Skeletal System Assessment

• Support - the skeletal system provides structural support for the entire body.

  • Bones provide attachments for soft tissues and organs

• Storage - stores calcium salts for body fluids

  • Lipids are stored in yellow marrow for energy reserves

• Blood cell production - happens in the red marrow: red blood cells, white blood cells, and platelets.

• Protection - protects soft tissue and organs that it surrounds.

  • Ex. skull protecting brain, ribs protecting heart.

• Movement -  bones function as levers. Muscle pulls on bone to initiate movement.

• Macroscopic - general and visible features of the bones

  • ex) compact bone, spongy bone, marrow cavity

• Microscopic - features of the bone not visible to the human eye

  • ex) osteocytes, osteoclasts, osteoblasts

• Long

  • Longer than wide

  • Ex: humerus

• Short

  • Wider than long

  • Ex: carpal bones

• Flat

  • Broad

  • Ex: scapula

• Irregular

  • Complex

  • Ex: vertebrae

• Epiphysis = wider portions at each end

  • Proximal = round

  • Distal = looks like a heart

• Diaphysis = central shaft

• Articular Cartilage = covers the epiphyses

• Spongy Bone = aka cancellous bone, projections of bone separated by space like a sponge, found in epiphyses

• Compact Bone = densely packed, forms the diaphysis

• Marrow Cavity = bone marrow filling found in the diaphysis

• Endosteum = lines the marrow cavity and spongy bone

• Periosteum = the outer covering of bone

• Epiphyseal Line = aka growth plate, a cartilaginous plate located in the epiphyses

• Osteocytes:

  • Bone cells

  • Mature cells that maintain bone structure

• Osteoclasts

  • Large cells that secrete acid and enzymes

  • 50+ nuclei

• Osteons

  • Basic functional unit of compact bone

• Osteoblasts:

  • Help produce new bone

• Lacunae

  • Packers in the osteocytes

• Lamellae

  • Found between the sheets of the matrix in osteocytes

• Canaliculi

  • Small channels that connect the lacunae and other blood vessels and run through the matrix

• Trabeculae

  • Rods or plates that create an open network

  • Arrangement of spongy bone

• Ossification

  • Producing new bone

• Calcification

  • Calcium builds up in body tissue

  • Hardening the tissue

• Intramembranous ossification

  • Occurs during fetal development

  • Osteoblasts develop calcified matrix

  • Ossification happens (starting at the ossification center)

  • New bone created and develops body supply

    • Ex: spongy bones remodel into compact flat bones

• Endochondral ossification

  • Embryonic cartilaginous skeletal structures replaced by true bone

    • Chondrocytes enlarge and matrix begins to calcify

      • Causing chondrocytes to die as they are closed off from nutrients

    • Bones start forming at the shaft surface

      • Osteoblasts produce bone matrix

    • Blood vessels invade the inner region of cartilage

      • New osteoblasts form spongy bone

    • Osteoclasts break down spongy bone

      • Forming marrow cavity

      • Epiphyseal cartilage continue to to enlarge

    • Center of the epiphyses calcifies

• Osteoblasts → form osteons

• Osteoclasts → destroy osteons

• Osteocytes → maintain the bone matrix

• Osteocytes in lacunae

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The turnover rate for bone is quite high, and in young adults almost ⅕ of the skeleton is recycled and replaced each year.

• Not every part of every bone is affected; regional and even local differences in the rate of turnover occur.

• For example, the spongy bone in the head of the femur may be replaced 2 or 3 times each year, whereas the compact bone remains largely untouched.

• Regular mineral turnover (bone remodeling) gives each bone the ability to adapt to new stresses.

• Heavily stressed bones become thicker and stronger and develop more pronounced surface ridges.

• Bones not subjected to ordinary stresses become thin and brittle.

• Degenerative changes occur after even brief periods of inactivity.

• Regular exercise is an important stimulus in maintaining normal bone structure.

When using a crutch the weight is taken off the injured leg, so the bone will become thinner and more brittle. After a few weeks, the unstressed leg will lose ⅓ of its bone mass. The bones rebuild just as quickly once they again carry their normal weight.

Calcium

• Calcium levels must be very carefully controlled as they play an important role in many physiological processes.

• Even small variations from the normal concentration affect cellular operations, and larger changes can cause a clinical crisis.

• Neurons and muscle cells are particularly sensitive to changes in calcium ion concentrations.

• If the calcium concentration in body fluids increases by 30%, neurons and muscle cells become unresponsive.

• If calcium levels decrease by 35%, they become so excitable that convulsions may occur.

• If calcium levels decrease by 50%, death occurs.

• However, our bodies closely regulate our calcium concentrations so that levels usually don’t fluctuate more than 10%.

• The hormones Parathyroid Hormone (PTH) from the parathyroid glands and calcitriol from the kidneys work together to elevate calcium levels in body fluids.

Their opp is calcitonin, a hormone from the thyroid gland that depresses calcium levels.

• Extreme loads

• Sudden impacts

• Stresses from unusual directions

Bones usually heal on their own so long as blood supply remains and the cellular components of the endosteum and periosteum survive.

The repair process can take from 4 months to well over a year.

• Extensive bleeding

  • Large blood clot → hematoma forms

• Internal callus forms

  • Spongy bones unite the inner edges

  • External callus of cartilage and bone stabilize the outer edges

• External callus is replaced by bone

• Swollen area at fracture site

  • Overtime the site will be remodeled

• Osteopenia

  • Inadequate ossification that naturally occurs when aging (30-40)

    • Osteoblastic activity begins to slow down

• Osteoporosis

  • Loss of bone mass that impairs normal functions and can lead to more fractures

• More common in women due to decline is circulating estrogen after menopause

• Tendons and ligaments where adjacent bones articulate at joints

• Process = any projection or bump

• Trochanter = a large, rough projection

• Tuberosity = a smaller, rough projection

• Tubercle = a small, rounded projection

• Spine = a pointed process

• Head = the expanded articular end of an epiphysis, separated from the shaft by a neck

• Neck = a narrow connection between the epiphysis and the diaphysis

• Condyle = a smooth, rounded articular process

• Trochlea = a smooth, grooved articular process shaped like a pulley

• Crest = not described

• Foramen = a rounded passageway for blood vessels or nerves

• Canal = a duct or channel

• Fissure = an elongated cleft or slit

• Sinus = a chamber within a bone, normally filled with air

Appendicular 126 appendicular bones 32 in the upper limb 31 in lower limb Axial 22 bones of the skill with 7 associated bones 6 auditory and hyoid Thoracic cage Composed of 24 ribs and sternum 26 bones of the vertebral column

• Partial

  • Break that does not go through the bone completely

• Complete

  • Fracture in which the bone goes through the skin and can be seen through the surface

• Closed

  • (known as simple fracture)

  • Bone that does not break

• Non-displaced

  • Break in which the two ends are lined up and not moves out of place

• Displaced

  • Break in which two ends are NOT lined up and are moved out of place

• Transverse

  • Break that occurs in a straight line

• Oblique

  • Break that occurs in a diagonal

• Greenstick

  • Partial fracture that occurs bones to break (in children)

• Impacted

  • Broken ends of bone that are jammed together by the force of injury

• Comminuted

  • Bone is broken in at least three different places with many fragments at the site

• Segmental

  • Bone is broken into two places ; floating segment between the two bones

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• Synarthrosis (immovable)

• Amphiarthrosis (slightly movable)

• Diarthrosis (freely movable)

• Fibrous and Cartilaginous

  • Limited movement

• synovial

  • Freely moveable

• Gliding

  • Flat or slightly curved surfaces

  • Movement is slight

• Hinge

  • Permit angular movement in one plane

  • Ex: closing and opening a door

• Pivot

  • Allows for rotation only

  • Ex: turning the head ; supinating or pronating the palm

• Condylar

  • Allows angular motion in two planes

• Saddle

  • Allows for circumduction ; not rotation

• Ball and socket

• Synovial fluid

  • Helps reduce friction

• Menisci

  • Additional synovial joint padding

• Fat pads

  • Cushions for joints

• Bursae

  • Packets of connective tissue that contain synovial fluid

  • Reduce friction and absorb shock

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axial

appendicular

3. axial

1. appendicular

1. appendicular

1. appendicular

1. axial

1. appendicular

1. appendicular

1. appendicular

1. axial

1. axial

1. axial

1. axial

1. appendicular

1. appendicular

1. appendicular

1. appendicular

1. axial

1. appendicular

1. appendicular

1. axial

1. axial

1. appendicular

1. axial

1. Fibrous - Limited movement

2. Cartilaginous - Limited movement

   1. Synovial - Freely moveable

1. Synarthrosis - Immovable

2. Amphiarthrosis - Slightly movable

   1. Diarthrosis - Freely movable

1. Gliding joints → have flattened or slightly curved faces, slide across one another

2. Hinge joints → permit angular movement in a single plane, like a door

3. Pivot joints → rotation only

4. Condylar joints → aka ellipsoid joints, oval articular face nestles within a depression on the opposing surface

5. Saddle joints → have articular faces that fit together like a rider in a saddle, each face is concave on one side and convex on the other, permits angular movement and circumduction

   1. Ball-and-Socket joints → the round head of one bone rests within the cup-shaped depression of another bone, all combinations of movements are possible

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1. • leg is going away from the body

1. leg is going towards the body

1. front double bicep flex

1. not bending your arm

1. putting ur shoulder down

1. raising your shoulders up

1. foot is pointed towards the opposite foot

1. foot is pointed away from the opposite foot

1. toes are facing down ; raising the heels up

lift toes up ; rocking back on the heel

- palm faces ground → palm faces face

palm faces face → palm faces ground

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