TRINITY UNIVERSITY OF ASIA - ST.

LUKES COLLEGE OF NURSING

CHAPTER 6: SKELETAL SYSTEM
MC_101_ ANATOMY & PHYSIOLOGY | 1ST SEMESTER | A.Y. 2022-2023
DRA. OLIVIA MAE RAMOS | ADAPTED FROM: Seeley’s Essentials of AnaPhy & Powerpoint/Lecture

SKELETAL SYSTEM FUNCTIONS OF SKELETAL SYSTEM: (SPaMSoB)

1. Support
● a collection of bones and associated a. framework
connective tissues 2. Protection
● include cartilage, tendons(muscle to a. Vital organs
bone), and ligaments(bone to bone) 3. Movement
4. Storage
a. Minerals (calcium and phosphate)
5. Blood cell production
a. RBM

EXTRACELLULAR MATRIX

● The bones, cartilages, ligaments, and

tendons of the skeletal are all connective
tissues

Collagen
● tough ropelike protein
Proteoglycans
● large molecules consisting of
polysaccharides attached to core proteins
Tendons and ligaments
● Large amounts of collagen fiber
Cartilage
● contains collagen
● Contains proteoglycans
Bone
● contains collagen
● Contains minerals (calcium and
phosphate)
Hydroxyapatite
● calcium phosphate crystals

CLINICAL CORRELATES
Osteogenesis imperfecta *rare condition
● brittle bone disease
● imperfect bone formation

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 ● caused by faulty genes resulting to either
little collagen formation or poor collagen
quality
● bone matrix has decreased flexibility
● Prone to fractures

STRUCTRURE OF LONG BONES:

1. Diaphysis
- central shaft
2. Epiphysis
- bone ends
3. Epiphyseal plates
- growth plate
- where the bone grows in length
GENERAL FEATURES OF BONE 4. Metaphysis
- prominent in growing children
- Contains the epiphyseal plates
Long bones
● bones of the upper and lower limbs
Articular cartilage
Short bones
● covers the end of the epiphysis
● wrist and ankle (all sides are equal)
Epiphyseal line
Irregular bones
● bone growth stops and the epiphyseal
● vertebrae and facial bones
plate is replaced by bone
Flat bones
Medullary cavity
● some skull bones, scapula and ribs (cranial
● large cavity in the diaphysis
bones)
● Contains the marrow
Sesamoid
Marrow
● patella/knee cap
● soft tissue within the cavity
Yellow marrow
● consists of adipose tissue (fat)
Red marrow
● consists of bone-forming cells
● site of blood formation

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 TYPES OF BONE TISSUE
1. Compact bone
● forms the perimeter of the diaphysis of a
long bone
● denser and has fewer pores than spongy
bone

Central canal – surrounded by concentric rings that

LAYERS OF BONE contains blood vessels
Periosteum
● outermost layer ● composed of units lamellae surrounding a
● surrounds the diaphysis central canal called osteons/haversian
● contain blood vessels, nerves, and system
osteoblasts
Endosteum Lacunae – spaces within the lamellae
● innermost layer Canaliculi – tiny canals within the lamellae
● lines the medullary cavity (thinner
connective tissue)
Bone substance
● EM and cells

2. Spongy bone
● located in the epiphysis of long bones
● lines its medullary cavities
● very porous and consists of delicate
interconnecting rods of bone called
HISTOLOGY OF BONE trabeculae (func unit; doesn’t have central
Osteoblasts canal)
● cells which are responsible for bone ● contains red bone marrow that gives out
formation the nutrients (RBC, WBC)
● Maintenance of bones ● three types of bone cells are present
Osteocytes
● osteoblasts which are surrounded by bone
matrix
Osteoclasts
● responsible for bone remodeling and
reabsorption
● Taga-sira ng bone to initiate bone repair
from macrophages (WBC)
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BONE OSSIFICATION
Ossification
● another term for bone formation
TYPES OF BONE OSSIFICATION
1. Intramembranous ossification
● occurs when ossification centers enlarge
then fuse together
● Happens only in skull bone
– Ossification centers
● where intramembranous ossification
begins
2. Endochondral ossification
● occurs when (start as) cartilage models
enlarge then eventually ossify to become
bone
● Chondrocytes
○ cartilage cells
● Primary ossification
○ where bone first begins to appear
○ found in diaphysis
■ If there’s a supply of
nutrients, blood vessels
are present
● Secondary ossification center
○ form in the epiphysis
BONE GROWTH
● occurs when (increase in) new bone
lamellae is deposited into existing bone
matrix
● in long bones, this usually occurs on the
epiphyseal plates
Appositional growth
● increase in bone width or diameter
BONE REMEDOLING
● removal of existing bone by osteoclasts
● deposition of new bone by osteoblasts
○ Joint function of osteoclasts &
osteoblasts
● responsible for change in bone shape,
bone adjustment, repair, and calcium
regulation
BONE REPAIR
FOUR STAGES OF BONE REPAIR
1. Hematoma formation
● Blood is released into the damaged bone,
forming a clot of hematoma
○ Blood clot formation
2. Callus formation
● Cartilage [chrondocytes] then invades the
hematoma, forming a fibrous structure
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 called a callus in between the two edges Open fracture
of the broken bone

3. Callus ossification – open wound extends to the site of

● osteoblasts enter the callus and form a the fracture of a fragment of bone
spongy bone protrudes through the skin
○ Papalitan ng spongy by
osteoblasts
4. Bone remodeling Closed fracture – skin is not perforated
● woven, spongy bone is then remodeled
Complicated – soft tissues around a closed
into compact bone
fracture fracture are damaged
○ Occurs in 2 reasons:
Incomplete – does not extend completely across
○ Fracture and Low in calcium
fracture the bone
Complete fracture – broken into at least two fragments
– bone breaks into more than two
Comminuted pieces
fracture – usually two major fragment and a
small fragment
– one fragment is driven into the
Impacted fracture
spongy portion of the other fragment
– run parallel to the length of the
Linear fracture
bone
Transverse – right angles to the length of the
fracture bone
– take a helical course around the
Spiral fracture
bone
– run obliquely in relation to the
Oblique fracture
length of the bone
– have rough, toothed, and broken
Dentate fracture
ends
– breakage lines radiating from a
Stellate fracture
central point

CLINICAL CORRELATES
Fracture
● any break or discontinuity in a bone

BONE AND CALCIUM HOMEOSTASIS

There are two hormones that control the blood

calcium levels in the body:
○ Parathyroid Hormone and
Calcitonin
● Osteoclast
remove calcium = blood calcium levels increases
● Osteoblast

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deposit calcium = blood calcium decreases

HORMONES THAT MAINTAIN CALCIUM Tubercle / Tuberosity

BALANCE/HOMEOSTASIS ● lump on a
1. Parathyroid hormone (PTH) bone
● secreted by parathyroid gland
● increase bone breakdown and increase
blood calcium levels
● stimulates the kidneys to from active
vitamin D [starts at skin] Process
2. Calcitonin “too much calcium” ● projection
● secreted by thyroid gland from a bone
● decrease bone breakdown and decrease
blood calcium levels

Condyle
● end of a bine
that forms a
joint with
another bone

Facet
● small flattened
articular
BONE ANATOMY
surface
● 206 bones = adult
● 276 bones = new born
Crest
● subdivided into two classification:
● prominent
Appendicular(126) and Axial (80)
ridge

Foramen
● hole in a
bone

Trochanter
Canal / Meatus
– tuberosity found
● elongated
only on proximal
hole in a
femur
tunnel like
body

Fissure
● cleft
Fossa
● depression
in a bone

Sinus
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 ● cavity ● composed of the skull, vertebral column,
and throracic cage
● form the longitudinal axis of the body

SKULL
Suture ● Composed of 2 categories of bones;
● a joint uniting cranial and the facial bones
the bones of the ● 22 bones
skull ● The cranial bones include the following
○ Frontal bone
○ Parietal bone
○ Occipital bone
○ Temporal bone
○ Sphenoid bone
○ Ethmoid bone
● The facial bones include the following:
○ Maxilla
○ Palatine bones
○ Zygomatic bones
○ Lacrimal bones
○ Nasal bones
○ Vomer
○ Inferior nasal conchae
○ Mandible
● The skull also has large cavities within
which are called paranasal sinuses.
○ Frontal sinuses
○ Maxillary sinuses
○ Sphenoid sinuses
○ Ethmoid sinuses

AXIAL LSKELETON

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 ● the superior and lateral walls of the
cranium; coronal suture
4 - 5. Temporal bone (paired)
● lies inferior to the parietal bone
● squamous suture
External auditory meatus (EAM)
● a canal that leads to the eardrum and the
middle ear
Styloid process
● a sharp, needlelike structure located
inferior to the EAM
Zygomatic process
● a bridge of bone that joins with the
cheekbone anteriorly
Mastoid process
● a rough projection posterior and inferior
to the EAM

6. Occipital bone
● inferior and posterior bone of the
cranium
● lambdoid suture
Foramen magnum
● where the spinal cord joins the brain
Occipital condyles
● rests on the first vertebra of the vertebral
column
Foramen ovale
● allows the fiber of cranial nerve 5 to pass

7. Sphenoid bone
● butterfly-shaped bone that spans the
width of the skull
Sella turtica
● saddle-shaped structure at the central
region
● contains the pituitary gland

8. Ethmoid bone
BRAINCASE ● irregularly shaped bone that lies anterior
● 8 bones to the sphenoid bone
● covers and protects the fragile brain tissue
FACIAL BONES
1. Frontal bone ● 14 bones
● forehead, bony projections under the ● 13 solidly connected, 1 movable
eyebrow, part of the eye’s orbit (mandible)
2 - 3. Parietal bone (paired) ● holds the facial muscles in place

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 ● joined together by sutures (interlocking, VERTEBRAL COLUMN
immovable) ● central axis of the skeleton
● 26 individual bones;
1-2. Maxillae 7 cervical vertebrae (cervical region)
● main bones of the face; carries the upper 12 thoracic vertebrae (thoracic region)
teeth 5 lumbar vertebrae (lumbar region)
3-4. Palatine bones 1 sacral bone (sacral region)
● lies posterior to the palatine processes of 1 coccyx bone/ fused cocygeal vertebra
the maxilla (coccygeal region)
5-6. Zygomatic bones – cranial fosa: depressions
● cheekbones – olfactory nerve: very sensitive to touch
7-8. Lacrimal bones
● bones forming part of the medial wall of FUNCTIONS
each orbit 1. Supports the weight of the head and the trunk.
9-10. Nasal bones 2. Protects the spinal cord.
● bones forming the bridge of the bone 3. Allows the spinal nerves to exit the spinal cord.
11-12. Inferior nasal conchae 4. Site for muscle attachment.
● thin curved bones projecting from the 5. Permits movement of the head and trunk.
lateral wall of the nasal cavity
13. Vomer bone CLINICAL CORRELATES:
● single bone in the median of the nasal Kyphosis (kuba)
cavity ● posterior curvature
14. Mandible ● hunchback
● lower jaw; only freely movable joint of the Lordosis (lumbar)
face ● Anterior curvature;
● swayback condition
Hyoid bone Scoliosis (lateral)
● lateral curvatures
● Unpaired, U-shaped bone;
● provides attachment to tongue muscle
● Attachment point for important neck
muscles that elevate the larynx

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 Articular facet
● smooth ‘little face’

REGIONAL DIFFERENCES IN VERTEBRAE

1. Cervical Vertebrae
● very small bodies, dislocation, and
fractures are common in his area
Atlas
● 1st CV; holds up the head
● ‘yes’ shaking
Axis
● 2nd CV
● considerable amount of rotation
● ‘no’ shaking
Dens
● where the rotation occurs
2. Thoracic vertebrae
● long, thin spinous processes
● articulate the ribs
GENERAL PLAN OF THE VERTEBRAL COLUMN 3. Lumbar vertebrae
● large, thick bodie
Body – weight-bearing portionosis ● Heavy, rectangular transverse + spinous
Intervertebral disks body processes
● separates the vertebral bodies ● carry large amount of weight
Vertebral arch – Surrounds the vertebral foramen ● ruptured intervertebral disks are common
● 2 Pedicles – extends from the body to the 4. Sacrum
transverse process ● five sacral vertebrae fused in one
● 2 Laminae – extends from the transverse → Median Sacral Crest
to the spinous process ● spinous process of the 1st four SV
● provides attachment sites for the muscles → Sacral Hiatus
that move the vertebral column; ● inferior end of the sacrum;
○ Transverse process – extends ● the 5th process of the SV that does not
laterally bet. the lamina and form
pedicle ● common side of caudal anesthetic
○ Spinous process – projects injections
dorsally where the two laminae → Sacral Promontory
meet ● anterior edge of the 1sy SV that bulges
Vertebral foramen ● landmark felt during vaginal examination
● a large opening ● reference point in vaginal delivery of a
Vertebral canal baby
● where the spinal cord is located 5. Coccyx
● Protects the spinal cord from injury ● Tailbone
Intervertebral foramina ● fusion of 4 or more/less fused vertebrae
● where spnal nerves exit the spinal cord ● easily broken
Articular process
● where the vertebra articulate with each
other
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THE THORACIC CAGE PECTORAL GIRDLES
*connection between appendages and axial
RIBCAGE
● also called the shoulder girdle
● also called the thoracic cage ● consists of 4 bones; 2 scapulae [attached
● protects the vital organs to the clavicle] + 2 clavicles [directly
● prevents thorax collapse during respiration attached]
● The sternum is composed of 3 parts 1. Scapula
○ Manubrium ● shoulder blade
○ Body ● where muscles extending to the arm are
○ Xiphoid process attached
2. Glenoid cavity
1. Rib Cage ● 4th fossa
● 12 pair of ribs ● where the head of the humerus connects
● 1 – 7 true ribs (attached directly to the to the scapula
sternum via costal cartilages) ○ Spine – a ridge that runs across
● 8 – 12 false ribs (do not attach directly to the posterior surface fo the
the sternum; attach via common scapula
cartilage) 3. Acromion process
○ 11 – 12 floating ribs (do not ● extends from the scapular spine to form
attach to the sternum) the point of the shoulder
4. Clavicle
● Collarbone; articulates with the scapula
art the acromion process
5. Coracoid process –
● provides for the attachment of arm and
chest muscles

2. Sternum
● also called the breastbone
● Jugular notch – a depression bet. the ends
of the clavicles where they articulate with
the sternum
● Sternal angle of Louis – a slight elevation
felt at the junction of the manubrium and
the sternum;
– important landmark because it identifies
the 2nd rib
● Xiphoid process – important landmark of
the sternum during CPR

APPENDICULAR SKELETON
● 126 bones
● consists of the bones of the upper and
lower limbs, as well as the girdles

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 ● helps complete the grip of the ulna
→ Olecranon process
● extension of the ulna
→ Styloid process
● articulates with the bones of the wrist

UPPER LIMB
1. Arm
● Region between the shoulder and the
elbow
● contains the humerus; has two tubercles:
greater tubercle and lesser tubercle
○ Deltoid tuberosity – where the
deltoid muscle attaches
○ Epicondyles – provide 3. Wrist
attachment sites for orearm ● short region between the forearm and the
muscles hand
● 8 carpal bones (SLTPHCTT)
○ Scaphiod
○ Lunate
○ Triquetrum
○ Pisiform
○ Hamate
○ Capitate
○ Trapezoi
○ Trapezium
4. Hand
● 5 metacarpal bones are attached to the
carpal bones
Phalanges
2. Forearm
● 3 small bones on each finger
Radius – lateral to the thumb
→ Radial tuberosity
● where the arm muscles (biceps brachii)
attaches

Ulna – medial to the little finger

→ Trochlear notch
● Forms most of the elbow joint
→ Coronoid process

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 Iliac crest – seen along the superior margin of each
ilim
● Anterior Superior Iliac Spine
○ important hiplandmark
○ anterior end of the iliac crest

Pubic symphysis – where coxal bones join

anteriorly
● Sacroiliac joints – joins the sacrum
posteriorly
Acetabulum –socket of the hip joint
Obturator foramen – large hole in each coxal bone
Pelvic inlet – formed by the pelvic brim and the
sacral promontory
Pelvic outlet – bounded by the ischial spines, pubic
symphysis, and coccyx

Male pelvis: larger and massive

Female pelvis: broader

PELVIC GIRDLE
● where lower limbs attach to the body
● Protection for pelvic organs

Coxal bones – hip bones

– join each other anteriorly and thesacrum
posteriorly to form a ring of bone called the pelvic
girdle
COMPOSED OF A FUSION OF 3 BONES:
● Ilium most superior
● Ischium –
○ nferior and posterior
○ sit down bone
● Pubis – inferior and anterior
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 LOWER LIMBS
- Connected to pelvic girdle 2. Leg
Composed of the following bones: – region between the knee and the ankle
● Femur ● Tibia (thick)
● Patella ○ Shinbone
● Tibia ○ Larger
● Fibula ○ major weight-bearing
● Tarsal bones ○ bone of the le
● Metatarsal bones ○ medial malleolus
● Phalanges ● Fibula (thin)
○ thin and sticklike that forms the
lateral side of the leg
○ lateral malleolus

3. Ankle
– 7 tarsla bones
● Talus
○ ankle bone (tibia)
● Calcaneus
○ heel bone
● Cuboid (cube shaped)
● Navicular (boat shaped)
● Cuneiforms; medial, intermediate, lateral

4. Foot
● Metatarsal bones and phalanges
○ arranged and numbered in a
similar manner to the hand
● has 3 primary arches

1. Thigh
– region bet. the hip and the knee;
– contains the femur
● Head of the femur – articulates with the
acetabulum of the coxal bone
● Condyles – articulates with the tibia
[medial & lateral]
● Epidondyles– points of ligaments
attachments
● Trochanters – lateral to the head after the
neck
● Patella
○ knee cap
○ enables the tendon to bend over
the knee

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 1. Sutures
2. Syndesmoses
3. Gomphoses
JOINTS
● also called an articulation
● where two bones come together
● Serves as points of movement for the
body
● Structurally, they are categorized into the
ff:
1. Fibrous joints – united by fibrous tissue
2. Cartilaginous joints - united by means of
cartilage
3. Synovial joints – joined by fluid cavity
● Functionally, they can be categorized into
the ff:
1. Synarthrosis joints – non-movable
2. Amphiarthrosis joints – slightly movable
3. Diarthrosis – freely movable
FIBROUS JOINTS
● 2 bones that are united by fibrous tissue
● exhibit little or no movement
● between the bones of the skull
● Squamous, lambdoid, coronal
○ Fontanels – sutures that are quite
wide in a newborn
● bones are separated by some distance and
held together by ligaments
● FB connecting the radius and ulna
● consists of pegs fitted into sockets and
held in place by ligaments
● joint beween a tooth and its socket
CARTILAGINOUS JOINTS
● unites two bones by means of cartilage
● slight movement can occur
● epiphyseal plates of growing long bones
● cartilage between the ribs and the
sternum
● fibrocartilage forms joints such as the
intervertebral disks
SYNOVIAL S JOINTS
● freely movable joints
● contains fluid in a cavity surrounding the
ends of articulating bones
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Articulating cartilage ○ Menisci – shock-absorbing
● thin layer that covers the articular fibrocartilage pads
surfaces of bones w/in the synovial joints
Joint cavity 4. Pivot Joints
● filled with fluid ● restrict movement to rotation around a
Joint capsule single axis
● encloses the cavity that helps hold the ● rotation that occurs between the axis and
bones together and allows for movement atlas;
Synovial membrane ● articulation between the ulna and radius
● lines the joint cavity everywhere 5. Ball and socket joints
Synovial fluid ● consist of a ball (head) and a socket;
● produced by the SM; covers the surfaces ● shoulder and hip joints
of the joint 6. Ellipsoid/Condyloid joints
Bursa ● elongated ball and socket joints
● a pocket or sac; located between ● joint between the occipital condyles
structures that rub together (skull) and the atlas (vertebral column);
Bursitis ● joints between the metacarpals and
● inflammation of the bursa; often results to phalanges
abrasion
Tendon Sheath
● extension of SM along some tendons

TYPES OF SYNOVIAL JOINTS

TYPES OF MOVEMENT

1. Flexion
○ movement that takes place in a
frontal/coronal plane
Plantar flexion – when standing on the toes
Dorsiflexion – movement of the foot toward the
shin (walking on heels)
2. Extension
○ movement that takes place in a
1. Plane/Gliding Joints posterior direction
● two opposed flat surfaces that glide over
each other
2. Saddle Joints
● two saddle shaped articulating surfaces
oriented at right angle
● joint between the metacarpal bone and
the carpal bone of the thumb
3. Hinge Joints
● permit movement in one plane only
● elbow and knee joints

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3. Lateral Flexion
○ movement of the trunk in the
coronal
plane

4. Abduction
○ movement away from the median 10. Rotation
plane ○ movement of a part of the body
5. Adduction around its long axis
○ movement toward the median 11. Circumduction
plane ○ combination in sequence of the
flexion, extension, abduction,
adduction

6. Pronation
○ rotation of the forearm so that
the palm is down
7. Supination 12. Protraction
○ rotation of the forearm so that ○ to move forward
the palm faces up 13. Retraction
○ to move backward
14. Hyperextension
○ abnormal, forced extension of a
joint beyond its normal range of
motion

8. Eversion
○ opposite movement of the foot
so that the sole faces in a lateral
direction
9. Inversion
○ movement of the foot so that the
sole faces medially
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EFFECTS OF AGING ON THE SKELETAL SYSTEM

● As our body ages, the structural integrity

of the bone weakens due to the following
reasons:
v Decreased Collagen Production
v Loss of Bone Density
v Degenerative Changes
● These changes make the elderly prone to
having bone fractures.
● To prevent this, Vitamin D and calcium
intake as well as regular exercise is key to
maintain bone integrity

CLINICAL CORRELATES
● OSTEOPOROSIS
— Porous bone
— Decreased bone density due to aging or lack of
calcium and minerals
— Brittle bone disease in elderly

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