HS 1-1.03 Functions & Disorders of Skelet

Welcome to the video lecture for objective 1.03, understand the functions and disorders of the skeletal system. Our essentials questions for this objective are, what are the functions of the skeletal system? What are some disorders of the skeletal system? How are skeletal disorders treated? And how does the skeletal system relate to the body's systems of support and movement? So let's look at our picture of our football player here. What functions of the skeletal system are demonstrated in this picture? If we look at it, we can one could be movement, right? Because we have football player that's going to run, protection, okay? We have all these bones that are protecting vital organs and support, because without his skeletal system, he would be a big old blob. One of the functions of the skeletal system is hemolysis. Hemolysis is the formation of blood cells. All blood cells are formed in the red marrow in long poems and the sternum. All blood cells develop from stem cells. They can be called undifferentiated cells or even un potential stem cells. Stem cells are these little baby cells that can grow up to be whatever they want. And in this case, they are going to grow up to be one of the blood cells, either on a red blood cell, erythrocyte or white blood cell, a leukocyte or maybe a platelet, so hemolysis is that is how we produce red blood blood cells, and that happens in the skeletal system. Another function of a skeletal system is mineral storage. Bones serve as a storage area for minerals such as calcium and phosphorus. In fact, 99% of the body's calcium is actually stored in the bones. If we don't have an adequate intake of calcium or phosphorus, the body is able to use those stored minerals, okay? So let's say the body's calcium level drops too low. The bones are then going to release calcium into the bloodstream to help bring the levels back to a normal level. Once the blood level reaches that normal amount, the bones will stop releasing the stored calcium. So it's very necessary that we take in calcium and phosphorus, especially those two through our diet or maybe through vitamins. And it is the job or the function of the bones to hold onto calcium and phosphorus and other minerals so that our body can use it later on. So it's kind of like a, it's kind of like a holding tank. The bones kind of just hold onto it for later. Movement is another function of the skeletal system. When skeletal muscles contract, they pull on a bone, causing it to move. Bones play a vital part in body movement. They act as a passive lever. Ligaments and tendons also work with the bone. Ligaments, sorry. Ligaments connect bone to bone and cartilage serves as a support for muscles. Tendons connect muscle to bone, altogether they enable the body to move. So what types of movement? Are there? There is, let me, okay, let me go back. We have flexion, all right? Flexion is when we bring two bones closer together, which decreases the angle between the two bones. Think about when you flex your muscles when you show somebody your guns in your arm. That's flexion. So you're bringing those two bones closer together and it decreases that angle. And when you straighten it out, that's called extension. Okay, so flexion is bringing those bones closer together, extension is the opposite action moving them apart. Okay, so extension increasing the angle with two bones, which results in a straightening motion. When you're sitting down and then you stand up, that joint movement of the knee is extension to sit down, your flexing your knee, and when you stand up, you're extending your knee. Abduction and adduction. Abduction is moving and extremity away from the midline. Think about when somebody is abducted, what happens? They're taking somebody away, right? So ab induction, ABD. This first one right here, abduction is to take something away. Add duction is movement towards the midline. What are the first three letters ADD ad? So you're adding something to the body. So right here, this is showing it. To take your arm up, that's add induction to bring it back down to your side is adduction. Abduction, take it away, adduction, bring it back. I have miss it. Go to pronation. Pronation is when a forearm is turned, so the palm is facing downwards. And the opposite action is supination where the forearm is turned so the palm is facing upwards. And I'll show you in class this motion and the way I remember it is with a palm up, you have pro nation oh, sorry. Let me go back. I apologize pronation is the palm is facing downwards, supination is up. What I like to do, what I like to think is supination, I'm holding soup in my hand. And then pronation I'm pouring the soup so that you're turning your palm downwards. And I'll show you in class that. Rotation allows bone to move around one central axis. So when you shake your head no, that's rotation. Circumduction includes kind of everything all together includes a flexion, extension, abduction, adduction. This is when you make big circles with your arm. And we will practice these movements when we are in class. All right, so which skeletal structures provide protection. Well, bones provide our soft delicate internal organs protection, okay? So in our chest, let's say our ribs definitely are ribs and our breastbone in our sternum. Those protect the heart and the lungs, okay? Our skull definitely that protects our brain, right? Those are our vital organs without a heart, a brain, and lungs, you're not going to be living. So it's essential that these bones are there to protect those organs. In addition, the skull will also protect the inner ear and parts of the eye. The vertebra protects our nerves of the spinal column. Remember we learned in the last unit how we have this foramen or this hole in every vertebra and that's where our nerves for our spinal cord go through. Our skeletal system provides support. Bone support the body structures and they also provide shape to the body. If we did not have bones, we would be a big old blob. We would be like a jellyfish, okay? Our bones give us provide us a framework and provide structure and support for the body. Those are the functions of the skeletal system. Let's talk about some disorders of the skeletal system. First one we're going to talk about is arthritis. Let's break down that word. Earth or arthro means joint, and itis means inflammation. So this is an inflammatory condition of one or more joints. It causes pain. And often bone changes. There are at least 20 different types of arthritis. The most common are osteoarthritis and rheumatoid arthritis. Osteoarthritis is also known as degenerative joint disease. It occurs with aging people and almost 80% of the population is affected by some level of osteoarthritis. The articular cartilage member that at the end of the bone joint are at the end of the bone, that actually degenerates or wears away, and a bony spur will form at that joint. The joint may become larger and there will be pain and swelling. This can get worse with activity. So the more somebody is using that joint, making that joint move, it will get worse. There is no cure for osteoarthritis. However, the pain and swelling is treated, so hopefully it will increase mobility. We give NSAIDs which are non steroidal anti inflammatory drugs, such as motrin, aleve, ibuprofen, some stuff like that, that can help relieve the pain. Also, dietary supplements such as glucosamine and chondroitin can help with pain relief. So, in osteoarthritis, that protective articular cartilage is getting worn away or degenerates. So it exposes the bone, all right? And then they have the little bone spurs. So you don't have any kind of lubrication in that area, and there is actual wearing a way of bone. Rheumatoid rheumatoid arthritis is also called RA, you may have heard some commercials on TV about RA. RA or rheumatoid arthritis is a chronic autoimmune disease which affects the connective tissue and the joints. When I say autoimmune, I mean that the bodies of immune system actually attacks itself. For some reason your body thinks that something in that joint is foreign and attacks that. Connective tissue. There will be swelling of the connective tissue, a thickening of that synovial membrane, and the joints will actually fuse together. That is why you see the disfiguration going on because the bones actually, the joints, those two bones, fuse together, they should not be fused together, but in RA they do. The joints will become very swollen and very painful, and the pain will cause muscle spasms, which then will cause that deformity in that joint. So it's kind of a vicious cycle. The joints will become stiff and unable to be moved, and since the joint is not moving, the muscles attach to that joint are going to atrophy. Atrophy means to shrink. So let's say I'm just going to throw out a number. Normally, let's say the muscle is two inches. When it atrophies, it may be one inch. It could get even smaller than that, but anything less than that two inch is atrophy. Once again, I just picked that number out of anywhere, okay? That's not specific to this. Just you need to understand that atrophy means to shrink. And actually, if you break it down to a trophy a means without entropy means development. So without development, that bone, sorry, that muscle will shrink. It won't. Stay developed. The cause is unknown and there is no cure. It affects three times more women than men. Treatment includes pain relief and try to reduce that swelling. Somebody may go to occupational or physical therapy to help protect from further damage. Surgery might be considered for joint replacement or even tendon repair. So what we want to do is we want somebody to function at their highest ability and we teach them ways to do that. And that's why they would go to physical therapy or even occupational therapy. Gout. Gout is another disorder of the skeletal system. Gout is a joint disorder, and it's characterized by a sudden inflammation, just one day all of a sudden you're going to have some inflammation. It most often affects that big toe, but can other joys can be infected also. But majority of the time, it's going to be the big toe. There's pain and swelling, and that occurs because there's a buildup of uric acid crystals in the joint. What they do to treat gout, they have a prescription medicine that will help reduce those uric acid crystals from forming, you can also take things like motrin aleve, ibuprofen, things like that and to help treat it. So you can see in this picture here, it's all red and swollen. And in here, this is those uric acid crystals building up. Here's a normal foot x-ray. You can see and see how this is kind of just a big old mess. It's because the uric acid crystals are forming in there. Here's a picture of a hand cut open that had gout. Here, this big ball, yes, this is a real hand. This big ball of stuff right here is uric acid crystals that have accumulated in that joint. So you can see when you have all that stuff accumulating in there, it definitely is going to become painful. You're not going to be able to move that joint. And it's going to become red and swollen. So once again, this is an example of uric acid crystals. Accumulating in the hand, which results in gout. Osteoporosis. Osteoporosis is a porous bone disease, and it's characterized by a low bone mass and structural deterioration of bone tissue. It affects estimated about about 44 million Americans. 80% of those are women. So what you see here is normal bone. This is what your spinal should look like. Your spinal cord should look like this, right? What happens in osteoporosis, it starts wearing away. And it will actually collapse on each other. It will eventually there will be no structure, no scaffolding in there to hold it. And it will collapse on each other. The cause of this is new bone creation doesn't keep up with the removal of old. Some risk factors, if you don't take in enough calcium. Remember I said one of those functions of the skeletal system is to store minerals. One of those being calcium. If we're not bringing it in, then the bones can't store it. Women are more likely to develop osteoporosis than men. So your sex puts you at risk. So if you're a woman, you're more at risk for osteoporosis. Your age, the older you get, the greater your risk of osteoporosis. Your race, you're at greatest risk for osteoporosis if you're white or of Asian descent. Your family history. Having a parent or a sibling with osteoporosis puts you at greater risk, especially if you have a family history of fractures. Your frame size, men and women who have small body frames tend to have a higher risk because they may have less bone mass to begin with to draw off of as they age. Sex hormones. The reduction of estrogen levels also will put you at risk for osteoporosis, men experience a gradual reduction in testosterone levels as they age, lowered sex hormone levels tend to weaken bone. So whether you're a man or a woman, because you have decreased levels of sex hormones, you are at risk for osteoporosis. People who have thyroid problems are at risk, too much thyroid hormone can cause bone loss. This can occur if your thyroid is overactive, or if you take too much thyroid hormone medication to treat your underactive thyroid. And other glands can put you at risk osteoporosis has been associated with overactive parathyroid and also overactive, adrenal glands. Here you have a illustration of a normal spine here on the left, you see right here that has the normal curvature that belongs there, beginning of osteoporosis changes. You can see up here in the cervical spine. It's starting to get more curved than the normal one. Not quite, it's more in the thoracic, it's more sticking out there. And then as this is at age 60, ten years later at age 70, you have this hump. That's right there. And that's that curvature of the spine due to osteoporosis. It's actually caused because the vertebra is collapsing because of the weakened bone. It doesn't have that scaffolding. It doesn't have that structure that bone's not present inside there that spongy bone that has worn away. And so your vertebra are actually collapsing on one another. And that's what's causing that hump. Rickets, rickets is caused by an extreme and a pro prolonged lack of vitamin D intake. Bones become soft and because they don't calcify or they don't get hard because they're soft, it will cause deformities such as bow legged Ness. How do we prevent it? We can prevent it by making sure that we take in vitamin D we take in calcium and our exposure to sunshine, we make sure that we're going out in the sunshine because in order for the production of vitamin D, we have to have sunshine. And in order for calcium to be utilized, we have to have vitamin D they kind of work hand in hand. We don't see rickets a whole lot in this country. We do see rickets a lot in third world countries just because their diet is so poor. If you were to be diagnosed with rickets, if the vitamin D or calcium deficiency causes it, we're just going to add those vitamins and the vitamin D and calcium to the diet. And generally, it will correct any resulting bone problems. If rickets is due to a genetic condition, it may require additional medications or even treatment. Some skeletal deformities caused by ricketts may need correction by surgery. So you can see this older child right here really has some bone deformity going on this child most likely need to have surgery to help fix that. This little guy that's full legged here probably if we can give him his calcium and vitamin D it might correct itself. Unless once again, if it's genetic, then we're going to have to deal with some other medications. This is how you're this is how your typical bone structure should be, okay? Out from the hips comes in at the knee and then should go straight down. And you can see these kids definitely do not have that typical bone structure. Once again, rickets is not very common in the United States. We do have a few. I can recall when I worked at a summer camp. I had a whole family. Four kids that had, it was genetically linked. And so they took a medication. It's called Julie's solution. It's a liquid. And every day, three times a day, they have to take it. To help prevent any of these deformities from happening. Chi, we're going to start talking about abnormal spine curvatures. Chip phocis. This is a humped curvature of the thoracic spine. The individual bones that make up a healthy spine usually look like squares and stacked in a column. Kyphosis occurs when the vertebra in the upper back become more wedge shaped. This deformity can be caused by a variety of problems, and that includes osteoporosis. Disc degeneration, cancer or cancer treatments, and even birth defects. So kyphosis is an abnormal curvature up here in the top, okay? And its treatment is pain relievers. We may do some osteoporosis drug therapy, exercises, they may build a brace to help correct this. This one's pretty in your picture. It's pretty extreme. And then surgery can help replace it. So we want these vertebra to, you know, be stacked on top of one another nice and like kind of like squares. And what happens is they become more pi or wedge shaped because of the sorry, the degeneration. Either from the bone wearing down or maybe the disc in between them wearing down. Lower doses is a spinal curvature on the lower back. Yeah, that one, this lady in the picture, it's very extreme lordosis. It can affect a person of any age, certain conditions can contribute to this condition, including disc itis. So if you have inflammation of the discs, discs between your vertebra, it can cause this. If you have kyphosis, which we just talked about about the curvature on the top, it actually can cause your lower back to have an abnormal curvature. Obesity and also osteoporosis. We use drugs to relieve the pain and the swelling, physical therapy to help build strength and flexibility and also to help increase their range of motion. They will wear a brace to help control the growth of the curvature, especially in children and teens. All right, so as soon as a doctor suspects or sees any little curvature going on, they're going to try embrace build a brace. Sometimes we call it a turtle shell to keep that back straight. We want to reduce excess body weight if the cause is obesity, we want the person to lose weight. And then maybe that curvature will correct itself. If the curvature is severe and causing other symptoms, spinal instrumentation or like putting a rod in the back, or artificial disc replacement, are all potential surgical treatments for lower doses. Okay? Or if it's the if they have kyphosis up on the top, that's causing the lower doses, they'll correct the kyphosis. And that's called a kyphoplasty. All right, so they look at what is causing this abnormal curvature in the spine. And then they correct it. So remember kyphosis was the curvature up on the top. Think about a kite, a kite is up high. And then lower doses is your lower back. A lot of you may have heard of scoliosis, scoliosis is a side curvature of the spine that occurs most often during the gross part just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown. Scoliosis starts with an S and it's got a lateral or a side curve, right? It's the same thing that you'll see in the back. Scoliosis is a sideways curvature. Treatment for this is a brace. Okay? They will as soon as a doctor finds this out. They're going to put you in a brace. They start looking at girls, usually girls, right before puberty. If you've ever gone to the doctor and they tell you to kind of bend over, they're looking at your back, they're looking at your spine, and that's how the initial diagnosis is going to happen is just from checking out your spine. You know, you're at the doctor, they say, go ahead and bend over because they're looking at your spine. You might need to have surgery. Surgeons will connect two or more of the bones in the spine together so that they can't move independently. Pieces of bone or a bone like material are placed between the vertebra, metal rods, hooks and screws, or even wires typically will hold that part of the spine straight. And still while the old and the new bone material fuse together. So it's going to hold it straight and still so that new bone can form and it confused together. And it will straighten it out. Excuse me. Trauma. We can have two different types of trauma to our bones. Okay, so we are going to talk about dislocation and fractures. Dislocation. A dislocation, the bone is displaced from its proper position in a joint. Subluxation is the presence of an incomplete or a partial dislocation. So when we dislocate comes all the way out of the joint, a subluxation is just kind of kind of a little bit out of the joint, but not completely out of the joint. We have different types of fractures, a fracture is a crack or a splinter in the bone. How is a fracture treated? Well, we can treat a fracture with a cast. That's what you have in the first one. We might, in the last one on the right, is a splint that just kind of immobilizes it, or in the middle, this is called an ORIF. In. Sorry. And you have pins and plates. It's a open reduction, so they open up the skin, get to the bone, they reduce it, meaning that they'll put it back in line. And then internal fixation, meaning they put bones or screws in it. Okay? So we can treat a trauma either with a cast or an ORIF where we put pins and screws and maybe rods in there, or we splint it. We just immobilize it. And sometimes depending on the fracture, we'll put a splint on first or a soft cast, and then once the swelling goes down, then we put a hard cast on. The first type of fracture is a simple or closed fracture. This is a single crack in the bone structure. Right here in this picture, you see, what do we see? What we got going on right here. This looks like a radius and ulnar fracture. They got both of them right there. That's rough. Typical arm fracture. Let me go back to sorry. Simple or closed, simple or closed fracture. It's just one single break in it, and it's closed. The bone doesn't come outside the skin. Here you go, nasty. Open or compound fracture. Yes, that is his leg bone and it is tibia coming out of his leg. This is a fracture in which the skin is pierced by the bone. And open or compound fracture means that the bone has broken all the way apart in his come out of the skin. Some of you, I think it was, was it a basketball player? Last year that had that open fracture, it just brought tears to my eyes. As soon as he landed that bone came out. A comminuted fracture. This is a fracture in which one or more areas of the bone is displaced. So right here, we have a tib fib fracture in the leg, the tibia and the fibula have all broken. So you can see there's more than one break going on in the tibia. A green stick fracture, a green stick fracture is a bone that cracks, but not all the way through, okay? In this picture, we see a radius is broken, but not all the way through. Think about when you go to break a green stick outside. It's really hard to break it all the way through, right? It kind of just splinters. That's the same thing when we talk about a green stick fracture. It just kind of splinters. It doesn't go all the way through. A sprain ouch, a sprain is a stretching or tearing of ligaments. The tough bands of fibrous tissue that connect one bone to another in your joint. The most common location for a sprain is in your ankle. That looks really, really bad, but there are no broken bones. It is just that tearing or stretching of a ligament. On the other hand, we have a strain, a strain is a stretching or tearing of a muscle or a tendon. So if you can think of strain ST our AIN has a tendon or a muscle in it. A tendon, remember, is a fibrous cord of tissue that connects muscle to bone. Strains often occur in the lower back and in the hamstring muscles in the back of your thigh. A sprain is your ligament is affected in that. So, once again, no broken bones, it's just in a sprain, the ligament has been pulled or stretched, and or actually torn. And in a strange, you have either pulled stretched or tore a muscle or a tendon. So those are the functions and disorders of the skeletal system, you should be able to answer these questions. What are the functions? What are some of the disorders? How do we treat them and then how does the skeletal system relate to the body's system of support and movement? Make sure you have watched the video. You've wrote your notes on what was presented. You summarize your sorry you summarize what you've learned throughout this presentation. And then you ask at least one question about something you don't understand. And I will see you in class.