chapter 15 musculoskeletal system. 1. bones (oste/o=bone)- provides the framework around which the...

Chapter 15Chapter 15

Musculoskeletal SystemMusculoskeletal System

Musculoskeletal SystemMusculoskeletal System

• 1. Bones (oste/o=bone)- provides the framework around which the body is constructed and protect and support internal organs

• 2. Joints (arthr/o; articul/o= joint)- places at which bones come together

• 3. Muscles (my/o; myos/o=muscle)- attached to bones, or to internal organs and blood vessels. They are responsible for movement

• 1. Bones (oste/o=bone)- provides the framework around which the body is constructed and protect and support internal organs

• 2. Joints (arthr/o; articul/o= joint)- places at which bones come together

• 3. Muscles (my/o; myos/o=muscle)- attached to bones, or to internal organs and blood vessels. They are responsible for movement

TermsTerms

• -Orthopedic- (orth/o= straight; ped/i= child); physicians who treat bone & joint disease

• -Rheumatologist- (rheumat/o= watery flow); one who specializes in the study of joint diseases (because joint diseases are marked by collection of fluid in joint spaces

• Chiropractor- (chir/o= hand)- use physical means to manipulate the spinal column

• -Osteopathy- (oste/o=bone; path= disease)- p/t to diseases of the bone– Osteopathic physicians (DO)

• -Orthopedic- (orth/o= straight; ped/i= child); physicians who treat bone & joint disease

• -Rheumatologist- (rheumat/o= watery flow); one who specializes in the study of joint diseases (because joint diseases are marked by collection of fluid in joint spaces

• Chiropractor- (chir/o= hand)- use physical means to manipulate the spinal column

• -Osteopathy- (oste/o=bone; path= disease)- p/t to diseases of the bone– Osteopathic physicians (DO)

BonesBones• -Complete organs composed of connective tissue

called osseous (bony) tissue ; plus a rich supply of blood vessels and nerves

• Osseous tissue consists of osteocytes (bone cells), collagen (dense connective tissue), and calcium salts

• Ossification- bone formation• Osteoblasts- immature osteocytes that produce bony

tissue that replaces cartilage during ossificationa• Osteoclasts- (-clast=to break); large cells that function

to reabsorb, digest bony tissue. They enlarge the inner bone cavity so bones do not become too heavy

• *Calcium and Phosphorus are minerals necessary to produce enzymes to give bones strength

• -Complete organs composed of connective tissue called osseous (bony) tissue ; plus a rich supply of blood vessels and nerves

• Osseous tissue consists of osteocytes (bone cells), collagen (dense connective tissue), and calcium salts

• Ossification- bone formation• Osteoblasts- immature osteocytes that produce bony

tissue that replaces cartilage during ossificationa• Osteoclasts- (-clast=to break); large cells that function

to reabsorb, digest bony tissue. They enlarge the inner bone cavity so bones do not become too heavy

• *Calcium and Phosphorus are minerals necessary to produce enzymes to give bones strength

Structure of bonesStructure of bones

• 206 bones in the body• Long bones- found in thigh, lower leg, and upper and

lower arm; strong and broad at end where they join other bones. They have large surface areas for muscle attachment.

• Short bones- found in wrist and ankle and are small with irregular shapes

• Flat bones- cover soft body parts• Sesamoid bones- small, round and resembles a

sesame seed in shape. They are found near joint.• What is the largest sesamoid bone in the body?

____________________

• 206 bones in the body• Long bones- found in thigh, lower leg, and upper and

lower arm; strong and broad at end where they join other bones. They have large surface areas for muscle attachment.

• Short bones- found in wrist and ankle and are small with irregular shapes

• Flat bones- cover soft body parts• Sesamoid bones- small, round and resembles a

sesame seed in shape. They are found near joint.• What is the largest sesamoid bone in the body?

____________________


• Diaphysis- shaft or middle region of a long bone

• Epiphysis- end of the long bones• Metaphysis- flared portion of the bone• Periosteum- strong, fibrous, vascular

membrane that covers the surface of long bones

• Articular cartilage- where the ends of long bones and the surface of any bone meet

• *the bones of a fetus are mostly made of cartilage

• Diaphysis- shaft or middle region of a long bone

• Epiphysis- end of the long bones• Metaphysis- flared portion of the bone• Periosteum- strong, fibrous, vascular

membrane that covers the surface of long bones

• Articular cartilage- where the ends of long bones and the surface of any bone meet

• *the bones of a fetus are mostly made of cartilage


• Compact bone- layer of hard, dense bone that lies under the periosteum near the diaphysis of long bones

• Haversian canal- small canals containing blood vessels that bring O2 and nutrients; remove waste products (CO2)

• Cancellous bone- “spongy or trabecular”; porous and less dense than compact bone; red bone marrow is located here– Trabeculae- spongy latticework

• Compact bone- layer of hard, dense bone that lies under the periosteum near the diaphysis of long bones

• Haversian canal- small canals containing blood vessels that bring O2 and nutrients; remove waste products (CO2)

• Cancellous bone- “spongy or trabecular”; porous and less dense than compact bone; red bone marrow is located here– Trabeculae- spongy latticework

Bone ProcessesBone Processes

• Bone processes are enlarged areas to serve as attachment for muscles and tendons

• Bone head- rounded end of a bone separated from the body of the bone by a neck

• Greater Trochanter- large process on the femur for attachment of tendons and muscle (lesser trochanter is just smaller)

• Condyle- rounded, knuckle-like process at a joint• Tubercle- rounded process on many bones for

attachment of tendons and muscles– Tuberocity- small rounded elevation on a bone

• Bone processes are enlarged areas to serve as attachment for muscles and tendons

• Bone head- rounded end of a bone separated from the body of the bone by a neck

• Greater Trochanter- large process on the femur for attachment of tendons and muscle (lesser trochanter is just smaller)

• Condyle- rounded, knuckle-like process at a joint• Tubercle- rounded process on many bones for

attachment of tendons and muscles– Tuberocity- small rounded elevation on a bone

Bone openings or hollow regionsBone openings or hollow regions

• Fossa- shallow cavity in or on a bone• Foramen- opening for blood vessels and

nerves• Fissure- narrow, deep, slit-like opening• Sinus- hollow cavity within a bone

• Fossa- shallow cavity in or on a bone• Foramen- opening for blood vessels and

nerves• Fissure- narrow, deep, slit-like opening• Sinus- hollow cavity within a bone

Copyright © 2001 by W. B. Saunders Company. All rights reserved.

A) Divisions of a long bone and interior bone structure.B) Composition of compact (cortical) bone.A) Divisions of a long bone and interior bone structure.B) Composition of compact (cortical) bone.

Fig. 15-1AB.

Fig. 15-1AB.

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A) Divisions of a long bone and interior bone structure.B) composition of compact (cortical) bone.A) Divisions of a long bone and interior bone structure.B) composition of compact (cortical) bone.

Fig. 15-1AB.

Fig. 15-1AB.



Bone processes on the femur and humerus.Bone processes on the femur and humerus.

Fig. 15-2AB.

Fig. 15-2AB.



Cranial bones (lateral view).Cranial bones (lateral view).

Fig. 15-3.

Fig. 15-3.



Cranial bones (looking downward at floor of cranial cavity).Cranial bones (looking downward at floor of cranial cavity).

Fig. 15-4.

Fig. 15-4.



Facial bones.Facial bones.

Fig. 15-5.

Fig. 15-5.



Sinuses of the skull.Sinuses of the skull.

Fig. 15-6.

Fig. 15-6.



Vertebral column.Vertebral column.

Fig. 15-7.

Fig. 15-7.


Bones of the Thorax (chest cavity)Bones of the Thorax (chest cavity)

• Clavicle

• Scapula

• Sternum

• Ribs• Acromion

• Clavicle

• Scapula

• Sternum

• Ribs• Acromion

Bones of the Arm and HandBones of the Arm and Hand

• Humerus– Olecranon

• Ulna• Radius• Carpals• Metacarpals• Phalanges

• Humerus– Olecranon

• Ulna• Radius• Carpals• Metacarpals• Phalanges

Pelvic BonesPelvic Bones• Pelvic girdle – pelvis;

collection of bones composed of:

ilium

ischium

pubis

*Pubic Symphysis-

Anterior part of pelvis where cartilage connects

• Pelvic girdle – pelvis; collection of bones composed of:

ilium

ischium

pubis

*Pubic Symphysis-

Anterior part of pelvis where cartilage connects

Bones of the Leg and FootBones of the Leg and Foot• Femur• Patella• Tibia

-Malleous• Fibula• Tarsals -(7 bones)-

calcaneus- heel bone is the largest

• Metatarsals• Phalanges of the toes

• Femur• Patella• Tibia

-Malleous• Fibula• Tarsals -(7 bones)-

calcaneus- heel bone is the largest

• Metatarsals• Phalanges of the toes


Bones of the thorax, pelvis, and extremities.Bones of the thorax, pelvis, and extremities.

Fig. 15-9.

Fig. 15-9.



Bones of the foot.Bones of the foot.

Fig. 15-11AB.Fig. 15-11AB.

A B


Fractures- break in a boneFractures- break in a bone• Closed fx – bone is broken but no open wound• Open fx- bone is broken and a fragment of bone

protrudes through skin• Crepitus- crackling sound when ends of bones rub

each other or roughened cartilage• Colles fx- occurs near the wrist joint at lower end of

radius• Comminuted fx- bone splintered or crushed into

several pieces• Compression fx- bone is compressed• Greenstick fx- bone is partially broken; typically

occurs in children• Impacted fx- one fragment is driven firmly into another

• Closed fx – bone is broken but no open wound• Open fx- bone is broken and a fragment of bone

protrudes through skin• Crepitus- crackling sound when ends of bones rub

each other or roughened cartilage• Colles fx- occurs near the wrist joint at lower end of

radius• Comminuted fx- bone splintered or crushed into

several pieces• Compression fx- bone is compressed• Greenstick fx- bone is partially broken; typically

occurs in children• Impacted fx- one fragment is driven firmly into another

Open fractureOpen fracture

Colles FractureColles Fracture

Comminuted FractureComminuted Fracture


Types of fractures.Types of fractures.

Fig. 15-13.

Fig. 15-13.


Pathologic conditions Pathologic conditions • Ewing Sarcoma- malignant bone tumor• Exostosis- bony growth arising from the surface of

bone (ex=out; -ostosis= bone condition)• Osteogenic sarcoma- malignanat tumor arising from

bone (osteosarcoma)• Osteomalacia- softening of bone (loss of calcium)• Osteomyelitis- inflammation of bone & bone marrow

due to infection• Osteoporosis- decrease in bone density (mass);

thinning of bone• Osteopenia- interior of bones is diminished in

structure • Osteodystrophy- poor formation of bone

• Ewing Sarcoma- malignant bone tumor• Exostosis- bony growth arising from the surface of

bone (ex=out; -ostosis= bone condition)• Osteogenic sarcoma- malignanat tumor arising from

bone (osteosarcoma)• Osteomalacia- softening of bone (loss of calcium)• Osteomyelitis- inflammation of bone & bone marrow

due to infection• Osteoporosis- decrease in bone density (mass);

thinning of bone• Osteopenia- interior of bones is diminished in

structure • Osteodystrophy- poor formation of bone

Pathological ConditionsPathological Conditions• Talipes- congenital abnormality in hindfoot

(involving talus; clubfoot)• Kyphosis- “hunchback”; spine curvature in

thoracic cavity• Lordosis- lumbar spine curves outward• Scoliosis- lateral curvature of spine• Sciatica- pain radiating down the leg

(nerve)

• Talipes- congenital abnormality in hindfoot (involving talus; clubfoot)

• Kyphosis- “hunchback”; spine curvature in thoracic cavity

• Lordosis- lumbar spine curves outward• Scoliosis- lateral curvature of spine• Sciatica- pain radiating down the leg

(nerve)


Scanning electromicrograph(A: Normal bone; B: Bone with osteoporsis).Scanning electromicrograph(A: Normal bone; B: Bone with osteoporsis).

Fig. 15-15AB.

Fig. 15-15AB.(From Dempster DW, Shane E, Horbert W, et al: A simple method for correlative light and

scanning electron microscopy of human iliac crest bone biopsies: qualitative observations in normal and osteoporotic subjects. J Bone Miner Res, 1986; 1:15.)


Types of jointsTypes of joints

• Joint (arthr/o)- a coming together of two or more bones

• Suture joint- immovable joint• Synovial joint- freely moveable• Joint capsule- bones in a synovial joint

composed of fibrous tissue• Ligaments- connect bone to bone; thick

fibrous band of connective tissue– Sprain - trauma to a joint with pain, swelling

and injury to ligaments• Articular Cartilage- covers the smooth end of

the joints surface

• Joint (arthr/o)- a coming together of two or more bones

• Suture joint- immovable joint• Synovial joint- freely moveable• Joint capsule- bones in a synovial joint

composed of fibrous tissue• Ligaments- connect bone to bone; thick

fibrous band of connective tissue– Sprain - trauma to a joint with pain, swelling

and injury to ligaments• Articular Cartilage- covers the smooth end of

the joints surface

Types of JointsTypes of Joints• Synovial Membrane- lies under the joint

capsule and lines the synovial cavity

between the bones. - The synovial fluid contains water and nutrients

that lubricate the joint.- Bursae (bursa)-sac that contains synovial fluid

that are located near but not within a joint- Tendons -connective tissue that connects

muscle to bone- Tenorrhaphy- suture of a tendon

• Synovial Membrane- lies under the joint capsule and lines the synovial cavity

between the bones. - The synovial fluid contains water and nutrients

that lubricate the joint.- Bursae (bursa)-sac that contains synovial fluid

that are located near but not within a joint- Tendons -connective tissue that connects

muscle to bone- Tenorrhaphy- suture of a tendon


The knee (A: Sagittal; B: Frontal).The knee (A: Sagittal; B: Frontal).

Fig. 15-18AB.

Fig. 15-18AB.

A B


Pathological conditionsPathological conditions• Arthritis- inflammation of a joint

– Ankylosing Spondylitis- chronic, progressive arthritis with stiffening of joints

– Gouty Arthritis -inflammation and painful swelling of joints caused by excessive uric acid in the body (hyperuricemia); typically affects the big toe and is often called “podagra”

– Osteoarthritis -(OA); progressive, degenerative joint disease characterized by loss of articular cartilage and hypertrophy of bone

• Arthritis- inflammation of a joint– Ankylosing Spondylitis- chronic,

progressive arthritis with stiffening of joints– Gouty Arthritis -inflammation and painful

swelling of joints caused by excessive uric acid in the body (hyperuricemia); typically affects the big toe and is often called “podagra”

– Osteoarthritis -(OA); progressive, degenerative joint disease characterized by loss of articular cartilage and hypertrophy of bone

Pathological ConditionsPathological Conditions• Rheumatoid Arthritis (RA)- Chronic disease in which

joints become inflamed and painful. It is thought to be an autoimmune reaction against joint tissues– Pyrexia (fever) – symptom of RA

• Ankylosis - condition of stiff, bent joint• Bunion - abnormal swelling of the medial aspect of the

joint between the big toe and first metatarsal• Carpal Tunnel Syndrome-compression of the median

nerve as is passes between the ligament, bones and tendons of the wrist.

• Arthroplasty- surgical repair of a joint• Spondyloliasthesis- slipping or subluxation of

vertebrae

• Rheumatoid Arthritis (RA)- Chronic disease in which joints become inflamed and painful. It is thought to be an autoimmune reaction against joint tissues– Pyrexia (fever) – symptom of RA

• Ankylosis - condition of stiff, bent joint• Bunion - abnormal swelling of the medial aspect of the

joint between the big toe and first metatarsal• Carpal Tunnel Syndrome-compression of the median

nerve as is passes between the ligament, bones and tendons of the wrist.

• Arthroplasty- surgical repair of a joint• Spondyloliasthesis- slipping or subluxation of

vertebrae

Pathological ConditionsPathological Conditions

• Herniation of an intervertebral disk- abnormal protrusion of a fibrocartilaginous intervertebral disc into the spinal nerves

• Ganglion cyst- A fluid-filled cyst arising from the joint capsule or a tendon

• Dislocation -Displacement of a bone from its joint– Reduction= restoration of bones to normal

position– Subluxation= partial dislocation

• Herniation of an intervertebral disk- abnormal protrusion of a fibrocartilaginous intervertebral disc into the spinal nerves

• Ganglion cyst- A fluid-filled cyst arising from the joint capsule or a tendon

• Dislocation -Displacement of a bone from its joint– Reduction= restoration of bones to normal

position– Subluxation= partial dislocation

Pathological ConditionsPathological Conditions• Lyme Disease- a recurrent disorder marked

by severe arthritis, myalgia, malaise, and neurologic and cardiac syndromes

• Sytemic Lupus Erythematosus (SLE)- chronic inflammatory autoimmune disease involving joints, skin, kidneys, nervous system, heart and lungs; characterized by ‘butterfly rash”

• Lyme Disease- a recurrent disorder marked by severe arthritis, myalgia, malaise, and neurologic and cardiac syndromes

• Sytemic Lupus Erythematosus (SLE)- chronic inflammatory autoimmune disease involving joints, skin, kidneys, nervous system, heart and lungs; characterized by ‘butterfly rash”


Osteoarthritis and rheumatoid arthritis.Osteoarthritis and rheumatoid arthritis.

Fig. 15-19.

Fig. 15-19.



Carpal tunnel syndrome.Carpal tunnel syndrome.

Fig. 15-20AB.

Fig. 15-20AB.



Protrusion of an intervertebral disc. *Laminectomy- opertation to relieve symptoms of a

slipped disk

Protrusion of an intervertebral disc. *Laminectomy- opertation to relieve symptoms of a

slipped disk

Fig. 15-22.

Fig. 15-22.


MusclesMuscles• Cardiac muscle- striated in appearance but is like

smooth muscle in action; no conscious controlled; • Smooth muscle- involuntary or visceral muscle that

move internal organs. They have no dark or light bands, fibrils, or cytoplasm

• Leiomyosarcoma- malignant tumor of smooth muscle• Striated muscle- voluntary or skeletal muscle that

move all bones– Fascia- fibrous tissue that envelops and separates

muscles and contains the blood, lymph, and nerves

• Cardiac muscle- striated in appearance but is like smooth muscle in action; no conscious controlled;

• Smooth muscle- involuntary or visceral muscle that move internal organs. They have no dark or light bands, fibrils, or cytoplasm

• Leiomyosarcoma- malignant tumor of smooth muscle• Striated muscle- voluntary or skeletal muscle that

move all bones– Fascia- fibrous tissue that envelops and separates

muscles and contains the blood, lymph, and nerves

MusclesMuscles• Skeletal muscle- over 600 in the human body.• The point of attachment of the muscle to a

stationary bone is called origin (beginning).• When the muscle contracts, another bone to

which it is attached to does move. The point of junction of the muscle to the bone that does move is called the insertion of the muscle.

• *Most often, the origin of a muscle lies proximal in the skeleton and insertion lies distal.

• Atrophy- wasting away of muscle (shrinking of size)

• Skeletal muscle- over 600 in the human body.• The point of attachment of the muscle to a

stationary bone is called origin (beginning).• When the muscle contracts, another bone to

which it is attached to does move. The point of junction of the muscle to the bone that does move is called the insertion of the muscle.

• *Most often, the origin of a muscle lies proximal in the skeleton and insertion lies distal.

• Atrophy- wasting away of muscle (shrinking of size)


Origin and insertion of the biceps.Origin and insertion of the biceps.

Fig. 15-26.

Fig. 15-26.


Terms for muscle/joint movementTerms for muscle/joint movement• Abduction• Adduction• Dorsiflexion• Plantarflexion• Extension• Flexion• Supination• Pronation• Rotation

• Abduction• Adduction• Dorsiflexion• Plantarflexion• Extension• Flexion• Supination• Pronation• Rotation


Types of muscular actions.Types of muscular actions.

Fig. 15-27.

Fig. 15-27.

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AbbreviationsAbbreviations• ROM• ACL• PCL• MCL• LCL• EMG• RA• PT• NSAID• TMJ• THR• TKR

• ROM• ACL• PCL• MCL• LCL• EMG• RA• PT• NSAID• TMJ• THR• TKR

chapter 15 musculoskeletal system. 1. bones (oste/o=bone)- provides the framework around which the...

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bones osteo

structure of bones

short bones

bones complete organs

bone path

bones strength slide

body long bones

osteocytes bone cells