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Chapter 1
BONES & JOINTS
Arthrology – Joints (10-13)
Study of joints Classification
Function Structure Movement
ClassificationStructure Movement Types
Syn-arthrosis
Fibrous Immovable SyndesmosisSutureGomphosis
Ampi-arthrosis
Cartilaginous Slightly movable
SymphysisSynchondrosis
Di-arthrosis
Synovial Freely movable
Plane – glidingGinglymus – hingeTrochoid – pivotEllipsoid – condyloidSellar – saddleSpheroid – ball/socket
TYPES OF SYNOVIAL JOINTS
Preferred name
Old Name Direction of Movement Examples
Plane gliding slide over one another -carpals -tarsals
Ginglymus hinge movement in one direction – flex/ext
-elbow –knee
Trochoid pivot rotational movement -C1/C2 -radioulnar joints
Ellipsoid condyloid movement in 2 directions - 90° to each other- flexion/extension - abduction/adduction
-2nd through 5th MCP jts -MCT jts, - wrist
Sellar saddle opposing surfaces are concavoconvex
-1st CMP jt. -calcaneal-cuboid jt,-ankle
Spheroid ball &socket
movement in all directionscircumduction
-hip-shoulder
Parts of a Synovial Joint Fibrous capsule
Encircles the joint Joint cavity
Space within the capsule Synovial tissue
Lines the joint cavity Synovial fluid
Viscous lubricating fluid to reduce friction produced by tissue Hyaline articular cartilage
Protects the ends of the bone making up the joint Accessory ligament
Give the joint stability See page 219 - knee ACL, PCL, Medial, Lateral
Osteology – bones (6-9)
Study of bones 206 bones Born with 300+ Axial – 80 Appendicular – 126
Classification
Long - radius, ulna, phalanges Short – carpal and tarsal Flat – scapula, sternum Irregular - vertebrae Sesamoid - patella
Function
1. Protection2. Support3. Movement - work as levers4. Hemopoises5. Reservoir
Parts of a long bone Body 2 bone ends Spongy Cancellous Periosteum Medullary cavity Endosteum Bone marrow
Red bone marrow – cancellous bone – bone ends Yellow bone marrow – in medullary cavity
Hyaline cartilage Nutrient artery Nutrient foramen
Ossification
Bone formation Intramembaranous - starts as a membrane –
found in places that are needed for protection – forms rapidly
Endochondral – starts as cartilage – found in long bones – forms slowly
Ossification cont
Totally formed at age 25 – last bone to form is the clavicle
Primary ossification centers Diaphysis
Secondary ossification centers Epiphysis & metaphysis Epiphyseal plate – between epiphysis and
diaphysis/metaphysis
Bone Cells Osteoblasts
On surface of bone cells Have processes and organelles Very active Secrrete a substance to make osteoid tissue “bone forming cells”
Osteocytes Developed osetoblasts Found within matrix “bone cell”
Osteoclasts On surface of growing tissue giant cells with many
nuclei and organelles Secrete substance that breaks down mineral salts Bone destroying cells
COMPACT BONE Microscopic – dense and formed into a Haversian
system – surrounds all bone System – parts
Lamellae – concentric, cylinder shaped layers of calcified matrix
Lacunae – “little lakes”, small spaces containing tissue fluid where osteocytes are located between the layers of lamellae
Canaliculi – canals that connect the lamellae to each other and then to the Haversian canal
Haversian canal – extend lengthwise through the center of each system – contain a lymph and blood vessel
Volkmann’s canal small channels that connect the Haversian systems
CANCELLOUS BONE
Meshwork of bone tissue – spongy in appearance
Forms the ends of long bones and the middle of flat bones
No Haversian systems Web-like arrangement of marrow filled spaces
separated by thin processes of bone called trabeculae
Located along the lines of stress placed on the bone
Enhances bone’s strength
PARTS of a BONE Condyle – rounded process Coracoid/coronoid – beak-like process Cornu – horn-like process Crest – ridge-like process Epicondyle – process above a condyle Facet – smooth surface for articulation Hamulus – hook-like process Head – expanded end of the bone – prox or distal Line – ridge-like process – smaller than a crest Malleolus – mallet or hammer like process Protuberance – bony projection Spine – sharp process Styloid – long pointed process – 3 in body Trochanter – Tubercle - Tuberosity
BONE DEPRESSIONS Fissure – cleft or groove Foramen – hole in a bone Fossa – pit , fovea or hollow Groove – shallow linear depression Meatus – tubular boney passage in a bone Sinus
A channel for venous blood An air filled cavity – within bone Fistula or channel
Sulcus – trench or fissure-like depression
FRACTURES
Partial Complete Simple – closed Compound – open Non-displaced – anatomic apposition Displaced – lack of apposition
FXs cont Incomplete
Chip Avulsion Greenstick Torus - Buckle
Comminuted butterfly
Complete Transverse Oblique Spiral
Specifically named Salter – epipyseal fx Bimallar, Trimallar Colles’ –distal radius– posterior angulation Smith – distal radius – anterior angulation
HEALING of a FRACTURE
4 steps 1. Blood escapes from ruptured blood vessels
an d forms a hematoma 2. Spongy bone forms in regions close to
developing blood vessels and fibrocartilage (COLLAGEN) forms in more distant regions
3. Fibrocartilage is replaced by a BONY CALLUS
4. Osteoclasts remove excess bone tissue, making new bone structure much like the original
BONE DISORDERS
Osteoporosis – bones become less dense Osteopetrosis – bones become more dense Paget’s disease – irregular thickening and
softening of the bone Osteomyelitis – infectious diseases of the
bone Osteomalacia - (Demineralization) bones
loose their calcium content and become soft
POSITIONING ROUTINES pg 36 Long bone
2 images – AP/PA – shows if things are medial or lateral Lateral –shows if things are anterior or posterior
90 degrees from each other include both joints
Joints – min 3 images - AP/PA, Lateral and Oblique Do not remove splints, BBs If fractured – support proximal and distal to fx site Radiograph each side separately if ordered bilateral Radiograph each exam separately if multiple exams are
ordered
POSTIONING cont One exposure per cassette when using
CR/DR Place marker on lateral aspect for an AP/PA Place marker on the anterior aspect for a
lateral Name blocker
Patient name Date of exam Institution Patient/exam identification number