Skeletal System Ch. 23. Dr. Ken Thorson

Transcription

1 Skeletal System Ch. 23 Dr. Ken Thorson

2 Lesson Objectives Upon completion of this lesson, students should be able to: 1.Define and spell the terms to learn for this chapter. 2.List the various types of bones in the body. 3.Identify specific bones for each bone classification.

3 Lesson Objectives Upon completion of this lesson, students should be able to: 4.Discuss the functions of the bones of the human skeleton. 5.Explain various types of joints and body movements. 6.Describe the axial skeleton. 7.Describe the appendicular skeleton.

4 Skeletal System Makes up framework of the human body Responsible for: Providing shape and support Protecting internal organs Serving as a storage place for mineral salts, calcium, and phosphorus

5 Skeletal System Responsible for: Plays important role in formation of blood cells Providing an area for attachment of skeletal muscles

6 Skeletal System Two divisions compose skeletal system 206 bones Axial skeleton made of 80 bones Appendicular skeleton consists of remaining 126 bones

7 FIGURE 23-1 Anterior and posterior human skeleton.

8 Bones and Their Classification Bones consist of 50 percent water Remaining 50 percent is a rigid, calcified substance known as osseous tissue Pearson's Comprehensive Medical Assisting: Administrative and Clinical Competencies, 3/e Beaman Routh Papazian-Boyce Sesser Mills Maly Copyright 2015, 2011 by Pearson Education, Inc. All Rights Reserved

9 FIGURE 23-2 Microscopic components of osseous tissue.

10 TABLE 23-1 Microscopic Components of Osseous Tissue

11 TABLE 23-1 (continued) Microscopic Components of Osseous Tissue

12 Bones and Their Classification Bones classified according to shape Six common shapes of bones are: Long Short Flat Irregular Sesamoid Sutural (wormian)

13 FIGURE 23-3 Classification of bones by shape.

14 Bones and Their Classification Six Main Functions of Bones Provide shape, support, framework of body Provide protection for body s internal organs Serve as a storage place for mineral salts, calcium, and phosphorus

15 Bones and Their Classification Six Main Functions of Bones Play important role in formation of blood cells as hemopoiesis takes place in bone marrow Provide area for attachment of skeletal muscle Help to make movement possible through articulation

16 Structure of a Long Bone Epiphysis Ends of a developing bone Diaphysis Shaft of the long bone Periosteum Membrane that forms the covering of bones, except at their articular surfaces

17 Structure of a Long Bone Compact bone Dense, hard layer of bone tissue Medullary canal Narrow space or cavity throughout the length of the diaphysis that contains yellow bone marrow, which is made of fat cells

18 Structure of a Long Bone Endosteum Tough, connective tissue membrane lining the medullary canal and containing the bone marrow Cancellous or spongy bone Reticular tissue that makes up most of the volume of bone

19 FIGURE 23-4 The features found in a long bone.

20 Bone Markings Condyle Crest Epicondyle Line Process Trochanter Tubercle Tuberosity

21 Joints and Movement A joint, called an articulation, is located at the place where two bones connect

22 Joints and Movement Joints classified according to the type of movement they provide Synarthrotic joint Produces no movement (Sutures- connect bones of the skull) Amphiarthrotic joint Permits very slight movement (intervertebral joints of spinal column) Diarthrotic joint Allows for free movement in a variety of directions (knee,elbow,shoulder)

23 FIGURE 23-5 A typical joint.

24 Joints and Movement Movements of the Body Abduction Moving a body part away from the midline Adduction Moving body part toward midline Circumduction Moving a body part in a circular motion

25 Joints and Movement Movements of the Body Dorsiflexion Bending a body part backward Eversion Turning outward Extension Straightening a flexed limb Flexion Bending (or curving) the spine

26 Joints and Movement Movements of the Body Inversion Turning inward Pronation Lying prone or face down; turning the hand so that the palm points downward Protraction Moving a body part forward

27 Joints and Movement Movements of the Body Retraction Moving a body part backward Rotation Moving body part around central axis Supination Lying supine or face upward; process of turning the palm or foot upward

28

29 TABLE 23-3 Movements of the Body

30 TABLE 23-3 (continued) Movements of the Body

31 FIGURE 23-7 A contrasting comparison of the axial and appendicular skeleton.

32 The Axial Skeleton Central portion of the skeleton Skull Sternum Ribs Vertebrae Sacrum Coccyx Head composed of 22 bones; skull has 8 bones, and bones of the face

33

34

35 The Axial Skeleton Vertebral column, which houses the spinal cord, consists of a series of vertebrae Vertebrae divided into five regions Cervical Thoracic Lumbar Sacral Coccyx, or tailbone

36 The Axial Skeleton Ribs Form protective cage that houses heart, lungs, other vital components of body Rib cage consists of 12 pairs of ribs divided into three categories: true, false, floating ribs

37

38

39 The Appendicular Skeleton Responsible for movement Upper extremities Lower extremities Clavicles Scapula Pectoral girdle

40 The appendicular skeleton.

41 The Appendicular Skeleton Upper extremity bones Humerus Radius Ulna Carpals Metacarpals Phalanges

42

43 The Appendicular Skeleton Lower extremity bones Femur Patella Tibia Fibula Tarsals Metatarsals Phalanges

44

45 FIGURE 23-13A The male pelvis

46 FIGURE 23-13B female pelvis The

47 Critical Thinking Questions 1.How can you remember the difference between the ulna and the radius? 2.How can you remember the difference between the carpals and metacarpals?

48 Common Disorders Associated with the Skeletal System Scoliosis Abnormal lateral curvature of the spine Often diagnosed early in toddlers, children, and adolescents Appears to have an S or C shape May often appear as if either their shoulders or their legs are uneven Treatment: orthopedic braces, physical therapy, and in severe cases, surgery

49 Common Disorders Associated with the Skeletal System Lordosis Often called swayback Exaggerated curvature of lumbar spine When diagnosed in adults, may be commonly found in those who are overweight and in pregnant women When diagnosed in children, most common symptom is prominently protruding abdomen and/or buttocks

50 Common Disorders Associated Lordosis with the Skeletal System Treatment depends on patient s overall health, age, and severity of condition Overall goal of treatment is to stop the curvature and prevent spinal deformity

51 Common Disorders Associated with the Skeletal System Kyphosis Sometimes known as humpback Exaggeration of thoracic curvature

52 Common Disorders Associated with the Skeletal System Kyphosis May be result of: Congenital defect Disease process Compression fracture Faulty posture, osteoarthritis Rheumatoid arthritis, rickets, osteoporosis, or other conditions

53 Common Disorders Associated with the Skeletal System Kyphosis Rounded appearance of upper back Fatigue, mild back pain, either tender or stiff feeling within the spine In severe cases, shortness of breath

54 Common Disorders Associated Kyphosis with the Skeletal System Treatment depends on overall health and age of patient as well as cause or source of disease Physical therapy or bone-strengthening medications

55 Kyphosis.

56 Lordosis.

57 Scoliosis.

58 Common Disorders Associated with the Skeletal System Arthritis Inflammation of one or more joints Causes include: Joint injury Autoimmune disorders Normal to excessive wear and tear on joints Can occur at any age Most commonly develops in older adults

59 Common Disorders Associated with the Skeletal System Arthritis Signs and symptoms vary with every patient Joint pain and swelling Morning stiffness Warmth and redness around a joint Decreased ability to move the joint

60 Common Disorders Associated Arthritis with the Skeletal System Treatment depends on age, occupation, other activities of patient, cause and severity, joint affected Modification to daily activities and low-impact aerobic exercise

61 Common Disorders Associated with the Skeletal System Arthritis Medications to reduce joint pain and swelling Application of heat or cold Joint protection Surgery

62 Common Disorders Associated with the Skeletal System Osteoarthritis Most common type of arthritis resulting from years of wear and tear on joints Most frequently occurs in hips, knees, and finger joints of elderly patients Obesity, history of trauma, various genetic and metabolic diseases increase the risk of osteoarthritis Referred to as degenerative joint disease (DJD)

63 Common Disorders Associated with the Skeletal System Osteoarthritis Swelling and fluid accumulation around joints Aching pain associated with changes in the weather Permanent joint deformity may occur

64 Common Disorders Associated with the Skeletal System Osteoarthritis Treatment Nonsteroidal antiinflammatory drugs (NSAIDs) Steroid injections to affected joint In severe cases, joint replacement

65 osteoarthritis

66 Common Disorders Associated with the Skeletal System Rheumatoid Arthritis Autoimmune disorder in which inflammation causes joints to become deformed Increased growth of both cartilage and bone Marked by inflammation, joint swelling, and joint deformity

67 Common Disorders Associated with the Skeletal System Rheumatoid Arthritis Morning joint stiffness very common Fatigue and loss of appetite Smaller joints of body are affected along with the surrounding tissue

68 Common Disorders Associated with the Skeletal System Rheumatoid Arthritis There is no cure Early detection, diagnosis, and treatment may deter pain and joint decay

69 Common Disorders Associated with the Skeletal System Rheumatoid Arthritis Medications Antirheumatic drugs Nonsteroidal antiinflammatory drugs Corticosteroids Heat and cold treatments Low impact exercises

70 rheumatoid arthritis.

71 Common Disorders Associated with the Skeletal System Gouty Arthritis Also called gout Caused by formation and accumulation of uric acid crystals in the joints that result from high levels of uric acid in bloodstream Accumulation of these crystals leads to inflammation Gouty joint often very warm and very sore to the touch

72 Common Disorders Associated with the Skeletal System Gouty Arthritis After joints have been persistently affected by gout, they may become disfigured Medications available to reduce uric acid Diet rich in colorful fruits and vegetables Dietary restrictions include avoiding caffeine, alcohol, liver, and other purine-rich foods

73 Gouty arthritis of the finger joint.

74 Common Disorders Associated with the Skeletal System Bursitis Bursa is small sac of fluid that cushions and lubricates an area where joint-related tissues rub against one another Bursitis is inflammation of the bursa Joint pain Limited joint mobility Swelling Tenderness surrounding the joint

75 Common Disorders Associated with the Skeletal System Bursitis Rest Pain medication Steroid injections Aspiration of excess fluid from the bursa Antibiotics Physical therapy may be utilized to increase and promote joint movement

76 Common Disorders Associated with the Skeletal System Carpal Tunnel Syndrome Carpal tunnel narrow passageway in wrist Occurs when pressure placed on median nerve Repetitive movements involving the wrist may contribute to the condition

77 Common Disorders Associated with the Skeletal System Carpal Tunnel Syndrome Risk factors include obesity, diabetes, and rheumatoid arthritis Pain with numbness and hand weakness Hands and fingers may feel tingly, itchy, and swollen, even if swelling is not visibly present

78 Common Disorders Associated with the Skeletal System Carpal Tunnel Syndrome Wrist splints at night for several weeks Hot and cold compresses Resting the hand and wrist Proper ergonomics

79 Common Disorders Associated with the Skeletal System Carpal Tunnel Syndrome NSAIDs such as ibuprofen or naproxen to relieve pain and reduce inflammation Diuretics Injections of corticosteroids Surgical procedure

80 tendons and nerves involved in carpal tunnel syndrome.

81 Common Disorders Associated with the Skeletal System Fractures Bone cracks or breaks Classified based on: Site of fracture Nature of crack or break Whether or not fracture has caused a break in skin Diagnosed based on X-ray of the broken bone

82 Common Disorders Associated with the Skeletal System Types of Fractures Closed (simple) Does not involve a break in the skin and is completely internal. Open (compound) More dangerous fractures because fracture has broken through the skin. Risk of infection or hemorrhage is greater than with a closed fracture.

83 Common Disorders Associated with the Skeletal System Types of Fractures Comminuted Part of the bone is shattered into a multitude of bony fragments. Transverse Break the shaft of bone across its longitudinal access.

84 Photo

85 Common Disorders Associated with the Skeletal System Types of Fractures Greenstick Usually occurs in young children. Only one side of shaft is broken; the other side is bent, similar to breaking a green plant stick. Spiral Spread along length of a bone and produced by twisting stresses.

86 Common Disorders Associated with the Skeletal System Types of Fractures Pott Occur in the ankle and affect both bones of the lower leg (tibia and fibula). Compression Occur in vertebrae after severe stress, such as when someone falls and lands with significant amount of force.

87 Common Disorders Associated with the Skeletal System Types of Fractures Epiphyseal Commonly seen in children in areas of bone where growth plate is undergoing calcification and the chondrocytes are dying.

88 Various types of fractures.

89 Common Disorders Associated with the Skeletal System Fractures Generally casted by a physician At times, in severe fractures, surgical intervention must be performed Common that both pins and metal plating used to stabilize joints and bones during surgery Pain and antiinflammatory medications often prescribed for patient comfort

90 Common Disorders Associated with the Skeletal System Dislocations Occurs when a bone slips out of the joint Usually follows a blow, a fall, or other trauma Usually joint capsule and ligaments tear when a dislocation occurs Often the nerves are injured

91 Common Disorders Associated with the Skeletal System Dislocations May be visibly out of place Discolored Misshapen Limited in movement Bruised or swollen Intensely painful Very difficult to move the affected joint

92 Common Disorders Associated with the Skeletal System Dislocations Patients should seek emergency treatment in hospital or urgent care setting Many physicians offices not equipped to handle this injury Procedure known as reduction used to align and reposition the joint Pain relievers and antiinflammatory medications

93 Common Disorders Associated with the Skeletal System Osteoporosis Characterized by progression of loss of bone density and thinning of bone tissue Affects more than 25 million Americans, mostly women ages 50 to 70 years old Subject to increased fracture potential, especially in the hips, vertebrae, wrists

94 Critical Thinking Question 1.Why might an individual be more at risk for developing osteoporosis?

95 Common Disorders Associated with the Skeletal System Higher Risk of Developing Osteoporosis Family history of osteoporosis Those who do not engage in weight-bearing exercise as part of their lifestyle Caucasian women who have never been pregnant and experience early menopause Individuals with history of frequent corticosteroid use

96 Common Disorders Associated with the Skeletal System Higher Risk of Developing Osteoporosis Individuals who excessively smoke, drink alcohol, and consume diets high in salt, fat, and caffeine Individuals who have insufficient intake of calcium or vitamin D

97 Common Disorders Associated with the Skeletal System Osteoporosis Decreased height and stooped posture Back pain and frequent fractures Treatment includes: Calcium and vitamin D supplementation Medications to help preserve calcium and decrease bone loss Exercise

98 Common Disorders Associated with the Skeletal System Hallux Valgus Also called a bunion Enlargement of inner portion of metatarsophalangeal joint at base of big toe Reddened skin surrounds the inflamed joint of the big toe Joint may be filled with fluid and feel tender to the touch

99 Common Disorders Associated with the Skeletal System Hallux Valgus Properly fitting shoes should be worn Proper padding and cushioning of the joint Pain medications and antiinflammatory medications

100 Common Disorders Associated with the Skeletal System Hallux Valgus Foot surgery may be required for severe cases Patient may need to be fitted with special adaptive shoes made by orthopedic shoe specialist

101 Common Disorders Associated with the Skeletal System Hammer Toe Toe bends into hammer shape or claw shape because of abnormal flexion of proximal interphalangeal joint Frequently caused by wearing shoes that are too narrow or too short or wearing extremely high heels that force the toe to bend Pain and visible joint deformation

102 Common Disorders Associated with the Skeletal System Hammer Toe Toe bends into hammer shape or claw shape because of abnormal flexion of proximal interphalangeal joint Frequently caused by wearing shoes that are too narrow or too short or wearing extremely high heels that force the toe to bend Pain and visible joint deformation

103 Common Disorders Associated Rickets with the Skeletal System Early childhood disease caused by deficiency in calcium, vitamin D, and phosphate Results in bone deformities, especially bowed legs Genetics may increase risk of developing rickets

104 Common Disorders Associated with the Skeletal System Rickets Pain and tenderness of the bones Increased likelihood of bone breakage Impaired growth and decreased height Muscle cramps Treatment: increasing vitamin and mineral intake and comfort measures, including rest and heat and ice applications

105 Common Disorders Associated with the Skeletal System Osteomalacia Adult onset of rickets Causes: deficiencies in calcium and vitamin D Additional causes: cancers, liver disease, kidney failure, side effects associated with antiseizure medications

106 Common Disorders Associated with the Skeletal System Osteomalacia Bone pain, bowing legs, frequent fractures Treatment similar to rickets: increasing vitamin and mineral intake and comfort measures to relieve symptoms