Download Skeletal System-2

Chapter 5
The Skeletal System
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
The Skeletal System
 Parts of the skeletal system
 Bones (skeleton)
 Joints
 Cartilages
 Ligaments (bone to bone)(tendon=bone to
muscle)
 Divided into two divisions
 Axial skeleton
 Appendicular skeleton – limbs and girdle
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.1
Functions of Bones
 Support of the body
 Protection of soft organs
 Movement due to attached skeletal
muscles
 Storage of minerals and fats
 Blood cell formation
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.2
Bones of the Human Body
 The skeleton has 206 bones
 Two basic types of bone tissue
 Compact bone
 Homogeneous
 Spongy bone
 Small needle-like
pieces of bone
 Many open spaces
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Figure 5.2b
Slide 5.3
Classification of Bones on the
Basis of Shape
Figure 5.1
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.4c
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
 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
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
Bone Growth
 Bones are remodeled and lengthened
until growth stops
 Bones change shape somewhat
 Bones grow in width
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
Long Bone Formation and Growth
Figure 5.4a
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
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
Do you know??
• The bone cells that function in the forming
of bone tissue are called?
Bone Fractures
 A break in a bone
 Types of bone fractures
 Closed (simple) fracture – break that does not
penetrate the skin
 Open (compound) fracture – broken bone
penetrates through the skin
 Bone fractures are treated by reduction
and immobilization
 Realignment of the bone
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.16
Common Types of Fractures
Table 5.2
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.17
What type am I?...
And ME????
Who am I??
Next!??
Hey don’t forget ME!!!
I feel left out

THE BEST FOR LAST!!!
Repair of Bone Fractures
 Hematoma (blood-filled swelling) is
formed
 Break is splinted by fibrocartilage to
form a callus
 Fibrocartilage callus is replaced by a
bony callus
 Bony callus is remodeled to form a
permanent patch
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.18
Stages in the Healing of a Bone
Fracture
Figure 5.5
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.19
The Axial Skeleton
 Forms the longitudinal part of the body
 Divided into three parts
 Skull
 Vertebral column
 Bony thorax
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
The Axial Skeleton
Figure 5.6
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
The Skull
 Two sets of bones
 Cranium
 Facial bones
 Bones are joined by sutures
 Only the mandible is attached by a
freely movable joint
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
The Skull
Figure 5.7
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Slide
Bones of the Skull
Figure 5.11
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.22
Human Skull, Superior View
Figure 5.8
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.23
Paranasal Sinuses
 Functions of paranasal sinuses
 Lighten the skull
 Give resonance and amplification to voice
Figure 5.10
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
The Hyoid Bone
 The only bone that
does not articulate
with another bone
 Serves as a
moveable base for
the tongue
Figure 5.12
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.26
The Fetal Skull
 The fetal skull is
large compared
to the infants
total body length
Figure 5.13
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
The Fetal Skull
 Fontanelles –
fibrous membranes
connecting the
cranial bones
 Allow the brain
to grow
 Convert to bone
within 24 months
after birth
Figure 5.13
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
The Vertebral Column
 Vertebrae
separated by
intervertebral discs
 The spine has a
normal curvature
 Each vertebrae is
given a name
according to its
location
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Figure 5.14
Slide 5.28
The Bony Thorax
 Forms a
cage to
protect
major
organs
Figure 5.19a
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
The Bony Thorax
 Made-up of
three parts
 Sternum
 Ribs
 Thoracic
vertebrae
Figure 5.19a
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
The Appendicular Skeleton
 Limbs (appendages)
 Pectoral girdle
 Pelvic girdle
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
The Appendicular Skeleton
Figure 5.6c
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
The Pectoral (Shoulder) Girdle
 Composed of two bones
 Clavicle – collarbone
 Scapula – shoulder blade
 These bones allow the upper limb to
have exceptionally free movement
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.33
Bones of the Shoulder Girdle
Figure 5.20a, b
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Slide
Bones of the Upper Limb
 The arm is
formed by a
single bone
 Humerus
Figure 5.21a, b
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Slide
Bones of the Upper Limb
• The forearm
has two bones
• Ulna
• Radius
Figure 5.21c
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Slide
Bones of the Upper Limb
 The hand
 Carpals – wrist
 Metacarpals –
palm
 Phalanges –
fingers
Figure 5.22
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.36
Bones of the Pelvic Girdle
 Hip bones
 Composed of three pair of fused bones
 Ilium
 Ischium
 Pubic bone
 The total weight of the upper body rests on the
pelvis
 Protects several organs
 Reproductive organs
 Urinary bladder
 Part of the large intestine
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.37
The Pelvis
Figure 5.23a
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Slide
Gender Differences of the Pelvis
Figure 5.23c
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Slide 5.39
Bones of the Lower Limbs
 The thigh has
one bone
 Femur – thigh
bone
Figure 5.35a, b
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
Bones of the Lower Limbs
 The leg has
two bones
 Tibia
 Fibula
Figure 5.35c
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Slide
Bones of the Lower Limbs
 The foot
 Tarsus – ankle
 Metatarsals –
sole
 Phalanges –
toes
Figure 5.25
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.41
Joints
 Articulations of bones
 Functions of joints
 Hold bones together
 Allow for mobility
 Ways joints are classified
 Functionally
 Structurally
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.43
Functional Classification of Joints
 Synarthroses – immovable joints
 Amphiarthroses – slightly moveable
joints
 Diarthroses – freely moveable joints
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.44
Structural Classification of Joints
 Fibrous joints
 Generally immovable
 Cartilaginous joints
 Immovable or slightly moveable
 Synovial joints
 Freely moveable
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.45
Fibrous Joints
 Bones united by fibrous tissue –
synarthrosis or largely immovable.
Figure 5.27d, e
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.46
Cartilaginous Joints – mostly
amphiarthrosis
 Bones connected by cartilage
 Examples
 Pubic
symphysis
 Intervertebral
joints
Figure 5.27b, c
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.47
Synovial Joints
 Articulating
bones are
separated by a
joint cavity
 Synovial fluid
is found in the
joint cavity
Figure 5.27f–h
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.48
Features of Synovial JointsDiarthroses
 Articular cartilage (hyaline cartilage)
covers the ends of bones
 Joint surfaces are enclosed by a fibrous
articular capsule
 Have a joint cavity filled with synovial
fluid
 Ligaments reinforce the joint
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.49
Structures Associated with the
Synovial Joint
 Bursae – flattened fibrous sacs
 Lined with synovial membranes
 Filled with synovial fluid
 Not actually part of the joint
 Tendon sheath
 Elongated bursa that wraps around a tendon
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.50
Think about this…
• A patient with bursitis of the shoulder asks
the nurse what the bursa does. The nurses
response is based on the knowledge that
bursae does?
• A. connects bone to bone
• B. Separates muscle from muscle
• C. Lubricates joints with synovial fluid
• D. relieve friction between moving parts
The Synovial Joint
Figure 5.28
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.51
Types of Synovial Joints Based on
Shape
Figure 5.29a–c
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Slide
Types of Synovial Joints Based on
Shape
Figure 5.29d–f
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
Inflammatory Conditions
Associated with Joints
 Bursitis – inflammation of a bursa usually
caused by a blow or friction
 Tendonitis – inflammation of tendon sheaths
 Arthritis – inflammatory or degenerative
diseases of joints
 Over 100 different types
 The most widespread crippling disease in the
United States
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.53
Clinical Forms of Arthritis
 Osteoarthritis
 Most common chronic arthritis
 Probably related to normal aging processes
 Rheumatoid arthritis
 An autoimmune disease – the immune system
attacks the joints
 Symptoms begin with bilateral inflammation of
certain joints
 Often leads to deformities
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide
Clinical Forms of Arthritis
 Gouty Arthritis
 Inflammation of joints is caused by a
deposition of urate crystals from the blood
 Causes- Mostly middle age men
 Excessive alcohol consumption, hypertension,
purine rich foods.
 Can usually be controlled with diet
Slide
Osteoporosis
• Porous bone (fragile bone disease)
Etiology– Risk factors female, increasing age, family
history, white (European descent) or Asian,
small stature, early menopause, anorexia,
oophorectomy, sedimentary, insufficient
vitamin D.
Treatment: Calcium and Vit D, Moderate amount
of exercise, stop smoking and drinking alcohol,
and medications if needed.
Osteomyelitis
• Severe infection of the bone, bone marrow,
and surrounding tissue. Most commonly
caused by Staphylococcus aureus.
– Clinical Manifestations– Fever, night sweats, chills, restlessness, nausea, and
maliasie, constant bone pain unrelieved by rest and
worsens with activity, swelling, tenderness, and warmth.
– Can be chronic or acute
TreatmentAntibiotics and surgical treatment
Kyphosis
• Forward bending of thoracic spine, slight
flexion of knees, and exaggerated thoracic
spine.
• Possible Etiology– Poor posture, TB, arthritis, osteoporosis,
Kyphosis
Lordosis
• Asymmetric scapulae and shoulders,
exaggerated lumbar
• Etiology– Spinal deformities, muscular dystrophy,
obesity, congenital hip dislocation.
Lordosis
Scoliosis
• Asymmetic elevation of shoulders,
scapulae, and iliac crest
• Etiology
– Idiopathic or congenital condition, fracture or
dislocation, osteomalacia
Scoliosis
Good Luck and Break a leg on
these questions 
• The nurse advises the patient with early
osteoporosis (osteopenia) to
• A. lose weight
• B. stop smoking
• C. eat a high protein diet
• D. start swimming for exercise
A patient with osteomyelitis is
treated with surgical debridement
followed by continuous irrigation
of the affected bone with
antibiotics.
In responding to the patient who
asks
why
oral
or
IV
Antibiotics can not be used alone, the nurse
explains that
A. the irrigation is necessary to wash out dead
tissue and pus from the infected area.
• B. there are no effective oral or IV
antibiotics to treat S. aureus the most
common cause of osteomyelitis.
• C. an irrigation can penetrate involucrum
created by the infection and prevent
bacterial spreading to other tissues
• D. the ischemia and bone death associated
with osteomyelitis are frequently
impenetrable to most blood borne
antibiotics
You know I had to throw an
oncology question in…
• A patient with metastatic bone cancer has a
nursing diagnosis of risk for injury related
to bone tissue changes the nursing
management of this patient is primarily
directed toward preventing
• A. preventing pain
• B. relieving edema
• C. increasing physical mobility
• D. supporting and positioning the leg.
Are you ready to break a leg???
•
•
•
•
•
•
•
•
Skeletal Abnormality Disease List (choose only 1)
Osteoarthritis
Rheumatoid arthritis
Osgood-Schlatter disease
Osteomyelitis
Osteoporosis
Repetitive stress injures (as they pertain to the skeletal system)
Scoliosis
•
bone spurs shin splints (osteophytes)
•
•
•
•
•
•
•
•
•
•
•
(periostitis)
Fibrous dysplasia
Rickets
Osteomalacia
Gout
Bunions
Temporomandibular
joint syndrome (TMJ)
Marfan syndrome
(as it pertains to the
Osteosarcoma
Ewing’s sarcoma
Name: ______________________________
Abnormality: ________________________
Create a tri-fold brochure/poster that includes the following information on a skeletal system disorder that you have chosen from
It would be great if the brochure was in color, but I will NOT deduct points if it is not.
* Only 1 reference may be Wikipedia.
Information Required
Name of the Disorder
5 points if:
Present
Cause of abnormality
Symptoms
Listed but no elaboration
Some symptoms are listed
Prognosis
Describe either life
expectancy or quality of life
Treatment of symptoms
Some treatments are
mentioned
Basic information on how it is
diagnosed
Diagnosis
Graphics
Incidence Rate & location
Sources
Neatness
1-2 graphics are included
Mentions either incidence rate
OR geographic locations
where most common
1-2 sources used and correctly
documented*
Adequate
10 points if:
Present, with picture or
drawings to aid understanding
Described in detail
Most symptoms are listed and
described
Describe what the life
expectancy and quality of life
are for patient
Treatments are mentioned
with details
Diagnosis methods related
back to symptoms or cause of
abnormality
3 or more graphics
Mentions both incidence rate
and if there are geographic
locations where most common
3-4 sources used and correctly
documented*
Excellent