Name 4 characteristics of the Anatomical Position?
- 1. Person stands erect.
- 2. Feet parallel, flat on the floor.
- 3. Arms are at the sides of the body.
- 4. Palms forward.
If the body is lying face down, what is this position described as?
If the body is lying face up, what is this position described as?
Directional Terms: Part A
Describe the Anatomical Terms with their meaning.
- Medial - nearer to the midline.
- LAteral - further (away) from the midline,towards the sides.
- Bilateral - both sides.
- Unilateral - one side.
- IpSilateral - on the same side.
- Contralateral - on the opposite side.
- Proximal - nearer to the 'attachment'.
- Distal - further from the 'attachment'.
Directional Terms: Part B
Describe the Anatomical Terms with their meaning.
- Cranial - head/towards the head.
- Caudal - tail/towards the tail.
- Anterior/Ventral - nearer the front.
- Posterior/Dorsal - Nearer the back.
- Superior - Towards the top.
- Inferior - Towards the bottom.
- Superficial - Closer to the skin/surface.
- Deep - further under the skin.
Describe the 3 planes of the body?
- 1. Coronal/Frontal Plane - vertical plane that divides the anterior (front) and posterior (back) parts of the body.
- 2. Sagittal - vertical plane that divides the left and right parts of the body.
- 3. Transverse - horizontal plane that divides the superior (top) and inferior (bottom) parts of the body.
How many bones are the in the human body?
What are the 7 functions of the human skeleton?
- 1. Haemopoiesis - formation and development of blood cells.
- 2. Mineral haemopoiesis (mostly calcium and phosphate).
- 3. Support framework for the body.
- 4. Forms boundaries (skull).
- 5. Attachment for muscles and tendons.
- 6. Permits movement (joints).
- 7. Triglyceride storage (yellow bone marrow).
Bone Cells: Define what Osteogenic Cells are and their function?
[Osteo] = bone
- Osteogenic Cells are unspecialised stem cells.
- They are the only bone cell to undergo division, which produces Osteoblasts.
Bone Cells: Define what Osteoblasts are and their function?
- Osteoblasts are bone building cells.
- They surround themselves with extracellular matrix and become trapped in their secretions and become osteocytes.
Bone Cells: Define what Osteocytes are and their function?
- Osteocytes are mature bones cells.
- They maintain daily metabolism of bone, such as nutrient/waste exchange.
Bone Cells: Define what Osteoclasts are.
Osteoclasts are huge cells derived from fusion of as many monocytes(white blood cells).
What does resorption mean?
It is when Osteoclasts break down the tissue in bones.
Describe Compact Bone?
Compact bone is tightly-packed, contains few spaces and is strong.
What is an Osteon?
An Oeston is a structural unit of compact bone.
An Osteon contains what 4 parts?
- 1. Central canal - contains blood vessels and nerves.
- 2. Lamellae - calcified extracellular matrix containing minerals and collagen.
- 3. Lacunae - between lamellae, are small spaces called lacunae that contain osteocytes.
- 4. Canaliculi - interconnected canals that provides a route for nutrients/waste.
What are the characteristics of Spongy/Cancellous Bone?
- 1. Does not contain osteons - instead it consists of thin columns called trabeculae.
- 2. Small spaces between trabeculae help make bone lighter and can be filled with bone marrow.
- 3. Spongy bone is always covered with a layer of compact bone.
Like other connective tissues, what does the bone have?
Bone contains an extracellular matrix that surrounds separated cells.
What is the most abundant mineral in the bone matrix?
What is a long bone?
- 1. A bone that has a greater length than width.
- 2. Contains a shaft=diaphysis and 2 heads=epiphyses.
- 3. Mostly compact bone in diaphysis and spongy bone in epiphysis.
How are the Epiphyses separated from the Diaphysis?
They are separated by the epiphyseal plate.
Describe the function of the epiphyseal plate?
- The epiphyseal plate is a layer of hyaline (thin glass-like) cartilage.
- This allows the diaphysis to grow in length.
What type of bones does the Epiphysis contain?
- Thin outer compact bone covered by hyaline cartilage.
- Inner spongy bone with red marrow.
Describe the diaphysis part of the long bone?
- Diaphysis are the tubular shaft part of the long bone.
- The outer compact bone is covered by periosteum.
- Central, medullary(bone marrow cavity) contains red/yellow bone marrow.
What is Periosteum?
Peri = surrounding Osteon = bone
Periosteum is a dense layer of vascular connective tissue that surround the external bone surface.
Describe the function of the Periosteum?
- 1.Outer fibrous layer - protects bone.
- 2. Inner layer - mostly of osteoblasts and osteoclasts for growth and repair.
- 3. Serves as attachment for ligaments and tendons.
What is Endosteum?
Endosteum is a thin layer of vascular connective tissue that surrounds the internal medullary (bone marrow cavity) cavity.
Name 5 types of bone?
- 1. Short bones - curved shaped.
- 2. Irregular bones - complex shapes.
- 3. Flat bone - 2 plates of compact bone.
- 4. Sesamoid bone - e.g. patella(knee).
- 5. Long bones - e.g femur(thigh).
What general structure do all bones have?
- Compact Bone
- Spongy Bone - containing red bone marrow.
Name the 2 types of Bone Marrow?
- Red bone marrow - red blood cells, platelets, most white blood cells are created here.
- Yellow bone marrow - contains fat cells, some white blood cells are created here.
The natural process of bone formation.
When does Ossification occur?
- During foetal development.
- During growth.
- Throughout life.
Name the 2 types of Ossification?
- 1. Intramembranous ossification - bone growth at embryo & foetus stage. All flat bones i.e. skull.
- 2. Endochondral ossification - bone growth from 2 months onwards. cartilage is broken down as ossification proceeds.
Name the 2 types of Bone Growth?
- Long bones growth in length = interstitial growth.
- All other bones growth in thickness = appositional growth.
Describe the process of Interstitial Growth.
- Epiphyseal Plate - a layer of hyaline cartilage in the epiphyses where bones cells are produced.
- Osteoblasts - move in to ossify the matrix to form bone.
- Early 20's epiphyseal plate completely ossifies to leve a thin epiphyseal line. Bone can no longer grow.
If a bone fracture damages the epiphyseal plate during childhood, what might happen?
The fractured bone may be shorter than normal once adult bone formation is reached.
Describe the process of Appositional Growth?
Osteoclasts resorb old bone that lines the medullary cavity, while osteoblasts, via intramembranous ossification, produce new bone tissue beneath the periosteum.
How do hormones affect bone growth and remodelling (density)?
Hormones affect bone growth and remodelling by altering the ratio of osteoblast to osteoclast activity.
What hormones affect a child and how?
- 1. Growth hormone - stimulate osteoblasts(bone-forming cells).
- 2. Thyroid hormone - promotes osteoblasts.
- 3. Cortisol(stress hormone) & steroid medications - Promotes osteoclasts (breaking down of bone cells).
What hormones affect an adult and how?
- 1. Testosterone & Oestrogen - Promotes osteoblasts.
- 2. Calcitonin(lowers blood calcium) - Promotes osteoblasts.
- 3. Parathyroid hormone(increases blood calcium) - Promotes osteoclasts.
What is the importance of Bone Homeostasis?
Bone is made up 99% calcium. Blood calcium levels have to be tightly controlled to ensure proper blood clotting, nerve and muscle function.
What happens if blood calcium levels are too low?
Osteoclasts break down bone and release calcium into the blood. This is referred to as hypocalcemia.
What happens if blood calcium levels are too high?
An increased osteoblast activity takes calcium back into the bone. This is referred to as hypercalcemia.
How is calcium exchange regulated?
Calcium exchange is regulated by the parathyroid glands and the thyroid gland.
1. Where is it produced?
2. Effect on blood calcium levels?
3. Describe its mechanism?
- 1. Parathyroid gland.
- 2. Increases blood calcium levels.
- 3. a. Increases osteoclast activityb. increased renal(kidney related) calcium absorption. c. increases calcitriol (active form of vitamin d).
1. Where is it produced?
2. Effect on blood calcium levels?
3. Describe its mechanism?
- 1. Thyroid gland.
- 2. Decreases blood calcium levels.
- 3. a. Inhibits osteoclasts.
- b. Promotes osteoblasts.
Why is Vitamin D so important to bones?
- 1. Vitamin D facilities calcium absorption.
- 2. Crucial for healthy bones.
Vitamin D levels decrease with age. What other combination of factors could be associated?
- 1. Low sun exposure.
- 2. Reduced dietary absorption.
- 3. Reduced ability to produce an active form of vitamin D through liver, kidneys and skin.
What chemical co-factor is needed for the conversion of vitamin d?
Why is exercise so important to bones?
- 1. Bones can become stronger in response to mechanical stress e.g. pull of skeletal muscle.
- 2. Mechanical stress leads to increased mineral deposition and increased production of collagen fibres.
- 3. Mechanical stress is important for ensuring bone formation occurs more quickly than bone resorption.
How bones does the Axial Skeleton contain?
The axial skeleton is the 'central skeleton' and consists of 80 bones.
What 5 parts consist of the Axial Skeleton?
- 1. Skull
- 2. Inner ear ossicles.
- 3. Throat hyoid bone.
- 4. Chest (thoracic cage).
- 5. Vertebral column.
Describe the function of the Skull and what are the bones joined with?
- The Skull forms the cranium and face and encapsulates the brain.
- The skull bones are joined with fibrous joints called sutures.
Describe the function of Sinuses?
Sinuses are spaces within the skull.
- 1. Communicate with nasal cavity.
- 2. Give resonance to the voice.
- 3. Lighten bones of face and cranium.
How many vertebrae are there?
- There are 33 vertebrae. The upper 24 are articulating and separated from each other by intervertebral discs.
- The lower nine are fused in adults, five in the sacrum and four in the coccyx.
Name and number the vertebrae in the human body?
- Cervical (7) C1-C7
- Thoracic (12) T1-T12
- Lumbar (5) L1-L5
- Sacrum (5 in human embryo) Fuse together once born.
- Coccyx (4 in human embryo) Fuse together once born.
What are the vertebrae's function?
- 2. Support.
- 3. Axis.
- 4. Movement.
How many intervertebral discs are there?
There are 24 intervertebral discs which make up 1/3 of the length of spinal column.
Name the 2 parts of the intervertebral discs and their function?
- Intervertebral discs are composed of an annulus fibrosus and a nucleus pulposus.
- 1. Annulus Fibrosus - strong radial tire–like structure made up of lamellaeThe annulus fibrosus encloses the nucleus pulposus.
- 2. Nucleus Pulposus - gel-like pad that absorbs shock.
What does the Thoracic cage and Ribs consist of?
- Ribs (12 pairs).
Why are Ribs 11 + 12 called 'floating ribs'?
They are called 'floating ribs' because they are only attached to the vertebrae.
How many bones in the Appendicular Skeleton and what is it's function?
- There are 126 bones in the appendicular skeleton.
- Their main functions are;
- 1. Body movement
- 2. Protects organs of digestion, excretion and reproduction.
What are the 6 major areas of the Appendicular Skeleton?
- 1. Shoulder Girdle.
- 2. Arm.
- 3. Hand.
- 4. Pelvic Girdle.
- 5. Leg.
- 6. Foot.
Name the main bones in the Arms and Shoulder.
- 1. Clavicle (collar bone).
- 2. Scapula (shoulder blade).
- 3. Humerus (funny bone).
- 4. Ulna (elbow)
- 5. Radius (arm bone).
- 6. Carpals (wrist bones).
- 7. Metacarpals ([meta=after/along], hand bones).
- 8. Phalanges (finger/toe bones).
Name the main bones in the Pelvic Girdle?
- 1. Hip Bones.
- 2. Sacrum.
- 3. Coccyx.
Name the main bones in the Leg?
- 1. Femur - (thigh bone) longest and strongest bone in the body.
- 2. Tibia (shin bone).
- 3. Fibular (lower leg bone).
- 4. Tarsals (anke bones).
- 5. Metatarsals ([meta=after/along], foot bones).
- 6. Phalanges (toe/finger bones).
Muscle Origin and Insertion: Definition and Actions
- The muscle's points of attachment to bones or other muscles are designated as origin or insertion.
- 1. The part of the muscle that does move is is called the origin.
- 2. The part of the muscle that does move is called insertion.
What fibrous structures are attached to muscles?
Why are the attachment of joints so important to our muscles?
Attachments bridge one or more joints so that muscle contraction produces movement of these joints.
How many joints are there in the human body?
What are the characteristics of fibrous joints and give an example?
E.g. Suture, like those between skull bones.
- 1. Connected by dense connective tissue.
- 2. Limited movement.
What are the characteristics of cartilaginous joints and give an example?
e.g intervertebral discs, epiphyseal growth plate.
- 1. Limited to no movement.
- 2. Connected by hyaline cartilage or fibrocartilage.
What are the characteristics of synovial joints and give an example?
e.g. ‘ball and socket’ (shoulder & hip) & hinge (elbow & knee).
- 1. Free movement.
- 2. Covered by a layer of hyaline cartilage called articular cartilage that reduces shock/friction.
- 3. Covered by articular capsule which unites articulating bones.
- 4. Contains synovial fluid.
What are Bursae?
Bursae are sac-like structures that are strategically located to reduce friction.
As well as the Bursae we also have Tendon Sheaths. What are these?
A tendon sheath is a layer of synovial membrane around a tendon.
Describe what Angular Movements are?
Increase or decrease in the angle between bones.
List the 8 angular movements?
- 1. Flexion - Decrease in angle (usually saggital plane)
- 2. Extension - Increase in angle (usually saggital plane)
- 3. Hyperextension - Extension beyond anatomical position
- 4. Rotation - movement around its longitudinal axis. In the limbs it can be medial
- (towards the midline) or lateral (away from the midline)
- 5. Lateral flexion - Movement of trunk away from the midline
- 6. Abduction – Movement away from Midline
- 7. Adduction – Movement towards Midline
- 8. Circumduction – Circular - flexion, abduction, extension, hyperextension,
- adduction in succession.
What is hypermobility and how could it affect bones and joints?
- Joint hypermobility means that some or all of a person's joints have an unusually large range of movement.
- This can cause dislocations.
List the 11 Special Movements?
Occur at specific joint:
- 1. Elevation - Superior movement (up)
- 2. Depression - Inferior movement (down)
- 3. Protraction - Anterior movement in transverse plane (forward).
- 4. Retraction - Posterior movement in transverse plane (backward)
- 5. Inversion – Medial movement of sole (turn in).
- 6. Eversion – Lateral movement of sole (turn out).
- 7. Dorsiflexion – Bending foot up.
- 8. Plantar flexion – Bending foot down.
- 9. Supination – Movement of forearm to turn the palm up.
- 10. Pronation – Movement of forearm to turn the palm posteriorly.
- 11. Opposition – Movement of thumb across palm to touch fingertips.
What is a fracture and how is it caused?
A fracture is any break in a bone.
Causes included trauma, low bone density, Vitamin D deficiency.
Name the 6 different classified Fractures.
- 1. Complete - completely separated.
- 2. Incomplete - remains intact/simple fracture.
- 3. Linear - along bone length.
- 4. Transverse - dissects across bone.
- 5. Compound - protrudes through skin.
- 6. Simple - does not protrude skin.
Name the 4 stages of Fractures Repair?
- 1. Haematoma & Inflammation.
- 2. Fibrocartilaginous Callus Formation.
- 3. Bony Callus Formation.
- 4. Bone Remodelling.
Describe the 4 stages of Fractures Repair.
- Blood leaks into fracture site.
- Phagocytes breakdown damaged cells. Fibroblasts invade fracture site and lay down collagen forming a soft callus. (2-3 weeks).
- Osteoblasts replace fibrocartilage with new bone (3 months).
- The callus is mineralised & compact bone laid down. Osteoclasts reshape the new bone. (months-years).
What are some treatments for a fracture?
Improve circulation and nutrients to the bone to aid repair.
Describe what a sprain is and how to treat it?
- A sprain is when trauma forces the joint to go beyond its normal range.
- This causes stretching/tearing of ligaments.
What are ligaments?
Ligaments are bands of connective tissue that attach bone to bone. They are tougher than muscle but less flexible.
How would you normally treat a sprain?
RICE - Rest, Ice, Compression, Elevation
What is a Subluxation?
Incomplete or partial dislocation of a joint or organ.
What is a Dislocation?
Complete separation of two bones at a joint.
Name a complication due to Dislocation?
Soft tissue damage possibly involving nerves and blood vessels.
What are X-Rays used for?
Commonly used to visualise lungs, heart, teeth and skeletal system.
What do X-Rays release upon a specified region in the body?
How does an X-Ray work?
- An X-ray will pass through less dense matter like air, fat, muscle, but absorbed or scattered by denser materials such as bones, lungs affected by severe
- pneumonia, appearing white.
What is one of the main side affects of having an X-Ray.
The radiation can cause cancer.
Describe what Kyphosis is?
A normal healthy spine curve will include a thoracic spine kyphosis.
[Kyphos] - hump
What is the term called when one has an excess curvature of the upper back?
Describe what Lordosis is?
A normal, healthy spinal curve will include a cervical spine and lumbar spine lordosis.
When would Lordosis be adapted in women?
During pregnancy to support the cervical and lumbar spine.
What are some of the side affects of exaggerated lordosis?
- 1. Muscular Fatigue.
- 2. Encourages the vertebral joints to move closer causing inflammation.
What is Scoliosis?
A lateral 'S' shaped curve in the spine.
What symptoms does a Scoliolisis have?
People often live with a scoliosis and are asymptomatic.
What damage can Scoliosis do?
Scoliosis can build up pressure on the nerves and cause spinal nerve impingement.
What is Osteoporosis?
Chronic, progressive thinning of the bone.
How is Osteoporosis characterised?
It's characterised by decreased bone mineral density (BMD).
Name the 2 types of Osteoporosis?
- 1. Primary osteoporosis: Age related or idiopathic (unknown cause).
- 2. Secondary osteoporosis: Secondary to
- another condition/medication/lifestyle.
What type of scan would you use to measure BMD?
a Dexa Scan.
What 2 types of readings are there in a Dexa Scan?
- 1. T-Score (compared to young normal adult of same sex -age 30)
- 2. Z-Score <50yrs (compared to normal adult of same age, sex, height)
What are the risk factors for Osteoporosis?
- 1. Increasing age. (over 30 years o age the ability o retain calcium lowers).
- 2. Female & Post-menopausal.
- 3. Poor diet.
- 4. Drugs.
- 5. High alcohol consumption and smoking.
- 6. Genetics.
- 7. GIT diseases - liver disease, malabsorption syndromes.
- 8. Sedentaty lifestyle - little or no physical activity.
- 9. Endocrine problems - e.g. hyperparathyroidism, hyperthyroidism, inability to produce oestrogen.
- 10. Toxins (metals).
- 11. Low body weight.
What are the signs of Osteoporosis?
Asymptomatic until the bone has reached critical thinness whereby fragility fractures occur spontaneously with minor trauma.
What are the symptoms and side affects of Osteoporosis?
- Pain is usually severe.
- Pain is aggravated by increased sitting, standing or bending.
- Rib or spinal deformities such as kyphotic posture.
- Loss of height due to vertebral crushing and fracture.
Treatment of Osteoporosis: Give one Allopathic and one Alternative?
Allopathic: Bisphosphonates (Aledronic Acid) – Inhibit osteoclast activity.
Alternative: Healthy non acidic diet.
Describe Osteomalacia & Rickets?
- [Osteo] =bone [malacia] = 'softening'
- Osteomalacia is characterised by decalcification of bone and 'softening'.
- Rickets occurs in patients under 18 years old.
- Osteomalacia occurs in adults or adolescents.
What are some causes of Osteomalacia & Rickets?
- Mainly caused by Vitamin D Deficiency.
- Could also have a secondary deficiency: malabsorption disorders.
What are the signs and symptoms of Osteomalacia & Rickets?
- 1. Deformed bones (bowing of legs).
- 2. Severe back pain.
- 3. Severe muscle weakness.
- 4. Fracture
- 5. In rickets: Delayed closure of fontanelles and skull softening.
What is Hypercalcaemia?
[Hyper] =elevated [calc] =calcium [aemia] = in the blood
Elevated blood calcium.
What are some causes of Hypercalcaemia?
- 1. Uncontrolled release of calcium from bones e.g. tumour.
- 2. Hyperparathyroidism. (hyperparathyroidism, an enlargement of one or more of the parathyroid glands causes overproduction of the hormone, resulting in high levels of calcium in the blood)
What are some signs and symptoms of Hypercalcaemia?
- 1. Muscle weakness.
- 2. If high calcium is coming from the bones, bone density will be compromised and fractures may occur.
What is Osteomyelitis?
[Osteo] = bone [myelo] = marrow [itis] = inflammation
- A bacterial infection of the bone marrow resulting in necrosis(death of cells) of bone cells and hence becomes weak.