6 - ANATOMY - SKELETAL and MUSCULOSKELETAL SYSTEM - Dr. Vatanagul - UPLOAD

Correlative Anatomy- Skeletal and Musculoskeletal System
Human Anatomy Human Anatomy

Skeletal System BONES
s
Type & Functions of Bones
rd
Dr. Jarungchai Anton S. Vatanagul, FPCP, FPN
oa
Internal Medicine- Adult Neurology
Bone tissue
• Bone is made up of bone
cells in a matrix of
collagen and minerals.
'B • Cells:
– Osteoblast
• Form organic components of matrix
– Osteocyte
– Osteoblasts
D
• Three types of bone cells: • From monocytes
osteocytes, osteoblasts, • Secrete citric and lactic acids
and osteoclasts. • Collagenases and other enzymes
• Functional unit: OSTEON • Stimulated by PTH
• Inhibited by Calcitonin
ng
4
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Bones Types of Bone

• Bones may made • Dense or Compact (85%)
up of: – Osteon (Haversian System)
• Compact bone
ra
– Central (Haversian) canal

tissue.
– Lamellae
• Spongy bone
(location of red – Lacunae with osteocytes
marrow) – Canaliculi
• Marrow cavity • Spongy (cancellous) bone (15%)
C
(location of – trabeculae
yellow marrow)
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The Skeletal System The Skeletal System

•  Parts of the skeletal system •  Divided into two divisions
s
• Bones (skeleton) • Axial skeleton: bones of the skull,
• Joints vertebral column, and rib cage
rd
• Cartilages • Appendicular skeleton: bones of the
• Ligaments (bone to bone)(tendon=bone to upper and lower limbs, shoulder and hip
muscle)
oa
Skeletal System at a Glance
• Functions of Skeletal System
– Internal framework of body
'B Skeletal System at a Glance
• Organs of Skeletal System
– Bones of the skeleton
D
– Supports body – Joints
– Protects internal organs
– Point of attachment for muscles
– Produces blood cells
– Stores minerals
i ng
ck
Bones of the Human Body Bones

•  The adult skeleton has 206 bones • Also called osseous tissue
•  Two basic types of bone tissue • One of hardest materials in body
ra
• Compact bone • Formed from gradual process before birth

called ossification
• Homogeneous
• Fetal skeleton is formed from a cartilage
• Spongy bone
model
• Small needle-like
C
pieces of bone
• Many open spaces
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Bones Four Shapes of Bones

Long Short Flat Irregular
s
• Flexible tissue is gradually replaced by
bones bones bones bones
osteoblasts (immature bone cells)
Longer than Roughly as Plate- Shape very
• In adult bones osteoblasts mature into wide long as wide shaped irregular
rd
osteocytes
Example: Example: Example: Example:
• Formation of strong bones dependant on l femur l carpals l sternum l vertebrae
adequate supply of minerals l humerus l tarsals l scapula
l pelvis
oa
Classification of Bones on the
Basis of Shape
'B Classification of Bones
•  1. Long bones
• Typically longer than wide
D
• Have a shaft with heads at both ends
• Contain mostly compact bone
• Examples: Femur, humerus
ng
Figure 5.1
i
ck
Long Bones Gross Anatomy of a Long Bone
• Majority of bones in •  Diaphysis

body • Shaft (middle)
ra
• Divided into: • Composed of

compact bone
– Diaphysis
– Epiphysis •  Epiphysis
• Ends of the bone
C
• Composed mostly of
spongy bone Figure 5.2a
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Periosteum Compact Bone
s
• Covers surface of • Also called cortical
bone not covered by bone
articular cartilage • Ve r y d e n s e a n d
rd
• Thin connective hard
tissue membrane • Outer layer of bone
• Contains numerous • Found in both
nerve and lymphatic epiphysis and
vessels diaphysis
oa
Cancellous Bone
• Also called spongy
bone
'B
D
• Found inside bone
• H a s s p a c e s
containing red bone
marrow
– Manufactures blood
ng
cells
Figure 4.2 – Components of a long bone.
Copyright ©2009 by Pearson Education, Inc.

Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458
Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
i
ck
Classification of Bones Classification of Bones
•  3. Flat bones
•  2. Short bones
ra
• Thin and flattened

• Generally cube-shape • Usually curved
• Contain mostly spongy bone • Thin layers of compact bone around a layer
• Examples: Carpals, tarsals of spongy bone
C
• Examples: Skull, ribs, sternum
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Classification of Bones
s
•  4. Irregular bones
• Irregular shape
rd
• Do not fit into other bone classification
categories
• Example: Vertebrae and hip
oa
Figure 4.1 – Classification of bones by shape.

Bone Markings
•  Surface features of bones
•  Sites of attachments for muscles, tendons,
'B Changes in the Human Skeleton
•  In embryos, the skeleton is primarily hyaline
cartilage
D
and ligaments •  During development, much of this cartilage
is replaced by bone
•  Passages for nerves and blood vessels
•  Cartilage remains in isolated areas
•  Categories of bone markings
• Bridge of the nose
• Projections and processes – grow out from the
bone surface • Parts of ribs
ng
• Depressions or cavities – indentations • Joints

i
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Bone Growth Bone Growth
•  Epiphyseal plates allow for growth of

long bone during childhood •  Bones are remodeled and lengthened
ra
• New cartilage is continuously formed until growth stops

• Older cartilage becomes ossified • Bones change shape somewhat
• Cartilage is broken down • Bones grow in width

C
• Bone replaces cartilage
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Long Bone Formation and Growth Types of Bone Cells

•  Osteocytes
s
• Mature bone cells
•  Osteoblasts
• Bone-forming cells
rd
•  Osteoclasts
• Bone-destroying cells
• Break down bone matrix for remodeling and release
of calcium
oa
Figure 5.4a
Bone Fractures
•  A break in a bone
•  Types of bone fractures
'B Common Types of Fractures
D
• 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
ng
• Realignment of the bone Table 5.2

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ck
Repair of Bone Fractures Stages in the Healing of a Bone

Fracture
•  Hematoma (blood-filled swelling) is
formed
ra
•  Break is splinted by fibrocartilage to

form a callus
•  Fibrocartilage callus is replaced by a
bony callus
C
•  Bony callus is remodeled to form a Figure 5.5
permanent patch
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The Skeleton Axial Skeleton
s
• Skeleton has two divisions • Includes bones in:
– Axial skeleton – Head
– Appendicular skeleton – Neck
rd
– Spine
– Chest
– Trunk
oa
The Axial Skeleton
•  Divided into
three parts 'B The Skull
• Is divided into two parts
– Cranium
D
• Skull
– Facial bones
• Vertebral column • Protects brain, eyes, ears, nasal cavity,
• Bony thorax and oral cavity
• Attachment for muscles of chewing and
turning the head
i ng
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Cranium Cranium
• Frontal – 1 • Ethmoid – 1
– Forehead – Part of eye orbit,
nose, & floor of
ra
• Parietal – 2 skull
– Upper sides and • Sphenoid – 1
roof of skull
– Part of floor of skull
• Temporal – 2 • Occipital – 1
– Sides & base of – Back & base of
C
skull skull
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Facial Bones
• Mandible – 1
s
– Lower jawbone
• Maxilla – 1
rd
– Upper jawbone
• Zygomatic – 2
– Cheek bones
• Vomer – 1
– Part of nasal
oa
Figure 4.5 – Bones of the skull. septum
• Palatine – 1
– Hard palate and
Facial Bones
'B Paranasal Sinuses

•  Hollow portions of bones surrounding
the nasal cavity
D
floor of nose
• Nasal – 2
– Part of nasal
septum and bridge
of nose
• Lacrimal – 2
ng
– Inner corner of eye

Figure 5.10
i
ck
Paranasal Sinuses The Hyoid Bone

•  Functions of paranasal sinuses •  The only bone that
• Lighten the skull does not articulate
• Give resonance and amplification to voice
(move) with
ra
another bone
•  Serves as a
moveable base for
the tongue
C
Figure 5.10
Figure 5.12
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The Trunk The Vertebral Column
s
• Vertebral column • Divided into five
• Sternum sections
• Rib cage – Cervical
rd
– Thoracic
– Lumbar
– Sacrum
– Coccyx
oa
The Vertebral Column
• Cervical
– 7 vertebrae of neck
• Sacrum
– 5 fused vertebrae at
base of spine
'B
D
• Thoracic
– 12 vertebrae of chest • Coccyx
• Lumbar – 3–5 small vertebrae
attached to sacrum
– 5 vertebrae of low
back
ng
Figure 4.6 – Divisions of the vertebral column.

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ck
The Rib Cage The Rib Cage
• 12 pairs of ribs • True ribs

• Attached to – 10 pairs attached
ra
vertebral column to sternum in front

at back • Floating ribs
• Provides support – Inferior 2 pairs
for organs, such – No attachment in
as heart and lungs front
C
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The Appendicular Skeleton
s
•  Limbs (appendages)
rd
•  Pectoral girdle
•  Pelvic girdle
oa
Figure 4.7 – The structure of the rib cage.

The Appendicular Skeleton
'B Appendicular Skeleton
• Includes bones of:

– Pectoral girdle
D
– Upper extremity
– Pelvic girdle
– Lower extremity
ng
Figure 5.6c
i
ck
Pectoral Girdle Bones of the Shoulder Girdle
• Attaches upper extremity to axial

skeleton
• Articulates with:
ra
– Sternum anteriorly
– Vertebral column posteriorly
• Consists of:
– Clavicle – collar bone
C
– Scapula – shoulder blade
Figure 5.20a, b
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Bones of the Upper Limb Bones of the Upper Limb
s
•  The arm is
• The forearm
formed by a
has two bones
rd
single bone
• Ulna
• Humerus
• Radius
oa
Figure 5.21a, b Figure 5.21c
Bones of the Upper Limb
•  The hand 'B Pelvic Girdle

• Also called os coxae, innominate bone,
or hipbone
D
• Carpals – wrist • Attaches lower extremity to axial skeleton
• Metacarpals – • Articulates with sacrum posteriorly
palm • Consists of:
• Phalanges – – Ilium
fingers – Ischium
ng
– Pubis
Figure 5.22
i
ck
The Pelvis Gender Differences of the Pelvis

ra
C
Figure 5.23a
Figure 5.23c
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Lower Extremity
• Leg
s
• Consists of:
– Femur – thigh bone
rd
– Patella – knee cap
– Tibia – shin bone
– Fibula – lower leg bone
– Tarsals – ankle bones
– Metatarsals – foot bones
Figure 4.10 – Anatomical and common names for the pelvic girdle
oa
– Phalanges – toe bones and lower extremity.

Bones of the Lower Limbs
•  The thigh has

'B Bones of the Lower Limbs
•  The leg has

D
one bone two bones
• Femur – thigh • Tibia
bone
• Fibula
ng
Figure 5.35a, b Figure 5.35c

i
ck
Bones of the Lower Limbs Human Anatomy

Musculoskeletal System
•  The foot
ra
• Talus – ankle
• Metatarsals –
• Phalanges – toes
C
Dr. Jarungchai Anton S. Vatanagul, FPCP, FPN

Figure 5.25 Internal Medicine- Adult Neurology
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Structure and Function Locomotion

Forms the body framework
• Locomotion is
s
the result of
Enables the Protects and muscles
supports internal pulling on
rd
body
organs skeletal
to move systems, which
is why we
often study
these systems
oa
together.
73
Skeletal Muscle Actions

• Skeletal muscles attach to two different
bones and overlap a joint
'B • Action
Skeletal Muscle Actions
– Type of movement produced by the muscle

D
• When muscle contracts both bones move, • Antagonistic pairs
but not equally – Pair of muscles arranged around a joint
– Origin: less moveable of 2 bones – Produce opposite actions
– Insertion: more moveable of 2 bones
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Tendon
Cartilage
• Generally regular
• Cartilage tissue connective tissue
consists of • Musculo-skeletal
chondrocytes connections
ra
(cartilage cells) in – Muscle to bone

a matrix of – Muscle to muscle
collagen protein. – Bone to bone
• Cartilage is tough,
flexible material
that pads joints
C
and is found in the

Fig. 4.15f, M&M
nose and ears.
Frolich, Human Anatomy, Mechanics of Movement
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Tendons Ligaments
• Tendons are structures that
connect bone to muscle and • Ligaments
s
are made up of tendon tissue connect bone-to-
• Can have various shapes bone or reinforce
• Typical is cord-like tendon of joints--they are
rd
biceps made up of
• Sheeths are tendinous tissue
common--”aponeuroses” e.g. as well
acromiotrapezius origin from
thoracic vertebral spines
• E.g. knee
ligaments
oa
Fig. 10.3, M&M
Frolich, Human Anatomy,
Frolich, Human Anatomy, Mechanics of Movement Mechanics of Movement
Joints
• Formed where two bones meet
• Also called an articulation
'B Functional Classification of Joints
•  Synarthroses – immovable joints

D
• Three types based on movement allowed
•  Amphiarthroses – slightly moveable
between the 2 bones:
joints
– Synovial
– Cartilaginous •  Diarthroses – freely moveable joints
– Fibrous
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Structural Classification of Joints Fibrous Joints

•  Fibrous joints • Allow almost no
movement
• Generally immovable • Joined by thick
ra
•  Cartilaginous joints fibrous tissue

• Example
• Immovable or slightly moveable – Sutures of the skull
•  Synovial joints
C
• Freely moveable
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Fibrous Joints Cartilaginous Joints

•  Bones united by fibrous tissue –
s
synarthrosis or largely immovable. • Allow slight
movement
• Hold bones firmly in
rd
place by solid piece of
cartilage
• Example
– Pubic symphysis
oa
Figure 5.27d, e
Cartilaginous Joints – mostly

amphiarthrosis
•  Bones connected by cartilage
•  Examples
'B Cartilaginous Joints
• Synchondrosis
– Hyaline cartilage unites bones
– Epiphyseal growth plates
– Costal cartilage-sternum
D
• Pubic Fig. 9.2, M&M • Symphyses
symphysis – Fibrocartilage unites bones
– Pubic symphysis
• Intervertebral – Intervertebral disc
joints
ng
Figure 5.27b, c
Frolich, Human Anatomy, Mechanics of Movement

i
ck
Synovial Joints
• Freely moving joints
• Most common type of joint
ra
• Example is ball-and-socket joint

• Bones held together by ligaments
– Strong bands of connective tissue
• Some contain a bursa
C
– Sac-like structure lined with synovial

membrane
Also see Fig. 9.3, M&M
Mechanics of Movement
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Ball and socket joint

• A ball and
s
socket
arrangement
allows
rd
rotational
movement.
• Multiple pairs
of muscles
allow
movement in a
range of
oa
directions.
Synovial Joints
•  Articulating
bones are
'B Synovial Joints
• Enclosed in an
elastic joint
capsule
D
separated by a • Contains synovial
fluid
joint cavity – Lubricant secreted
by synovial
•  Synovial fluid membrane
is found in the • Ends of bones are
covered with
joint cavity
ng
articular cartilage
Figure 5.27f–h
i
ck
Structures Associated with the

Synovial Joint
•  Bursae – flattened fibrous sacs
• Lined with synovial membranes
ra
• Filled with synovial fluid

• Not actually part of the joint
•  Tendon sheath
C
• Elongated bursa that wraps around a tendon

Figure 4.12 – Structure of a synovial joint.

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The Synovial Joint Synovial Joint Shape Types

• Plane joints--intercarpal joints
s
• Hinge joints--elbow,ankle, interj-phalangeal
• Pivot joints--radio-ulnar joint
• Condyloid joints (egg into oval)--metacarpo-
rd
phalangeal
• Saddle joints--carpo-metacarpal joint of thumb
• Ball-and-socket--hip, shoulder
The type of joint, in part, determines the range
oa
and direction of movement
Figure 5.28
Types of Synovial Joints Based on

Shape
'B Types of Synovial Joints Based on
Shape
D
ng
Figure 5.29a–c Figure 5.29d–f

i
ck
Hinge joint
• A hinge joint
allows flexing and
ra
extending along
one plane.
• Pairs of muscles
work opposite one
another to create
C
motion.
Fig. 9.9, M&M
17
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s
rd
oa
Frolich, Human Anatomy, Frolich, Human Anatomy,
Mechanics of Movement Mechanics of Movement
Gliding joints
• In gliding joints, bones slide past one
another.
'B Movement
Patterns at Joints
D
• Gliding joints allow twisting motion.
i ng
ck
• Synovial joints • Synovial fluid

– Joint capsule – Plasma filtrate
• Fibrous CT – Synovial cells and leukocytes
• Tendons and ligaments phagocytize debris and microbes
ra
• Nerves, blood and lymph vessels • Articular cartilage

– Synovial membrane – Reduce friction
• Loose fibrous CT – Distribute force
• Many blood vessels – good repair
C
– Joint (synovial) Cavity
107 108
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Movement Terminology
s
abduction movement away from midline of body
adduction movement toward midline of body
rd
flexion act of bending or being bent
extension brings limb into a straight condition
dorsiflexion backward bending of foot

plantar flexion bending sole of foot; pointing toes
oa
109
• Bending
Flexion
• This occurs when the angle
'B • Straightening
Extension
• This occurs when the angle
D
between the articulating bones is between the articulating bones is
decreased increased
i ng
ck
Joint Movement
ra
C
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s
rd
oa
'B • ab–
Muscular System Prefixes
away from
D
• ad– towards
• circum– around
i ng
ck
Abduction Adduction
• Occurs when a body part is • Opposite of abduction
moved away from the midline of • Occurs with movement towards
ra
the body or other body part the midline of the body

C
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Joint Movement
s
rd
oa
Different Circular Movements
• Circumduction
– Movement in circular direction from a central
'B Circumduction
• Occurs when a circle is drawn by
a body part
D
point
• Opposition
– Moving thumb away from palm to contact tip
of other fingers
• Rotation
– Moving around a central axis
i ng
ck
Rotation
• This occurs when the bone turns
about its long axis within the joint
ra
C
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Opposition
s
– Moving thumb away from palm
to contact tip of other fingers
rd
oa
Internal/Medial
Rotation 'B External / Lateral
Rotation
D
• Rotation towards the body • Rotation away from the body
i ng
ck
ra
C
Figure 4.23 – Abduction and adduction. Figure 4.24 – Flexion and extension.
Copyright ©2009 by Pearson Education, Inc. Copyright ©2009 by Pearson Education, Inc.
Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458 Medical Terminology: A Living Language, Fourth Edition Upper Saddle River, New Jersey 07458
Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved. Bonnie F. Fremgen and Suzanne S. Frucht All rights reserved.
22
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pronation turning palm

downward
supination turning palm
s
upward
rd
oa
Figure 4.27 – Pronation and supination.

'B dorsiflexion backward bending of
plantar
foot
bending sole of foot;
D
flexion pointing toes
i ng
ck
ra
C
Figure 4.25 – Dorsiflexion and plantar flexion.

23
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eversion turning
outward
s
inversion turning inward
rd
oa
Figure 4.26 – Eversion and inversion.

'B
D
i ng
ck
ra
C
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Correlative Anatomy- Skeletal and Musculoskeletal System

Human Anatomy Human Anatomy

Bones Types of Bone

– Central (Haversian) canal

The Skeletal System The Skeletal System

Bones of the Human Body Bones

• Compact bone • Formed from gradual process before birth

Bones Four Shapes of Bones

Long Bones Gross Anatomy of a Long Bone

• Majority of bones in • Diaphysis

• Divided into: • Composed of

Periosteum Compact Bone

Copyright ©2009 by Pearson Education, Inc.

Classification of Bones Classification of Bones

• Thin and flattened

• Examples: Skull, ribs, sternum

Copyright ©2009 by Pearson Education, Inc.

• Depressions or cavities – indentations • Joints

Bone Growth Bone Growth

• Epiphyseal plates allow for growth of

• New cartilage is continuously formed until growth stops

• Cartilage is broken down • Bones grow in width

• Bone replaces cartilage

Long Bone Formation and Growth Types of Bone Cells

• Realignment of the bone Table 5.2

Repair of Bone Fractures Stages in the Healing of a Bone

• Break is splinted by fibrocartilage to

• Bony callus is remodeled to form a Figure 5.5

The Skeleton Axial Skeleton

'B Paranasal Sinuses

– Inner corner of eye

Paranasal Sinuses The Hyoid Bone

The Trunk The Vertebral Column

Figure 4.6 – Divisions of the vertebral column.

Copyright ©2009 by Pearson Education, Inc.

The Rib Cage The Rib Cage

• 12 pairs of ribs • True ribs

vertebral column to sternum in front

The Appendicular Skeleton

Copyright ©2009 by Pearson Education, Inc.

The Appendicular Skeleton

'B Appendicular Skeleton

• Includes bones of:

Pectoral Girdle Bones of the Shoulder Girdle

• Attaches upper extremity to axial

– Scapula – shoulder blade

Bones of the Upper Limb Bones of the Upper Limb

Bones of the Upper Limb

• The hand 'B Pelvic Girdle

The Pelvis Gender Differences of the Pelvis

Copyright ©2009 by Pearson Education, Inc.

Bones of the Lower Limbs

• The thigh has

• The leg has

Figure 5.35a, b Figure 5.35c

Bones of the Lower Limbs Human Anatomy

Dr. Jarungchai Anton S. Vatanagul, FPCP, FPN

Structure and Function Locomotion

Skeletal Muscle Actions

– Type of movement produced by the muscle

(cartilage cells) in – Muscle to bone

and is found in the

• Synarthroses – immovable joints

• Compact bone • Formed from gradual process before birth

• Majority of bones in •  Diaphysis

• Divided into: • Composed of

• Thin and flattened

• Examples: Skull, ribs, sternum

• Depressions or cavities – indentations • Joints

•  Epiphyseal plates allow for growth of

• New cartilage is continuously formed until growth stops

• Cartilage is broken down • Bones grow in width

• Bone replaces cartilage

• Realignment of the bone Table 5.2

•  Break is splinted by fibrocartilage to

•  Bony callus is remodeled to form a Figure 5.5

•  The hand 'B Pelvic Girdle

•  The thigh has

•  The leg has

•  Synarthroses – immovable joints

•  Cartilaginous joints fibrous tissue

• Filled with synovial fluid

• Elongated bursa that wraps around a tendon