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Anatomy: Skeletal
System
functions, names and
numbers of bones, problems
Skeletal System: Functions
Bones are living structures with 5
functions:
• protect internal organs
• support the body
• make blood cells
• store minerals
• provide for muscle attachment
Classification of bones
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Long bones
Short bones
Flat bones
Irregular
bones
• Sesamoid
bones
Classification of bones
The femur is an
example of a long
bone
Classification of bones
These are short
bones
Classification of bones
These are
considered flat
bones
Classification of bones
Vertebrae are
irregular bones
Classification of bones
kneecap (patella)
is a sesamoid
bone
Review of bone tissue
1.
2.
3.
4.
Osteocyte
Canaliculi
Matrix
Haversian (central)
canal
5. Lamella
6. Haversian system
(osteon)
Parts of a bone
•Diaphysis - shaft of bone
•Epiphyses - ends of bone
•Articular cartilage - covers
epiphysis at a joint
•Periosteum - membrane covers
outer bone surface
•Endosteum - lines medullary
cavity
www.bmb.psu.edu/courses/
bisci004a/bone/bone.htm
Parts of a bone
1.
2.
3.
4.
5.
WHY WE NEED CALCIUM
You may know that calcium plays an
important role in building healthy teeth and
bones. What you may not know is that
calcium is vital to every cell of the body for
muscle function, nerve transmission, blood
clotting and many other uses. When you don't
get enough calcium in your diet, the calcium
stored in your bones is "stolen" to supply the
rest of your body. Hence, your bones suffer
the consequences of a low-calcium diet. This
is why the bones become more susceptible to
fractures.
Where bones meet
A point where two or more bones
connect is called a joint. There are two
different types of joints in the body:
• Movable joints (like ball-and-socket,
hinge, gliding and pivot joints)
• Immovable joints (like the bones of
the skull and pelvis) which allow little or
no movement
There are approximately 206 bones in the body.
How many of them can you identify on this
skeleton?
Account for 206
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8 cranium (1 Occipital, 2 Parietal, 1Frontal, 2
Temporal, 1 Sphenoid, 1 Ethmoid)
14 face (2 Nasal, 2 Maxillæ, 2 Lacrimal, 2
Zygomatic, 2 Palatine, 2 Inferior Nasal
Conchæ, 1 Vomer, 1 Mandible)
6 ears
1 hyoid
26 Vertebral column-7 cervical, 12 thoracic, 5
lumbar, (1)5 sacral, (1) 4 coccygeal
25 Sternum and ribs
64 Upper extremities
62 Lower extremities
Skull
The skull is made up of
22 bones (8 paired and
6 unpaired) joined by
tight sutures
• 8 bones to cranium
• 14 bones in the face
Other bones in the
area:
• 6 bones (3 each) ears
• 1 hyoid
In the lateral view above
label the following bones:
Cranium
•Frontal 1
•Parietal 2
•Temporal 2
•Occipital 1
•Sphenoid 1
•Ethmoid 1
In the lateral view above
label the following bones:
Face
Maxilla 2
Zygomatic 2
Lacrimal 2
Nasal 2
Vomer 1 NS
Palatine 2 NS
Inferior nasal concha 2 NS
Mandible 1
Hyoid bone
Bones of the ear
each ear
malleus
incus
stapes
Vertebral column
Your back is made up of a series of
bones called “vertebrae." Together
they form a flexible column.
(left) There are a total of thirtythree vertebrae and they are
grouped under the names cervical,
thoracic, lumbar, sacral, and
coccygeal. There are 7 cervical
region, 12 thoracic, 5 lumbar, 5
sacral, and 4 coccygeal
Lumbar vertebrae
fibrocartilage
intervertebral disc
Name the vertebrae
1.
2.
3.
4.
5.
Scapula
Compare the shoulder
joint (glenoid) with the
hip joint (acetabulum)
Note the spine,
acromion process &
coracoid process.
Scapula and clavicle
Clavicle
Pectoral girdle for
the humerus
Sternum and ribs
Notice the parts:
manubrium, blade
(gladiolus) and
xiphoid process
The ribs enclose the
thoracic cavity. What
are true ribs, false
ribs & floating ribs?
Upper limb
scapula
clavicle
humerus
radius
ulna
Shoulder joint
The shoulder joint is the joint with greatest ROM
(range of motion) of any joint. But the wide range of
motion is at the expense of stability. A lack of
stability results in a joint that is loose with a
tendency to dislocate (come out of its socket). The
joint and the tendons about the joint are subjected
to considerable wear and tear leading to
degeneration of the joint surface giving rise to
arthritis and tears in the supporting tendons .
Anatomy of shoulder
The shoulder is made up of three bones, the
scapula, clavicle and humerus.
Torn rotator cuff
MRI of a torn rotator cuff. The supraspinatus
tendon normally extends over the head of the
humerus. Courtesy S. Sadiq, M.D.
x-ray of elbow
Lower arm
• radius
• ulna
Bones of the wrist and
hand
Label:
phalanges
metacarpals
carpals
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Hamate
Capitate
Trapezoid
Trapezium
Triangular
Lunate
Scaphoid
Pisiform (not shown in
this posterior view)
Male pelvis, hip, os coxa
• ilium
• ischium
• pubis
Female pelvis
The pelvic girdle is formed
from 2 pelvic bones joined
to the sacrum (base of
spinal cord). In front the
pelvic bones are held
together by the pubic
symphysis joint. This joint
allows only slight bending
movement, but it softens
and becomes more flexible
in a female giving birth.
Acetabulum
This is a view of the
right pelvic bone. It
is formed from 3
fused bones: the
ilium (green),
ischium (yellow) and
pubis (red). The 3
bones meet in the
acetabulum (hip
socket) at point A.
Leg bones
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Femur
Tibia
Fibula
Patella
X-ray of knee
knee surgery post-op 48
hours
Basically, the ACL runs
in a left to right
direction and provides
support for pivoting
motions. In most cases
people can live with an
ACL tear they just have
to be careful and
potentially limit certain
activities
Bones of the foot
• phalanges
• metatarsals
• tarsals: Talus, Calcaneus, Navicular, Cuboid,
Lateral cuneiform, Intermediate cuneiform,
Medial cuneiform
Trauma
Fracture Definition - a break in the
continuity of a bone or cartilage.
Classification
• Closed fracture (simple) - no
communication with the outside
environment.
• Open fracture (compound) communication with the outside
environment.
Bone fractures
Comminuted Fracture
This is a plain film of
the left forearm and
wrist which has at
least five fragments of
bone.
Bone fractures
A skeletally immature person
suffered an ankle injury,
resulting in a Salter-Harris
Type III fracture. Note that
the lateral aspect of the
distal physis of the left tibia
is separated with extension
of the fracture line into the
epiphyseal component of the
distal tibia.
Bone fractures
Open fractures have
contacted the
environment. They are
most commonly seen
in vehicular or
motorcycle accients
and they are at high
risk for infection or
osteomyelitis.
Bone fractures
This is an image of a spiral
fracture. Note the wavy
appearance of the fracture
due to torque through the
bone. You often see spiral
fractures in children when
they twist an ankle or knee.
This can be extremely
alarming because a spiral
fracture in children who are
not yet walking can be due
to child abuse.
Bone fractures
This is an image of a
greenstick fracture. Due
to the pliability of
pediatric bone, the bone
does not completely
fracture. The medial side
of the radius is open
where as the lateral
cortex has simply
buckled.
Bone fractures
This is an example of a stress
fracture of the tibia (arrows).
Stress fractures are a
common result of overuse or
stress on the bone. It is
desirable to catch them
before they become complete
fractures because they are
non-displaced and in perfect
anatomic alignment so they
tend to heal well with
appropriate treatment.
Bone fractures
This is a radiograph of the
anterior superior illiac spine of
the pelvis of a high school
sprinter. Note the bony
fragment that has dissociated
from the pelvis (arrow). The
patient pulled the bone
fragment off the pelvis at the
point of the Sartorious muscle
attachment and subject to
possible fracture at times of
intense stress.
Bone fractures
This is an image of a
both bone forearm
fracture. The callus or
fracture fragments
have caused the bone
to ossify between the
radius and ulna fusing
the forearm and
preventing pronation
or supination.
Dislocation of the elbow
Osteomyelitis (bone infection)
This is an advanced case
of osteomyelitis that had
been developing for
approximately 3 to 4
months at the time of the
plain film. Note the
mixed lytic and sclerotic
processes that are
occurring in the bone.
Degenerative Joint Disease
(DJD or osteoarthritis)
• Primary osteoarthritis - most common in
the older age group as the result of wear
and tear on articular cartilage over time.
• Secondary osteoarthritis - results from a
previous process that damaged cartilage
such as trauma, inflammatory arthritis.
• The most commonly involved joints
in primary osteoarthritis are:
– Distal interphalangeal joints
– First carpometacarpal joint
– Weight bearing joints: spine, hips, knees
Inflammatory Arthritis
• An inflammatory process with the
target organ being the synovial
membrane leading to pannus
formation (inflammatory exudate
in the lining of the synovial cells).
Rheumatoid arthritis
Diagnosis usually made by plain film
Osteopenia - a demineralization of the
bone - is the result of increased blood
flow, due to inflammation, which
washes out the calcium.
Rheumatoid arthritis
Rheumatoid
arthritis affecting
the hands
Tumor involving bone
• Primary tumors
Benign
– Osteoid (e.g., osteoid osteoma,
osteoblastoma)
– Chondroid (e.g., enchondroma)
– Fibrous (e.g., non-ossifying fibroma)
– Mixed (e.g., osteochondroma)
Malignant
– Osteoid (e.g., osteosarcoma)
– Chondroid (e.g., chondrosarcoma)
– Fibrous (e.g., fibrosarcoma)
– Mixed (e.g. dedifferenciated chondrosarcoma)
– Metastatic tumors
Benign Versus Malignant
Tumor
Left image is an enchondroma
in a metacarpal bone. It is a
sharply marginated, lucent
structure. It is a slow growing
tumor.
•
The right image, however, is
an osteosarcoma in the femur.
The tumor is growing beyond the
margins of the bone and it is
difficult to discern the full extent
of the tumor. These features
suggest it is an aggressively
growing tumor.
•
Ankle sprain
A sprain is a stretched or
torn ligament.
Ligaments connect one
bone to another bone at
a joint and help keep the
bones from moving out
of place. The most
common site of sprains
is the ankle
Ankle sprain
Although ligament damage
frequently occurs during athletics
or exercise, ankles are just as
often injured stepping off a curb,
into a pothole, or onto uneven
ground.
Ankle sprain
Upon physical examination, the
ankle will exhibit swelling and
discoloration (black and blue) over
the outside part of the joint.
Touching of the area will result in a
variable amount of discomfort.
Frequently, there is instability
notes on the drawer test as the
heel structures are moved forward
and back as the leg is stabilized.
Range of motion (ROM) in the
ankle can be limited due to pain
and swelling, but strength is not
usually affected. X-rays are
essential, as the possibility of a
fracture must be ruled out.
Ankle sprain-Grade I
• Mild sprain, mild pain, little swelling,
and joint stiffness may be apparent
• Stretch and/or minor tear of the
ligament without laxity (loosening)
• Usually affects the anterior talofibular
ligament
• Minimum or no loss of function
• Can return to activity within a few days
of the injury (with a brace or taping)
Ankle sprain-Grade II
Ankle sprain-Grade II
• Moderate to severe pain, swelling, and
joint stiffness are present
• Partial tear of the lateral ligament(s)
• Moderate loss of function with difficulty
on toe raises and walking
• Takes up to 2-3 months before
regaining close to full strength and
stability in the joint
Ankle sprain-Grade III
• Severe pain may be present initially, followed by
little or no pain due to total disruption of the nerve
fibers
• Swelling may be profuse and joint becomes stiff
some hours after the injury
• Complete rupture of the ligaments of the lateral
complex Usually requires some form of
immobilization lasting several weeks
• Complete loss of function and necessity for crutches
• Usually managed conservatively with rehabilitation
exercises, but a small percentage may require
surgery
• Recovery can be as long as 4 months
How can ankle sprains be
treated?
Many doctors suggest using the
RICE approach—
Rest
Ice
Compression
Elevation
RICE approach Rest
• Rest--You may need to rest your ankle, either completely or
partly, depending on how serious your sprain is. Use crutches for
as long as it hurts you to stand on your foot.
• Ice--Using ice packs, ice slush baths or ice massages can
decrease the swelling, pain, bruising and muscle spasms. Keep
using ice for up to 3 days after the injury.
• Compression--Wrapping your ankle may be the best way
to avoid swelling and bruising. You'll probably need to keep your
ankle wrapped for 1 or 2 days after the injury and perhaps for up
to a week or more.
• Elevation--Raising your ankle to or above the level of your
heart will help prevent the swelling from getting worse and will
help reduce bruising. Try to keep your ankle elevated for about 2
to 3 hours a day if possible.
References
The Sourcebook of Medical Illustration, edited by Peter
Cull (Park Ridge, NJ: Parthenon, 1989)
members.aol.com/Attic21/Anatomy/skullans.html
Virtual Hospital ® is the Apprentice's Assistant
www.vh.org/.../Lectures/icmrad/
skeletal/Parts/Compound.html
The Nicholas Institute of Sports Medicine and Athletic
Trauma www.nismat.org/ptcor/ ankle_sprain/