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AOHS Foundations of Anatomy and Physiology I

Lesson 5The Skeletal System

Student Resources

Resource Description

Student Resource 5.1 Survey: Who Knows about….

Student Resource 5.2 Diagram: Major Bones of the Body

Student Resource 5.3 Reading: Major Bones of the Body

Student Resource 5.4 Notes: Anatomy and Function of the Skeletal System

Student Resource 5.5 Reading: Anatomy and Function of the Skeletal System

Student Resource 5.6 Chart: My Daily Calcium

Student Resource 5.7 Reading: Skeletal System Disorders

Student Resource 5.8 Glossary: The Skeletal System (separate Word file)

Student Resource 5.9 Vocabulary: Describing Skeletal System Symptoms

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AOHS Foundations of Anatomy and Physiology ILesson 5 The Skeletal System

Student Resource 5.1

Survey: Who Knows about….Student Name:_______________________________________________________ Date:___________

Directions: Survey your classmates for responses to each of the following statements. In the box below each statement, write the initials of each classmate in the row that corresponds to whether the answer was yes and no. Then total up the number of classmates you surveyed who answered yes and who answered no.

1. I know someone who has broken a bone.

Answer

Initials of Classmates Total

Yes

No

2. I‘ve seen an X-ray of a human bone.

Answer


Yes

No

3. I know someone who has scoliosis.

Answer


Yes

No

4. I’ve touched a real human bone.

Answer


Yes



No




Diagram: Major Bones of the BodyName:______________________________________ Date: __________________________

Directions: Label the bones on the diagram below and complete the sections that follow.



The bones that make up the axial skeleton are:

_______________________________

_______________________________

_______________________________

______________________________

_______________________________

The bones that make up the appendicular skeleton are:

The ___________________girdle, which includes:

o _______________________________

o _______________________________

Bones that make up the appendages attached to this girdle:

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________



Bones that make up the appendages attached to the ___________________girdle include:

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________

_______________________________




Reading: Major Bones of the Body



Although all bones give your body structure, many of them perform other roles as well. Your rib cage protects your heart and lungs. The bones in your legs hold you up and let you walk. Bones have different shapes that make it possible for them to play these roles. As an adult, you have 206 bones in your body. Half of all the bones in your body are in your hands and feet.



The most familiar shape of bone is probably the long bone. The top image is an anterior view of a femur, or thigh bone, which is the biggest, heaviest bone in your body. Long bones can support a lot of weight relative to their size, and they tend to be very strong bones. Your femur bone is stronger than a bone the same shape and size would be if it were made out of steel. Some familiar long bones are the bones in your legs and arms. Long bones give your body a lot of structural support and are important in movement. Your finger and toe bones are also long bones.

Short bones are just that―short and squat. The best-known short bones are the sets of bones that make up your wrists and ankles, called the carpals and the tarsals. These bones are clustered together in arrangements that allow them to glide past each other. Because there are so many small bones so close together in the wrist and ankle, they come together in ways that allow for lots of different kinds of movement.



As you can see, flat describes the structure of the bone, but flat bones aren’t usually completely flat. Unlike long and short bones, flat bones are thin and have flat, rather than rounded surfaces. Some other flat bones in your body include your cranium, the part of your skull that protects your brain, and your pelvis, which protects your reproductive organs and your kidneys. Your shoulder blade, a bone called the scapula, is also a flat bone, and that has anchor points for the muscles that move your arms. Along with protecting organs, flat bones also produce most of your blood cells―another very important function of your skeletal system.



Irregular bones are irregularly shaped and don’t really fall into any of the other categories. Sometimes their shape allows for the attachment of muscles that move these bones in important ways. Take your mandible (lower jawbone), for instance. You move it in many directions when you eat and when you make facial expressions. And as a human, you use your mandible to talk. Read the slide out loud: what do you notice about how your jaw is moving while you’re speaking? Some other irregular bones are a trio of tiny bones in your ear, the auditory ossicles, which are the smallest bones in your body. Together they would fit onto the surface of a dime. They transmit the vibrations of sound waves into your inner ear, where another organ allows you to perceive sound. Irregularly shaped bones in your spine have a shape that makes them excellent protectors of your spinal cord.



The enamel of your teeth has even more calcium in it than bones do. Unlike the outer, hard layer of your bones, called compact bone, the enamel of your teeth doesn’t have any blood supply. Enamel is very brittle, and isn’t alive, like compact bone is. The living part of a tooth is inside, under the enamel. The inside of the tooth contains dental pulp and has many blood vessels and nerve fibers.



Eighty of your bones are in the axial skeleton. It’s anchored in your spine (sometimes called your backbone or vertebral column) and includes all the bones that are attached to it, meaning your ribs and your skull. Running through the midline of your body (and of the axial skeleton) is your spine, which follows the main vertical axis of your body. If you were to spin in a circle, you could be pivoting around your axis. Thus, the name axial skeleton. Many of the bones in your axial skeleton are primarily for protection. Your upper portion of your skull protects your brain. Your spine, made of irregular bones called vertebrae, protects your spinal cord, and your pelvis protects your reproductive organs. A woman’s pelvis is a little wider than a man’s, making more room for a baby to pass through. Many of the bones in your axial skeleton don’t move very much in relation to one another. The bones surrounding your brain, for example, do not move separately from one another (although they move as a group when you turn your head). The ribs move very little. A woman’s pelvis, however, can expand ever so slightly in ways a man’s can’t―again, to make room for a baby on the way.



Your appendicular skeleton is the part that does most of the activity of your body. The appendicular bones don’t protect any of your organs; they support you and do most of your physical interacting with the world around you. The terms appendicular and appendage come from the word “append,” which means to add a part to something larger. Animals that have backbones share similarities in the appendicular skeletons as well. For example, most vertebrates have appendages of some sort or another.



The two girdles circle the axis of the body. At each of the girdles, bones from the axial skeleton meet bones of the appendicular skeleton. The pectoral girdle is made up of your clavicle (collarbone) and parts of the scapula (shoulder blade). Your pelvic girdle―often just called your pelvis―is made up of your hip bones and several smaller bones fused together to create the sacrum at the very base of your spine.



As we go along, see if you can find all these bones in your own body and determine their shape and where they begin and end. Your skull has two parts: the cranium protects your brain and is the support for your face. It’s made of many bones fused together. Your mandible is your jawbone. It’s a horseshoe shape that gives you your chin. See if you can tell where your mandible meets your cranium. Your skull connects to your spine, which is made of 24 bones called vertebrae. If you hunch your back forward slightly, you can feel the spines (bumpy ridges) of your vertebrae running down your back. Each bump is a part of a different vertebra. You can remember that your vertebrae help keep you vertical. Your vertebrae protect your spinal cord, a big bundle of nerves that serves as an information highway between your body and your brain. The vertebrae are separated from each other by a disk of cushiony connective tissue. At the base of the spine is the sacrum, which is made of several bones fused together and is considered part of the pelvic girdle. The pelvic girdle protects your reproductive organs and parts of your urinary system. Posteriorly, your ribs are attached to the upper (superior) vertebrae, and anteriorly, most of them also attach to the sternum. Together, the ribs and sternum protect your heart and lungs.



The clavicle, or collarbone, and scapula, or shoulder blade, make up the pectoral girdle. The clavicle is the most frequently broken bone in the body, and doctors can’t give you a cast for it, so be careful with your clavicle! You can feel the bumps of the scapula on your back, just below your shoulder. Your upper arm bone is the humerus. It joins with your two lower arm bones, the radius and the ulna, to form your elbow. Your radius is lateral to your ulna, meeting your hand near your thumb. You can remember the name of your radius by remembering that it’s the bone that rotates. Hold your arm straight out and hold your elbow with the opposite hand. Now turn your hand (the one attached to the arm you’re holding out). Notice that one of the bones, your ulna, stays pretty much in the same place. The other one, your radius, moves in a semicircle.

Your wrists are made up of eight short bones called carpals. Distal to your carpals are the bones that make up the palm of your hand, called the metacarpals. The prefix meta refers to something that is beyond, or built on something else. You can see the distal ends of your metacarpals; they’re your knuckles when you make a fist. There are five metacarpals, each leading to a finger. The bones that make up your fingers are called phalanges. Your thumb has two phalanges, and the rest of your fingers have three.



The structure of your arms and legs is remarkably similar. Your thighbone, or femur, is the biggest and strongest bone in your body. Your lower legs, like your lower arms, have two bones: the tibia is the edgy bone you feel as your shin bone. Lateral to the tibia is a smaller bone, the fibula. Where your femur meets your tibia and fibula, you’ll find your kneecap, called your patella. Stand up and you’ll be able to feel that you can move your kneecap around a bit, but you can’t move your femur or tibia like that. Your kneecap is anchored to your leg bones in a flexible way that allows smooth walking movements. Your ankles are made of many seven short bones called tarsals. The tarsals meet with five long bones that make up your feet, call the metatarsals. There are five metatarsals, each leading to a toe. The distal ends of your metatarsals make up the ball of your foot. Like the bones in your fingers, the bones in your toes are phalanges. Your feet are wondrously capable of bearing your body weight and cushioning the shock from walking and running.




Notes: Anatomy and Function of the Skeletal SystemStudent Name:_______________________________________________________ Date:___________

Directions: To take notes on this presentation, fill in the tables below and answer all questions. You will need these notes to study for the quiz, so be thorough.

1. In the box below, draw the outline of a long bone in the anterior view. Label the following parts of the bone and also add labels to show which part is lateral, medial, superior, and inferior:

Periosteum

Compact bone

Spongy bone

2. What is the purpose of the periosteum?

3. What is compact bone and how is it formed?



4. How is spongy bone different from compact bone?

5. Fill in the table below.

Red Marrow Bone Matrix Questions

Where is it located?

What does it do?

How does the amount or quality of it change with age?

6. a. What does an osteoblast do?

b. How do osteoblasts affect bone strength in elderly people?



c. How can you stimulate your body to make more osteoblasts? Why would this be a good idea?

7. What is an osteoclast? Why do you need them as well as osteoblasts?

8. Fill in the blanks.

A ligament connects _____________________________ to __________________________.

A tendon connects ______________________________ to __________________________.

9. a. What is the function of cartilage?

b. Name at least four places on our bodies where cartilage is found:



10. Fill in the table below.

Name of joint How it works Example(s)—joint between which bones

Hinge joint

Pivot joint

Ball-and-socket joint

Saddle joint

Gliding joint

Condyloid joint




Reading: Anatomy and Function of the Skeletal System



Your skeletal system does a lot more than just hold you up. You can think of your bones as levers in the machine that creates your body movements. Hold your arm out and flex your bicep, for example. What’s really happening is that the bones of your are forearm are acting as the arm of a lever, lifting the weight of your forearm and hand (and anything you’re holding in your hand). The energy to do this lifting comes from the contraction of your forearm muscle. Throughout your body, bones and muscles work together in this kind of way to create movement. Without your bones acting as levers, your muscles wouldn’t be able to make you move. Less visible are two other important functions of bone: bone tissue is a reservoir for important minerals like calcium, and most of your blood cells are made by tissues on the insides of your bones.



The periosteum protects the bone and helps to provide nutrients and a blood supply. When you’re younger, it also provides some cells that become part of the hard part of your bones, and which help determine how long and wide your bones will be. The periosteum stops producing new bone cells once you’re an adult, but if you injure or break a bone, the periosteum can take on this function again. The periosteum also contains lots of nerves; it’s these nerves that sense pain when you break a bone.



Compact bone is the hard, strong part of your bones, the part we usually think of as “bone.” It contains densely packed calcium and other minerals that provide the outer regions of bone with a lot of strength. Compact bone forms in densely packed concentric circles around tiny canals that house blood vessels. Inside the rings are mature bone cells. Compact bone forms the shapes our bones take. Anthropologists can study bones to learn many things, such as whether the person was male or female, how tall they were, and if they had illnesses that affected their ability to absorb nutrients. These types of details are of interest to anthropologists trying to understand historical details from ancient people and cultures. Anthropologists can also assess details from modern bones to identify missing persons and disaster victims or look for signs of abuse or injury that can indicate a crime.



It’s easy to think of bone as something sort of like a rock, because it’s so hard. But bone is very much alive, and there’s a lot going on inside of it. Bone is constantly breaking itself down to release minerals and replacing itself with new bone. Bone tissues are rich with blood vessels to supply oxygen and nutrients that help carry out all this work.



Spongy bone is made of the same kind of calcium-rich stuff as compact bone, but it’s less dense and has lots of little holes in it―like a sponge! These little holes make spongy bone lighter than compact bone. The weight difference is something of a trade-off: it’s less work for us to carry around lighter bones, but less dense bones are less strong. Spongy bone also has a lot of blood vessels and contains bone marrow. Most of your spongy bone is in the ends of long bones like the femur and humerus. We can sacrifice the bone strength for the lighter weight at the ends of our bones: the greater width at the ends makes them less vulnerable to fractures there. You also have spongy bone in your vertebrae and hip bones.



Marrow is a flexible tissue that’s found in many bones. Yellow marrow fills the shaft of long bones and helps absorb and cushion forces, like the force on your legs when walking. The end of some long bones and the insides of many flat bones contain red marrow. Here, you can see red marrow in beef bones. Red marrow produces all of our blood cells, around 500 billion (half a trillion) blood cells a day! We have a lot of bone marrow: It makes up about 4% of an adult’s body weight. A baby has mostly red marrow, and as we become adults about half of our red marrow becomes yellow marrow. By the time we reach old age, though, much of our red marrow has become yellow marrow—we don’t need to make as many blood cells, and our marrow makes fewer bone cells as we age. But if our bodies are injured and suddenly lose a lot of blood, yellow marrow can convert itself to red marrow in order to make more blood cells.



Along with blood cells, another important cell that forms in the bone marrow is a cell called an osteoblast. Osteoblasts help build new bone. They produce the collagen-containing matrix that gets mineralized to make bones strong, and they help deposit calcium and other minerals into that matrix. Once they’ve done their duty as bone builders, many osteoblasts turn into other types of bone cells. As a person ages, they produce fewer osteoblasts and therefore produce less new bone. This is one reason why the bones of older people aren’t as strong.



If you want to strengthen your muscles, what do you do? You make that muscle work. The same is true for bones. Bones serve the function of supporting your weight. The more you make them work at that, the more they will adapt to the extra work by getting stronger, just like muscles do. When you do exercise that has your bones working against gravity, it stimulates the activity of osteoblasts. You make more new bone cells and your osteoblasts make more collagen matrix that then gets mineralized. This process is called increasing your bone density, and it’s especially important during your teenage years, when your bones are still growing. Exercise also helps strengthen the muscles you use to keep your balance and hold yourself up. You don’t have to put on running shoes to get some useful weight-bearing exercise. It can be as simple as taking the stairs or walking across the parking lot.



Osteoclasts are also made in the bone marrow. They go into the compact bone and dissolve the hard matrix. When that happens, the minerals, such as calcium, are released and can go into the bloodstream to other places in the body where they’re needed. Osteoblasts and osteoclasts have opposing roles, but together they ensure that old bone tissue is disposed of and new, strong bone tissue is formed. Together, along with several hormones, they also manage calcium homeostasis, making sure that the amount of calcium in your body is kept at a steady level.



There’s more than just bones in the skeletal system. In order to support you and keep you moving, bones need ways to connect to each other and to your muscles. Those connectors, called ligaments and tendons, grow out of the fibrous connective tissue that makes up the periosteum. Both tendons and ligaments are tough, cordlike structures, and it’s sometimes hard to tell where the periosteum ends and the tendon or ligament begins. It’s as if the fibrous proteins in the connective tissue of the periosteum come together to make bunches of strings or ropes. Ligaments connect bone to bone and tendons connect bone to muscle. Tendons and ligaments contain few living cells, which is one reason they take so long to heal when they are injured.



Cartilage is tough tissue that gives support as well as being able to connect parts of your skeleton. Cartilage is also an important part of joints, the places where bones come together, making a smooth surface so bones can move past each other easily. Some of your body parts, such as your nose, ears, and voicebox, are made of cartilage. Cartilage connects your ribs to your sternum, and it forms the material between your vertebrae. Unlike bone, cartilage has few living cells and also doesn’t have a lot of calcium. When a baby is developing before its born, its skeleton starts out mostly as cartilage. During the nine months of development, most of the cartilage becomes bone, except for the ends of some long bones. At these ends, the bones keep growing longer, and cartilage has a role in building new bone as bones grow. If you pull apart the bones of a chicken leg, the white ends you see are cartilage.



Your bones take many shapes, and so they come together in different kinds of joints. The shape of a joint (and the bones that make up that joint) are what enables movement in a given direction.



It would be easy to mistake some bones in your body as just one bone, when they’re really made of many bones. Take the skull, for example. If you feel the top of a baby’s head, you can find what’s often called the “soft spot.” You had soft spot, too, when you were born. A newborn’s skull is a bunch of plates that fit together, with cartilage between them, and even a bit of space. That’s so, as your brain was growing, your skull could grow too to accommodate it. Also, getting a baby’s head through the mother’s birth canal can be a big challenge at birth. Having movable bones in the skull allows the bones to compress against each other and makes it easier to give birth. The spot at the top of a baby’s skull is where several plates come together but haven’t yet grown to meet each other. As a baby grows, the bones of the skull fuse. So now your skull may seem like it’s all one bone, but it’s really the joining of many bones. Your pelvis may also seem like it’s just one bone, but it’s also made of several bones, some fused together and others held together by cartilage. Your ribs, too, connect to your sternum with cartilage and only move very slightly.



Flex your arm. Notice how you can fold it and unfold it, but the flexing motion is all in one plane. A hinge joint has a concave surface meeting with a convex surface.



Turn your head from side to side and notice how your head rotates on the axis of your spine, or vertebral column. Now hold your arm up again, but this time rather than flexing it, turn it so your palm is facing up, then facing down. This is the pivot joint that joins your radius and ulna.



Swing your arm around. How far can it go? Ball-and-socket joints allow for any kind of movement, as long as the bones aren’t bumping up against one another or being pulled apart. You have ball-and-socket joints in your shoulders and your hips.



Check out the motion of your thumb. The joint between the metacarpal of the thumb and your wrist is shaped sort of like a saddle and its rider. This joint doesn’t have as much circular motion as your shoulder or hip, but it has greater motion than a hinge joint. That range of motion allows you to grasp things using your thumbs. Notice how you can press your thumb into your palm, but most of us can’t press that far into our palms with our fingers.



Hold onto your forearm with one hand to keep from moving your radius and ulna, and then move your hand up and down. Then wave. These actions are the result of several wrist bones (the carpals), each meeting the other at gliding joints, moving past each other at the same time.



Like a saddle joint, a condyloid joint allows for a wide range of motion, but your shoulders and thumbs have a bit more freedom of movement. Compare how far you can bend your fingers in certain directions with how far you can bend your thumbs.




Chart: My Daily CalciumStudent Name:_______________________________________________________ Date:___________

Directions: PART 1 (to be completed for homework): For at least one day, keep track of all of the food that you eat. You need to note not just what you ate but how much of it. If you ate something that comes in pieces, like slices of bread, write down how many slices you ate and what kind of bread it was. With other foods, record the number of ounces and the cup or teaspoon measurement if you know both of them. Record the name of the food and how much you ate in the first two columns of the chart. You’ll find some examples of common foods and how much calcium is in them in the chart at the end of this resource.

PART 2 (to be completed in class): Determine how much calcium you ate during the day. Visit the website https://www.supertracker.usda.gov/default.aspx. Use the food tracker to enter in what you ate at each meal and for snacks.

On average, teenagers between 14 and 18 years old require 1300 mg/calcium per day to keep up with their growing bones.

Breakfast

Food How much I ate Mg calcium per serving

How often I eat this food

Total mg of calcium I ate of this food today


https://www.supertracker.usda.gov/default.aspx


Lunch and snacks




Dinner









How does your calcium intake compare with the recommended amount?

If you need to add calcium, what foods could you add or eat more of to do that? Check the chart below for ideas.



Calcium in Different Foods

Dairy Foods

Food Serving size Mg calcium per serving

Plain low-fat yogurt 8 oz. (1 cup) 420

Yogurt and fruit mixture 8 oz. (1 cup) 340

Whole milk 8 oz. (1 cup) 290

Reduced-fat milk 8 oz. (1 cup) 300

Skim milk 8 oz. (1 cup) 300

Cheddar cheese 1.5 oz. 300

American cheese 1.5 oz. 250

Mozzarella cheese 1.5 oz. 275

Vanilla ice cream ½ cup 85

Macaroni and cheese 1 cup 100

Nondairy Foods and High-Calcium Vegetables


Orange juice 8 oz. (1 cup) 30

Orange juice, fortified with calcium 8 oz. (1 cup) 300

Almonds 1 oz. (24 nuts) 70

Broccoli, cooked ½ cup 50

Corn tortillas 1 40




Tofu fortified with calcium ½ cup 140

Pinto beans 1 cup cooked 80

Black beans 1 cup cooked 100

Kale 1 cup cooked 90

Eggs, scrambled 2 eggs 87

Favorites


Pizza 1 slice 175

Pasta, cooked 3 oz. 20

Cheerios 3.5 oz. 330

Milk chocolate bar 1.5 oz. 90

Gatorade energy drink 8 oz. (1 cup) 6

Soda (cola, lemon-lime soda, etc.) 1 can 0

Coffee 8 oz. (1 cup) 5

Hamburger 1 small patty (4 oz.) 40

French fries, medium 3.5 oz. 16

Hot dog 1 24

Oranges 1 (medium) 52

Bananas 1 banana 6




Reading: Skeletal System DisordersStudent Name:_______________________________________________________ Date:___________

Directions: Read the descriptions of various disorders of the skeletal system, and answer the questions as you read. Make notes on the prompts your teacher gives you in the margins of this reading.

Abnormal Curvature of the Spine

X-ray of a spine with scoliosis

If you could see a person’s spine from the side (sagittal view), you would see some gentle curves. At the top of the spine—the neck—there is a gentle curve inward (cervical curve), and below that in the middle of the spine there is a slight curve outward (thoracic curve). Below the thoracic region there is another inward curve (lumbar curve), finally arching into another outward curve (sacral curve). These natural curves in the spinal column (along with the discs between your vertebrae) help to cushion the forces of walking and other movements. If you look at someone’s spine from behind, you’ll see that the spinal column goes straight down a person’s back.

Sometimes these curves are exaggerated and can cause problems. In lordosis (or swayback), the lumbar curve of the spine is greater than usual. To emphasize that the spine is abnormal rather than naturally curving in the lumbar region, professionals may use the term hyperlordosis. Lordosis can be caused by osteoporosis (see below), when the vertebrae become fragile and easily

crushed. Many pregnant women develop lordosis from carrying additional weight in front of them. Obese people often develop lordosis for the same reason. In both cases, the spine can return to normal after the weight is gone, but not always.

Older people with osteoporosis can develop an exaggerated curve in the middle of their back, where their thoracic curve increases. This is a condition called kyphosis (or hunchback). As with lordosis, kyphosis is sometimes called hyperkyphosis to emphasize its abnormal size. Kyphosis can also be caused by arthritis, spinal infections, or genetics.

At some point you may have had your spine checked for scoliosis, a condition where the spine develops an S-shaped curve in an anterior or posterior view. Scoliosis is the most common spinal abnormality among young people. Scoliosis isn’t visible from the side, but from behind you would see a slight curve to the left or right. Doctors aren’t certain about the cause of scoliosis, but it seems to run in families.

Question 1: If someone has a curve in his or her spine, what other bones might also be affected by the way the curve shifts that person’s weight?



OsteoporosisYou’ve already learned that we build our bones when we’re younger and lose minerals and strength from our bone tissue when we’re older. Many people lose so much bone as they age that their bones become very brittle and break easily. This condition is called osteoporosis. The osteo means it relates to bone, the porosis means porous, with holes in it. If you compare healthy bone tissue with bone tissue from someone who has osteoporosis, you’ll see that the healthy tissue is much denser. With osteoporosis, bones can become so weak that simple actions like coughing can fracture a bone.

Osteoporosis can be caused by bone loss in old age or by making too little bone while your bones are growing. There aren’t usually any symptoms with osteoporosis; people usually find out they have it when they break a bone. As people age, their osteoblasts become less active. That means that while osteoclasts are releasing calcium from the bone for other uses in the body, osteoblasts aren’t replacing it as effectively as they do in a younger person. The result is a loss of calcium and other minerals from the bone matrix, which leaves the bone porous.

Broken bones, especially in older people, can be disabling and even cause death. People with osteoporosis commonly experience hip fracture, which is actually a fracture of the proximal end of the femur. A hip fracture almost always requires surgery. Osteoporosis can also cause fragmented vertebrae, which, along with compression of the spinal column, cause kyphosis.

Osteoporosis is more common in women than in men, and a family history of it increases a person’s risk. Once someone has developed osteoporosis, he or she can take drugs that slow bone loss. Postmenopausal women also sometimes take the hormone estrogen to maintain bone density. While bone loss is unavoidable to an extent, there are some activities than exacerbate it: a sedentary lifestyle, tobacco use, and excessive alcohol use. Eating disorders like anorexia can reduce calcium intake and bone building. On the other hand, making sure you get enough calcium and exercise can ward off bone loss.

Question 2: Why would weight-bearing exercise help prevent osteoporosis?



ArthritisArthritis is painful inflammation at the joints. There are over 100 types of arthritis, with a variety of causes. The most common cause of arthritis is plain old wear and tear on our joints. Over time, the cartilage that helps our bones slide smoothly past each other gets worn down or damaged. In some cases, the cartilage is so damaged that bones are grinding against bones. This kind of arthritis, called osteoarthritis, can restrict a person’s movement and often develops slowly over many years.

Rheumatoid arthritis is an autoimmune condition in which the body’s immune system inappropriately wages war on the thin membrane that surrounds the joints. The immune response causes fluid to build up in the joints, making them swell. Over time, the inflammation can also affect the cartilage itself.

Gout is joint pain caused by tiny uric acid crystals that build up in the cartilage. Uric acid, which is created when your body breaks down certain kinds of molecules, is usually swept into your body’s waste stream (in other words, urine) by your kidneys. Sometimes, though, your body makes too much of it or your kidneys excrete too little of it. When that happens, the uric acid forms tiny crystals that lodge in the joints. Gout can come on quickly, making the affected joints tender and painful to move.

Because different types of arthritis have different causes, there are also different treatments. For patients with osteoarthritis, physical therapists can be helpful, providing ways to protect the joints and strengthen the muscles around them. Sometimes osteoarthritis patients require a joint replacement. Patients with rheumatoid arthritis often take drugs to address the autoimmune activity in their body. For gout patients, there are drugs that decrease uric acid production and help remove uric acid from the body. For all forms of arthritis, doctors will likely encourage anti-inflammatory medications and painkillers to help deal with inflammation and manage pain.

Question 3: Why would tools with bigger handles, like a can opener or a toothbrush, be easier for an arthritis patient to hold?



Bone FractureBroken bones aren’t just for people with osteoporosis! You probably know several people who’ve broken a bone or two. Bone fractures can range from a small crack in a bone to a bone broken in many places and injuring muscles and skin, too. Breaking a bone can lead to a lot of trauma for your body: because bone has such a rich supply of blood and nerves, a broken bone can cause some significant pain and blood loss.

When you break a bone, what you want, ideally, is for it to grow back together into the same shape it had before. That means the bone needs to be set, or aligned, into the right position—and that you might have to wear a cast to keep it that way. Often a doctor can align the bones by hand, but sometimes setting the bones requires surgery.

As soon as a bone is broken, the blood from the injury forms a pool, called a hematoma, around the break. Eventually, the hematoma forms a large clot. The clot cuts off the blood supply to nearby bone cells, and they die. In their place, new blood vessels form, and special cells form a sort of repair brigade, bringing in collagen, creating cartilage, and depositing bone matrix. This material fills the gap of the break. Soon, osteoblasts move into the site to start making new bone and forming a sort of spongy bone filler, called a bony callus. Over the next several weeks or months, the osteoblasts and osteoclasts build and rebuild the bone. During this time, it’s important to subject the bone to some stresses because, as you learned earlier, putting your bones to use helps stimulate the growth of new bone. That’s why patients with a broken leg will get an immobilizing cast first and then have a walking cast for a while before the cast is finally removed.

Question 4: Why do you think it would be harder for a broken bone to heal in an older person? What aspect of the healing process is slowed down with age?



Herniated DiscThis picture is probably a familiar image: a person bent over, putting a hand against his back as if it would stop the pain he’s feeling that keeps him from standing upright. It’s likely that someone in that state is suffering from a herniated disc, also known as a slipped disc or a bulging disc. Herniated discs are very common injuries and mostly happen to people during their middle years of life. They can cause excruciating pain that can seem mysteriously unrelated to the site of the injury: the spine.

Between your vertebrae are discs of cartilage that cushion the impact of your movements. They’re composed sort of like a donut with filling; the outside is a little tougher, and the inside is a soft, jellylike substance. As people age, their vertebral discs get worn down by wear and tear, and they also lose a bit of water. This process, called disc degeneration, starts to happen to most people in their 30s and makes discs more vulnerable to small tears or other injuries.

When you twist your spine to look over your shoulder, you put pressure on the discs. That pressure can force a bit of the jellylike substance inside the disc to push through a weakened spot in the outer covering (the dough of the donut), tearing it open. Sitting in a chair, particularly if you’re slouching, puts a similar kind of pressure on your discs and can cause the same kind of rupture.

Your vertebrae and discs protect your spinal cord, which is all well and good, until a bit of that jelly that is bulging through the rupture presses against the nerves entering your spinal column. That kind of pressure can make for some real pain. If the bulge is in a certain place, standing upright will press it harder against the nerve, which is why people with herniated discs are often bent over. Often the disc is pressing against nerves that lead to the upper or lower leg or to the buttocks, so that may be where a person with a disc injury will feel the pain, even though the injury is in their back.

Often the best treatment for a herniated disc is to avoid movements that stress the spine and to be patient while the disc heals. A physical therapist can show patients positions and movements that are easy on the back, and offer strengthening exercises. Many people take over-the-counter or prescription painkillers and anti-inflammatory drugs. Sometimes a shot of the steroid cortisone is needed to reduce the inflammation. In rare cases, some people need surgery.

Herniated discs are very common and very painful, so it’s good to take measures to prevent them. Maintaining a healthy weight and strong core muscles (the abdominal muscles that are deeper than your “six pack”) helps keep pressure off your spine. Sitting upright and keeping good posture, especially at your computer or desk, also goes a long way to reducing your risk.

Question 5: What is the benefit of having discs that are tougher on the outside and jellylike on the inside?




Vocabulary: Describing Skeletal System SymptomsStudent Names:_______________________________________________________ Date:___________

Directions: With your partner, rewrite the scenario below as if you were the physical therapist taking notes on the patient’s condition. A physical therapist is a health care professional who specializes in helping people be able to move again after being injured and in helping people who are ill retain as much movement as they can. While doing this activity, you can stand and move your own body to demonstrate the motions and inspect your own bones, if you find that’s helpful. Describe the patient’s injuries and symptoms using anatomical language.

Example: When the patient tries to move his leg in the same way as shown in the figure above, he feels pain in the spot indicated. Note what bone he is moving, what type of joint it makes, the bone(s) the pain is near, and what plane he is trying to move his leg in.

Description in anatomical language: When the patient tries to move his femur in the sagittal plane from the ball-and-socket joint, he feels pain near his pelvis.

Rhonda is visiting the physical therapist following a little skateboarding accident in which she injured her shoulder and sprained her right wrist. The physical therapist needs to evaluate where Rhonda is having pain when she moves so that he can prescribe the right treatment and exercises.

He tells Rhonda to stand in front of him with her arms at her sides and her palms facing her thighs. He asks her to try to make some movements. This is what he observes and needs to record in Rhonda’s chart:



When she tries to raise her arm as shown in Figure A, she feels pain where the pink spots are, near her shoulder and in the back of her neck. Note what bone she is moving, what type of joint it makes, the bone(s) the pain is near, and what plane she is trying to move her arm in.

When she bends her elbow, as shown in Figure B, she doesn’t feel any pain as long as her arm is at her side. Note what bone she is moving, what type of joint she is moving, and what plane she is moving her arm in.


Figure A

Figure B


When she tries to move her hand as shown in Figure C, she feels pain in the places indicated. Note what joint type of joint and what bones she is trying to move, and where she feels pain and where the sites of pain are located relative to each other.


Figure C

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