Osteology- study of bones Skeletal system = bones, cartilage, ligaments & other connective tissue that stabilizes/connects bone ANATOMY Adult human skeleton has 206 individual bones arranged into a supporting but flexible framework Number of bones varies person to person due to age & genetic factors Birth- 270 bones Number increases during infancy as ossification occurs Number decreases during adolescence as bones fuse together Some adults have sutural bones within skull joints & sesamoid bones form in tendons in response to repeated stress on a joint Skeleton divided into axial & appendicular Axial- 80 bones; more rigid structure; includes cranial, facial & vertebral bones as well as thorax Appendicular- 126 bones; consists of pectoral & pelvic girdles & bones of the appendages Bone shapes can help indicate function Long bones- longer than they are wide; provide body support & function as levers during body movement; ex. Humerus, femur, ulna, radius, tibia, fibula, phalanges Short bones- cube shaped; transfer forces of movement; ex. Carpals, tarsals, sesamoid bones Flat bones- have broad surfaces for muscle attachment or protection of underlying organs ex. Ribs, cranial bones, sternum, scapula Irregular bones- varied shapes & many surface features for muscle attachment; ex. Vertebrae, hip bones, some cranial/facial bones Structure of long bone Compact bone- hard & dense; protective exterior of all bone Spongy bone- deep inside compact bone; porous Diaphysis- bone shaft or cylinder of compact bone around central medullary cavity; provides leverage & major weight support Medullary cavity- inside diaphysis; lined with connective tissue layer (endosteum which covers internal surfaces & is used for bone growth/repair); contains yellow bone marrow in adults Epiphysis- ends of shaft containing spongy bone surrounded by layer of compact bone; red bone marrow found here; enlarge to strengthen joint & provide surface area for tendon & ligament attachment Articular cartilage- thin layer of hyaline cartilage capping each epiphysis; reduces friction & absorbs shock in joint Nutrient foramina- small openings into bone along diaphysis where blood vessels can enter bone Epiphyseal plate- cartilage region between epiphysis & diaphysis where linear bone growth occurs as well as ossification; called metaphysis in mature bone Periosteum- dense irregular connective tissue covering bone surface; lots of blood vessels; where tendons/ligaments attach; where bone growth in width occurs; held to bone by perforating fibers Bone tissue- many bone cell types embedded in matrix of calcium/phosphorous salts as well as collagenous fibers Types of bone cells Osteogenic (osteoprogenitor) cells- found next to endosteum & periosteum; stem cells that will give rise to osetoblasts & osteoclasts Osteoblasts- bone forming cells that make/secrete matrix substance; found in periosteum & medullary cavity; as they become entrapped in matrix they become osteocytes Osteocytes- mature bone cells made of osteoblasts that have secreted bone tissue around themselves; found in compact bone; help keep bone healthy by secreting enzymes & influencing bone mineral content; regulates release of calcium ions by bone into blood; maintain matrix & detect mechanical stress Osteoclasts- large multi-nucleated cells that break down bone tissue during building/remodeling Bone lining cells- made of osteoblasts along surface of bones; regulate movement of calcium & phosphorous in/out of bone Compact bone- cylindrical osteons or haversian systems run parallel to long axis of bone; central haversian canal surrounded by concentric rings or lamellae; inside central canal & haversian canals are blood vessels & nerves that run through the bone; lacunae (osteocytes) arranged between lamellae & connect together by canaliculi or tiny channels; nutrients, wastes, minerals, & gases travel through canaliculi; perforating canals run at right angles to central canals & have blood vessels & nerves Spongy bone- has lattice appearance due to spikes of bone tissue called trabeculae; lots of blood, gives bone strength without adding weight; no osteons present; osteocytes found between parallel lamellae In most bones, a cartilage structure is replaced by bone tissue through endochrondral bone formation Bone continues to change shape- prominences develop as stress is applied to periosteum & new bone tissue forms; ex. Greater trochanter of femur enlarges as adult if physically active Inactivity causes bones to lose tissue Absence of gravity (such as during space flight) results in bone mineral loss if no exercising is done Human skull has 8 cranial bones & 14 facial bones Cranial bones fit together to enclose & protect brain & sense organs Facial bones form framework of face & support teeth; do not come into contact with brain; most are paired Cavities of skull Cranial cavity- largest; holds brain Nasal cavity- divided into 2 nasal fossae by nasal septum Paranasal sinuses- 4 sets of cavities within bones around nasal area Middle & inner ear cavities- below cranial cavity; houses sense organs & balance organs Orbits- around eyes; formed by both facial/cranial bones Buccal cavity- mouth; formed partially by bone Babies are born with soft spots (fontanels) in scalp; these are connective tissue membranes that cover gaps between developing bone; ossification of these is complete by 2 years of age Fontanels permit rapid brain growth in infant as well as molding of head during birthing process Sutures of cranium connect the fontanels & will form future joints between bones Cranial bones Frontal- anterior roof of cranium, forehead, roof of nasal cavity & superior arch of orbits; contains frontal sinuses to less weight of skull & act as resonance chambers for voice Parietal- upper sides & roof of cranium Temporal- lower sides of cranium; contains ear canal Occipital- posterior & base of skull; foramen magnum is large hole through which spinal cord passes; occipital condyles are structures that articulate with first vertebrae Sphenoid- anterior base of cranium; contains several foramen such as optical canal through which nerves & vessels pass Ethmoid- anterior portion of floor of cranium; forms the roof of nasal cavity & separates it into 2 chambers Facial bones Maxilla- two join to form upper jaw; supports upper teeth; contains large maxillary sinus Palatine- L shaped bones that form posterior third of hard palate & part of nasal cavity Zygomatic- cheek bones & lateral margin of orbits Lacrimal- thin bones that form anterior part of medial wall of orbit; smallest of facial bones; allows tears to drain into nasal cavity Nasal- small rectangular bones forming part of nasal septum Vomer- thin flat bone forming lower part of nasal septum Mandible- largest strongest facial bone; only movable bone of skull Hyoid bone- single bone; not attached directly to any other bone; supports tongue & provides attachment for muscles; frequently fractured during strangulation Auditory ossicles- small bones in middle ear cavity; malleus, incus, stapes Vertebral column- made of vertebrae separated by fibrocartilaginous intervertebral discs; enclose & protect spinal cord; support skull, articulate with rib cage & provides attachment for trunk muscles; typically 33 individual vertebrae; between vertebrae are intervertebral foramina where spinal nerves pass 4 curves of vertebral column- cervical, thoracic, lumbar, pelvic Curves needed for increasing strength & maintaining balance of upper body as well as making possible bipedal stance Develop at about 3 months of age Parts of vertebrae Body- anterior drum shaped region in contact with intervertebral discs Arch- posterior surface that helps form the vertebral formen where the spinal cord is Processes- several bumps etc on vertebrae where muscles attach & vertebrae interlock Types of vertebrae Cervical- 7; form neck & support head; bone tissue densest here; atlas is first cervical vertebrae & it lacks a body; joint here allows for nodding of head; 2nd is called axis & it allows for rotation of head Thoracic- 12; articulate with ribs to form the posterior anchor of rib cage; larger than cervical & T12 is larger than T1 Lumbar- 5; heavy bodies & thick processes for attaching powerful back muscles Sacrum- wedge shaped & provides foundation for pelvic girdle; 4-5 vertebrae that are fused by age 26 Coccyx- triangular tailbone made of 3-5 fused coccyeal vertebrae; start to fuse at puberty Rib cage- made of thoracic vertebrae, 12 paired ribs, costal cartilages & sternum; its job is to enclose & protect the heart & lungs as well as supporting the pectoral girdle & playing a role in breathing Sternum- elongated flat bony breastplate; 3 parts- manubrium, body & xiphoid process; ribs attach to sides of manubrium & body while abdominal muscles attach to xiphoid process Ribs- 12 pairs that each attaches to a different thoracic vertebrae True ribs- first 7 pairs anchored to a different thoracic vertebrae False ribs- pairs 8-10; anchored to sternum indirectly by common cartilage Floating ribs- pairs 11 & 12; don’t attach to sternum at all Pectoral girdle- made of 2 scapulae & 2 clavicles; only attaches to anterior part of axial skeleton; primary function is to provide attachment for muscles that move shoulder & elbow Clavicle- slender collarbone; connects arm to axial skeleton & holds shoulder joint away from body Scapula- large triangular shoulder blade on back of rib cage; spine is bony ridge on posterior surface that strengthens scapula so its won’t bend; should joint formed by glenoid cavity; 15 muscles attaché here Brachium- arm; extends from shoulder to elbow Humerus- longest bone of upper extremity whose head fits in glenoid cavity; distal end articulates with bones of forearm; large medial epicondyle protects the ulnar nerve, hitting this nerve is called “hitting your funny bone” Antebrachium- forearm; extends from elbow to wrist Ulna- on medial side; more firmly connected to humerus; longer of the 2 bones of forearm; articulates at both ends with radius Radius- on lateral or thumb side; articulates with wrist bones at distal end Manus- hand; contains 27 bones Carpus- wrist; made of 8 carpal bones arranged in 2 rows Metacarpals- palm of hand containing 5 metacarpal bones; heads form your knuckles when you clench your fist Phalanges- 14 bones of your digits; thumb has 2 & all other fingers have 3 Pelvic girdle- made of 2 ossa coxae (hip bones) united anteriorly at the symphysis pubis; attaches to sacrum of vertebral column; supports the weight of body from the vertebral column and supports/protects your lower viscera Pelvis- deep bowl-like structure of ossa coxae, sacrum & coccyx Greater (false) pelvis- expanded part of pelvis above pelvic rim Lesser (true) pelvis- below pelvic brim to pelvic outlet Hipbone- 3 parts: ilium, ischium & pubix; fused together in adult, large circular depression (acetabulum) is where leg attaches Ilium- uppermost & largest; has crest & 4 spines; your hip is the iliac crest sticking out Ischium- posterionferior bone of os coxae; ischial tuberosity supports weight of body when you sit Pubis- anterior bone; forms the symphysis pubis joint of the pelvis Male pelvis & female pelvis are different due to pregnancy & birth requirements Male- more massive, heart shaped outlet, narrower outlet, iliac spines closer together, acetabulum faces to sides, symphysis pubis deeper & longer Female- more delicate, round or oval outlet, wider outlet, wider between iliac spines, acetabulum faces more anteriorly, shallower shorter symphysis pubis, pubic arch wider Femur- thighbone; longest heaviest strongest bone of body; head fits into acetabulum; slightly curved so knee joint is in line with body’s plane of gravity & female’s curves more since her pelvis is wider Patella- kneecap; large sesamoid bone on anterior side of distal femur; develops due to strain in tendon of quadriceps femoris muscle; functions to protect knee joint & to strengthen tendon Leg- lower portion of lower limb between knee & foot Tibia- articulates with femur & ankle at ends and on the sides of fibula; larger bone of lower leg since it bears the weight Fibula- long slender bone; used mostly for muscle attachment Pes- foot; contains 26 bones that support weight of body & provide leverage/mobility during walking Tarsus- 7 tarsal bones in ankle; talus connects to tibia & fibula; calcaneous is largest & forms the heel Metatarsus- 5 metatarsal bones; with first being the largest & it is attached to the big toe; ball of foot is formed by heads of first metatarsal bones Phalanges- 1; big toe (hallus) has only 2 but other toes have 3 Arches of foot- formed by structure/arrangement of bones & held in place by ligaments/tendons Longitudinal arch- goes from talus in ankle to distal ends of metatarsals Transverse arch- extends across width of foot Flat feet or fallen arches due to weakening of ligaments/tendons in feet Arthrology- study of joints; looks at structure, classification & function of joints Kinesiology- study of the mechanics of human motion as it relates to bones, muscles & joints Ligaments- tough bands of connective tissue that hold bones together at a joint Joint- junction of two or more bones; articulation Types or Classes of Joints Fibrous or synarthorses- firmly bind bones together with dense regular fibrous connective tissue Cartilaginous or amphiarthorses- firmly unites bones with cartilage Synovial or diarthoses- freely movable joints; enclosed by joint capsules that contain fluid Structure of joint determines the direction & range of movement it allows Fibrous joints- tightly bound by fibrous connective tissue; some stay rigid & others are slightly movable Types of fibrous joints Suture- found only in the skull; have thin layer of dense irregular connective tissue; immovable or slightly mobile; form at 18 months of age to replace fontanels Serrated- interlocking saw-like joint; ex. Between parietal bones Squamous- edge of one bone overlaps articulating bone; ex. Between temporal & parietal Plane- edges are smooth & do not overlap; ex. Between maxillary & palatine bones to make hard palate Syndesmoses- held together by collagenous fibers & interosseous ligaments; slight movement is allowed here; ex. Joint between ear drum & middle ear bones, between ulna & radius as well as between tibia & fibula Gomphoses- fibrous joints between teeth & jaw bones Cartilaginous joints- allow limited movement in response to twisting & compression Types of cartilaginous joints Symphyses- adjoining bones covered by hyaline cartilage; pad of fibrocartilage cushions joint; ex. Symphysis pubis & intervertebral discs Synchondroses- hyaline cartilage between articulating bones; some form between diaphysis & epiphyses of long bones in children & then become ossified; others don’t ossify like between sphenois, occipital, temporal & ethmoid bones Synovial joints- freely movable; enclosed by joint capsules containing synovial fluid; provide wide range of precise, smooth movements; range of movement is determined by structure of bones involved, strength of joint capsule & strength of associated ligaments/tendons, size, arrangement & action of muscles spanning joint Structure of synovial joint Joint capsule- fibroelastic encasing that is filled with lubricating synovial fluid Synovial fluid- secreted by synovial membrane lining capsule; rich in hyaluronic acid & albumin; contains phagocytic cells to clean up debris caused by wear; lubricating material found between articular cartilages; egg white-like consistency Articular cartilage- hyaline cartilage that caps the bone ends; no blood vessels so must be nourished by synovial fluid movement; provide smooth surface at ends of bones in joints Ligaments- flexible connective tissue cords that connect bone to bone; found inside/outside of joint capsule Meniscus- only in knee joint; tough fibrous cartilaginous pads that cushion bones Bursa- flattened pouch-like sacs filled with synovial fluid; found between muscles or where tendons pass over bones; needed to cushion Types of synovial joints Plane (gliding)- side to side & back/forth movements; surfaces are nearly flat; ex. Intercarpal & intertarsal Hinge- permit movement in only one plane; one bone surface always concave & the other is convex; most common type; ex. Knee (considered most complex joint), elbow Pivot- rotates around a central axis; conical bone fits into a depression; ex. Axis & atlas Condyloid (angular, ellipsoid)- oval convex surface fits in concave depression; allows movement up/down as well as side to side; ex. Wrist, ankle, knuckles Saddle- modified condyloid; only found at thumb & hand joint and between incus & malleus Ball & Socket- rounded covex surface fits in a cuplike cavity; has greatest range of movements; free circular movement; ex. Hip & shoulder In skeletal system the bones work as levers & joints as fulcrums while muscle action supplies the force Joint actions Angular movements- increase or decrease joint angle Flexion- joint bends; closes angle; moving arm or leg from its normal position straight in front of body; bones are brought closer together Plantar flexion- pressing foot downward as to rise on toes Extension- joint unbends or straightens; opens angle; move arm or leg from its normal position toward the rear; articulating bones move farther apart; returning body part to its anatomical position Hyperextension- body part is extended beyond the anatomical position Abduction- moving arm or leg away from the midline of the body in a lateral direction Adduction- opposite of abduction; moving arm or leg toward midline of body Circular movements Rotation- movement of body part around its own axis Supination- rotating forearm so palm faces forward Pronation- rotating forearm so palm faces downward Circumduction- movement of body part so a cone-shaped airspace is traced Other movements Inversion- movement of foot sole inward Eversion- movement of foot sole outward Protraction- movement of body part forward on plane parallel to ground Retraction- returning protracted body part on plane parallel to ground Elevation- raises body part Depression- lowers body part PHYSIOLOGY Functions Storage- stores mineral salts such as calcium/phosphorous for use in body; also lipids are stored in the yellow bone marrow Support/Protection- many bones protect internal organs; ex. Cranium, rib cage, vertebrae, pelvis Movement- works with muscular system to move body Hemopoiesis- blood formation Bone is both light & strong Made of very hard, tiny crystals formed from minerals Mineral crystals held together by collagen If you remove the collagen from bone, the crystals don’t stick together & bones can easily crumble If you remove the crystals of minerals, the bones become rubbery & flexible Near distal end of each bone is epiphyseal plate where cartilage cells divide & lengthen a bone Growth continues until full length is reached & then cartilage is completely replaced & no further growth occurs Ossification (calcification) Process of bone formation Mainly occurs by converting cartilage to bone Types of ossification: endochondral & intramembranous Intramembranous ossification Some bones form from embryonic membranous connective tissue without a cartilage phase Flat bones, facial bones, mandible, clavicle Membranes eventually ossify & form flat bones Endochondral ossification Begins in 2nd month of fetal development Cartilage cells in center of shaft become filled with minerals by calcification Some cells around cartilage change into osteoblasts that secrete osteoid (hardened organic part of bone) Cartilage becomes surrounded by compact bone periosteal bone collar which in turn is surrounded by periosteum Periosteal bud moves from periosteum to center of cartilage & a primary ossification center is established; bud consists of osteoblasts & blood vessels Secondary ossification centers form where spongy bone develops & eventually bone completely replaces cartilage Some Disorder s of the Skeletal System Sprain- tearing or straining of tendons/ligments around a joint RICE Rest- if activity of joint causes pain; begin rehab exercises ASAP to increase flexibility/strength and to reduce the chance of repeat injury; keep moving since it will draw fluids away & reduce swelling Ice- 20 min every 2 hours after injury to limit swelling/inflammation Compression- wrap with ACE bandage to limit swelling Elevate- reduces swelling Reducing swelling SASP shortens recovery time by several days Torn ligaments- ex. ACL in knee Popping sound followed by swelling, pain, inflammation, weakness & stiffness Non-operative treatment includes physical therapy to improve strength/endurance of muscles that cross the joint & use of a knee brace Reconstructive surgery involves replacing the ligament with a section of the patellar tendon, follow surgery with physical therapy Fracture- bone crack; begins to repair itself immediately because bones have so many blood vessels; still may take 2-3 months to repair Dislocation- when bone is forced out of its proper joint position; should only be realigned by doctor; shoulder joint is most susceptible to dislocation due to less ligament reinforcement; symptoms include tenderness & swelling Hyperextension- extension of a joint beyond the anatomical position so joint angle is greater than 180 Bursitis- inflammation, pain & stiffness in bursa sac near a joint caused by stress to joint Arthritis Osteoarthritis (degenerative arthritis, degenerative joint disease)- occurs as a result of aging; bones begin to rub together & become painful; irritation of joints or wear/abrasion of joints; joints become stiff/knobby; formation of bony spurs in joint cavities; may lead to joint replacement Rheumatoid- joints become swollen/painful due to inflammation of synovial membrane; autoimmune disorder where immune system begins to destroy joint tissue; cartilage in joint is destroyed & replaced by calcium Damaged joints can be replaced by artificial joints which can be inserted/cemented into place; but bone must bind tightly to the artificial surface so joint must be coated with ceramic substance to encourage bone cells to grow close to surface of artificial joint Rickets Vitamin D deficiency in children whose cartilage continues to form rather than being replaced by bone Vitamin D enables bloodstream to absorb calcium which is then stored in bones Bones remain soft & become bent or distorted Symptoms include muscular weakness, disturbances in growth, cramps, muscle twitches, irritability Osteoporosis Condition that makes bones fragile & easily broken (especially hip, wrist or backbone) Bone matrix & calcium is lost in spongy bone Symptoms: loss of bone mass, deterioration of bone quality leading to reduced bone strength & increased risk of fractures Risk factors: female (1 in 2 women, 1 in 8 men), advanced age, family history, Asian or Caucasian, estrogen deficiency, low calcium intake, inactivity, ingestion of certain medications, smoking, drinking alcohol, underweight, short small boned body type, caffeine, soft drinks/processed foods Treatments: estrogen replacement therapy, calcitonin works to prevent further bone loss, some meds suppress osteoclast activity, weight bearing exercises 3-4 times a week for prevention (walking, jogging, tennis, dancing, etc), 1000-1500 mg calcium supplements & 400-800 units of vitamin D daily Acromegaly- too much growth hormone is released after puberty when epiphyseal plates have closed; cartilage & small bones react to hormone resulting in abnormal growth of hands, feet, lower jaw, skull & clavicle; President Lincoln believed to have this Paget’s Disease = osteitis defromans May be caused by inherited weakness of immune system or viral infection or both Osteoclast activity accelerates producing acute osteoporosis; skeleton becomes deformed because new bone is poorly formed; quickens pace of bone breakdown/reformation so that new layers of bone are structurally disorganized, misshapen & considerably larger than original ones Occurs in pelvis, skull, vertebrae, femur, tibia Affects slightly more men than women, occurs after age 40 Diagnosis relies on Xrays or blood tests (looking for increased levels of alkaline phosphatase) Treated by drugs (calcitonin) that slows or blocks rate of bone breakdown/formation Sinusitis- inflammation/congestion of sinuses in the facial bones caused by increased nasal mucus which slows drainage & pressure builds up TMJ syndrome = myofascial pain syndrome Mandible is pulled out of alignment; person experiences facial pain & the inability to open mouth fully Linked to grinding teeth during sleep & emotional stress Treatment includes application of heat to joint & use of anti-inflammatory drugs Kyphosis- hunchback appearance due to exaggerated curvature of thoracic area of spine; caused by osteoporosis, compression fractures to anterior portions of vertebrae, heavy weightlifting during adolescence, chronic contractions of muscles that insert on vertebrae or abnormal vertebral growth Lordosis- swayback; abdomen/buttocks protrude because of exaggeration of lumbar curvature; may be due to excess abdominal weight (pregnancy or obesity) Scoliosis- abnormal lateral curvature of spine; most often in thoracic region; may result from developmental problems; treatment consists of exercises, braces & surgical procedures Slipped disc- supporting posterior ligaments of spine are weakened & the disc is forced partially into the vertebral canal; often occurs due to advancing age but can also occur due to whiplash Herniated disc- disc again protrudes into vertebral canal but now sensory nerves are distorted/compressed; results in severe backache, abnormal posture, or sensory function; most common in cervical or lumbar regions