Bài giảng môn Medical Assisting - Chapter 21: The Skeletal System

21The Skeletal System21-*Learning Outcomes21.1 Describe the parts of a long bone.21.2 List the substances that make up bone tissue.21.3 List the functions of bones.21.4 Identify bones by their classifications. 21.5 Describe how long bones grow.21-*Learning Outcomes (cont.)21.6 List and describe the skeletal structures and one location of each structure.21.7 List the bones of the skull, spinal column, rib cage, shoulders, arms, hands, hips, legs, and feet. Describe the location of each bone.21.8 Define fontanels and explain their importance. 21-*Learning Outcomes (cont.)21.9 Describe the three major types of  joints and give examples of each.21.10 Describe the structure of a synovial  joint.21.11 Describe the causes, signs and  symptoms, and treatments of various  diseases and disorders of the skeletal  system. 21-*Introduction Bones provide the body with structure and support206 bones with joints and connective tissueDivisionsAxial – 80 bonesSkullVertebral columnRib cageAppendicular – 126 bonesArms and legsPectoral girdlePelvic girdle21-*The Skeletal System21-*Bone StructureBones contain various kinds of tissues, includingOsseous tissueBlood vesselsNervesOsseous tissue can appear compact or spongyCompact BoneSpongy Bone21-*Bone Structure (cont.)Compact bone looks solidStructures can be observed with a microscope All bones are made up of both compact and spongy bone 21-*Bone Structure (cont.)21-*Bone Structure (cont.)Flat bones – located in the skull and rib cage Ribs Frontal bone Irregular bones Vertebrae Bones of the pelvic girdle21-*Gender DifferencesMale SkullLarger and heavierForehead shorterFace less roundJaw larger Mastoid processes more prominentMale pelvic bonesHeavier and thickerObturator foramina and acetabula are larger and closer together21-*Gender Differences (cont.)Male pelvic cavityNarrower and longerLess roomy and more funnel shapedMale sacrumNarrowerSacral promontory projects forwardSacral curvature is less sharp posteriorlyMale coccyxLess movable21-*Apply Your KnowledgeMatch bone to classification.___ Humerus L. Long bones___ Rib S. Short bones___ Femur F. Flat bones___ Pelvic bones I. Irregular bones___ Carpals___ Frontal bone___ Vertebra___ TarsalsFLISIFSLANSWER:Very Good!21-*Functions of BonesGive shape to body parts Support and protect soft structures Examples – brain, lungs, heart Allow body movement, because skeletal muscles attach to themAllow for voluntary movement21-*Functions of Bones (cont.)Red bone marrow of bone produces new blood cells – hematopoiesisStore calcium21-*Apply Your KnowledgeANSWER: Every 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?Correct!21-*Bone 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)21-*Bone Growth (cont.)Endochondral ossification Bones begin as cartilage modelsPrimary ossification centerBone formed in the diaphysisSecondary ossification centerEpiphyses turn to bone Bones with some cartilage between an epiphysis and the diaphysis will continue to grow Medullary cavity and spaces in cancellous bone form Cells that form holes in bone are called osteoclasts 21-*Building Better BonesTeach healthy behaviorsBone-healthy diet with calcium and vitamin DBone-health exercises Weight-bearing Strength trainingBone-healthy lifestyle Avoid smoking Avoid alcohol21-*Bone TestsBone densityBone scansDiagnose causes of Bone pain Arthritis Bone infections Bone cancers21-*Apply Your KnowledgeWhat are the two types of bone growth?ANSWER: Intramembranous ossification, in which bones begin as tough membrane and are turned to bone by osteoblasts, and endochondral ossification, in which primary ossification occurs in the diaphysis of the bone and secondary ossification occurs in the epiphysis.Good Job!21-*Bony Structures Rigid foundation Projections and processes for muscle and ligament attachmentDepressions and hollows for articulations – the connection of bones at joints Openings for blood vessels and nerves21-*Bony Structures (cont.)TermDefinitionCondyleA rounded process that usually articulates with another boneCrestA narrow, ridge-like projectionEpicondyleA projection situated above a condyleForamen An opening through a bone that is usually a passageway for blood vessels, nerves, or ligaments FossaA relatively deep pit or depression21-*Bony Structures (cont.)TermDefinitionHeadAn enlargement on the end of a boneProcessA prominent projection on a bone SutureAn interlocking line of union between bonesTrochanterA relatively large processTubercleA small, knoblike processTuberosityA knoblike process, usually larger than a tubercle21-*Apply Your KnowledgeMatch the following:___ Epicondyle A. A relatively deep pit or depression___ Fontanels B. An interlocking line of union between bones___ Fossa C. “Soft spots” felt on an infant’s skull ___ Process D. A knoblike process, usually larger than a  tubercle___ Suture E. A projection situated above a condyle ___ Tuberosity F. A prominent projection on a bone CAFBDEANSWER:GREAT!21-*The SkullTwo bone types: Cranial – form the top, sides, and back of the skullFacial – form the face “Soft spots” felt on an infant's skull are actually fontanelsTough membranes that connect the incompletely developed bones 21-*Cranial BonesFrontal – anterior Parietal – top and most of the sidesOccipital – back Temporal – form the lower sides of the skullSphenoid and ethmoid bones – floor Ear ossicles are the smallest bones of the body MalleusIncusStapes21-*The Skull (cont.)Mandible – forms the lower jawboneMaxillae – form the upper jawboneZygomatic – 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 cavityClick to see Skull21-*The Skull (cont.)Can you name the bones of the skull?Back21-*Apply Your KnowledgeMatch the bones of the skull:___ Occipital A. Form the upper jawbone___ Sphenoid B. A thin bone that divides the nasal  cavity___ Mandible C. Part of the floor of the skull ___ Maxillae D. Form the prominence of the cheeks___ Zygomatic E. Back of skull___ Vomer F. Lower jawboneCFADBEANSWER:Very Good!21-*The Spinal Column 7 cervical vertebrae12 thoracic vertebrae 5 lumbar vertebraeSacrumCoccyx 21-*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 21-*The Spinal Column (cont.)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 tailbone21-*Apply Your KnowledgeIdentify the sections of the spinal column and give the number of vertebrae for each.Thoracic – 12Lumbar – 5Sacrum – 5 fusedCoccyx – 3 to 5 fusedCervical – 7ANSWER:Right!21-*The Rib CageSternum BreastplateForms the front middle portion of the rib cage Joins with the clavicles and most ribsXiphoid processCartilaginous tip 21-*The Rib Cage (cont.)12 pairs of ribsAll are attached posteriorly to thoracic vertebraeTrueFirst seven pairs of ribsAttach to sternum by costal cartilageFalseRib pairs 8, 9, and 10Attach to the costal cartilage of rib pair 7FloatingRib pairs 11 and 12Do not attach anteriorly to any structure21-*Apply Your KnowledgeTrue or False:___ The sternum forms the front middle portion of the rib cage.___ The xiphoid process is a boney tip of the sternum.___ The true ribs are the first five pairs of ribs. ___ False ribs attach to the costal cartilage of rib pair seven.___ Floating ribs attach to the xiphoid process.TTANSWER:FcartilaginousFseven Fdo not attach anteriorly to any structure.BRAVO!21-*Bones of the Shoulders, Arms, and HandsShoulders – pectoral girdles Clavicles ScapulaeUpper limb or arm bones HumerusRadius Ulna 21-*Bones of the Shoulders, Arms, and Hands (cont.)Hand 8 carpals per hand5 metacarpals per hand14 phalanges per hand3 in each finger2 in each thumb21-*Apply Your KnowledgeMatch the following:___ Clavicle A. Pectoral girdle___ Radius B. Arm bones___ Humerus C. Hands___ Carpals___ Scapula___ Ulna___ Phalanges___ MetacarpalsABBBCCCAANSWER:Excellent!21-*Bones of the Hips, Legs, and FeetHipbones Coxal bones form the pelvic girdleIliumIschiumPubis 21-*Bones of the Hips, Legs, and Feet (cont.)Bones of leg Femur Patella Tibia Fibula 21-*Bones of the Hips, Legs, and Feet (cont.)Bones of the foot TarsalsMetatarsalsPhalanges 21-*Apply Your KnowledgeMatch the following:A. Coxal bones B. Leg bones C. Foot bones___ Tibia ___ Patella ___ Ilium ___ Ischium ___ Femur ___ Metatarsals___ Pubis ___ Fibula___ Calcaneus ___ TarsalsBBBAAACCCBANSWERS:Super!21-*JointsJunctions between bones Classification based on structure Fibrous joints Connected together with short fibers Between cranial bones and facial bonesSutures – fibrous joints in the skull21-*JointsCartilaginous jointsConnected together with a disc of cartilage Between vertebrae21-*JointsSynovial joints Covered with hyaline cartilageHeld together by a fibrous joint capsule lined with synovial membraneSecretes synovial fluid so bones move easily against each otherFreely movableBones are also held together through tough, cord-like structures called ligaments21-*Apply Your KnowledgeMatch the following:A. Fibrous joints B. Cartilaginous joints C. Synovial joints____ Between cranial bones and facial bones____ Covered with hyaline cartilage____ Between vertebrae____ Freely movable____ Sutures in the skullABCCAANSWER:Yippee!21-*Common Diseases and DisordersArthritis – general term meaning joint inflammationOsteoarthritis – degenerative joint disease, primarily of weight-bearing jointsRheumatoid arthritis – chronic systemic inflammatory disease of smaller joints and surrounding tissues21-*Common Diseases and Disorders (cont.)Bursitis – inflammation of a bursa (fluid-filled sac that cushions tendons)Carpal tunnel syndrome – overuse of wrist; the median nerve in the wrist becomes compressedEwing’s family of tumors (EFT) – a group of tumors that affect different tissue types; primarily boneGout – a type of arthritis; deposits of uric acid crystals in the joints 21-*Common Diseases and Disorders (cont.)Kyphosis – abnormal curvature of the spine (humpback)Lordosis – exaggerated inward curvature of the lumbar spine (swayback) Osteogenesis imperfecta – brittle-bone diseaseOsteoporosis – a condition in which bones thin (become porous) over time21-*Common Diseases and Disorders (cont.)Osteosarcoma – a type of bone cancer that originates from osteoblasts, the cells that make bony tissuePaget’s disease – causes bones to enlarge and become deformed and weak Scoliosis – an abnormal S-shaped curvature of the spine21-*Apply Your Knowledge 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 an osteosarcoma. What do you know about this disorder? Nice Work!21-*In Summary21.1 Bones consist of the following substances: Osteons or Haversian systems, bone matrix between osteocytes (bone cells), collagen fibers and proteins, the lamella, and canaliculi. 21.2 Diaphysis is the shaft of a long bone. Epiphysis is an end of a long bone. Articular cartilage covers the end of long bones. The medullary cavity is lined by the endosteum. The periosteum is the membrane surrounding the diaphysis. 21.3 Bone functions include giving shape to body parts, protecting the soft structures of the body, and assisting in movement. The red bone marrow is responsible for hematopoiesis. Bones also store calcium.21-*In Summary (cont.)21.4 Long bones include the femur and humerus; short bones include the carpals and tarsals; flat bones include the ribs and frontal bone; irregular bones include the vertebrae and bones of the pelvic girdle.21.5 Bones grow through the two types of ossification: intramembranous ossification and endochondral ossification. The cartilage plate between the diaphysis and epiphysis allows for growth of the long bone.21.6 Skeletal structures include the following: Condyles, crests, epicondyles, foramens, fossas, heads, processes, sutures, trochanters, tubercles and tuberosities.21-*In Summary (cont.)21.7 The major bones of the skull are the frontal, parietal, temporal, and occipital bones. Within the skull are the mastoid processes, sphenoid, ethmoid, and ear ossicles. The facial bones include mandible, maxilla, zygomatic, nasal and palatine bones, and vomer. The spinal column includes cervical, thoracic, and lumbar vertebrae and the sacrum and coccyx. There are12 pair of ribs, a sternum, and xiphoid process. An upper extremity includes the clavicle, scapula, humerus, radius, ulna, carpals, metacarpals, and phalanges. The bones of the hip, leg, and foot include the coxal bones, femur, patella, tibia, fibula, metatarsals, tarsals, and phalanges. 21-*In Summary (cont.)21.8 The fontanels are the membranous structures that connect the incompletely developed cranial bones. 21.9 The three joint types are fibrous joints, cartilaginous joints, and synovial joints.21.10 A synovial joint consists of hyaline-covered bones held together by a fibrous joint capsule, which is lined by a synovial membrane that secretes synovial fluid. Ligaments hold the bones of these joints together. 21-*In Summary (cont.)21.11 There are many diseases and disorders of bones and skeletal system with varied signs, symptoms, and treatments found in the Pathophysiology section of this chapter. Some of the common diseases and disorders discussed include arthritis, bursitis, carpal tunnel syndrome, EFT, gout, kyphosis, lordosis, and scoliosis, as well as osteoporosis and osteosarcoma.21-*Rigid, the skeleton of habit alone upholds the human frame.~ Virginia WoolfEnd of Chapter 21