Lecture: The articulating skeleton

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VASUpharm14
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Lecture: The articulating skeleton
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2010-10-03 16:26:40
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im too cool
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IBHS: munson 2nd lecture (woo hoo it's almost test time!) good luck!
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  1. Context: bone lingo
    condyle
    rounded articular area
  2. Context: bone lingo
    crest
    ridge of bone
  3. Context: bone lingo
    foramen
    • passage through a bone
    • (look for a hole)
  4. Context: bone lingo
    fossa
    • hollow or depressed area
    • (not mu-fossa from the lion king)
  5. Context: bone lingo
    malleolus
    rounded process
  6. Context: bone lingo
    notch
    indentation at the edge of a bone
  7. Context: bone lingo
    protuberance
    projection of bone
  8. Context: bone lingo
    spine
    thornlike process
  9. Context: bone lingo
    process
    projection from the surface
  10. Context: bone lingo
    trochanter
    • large blunt elevation
    • (you're beautiful, you're beautiful it's true ... james blunt)
  11. Context: bone lingo
    tubercle
    • small raised eminence
    • (she put a square around this for some unknown reasons)
  12. Context: bone lingo
    tuberosity
    large rounded elevation
  13. Context: bone lingo
    medial
    • closest to midline
    • (this was a medterm so i doubt that you'll get this wrong)
  14. Context: bone lingo
    lateral
    furthest from midline
  15. Context: bone lingo
    proximal
    closest
  16. Context: bone lingo
    distal
    furthest
  17. Parts of the axial and appendicular skeleton
    what is circled (5 sets)
    • 1. cranium, face (of the skull)
    • 2. hyoid (associated bones), sternum, ribs (thoracic cage)
    • 3. vertebrae, sacrum, coccyx (vertebral column)
    • (for some reason i have a hard time spelling coccyx - it's weird)
    • 4. clavicle, scapula (pectoral girdle)
    • 5. tarsal bones, metatarsal bones, phalanges (lower limbs)
  18. context: skull
    bones of the cranium (6) and how much of each
    • 1. frontal bone (1)
    • 2. occipital bone (1)
    • 3. parietal bones (2)
    • 4. temporal bones (2)
    • 5. sphenoid bone (1)
    • 6. ethmoid bone (1)
  19. FOCUS: on parietal bone, temporal bone, ethmoid
  20. FOCUS: frontal bone, sphenoid, occipital bone, occipital condyle, foramen magnum
  21. context: skull
    List the Bones of the face (8)
    • 1. mandible (1)
    • 2. maxillae (maxillary bone) (2)
    • 3. zygomatic bones (2)
    • 4. lacrimal bones (2)
    • 5. nasal bones (2)
    • 6. inferior nasal conchae (2)
    • 7. palatine bones (2)
    • 8. vomer bone (1)
  22. FOCUS: vomer, zygomatic bone, nasal bone
  23. FOCUS: palatine bone
  24. FOCUS: lacrimal bone, maxillary bone, inferior nasal concha, mandible
  25. 3 parts of the central axial skeleton
    • 1. Hyoid bone - level of C3, suspended by muscles that attach it to the larynx, tongue, pharynx
    • 2. sternum - manubrium, body, xyphoid process
    • 3. costae (Ribs) - 1-7 (true), 8-10 (false), 11-12 (floating of the false)
  26. 3 parts of the Spinal Column
    • 1. vertebrae (7 cervical - atypical vertebrae: different, C1 (atlas), C2 (axis); 12 thoracic; 5 lumbar) --> REMEMBER: breakfast at 7, lunch at 12, and dinner at 5; t before x for atlas vs axis; you say yes before no (atlas - nod head, axis - shake head)
    • 2. sacrum (5-6 fused vertebrae)
    • 3. coccyx (3-4 fused vertebrae)
  27. Pectoral Girdle
    • connects arms to trunk via scapular and clavicle
    • FOCUS: acromion, coracoid process
    • FOCUS: acromion, coracoid process in relation to manubrium (sternum)
    • and the acromial end and sternal end
  28. Bones of the ankle and foot (6)
    • 1. tarsus: 7 tarsal bones
    • 2. calcaneus: largest of the tarsals, attachment site of Achilles tendon
    • 3. talus: articulates proximally with tibia
    • 4. metatarsals: foot bone (I-V)
    • 5. hallux (big toe): 2 phalanges
    • 6. 4 toes: 3 phalanges each toe
  29. FOCUS: calcaneus, talus, proximal phalanx (2), middle phalanx, distal phalanx (2), metatarsal bones
  30. Axial and appendicular skeleton
    • FOCUS: vertebrae (24), sacrum, coccyx : of the vertebral column
    • humerus (2), radius (2), ulna (2), carpal bones (16), metacarpal bones (10), phalanges (28) (proximal, middle, distal) : upper limbs
    • pelvic girdle (2)
    • femur (2), patella (2), tibia (2), fibula (2) : lower limbs
  31. Arthros/ arthrosis
    Joint
  32. syn (arthosis)
    • syn = together (2 bones together)
    • NO movement, STRONGEST joint
  33. Di ((a)rthrosis)
    • aka Synovial
    • Dia = through, across, apart
    • supported, BUT not connected
    • free movement, weakest joint
  34. amphi (arthrosis)
    • amphi = on BOTH sides, of both kinds, BOTH
    • held together by fibrous or cartilaginous connection
    • Slight movement, INTERMEDIATE strength joint
  35. put in order from weakest to strongest joint:
    amphi, syn, di (arthrosis)
    di < amphi < syn
  36. 3 types of synarthosis
    • 1. fibrous
    • 2. cartilaginous
    • 3. body fusion
  37. context: 3 types of synarthosis
    fibrous
    • 1. suture (sewing) - interlocking bones with fibrous connections
    • 2. gomphosis (bolting) - insertion plus fibrous wrap
  38. context: 3 types of synarthosis
    cartilaginous
    synchondrosis - rigid, cartilage bridge
  39. context: 3 types of synarthosis
    bony fusion
    synostosis - bone to bone
  40. FOCUS: i dunno just memorize this
  41. 2 types of Amphiarthosis
    • 1. syndesmosis
    • 2. symphysis
  42. context: 2 types of Amphiarthosis
    syndesmosis
    • desmos = band/ligaments
    • bones connected by a ligament
  43. context: 2 types of Amphiarthosis
    symphysis
    • physis = growth
    • fibrous cartilage pad between two bones
  44. FOCUS: top and bottom ... for Amphiarthosis: syndesmosis vs symphysis
  45. context: intervertebral articulations
    TO be FILLED IN cause i didn't pay attention here
  46. 2 Problems with the vertebral articulations
    • 1. Disk protusion/distortion - weakened posterior longitudinal ligaments, intervertebral disc distorted but intact
    • 2. herniated disk - weakened posterior longitudinal ligament, intervertebral disc ruptures (nucleus pulposus escapes)
    • BOTH: spinal nerve or spinal cord can be compressed.
  47. problems with the vertebral articulations
  48. 3 types of diarthosis (synovial)
    • 1. monoaxial
    • 2. biaxial
    • 3. triaxial
  49. context: 3 types of diarthosis (synovial)
    monoaxial
    • joint moves 1 dimension
    • MOST stable
  50. context: 3 types of diarthosis (synovial)
    biaxial
    • joint moves 2 dimension
    • less stable
  51. context: 3 types of diarthosis (synovial)
    triaxial
    • joint moves 3 dimension
    • LEAST stable
  52. put 3 types of diarthosis (synovial) in order of stability (weak to strong):
    triaxial, monoaxial, biaxial
    triaxial < biaxial < monoaxial
  53. context: 3 types of diarthosis (synovial)
    Things that limit motion/ stabilize joints (7)
    • 1. shapes of articulating surfaces
    • 2. fat pads
    • 3. bones
    • 4. ligaments
    • 5. muscles
    • 6. tendons
    • 7. joint capsule
  54. 6 Features of synovial joints (diarthrosis)
    • 1. articular capsule
    • 2. additional cartilage pads
    • 3. fat pads
    • 4. ligaments
    • 5. tendons
    • 6. bursae
  55. context: 6 Features of synovial joints (diarthrosis)
    articular capsule
    • lined by:
    • -synovial membrane - areolar tissue, epithelium
    • -articular cartilage : ends of bone (epiphysis), slick, smooth
    • joint cavity - synovial fluid: lubricant (proteoglycan rich, clear, viscous solution), nutrient distribution, shock distribution
  56. context: 6 Features of synovial joints (diarthrosis)
    additional cartilage pads
  57. context: 6 Features of synovial joints (diarthrosis)
    fat pads
    • often outside the capsule
    • support, shock absorption
  58. context: 6 Features of synovial joints (diarthrosis)
    ligaments
    • bone to bone
    • support, strengthen, reinforce
  59. context: 6 Features of synovial joints (diarthrosis)
    tendons
    • muscles to bones
    • support, limit range of motion
  60. context: 6 Features of synovial joints (diarthrosis)
    bursae
    • pouch
    • synovial fluid filled pockets
    • response to friction between tissues
    • reduce friction
    • shock absorption
  61. 3 movements permitted by synovial joints
    • 1. linear/planar- gliding
    • 2. angular - flexion/extension, abduction/adduction, circumduction
    • 3. rotation
  62. 6 structural classification of synovial joints (types for movement)
    • 1. gliding joints
    • 2. hinge joints
    • 3. pivot joints
    • 4. ellipsoidal joints
    • 5. saddle joints
    • 6. ball and socket joints
  63. context: 6 structural classification of synovial joints (types for movement)
    gliding joints
    • limited motion
    • nonaxial or multiaxial
    • ex: intercarpal joints, sacroiliac joints, acromion (scapula)-clavicle and clavicle-manubrium (sternum)
  64. context: 6 structural classification of synovial joints (types for movement)
    hinge joints
    • monoaxial: 1D: flexion/extension
    • ex: elbow and knee
    • 2 types
  65. context: 6 structural classification of synovial joints (types for movement)
    pivot joints
    • monoaxial: 1D : rotation
    • ex: atlas (1C)/ axis (C2), radius and ulna (proximal)
  66. context: 6 structural classification of synovial joints (types for movement)
    ellipsoidal joint
    • biaxial: 1D: flexion/extension - perpendicular to the plane of the body
    • 2D: abduction/adduction - in the plane of the body, circumduction (2D)
    • ex: radius to carpal bones, metacarpal to phalange
  67. context: 6 structural classification of synovial joints (types for movement)
    saddle joint
    • biaxial: 1D: flexion/extension
    • 2D: abduction/adduction -circumduction (2D), opposition (2D)
    • ex: metacarpal-carpal joints (thumb)
  68. context: 6 structural classification of synovial joints (types for movement)
    ball and socket joint
    • triaxial: 1D: flexion/extension
    • 2D: adduction/abduction - circumduction (2D)
    • 3D: rotation
    • ex: hip and shoulders
    • 2 types
  69. arachidonic acid cascade
    membrane phospholipids --phospholipase A2 (PLA2) --> Arachidonic acid -- (1.lipoxygenases/2. Cyclooxygenase [Cox-1,Cox-2]) --> 1. leukotrienes/2. PGH2 --(1. PG synthesis/2. TBX synthases) --> 1. other prostaglandins/2. thromboxanes
  70. 3 types of control over inflammation (in the arachidonic acid cascade)
    • 1. steroidal anti-inflammatory drugs (SAIDs)
    • 2. Non- steroidal anti-inflammatory drugs (NSAIDs)
    • 3. Acetaminophen (Tylenol) ?? possible
  71. 3 types of control over inflammation (in the arachidonic acid cascade)
    steroidal anti-inflammatory drugs (SAIDs)
    • PLA 2 inhibitors
    • -glucocorticoids (cortisone, betamethasone)
  72. 3 types of control over inflammation (in the arachidonic acid cascade)
    non-steroidal anti-inflammatory drugs (NSAIDs)
    • mixed COX-1 and COX-2 inhibitors (aspirin, ibuprofen, naproxen)
    • COX-2 inhibitors (Celecoxib [Celebrex], Valdecoxib [Bextra], Rofecoxib [Vioxx])
  73. 3 types of control over inflammation (in the arachidonic acid cascade)
    acetaminophen (Tylenol)
    • possible COX-3 inhibitor
    • not considered an NSAID
    • reduces pain (analgesic) and fever, but not anti-inflammatory
  74. Bursitis
    • inflammation of bursae
    • increased irritation and very painful
    • causes: repetitive movements, prolonged or excessive pressure, trauma (car accident, falls), infection
    • treatment: rest and protect, ice packs, NSAIDs, SAIDs
  75. 3 types of arthritis
    • 1. osteoarthritis
    • 2. rheumatoid arthritis
    • 3. gouty arthritis
  76. context: 3 types of arthritis
    osteoarthritis
    • 1. degenerative arthritis - in hands (distal fingers), weight bearing joints
    • 2. MOST COMMON arthritis (60 years +) - articular cartilage wears away with time, creates friction
    • 3. risk factors (collagen) - age, genetics, injury, obesity, hypermobility
    • 4. symptoms - joints aching and sore, pain after overuse or prolonged inactivity, bony enlargements
    • 5. treatment - acetaminophen; NSAIDs, SAIDs, physical therapy; weigh control; surgery, Glucosamine and Chondroitin? (why is there a question mark here, just tell me upfront with me!)
  77. context: 3 types of arthritis
    rheumatoid arthritis
    • 1. inflammatory arthritis - hands (proximal fingers), feet, wrists, ankles
    • 2. immune mediated disorder - synovial membrane --> inflamed --> thicken, with time affects articular cartilage, WBC, caused by: unknown, genetics, autoimmune disease?, rheumatoid factors
    • 3. risk factors- gender (women 2-3x); smoking
    • 4. symptoms - joints aching and sore; joints change appearance, bony enlargements; low grade fever
    • 5. treatment - acetaminophen; anti-inflammatory agents, SAIDs, TNFa Ab: Infliximab (Remicade)
  78. context: 3 types of arthritis
    gouty arthritis
    • 1. deposition of uric acid crystals in synovial joints - Xanthine oxidase: converts purines to uric acids, usually excreted by kidney (most cases decreased uric acid clearance)
    • 2. risk factors - high purine diet (meat/seafood main culprit); men more likely, excessive alcohol consumption.
    • 3. symptoms - excruciating and sudden pain, swelling, redness, stiff joint, usually affects big toe, but other possible
    • 4. treatment - acetaminophen; NSAIDs, Xanthine oxidase inhibitors (Allopurinol), Uricosurics (Probenecid) , dietary changes --> low purine diet, reduce alcohol, keep well hydrated

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