Download Part 1: Musculo-Skeletal Anatomy and Physiology

MS Anatomy and Physiology
with Med Terms
MHA
May 21, 2009
Irene Mueller, EdD, RHIA
Objectives
• Coding-Focused Review of MS A&P and
Med terms
A & P Review
• Cells
• Connective Tissues
– Cartilage, ligaments, tendons
• Bones
• Joints
• Muscles
MS Cells
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Osteoblasts
Osteoclasts
Osteocytes
Chondrocytes (Cartilage)
Leucocytes (Marrow)
Erythrocytes (Marrow)
Striated Muscle
MS Connective Tissues
• Dense Fibrous Tissue
– Ligaments
• Hold bones together
– Tendons
• Attach muscles to
bones
– Aponeuroses
• Hold muscles together
or to periosteum
– Fasciae
• Cover and hold muscle
bundles together
• Supportive Tissue
– Osseous (bone)
– Cartilage
• Hyaline
– Embryo skeleton
– Costal cartilage
– Bronchi, larynx, etc.
• Fibrocartilage
– w/in vertebral discs
– Pubic symphysis
• Elastic
– Auditory ear tube
– Epiglottis, larynx
Skeleton
• Five Functions
– Supports/Shapes
– Protects
– Anchors movement
– Stores minerals
– Hemopoiesis
Types of Bones
• Long bones (Arms/Legs)
– Support/Shape/Anchorage
• Flat bones (Skull/Ribs)
– Protect
• Irregular bones (Spine)
– Movement
• Short bones (Wrist/Ankle)
– Movement
Bone Composition
• 35% organic
• Osteoblasts = new
bone
• Osteocytes = matrix
• Osteoclasts =
enzymes to dissolve
• Bone Collagen
– Fibers, reinforcement
– Some flexibility
• 65% inorganic
• Minerals
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Calcium Phosphate
Calcium Carbonate
Magnesium Fluoride
Sodium Oxide
Sodium Chloride
Bone Growth
• 2-step process of
remodeling
• Resorption
– Old bone dissolved
and removed
• Osteoclasts (clearing)
• Formation
– New bone tissue
formed
• Osteoblasts (building)
• Bone length
– Growth plates
between shaft and
ends of bones
• Epiphyseal cartilage
– Present = more growth
– Not present = growth
completed
• Females = 18
• Males = 20/21
Bones as organs
• Osteogenesis
– development of bones
• Ossification
– Replacement of cartilage skeleton by bone
Long Bones/Bone Marrow
• Diaphysis = Shaft of long bone
• Epiphysis = End of long bone
– Red marrow = Erythrocytes, leukocytes
• Medullary Canal = bone marrow
– Yellow marrow = fat cells, leukocytes
• Endosteum – lining of canal
• Periosteum – cover of bones
Bones of Axial Skeleton
• Skull (22 bones)
– Cranium (8 bones)
– Facial (14 bones)
– Sinuses
– Sutures
– Cartilage
– Fontanel
• Hyoid
Functions?
Bones of Axial Skeleton
• Spine
– Vertebrae
• Foramen
• Laminae
• Processes
– Discs
– 5 sections
– Curves
• Cervical (7 vertebrae)
– Atlas (nod)
– Axis (turn)
• Thoracic (12)
– Articulate w/ribs
• Lumbar (5)
– Bears most of weight
• Sacrum (5, fused)
– Articulation for hips
– Posterior of pelvic girdle
• Coccyx (4, fused)
– Tailbone
Bones of Axial Skeleton
• Spinal curves
– Make stronger
– Cervical = concave
– Thoracic = convex
– Lumbar = concave
– Sacral = convex
Bones of Axial Skeleton
• Parts of Vertebra
– Body
– Foramen
– Processes
• Transverse
• Spinous
• Articular
Bones of Axial Skeleton
• Sternum
– Manubrium
– Body
– Xyphoid
• Cartilage
• Articulates with
– Ribs (Axial Skeleton)
– Clavicles
• (Appendicular skeleton)
Bones of Axial Skeleton
• Ribs (12 pairs)
– True Ribs (7)
• Joined to Sternum
• Costal Cartilage
– False Ribs (3)
• Joined to 7th rib
– Floating Ribs (2)
• Not connected to
Sternum or Rib
Bones of Appendicular Skeleton
• 126 bones
• Shoulder (Pectoral) girdle
– 2 Clavicles (Collar bones)
– 2 Scapulae (Shoulder bones)
• Hip (Pelvic) girdle
– 2 Ilium
– 2 Ischium
– 2 Pubic
• Extremities
Bones of Appendicular Skeleton
• Arm
– Humerus
– Radius
– Ulna
• Hand
– Carpals
– Metacarpals
– Phalanges
• Proximal
• Medial
• Distal
Bones of Appendicular Skeleton
• Leg
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Femur
Patella
Tibia
Fibula
Ankle
• Tarsals
– Foot
• Metatarsals
• Phalanges
Ossicles and Sesamoids
• Ossicles
– 3 bones in middle ear
– Malleus (Hammer)
– Incus (Anvil)
– Stapes (stirrup)
• Sesamoids
– nodular mass of bone or cartilage in a tendon,
especially at a joint or bony prominence
– Patella, some in feet and hands
Joints (Articulations)
• 3 types
– Diarthroidal (moveable)
– Amphiarthroidal (partially moveable)
– Synarthroidal (immovable)
Joint Motions
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Flexion
Extension
Abduction
Adduction
Circumduction
– All of the above
What are motions of elbow and wrist?
• Rotation
• Pronation
• Supination
Diarthroses Joints
• Most common in Human body (Synovial)
• 3 main parts
– Articular cartilage w/in articular capsule
• Absorbs shocks, prevents friction
– Bursa (Shoulder, Elbow, Hip, Knee)
• Closed sacs or cavities of synovial fluid lined with synovial
membrane, between muscles, tendons, ligaments and bones
• Allow tissues to glide over each other
• Secrete synovial fluid that is a lubricant
– Joint Capsule (Synovial cavity)
• Area between 2 articular cartilages
• Synovial membrane secretes synovial fluid
Diarthroidal Joints
• 4 types
– Ball and Socket
• Most ROM
– Hinge
• Movement in one direction or plane
– Pivot
• Extension rotating in another bone
• Atlas and Axis (Odontoid process)
– Gliding
• Nearly flat surfaces slide across each other
• Vertebrae of spine
Amphiarthroses Joints
• Have cartilage between articular surfaces
– Ribs to spine
– Symphysis pubis
Synarthroidal Joints
• Immovable
• Fibrous connective tissue
• Sutures of Adult Cranium
Ligaments & Tendons
• Ligaments
– Tough, dense, fibrous
bands of connective
tissue
– Hold bones together
– Allow movement
– Provide stability
• Tendons
– Strong, tough
stands/cords of dense
connective tissue
– Attach muscles to
bones/other parts
– Non-elastic
Cartilage
• Semi-smooth, dense supporting
connective tissue
• At end of bones
• Shock absorber
Collagen
• Fibrous protein
• Major supporting element (glue) in
connective tissue that holds cells together
• 1/3 – ½ of all body protein in adults
Muscles
• 656 muscles
• Nearly half body weight = Muscles
• Functions
– Movement
– Form and shape
– Produce most of our body heat
– Involuntary functions (breathing)
Types of Muscles
• Skeletal (Striated (Striped))
– Voluntary
– Sarco- = flesh, striated muscle
– Also in pharynx wall and esophagus
– Approx. 40% of total body mass
– Voluntary, under control of conscious mind
• Smooth (Spindle-shaped, Non-striated)
• Cardiac (Non-striated)
Muscle Characteristics
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Contractibility
Excitability (Irritability)
Extensibility
Elasticity
• Fascia – flat band of tissue that covers
and separates muscle/other layers
Skeletal Muscles
• Contract quickly
• Fatigue easily
• Can’t remain contracted for long
Skeletal Muscle Movement
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Muscles ALWAYS pull
Need to be attached to bones for leverage
Tendons attach muscles to bones
Muscle attachments bridge joints
Muscles are attached at each end
– Bone, cartilage, ligaments, tendons, skin,
other muscles
Muscle Attachments
• Origin
– Attachment to fixed bone/structure
– Moves least during contraction
• Insertion
– Attachment to movable part
– Moves most during contraction (pull)
– Moves toward the origin
• Belly
– Central part of muscle
Muscle Pairs
• Prime mover
– Movement in a single direction
• Antagonist
– Movement in opposite direction
• Example: Biceps/Triceps
– Roles reversed in Extension / Flexion
It takes 17 muscles to smile; 43 muscles to frown
Med Terms
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Avulsion
Bursae
Calcanean
Calcitonin
Crepitation
Fascia
Hematopoiesis
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Meniscus
Metatarsophalangeal
Ossification
Osteogenesis
Plantar
Subluxation
Synovial
Tendinitis
Lab Tests
• Handout
Other Tests
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X-rays
Bone scans
CT scan
DEXA
MRI
Bone bx
Myelogram
Aspiration from joint/bursa
Resources
• Frazier, M. S. & Drzymkowski, J. W. Essentials
of Human Diseases and Conditions, 4th ed.,
Saunders, 2009
• MedlinePlus. Dictionary.
• http://www.nlm.nih.gov/medlineplus/mplusdiction
ary.html
• MedlinePlus. Understanding Medical Words: A
Tutorial from the National Library of Medicine.
(includes Appx A (Word parts and what they
mean) and Appx B (Common abbreviations and
acronyms)).
http://www.nlm.nih.gov/medlineplus/medicalword
s.html
Resources
• Merriam-Webster Dictionary (includes
audio pronunciation)
• http://www.merriam-webster.com/
• Moisio M. A. & E. W. Moisio, Understanding
Laboratory and Diagnostic Tests, Delmar, 1998
(2nd ed? later)
• Scott, A. S. & Fong, E. Body Structures and
Functions, 11th ed., Delmar, 2009