The Skeletal System
• The adult skeleton is composed of 206 bones
• Newborns have about 300 bones!
• Bones begin to develop during the second
month of fetal development
• The smallest bone in your body is the stapes
which of one of 3 tiny bones found in the inner
ear
• The largest bone in your body is the femur
• Blood cells are formed in the red bone marrow
in your bones
What can bones tell us?
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Age at time of death
Gender
Whether or not a woman has had a vaginal birth
Whether you are right or left handed
What kind of a occupation or activities you may
have done
• What kind of a diet you may have had
• What you may have looked like in life
• What race/ethnicity you may have been
Anatomy & Physiology
Major structures that make the framework of
the skeleton
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206 Bones (primary)
Cartilage
Tendons (connect muscles to bones)
Ligaments (connect bones to bones)
Anatomy & Physiology
The skeleton is divided into main
groups
• The Axial Skeleton
Consists of 80 bones
Includes the skull, vertebral column,
and thoracic cage
• The Appendicular Skeleton
Consists of 126 bones
Includes shoulder girdle, arms and
hands, pelvic girdle, legs, and feet
Anatomy & Physiology
Bones are composed of:
50%Water
50% Solid matter (osseous tissue)
– Calcium phosphate contributes to hardness of bones
– Collagen contributes to the slight elasticity/flexibility of
bones
Functions of the Skeletal System
• Provide shape, support, and the framework of
the body
• Provide protection for internal organs
• Serves as a storage place for mineral salts,
calcium, and phosphorus
• Formation of blood cells (hematopoiesis)
• Provides sites for attachment of muscles
• Helps make movement possible through
articulations (joints)
Classifications of Bones
• Long Bones
– Most of the bones of the appendages
– Longer than they are wide
• Short Bones
– Cube shaped bones
– Found in the wrist and ankles
• Sesamoid – special class of short bone found in
tendons (kneecap)
Classifications of Bones
• Flat Bones
– Layer of spongy bone sandwiched between to
layers of compact bone
– Found in skull, sternum, ribs
• Irregular Bones
– Irregularly shaped bones that do not fit in the
other categories
– Examples include: vertebrae, hip bones, and some
skull bones
• Sutural or Wormian bones – small bones between the
flat bones of the skull
Classifications of Bones
Classifications of Bones
Structure of a Long Bone
Bell Work
• List the classifications of bone and provide an
example of each
• Draw a long bone and identify both external
and internal structures
• Describe the 2 divisions of the skeletal system
Bell Work
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What class of bone do the ribs fall in?
What class of bone does the sacrum fall in?
Where is spongy bone found in a long bone?
What is found inside the medullary cavity?
Joints
• A joint (jt) is an articulation
• A place where 2 or more bones connect
Classifications of Joints
• Synarthroses (Fibrous)
– Immoveable joints
– No joint cavity
– Example Sutures of skull
Classification of Joints
• Amphiarthroses (cartilaginous)
– Slightly moveable
– Connects bone to bone with cartilage
– Example would be vertebrae
Classification of Joints
• Diarthroses (Synovial)
– Freely moveable
– Contains a joint capsule with synovial fluid
– Example would be knee, elbow,
Joint Movements
(synovial joints)
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Flexion/Extension
Abduction/Adduction
Circumduction/Rotation
Protraction/Retraction
Pronation/Suppination
Dorsiflexion/Plantar Flexion
Inversion/Eversion
Fractures (Fx)
All fractures can be classified as Simple or
Compound
Simple (closed) fractures: do not penetrate the
skin
Compound (open) fractures break the skin
Transverse Fx
• Bone breaks across
the longitudinal axis
Comminuted Fx
• Bone shatters into 3
or more pieces
Green Stick
FX
• Only one side of
shaft broken
• Common in
children who’s
bones have not
yet ossified
Spiral Fx
• Caused by twisting
forces
• Common in sports
injuries
• May indicate abuse
Bell Ringer!!!
All Bell Ringers Due Friday
• Great Aunt Martha was watching her neighbor’s yorkie. Upon waking in
the middle of the night to go to the bathroom, she tripped upon the
poor yorkie and attempted to cushion her fall with her arms. This
resulted in breaking the distal portion of her radius. What kind of a Fx
did Great Aunt Martha sustain?
• Little Timmy loves to see how high he can jump off the swings at the
playground. One day, he landed wrong and broke his leg. His Dr. told his
mom that he broke his growth plate. What kind of Fx did Timmy
sustain?
• Suzie was riding her bike no-handed with her eyes closed…This was
quite a site to see until she crashed her bike into a parked car. When she
looked down, she could see a piece of her humerus (she didn’t find it
very funny poking out of her skin. What kind of Fx did Suzie have?
Arthritis
Arthr= (?) -itis = (?)
• Common types of arthritis include:
– Osteoarthritis (OA)
– Rheumatoid Arthritis (RA)
– Gouty Arthritis
All present with similar symptoms including
inflammation and arthralgia (?) but differ in their
etiology (cause)
Osteoarthritis (OA)
• Most common form of arthritis
• Considered “wear and tear” related to articular
cartilage wearing down over time
• Can affect any joint in the body, but hands, knees,
hips, & spine most commonly affected
• Gradually worsens over time
• No cure exists but maintaining a healthy weight,
and keeping active may slow progression
• Pain is usually worse in the morning
Osteoarthritis (OA)
Risk Factors
– Genetics
– Age (55 and older more affected)
– Gender (women are at higher risk)
– Obesity
– Joint injuries
– Certain occupations
Osteoarthritis (OA)
Treatments include :
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Analgesics such as acetaminophen (Tylenol)
NSAID’s such as ibuprofen or Alieve (anti-inflammatory)
Corticosteroids (limited in frequency per year)
Lubrication injections
Physical therapy and low-impact activity
Surgical interventions (i.e. joint replacement surgery
Rheumatoid Arthritis (RA)
• Chronic autoimmune disease where the body’s
immune system attacks the lining of the joints
• Usually affects the small joints of the hands and
feet
• Causes swelling that erodes bone and causes
deformities which can lead to disability
• Can occur at any age (i.e. juvenile rheumatoid
arthritis) but is more common after age 40
• More common in women than men
Rheumatoid Arthritis (RA)
Symptoms
– Similar to OA but may also include:
• Firm bumps of tissue under the skin on your arms
(rheumatoid nodules)
• Fatigue, fever and weight loss
– May come and go in periods of remission and
exacerbation
Rheumatoid Arthritis (RA)
Treatments include:
• Analgesics & NSAIDs
• DMARDs (disease modifying antirheumatic drugs) which suppress the
immune response to tissues but may also increase risk for infections
• Surgical interventions
• PT/OT (including assistive devices)
Gouty Arthritis
• Complex form of arthritis
• Occurs when urate crystals accumulate in joints
• Urate crystals form when high levels of uric acid
accumulates in the blood
• Uric acid is produced by the breakdown of purines—
substances that are found naturally in the body, as
well as in certain foods, such as organ meats,
anchovies, herring, asparagus and mushrooms
• Uric acid builds up, forming sharp, needle-like urate
crystals in a joint or surrounding tissue that cause
pain, inflammation and swelling
Gouty Arthritis
Symptoms:
• sudden, severe attacks of pain, redness and
tenderness in joint
• often affects the joint at the base of the big toe
but can affect the knees, feet, hands, ankles &
wrists
• Pain is most sever in first 12-24 hours of flare-up
• Historically gout was stereotyped as the “lazyman’s disease”
Gouty Arthritis
Risk Factors Include:
• Lifestyle- excessive alcohol intake, and purine-rich
diet if you are susceptible
• Gender - occurs more often in men
• Family History of Gout
• Age – men in their 40s-50s and post-menopausal
women
• Certain medications
• Medical conditions such as hypertension,
hypercholesterolemia, and diabetes
Gouty Arthritis
Treatments
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NSAID’s and corticosteroids to reduce inflammation
Hydration- 2-4L of fluid each day
Avoid alcohol
Limit your daily intake of meat, fish and poultry to
4 to 6 ounces (about the size of a deck of cards)
• Avoid purine rich foods such as
– Organ meats, such as liver, kidneys, sweetbreads,
and brains
– Meats, including bacon, beef, pork, and lamb
– Game meats
– Any other meats in large amounts
– Anchovies, sardines, herring, mackerel, and scallops
– Gravy
– Beer
Gouty Arthritis
Before you leave…
• What makes gouty arthritis different from OA
or RA?
• How are all 3 forms of arthritis the same?
• What is the difference between OA and RA?
Bell Ringer
• Great Uncle Rupert loves is bedtime snack of
sardines washed down with an ice-cold beer. Last
night, Great Uncle Rupert woke up in pain stating
that his right great toe felt like it was on fire!
Upon inspection, his toe was swollen, angry red,
and it appeared to have white stone-like rocks
embedded into the tissue. What do you suppose
he has?
• What is causing his problems?
• What can he do to avoid future problems of this
nature?