Chapter 16 - Bones & Soft Tissues Skeletal System

Chapter 16 - Bones & Soft Tissues Skeletal System Two Parts Axial skeleton = 80 bones Skull Spine Ribs Sternum Appendicular skeleton – 126 bones Arms Legs Axial = 80 bones; Skull, Spine, Ribs, Sternum Appendicular =126 bones; Arms & Legs Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Skeletal System Two Parts Axial skeleton = 80 bones Appendicular skeleton – 126 bones Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Functions of the Skeletal System Chapter 16 - Bones & Soft Tissues Functions of the Skeletal System Shape & Support Aids in movement Supports and protects internal organs Produces red and white blood cells Stores minerals Protect – Heart, lungs, brain Mineral storage – calcium & phosphorus Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Skull Skull – 22 bones in the skull 8 bones in the cranium Skeletal System Skull Skull – 22 bones in the skull 8 bones in the cranium Parietal – 2 – form the roof & sides of skull Frontal – 1 – forms the forehead Occipital -1 – forms the base of the skull Temporal – 2 – house the ears Ethmoid – 1 – located between the eyes; forms part of the nasal septum Sphenoid – 1 – key bone in the skull – all other bones connect to it Cranium = Round box-like structure protecting the brain Adapted from North Carolina Curriculum, Fall, 2007

Facial Bones Facial bones – 14 bones Nasal – 5 bones Skeletal System Facial Bones Facial bones – 14 bones Nasal – 5 bones nasal bones – 2- forming the bridge of the nose vomer – 1 – forms the lower or midline of the nasal septum inferior concha – 2 – form the side walls of the nasal cavity Maxilla – 2 – make up the upper jaw Lacrimal – 2 – the inner aspect of the eyes – contain tear ducts Zygomatic – 2 – form the cheek bones Palatine – 2 – form the hard palate of the mouth Mandible – 1 – lower jaw & is the only movable bone in the face Adapted from North Carolina Curriculum, Fall, 2007

Vertebral Column Cervical vertebrae – 7 – located in the neck area Skeletal System Vertebral Column Cervical vertebrae – 7 – located in the neck area Thoracic vertebrae – 12 – located in the thoracic area; articulate with the ribs Lumbar vertebrae – 5 – located in the lower back area Sacrum – 5 fused bones Coccyx – 4 fused bones; aka tailbone Vertebral Column – curved vs straight? Curved provides more strength Total of 26 bones Adapted from North Carolina Curriculum, Fall, 2007

Intervertebral Discs Pads of cartilage tissue separating the vertebrae Skeletal System Intervertebral Discs Pads of cartilage tissue separating the vertebrae Act as shock absorbers Permit bending & twisting movements of the vertebral column Adapted from North Carolina Curriculum, Fall, 2007

Spinal Defects Kyphosis Lordosis Scoliosis Skeletal System Spinal Defects Kyphosis Hunchback - rounding or bowing of the back at the thoracic vertebrae Lordosis Swayback – abnormal inward curvature of the lumbar vertebrae Scoliosis Lateral (side to side) curvature of the spine Adapted from North Carolina Curriculum, Fall, 2007

Normal Lordosis Kyphosis Skeletal System Normal Lordosis Kyphosis Adapted from North Carolina Curriculum, Fall, 2007

Sternum/Costals Sternum – three parts Costals manubrium gladiolus Skeletal System Sternum/Costals Sternum – three parts manubrium gladiolus xyphoid process Costals true ribs false ribs floating ribs Manubrium – superior part Gladiolus – center body Xyphoid process – cartilaginous tip – inferior part Costals - 12 pair = 24 ribs, first 7 pr – attached directly to the sternum anteriorly & posteriorly attached to the thoracic vertebrae next 3 pr – attached to the cartilage of the 7th costal & posteriorly to the thoracic vertebrae last 2 pr – connected only posteriorly to the vertebral column – has no anterior attachment Adapted from North Carolina Curriculum, Fall, 2007

Pectoral Girdle Clavicle – 2 and Scapula - 2 Skeletal System Adapted from North Carolina Curriculum, Fall, 2007

Arm Humerus Radius Ulna Skeletal System Humerus – 2nd largest bone in the body, upper arm bone Radius – on the thumb side Ulna - Larger bone of lower arm; containing a projection called the OLECRANON PROCESS at the upper end forming the elbow – “funny bone” Adapted from North Carolina Curriculum, Fall, 2007

Hand Carpals (8) Metacarpals (5) Phalanges (14) Thumb Skeletal System Hand Carpals (8) Metacarpals (5) Phalanges (14) Thumb First through fourth digits Carpals – 8 small bones Metacarpals – 5 bones Phalanges – 14 bones; thumb – 2 phalanges; other first-fourth digits – each have 3 phalanges; proximal, middle, & distal phalanx Total of 27 bones in the hand Adapted from North Carolina Curriculum, Fall, 2007

Pelvic Girdle Ilium Ischium Pubis Skeletal System Ilium – uppermost & largest portion of the hipbone Ischium – strongest portion of the hipbone; the ‘sit down’ bone Adapted from North Carolina Curriculum, Fall, 2007

Upper Leg/Lower Leg Upper Leg Lower Leg Femur Patella Tibia Fibula Skeletal System Upper Leg/Lower Leg Upper Leg Femur Lower Leg Patella Tibia Fibula Femur – longest, heaviest & strongest bone in the body Patella – kneecap; found in front of the knee joint; largest sesamoid bone Tibia – largest of the two; aka shin bone Fibula – slenderest bone in the body; aka calf Adapted from North Carolina Curriculum, Fall, 2007

Foot Tarsals (7) Calcaneus Metatarsals (5) Phalanges (14) Skeletal System Foot Tarsals (7) Calcaneus Metatarsals (5) Phalanges (14) Tarsals – 7 bones Calcaneus – heel bone; largest bone in the foot Metatarsals – 5 bones Phalanges – 14 phalanges - each have 3 phalanges – proximal, middle & distal phalanx (except the great toe – only proximal & distal) Total of 26 bones in the foot Adapted from North Carolina Curriculum, Fall, 2007

Chapter 16 - Bones & Soft Tissues Bone Growth Epiphyseal cartilage – absence of epiphyseal cartilage – growth stops Growth in females – up to age 18 Growth in males – between 20-21 yrs Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Bone Types Bones are classified according to their shape Long – have a shaft Arms & legs – femur, radius, tibia, clavicle Flat – Skull, ribs, sternum, scapula, pelvis Irregular – specialized bones w/specific shapes Spinal column, (vertebrae) ears, face Short – cube-like shapes Carpals & tarsals Sesamoid – small, rounded bones Patella Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Long Bone Anatomy The structure of bones in the body allows them to be both lightweight and strong. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Fractures Fractures are classified based on the various characteristics of the broken bone. Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

FRACTURES Any break in a bone Most common injury to a bone Types Skeletal System FRACTURES Any break in a bone Most common injury to a bone Types Closed/Simple Open/Compound Greenstick Comminuted Stress Complex Colles’ Fracture Impacted Compression Spiral Adapted from North Carolina Curriculum, Fall, 2007

Skeletal System Greenstick – incomplete break/crack in the bone-common in young children Closed/Simple - complete break with no damage to the skin Simple fractures – aka hairline fracture – doesn’t move any part of the bone out of place Open/Compound - bone protrudes through the skin Comminuted - bone is splintered or crushed - three or more pieces Complex – separation of part of the bone – usually requires surgery Colles’ fracture – a break of the lower end of the radius usually caused by falling and landing on the outstretched hand Impacted – when a part of one bone is pushed into the tissue of another part Compression – a break in one or more vertebrae Spiral - severe twisting of a bone causes break – common in skiing and skating accidents Adapted from North Carolina Curriculum, Fall, 2007

Chapter 16 - Bones & Soft Tissues Fracture Types Compound (open) fracture: skin penetrated Wound & bone infection Simple (closed) fracture: no skin penetration Complete break Two separate pieces Comminuted: three or more pieces Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues

Chapter 16 - Bones & Soft Tissues Fracture Types (cont.) Simple (closed) fracture: no skin penetration Incomplete Greenstick: in children with flexible bones Stress: due to overuse, weakness, biomechanical problems Epiphyseal plate: young people near growth plate Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Fractures cont’d Signs & Symptoms Swelling Deformity Pain Tenderness Discoloration Possible bleeding Nerve injury Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Fracture Treatments Remodeling – process of absorbing and replacing bone Bones often heal naturally Reduction – putting bones into proper alignment External fixation – using a cast for alignment Internal fixation – surgery is needed Wires Plates Screws Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

FRACTURE REPAIR Skeletal System Adapted from North Carolina Curriculum, Fall, 2007

Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. SOFT TISSUE INJURIES Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Soft Tissue Injuries Most are due to traumatic injury or overuse of muscles or joints Most sport injuries are due to minor trauma involving soft tissue Affect the skin, muscles, ligaments, and tendons Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Soft Tissue Injuries Classified as Open or Closed Open Abrasions Lacerations Avulsions Puncture wounds Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Soft Tissue Injuries Closed Contusions Hematomas Ecchymosis Sprains Strains Tendonitis Bursitis Stress-related injuries Stress fractures Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Abrasions and Scrapes Occur when several layers of skin are torn loose or totally removed Treatment Wash to remove dirt & debris Leave open to air Ice packs or cool towels help with pain May need a tetanus shot Medical attention if Pain increases Redness or streaks appear Swelling Purulent drainage Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Lacerations A tear in the skin resulting from an injury. AKA a cut Lacerations less than ¼” deep and ½” long with smooth edges can be treated at home Deep lacerations must be treated by a physician Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Lacerations cont’d Treatment Clean the wound Wash & irrigate Treat bruising & swelling with ice and elevation Contact a Dr if Laceration is deep/long Wound is on the face, eyelids, lips Deep cuts to the palm, fingers, elbow, or knee Loss of sensation or normal ROM Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Avulsions An injury where layers of the skin are either torn completely off or a flap of skin remains Treatment Cleanse the wound Deep wound – see a Dr Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Puncture Wounds Caused by sharp, pointed objects that penetrate the skin Nails, tacks, ice picks, teeth, needles Treatment Remove object Clean wound See a Dr if inflammation is seen Tetanus shot may be needed Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Contusions Direct blow that does not break the skin Usually has a bruise Treatment is RICE May need to see a Dr Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Hematomas Blood and fluid pooling within a tissue space, compartment, or organ Usually the result of a contusion Treatment RICE Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Ecchymosis The accumulation of blood in the skin and subcutaneous tissues AKA bruising A result of injury Treatment Anti-inflammatory Compression dressings Ice Larger than 1 cm in diameter Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Injury Response Inflammation – the body’s reaction by an infectious agent or physical, chemical or traumatic damage Tissues are subjected to physical trauma; pain, heat, redness & swelling occur Oldest defense mechanism Can become chronic Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Chapter 16 - Bones & Soft Tissues Cell Regeneration Regeneration – the act of wound healing (tissue rebuilding) Cells work to close and repair the wound Cannot repair – scarring occurs Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. JOINTS Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Articular System Joint articulation – when two bones come into contact Freely moveable – knees & hips Slightly moveable – pubic symphysis Immobile – skull Arthrology – the study of joints Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Articular System Joints provide two main functions: motion and stability There are three classifications Synarthroses Amphiarthroses Diarthroses Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Synarthrotic Joints lack a synovial cavity bones are held together by fibrous connective tissue or cartilage immovable joint Three types: Sutures Syndesmoses Gomphoses Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. Synarthrotic Joints Three types: Sutures – found in the skull Syndesmoses - bones connected by ligaments between the bones Fibula & tibia Ulna & radius Gomphoses – fits into a socket and held in place by a ligament tooth Sutures – fuse together completely by adulthood Syndesmoses – bones move as one when pronating or supinating Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Amphiarthrotic Joints joint type where bones are connected by hyaline cartilage or fibrocartilage slightly movable joint ribs to the sternum symphysis pubis vetebral joints Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Diarthrotic Joints or Synovial Joints type of joint connecting bones by cartilage separated by a joint cavity contain a synovial membrane secreting the synovial fluid freely movable joints six different types Pivot Gliding Hinge Condyloid Ball-and-socket Saddle Articular cartilage – covering the ends of the bones Pivot – bone moves around a central axis Freely moveable radius & ulna Gliding – bones makes a sliding motion Freely moveable Tarsal & carpal bones Clavicle & sternum Hinge – allows only extension & flexion Elbow, knee, ankle Phalanges Condyloid – Ellipsoidal – bones can move about in many directions but cannot rotate Metacarpals, phalanges Metatarsals, phalanges Ball-and-socket – provides widest range of movement Hips Shoulders Saddle – Allows a wide range of motion Thumb – only saddle joint in the body Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Types of Diarthrotic Joints Skeletal System Types of Diarthrotic Joints Ball and socket joints – allow the greatest freedom of movement ex: shoulders, hips Hinge joints – move in one direction or plane (flexion/extension) ex: knees, elbows Pivot joints – allows for rotation ex: neck, forearm Gliding joints - allow for flexing forward, backward, sideways ex: wrist, ankles Saddle joints – rock up and down; side to side ex: base of thumb Condyloid joints – movement from one plane to another but no rotation ex: knuckles of fingers Ellipsoidal joints – movement through the same bone ex: wrist-ulna/radius Adapted from North Carolina Curriculum, Fall, 2007

Diarthrotic Joints or Synovial Joints Pivot – bone moves around a central axis Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Diarthrotic Joints or Synovial Joints Gliding – bones makes a sliding motion Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Diarthrotic Joints or Synovial Joints Hinge – allows only extension & flexion Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Diarthrotic Joints or Synovial Joints Condyloid – Ellipsoidal – bones can move about in many directions but cannot rotate Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Diarthrotic Joints or Synovial Joints Ball-and-socket – provides widest range of movement Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Diarthrotic Joints or Synovial Joints Saddle – Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Diarthrotic Joint or Synovial Joint Movements Synovial joints allow for 18 different movements Flexion Extension Hyperextension Abduction (movement of limbs only) Adduction (movement of limbs only) Rotation Circumduction - Retraction Supination - Elevation Pronation - Depression Plantar flexion - Opposition Dorsiflextion Inversion Eversion Protraction Copyright ©2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.

Skeletal System Adapted from North Carolina Curriculum, Fall, 2007