Health Occupations

Skeleton System – Unit 3

Joints

Area where 2 or more bones join together Ligaments – connective tissue bands holding

long bones together Also called an ARTICULATION Commonly named by the bones that are

joined– Sternoclavicular– Sacroiliac

3 types of joints Synarthrosis

– Immoveable• Cranium sutures• Pelvic girdle

Amphiarthrosis– Slightly moveable

• Vertebral disks• Symphysis pubis• Sacroiliac

Diarthrosis (also called synovial joints)– Freely moveable

• Shoulder, elbow, wrist, fingers• Hips, knees, ankles, toes

6 types of diarthrosis joints

All contain a protective bursa– Sac filled with synovial fluid– Cushions moving parts

Types of joints are named depending on type of movement

Ball & Socket

1. Allows for flexion, extension, abduction, adduction, & limited rotation

2. Shoulder & Hip

Hinge joints

1. Limited movement in one direction, like a hinge

2. Elbow & knee

Gliding Joint

1. Allows bones to slide over one another

Wrist

Pivot Joint

1. Allows rotation from side to side 2. Rotation of head 3. Rotation of lower arm from side to

side

Saddle Joint

Only on thumb – OPPOSABLE THUMB Allows the thumb to touch fingertips

Gomphosis Attachment of tooth into its socket Specialized joints allowing very slight

movement Attachs a peglike structure (tooth) into a

socket (jaw)

Teeth Adult human has 32 teeth Baby teeth are called deciduous or primary teeth Tooth parts

– Crown – white section above gum– Root – below gum– Enamel – hardest substance in body, found covering

crown– Cementum – hard, bonelike structure covering root– Dentin – located between enamel & pulp– Pulp – soft living portion of tooth, contains nerves &

blood vessels

Enamel

Crown

Cementum

Root

Dentin

Pulp

Types of teeth

Type of teeth

Number Function Location Descrip-tion

Incisor, central or lateral

8 Cuts food Front of mouth

Broad,

sharp

Cuspid, canine

4 Tears food Angles of lips Longest in mouth

Bicuspid or premolars

8 Grinds food Between cuspids & molars

Flat

Molar 12 (3rd molars are wisdom teeth)

Grinds food Back of mouth

Largest & strongest

Central Incisor

Lateral incisorCuspid

BicuspidBicuspid

Molar

MolarMolar

Disorders of teeth

Caries– Cavities– MAJOR cause of tooth loss – Caused by bacteria– Placque – thin, filmlike deposit that adheres to

teeth & leads to decay – microorganisms & protein– With extensive infection, may see loss of the bone

that supports the tooth– Treatment – fill the cavity with a restorative

material like amalgam or remove the tooth

Disorders of teeth (cont)

Periodontitis– Affects 90% of adults in U.S.– Causes most tooth loss in adults >35 – Tissues that hold teeth in place become inflamed– Symptoms

• Sore, bleeding, swollen, receding gums• Persistent bad breath, HALITOSIS• Advanced – pus formation, loose teeth

– Treatment – • Remove tooth• Scrape gums• Root canal therapy

Dental Health Care More than repair of caries & treatment of

disease Correct damaged, discolored, misplaced teeth Bonding – covering surface Porcelain facing Sealants – plastic coating Bleaching Braces Osteointegration – implants

Brushing Teeth

Clean all 5 surfaces of tooth– Chewing or biting surface– Facial surface – faces inside of lips &

cheeks– Lingual surface – tooth side nearest tongue– Side or interproximal surfaces – located

between teeth, 2 on each tooth. Needs floss to clean

Brushing teeth Raise HOB to 30 degrees Place towel across chest to protect clothing & bedding Have pt. hold emesis basin Put toothpaste on wet toothbrush Wear gloves Offer mouthwash solution (1:3) first to rinse,

moistening gums and making brushing easier Brush upper teeth & gums first (decreases saliva) then

lower, then tongue Rinse with mouthwash solution Dry face, remove towel, clean-up, remove gloves

Skeletal System - Abnormal

Arthritis – group of diseases involving joint inflammation

2 types – osteoarthritis & rheumatoid arthritis

Osteoarthritis Chronic disease occuring as a result of aging Often affects hips & knees Symptoms

– Joint pain, stiffness, aching– Limited ROM

Treatment – Rest– Heat/cold applications– Aspirin & antiinflammatory meds– Steroid injections into joints– Special exercises

Rheumatoid Arthritis Chronic, inflammatory disease affecting connective

tissue & joints More common in women, ages 35-45 Progressive attacks can cause scar tissue formation

& atrophy of bone & muscle Can result in permanent deformity & immobility Early tx important to reduce pain and damage Treatment –

– Rest– Anti-inflammatory meds, aspirin, steroids– Arthroplasty to replace damaged joints sometimes done

Bursitis Inflammation of the bursae

– Small fluid filled sacs surrounding joints Symptoms

– Severe pain– Limited movement– Fluid accumulation in joint

Treatment– Pain meds– Steroid & anesthetic injections into joint– Rest– Aspiration– PT to preserve joint function

Types of Fractures Crack or break in bone Greenstick

– Bone bends & splits– Crack or incomplete break– Common in kids

Simple or closed– Complete break of bone– No skin damage

Compound or open– Bone breaks & ruptures through skin– Increased chance of infection

Types of Fractures (cont)

Impacted – Broken bone ends jam into one another

Comminuted – Bone fragments or splinters into more than

2 pieces

Types of fractures (cont)

Spiral– Bone twists – Results in 2 or more breaks– Common with skiing & skating

Colles– Break & dislocation of distal radius– Characteristic bulge at wrist– Caused by falling on outstretched hand

Types of Fractures (cont)

Depressed – Bone is depressed or sunken

Types of fractures (cont)

Avulsion– Occurs when a ligament or tendon pulls off

part of a bone during an injury– Ankles, legs, hip, upper arm common– Small fracture may not require treatment &

may not hurt– Large fracture may require surgical

attachment

Treatment for fracture

REDUCTION– Bone is put back into proper alignment– Closed reduction

• Position into alignment (usually with traction)• Apply splint or cast to maintain position until fracture

heals

– Open reduction• Surgical repair of bone• May implant pins, plates, or other devices to maintain

correct position of bone

Dislocation

Bone forcibly removed from a joint Occurs in shoulders, fingers, knees, & hips

frequently Treatment –

– Reduce dislocation– Immobilize joint with cast, splint, or traction

Sprain Twisting action tears ligaments at a joint Common with wrists & ankles Symptoms

– Pain & swelling– Discoloration– Limited movement

Treatment– Rest – Elevation– Immobilization with elastic bandage– Cold applications

Subluxation

Partial dislocation of a joint Like a whiplash injury May feel mild or severe pain in areas

affected by spinal nerves Treatment

– Manipulation of spine– Bracing or surgery

Talipes

Congenital deformity of feet & ankle Clubfoot

– One type– One or both feet are turned, usually

inward, affecting mobility– Treatment

• Surgery• Corrective shoes

Osteomyelitis Bone inflammation, usually caused by pathogen Abscess forms within bone Pus accumulates in medullary canal Symptoms

– Pain at site– Swelling– Chills, fever

Treatment– Antibiotics– Debridement

Osteoporosis Increased porosity or softening of bone Metabolic disorder caused by

– Lack of estrogen– Prolonged lack of calcium in diet– Sedentary lifestyle

Bones lose calcium & phosphate causing bones to become brittle, porous, & prone to fracture

Bone density tests – lead to early prevention & preventive treatment– Increase calcium & Vitamin D intake– Meds to increase bone mass– Exercise– Estrogen replacement

Osteoporosis

Ruptured or Herniated Disk Occurs when intervertebral disk ruptures or protrudes

out of place, causing pressure on spinal cord Common site – lumbar/sacral area but can occur

anywhere Symptoms

– Severe pain & muscle spasm– Impaired movement & numbness

Treatment – Rest & traction– Physical, massage, & chiropractic therapy– Heat & cold applications– Surgery in some cases (laminectomy)

Herniated Disk

Abnormal curvature of spinal column Kyphosis – hunchback, rounded bowing

of back at thoracic area Scoliosis – lateral curvature

Abnormal Curvature

Lordosis – swayback, inward curvature of lumbar region

Abnormal Curvature (cont) Causes –

– Poor posture– Congenital defects– Structural defects– Malnutrition– Degeneration of vertebrae

Treatment– Therapeutic exercises– Firm mattresses– Braces– May require surgery if severe

Carpal Tunnel Syndrome Common disorder Caused by pressure on median nerve of the wrist Results from repetitive motion or trauma Symptoms

– Numbness & tingling– Pain & weakness

Treatment– Rest affected wrist, splinting– Anti-inflammatory meds– Surgery

GoutResults from uric acid crystals building up Common in great toe Caused by inability to adequately remove uric acid

from blood Often a complication of other disorders Symptoms

– Pain & swelling of joint– May have fever & chills

Treatment– Medications – Weight loss & diet management

Meningomyelocele

Congenital condition of spinal column Called spina bifida Can cause paralysis & nervous system

disorders due to pressure on spinal cord Treatment

– Surgery– Prevent infection

Osteoma

Bone tumor May be benign or malignant Symptoms – depend upon size &

location of growth Tx – removal, sometimes chemo

Osteomalacia

Rickets Softening of bones due to Vitamin D &

calcium deficiency Symptoms

– Pain, muscular weakness– Anorexia, weight loss– Deformity

Treatment – add nutrients

Paget’s disease Osteitis deformans Unknown cause Occurs after age 35 Excessive destruction of bone cells causing long bones to be

bowed & flat Symptoms

– None to bone pain– Dizziness– Headache– Deafness

Treatment– Meds, mild exercise– High protein diet

Knee anatomy