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Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley CHAPTER.

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Presentation on theme: "Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Medical Language, Second Edition Susan Turley CHAPTER."— Presentation transcript:

1 Copyright ©2011 by Pearson Education, Inc. Upper Saddle River, New Jersey All rights reserved. Medical Language, Second Edition Susan Turley CHAPTER Medical Language Second Edition Orthopedics 8

2 The medical specialty that studies the anatomy and physiology of the skeletal and muscular systems and uses diagnostic tests, medical and surgical procedures, and drugs to treat skeletal and muscular diseases.

3 Figure 8-1 The skeletal system

4 Anatomy and Physiology The Skeletal System – Bony framework on which the body is built – Composed of 206 bones, as well as cartilage and ligaments – Provides structural support for the body, works with the muscles to maintain body posture and produce movement, and protects the body's organs – Also known as the skeletomuscular system and the musculoskeletal system

5 Anatomy of the Skeletal System Axial Skeleton – Consists of the bones of the head, chest, and spine Appendicular Skeleton – Consists of the bones of the shoulders, arms, hips, and legs

6 Anatomy of the Skeletal System (cont’d) Bones of the Head – Cranium – Facial bones

7 Anatomy of the Skeletal System (cont’d) The cranium is made up of eight bones: – Frontal bone – Parietal bones – Occipital bone – Temporal bones – Sphenoid bone – Ethmoid bone

8 Figure 8-2 Side view of the cranium and facial bones

9 Anatomy of the Skeletal System (cont’d) There are 12 bones in the face: – Nasal bones – Vomer – Lacrimal bones – Zygomatic bones – Maxillary bones – Palatine bones – Mandible

10 Figure 8-3 Front view of the cranium and facial bones

11 Figure 8-4 Fontanel Reprinted from McMinn’s Color Atlas of Human Anatomy, 2/E. McMinn, Hutchings, Human Anatomy, 19,46,66,71,127,137,237,238. Copyright 2002, with permission from Elsevier.

12 Anatomy of the Skeletal System (cont’d) Other bones of the head are found in the ear and are called ossicles or the ossicular chain because they are arranged in a row: – Malleus – Incus – Stapes Hyoid bone (neck)

13 Anatomy of the Skeletal System (cont’d) Bones of the Chest – The chest contains the thorax or rib cage. 12 pairs of ribs (true ribs, false ribs, floating ribs) – Within the thorax is the thoracic cavity that contains the heart, lungs, and other structures.

14 Anatomy of the Skeletal System (cont’d) Bones of the Chest (cont’d) – The sternum, or breast bone, is in the center of the anterior thorax. – The sternum consists of the triangular-shaped manubrium, the body of the sternum, and the xiphoid process at the posterior tip.

15 Figure 8-5 Bones of the chest and shoulder

16 Anatomy of the Skeletal System (cont’d) Bones of the Neck and Back – Spine or backbone is a vertical column of bones that is also known as the spinal column or vertebral column – Composed of 24 individual vertebrae, plus the sacrum and coccyx – Supports the weight of the head, neck, and chest and protects the spinal cord

17 Anatomy of the Skeletal System (cont’d) The spinal column is divided into five regions: – Cervical vertebrae – Thoracic vertebrae – Lumbar vertebrae – Sacrum – Coccyx

18 Anatomy of the Skeletal System (cont’d) Cervical Vertebrae (C1-C7) – Cervical vertebrea are located in the neck. – C1 (the atlas) is directly below the occipital bone of the cranium. – C2 (the axis) fits into the atlas to form a joint that allows the head to move from side to side.

19 Anatomy of the Skeletal System (cont’d) Thoracic Vertebrae (T1-T12) – Thoracic vertebrae are located in the chest. – Each thoracic vertebra joins with one of the 12 pairs of ribs.

20 Anatomy of the Skeletal System (cont’d) Lumbar Vertebrae (L1-L5) – Located in the lower back – Larger than the cervical or thoracic vertebrae because they bear the weight of the head, neck, and trunk of the body

21 Anatomy of the Skeletal System (cont’d) Sacrum – A group of five fused vertebrae – Joins with the hip bones in the posterior pelvis Coccyx (tail bone) – A group of several small, fused vertebrae

22 Figure 8-6 Bones of the spinal column

23 Figure 8-7 Lumbar vertebra Reprinted from McMinn’s Color Atlas of Human Anatomy, 2/E. McMinn, Hutchings, Human Anatomy, 19,46,66,71,127,137,237,238. Copyright 2002, with permission from Elsevier.

24 Figure 8-8 The skeleton An anatomical illustration of the skeleton by Andreas Vasalius

25 Anatomy of the Skeletal System (cont’d) Bones of the Shoulder – Include two clavicles and two scapulae – Clavicle or collar bone is a thin, rodlike bone on each side of the anterior neck – Connects to the manubrium of the sternum and laterally to the scapula

26 Anatomy of the Skeletal System (cont’d) Bones of the Shoulder (cont’d) – Scapula, or shoulder blade, is a triangular-shaped bone on either side of the vertebral column in the upper back – Has a long, bony blade across its upper half that ends in a flat area (the acromion) that connects to the clavicle – The glenoid fossa, a shallow depression, is where the head of the humerus joins the scapula to make the shoulder joint

27 Figure 8-9 Bones of the shoulder

28 Anatomy of the Skeletal System (cont’d) Bones of the Upper Extremity – Upper and Lower Arm Humerus Radius Ulna

29 Anatomy of the Skeletal System (cont’d) Humerus – The long bone in the upper arm – Fits into the glenoid fossa of the scapula to form the shoulder joint and, at its distal end, joins with both the radius and the ulna to form the elbow joint

30 Anatomy of the Skeletal System (cont’d) Radius – One of the two bones in the forearm. – Lies on the thumb side of the forearm, and at its distal end, connects to the bones of the wrist.

31 Anatomy of the Skeletal System (cont’d) Ulna – Lies on the little finger side of the forearm. – At its proximal end is the olecranon, a large square projection that forms the point of the elbow. – At its distal end, the ulna connects to the bones of the wrist.

32 Figure 8-10 Bones of the upper extremity

33 Anatomy of the Skeletal System (cont’d) Wrist, Hand, and Fingers – Wrist contains eight small carpal bones arranged in two rows. – One row connects to the radius and ulna; the other row connects to the bones of the hand.

34 Anatomy of the Skeletal System (cont’d) Wrist, Hand, and Fingers (cont’d) – Each hand contains five individual metacarpal bones, one for each finger. – Each finger or digit contains three individual phalangeal bones or phalanges (except the thumb, which contains two). – The distal phalanx is the final bone at the very tip of each finger. – The fingers are also known as rays.

35 Anatomy of the Skeletal System (cont’d) Bones of the Hip – Pelvis includes the hip bones as well as the sacrum and coccyx of the vertebral column – Ilium – Ischium – Pubis or pubic bone

36 Anatomy of the Skeletal System (cont’d) Ilium – Most superior of the hip bones – Broad, flaring rim known as the iliac crest – Contains the acetabulum (the deep socket of the hip joint)

37 Anatomy of the Skeletal System (cont’d) Ischium – Most inferior of the hip bones – One of the “seat bones” that you sit on – Contains a large opening that is covered by a fibrous membrane and is the point of attachment for tendons of some muscles of the hip

38 Anatomy of the Skeletal System (cont’d) Pubis or Pubic Bone – Most anterior of the hip bones – A small, bridgelike bone whose two halves meet in the midline, where they form the pubic symphysis – Pubis also forms the inferior part of the acetabulum

39 Figure 8-11 Bones of the hip

40 Anatomy of the Skeletal System (cont’d) Bones of the Lower Extremity – Upper and Lower Leg Femur Tibia Fibula Patella

41 Anatomy of the Skeletal System (cont’d) Femur or Thigh Bone – The long bone in the upper leg – Head of the femur fits into the acetabulum to form the hip joint

42 Anatomy of the Skeletal System (cont’d) Tibia or Shin Bone – The large bone on the medial side of the lower leg

43 Anatomy of the Skeletal System (cont’d) Fibula – The very thin bone on the lateral side of the lower leg – Proximal end connects to the tibia, not to the femur, and it is not a weight-bearing bone in the leg

44 Anatomy of the Skeletal System (cont’d) Patella or Kneecap – A small, round bone anterior to the knee joint – Most prominent in thin people and when the knee is partially bent

45 Figure 8-12 Bones of the lower extremity

46 Anatomy of the Skeletal System (cont’d) Ankle, Foot, and Toes – Each ankle contains seven tarsal bones: Talus (the first tarsal bone) Calcaneus or heel bone Midfoot contains five metatarsal bones, one for each toe Instep, or arch of the foot, contains both tarsal bones and metatarsal bones

47 Anatomy of the Skeletal System (cont’d) Ankle, Foot, and Toes (cont’d) – Each toe or digit contains three phalangeal bones or phalanges (except the great toe, which contains two). – The distal phalanx is at the very tip of the toe. – The toes are also known as rays. – The great toe is known as the hallux.

48 Figure 8-13 Bones of the ankle and foot

49 Anatomy of the Skeletal System (cont’d) Joints, Cartilage, and Ligaments – A joint, or articulation, is where two bones come together. – Three types of joints: Suture Symphysis Synovial

50 Anatomy of the Skeletal System (cont’d) Joints, Cartilage, and Ligaments (cont’d) – A suture joint between two cranial bones is immovable and contains no cartilage. – A symphysis joint, such as the pubic symphysis or the joints between the vertebrae, is a slightly moveable joint and contains a fibrocartilage pad or disk. – A synovial joint is a fully moveable joint.

51 Figure 8-14 Suture joint

52 Anatomy of the Skeletal System (cont’d) Joints, Cartilage, and Ligaments (cont’d) – Two kinds of synovial joints: Hinge joints (the elbow and knee) Ball-and-socket joints (the shoulder and hip) – A synovial joint joins two bones whose ends are covered with articular cartilage.

53 Anatomy of the Skeletal System (cont’d) Joints, Cartilage, and Ligaments (cont’d) – Ligaments hold the two bones together in a synovial joint. – The entire joint is encased in a joint capsule, with the synovial membrane producing synovial fluid that lubricates the joint.

54 Figure 8-15 Synovial joint

55 Joint Classification Animation Click on the screenshot to view an animation on the topic of joint classification. Back to Directory

56 Joint Movement Animation Click on the screenshot to view an animation on the topic of joint movement. Back to Directory

57 The Structure of Bone Bone, or osseous tissue, is a type of connective tissue. The surface of a bone is covered with periosteum, a thick, fibrous membrane. A long bone such as the humerus or femur has a straight shaft or diaphysis and two widened ends or epiphyses. Bone growth takes place at the epiphysial plates.

58 The Structure of Bone (cont’d) Along the diaphysis is a layer of dense compact cortical bone for weight bearing. Inside this is the medullary cavity, which is filled with yellow bone marrow that contains fatty tissue. In each epiphysis is cancellous bone, or spongy bone.

59 Figure 8-16 Structure of a bone

60 Physiology of Bone Growth Ossification is the gradual replacing of cartilage by bone that takes place during childhood and adolescence. New bone is formed along the epiphysial growth plates at the ends of long bones as the body grows taller.

61 Physiology of Bone Growth (cont’d) About 10% of the entire skeleton is broken down and rebuilt each year; this process occurs in areas that are damaged or subjected to mechanical stress. Osteoclasts break down areas of old or damaged bone. Osteoblasts deposit new bone tissue in those areas.

62 Physiology of Bone Growth (cont’d) Osteocytes maintain and monitor the mineral content (calcium, phosphorus) of the bone. Almost all of the body’s calcium is stored in the bones, but calcium is needed to help the heart and skeletal muscles contract.

63 Physiology of Bone Growth (cont’d) As osteoclasts break down old or damaged bone, the calcium in that bone is released and made available to the rest of the body.

64 Figure 8-17 Pediatric growth chart

65 Diseases and Conditions Diseases of the Bones and Cartilage – Avascular necrosis – Bone tumor – Chondroma – Chondromalacia patellae – Fracture

66 Table 8-1 Fracture Names and Descriptions

67 Table 8-1 (cont’d) Fracture Names and Descriptions

68

69

70

71

72 Diseases and Conditions (cont’d) Diseases of the Bones and Cartilage (cont’d) – Osteomalacia – Osteomyelitis – Osteoporosis

73 Figure 8-19 Normal bone versus bone with osteoporosis ESRF-CREATIS/Phanie Agency/Photo Researchers, Inc.

74 Diseases and Conditions (cont’d) Diseases of the Vertebrae – Ankylosing spondylitis – Kyphosis – Lordosis – Scoliosis – Spondylolisthesis

75 Figure 8-20 Kyphosis Dr. P. Marizzi/Photo Researchers, Inc.

76 Figure 8-21 Scoliosis Princess Margaret Rose Orthopaedic Hospital, Edinburgh, Scotland/Science Photo Library/Photo Researchers, Inc.

77 Diseases and Conditions (cont’d) Diseases of the Joints and Ligaments – Arthralgia – Arthropathy – Dislocation – Gout – Hemarthrosis

78 Diseases and Conditions (cont’d) Diseases of the Joints and Ligaments (cont’d) – Lyme disease – Osteoarthritis – Rheumatoid arthritis – Sprain – Torn meniscus

79 Figure 8-22 Osteoarthritis Custom Medical Stock Photo, Inc.

80 Figure 8-23 Rheumatoid arthritis Custom Medical Stock Photo, Inc.

81 Diseases and Conditions (cont’d) Diseases of the Bony Thorax – Pectus excavatum

82 Diseases and Conditions (cont’d) Diseases of the Bones of the Legs and Feet – Genu valgum – Genu varum – Hallux valgus – Talipes equinovarus

83 Figure 8-24 Bilateral hallux valgus NMSB/ Custom Medical Stock Photo, Inc.

84 Figure 8-25 Bilateral clubfeet Shea, MD/ Custom Medical Stock Photo, Inc.

85 Laboratory and Diagnostic Procedures Laboratory Tests – Rheumatoid factor (RF) – Uric acid

86 Laboratory and Diagnostic Procedures (cont’d) Radiology and Nuclear Medicine Procedures – Arthrography – Bone density tests

87 Laboratory and Diagnostic Procedures (cont’d) Radiology and Nuclear Medicine Procedures – Bone scintigraphy – X-ray

88 Medical and Surgical Procedures Medical Procedures – Cast – Closed reduction – Extracorporeal shock wave therapy (ESWT)

89 Medical and Surgical Procedures (cont’d) Medical Procedures (cont’d) – Goniometry – Orthosis – Physical therapy

90 Medical and Surgical Procedures (cont’d) Medical Procedures (cont’d) – Prosthesis – Traction

91 Figure 8-29 Goniometer Patrick Watson/Pearson Education/PH College

92 Medical and Surgical Procedures (cont’d) Surgical Procedures – Amputation – Arthrocentesis – Arthrodesis

93 Medical and Surgical Procedures (cont’d) Surgical Procedures (cont’d) – Arthroscopy – Bone graft – Bunionectomy – Cartilage transplantation

94 Figure 8-31 Arthroscopic surgery Custom Medical Stock Photo, Inc.

95 Medical and Surgical Procedures (cont’d) Surgical Procedures (cont’d) – Bunionectomy – External fixation – Joint replacement surgery – Open reduction and internal fixation (ORIF)


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