MUSCULOSKELETAL

SYSTEM

EMERITA C. MENDOZA,
R.N., M.D.
 FUNCTIONS OF THE SKELETAL
SYSTEM

1. Bony framework for the body

2. Protects delicate vital organs
3. Levers that transmit muscular forces
 tendons
 ligaments
4. Bone marrow produces blood cells
5. Storage for calcium and phosphorus
 Structure of a Bone

• periosteum
• Diaphysis
• Epiphysis
• Metaphysis  mature
to epiphyseal lines
• Marrow cavity with
yellow bone marrow
• endosteum
PARTS OF
A BONE
 Types of Bone

• According to location:
• Axial – found along our midline axis
• Appendicular – found in our extremities

• According to shape:
• flat & irregular bones – many axial bones
• long and short bones – in our limbs
• pneumatic bones – have air spaces, e.g., skull
• sesamoid – in tendons, e.g., patella
 Types of Bone
• According to structure:
• Compact or dense bone – outer casing
• Spongy or cancellous bone – interior marrow

• According to development:
• Endochondral – during fetal development,
ossifies from a cartilage stage, e.g., long bones
• Membranous – develop from non-cartilage
connective tissue, e.g., flat, irregular bones
 Bone Ossification
OSTEOBLASTS
• bone-building cells
• Secrete the protein collagen
• Apatite – CaPO4 that crystallizes around
collagen fibers, forming hard bone matrix
• Osteoblasts become isolated/trapped in
the lacunae  osteocytes
 Bone Resorption
OSTEOCLASTS
• Cells that break down or collapse bone
• Large cells that move about secreting
enzymes that digest bone
*Osteoclasts & osteoblasts work together to
shape bones and to form the precise grain
needed in the finished bone
 How many bones
are in our skeleton?
• Axial: • Appendicular:

• upper limb girdle 64

• skull
• lower limb girdle 62
• cranium 22
& face
• auditory oss 6 • Axial = 80
• hyoid 1 • Appendicular = 126
• vertebrae 26
•
•
Ribs
sternum
24
1
• Total = 206
 The Skull

• 8 cranial bones
• 14 facial bones
• 6 small bones in the
middle ear
The Cranium
• protects the brain
• 4 major divisions:
• frontal bone - anterior
• parietals – central
• temporals - lateral
• occipital – posterior
• Plus the:
• sphenoid - base
• ethmoid – roof of nostrils

• frontal bone also known as

the “forehead bone”
 The Facial
bones
• 2 nasal bones
• 2 inferior nasal conchae
• 1 vomer – floor of nasal cavity
• 2 palatine – roof of oral cavity
• 2 zygomatic “cheekbones”
• 2 maxillae for upper jaw
• 1 mandible for lower jaw
• 2 lacrimal, where tears flow

• Mandible articulates with the

cranium at the temporomandibula
joint (TMJ)
The Auditory Ossicles
• sense vibration

• 3 inner ear bones:

• malleus or hammer –
articulates with
eardrum

• incus or anvil – articulates

with malleus & stapes

• stapes or stirrup –
articulates with oval
window
 Cranial Sutures
• Sagittal – joint bet the
two parietal bones
• Coronal – joins the
parietal bones to the
frontal bone
• Lambdoidal – joint bet
the parietal bones
and the occipital bone
 Fontanelles or soft spots

• Fibrous connective
tissue or cartilage that
occur at the angles of
the parietal bone
• Anterior – closes at 12-
18 months
• Posterior – closes at 3-
4 months
 Sinuses
• Air spaces lined w/
mucous membrane
found in some cranial
bones
• The paranasal
sinuses (located in
the frontal, maxillary,
sphenoid, & ethmoid
bones) are
continuous w/ the
nose and throat
 The Vertebral Column or Spine

• Supports the body & bears

its weight
• Regions:
– 7 cervical
– 12 thoracic
– 5 lumbar
– Sacrum
– Coccygeal
• S-shaped
• Vertebrae are attached to
each other via synovial
joints & by intervertebral
discs
 The Normal
Spine
• Has normal curves:
• lordosis – cervical, lumbar
concaving
• kyphosis – thoracic convexity

• intervertebral discs – maintain

flexibility, absorb shock; outer
annulus fibrosis, inner
gelatinous nucleus pulposus

• With age, loss of H2O content

causes decrease in disc height
 The Thoracic Cage or rib cage
• Bony cage formed by
the sternum, the
thoracic vertebrae, &
12 pairs of ribs
• Protects the organs of
the chest
• Supports the pectoral
girdle & upper
extremities
• Role in respiration
The Ribs

• Articulates with the

thoracic vertebrae at
facets
• Since there are 12
thoracic vertebrae, how
many ribs should we
have?
• 12 pairs or a total of 24
• Spaces in between the
ribs are called
intercostal spaces
(ICS)
True, False, & Floating Ribs
• Ribs 1-7 are “true”
ribs, because they
attach directly to the
sternum
• Ribs 8-10 are “false”
ribs, because they
attach to the rib
above
• Ribs 11-12 are
“floating” ribs,
because they have no
anterior attachments
 The Pectoral Girdle or shoulder

• Attaches the UE to
the axial skeleton
• Consists of:
– Scapula – shoulder
blade
– Clavicle – collar
bone
• Articulates with the
sternum via the
clavicle but not with
the vertebral
column
The “Shoulder Blade”: Scapula
• Major parts of the
shoulder blade:
• spine of scapula, or
acromion, with
coronoid
• coracoid process
• glenoid fossa
• clavicular facet

• The scapula serves as

origin for many muscles,
articulates with the
clavicle, and offers the
fossa for humeral
articulation (the shoulder
joint).
The “Collar bone”: Clavicle
• small, thin, long & flat
bone
• articulates with the
sternum at the angle of
Louis; and with the
shoulder blade by a facet
that accepts the shoulder
blade, and by strong
ligaments to the shoulder
blade
• If fractured, the shoulder
falls medially, forward, and
slightly downward
• commonly known as a
“greenstick” fx in children
The Upper Extremity
• Consists of 30 bones:
– Humerus – upper arm
– Ulna - forearm
– Radius - forearm
– Carpal bones - wrist
– Metacarpals - palm
– Phalanges - fingers
Upper Arm: The Humerus
• articulates with the
pectoral girdle at the
glenoid fossa of the
shoulder joint
• typical long bone
• articulates with the
radius & ulna at the
humeral capitulum &
olecranon fossa-trochlea
of the elbow joint,
respectively
• has radial and ulnar
grooves – for nerves
• Commonly fractured,
described in 1/3’s
Forearm: Radius & Ulna
• The smaller radius articulates
with the humerus with its
head
• The larger, wrench-shaped
ulna, articulates with the
humerus at the ulnar
olecranon
• Both articulate with carpals of
the hand as the carpal or
wrist joint via facets and
styloid processes
• Radial = thumb side
• Ulnar = pinky side
Hand bones, Palm: Carpals
• 8 short bones in 2 rows
• Proximal: (r-u) scaphoid,
lunate, triquetrium,
pisiform
• Distal: (r-u) trapezium,
trapezoid, capitate, hamate
• “Scared Lovers Try
Positions That They Can’t
Handle”
• If you fall and land on your
hand, which bone is most
likely to break?
• Colle’s fx = dinner fork
deformity of the wrist due
to fx of the radius
More Hand bones:

• There are 5 pairs of

metacarpals, or “knuckles
bones”
• Each finger, or digit, has 3
phalanges
• The thumb has 2
phalanges
• metacarpo-phalangeal
joints are MCP’s
• joints between 1st & 2nd
phalanges are PIP’s
metacarpals and • joints between 2nd & 3rd
phalanges are DIP’s
phalanges
 The Pelvic Girdle
• Supports the LE &
is the site of
attachment of major
muscles of the
trunk and LE
• Supports the weight
of the upper body &
protects the organs
that lie within
• Two innominate
bones + sacrum &
coccyx = pelvic
girdle
Parts of the “Hip • Looks like two fish eating a

bone”
butterfly
• ASIS = anterior superior iliac
spine, important landmark
• PSIS – lies deep to a dimple
• ischial tuberosity – part we sit on
• symphysis pubis – fibroelastic
connection between two pubic
bones
• acetabulum – depression for the
head of the femur
• greater sciatic notch – opening
for sciatic nerve
• lesser sciatic notch
• obturator foramen – for obturator
nerve
• linea terminalis, or pelvic brim –
separates “false pelvis” above
from “true pelvis” below
 Female pelvis
• Broader and more
shallow
• Pelvic inlet is larger &
more circular
• Ischial spines are shorter
with greater relative
distance bet them
• Greater angle bet the
pubic bones
• Adapted for a developing
baby & its delivery
 The Lower Extremity

• Consists of 30
bones:
– Femur – upper leg
or thigh
– Patella – or kneecap
– Tibia & fibula –
lower leg or shin
– Tarsal bones – back
part of foot & heel
– Metatarsals – main
part of the foot
– Phalanges - toes
The “thigh bone”: Femur
• longest bone of the body
• acetabular head articulates with
the pelvic acetabulum
• neck – commonly fractured, esp.
in postmenopausal women with
osteoporosis (excessive bone
resorption)
• greater trochanter – for
attachments, e.g., gluteus m
• lesser trochanter – for the
iliopsoas m.
• shaft
• epicondyles – for attachment of
medial & lateral collateral
ligaments of the knee joint to the
leg bones, and articulation with
the tibia
• trochlea – facet for patella
The “knee cap”: Patella
• sesamoid bone
• articulates with the femoral
trochlea above and the
tibial head below
• surrounded by
ligaments,e.g., anterior &
posterior cruciates, medial
(tibial) & lateral (fibular)
collaterals
• prepatellar bursa is
associated with gouty
arthritis when excess uric
acid is produced, causing
arthritic pain
The leg bones: Tibia & Fibula
• leg also known as crus,
• anterior leg as shin
• articulates with the femur via the
larger, medial tibia
• the smaller, lateral fibula is
mostly for attachment of mm
• tibia-fibula joined together by an
interosseous membrane
• medial (tibial) malleolus = inner
ankle, area prone to sprain
• lateral (fibular) malleolus = outer
ankle, prone to fracture
• lower quadrangular surface of
tibia bears much weight on the
foot
 The
Ankle
Bones

tibia
fibula
talus
The Foot bones, Sole: Tarsals
• the tall talus receives
the weight from the
tibia
• rests on a “calcified
rock,” the calcaneus
• mid-sole are the
navicular, cuboid, and
three cuneiforms
• cuboid and
cuneiforms articulate
with the metatarsals
The Toes: Metatarsals & Phalanges

• cuboid articulates with

metatarsals 4-5
• cuneiforms articulate
with metatarsals 1-3
• the four smaller toes
have 3 phalanges
• the big toe, like the
thumb, has two
• the second metatarsal
is prone to march fx
• hallux valgus - The 1st
MTP joint may be
affected by pointed
shoes
• The 1st MTP is also
commonly inflamed in
gouty arthritis
 Joints (Articulations)
• Point of contact bet
two bones
• For flexibility and
movement
 Synovial Joints
• Most of body’s joints
• Joint capsule lined w/ a smooth
synovial membrane that secretes a
lubricating synovial fluid
• Fluid-filled sacs called bursae
cushion the movement of bone over
other tissues
Types of Movable
Joints

• Enarthrosis – ball-and-socket
of shoulder, hip
• Ginglymus – hinge of
elbow, digits, ankle,
mandible
• Condyloid – knee, MCP, wrist
• Trochoid – pivot of atlas,
radioulnar
• Arthrodial – sliding of
acromioclavicular jt, CMC,
knee, ribs, sternoclavicular,
subtalar, tibiofibular
• Saddle - vertebra
 MUSCULAR
SYSTEM
• ORIGIN:
– The attachment of
muscle to the less
movable bone

• INSERTION
– The attachment of
the muscle to the
more movable bone
Flexion Decreasing the angle between two
bones; bending a limb
Extension Increasing the angle between two bones;
straightening out a limb
Abduction Movement away from the midline of the
body
Adduction Movement toward the midline of the body
Rotation Circular movement around an axis
Dorsiflexion Backward (upward) bending of the foot
Plantar flexion Bending the sole of the foot downward
toward the ground; toe pointing
Supination As applied to the hand, the act of turning
the palm forward, or up
Pronation As applied to the hand, the act of turning
the palm backward, or down