: Humerus, radius, ulna, hand Pelvic girdle: Hip bones; lower limb movement; forms pelvis Lower limbs: Femur, tibia, fibula, patella, foot Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 45  206 BONES!!! Holy ! Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 24 Vertebra  Atlas, Axis, Cervical, Thoracic, Lumbar  5 24 Ribs  True and False Ribs  2 22 Skull  Only need to know 11 80 Appendicular  divide by 2  40 Simple rules for bones of hand and foot Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 7.6 The Skull The skull is typically composed of 22 bones All skull bones are interlocked along sutures, except the lower jaw (mandible) The skull = cranium + facial skeleton Cranium contains 8 bones; encloses and protects brain Facial skeleton contains 14 bones; forms shape of face Mandible is movable, and held in place next to cranium by ligaments Orbit of eye is formed by some facial and cranial bones Paranasal sinuses: Air-filled cavities found in some cranial and facial bones Reduce weight of skull and increase intensity of voice Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 49 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  The skull  * The cranial bones (8) o The occipital bone o The parietal bones (2) o The frontal bone o The temporal bones (2) o The sphenoid bone o The ethmoid bone * The facial bones (14) o The nasal bones (2) o The maxillae (upper jaw) (2)  o The lacrimal bone (2) o The zygomatic bone (2)  o The palatine bone (2) o The inferior nasal concha (2) o The vomer o The mandible (lower jaw)  Nice Video on Skull https://www.youtube.com/watch?v=ocqoZyY12GM Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Skull 3 min http://www.youtube.com/watch?v=Nc5IRj3OJhE Figure 7.3a Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Figure 7.2a Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Temporal Bone Figure 7.5 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Figure 7.2b Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  cranial base or the cranial floor Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Figure 7.4b Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  sphenoid bone Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Sella turcica is a depression on the upper part of the body. It houses the pituitary gland Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. ethmoid bone Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Nasal Cavity Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  facial bones Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Figure 7.8a Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Holes (Foramen) to allow cranial nerves to exit skull Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Jugular Foramen  Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Jugular Foramen Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. The Skull in Infancy and Childhood Fontanelles—spaces between unfused cranial bones Contain fibrous membrane Allow shifting of bones during birth and growth of brain Anterior, posterior, sphenoid (anterolateral), and mastoid (posterolateral) fontanels Two frontal bones fuse by age 6 (metopic suture) Skull approaches adult size by 8 or 9 years of age Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Video Overview of Bones https://www.youtube.com/watch?v=nDY_pA8yntE Skull https://www.youtube.com/watch?v=ocqoZyY12GM Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Vertebral column Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Vertebral column Consists of 26 bones (24 vertebrae, 1 sacrum, 1 coccyx) Average adult length is 71 cm (28 in.) Functions Provides a column of support to bear weight of head, neck, and trunk Transfers weight to lower limbs Protects spinal column Helps maintain upright position Vertebral Column Watch tutorial Videos below http://www.youtube.com/watch?v=NAd9g5nUurE https://www.youtube.com/watch?v=TEXASYF5xZc good Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Vertebral Regions Regions are defined  by anatomical C1 characteristics of C2 individual vertebrae. C3 C1-C7 C4 Cervical C5 C6 C7 (7 vertebrae) T1 T2 T3 T4 T5 T6 T1-T12 T7 T8 Thoracic T9 (12 vertebrae) T10 T11 T12 L1 L2 L1-L5 L3 Lumbar L4 (5 vertebrae) L5 Sacral (5 vertebrae) S1-S5 Coccygeal (4 vertebrae) Co1-Co4 Figure 7.9 1 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Learning Expectations  Be able to identify Atlas, Axis  Know differences between cervical, thoracic, and lumbar vertebrae  Know key features of ribs; true vs false ribs Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Parts of typical vertebra  Vertebral arch Spinous process (projects posteriorly) Laminae (form “roof” of vertebral foramen) Transverse processes (project laterally) Pedicles (form sides of vertebral arch) Vertebral foramen Formed by vertebral body and arch Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Articular processes Vertebral arch Know the parts of a typical vertebra Vertebral body Spinous process Superior view Vertebral foramen Transverse process Inferior view Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Know the difference between the Cervical, Thoracic, and Lumbar vertebrae General Rules – Going from Bottom to Top  Vertebral Body is Bigger  Vertebra supporting more weight  Foramen is Smaller  Spinal Cord is smaller  Cervical Vertebrae have foramen for vertebral arteries  Thoracic Vertebrae have articulation points for ribs Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Atlas and Axis  Figure 7.16 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. The first two cervical vertebrae: the atlas and the axis Anterior Atlas arch of atlas Dens (odontoid process) Ligament that enables Joint that permits rotation (as in shaking nodding (as in the head to indicate indicating “yes”) Axis “no”) Posterior arch of atlas Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Know the difference between the vertebrae A typical cervical vertebra Bifid spinous process Vertebral Transverse foramen foramen (Vertebral Artery) Transverse process Vertebral body Costal process Vertebral Video Watch tutorial Video below http://www.youtube.com/watch?v=VIpnyCof1xA Figure 7.10 1 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  A lateral view of Vertebral & Carotid Arteries 7 cervical vertebrae Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Attachment of Rib to Vertebra  Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Superior articular Pedicle process Transverse process Vertebral body Spinous process Inferior articular process Inferior articular facet Lateral view typical lumbar vertebra Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Two views of a typical lumbar vertebra Click to edit Master title style Spinous process Superior Superior articular articular Lamina facet process Transverse process Vertebral foramen Pedicle Vertebral body Superior view Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  sacrum x ray Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  A posterior view of two vertebrae Articular facet Superior articular process Inferior articular process Intervertebral disc (fibrocartilage) Figure 7.9 5 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Ligaments attached to bodies and processes of all vertebrae Primary Vertebral Ligaments Ligamentum flavum Intervertebral disc Anulus fibrosus Posterior longitudinal ligament Nucleus pulposus Spinal cord Interspinous ligament Spinal nerve Supraspinous ligament Posterior longitudinal ligament Anterior longitudinal ligament Lateral view Sectional view Figure 8.5 2 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Intervertebral discs lie between adjacent vertebrae in the spine. Each disc forms a fibrocartilaginous joint to allow slight movement of the vertebrae, and acts as a ligament to hold the vertebrae together. Their role as shock absorbers is crucial Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. A herniated disc, as seen in a superior view Compressed area Spinal nerve of spinal nerve Spinal cord Nucleus pulposus Anulus of herniated disc fibrosis Video on Herniated Disc http://www.spine-health.com/video/herniated-disc-video Figure 8.5 4 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Clinical Application 7.3 Disorders of the Vertebral Column Herniated or Ruptured (protruding) disc: break in the outer portion of an intervertebral disc; compresses spinal nerves, causing numbness, pain, loss of muscle function Kyphosis: exaggerated thoracic curvature of the spine; rounded shoulders and hunchback; caused by poor posture, injury, disease Scoliosis: abnormal lateral curvature of the spine; one shoulder or hip may be lower than the other, leading to compression of visceral organs Lordosis: exaggerated lumbar curvature of the spine; swayback Compression fractures: fractures of vertebral bodies become more common with age, as intervertebral discs become rigid and shrink; back may bow due to accentuated curvature Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. 102   Lordosis (also known as swayback) is when the lower back, above the buttocks, curves inward too much, causing the child's abdomen to protrude and buttocks to stick out. Kyphosis is when the upper spine curves too far outward, forming a hump on the upper back. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   The first seven ribs attach to the sternum (the breast bone) in the front and are known as true ribs Figure 7.19a Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Videos on Ribs http://www.youtube.com/watch?v=8GkIVeL6k9U http://www.youtube.com/watch?v=3Soj8NejXO0 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Figure 7.20 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Attachment of Rib to Vertebra Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Costal Groove protects nerve, artery, vein Note that the nerve, artery, and vein are on the inferior border of the rib Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Note Sternal Costal Joints & Sternoclavicular Joint Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Chapter 8 The Skeletal System – Upper & Lower Limbs Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Terminology O-lec-ra-non bony prominence of the elbow, on the upper end of the ulna. Styloid Process - points of attachment for muscles, refers to the slender, pointed process (protrusion) of a bone Trochlear - refers to a grooved structure reminiscent of a pulley's wheel Tubercle - a round nodule, small eminence, or warty outgrowth found on bones Tuberosity - a rough projection or protuberance of a bone, as for the attachment of a muscle Epicondyle - any of several prominences on the distal part of a long bone serving for the attachment of muscles and ligaments Fossa - A shallow depression (the word suggests "ditch" or "trench"). Such depressions in the surface of bones often receive another articulating bone with which a joint is formed. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Pectoral Girdle with Upper Limb Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Pectoral girdle (shoulder girdle) supports the arm Consists of two bones on each side of the body Clavicle (collarbone) Scapula (shoulder blade) Clavicle articulates medially to the manubrium  (sternum) and laterally to the scapula Scapula articulates with the clavicle and the humerus Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Pectoral girdle Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Clavicle Great Video – 7 min http://www.youtube.com/watch?v=D3GVKjeY1FM Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. acromioclavicular join  Manubrium Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Scapula—named for resemblance to a shovel  Triangular plate that posteriorly overlies ribs 2 to 7 Three sides: superior, medial, and lateral borders Three angles: superior, inferior, and lateral angles Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Lateral angle of scapula has three main features: Acromion—plate-like extension of the spine. Forms apex of the shoulder. Articulates with clavicle to form the sole point of attachment of scapula & upper limb to rest of skeleton Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Coracoid process—shaped like a bent finger. Provides attachment for tendons of biceps brachii and other arm muscles Glenoid cavity—shallow socket that articulates with the head of the humerus. Helps form glenohumeral joint Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Upper Limb has three regions & contains 30 bones Brachium (arm proper): extends from shoulder to elbow Contains only one bone—humerus Antebrachium (forearm): extends from elbow to wrist Contains two bones—radius & ulna Hand. Carpal region contains eight small bones arranged in two rows. Remaining 19 bones in two groups; 5 metacarpals in palm; 14 phalanges in fingers. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. humerus Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Humerus - Features of the proximal end: Head articulates with the glenoid cavity of scapula Anatomical neck Greater and lesser tubercles Deltoid tuberosity Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. The Humerus - distal end: Rounded capitulum articulates with head of radius Trochlea articulates with ulna Lateral and medial epicondyles Olecranon fossa holds olecranon process of ulna Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  HUMERUS ULNA RADIUS Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Elbow – 7 min video http://www.youtube.com/watch?v=3l3-5Ij3JZ8 eOrthoPod.Com Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Elbow - Ball & Socket joint, Hinge joint Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Note Note Radius Ulna is is Medial Lateral Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   The Radius: Head: disc-shaped, allows for rotation during pronation and supination Superior surface articulates with capitulum on humerus Side of disc spins on radial notch on ulna Styloid process can be palpated near thumb Ulnar notch accommodates head of ulna Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   The Ulna: Trochlear notch articulates with trochlea of humerus Olecranon: bony point at back of elbow Radial notch holds head of radius Ligament attaches radius to ulna along interosseous margin of each bone Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Note Note Radius Ulna is is Medial Lateral Thumb Side Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Bones of the hand https://www.youtube.com/watch?v=LlYUjR_mlHA  http://www.youtube.com/watch?v=xE3AYqVWCJc Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Bones of the hand Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   um Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. The Carpal Bones - Eight bones form wrist  Allow movements of flexion, extension, abduction, and adduction Two rows (four bones each) Proximal row: scaphoid, lunate, triquetrum, and pisiform Distal row: trapezium, trapezoid, capitate, and hamate Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. The lower limb is divided into three regions containing 30 bones Thigh (femoral region): extends from hip to knee region Contains femur and patella Leg proper (crural region): extends from knee to ankle Contains medial tibia and lateral fibula Foot Tarsal region—the union of the crural region with the foot Metatarsal region 5 metatarsals Toes (digits) 14 phalanges in the toes Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Pelvic Girdle Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Pelvic girdle - Ring composed of three bones  Two hip (coxal) bones, One sacrum (also part of vertebral column) Pelvis - Pelvic girdle plus ligaments and muscles that line the pelvic cavity and form its floor Sacroiliac joint - Joins coxal bone to vertebral column. Auricular surface of ileum to auricular surface of sacrum Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Each adult hip bone is formed by the fusion of three childhood bones: ilium, ishchium, pubis Sacrum articulates with the Ilium Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   acetabulum articulates with the head of femur Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Great Video https://www.youtube.com/watch?v=qlCvKEOZtpo Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Male—heavier and thicker Sex Differences of Pelvic Girdle Female—wider and shallower, and adapted to the needs of  pregnancy and childbirth, larger pelvic inlet and outlet for passage of infant’s head Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Thigh (femoral region): extends from hip to knee region Contains femur and patella Leg proper (crural region): extends from knee to ankle Contains medial tibia and lateral fibula Foot Tarsal region—the union of the crural region with the foot Metatarsal region 5 metatarsals Toes (digits) 14 phalanges in the toes Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Femur  Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. The Femur - Longest and strongest bone of the body  Head articulates with acetabulum of pelvis Patella - triangular sesamoid bone embedded in tendon of knee Quadriceps tendon extends from front of thigh to patella. Continues as the patellar ligament from patella to tibia Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Patella - triangular sesamoid bone embedded in tendon of knee Quadriceps tendon extends from front of thigh to patella. Continues as the patellar ligament from patella to tibia Tibia and Fibula Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   The tibia - thick, medial, leg bone Only weight-bearing bone of the crural region Features of the tibia: Medial malleolus—bony knob on inside of ankle Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   The fibula is a slender, lateral strut that helps stabilize ankle. Does not bear any body weight. Features of the fibula: Lateral malleolus—distal expansion, bony knob on lateral side of ankle. Fibula is joined to tibia by interosseous membrane. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Tibia and Fibula Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  foot x-ray Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  The Ankle and Foot  Tarsal bones differ from carpal bones due to load-bearing role Calcaneus — largest tarsal bone Forms heel Calcaneal (Achilles) tendon attaches to distal portion Talus — most superior tarsal bone Forms talo-crural joint with tibia and fibula Sits upon calcaneus and articulates with navicular Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Other foot bones resemble the The Ankle and Foot  hand bones in name and position Metatarsals: Metatarsal I is proximal to the great toe (hallux) Proximal base, intermediate shaft, and distal head Phalanges: Two in great toe Proximal and distal phalanx Three in all other toes Proximal, middle, distal phalanx Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Ankle Joint – Tibia articulates with the Talus; Achilles Tendon attaches to the Calcaneous; Fibula is NOT a weight bearing bone.  Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Sole of foot is not flat on ground  —three arches absorb stress Arches held together by short, strong ligaments Pes planus (flat feet) can be caused by excessive weight, repetitious stress, or congenital weakness. Medial longitudinal arch Lateral longitudinal arch Transverse arch Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Figure 7.32 Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.  Access the text alternative for slide images. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.   Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC. Copyright 2022 © McGraw Hill LLC. All rights reserved. No reproduction or distribution without the prior written consent of McGraw Hill LLC.