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Care of the Patient with a Musculoskeletal Disorder PN 135.

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Presentation on theme: "Care of the Patient with a Musculoskeletal Disorder PN 135."— Presentation transcript:

1 Care of the Patient with a Musculoskeletal Disorder PN 135

2 Overview of Anatomy and Physiology Divisions of the skeleton – Axial- Cranium (skull, face, and ears), vertebrae, ribs – Appendicular Limbs, shoulders, pelvis, hips

3 Divisions of Skeleton 206 bones total Axial skeleton – 80 bones – Head & trunk Appendicular skeleton – 126 bones – Extemeties, shoulders, hips

4 Figure 44-2 Skeleton, anterior view. (From Thibodeau, G.A., Patton, K.T. [1997]. The human body in health and disease. [2 nd ed.]. St. Louis: Mosby.)

5 Figure 44-3 Skeleton, posterior view. (From Thibodeau, G.A., Patton, K.T. [1997]. The human body in health and disease. [2 nd ed.]. St. Louis: Mosby.)


7 Overview of Anatomy and Physiology Functions of the skeletal system – Support – Protection – Mineral storage-calcium/phosphorus – Movement – Hemopoiesis Structure of bones – Long, short, flat, and irregular

8 Functions of the Skeletal System Support – Rigid framework – Supports against pull of gravity – “hanger” for our muscles!

9 Functions of the Skeletal System Protection – Soft body parts – Brain – Heart – Lungs – Vascular system

10 Functions of the Skeletal System Movement – Provide sites for muscle attachment – Bones and muscles work together as simple mechanical lever systems to produce body movements.

11 Functions of the Skeletal System Mineral Storage – The bones serve as a storage specifically for 2 minerals—calcium and phosphorus – Intercellular matrix of bone contains large amounts of… Calcium When blood calcium levels drop Calcium is released from the bones Excess Calcium is stored in the bone

12 Functions of the Skeletal System Storage – Bone tissue contains smaller amounts of… Sodium Magnesium Potassium Carbonate

13 Functions of the Skeletal System Hematopoesis – Blood cell formation – Takes place in red marrow of bones – Infants primarily have red marrow – As we age red marrow changes to yellow marrow for fat storage

14 Functions of the Skeletal System Hematopoesis (cont.) – Adults Red marrow is limited to the spongy bone – Skull – Ribs – Sternum – Clavicles – Vertebrae – Pelvis

15 Functions of the Skeletal System Red Marrow Functions – Formation of… Red Blood Cells White Blood Cells Blood Platelets

16 Functions of the Skeletal System Red Marrow (summary) – Manufactures blood cells – Found in ends of long bones – Center of other bones Yellow Marrow (summary) – Shaft of long bones – Composed largely of fat

17 Bones Bones stop growing in length by late teens, early 20’s Children- bone repair is much faster Elderly- past active phase, repair takes longer, bones more fragile

18 Types of Bone Types of Osseous/Bone Tissue Cancellous – Spongy Epiphysis, end of long bone & center or others Filed with red marrow Cortical – Compact Diaphysis, shaft of long bone Outer layer of other bones Haversion canal contains nerves and blood vessels

19 Types of Bones Short bones and flat bones – Cancellous/spongy covered by Cortical/compact Irregular – e.g. vertebrae Long bones – Ends are Cancellous/Spongy – Shafts are Cortical/Compact

20 Types of Bone Four classifications based on form and shape: – 1. Long – eg. Humerus – 2. Short – eg. Phalanges of the fingers – 3. Flat – eg. Occipital, sternum – 4. Irregular - eg. Vertebrae


22 Classification Long Bones: longer than they are wide Short Bones: – roughly cube-shaped – Vertical and horizontal dimensions approx. = – E.g. Wrist, ankle

23 Classification Flat bones: – Thin, flattened, usually curved – Made like sandwich with a middle layer of spongey bone called diploӫ. The diploӫ is covered on each side by a layer of compact bone. – E.g. Cranium

24 Classification Irregular Bones – One of a group of bones having peculiar or complex forms E.g vertebrae

25 Structure of Bones


27 Bone Membranes Periosteum – Membrane on outside of bone – Contain osteoblasts Endosteum – Lines marrow cavity – Cells aid in growth and repair

28 Bone Cells and Actions Osteoblasts- build bone Osteocytes- are mature bone cells Osteoclasts- break bone down

29 Projections Head- rounded knob – At end of bone – E.g. ____________________ Process- large projection – E.g. Spinous process on vertabrae Crest- border or ridge – E.g. __________________ Spine- sharp projection – E.g. spine of scapula


31 Depressions or Holes Foramen- hole allows vessel or nerve to pass through Sinus- air space in some skull bones Fossa- depression Meatus- short channel or passage – E.g. Passage to inner ear

32 12 Ribs True Ribs – First seven pair – Attach to sternum by costal cartilage False Ribs – Next five pair 8 th, 9 th, & 10 th attach to rib above 11 th & 12 th have no anterior attachment (Floating ribs)

33 Vertebral Column Cervical vertebrae- 7, support & move head Thoracic vertebrae- 12, ribs attached here Lumbar vertebrae- 5, support weight Sacral vertebrae- 5, fuse to single bone Coccyx – 4-5 in child – Fuse to 1 in adult

34 Bones and Joints

35 Bursa – Fluid-filled sacs – Joint movement Fascia – Connective tissue – Includes tendons, ligaments, and aponeuroses Tendons – Attach muscle to bones Ligaments – Bind joints together

36 Overview of Articulations Articulations (joints)  Connect bones and allow movement – Three types according to degree of movement Synarthrosis—no movement Amphiarthrosis—slight movement Diarthrosis—free movement

37 Joints Diarthrosis-freely moveable – Hinge: elbow, knee – Ball and socket: hip and shoulder – Pivot: skull and 1 st vertabrae Synarthrosis-immovable – Sutures Amphiarthrosis-slightly movable – Vertebrae and pelvis

38 Diarthrosis Hinge: permitting only flexion and extension as in the elbow and knee joints. Gliding: Flat or slightly flat surfaces move against each other allowing sliding or twisting. This happens in the carpals in the wrist and the tarsals in the ankle.

39 Diarthrosis Ball-and-Socket: The ball-shaped end of one bone fits into a cup shaped socket on the other bone allowing the widest range of motion including rotation. Examples include the shoulder and hip. Pivot: An example is the joint between the axis and atlas in the neck.

40 Diarthrosis Articulating Joints – Covered with articular cartilage – Have joint capsules Outer layer-fibrous Inner layer- synovial, secretes synovial fluid to lubricate joints

41 Types of Joints

42 Structure of a freely movable (diarthrotic) joint.

43 Synovial Joint Movement Flexion-decreases angle between bones (close fingers) Extension-increases angle between bone (open fingers) Abduction-movement away from midline Adduction-movement toward midline


45 Joint Movement Rotation-twisting or turning – Supination-turn up – Pronation-turn down – Inversion-turning inward – Eversion-turning outward

46 Synarthrosis and Amphiarthrosis Fibrous joint – Fibrous connective tissue – E.g. sutures in skull – Immovable, synarthrosis Cartilaginous joint – Connected by cartilage – E.g. vertebrae and ribs connecting to sternum – Slightly movable, amphiarthrosis

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