Anatomy of the Skeletal System (cont`d)

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Medical Language
Second Edition
CHAPTER
8
Orthopedics
Medical Language, Second Edition
Susan Turley
Copyright ©2011 by Pearson Education, Inc.
Upper Saddle River, New Jersey 07458
All rights reserved.
Orthopedics
• 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.
Figure 8-1 The skeletal system
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
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
Anatomy of the Skeletal System
(cont’d)
• Bones of the Head
– Cranium
– Facial bones
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
Figure 8-2 Side view of the cranium and facial bones
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
Figure 8-3 Front view of the cranium and facial bones
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.
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)
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.
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.
Figure 8-5 Bones of the chest and shoulder
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
Anatomy of the Skeletal System
(cont’d)
• The spinal column is divided into five regions:
– Cervical vertebrae
– Thoracic vertebrae
– Lumbar vertebrae
– Sacrum
– Coccyx
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.
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.
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
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
Figure 8-6 Bones of the spinal column
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.
Figure 8-8 The skeleton
An anatomical illustration of the skeleton by Andreas Vasalius
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
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
Figure 8-9 Bones of the shoulder
Anatomy of the Skeletal System
(cont’d)
• Bones of the Upper Extremity
– Upper and Lower Arm
• Humerus
• Radius
• Ulna
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
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.
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.
Figure 8-10 Bones of the upper extremity
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.
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.
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
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)
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
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
Figure 8-11 Bones of the hip
Anatomy of the Skeletal System
(cont’d)
• Bones of the Lower Extremity
– Upper and Lower Leg
•
•
•
•
Femur
Tibia
Fibula
Patella
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
Anatomy of the Skeletal System
(cont’d)
• Tibia or Shin Bone
– The large bone on the medial side of the lower leg
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
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
Figure 8-12 Bones of the lower extremity
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
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.
Figure 8-13 Bones of the ankle and foot
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
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.
Figure 8-14 Suture joint
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.
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.
Figure 8-15 Synovial joint
Joint Classification Animation
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Joint Movement Animation
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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.
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.
Figure 8-16 Structure of a bone
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.
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.
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.
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.
Figure 8-17 Pediatric growth chart
Diseases and Conditions
• Diseases of the Bones and Cartilage
– Avascular necrosis
– Bone tumor
– Chondroma
– Chondromalacia patellae
– Fracture
Table 8-1 Fracture Names and Descriptions
Table 8-1 (cont’d) Fracture Names and Descriptions
Table 8-1 (cont’d) Fracture Names and Descriptions
Table 8-1 (cont’d) Fracture Names and Descriptions
Table 8-1 (cont’d) Fracture Names and Descriptions
Table 8-1 (cont’d) Fracture Names and Descriptions
Diseases and Conditions (cont’d)
• Diseases of the Bones and Cartilage (cont’d)
– Osteomalacia
– Osteomyelitis
– Osteoporosis
Figure 8-19 Normal bone versus bone with osteoporosis
ESRF-CREATIS/Phanie Agency/Photo Researchers, Inc.
Diseases and Conditions (cont’d)
• Diseases of the Vertebrae
– Ankylosing spondylitis
– Kyphosis
– Lordosis
– Scoliosis
– Spondylolisthesis
Figure 8-20 Kyphosis
Dr. P. Marizzi/Photo Researchers, Inc.
Figure 8-21 Scoliosis
Princess Margaret Rose Orthopaedic Hospital, Edinburgh, Scotland/Science Photo Library/Photo
Researchers, Inc.
Diseases and Conditions (cont’d)
• Diseases of the Joints and Ligaments
– Arthralgia
– Arthropathy
– Dislocation
– Gout
– Hemarthrosis
Diseases and Conditions (cont’d)
• Diseases of the Joints and Ligaments (cont’d)
– Lyme disease
– Osteoarthritis
– Rheumatoid arthritis
– Sprain
– Torn meniscus
Figure 8-22 Osteoarthritis
Custom Medical Stock Photo, Inc.
Figure 8-23 Rheumatoid arthritis
Custom Medical Stock Photo, Inc.
Diseases and Conditions (cont’d)
• Diseases of the Bony Thorax
– Pectus excavatum
Diseases and Conditions (cont’d)
• Diseases of the Bones of the Legs and Feet
– Genu valgum
– Genu varum
– Hallux valgus
– Talipes equinovarus
Figure 8-24 Bilateral hallux valgus
NMSB/ Custom Medical Stock Photo, Inc.
Figure 8-25 Bilateral clubfeet
Shea, MD/ Custom Medical Stock Photo, Inc.
Laboratory and Diagnostic
Procedures
• Laboratory Tests
– Rheumatoid factor (RF)
– Uric acid
Laboratory and Diagnostic
Procedures (cont’d)
• Radiology and Nuclear Medicine Procedures
– Arthrography
– Bone density tests
Laboratory and Diagnostic
Procedures (cont’d)
• Radiology and Nuclear Medicine Procedures
– Bone scintigraphy
– X-ray
Medical and Surgical Procedures
• Medical Procedures
– Cast
– Closed reduction
– Extracorporeal shock wave therapy (ESWT)
Medical and Surgical Procedures
(cont’d)
• Medical Procedures (cont’d)
– Goniometry
– Orthosis
– Physical therapy
Medical and Surgical Procedures
(cont’d)
• Medical Procedures (cont’d)
– Prosthesis
– Traction
Figure 8-29 Goniometer
Patrick Watson/Pearson Education/PH College
Medical and Surgical Procedures
(cont’d)
• Surgical Procedures
– Amputation
– Arthrocentesis
– Arthrodesis
Medical and Surgical Procedures
(cont’d)
• Surgical Procedures (cont’d)
– Arthroscopy
– Bone graft
– Bunionectomy
– Cartilage transplantation
Figure 8-31 Arthroscopic surgery
Custom Medical Stock Photo, Inc.
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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