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Chapter 06 Lecture Outline See separate PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. 1 6.1 Skeleton: Overview 2 A. Functions of the Skeleton 1. 2. 3. 4. 5. Support Protection of soft body parts Blood cell production Storage of fats and minerals Movement using muscles and joints 3 B. Anatomy of bones 1. Classification of bones a. Long – longer than they are wide b. Short – cube shaped c. Flat – plate-like, with broad surfaces d. Irregular – varied shapes e. Round – circular in shape 4 2. Anatomy of a long bone a. Periosteum – tough, connective tissue covering that contains blood vessels b. Epiphysis – expanded portion at the ends of bones; made of spongy bone c. Diaphysis – portion between the epiphyses; the shaft; made of compact bone d. Medullary cavity – hollow portion of diaphysis containing yellow marrow e. Articular cartilage – layer of hyaline cartilage where bones join together f. Endosteum – lines the medullary cavity and the spaces of spongy bone g. Red bone marrow – found in spongy bone in adults; where hematopoiesis occurs 5 Anatomy of a Long Bone 6 3. Compact bone structure a. Osteons are made of concentric layers of matrix, called lamellae, containing collagen fibers and mineral salts b. Lacunae – contain bone cells (osteocytes) c. Central canal – contains blood vessels and nerves d. Canaliculi – small canals that connect lamellae and osteocytes to blood supply and nerves e. Perforating canals – run from the periosteum to the central canal of each osteon 7 Compact bone structure 8 4. Spongy bone structure a. b. Contains bony bars and plates called trabeculae Trabeculae follow lines of stress, giving bones strength 9 C. Physiology of bones 1. Types of bone cells a. Osteoprogenitor cells – unspecialized cells b. Osteoblasts – bone forming cells c. Osteocytes – mature bone cells d. Osteoclasts – bone resorption 10 2. Bone development and growth a. Ossification – formation of bone 1) Intramembranous ossification a) Spongy bone forms between two sheets of fibrous connective tissue b) Forms bones of the skull 2) Endochondral ossification a) Forms most bones of the human body b) Hyaline cartilage models are replaced by spongy bone, and then compact bone 11 Endochondral ossification 12 Bone growth and development, cont b. Epiphyseal plate 1) Band of hyaline cartilage in the epiphyses of long bones 2) Allows the bone to growth in length 3) Long bone growth continues until plate is ossified c. Appositional growth – increase in bone diameter 13 3. Remodeling of bones a. Bone is continually being broken down and built up again b. Osteoclasts remove worn cells and deposit calcium in the blood c. Osteoblasts remove calcium from the blood and form new bone d. Three important hormones regulating bone growth 1) Parathyroid hormone 2) Calcitonin 3) Growth hormone e. Proper levels of calcium are needed to prevent osteoporosis 14 4. Bone repair a. Required after it fractures (breaks) b. Steps involved in bone repair 1) Hematoma formation 2) Fibrocartilaginous callus 3) Bony callus 4) Remodeling c. Reduction – repair of a fracture 1) Closed reduction – re-aligning bone fragments without surgery 2) Open reduction – surgical repair of the bone using plates, screws, or pins 15 Repair of a broken bone 16 d. Naming of fractures 1) 2) 3) 4) 5) 6) Complete – bone is broken through Incomplete – bone is not separated into two parts Simple – does not pierce the skin Compound – pierces the skin Impacted – broken ends are wedged into each other Spiral – ragged break due to twisting of bone 17 D. Surface features of bones 18 6.2 Axial Skeleton 19 A. Introduction 1. Tissues of the skeleton – compact and spongy bone, cartilage, and dense connective tissue 2. Axial skeleton a. Lies in the midline of the body b. Bones of the axial skeleton – skull, hyoid bone, vertebral column, thoracic cage, and middle ear bones 3. Appendicular skeleton a. Bones of the extremities b. Includes the pectoral girdle, upper limbs, pelvic girdle, and lower limbs 20 Major bones of the skeleton 21 B. Skull 1. Formed by the cranium and the facial bones 2. Sinuses - air spaces within the bones a. Lined by mucous membranes b. Reduce the weight of the skull c. Give the voice a resonant sound d. Paranasal sinuses – connected to nasal cavity 1) Maxillary 2) Frontal 3) Sphenoidal 4) Ethmoidal e. Mastoid sinuses – connected to middle ear 22 Sagittal section of the skull 23 C. Bones of the cranium 1. Protects the brain 2. Sutures – immovable joints between cranial bones 3. Fontanels – membranous regions in newborns where cranial bones have not yet fused together 4. Composed of eight bones a. Frontal bone (1) b. Parietal bones (2) c. Occipital bone (1) 1) Foramen magnum 2) Occipital condyles 24 Bones of the cranium, cont d. Temporal bones (2) 1) External acoustic meatus 2) Mandibular fossa 3) Mastoid process 4) Styloid process 5) Zygomatic process e. Sphenoid bone (1) 1) Sella turcica f. Ethmoid bone (1) 1) Crista galli 2) Cribriform plate 3) Perpendicular plate 4) Superior and middle nasal conchae 25 Skull Anatomy 26 Skull Anatomy 27 D. Bones of the face 1. Maxillae (2) a. Alveolar process b. Palatine process 2. Palatine bones (2) 3. Zygomatic bones (2) a. Temporal process b. Zygomatic arch 4. Lacrimal bones (2) 5. Nasal bones (2) 6. Vomer bone (1) 7. Inferior nasal conchae (2) 8. Mandible (1) a. Mandibular condyle b. Coronoid process c. Alveolar process 28 Skull Anatomy 29 Skull Anatomy 30 E. Hyoid Bone 1. Superior to larynx 2. Only bone in the body that does not articulate with another bone 3. Anchors the tongue 4. Site of attachment for muscles associated with swallowing 31 F. Vertebral Column (Spine) 1. Functions a. Supports rib cage b. Serves as a point of attachment for the pelvic girdle c. Protects the spinal cord 2. Consists of a series of separate bones named for their location a. Seven cervical (neck) b. Twelve thoracic (chest) c. Five lumbar (lower back) d. Five sacral (fused) e. Three to five coccygeal (fused) 32 Curvatures of the Spine 33 Vertebral Column, cont 3. Normal curvatures a. Cervical and lumbar – convex anteriorly b. Thoracic and sacral – concave anteriorly c. Provide support and balance 4. Abnormalities a. Lordosis – exaggerated lumbar curvature b. Kyphosis – increased roundness of the thoracic curvature c. Scoliosis – abnormal lateral curvature that occurs most often in the thoracic region 34 Abnormal Vertebral Curvatures 35 Vertebral Column, cont 5. Intervertebral Disks a. Fibrocartilage pads between the bodies of the vertebrae b. Prevent vertebrae from grinding against one another c. Absorb shock d. Allow motion between vertebrae e. Allows space for the exit of spinal nerves from the spinal cord through intervertebral foramina f. Can slip or rupture 36 6. General vertebrae structure a. b. c. Body – anterior portion Vertebral foramen – canal for spinal cord Bony projections serve as sites for muscle attachment 1) Spinous process (spine) – posterior projection 2) Transverse processes – lateral projections d. Vertebral arch – lamina and pedicle e. Superior and inferior articulating processes with vertebra above and below 37 Vertebrae 38 7. Characteristics of specific vertebrae a. b. c. d. e. Cervical vertebrae 1) Have transverse foramina and short spines 2) Atlas (C1) – supports the head; allows head movement up and down 3) Axis (C2) - serves as a pivot for the atlas; allows head movement from side to side Thoracic vertebrae – have long, slender spines and costal facets Lumbar vertebrae – have massive bodies and square spines Sacrum – fused sacral vertebrae; forms posterior wall of the pelvic cavity Coccyx – formed from a fusion of three to five vertebrae 39 Atlas and axis 40 G. The rib cage 1.Protects the heart and lungs, yet is flexible 2.Provides support for the bones of the pectoral girdle 3.The ribs a. Twelve pair that connect to the thoracic vertebrae b. True ribs – upper seven pairs connect directly to the sternum by costal cartilages (vertebrosternal) c. False ribs – next five pair that attach indirectly to the sternum or not at all 1) Ribs 8,9,10 – vertebrochondral 2) Ribs 11,12 – vertebral or floating ribs 41 The rib cage, cont 4. The sternum a. Flat, blade-shaped bone b. Composed of three bones that fuse – Manubrium, Body, and Xiphoid process c. Provides anatomical reference points for healthcare professionals 42 The Rib Cage 43 6.3 Appendicular Skeleton 44 A. Pectoral (shoulder) girdle 1. Clavicles (collar bones) a. Articulate medially with the manubrium as the only attachment to the axial skeleton b. Articulates laterally with the scapula c. Serves as a brace for the scapula and stabilizes the shoulder 45 Pectoral girdle, cont 2. Scapulae (shoulder blade) a. Spine b. Acromion process c. Coracoid process d. Glenoid cavity – articulates with the head of the humerus 46 Pectoral Girdle 47 B. Upper limb 1. Humerus a. Long bone of the arm b. Proximal end features 1) Head articulates with the glenoid cavity of the scapula 2) Greater and lesser tubercles 3) Intertubercular groove 4) Deltoid tuberosity c. Distal end features 1) Capitulum articulates with the head of the radius 2) Trochlea articulates with the ulna 3) Coronoid fossa 4) Olecranon fossa 48 Right Humerus 49 2. Radius a. Lateral side of the forearm (thumb side) b. Head articulates with the capitulum of the humerus and fits into the radial notch of the ulna c. Radial tuberosity d. Ulnar notch e. Styloid process 50 3. Ulna 1. 2. 3. 4. 5. 6. 7. Longer bone of the forearm Coronoid process Olecranon process Trochlear notch articulates with the trochlea of the humerus Radial notch Head Styloid process 51 Right Radius & Ulna 52 4. Hand and wrist a. Wrist (carpus) contains eight small bones b. Five metacarpal bones form the palm c. Phalanges 1) Bones of the fingers 2) The thumb has only two phalanges (proximal and distal) 3) The other fingers have three phalanges each (proximal, middle, and distal) 53 Right Wrist & Hand 54 C. Pelvic Girdle (hip) 1. Bony pelvis – two coxal bones, sacrum, and coccyx 2. False and true pelvises a. False pelvis - bounded laterally by flared parts of ilium – large b. True pelvis – ring bounded by sacrum, lower ilium, ischium, and pubic bones – smaller 55 3. Coxal bones a. Ilium (superior bone) 1) Iliac crest 2) Anterior and posterior iliac spines 3) Greater sciatic notch 4) Sacroiliac joint with sacrum b. Ischium (inferior & posterior bone) 1) Ischial tuberosity 2) Ischial spine 56 Coxal bones, cont c. Pubis (anterior, inferior bone) 1) Pubic symphysis 2) Obturator foramen d. The three bones meet in the acetabulum – the socket articulation with the head of the femur 57 4. Pelvic gender differences a. b. c. d. e. f. Female has broader hips Female pelvis is wider Female inlet and outlet of the true pelvis are wider Female pelvic cavity is more shallow Female bones are lighter and thinner Female pubic arch is wider 58 The Pelvis 59 D. Lower Limb 1. Femur a. Longest and strongest bone in the body b. Proximal end features 1) Head fits into acetabulum of coxal bone 2) Greater and lesser trochanters 3) Linea aspera c. Distal end features 1) Medial and lateral epicondyles 2) Lateral and medial condyles articulate with the tibia 3) Patellar surface articulates with the patella 60 Right Femur 61 Lower limb, cont 2. Tibia a. Medial bone of the lower leg b. Bears the weight from the femur c. Medial and lateral condyles articulate with the femur d. Tibial tuberosity e. Anterior crest f. Medial malleolus articulates with the talus in the ankle 3. Fibula a. Lateral to the tibia b. Stabilizes ankle c. Lateral malleolus 62 Bones of the Right Leg 63 Lower limb, cont 4. Foot and ankle a. Seven tarsal bones 1) Only the talus can move freely 2) The calcaneus and the talus support the weight of the body b. Five metatarsal bones form the instep c. The phalanges form the toes 1. Big toe has only two phalanges – proximal and distal 2. Three phalanges in other toes – proximal, middle, and distal 64 The Right Foot 65 6.4 Joints (Articulations) 66 A. Classification of Joints 1. Classification according to the amount of movement a. Synarthrosis – immovable b. Amphiarthrosis – slightly moveable c. Diarthrosis – freely moveable 2. Classification according to structure a. Fibrous b. Cartilaginous c. Synovial 67 B. Fibrous Joints 1. Fibrous connective tissue joins bone to bone 2. Typically immovable 3. Sutures of the cranium a. Coronal – between the parietal bones and the frontal bone b. Lambdoidal – between the parietal bones and the occipital bone c. Squamosal – between each parietal bone and each temporal bone d. Sagittal – between the parietal bones 4. Joints formed by each tooth in its socket 68 Sutures 69 C. Cartilaginous Joints 1. Bones are joined by fibrocartilage or hyaline cartilage 2. Usually slightly moveable 3. Hyaline cartilage a. Ribs to sternum b. Epiphysis to diaphysis 4. Fibrocartilage a. Between bodies of vertebrae – intervertebral disks b. Pubic symphysis 70 D. Synovial joints 1. General characteristics a. Bones do not touch each other b. Bones are separated by a joint cavity c. Usually freely moveable d. Joint cavity formed by extensions of the periosteum called the joint capsule e. Joint cavity lined by synovial membrane that produces synovial fluid f. Joint stabilized by the joint capsule, ligaments, and tendons 71 Synovial joints, cont 2. Protection of joint surfaces a. Articular cartilage b. Bursae – fluid-filled sacs around the joint c. Menisci – fibrocartilage pads in the knee 72 General synovial joint Knee Joint 73 3. Types of synovial joints and examples a. Saddle joint –carpometacarpal joint of thumb b. Ball-and-socket joint – shoulder and hip c. Pivot joint – ends of ulna and radius, atlas and axis d. Hinge joint – elbow and knee e. Gliding joint – within wrist and ankle f. Condyloid joint – knuckles 74 Types of Synovial Joints 75 4. Movements permitted by synovial joints a. Angular movements 1) Flexion a) Dorsiflexion b) Plantar flexion 2) Extension a) Hyperextension 3) Adduction 4) Abduction 76 Movements permitted by synovial joints, cont b. Circular movements 1) Circumduction 2) Rotation 3) Supination 4) Pronation c. Special movements 1) Inversion and eversion 2) Elevation and depression 77 Joint Movements 78 E. Joint damage and repair 1. 2. Joint inflammation and destruction Arthritis a. Osteoarthritis – deterioration of the articular cartilage; most common b. Rheumatoid arthritis – synovial membrane becomes inflamed and thickens; autoimmune disease c. Gout – excessive buildup of uric acid 79 Joint damage and repair, cont 3. Treatments for arthritis a. Main goal is to preserve function b. Pain management, physical therapy, and exercise c. Autologous chondrocyte implantation (ACI) surgery d. Joint replacement 80 Artificial joint replacement 81 6.5 Effects of Aging 82 A. Cartilage 1. 2. 3. 4. 5. Cartilage deteriorates Chemical nature and color changes Chondrocytes die Calcification occurs Symptoms of arthritis appear B. Bone 1. Bone deteriorates 2. Osteoporosis develops 3. Increased incidence of fractures 83 6.6 Homeostasis 84 A. Functions of the skeletal system 1. 2. 3. 4. 5. 6. Protection of internal organs Bones assist in all phases of respiration Bones store and release calcium Bones assist the lymphatic system and immunity Bones assist digestion The skeleton is necessary to locomotion 85 B. Functions of other systems 1. 2. 3. 4. The integumentary and the muscles assist in protecting internal organs The digestive system absorbs calcium from food and the endocrine system regulates the storage of calcium in the bones Cardiovascular system transports oxygen and nutrients to bones and wastes from bones Movement of the bones is only possible because of the contraction of skeletal muscle 86 87