Skeletal system.pptnursing

By: Dr Krishna Bhatt, Arip,
Charusat
Human Anatomy:Human Anatomy:
The Skeletal System:The Skeletal System:

Structure, Function,Structure, Function,
and Diseasesand Diseases
of the bones and jointsof the bones and joints

Is this the correct anatomical position?

Introduction
• One of the most remarkable tissues of the
human body
• Far from inert and lifeless, bones are living,
dynamic structures
• Bones serve a wide variety of very diverse
functions within us
• Noted for their strength and resiliency
during life, bones will remain after we are
long gone

The Skeletal SystemThe Skeletal System
Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
• Parts of the skeletal system
• Bones (skeleton)
• Joints
• Cartilages
• Ligaments (bone to bone)(tendon=bone to
muscle)
• Divided into two divisions
• Axial skeleton
• Appendicular skeleton – limbs and girdle

Bones of the Human BodyBones of the Human Body
• The skeleton has 206 bones
• Two basic types of bone tissue
•Compact bone
• Homogeneous
•Spongy bone
• Small needle-like
pieces of bone
• Many open spaces
Figure 5.2b

Microscopic Anatomy of BoneMicroscopic Anatomy of Bone
Figure 5.3

Skeletal Cartilages
• Initially our skeleton is made up of
cartilages and fibrous membranes
• Gradually our skeletal cartilages are
replaced by bone
• Upon reaching adulthood the skeleton
becomes almost fully ossified
• Only a few cartilages remain in the adult
skeleton

Basic structure, type & location
• A skeletal cartilage is made of some variety
of cartilage tissue
• Each type contains a high proportion of
water which makes them resilient
• Cartilage has no nerves or blood supply
• It is surrounded by a dense tissue membrane
called a perichondrium

Basic structure, type & location
• There are three types of cartilage tissue:
hyaline, elastic, and fibrocartilage
• Each contains a matrix of jellylike ground
substance and fibers

Hyaline cartilages
• The most prevalent type of cartilage
• Its high proportion of collagen fibers give it
flexibility and resilience while providing
support
• Upon examination the tissue appears white,
frosted, and smooth

Elastic cartilage
• Elastic cartilage is similar to hyaline
cartilage but with more elastic fibers
• Its elastic fibers enable it to withstand
repeated bending
• Found only in the external ear and the
epiglottis

Fibrocartilage
• The tissue contains parallel rows
chondrocytes alternating with collagen
fibers
• Tissue is highly compressible and has great
tensile strength
• Found in thick pad-like structures like the
menisci of the knee or the discs of the
vertebral column

Growth of cartilage
• Cartilage grows in two ways
• Appositional growth occurs when cells in
the surrounding perichondrium secrete new
matrix next to existing cartilage tissue
(growth from the outside)
• Interstitial growth occurs when the
chondrocytes within the cartilage divide and
secrete new matrix, expanding the cartilage
(growth from within)

Functions of BonesFunctions of Bones
• Support of the body
• Protection of soft organs
• Movement due to attached skeletal
muscles
• Storage of minerals and fats
• Blood cell formation

Function of Bones
• Support • Bones provide a hard
framework that
supports the body
• Bones provide support
for internal organs

Function of Bone
• Protection • Fused bones provide a
brain case that protects
this vital tissue
• Spinal cord is
surrounded by
vertebrae
• Rib cage protects vital
organs

Function of Bone
• Movement • Skeletal muscle
attached to bones use
the bones as levers to
move the body
• Arrangement of bones
and joints determine
the movements
possible

Function of Bones
• Mineral Storage • Bone serves as a
mineral reservoir
• Phosphate and calcium
ions can be released
into the blood steam
for distribution
• Deposition and
removal are ongoing

Function of Bones
• Blood cell formation • Hematopoiesis occurs
within the marrow
cavities of the long
bones
• The majority of
hematopoiesis occurs
in bones

Classification of Bone:
• Bones vary in shape and size
• The unique shape of each bone fulfills a
particular need
• Bones are classified by their shape as long,
short, flat, or irregular bone
• Bones differ in the distribution of compact
and spongy osseous tissues

Bones are classified
by their shape:
1.long
2.short
3.flat
4.irregular

Classification of Bones on theClassification of Bones on the
Basis of ShapeBasis of Shape
Figure 5.1

Classification of BonesClassification of Bones
• Long bones
•Typically longer than wide
•Have a shaft with heads at both ends
•Contain mostly compact bone
• Examples: Femur, humerus

Gross Anatomy of a Long BoneGross Anatomy of a Long Bone
• Diaphysis
•Shaft
•Composed of
compact bone
• Epiphysis
•Ends of the bone
•Composed mostly of
spongy bone Figure 5.2a

Structures of a Long BoneStructures of a Long Bone
• Periosteum
• Outside covering of
the diaphysis
• Fibrous connective
tissue membrane
• Sharpey’s fibers
• Secure periosteum to
underlying bone
• Arteries
• Supply bone cells
with nutrients
Figure 5.2c

Blood Vessels
• Unlike cartilage bone
is well vascularized
• Nutrient arteries
serve the diaphysis
• The nutrient artery
runs inward to supply
the bone marrow and
the spongy bony

Medullary cavity
• The interior of all bones
consists largely of spongy
bone
• The very center of the
bone is an open cavity or
marrow cavity
• The cavity is filled with
yellow bone marrow

Membranes
• Periosteum covers
outer bone surface
• Consists of dense
irregular connective
tissue & osteoblasts
• Contain nerve fiber
blood and lymph
vessels secured by
Sharpey’s fibers
• Endosteum covers
internal bone surfaces

Short, Irregular
and Flat Bones
• Bones consist of thin
layers of compact
bones over spongy
bone
• No shaft, epiphysis or
marrow cavity
• Spongy area between is
a diploe
• Flat sandwich of bone

• Short bones
•Generally cube-shape
•Contain mostly spongy bone
•Examples: Carpals, tarsals

• Flat bones
•Thin and flattened
•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 and hip

• Surface features of bones
• Sites of attachments for muscles, tendons,
and ligaments
• Passages for nerves and blood vessels
• Categories of bone markings
• Projections and processes – grow out from the
bone surface
• Depressions or cavities – indentations

Compact Bone
• Compact bone appears very dense
• It actually contains canals and passageways
that provide access for nerves, blood vessels,
and lymphatic ducts
• The structural unit of compact bone is the
osteon or Haversian system
• Each osteon is an elongated cylinder running
parallel to the long axis of the bone
• Structurally each osteon represents a weight
bearing pillar

An Osteon
• Each osteon is a
group of hollow
tubes of bone
matrix
• Each matrix tube is
a lamella
• Collagen fibers in
each layer run in
opposite directions
• Resists torsion
stresses

An Osteon
• Running through
the core of each
osteon is the central
or Haversian canal
• The canal contains
small blood vessels
that supply the cells
of the osteon

Perforating (Volkmann’s) Canal
• Canals lie at
right angles to
long axis of
bone
• Connect the
vascular supply
of the
periosteum to
those of the
central canal
and medullary
cavity

Types of Bone CellsTypes of Bone Cells
• Osteocytes
• Mature bone cells
• Osteoblasts
• Bone-forming cells
• Osteoclasts
• Bone-destroying cells
• Break down bone matrix for remodeling and
release of calcium
• Bone remodeling is a process by both
osteoblasts and osteoclasts

Changes in the Human SkeletonChanges in the Human Skeleton
• 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

Bone GrowthBone Growth
• 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

Bone FracturesBone Fractures
• A break in a bone
• Types of bone fractures
• Closed (simple) fracture – break that does not
penetrate the skin
• Open (compound) fracture – broken bone
penetrates through the skin
• Bone fractures are treated by reduction
and immobilization
• Realignment of the bone

Common Types of FracturesCommon Types of Fractures
Slide 5.17Copyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
Table 5.2

Stages in the Healing of a BoneStages in the Healing of a Bone
FractureFracture
Figure 5.5

Axial skeleton supports and protects organs of
head, neck and trunk
Axial skeleton:
skull (cranium and facial bones)
hyoid bone (anchors tongue and muscles
associated with swallowing)
vertebral column (vertebrae and disks)
bony thorax (ribs and sternum)
Appendicular skeleton includes bones of limbs
and
bones that anchor them to the axial
skeleton
Appendicular skeleton:
pectoral girdle (clavicles and scapulae)
upper limbs (arms)
pelvic girdle (sacrum, coccyx)
lower limbs (legs)

22 bones in skull
6 in middle ears
1 hyoid bone
26 in vertebral column
25 in thoracic cage
4 in pectoral girdle
60 in upper limbs
60 in lower limbs
2 in pelvic girdle
206 bones in all

The Axial SkeletonThe Axial Skeleton
SlideCopyright © 2003 Pearson Education, Inc. publishing as Benjamin Cummings
• Forms the longitudinal part of the body
• Divided into three parts
•Skull
•Vertebral column
•Bony thorax

The Axial SkeletonThe Axial Skeleton
Figure 5.6

The skull
8 sutured bones in cranium
Facial bones: 13 sutured bones, 1 mandible
Cranium
encases brain
attachments for muscles
sinuses

Bones of the SkullBones of the Skull
Figure 5.11

Human Skull, Superior ViewHuman Skull, Superior View
Figure 5.8

Human Skull, Inferior ViewHuman Skull, Inferior View
Figure 5.9

Paranasal SinusesParanasal Sinuses
• Hollow portions of bones surrounding
the nasal cavity
Figure 5.10

The Hyoid BoneThe Hyoid Bone
• The only bone that
does not articulate
with another bone
• Serves as a
moveable base for
the tongue
Figure 5.12

The Vertebral ColumnThe Vertebral Column
• Vertebrae
separated by
intervertebral discs
• The spine has a
normal curvature
• Each vertebrae is
given a name
according to its
location Figure 5.14

Vertebral column
7 cervial vertebrae
12 thoracic
5 lumbar
1 sacrum (5 fused
1 coccyx (4 fused)
Vertebrae vary in size and morphology

Structure of a Typical VertebraeStructure of a Typical Vertebrae
Figure 5.16

Thoracic cage
ribs
thoracic vertebrae
sternum
costal cartilages
True ribs are directly attached to the sternum
(first seven pairs)
Three false ribs are joined to the 7th
rib
Two pairs of floating ribs

Structures Associated with theStructures Associated with the
Synovial JointSynovial 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

The Synovial JointThe Synovial Joint
Figure 5.28

Types of Synovial Joints Based onTypes of Synovial Joints Based on
ShapeShape
Figure 5.29a–c

Types of Synovial Joints Based onTypes of Synovial Joints Based on
ShapeShape
Figure 5.29d–f

Diseases and
Conditions
of the Skeletal
System

Bursitis
• Inflammation of the Bursa (fluid
filled sac surrounding the joint).
• A bursa can become inflamed from
injury, infection (rare in the
shoulder), or due to an underlying
rheumatic condition.
• Bursitis is typically identified by
localized pain or swelling,
tenderness, and pain with motion of
the tissues in the affected area.

Tendonitis
• Sometimes the tendons become inflamed
for a variety of reasons, and the action of
pulling the muscle becomes irritating. If
the normal smooth gliding motion of your
tendon is impaired, the tendon will
become inflamed and movement will
become painful. This is called
tendonitis, and literally means
inflammation of the tendon.
• The most common cause of tendonitis is
overuse.

Carpal Tunnel Syndrome
• Any condition that causes swelling
or a change in position of the tissue
within the carpal tunnel can squeeze
and irritate the median nerve.
Irritation of the median nerve in this
manner causes tingling and
numbness of the thumb, index, and
the middle fingers, a condition
known as "carpal tunnel syndrome."

Osteoporosis
• Osteoporosis is a term that means
"porous bones." It is a skeletal disease
affecting women and men. Osteoporosis
is a condition in which bones have lost
minerals especially calcium ﾑ making
them weaker, more brittle, and
susceptible to fractures (broken bones).
Any bone in the body can be affected by
osteoporosis, but the most common
places where fractures occur are the
back (spine), hips, and wrists.

Scoliosis
• Scoliosis is an abnormal curvature of the
spine. If your child has scoliosis, the view
from behind may reveal one or more
abnormal curves.Scoliosis runs in
families, but doctors often don't know the
cause. More girls than boys have severe
scoliosis. Adult scoliosis may be a
worsening of a condition that began in
childhood, but wasn't diagnosed or
treated. In other cases, scoliosis may
result from a degenerative joint condition
in the spine.

Kyphosis
• With kyphosis, your spine may look
normal or you may develop a hump.
Kyphosis can occur as a result of
developmental problems; degenerative
diseases, such as arthritis of the spine;
osteoporosis with compression fractures
of the vertebrae; or trauma to the spine. It
can affect children, adolescents and
adults.

Lordosis
• A normal spine, when viewed from
behind appears straight. However, a
spine affected by lordosis shows
evidence of a curvature of the back
bones (vertebrae) in the lower back
area, giving the child a "swayback"
appearance.

Tuberculosis of the
Spine- Pott’s Disease
• As a form of extrapulmonary tuberculosis that impacts the
spine, Pott’s disease has an effect that is sometimes
described as being a sort of arthritis for the vertebrae that
make up the spinal column. More properly known as
tuberculosis spondylitis, Pott’s disease is named after Dr.
Percivall Pott, an eighteenth century surgeon who was
considered an authority in issues related to the back and
spine.Pott's disease is often experienced as a local
phenomenon that begins in the thoracic section of the
spinal column. Early signs of the presence of Pott’s
disease generally begin with back pain that may seem to
be due to simple muscle strain. However, in short order,
the symptoms will begin to multiply.

Rickets
• Rickets is the softening and
weakening of bones in children,
usually because of an extreme and
prolonged vitamin D deficiency.
• Some skeletal deformities caused by
rickets may need corrective
surgery.

Scurvy
• The human body lacks the ability to
synthesize and make vitamin C and
therefore depends on exogenous dietary
sources to meet vitamin C needs.
Consumption of fruits and vegetables or
diets fortified with vitamin C are essential
to avoid ascorbic acid deficiency. Even
though scurvy is uncommon, it still occurs
and can affect adults and children who
have chronic dietary vitamin C deficiency.

Gout
• Gout is a disease that results from an
overload of uric acid in the body. This
overload of uric acid leads to the
formation of tiny crystals of urate that
deposit in tissues of the body, especially
the joints. When crystals form in the joints
it causes recurring attacks of joint
inflammation (arthritis). Chronic gout can
also lead to deposits of hard lumps of uric
acid in and around the joints and may
cause joint destruction, decreased kidney
function, and kidney stones.

Acromegaly
• Acromegaly is a serious condition that occurs
when the body produces too much of the
hormones that control growth. ･ The hormone
most often affected is called growth hormone, or
GH. It ﾊ is produced by the pituitary gland, a tiny
organ at the base of the brain. ･･ Growth
hormone ﾊ promotes growth of bone, cartilage,
muscle, organs, and other tissues. ･･ When
there is too much growth hormone in the body,
these tissues grow larger than normal. This
excessive growth can cause serious disease and
even premature death.

Poliomyelitis
• Poliomyelitis (polio) is a highly infectious disease caused by a
virus. It invades the nervous system, and can cause total
paralysis in a matter of hours. It can strike at any age, but affects
mainly children under three (over 50% of all cases). The virus
enters the body through the mouth and multiplies in the intestine.
Initial symptoms are fever, fatigue, headache, vomiting, stiffness
in the neck and pain in the limbs. One in 200 infections leads to
irreversible paralysis (usually in the legs). Amongst those
paralysed, 5%-10% die when their breathing muscles become
immobilized. Although polio paralysis is the most visible sign of
polio infection, fewer than 1% of polio infections ever result in
paralysis. Poliovirus can spread widely before cases of paralysis
are seen. As most people infected with poliovirus have no signs
of illness, they are never aware they have been infected. After
initial infection with poliovirus, the virus is shed intermittently in
faeces (excrement) for several weeks. During that time, polio can
spread rapidly through the community.

Spina Bifida
• Spina bifida is a birth defect that involves
the incomplete development of the spinal
cord or its coverings. The term spina
bifida comes from Latin and literally
means "split" or "open" spine.Spina bifida
occurs at the end of the first month of
pregnancy when the two sides of
the ﾊ embryo's spine fail to join together,
leaving an open area. In some cases, the
spinal cord or other membranes may
push through this opening in the back.
The condition usually is ﾊ detected before
a baby is born and treated right away.

Talipes Equinovarus-
“Clubfoot”
• Clubfoot is a deformity of the whole foot
that is present at birth. There are several
types of clubfoot that are jointly known as
'talipes', as the deformity is mostly in the
talus (a bone in the ankle). The most
common of the talipes is what is known as
"talipes equino varus" - it is so common
that the word clubfoot is commonly used
to refer to this. In talipes equino varus,
the child is born with the foot pointing
down and twisted inwards at the ankle.

Sarcoma
• Osteosarcoma-The most common
type of bone cancer. It arises in
bone and is most commonly found in
children and adolescents but a rare
form occurs in adults, particularly in
patients who have been cured of
other cancers with radiation
therapy.

Myeloma
• Multiple myeloma is a cancer in which abnormal
cells collect in the bone marrow and form
tumors. Sometimes these abnormal cells (called
myeloma cells) collect in only one bone and form
a single tumor known as a plasmacytoma.
However, in most cases, the myeloma cells
collect in many bones, forming several tumors
and causing other problems. When this happens,
the disease is called multiple myeloma.

Leukemia
• Leukemia is cancer of the blood cells. It starts in
the bone marrow, the soft tissue inside most
bones. Bone marrow is where blood cells are
made.When you are healthy, your bone marrow
makes: ･ White blood cells, which help your body
fight infection. ･ Red blood cells, which carry
oxygen to all parts of your body. ･ Platelets,
which help your blood clot.When you have
leukemia, the bone marrow starts to make a lot
of abnormal white blood cells, called leukemia
cells. They don't do the work of normal white
blood cells, they grow faster than normal cells,
and they don't stop growing when they should.

Joints
• Fibrous-Fibrous joints connect bones without
allowing any movement. The bones of your
skull and pelvis are held together by fibrous
joints.
• Cartilaginous-Cartilaginous joints are joints
in which the bones are attached by cartilage.
These joints allow for only a little movement,
such as in the spine or ribs.
• Synovial-Synovial joints allow for much more
movement than cartilaginous joints. Cavities
between bones in synovial joints are filled
with synovial fluid. This fluid helps lubricate
and protect the bones. Bursa sacks contain
the synovial fluid. within fixed limits

• A joint, or articulation, is the
place where two bones come
together.
• There are three types of joints
classified by the amount of
movement they allow:
 Immovable
 slightly movable
 freely movable

Types of Joints
Hinge- A hinge joint allows extension and
retraction of an appendage. (Elbow,
Knee)

Ball and Socket- A ball and socket joint
allows for radial movement in almost
any direction. They are found in the
hips and shoulders. (Hip, Shoulder)

Gliding- In a gliding or plane joint bones
slide past each other. Mid-carpal and mid-
tarsal joints are gliding joints. (Hands,
Feet)

Saddle- This type of joint occurs when the
touching surfaces of two bones have both
concave and convex regions with the
shapes of the two bones complementing
one other and allowing a wide range of
movement. (Thumb)

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