PLT COLLEGE, INC.

Bayombong, Nueva Vizcaya

School of Health Sciences – College of Nursing

Orthopedic Nursing
Ortho Lecture Series # 1 (Prepared By: Prince Rener V. Pera, RN)

Anatomy and Physiology of the Musculoskeletal System

Muscular System- Refers to the voluntary skeletal muscle system; the skeletal muscle
tissue and the connective tissue and connective tissues that make up individual muscle
organs.

Review of Anatomy and Physiology

- The musculo-skeletal system consists of the muscles, tendons, bones and
cartilage together with the joints. The primary function of which is to:

1. Support the soft tissues of the body and provide form and shape
2. Facilitate movement when overlying muscles contract
3. Afford protection to the underlying organs of the body
4. Produce blood cells (Hematopoesis)
5. Store minerals for body use, especially Calcium and Phosphorous

Skeletal system- is the supporting framework of the body is composed of 206 bones and
intervening cartilages.

Skeletal Structure of Bones:

Appendicular Bones-126 Axial Bones-80
Shoulder Girdle Skull
Scapula- 2 Cranium- 8
Clavicle- 2 Face- 14
Upper Extremity Hyoid- 1
Humerus- 2 Vertebral Column- 26
Radius- 2 Thorax
Ulna- 2 Ribs- 12 pairs
Carpus- 16 Sternum- 1
Metacarpals- 10 Ossicles of the Ears- 6
Phalanges- 28
Pelvic Girdle
Innominate, Coxa, Hip- 2
Lower Extremity
Femur- 2
Tibia- 2
Fibula- 2
Patella- 2
 Tarsus- 14
Metatarsals- 10
Phalanges- 28

Muscles
Three types of muscles exist in the body
1. Skeletal Muscles
 Voluntary control (but can also be activated by reflexes)
 (+) Striations
 Multinucleated
 Shape: Cylindrical
 Speed of contraction: Variable
 accounts for at least 40% of body mass
 aids in the formation of the smooth contour of the body
Parts:
1.1 Epimysium
 Tough connective tissue covering of the entire muscle.
 It binds many fascicles together.
 Tendon/Apponeurosis : blending of the epimysia
1.2 Perimysium
 Fibrous membrane covering several sheathed muscle fibers
 Fascicles – are bundles of muscle fibers covered by perimysium.
1.3 Endomysium
 This is connective tissue sheath enclosing individual muscle fiber.

2. Cardiac muscles
 Found only in the heart (cardiac).
 Cardiac fibers are cushioned by small amounts of soft connective tissue
and arranged in spiral or figure 8-shaped bundles.
 Involuntary control
 (+) Striations
 Multinucleated
 Branched
 Speed of contraction: Variable
3. Smooth/Visceral muscles
 Visceral, plain muscles
 Found mainly in the walls of hollow visceral organs such as the stomach,
urinary bladder and respiratory passages.
 Propels substances along a definite tract, or pathway, within the body.
 Smooth Muscle Characteristics:
 Involuntary control
 (-) Striations; no distinct sarcomeres
 Uninucleated
 Spindle-shaped
 Speed of Contraction: slow and sustained; does not develop an oxygen
debt
Muscle Physiology

Stimulation and Contraction of a Single Skeletal Muscle Cell

Functional Properties of Muscle Fibers:

1. Irritability – ability to react and respond to stimulus

2. Contractility – ability of muscle tissue to contract forcefully when stimulated by
an action potential.
3. Excitability- is the ability to respond to certain stimuli by producing electrical
signals.
4. Extensibility- ability of the muscle to stretch without being damaged

The Nerve Stimulus and Action Potential

1. Motor Unit - single motor neuron and all of the corresponding muscle fibers it
innervates.
2. Action Potential - the electrical signal sent out by the body to control bodily
processes such as muscular movement.

Two types of connective tissue found in the skeletal system:

 Cartilage – semi-rigid and slightly flexible structures that plays an essential role in
prenatal and childhood development of the skeleton and as a surface for the
articulating ends of the skeletal joint.
 Bones – which provide the firm structure of the skeleton and serve as reservoir for
calcium and phosphate storage.

Three types of cartilage

 Elastic Cartilage- Contain some elastin in each intracellualr substance. ( ears)

 Hyaline Cartilage- Pearly white, found in the articulating ends of the bones.
- form the fetal skeleton .
 Fibro cartilage- has a characteristic that are intermediate between dense
connective tissue and hyaline cartilage. It is found in the intervertebral disks, in
areas where tendons are connective to bone and in the symphysis pubis.
- 65-80% is water.

Bone Classification According to Shape

1. Long Bones- Are found on the extremities and consists of diaphysis with two
expanded epiphysis (e.g. Femur)
2. Short Bones- are cubed shaped and consist mainly of spongy bone with
compact shell (eg. Carpal bones)
3. Flat Bones- thin and composed of two plates of compact bone with an
intervening layer of cancellous bone (e.g. Scapula)
4. Irregular Bones- are of various shapes and do not fill in the groups. (eg. Skull
bones)
Other Bones not classified under shape:

 Sesamoid Bones- are free floating bones usually found in tendons or joint
capsules. (e.g. Patella)

 Bone is made up of four major components:

 mineral (mainly calcium and phosphorus)
 matrix (collagen fibers)
 osteoclasts (bone-removing cells)
 osteoblasts (bone-producing cells).

 Osteocytes ( mature bone cells for bone maintenance functions)

SKELETAL SYSTEM: BONE STRUCTURE

 PERIOSTEUM:
 Dense fibrous membrane covering the bone
 Periosteal vessels supply bone tissue
 EPIPHYSIS:
 Widened area at the end of the long bone
 EPIPHYSEAL PLATE (growth zone)
 Cartilage area in children w/c provides for longitudinal growth of the
bone
 ARTICULAR CARTILAGE:
 Provides smooth surface over the ends of the bone to facilitate joint
movement

Type of Bone Cell

 Osteogenic cells- Undifferentiated cells that differentiate into osteoblasts. They
are found in the periosteum, endosteum, and epiphyseal growth plate of
growing bones.
 Osteoblasts- Bone building cells that synthesize and secrete the organic matrix of
bone. It also participate in the calcification of the organic matrix.
 Osteocytes- Mature bone cells that function in the maintenance of bone matrix.
Osteocytes also play an active role in releasing calcium in the blood.
 Osteoclasts- Bone cells responsible for the resorption of bone matrix and the
release of calcium and phosphate from bone.
 RED BONE MARROW:

 Hemopoietic tissue located in the central bone cavities.

 Adults: ribs, sternum, vertebrae, portions of hips & pelvic bones
 Long Bones filled with fatty, yellow marrow

FUNCTIONS:
 Formation of RBC, WBC & platelets
 Destruction of old RBC (phagocytosis)

BONE FORMATION (Osteogenesis)

 OSSIFICATION
o Process by which matrix (collagen fiber & ground substance) is formed &
hardening minerals are deposited on collagen fibers (give tensile strength)
 ENDOCHONDRAL
o Osteoid (cartilage-like tissue) is formed, reabsorbed, & replaced by bone
 INTRAMEMBRANOUS
o Bone develops within membrane (e.g. face, skull)

“To dream anything that you want to dream. That’s the beauty of the human MIND.
To do anything that you want to do. That is the strength of the Human WILL.
To trust yourself to test your limits. That’s the courage to SUCCEED.”
-princerenerpera-