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NURS1004 Week 6 Part I Prepared by Didy Button Skeletal system © 2012 Pearson Education, Inc. An Introduction to the Skeletal System • The Skeletal System • Includes: • Bones of the skeleton • Cartilages, ligaments, and connective tissues © 2012 Pearson Education, Inc. 6-1 Functions of the Skeletal System • Five Primary Functions of the Skeletal System 1. Support 2. Storage of Minerals (calcium) and Lipids (yellow marrow) 3. Blood Cell Production (red marrow) 4. Protection 5. Leverage (force of motion) © 2012 Pearson Education, Inc. 7-1 The Axial Skeleton • The Axial Skeleton • Forms the longitudinal axis of the body • Has 80 bones • The skull • 8 cranial bones • 14 facial bones • Bones associated with the skull • 6 auditory ossicles • The hyoid bone © 2012 Pearson Education, Inc. 7-1 The Axial Skeleton • The Axial Skeleton • The vertebral column • 24 vertebrae (singular = vertebra) • The sacrum • The coccyx • The thoracic cage • 24 ribs • The sternum © 2012 Pearson Education, Inc. Figure 7-1b The Axial Skeleton Skull Cervical vertebrae Sternum Ribs Thoracic vertebrae Costal cartilages Lumbar vertebrae Sacrum Coccyx Anterior (left) and posterior (right) views of the axial skeleton. The individual bones associated with the skull are not visible. © 2012 Pearson Education, Inc. An Introduction to the Appendicular Skeleton • The Appendicular Skeleton • 126 bones • Allows us to move and manipulate objects • Includes all bones besides axial skeleton • The limbs • The supportive girdles © 2012 Pearson Education, Inc. Figure 8-1 The Appendicular Skeleton SKELETAL SYSTEM AXIAL SKELETON 80 206 APPENDICULAR SKELETON 126 (see Figure 7–1) Pectoral girdle Upper limbs Clavicle 2 Scapula 2 Humerus 2 Radius 2 Ulna 2 Carpal bones 16 4 60 Metacarpal 10 bones Phalanges 28 Pelvic girdle © 2012 Pearson Education, Inc. 2 Hip bone 2 8-3 The Pelvic Girdle • The Pelvic Girdle • Made up of two hip bones (coxal bones) • Strong to bear body weight, stress of movement • Part of the pelvis • Coxal bones • Made up of three fused bones 1. Ilium (articulates with sacrum) 2. Ischium 3. Pubis © 2012 Pearson Education, Inc. Figure 8-1 The Appendicular Skeleton (Part 2 of 2) Lower limbs 60 Femur 2 Patella 2 Tibia 2 Fibula 2 Tarsal bones 14 Metatarsal bones 10 Phalanges 28 © 2012 Pearson Education, Inc. 6-2 Classification of Bones • Bones • Are classified by: • Shape • Internal tissue organization • Bone markings (surface features; marks) © 2012 Pearson Education, Inc. 6-2 Classification of Bones • Six Bone Shapes 1. Sutural bones 2. Irregular bones 3. Short bones 4. Flat bones 5. Long bones 6. Sesamoid bones © 2012 Pearson Education, Inc. Figure 6-1 A Classification of Bones by Shape Flat Bones Sutural Bones Sutures External table Parietal bone Sutural bone Internal Diploë table (spongy bone) Irregular Bones Long Bones Vertebra Humerus Short Bones Carpal bones © 2012 Pearson Education, Inc. Sesamoid Bones Patella An Introduction to the Axial Skeleton • Structures of Bones • Articulations • Contacts with other bones • Landmarks (bone markings; marks) • Areas of muscle and ligament attachment • Foramina • Openings for nerves and blood vessels © 2012 Pearson Education, Inc. 6-2 Classification of Bones • Bone Markings • Depressions or grooves • Along bone surface • Elevations or projections • Where tendons and ligaments attach • At articulations with other bones • Tunnels • Where blood and nerves enter bone © 2012 Pearson Education, Inc. Table 6-1 An Introduction to Bone Markings Trochanter Sinus Head Neck Head Sulcus Tubercle Crest Neck Fossa Foramen Fissure Process Tuberosity Ramus Line Facet Fossa Tubercle Trochlea Femur © 2012 Pearson Education, Inc. Foramen Ramus Pelvis Skull Condyle Spine Condyle Humerus 6-2 Classification of Bones • Structure of a Long Bone • Diaphysis • The shaft • A heavy wall of compact bone, or dense bone • A central space called medullary (marrow) cavity • Epiphysis • Wide part at each end • Articulation with other bones • Mostly spongy (cancellous) bone • Covered with compact bone (cortex) • Metaphysis • Where diaphysis and epiphysis meet © 2012 Pearson Education, Inc. Figure 6-2a Bone Structure Epiphysis Spongy bone Metaphysis Compact bone Diaphysis (shaft) Medullary cavity Metaphysis Epiphysis The structure of a representative long bone (the femur) in longitudinal section © 2012 Pearson Education, Inc. 6-3 Bone (Osseous) Tissue • Bone (Osseous) Tissue • Dense, supportive connective tissue • Contains specialized cells • Produces solid matrix of calcium salt deposits • Around collagen fibers © 2012 Pearson Education, Inc. 6-3 Bone (Osseous) Tissue • Characteristics of Bone Tissue • Dense matrix, containing: • Deposits of calcium salts • Osteocytes (bone cells) within lacunae organized around blood vessels • Canaliculi • Form pathways for blood vessels • Exchange nutrients and wastes © 2012 Pearson Education, Inc. 6-3 Bone (Osseous) Tissue • Characteristics of Bone Tissue • Periosteum • Covers outer surfaces of bones • Consists of outer fibrous and inner cellular layers © 2012 Pearson Education, Inc. 6-3 Bone (Osseous) Tissue • Bone Matrix • Matrix Proteins • One third of bone matrix is protein fibers (collagen) © 2012 Pearson Education, Inc. 6-4 Compact Bone and Spongy Bone • The Structure of Compact Bone • Osteon is the basic unit • Osteocytes are arranged in concentric lamellae • Around a central canal containing blood vessels • Perforating canals • Perpendicular to the central canal • Carry blood vessels into bone and marrow © 2012 Pearson Education, Inc. Figure 6-13 The Blood Supply to a Mature Bone Articular cartilage Branches of nutrient artery and vein Periosteum Epiphyseal artery and vein Metaphyseal artery and vein Periosteum Periosteal arteries and veins Connections to superficial osteons Compact bone Medullary cavity Nutrient artery and vein Nutrient foramen Metaphyseal artery and vein Metaphysis Epiphyseal line © 2012 Pearson Education, Inc. Figure 6-5a The Structure of Compact Bone Venule Circumferential lamellae Capillary Periosteum Osteons Perforating fibers Interstitial lamellae Concentric lamellae Trabeculae of spongy bone (see Fig.6–6) Vein Artery Arteriole Central canal Perforating canal The organization of osteons and lamellae in compact bone © 2012 Pearson Education, Inc. 6-3 Bone (Osseous) Tissue • Bone Matrix • Minerals • Two thirds of bone matrix is calcium phosphate, Ca3(PO4)2 • Reacts with calcium hydroxide, Ca(OH)2 • To form crystals of hydroxyapatite, Ca10(PO4)6(OH)2 • Which incorporates other calcium salts and ions © 2012 Pearson Education, Inc. 6-3 Bone Landmarks for Physical examinaiotn • Most prominent spinous process is C7/T1. • Inferior points of scapulae are at interspace between T7 & T8. • Superior margin of each iliac crest crosses L4. • Two symmetric dimples overlying posterior superior iliac spine are at level of S2. • Coccyx . © 2012 Pearson Education, Inc. Figure 8-1 The Appendicular Skeleton SKELETAL SYSTEM AXIAL SKELETON 80 206 APPENDICULAR SKELETON 126 (see Figure 7–1) Pectoral girdle Upper limbs Clavicle 2 Scapula 2 Humerus 2 Radius 2 Ulna 2 Carpal bones 16 4 60 Metacarpal 10 bones Phalanges 28 Pelvic girdle © 2012 Pearson Education, Inc. 2 Hip bone 2 Physical Examination Landmarks You should be able to palpate these: • Elbow (lateral and medial epicondyles of humerus, olecranon process of ulna) • Hip (iliac crest, greater trochanter of femur) • Wrist (styloid process of radius – thumb side, & of ulna) • Shin (anterior crest of tibia) • Shoulder (acromian process of scapula) • Knee (patella) • Ankle (lateral malleolus of fibula & medial malleolus of tibia) • Heel (calcaneus). © 2012 Pearson Education, Inc. NURS1004 Week 6 Lecture Part II Articulations Prepared by Didy Button © 2012 Pearson Education, Inc. An Introduction to Articulations • Articulations • Body movement occurs at joints (articulations) where two bones connect • Joint Structure • Determines direction and distance of movement (range of motion or ROM) • Joint strength decreases as mobility increases © 2012 Pearson Education, Inc. 9-1 Classification of Joints • Functional Classifications • Synarthrosis (immovable joint) • Amphiarthrosis (slightly movable joint) • Diarthrosis (freely movable joint) © 2012 Pearson Education, Inc. 9-1 Classification of Joints Structural Classifications • Fibrous joints. Articulating bones bound tightly together by fibrous connective tissue (sutures, syndesmosis between tibia & fibula, gomphoses). • b) Cartilaginous joints. Articulating bones held tightly together by cartilage (synchondroses between rib & sternum, pubic symphysis). • c) Synovial joints. Articulating bones have a fluid-filled space between them (gliding, hinge, pivot, ellipsoidal, saddle, ball & socket). © 2012 Pearson Education, Inc. 9-2 Synovial Joints • Synovial Fluid (e.g. knee, hip, elbow, shoulder, fingers, toes, jaw) • Contains slippery proteoglycans secreted by fibroblasts • Functions of synovial fluid 1. Lubrication 2. Nutrient distribution 3. Shock absorption © 2012 Pearson Education, Inc. Figure 9-1a The Structure of a Synovial Joint Medullary cavity Spongy bone Periosteum Fibrous joint capsule Synovial membrane Articular cartilages Joint cavity (containing synovial fluid) Compact bone Synovial joint, sagittal section © 2012 Pearson Education, Inc. 9-2 Synovial Joints • Accessory Structures • Cartilages • Fat pads • Ligaments • Tendons • Bursae © 2012 Pearson Education, Inc. 9-2 Synovial Joints • Factors That Stabilize Synovial Joints • Prevent injury by limiting range of motion • Collagen fibers (joint capsule, ligaments) • Articulating surfaces and menisci • Other bones, muscles, or fat pads • Tendons of articulating bones © 2012 Pearson Education, Inc. Figure 9-1b The Structure of a Synovial Joint Bursa Joint capsule Quadriceps tendon Femur Synovial membrane Meniscus Intracapsular ligament Patella Articular cartilage Fat pad Patellar ligament Tibia Joint cavity Meniscus Knee joint, sagittal section © 2012 Pearson Education, Inc. Inflammation of the synovial joint • Osteoarthritis bony growths (osteophytes) at joints • Rheumatoid arthritis is an autoimmune disease characterised by chronic inflammation of the synovial membrane leading to deformity, loss of function, pain, swelling, ultimately to joint destruction. • Psoriatic arthritis associated with the skin condition psoriasis. © 2012 Pearson Education, Inc. Figure 9-3a Angular Movements Extension Flexion Hyperextension Flexion Flexion Extension Hyperextension Extension Flexion Hyperextension Extension Flexion/extension © 2012 Pearson Education, Inc. Figure 9-3b Angular Movements Abduction Abduction Adduction Adduction Abduction Adduction Abduction Adduction Abduction/adduction © 2012 Pearson Education, Inc. Figure 9-3c Angular Movements Adduction Abduction Adduction/abduction © 2012 Pearson Education, Inc. Figure 9-3d Angular Movements Circumduction © 2012 Pearson Education, Inc. Figure 9-4a Rotational Movements Head rotation Right rotation Lateral (external) rotation © 2012 Pearson Education, Inc. Left rotation Medial (internal) rotation Figure 9-4b Rotational Movements Supination Pronation Supination Pronation © 2012 Pearson Education, Inc. Figure 9-5 Synovial Joints Eversion © 2012 Pearson Education, Inc. Inversion Figure 9-5 Synovial Joints Dorsiflexion (ankle flexion) Plantar flexion (ankle extension) © 2012 Pearson Education, Inc. 9-6 The Knee Joint • Seven Major Supporting Ligaments 1. Patellar ligament (anterior) 2. & 3. Two popliteal ligaments (posterior) 4. & 5. Anterior and posterior cruciate ligaments (inside joint capsule) 6. Tibial collateral ligament (medial) 7. Fibular collateral ligament (lateral) © 2012 Pearson Education, Inc. Figure 9-12a The Right Knee Joint Quadriceps tendon Patella Patellar retinaculae Fibular collateral ligament Tibial collateral ligament Patellar ligament Tibia Anterior view, superficial layer © 2012 Pearson Education, Inc. Joint capsule Figure 9-12b The Right Knee Joint Femur Joint capsule Plantaris muscle Gastrocnemius muscle, lateral head Gastrocnemius muscle, medial head Bursa Fibular collateral ligament Tibial collateral ligament Cut tendon of biceps femoris muscle Popliteal ligaments Popliteus muscle Tibia Fibula Posterior view, superficial layer © 2012 Pearson Education, Inc. Figure 9-12c The Right Knee Joint Patellar surface Fibular collateral ligament Posterior cruciate ligament Lateral condyle Medial condyle Tibial collateral ligament Lateral meniscus Cut tendon Medial meniscus Tibia Fibula Deep anterior view, flexed © 2012 Pearson Education, Inc. Anterior cruciate ligament Figure 9-12d The Right Knee Joint Femur Posterior cruciate ligament Fibular collateral ligament Medial condyle Lateral condyle Tibial collateral ligament Lateral meniscus Cut tendon Medial meniscus Anterior cruciate ligament Fibula Tibia Deep posterior view, extended © 2012 Pearson Education, Inc. 9-7 Effects of Aging on Articulations • Joint Immobilization • Reduces flow of synovial fluid • Can cause arthritis symptoms • Treated by continuous passive motion or CPM (therapy) • Bones and Aging • Bone mass decreases • Bones weaken • Increases risk of hip fracture, hip dislocation, or pelvic fracture © 2012 Pearson Education, Inc. 9-8 Integration with Other Systems • Factors Affecting Bone Strength 1. Age 2. Physical stress 3. Hormone levels 4. Calcium and phosphorus uptake and excretion 5. Genetic and environmental factors © 2012 Pearson Education, Inc. 9-8 Integration with Other Systems • Bones Support Body Systems • Support and protect other systems • Store fat, calcium, and phosphorus • Manufacture cells for immune system © 2012 Pearson Education, Inc. The End Knee joint © 2012 Pearson Education, Inc.