Lec 1

Musculoskeletal System
1. Structure and Function of the Normal Musculoskeletal System

Functions of the Bones
Bones are living organs that actively contribute to the maintenance of the internal environment of the body. The skeletal system consists of bones and other structures that make up the joints of the skeleton. The types of tissue present are bone tissue, cartilage, and fibrous connective tissue.The functions of the bones are categorized as follow: 1. 2. 3. 4. Provides a framework that supports the body Protects some internal organs Contains and protects the red bone marrow Provides a storage site for excess calcium
The Skeletal System

y Parts of the skeletal system
y Bones (skeleton) y Joints y Cartilages y Ligaments
y Divided into two divisions

y Axial skeleton y Appendicular skeleton
Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Slide 5.1
Functions of Bones
y Support of the body y Protection of soft organs y Movement due to attached skeletal muscles y Storage of minerals and fats y Blood cell formation
Slide 5.2
Ctn. Structure and Function of the Normal Musculoskeletal System
Histology
Bone cells are called Osteocytes, and the matrix of bone is made of calcium salts and collagen. Bone matrix is non-living, but it changes constantly, with calcium that is taken from bone into the blood replaced by calcium from the diet (performed by osteocytes). Two types of bone tissue: 1. Compact bone looks solid but is very precisely structured. Compact bone is made of osteons or haversian systems, microscopic cylinders of bone matrix with osteocytes in concentric rings around central haversian canals. 2. Spongy bone, which does look rather like a sponge with its visible holes or cavities. The cavities in spongy bone often contain red bone marrow, which produces red blood cells, platelets, and the five kinds of white blood cells.
Bones of the Human Body

y The skeleton has 206 bones y Two basic types of bone tissue
y Compact bone
y Homogeneous
y Spongy bone
y Small needle-like pieces of bone
Figure 5.2b
y Many open spaces

Slide 5.3
Classification of Bones on the Basis of Shape
Figure 5.1
Slide 5.4c
Gross Anatomy of a Long Bone

y Diaphysis
y Shaft y Composed of compact bone
y Epiphysis
y Ends of the bone y Composed mostly of spongy bone
Figure 5.2a
Slide 5.6
Structures of a Long Bone

y Periosteum
y Outside covering of the diaphysis y Fibrous connective tissue membrane
y Sharpeys fibers
y Secure periosteum to underlying bone
y Arteries
y Supply bone cells with nutrients
Figure 5.2c
Slide 5.7

y Articular cartilage
y Covers the external surface of the epiphyses y Made of hyaline cartilage y Decreases friction at joint surfaces
Figure 5.2a
Slide 5.8a

y Medullary cavity
y Cavity of the shaft y Contains yellow marrow (mostly fat) in adults y Contains red marrow (for blood cell formation) in infants
Figure 5.2a
Slide 5.8b
Bone Markings
y Surface features of bones y Sites of attachments for muscles, tendons, and ligaments y Passages for nerves and blood vessels y Categories of bone markings
y Projections and processes grow out from the bone surface y Depressions or cavities indentations
Slide 5.9
Microscopic Anatomy of Bone

y Osteon (Haversian System)
y A unit of bone
y Central (Haversian) canal

y Opening in the center of an osteon y Carries blood vessels and nerves
y Perforating (Volkmans) canal

y Canal perpendicular to the central canal y Carries blood vessels and nerves
Slide 5.10a
Figure 5.3
Slide 5.10b

y Lacunae
y Cavities containing bone cells (osteocytes) y Arranged in concentric rings
y Lamellae
y Rings around the central canal y Sites of lacunae
Figure 5.3
Slide 5.11a

y Canaliculi
y Tiny canals y Radiate from the central canal to lacunae y Form a transport system
Figure 5.3
Slide 5.11b
Changes in the Human Skeleton

y In embryos, the skeleton is primarily hyaline cartilage y During development, much of this cartilage is replaced by bone y Cartilage remains in isolated areas
y Bridge of the nose y Parts of ribs y Joints
Slide 5.12
Bone Growth
y Epiphyseal plates allow for growth of long bone during childhood
y New cartilage is continuously formed y Older cartilage becomes ossified y Cartilage is broken down y Bone replaces cartilage
Slide 5.13a
Bone Growth
y Bones are remodeled and lengthened until growth stops

y Bones change shape somewhat y Bones grow in width
Slide 5.13b
Long Bone Formation and Growth
Figure 5.4a
Slide 5.14a
Long Bone Formation and Growth
Figure 5.4b
Slide 5.14b
Types of Bone Cells

y Osteocytes
y Mature bone cells
y Osteoblasts
y Bone-forming cells
y Osteoclasts
y Bone-destroying cells y Break down bone matrix for remodeling and release of calcium
y Bone remodeling is a process by both osteoblasts and osteoclasts

Slide 5.15
Factors that affect bone growth and maintenance

Heredity: each person has a genetic potential for height, that is, a maximum height, with genes inherited from both parents. Nutrition: nutrients are the raw materials of which bones are made. Calcium, phosphorus, and protein become part of the bone matrix itself. Vitamin D is needed for the efficient absorption of calcium and phosphorus by the small intestine. Hormones: endocrine glands produce hormones that stimulate specific effects in certain cells. Affective hormones are growth hormone, thyroxine, parathyroid hormone, and insulin. Exercise or stress: for bones, exercise means bearing weight, which is just what bones are specialized to do.
Terminology of Bone Markings: o o o o o o o o o Foramen: a hole or opening Meatus: a tunnel-like cavity Condyle: a rounded projection Fossa: a depression Process: a projection Plate: a flat projection Crest: a ridge or edge Facet: a flat projection Tubercle: a round projection
Bone Fractures
y A break in a bone y Types of bone fractures
y Closed (simple) fracture break that does not penetrate the skin y Open (compound) fracture broken bone penetrates through the skin
y Bone fractures are treated by reduction and immobilization

y Realignment of the bone
Slide 5.16
Common Types of Fractures
Table 5.2
Slide 5.17
Repair of Bone Fractures

y Hematoma (blood-filled swelling) is formed y Break is splinted by fibrocartilage to form a callus y Fibrocartilage callus is replaced by a bony callus y Bony callus is remodeled to form a permanent patch
Slide 5.18
Stages in the Healing of a Bone Fracture
Figure 5.5
Slide 5.19
The Axial Skeleton

y Forms the longitudinal part of the body y Divided into three parts
y Skull y Vertebral column y Bony thorax
Slide 5.20a
The Axial Skeleton
Figure 5.6
Slide 5.20b
The Skull
y Two sets of bones
y Cranium y Facial bones
y Bones are joined by sutures y Only the mandible is attached by a freely movable joint
Slide 5.21a
The Skull
Figure 5.7
Slide 5.21b
Bones of the Skull
Figure 5.11
Slide 5.22
Human Skull, Superior View
Figure 5.8
Slide 5.23
Human Skull, Inferior View
Figure 5.9
Slide 5.24
Paranasal Sinuses
y Hollow portions of bones surrounding the nasal cavity
Figure 5.10
Slide 5.25a
Paranasal Sinuses
y Functions of paranasal sinuses
y Lighten the skull y Give resonance and amplification to voice
Figure 5.10
Slide 5.25b
The Hyoid Bone

y The only bone that does not articulate with another bone y Serves as a moveable base for the tongue
Figure 5.12
Slide 5.26
The Fetal Skull
y The fetal skull is large compared to the infants total body length
Figure 5.13
Slide 5.27a
The Fetal Skull

y Fontanelles fibrous membranes connecting the cranial bones
y Allow the brain to grow y Convert to bone within 24 months after birth
Figure 5.13
Slide 5.27b
The Vertebral Column

y Vertebrae separated by intervertebral discs y The spine has a normal curvature y Each vertebrae is given a name according to its location
Figure 5.14
Slide 5.28
Vertebral Column
The vertebral column (spinal column or backbone) is made of individual bones called vertebrae. The names of vertebrae indicate their location along the length of the spinal column. There are 7 cervical vertebrae, 12 thoracic, 5 lumbar, 5 sacral fused into 1 sacrum, and 4 to 5 small coccygeal vertebrae fused into 1 coccyx. The seven cervical vertebrae are those within the neck. The first vertebra is called the atlas, which articulates with the occipital bone to support the skull and forms a pivot joint with the odontoid process of the axis, the second cervical vertebra. This pivot joint allows us to turn our heads from side to side. The coccyx is the remnant of tail vertebrae, and some muscles of the perineum (pelvic floor) are anchored to it.
Vertebras form the vertebral canal, a continuous tunnel within the bones that contains the spinal cord and protects it from mechanical injury. The bodies of adjacent vertebrae are separated by discs of fibrous cartilage. These discs cushion and absorb shock and permit some movement between vertebrae (symphysis joints). Herniated Disc (ruptured disc): An intervertebral disc has a tough outer covering and a soft center called the nucleus pulposus. Extreme pressure on a disc may rupture the outer layer and force the nucleus pulposus out. This may occur when a person lifts a heavy object improperly, that is, using the back rather than the legs and jerking upward, which puts sudden, intense pressure on the spine. Most often this affects discs in the lumbar region.
Structure of a Typical Vertebrae
Figure 5.16
Slide 5.29
1.
Abnormalities of the curves of the spine: Scoliosis: an abnormal lateral curvature, which may be congenital, the result of having one leg longer than the other, or the result of chronic poor posture during childhood while the vertebrae are still growing. Usually the thoracic vertebrae are affected, which displaces the rib cage to one side. In severe cases, the abdominal organs may be compressed, and the expansion of the rib cage during inhalation may be impaired. Kyphosis: an exaggerated thoracic curve; sometimes referred to as hunchback. Lordosis: an exaggerated lumbar curve; sometimes referred to as swayback.
2.
3.
The Bony Thorax

y Forms a cage to protect major organs
Figure 5.19a
Slide 5.31a
The Bony Thorax

y Made-up of three parts
y Sternum y Ribs y Thoracic vertebrae
Figure 5.19a
Slide 5.31b
The Appendicular Skeleton
y Limbs (appendages) y Pectoral girdle y Pelvic girdle
Slide 5.32a
The Appendicular Skeleton
Figure 5.6c
Slide 5.32b
The Pectoral (Shoulder) Girdle

y Composed of two bones
y Clavicle collarbone y Scapula shoulder blade
y These bones allow the upper limb to have exceptionally free movement
Slide 5.33
Bones of the Shoulder Girdle
Figure 5.20a, b
Slide 5.34a
Bones of the Shoulder Girdle
Figure 5.20c, d
Slide 5.34b
Bones of the Upper Limb

y The arm is formed by a single bone
y Humerus
Figure 5.21a, b
Slide 5.35a
The forearm has two bones

Ulna Radius
Figure 5.21c
Slide 5.35b

y The hand
y Carpals wrist y Metacarpals palm y Phalanges fingers
Figure 5.22
Slide 5.36
Bones of the Pelvic Girdle

y Hip bones y Composed of three pair of fused bones
y Ilium y Ischium y Pubic bone
y The total weight of the upper body rests on the pelvis y Protects several organs
y Reproductive organs y Urinary bladder y Part of the large intestine
Slide 5.37
The Pelvis
Figure 5.23a
Slide 5.38a
Bones of the Lower Limbs
y The thigh has one bone

y Femur thigh bone
Figure 5.35a, b
Slide 5.40a
y The leg has two bones

y Tibia y Fibula
Figure 5.35c
Slide 5.40b

y The foot
y Tarsus ankle y Metatarsals sole y Phalanges toes
Figure 5.25
Slide 5.41
Arches of the Foot

y Bones of the foot are arranged to form three strong arches
y Two longitudinal y One transverse
Figure 5.26
Slide 5.42
Joints
y Articulations of bones y Functions of joints
y Hold bones together y Allow for mobility
y Ways joints are classified

y Functionally y Structurally
Slide 5.43
Functional Classification of Joints
y Synarthroses immovable joints y Amphiarthroses slightly moveable joints y Diarthroses freely moveable joints
Slide 5.44
Structural Classification of Joints

y Fibrous joints
y Generally immovable
y Cartilaginous joints
y Immovable or slightly moveable
y Synovial joints
y Freely moveable
Slide 5.45
Fibrous Joints
y Bones united by fibrous tissue y Examples
y Sutures y Syndesmoses
y Allows more movement than sutures y Example: distal end of tibia and fibula
Figure 5.27d, e
Slide 5.46
Cartilaginous Joints
y Bones connected by cartilage y Examples
y Pubic symphysis y Intervertebral joints
Figure 5.27b, c
Slide 5.47
Synovial Joints
y Articulating bones are separated by a joint cavity y Synovial fluid is found in the joint cavity
Figure 5.27fh
Slide 5.48
Features of Synovial Joints

y Articular cartilage (hyaline cartilage) covers the ends of bones y Joint surfaces are enclosed by a fibrous articular capsule y Have a joint cavity filled with synovial fluid y Ligaments reinforce the joint
Slide 5.49
Structures Associated with the Synovial Joint

y Bursae flattened fibrous sacs
y Lined with synovial membranes y Filled with synovial fluid y Not actually part of the joint
y Tendon sheath
y Elongated bursa that wraps around a tendon
Slide 5.50
The Synovial Joint
Figure 5.28
Slide 5.51
Types of Synovial Joints Based on Shape
Figure 5.29ac
Slide 5.52a
Types of Synovial Joints Based on Shape
Figure 5.29df
Slide 5.52b
Inflammatory Conditions Associated with Joints

y Bursitis inflammation of a bursa usually caused by a blow or friction y Tendonitis inflammation of tendon sheaths y Arthritis inflammatory or degenerative diseases of joints
y Over 100 different types y The most widespread crippling disease in the United States
Slide 5.53
Clinical Forms of Arthritis

y Osteoarthritis
y Most common chronic arthritis y Probably related to normal aging processes
y Rheumatoid arthritis
y An autoimmune disease the immune system attacks the joints y Symptoms begin with bilateral inflammation of certain joints y Often leads to deformities
Slide 5.54a
Clinical Forms of Arthritis
y Gouty Arthritis
y Inflammation of joints is caused by a deposition of urate crystals from the blood y Can usually be controlled with diet
Slide 5.54b
Developmental Aspects of the Skeletal System

y At birth, the skull bones are incomplete y Bones are joined by fibrous membranes fontanelles y Fontanelles are completely replaced with bone within two years after birth
Slide 5.55

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Musculoskeletal System

1. Structure and Function of the Normal Musculoskeletal System

The Skeletal System

y Divided into two divisions

Ctn. Structure and Function of the Normal Musculoskeletal System

Bones of the Human Body

y Many open spaces

Classification of Bones on the Basis of Shape

Gross Anatomy of a Long Bone

Structures of a Long Bone

Structures of a Long Bone

Structures of a Long Bone

Microscopic Anatomy of Bone

y Central (Haversian) canal

y Perforating (Volkmans) canal

Microscopic Anatomy of Bone

Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Microscopic Anatomy of Bone

Microscopic Anatomy of Bone

Changes in the Human Skeleton

y Bones are remodeled and lengthened until growth stops

Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Long Bone Formation and Growth

Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Long Bone Formation and Growth

Types of Bone Cells

y Bone remodeling is a process by both osteoblasts and osteoclasts

Ctn. Structure and Function of the Normal Musculoskeletal System

Factors that affect bone growth and maintenance

Ctn. Structure and Function of the Normal Musculoskeletal System

y Bone fractures are treated by reduction and immobilization

Ctn. Structure and Function of the Normal Musculoskeletal System

Common Types of Fractures

Repair of Bone Fractures

Stages in the Healing of a Bone Fracture

Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings

The Axial Skeleton

Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings

The Axial Skeleton

Bones of the Skull

Human Skull, Superior View

Human Skull, Inferior View

The Hyoid Bone

The Fetal Skull

The Fetal Skull

The Vertebral Column

Ctn. Structure and Function of the Normal Musculoskeletal System

Ctn. Structure and Function of the Normal Musculoskeletal System

Structure of a Typical Vertebrae

Ctn. Structure and Function of the Normal Musculoskeletal System

The Bony Thorax

The Bony Thorax

The Appendicular Skeleton

y Limbs (appendages) y Pectoral girdle y Pelvic girdle

Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings

The Appendicular Skeleton

The Pectoral (Shoulder) Girdle

Copyright 2003 Pearson Education, Inc. publishing as Benjamin Cummings

Bones of the Shoulder Girdle

Bones of the Shoulder Girdle

Bones of the Upper Limb

Bones of the Upper Limb