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THE MUSCULOSKELETAL SYSTEM

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ObjectivesObjectives

• Name the parts of the musculoskeletal system and discuss the function of each part.

• Define combining forms used in building words that relate to the musculoskeletal system.

After studying this chapter, you will be able to:

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Objectives Part 2Objectives CONT’D

• Name the common diagnoses, laboratory tests, and clinical procedures used in treating the musculoskeletal system.

• Define the major pathological conditions of the musculoskeletal system.

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Objectives Part 3 Objectives CONT’D

• Define surgical terms related to the musculoskeletal system.

• List common pharmacological agents used in treating the musculoskeletal system.

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Ch 5 Vocabulary

• Acetabul(o)• Brachi(o)• Burs(o)• Calci(o)• Cervic(o)• Cost(o)• Dactyl(o)• Femor(o)• Fibr(o)• Kyph(o)

• Lamin(o)• Lumb(o)• Myel(o)• Patell(o)• Ped(i)• Radi(o)• Scapul(o)• Stern(o)• Synov(o)• Uln(o)

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Structure and FunctionForms the body framework

Enables the bodyto move

Protects and supports internal organs

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Bones

Bones

• Consists of a rich supply of blood vessels and nerves

• Osteoblasts are bone-forming cells

• Osteoclasts are responsible for reabsorbing dead bone tissue

• Bone cells are called osteocytes

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OssificationBones

The development of osteocytes and the hardening process is called ossification.

calcium

phosphorusvitamin D

Ossification depends on:

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Divisions of the Skeleton

• Axial– Skull– Spinal column– Ribs– Sternum

• Appendicular– Upper & lower

extremities– Pelvic girdle

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Common Bone CategoriesBonesThe adult skeleton has 206 bones.

Common Bone Categories• Long bones(Femur)

• Short bones(Wrist bones)

• Flat bones(Skull)

• Irregular bones(Vertebrae/Facial)

• Sesamoid bones(Kneecap)

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Parts of the Long Bone

• Diaphysis– Shaft or longest portion– Compact bone

• Hard dense part of bone that does not bend

– Spongy bone• Covers medullary cavity

• Epiphysis– Ends of long bone– Epiphyseal plates: growth

plates– Contains red marrow

Femur

Distal epiphysis

Diaphysis

Proximal epiphysis

Epiphyseal disksSpongy boneArticular

cartilage

Space containing red marrow

Compact bone

Medullary cavity

Yellow marrow

Periosteum

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Parts of the Long Bone

• Medullary cavity– Hollow space– Contains yellow marrow

• Tissues of a bone– Periosteum-outer covering

of bone– Endosteum-lines medullary

cavity

Femur

Distal epiphysis

Diaphysis

Proximal epiphysis

Epiphyseal disksSpongy boneArticular

cartilage

Space containing red marrow

Compact bone

Medullary cavity

Yellow marrow

Periosteum

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Parts of Long Bones

• Bone marrow– Red bone marrow

• Manufactures erythrocytes & leukocytes

– Yellow bone marrow• Composed of fat cells • Functions as fat storage

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Parts of Long Bones Part 2 • Articular cartilage is a thin flexible substance that provides protection at movable points.

Parts of a Long Bone

Femur

Distal epiphysis

Diaphysis

Proximal epiphysis

Epiphyseal disksSpongy boneArticular

cartilage

Space containing red marrow

Compact bone

Medullary cavity

Yellow marrowPeriosteum

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Bones of the Skull

• Cranium: encloses the brain (skull)– Frontal

• forehead– Parietal

• Roof and upper sides of cranium

– Occipital• Posterior floor and

walls of cranium– Temporal

• Sides and base of cranium

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Bones of the Jaw

• Mandible– Lower jaw bone

• Maxilla– Upper jaw bone

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Sutures

• Where cranial bones join & fuse

• Fontanelles:– Soft spots on infant

skull

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SinusesCavities that reduce the weight of a bone.

• Frontal sinuses

• Ethmoid sinuses

• Maxillary sinuses

• Sphenoid sinuses

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Spinal ColumnSpinal Column

Consists of five sets of vertebrae

• Cervical = 7

• Thoracic = 12

• Lumbar = 5

• Sacrum = 5 fused

• Coccyx = 4 fused

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Thoracic cavity

• Ribs– 12 pairs

• Called costals• Attach posterior to thoracic

vertebrae– 7 pairs

• True ribs• Attached anterior to sternum

– 3 pairs• False ribs• Attached anterior to cartilage• Joins with sternum

– 2 pairs• Floating ribs• Not attached anteriorly

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Thoracic Cavity

Sternum:– Manubrium

• Upper portion of sternum

– Body of sternum• Middle portion of

sternum– Xiphoid process

• Cartilage• Lower portion of

sternum

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Shoulders

• Clavicle– Collar bone– Connects sternum

• Scapula– Shoulder blade

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Pelvic girdle HIPS

• Ilium– Upper blade shape

• Ischium– Lower portion near

hips

• Pubic bone– Fuse together with

sacrum

• Pubic symphysis– Cartilage joint that

holds bones together

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Bones of the ExtremitiesBones of the Extremities

Upper Arm• Humerus

Lower Arm• Ulna• Radius

Hand and Fingers• Carpals (wrist)• Metacarpals (palm)• Phalanges (fingers)

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Bones of the Extremities Part 2Bones of the Extremities (Cont’d)

Upper Leg

• Femur (thigh)

Lower leg• Tibia (shin)• Fibula (little fibber)• Patella (kneecap)

Feet and Toes

• Tarsals (ankle)• Calcaneus (heel)• Metatarsals (arch)• Phalanges (toes)

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Joints

Joints (articulations)

Amphiarthroses• Moves slightly• Vertebrae

Diarthroses

• Moves freely• knee

Synarthroses• No movement• Skull

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Freely Moveable Joints

• AKA: Synovial joints• Lined with a synovial

membrane• Synovial fluid

– A joint lubricator– Helps synovial joints move

easier

• Bursa– Sac lined with synovial

membrane– Helps reduce friction

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Tendons and LigamentsTendons are bands of fibrous tissue that connect muscles to bone.Ligaments connect bones to other bones.

Tendons and Ligaments

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Muscles - FasciaMusclesMost muscles are covered by a band of connective tissue called fascia, that covers & supports the muscle.

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MusclesMusclesMuscles contract (shorten) and extend to provide body movement.

Types of Muscles

• Voluntary (striated)• skeletal

• Involuntary • smooth or visceral- Move

internal organs• Cardiac (striated)

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• Origin-– Attachment to a stationary bone

• Insertion-– Attachment to a movable bone

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Muscles – Origin or InsertionLift up your right forearm to flex your bicep brachii as if making a fist. Identify the origin and insertion attachment by agreeing with one of the following statements:

The radius is the origin and the scapula is the insertion.

The scapula is the origin and the radius is the insertion.

---OR---

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Diagnostic, Procedural, and Laboratory Terms

• Arthrography– Examine joints using

x-ray

• Arthroscopy– Internal exam of a joint

using an instrument

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Diagnostic, Procedural, and Laboratory Terms

• Diskography– Exam of disks by

injection of dye then an x-ray

• Electromyogram– Image of electrical

activity of muscles

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Diagnostic, Procedural, and Laboratory Terms

• Computerized tomography (CT)– Multiple X-rays– Computer puts in cross

sectional views

• Magnetic resonance imaging (MRI)– Magnets excite H ions– Computer makes pic

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Diagnostic, Procedural, and Laboratory Tests Pt 5

Other Tests

Goniometer-Tests for ROM

Densitometer-Measures bone density

Goniometer

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PathologyCauses of musculoskeletal disorders

• Birth defects

• Injury

• Degenerative disease

• Systemic disorders

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• Spina bifida– Incomplete closure of

spinal cord & protrusion-meningocele

Pathology-Birth Defects

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Pathology-Birth Defects

• Talipes– AKA: club foot– congenital deformity

of the foot – curled shape or twisted

position of the ankle, heel & toes

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Pathology-Injuries

• Herniated disk– Disk is compressed &

protrudes– Presses on nerve

causing sciatica– Pain radiates from butt

down leg to foot/toes

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Pathology-Injuries

• Fractures– Incomplete fracture

• Fracture line doses not extend through bone or disrupt the entire thickness of bone

– Greenstick fracture• Incomplete break that

occurs almost exclusively in children

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Pathology-Injuries

• Fractures, cont.– Comminuted fractures

• Bone broken in several places and splinters of bone can be embedded in surrounding tissue

– Compression fracture• Bone collapses due to

disruption of bone tissue

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Pathology-Injuries

• Fractures, cont– Compound:

• Causes disruption of skin and soft tissue

• Fragment of bone punctures skin

• Often complicated by infection

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Pathology-Injuries• Injury or trauma to the

joints or muscle may cause a sprain.

• Overuse of a muscle may cause a strain.

• Tendinitis: overuse of a joint

• Dislocation: when bones in a joint become displaced or misaligned

• Subluxation: partial dislocation

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Pathology-Pain & Discomfort

• Myalgia: muscle pain• Myositis: muscle

inflammation• Arthritis:

inflammation of joints– Arthralgia: joint pain– Ankylosis: stiff joints– Osteoalgia- bone pain

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Pathology-Abnormal Muscle Tone

• Hypertrophy: abnormal increase in muscle size

• Atrophy: muscles shrink in size from disuse

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Pathology-Abnormal Muscle Tone

• Spasms: abnormal contractions

• Rigor: abnormal muscle stiffness

• Tetany: painfully long spasm

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Pathology-Abnormal Postures

• Kyphosis– Rounded bowing of

back at thoracic area

• Scoliosis– Lateral curvature of

spine

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Pathology-Abnormal Postures

• Lordosis– Abnormal inward

curvature of lumbar vertebrae

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Surgical TermsAlmost any major part of the musculoskeletal system can now be surgically repaired.

Supportive devices

• Cast

• Splints

• Traction

• Prosthetic devices

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Surgical Terms

External fixation – Splints or casts

Internal fixation – Pins or rods

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Surgical Terms

• Reduction: return of a part to normal position

• Open reduction: done surgically

• Closed reduction: external manipulation of dislocated bones

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Surgical Terms

• Traction– Aligns ends of a

fracture by pulling the limb into a straight position

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Surgical Terms

• Amputation– Surgical removal of

limb– Prosthesis replaces

limb or joints

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Surgical Terms

• Osteoplasty: surgical repair of bone• Osteoclasis: breaking of bone when not healed

properly• Osteotomy: incision into a bone• Tenotomy: cutting of tendon to repair muscle• Myoplasty: muscle repair• Arthroplasty: joint repair• Arthrocentesis: puncture of a joint

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Surgical Terms

• Bunionectomy– Removal of bunion on

hallux

• Laminectomy– removes parts of the

vertebrae) that is narrowing the spinal canal and squeezing the spinal cord and nerve roots.

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Pharmacology Part 2Common medications for the Musculoskeletal System

• Analgesics- relieves pain

• Steroids- reduce inflammation

• Muscle Relaxants- relieve stiffness

• NSAID’s- Non-steroidal anti-inflammatory drugs

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Apply Your KnowledgeMrs. Jones is concerned with the “soft spots” she feels on her baby’s head. You realize the medical term for these “soft spots” is:

A. FontanelleB. FissureC. Foramen

A. Fontanelle

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Apply Your Knowledge Part 2Head & Trunk

Arms & Legs

Identify the axial and appendicular portions of the skeleton.

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Apply Your Knowledge Part 3Mary is complaining of headache, stuffy nose and pressure with facial discomfort. Her physician tells her she has allergies. Which of the following conditions might she be experiencing?

A. fracture of her vomerB. sinusitisC. stroke

B. sinusitis

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Apply Your Knowledge Part 4Relieves pain

Reduces swelling

Relieves stiffness

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2

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A. steroids

B. analgesics

C. muscle relaxants

Match the correct medication with its action.

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Combining Forms Match the following combining forms and meanings.

ankyl (o)

arthr (o)

brachi (o)

calcane (o)

heel

bent

joint

arm

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Combining Forms Part 2Match the following combining forms and meanings.

carp (o)

cephal (o)

chondr (o)

dactyl (o)

kyph (o)

cartilage

hump

head

wrist

fingers, toes

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Combining Forms Part 3Match the following combining forms and meanings.my (o)

myel (o)

pod (o)

oste (o)

phalang (o)

foot

finger or toe bone

muscle

bone

spinal cord; bone marrow

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Combining Forms Part 4Match the following combining forms and meanings.

rachi (o)

scoli (o)

spondyl (o)

ten (o)

uln (o)

curved

vertebra

spine

ulnar

tendon