Bài giảng Medical Assisting - Chapter 25: The Skeletal System

ChapterPowerPoint® to accompany Second EditionRamutkowski  Booth  Pugh  Thompson  WhickerCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.Medical AssistingChapter 251Objectives25-1 Describe the parts of a long bone.25-2 List the substances that make up bone tissue.25-3 List the functions of bones.25-4 Describe how long bones grow.25-5 List the bones of the skull, spinal column, rib cage, shoulders, arms, hands, hips, legs, and feet. 25-6 Describe the location of each bone.25-7 Define fontanels and explain their importance.The Skeletal System 2Objectives (cont.)25-8 List different types of bone fractures and describe their characteristics.25-9 Explain how fractures heal.25-10 Describe the three major types of joints and give examples of each.25-11 Describe the structure of a synovial joint.25-12 Describe the characteristics, causes, and treatments of various diseases and disorders of the skeleton.The Skeletal System3Introduction Bones provide the body with structure and support. You will learn about the bones of the body, their structure, and how the joints of the body work.The skeletal system is composed of 206 bones as well as joints and related connective tissues. 4The Skeletal System5Bone StructureBones contain various kinds of tissues, including osseous tissue, blood vessels, and nerves. Osseous tissue can appear compact or spongy6Bone Structure (cont.)Compact bone looks solid; however, the following structures can be observed with a microscope All bones are made up of both compact and spongy bone 7Classification of BonesLong bones - located primarily in the arms and legs -femur (thigh bone) & humerus (upper arm bone)Short bones - small bones are located in the wrists and ankles - carpals (wrist bones) & tarsals (ankle bones)Flat bones - located in the skull and rib cage - ribs and frontal boneIrregular bones - vertebrae and the bones of the pelvic girdle.8Functions of BonesShape to body parts Support and protect soft structures in the bodyBody movement since skeletal muscles attach to themRed bone marrow of bone produces new blood cells Store calcium for the body 9Bone Growth Ossification – process of bone growthIntramembranous ossification – bones begin as tough, fibrous membranebone-forming cells called osteoblasts turn the membrane to bone (located in skull)Endochondral ossification bones containing some cartilage between an epiphysis and the diaphysis will continue to grow cells that form holes in bone are called osteoclasts 10Apply Your KnowledgeWhy is it important for the bones to store calcium?11Apply Your Knowledge -AnswerEvery cell in the body needs calcium so the body must have a large supply readily available.Why is it important for the bones to store calcium?12Bones of the SkullTwo types: Cranial-form the top, sides, and back of the skullFacial bones-form the face “Soft spots" felt on an infant's skull are actually fontanels.Tough membranes that connect the incompletely developed bones. 13Bones of the Skull (cont.)Parietal -form most of the top and sides of the skull. Occipital - forms the back of the skull Temporal - form the lower sides of the skull Sphenoid bone - part of the floor of the craniumEar ossicles are the smallest bones of the body MalleusIncusStapes14Bones of the Skull (cont.)Mandible - the lower jaw bone Maxillae - form the upper jawbone Zygomatic - form the prominence of the cheeksNasal bones - fuse together to form the bridge of the nose Palatine - form the anterior portion of the palate Vomer - a thin bone that divides the nasal cavity. Click to see Skull15Bones of the Skull (cont.)Can you name these bones of the skull?Back16Bones of the Spinal Column Spinal column 7 Cervical vertebrae12 thoracic vertebrae 5 lumbar vertebraeA sacrumA coccyx 17Bones of the Spinal Column (cont.)Cervical vertebrae Smallest and lightest Located in the neck region First one is atlasSecond one is axisThoracic vertebrae Join the 12 pairs of ribs Lumbar vertebrae Have very sturdy structures Sacrum A triangular-shaped bone that consists of five fused vertebraeCoccyx A small, triangular-shaped bone made up of 3 to 5 fused vertebrae Considered unnecessary. More commonly called the tailbone. 18Bones of the Rib Cage12 pairs of ribsAttached posteriorly to thoracic vertebrae Sternum Forms the front, middle portion of the rib cage 19Bones of the Shoulders, Arms and HandsShoulders - pectoral girdles and include clavicles and scapulae Upper limb or arm bones- the humerus, radius, and ulna Hand - carpals, metacarpals, and phalanges 20Bones of the Hips, Legs and FeetHipbones - pelvic girdle or coxal bones Bones of the lower limb or leg - femur, the patella, the tibia, and the fibula Bones of the foot - the tarsal,the metatarsals, and the phalanges. 21Apply Your KnowledgeA patient has arrived in the office complaining of hurting his finger while playing basketball. You would suspect that he had hurt which bone of the hand?22Apply Your Knowledge -AnswerPhalanges are the bones of the fingers. A patient has arrived in the office complaining of hurting his finger while playing basketball. You would suspect that he had hurt which bone of the hand?23Bone FracturesBone fractures can be classified in many ways Broken bone may take 3 months or longer to healHealing depends on type of fracture and the general health of the patient. Stress fracture - bone breaks due to trauma such as a car accident or sports injury Pathologic fracture -bone breaks due to some disease process24Bone Fractures (cont.)Closed (simple)Open (compound)CompleteIncompleteGreenstickHairlineComminutedDisplacedNondisplacedImpactedDepressedLinearTransverseObliqueSpiralCollesPotts25Body’s Repair of the Bone A hematoma (blood clot) forms around the fracture.Granulation tissue slowly replaces the hematoma. Soft callus is formed that replaces the granulation tissue. Hard callus replaces the soft callus. Hard callus is remodeled so that it takes on the shape of the original bone. 26Falls and FracturesFalls account for about 50% of all fractures Teach patients about preventing falls Persons most at risk for falling are those with the following conditions:Muscle weakness & poor visionDifficulty walkingDependence on bifocalsHearing lossAlzheimer’s diseaseParkinson’s disease27Falls and Fractures (cont.)Falls can be prevented through the following steps:Awareness - Educate patients to try not to climb or stretch for items that they use regularly. Balance - Patients should stand up gradually, especially from a lying-down position Lifestyle - Recommend that patients clean up any clutter in their living space so that they are less likely to trip on items 28JointsJunctions between bones Classified as: Fibrous - connected together with short fibers Cartilaginous - connected together with a disc of cartilage Synovial –joints are covered with hyaline cartilage and are held together by a fibrous joint capsule  29Synovial Joints Joint capsule is lined with a synovial membrane. Membrane secretes a slippery fluid called synovial fluid, which allows the bones to move easily against each other. Bones are also held together through tough, cord-like structures called ligaments. Synovial joints are freely moveable. 30Apply Your KnowledgeYour patient complains of getting dizzy every time she gets up from her chair. What patient education fact should you give the patient that would prevent her from falling?31Apply Your Knowledge -AnswerYou should stand for a few seconds before walking. This allows time for blood flow to reach the brain, preventing dizziness.Your patient complains of getting dizzy every time she gets up from her chair. What patient education fact should you give the patient that would prevent her from falling?32Diseases and Disorders of BoneBursitis - inflammation of a bursa Carpal Tunnel Syndrome - occurs when the median nerve in the wrist is excessively compressed. Ewing’s Family of Tumors (EFT) - a group of tumors that affect different tissue types Gout - a type of arthritis 33Diseases and Disorders of Bone (cont.)Osteogenesis Imperfecta - more commonly called brittle-bone disease Osteoporosis - a condition in which bones become thinned over time Osteosarcoma - a type of bone cancer that originates from osteoblasts, the cells that make bony tissue 34Diseases and Disorders of Bone (cont.)Paget’s Disease - causes bones to enlarge and become deformed and weak. Scoliosis - an abnormal curvature of the spine. 35Educating the Patient Teach your patients about:Building Better BonesBone-Healthy DietBone-Healthy Exercises Bone-Healthy Exercises Bone Tests36Apply Your KnowledgeThe doctor has told your patient that he has a osteosarcoma. What do you know about this disorder? 37Apply Your Knowledge -Answer Osteosarcoma is a type of bone cancer that originates from osteoblasts, the cells that make bony tissue. The doctor has told your patient that he has a osteosarcoma. What do you know about this disorder? 38Summary Medical Assistant You will provide patient education and assist the physician in the office when patients have problems with the skeletal system. You will need to know about the bones of the body, their structure, and how the joints of the body work.39End of ChapterEnd of Chapter40