Skeletal System Flashcards
Describe the Anatomical position
Person stands erect with feet parallel flat on the floor, palms facing forward and arms at the sides of the body
What does supine describe
the body laying down face up
What does prone describe
body laying down face down
What is the definition of the following:
Medial
Lateral
Bilateral
Unilateral
Ipsilateral
Contralateral
Proximal
Distal
Anterior
Posterior
Superior
Inferior
Nearer the midline
Away from the midline
Both sides
One side
Same side
Opposite side
Nearer the trunk
Further from the trunk
Nearer the front
Nearer the back
Towards the top
Towards the bottom
What plane separates the body from front to back
Coronal/Front plane
What plane separates body from left and right
Sagittal plane
What plane separates the body from bottom to top
Horizontal/Transverse plane
How many bones are there in the human skeletal system
206
What percentage of the body weight is the skeletal system
18%
List 8 functions of the skeletal system.
Provides protection for internal organs.
Supports framework for the body.
Forms boundaries e.g skull
Attachment for tendons and ligaments
Permits movement of joints
Haematopoiesis - formation and development of blood cells from the red bone marrow.
Mineral homeostasis - calcium and phosphate
Tryglycedride storage - (yellow bone marrow
What are Osteogenic cells and what ais their function
Osteogenic cells are bone stem cells that are unspecialised, their function is to go on and become Osteoblasts
What are Osteoblasts and what is their function
Osteoblasts are immature cells that are bone building cells.
They synthesis and secrete collagen and other components of bony matrix such as Chondroitin.
They get trapped in their own matrix and then go on to become Osteocytes
What are Osteocytes and what is their function
Osteocytes are fully matured cells
They maintain daily metabolism in bone and the exchange of nutrients.
What are Osteoclasts and what is their function
Osteoclasts are huge cells made up of over 50 monocytes (white blood cells)
On the side facing the bone they have a ruffled board that secretes powerful lysosomal enzymes and acids, which digest bone matrix
What does resorption refer to in bone cells
The breakdown of bone matrix
What does resorption refer to in bone cells
The breakdown of bone matrix
Fill in the xxxx
xxxxxx and xxxxxx work together to xxxxx bone throughout life. Excess xxxxx activity leads to a loss of xxxx xxxx and can lead to xxxxxxx
Osteoblasts
Osteoclasts
Remodel
Osteoclast
bone density
Osteoporosis
What are the 2 types of bone called
Compact and Spongy bone
How much of the skeleton is made up of compact bone
80%
Where is compact bone found
Beneath the Periosteum of all bones
What cells does bone contain
Osteogenic, Osteoblasts Osteocytes and Osteoclasts
Which bone contains few spaces and is strong? What kind of tissue is bone made up of?
Compact Bone and Connective tissue
Where do we mainly find compact bone
Found beneath the Periosteum of all bones and makes up the bulk of the diaphysis in long bone
What is and Osteon and how is it aligned
Structural Unit of Compact bone and it is aligned in the same lines as stress
What are the 4 parts that Osteons are made up of and describe each.
Haversian Canal - contains the blood vessels and the nerves
Lamellae - Concentric rings of calcified extracellular matrix containing minerals and collagen
Canaliculi - a mini system of interconnected canals that provide a route for minerals and waste
Lacunae - small spaces filled with Osteocytes
Describe Spongy Bone
Spongy bone does not contain Osteons. It is an irregular lattice of thin columns called Trabeculae arranged along the lines of stress.
Macroscopic spaces between Trabeculae helps to keep bone lighter and can be filled with bone marrow. They contain blood vessels that nourish the bone.
Define a long bone
Bones that have a greater length than width
Describe a long bone
Long bones contain a Diaphysis and 2 heads Epiphyses.
They are slightly curve for strength which allows for better force distribution.
They contain mainly compact bone in the diaphysis and spongy bone in the Epiphyses.
Examples include the femur, tibia and humerus
Where do we find the Epipysises
forms the proximal and distal ends of long bones
What separates the Epiphysis and Diaphysis what is made up of. What does is do?
The Epiphyses and Diaphysis are separated by the epiphyseal plate which is a layer of hyaline cartilage that allow the diaphysis to grow in length.
What is the structure of epiphysis
Epiphysis contains a thin outer region of compact bone covered by articular/Hyaline cartilage and inner bone with red bone marrow
What does Diaphysis describe
Tubular shaft of long bones
What is the outside of compact bone covered by
Periosteum
Where do we find the central medullary cavity and what does it contain?
It is found in the Periosteum and contains red/yellow bone marrow
Does all bone marrow start of as Red or Yellow
All bone marrow starts at birth as red and gradually some of the red bone marrow is replaced with yellow bone marrow (fat) which
Why would the body need to convert yellow bone marrow.
The body can covert yellow bone marrow very quickly to red bone marrow if needed. For example if some one has had an accident or Hemorrhaging and will provide more blood cells.
What does peri mean?
Surrounding e.g periosteum surrounding bone
Where do we find the Periosteum?
Surrounding the external surface of the bone that is not covered in cartilage.
What replaces the Periosteum on joint surfaces
Hyaline cartilage
Fill in the gaps
The Periosteum is a xxxx-xxxxx, highly-xxxxx xxxxx that xxxxx bone and serves as an xxxxxx for xxxxx and xxxxx
pain-sensitive
vascular membrane
protects
attachment for ligaments and tendons
How do bones receive oxygenated blood?
Periosteal arteries enter the diaphysis through many perforating canals
Describe the structure of the Periosteum
It is double layered membrane containing a tough fibrous outer layer that protects bone.
Inner ‘Osteogenic layer’ that contains Osteoblasts and Osteoclasts, assisting in bone growth and repair.
What type of bone is the Patella
Sesamoid bone
Where do we find irregular shaped bones
Vertebrae
Give examples of 2 flat bones
Scapular and skull or pelvis
What is the Diaphysis
The central shaft between proximal and distal Epiphyses
Define what is means to ossify something
To harden something
What does Ossification mean?
To produce a bone
When do our bones stop remodeling
They don’t we continue to remodel our bones throughout life.
What are the 2 Ossification pathways used to produce bone and what do they do? Give 2 examples of each?
- Intramembranous ossification -
Bone develops from connective tissue sheets
Flat bones (i.e the skull) and the clavicles develop this way. - Endrochondral ossification - Bone develops by replacing hyaline cartilage i.e ribs, arms and leg bones
What does endo stand for
Within
What does chondral stand for
Cartilage
What is the name of the plate needed for bones to grow
Epiphyseal Growth plate
What are the 2 ends of the Epiphyseal plate called and define
Proximal Epiphyseal Growth Plate - Growth plate nearer the trunk
Distal Epiphyseal Growth Plate - Growth plate further from the trunk
Where do we find the Epiphyseal Growth plate
Found in long bones between the Epiphysis and the Diaphysis
Where do we find Hyaline Cartilage
In the Epiphyses top and bottom of bones
What is produced in the epiphyses and what does it do
Osteoblasts are produced, ossifying the bone matrix
At what age does the Epiphyseal Growth Plate ossify?
Between 18 - 21 years of age
What remains after the Epiphyseal Growth plate has ossified
Epiphyseal line remains
What might we see if a bone fracture damages the epiphyseal plate during childhood?
The bone may grow shorter - seeing a discrepancy in leg length
How can bones grow in thickness
Using Osteoblasts in the Periosteum
Describe the activity within the growth plate
Cartilage cells (Chondrocytes) undergo mitosis
Then chondrocytes stop dividing
Then minerals start to deposit, capillaries invade and deliver Osteoblasts/Osteoclasts and new bone is formed.
What are Chondrocytes
Cartilage cells
What happens to bone in Menopause
We lose the balance of osteoblasts/osteoclasts. Osteoblasts drive goes down and Osteoclasts keep going as normal causing the loss of bone density.
What 3 hormones promote Osteoblast activity
Growth hormone and Thyroid hormone - stimulate the growth of bone
Testosterone and Oestrogen - promotes the laying down of boney matrix
Calcitonin
Where do we find the Parathyroid Gland
they are 4 small glands that sit on top of the thyroid gland and are located anterior
What hormones promote Osteoclast activity
Parathyroid hormone
Cortisol
What hormones breakdown calcium for you
Cortisol and Steroid medication
What does long term use of steroid medication do to bone
It breaks down bone density
What mineral is highest in bones
Calcium
Why do blood calcium levels have to be tightly controlled
To ensure proper blood clotting
Without Calcium present it would be impossible to contract muscle
Calcium is also needed to relay messages to different nerve cells.
What is the name given when calcium levels are low and what happens.
Hypocalcaemia - Osteoclasts breakdown bone and release calcium into the blood to bring back homeostasis.
What happens if calcium levels are too high
Hypercalcaemia - Osteoblast activity is increased (takes calcium back into the bone)
Calcium exchange is regulated by the Parathyroid glands and thyroid gland.
What hormone do we use to take blood to the bones
Calcitonin
What hormone do we use to take bone to the blood
Parathyroid hormone
Where is yellow bone marrow found on the bones
is stored in the distal part of the bone
What does vitamin D do
Facilitates calcium absorption in the intestines and is directly involved in bone turnover.
Why do we need vitamin K2 when we take vitamin D
Vit D3 and K2 work closely together. D3 assists in the absorption of Calcium into the blood and K2 activates a protein called ‘osteocalcin’ which controls utilisation of calcium in the body (depositing it in bones).
What food is the best source of vitamin D3
Oily fish is the best source such as Salmon. Has to be wild Salmon though as farmed Salmon contains only 10% of the D3 that wild contains.
Also found in Eggs
Explain why a patient might be deficient in Vitamin D
lack of sunlight, reduced dietary absorption, or reduced ability to produce an active form of Vitamin D. Excessive use of sunscreens, Magnesium deficiency and high alcohol intake reduces vitamin D conversion into it’s active form
Does Calcitonin reduce calcium blood levels or increase
Lowers blood calcium levels
Where is Calcitonin secreted from
para-follicular cells of the thyroid gland
Describe the process of how Calcitonin works and what the outcome is?
Para-follicular cells of the thyroid gland secretes Calcitonin
It inhibits osteoclast and promotes osteoblast deposition of calcium in the bones
The result is increased bone formation and decreased blood calcium
What 2 substances does the Thyroid gland excrete
Thyroid hormone and Calcitonin
What is parathyroid hormone and what does it do?
Increases the activity of Osteoclasts
Stimulates the kidneys to reabsorb and retain calcium in the blood
Increases the formation of calcitriol which promotes calcium update form food in the intestines.
What is the active form of vitamin D
Calcitriol active form of vitamin D it promotes calcium uptake from food in the intestines
Why is weight baring exersize so important
It stimulates the activity of Osteoblasts which lay down the collagen and minerals to help form hard tough bone.
What are the names of the 2 sections that the Skeleton is divided into?
Appendicular and Axial sections
What is the Axial skeleton and how many bones does it contain.
Axial Skeleton is the Central Skeleton and has 80 bones
What part of the skeleton protects our most vital organs.
Axial skeleton
The axial skeleton contains - give 5 examples
Skull, inner ear, thoracic cage, vertebrae, hyoid bone
What are the skull bones joined with
Fibrous joints called ‘sutures’
What are sinuses and what is their function
Sinuses are air filled cavities in the skull that
Give resonance to the voice
Lighten bones of the face and cranium
What are fontanelles and why are they present.
Fibrous sutures (soft spots) on a baby’s head joining the skull bones together. They ossify at 12-18 months
They are present to allow the baby’s head through the birth canal.
What does a sunken fontanelle indicate
Indication the baby is very dehydrated
What is a bulging fontanelle a sign of
Indication of Hdyrocephalus - water on the brain
How many vertebrae does the vertebrae column consist of
24
What are the 4 regions of the vertebrae? What are their numbers
Cervical - C1 - C7
Thoracic - T1 - T12
Lumbar - L1-L5
Sacrum and coccyx - fused bones
How do vertebrae connect
Via intervertebral discs
What are the functions of the vertebral column
Protection for the spinal cord
movement e.g side bending
support of the skull
forms axis of the trunk
What does the thoracic cage consist of
Sternum and 12 ribs
Where does the first rib sit.
Behind the clavical in the anterior chest
Where is the apex of the lung
Superior to the clavicle
How do ribs attach to the sternum
Via costal cartilage
Which ribs are floating ribs and how do they attach.
Ribs T11 - T12 are floating ribs they have no anterior bony attachment and attach posteriorly to vertebrae T11 - T12
How many discs are present in the spine
23 Discs
What structures are discs and what do they do?
Shock absorbing structures. They bind vertebral bodies and separate individual vertebrae.
Do we have discs in the Sacrum
No
When are discs most hydrated
In the morning and between the ages of 30-40 years
How much of the spinal column do discs make up.
One third
What are the 2 parts of the vertebral discs called
Annulus fibrosus and Nucleus pulposus
The nucleus pulposus is a gel like pad.
What is the appendicular skeleton
It is the distal skeleton consisting of the limbs
How many bones does the appendicular skeleton have
126
What are the functions of the appendicular skeleton
Movement and organ protection
What does the appendicular skeleton consist of
Shoulder girdle, arm, hand pelvic girdle, leg and foot
What bone is the Ulna
Medial forearm bone
What are the phalanges and how are they divided up
They are the fingers and divided into proximal, intermediate and distal phalanges
Where do we find the metacarpals
between the wrist and fingers
What bone is the radius
lateral elbow bone
Where do we find the humerus
Upper arm
What is the pelvic girdle made up of
Hip bones
Sacrum
Coccyx
Sacro-iliac joint
Where do we find the sacro-iliact joint
We have dimples in our lower back the sacro-iliac joint is found inside there.
Which bone in the body is the longest and strongest
Femur
What bone is the Tibia
Shin bone
Where is the fibula
Bone in the lateral lower leg
Where are tarsals found
Ankle
Metatarsals
Bones connecting middle section of the foot
Where do we find the Phalanges in the foot
Toes
What are the 8 bones of the arms and shoulder and where are they found
Clavicle - Anteriorly
Scapular - Posteriorly
Humerus - Upper Arm
Ulna - Medial forearm
Radius - lateral elbow bone
Carpals - wrist bones
Metacarpals - bones between carpals and digits
Phalanges - which are divided into proximal intermediate and distal
What are muscles that are attached to bone and move joints called?
Skeletal Muscle
How are skeletal muscles attached to bone
via tough fibrous structures called tendons
How many joints are there in the human body
187
t What are the 3 types of joint and give an example of each.
Fibrous joints - bones are held tightly together permitting very limited movement. E.g Sutures in the skull
Cartilaginous joints - Articulating bones tightly connected by cartilage permit little or no movement. E.g Epiphyseal growth plate and intervertebral discs
Synovial joints - permit the most movement and act as a shock absorber E.G ball and socket joints such as hip and shoulder and hinge joints such as elbow and knee
What does Synovial mean
Moveable/joint containing fluid
What is the fluid that Synovial joints contain and what does it consist of?
Synovial fluid consists of Hyaluronic acid and interstitial fluid filtered from the blood.
How do Synovial joints obtain nutrients.
As they have no direct blood supply they obtain nutrients by diffusion. This is essential for joint movement to happen
What are Bursae
Small fluid filled sac-like structures that reduce friction
Where are Bursae located and what is their function.
between skin and bone, tendon and bone, muscle and bone or ligament and bone. They allow for frictionless movement.
Describe the structure of a synovial joint
A joint that has a Synovial membrane and synovial fluid, and a small bit of hyaline cartilage lining the joints.
Define what is meant by the movement flexion
decrease in joint angle
Define what is meant by Extension
Increase in joint angle
What is meant my rotation
movement around longitudinal axis. In the limbs it can be medial or lateral (away from the midline)
Define Lateral Flexion
movement of trunk away from the midline
What is Abduction
movement away from the midline
Adduction
movement towards the midline
Circumduction
Circluar (flexion, abduction, extension, hyperextension, adduction in succession.)
What is a pathological fracture
A fracture that wouldn’t have happened if the patient didn’t have an underlying disease.
Why is it important to have a dislocation in the shoulder fixed as soon as possible after the event
Because we have lots of blood vessels running down our arm supplying one and surrounding nerves. if this is cut off it can damage the blood vessels
What are common causes of fractures?
Trauma, low bone density (associated with Osteoporosis) Vitamin D deficiency.
What are the 5 types of Fracture classification and explain each.
Complete - Bone broken into 2 or more fragments can either be open (perforated skin) or closed (soft tissues not comprised .
Incomplete - bone is fractured but not into fragments
Linear fractures along bone length
Transverse fractures - across the bone
Avulsion fracture - when a tendon or ligament pulls off a piece of bone.
What does Callus mean
Mass of tissue
What are the 4 stages of Fracture repair. Explain each stage
- Haematoma (and inflammation)
Blood vessels at the fracture site are broken and blood leaks into the site. Causes death of local cells and swelling
Fibrocartilaginous callus formation. Phagocytes clean up the debris. Fibroblasts invade and lay down collagen forming a soft callus which takes 2-3 weeks.
Bony Callus formation
Osteoblasts replace soft callus with new bone which takes less than 3 months.
Bone remodelling
The callus is mineralised and compact bone laid down. Then Osteoclasts reshape the new bone. Remodelling occurs over months to years.
What herbs can we use for treatment of fractures
Comfrey, gotu kola
What nutrients are important for treatment of fractures.
Vitamin D, C and calcium
What are the Homeopathic remedies used for:
Bruising
Injured nerves
Fusing bones together (and when should it be given)
Arnica
Ruta
Calc Phos 4c given for the first 2 weeks to help fuse bones together.
What is the treatment for a sprain
RICE -
Rest
Ice
Compression
Elevation
Herbs locally and internally - to assist with tissue repair. e.g comfrey manual therapy and rehab
What nutrients do we need more of to support recovery of a sprain
Glucosamine, vitamin C, Zinc, and Vit E
What are ligaments
Tough bands of connective tissue that attach bone to bone
What Homeopathic remedies could we use for sprains
Arnica ruta and acupuncture
