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?

• 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

• 206 Bones (primary)• Cartilage• Tendons (connect muscles to bones)• Ligaments (connect bones to bones)

Anatomy & PhysiologyThe skeleton is divided into main groups• The Axial Skeleton

Consists of 80 bones Includes the skull, vertebral column,

and thoracic cage

• The Appendicular SkeletonConsists of 126 bonesIncludes shoulder girdle, arms and

hands, pelvic girdle, legs, and feet

Anatomy & Physiology

Bones are composed of:50%Water50% 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

• 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)

• 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?

ArthritisArthr= (?) -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 :– 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 “lazy-

man’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 ArthritisTreatments• 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?