* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Frontal bone
		                    
		                    
								Survey							
                            
		                
		                
                            
                            
								Document related concepts							
                        
                        
                    
						
						
							Transcript						
					
					Anatomy of Skeletal System SKELETAL SYSTEM  COMPOSED OF: -Bones -Cartilage -Joints -Ligaments Functions of Skeletal System  SUPPORT: Hard framework that supports and anchors the soft organs of the body.  PROTECTION: Surrounds organs such as the brain and spinal cord.  MOVEMENT: Allows for muscle attachment therefore the bones are used as levers.  STORAGE: Minerals and lipids are stored within bone material.  BLOOD CELL FORMATION: The bone marrow is responsible for blood cell production. Bone Markings  Bone Surface is not smooth, but shows:  Bone markings which reveal where: -muscles, tendons, and ligaments attatched -nerves and blood vessels pass *bone marking may be: 1-projections or processes or 2-depressions or cavities Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.9 Structure  Compact bone      Outer layer of bone, very hard and dense. Organized in structural units called Haversian systems. Matrix is composed of Ca salts (Ca carbonate and Ca phosphate) Osteocytes – living bone cells that live in matrix. Porous (Spongy) bone   Located in the ends of long bones. Many spaces that are filled with red bone marrow which produces bone cells. Structure  Spongy bone (cont’d)   Trabeculae – needle-like threads of spongy bone that surround the spaces. Add strength to this portion of the bone. Cartilage  Matrix is a firm gel with chondrocytes suspended in the matrix. Classification of Bones  Long bones  Typically longer than wide  Have a shaft with heads at both ends  Contain mostly compact bone • Examples: Femur, humerus Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.4a Classification of Bones  Short bones  Generally cube-shape  Contain mostly spongy bone  Examples: Carpals, tarsals Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.4b Classification of Bones on the Basis of Shape Figure 5.1 Slide 5.4c Classification of Bones  Flat bones  Thin and flattened  Usually curved  Thin layers of compact bone around a layer of spongy bone  Examples: Skull, ribs, sternum Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.5a Classification of Bones  Irregular bones  Irregular shape  Do not fit into other bone classification categories  Example: Vertebrae and hip Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.5b Gross Anatomy of a Long Bone  Diaphysis  Shaft  Composed of compact bone  Epiphysis  Ends of the bone  Composed mostly of spongy bone Figure 5.2a Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.6 Structures of a Long Bone  Periosteum  Outside covering of the diaphysis  Fibrous connective tissue membrane  Sharpey’s fibers  Secure periosteum to underlying bone  Arteries  Supply bone cells with nutrients Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Figure 5.2c Slide 5.7 Structures of a Long Bone  Articular cartilage  Covers the external surface of the epiphyses  Made of hyaline cartilage  Decreases friction at joint surfaces Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Figure 5.2a Slide 5.8a Structures of a Long Bone  Medullary cavity  Cavity of the shaft  Contains yellow marrow (mostly fat) in adults  Contains red marrow (for blood cell formation) in infants Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Figure 5.2a Slide 5.8b Microscopic Anatomy of Bone  Osteon (Haversian System)  A unit of bone  Central (Haversian) canal  Opening in the center of an osteon  Carries blood vessels and nerves  Perforating (Volkman’s) canal  Canal perpendicular to the central canal  Carries blood vessels and nerves Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.10a Microscopic Anatomy of Bone Figure 5.3 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.10b Microscopic Anatomy of Bone  Lacunae  Cavities containing bone cells (osteocytes)  Arranged in concentric rings  Lamellae  Rings around the central canal  Sites of lacunae Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Figure 5.3 Slide 5.11a Microscopic Anatomy of Bone  Canaliculi  Tiny canals  Radiate from the central canal to lacunae  Form a transport system Figure 5.3 Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.11b Changes in the Human Skeleton  In embryos, the skeleton is primarily hyaline cartilage  During development, much of this cartilage is replaced by bone  Cartilage remains in isolated areas  Bridge of the nose  Parts of ribs  Joints Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.12 Bone Growth  Epiphyseal plates allow for growth of long bone during childhood  New cartilage is continuously formed  Older cartilage becomes ossified  Cartilage is broken down  Bone replaces cartilage Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.13a Bone Growth  Bones are remodeled and lengthened until growth stops  Bones change shape by gravity &muscle pull  Bones grow in width through periostium Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.13b Long Bone Formation and Growth Figure 5.4a Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.14a Long Bone Formation and Growth Figure 5.4b Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.14b Types of Bone Cells  Osteocytes  Mature bone cells  Osteoblasts  Bone-forming cells  Osteoclasts  Bone-destroying cells  Break down bone matrix for remodeling and release of calcium  Bone remodeling is a process by both osteoblasts and osteoclasts Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings Slide 5.15 Fractures Closed fracture (simple): skin is intact  Open fracture (compound): skin is open  Fracture reduction : 1-closed reduction ,no surgery is needed 2-open reduction ,surgery is needed  Repair of fracture       Healing time for simple fracture is 6-8 weeks (longer in elderly people) It occurs in FOUR major events 1-hematoma formation 2-fibrocartilage callus formation 3-bony callus formation 4-bone remodelling Skeletal system includes  Axial division    • Skull and associated bones  Auditory ossicles  Hyoid bones Vertebral column Thoracic cage(Ribs+ sternum) Appendicular division -Pectoral girdle -Pelvic girdle The Axial Skeleton  Axial division  Skull and associated bones:     Auditory ossicles Hyoid bones Vertebral column Thoracic cage  Ribs + sternum The Skull and Associated Bones Sutures    Sutures – Immovable joints that join skull bones together Form boundaries between skull bones Four sutures: Coronal – between parietal and frontal  Sagittal– between parietal bones  Lambdoid – between the parietal and occipital  Squamous – between the parietal and temporal  Fontanels – usually ossify by 2 years of age  Sagittal Frontal (Coronal) Squamous Lambdoid Sutures The Adult Skull •skull = 22 bones •cranium = 8 bones: frontal, occipital, 2 temporals, 2 parietals, sphenoid and ethmoid •facial bones = 14 bones: nasals, maxillae, zygomatics, mandible, lacrimals, palatines, inferior nasal conchae, vomer. •skull forms a larger cranial cavity -also forms the nasal cavity, the orbits, paranasal sinuses mandible and auditory ossicles are the only movable skull bones •cranial bones also: attach to membranes called meninges -stabilize positions of the brain, blood vessels -outer surface provides large areas for muscle attachment that move the head or provide facial expressions Bones of the Cranium Frontal View Frontal Frontal View Parietal Frontal View Temporal Frontal View Nasal Frontal View Vomer Frontal View Zygoma Frontal View Maxilla Frontal View Mandible Frontal View Frontal Parietal Temporal Nasal Vomer Zygoma Maxilla Mandible Frontal View Lateral View Frontal Lateral View Parietal Lateral View Temporal Lateral View Nasal Lateral View Zygoma Lateral View Maxilla Lateral View Mandible Lateral View Occipital Lateral View Mastoid Process Lateral View External Auditory Meatus Lateral View Parietal Frontal Sphenoid Temporal Occipital Mastoid Process Nasal Zygoma Maxilla Mandible External Auditory Meatus Lateral View Figure 6.4 Sectional Anatomy of the Skull, Part I  Frontal bone      Forms the forehead Roof of the orbit articulates with parietal, sphenoid, lacrimal, nasal, ethmoid, zygomatic and maxilla superior and lateral to glabellar region – frontal sinuses inferior portion – supraorbital ridges with supraorbital notch (supraorbital nerve and artery) •Parietal bones -Part of the superior and lateral surfaces of the cranium -articulate with each other – sagittal suture -articulate with occipital, frontal, temporal and sphenoid bones •Temporal bone -Forms wall of jugular foramen -Petrous part: posterior portion -Tympanic part: associated with ear canal -Squamous part: anterior portion, fan-shaped -zygomatic process -forms cranial portion of the TMJ joint -inferior to zygo. process – mandibular fossa (mandibular condyle) •Temporal bone – petrous portion •houses the inner ear -inferior aspect – mastoid process (air spaces that communicate with the middle ear) -also for attachment of sternocleidomastoid muscle -inferior to mastoid process – mastoid foramen -anterior to mastoid process – external acoustic meatus -inferior and medial to the MP – styloid process (muscle attachment) -stylomastoid foramen (7th cranial)  Occipital bone       Part of the base of the skull articulates with parietal, temporal and sphenoid Surrounds the foramen magnum lateral to the FM – hypoglossal canal (12th cranial) projections = occipital condyles Forms part of the jugular foramen  Sphenoid bone     Contributes to floor of cranium articulates with the frontal, ethmoid, temporal zygomatic, parietal maxillary, palatine, vomer & occipital bones Bridges cranial and facial bones Optic canal allows passage of optic nerve Ethmoid bone       Irregularly shaped bone Forms part of orbital wall Forms roof of nasal cavity articulates with: frontal, sphenoid, lacrimal and maxillary bones connects with the vomer two lateral masses – contain the ethmoid sinuses  projections called the superior and middle nasal conchae two plates: perpendicular plate & the cribiform plate  Cribiform plate: perforations for olfactory nerve, midline is the crista galli  Perpendicular plate = upper part of nasal septum  14 Facial Bones Nasal (2) Zygomatic (2) Mandible (1) (2) Maxillae (2) Lacrimal (2) Palatine Bones of the Face  Maxillae      Paired bone Largest of facial bones Form upper jaw body = orbital, nasal, infratemporal and facial surfaces body contains the maxillary sinuses Maxillary bones: Anterior View   frontal process – articulates with frontal bone and nasal bones & forms medial orbital rim facial surface – body of maxilla    infraorbital foramen – landmark for local inferior to this IF – canine fossa inferior portion of the maxilla – alveolar processes of the teeth (contains the roots of the maxillary teeth Zygomatic Bones    Cheekbones Lateral wall of orbit along with sphenoid Part of zygomatic arch along with part of temporal  Palatine bones Small, L-shaped  link between maxilla and sphenoid  Form posterior portion of hard palate  Contribute to floor of orbit  made up of horizontal plate and a vertical plate + orbital process  -two  Inferior nasal concha Located on each side of nasal septum  Increase epithelial surface  Create turbulence in inspired air   Lacrimal  Smallest bones bones in skull  Forms nasolacrimal groove leading to nasolacrimal canal  Delivers tears to nasal cavity Palatine & Vomer  Vomer    posterior part of nasal septum Forms inferior portion of nasal septum Articulates with maxillae and palatines Mandible    lower jaw only freely movable bone of the skull moving articulations with temporal bone Mandible: Inferior surface -visible are the genial tubercles – or mental spines -muscle attachment area -two fossas: 1) sublingual (sublingual salivary gl.) 2) submandibular (submandibular gl.) -divided by the mylohyoid line (mylohyoid m.) -mandibular foramen – opening of the mandibular canal -for the exit of the alveolar nerve and vessels -can be lost with alveolar process reabsorption -overhanging the foramen – lingula (attachment of sphenomandibular ligament – TMJ) The Hyoid Bone    Suspended by stylohyoid ligaments Consists of a body, greater horns and lesser horns Base for muscles of the tongue and larynx Paranasal Sinuses part of the nasal complex  Paired cavities in ethmoid, sphenoid, frontal and maxillary  Lined with mucous membranes and open into nasal cavity though openings called ostia  Resonating chambers for voice, lighten the skull frontal sinuses: frontal bone, separated by a  Sinusitis is inflammation of the membrane (allergy) septum  connects with nasal cavity – frontonasal duct  infection can easily spread sphenoid sinuses: body of the sphenoid bone from one sinus to the other through the nasal cavity  also drain into nasal cavity ethmoid sinuses: or ethmoid air cells, located in can also spread to other the lateral masses tissues       anterior, middle and posterior sinuses maxillary: body of the maxilla    size varies with individual and age largest of the sinuses close proximity to alveolar processes – periodontal tissues may be in direct contact with sinus’ mucus membranes  secondary sinusitis The Vertebral Column http://www.wisc-online.com/objects/index.asp?objID=AP12104 Adult Vertebral Column  26 vertebrae         24 individual vertebrae Sacrum Coccyx Seven cervical vertebrae Twelve thoracic vertebrae Five lumbar vertebrae Sacrum and coccyx are Fused together. Typical Vertebrae  Body   Vertebral arch     weight bearing pedicles laminae Vertebral foramen Seven processes    2 transverse 1 spinous 4 articular Typical Cervical Vert. (C3-C7)    Smaller bodies Larger spinal canal Transverse processes     shorter transverse foramen for vertebral artery Spinous processes of C2 to C6 often bifid 1st and 2nd cervical vertebrae Atlas & Axis (C1-C2) The Atlas    C1 is termed the atlas Lacks a body and spinous process Supports the skull   Superior articular facets receive the occipital condyles Allows flexion and extension of neck  Nodding the head “yes” The Atlas Figure 7.16a The Axis   Has a body and spinous process Dens (odontoid process) projects superiorly   Acts as a pivot for rotation of the atlas and skull Participates in rotating the head from side to side The Axis Thoracic Vertebrae (T1-T12)    All articulate with ribs Have heart-shaped bodies from the superior view Each side of the body bears demifacts for articulation with ribs Thoracic Vertebrae  Spinous processes are long and point inferiorly  Vertebral foramen are circular  Transverse processes articulate with tubercles of ribs  Allows rotation and prevents flexion and extension Lumbar Vertebrae      Bodies are thick and strong Transverse processes are thin and tapered Spinous rocesses are thick, blunt, and point Vertebral foramina are triangular Allows flexion and extension – rotation prevented Sacrum (S1 – S5)      Forms the posterior wall of pelvis Formed from 5 fused vertebrae Superior surface articulates with L5 Inferiorly articulates with coccyx Sacral promontory   Where the first sacral vertebrae bulges into pelvic cavity Center of gravity is 1 cm posterior to sacral promontory Sacrum  Sacral foramina  Ventral foramina   Passage for ventral rami of sacral spinal nerves Dorsal foramina  Passage for dorsal rami of sacral spinal nerves Sacrum Figure 7.18a, b Coccyx    Is the “tailbone” Formed from 3 – 5 fused vertebrae Offers only slight support to pelvic organs Bony Thorax   Forms the framework of the chest Components of the bony thorax       Thoracic vertebrae – posteriorly Ribs – laterally Sternum and costal cartilage – anteriorly Protects thoracic organs Supports shoulder girdle and upper limbs Provides attachment sites for muscles The Bony Thorax Figure 7.19a The Bony Thorax Figure 7.19b Sternum  Formed from three parts :  Manubrium – superior part   Body – bulk of sternum   Articulates with medial end of clavicles Sides are notched as articulations for costal cartilage of ribs 2–7 Xiphoid process – inferior end of sternum  Ossifies around age 40 Sternum  Anatomical landmarks  Jugular notch   Central indentation at superior border of the manubrium Sternal angle  A horizontal ridge where the manubrium joins the body Ribs  All ribs attach to vertebral column posteriorly  True ribs - superior seven pairs of ribs   Attach to sternum by costal cartilage False ribs – inferior five pairs of ribs ,attatch indirectly to the sternum  floating ribs ribs 11–12 are short and free anteriuorly. Ribs Figure 7.20a Ribs Figure 7.20b Disorders of the Axial Skeleton  Abnormal spinal curvatures     Scoliosis – an abnormal lateral curvature Kyphosis – an exaggerated thoracic curvature Lordosis – an accentuated lumbar curvature – “swayback” Stenosis of the lumbar spine  A narrowing of the vertebral canal The Appendicular Skeleton Allows us to move and manipulate objects  Includes all bones other than axial skeleton, it includes:  the limbs (upper & lower limbs)  the supportive girdles (pectoral &pelvic girdles)  th Figure 8–1 What are the bones of the pectoral girdle, their functions, and features? The Pectoral Girdle     Also called the shoulder girdle Connects the arms to the body Positions the shoulders Provides a base for arm movement The Pectoral Girdle Figure 8–2a The Pectoral Girdle  Consists of:    2 clavicles 2 scapulae Connects with the axial skeleton only at the manubrium(claviculosternal joint) The Clavicles Figure 8–2b, c The Clavicles     Also called collarbones Long, S-shaped bones Originate at the manubrium (sternal end) Articulate with the scapulae (acromial end) The Scapulae    Also called shoulder blades Broad, flat and triangular Articulate with arms and collarbone Anatomy of The scapula Figure 8–3a What are the bones of the upper limbs, their functions, and features? The Upper Limbs  Arms, forearms, wrists, and hands Note: arm (brachium) = 1 bone, the humerus ANATOMY OF The Humerus Figure 8–4 The Humerus    Also called the arm The long, upper armbone Articulates with the pectoral girdle The Forearm Figure 8–5 The Forearm  Also called the antebrachium  Consists  ulna of 2 long bones: (medial)  radius (lateral) Interosseous Membrane   A fibrous sheet provides strength Connects lateral margin of ulnar shaft to radius The Wrist Figure 8–6 The Wrist 8 carpal bones: 4 proximal carpal bones 4 distal carpal bones allow wrist to bend and twist Metacarpal Bones  The 5 long bones of the hand  Numbered I–V from lateral (thumb) to medial  Articulate with proximal phalanges Phalanges of the Hands  Pollex (thumb): 2 phalanges (proximal, distal)  Fingers: 3 phalanges (proximal, middle, distal) What are the bones of the pelvic girdle, their functions, and features? The Pelvis  Consists of 2 ossa coxae, the sacrum, and the coccyx  Stabilized by ligaments of pelvic girdle, sacrum, and lumbar vertebrae The Pelvic Girdle Figure 8–7 The OSSA COXAE Also called hipbones  Strong to bear body weight &stress of movement  Each is made up of 3 fused bones:  ilium (articulates with sacrum)  ischium  pubis  The Acetabulum (vinegar cup) called the hip socket  Is the meeting point of the ilium, ischium, and pubis  Articulates with head of the femur (Hip joint))  Also Marks of the Pubis  Pubic symphysis: gap between pubic tubercles  padded with fibrocartilage  Marks of the Ischium • Ischial tuberosity:posterior projection you sit on • Ischeal spine,superior to the tuberosity ,important during labour The Pelvis Figure 8–8 Divisions of the Pelvis Figure 8–9 The Pelvis  Perineum region:    inferior edges of true pelvis forms pelvic outlet perineal muscles support organs of pelvic cavity What are the structural and functional differences between the male and female pelvis? Comparing the Male and Female Pelvis  Female pelvis:  smoother  lighter  less prominent muscle and ligament attachments Comparing the Male and Female Pelvis Figure 8–10 Pelvis Modifications for Childbearing       Enlarged pelvic outlet Broad pubic angle (> 100°) Less curvature of sacrum and coccyx Wide, circular pelvic inlet Broad, low pelvis Ilia project laterally, not upwards What are the bones of the lower limbs, their functions, and features? The Lower Limbs  Functions:  weight bearing  motion Note: leg = lower leg; thigh = upper leg Bones of the Lower Limbs  Femur (thigh)  Patella (kneecap)  Tibia and fibula (leg)  Tarsals (ankle)  Metatarsals (foot)  Phalanges (toes) The Femur(longest, heaviest ) Figure 8–11 The Patella   Also called the kneecap Formed within tendon of quadriceps femoris The Tibia and Fibula Figure 8–13 The Tibia     Also called the shinbone Supports body weight Larger than fibula Medial to fibula The Fibula • Attaches muscles of feet and toes • Smaller than tibia • Lateral to tibia Bones of the Ankle   Talus: Calcaneus (heel bone):   transfers weight to ground attaches Achilles tendon The Ankle  Also called the tarsus:  consists of 7 tarsal bones Figure 8–14a Feet: Metatarsal Bones    5 long bones of foot Numbered I–V, medial to lateral Articulate with toes Feet: Phalanges  Phalanges:   Hallux:   bones of the toes big toe, 2 phalanges (distal, proximal) Other 4 toes:  3 phalanges (distal, medial, proximal) Feet: Arches  Arches transfer weight from 1 part of the foot to another Figure 8–14b Arches of the Foot    Bones are arranged to form THREE strong arches, 2 longitudinal (medial & lateral)& 1 transverse Ligaments & tendons help to hgold the bones firmly in the arched position but still allow a certain amount of spriginess Week arches are referred to as flat foot Articulations (Joints) Function    Holds bones together Allows bones to move All bones articulate with at least one other bone except the hyoid. Classification of joints    Functional classification: focuses on the amount of movement (synarthrosis, amphiarthrosis and diarthrosis) Structural classification:based on whether Fibrous, Cartilage or a joint cavity separates the bony regions at the joint. As a general rule, fibrous joints are immovable and synovial joints are freely movable . Types   Synarthroses No movements    Primarily axial skeleton Bones connected with fibrous tissue ligament Examples:Skull sutures and distal Tibia/Fibula Types  Amphiarthroses     Slightly movable Axial skeleton Connected by cartilage Intervertebral joints, pubic symphysis Types  Diarthroses – freely movable    Also called synovial (fluid filled joint cavity) Primarily found in the limbs Plane of movement depends on the joint Synovial Joints - Structure 1. Articular cartilage: hyaline 2. Joint Cavity: space filled with lubricating fluid 3.Fibrous Capsule: fibrous CT lined with a smooth synovial membrane 4. Reinforcing Ligament: can be inside or outside the joint capsule 5.Synovial Fluid: viscous and lubricating 6. Bursae: fluid filled sacs ,see later 7. Tendons sheath an elongated bursa that rapes around a tendon subjected to friction. 8. Menisci: cartilaginous discs Synovial Joint Types of synovial joints based on shape  Plane(nonaxial) -Slipping or gliding movements -Intercarpel joints are best examples Hinge joints( uniaxial)   Angular movement is allowed in only one plane like a hinge Examples :elbow,ankle and interphalangeal joints Ball-and-socket joints    A spherical head of one bone fits into a round socket in another These Multiaxial joints allow movements in all axes including rotation Shoulder and Hip are examples Bursae   Flattened fibrous sac lined with synovial membrane with thin synovial fluid Acts as bags of lubricant to reduce friction where ligaments, muscle, skin, tendon or bones rub together Disorders of joints     Dislocation:Bone is forced out of its position,Reduction is done by experts only Bursitis: example falling on the knee Sprain: excessive stretch on a ligament Arthritis: inflammation of joints, may be -Acute: usually bacterial -Chronic: Rheumatoid ,Osteoarthritis and Gouty arthritis Developmental aspects      Long bones are formed of Hyaline cartilage Flat bones of skull are formed of fibrous membranes At birth,some fontanels still remain By end of adolescence, the epiphysial plates are fully ossified Adult skull is 1/8 & infant skull is 1/4 of the total body length       At birth,cranium is huge relative to face,it is related to rapid growth of brain By 2 years skull is 3/4 adult size By 9 years,skull become nearly of adult size At birth, the spine is arched (primary) and convex posteriorly Secondary curvature are convex anteriorly, cervical with raising the head & lumber with start of walking S-shaped spine in adult At birth the UL ratio is 1.7 to 1  At 10, UL is 1 to 1  Bones become stronger with pull of gravity &muscle contractions  Osteoporosis, thin and fragile bones occurs in totally inactive persons. It occurs in half women after 65 and in20% of men after70(estrogen maintain healthy bones)  Causes of Osteoporosis: - estrogen deficiency - diet poor in calcium & protein - lack of vitamin D - smoking - lack of exercise - pathologic fracture is the result END of Sk. system 
 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                            