Angie Guggino, MS, ATC, LAT


What is the structure and function of the
skeletal system?
What are the common diseases and injuries
effecting the skeletal system?
Evaluate the anatomy, physiology, and basic pathophysiology of the
muscular and skeletal systems, and perform technical skills related to the
systems.

6.2 Analyze the basic structures and functions of the skeletal system,
including locating and identifying the bones of the skeletal system and
hemopoiesis.

6.4 Identify and explain medical terms related to the muscular and
skeletal systems, and utilize when documenting in the electronic medical
record.

6.5 Research common diseases, disorders, and emerging disorders of the
muscular and skeletal systems including pathophysiology, prevention,
diagnosis and treatment that might be utilized.

6.6 Differentiate between the axial and appendicular skeletons.

6.7 Describe the development of the skeletal system.

6.8 Locate and identify the types of joints in the skeletal system.

6.12 Demonstrate proper techniques for ambulation with assistive devices
(crutches, cane, walker); and identify limitations and abnormalities.

How many bones in the human body?


What is a joint?


Place where two bones meet.
What is the name for the connective tissue that
attaches bone to bone?


206
ligaments
What are the two segments of the skeleton?


Appendicular skeleton
Axial skeleton





Support
Protection
Movement
Storage
Blood cell formation

Osteocytes


Osteoblasts


Mature bone cells
Bone-forming cells
Osteoclasts


Bone-destroying cells
Break down bone matrix for remodeling and release
of calcium
COMPACT




Dense
Compact
High mineral content
Strong
CANCELLOUS (TRABECULAR)


Spongy
Porous with honeycomb
structure

Short bones




Generally cube-shape
Contain mostly spongy bone
Examples: Carpals, tarsals
Long bones




Typically longer than wide
Have a shaft with heads at both ends
Contain mostly compact bone
Examples: Femur, humerus

Flat bones
Thin, flattened and usually curved
 Thin layers of compact bone around a layer of
spongy bone
 Examples: Skull, ribs, sternum


Irregular bones



Irregular shape
Do not fit into other bone classification categories
Example: Vertebrae

Diaphysis



Shaft
Composed of
compact bone
Epiphysis


Ends of the bone
Composed mostly of
spongy bone

Periosteum



Sharpey’s fibers


Outside covering of
the diaphysis
Fibrous connective
tissue membrane
Secure periosteum to
underlying bone
Arteries

Supply bone cells
with nutrients

Articular cartilage




Covers the external
surface of the epiphyses
Made of hyaline cartilage
Decreases friction at joint
surfaces
Medullary cavity



Cavity of the shaft
Contains yellow marrow
(mostly fat) in adults
Contains red marrow (for
blood cell formation) in
infants




Ossification
In embryos, the skeleton is primarily hyaline
cartilage
During development, much of this cartilage is
replaced by bone
Cartilage remains in isolated areas
Bridge of the nose
 Parts of ribs
 Joints




Epiphyseal plates allow for growth of long
bone during childhood
New cartilage is continuously formed
Older cartilage becomes ossified



Cartilage is broken down
Bone replaces cartilage
Bones are remodeled and lengthened until
growth stops

Bone mineral peaks



Remodeling



Women age 25-28
Men age 30-35
Process through which adult bone can change in
density, strength, and sometimes shape
When bone is subjected to high force it tends to
increase density
Bone only accounts for about 15% of body
weight

Astronauts can experience a dramatic decrease
in bone density while in a weightless
environment. Explain how this happens and
suggest a way to slow the loss of bone tissue.


Articulations of bones
Functions of joints



Hold bones together
Allow for mobility
Ways joints are classified


Functionally
Structurally

Synarthroses


Amphiarthroses


immovable joints
slightly moveable joints
Diarthroses

freely moveable joints

Fibrous joints


Cartilaginous joints


Generally immovable
Immovable or slightly moveable
Synovial joints

Freely moveable





Articulating bones are separated by a joint
cavity
Synovial fluid is found in the joint cavity
Articular cartilage (hyaline cartilage) covers the
ends of bones
Joint surfaces are enclosed by a fibrous
articular capsule
Ligaments reinforce the joint

Bursae – flattened fibrous sacs




Lined with synovial membranes
Filled with synovial fluid
Not actually part of the joint
Tendon sheath

Elongated bursa that wraps around a tendon






Gliding (plane)
Hinge
Pivot
Condyloid
Saddle
Ball-and- Socket
The Skeletal System

Dislocations
One of the articulating bones is displaced
 Shoulder, patella, fingers, elbow, jaw


Subluxation


Bursitis


Inflammation of the bursa
Sprains


Partial dislocation
Overstretching or tearing of a ligament
Fractures

Broken bone


Extremities most common
Statistics:
men up to 45 years of age
 women over 45 years of age
 Before 75 years wrist fractures most common
 75 years hip fractures most common





Magnitude and direction of force
Closed
– Bone fragments do not pierce skin
Open/compound
– Bone fragments pierce skin
Displaced or non-displaced

Usually caused by
directly applied force
to fracture site


Caused by violence
transmitted through
the distal limb
twisting movement


Occurs in children
Bones soft and bend
without fracturing
completely


Traction
Bony fragment usually
torn off by a tendon or
ligament

Abnormal stress on
normal bone


Fatigue fracture
Normal stress on
abnormal bone

Insufficiency fracture



Two or more bone
pieces
High energy trauma
Can require serious
hardware to repair


Splinting
Red Cross Videos


Reduction
Open reduction (surgery)
very accurate
 risk of infection
 Usually when internal fixation is needed


Manipulation


Usually with anesthesia
Traction

pulling




4-12 weeks
External fixation
Internal fixation
Frame fixation


Used for fractures that
are too unstable for a
cast.
Can shower and use
the hand gently with
the external fixator in
place.

Allows correction of
deformities by
moving the pins in
relation to the frame.
“Homedepot Method”
 Rods
 Screws
 Pins
 Plates
1.
2.
3.
4.
Fracture hematoma
Fibrocartilaginous callus
Bony callus
Bone Remodeling



blood from broken
vessels forms a clot.
6-8 hours after injury
swelling and
inflammation to dead
bone cells at fracture
site





About 3 weeks
New capillaries
organize fracture
hematoma into
granulation tissue called
a procallus
Fibroblasts and
osteogenic cells invade
procallus.
Make collagen fibers
which connect ends
together
Chondroblasts begin to
produce fibrocartilage



After 3 weeks
Lasts about 3-4
months
Osteoblasts make
woven bone.



Osteoclasts remodel
woven bone into
compact bone and
spongy bone
Often no trace of
fracture on X-ray
Several months
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
What is the definition of arthritis?
Approximately how many different varieties of arthritis
have been identified?
How do young or middle-aged adults usually experience
the disease?
Describe the four functional classifications of arthritis.
How are nerves affected with arthritis?
What are the general goals of arthritis therapy?
How does heat therapy help with arthritis?
What are NSAIDS?
Why should heat modalities not be used in acute cases of
arthritis?
What is the benefit of the COX-2 inhibitor vs. the COX-1
inhibitor?