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Chapter 19
Bones and Skeletal System (BOOK)
| Term | Definition |
|---|---|
| Bones | Are the hard connective tissues that make up the skeletal system (Adult human body contains 206 bones). |
| Osteology | The study of bones. Bones: Including associated structures, such as cartilage. Joints: Including associated structures, such as ligaments. |
| Support | The skeletal system provides support for the body through a bony framework. |
| Protection | Bones help protect internal organs. |
| Movement | Bones are attachment sites for tendons of skeletal muscles. |
| Blood Cell Production | Blood cells are produced in the red marrow of bones, especially long bones, through a process called hematopoiesis. |
| Fat Storage | Fats are stored in yellow bone marrow and are released when needed. |
| Mineral Storage | Minerals, such as phosphorus, magnesium, and sodium, and mineral compounds,such as calcium phosphate and calcium carbonate, are stored in bone and are released when needed. |
| Bone/Osseous Tissue | A type of connective tissue. Osteoblasts- Bone forming cells. |
| Osteocytes | Mature bone cells. |
| Osteoblasts | Bone forming cells. |
| Osteoclasts | Bone-destroying cells. |
| Compact Bone | Forms the hard outer shell of bone and constitutes approximately 80% of the total adult bone mass. |
| Osteons/Haversian Systems | Cylindrical-shaped units that run lengthwise in a compact bone. |
| Central Canal (Haversian) | Canal surrounded by an osteon and contains blood vessels, lymphatic vessels, and nerves. |
| Transverse Canals (Volkmann) | Canals that are interconnected by central canal. |
| Spongy Bone/Cancellous Bone | Lighter and less dense than compact bone and constitutes approximately 20% of the total bone mass. |
| Trabeculae | Thin strips that give the spongy bone a spongy appearance. |
| Ossification/Osteogenesis | The process of bone tissue development by osteoblasts. |
| Intramembranous Ossification | Bone development from membranes, such as those found in the flat bones of the skull. |
| Endochondral Ossification | Bone development from cartilage. |
| Epiphyseal, Articular Cartilage, Epiphyseal Plate, and Epiphyseal Line | Sites where bone growth occurs. |
| Bone Remodeling | The process of bone destruction by osteoclasts and bone formation by osteoblasts. |
| Wolf Law | States that bone is laid down in areas of high stress and reabsorbed in areas of low stress. |
| Long Bones | Longer that they are wide. Long bones are those of the arm (humerus), forearm (ulna and radius), thigh (femur), and leg (tibia and fibula). |
| Short Bones | Generally small, cube-shaped, and contain multiple articulating surfaces. Short bones are those of the wrist (carpals) and the ankles (tarsals). |
| Flat Bones | Possess a broad, flat surface. Flat bones are those of the chest (sternum), upper back (scapula), ribcage, pelvis, and the skull. |
| Irregular Bones | Oddly shaped and so not fit well in other shape/size categories. Irregular bones are found in the skull and spine (vertebrae). |
| Sesamoid Bones | Small bones embedded in tendons and ligaments. Sesamoid bones are round and found in the knee (patella), hands, feet, and throat (hyoid). |
| Diaphysis | The cylindrical shaft of the long bone. Blood vessels enter the diaphysis through a small opening called the nutrient foramen (foramina, plural). |
| Periosteum | Surrounds the diaphysis and is a dense, fibrous sheath containing blood and lymphatic vessels, nerves, osteoblasts for growth and fracture healing. Attaches to the underlying bone via perforating fibers called Sharpey fibers. |
| Interosseous Membrane/Interosseous Ligament | Where the bones in the forearms and legs are connected by extensions of the periosteum. |
| Medullary Cavity | The hollow space within the diaphysis. Filled with red and yellow bone marrow. |
| Endosteum | A thin connective membrane that is lined on the surface of the medullary cavity and contains osteoclasts. |
| Epiphysis | Two ends of a long bone (epiphysis, sing.). |
| Articular Cartilage | Covers the surfaces of the epiphyses. |
| Epiphyseal Plate | Hyaline cartilage found near the ends of growing bone, allowing them to increase in length. |
| Growth Plate | Cartilage within the epiphyseal plate continues to grow throughout childhood until the early part of the second decade of life. |
| Epiphyseal Line | Line of ossified bone indicating where previous bone growth occurred at the epiphyseal plate in long bones. |
| Axial Skeleton | Consists of 80 named bones along the skeleton’s central axis and includes the skull, vertebral column, sternum, and the ribs. |
| Skull | The skull consists of 29 bones: 8 cranial bones (1 frontal, 2 parietal, 2 temporal, 1 occipital, 1 sphenoid, 1 ethmoid); 14 facial bones (2 maxilla, 2 zygomatic, 2 palatine, 1 mandible, 2 lacrimal, 2 nasal, 2 2 inferior conch, 1 vomer); 6 ear ossicles in |
| Vertebral Column | There are 26 bones in the vertebral or spinal column: 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 1 sacrum, and 1 coccyx. |
| Sternum | There is one sternal bone. |
| Ribs | There are 24 individual or 12 pairs of ribs. |
| Appendicular Skeleton | Consists of bones of the shoulder and pelvic girdles and bones of the upper and lower extremities. There are 126 named bones in the appendicular skeleton. |
| Shoulder Girdle | There are four bones in the shoulder (pectoral) girdle: two scapulae and two clavicles. |
| Upper Extremities | There are 60 bones in the upper extremity, 30 bones on each side. There are 2 humeri, 2 ulna, 2 radii, 16 carpals, 10 metacarpals, and 28 phalanges. The hands contain small sesamoid bones. |
| Pelvic Girdle | There are two bones in the pelvic girdle or pelvis. Each of these two pelvic bones are made up of three fused bones–ilium, ischium, and pubis. |
| Lower Extremities | There are 60 bones in the lower extremity, 30 bones on each side. There are 2 femurs, 2 patellae, 2 tibias, 2 fibulas, 14 tarsals, 10 metatarsals, and 28 phalanges. The feet contain small sesamoid bones. |
| Joints | Where two or more bones come together or join. |
| Fibrous Joints | Bones in fibrous joints are joined by dense fibrous connective tissue, and fibrous joints do not have a joint capsule. The skull contains fibrous joints called sutures. Fibrous joints resemble synarthrotic joints. |
| Cartilaginous Joints | Bones in cartilaginous joints are joined by cartilage (fibrocartilage and occasionally hyaline) and cartilaginous joints do not have a joint capsule. Cartilaginous joints resemble amphiarthrotic joints. |
| Synovial Joints | Bones in synovial joints have synovial membranes and are enclosed by a joint capsule which continues which contains a joint cavity filled with synovial fluid. Synovial joints resemble diarthrotic joints. |
| Synarthrotic Joints | Movement in synarthrotic joints, or synarthroses, is not permitted or extremely limited under normal conditions. Synarthrotic joints resemble fibrous joints. |
| Amphiarthrotic Joints | Amphirathrotic joints, or amphiarthroses, are slightly moveable joints. Amphiarthrotic joints resemble synovial joints. |
| Diarthrotic Joints | Diarthrotic joints, or diarthroses, are freely movable joints. Diarthrotic joints resemble synovial joints. |
| Joint Capsule/Articular Capsule | Joints that have a double-layered structure. |
| Joint Cavity | The spaces between the two layers of a joint capsule. |
| Synovial Membrane | Tissue layer that lines joint cavities or spaces between bones and joints; synovial membranes secrete a thick clear liquid called synovial fluid. |
| Synovial Fluid/Synovium | Thick clear liquid that provides nutrition and lubrication of the articular cartilage so the joint can move easily and without friction. |
| Ligaments | Connective tissues that unite articulating bones, which strengthens the joint. |
| Articular Cartilage | Covers the articulating surfaces of bones. |
| Labrum | A ring of fibrocartilage around the edge of the articular cartilage to increase the surface area of the articular surface of the joint. |
| Fat Pads | Structures that protect articular cartilages and act as packing material to fill spaces that occur as the joint cavity changes shape during movement. |
| Bursae | Flattened, saclike structures located between ligaments and bones within joints; contain synovial fluid; bursae provide cushion that prevents muscle tendons from rubbing against bones during contraction. |
| Synovial Sheaths/Tendon Sheaths | Elongated bursae that surround long tendons located in the forearms, legs, wrist, ankles, hands, and feet; these tubular structures are lined with synovial membranes to increase their gliding capacity. |
| Menisci | Crescent-shaped fibrocartilaginous pads located in select joints such as knees and jaw; menisci help joints to move smoothly and serve as a shock absorber. |
| Uniaxial Joints | Joints that provide movement around only one axis and in only one plane. |
| Hinge Joints | Joints that possess a convex surface that fits into the concave surface of another bone; movements allowed by hinge joints are flexion and extension. |
| Pivot Joints | Joints that possess a ringed or notched surface of one bone that fits into a projection of another bone; movement limited to rotation. |
| Biaxial Joints | Joints that provide movement around two perpendicular axes and in two perpendicular planes. Types include saddle, condyloid/ellipsoidal. |
| Saddle Joints | Joints that possess a concave surface of one bone that fits into a convex surface of another; positional relationship resembles a rider in a saddle; movements allowed are flexion, extension, abduction, adduction, opposition, reposition, and circumduction, |
| Condyloid (Ellipsoidal) Joints | Possess an oval-shaped surface or condyle of one bone that fits into a depression or socket of another bone. |
| Multiaxial Joints | Permit movement around three axes and in three planes. |
| Gliding Joints/Planar Joints | Joints that allow interaction of relatively flat surfaces of articulating bone; gliding joints allow limited movement along all axes. |
| Ball and Socket Joints/Spheroid Joints | Joints with one bone containing a ball-shaped head that fits into a rounded socket-shaped surface of another bone; these joints offer the greatest range of motion and permit all movement in all planes, including flexion, extension, abduction, adduction, c |
| Joint Play | Small involuntary joint movements that are independent of muscle contraction, due to joint capsule laxity, and are limited to approximately ⅛ inch in any plane and occur along the contours of the joint surfaces. |
| Crepitus | Joint sounds, sometimes described as creaking, cracking, grating, crunching, or popping. |
| Flexion | Bending a joint so that the angle of a joint decreases. |
| Extension | Straightening a joint so that the angle of a joint increases. |
| Hyperextension | Overextending a joint beyond its normally straightened position, as in moving the head back to look upward. |
| Abduction | Movement of a joint so that a body part moves away from the midline of the body. |
| Adduction | Movement of a joint so that a body part moves toward the midline of the body. |
| Radial Deviation | Hand movement away from the midline of the body in the anatomic position. |
| Ulnar Deviation | Hand movement toward the midline of the body in anatomic position. |
| Horizontal Adduction | Movement which occurs as the shoulder or hip moves the extremity toward the midline in the transverse/horizontal plane. |
| Horizontal Abduction | Movement which occurs as the shoulder or hip moves the extremity away from the midline in the transverse/horizontal plane. |
| Opposition | Movement in which the thumb comes into contact with any finger on the same hand. |
| Reposition | Returning the thumb to its anatomic position next to the index finger. |
| Circumduction | Conical movement in which distal end of a structure moves in a circle and proximal end remains relatively fixed; circumduction is actually a combination of several movements, including flexion, extension, adduction, and abduction. |
| Rotation | Movement that occurs when a bone pivots or rotates around its own central axis. |
| Left/Right Rotation | Refers to the direction of rotation and is used to describe joint movement in the central axis, such as the neck and spine. |
| Lateral (External) Rotation | Refers to the outward rotation of joints in the appendicular skeleton, such as the shoulder, hip, and knee (the knee can rotated slightly when flexed), and occurs in the transverse/horizontal plane. |
| Medial (Internal) Rotation | Refers to the inward rotation of joints in the appendicular skeleton, such as the shoulder, hip, and knee (the knee can be rotated slightly when flexed), and occurs in the transverse/horizontal plane. |
| Upward (Superior) Rotation | Scapular movement that occurs as the glenoid cavity rotates to orient superiorly. |
| Downward (Inferior) Rotation | Scapular movement that occurs as the glenoid cavity rotates to orient inferiorly. |
| Supination | Lateral rotation of the forearm so that the palm is facing upward or forward. |
| Pronation | Medial rotation of the forearm so that the palm is facing downward or backward. |
| Plantar Flexion | Movement of ankle so the foot moves inferiorly—toes are pointing downward. |
| Dorsiflexion | Movement of the ankle as the foot moves superiorly—toes are moving toward the shin or tibia. |
| Inversion | Elevation of the medial edge of foot so it turns inward or toward the midline of the body. |
| Eversion | Elevation of the lateral edge of the foot so it turns outward or away from the midline of the body. |
| Elevation | Movement at a joint in a superior or upward direction; essentially it is rising or lifting a body part. |
| Depression | Movement at a joint in an inferior or downward direction; essentially it is lowering or dropping a body part. |
| Protraction | Movement at a joint in an anterior or forward direction. |
| Retraction | Movement at a joint in a posterior or backward direction. |
| Excursion | Side-to-side movements of the jaw or mandible. |
| Lateral Excursion | Moves the jaw away from the midline. |
| Medial Excursion | Returns the jaw to the midline position. |
| Adhesive Capsulitis | Chronic inflammation and thickening of the shoulder joint capsule, causing pain and limited range of motion. |
| Freezing Stage | In this stage, there is a gradual onset of a dull shoulder ache and stiffness that slowly develops into pain, which occurs both at rest and during movement. |
| Frozen Stage | During this stage, shoulder pain may lessen, but remain stiff and movement is difficult. |
| Thawing (Recovery) Stage | In this stage, shoulder pain lessens, and range of motion slowly improves. |
| Shoulder PROM/Traction (Pendulum Method | Asking the client to lay prone near the edge of the table and allow the affected arm to hang over the table’s edge. |
| Baker Cyst/Popliteal Cyst | Accumulation of synovial fluid behind knee. |
| Bursitis | Inflammation of a bursa. |
| Dislocation | Temporary displacement of bones within a joint, with complete loss of contact between articulating surfaces. |
| Subluxation | Partial loss of contact between two articulating surfaces in a joint. |
| Fracture | Any crack or break in a bone. |
| Complete Fractures | Occurs when a bone breaks all the way through. |
| Incomplete Fractures | Occurs when a bone is damaged but is still in one piece. |
| Open Fractures | Formerly known as compound fractures, describe fractures in which the skin is broken. |
| Closed Fractures | Formally called simple fractures, the skin over the broken bone is intact. |
| Ganglion Cyst | Fluid-filled pouch that forms on tendons or joints, usually the wrist or hands. |
| Gout/Gouty Arthritis/Metabolic Arthritis | A type of arthritis caused by the accumulation of acid crystals in joints. |
| Tophi | Painless nodules that may form in subcutaneous tissues over the ear, extensor surfaces of the arms and feet, and over the Achilles’ tendon and patella. |
| Hyperkyphosis | Exaggeration of the normal kyphotic (posterior) curvature in the thoracic spine. |
| Hyperlordosis/Swayback/Saddleback | Exaggeration of the normal lordotic (anterior) curvature in the lumbar spine. |
| Lyme Disease/Lyme Arthritis | Recurrent form of arthritis that affects not only joints but also skin, heart, and nervous system; large joints, such as knee and hip, are most commonly involved. |
| Borrelia Burgdorferi, Borrelia Mayonii, Borrelia Afzelii, Borrelia Garinii | Four species of bacteria that cause lyme disease. The causative bacterium is introduced into the body by a bite of an infected black-legged tick, commonly called a deer tick. |
| Osgood-Schlatter Disease | Patellar tendinitis in immature bone at the tibial tuberosity where the quadriceps attach. |
| Osteoarthritis/Degenerative Joint Disease/Degenerative Arthritis/Wear and Tear Arthritis | Age-related arthritis characterized by inflammation of the joint capsule and progressive joint damage leading to loss of articular cartilage. |
| Spondylosis | A type of isthmic spondylolisthesis caused by a fracture in a thin portion of the lamina called the pars interarticularis. |
| Osteophytes | Both osteoarthritis and spondylosis can lead to the formation of bony projections or bone spurs. |
| Spinal Stenosis | The abnormal narrowing of vertebral spaces, such as the central canal and intervertebral foramen. |
| Osteoporosis | Loss of normal bone density and increased bone porosity. |
| Pathologic Fracture | A broken bone caused by disease rather than an injury. |
| Patellofemoral Pain Syndrome/Patellofemoral Syndrome/Jumper’s Knee/Runner’s Knee | Pain and stiffness in front or around the kneecap. |
| Chondromalacia Patellae | Softening and degeneration of articular cartilage on the posterior patella. |
| Rheumatoid Arthritis | Arthritis caused by an autoimmune response in which the body attacks, inflames, and destroys synovial joint membranes; over time, joint inflammation spreads through the joint capsule, to articular cartilages and surrounding ligaments, then to underlying |
| Juvenile Rheumatoid Arthritis | Rheumatoid arthritis that develops in children and adolescents. |
| Scoliosis | Lateral curvature in the normally straight vertical line of the spine, usually in the thoracic region. |
| Spondylolisthesis | Anterior displaced vertebrae, usually L4 or L5; types are isthmic (spondylolytic) and degenerative. |
| Sprain | An injury caused by an overstretched or torn ligament. |
| Gade 1 (1st Degree) | Affected ligaments are overstretched and damaged microscopically but are not torn. |
| Grade 2 (2nd Degree) | Affected ligaments are torn. |
| Grade 3 (3rd Degree) | Affected ligaments are completely ruptured and swelling is significant. |
| Temporomandibular Disorder (TMD) | Term used to describe a group of conditions that cause pain and dysfunction of the temporomandibular joint and muscles controlling movement. |
| Myogenic TMD | This is the most common form and only involves the masticatory muscles. |
| Articular TMD | This is joint-related and described as an abnormal relationship between the articular discs and the coronoid process of the mandible. |
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