Chapter 2-I

Musculoskeletal
Anatomy

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 Bones
 Bones of the skeleton
are organs because
they contain several
different tissues.
 Besides giving you
shape, bones:
– Support the weight of the
body
– Protect sensitive organs
(skull, rib cage)
– Move via connection to
tendons
– Provide mineral storage
– Allow blood cell
formation

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 Classification of Bones
 Long Bones – longer than wide; have a
shaft plus two ends. Includes legs, arms,
fingers, toes.
 Short Bones – roughly cube shaped.
Includes wrist, kneecap.
 Flat Bones – thin, flattened, and usually
curved. Includes ribs, skull.
 Irregular Bones – don’t fit other types.
Includes vertebrae, hip bones.

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 Structure of Bones
 Most have a dense outer layer –
compact bone, and a spongy
cancellous bone interior filled with
marrow.
 Blood vessels run through bones; up
to 11% of the body’s blood supply is
in the skeleton

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Bone Fractures
Fractures are
repaired via
reduction:
•Closed
(physician
manipulates into
place)
•Open (bone
ends are
surgically joined
with pins or
wires)

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 The Skull
The skull
is the
most
complex of
our bony
structures

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 Construction of the Skull
Composed of:
 Cranial bones
– Enclose and protect the brain
– Provide attachment for head and neck muscles
 Facial bones
– Form framework of face
– Form cavities for sense organs (sight, taste, smell)
– Provide passage for air/food
– Hold the teeth
– Anchor the muscles of the face

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 The Spine
Composed of four
regions
-Cervical -Lumbar
-Thoracic -Sacrum

Lumbar 4 and 5 are the

biggest problem areas
because they angle
downward. Disc
pressure there is 50-
100% greater when
sitting than standing.

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 Composition of the Spine
 Formed by 26 bones providing the major
axis extending from the skull to the pelvis
 Each bone is cushioned from the next by
an intervertebral disc
– These discs have a gel nucleus with 12
concentric annulus rings
– These discs act as shock absorbers and allow
the spine to bend
– The discs can wear out from cumulative
microdamage until they leak or bulge
– Warning! Damage can occur with lack of pain

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Upper Extremities
 The shoulder is
stabilized by
tendons, not
mechanical fit of
bones
 The rotator cuff is
the co-joined sheet
of 3 tendons
surrounded by
connective tissue
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 Shoulder Problems
 Tendinitis – rotator cuff tendons
inflamed or damaged
 Bursitis – inflammation of the bursa
between the tendons and shoulder
bone (the bursa is a fluid filled sac
that acts like ball bearings)
 Tendon or muscle tear
 Frozen shoulder – inflammation of
the shoulder capsule
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 The Hand / Wrist
 The hand
consists of
– Carpus bones
– in the wrist
– Metacarpus
bones- in the
palm
– Phalanges –
finger bones

The carpus contains 8 marble-

sized short bones called carpals,
closely united by ligaments and
surrounds a median nerve 12
Lower Extremities
 Sound structurally
except for ankles, feet
 People constantly shift
weight from side to
side, even when
supposedly standing
still
 Back pain occurs when
there is leg length
discrepancy

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 The Feet
 Approximately 80% of foot injuries involve
broken toes. These injuries could be
avoided with safety shoes.
 The heel supports 50% of body weight,
another 25% with first two toes, remaining
25% with other three toes.
 In between heel and toes running
longitudinally are the lateral and medial
arches. Along with the transverse arch, they
distribute weight to heels and toes while
walking or standing.
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 Skeletal Changes
 Throughout life, not only does our
height change, but also our proportions
 At birth, the head and trunk are >1.5
times longer than the legs
 By age 10, the ratio is 1:1 (upper-
lower body)
 By middle age, the skeleton loses
mass; and osteoporosis and fractures
are more common
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 The Joints
 Joints are formed by two
or more bones connected
by thick tissues.
 The ends of bones are
covered by cartilage to
prevent bone-to-bone
contact.
 Many joints are enclosed
by a capsule that
produces lubricant.
 Arthritis is a disease that
causes joint inflammation.
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 Types of Joints
 Ball-and-socket – a large round ended
bone fits into the hollow of another; allows
swinging/rotating motion.
Ex.- hips, shoulders
 Hinge – operates like door hinge.
Ex. – knees
 Pivot – allows rotation.
Ex. – elbow (can rotate palm up or down)
 Fixed – don’t move, except to absorb
shock.
Ex. - skull
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 Ligaments
 Connects bones to bones
 Both ligaments and tendons are
made of collagen
 Ligaments are a flat sheet of
collagen fibers in differing
orientations with lots of nerves and
blood vessels
 Sprains are a tearing of the ligament

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 Tendons
 Connects muscles to
bones
 Are made of collagen
fibers running in the
same direction like a
rope surrounded by a
lubricating sheath
 Have few blood vessels
 Strains are tearing
apart of tendon fibers

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 Tendon Problems
Besides strains, other tendon problems:
– Tendinitis – inflamed tendon
– Tenosynovitis – swelling from excess synovial
fluid; causes pain to sheath; heals slowly
– Stenosing tenosynovitis – constricted sheath
– Trigger finger – tendon locked in swollen sheath
– Elbow problems – unsheathed tendons; golfer’s
elbow (inner arm), tennis elbow (outer arm)
– Deformation – cannot easily recover from >6%
– Rupture – deformation above 8-10%

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 Nervous System
 Master control and communications
system of the body
 Every thought, action, instinct, and
emotion reflects its activity
 Communicates via electrical signals

 The human body contains billions of

neurons or nerve cells

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 Nerves
 Central nervous system (CNS—brain and
spinal cord)
 Peripheral nervous system (PNS-
communication with body)
 Motor nerves bring messages (efferent
signals) from brain to muscles.
 Sensory nerves bring messages (pain,
pressure) from muscles to brain.
 Autonomic nerves control functions, such
as sweating.

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 Muscle
Functions Unique Features
 Movement – by  Contractility
moving bones  Excitability – nerves

 Maintenance of signal electrical

posture impulses
 Joint stabilization  Extensibility – can

 Heat generation – stretch back by

maintains normal contraction of an
body temps opposing muscle
 Elasticity – can recoil

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 Types of Muscles
 Cardiac muscle (heart)
 Smooth muscle (internal organs,
walls of blood vessels)
 Skeletal muscles (attached to bones)

– Striated
– Usually attached in pairs
– Controlled by neurons
– Nourished by arteries

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Skeletal Muscles Span Joints

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 First-class lever
 Fulcrum in the
middle (e.g.
seesaw)

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 Second-class lever
 Fulcrum at one end
(e.g. wheelbarrow)

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 Third-class lever
 Fulcrum at one
end, resistance has
mechanical
advantage (e.g.
forceps)

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 Force Capability

Forces (kg) exertable on a vertical handgrip

with the right arm at various elbow angles:

60 90 120 150 180

Pull 28.6 40.0 47.3 55.5 54.5
Push 41.8 39.1 46.8 55.9 62.7

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 Gender, Age,
and Training Effects
 On average females have 2/3 strength of
males.
 Primarily due to smaller size and muscle
mass.
 Speed of movement and grip strength
decrease with age.
 Training may increase gender differences.
 Increased job endurance can come from
improved micro-motions and coordination.

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 Electromyography
 Electrodes measure activity of
specific muscles.
 Provides information about:

– Whether muscle is in use

– Relative activity level
– Force generation
– Muscle fatigue

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