Chapter 3 Medical Chapter 3 Medical Terminology andTerminology andChapter 6 Body Chapter 6 Body

StructuresStructures

THE SKELETAL SYSTEMTHE SKELETAL SYSTEM

Structures of the Skeletal Structures of the Skeletal SystemSystem

INCLUDES:INCLUDES:

BonesBones CartilageCartilage LigamentsLigaments JointsJoints BursaBursa

Functions of the Skeletal SystemFunctions of the Skeletal System

BonesBones – act as framework of body, support – act as framework of body, support and protect the internal organs – stores and protect the internal organs – stores calcium required for normal nerve and calcium required for normal nerve and muscle functionmuscle function

Joints/Muscles/Ligaments, and tendonsJoints/Muscles/Ligaments, and tendons – – make variety of body movements possiblemake variety of body movements possible

Red Bone MarrowRed Bone Marrow – located in spongy – located in spongy bone, has important function in the formation bone, has important function in the formation of bloodof blood

The Structure of BonesThe Structure of Bones

Bone is a form of Bone is a form of connective tissue and connective tissue and is almost the hardest is almost the hardest tissue in the human tissue in the human body (dental enamel is body (dental enamel is harder)harder)

Tissues of BoneTissues of Bone:: Although it is very hard Although it is very hard

and dense, bone is a and dense, bone is a living structure that living structure that changes and is changes and is capable of healing capable of healing itself itself

Bone MarrowBone Marrow Located w/in spongy bone, Located w/in spongy bone, is hematopoietic and is hematopoietic and manufactures red blood manufactures red blood cells, hemoglobin, white cells, hemoglobin, white blood cells, thrombocytesblood cells, thrombocytes

CAUTION:CAUTION: the word part the word part myel/omyel/o means either bone means either bone marrow or spinal cordmarrow or spinal cord

Hematopoietic/hemopoietic: Hematopoietic/hemopoietic: pertaining to formation of pertaining to formation of blood cells blood cells

Hemato/Hemo = bloodHemato/Hemo = blood Poietic = pertaining to Poietic = pertaining to

formationformation

Yellow Bone MarrowYellow Bone Marrow: : found in medullary cavity, found in medullary cavity, composed chiefly of fat cells composed chiefly of fat cells and functions as a fat and functions as a fat storage areastorage area

JointsJoints - - aka aka articulationsarticulations

– – connections btwn. Bonesconnections btwn. Bones ArticulateArticulate: : to join or to come together in a to join or to come together in a

manner that allows motion between partsmanner that allows motion between parts Types of JointsTypes of Joints

SuturesSutures SymphysesSymphyses Synovial JointsSynovial Joints

SuturesSutures

The jagged line where The jagged line where bones join and form an bones join and form an immovable joint immovable joint

Fontanel/fontanellFontanel/fontanell: : AKA soft spot – where AKA soft spot – where the sutures btwn. the the sutures btwn. the frontal/parietal bones frontal/parietal bones have not yet closed have not yet closed

on a baby’s headon a baby’s head disappears as the child disappears as the child

grows and the sutures grows and the sutures close close

SymphysesSymphyses

SymphysisSymphysis: : where 2 where 2 bones join and are bones join and are held firmly together held firmly together so they function as so they function as one boneone bone

(ie: pubic symphysis(ie: pubic symphysis))

Synovial JointsSynovial Joints

Movable joints of bodyMovable joints of body Ball and Socket Joints: Ball and Socket Joints: synovial joints that allow a synovial joints that allow a

wide range of movement in many directions (ie: hips wide range of movement in many directions (ie: hips and shoulders)and shoulders)

Hinge Joints: Hinge Joints: synovial joints that allow movement synovial joints that allow movement primarily in one direction or plane (ie: knees and primarily in one direction or plane (ie: knees and elbows)elbows)

The SkeletonThe Skeleton

206 bones total in adult human body206 bones total in adult human body divided into 2 systemsdivided into 2 systems

AxialAxial: (80 bones) protects the major organs of the : (80 bones) protects the major organs of the nervous, respiratory, and circulatory systems – axial refers nervous, respiratory, and circulatory systems – axial refers to an imaginary line or axis thru the center of the body to an imaginary line or axis thru the center of the body – – includes skull, spinal column, ribs, and sternumincludes skull, spinal column, ribs, and sternum

AppendicularAppendicular: : (126 bones) makes body mvmt. Possible, (126 bones) makes body mvmt. Possible, also protects the organs of digestion, excretion, and also protects the organs of digestion, excretion, and reproduction – appendicular refers to an appendage, reproduction – appendicular refers to an appendage, which is anything attached to a major part of the bodywhich is anything attached to a major part of the body

Organized into:Organized into: Upper extremities: Upper extremities: shoulders, arms, forearms, wrists shoulders, arms, forearms, wrists

and handsand hands Lower Extremities: Lower Extremities: hips, thighs, legs, ankles, and feethips, thighs, legs, ankles, and feet

Cranium - Cranium - portion of the skull that portion of the skull that encloses the brain encloses the brain

CONSISTS OF:CONSISTS OF: Frontal boneFrontal bone: : forms the foreheadforms the forehead Parietal bonesParietal bones: : form most of the roof and upper sides form most of the roof and upper sides

of the of the CraniumCranium Occipital boneOccipital bone: forms the posterior floor and walls of : forms the posterior floor and walls of

the craniumthe cranium foramen magnumforamen magnum: opening in occipital bone thru which : opening in occipital bone thru which

spinal cord passesspinal cord passes

Temporal bonesTemporal bones:: form the sides and base of the form the sides and base of the craniumcranium

Sphenoid boneSphenoid bone: : forms part of the base of the skull and forms part of the base of the skull and parts of the floor and sides of the bony socket parts of the floor and sides of the bony socket surrounding and protecting the eyeballsurrounding and protecting the eyeball

Ethmoid boneEthmoid bone: : forms part of the nose, the orbit, and forms part of the nose, the orbit, and the floor of the craniumthe floor of the cranium

Auditory OssiclesAuditory Ossicles

bones of the middle earbones of the middle ear EAMEAM: external auditory meatus – external opening of : external auditory meatus – external opening of

the ear, is located in the temporal bonethe ear, is located in the temporal bone

Thoracic Cavity, Ribs, and Thoracic Cavity, Ribs, and SternumSternum

Thoracic CavityThoracic Cavity: AKA rib cage : AKA rib cage – – made up of the ribs, sternum, and made up of the ribs, sternum, and thoracic vertebraethoracic vertebrae

RibsRibs: 12 pair (costals) attach to : 12 pair (costals) attach to thoracic vertebrae posteriorlythoracic vertebrae posteriorly First 7 pair – true ribs – attach First 7 pair – true ribs – attach

anteriorly to the sternumanteriorly to the sternum (FIG (FIG 3.11)3.11)

Next 3 pair – false ribs – attach Next 3 pair – false ribs – attach anteriorly to cartilage that joins anteriorly to cartilage that joins with the sternumwith the sternum

Last 2 pair – floating ribs – are not Last 2 pair – floating ribs – are not attached anteriorlyattached anteriorly

SternumSternum: : forms middle of the forms middle of the front of the rib cage – divided into front of the rib cage – divided into 3 parts3 parts

Manubrium:Manubrium: bone, upper portion bone, upper portion of the sternumof the sternum

Body:Body: bone, middle portion bone, middle portion Xiphoid process:Xiphoid process: cartilage, lower cartilage, lower

portionportion

ShouldersShoulders Pectoral girdle:Pectoral girdle: AKA AKA

shoulder girdle – supports shoulder girdle – supports arms and handsarms and hands

Clavicle:Clavicle: slender bone slender bone that connects the sternum that connects the sternum to scapulato scapula

Scapula:Scapula: shoulder blade shoulder blade Acromion:Acromion: an extension an extension

of the scapula that form of the scapula that form highest point of the highest point of the shouldershoulder

ArmsArms humerus:humerus: bone of upper arm bone of upper arm radiusradius:: smaller bone in the smaller bone in the

forearm, runs up the thumb forearm, runs up the thumb (lateral) side of arm(lateral) side of arm

ulnaulna:: larger bone of the larger bone of the forearm, articulates with the forearm, articulates with the humerus to form the elbow humerus to form the elbow jointjoint

olecranon processolecranon process:: large large projection on the proximal end projection on the proximal end of the ulna that forms the point of the ulna that forms the point of the elbowof the elbow

Wrists and HandsWrists and Hands

carpalscarpals: : bones of the bones of the wristwrist

metacarpalsmetacarpals: : form form the palm of the handthe palm of the hand

phalangesphalanges: : bones of bones of the fingers (and toes)the fingers (and toes) each finger has 3 each finger has 3

bones: distal, middle, bones: distal, middle, proximal phalangesproximal phalanges

thumbthumb: only distal and : only distal and proximal phalangesproximal phalanges

Spinal ColumnSpinal Column

consists of 26 vertebrae consists of 26 vertebrae – functions to support – functions to support head and body and head and body and protect spinal cordprotect spinal cord

Types of VertebraeTypes of Vertebrae CervicalCervical: first set of 7 – : first set of 7 –

form neck C1 – C7form neck C1 – C7

Thoracic vertebraeThoracic vertebrae: second : second set of 12 vertebrae – set of 12 vertebrae – form outward curvature of spine T1 form outward curvature of spine T1

– T12– T12

Lumbar vertebraeLumbar vertebrae: third set of : third set of vertebraevertebrae L1 – L5 – largest and strongest of L1 – L5 – largest and strongest of

the vertebrae – form the inward the vertebrae – form the inward curvature of spinecurvature of spine

Intervertebral Disks• made of cartilage, separate and cushion the vertebrae from each other, act as shock absorbers and allow for movement of the spinal column

Sacrum/ Coccyx Sacrum/ Coccyx

SacrumSacrum triangular shaped bone near the base of the triangular shaped bone near the base of the

spine spine (FIG 3.15)(FIG 3.15) at birth = 5 separate sacral bones = fuse to at birth = 5 separate sacral bones = fuse to

form one in young childform one in young child

CoccyxCoccyx tailbone, forms end of spine and is made up tailbone, forms end of spine and is made up

of four small bones fused togetherof four small bones fused together

Pelvic Girdle Pelvic Girdle - - Protects internal organs and Protects internal organs and

supports lower extremitiessupports lower extremities 3 BONES FUSED TOGETHER – posteriorly w/ 3 BONES FUSED TOGETHER – posteriorly w/

sacrumsacrum iliumilium: upper, blade shaped part of hip on each side : upper, blade shaped part of hip on each side

of the pelvic girdleof the pelvic girdle sacroiliacsacroiliac:: slightly moveable articulation btwn. Sacrum and slightly moveable articulation btwn. Sacrum and

iliumilium ischiumischium:: lower and posterior portion of the pelvic lower and posterior portion of the pelvic

girdlegirdle pubispubis: anterior portion of the pelvic girdle: anterior portion of the pelvic girdle

2 pubic bones join at anterior midline to form 2 pubic bones join at anterior midline to form pubic pubic symphysis – symphysis – cartilaginous joint that holds the bones firmly cartilaginous joint that holds the bones firmly togethertogether

acetabulum: acetabulum: large socket in pelvic bones, forms hip socket large socket in pelvic bones, forms hip socket for head of femurfor head of femur

Legs and KneesLegs and KneesFemurFemur upper leg bone – largest bone in bodyupper leg bone – largest bone in body

head:head: articulated with the acetabulumarticulated with the acetabulum femoral neckfemoral neck:: narrow area just below the head of the femur narrow area just below the head of the femur trochantertrochanter:: one of the two large bony projections of the one of the two large bony projections of the

proximal end of the femur just below the femoral neckproximal end of the femur just below the femoral neck

KneesKnees patellapatella: : bony anterior portion of the kneecapbony anterior portion of the kneecap poplitealpopliteal:: refers to the posterior surface of the knee – used to refers to the posterior surface of the knee – used to

describe the structures in this areadescribe the structures in this area anterior cruciate ligament (ACL)/posterior cruciate ligament anterior cruciate ligament (ACL)/posterior cruciate ligament

(PCL(PCL):): make the movements of the knee possible – shaped like make the movements of the knee possible – shaped like a cross a cross

Lower LegLower LegTibia:Tibia: larger weight-bearing bone in the anterior of the lower leglarger weight-bearing bone in the anterior of the lower leg fibula:fibula: smaller of the 2 bones of the lower leg smaller of the 2 bones of the lower leg

Medical Specialties Related to Medical Specialties Related to the Skeletal Systemthe Skeletal System

chiropractorchiropractor orthopedic surgeonorthopedic surgeon orthoticsorthotics osteopathic physiciansosteopathic physicians podiatristpodiatrist rheumatologistrheumatologist

Curvatures of the spineCurvatures of the spine

kyphosis: kyphosis: abnormal increase in the abnormal increase in the outward curvature of thoracic spine outward curvature of thoracic spine (dowager’s hump)(dowager’s hump)

lordosis:lordosis: abnormal increase in forward abnormal increase in forward curvature of the lumbar spine (swayback)curvature of the lumbar spine (swayback)

scoliosis:scoliosis: lateral curvature of the spine lateral curvature of the spine

Scoliosis

KyphosisLordosis

Fractures - Fractures - broken bonebroken bone greenstick fxgreenstick fx:: bone is partially bent and only partially bone is partially bent and only partially

brokenbroken usually longitudinal and occurs primarily in childrenusually longitudinal and occurs primarily in children

closed fxclosed fx: complete fx – bone is broken but there is no : complete fx – bone is broken but there is no open wound in the skinopen wound in the skin

transverse fxtransverse fx: straight across the bone: straight across the bone oblique fxoblique fx: at an angle: at an angle open fxopen fx: compound fx – bone is broken and there is an : compound fx – bone is broken and there is an

open wound in the skinopen wound in the skin comminuted fxcomminuted fx: the bone is splintered or crushed: the bone is splintered or crushed compression fxcompression fx: bone is pressed together on itself: bone is pressed together on itself spiral fxspiral fx: bone has been twisted apart – occurs as a : bone has been twisted apart – occurs as a

result of a severeresult of a severe twisting motion as in a sports injurytwisting motion as in a sports injury stress fxstress fx: small crack in bones that often develop from : small crack in bones that often develop from

chronic, excessive impact – usually due to a sports injurychronic, excessive impact – usually due to a sports injury

Diagnostic Procedures of the Diagnostic Procedures of the Skeletal SystemSkeletal System

arthrocentesisarthrocentesis: : surgical puncture of joint to remove synovial fluid surgical puncture of joint to remove synovial fluid for analysisfor analysis

arthroscopyarthroscopy: : visual exam of internal structure of joints, using an visual exam of internal structure of joints, using an arthroscopearthroscope

Bone density testing:Bone density testing: densitometry, use of radiation tests to densitometry, use of radiation tests to determine bone densitydetermine bone density

Bone marrow biopsyBone marrow biopsy: : insertion of a sharp needle into the hipbone insertion of a sharp needle into the hipbone or sternum and removing bone marrow cells, used to determine why or sternum and removing bone marrow cells, used to determine why blood cells are abnormal, also to find a donor matchblood cells are abnormal, also to find a donor match

Bone scanBone scan: use of nuclear medicine to detect bone cancer and : use of nuclear medicine to detect bone cancer and osteomyelitisosteomyelitis

Dual X-ray absorptiometryDual X-ray absorptiometry MRIMRI RadiographsRadiographs

arthrocentesis

arthroscopy

Bone density testing

Bone marrow biopsy and tools

X-rays

Treatment procedures for JointsTreatment procedures for Joints

arthroscopic surgeryarthroscopic surgery: : use of an arthroscope use of an arthroscope and other instruments to treat the interior of a and other instruments to treat the interior of a joint, ie: removal of torn cartilagejoint, ie: removal of torn cartilage

bursectomybursectomy:: surgical removal of a bursa surgical removal of a bursa chondroplastychondroplasty:: surgical repair of cartilage surgical repair of cartilage synovectomysynovectomy:: surgical removal of a synovial surgical removal of a synovial

membrane from a joint, used to repair a joint membrane from a joint, used to repair a joint damaged by rheumatoid arthritisdamaged by rheumatoid arthritis

arthrodesisarthrodesis:: fusion, surgical procedure to fusion, surgical procedure to stiffen a joint to join spinal vertebraestiffen a joint to join spinal vertebrae

arthrolysisarthrolysis:: surgical loosening of an ankylosed surgical loosening of an ankylosed jointjoint

periosteotomyperiosteotomy:: incision thru the periosteum incision thru the periosteum

arthroscopy bursectomychondroplasty

synovectomy arthrodesis

ArthroplastyAnd

prosthesis

Joint ReplacementJoint Replacement

arthroplastyarthroplasty: : surgical repair of a surgical repair of a damaged joint – surgical replacement of a damaged joint – surgical replacement of a jointjoint

prosthesisprosthesis:: implant or substitute for implant or substitute for diseased or missing part of the bodydiseased or missing part of the body

total knee replacementtotal knee replacement partial knee replacementpartial knee replacement total hip replacementtotal hip replacement revision surgeryrevision surgery

Spinal ColumnSpinal Column

diskectomydiskectomy: : surgical removal of an surgical removal of an intervertebral diskintervertebral disk

percutanious diskectomypercutanious diskectomy:: thin tube is inserted thin tube is inserted thru skin of the back – suction is used to remove thru skin of the back – suction is used to remove ruptured disk or vaporize it with a laserruptured disk or vaporize it with a laser

laminectomylaminectomy:: surgical removal of the lamina surgical removal of the lamina from vertebraefrom vertebrae

spinal fusionspinal fusion:: immobilize part of the spine by immobilize part of the spine by fusing 2 or more vertebraefusing 2 or more vertebrae

BonesBones craniectomycraniectomy: : surgical removal of a portion of surgical removal of a portion of

the skullthe skull craniotomycraniotomy:: bone flap – surgical incision or bone flap – surgical incision or

opening into the skull that is performed to gain opening into the skull that is performed to gain access to part of the brainaccess to part of the brain

cranioplastycranioplasty:: surgical repair of the skull surgical repair of the skull osteoclasisosteoclasis:: surgical fx of bone to correct a surgical fx of bone to correct a

deformitydeformity ostectomyostectomy:: surgical removal of bone surgical removal of bone osteoplastyosteoplasty:: surgical repair of bones surgical repair of bones osteorrhaphyosteorrhaphy:: suturing or wiring together of suturing or wiring together of

bonesbones osteotomyosteotomy:: surgical incision or sectioning of a surgical incision or sectioning of a

bonebone

Treatment of FracturesTreatment of Fractures

manipulation:manipulation: attempted realignment of the bone attempted realignment of the bone (closed reduction)(closed reduction)

traction:traction: pulling force exerted on a limb in a distal pulling force exerted on a limb in a distal direction in an effort to return the bone or joint to normal direction in an effort to return the bone or joint to normal alignmentalignment

immobilization:immobilization: holding or suturing or fastening the holding or suturing or fastening the bone in a fixed position (ie casting)bone in a fixed position (ie casting)

External FixationExternal Fixation fx treatment where pins are place thru the soft tissues fx treatment where pins are place thru the soft tissues

and bone for the use of external appliance to hold pieces and bone for the use of external appliance to hold pieces of bone firmly in place during healingof bone firmly in place during healing

ex fix removed after healingex fix removed after healing

Internal FixationInternal Fixation open reduction – fx in treated with pins or a plate placed open reduction – fx in treated with pins or a plate placed

directly into bone to hold broken pieces in placedirectly into bone to hold broken pieces in place not usually removed after healing occursnot usually removed after healing occurs