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| MUSCULOSKELETAL SYSTEM |
Musculoskeletal system Parts: An organ system made up of bones, cartilage, joints, muscles, tendons, and ligaments.
Functions of the Musculoskeletal system: Provides form, support, and stability to the body and also provides the ability to move.
Human skeleton bones: 206 bones (80 bones of axial skeleton +126 bones of appendicular bones)
Functions of bones:
1. Bones gives shape and form.
2. Bones support the body (bones in legs and pelvis support trunk and C1 supports the skull).
3. Bones protect the underlying organs (the skull protects the brain, ribcage protects the heart and lungs, and vertebrae protect the spinal cord).
4. Bones help in bodily movement.
5. Hemopoiesis is done in the red marrow of a bone.
6. Bones store minerals.
Classification of bones:
1. Long bones - Consist of the shaft with two ends - Ex: femur, humerus
2. Short bones - Cube-like bones - Ex: carpals, tarsals
3. Flat bones - Thin and usually curved - Ex: sternum, scapula, most of the skull bones.
4. Irregular bones - Not short, long, or flat - Ex: Vertebrae, auditory ossicles
5. Sesamoid bones - Develop within a tendon - Ex: Patella
6. Wormian / Sutural bones - Tiny bones within the skull that lies between major skull bones
Patella / kneecap: Human sesamoid bone.
Long bones in the human body: Humerus, radius, ulna, femur, tibia, fibula, phalanges, metacarpals, metatarsals
Long bone parts:
1. Diaphysis - Shaft (middle region) of a long bone
2. Epiphysis - End part of a long bone (proximal and distal)
3. Medullary canal - Tunnel along diaphysis, consists of yellow bone marrow
4. Compact (cortical) bone - A layer of hard dense tissue that lies under the periosteum.
5. Cancellous (spongy) bone - Inner layer of a bone, found at the end of long bones, less dense than compact bone. The spaces of spongy bone contain red marrow
6. Bone marrow - Soft pulpy tissue, red bone marrow (immature and mature blood cells), and yellow bone marrow (fatty tissue).
7. Endosteum - layer surrounds the medullary cavity
8. Periosteum - layer covers the outer surface of a long bone.
9. Articular cartilage - covers the end of bones, helps in joint movement
Bone processes: Enlarged tissues that grow out from the bone. They serve as points of attachments for muscles, tendons, and ligaments and help to form a joint. Bone processes: head, spine, ramus, condyle, epicondyle, crest, tubercles, tuberosity, and trochanter.
Bone depressions: Grooves or hollow regions of the bone. They help to join one bone to another and serve as a passageway for blood vessels and nerves. Bone depressions: meatus, fossa, sinus, sulcus, fissure, and foramen
Divisions of Skeleton:
1. Axial skeleton - 80 bones. Includes bone of the head (skull, hyoid bone, auditory ossicles), vertebral column, ribcage
2. Appendicular skeleton - 126 bones. Includes shoulder or pectoral girdle, upper extremity, pelvic girdle, lower extremity.
Bones of Head - Skull / Cranium: Skull is the bony skeleton of the head.
Functions of the skull - protects the brain, supports organs and special senses provide the foundation for mouth and nose and provides attachment for muscles of mastication and facial expression.
Skull bones - Total 22 bones - Neurocranium (cranial bones) - 8 bones and Viscerocranium (facial bones) - 14 bones
Neurocranium / cranial bones: The part of the skull that encloses the brain. Consists of 2 parietal bones, 2 temporal bones, 1 frontal bone, 1 occipital bone, 1 sphenoid bone, and 1 ethmoid bone.
The only movable joint of the skull: TMJ (Temporomandibular joint)
The largest cranial bone that forms the forehead and roof of the orbit: Frontal bone.
Which part connects the brain and spinal cord: Medulla oblongata passes through the foramen magnum, links the brain, and spinal cord.
Which cranial bone forms the base of the skull: Sphenoid bone.
Location of the pituitary gland: On the upper surface of the sphenoid bone, there is a depression called sella turcica, which houses the pituitary gland.
Atlas: First cervical vertebra (C1)
Which bones form the roof and upper part of the sides of the skull: Parietal bones.
Cranial sutures: An immovable fibrous joint between skull bones
1. Coronal suture - Suture between frontal and parietal bones of the skull
2. Sagittal suture - Suture uniting two parietal bones of the skull
3. Lambdoid suture - Suture between parietal and occipital bones of the skull
4. Squamous suture - Suture between parietal and temporal bones of the skull
Fontanelle / Soft spot: Area of the skull not covered by bone in the newborn.
Viscerocranium / Facial bones: Total 14 bones - 2 maxilla, 2 zygomatic bones, 2 palatine bones, 2 nasal bones, 2 lacrimal bones, 2 inferior nasal conchae, 1 mandible (lower jaw), and 1 vomer.
Small bones of the middle ear: Auditory ossicles (ear bones) - malleus, incus, stapes
Hyoid bone: Supports the tongue
How many vertebrae in the spinal column or vertebral column or spine: Total 33. Cervical - C1-C7; Thoracic - T1-T12; Lumbar - L1-L5; Sacral - S1-S5; Coccyx (tail bone) - 4 vertebrae fused.
Intervertebral disk: A flat, rounded, fibrocartilaginous plate between the bodies of vertebrae. It performs as a buffer and shock absorber for the spinal column.
Herniated disk: A condition where the annulus fibrosus is ruptured and the nucleus pulposus bulges causing pressure on the spinal nerves.
Thoracic cage/ribcage: The skeleton of the chest consisting of 12 thoracic vertebrae (T1-T12), 24 ribs, a sternum, and costal cartilages.
Functions of ribcage:
1. Supports shoulder girdle and upper limbs.
2. Protects vital organs like the heart and lungs.
3. Plays a vital role in breathing.
Sternum: Sternum is breast bone. It consists of
1. Manubrium - upper part of the sternum
2. Xiphoid process - The lower part of the sternum.
3. Body / Gladiolus - Middle portion of the sternum (between manubrium and xiphoid process)
Ribs: Ribs are long, curved bones which form ribcage. 12 pairs of ribs are there.
Divisions of ribs:
1. True ribs - First 7 pairs, they join the sternum anteriorly.
2. False ribs - Ribs 8-10 pairs, they join the 7th rib anteriorly.
3. Floating ribs - Ribs 11-12 pairs, they are completely free anteriorly.
Pectoral girdle/shoulder girdle: Formed by clavicle and scapula. Connects the upper limb to the axial skeleton.
Clavicle / Collar bone: 2 clavicles in total. A slender bone that connects the shoulder bone to the sternum.
Scapula / Shoulder blade / Shoulder bone: A large triangular flat bone lying over ribs posteriorly on either side of the body.
Humerus: Upper arm bone( shoulder to the elbow).
Radius: Thumb side bone of the forearm
Ulna: Little finger side bone of the forearm.
Carpals: Carpals are wrist bones. 8 bones in each wrist.
Metacarpals: Skeletal of the hand between the wrist and fingers. 5 bones in each hand.
Phalanges (hand): Bones of fingers.14 bones in each hand.
Kyphosis / Humpback: An abnormal posterior curvature of the thoracic spine.
Lordosis / Swayback: An abnormal anterior curvature of the lumbar spine.
Scoliosis / Crookedness: An abnormal lateral curvature of the spine.
Pelvic girdle / Hip bone: The bony arch by which lower limbs are attached to the axial skeleton.
Formation of hip bone: Hip bone is formed by the fusion of 3 bones (ilium, ischium, and pubis).
Acetabulum: A cup-shaped depression on the external surface of the hip bone with which the head of the femur articulates OR Socket in pelvic bone for the head of the femur.
Longest and thickest bone in the human body: Thighbone (femur) - hip to knee.
Tibia: Shinbone. The medial and larger bone of the 2 bones of the leg.
Fibula: Calf bone. The lateral and smaller bone of the 2 bones of the leg.
Tarsals: Ankle bones.
The largest bone of the tarsals: Calcaneus bone (heel bone).
Metatarsals: Bones of the foot. 5 bones in each foot.
Phalanges (foot): Bones of toes. 14 bones in each foot.
Big toe: hallux.
Joint: A place where 2 or more bones come together or make contact. They are designed in such a way to allow for different degrees and types of movement.
Classification:
Functional Classification:
1. Synarthroses - Immovable joints (sutures of the skull)
2. Amphiarthroses - Slightly movable joints (intervertebral disks)
3. Diarthroses - Freely movable joints (appendicular skeleton joints)
Structural Classification:
1. Suture - An immovable fibrous joint between the bones of the skull
2. Syndesmosis
3. Gomphosis
Cartilaginous joints: Joints composed of cartilage. Cartilaginous joints can be immovable or slightly movable.
2 type cartilaginous joints - Synchondrosis and Symphysis
Synovial joints: A freely movable joint characterized by a synovial cavity containing synovial fluid.
6 type of synovial joints - hinge joint, pivot joint, saddle joint, condylar joint, ball-and-socket joint, and gliding joint.
Joint movements:
1. Abduction - Moving the body part away from the midline.
2. Adduction - Moving the body part towards the midline.
3. Flexion - Bending a limb
4. Extension - Straightening a flexed limb.
5. Eversion - Turning outward
6. Inversion - Turning inward
7. Pronation - Lying prone or face downward
8. Supination - Lying supine or face upward
9. Protraction - Moving a body part forward
10. Retraction - Moving a body part backward
11. Rotation - Moving a body part around a central axis.
12. Circumduction - Moving a body part in a circular motion.
13. Dorsiflexion - Bending a body part backward
14. Plantar flexion - Flexion towards the sole
Fracture: A break in the bone.
Classification:
According to external appearance:
1. Open fracture - Fracture of the bone with an open wound of the skin at the fracture site.
(Terminology for Open Fracture: compound, infected, puncture, fracture with foreign body, and missile)
2. Closed fracture - Fracture of the bone with no open wound of the skin at the fracture site.
(Terminology for Closed Fracture: Communutive, depressed, elevated, suppressed, greenstick, linear, simple, and spiral)
According to the nature of crack/break:
1. Greenstick fracture
2. Spiral/torsion fracture
3. Compression fracture
4. Transverse fracture
5. Comminuted fracture
6. Fissured fracture
7. Oblique fracture
8. Depressed fracture
9. Colles' fracture
Cast: Bandage consisting of plaster of paris that immobilizes broken bones while they heal.
Traction: Applying weight (application of force to a limb). Types: Skin traction and skeleton traction.
Muscle and types: A tissue made up of predominantly contractile cells. Muscles enable voluntary or involuntary complex movements.
Role of muscular system: Movement, posture, heat generation, protection.
Muscle cell/fiber: A skeletal muscle consists of numerous muscle cells called muscle fibers.
Types of muscles:
1. Skeletal muscle: It is attached to bones and causes movements of the body.
2. Cardiac muscle: Responsible for rhythmic contractions of the heart. Cardiac muscle is involuntary.
3. Smooth muscle: lines the walls of hollow organs. Ex: walls of blood vessels and digestive tract.
Muscles sizes: vastus - huge, Maximus - large, Longus - long, minimus - small, Brevis - short
Total no. of muscles in a human body: A total of 600 muscles in the body accounting for 40% of total body weight.
Formation of muscle: Muscle fibers are grouped into fascicles, which are in turn grouped together to form muscle.
The largest bone of the tarsals: Calcaneus bone (heel bone).
Metatarsals: Bones of the foot. 5 bones in each foot.
Phalanges (foot): Bones of toes. 14 bones in each foot.
Big toe: hallux.
Joint: A place where 2 or more bones come together or make contact. They are designed in such a way to allow for different degrees and types of movement.
Classification:
Functional Classification:
1. Synarthroses - Immovable joints (sutures of the skull)
2. Amphiarthroses - Slightly movable joints (intervertebral disks)
3. Diarthroses - Freely movable joints (appendicular skeleton joints)
Structural Classification:
1. Suture - An immovable fibrous joint between the bones of the skull
2. Syndesmosis
3. Gomphosis
Cartilaginous joints: Joints composed of cartilage. Cartilaginous joints can be immovable or slightly movable.
2 type cartilaginous joints - Synchondrosis and Symphysis
Synovial joints: A freely movable joint characterized by a synovial cavity containing synovial fluid.
6 type of synovial joints - hinge joint, pivot joint, saddle joint, condylar joint, ball-and-socket joint, and gliding joint.
Joint movements:
1. Abduction - Moving the body part away from the midline.
2. Adduction - Moving the body part towards the midline.
3. Flexion - Bending a limb
4. Extension - Straightening a flexed limb.
5. Eversion - Turning outward
6. Inversion - Turning inward
7. Pronation - Lying prone or face downward
8. Supination - Lying supine or face upward
9. Protraction - Moving a body part forward
10. Retraction - Moving a body part backward
11. Rotation - Moving a body part around a central axis.
12. Circumduction - Moving a body part in a circular motion.
13. Dorsiflexion - Bending a body part backward
14. Plantar flexion - Flexion towards the sole
Fracture: A break in the bone.
Classification:
According to external appearance:
1. Open fracture - Fracture of the bone with an open wound of the skin at the fracture site.
(Terminology for Open Fracture: compound, infected, puncture, fracture with foreign body, and missile)
2. Closed fracture - Fracture of the bone with no open wound of the skin at the fracture site.
(Terminology for Closed Fracture: Communutive, depressed, elevated, suppressed, greenstick, linear, simple, and spiral)
According to the nature of crack/break:
1. Greenstick fracture
2. Spiral/torsion fracture
3. Compression fracture
4. Transverse fracture
5. Comminuted fracture
6. Fissured fracture
7. Oblique fracture
8. Depressed fracture
9. Colles' fracture
Cast: Bandage consisting of plaster of paris that immobilizes broken bones while they heal.
Traction: Applying weight (application of force to a limb). Types: Skin traction and skeleton traction.
Muscle and types: A tissue made up of predominantly contractile cells. Muscles enable voluntary or involuntary complex movements.
Role of muscular system: Movement, posture, heat generation, protection.
Muscle cell/fiber: A skeletal muscle consists of numerous muscle cells called muscle fibers.
Types of muscles:
1. Skeletal muscle: It is attached to bones and causes movements of the body.
2. Cardiac muscle: Responsible for rhythmic contractions of the heart. Cardiac muscle is involuntary.
3. Smooth muscle: lines the walls of hollow organs. Ex: walls of blood vessels and digestive tract.
Muscles sizes: vastus - huge, Maximus - large, Longus - long, minimus - small, Brevis - short
Total no. of muscles in a human body: A total of 600 muscles in the body accounting for 40% of total body weight.
Formation of muscle: Muscle fibers are grouped into fascicles, which are in turn grouped together to form muscle.
Prime mover: The muscle which is most responsible for movement.
Synergists: Other muscles that assist the prime mover.
Agonist vs Antagonists: Contracting muscle called as agonist and muscles that cause a relaxing or lengthening or moving against the prime mover is called as antagonists.
Decalcification: Loss of calcium from bone, which results in loss of density and strength of the bone tissue
Lumbago / Lumbodynia: Low back pain or pain in the lumbar region of the spine.
Ligament: fibrous connective tissue(a strong brand) that connects one bone to another.
Calvaria/skull cap: Upper dome-like portion of the skull
Ganglion: Knot or knot-like mass
Prosthesis: Artificial substitute for a damaged and missing part of the body. Ex: Artificial limb.
Stump: Part of the limb left after an amputation.
Crutches: Wooden or metal stick used by a disabled person for walking.
Reflex: Involuntary, Repetitive, Reaction, Unlearned automatic in response to a stimulus.
Contracture: Abnormal shortening of muscles (permanent contraction).
Gout: The disorder of uric acid metabolism characterized by raised uric acid levels in the blood and accumulation of uric acid crystals in the joints and soft tissue.
Nonunion: Failure of normal healing of a fractured bone (bone ends fail to grow together)
Malunion: Incorrect alignment of fractured bone ends leading to deformity.
Sprain: An injury to a ligament caused by twisting or overstretching.
Rheumatoid arthritis: Inflammation of joint(s) due to immune disease.
Gouty arthritis: Inflammation of joints due to the accumulation of uric acid crystals in joints.
Amputation: Partial or complete removal of a limb.
External fixation: Fixation of fractured bones using splints and pins. Does not require surgery.
Internal fixation(ORIF): To stabilized fractured with the help of surgical wires, screws, rods, and plates.
Skin traction: Application of force to bone by means of tape applied to the skin.
Skeletal traction: Application of force to bone by means of pins and/or wires inserted in the bone.
Acromion: Extension of the scapula.
Meniscus: Crescent-shaped cartilage found in the knee.
Bursa(Cushion between joint): A small sac between joint for easy movement.
Tendon: A connective tissue, connects muscle to bone.
Carpal tunnel syndrome: Painful wrist, caused by compression of the nerve.
Colles' fracture: Wrist fracture, the lower end of the radius.
Exostosis: Benign growth of the surface of a bone.
Muscular dystrophy: Hereditary, degeneration of muscle, and weakness.
Myasthenia gravis: Chronic muscle weakness, defect in nerve impulses to muscles
Connective tissue: Supports the organs of the body, sheaths muscles, connects muscles to bones and bones to joints.
Osteocytes: Bone cells
Orthopedics: Branch of Medicine that deals with diagnosis and treatment of diseases of the musculoskeletal system
Orthopedist: Specialist in orthopedics
Bursitis: Inflammation of the bursa
Spondylitis: Inflammation of the vertebra
Tendonitis/tendinitis: Inflammation of the tendon
Tenosynovitis: Inflammation fluid-filled sheath (called the synovium) of a tendon(due to infection, injury, or strain) and its enveloping sheath.
Arthritis: Inflammation of a joint
Osteoarthritis: Inflammation of a joint caused by chronic degeneration of the cartilage and synovial membrane.
Osteoporosis: Bone thinning due to lack of calcium.
Osteomyelitis: Inflammation of bone marrow and adjacent bone.
Osteochondritis: Inflammation of bone and its overlying cartilage
Arthrodesis: Surgical immobilization of a joint
Fasciotomy: Surgical incision into the fascia
Fasciectomy: Removal of fascia
Facetectomy: Removal of facet
Corpectomy: Surgical removal of a vertebral body
Laminectomy: Surgical removal of the vertebral lamina
Discectomy: Surgical removal of the intervertebral disc
Arthrocentesis: Puncturing of a joint for removal of fluid
Arthroplasty: Surgical repair of a joint or artificial replacement of a joint.
Chondroplasty: Surgical repair of cartilage
Ankylosis: Stiffness of a joint.
Chondromalacia: Softening of cartilage
Diskitis: Inflammation of intervertebral disk
Myasthenia: Muscle weakness
Myeloma: Malignant tumor of the bone marrow
Osteitis: Inflammation of the bone
Osteocarcinoma: Cancerous tumor of the bone.
Osteomalacia: Softening of the bones
Osteosarcoma: Malignant tumor of the bone
Polymyositis: Inflammation of many muscles
Tenodynia: Pain in tendon
Bunion: Enlargement of the joint at the base of the great toe.
Myoplasty: Surgical repair of a muscle
Myorrhaphy: Suture of a muscle
Osteoplasty: Surgical repair of a bone
Phalengectomy: Excision of finger or toe bone.
Spondylosyndesis: Spinal fusion (fusion of vertebrae)
Synovectomy: Removal of the synovial membrane of a joint.
Tarsectomy: Excision of one or more tarsal bones.
Tenorrhaphy: Suture of a tendon
Arthralgia: Pain in the joint
Atrophy: Absence of development
Bradykinesia: Slow movement
Dyskinesia: difficult movement
Dystrophy: abnormal development
Hyperkinesia: Excessive movement
Hypertrophy: Excessive development
Intercostal: Pertaining to between the ribs
Intervertebral: Pertaining to between the vertebrae
Osteoblast: Developing bone cell
Osteonecrosis: Death of bone
Subcostal: Pertaining to below rib
Subscapular: Pertaining to below scapula
Symphysis: growing together
Substernal: Pertaining to below sternum
Podiatrist: Specialist who deals with the diagnosis and treatment of diseases of the foot.
Chiropractic: A therapy involves the manipulation of the vertebral column
Chiropractor: Specialist in chiropractic treatment
Orthotic: Making and fitting of orthopedic appliances to correct the deformities.
Orthotist: Specialist in Orthotics.
Arthroscopy: Visual examination of a joint
Electromyogram: To record electrical activity in a skeletal muscle.
Vertebrae: A series of bones extending from atlas (C1 in the neck) to tailbone. Each bone is called a vertebra.
Divisions of the spinal column:
1. Cervical Neck region C1-C7 7
2. Thoracic Chest region T1-T12 12
3. Lumbar Waist/Flank region L1-L5 5
4. Sacral Sacral region S1-S5 (fused) 5
5. Coccygeal Tail region tail bone (4 bones fused) 4
1. Cervical Neck region C1-C7 7
2. Thoracic Chest region T1-T12 12
3. Lumbar Waist/Flank region L1-L5 5
4. Sacral Sacral region S1-S5 (fused) 5
5. Coccygeal Tail region tail bone (4 bones fused) 4
Osteomyelitis: Inflammation of bone marrow and adjacent bone
Condyle: A rounded articular surface at the extremity of a bone
Callus: A composite mass of tissue that forms at a fracture site to establish continuity between both ends.
Condyle: A rounded articular surface at the extremity of a bone
Callus: A composite mass of tissue that forms at a fracture site to establish continuity between both ends.
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