Anatomy Additional notes
Anatomy Additional notes KNR 181
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This 39 page Bundle was uploaded by Bridget Hill on Tuesday January 26, 2016. The Bundle belongs to KNR 181 at Illinois State University taught by Dr. Torry in Fall 2013. Since its upload, it has received 24 views.
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Date Created: 01/26/16
• The skeletal system consists of bones, cartilage, tendons, and ligaments. • Cartilage - shock absorption and reduction of friction • Ligaments - connect bone to bone • Tendons - connect muscle to bone Skeletal Cartilage • Has high water content which accounts for its resilience or ability to spring back to its original shape after being compressed • Contains no nerves or blood supply and is surrounded by a layer of dense irregular connective tissue (perichondrium) that resis ts outward expansion when the cartilage is compressed. • 3 Types: 1. Hyaline Cartilage i. Provide support with resilience ii. Most abundant iii. Includes: 1. Articular cartilages - cover ends of most bones at moveable joints 2. Costal cartilage - connect the ribs to the sternum 3. Respiratory cartilages - form the skeleton of the larynx (voice box) and reinforces respiratory passageways 2. Elastic Cartilages i. Contain stretchy elastic fibers so they are better able to stand up to repeated bending ii. Found 1. External ear 2. Epiglottis - the flap that covers the opening of the larynx each time we swallow 3. Fibrocartilages i. Highly compressible ii. Have great tensile strength iii. Consist of roughly parallel rows of chondrocytes alternating with thick collagen fibers iv. Found in sites that are subjected to bo th heavy pressure and stretch, such as the pad-like cartilages (menscii) of the knee and discs between the vertebrae. Bone • Supports the body • Protects organs • Facilitates movement • Stores minerals and fats • Site of blood cell production • 206 bones divided into two groups: 1. Axial i. Skull, vertebral column, and rib cage 2. Appendicular i. Bones of the upper and lower limbs and the girdles (shoulder and pelvic) Classification of Bones • Bone shape o Individual bones can be described as: • Long (humerus, femur) § • Short (carpals, tarsals) § • Flat (parietal, sternum) § • Irregular (vertebrae, pelvic) § Bone Anatomy • The diaphysis is the shaft of a long bone, and the epiphyses are the ends • The epiphyseal plate is the site of bone growth in length • The medullary cavity is a space within the diaphysis • Red marrow is the site of blood cell production, and yellow marrow consists of fat • The periosteum covers the outer surface of bone. o The outer layer contains blood vessels and nerves o The inner layer contains osteoblasts and osteoclasts. • Perforating fibers hold the periosteum, ligaments, and tendons in place • The endosteum lines cavities inside bone and contains osteoblasts and osteoclasts • Short, flat, and irregular bones have an outer covering of compact bone surrounding cancellous bone. Bone Histology • Bone Matrix o Bone is composed of an organic matrix (mostly collagen) that provides flexible strength and an inorganic matrix that pr ovides compressional strength. o o Osteoblasts produce bone matrix and become osteocytes o Osteocytes are located in lacunae and are connected to each other through canaliculi. o Osteoclasts break down bone 2. Cancellous bone • Lamellae (little plate) combine to form trabeculae, beams of bone that interconnect to form a latticelike structure • The trabeculae are oriented along lines of stress and provide structural strength 3. Compact Bone • Canals within compact bone provide a means for the exchange of gases, nutrients, and waste products: o Canaliculi connect osteocytes to each other and to haversian canals; • Haversian canals contain blood vessels that pass to Volkmann's canals; • And Volkmann's canals carry blood to and from the periosteum or endosteum Bone Histology: • Compact bone consists of highly organized lamellae: • Circumferential lamellae cover the outer surface of compact bones • Concentric lamellae surrounding Haversian can als forming osteons • Interstitial lamellae are remnants of the other lamellae left after bone remodeling Bone Formation or Ossification • All embryonic connective tissue begins as mesenchyme • Intramembranous bone formation = formation of bone directly from mesenchymal cells • Endochondral ossification = formation of bone with hyaline cartilage Intramembranous Bone Formation 1. Fibrous connective tissue membrane 2. Bone matrix is secreted 3. Woven bone and periosteum form 4. Compact bone forms and red marrow appears Intramembranous Ossification: • Beneath the periosteum, osteoblasts lay down compact bone to form the outer surface of the bone • Fontanels are areas of the membrane that are not ossified at birth Endochondral Bone Formation (1) • Development of Cartilage model o Mesenchymal cells form a cartilage model of the bone during development • Growth of Cartilage model o In length by chondrocyte cell division and matrix formation (interstitial growth) o In width by formation of new matrix on the periphery by new chondroblasts from the perichondrium (appositional growth) o Cells in the midregion burst and change pH triggering calcification and chondrocyte death Endochondral Ossification • Begins the second month of development 1. Formation of a bone collar around a hyaline cartilage model 2. Cartilage deteriorates in the center 3. A nutrient artery supplies the internal cavity 4. The diaphysis elongates and a medullary cavity forms 5. Ossification of the epiphyses Endochondral Bone Formation Bone Growth in Length • Epiphyseal plate or cartilage growth plate o Cartilage cells are produced by mitosis on epiphyseal side of plate o Cartilage cells are destroyed and replaced by bone on diaphyseal side of plate • Between ages 18 to 25, epiphyseal plate closes o Cartilage cells stop dividing and bone replaces the cartilage (epiphyseal line) • Growth in length stops at age 25 Bone Growth in Width • Only by appositional growth at the bone's surface • Periosteal cells differentiate into osteoblasts and form bony ridges and then a tunnel around periosteal blood vessel • Concentric lamellae fill in the tunnel to form an osteon Bone Growth • Appositional Growth o Long bones grow in width by bone apposition on the outer surface of the bone o Short, flat, and irregular bones mostly increase in size by appositional growth • Endochondral Growth o Endochondral growth involves the interstitial growth of cartilage followed by endochondral ossification of the cartilage o The result is an increase in bone length Factors Affecting Bone Growth • Nutrition o Adequate levels of minerals and vitamins • Calcium and phosphorus for bone growth • Vitamin C for collagen formation • Vitamins K and B12 for protein synthesis • Hormones o Sufficient levels of specific hormones • During childhood need insulin -like growth factor § Promotes cell division at epiphyseal plate § Need hGH (growth), thyroid (T3 andT4) and insulin o Sex steroids at puberty • Growth spurt and closure of the epiphyseal growt h plate • Estrogens promote female changes - wider pelvis Hormonal Abnormalities • Oversecretion of hGH during childhood produces gigantism • Undersecretion of hGH or thyroid hormone during childhood produces dwarfism • Both men or women that lack estrogen rec eptors on cells grow taller than normal o Estrogen responsible for closure of growth plate Bone Remodeling • Ongoing since osteoclasts carve out small tunnels and osteoblasts rebuild osteons o Osteoclasts form leak -proof seal around cell edges o Secrete enzymes and acids beneath themselves o Release calcium and phosphorus into interstitial fluid o Osteoblasts take over bone rebuilding • Continual redistribution of bone matrix along lines of mechanical stress o Distal femur is fully remodeled every 4 mon ths Fracture and Repair of Bone • Fracture is break in a bone • Healing is faster in bone than in cartilage due to lack of blood vessels in cartilage • Healing of bone is still slow process due to vessel damage • Clinical treatment o Closed reduction - restore pieces to normal position by manipulation o Open reduction - surgery Fractures • Named for the shape or position of fracture line • Common types of fracture o Closed - no break in skin o Open fracture - skin broken o Comminuted - broken ends of bones are fragmented o Greenstick - partial fracture o Impacted - one side of fracture driven into the interior of the other side o Pott's - distal fibular fracture o Colles's - distal radial fracture o Stess fracture - microscopic fissu res from repeated strenuous activities Repair of a Fracture (1) • Formation of fracture hematoma o Damaged blood vessels produce clot in 6 -8 hours, bone cells die o Inflammation brings in phagocytic cells for clean -up duty o New capillaries grow in to damaged area • Formation of fibrocartilagenous callus formation o Fibroblasts invade the procallus and lay down collagen fibers o Chondroblasts produce fibrocartilage to span the broken ends of the bone Repair of a Fracture (2) • Formation of bony callus o Osteoblasts secrete spongy bone that joins 2 broken ends of bone o Last 3-4 months • Bone Remodeling o Compact bone replaces the spongy bone in the bony callus o Surface is remodeled back to normal shape Calcium Homeostasis and Bone Tissue • Skeleton is reservoir of Calcium and Phosphate • Calcium ions involved with many body systems o Nerve and muscle cell function o Blood clotting o Enzyme function in many biochemical reactions • Small changes in blood levels of Ca+2 can be deadly (plasma level maintained 9 -11 mg/100 mL) o Cardiac arrest if too high o Respiratory arrest if too low Exercise and Bone Tissue • Pull on bone by skeletal muscle and gravity is mechanical stress • Stress increases deposition of mineral salts and production of collagen (calcitonin prevents bone loss) • Lack of mechanical stress results in bone loss o Reduced activity while in a cast o Astronauts in weightlessness o Bedridden person • Weight- bearing exercises build bone mass (walking or weight -lifting) Development of Bone Tissue • Both types of bone formation begin with mesenchymal cells • Mesenchymal cells transform into chondroblasts which form cartilage OR • Mesenchymal cells become osteoblasts which form bone Developmental Anatomy • 5th week = limb bud appears as mesoderm covered with ectoderm • 6th week = constriction produces hand or foot plate and skeleton now totally cartilaginous • 7th week = endochondral ossification begins • 8th week = upper and lower limbs appropriately named Aging and Bone Tissue • Bone is being built through adolescence, holds its own in young adults, but is gradually lost in aged • Demineralization = loss of minerals o Very rapid in women 40 -45 as estrogen levels decrease o In males, begins after age 60 • Decrease in protein synthesis o Decrease in growth hormone o Decrease in collagen productio n which gives bone its tensile strength o Bone becomes brittle and susceptible to fracture Osteoporosis • Decreased bone mass resulting in porous bones • Those at risk: o White, thin, menopausal, smoking, drinking, female with family history o Athletes who are not menstruating due to decreased body fat and decreased estrogen levels o People allergic to milk or with eating disorders whose intake of calcium is too low • Prevention o Adequate diet, weight-bearing exercise, and estrogen replacement therapy (for menopausal women) o Behavior when young may be most important factor Disorders of Bone Ossification • Rickets o Calcium salts are not deposited properly o Bones of growing children are soft o Bowed legs, skull, rib cage, and pelvic deformities result • Osteomalacia o New adult bone produced during remodeling fails to ossify o Hip fractures are common EXAM 2 STUDY PREP QUESTIONS: Chapter 6 List the two types of cartilage growth and explain the difference between each. 1. Appositional Growth a. Cartilage-forming cells in the surrounding perichondrium secrete new matrix against of external face of the existing cartilage tissue (growth from the outside) 2. Interstitial Growth a. The lacunae bound chondrocytes divide and secrete new matrix, expanding the cartilage from within (growth from the inside) List the 3 types of skeletal cartilage 1. Hyaline 2. Elastic 3. Fibrocartilage List the 4 types of skeletal hyaline cartilage and give an example of where each can be found 1. Articular Cartilage: covers the ends of most bones at movable joints 2. Costal Cartilages: connects the ribs to the sternum 3. Respiratory Cartilage: forms the skeleton of the larynx and reinforces respiratory passageways 4. Nasal Cartilage: supports the external nose What are the primary functions of the axial and appendicular skeleton - Axial: includes the skull, vertebral column, and rib cage - Appendicular: includes the bones of the upper and lowe limbs and the shoulder and pelvic girdles Describe the 4 classification of bones and the basic characteristics of each - Long bones: longer than they are wide - Short bones: roughly cube shaped - Flat bones: thin, flattened, and usually a bit curved - Irregular bones: complicated shapes that fit none of the preceding classes For the following types of bone; long bone, short bone, flat bone, irregular bone – provide at least one example of each classification of bone. - Long bones: humerus and femur - Short bones: carpals and tarsals - Flat bones: parietal (facial) and sternum - Irregular bones: vertebrae and pelvic List the 6 major functions of bones 1. Supports the body 2. Protects organs 3. Facilitates movement 4. Stores minerals and fats 5. Site of blood cell production 6. Hormone production What are the major structures of a long bone and components of a long bone - Diaphysis: shaft of a long bone - Epiphyses: at the ends of a long bone - Epiphyseal plate: site of bone growth in length - Medullary cavity: space within the diaphysis - Red marrow: site of blood cell production - Yellow marrow: consists of fat - Periosteum: covers the outer surface of bone - Endosteum: lines the cavities inside bone and contains osteoblasts and osteoclasts What is periosteum and what does it do - Covers the outer surface of bones o The outer layer contains blood vessels and nerves o The inner layer contains osteoblasts and osteoclasts What is endosteum and what does it do - Lines the cavities inside bone and contains osteoblasts and osteoclasts What is intramembranous ossification and endochondral ossification - Intramembranous ossification o Formation of bone directly from mesenchymal cells - Endochondral ossification o Formation of bone with hyaline cartilage What are the 5 steps involved with “bone chases cartilage” (endochondral ossification) 1. Formation of a bone collar around a hyaline cartilage model 2. Cartilage deteriorates in the center 3. A nutrient artery supplies the internal cavity 4. The diaphysis elongates and a medullary cavity forms 5. Ossification of the epiphyses Understand the hormonal and mechanical components that regulate bone remodeling and how mechanical stress affects bone remodeling as describ ed by Wolff’s law. Hormones: - During childhood need insulin like growth factor o Promotes cell division at the epiphyseal plate o Need hGH (growth), thyroid (T3 &T4) and insulin What are the 4 major steps in bone repair 1. Formation of a fracture hematoma a. Damaged blood vessels produce clot in 6 -8 hours, bone cells die b. Inflammation brings in phagocytic cells for clean up duty c. New capillaries grow into damaged area 2. Formation of fibrocarilagenous callus formation a. Fibroblasts invade the procallus and lay down collagen fibers b. Chondroblasts produce fibrocartilage to span the broken ends of the bone 3. Formation of bony callus a. Osteoblasts secrete spongy bone that joins 2 broken ends of bone b. Lasts 3-4 months 4. Bone remodeling a. Compact bone replaces the spongy in the bony callus b. Surface is remodeled back to normal shape Describe the following bone fractures: greenstick, comminuted, epiphyseal, open versus closed fracture - Greenstick: partial fracture - Comminuted: broken ends of bones are fragmented - Epiphyseal: epiphysis separates from the diaphysis along the epiphyseal plate - Open: skin broken - Closed: no break in skin JOINTS • Joints hold bones together but permit movement • Point of contact o Between two bones o Between cartilage and bone o Between teeth and bone • Arthrology = the study of joints • Kinesiology = study of motion Classification of Joints • Structural classification based upon: o Presence of space between bones o Type of connective tissue holding bones together • Collagen fibers • Cartilage • Joint capsule and accessory ligaments • Functional classification based upon movement: o Immovable = synarthroses o Slightly movable = amphiarthroses o Freely movable = diarthroses Fibrous Joints • Lack a synovial cavity • Bones held closely together by fibrous connective tissue • Little or no movement (synarthorses or amphiarthorses) • 3 structural types 1. Sutures 2. Syndesmoses 3. Gomphoses 1. Sutures o Thin layer of dense fibrous connective tissue unites bones of the skull o Immovable (synarthrosis) o If fused completely in adults is synostosis 2. Syndesmosis o Fibrous joint 1. Bones united by ligament o Slightly movable (amphiarthrosis) o Anterior tibiofibular joint and Interosseous membrane 3. Gomphosis o Ligament holds cone-shaped peg in bony socket o Immovable (amphiarthrosis) o Teeth in alveolar processes Cartilaginous Joints • Lacks a synovial cavity • Allows little or no movement • Bones tightly connected by fibrocartilage or hyaline cartilage • 2 types 1. Synchondroses 2. Symphyses 1. Synchondrosis o Connecting material is hyaline cartilage o Immovable (synarthrosis) o Epiphyseal plate or joints between ribs and sternum 2. Symphysis o Fibrocartilage is connecting material o Slightly movable (amphiarthroses) o Intervertebral discs and pubic symphysis Synovial Joints • Synovial cavity separates articulating bones • Freely movable (diarthroses) • Articular cartilage o Reduces friction o Absorbs shock • Articular capsule o Surrounds joint o Thickenings in fibrous capsule called ligaments • Synovial membrane o Inner lining of capsule o Secretes synovial fluid containing hyaluronic acid (slippery) o Brings nutrients to articular cartilage Example of a Synovial Joint • Joint space is synovial cavity • Articular cartilage covering ends of bones • Articular capsule Other Special Features • Accessory ligaments o Extracapsular ligaments • Outside joint capsule o Intracapsular ligaments • Within capsule • Articular discs or menisci o Attached around edges to capsule o Allow 2 bones of different shape to fit tightly o Increase stability of knee- torn cartilage • Bursae = saclike structures containing lubricant and found between structures o Skin/bone or tendon/bone or l igament/bone o Bunion are enlarged bursa at the base of the big toe, swollen from rubbing of a tight or poorly fitting shoe Arthroscopy and Arthroplasty • Arthroscopy = examination of a joint o Instrument size of pencil o Remove torn knee cartilages and repair ligaments o Small incision only • Arthroplasty = replacement of joint o Total hip replaces acetabulum and head of femur o Plastic socket and metal head o Knee replacement common Torn Cartilage and Arthroscopy • Damage to menisci of the knee joint • Visualization of the inside of a joint o Arthroscope o Requires only small incisions • Repair may include removal of torn cartilage Sprain vs. Strain • Sprain o Twisting of joint that stretches or tears ligaments o No discoloration of the bones o May damage nearby blood vessels, muscles or tendons o Swelling and hemorrhage from blood vessels o Ankle is frequently sprained • Strain o Less serious injury o Overstretched or partially torn muscle Planar Joint • Bone surfaces are flat or slightly curved • Side to side movement only • Rotation prevented by ligaments • Examples: o Intercarpal or intertarsal joints o Sternovlavicular joint o Vertebrocostal joints Hinge Joint • Convex surface of one bone fits into concave surface of 2nd bone • Uniaxial like a door hinge • Examples: o Knee, elbow, ankle,, interphalangeal joints • Movements produced: o Flexion = decreasing the joint angle o Extension = increasing the angle o Hyperextension = opening the joint beyond the anatomical position Pivot Joint • Rounded Surface of bone articulates with ring formed by 2nd bone and ligament • Monoaxial since it allows only rotation around longitudinal axis • Examples: o Proximal radioulnar joint • Supination • Pronation o Atlanto-axial joint • Turning the head side to side "no" Condyloid or Ellipsoidal Joint • Oval - shaped projection fits into oval depression • Biaxial = flex/extend or abduct/adduct is possible • Examples: o Wrist and metacarpophalangeal joints for digit 2 to 5 Saddle Joint • One bone saddled-shaped; other bone fits as a person would sitting on a saddle • Biaxial o Circumduction allows tip of thumb to travel in circle o Opposition allows tip of thumb to touch tip of other fingers • Example: o Trapezium of carpus and metacarpal of thumb Ball and Socket Joint • Ball fitting into a cuplike depression • Multiaxial o Flexion/extension o Abduction/adduction o Rotation • Examples o Shoulder joint o Hip joint Bursae and Tendon Sheaths • Bursae o Fluid - filled saclike extension of the joint capsule o Reduce friction between moving s tructures • Skin rubs over bone • Tendon rubs over bone • Tendon sheaths o Tubelike bursae that wrap around tendons at wrist and ankle where many tendons come together in a confined space • Bursitis o Chronic inflammation of a bursa Summary of Movements at Synovial Joints • Gliding o No change in angle of joint • Angular movements o Increase or decrease in angle between articulating bones • Flexion, extension, hyperextension • Adduction, abduction • Circumduction is a combination of the above movements • Rotation o Bone revolves around its own axis • Special movements o Uniquely named movements for the jaw, hand and foot Circumduction • Movement of a distal end of a body part in a circle • Combination of flexion, extension, adduction, and abduction • Occurs at ball and socket, saddle, and condyloid joints Rotation • Bone revolves around its own longitudinal axis o Medial rotation is turning of anterior surface in towards the midline o Lateral rotation is ruing of anterior surface away from the midline • At ball and socket and pivot type joints Special Movements of the Mandible • Elevation = upward • Depression = downward • Protraction = forward • Retraction = backward Special Hand and Foot Movements • Inversion • Eversion • Dorsiflexion • Plantarflexion • Pronation • Supination Shoulder Joint • Head of humerus and glenoid cavity of scapula • Ball and socket • All types of movement Glenohumeral Joint • Articular capsule from glenoid cavity to anatomical neck • Glenoid labrum deepens socket • Many nearby bursa (subacromial) Supporting Structures at Shoulder • Associated ligaments strengthen joint capsule • Transverse humeral ligament holds bicep tendon in place Rotator Cuff Muscles • SITS muscles (Supraspinatus, Infraspinatus, Teres Minor, Subscapularis) o Attach humerus to scap ula o Encircle the joint supporting the capsule o Hold head of humerus in socket Elbow Joint • Hinge Joint o Trochlea notch of ulna and trochlea of humerus o Flexion and extension of elbow • Pivot joint o Head of radius and capitulum of humerus o Supination and pronation of forearm Articular Capsule of the Elbow Joint • Radial annular ligament hold head of radius in place • Collateral ligaments maintain integrity of joint Hip Joint • Head of femur and acetabulum of hip bone • Ball and socket type of joint • All types of movement possible Hip Joint Structures • Acetabular labrum • Ligament of the head of the femur • Articular capsule Hip Joint Capsule • Dense, strong capsule reinforced by ligaments o Iliofemoral ligament o Ischiofemoral ligament o Pubofemoral ligament • One of the strongest structures in the body Tibiofemoral Joint • Between femur, tibia, and patella • Hinge joint between tibia and femur • Gliding joint between patella and femur • Flexion, extension, and slight rotation of tibia on femur when kne e is flexed • Articular capsule o Mostly ligaments and tendons • Lateral and medial menisci o Articular discs • Many bursa • Vulnerable Joint • Knee injuries damage ligaments and tendons since bones do not fit together well External Views of Knee Joint • Patella is part of joint capsule anteriorly • Rest of articular capsule is extracapsular ligaments o Fibular and Tibial collateral ligaments Intracapsular Structures of Knee • Medial meniscus o C-shaped fibrocartilage • Lateral Meniscus o Nearly circular • Posterior Cruciate ligament • Anterior cruciate ligament Temporomandibular Joint • Synovial Joint • Articular disc • Gliding above disc • Hinge below disc • Movements o Depression o Elevation o Protraction o Retraction o Excursion Atlanto- Occipital Joints • Atlas and occipital condyles • Condyloid joint • Flexion • Extension • Slight lateral tilting Intervertebral Joints • Between bodies and intervertebral discs o Symphysis • Between vertebral articular processes o Synovial • Flexion • Extension • Lateral Flexion Elbow Joint • Trochlea of humerus, trochlear notch of ulna and head of radius • Pivot and hinge types • Flexion, extension, pronation and supination Radiocarpal Joint • Articular disc • Condyloid type • Flexion, extension, abduction, adduction Talocrural Joint • Tibia and Fibula with talus • Hinge • Inversion, eversion, plantarflexion, and dorsiflexion Range of Motion in a Synovial Joint • Shape of articulating bones • Tension and strength of joint ligaments • Arrangement of muscles around joints • Apposition (coming together) of soft parts • Hormones o Relaxin from placenta loosens pubic symphysis • Disuse o Decreased synovial fluid, decreased flexibility of ligaments, reduced size of muscles Rheumatoid Arthritis • Autoimmune disorder • Cartilage attacked • Inflammation, swelling, and pain • Final step in fusion of a joint Osteoarthritis • Degenerative Joint Disease o Aging, wear and tear • Noninflammatory - no swelling o Only cartilage is affected not synovial membrane • Deterioration of cartilage produces bone spurs o Restrict movement • Pain upon awakening - disappears with movement Gouty Arthritis • Urate crystals build up in joints - pain o Waste product of DNA and RNA metabolism o Builds up in blood o Deposited in cartilage causing inflammation and swelling • Bones fuse • Middle-aged men with abnormal gene
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