SISTEM RANGKA

Disediakan Oleh: VICKNESWARAN A/L NAKAR SALAPAN

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FUNGSI TULANG & STRUKTUR TULANG

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Sistem Rangka
Berasal dari Greek yang bermaksud badan yang kering dried up body

Sistem rangka adalah kerangka kerja dimana keseluruhan badan dibina

Osteo = Bone Tulang kita adalah ringan tetapi kuat, disesuaikan untuk memberi perlindungan dan pergerakan (locomotion)

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Terdiri dari pelbagai tisu

Kebanyakkannya ialah collagen dan hydroxyapatite - Ca10(PO4)6(OH)2

About 206 bones in the human body

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Rangka terbahagi kepada dua bahagian

Rangka aksial, yang terdiri dalam bentuk longitud aksial badan

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Rangka apendikular, terdiri dari tulang anggota luar/ lengkungan

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FUNGSI TULANG
Tulang memberikan bentuk badan serta membantu homeostasis dalam beberapa cara penting

1)

Sokongan: Tulang adalah sumber sokongan badan, ini dilakukan melalui memberikan tempat berpaut otot

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FUNGSI TULANG
2) Perlindungan : Tulang memberi perlindungan kepada tisu lembut seperti otak, saraf tunjang dan organ dalam ruang kosong torasik.

3)

Pergerakan :

Tulang bekerjasama dengan otot dalam mengerakkan anggota dengan bantuan tendon.

Tulang bertindak sebagai tuas dalam pergerakan badan dan anggota yang terlibat.
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FUNGSI TULANG
4) Penyimpanan : Ruang kosong dalam tulang digunakan untuk menyimpan lemak.

Tulang juga menjadi sumber / khazanah mineral seperti Kalsium dan phosphorous. Pertukaran ini dikawal oleh kehadiran hormon
5) Tempat Formasi sel darah: Hematopoiesis berlaku dalam ruang kosong sum-sum beberapa tulang

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TULANG BADAN MANUSIA

Terdapat

206 tulang dalam badan manusia

dewasa
Dua

jenis tisu tulang asas

Tulang padu (Compact bone)

Homogeneous Banyak bentuk kecil seperti jarum Banyak ruangan kosong

Tulang anjal / lembut (Spongy bone)

Tulang boleh juga diklasifikasi mengikut bentuk

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KLASIFIKASI TULANG BERDASARKAN BENTUK

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KLASIFIKASI TULANG
TULANG PANJANG Panjang berbanding lebar (Are longer than they are wide) Ada syaf (batang), kedua-dua hujung yang besar Kebanyakkannya terdiri dari tulang padu

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KLASIFIKASI TULANG
Kesemua tulang utama di anggota luar adalah tulang panjang

Tangan

Humerus, tulang lengan atas, berartikulasi dibahu

Radius tulang lateral lengan bawah Ulna tulang medial lengan bawah

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KLASIFIKASI TULANG
Kaki Femur, tulang besar dan kuat badan. Berartikulasi di pinggul dan dibahagian distal terletak tibia / pattela Tibia, tulang besar di anggota kaki bawah, dikenali juga dengan nama shin bone (tulang kering); proksimal berartikulasi dengan distal femur (lutut).Distal berartikulasi dengan tarsal menjadi pergelangan kaki Fibula tulang kecil anggota kaki bawah, proksimal tidak berada di lutut, tetapi distal ada kaitan dengan dengan pergelangan kaki
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KLASIFIKASI TULANG
TULANG PENDEK

Selalunya berbentuk kiub, dan terdiri dari tulang anjal

Patella, karpal (pergelangan tangan), tarsal (pergelangan kaki)

Patella adalah tulang jenis sesamoid kerana ianya terletak didalam tendon

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KLASIFIKASI TULANG
TULANG LEPER Nipis, rata dan selalunya melengkung Tulang anjal dihimpit oleh dua lapisan tulang tulang padu sandwitch. Tulang tengkorak

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KLASIFIKASI TULANG
TULANG TIDAK SEKATA Semua tulang yang tidak terlibat dengan klasifikasi sebelum ini adalah tergolong dalam jenis ini Tulang vertebrae

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Epiphysis: Hujung tulang. Diaphysis: Batang tulang yang meliputi ruang medullary. Rawan Articular: Melindungi hujung tulang, dan melicinkan pergerakan. Epiphyseal Plate: Kawasan pertumbuhan/pemanjangan tulang.
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Anatomi Kasar Tulang Panjang

Diaphysis

Batang Terdiri dari tulang padu

Hujung tulang Kebanyakkannya adalah tulang anjal Dilitupi oleh rawan hyaline (articular)

Epiphysis

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Ruang kosong Medullary

Ruang ini terdapat dalam tulang panjang. Ruang ini dipenuhi dengan lemak (dewasa).

Ruang ini dipenuhi dengan sumsum merah, penghasilan sel darah (kanak-kanak/bayi) Sel darah dihasilkan oleh sumsum merah dikalangan dewasa. Ianya terIetak dalam tulang leper dan epiphyses setengah tulang

panjang

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Figure 5.2a 24

PERKEMBANGAN DAN PERTUMBUHAN TULANG

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Perubahan Tulang Manusia

Proses pembentukan tulang Ossification.
Semasa

embrio, kebanyakkan tulang dalam bentuk rawan hyaline Semasa perkembangan, rawan diganti dengan tulang Rawan masih wujud dibeberapa bahagian tertentu

Jambatan Hidung (Bridge of the nose) Sebahagian tulang rusuk sendi

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Untuk suatu jangka masa pendek, fetus mempunyai tulang rawan yang dilitupi dengan tulang halus Kedua: rawan yang terdapat dalam tulang terhakis, dan membuka ruang untuk ruang kosong medullary dalam tulang baru Selepas lahir, rawan ditukar menjadi tulang, kecuali di dua kawasan

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Figure 5.4a 28

 Epiphyseal

plates membenarkan perkembangan tulang panjang dari awal bayi

Rawan baru sentiasa wujud Rawan lama menjadi ossified (Ossification)

Rawan dipecahkan Rawan diganti oleh tulang

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Pertumbuhan Tulang
Tulang

dibentuk dan dipanjangkan sehingga pertumbuhan berhenti

Berlaku perubahan bentuk pada tulang Tulang bertambah leber

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Osteoblasts dalam periosteum menambah tisu tulang baru kepermukaan tulang Proses perkembangan Appositional menyebabkan tulang melebar.

Pertumbuhan tulang panjang dibawah kawalan hormon, hormon pertumbuhan dan hormon seks (jantina)
Tulang adalah struktur dinamik yang sentiasa bertindakbalas dengan:

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Kehadiran Ca+ dalam darah

Stres akibat graviti Daya yang dikenakan oleh otot skeletal

Apabila kadar Ca+ turun dalam darah, maka kelenjar parathyroid akan merembeskan parathyroid hormone (PTH) yang memulakan aktiviti osteoclast (klast-keluar
kalsium).

Ini menyeimbangkan Ca+ dalam darah. Homeo.

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Jika tahap Ca+ tinggi dalam darah, maka keadaan ini dikenali sebagai hypercalcemia, Ini akan mengakibatkan Ca+ didepositkan di atas tulang.

Tulang sentiasa mengekalkan kadar pertumbuhan yang sekata walaupun jangka masa yang panjang.

Pertambahan keperluan ke atas tulang skeletal menyebabkan ianya mengubah tindakbalas. (atlit angkat
berat, tulang lebar berbanding panjang)

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Aktiviti menyebabkan tulang menjadi kuat Kurang / tiada aktiviti menyebabkan tulang kehilangan jisim akibat kehilangan Ca, (atrophy)

PTH menentukan bila dan kadar tulang dipecahkan (osteoclast). Stres fizikal menentukan bila tulang perlu dibina

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Keretakan tulang (Fractures)

Tulang

ada keretakan Jenis keretakan tulang

Tertutup(ringkas) keretakan yang tidak tertusuk keluar melalui kulit Terbuka(majmuk) tulang yang patah, tertusuk menerusi kulit

Rawatan

melalui pengurangan pergerakan (immobilization)

Tulang yang patah diluruskan semula

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Common Types of Fractures

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Pembaikan keretakan tulang

Hematoma

(pembengkakkan akibat darah) Disambung oleh fibrocartilage untuk menjadikan callus Fibrocartilage callus diganti oleh bony callus Bony callus dibentuk menjadi lekatan kekal

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Figure 5.5 39

RANGKA AKSIAL

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RANGKA AKSIAL
Membentuk

bahagian longitud badan Terbahagi kepada 3 bahagian

Tengkorak Kolum Vertebra (tulang belakang) Thoraks

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RANGKA AKSIAL

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Figure 5.6 42

Rangka aksial
- TENGKORAK
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Tengkorak
Dua

set tulang

Kranium Tulang muka

Tulang

disambung dengan bentuk jahitan Hanya mandibel sahaja yang boleh bergerak bebas

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Figure 5.7 45

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Tulang kranium terdiri dari 8 tulang, kecuali 2 tulang yang berpasangan.

Tulang Frontal: tulang dahi dan berlanjutan sehingga tulang kening,dan bahagian superior tulang orbit (mata)

Tulang Parietal: bergabung menjadi tulang dibahagian dinding superior dan lateral tengkorak

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Frontal View
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Frontal

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Parietal

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Temporal

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Nasal

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Vomer

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Zygoma

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Maxilla

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Mandible

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Frontal

Parietal
Temporal Vomer Maxilla Nasal Zygoma

Mandible

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Lateral View
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Frontal

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Parietal

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Temporal

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Nasal

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Zygoma

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Maxilla

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Mandible

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Sphenoid

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Occipital

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Mastoid Process

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External Auditory Meatus

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Frontal Nasal Zygoma Maxilla Mandible External Auditory Meatus

Parietal Sphenoid Temporal Occipital Mastoid Process

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Sutures
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Sagittal

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Frontal (Coronal)

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Squamous

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Lambdoid

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Sagittal

Frontal (Coronal)
Squamous Lambdoid

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Human Skull, Inferior View

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TULANG MUKA
Terdapat 14 tulang 12 tulang berpasangan dan hanya 2, tulang individu (mandible and vomer)

Maxillae ( maxillary bones) bergabung menjadi rahang atas (upper jaw). Kesemua tulang muka bercantum disini kecuali tulang mandible

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Sinuses
Hollow

portions of bones surrounding the nasal cavity

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Tulang Zygomatic : dikenali juga dengan nama tulang pipi, membentuk sebahagian besar soket mata

Mandible : rahang bawah, tulang paling besar di muka dan paling kuat

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Tulang Hyoid:

Satu-satunya tulang yang tidak berartikulasi dengan tulang lain secara langsung.
Terletak di pertengahan leher, di atas larynx, dan dilekatkan di styloid process dengan ligamen Berbetuk ladam kuda, menjadi tapak lidah dan tempat otot leher berpaut

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Tengkorak Fetal / bayi

Besar berbanding badan fetus.

Banyak bahagian tulang tengkorak yang masih dalam bentuk rawan.

Bahagian lembut di kepada dikenali sebagai fontanels ( little fountains) Degupan jantung bayi boleh dikesan dikawasan ini. Selalunya akan diganti menjadi tulang selepas 22 ke 24 bulan selepas lahir (post partum).
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 Fontanelles

ruang fibrous berserat yang

akan membenarkan sambungan tulang

kranial berlaku

Membenarkan otak membesar Memudahkan/membenarkan bayi keluar melalui saluran peranakan

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Rangka aksial
- TULANG BELAKANG
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Kolum Vertebra (Vertebral Column)

Terdiri

dari 26 tulang tidak sekata Fleksibel, melengkung, bemula dari tengkorak ke tulang pelvis Menjaga saraf tunjang yang amat sensitif Mengagihkan berat badan ke anggota bawah.
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 Tulang

Vertebra diasingkan melalui intervertebral discs lengkungan yang normal

Mempunyai

Diberikan

nama mengikut kedudukannya

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Figure 5.14 89

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Mengandungi 33 tulang vertebrae berasingan semasa lahir Sembilan tulang akan bercantum menjadi sakrum dan coccyx Bermula dari superior ke inferior terdapat 24 tulang berdasarkan kedudukan dan bilangannya Cervical / Servikal 7 Thoracic / Torasik 12 Lumbar / Lumbar 5
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 Ingat

masa makan.. 7 Cervical (sarapan pagi) 12 Thoracic (tengahari) 5 Lumbar (malam)

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Intervertebral disks berfungsi sebagai penyerap hentakan dan boleh menerima daya mampatan amat tinggi.

Ianya 90% air

Apabila bertambah tua, kandungan air akan berkurangan dan disk menjadi kurang fleksibel

Inilah yang menyebabkan orang tua menjadi pendek apabila tua.

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Herniated, atau disks yang terkeluar akan menekan saraf tunjang atau saraf yang keluar. Ini akan menyebabkan kesakitan yang teruk, atau kehilangan fungsi
Mempunyai lengkungan, agar dapat menyerap hentakan.

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 Lengkungan

torasik dan lengkungan sakral dipanggil lengkungan primer kerana wujud dari semasa lahir. Lengkungan sekunder berkembang kemudian. Lengkungan servikal cervical wujud apabila bayi mula menaikkan kepada, lengkungan lumbar apabila bayi mula berjalan.
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Kesemua vertebrae mempunyai beberapa paten yang sama. Bahagian Badan centrum: bahagian yang menanggung berat, selalunya menghadap anterior

Vertebral foramen: laluan dimana saraf tunjang berada

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Transverese Process: Dua projeksi di bahagian lateral vertebra

Spinous Process : Satu projeksi yang keluar dari bahagian posterior vertebra Superior dan Inferior Articular Processes : dua pasang yang akan membenarkan vertebra berartikulasi Vertebral arch: wujud apabila kesemua ekstensi posterior badan vertebra bergabung.

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Struktur Cervical Vertebrae

Cervical vertebrae ( C1 to C7 ) membentuk bahagian leher di tulang belakang C1 dan C2 adalah tulang khas, fungsinya tidak dikongsi oleh tulang cervical vertebrae yang lain Tulang Atlas ( C1) Tiada badan

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Transverse processes mempunuai lekukan untuk menerima occipital condyles. The Axis ( C2 ) menjalankan tugas pivot untuk atlas dan tengkorak C3 hingga C7 adalah tulang kecil dan teringan dalam vertebrae
Spinous proces pendek dan terbahagi kepada dua cabang.

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 Transverse

processes pula mengandungi foramina yang akan membenarkan arteri melaluinya untuk sampak ke otak. kumpulan tulang ini sahaja yang mempunyai kelebihan ini.

Hanya

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Structure of Thoracic Vertebrae

Thoracic vertebrae ( T1 T 12 ). Lebih besar berbanding cervical vertebrae Mempunyai dua costal demifacets di kedua-dua bahagian untuk menerima kepala tulang rusuk Mempunyai spinous processes yang panjang dan bersudut ke bawah. Apabila dilihat dari sisi, ianya mempunyai watak kepala giraffe
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Structure of Lumbar Vertebrae

Lumbar vertebrae ( L1 L 5 ).

Paling kuat dan teguh berbanding semua vertebrae.

Mempunyai blok badan yang besar Spinous processes pendek, dan berbentuk kapak.

Apabila dilihat dari sisi, ianya mempunyai watak kepala moose.

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The Sacrum (sakrum)

5 vertebrae yang bercantum

Superior berartikulasi dengan inferior L5

Dibahagian lateral ada alae yang akan artikulasi dengan tulang pinggang untuk membentuk sacroiliac joints Membentuk dinding posterior pelvis

Saluran vertebra masih bersambung dalam sacrum

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The Coccyx

Cantuman 3 hingga 5 tulang tidak sekata yang kecil

Ekor tidak jelas dalam manusia

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Rangka aksial - TORAKS

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The sternum, ribs and thoracic vertebrae make up the thorax, or thoracic cage

Sangkar Torasik meliputi dan menjaga jantung, paru-paru dan saluran darah major. Sternum Tulang leper yang terdiri dari sambungan tiga tulang. Dalam kedudukan Superior ke inferior: Manubrium Body ( Gladiolus) Xiphoid process
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The sternum articulates with the first 7 pairs of ribs. The sternum has 3 important landmarks The jugular notch The sternal angle The xiphisternal joint

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The jugular notch: the concave upper part of the manubrium, usually at the level of T3 The sternal angle : site where the manubrium and the gladiolus meet to form a slight angle. It is the reference point for locating the second intecostal space for listening to the heart valves Xiphisternal joint : Where the sternal body and the xiphoid process meet. Used as a landmark to locate the level of T9

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The Ribs

12 Pairs of ribs form the thoracic cage Men and women have the SAME number of ribs All ribs articulate with the vertebral column posteriorly The first 7 pairs are known as true ribs because they attach directly to the sternum by costal cartilage
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The Ribs

The next 5 pairs are false ribs because they either attach indirectly to the sternum, or not at all The last 2 pairs of false ribs lack sternal attachment, and are called floating ribs

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Rangka Apendikular

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Appendicular skeleton

Composed of 126 bones Shoulder girdle Also known as the pectoral or shoulder girdle, consists of 2 bones Clavicle Scapula

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Clavicle

Also called the collar bone Attaches medially to the manubrium Attaches laterally to the scapula Serves to hold the arm away from the thorax, and helps prevent shoulder dislocation A broken clavicle causes the shoulder to collapse medially

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Scapulae

Also called the shoulder blades Flat, triangular in appearance, has 2 important processes Acromion process: the enlarged end of the spine of the scapula Coracoid process : points over the top of the shoulder and helps anchor the muscles of the arm

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Scapulae

The scapula does not attach directly to the axial skeleton, but is held in place by muscles The scapula has three borders: Superior Medial Lateral

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Scapulae

The scapula has three angles: Superior Inferior Lateral

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Scapulae

The glenoid cavity is the shallow socket that receives the head of the humerous The shoulder girdle is exceptionally free to move However the price of this range of motion is that it is easily dislocated

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Bones of the upper limbs

There

are 30 bones in each upper

limb The arm is formed by the single long bone, the humerus The proximal end has a rounded head that fits into the glenoid cavity

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Bones of the upper limbs

The greater and lesser tubercles opposite the head are sites for muscular attachment The deltoid tuberosity is a roughened are at the midpoint of the shaft where the deltoid muscle attaches The radial grove allows for the passage of the radial nerve.

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Bones of the upper limbs

The distal end of the humerus has a spool shaped trochlea on the medial side, and the ball like capitulum on the lateral side On the anterior surface the coronoid fossa is a depression above the trochlea On the posterior surface you will find the olecranon fossa These 2 depressions allow for free movement of the elbow
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The Forearm

The radius and ulna form the forearm In anatomical position the radius is the lateral bone The radius and ulna articulate with each other proximally and distally at small radio-ulnar joints The bones are also connected by a long interosseous membrane

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Bones of the Upper Limb

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Figure132 5.21c

The Forearm

The head of the radius forms a joint with the capitulum The radial tuberosity is the location for the attachment of the biceps tendon The ulna is the medial bone The coronoid fossa can be found on the proximal anterior surface of the bone The olecranon process can be found on the proximal posterior surface

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The Forearm

The coronoid and olecranon processes grip the trochlea like pliers to form the elbow.

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The Hand
The hand consists of the carpals, metacarpals and phalanges. The carpals are 2 rows of 4 irregular bones, and form the wrist Hamate Pisiform Triquetral Lunate

Trapezoid Trapezium Scaphoid Capitate

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The Hand
The carpals are bound together by ligaments that restrict movement between them The palm consists of metacarpals numbered 1 to 5, starting on the thumb side. Each hand has 14 phalanges, and all of the fingers are composed of three phalanges, except for the thumb, which has 2.

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Bones of the Pelvic Girdle

Hip bones Composed of three pair of fused bones

Ilium Ischium Pubic bone

The total weight of the upper body rests on the pelvis Protects several organs

Reproductive organs Urinary bladder Part of the large intestine

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The Pelvic Girdle

The pelvic bone is formed by 2 coxal bones Each of these bones is formed by the fusion of 3 bones. Ilium Ischium Pubis

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Figure141 5.23b

The Pelvic Girdle

The pelvis is constructed of fairly large and heavy bones The hips are responsible for bearing the entire weight of the torso They also bear the stress associated with locomotion Reproductive organs, urinary bladder, and part of the large intestine are protected by the pelvis

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Gender Differences of the Pelvis

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The Thigh

The femur is the only bone in the thigh It is the largest, strongest bone of the body The proximal end of the femur has a ball-like head, and an obvious neck The femur slants medially to bring the knees in line with the bodys center of gravity

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Bones of the Lower Limbs

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Distally, the lateral and medial condyles articulate with the tibia The LEG The larger and more medial bone in the lower leg is the tibia(shinbone) Proximally, it articulates with the distal femur to form the knee joint Distally the medial malleolus forms the inner bulge of the ankle

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Bones of the Lower Limbs

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The fibula
The smaller, lateral bone of the lower leg The fibula does not form the knee joint The distal end of the fibula forms the outer part of the ankle with its lateral malleolus The tibia and fibula are connected by an interosseous membrane, just like the radius and ulna are.

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Bones of the Lower Limbs

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Bones of the ankle and foot

The

foot

Tarsus ankle Metatarsals sole Phalanges toes

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ARTIKULASI

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Joints of the Skeletal System

Articulations Junctions between bones Bind parts of skeletal system together Make bone growth possible Permit parts of the skeleton to change shape during childbirth Enable body to move in response to skeletal muscle contraction

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Joints = Articulations
Articulation site where two or more bones meet Two Fundamental Functions of Joints: Allow the skeleton to have mobility Hold the skeleton together

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Joints Structural and Functional Classes

Three Structural Classifications:
Fibrous suture, syndesomosis, gomphosis Cartilaginous synchondrosis, symphysis Synovial

Three Functional Classifications

Synarthrosis immovable Amphiarthrosis slightly movable Diarthrosis freely movable
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Classification of Joints
Fibrous Joints dense connective tissues connect bones between bones in close contact

Cartilaginous Joints hyaline cartilage or fibrocartilage connect bones

Synovial Joints most complex allow free movement

synarthrotic immovable amphiarthrotic slightly movable diarthrotic freely movable

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Fibrous Joints
3 Types Syndesmosis Suture Gomphosis

Syndesmosis long fibers connect bones amphiarthrotic distal ends of tibia and fibula

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Fibrous Joints
Suture between flat bones synarthrotic thin layer of connective tissue connects bones

Gomphosis cone-shaped bony process in a socket tooth in jawbone synarthrotic

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Cartilaginous Joints
2 Types Synchondrosis Symphysis Synchondrosis bands of hyaline cartilage unite bones epiphyseal plate (temporary) between manubrium and first rib synarthrotic

VINAS

158

Cartilaginous Joints
Symphysis pad of fibrocartilage between bones pubis symphysis joint between bodies of vertebrae amphiarthrotic

VINAS

159

Synovial Joints

diarthrotic joint cavity synovial fluid joint capsule synovial membrane bursae

VINAS

160

VINAS

161

Types of Synovial Joints

Ball-and-Socket Joint
hip shoulder

Condyloid Joint
between metacarpals and phalanges

VINAS

162

Types of Synovial Joints

Gliding Joint
between carpals between tarsals

Hinge Joint
elbow between phalanges

VINAS

163

Types of Synovial Joints

Pivot Joint
between proximal ends of radius and ulna

Saddle Joint
between carpal and metacarpal of thumb

VINAS

164

Angular Movement Change

of Angle Between Bones
Flexion bending movement that decreases the angle of the joint Extension reverse of flexion; joint angle increases Dorsiflexion and Plantar flexion up and down movement of the foot Abduction movement of a limb away from the midline or median plane Adduction movement of a limb toward the midline or median plane Circumduction movement of a limb describing a cone in space
VINAS 165

Types of Joint Movements

abduction/adduction dorsiflexion/plantarflexion flexion/extension/hyperextension

VINAS

166

Rotation
The turning of a bone around its own long axis Examples: Between first two vertebrae Hip and shoulder joints

VINAS

167

Types of Joint Movements

rotation/circumduction supination/pronation

VINAS

168

Special Movements
Supination and Pronation refer to movements of radius around the ulna (also applied to foot movements)

VINAS

169

Types of Joint Movements

eversion/inversion protraction/retraction elevation/depression

VINAS

170

Special Movements
Inversion and Eversion

Protraction and Retraction

VINAS 171

Special Movements
Elevation and Depression

Opposition
VINAS 172

Shoulder Joint
ball-and-socket head of humerus glenoid cavity of scapula loose joint capsule bursae ligaments prevent displacement very wide range of movement
VINAS 173

Shoulder Joint

VINAS

174

Elbow Joint
hinge joint
trochlea of humerus trochlear notch of ulna

gliding joint
capitulum of humerus head of radius

flexion and extension many reinforcing ligaments stable joint

VINAS

175

VINAS

176

Elbow Joint

VINAS

177

Hip Joint

ball-and-socket joint head of femur acetabulum heavy joint capsule many reinforcing ligaments less freedom of movement than shoulder joint

VINAS

178

Hip Joint

VINAS

179

Knee Joint
largest joint most complex medial and lateral condyles of distal end of femur medial and lateral condyles of proximal end of tibia femur articulates anteriorly with patella modified hinge joint flexion/extension/little rotation strengthened by many ligaments and tendons menisci separate femur and tibia bursae
VINAS 180

Knee Joint

VINAS

181

Life-Span Changes
Joint stiffness is an early sign of aging

Regular exercise can prevent stiffness Fibrous joints first to strengthen over a lifetime Changes in symphysis joints of vertebral column diminish flexibility and decrease height Synovial joints lose elasticity
VINAS 182

Clinical Application
Joint Disorders

Sprains damage to cartilage, ligaments, or tendons associated with joints forceful twisting of joint
Bursitis inflammation of a bursa overuse of a joint

Arthritis inflamed, swollen, painful joints

Rheumatoid Arthritis Osteoarthritis Gout
VINAS 183

Joint Injuries Sprains & Cartilage Injury

Sprain - the ligaments in a joint are stretched or torn. Partially torn ligaments may repair themselves, but healing is slow due to lack of vascularization. Completely torn ligaments require surgical repair.
Cartilage is mostly avascular and largely unable to repair itself when torn. Most cartilage injuries involve tearing of the menisci.

VINAS

184

Dislocations - Luxation
Occur when bones are forced out of alignment
Usually accompanied by sprains, inflammation, and joint immobilization Subluxation partial dislocation of a joint

VINAS

185

Inflammatory Conditions
Bursitis Inflammation of a bursa, usually caused by a blow or friction. Symptoms are pain and swelling. Treated with anti-inflammatory drugs; excessive fluid may be aspirated. Tendonitis Inflammation of tendon sheaths. Symptoms and treatment are similar to bursitis.
VINAS 186

Ligament and Cartilage Tears: Example of the Knee Joint

VINAS

187

Knee Ligaments and Tendons Anterior View

Tendon of the Quadriceps Femoris Lateral and Medial Patellar Retinacula

Fibular and Tibial Collateral Ligaments Patellar Ligament

VINAS 188

Knee Ligaments and other Supporting Structures

Intracapsular Ligaments (but outside of synovial cavity) Ant.Cruciate Ligament Post. Cruciate Ligament

Semilunar Cartilages
Medial Meniscus Lateral meniscus

VINAS

189

Knee Ligaments and other Supporting Structures

Adductor Magnus Tendon Articular Capsule Oblique Popliteal Ligament Arcuate Popliteal Ligament Semimembranosus Tendon
VINAS 190

Knee Injury

VINAS

191

Arthritis

More than 100 different types of inflammatory or degenerative diseases that damage the joints Most widespread crippling disease in the U.S. (1 out of every 7 people) Symptoms pain, stiffness, and swelling of a joint Acute forms are caused by bacteria and are treated with antibiotics Chronic forms include osteoarthritis, rheumatoid arthritis, and gouty arthritis
VINAS

192

Osteoarthritis (OA)

Most common chronic arthritis; often called wear-and-tear arthritis Affects women more than men 85% of all Americans develop OA More prevalent in the aged, and is probably related to the normal aging process

VINAS

193

VINAS

194

Osteoarthritis: Course

OA reflects the years of abrasion and compression causing increased production of metalloproteinase enzymes that break down cartilage As one ages, cartilage is destroyed more quickly than it is replaced The exposed bone ends thicken, enlarge, form bone spurs, and restrict movement Crepitus crunching noise as roughened articular surfaces rub together Joints most affected are the cervical and lumbar spine, fingers, knuckles, knees, and hips
VINAS 195

Osteoarthritis: Treatments

OA is usually slow and irreversible Treatments include:

Mild pain relievers, along with moderate activity Magnetic therapy? Glucosamine sulfate? said to decrease pain and inflammation

VINAS

196

Rheumatoid Arthritis (RA)

Chronic, inflammatory, autoimmune disease of unknown cause, with an insidious onset Usually arises between the ages of 40 to 50, but may occur at any age Signs and symptoms include joint tenderness, anemia, osteoporosis, muscle atrophy, and cardiovascular problems The course of RA is marked with exacerbations and remissions

VINAS

197

Rheumatoid Arthritis: Course

RA begins with synovitis of the affected joint Inflammatory chemicals are inappropriately released Inflammatory blood cells migrate to the joint, causing swelling Inflamed synovial membrane thickens into a pannus Pannus erodes cartilage, scar tissue forms, articulating bone ends fuse The end result, ankylosis, produces bent, deformed fingers
VINAS

198

Rheumatoid Arthritis: Treatment

Conservative therapy aspirin, long-term use of antibiotics, and physical therapy Progressive treatment anti-inflammatory drugs or immunosuppressants The drug Enbrel, a biological response modifier, neutralizes the harmful properties of inflammatory chemicals

VINAS

199

Gouty Arthritis

Deposition of uric acid crystals in joints and soft tissues, followed by an inflammatory response Typically, gouty arthritis affects the joint at the base of the great toe In untreated gouty arthritis, the bone ends fuse and immobilize the joint Treatment colchicine, nonsteroidal antiinflammatory drugs, and glucocorticoids

VINAS

200

THE HUMAN SKELETON IS MULTI-FUNCTIONAL

Gives structure to the body Provides for red and white blood cell development Allows for movement in a variety of directions, depending on the type of joint Protects internal organs
VINAS 201

NAME THE JOINT

As the arrow points out a joint (the point at which two bones meet) --name the type of joint decide what kind of motion occurs there write answers in your journal
VINAS 202

NAME THE JOINT

Hinge joint

Allows movement back and forth in one plane.

VINAS

203

NAME THE JOINT

Ball and socket joint

Allows for most range of movement.

VINAS 204

NAME THE JOINT

Pivot joint

Rotation of the head on the spine

VINAS

205

NAME THE JOINT

Gliding joints

Bones slide over one another.

VINAS

206

NAME THE JOINT

Immovable joint

No movement

VINAS

207

NAME THE JOINT

Hinge joint

Allows movement back and forth in one plane.

VINAS

208

Most joints allow movement of the body framework. Imagine that you did not have a joint where your bones meet at your knee or where your bones meet at the elbow.

Would your world and life be any different?

VINAS 209

VINAS

210

Initial skeleton of cartilage in infants

Bone Development

Replaced with bone by osteoblasts

More than 300 bones at birth fuse to 206 Always growing and breaking down

Osteoblasts form new bone cells Osteoclasts break bone cells down Osteocytes mature bone cells
VINAS 211

Broken Bones

Fracture is a break of the bone Simple or Complex fracture Regrowth of bone:

Spongy bone forms in first few days Blood vessels regrow and spongy bone hardens Full healing takes 1-2 months

VINAS

212

Homeostatic Imbalances

Rickets
Disease of children due to a lack of vitamin D. Calcium is not deposited in bones. Bones become soft. Bowing of the bones, and other deformities occur.
VINAS 213

Homeostatic Imbalances

Osteomalacia
Rickets of adults. Due to a lack of vitamin D. Calcium is not deposited in the bones. Bones become brittle.
VINAS 214

Homeostatic Imbalances

Osteoporosis
Bone reabsorption is greater than bone deposition. Due to any of the following: Lack of estrogen in women. Lack of exercise to stress the bones. Inadequate intake of calcium and phosphorus. Abnormalities of vitamin D metabolism. Loss of muscle mass.
VINAS 215

Age Related Dysfunctions

Arthritis:

Osteoarthritis- 90% of pop. By age 40 chronic inflammation of articular cartilage can be normal age-dependent change can also be pathology due to ? Age-related changes decrease blood supply trauma

VINAS

216

Osteoarthritis

VINAS

217

Osteoporosis
Decline in Bone Density Bone Resorption > Bone Deposition Increase Risk for Fracture compression fractures of vertebrae hip fractures
Role of calcium, vitamin D, estrogen, exercise Calcitonin vs. Parathyroid Hormone
VINAS 218

Parts of the Skeletal System

Axial skeleton

Skull and bones that support it Includes vertebra and ribs 80 bones

Appendicular skeleton

Limbs 126 bones

VINAS 219

Joints

Where bone meets bone Ligament holds bone to bone Types of joints:

Immovable - skull Ball-and-socket - shoulder Hinge - knee Pivot forearm Gliding - vertebrae
VINAS 220

Joints

Cartilage covers ends of movable bones

Reduces friction

Lubricated by fluid from capillaries

VINAS

221

Cartilage

VINAS

222

Bone Marrow

Red marrow produces blood cells and clotting factors

Found in humerus, femur, sternum, ribs, vertebrae, pelvis Produces RBC 2 million per second

Yellow marrow stores fat

Found in many bones

VINAS

223

Osteoporosis

VINAS

224