SKELETAL SYSTEM q internal framework for the body 1. FUNCTIONS 1.

Support form the framework that supports the body and cradles soft organs 2. Protection provide a protective case for the brain, spinal cord, and vital organs 3. Movement provide levers for muscles 4. Mineral storage reservoir for minerals, especially calcium and phosphorus e.g. Ca, P, Mg, Na Calcium is necessary for: Transmission of nerve impulses Muscle contraction Blood coagulation Secretion by glands and nerve cells Cell division 5. Blood cell formation hematopoiesis occurs within the marrow cavities of bones e.g. In infants, found in the medullary cavity and all areas of spongy bone In adults, found in the diplo of flat bones, and the head of the femur and humerus Includes not only bones, but also joints, cartilages, and ligaments Skeletal Cartilages Contains no blood vessels or nerves Surrounded by the perichondrium (dense irregular connective tissue) that resists outward expansion Three types 1. Hyaline cartilage 2. elastic cartilage 3. fibrocartilage Hyaline Cartilage Provides support, flexibility, and resilience Is the most abundant skeletal cartilage

Is present in these cartilages: Articular covers the ends of long bones Costal connects the ribs to the sternum Respiratory makes up the larynx and reinforces air passages Nasal supports the nose Elastic Cartilage Similar to hyaline cartilage but contains elastic fibers Found in the external ear and the epiglottis Fibrocartilage Highly compressed with great tensile strength Contains collagen fibers Found in menisci of the knee and in intervertebral discs Microanatomy of the Bone Rigid form of CT with cell, fibers & ground substance / matrix Ground substance is calcified becomes hard and brittle Calcified matrix made up of organic elements (collagen, protein polysaccharide and chondroitin sulfate) Inorganic elements calcium, magnesium, and sodium; makes up the greater portion of the matrix Bone Cells 1. Osteoblasts 2. Osteocytes 3. Osteoclasts 4. Osteoprogenitor cells Undifferentiated cells On free bony surfaces, endosteum, periosteum, lining of the Haversian canal, epiphyseal plate Divide osteoblasts (bone - forming cells) Unite osteoclasts (bone - destroying cells) Bone Tissues Cancellous or Spongy bone (substancia spongiosa) Compact bone (substancia compacta) Spongy Bone Irregular branching bony

spicules forming a network of interconnecting spaces containing bone marrow With thin trabeculae made up of irregular lamellae of bone with lacunae containing osteocytes Trabeculae lined by endosteum containing osteoprogenitor cells, osteoblasts & osteoclasts Absence of haversian system Compact Bone Haversian system, or osteon the structural unit of compact bone Lamella weightbearing, column-like matrix tubes composed mainly of collagen Haversian, or central canal central channel containing blood vessels and nerves Volkmann s canals channels lying at right angles to the central canal, connecting blood and nerve supply of the periosteum to that of the Haversian canal Osteoblasts boneforming cells Osteocytes mature bone cells Osteoclasts large cells that resorb or break down bone matrix Osteoid unmineralized bone matrix composed of proteoglycans, glycoproteins, and collagen OSTEOGENESIS/ OSSIFICATION q Begins at week 8 of embryo development q Intramembranous ossification q Intracartilaginous ossification OSTEOGENESIS/ OSSIFICATION 1. Intramembranous Ossification occurs directly in primitive CT w/o cartilage formation e.g. Commonly seen in the flat bones of the face & skull

Stages: Stages of Intramembranous Ossification

2. Intracartilaginous / Endochondral Ossification Involves the replacement of a cartilage model by bone e.g. Involves the bones of the entire skeletal system except the bones of the face & skull Uses hyaline cartilage bones as models for bone construction Requires breakdown of hyaline cartilage prior to ossification Ectopic bone formation when bone arises in tissues not belonging to the skeletal system or in CT w/o osteogenic properties Steps: Classification of bones as to shape 1.Long bones longer than they are wide mostly compact bone have a shaft with heads at both ends function as levers e.g. limb bones such as humerus

Epiphyseal plate separates the epiphysis from the diaphysis Metaphysis a transitional region connecting the epiphyseal plate to the diaphysis Periosteum a layer of specialized CT w/ osteogenic potential Endosteum a thin cellular layer w/ osteogenic properties covering the marrow cavity 2. Short bones

Cube-shaped bones Contain mostly spongy bone Found in confined spaces, where they transfer forces of movement e.g. wrists and ankle bones 3. flat bones thin, flattened, and usually curved have 2 thin layers of compact bone sandwiching a layer of spongy bone provide protection for underlying organs and surfaces for muscle attachment e.g. ribs, sternum, and most skull bones 4. Irregular bones . bones with complicated shapes or . elaborated for muscle attachment or articulation e.g. vertebrae and hip bones, ethmoid Diploe found in the flat bones of the face and skull; a layer of spongy bone between 2 layers of compact bone forming an outer and inner table 5. Wormian bones accessory bones found between the joints of the skull when their edges meet e.g. Sutures of the skull 6. Sesamoid bones small bones which develop within tendons in response to stress e.g. Kneecap

Main Division of the Skeleton 1. Axial Division- bones that form the axis of the body and supports and protect the organs of the head, neck, and trunk 2. Appendicular Divisionbones of the girdles and the extremities. The girdles anchor the appendages to the axial skeleton. 1. AXIAL SKELETON A. Skull Cranium (including hyoid and ear ossicles) Facial Bones B. Vertebral Column/ Spine Cervical Thoracic Lumbar Sacrum Coccyx C. Bony Thorax Sternum Manubrium Body Xiphoid Ribs True ribs False ribs(including floating ribs) 11.Appendicular Skeleton A. Pectoral girdle Clavicle Scapula B. Upper Extremities Upper Arm Humerus Lower Arm Radius Ulna Hand Carpals Metacarpals Phalanges C. Pelvic Girdle Ilium Ischium Pubis D. Lower Extremities Thigh Femur Leg Tibia Fibula Foot Tarsals Metatarsals Phalanges There are 206 bones in typical human skeleton. 1. AXIAL SKELETON (80) 3. Ear ossicles (6) A. SKULL (22) malleus (2) 1. Cranial (8) incus (2) frontal (1) stapes (2) parietal (2) temporal (2) 4. Hyoid (1) occipital (1) ethmoid (1) B. Thorax (25) sphenoid (1) sternum (1) 2. Facial ribs (24) nasal (2)

lacrimal (2) C. Vertebral Column (26) maxlla (2) cervical (7) inferior nasal conchae (2) thoracic (12) zygomatic (2) lumbar (5) palatine (2) sacrum (1) 5 fused vertebrae vomer (1) coccyx (1) 4 fused vertebrae mandible (1) 11. APPENDICULAR SKELETON (126) A. Pectoral Girdle (4) C. Pelvic Girdle (2) scapula (2) os coxae (2) each contains clavicle (2) 3 fused bones B. Upper Extremities (60) D. Lower Extremities (60) humerus (2) femur (2) radius (2) tibia (2) ulna (2) fibula (2) carpals (16) patella (2) metacarpals (10) tarsals (14) phalanges (28) metatarsals (10) phalanges (28) 1. AXIAL SKELETON q divided into 3 parts: skull, vertebral column and thorax q divided into 3 parts: skull, vertebral column and thorax A. SKULL 1. Cranium -protects the brain -consist of 8 large, flat bones -all are single except the parietals and the temporals 1.1 Frontal -forms the forehead, the bony projections under the eyebrows and the superior part of each eye s orbit If the frontal suture uniting the left and right sides of the frontal bone persists, it is referred to as the metopic suture 1.2 Parietals -forms the lateral and superior walls of the skull -they meet in the midline of the skull at the sagittal suture - meet the frontal bone by a coronal suture Orbit roof is formed by the frontal lateral wall by the zygomatic and sphenoid medial wall by the nasals, lacrimals, and ethmoid

floor by the maxillaries 1.3 Temporals form the temple lie inferior to the parietal bones meet the parietals at the squamous suture with 5 bone markings 1.external acoustic (auditory) meatuscanal that leads to the eardrum and middle ear 2.styloid processinferior to the external auditory meatus needle like projection that serves as attachment point for some neck muscles 3.zygomatic processjoins the temporal process of the zygomatic bone to form the zygomatic arch 4.mastoid processrough breastlike projection posterior and inferior to the external acoustic meatus attachment site for some neck muscle easily palpated as a bony knob behind the ear lobe full of air cavities called mastoid sinuses high risk spot for infection because of its proximity to the middle ear and brain 5.Jugular foramenat the junction of the occipital and temporal bones allows passage of jugular vein (largest vein of the head)that drains the brain Carotid canal allows passage of carotid artery that supplies blood to the brain 6.temporal fossaa depression on the

inferior side of the zygomatic process of the temporal bone articulates with the mandible to form the TMJ 1.4 Occipital forms the floor and back wall of the skull joins parietal bones at the lambdoid suture. with 3 bone markings: 1.foramen magnumlarge opening at the base that allows the brain to connect with the spinal cord 2.occipital condylesround protrusions, lateral to the foramen magnum, that articulate with the atlas of the vertebral column 3.external occipital protruberanceprominent midline projection on the posterior surface just posterior to the foramen magnum that serve as attachment point for the ligamentum nucha, a large fibrous elastic ligament which helps support the head 1.5 Sphenoid bone butterfly shaped bone that spans the width of the skull keystone of the cranium forms the floor of the skull with 2 bone markings: 1. sella turcica(Turk s saddle)a depression at the center that holds the pituitary gland in place 2.foramen ovalea large opening at the posterior end of the sella turcica that allows the passage of cranial nerve V (trigeminal nerve)

1.6 Ethmoid bonean irregular bone in front of sphenoid and behind frontal bone forms the roof of the nasal cavity and part of the medial wall of the orbit with 4 bone markings: 1.crista galli (literally, cock s comb )projecting from its superior surface. serves as a point of attachment for the membranes that cover the brain 2.superior and middle nasal conchae (turbinates)scrollshaped bones in the lateral wall of the nasal cavity Turbinates allow the air to swirl so foreign particles may become trapped in the mucus that lines the nasal passageways. 3.perpendicular plateforms the superior portion of the nasal septum 4.cribriform platethe holey areas on each side of the crista galli that allow fibers carrying impulses from the olfactory (smell) receptors of the nose to reach the brain 2. FACIAL BONES consist of 14 bones 12 are paired only the mandible and vomer are single 2.1 Maxillae form the upper jaw the main, or keystone bones of the face because all facial bones except the mandible join the maxillae its extensions called palatine processes form the anterior part of the hard plate carry the upper teeth in the sockets of the alveolar margin 2.2 Palatines form the posterior part of the hard palate Failure of the palatines or the palatine processes to fuse medially

results in cleft palate 2.3 Zygomaticsthe cheekbones with temporal processes that unite with the zygomatic processes of the temporal bones to form the zygomatic arch 2.4 Lacrimalsform part of the medial walls of each orbit smallest facial bones about the size of a fingernail with grooves that serve as a passageway for tears 2.5 Nasals small rectangular bones forming the bridge of the nose 2.6 Vomer single bone in the median line of the nasal cavity forms the bridge of the nose 2.7 Inferior Nasal Conchaethin curved bones projecting from the lateral walls of the nasal cavity The Sutures of the Skull Which of the sutures is not shown? 2.8 Mandibleforms the lower jaw the horizontal part (the body) forms the chin the two upright bars (the rami) connect the mandible with the temporal bone each ramus presents 2 processesthe condylar and coronoid processes largest and the strongest bone of the face the only movable bone of the face Sinuses are airfilled cavities such as the paranasal sinuses (frontal, maxillary, ethmoid, sphenoid, sphenoid) and the mastoid sinuses. Function to lighten the weight of the skull and give resonance to the voice fontanels soft spots/ unossified areas in the

skull of newlyborn little fountain because rhythm of the baby s pulse can be felt in it allow the fetal skull to be compressed slightly during birth and the infant s brain to grow during the latter part of pregnancy Hyoid bonehorseshoeshaped, with a body and 2 pairs of horns suspended in the midneck region above the larynx anchored by ligaments to the styloid processes unique in that it is the only bone of the body that does not articulate directly with any other bone serves as movable base for tongue and attachment point for neck muscles Ear ossicles3 little paired bones found inside the middle ear cavity 1. anvil/ incus 2. hammer/ malleus 3. stapes/ stirrups smallest bones in the body amplify the sound Ear ossicles3 little paired bones found inside the middle ear cavity 1. anvil/ incus 2. malleus/ hammer 3. stapes/ stirrups smallest bones in the body amplify the sound B. Vertebral column (Spine) the axial support of the body

extends from the skull, which it supports, to the pelvis, where it transmits the weight of the body to the lower limbs formed from 26 irregular bones connected and reinforced by ligaments before birth, the spine consists of 33 separate vertebarae but 9 of these fuse to form 2 composite bones: the sacrum and coccyx the 24 single vertebrae include 7 cervical, 12 thoracic, and 5 lumbar vertebrae) the vertebrae are separated by pads of fibrocartilage (intervertebral discs) The Vertebrae Common features body (centrum)disclike, weight bearing part of the vertebra Vertebral archformed from joining of lamina and pedicle Vertebral foramencanal through which spinal cord passes Transverse process2 lateral projections from the vertebral arch Spinous processsingle projection arising from the posterior aspect of the vertebral arch Superior and inferior articular processespaired projections lateral to the vertebral foramen allow vertebra to form joints with adjacent vertebrae 1. Cervical Vertebrae forms the neck region first 2 are different 1 st CV: atlascarries the skull ringlike body(centrum) is absent with large neural canal with large depression that

articulates with the occipital condyles of the skull forming atlantooccipital joint allows you to nod yes 2 nd CV: axis (epistropheus)acts as a pivot for the rotation of the atlas and skull with odontoid process or dens which acts as the pivot point the joint between C1 and C2 allows you to rotate your head from side to side to indicate no 2. Thoracic vertebrae 12 thoracic vertebrae are all typical with heartshaped body the spinous process is long and hooks sharply downward has 2 costal demifacets on each side for articulating with the ribs 3. Lumbar vertebrae with massive block like bodies and short, hatchetshaped spinous processes strong because bears most of the body weight 4. Sacrum formed by fusion of 5 sacral vertebrae forms the posterior wall of the pelvis with winglike alae that articulate laterally with the hip bones and a median sacral crest The spinous process of the 5 th vertebra of sacrum (post view) does not form, leaving a sacral hiatus which is the site of caudal anesthetic injections given just before childbirth The anterior edge of the body of the first sacral vertebra bulges to form the sacral promontory, a landmark felt during the

vaginal examination to determine if pelvic openings are large enough to allow for normal vaginal delivery 5.Coccyx the human tailbone formed by fusion by 3 to 5 tiny vertebrae

Abnormal Spinal Curvatures Abnormalities may be congenital or result from disease, poor posture, or unequal muscle pull on the spine Scoliosis lateral bending of the vertebral column, usually in the thoracic region Kyphosis (hunch back) an exaggeration of the thoracic curve of the vertebral column Lordosis (swayback) -an exaggeration of the lumbar curve OSTEOPOROSIS q Osteoporosis, or porous bone, results from reduction in the over-all quantity of bone matrix. q A common consequence of aging, particularly in women q Factors that contribute to osteoporosis are a diet poor in Ca 2+ and protein, lack of Vit D, smokin g, and insufficient weight-bearing exercise, to stress the bones C. BONY THORAX consists of sternum, ribs, and thoracic vertebrae 1. Sternum commonly called breastbone attached to the clavicle by sternoclavicular joint it is a flat bone consisting of 3 segments: 1. manubrium (anteriormost),

2. body 3. Xiphoid process (swordlike) an important landmark in giving cardiopulmonary resuscitation (CPR) Because sternum is located close to the body surface, it is easy to obtain samples of blood-forming tissue for diagnosis of blood diseases. Markings: 1. Sternal angle (angle of Lewis) a slight elevation felt at the junction of the manubrium and body of the sternum; corresponds to the 2 nd rib or to the 2 nd intercostal space or to the point of bifurcation of trachea into bronchi or to the root of the arch of the aorta 2. Suprasternal (jugular) notch- a depression found at the level of sternoclavicular joint; attachment point of neck muscles 2. Ribs its head articulates posteriorly to the vertebra and anteriorly to the sternum thru costal cartilages Types a. true ribs (vertebrosternal ribs)the first 7 pairs attach directly to the sternum by costal cartilages b. false ribs vertebrochondral indirectly attached to the sternum because 8 th , 9 th , and 10 th ribs attach to each other and then to the 7 th pair of ribs floating (vertebral ribs) lack sternal attachment 11. Appendicular Skeleton qcomposed of 126 bones of the limbs and girdles A. Pectoral girdle Clavicle Scapula B. Upper Extremities Upper Arm Humerus Lower Arm Radius Ulna Hand Carpals Metacarpals Phalanges C. Pelvic Girdle Ilium Ischium Pubis D. Lower Extremities Thigh Femur

Leg Tibia Fibula Foot Tarsals Metatarsals Phalanges A. Pectoral Girdle light, poorly reinforced to allow upper extremities a greater deal of free movement however, shoulder joint is very easily dislocated consists of 2 bones : clavicle and scapula 1.Clavicle (collar bone) forms the bony root of the neck slender, Sshaped bone attaches to the manubrium of the sternum medially (by its sternal end) and to the scapula laterally (by its acromial end) it acts as a brace to hold the arm away from the top of the thorax and help prevent shoulder dislocation the whole shoulder region caves in medially when the clavicle is broken 2.Scapula (shoulder blade) -commonly called wings -triangular -with 2 impt processes: acromion and coracoid Acromion -expanded process of the scapular spine which can be felt as the high point of the shoulder -connects with the clavicle forming the acromioclavicular joint Coracoid - beak-like projection of the superior border of the scapula and to which the tendons of the muscles attach -has 3 borders: superior, vertebral (medial), and axillary (lateral) - has 3 angles: superior, inferior, and lateral A spine runs diagonally across the posterior surface of the scapula. Above the spine is the supraspinous fossa and below, is the infraspinous fossa.

Both serve as surfaces of attachment for the tendons of shoulder muscles. On the anterior surface is the subscapular fossa, also a surface of attachment for the tendons of shoulder muscles. Glenoid cavity a shallow socket that receives the head of the humerus found at the lateral angle of the scapula B.1. HUMERUS the arm bone the longest and largest bone of upper extremity at the proximal end is a rounded head that articulates with the glenoid cavity of the scapula opposite the head are 2 bony projectionsthe greater (lateral) and lesser (anterior) tubercles in the midpoint, is a roughened area called the deltoid tuberosity which is a point of attachment for the deltoid muscle of the shoulder at the distal end, are the medial trochlea (a spoolshaped surface that articulates with the ulna) and the lateral capitulum (a rounded knob that articulates with the head of the radius) the coronoid fossa is an anterior depression that receives the coronoid process of the ulna when the forearm is bent the olecranon fossa is a posterior depression that receives the olecranon of the ulna when the forearm is extended the medial and lateral epicondyles are rough projections on either side of the distal end to which most muscles of the forearm are attached 2.1. RADIUS the shorter, more robust bone located on the lateral (thumb) side of the forearm

the discshaped head articulates with the capitulum of the humerus and the radial notch of the ulna serves as attachment point for the tendon of biceps muscle 2.2. ULNA the longer bone with distinct depressions and is located on the medial (little finger) side of the forearm on its proximal end are anterior coronoid process and posterior olecranon process, which are separated by trochlear notch together these 2 processes grip the trochlea of the humerus in a plierslike joint -at the proximal end of the ulna is the olecranon which forms the prominence of the elbow 3.1 CARPALS 8 carpal bones, arranged in 2 irregular rows of 4 bones each navicular (lateral side) Scaphoid Lunate Lunate proximal row Triquetrum Triquetrum Pisiform Pisiform greater Multangular (lateral) Trapezium distal row lesser Multangular Trapezoid Capitate (largest) Capitate Hamate Hamate scaphoid, lunate, and triquetrum articulate with the distal end of the radius 3.2. METACARPALS numbered 1 to 5 from the thumb side toward the little finger when the fist is clenched, the heads or knuckles of the metacarpals become prominent 3.3 PHALANGES each hand contains 14 phalanges the 5 fingers are the pollex thumb), index, medius, medius, annularis, minimus there are 3 phalanges in each finger except in the thumb, which has only 2

C. Pelvic Girdle (2) C. PELVIC GIRDLE large, heavy, and securely attached to the sacrum because of its weight bearing function commonly called hip bones braces the lower extremities formed by 2 coxal bones called ossa coxae each coxal bone is formed by fusion of 3 bones: ilium, ischium and pubis united anteriorly by the symphysis pubis hip bones, sacrum, and coccyx forms the bony pelvis which supports and protects the reproductive organs, urinary bladder, and part of the large intestine Ilium uppermost, large, flaring bone when you put your hands on your hips, they rest over the ilia articulates with the sacrum at the sacroiliac joint Iliac crestprominent upper edge of ilium important anatomic landmark by those giving injections important in bone marrow aspiration Ischium sit down bone forms the most inferior part of the coxal bone Ischial tuberosity roughened area, receives body weight when sitting Greater sciatic notch found below posterior inferior iliac spine allows blood vessel and large sciatic nerve to pass from the pelvis

posteriorly into the thigh injection in the buttocks should always be given away from this area Ischial spinefound superior to the tuberosity an important landmark in pregnant woman because narrows the pelvic outlet

Pubis most anterior part of a coxal bone fused at the pubic sympysis obturator foramenformed by the fusion of rami of pubic and ischial bones allows blood vessels and nerves to pass into the anterior part of the thigh acetabulum vinegar cup a deep and heavily reinforced socket that receives the head of the femur Comparison Between Male and Female Pelvis In general, female pelvis is lighter and broader; inlet and outlet are larger; characteristic features are related to the child bearing functions D. 1.Femur thigh bone longest, heaviest, strongest bone of the body Its ball like head at the proxproximal end of the bone articulates with the acetabulum the constricted neck is a common fracture site in old people the greater and lesser trochanter located on the shaft all serve as sites for muscle attachment linea aspera is a vertical ridge on the posterior surface of the shaft the lateral and medial condyles whi ch are separated by intercondylar fossa articulate with the tibia and form a joint with the patella on either side above condyles are the lateral and medial epicondyles

Tibia the shin bone larger and more medial medial and lateral condyles articulate with the distal end of the femur to form the knee joint tibial tuberosity roughened area on the anterior tibial surface serves as attachment point for the ligament of the patella medial malleous forms the inner bulge of the ankle anterior crest anterior surface of the tibia (easily felt beneath the skin) Fibula No part in forming the knee joint Lateral malleous forms the the outer part of the ankle

FOOT supports body weight and serves as a lever that allows us to propel our bodies forward when we walk and run composed of tarsals, metatarsals, and phalanges Tarsus composed of 7 tarsal bones, 5 metatarsals and 14 phalanges the tarsal bones include a. talus (ankle bone) b. calcaneus (heel bone) ) c. navicular (boatshaped) d. cuboid e. the 3 cuneiforms 6. the metatarsals form the sole 7. phalanges form the toes each toe has 3 phalanges except the great toe which has only 2