1. health and fitness
2. disease
3. arthritis

PowerPoint® to accompany
Medical Assisting
Chapter 25
Second Edition
Ramutkowski  Booth  Pugh  Thompson  Whicker
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
1
The Skeletal System
Objectives
25-1
25-2
25-3
25-4
25-5
Describe the parts of a long bone.
List the substances that make up bone tissue.
List the functions of bones.
Describe how long bones grow.
List the bones of the skull, spinal column, rib
cage, shoulders, arms, hands, hips, legs, and feet.
25-6 Describe the location of each bone.
25-7 Define fontanels and explain their importance.
2
The Skeletal System
Objectives (cont.)
25-8 List different types of bone fractures and describe
their characteristics.
25-9 Explain how fractures heal.
25-10 Describe the three major types of joints and give
examples of each.
25-11 Describe the structure of a synovial joint.
25-12 Describe the characteristics, causes, and
treatments of various diseases and disorders of the
skeleton.
3
Introduction
 Bones provide the
body with
structure and
support.
 You will learn about
the bones of the
body, their structure,
and how the joints of
the body work.
The skeletal system is composed of 206 bones as well as joints
and related connective tissues.
4
The Skeletal System
5
Bone Structure
 Bones contain various
kinds of tissues,
including osseous
tissue, blood vessels,
and nerves.
 Osseous tissue can
appear compact or
spongy
6
Bone Structure (cont.)
 Compact bone
looks solid;
however, the
following
structures can be
observed with a
microscope
 All bones are made
up of both
compact and
spongy bone
7
Classification of Bones
Long bones - located primarily in the arms and legs femur (thigh bone) & humerus (upper arm
bone)
Short bones - small bones are located in the wrists and
ankles - carpals (wrist bones) & tarsals
(ankle bones)
Flat bones - located in the skull and rib cage - ribs and
frontal bone
Irregular bones - vertebrae and the bones of the
pelvic girdle.
8
Functions of Bones
 Shape to body parts
 Support and protect soft structures in the body
 Body movement since skeletal muscles attach
to them
 Red bone marrow of bone produces new
blood cells
 Store calcium for the body
9
Bone Growth
 Ossification – process of bone growth
Intramembranous ossification –
 bones begin as tough, fibrous membrane
 bone-forming cells called osteoblasts turn the
membrane to bone (located in skull)
Endochondral ossification
 bones containing some cartilage between an epiphysis
and the diaphysis will continue to grow
 cells that form holes in bone are called osteoclasts
10
Apply Your Knowledge
Why is it important for the bones to
store calcium?
11
Apply Your Knowledge -Answer
Why is it important for the bones to
store calcium?
Every cell in the body needs calcium so the
body must have a large supply readily available.
12
Bones of the Skull
Two types:
 Cranial-form the top, sides, and back of the
skull
 Facial bones-form the face
“Soft spots" felt on an infant's skull are
actually fontanels.
 Tough membranes that connect the
incompletely developed bones.
13
Bones of the Skull (cont.)
Parietal -form most of the
top and sides of the
skull.
Occipital - forms the back
of the skull
Temporal - form the
lower sides of the skull
Sphenoid bone - part of
the floor of the cranium
Ear ossicles are the
smallest bones of the
body
 Malleus
 Incus
 Stapes
14
Bones of the Skull (cont.)
Mandible - the lower jaw
bone
Maxillae - form the upper
jawbone
Zygomatic - form the
prominence of the
cheeks
Nasal bones - fuse
together to form the
bridge of the nose
Palatine - form the
anterior portion of the
palate
Vomer - a thin bone that
divides the nasal
cavity.
Click to see Skull
15
Bones of the Skull (cont.)
Back
16
Can you name these bones of the skull?
Bones of the
Spinal Column
Spinal column





7 Cervical vertebrae
12 thoracic vertebrae
5 lumbar vertebrae
A sacrum
A coccyx
17
Bones of the Spinal Column
(cont.)
Cervical vertebrae




Smallest and lightest
Located in the neck
region
First one is atlas
Second one is axis
Thoracic vertebrae

Join the 12 pairs of
ribs
Lumbar vertebrae

Have very sturdy
structures
Sacrum
A triangular-shaped bone
that consists of five fused
vertebrae
Coccyx
A small, triangular-shaped
bone made up of 3 to 5 fused
vertebrae
Considered unnecessary.
More commonly called the
tailbone.
18
Bones of the Rib Cage
12 pairs of ribs
 Attached
posteriorly to
thoracic
vertebrae
Sternum
 Forms the front,
middle portion
of the rib cage
19
Bones of the Shoulders,
Arms and Hands
Shoulders - pectoral girdles and include
clavicles and scapulae
Upper limb or arm bonesthe humerus, radius, and ulna
Hand - carpals, metacarpals,
and phalanges
20
Bones of the Hips, Legs
and Feet
Hipbones - pelvic girdle or coxal bones
Bones of the lower limb or leg - femur,
the patella, the tibia, and the fibula
Bones of the foot - the tarsal,the
metatarsals, and
the phalanges.
21
Apply Your Knowledge
A patient has arrived in the office
complaining of hurting his finger while
playing basketball. You would suspect
that he had hurt which bone of the hand?
22
Apply Your Knowledge -Answer
A patient has arrived in the office
complaining of hurting his finger while
playing basketball. You would suspect
that he had hurt which bone of the hand?
Phalanges are the bones of the fingers.
23
Bone Fractures
 Bone fractures can be
classified in many
ways
 Broken bone may take
3 months or longer to
heal
 Healing depends on
type of fracture and the
general health of the
patient.
 Stress fracture bone breaks due to
trauma such as a car
accident or sports
injury
 Pathologic fracture bone breaks due to
some disease process
24
Bone Fractures (cont.)









Closed (simple)
Open (compound)
Complete
Incomplete
Greenstick
Hairline
Comminuted
Displaced
Nondisplaced








Impacted
Depressed
Linear
Transverse
Oblique
Spiral
Colles
Potts
25
Body’s Repair of the Bone
 A hematoma (blood clot) forms around the
fracture.
 Granulation tissue slowly replaces the
hematoma.
 Soft callus is formed that replaces the
granulation tissue.
 Hard callus replaces the soft callus.
 Hard callus is remodeled so that it takes on
the shape of the original bone.
26
Falls and Fractures
 Falls account for about 50% of all fractures
 Teach patients about preventing falls
 Persons most at risk for falling are those with the
following conditions:






Muscle weakness & poor vision
Difficulty walking
Dependence on bifocals
Hearing loss
Alzheimer’s disease
Parkinson’s disease
27
Falls and Fractures (cont.)
Falls can be prevented through the following
steps:
Awareness - Educate patients to try not to climb
or stretch for items that they use regularly.
Balance - Patients should stand up gradually,
especially from a lying-down position
Lifestyle - Recommend that patients clean up any
clutter in their living space so that they are less
likely to trip on items
28
Joints
Junctions between bones
Classified as:
 Fibrous - connected together with short fibers
 Cartilaginous - connected together with a
disc of cartilage
 Synovial –joints are covered with hyaline
cartilage and are held together by a fibrous
joint capsule
29
Synovial Joints
 Joint capsule is lined with a
synovial membrane.
 Membrane secretes a
slippery fluid called
synovial fluid, which allows
the bones to move easily
against each other.
 Bones are also held together
through tough, cord-like
structures called ligaments.
 Synovial joints are freely
moveable.
30
Apply Your Knowledge
Your patient complains of getting dizzy
every time she gets up from her chair.
What patient education fact should you
give the patient that would prevent her
from falling?
31
Apply Your Knowledge -Answer
Your patient complains of getting dizzy
every time she gets up from her chair.
What patient education fact should you
give the patient that would prevent her
from falling?
You should stand for a few seconds before walking.
This allows time for blood flow to reach the brain,
preventing dizziness.
32
Diseases and Disorders
of Bone
 Bursitis - inflammation of a bursa
 Carpal Tunnel Syndrome - occurs when
the median nerve in the wrist is excessively
compressed.
 Ewing’s Family of Tumors (EFT) - a group
of tumors that affect different tissue types
 Gout - a type of arthritis
33
Diseases and Disorders
of Bone (cont.)
 Osteogenesis Imperfecta - more commonly
called brittle-bone disease
 Osteoporosis - a condition in which bones
become thinned over time
 Osteosarcoma - a type of bone cancer that
originates from osteoblasts, the cells that
make bony tissue
34
Diseases and Disorders
of Bone (cont.)
 Paget’s Disease causes bones to
enlarge and become
deformed and weak.
 Scoliosis - an
abnormal curvature
of the spine.
35
Educating the Patient
Teach your patients
about:





Building Better Bones
Bone-Healthy Diet
Bone-Healthy
Exercises
Bone-Healthy
Exercises
Bone Tests
36
Apply Your Knowledge
The doctor has told your patient that he has a
osteosarcoma. What do you know about this
disorder?
37
Apply Your Knowledge -Answer
The doctor has told your patient that he has a
osteosarcoma. What do you know about this
disorder?
Osteosarcoma is a type of bone cancer that
originates from osteoblasts, the cells that make
bony tissue.
38
Summary
Medical Assistant
You will provide patient education and assist the
physician in the office when patients have problems
with the skeletal system.
You will need to know about the bones of the body,
their structure, and how the joints of the body work.
39
End of Chapter
40