Musculoskeletal System Notes

Bones

• Act as a framework for the body.

• Protect internal organs.

• Store calcium.

Bone Marrow

• Present in long bones.

• Red bone marrow:

  • Helps with the production of all kinds of blood cells.

• Yellow bone marrow:

  • Stores fat.

• Hematopoiesis: $hemet$ means blood cells, $poiesis$ means production.

  • Production of all types of blood cells in red bone marrow.

Cartilage

• Found in areas like the ear and nose.

• Creates a smooth surface for motion within joints.

• Protects the ends of bones.

Joints

• Work with muscles to enable various motions.

• Types determined by the need for flexibility.

Ligaments and Tendons

• Tendons:

  • Join muscles to bones.

  • Memorization tip: tendons connect ‘‘two different things’’ (muscles and bones).

• Ligaments:

  • Connect bone to bone.

Synovial Membranes and Fluids

• Synovial membranes:

  • Line synovial joints.

  • Secrete synovial fluid.

• Synovial fluids:

  • Reduce friction in the joints for smooth movement.

Bursa

• Cushioning area in joints.

• Closed sac of synovial fluid with a synovial membrane, located near but not within a joint.

• Needed where sliding must take place.

Exam Focus

• Vocabulary (terms and meanings).

• Diseases (pathology).

• Multiple-choice questions and matchings.

• Diagram labeling (rare).

Musculoskeletal System Components:

• Bones, muscles, and joints.

Physicians Associated with the Musculoskeletal System

• Orthopedist:

  • Deals with bones and muscles.

• Rheumatologist:

  • Deals with arthritis and joint problems.

• Physiatrist:

  • Focuses on rehabilitation.

• Osteopathic physician:

  • Deals with bone infections and related issues. Related to the bones.

Bone Formation

• Ossification:

  • Replacement of cartilage with bone (hardening process).

  • Natural process of bone formation, the hardening of a muscular tissues into a bony substance.

• Bone remodeling:

  • Process of laying down new bone material by cells.

Bone Cells Types

• Osteoblasts:

  • Build new bone cells.

  • Construction crew that builds new bone cells.

  • Strengthen existing bones and form new bones, help with healing any damage or broken bones inside our body.

• Osteocytes:

  • Bone cells that nourish and maintain the bone.

  • $osteo$ means bone, $cyte$ means cell.

• Osteoclasts:

  • Reabsorb and digest bone, break off.

  • They break down the bones in simple words.

• Osteoblast and osteoclast:

  • Work to deposit and tear down bone throughout life.

• Skeleton as a Calcium Source

  • Bone formation depends on calcium, phosphorus, and vitamin D.

  • Vitamin D increases calcium absorption; calcium phosphate enzymes help create hard bones.

Calcium and Muscle Contraction

• Calcium is necessary for nerve transmission to muscles.

• Muscle contraction facilitates everyday activities.

• Calcium level is maintained in the blood by the parathyroid gland. It secretes a hormone to release calcium from the bone. Parathyroid increases calcium levels in the blood.

• Vitamin D deficiency impacts bones.

Calcitonin vs. Parathyroid

• Calcitonin:

  • Decreases calcium levels by sending extra calcium to bones for storage.

• Parathyroid:

  • Increases calcium levels by taking calcium from bones and releasing it into the bloodstream.

Bone Structure

• Long bones, short bones, flat bones, sesamoid bones, and irregular shaped bones

• Diaphysis: bone shaft (middle part)

• Epiphysis: ends of the bone

• Metaphysis: the middle part between the diaphysis and epiphysis

• Epiphyseal plate (growth plate): cartilage replaced by bone for bone growth in length

• Articular cartilage: cushions joints and allows smooth movement (joint)

• Cancellous bone: spongy bone

• Compact bone: dense bone

• Medullary cavity

• Periosteum

Bone Diagram Explanation

• Articular cartilage covers the end of the bone in the joint, cushioning it for smooth movement.

• Compact bone contains the Haversian system for blood vessels, nerves, and yellow bone marrow.

• Cancellous bone (spongy bone) contains red bone marrow for blood formation.

• Yellow marrow is primarily fat.

• Red bone marrow is rich in blood vessels and blood cells in development stages.

• Hematopoiesis is the production of all types of blood cells in the red bone marrow.

• Processes serve as attachments for muscles, tendons, and ligaments; depressions serve as passageways for nerves and vessels.

• Femur bone (thigh bone) is an example.

• Condyle and epicondyle are knuckle-like structures.

• Only long bones have red bone marrow and are responsible for blood cell production.

Cranial Bones

• Frontal (forehead).

• Ethmoid.

• Sphenoid.

• Temporal.

• Occipital.

• Parietal (crown bone).

• Sutures (brain joints): immovable joints.

• Mastoid and styloid processes (sharp projections).

• Temporomandibular joint: where the temporal bone joins the mandible bone.

Facial Bones

• Zygomatic (cheekbones).

• Lacrimal (tear bones near tear duct).

• Nasal.

• Vomer (tip of the nose).

• Maxillary (upper jawbone).

• Mandibular (lower jawbone).

• Mental foramen

Sinuses

• Air cavities located in facial cranial bones.

• Lighten skull and warm/moisten air.

Vertebrae (Spine Bones)

• Total of 26 bone segments from skull base to tailbone in five divisions.

• Separated by intervertebral discs (pads of cartilage).

• Cervical ($C1$ to $C7$).

• Thoracic ($T1$ to $T12$).

• Lumbar ($L1$ to $L5$).

• Sacral (sacrum).

• Coccyx (tailbone).

• Lower back problems usually occur at $L3$ and $L4$.

Other Bones:

• Thorax (clavicles, scapula, sternum, ribs).

• Pelvis (pelvic girdle, ilium, ischium, pubis).

• Arms and hands (humerus, ulna, radius, carpals, metacarpals, flanges).

• Leg and foot (femur, patella, tibia, fibula, tarsals, metatarsals, flanges).

Vocabulary (Important for Exams)

• Acetabulum: rounded depression in pelvis joining the femur.

• Acromion: outward extension of the shoulder blade.

• Bones: part of the skeletal system, supports and protects internal organs.

• Bone depressions: openings for connections or passageways.

• Bone process: enlarged area for muscle, tendon, and ligament attachments.

• Calcium: mineral constituent of bone.

• Phosphorus: Mineral constituent of bone.

• Cancellous bone: spongy, porous bone tissue/inner part of bone.

• Cartilage: hardest connective tissue.

• Collagen: protein strands in bone and tissues.

• Compact bone: hard, dense bone tissue.

• Cranial bones:

  • Skull bones (ethmoid, frontal, occipital, parietal, sphenoid, temporal).

• Diaphysis: long shaft of the bone.

• Disc: flat, round, plate-like structure.

• Epiphyseal plate: cartilaginous area at the end of long bones for lengthwise growth.

• Epiphysis: each end of a long bone.

• Facial bones:

  • Lacrimal (tear), mandibular (lower jaw), maxillary (upper jaw), nasal, vomer, zygomatic (cheek bones).

• Fontanel: soft spots in a baby’s skull that helps a baby's brain grow. Kids till the age of five have fontanels, not sutures.

• Foramen magnum: opening of the occipital bone through which the spinal cord passes.

• Haversian canal: contains blood vessels and nerves.

• Ligaments: connective tissues from one bone to another bone.

• Malleolus: rounded process on both sides of the ankle joint.

• Manubrium: upper portion of the sternum.

• Mastoid process: round projection on the temporal bone behind the ear.

• Medullary cavity: central hollowed-out area in the shaft of a long bone.

• Metaphysis: middle portion of a long bone between the epiphysis and diaphysis.

• Olecranon: large process on the proximal end of the ulna.

• Orthopedist: a medical doctor who specializes in bones, joints, and muscle condition.

• Osseous tissue: bone tissue.

• Ossification: process of bone formation.

• Osteoblast build new bone bone cells.

• Preostium: membrane that surrounds the bone and rich in blood vessels and nerve tissues.

• Phosphorus: mineral substance found in bone.

• Physiatrist: rehabilitation doctor.

• Pubic: area of the confluence of tubal pubic bones in the pelvis.

• Red bone marrow: production of all blood cells.

• Ribs: 12 pairs of curved bones protecting the lungs.

• Sacral

• Sacrum

• Electrotracica

• Depression on the siphonoid bone where the plutarary gland is located. Right

• Sinuses: hollow air cavities within a bone lighten the skull, warm, and moisten the air, enter the respiratory system.

• Styloid process: sharp processes extending downward from the temporal bone.

• Sutures: immovable joints between skull bones.

• Temporomandibular joint: connects temporal bone with the lower jaw bone.

• Tendon: fibrous connective tissue connecting muscle to bone.

• Trabeculae: supporting bundles of bony fibers in cancellous bone.

• Vertebra: segment of the spine.

• Xiphoid process: lower narrow portion of the sternum.

• Yellow bone marrow: mostly fat.

Combining Forms (Important Ones Noted)

• Calc/o: calcium.

• Lamino:

• Lardo:

• Myelo: bone marrow (important).

• Ortho: straight.

• Osteo: bone.

• Spondylo: vertebra.

Prefixes and Suffixes

• Prefixes are at the beginning of the word.

• Suffixes are at the end of the word.

• Combining forms are used to join prefixes and suffixes, such as -o-.

• -blast: building cells (embryonic cells).

• -clast: breaks down.

• -listhesis: slipping.

• -malacia: softening.

• -physis: to grow.

• -porosis: pore passage.

• -tome: instrument to cut.

Combining Forms (Examples)

• Acetabulo: acetabulum.

• Calcaneo: calcaneus (heel).

• Carpo: carpals (wrist bones).

• Claviculo: clavicle (collarbone).

• Costo: ribs.

• Cranio: cranium.

• Femoro: femur (thigh bones).

• Fibulo: fibula (smaller lower leg bone).

• Humero: humerus.

• Ilio: ilium.

• Ischio: ischium

• Malleolo:

Pathology (Diseases)

Bone Pathology

• Ewing sarcoma:

  • Malignant bone tumor (localized, metastatic, recurrent).

    • Localized: Found in bone or any soft tissue where it begins. Can spread to nearby tissues, including the lymph nodes as well.

    • Metastatic: Spreads very quickly to the different parts of the body.

    • Recurrent: The cancer has reoccurred after it has been treated

• Exostosis:

  • Benign (noncancerous) bone tumor. Bony overgrowth, but it's noncancerous.

• Osteogenic sarcoma:

  • Malignant tumor arising from bones.

• Osteomalacia:

  • Softening of the bone.

• Osteomyelitis:

  • Inflammation secondary to infection ($itis$ means inflammation).

• Talipes (clubfoot):

  • Congenital abnormality of the hindfoot involving the talus.

Fractures

• Simple fracture:

  • The bone is broken, but there is no open wound in the skin. Also known as a closed fracture.

• Compound fracture:

  • The bone is broken, and there is an open wound in the skin. The bone may come out or show a bruising. Also known as an open fracture.

• Comminuted fracture:

  • The bone is splintered or crushed into small pieces, painful fracture.

• Greenstick fracture:

  • Incomplete fracture where the bone is bent or partially broken, common in kids.

• Oblique fracture: Occurs at the ankle.

• Spinal fracture: again, the bone is twisted apart. Most of the time because of a sports injury.

• Stretch fracture: There are the small cracks from chronic or maybe excessive impact on the bone.

• Transverse fracture: Occurs straight across a bone.

Joints

• Articulation: coming together of two or more bones.

Joints Types

• Suture joints:
  * Immovable (skull joints).

• Synovial joints:
  * Freely movable.
  * Ball and socket (hip and shoulder).
  * Hinge (elbow joints, knee, and ankle).
  * Synovial joint capsule surrounds the bone.
  * Ligaments span bones together.
  * Bones are covered by articular cartilage, articular ganglion joint cartilage.
  * Synovial membranes, which lies under capsule, which has a synovial cavity, and that cavity is filled with the synovial fluid.
  * Meniscus as a productive cushions, and it's present in the knee.

Synovial Joints

• Joint capsule surrounds the bone.

• Ligaments span bones together.

• Bones are covered by articular cartilage.

• Synovial membrane lines the capsule with a synovial cavity filled with synovial fluid.

• Meniscus acts as a protective cushion (knee).

Joint Diagram

• Femur.

• Patella.

• Bursa.

• Articular cartilage/synovial joint.

• Tibia.

Synovial Fluid

• Within Synovial cavity (articulating). Provide librication.

Bursa (Bursae)

• Sac of fluid near joints where sliding occurs.

Ligaments

• Fibrous connected tissues.

Suture Joints

• Cronial Skull joints, Immovible.

Terminolgy relating Articulation

• Any type of joint is an articulation.

• Bursa. Sac of fluid near joints where there is a sliding thing that happens.

• Lgiamtes. Fuberous connecitve knee

• Surture joints
  Immobile

• Synovial cavity contains the sinnovial fluid, and Provides lubrication

• Synovial fluide provide librucation cavity

• Symnobial Joitns Frreely mobile joint.

• Sinovial Membrane, Linig, the, Linig, the syniovia cavity and Produce Snbovial fluid Which Provide lubrication

• Tendon Fiberiouse connective bana that Connect Muscles t bones

Combining Forms (Joints)

• Ankylo: stiff.

• Arthro: joint.

• Articulo: joint.

• Bursa: bursa.

• Chondro: cartilage.

• Ligamento: ligament.

• Rheumat/o: watery flow (rheuma).

• Sino: synovial membrane.

• Ten/o: tendon.

• Tendin/o: tendon.

Suffixes (Joints)

• -desis: to bind or tie together.

• -stenosis: narrowing.

Joint Pathology (Joints Related Diseases)

• Arthritis:

  • Inflammation of any joint.

• Ankylosing spondylitis:

  • Chronic progressive stiffening of the joint, mostly the spine (inflammation).

• Gouty arthritis:

  • Excessive uric acid forms crystals between joints (painful).

• Osteoarthritis:

  • Loss of articular cartilage, bone cysts occur (spine, hips, knees of older people).

• Rheumatoid arthritis:

  • Autoimmune (body attacks itself), chronic, with inflammation and joint/organ involvement. Causes inflammation in the joints. Symptoms worst after waking up, can't perform simple tasks that required hand movement.

• Bunion:

  • Swelling of the medial aspect of the joint between the big toe and first metatarsal bone.

• Carpal tunnel syndrome:

  • Compression of the median nerve (numbness in thumb, index finger, and middle finger). Nerve can be damaged permanently if not treated.

• Dislocation:

  • Displacement of a bone from a joint.

• Ganglion:

  • Fluid-filled cyst arising from the joint capsule and tendons in the wrist.

• Herniation:

  • Abnormal partition of the disc into the neural canal (spinal nerves).

• Lyme disease:

  • Recurrent arthritis, neurologic/cardiac symptoms. Bull's eye appears.

• Myalgia:

  • Muscle pain.

• Sprain:

  • Trauma to a joint with pain, swelling, and injury to ligaments (without rupture).

• Systemic lupus erythematosus:

  • Chronic inflammatory disease involving joints, skin, kidneys, nervous system, heart, lungs, and other body parts.

Muscles

• Three types

  • Striated muscles.

    • Voluntary control (moves bones, face, and eyes).

  • Smooth muscles.

    • Involuntary control (moves internal organs, digestion, blood vessels, and glands).

  • Cardiac muscles.

    • Involuntary control (found exclusively in the heart).

Diagram

• Striated

• Smooth

• Cardiac

Movement Terminology

• Flexion.

• Extension.

• Dorsiflexion.

• Plantar flexion.

• Supination.

• Pronation.

• Abduction, moves away from the mid line of the body.

• Adduction. Movement towards the mine of te body

• Dorsiflexion: Upper Movements Of the
  Extension Menins Straight of The Flest, Limp

• Flexion Downward movement of the foot

• Fascia. That Means Fluberous membrane Which Separate and and volve Some Muscles
  Insertion Of A Muscle It's very important
  Connection Of the Muscle to A Bone

• Origin (connection of a muscle to a stationary bone).

• Plantar: bending of the sole of a foot downward toward the ground.

• Pronation: turning the palm downwards.
  Supine

• Turning the palm upward, is is s upward of te quarranten, and then Pronation is downwards.

• Rotation
  Circular Movements

• Skaelatal Muscles Muscle Connected to
  Boness. Smooth Muscles We have

• Viseracle Muscle Viseracal Internaal muscles. Viseracall is internal

• Striated Muscle again Skeletal Muscles. suin Trining the palm upward

• Viseracl Muscles that means Interanlanal concerated muscles

Pathology (Muscles)

• Muscular dystrophy:

  • Group of inherited diseases with progressive muscle weakness/degeneration (nervous system involvement).

• Polymyositis:

  • Chronic inflammatory myopathy (maybe autoimmune, environmental, drug-related, or inherited).

Tests and Procedures

Muscle pathology

• Antinuclear antibody test.
  Test for Gout

• Antinuclear antibody test

• Blood test to check that inflaimation

• Erychortia Sedimentation Rate

  • What is the mening ESR Blood Check Check the Inflammation
    Serum Caustim (Test To see the Calcium Lavel
    *Serun Keratinn Kiness (Test The Keraton Lavel

• Proceduree s * arthrocentesis

  • Procedure to remove fluid from the joint.

  • arthrography
    Arthra means Joint

• X-ray Of the Joint (Graphite

  • Arthromeans joint, graphiymeann Visual Examination of the
    Arthoplasty : Surgical Respare Of The Joints.
    Arthroscopy means visual exam
    athe of joints arthrameann Joint, Graphiymeann x-ray
    BoneDensity Test (Test to see the Bone Loe Bone Density Bess
    CTscan (Test
    Diography

  • EMG Test
    Muscle Biobssey Texst test