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Chapter 10 The Musculoskeletal System Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Muscles Intro 1 Introduction Musculoskeletal System: bones, muscles, and joints of the body Bones: structural support and protection of internal organs Muscles: internal and external movement Joints: where bones come together/type determined by need for flexibility 2 3 Physicians Associated with Musculoskeletal System • Orthopedist: MD, bones, bone disease • Rheumatologist: MD, joints • Osteopathic physician: DO, body able to heal itself with proper nutrition and bone alignment • Chiropractor: physical manipulation of the spinal column to relieve pressures on nerves 4 Muscles • Three types of muscles: striated, smooth, cardiac • Striated: under voluntary control—they move all the bones as well as face and eyes • Smooth: control is involuntary—they move internal organs (digestive tract, blood vessels, ducts of glands) • Cardiac: not consciously controlled and found exclusively in the heart 5 6 Combining Forms – Muscles p. 455 • Fasci/o • Fibr/o • Leiomy/o (smooth (visceral) muscle) • Lumb/o 7 Combining Forms – Muscles p. 455 • Muscul/o • My/o • Ten/o • Tend/o • Tendin/o 8 Suffixes – p. 456 • -algia • -asthenia • -pathy • -plegia 9 Suffixes – p. 456 • -rrhaphy • -sarcoma • -tomy 10 https://www.youtube.com/watch?v=J8x6tZI2hVI 11 Bone Structure – page 579 206 bones in the body Long bones: legs and arms Short bones: wrist and ankle Flat bones: shoulder blades and ribs Irregular bones: vertebrae and facial bones Sesamoid bones: knee cap 12 13 Bone Marrow • Yellow marrow: chiefly fat • Red Marrow: rich with blood vessels and immature and mature blood cells in various stages of development; in later life replaced with yellow marrow 14 Bone Processes and Depressions • Processes: serve as attachments for muscles and tendons • Depressions: openings or hollow regions help join bones or serve as passageways for nerves and/or vessels 15 Bone Processes and Depressions 16 Cranial Bones 17 Cranial Bones and Associated Structures • Frontal bone • Parietal bone • Temporal bone o temporomandibular (TMJ) joint o mastoid process o styloid process • Occipital bone o foramen magnum • Sphenoid bone o sella turcica • Ethmoid bone 18 Facial Bones 19 SINUSES Air cavities located in facial and cranial bones. They lighten the skull and warm and moisten the air as it passes into the respiratory system. 20 Vertebral Column 21 Vertebral Column and Vertebrae • Vertebrae: 26 bone segments from base of skull to tailbone in five divisions and separated by pads of cartilage called intervertebral disks. • Cervical, thoracic, lumbar, sacral • Coccyx: tailbone 22 Thorax, Pelvis and Extremities 23 Thorax, Pelvis and Extremities Thorax Arm and Hand clavicle humerus Pelvis pelvic girdle scapula ulna ilium sternum radius ischium ribs carpals pubis metacarpals phalanges 24 25 Clavicle and Scapula 26 Arm and Hand 27 Bones of the Pelvis 28 Bones of Leg and Foot 29 Bones of Leg and Foot and Associated Structures • Femur o acetabulum • Patella • Tibia o medial malleolus • Fibula o lateral malleolus o talus • Tarsals o calcaneus o talus • Metatarsals • Phalanges 30 QUICK QUIZ: 2. Process of bone formation____________ A.olecranon B.ossification C.osteoblast D.xiphoid process 31 Combining Form • calc/o • calci/o • kyph/o • lamin/o • lord/o • lumb/o Meaning calcium calcium posterior curvature in thoracic region lamina curve loins, lower back 32 Combining Form Meaning • • • • • • bone marrow straight bone crooked vertebra vertebra myel/o orth/o oste/o scoli/o spondyl/o vertebr/o 33 Suffix Meaning • -blast embryonic cell to break slipping softening to grow pore, passage instrument to cut • • • • • • -clast -listhesis -malacia -physis -porosis -tome 34 Combining Form • • • • • • acetabul/o calcane/o carp/o clavicul/o cost/o crani/o Meaning acetabulum (hip socket) calcaneus (heal) carpals (wrist bones) clavicle (collar bone) ribs cranium (skull) 35 Combining Form Meaning • femor/o femur (thigh bones) • fibul/o fibula (smaller lower leg bone) • humer/o humerus (upper arm bone) • ili/o ilium (upper part of pelvic bone) • ischi/o ischium (part of pelvic bone) 36 Combining Form Meaning • mandibul/o mandible (lower jaw bone) • maxill/o maxilla (upper jaw bone) • metacarp/o metacarpals (hand bones) • metatars/o metatarsals (foot bones) 37 Combining Form Meaning • olecran/o olecranon (elbow) • patell/o patella (kneecap) • pelv/i pelvis 38 Combining Form • perone/o • phalang/o • pub/o • radi/o • scapul/o Meaning fibula phalanges (finger, toe bones) pubis radius scapula (shoulder blade) 39 Combining Form • stern/o • tars/o • tibi/o • uln/o Meaning sternum (breastbone) tarsals tibia (shin bone) ulna (lower arm bone) 40 Vocabulary 41 Hypercalcemia hyper- calc/o: calcium -emia Excessive calcium in the blood 42 Kyphosis kyph/o: humpback posterior curvature in the thoracic region -osis Abnormal posterior curvature of the thoracic vertebrae 43 Laminectomy lamin/o: lamina Part of the vertebral arch -ectomy Removal of a lamina To relieve the symptoms of a ruptured intervertebral disc (disk) or compression of the spinal cord after injury 44 Lordosis lord/o: curve, swayback anterior curvature of the lumbar region -osis Abnormal anterior curvature of the backbones in the lumbar region 45 Orthopedics orth/o: straight ped/o: child -ic -s Pertaining to bones Orthopedists originally straightened the bones of children 46 Scoliosis scoli/o: crooked, bent lateral curvature -osis Abnormal condition of a lateral curvature of the spine 47 Osteomalacia oste/o: -malacia: Softening of bone 48 Osteoporosis oste/o -porosis: pore, passage Condition of increased porosity of bone 49 50 Carpal carp/o: carpals wrist bones -al Pertaining to the carpals 51 Supraclavicular supra- clavicul/o: clavicle collar bone -ar Pertaining to above the clavicle 52 Chondrocostal chondr/o: cartilage cost/o -al Pertaining to the cartilage attached to the ribs 53 Craniotomy crani/o -tomy Incision of the cranium 54 Pathologic Conditions - bones • Ewing sarcoma: malignant bone tumor • exostosis: bony growth on surface of bone • osteogenic sarcoma: malignant tumor arising from bone 55 Pathologic Conditions - bones • osteomalacia: softening of bone • osteomyelitis: inflammation • secondary to infection • talipes: congenital abnormality of hindfoot involving the talus (clubfoot) 56 Fractures of Bones 57 58 59 Pathologic Conditions Normal Bone Bone with osteoporosis 60 Joints • Joint (articulation): coming together of two or more bones o Suture joints: immovable (skull) o Synovial joints: freely movable (ball and socket types, e.g. hip or shoulder), (hinge type, e.g., elbow, knee, ankle) 61 Synovial Joints • Joint capsule surrounds bone • Ligaments band bones together • Bones covered by articular cartilage • Synovial membrane lies under capsule and lines synovial cavity; filled with synovial fluid 62 63 Bursae • Closed sacks of synovial fluid with a synovial membrane located near, but not within a joint. Needed where sliding must take place • Common sites: o between tendons (connective tissue connecting muscle to bone) and bones o between ligaments (binding bone to bone) and bone o between skin and bones (with prominent bony anatomy) 64 65 Joints 66 QUICK QUIZ: 3. Connective tissue that binds muscles to bones____________ A.ligament B.articulation C.synovial membrane D.tendon 67 Combining Forms Combining Form Meaning • ankyl/o stiff • arthr/o joint • articul/o joint • burs/o bursa • chondr/o cartilage 68 Combining Forms Combining Form Meaning • ligament/o ligament • rheumat/o watery flow • synov/o synovial membrane • ten/o tendon • tendin/o tendon 69 SUFFIXES Suffix Meaning • -desis to bind, tie together • -stenosis narrowing 70 Pathology - Joints – • Arthritis: inflammation of joints oAnkylosing spondylitis: chronic progressive stiffening of joints, mostly spine oGouty arthritis: inflammation due to excessive uric acid in body 71 Arthritis oOsteoarthritis (OA): loss of articular cartilage and formation of bone spurs at articular surfaces oRheumatoid arthritis (RA): autoimmune reaction against joint tissues (synovial membrane) 72 Osteoarthritis and Rheumatoid Arthritis 73 74 Pathologic Conditions • Bunion: swelling of medial aspect of joint between big toe and first metatarsal bone • Carpal tunnel syndrome: compression of median nerve as it passes between ligament and bones and tendons of the wrist. • Dislocation: displacement of bone from a joint 75 Bunion 76 Pathological Joint Conditions Carpal tunnel syndrome 77 Dislocation 78 Pathologic Conditions • Ganglion: a fluid-filled cyst arising from the joint capsule or a tendon in the wrist. • Herniation of an intervertebral disk: abnormal protrusion of the disk into the neural canal or against spinal nerves. • Lyme disease: recurrent arthritis, myalgia, malaise and neurologic and cardiac symptoms. 79 Ganglion 80 Herniated Disk 81 Pathologic Conditions • Sprain: trauma to joint with pain, swelling and injury to ligaments • Systemic lupus erythematosus (SLE): chronic inflammatory disease involving joints, skin, kidneys, nervous system, heart and lungs affecting collagen in tendons, ligaments, bones, and cartilage all over the body 82 Muscles 83 Muscles • Three types of muscles: striated, smooth, cardiac • Striated: under voluntary control—they move all the bones as well as face and eyes • Smooth: control is involuntary—they move internal organs (digestive tract, blood vessels, ducts of glands) • Cardiac: not consciously controlled and found exclusively in the heart 84 Types of Muscle 85 Named Skeletal Muscles 86 Actions of Muscles • • • • flexion extension abduction adduction • • • • • rotation dorsiflexion plantar flexion supination pronation 87 Actions of Muscles 88 QUICK QUIZ: 4. Movement AWAY from the midline of the body____________ A.adduction B.abduction C.flexion D.dorsiflexion 89 Combining Form Meaning • fasci/o facia • fibr/o fibrous • leiomy/o smooth muscle • my/o muscle 90 Combining Form Meaning • myocardi/o heart muscle • myos/o muscle • plant/o sole of the foot • rhabdomy/o skeletal muscle connected to bones flesh • Sarc/o 91 SUFFIXES Suffix Meaning • -asthenia lack of strength • -trophy development, nourishment 92 PREFIXES Prefix Meaning • • • • away from toward back many, much abaddorsipoly- 93 Pathologic Conditions • Muscular dystrophy: group of inherited diseases with progressive muscle weakness and degeneration without nervous system involvement • Polymyositis: chronic inflammatory myopathy; may be an autoimmune disorder 94 Laboratory Tests – see text • Antinuclear antibody test (ANA) • Erythrocyte sedimentation rate (ESR) • Rheumatoid factor test (RF) • Serum calcium (Ca) • Serum creatine kinase (CK) • Uric acid test 95 Clinical Procedures – See text • • • • • • • Arthrocentesis Arthrography Arthroplasty Arthroscopy Bone density test Bone scan Computed tomography (CT) • Diskography • Electromyography (EMG) • Magnetic resonance imaging (MRI) • Muscle biopsy 96