BTEC National Diploma Health Studies
Unit 32
Mobility and Exercise for Health and
Social Care
Assignment Brief 1- Bones and Joints
Tutor Name: Matthew Hopton
Student Name: Clare Andrews
Assignment Commencement Date: 15th September
2008
Assignment Completion Date: 12th December 2008
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Assignment 1
Criteria to achieve:
Pass
P1x
P2x
P3
P4x
P5
P6
Merit
M1x
M2
M3
Distinction
D1
D2
Actual Criteria Achieved:
Criteria
P1
Date Achieved
26-01-09
P2
26-01-09
P4
26-01-09
Tutor Signature
M1
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TASK 1 P1, M1

On the diagram of the skeleton, clearly shade the appendicular
skeleton in any colour. (Do not shade the axial skeleton)

Label the bones numbered 1-24.

Describe how bone shape is linked to bone function in the axial and
appendicular skeletons

Describe the growth and repair of bones.

Analyse factors affecting growth and repair including examples of
common homeostatic disorders of the skeleton and joints to help you
explain the effects of different influences on skeletal development
TASK 2 P2

Draw a diagram of a named synovial joint.

Explain the structure and function of the three main types of joints
found in the body i.e. fixed, cartilaginous and freely moveable; name at
least one example of each type you have explained.

Identify the six different types of synovial joint found in the body

Describe the functions of the main components of a synovial joint,
describe at least two disorders that may affect this joint
TASK 3 P4

Describe an exercise which involves a ball and socket joint and a hinge
joint (other joints may also be involved)

For the exercise described, name the movements involved at the
joint(s) you have mentioned. Comment upon factors which affect these
movements including the muscles involved.
Delivery and Assessment Windows
Assignment 1
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Tarsal
Metatarsals
Phalanges
Start Date
Finish Date
Hand In Date
15th September 2008
12th December 2008
19th January 2009
Human Skeleton
Learning outcomes
On completion of this unit a learner should:
1 Understand the anatomy of the musculo-skeletal system
2 Understand mechanisms of muscle contraction
3 Be able to relate balance, posture and body movement to the co-ordinated
action
of muscles around joints
4 Understand how common injuries and disorders of the musculo-skeletal
system
relate to structure and function.
1 Understand the anatomy of the musculo-skeletal system
Ossification: intramembranous, endochondrial
Development of skeleton: skeletal growth — lengthening of bones, closure of
epiphyses, development of normal spinal curvatures (cervical, thoracic,
lumbar);
mineral storage, the dynamic state of bone
Types of bone: histology of skeletal tissues — ligaments, tendons, cartilage,
bone
(compact, cancellous); structure of long bones, flat bones, bone marrow
Influencing factors: genetics, age, diet, effect of weight-bearing exercise,
disease
Names of bones: relationship between structure, shape and function; main
identifying features of — mandible and maxillae, bones of cranium, spine,
girdles,
limbs, chest; function of ligaments
Types of joints:
- moveable, eg ball and socket, hinge, gliding; synovial capsule, range of
movement
- immoveable, eg sutures of cranium, face, pelvis
- slightly moveable — public symphysis
2 Understand mechanisms of muscle contraction
Types of muscle: voluntary (skeletal); involuntary (smooth); cardiac
Histological aspects: cell shape and alignment; myofibril ultrastructure —
sarcomeres, actin, myosin; neuromuscular junction in voluntary muscle tissue
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Biochemical aspects: actin, myosin; sliding filament theory — actomyosin,
calcium
ions, myoglobin; aerobic and anaerobic muscle contraction, fatigue, oxygen
debt
and recovery
Mechanical aspects: movement brought about by contraction of antagonistic
muscle groups; isotonic and isometric muscle contraction; stamina,
suppleness,
musculo-skeletal adaptations to regular exercise
3 Be able to relate balance, posture and body movement to the coordinated
action of muscles around joints
Named example: one of knee, hip, shoulder, elbow
Movements: all those relevant to joint chosen, eg flexion, extension,
adduction,
abduction, circumduction, principles of antagonistic and synergistic action
Muscle groups: eg quadriceps, hamstrings, calf, spinal muscles, gluteals,
pectorals, abdominals, shoulder, arm
Principles of levers: parts of a lever — effort, fulcrum, load; classes of lever —
first class, second class, third class; examples of levers in the body, eg
nodding of
head, straightening of bent arm, standing on tiptoe
Proprioception: spindle receptors in tendons, joints and muscles,
proprioception
reflexes, balance, visual input
4 Understand how common injuries and disorders of the musculoskeletal
system relate to structure and function
Injuries: sprain, muscle strain, fracture, dislocation, osteoarthritis, back pain,
paralysis
Disorders: kyphosis, scoliosis, lordosis; osteoporosis
Grading criteria
To achieve a pass grade the evidence must show that the learner is able
to:
P1 describe the structure and development of bone and the skeleton and the
factors that influence it
P2 explain the structure and functioning of different types of joints
P3 describe the structure and contraction of different types of muscle tissue
P4 explain the role of muscle groups and the principles of levers in bringing
about movement around a named moveable joint
P5 explain the concept of proprioception in relation to maintaining balance,
posture and locomotion
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P6 explain common injuries and disorders in relation to musculo-skeletal
structure.
To achieve a merit grade the evidence must show that, in addition to the
pass criteria, the learner is able to:
M1 explain the effect of different influencing factors on skeletal
Development
M2 compare the characteristics of two types of muscle in relation to their
structure and functions in the body
M3 explain interactions of muscle groups in maintaining posture and in
locomotion of the whole body.
To achieve a distinction grade the evidence must show that, in addition
to the pass and merit criteria, the learner is able to:
D1 analyse how musculo-skeletal functioning is affected by exercise and how
exercise helps maintain healthy functioning of the musculo-skeletal system
D2 use knowledge of the structure and functioning of the musculo-skeletal
system to analyse the impact of common musculo-skeletal disorders on
mobility and locomotion.
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Mobility and Exercise for Health and Social Care
Unit 32
Assignment One
Task One - P1
There are five different types of bones within the body which all have their
own specific shape which allows them to act in different ways. These consist
of:

Long bones

Short bones

Flat bones

Irregular bones

Sesamoid bones
Long bones are hard, dense bones which are longer than they are wide.
These types of bone contain yellow bone marrow and red bone marrow which
produces blood cells. Long bones have a shaft, which is known as diaphysis,
and two heads, which is known as epiphyses. The femur is therefore an
example of a long bone as well as the tibia, fibula and humerus. This type of
bone provides the body with strength, structure and mobility.
Short bones are cube-shaped meaning that the length, width and height of the
bone are about the same. This type of bone can be found in the carpal, which
is the wrist and also in the tarsals, which is the ankle. The function of short
bones is to enable the body to be able to do complex movements.
Flat bones are made up of a layer of spongy bone between two thin layers of
compact bone. This bone is made up of just a thin layer of bone and it is often
shaped around internal organs. The shape of this bone is flattened but not
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rounded. Flat bones also have a marrow but unfortunately not a bone marrow
cavity. Examples of flat bones include the pelvic girdle, cranium and scapula.
The function of flat bones is to provide the body with protection by means of
forming a protective wall around internal organs.
Irregular bones have a complex shape and can’t be grouped into any of the
above categories. They are made up of a spongy bone which is covered with
a thin layer of compact bone. Irregular bones include the vertebrae and some
of the facial bones.
Sesamoid bones are small bones which are located in the tendons where
pressure can develop such as in the wrist. These bones can vary in numbers
although the patellas are present in everyone.
The process of bones forming in the body is known as ossification. The cells
which are involved in the process of forming new bones are Osteoblasts and
Osteocytes. Osteoblasts are known as the bone forming cells and Osteocytes
are known as the mature bones cells which are from the Osteoblasts, this cell
also maintains the structure of the bone. There are two types of ossification
which are intramembraneous ossification and endochrondal ossification.
Intramembraneous ossification is where bones develop in between layers of
fibrous connective tissues to form bony tissue. Cells from the connective
tissue then become Osteoblasts. Osteoblasts then produce an organic mix
which makes the bones harden when calcium salts are added to this organic
mix. This process is known as calcification. Endochrondal ossification involves
the replacement of hyaline cartilage with bony tissue. Most of the bones in our
bodies are formed in this way. In this process the Osteoblasts form a collar of
compact bone around the diaphysis. At the same time, the cartilage which is
located in the centre of the diaphysis begins to disintegrate and the
Osteoblasts then penetrate the disintegrating cartilage and replace it with
spongy bone. Ossification starts at the centre of the bones and moves
towards the ends of the bones.
Bones grow in length at the epiphyseal plate by a process which is similar to
endochrondal ossification. The cartilage which is near to the epiphyseal plate
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continues to grow by a process known as mitosis. The chondrocytes near to
the diaphysis age and degenerate meaning the Osteoblasts move in so that
they can ossify the matrix in order to form bone. This process continues
throughout childhood and adolescent years up until the cartilage growth slows
and stops. When cartilage growth stops, which usually occurs in the early
twenties, the epiphyseal plate completely ossifies so that only a thin
epiphyseal line remains and the bones can no longer grow in length. In order
for bone growth to occur normally an individual needs to have:

Sufficient amounts of vitamins in their diet, especially vitamin D, as this
aids in the absorption of calcium.

Sufficient amounts of calcium and phosphorus in their diet in order for
the hardening of their bones.

The right amounts of hormones being produced in their bodies
including
growth
hormones,
sex
hormones,
calcitonin
and
parathormone.
The repair of bones is only needed when an individual has had some kind of
surgery, broken a bone or maybe they suffer from some sort of disease where
their bones can easily break. There are many different fracture types, these
include:
1. A simple fracture – this is basically a clean, closed fracture.
2. A compound fracture – this break opens the skin meaning that an
infection occurring could be possible.
3. A comminuted fracture – this is when the bone ends up as fragments.
4. A compression fracture – this is where all the bone becomes crushed.
5. A depressed fracture – this is where the bone is pressed inwards.
6. An impacted fracture – this is where both ends are forced into one
another at the joint.
7. A spiral fracture – this is where the bone becomes twisted.
8. A greenstick fracture – this is when an
incomplete break occurs.
The first process which happens when repair of
bones is needed is the site which is damaged
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will bleed and become inflamed causing a blood clot to form around the
injured bone, this is known as haematoma. The haematoma forms within the
space which is created due to the fracturing of the bone. Next tissue repair
begins with fibrocartilage filling in the space where the break occurred. Fibres
which come from the protein collagen begin connect the pieces of bone. The
body next receives messages, via the growth factors, that repair is required
and that more cells which build the bone, known as Osteoblasts, are needed.
A bony callus also forms in order to join the broken bones back together. This
occurs when the Osteoblasts create a spongy bone complete with the
framework, which is known as trabeculae. The last stage within repair of
bones is remodelling. This is where the bone is remodelled to resemble the
original bone but it however takes several months for this to happen. The
Osteoblasts which create the new bones cells set up a framework of new
bones cells which end up on the edges of the break. As the new cells are put
in place bone-destroying cells, which are known as osteoclasts, reabsorb the
spongy bone which in turn creates a medullary cavity.
(Image from: http://www.apatech.com/patient-bone.html).
Task Two – P2
There are many different types of joints within the body, the three main joints
include:

Fixed joints

Cartilaginous joints

Synovial joints
Fixed joints within the body are joints between
two bones which don’t move, for example in the
skull. The plates within the skull don’t move
together or against each other but they are
however connected or fused. This is why fixed
joints can also be known as fused joints. The
bones within fixed joints are joined by fibrous
connective tissue and have no joint cavity. The
function of a fixed joint is to provide a protective
atmosphere but they however don’t allow any growth to occur.
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(Image from: http://assets.disaboom.com/Images/HarvardImages/102313.jpg)
Cartilaginous joints within the body are joints in where the bones are tightly
connected together by cartilage and where there is no joint cavity. The
cartilage which is contained either contains hyaline cartilage or fibrocartilage
in order to allow movements between the bones to take place. These joints
only allow a little amount of movement. This type of joint can be found in the
ribs and spine. The function of a cartilaginous joint is to provide the body with
stability and mobility.
Synovial joints are the most common and most moveable type of joint within
the human body. The cavities which are located between the bones within a
synovial joint are filled with synovial fluid. This fluid helps lubricate and protect
the bones. The structure and function of a synovial joint differs from
cartilaginous joints and fibrous joints and this is noticed quite easily. The main
structural difference between synovial joints and fibrous joints is that in
synovial joints there is a capsule surrounding the surfaces of the joint and that
there is a synovial fluid with that capsule. This type of joint can be found in the
knee.
There are six different types of synovial joints within the human body. These
include:

Ball and socket joint

Hinge joint

Pivot joint

Gliding joint

Saddle joint

Ellipsoidal joint
A ball and socket joint is the most mobile type of joint in the human body. This
joint allows any movement to occur in any direction. The ball-shaped head of
one bone fits into a cup-like depression (socket) in another bone. This then
allows flexion/extension, abduction/adduction and rotation. This type of joint
can be found in the hips and shoulders.
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Hinge joints allow movement which is similar to the opening and closing of a
hinged door. This joint allows extension and retraction of an appendage.
Hinge joints occur at the elbow, knee and ankle.
Pivot joints allow rotation around an axis. Pivot joints occur between the atlas
and axis, which is the first two vertebrae, and also between the radius and
ulna. An example of a pivot joint is in the neck as this allows us to turn our
head from side to side.
Gliding joints are when surfaces of the bones are flat which allows side to side
movements and back and forth movements. These bones are usually held
together by ligaments. Gliding joints occur between carpals and tarsals.
Saddle joints allow movement back and forth and up and down although it
doesn’t allow any movement for rotation to occur like the ball and socket does.
An example of a saddle joint is the thumb.
Ellipsoidal joints are similar to a ball and socket joint. They allow the same
type of movement but with lesser magnitude. This type of joint can be found in
the wrist. Ellipsoidal joints can also be known as Condyloid joints.
The main components of a synovial joint are:

Periosteum

Ligament

Joint cavity

Articular cartilage

Fibrous capsule and the synovial membrane which are located within
the articular capsule
The periosteum is a membrane which has several cell layers which covers
almost all of the bone. The only parts of the bone which this doesn’t cover are
the parts covered by cartilage. Along with covering the bone, it also shares
some of its blood supply with the bone and it produces bone when it is
stimulated appropriately. Blood vessels pass from the periosteum into the
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bone so that they can provide nutrients and oxygen as well as removing
wastes and transporting newly created blood cells.
The function of the ligament within a synovial joint is to hold the bones
together. The ligaments are constructed from connective tissue and tend to be
quite tough. This connective tissue may be located either outside the joint or
in the joint cavity.
The joint cavity is an enclosed space which surrounds the two articulating
surfaces; it also contains the synovial fluid. The joint cavity is surrounded by a
joint capsule.
The articular cartilage is the thick, whitish covering of the end of the bone. The
cartilage is very smooth and provides the sliding surface of the joint. This
cartilage covers surfaces of articulating bones however it doesn’t bind these
together. The function of the articular cartilage is to hold together the ends of
the bones which form the joints and to also support the delicate inner layer
which is the synovial membrane.
The articular capsule surrounds the articular surfaces as well as enclosing the
joint cavity. Within the articular capsule are the fibrous capsule and the
synovial membrane. The fibrous capsule is the outer layer of the articular
capsule and this is attached to the periosteum of bones. It is also composed
of collagen. The synovial membrane is the inner layer of the articular capsule
in where the synovial fluid is found. The function of the fluid is to cushion the
joint and protect the ends of the bones from grating on one another. It also
provides nourishment for the articular cartilage.
Osteoarthritis is a disorder which can affect the synovial joint. Osteoarthritis
affects an individual’s joints and is the most common condition to affect
synovial joints. With this condition, the ends of the joints, which are covered in
cartilage, degenerate causing bone to rub against bone. The cartilage then
becomes worn and uneven due to this and causes the bones to get thicker
and broader. Osteophytes, which are bony outgrowths, can also form within
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this area and this in turn may lead to pain, stiffness and loss of function in the
area at times. Osteoarthritis also causes mild inflammation of the tissues
around the joints, known as synovitis. If an individual has osteoarthritis in their
knees it is likely that both their knees will be affected and so therefore this
means that both the synovial joints will be affected. This may also cause fluid
to build up in the joints causing them to swell up. The main symptoms of
osteoarthritis are:

Pain

Stiffness which appears to be worst in the morning but improves within
30 minutes once the individual has started to move

Difficulty moving the affected joints
There are many cases of osteoarthritis in where individuals don’t suffer from
any kinds of symptoms. The symptoms may begin to develop slowly and they
may be experienced within one joint or a few joints. Other symptoms of
osteoarthritis which aren’t as common as the others include:

Warm joints

Joint tenderness

Weakness and muscle wasting (loss of muscle bulk)

Increased pain and stiffness when an individual hasn’t moved their
joints for a while.

Joints appearing slightly larger, a grating or crackling sound or
sensation in your joints.

A limited amount of movements within the joints
The treatment for osteoarthritis is usually by means of taken medication, such
as paracetamol and anti-inflammatory tablets, due to the fact that
osteoarthritis can’t be cured it can only be helped. Treatment for this condition
can also include the use of cream, a tens machine and injections. As a last
resort individuals can have surgery if their symptoms are that bad. There are
not specific tests which diagnose osteoarthritis so when individuals think they
may have this, their GP will ask them about there symptoms and carry out an
examination of their joints. Tests such as X-rays and blood tests aren’t usually
required when diagnosing osteoarthritis, however in some cases an
individual’s GP may opt for the individual to have X-rays and blood tests just
to rule of any possible fractures or rheumatoid arthritis.
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Bursitis is another condition which can affect the synovial joints. A bursa is a
fluid-filled sac which reduces friction around the joints. The bursa is lined with
cells called synovial cells and these secrete a fluid rich in collagen and
proteins. When the bursa becomes swollen due to the fluid inside being
infected or irritated because of too much movement, the condition known as
bursitis occurs. Bursitis causes pain, swelling and difficulty moved the joint
which is affected. Bursitis can affect any joint within the body such as the
elbow, ankle or shoulder although it is mainly found to occur within the knee.
“Your chances of developing bursitis are higher if your job or hobby involves a
repetitive movement, for example tennis and golf are common causes of
bursitis
of
the
elbow”
(http://www.nhs.uk/Conditions/Bursitis/Pages/Introduction.aspx?url=Pages/wh
at-is-it.aspx). There are many symptoms of bursitis which includes:

Constant pain around the joint

Tenderness around the joint

Swelling around the joint

Difficulty in moving the affected joint

Pain becoming worse when moving the affected joint which can also
happen during the night

In some cases redness around the affected area

In some cases the individual may develop a fever
The treatment and diagnosis of bursitis includes having a physical
examination by a GP in order to see whether or not the individual has bursitis.
During the physical examination if the individual has tenderness directly over
the bursa, swelling with the bursa and pain with movement of overlying
muscles and tendons then it is likely that the individual has bursitis. The
individual may then need to have an x-ray in order to confirm the diagnosis. In
some cases a MRI scan may be needed, this is usually done if the individual
is having difficulty walking. Once an individual knows that they have bursitis
then the treatment in which they may be given may be as simple as resting
the affected area of the body. The individual may also be recommended to
take an anti-inflammatory drug such as ibuprofen in order to reduce the pain
and swelling. If the symptoms of bursitis continue after trying the above
treatment then they may have to have the bursa drained and have an injection
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of a corticosteroid drug which will help to reduce the inflammation. If the
individual has an infection then they will have to take a course of antibiotics in
order to clear the infection.
Task Three – P4
An exercise which involves a ball and socket joint and a hinge joint is football.
Football is probably one of the most common types of exercise in which both
the ball and socket joint and hinge joint are used. In football the ball and
socket joint will be the hip and the hinge joint will be the knee. With the ball
and socket joint circular movements can occur and the joints can move in all
planes as well as rotation been possible. This therefore means that when the
individual kicks the ball in football there hip joint will rotate along with circular
movements happening in order for the individual to be able to kick the ball.
When the individual kicks the ball abduction will occur as this is when a body
part moves to the side or away from the middle. When the individual is moving
their leg back towards their body then adduction occurs as this is when a body
part moves from the side towards the middle of the body. As the ball and
socket joint has a ball which is rounded and which fits in a cavity which is
shaped like a cup of another bone, movement is allowed in any direction due
to this. With the hinge joint the movement which is available consists of up
and down motions which happen in one place. This therefore means that
when the individual kicks the ball in football there knee joint will only either go
up or down in one motion in order for the individual to be able to kick the ball.
When the individual kicks the ball extension will occur as this is when the
angle is made larger. When the individual is moving the knee back towards
their body then flexion occurs as this is when the joint angle is decreased. As
the hinge joint only allows movement which is in a single plane-flexion this
then means that movement can only occur in one direction.
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