SKELETAL SYSTEM

FUNCTIONS OF THE BONES

1. Support
- bones are the “steel girders” and “reinforced concrete of the body”
- bones forms the internal framework that supports the body and cradles its soft organs
- ex. legs support the body trunk when we stand; rib cage supports the thoracic wall

2. Protection
- bones protect soft body organs
- ex. skull provide a snug closure for the brain; vertebrae surround the spinal cord; rib cage protects the organs of the thorax

3. Movement
- bones are used by the skeletal muscles as levers to move the body and its parts

4. Storage
- bone serves as a storage for minerals (calcium and phosphate)
- fat is stored in the internal marrow cavity of the bones

5. Blood cell formation

- hematopoiesis occurs within the marrow cavities of certain bones

CLASSIFICATION OF BONES
according to bone tissue:
1. Compact bone- dense and looks smooth and homogenous
2. Spongy bone- composed of small needlelike pieces of bone and lots of open space

according to shape:
1. long bones
- typically longer than they are wide
- they have a shaft with heads at both ends and are mostly compact bone
- ex. all the bones of the limbs except the patella, wrist, and ankle bones

2. short bones
- cube-shaped and contain mostly spongy bone
- ex. bones of the wrist and ankles; Sesamoid bones forms within tendons (patella)

3. flat bones
- thin, flattened, and usually curved
- have two thin layers of compact bone sandwiching a layer of spongy bone between them
- ex. cranium, ribs, sternum

4. irregular bones
- bones that do not fit one of the preceding categories
- ex. vertebrae, hip bones

STRUCTURE OF A BONE
diaphysis/shaft
- makes up mostly of the bone’s length and is composed of compact bone

periosteum
- a fibrous connective tissue membrane which covers and protect the diaphysis
perforating fibers / Sharpey’s fibers
- hundreds of connective tissue fibers that secure the periosteum to the underlying bone

epiphyses
- the ends of the long bone
- consists of a thin layer of compact bone enclosing an area filled with spongy bone
articular cartilage
- covers the external surface of the epiphyses
- a glassy hyaline cartilage which provides a smooth, slippery surface that decreases friction at joint surfaces

epiphyseal line
- a thin line of bony tissue spanning the epiphyses
- remnant of the epiphyseal plate

epiphyseal plate
- causes the lengthwise growth of a long bone

endosteum
- a delicate connective tissue lining which covers the inner bony surface of the shaft

yellow marrow / yellow medullary cavity

- in adults, a storage area for adipose (fat) tissue

red marrow
- in infants, it is where blood cells are formed

bone markings
- reveal where muscles, tendons, and ligaments were attached and where blood vessels and nerves passed
- categories:
a. projections/processes- grow out from the bone surface
b. depressions/cavities- indentions in the bone

osteocytes
- mature bone cells that are found within the matrix in tiny cavities called lacunae
- the lacunae is arranged in concentric circles called lamellae around central (Haversian) canals
- each complex consisting of central canal and matrix rings is called an osteon or Haversian system

canaliculi
- tiny canals that radiate outward from the central canals to all lacunae
- form a transportation system that connects all the bone cells to the nutrient supply through the hard bone matrix

perforating (Volkmann’s) canals

- completes the communication pathway from the outside of the bone to its interior which run in the compact bone at right
angles to the shaft

calcium salts
- give bones its hardness which resists compression

collagen fibers
- provide for bone’s flexibility and great tensile strength (the ability to be stretched without breaking)

BONE FORMATION AND GROWTH

ossification
- process of bone formation
- two major phases:
1.) the hyaline cartilage model is completely covered with bone matrix by osteoblasts (bone forming cells)
2.) the enclosed hyaline cartilage model is digested away, opening up a medullary cavity within the newly formed bone

appositional growth
- process by which bones increase in diameter
- controlled by the hormones: growth hormones and sex hormones
- ends during adolescence when the epiphyseal plates are converted to bone
HOW DO BONES WIDEN?
> osteoblasts in the periosteum add bone tissue to the external face of the diaphysis as osteoclasts in the endosteum remove
bone from the inner face of the diaphysis wall

BONE REMODELING
bone remodeling
- essential if bones are to retain normal proportions and strength during long-bone growth as the body increases in size and
weight
- accounts for the fact that bones become thicker and form large projections to increase their strength in areas where bulky
muscles are attached

BONES ARE REMODELED CONTNUALLY IN RESPONSE TO TWO FACTORS:

(1) calcium levels in the blood
(2) pull of gravity and muscles on the skeleton

osteoclasts
- giant bone-destroying cells in bones

parathyroid hormone (PTH)

- determines when (or if) bone is to be broken down or formed in response to the need for more or fewer calcium ions in the
blood

rickets
- disease of children in which the bones fail to calcify
- result: the bones soften, and the weight-bearing bones of the legs show a definite bowing
- usually due to lack of calcium in the diet or lack of Vitamin D

BONE FRACTURES
fracture
- breakage of bones
- closed fracture/simple fracture: bone breaks cleanly but does not penetrate the skin
- open fracture/compound fracture: broken bone ends penetrate through the skin

reduction
- treatment of fracture which is the realignment of the broken bone ends
- closed reduction: the bone ends are coaxed back into their normal position by the physician’s hands
- open reduction: surgery is performed, and the bone ends are secured together with pins or wires

*after reduction, it is immobilized by a cast or traction to allow the healing process to begin
*healing time for a simple fracture is 6 to 8 weeks, but is longer for large bones and for the bones of older people (because of
their poorer circulation)
EVENTS OF THE REPAIR OF BONE FRACTURES
(1) Hematoma forms
- blood vessels are ruptured when the bone breaks resulting to the formation of a blood-filled swelling called hematoma
- bone cells that are deprived of nutrition die

(2) Fibrocartilage callus forms

- there is a growth of new capillaries (granulation tissue) into the clotted blood at the site of the damage and disposal of dead
tissue by phagocytes
- connective tissue cells of various types form a mass repair tissue called fibrocartilage callus that contains several elements –
cartilage matrix, bony matrix, and collagen fibers – and acts to splint the broken bone, closing the gap

(3) Bony callus forms

- the fibrocartilage callus is gradually replaced by the bony callus (made of spongy bone) as more osteoblasts and osteoclasts
migrate into the area and multiply

(4) Bone remodeling occurs

- after few weeks or months, the bony callus is remodeled in response to the mechanical stresses placed on it, so that it forms a
strong, permanent “patch” at the fracture site

AXIAL SKELETON
- forms the longitudinal axis of the body

1.) Skull
- formed by the cranium and facial bones

1.1) cranium
- encloses and protects the fragile brain tissue

 frontal bone
- forms the forehead, the bony projections under the eyebrows, and the superior part of each eye’s orbit

 parietal bone
- form most of the superior and lateral walls of the cranium
- the pair meet in the midline of the skull at the sagittal suture and meet with the frontal bone at the coronal suture

 temporal bone
- lie inferior to the parietal bones
- they join at the squamous sutures

 external acoustic meatus

- a canal that leads to the eardrum and the middle ear
- the route by which sound enters the ear

 styloid process
- a sharp, needlike projection, is just inferior to the external auditory meatus
- many neck muscles use this as an attachment point

 zygomatic process
- a thin bridge of bone that joins with the cheekbone anteriorly

 mastoid process
- a rough projection posterior and inferior to the external acoustic meatus
- provides an attachment site for some muscles of the neck

 jugular foramen
- allows passage of the jugular vein which drains the brain

 internal acoustic meatus

- transmits cranial nerves VII and VIII (the facial and vestibulocochlear nerves)

 carotid canal
- the internal carotid artery (supplies blood to most of the brain) runs through here

 occipital bone
- the posterior bone of the cranium
- forms the base and back wall of the skull
- joins the parietal bones at the lambdoid suture

 foramen magnum
- a large opening at the base of the occipital bone
- surrounds the lower part of the brain and allows the spinal cord to connect with the brain
  occipital condyles
- lateral to the foramen magnum; rest on the first vertebra of the spinal column

 sphenoid bone
- a butterfly-shaped bone which spans the width of the skull and forms the part of the floor of the cranial cavity

 sella turcica / Turk’s saddle

- a small depression in the midline of the sphenoid bone
- forms a snug enclosure for the pituitary gland

 foramen ovale
- a large oval opening in line with posterior end of the sella turcica
- allows fibers of cranial nerve X (trigeminal nerve) to pass to the chewing muscles of the lower jaw

 optic canal
- allows optic nerve to pass to the eye

 superior orbital fissure

- where cranial nerves controlling eye movements (III, IV, VI) pass

 sphenoidal sinuses
- central part of the sphenoid bone, riddled with air cavities

 ethmoid bone
- very irregularly shaped and lies interior to the sphenoid
- forms the roof of the nasal cavity and part of the medial walls of the orbits

 crista galli
- cock’s comb
- projecting from the superior surface of the ethmoid bone where the outermost covering of the brain attaches to

 cribriform plates
- allow nerve fibers carrying impulses from the olfactory receptors of the nose to reach the brain

 superior nasal conchae & middle nasal conchae

- extensions of the ethmoid bone, forming a part of the lateral walls of the nasal cavity
- increase the turbulence of air flowing through the nasal passages

1.2) Facial bones

- holds the eyes in an anterior position and allow the facial muscles to show our feelings

1.3) Hyoid bone

- not really part of the skull
- only bone in the body that does not articulate directly with any other bone
- it is suspended in the midneck region, about 2cm above the larynx
- horseshoe-shaped, with a body and two pairs of horns or cornua
- served as a movable base for the tongue and as an attachment point for neck muscles that raise and lower the larynx as we
speak

fontanels
- fibrous membranes connecting the cranial bones
- where the rhythm of a baby’s pulse can be felt
- little fountain
- allow the fetal skull to be compressed slightly during birth
- allow the infant’s brain to grow during the later part of pregnancy and early infancy
- anterior fontanel: diamond-shaped; largest fontanel

2.) Vertebral Column / Spine

- serves as 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 in a flexible, curved structure
- before birth, it consists of 33 vertebrae, but 9 of these fused to form the sacrum and coccyx
- 7 vertebrae of the neck (cervical vertebrae), 12 vertebrae (thoracic vertebrae), 5 vertebrae supporting the lower back (lumbar
vertebrae)

intervertebral discs
- pads of flexible fibrocartilage that cushion the vertebrae and absorb shocks while allowing the spine flexibility and have a
high-water content and are spongy and compressible

herniated discs
- drying of the discs and weakening of the ligaments of the vertebral column
- may also result when the vertebral column is subjected to exceptional twisting forces

primary curvatures
- the spinal curvatures in the thoracic and sacral regions

secondary curvatures
- curvatures in the cervical and lumbar regions
- in adults, allow us to center our body weight on our lower limbs with minimal effort
- cervical: appears when the baby is able to raise its head
- lumbar: develops when a baby begins to walk

scoliosis- abnormal lateral curvature of the spine

kyphosis- outward curvature of the spine
lordosis- inward curvature of the spine
FEATURES OF VERTEBRAE
> Body or Centrum
- disc-like, weight-bearing part of the vertebral facing anteriorly in the vertebral column

> Vertebral arch

- arch formed from the joining of all the posterior extensions, the laminae and pedicles, from the vertebral body

> Vertebral foramen

- canal through which the spinal cord passes

> Transverse processes

- two lateral projections from the vertebral arch

> Spinous process

- single projection arising from the posterior aspect of the vertebral arch

> Superior and inferior articular processes

- paired projections lateral to the vertebral foramen, allowing a vertebra to form joints with adjacent vertebrae

cervical vertebrae
- form the neck region of the spine

atlas (C1)
- the superior surfaces of its transverse processes contain large depressions that receive the occipital condyles of the skull; it
allows you to nod “yes”

axis (C2)
- acts a pivot for the rotation of the atlas and skull
- dens: acts as a pivot point

*the joint between C1 and C2 allows one to rotate the head from side to side, like indicating “no”
typical vertebrae
- C3 through C7
- the smallest, lightest vertebrae, and most often their spinous processes are short and divided into two branches

foramina
- openings through which the vertebral arteries pass on their way to the brain above

thoracic vertebrae
- are larger than the cervical vertebrae
- the only vertebrae to articulate with the ribs

lumbar vertebrae
- have massive, block like bodies and are the sturdiest of the vertebrae

sacrum
- formed by the fusion of five vertebrae; forms the posterior wall of the pelvis
- alae: articulate laterally with the hipbones, forming the sacroiliac joints
- median sacral crest: fused spinous processes of the sacral vertebrae
- sacral canal: a vertebral canal which continues inside the sacrum
- sacral hiatus: a large inferior opening
coccyx
- formed by the fusion of three to five tiny, irregular shaped vertebrae
- the human “tailbone”

3.) Thoracic cage

- forms a protective, cone-shaped cage of slender bones around the organs of the thoracic cavity

3.1) sternum / breastbone

- a typical flat bone

 jugular notch
- at the level of the third thoracic vertebra

 sternal angle
- where the manubrium and body meet
- provides a handy reference point for counting ribs to locate the second intercostal space

 xiphisternal joint
- the point where the sternal body and xiphoid process fuse, lies the ninth thoracic vertebrae

sternal acupuncture
- a procedure wherein a needle is inserted into the marrow of the sternum and a blood-forming (hematopoietic) tissue is
withdrawn

3.2) ribs
- forms the walls of the bony thorax

 true ribs
- first seven pairs; attach directly to the sternum by costal cartilages

 false ribs
- next five pairs; either attached indirectly to the sternum or are not attached to the sternum at all

 floating ribs
- last two pairs of false ribs which lack attachments

intercostal spaces
- spaces between the ribs, are filled with intercostal muscles which aid in breathing
APPENDICULAR SKELETON
- composed of 126 bones of the limbs and the pectoral and pelvic girdles

1.) shoulder girdle / pectoral girdle

- consists of clavicle and scapula

1.1) clavicle / collarbone

- attaches to the manubrium of the sternum medially and to the scapula laterally, where it helps form the shoulder joint
- acts as a brace to hold the arm away from the top of the thorax and prevents shoulder dislocation

1.2) scapulae / shoulder blade

- are triangular and are commonly called “wings” because they flare when we move our arms posteriorly

 acromion
- the enlarged end of the spine of the scapula
 coracoid process
- beaklike
- anchors some of the muscles of the arm

 acromioclavicular joint
- the point where the acromion connects with the clavicle laterally

 suprascapular notch
- serves as a nerve passageway

 glenoid cavity
- a shallow socket that receives the head of the arm bone

FACTORS THAT ALLOW THE UPPER LIMB TO MOVE FREELY

1. Each shoulder girdle attaches to the axial skeleton at only one point- sternoclavicular joint.
2. The loose attachment of the scapula allows it to slide back and forth against the thorax as muscles act.
3. The glenoid cavity is shallow, and the shoulder joint is poorly reinforced by ligaments.

2.) Upper limbs

- form the foundations of the arm, forearm, and hand

2.1) Arm
- formed by a single bone, humerus
- anatomical neck: a slight constriction
- intertubercular sulcus: sites of muscle attachment (greater and lesser)
- surgical neck: the most frequently fractured part of the humerus
- deltoid tuberosity: where the large, fleshy deltoid muscle of the shoulder attaches
- radial groove: marks the course of the radial nerve
- trochlea (distal end; like a spool), capitulum (lateral; ball-like): articulate with bones of the forearm
- coronoid fossa (above the trochlea anteriorly), olecranon fossa (posterior): flanked by the medial and lateral epicondyles;
allow the corresponding processes of the ulna to move freely when the elbow is bent and extended

2.2) Forearm
- formed by the radius and ulna
- radius: on the thumb side of the forearm
- radioulnar joint: where the radius and ulna articulate
- interosseous membrane: connects the ulna and radius
- radial tuberosity: where the tendon of the bicep muscles attaches
- ulna: the medial bone of the forearm
- coronoid process (anterior proximal end), olecranon (posterior proximal end): separated by trochlear notch; grip the
trochlea of the humerus in a pliers-like joint
3.) Hand
- consists of the phalanges, carpals, and metacarpals

3.1) carpus / wrist

- composed of the eight carpal bones which are arranged in two irregular rows of four bones each

3.2) metacarpals
- form the palm of the hand

3.3) phalanges
- the bones of the finger
4.) Pelvic Girdle
- formed by the