Chapter 15 The Musculoskeletal System https://www.youtube.com/watch?v=J8x6tZI2hVI Copyright © 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. Learning Objectives Define terms relating to the structure and function of bones, joints, and muscles. Describe the process of bone formation and growth. Locate and name the major bones of the body. 1 Learning Objectives (cont’d.) Analyze the combining forms, prefixes, and suffixes used to describe bones, joints, and muscles. Explain various musculoskeletal disease conditions and terms related to bone fractures. 2 Learning Objectives (cont’d.) Describe important laboratory tests and clinical procedures related to the musculoskeletal system, and recognize relevant abbreviations. Apply your new knowledge to understanding medical terms in their proper contexts, such as medical reports and records. 3 Introduction – page 578 Musculoskeletal System: bones, muscles, and joints of the body Bones: structural support and protection of internal organs Muscles: internal and external movement Joints: where bones come together/type determined by need for flexibility 4 5 Physicians Associated with Musculoskeletal System Orthopedist: MD, bones, bone disease Rheumatologist: MD, joints Osteopathic physician: DO, body able to heal itself with proper nutrition and bone alignment Chiropractor: physical manipulation of the spinal column to relieve pressures on nerves 6 7 Bone Structure – page 579 206 bones in the body Long bones: legs and arms Short bones: wrist and ankle Flat bones: shoulder blades and ribs Irregular bones: vertebrae and facial bones Sesamoid bones: knee cap 8 BONE STRUCTURE – page 580 Long, short, flat, sesamoid (in shape) Diaphysis: shaft Epiphysis: end Metaphysis: cone-like flared portion between end and shaft Epiphyseal line or plate: growth plate where cartilage replaced by bone for bone growth (in length) 9 10 Bone Structure (cont’d.) Ends of bones covered by articular cartilage in the joint: cushions joint and allows it to move smoothly Compact bone: contains haversian systems for blood vessels, nerves, and yellow bone marrow (mostly fat) Cancellous (spongy/trabecular bone): spaces contain red bone marrow with elements for blood formation 11 Bone Marrow Yellow marrow: chiefly fat Red marrow: rich with blood vessels and immature and mature blood cells in various stages of development; in later life replaced with yellow marrow https://www.youtube.com/watch?v=EYd7On Ct7ug 12 Bone Processes and Depressions Processes: serve as attachments for muscles and tendons Depressions: openings or hollow regions help join bones or serve as passageways for nerves and/or vessels 13 Bone Processes and Depressions 14 Cranial Bones – page 582-583 15 Cranial Bones and Associated Structures Frontal bone Parietal bone Temporal bone Occipital bone foramen magnum Sphenoid bone temporomandibular (TMJ) joint mastoid process styloid process sella turcica Ethmoid bone 16 Facial Bones – page 584 17 SINUSES Air cavities located in facial and cranial bones. They lighten the skull and warm and moisten the air as it passes into the respiratory system. 18 Vertebral Column and Vertebrae 19 Vertebral Column and Vertebrae – page 586-587 Vertebrae: 26 bone segments from base of skull to tailbone in five divisions and separated by pads of cartilage called intervertebral disks. Cervical, thoracic, lumbar, sacral Coccyx: tailbone 20 BONES Thorax, Pelvis and Extremities 21 Thorax, Pelvis and Extremities Page 588 - 589 Thorax Arm and Hand clavicle humerus Pelvis pelvic girdle scapula ulna ilium sternum radius ischium ribs carpals pubis metacarpals phalanges 22 23 Clavicle and Scapula 24 Arm and Hand 25 Bones of the Pelvis – page 590 26 Bones of Leg and Foot – 590 - 591 27 Bones of Leg and Foot and Associated Structures Femur acetabulum Patella Tibia medial malleolus Tarsals calcaneus talus Metatarsals Phalanges Fibula lateral malleolus talus 28 QUICK QUIZ: 1. The knuckle-like process at the end of a bone near the joint… A. fossa B. condyle C. tubercle D.diaphysis 29 QUICK QUIZ: 2. Process of bone formation____________ A. olecranon B. ossification C. osteoblast D.xiphoid process 30 COMBINING FORMS AND SUFFIXES Combining Form calc/o calci/o kyph/o lamin/o lord/o lumb/o Meaning calcium calcium posterior curvature in thoracic region lamina curve loins, lower back 31 COMBINING FORMS AND SUFFIXES Combining Form myel/o orth/o oste/o scoli/o spondyl/o vertebr/o Meaning bone marrow straight bone crooked vertebra vertebra 32 COMBINING FORMS AND SUFFIXES Suffix -blast -clast -listhesis -malacia -physis -porosis -tome Meaning embryonic cell to break slipping softening to grow pore, passage instrument to cut 33 COMBINING FORMS AND SUFFIXES Combining Form acetabul/o calcane/o carp/o clavicul/o cost/o crani/o Meaning acetabulum (hip socket) calcaneus (heal) carpals (wrist bones) clavicle (collar bone) ribs cranium (skull) 34 COMBINING FORMS AND SUFFIXES Combining Form femor/o fibul/o humer/o ili/o ischi/o malleol/o Meaning femur (thigh bones) fibula (smaller lower leg bone) humerus (upper arm bone) ilium (upper part of pelvic bone) ischium (part of pelvic bone) malleolus 35 COMBINING FORMS AND SUFFIXES Combining Form mandibul/o maxill/o metacarp/o metatars/o olecran/o patell/o pelv/i Meaning mandible (lower jaw bone) maxilla (upper jaw bone) metacarpals (hand bones) metatarsals (foot bones) olecranon (elbow) patella (kneecap) pelvis 36 COMBINING FORMS AND SUFFIXES Combining Form perone/o phalang/o pub/o radi/o scapul/o Meaning fibula phalanges (finger, toe bones) pubis radius scapula (shoulder blade) 37 COMBINING FORMS AND SUFFIXES Combining Form stern/o tars/o tibi/o uln/o Meaning sternum (breastbone) tarsals tibia (shin bone) ulna (lower arm bone) 38 hypercalcemia hyper- calc/o: calcium -emia Excessive calcium in the blood 39 kyphosis kyph/o: humpback posterior curvature in the thoracic region -osis Abnormal posterior curvature of the thoracic vertebrae https://www.youtube.com /watch?v=DaoY7egfOc8 40 laminectomy lamin/o: lamina Part of the vertebral arch -ectomy Removal of a lamina To relieve the symptoms of a ruptured intervertebral disc (disk) or compression of the spinal cord after injury https://www.youtube.com/watch?v=S qWKWR4eR78 41 lordosis lord/o: curve, swayback anterior curvature of the lumbar region -osis Abnormal anterior curvature of the backbones in the lumbar region 42 orthopedics orth/o: straight ped/o: child -ic -s Pertaining to bones Orthopedists originally straightened the bones of children 43 scoliosis scoli/o: crooked, bent lateral curvature -osis Abnormal condition of a lateral curvature of the spine https://www.youtu be.com/watch?v=m iWPVMmn-zQ 44 osteomalacia oste/o -malacia Softening of bone https://www.youtube.com/watch?v= grCH4BHzuYo 45 osteoporosis oste/o -porosis: pore, passage Condition of increased porosity of bone 46 carpal carp/o: carpals wrist bones -al Pertaining to the carpals https://www.youtub e.com/watch?v=zSeJh5-nOo 47 supraclavicular supra- clavicul/o: clavicle collar bone -ar Pertaining to above the clavicle 48 chondrocostal chondr/o: cartilage cost/o -al Pertaining to the cartilage attached to the ribs 49 craniotomy crani/o -tomy Incision of the cranium 50 PATHOLOGIC CONDITIONS Ewing sarcoma: malignant bone tumor exostosis: bony growth on surface of bone osteogenic sarcoma: malignant tumor arising from bone osteomalacia: softening of bone osteomyelitis: inflammation secondary to infection talipes: congenital abnormality of hindfoot involving the talus (clubfoot) 51 52 Pathologic Conditions Fractures of Bones 53 Pathologic Conditions Normal Bone Bone with osteoporosis 54 Joints – page 602 Joint (articulation): coming together of two or more bones Suture joints: immovable (skull) Synovial joints: freely movable (ball and socket types, e.g. hip or shoulder), (hinge type, e.g., elbow, knee, ankle) 55 Synovial Joints Joint capsule surrounds bone Ligaments band bones together Bones covered by articular cartilage Synovial membrane lies under capsule and lines synovial cavity; filled with synovial fluid 56 Bursae Closed sacks of synovial fluid with a synovial membrane located near, but not within a joint. Needed where sliding must take place Common sites: between tendons (connective tissue connecting muscle to bone) and bones between ligaments (binding bone to bone) and bone between skin and bones (with prominent bony anatomy) 57 Joints 58 QUICK QUIZ: 3. Connective tissue that binds muscles to bones____________ A. ligament B. articulation C. synovial membrane D.tendon 59 COMBINING FORMS Page 604-605 Combining Form Meaning ankyl/o stiff arthr/o joint articul/o joint burs/o bursa chondr/o cartilage 60 COMBINING FORMS Combining Form Meaning ligament/o ligament rheumat/o watery flow synov/o synovial membrane ten/o tendon tendin/o tendon 61 SUFFIXES – page 604 Suffix Meaning -desis to bind, tie together -stenosis narrowing 62 Pathoology - Joints – page 606 Arthritis: inflammation of joints Ankylosing spondylitis: chronic progressive stiffening of joints, mostly spine Gouty arthritis: inflammation due to excessive uric acid in body Osteoarthritis (OA): loss of articular cartilage and formation of bone spurs at articular surfaces Rheumatoid arthritis (RA): autoimmune reaction against joint tissues (synovial membrane) 63 Osteoarthritis and Rheumatoid Arthritis https://www.youtube.com/watch?v=Yc-9dfem3lM 64 65 Pathologic Conditions Bunion: swelling of medial aspect of joint between big toe and first metatarsal bone Carpal tunnel syndrome: compression of median nerve as it passes between ligament and bones and tendons of the wrist. Dislocation: displacement of bone from a joint 66 Bunion 67 Pathological Joint Conditions (cont’d.) Carpal tunnel syndrome 68 Dislocation 69 Pathologic Conditions Ganglion: a fluid-filled cyst arising from the joint capsule or a tendon in the wrist. Herniation of an intervertebral disk: abnormal protrusion of the disk into the neural canal or against spinal nerves. Lyme disease: recurrent arthritis, myalgia, malaise and neurologic and cardiac symptoms. 70 Ganglion 71 Herniated Disk 72 Pathologic Conditions (cont’d.) Sprain: trauma to joint with pain, swelling and injury to ligaments Systemic lupus erythematosus (SLE): chronic inflammatory disease involving joints, skin, kidneys, nervous system, heart and lungs affecting collagen in tendons, ligaments, bones, and cartilage all over the body 73 Chapter 15 Muscles – page 611 74 Muscles Three types of muscles: striated, smooth, cardiac Striated: under voluntary control—they move all the bones as well as face and eyes Smooth: control is involuntary—they move internal organs (digestive tract, blood vessels, ducts of glands) Cardiac: not consciously controlled and found exclusively in the heart 75 Types of Muscle 76 Named Skeletal Muscles 77 Named Skeletal Muscles 78 Actions of Muscles – page 613 flexion rotation extension dorsiflexion abduction plantar adduction flexion supination pronation 79 Actions of Muscles (cont’d.) 80 QUICK QUIZ: 4. Movement AWAY from the midline of the body____________ A. adduction B. abduction C. flexion D.dorsiflexion 81 COMBINING FORMS page 614-615 Combining Form Meaning fasci/o fibr/o leiomy/o my/o facia fibrous smooth muscle muscle 82 COMBINING FORMS Combining Form myocardi/o myos/o plant/o rhabdomy/o Sarc/o Meaning heart muscle muscle sole of the foot skeletal muscle connected to bones flesh 83 SUFFIXES – page 615 Suffix Meaning -asthenia lack of strength -trophy development, nourishment 84 PREFIXES – page 615 PREFIXES Prefixe Meaning ab ad dorsi poly- away from toward back many, much 85 Pathologic Conditions - 616 Muscular dystrophy: group of inherited diseases with progressive muscle weakness and degeneration without nervous system involvement Polymyositis: chronic inflammatory myopathy; may be an autoimmune disorder 86 Laboratory Tests Related to Muscle – page 616 Antinuclear antibody test (ANA) Erythrocyte sedimentation rate (ESR) Rheumatoid factor test (RF) Serum calcium (Ca) Serum creatine kinase (CK) Uric acid test 87 Clinical Procedures Related to Bones, Joints, and Muscle Arthrocentesis Arthrography Arthroplasty Arthroscopy Bone density test Bone scan Computed tomography (CT) Diskography Electromyography (EMG) Magnetic resonance imaging (MRI) Muscle biopsy 88