1. Musculoskeletal System
Chapter 15
Musculoskeletal System

2. Musculoskeletal System
1. Bones (oste/o=bone)- provides the framework around which the body is constructed and protect and support internal organs
2. Joints (arthr/o; articul/o= joint)- places at which bones come together
3. Muscles (my/o; myos/o=muscle)- attached to bones, or to internal organs and blood vessels. They are responsible for movement

3. Terms
-Orthopedic- (orth/o= straight; ped/i= child); physicians who treat bone & joint disease
-Rheumatologist- (rheumat/o= watery flow); one who specializes in the study of joint diseases (because joint diseases are marked by collection of fluid in joint spaces
Chiropractor- (chir/o= hand)- use physical means to manipulate the spinal column
-Osteopathy- (oste/o=bone; path= disease)- p/t to diseases of the bone
Osteopathic physicians (DO)

4. Bones
-Complete organs composed of connective tissue called osseous (bony) tissue ; plus a rich supply of blood vessels and nerves
Osseous tissue consists of osteocytes (bone cells), collagen (dense connective tissue), and calcium salts
Ossification- bone formation
Osteoblasts- immature osteocytes that produce bony tissue that replaces cartilage during ossificationa
Osteoclasts- (-clast=to break); large cells that function to reabsorb, digest bony tissue. They enlarge the inner bone cavity so bones do not become too heavy
*Calcium and Phosphorus are minerals necessary to produce enzymes to give bones strength

5. Structure of bones 206 bones in the body
Long bones- found in thigh, lower leg, and upper and lower arm; strong and broad at end where they join other bones. They have large surface areas for muscle attachment.
Short bones- found in wrist and ankle and are small with irregular shapes
Flat bones- cover soft body parts
Sesamoid bones- small, round and resembles a sesame seed in shape. They are found near joint.
What is the largest sesamoid bone in the body?
____________________

6. Structure of bones Diaphysis- shaft or middle region of a long bone
Epiphysis- end of the long bones
Metaphysis- flared portion of the bone
Periosteum- strong, fibrous, vascular membrane that covers the surface of long bones
Articular cartilage- where the ends of long bones and the surface of any bone meet
*the bones of a fetus are mostly made of cartilage

7. Structure of bones
Compact bone- layer of hard, dense bone that lies under the periosteum near the diaphysis of long bones
Haversian canal- small canals containing blood vessels that bring O2 and nutrients; remove waste products (CO2)
Cancellous bone- “spongy or trabecular”; porous and less dense than compact bone; red bone marrow is located here
Trabeculae- spongy latticework

8. Bone Processes
Bone processes are enlarged areas to serve as attachment for muscles and tendons
Bone head- rounded end of a bone separated from the body of the bone by a neck
Greater Trochanter- large process on the femur for attachment of tendons and muscle (lesser trochanter is just smaller)
Condyle- rounded, knuckle-like process at a joint
Tubercle- rounded process on many bones for attachment of tendons and muscles
Tuberocity- small rounded elevation on a bone

9. Bone openings or hollow regions
Fossa- shallow cavity in or on a bone
Foramen- opening for blood vessels and nerves
Fissure- narrow, deep, slit-like opening
Sinus- hollow cavity within a bone

10. A) Divisions of a long bone and interior bone structure
A) Divisions of a long bone and interior bone structure. B) Composition of compact (cortical) bone.
Fig. 15-1AB.
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11. A) Divisions of a long bone and interior bone structure
A) Divisions of a long bone and interior bone structure. B) composition of compact (cortical) bone.
Fig. 15-1AB.
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12. Bone processes on the femur and humerus.
Fig. 15-2AB.
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13. Cranial bones (lateral view).
Fig
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14. Cranial bones (looking downward at floor of cranial cavity).
Fig
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15. Facial bones. Back MENU Forward Fig. 15-5.
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16. Sinuses of the skull. Back MENU Forward Fig. 15-6.
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17. Vertebral column. Back MENU Forward Fig. 15-7.
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18. Bones of the Thorax (chest cavity)
Clavicle
Scapula
Sternum
Ribs
Acromion

19. Bones of the Arm and Hand
Humerus
Olecranon
Ulna
Radius
Carpals
Metacarpals
Phalanges

20. Pelvic Bones Pelvic girdle – pelvis; collection of bones composed of:
ilium
ischium
pubis
*Pubic Symphysis-
Anterior part of pelvis where cartilage connects

21. Bones of the Leg and Foot
Femur
Patella
Tibia
-Malleous
Fibula
Tarsals -(7 bones)- calcaneus- heel bone is the largest
Metatarsals
Phalanges of the toes

22. Bones of the thorax, pelvis, and extremities.
Fig
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23. Bones of the thorax, pelvis, and extremities.
Fig
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24. Bones of the foot. A B Back MENU Forward Fig. 15-11AB.
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25. Fractures- break in a bone
Closed fx – bone is broken but no open wound
Open fx- bone is broken and a fragment of bone protrudes through skin
Crepitus- crackling sound when ends of bones rub each other or roughened cartilage
Colles fx- occurs near the wrist joint at lower end of radius
Comminuted fx- bone splintered or crushed into several pieces
Compression fx- bone is compressed
Greenstick fx- bone is partially broken; typically occurs in children
Impacted fx- one fragment is driven firmly into another

26. Open fracture

27. Colles Fracture

28. Comminuted Fracture

29. Types of fractures. Back MENU Forward Fig. 15-13.
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30. Pathologic conditions
Ewing Sarcoma- malignant bone tumor
Exostosis- bony growth arising from the surface of bone (ex=out; -ostosis= bone condition)
Osteogenic sarcoma- malignanat tumor arising from bone (osteosarcoma)
Osteomalacia- softening of bone (loss of calcium)
Osteomyelitis- inflammation of bone & bone marrow due to infection
Osteoporosis- decrease in bone density (mass); thinning of bone
Osteopenia- interior of bones is diminished in structure
Osteodystrophy- poor formation of bone

31. Pathological Conditions
Talipes- congenital abnormality in hindfoot (involving talus; clubfoot)
Kyphosis- “hunchback”; spine curvature in thoracic cavity
Lordosis- lumbar spine curves outward
Scoliosis- lateral curvature of spine
Sciatica- pain radiating down the leg (nerve)

32. Scanning electromicrograph (A: Normal bone; B: Bone with osteoporsis).
(From Dempster DW, Shane E, Horbert W, et al: A simple method for correlative light and
scanning electron microscopy of human iliac crest bone biopsies: qualitative observations in
normal and osteoporotic subjects. J Bone Miner Res, 1986; 1:15.)
Fig AB.
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33. Types of joints
Joint (arthr/o)- a coming together of two or more bones
Suture joint- immovable joint
Synovial joint- freely moveable
Joint capsule- bones in a synovial joint composed of fibrous tissue
Ligaments- connect bone to bone; thick fibrous band of connective tissue
Sprain - trauma to a joint with pain, swelling and injury to ligaments
Articular Cartilage- covers the smooth end of the joints surface

34. Types of Joints
Synovial Membrane- lies under the joint capsule and lines the synovial cavity
between the bones.
The synovial fluid contains water and nutrients that lubricate the joint.
Bursae (bursa)-sac that contains synovial fluid that are located near but not within a joint
Tendons -connective tissue that connects muscle to bone
Tenorrhaphy- suture of a tendon

35. The knee (A: Sagittal; B: Frontal).
Fig AB.
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36. Pathological conditions
Arthritis- inflammation of a joint
Ankylosing Spondylitis- chronic, progressive arthritis with stiffening of joints
Gouty Arthritis -inflammation and painful swelling of joints caused by excessive uric acid in the body (hyperuricemia); typically affects the big toe and is often called “podagra”
Osteoarthritis -(OA); progressive, degenerative joint disease characterized by loss of articular cartilage and hypertrophy of bone

37. Pathological Conditions
Rheumatoid Arthritis (RA)- Chronic disease in which joints become inflamed and painful. It is thought to be an autoimmune reaction against joint tissues
Pyrexia (fever) – symptom of RA
Ankylosis - condition of stiff, bent joint
Bunion - abnormal swelling of the medial aspect of the joint between the big toe and first metatarsal
Carpal Tunnel Syndrome-compression of the median nerve as is passes between the ligament, bones and tendons of the wrist.
Arthroplasty- surgical repair of a joint
Spondyloliasthesis- slipping or subluxation of vertebrae

38. Pathological Conditions
Herniation of an intervertebral disk- abnormal protrusion of a fibrocartilaginous intervertebral disc into the spinal nerves
Ganglion cyst- A fluid-filled cyst arising from the joint capsule or a tendon
Dislocation -Displacement of a bone from its joint
Reduction= restoration of bones to normal position
Subluxation= partial dislocation

39. Pathological Conditions
Lyme Disease- a recurrent disorder marked by severe arthritis, myalgia, malaise, and neurologic and cardiac syndromes
Sytemic Lupus Erythematosus (SLE)- chronic inflammatory autoimmune disease involving joints, skin, kidneys, nervous system, heart and lungs; characterized by ‘butterfly rash”

40. Osteoarthritis and rheumatoid arthritis.
Fig
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41. Carpal tunnel syndrome.
Fig AB.
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42. Protrusion of an intervertebral disc
Protrusion of an intervertebral disc. *Laminectomy- opertation to relieve symptoms of a slipped disk
Fig
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43. Muscles
Cardiac muscle- striated in appearance but is like smooth muscle in action; no conscious controlled;
Smooth muscle- involuntary or visceral muscle that move internal organs. They have no dark or light bands, fibrils, or cytoplasm
Leiomyosarcoma- malignant tumor of smooth muscle
Striated muscle- voluntary or skeletal muscle that move all bones
Fascia- fibrous tissue that envelops and separates muscles and contains the blood, lymph, and nerves

44. Muscles Skeletal muscle- over 600 in the human body.
The point of attachment of the muscle to a stationary bone is called origin (beginning).
When the muscle contracts, another bone to which it is attached to does move. The point of junction of the muscle to the bone that does move is called the insertion of the muscle.
*Most often, the origin of a muscle lies proximal in the skeleton and insertion lies distal.
Atrophy- wasting away of muscle (shrinking of size)

45. Origin and insertion of the biceps.
Fig
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46. Terms for muscle/joint movement
Abduction
Adduction
Dorsiflexion
Plantarflexion
Extension
Flexion
Supination
Pronation
Rotation

47. Types of muscular actions.
Fig
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48. Abbreviations
ROM
ACL
PCL
MCL
LCL
EMG RA PT
NSAID
TMJ
THR
TKR