TRINITY UNIVERSITY OF ASIA

COLLEGE OF NURSING BATCH 2026

SKELETAL SYSTEM
DOC. OLIVIA RAMOS
ADAPTED FROM: SKELETAL LECTURE

SKELETAL SYSTEM
➢ A collection of bones and associated connective
tissue includes:
• Cartilage
• Tendons
• Ligaments
➢ Functions of the Skeletal System
• Support
• Protection
• Movement
• Storage
• Blood cell production
➢ Connective tissue Matrix of the Bone ➢ Types of bone cells
• The bones, cartilage, ligaments, and tendons of • Osteoblasts
the skeletal system are all connective tissues. o Cells which are responsible for bone formation
• The connective tissue matrix of bone is mostly • Osteocytes
composed of collagen and proteoglycans, with a o Osteoblasts which are surrounded by bone
mineral matrix of calcium phosphate matrix
(combination of calcium and phosphorous) called • Osteoclasts
hydroxyapatite. o Responsible for bone remodeling and
➢ Clinical Correlates reabsorption
• Osteogenesis Imperfecta
o Brittle bone disease
o Imperfect bone formation
o Bone matrix has decreased flexibility
o Caused by faulty genes resulting to either little
collagen formation or poor collagen activity.

BONES
➢ 4 categories of Bones:
• Long bones
o Ex. Bones of the upper and lower limbs
• Short bones
o Ex. Bones in the wrist and ankles
• Flat bones
o Some skull bones, scapula, and ribs
• Irregular bones
o Vertebrae and facial bones
➢ Structure of the long bone

➢ 2 types of bones (according to Histology)

• Compact or Cortical Bones
o Forms the perimeter of the diaphysis of a long
bone
o Is denser and has fewer pores than spongy bone
o Is composed of units of concentric lamellae
surrounding a central canal called osteons
 TRINITY UNIVERSITY OF ASIA
COLLEGE OF NURSING BATCH 2026
SKELETAL SYSTEM
DOC. OLIVIA RAMOS
ADAPTED FROM: SKELETAL LECTURE
• Spongy or Cancellous Bones
o Located in the epiphysis of long bones and lines
its medullary cavities
o It is very porous and consists of delicate
interconnecting rods of bone called trabeculae
➢ Bone Ossification / Bone Formation
• Two types of bone ossification:
o Intramembranous Ossification
- Occurs when ossification centers enlarge
then fuse together. Tis usually occurs only on
the bones of the skull.
o Endochondral Ossification
- Occurs when cartilage models enlarge then
eventually ossifies to become bone. This
usually occurs on the rest of the bones of the
body.
➢ Bone Growth
• Occurs when new bone lamellae are deposited
into existing bone matrix
• In long bones, this usually occurs on the
epiphyseal plates.
➢ Bone Remodeling
• Is the removal of existing bone by osteoclast and
the deposition of new bone by osteoblast.
• Is a process that ensures good bone structure and
integrity.
• It is an important process in maintaining blood
calcium levels.
➢ Bone Repair
• 4 stages of Bone Repair:
➢ Clinical Correlates
• Fracture
o Any break or discontinuity in a bone.
➢ Bone and Calcium Homeostasis
• There are two hormones that control the blood
calcium levels in the body
o Parathyroid hormone
- Increases the activity of osteoclasts,
increasing bone breakdown thus releasing
stored calcium into the blood which results to
increase blood calcium levels.
o Calcitonin
- Inhibits the action of osteoclasts, decreasing
bone breakdown and allowing the action of
osteoblasts to remove calcium from the blood
and store it into the bone.
• These two hormones maintain calcium balance by
affecting the action of the osteocytes
➢ Bone Anatomy
• Axial Skeleton (80 Bones)
o Skull
 TRINITY UNIVERSITY OF ASIA
COLLEGE OF NURSING BATCH 2026
SKELETAL SYSTEM
DOC. OLIVIA RAMOS
ADAPTED FROM: SKELETAL LECTURE

- Sternal angle – an elevation at the junction

o Vertebral column
– Composed of 26 bones
– Cervical (7 bones)
– Thoracic (12 bones)
– Lumbar (5 bones)
– Sacral (1 bone)
– Coccygeal Region (1 bone)
– Each vertebra consists of different parts,
namely:
▪ Cervical Vertebrae – very small bodies,
dislocation and fractures are common in
this area
▪ Atlas (C1) – 1st CV; holds up the head;
‘yes’ shaking
▪ Axis (C2) – 2nd CV; considerable amount
of rotation; ‘no’ shaking
▪ Dens – where the rotation occurs
▪ Thoracic vertebrae – long, thin spinous
processes; articulate the ribs
▪ Lumbar vertebrae – large, thick bodies;
heavy, rectangular transverse + spinous
processes; carry large amount of weight;
ruptured intervertebral disks are
common
▪ Sacrum – five sacral vertebrae fused in
one
o Thoracic cage
– Protects the vital organs in the thoracic
region
– Composed of the sternum (breastbone) and
the 12 ribs
– The sternum is composed of 3 parts:
▪ Manubrium
▪ Body
▪ Xiphoid process – important landmark of the
▪ sternum during CPR
of the manubrium and the body of the
sternum which serves as a landmark for the
location of the second ribs
▪ Ribs are divided into 3 parts:
- True ribs
✓ attached directly to the sternum via
costal cartilages
✓ consists of 1st – 7th rib
- False ribs
✓ Attached to the sternum via a
common cartilage
✓ Consists of 8th – 10th rib
- Floating ribs
✓ Are not attached to the sternum
✓ Consists of 11th – 12th rib
o The Hyoid Bone
- Unpaired and U-shaped, provides an
attachment for some tongue muscles, and it
is an attachment point for important neck
muscles that elevate the larynx.
• Clinical Correlates
o Kyphosis (Kuba)
- Abnormal posterior curvature of thoracic spine
o Lordosis (Duck)
- Abnormal anterior curvature of lumbar spine
o Scoliosis
- Abnormal lateral curvature of spine
• Appendicular Skeleton (126 bones)
o Upper limb
o Lower limb
o Girdles
 TRINITY UNIVERSITY OF ASIA
COLLEGE OF NURSING BATCH 2026
SKELETAL SYSTEM
DOC. OLIVIA RAMOS
ADAPTED FROM: SKELETAL LECTURE
JOINTS
➢ Are structures that serves as connection between
two sections of bone
➢ These structures serve as points of movement for the
body.
➢ Structurally, they are categorized into the following:
• Fibrous joints – united by fibrous tissue
• Cartilaginous joints – united by most cartilage
• Synovial joints – joined by a fluid cavity
➢ Functionally, they can be categorized into the
following:
• Synarthrosis – non-movable joints
• Amphiarthrosis – slightly movable joints
• Diarthrosis – freely movable joints
➢ Effects of aging on the skeletal system
• As our body ages, the structural integrity of the
bone weakens due to the following:
o Decreased collagen production
o Loss of bone density
o 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
o Porous bone
o Decreased bone density due to aging or lack of
calcium and minerals
o Brittle bone disease in elderly