Lab exam 2 A&P 1 - Material that is needed to know for the lab exam 2 over the bones and their PDF

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Summary

Material that is needed to know for the lab exam 2 over the bones and their structures; including clinical applications ...

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Vocab 1) Fissure = a slit-like opening between 2 bones 2) Foramen = a hole in bone 3) Paranasal sinus = air-filled cavity within a bone connected to nasal cavity 4) Meatus = canal running through a bone 5) Fossa = a shallow depression in a bone 6) Condyle = smooth, rounded process forming joint 7) Head = enlarged, rounded, articular surface found at end of bone 8) Facet = smooth, flat surface which articulates with another bone 9) Tubercle = small, rounded process 10) Tuberosity = large, rounded process 11) Trochanter = large blunt process found only in the femur 12) Crest = a prominent ridge or border on a bone 13) Styloid process= sharp, slender, often pointed process 14) Epicondyle = a prominence above a condyle 15) Long bones = longer than they are wide, have a epiphysis at each end and a diaphysis in the middle 16) Short bones = as long as wide a) Sesamoid bone = short bone found in a tendon or ligament (patella) 17) Flat bones = are thin and flattened (sternum, ribs) a) Sutural bones = small, flat bones found between adjacent skull bones 18) Irregular bones = bones that are irregularly shaped and do not fit into any of the above categories 19) Axial skeleton = consists of bones that lie along the long axis of the body and includes bones of the skull, vertebral column, and rib cage. (80 bones) 20) Appendicular skeleton = consists of bones located in the limbs, forming the shoulder joints and hip joints. (126 bones)

Bones and Features

1. Frontal 2. Parietal 3. Temporal a. Zygomatic process b. External auditory meatus c. Styloid process d. Mastoid process e. Mandibular fossa f. Carotid canal g. Jugular foramen h. Stylomastoid foramen i. Internal acoustic meatus 4. Occipital a. Foramen magnum b. Occipital condyles c. Hypoglossal canals d. External occipital protuberance 5. Shenoid a. Greater wing b. Lesser wing c. Sphenoid sinuses d. Superior orbital fissures e. Optic foramina f. Sella turcica g. Foramen rotundum h. Foramen ovale i. Foramen lacerum j. Foramen spinosum 6. Ethmoid a. Crista galli b. Cribriform plate c. Ethmoid sinuses d. Perpendicular plate e. Superior and middle nasal conchae 7. Maxillae a. Palatine plate b. Infraorbital foramen c. Maxillary sinus 8. Palatines 9. Mandible a. Body b. Ramus c. Mandibular condyle

d. Coronoid process e. Mental foramen f. Mandibular foramen 10. Zygomatic 11. Lacrimal 12. Nasal 13. Vomer 14. Inferior nasal conchae 15. Hyoid 16. Sutures a. Coronal b. Sagittal c. Squamous d. Lambodial 17. Fontanels a. Anterior b. Posterior c. Anterolateral d. Posterolateral 18. Vertebrae a. Body b. Vertebral arch c. Spinous process d. Lamina e. Vertebral foramen f. Transverse process g. Pedicel h. Intervertebral foramina i. Superior articulating facets j. Inferior articulating facets 19. Cervical (pigs) a. Transverse foramina b. Bifid spinous process c. Atlas (C1) d. Axis (C2) 20. Thoracic (giraffe) a. Spinous process b. Costal facets

21. Lumbar (moose) a. Spinous process b. Larger bodies

c. Articulating facets 22. Sacrum a. Sacral canal b. Sacral promontory c. Median sacral crest d. Sacral foramina (anterior and posterior) e. Ala f. Sacral hiatus 23. Cocyx 24. Sternum a. Manubrium b. Sternal angle c. Jugular notch d. Body e. Xiphoid process 25. Ribs a. True ribs (7) b. False ribs (5) i. 8-10 cartilage attached to ribs above ii. 11-12 no attachment (floating ribs) c. Costal groove d. Intercostal spaces e. Head f. Shaft g. Neck h. Tubercle 26. Shoulder girdle a. Clavicle i. Acromial end ii. Sternal end 27. Scapula a. Spine b. Acromion process c. Supraspinous fossa d. Infraspinous fossa e. Glenoid fossa f. Coracoid process g. Medial border h. Lateral border i. Subscapular fossa

28. Humerous

a. Proximal humerus i. Head ii. Surgical neck iii. Body iv. Greater tubercle v. Lesser tubercle vi. Intertubercular groove b. Midpoint of humerus i. Deltoid tuberosity c. Distal humerus i. Capitulum ii. Trochlea iii. Medial epicondyle iv. Coronoid v. Radial fossa vi. Olecranon fossa 29. Ulna a. Olecranon process b. Trochlear notch c. Coronoid process d. Radial notch e. Head f. Styloid process 30. Radius a. Head b. Styloid process c. Radial tuberosity d. Ulnar notch 31. Carpals a. Scaphoid (Some) b. Lunate (Lovers) c. Triquetrum (Try) d. Pisiform (Positions) e. Trapezium (That) f. Trapezoid (They) g. Capitate (Can’t) h. Hamate (Handle) 32. Metacarpals 33. Phalanges 34. Pelvic (Os Coxae) a. Ilium i. Iliac crest ii. Anterior inferior iliac spine iii. Anterior superior iliac spine

iv. v. vi. vii. viii.

b.

c.

Posterior superior iliac spine Posterior inferior iliac spine Greater sciatic notch Iliac fossa Auricular surface 1. Sacroiliac joint Ischium i. Ischial spine ii. Ischial tuberosity lesser sciatic notch Pubis i. Pubic crest ii. Articulating surface at pubic symphysis iii. Obturator foramen Acetabulum Pelvic brim True pelvis False pelvis (b/w hips)

d. e. f. g. 35. Femur a. Proximal femur i. Head ii. Neck iii. Greater trochanter iv. Lesser trochanter v. Fovea capitis b. Distal femur i. Medial and lateral condyles ii. Medial and lateral epicondyles iii. Patellar surface iv. Linea aspera 36. Patella 37. Tibia a. Medial and lateral condyles b. Intercondylar eminence c. Tibial tuberosity d. Medial malleolus 38. Fibula a. Head b. Lateral malleolus

39. Tarsals a. Calcaneus (Call) b. Talus (The) c. Navicular (Next) d. Medial cuneiform (Man) e. Intermediate cuneiform (In) f. Lateral cuneiform (Line) g. Cuboid (Cute) 40. Metatarsals 41. Phalanges

Left from Right 1. Maxillae 2. Temporal a. Look at mastoid process and the projection (zygomatic process) is missing the zygomatic bone 3. Tibia a. Medial process, always goes towards inside/midline 4. Femur a. Look at head 5. Humerus a. Look at head and part where ulna fits into (olecranon fossa) 6. Scapulae 7. Os Coxae

Clinical Apps 1. Mastoid Infections a. Children often get middle ear infections when upper respiratory infections (sore throat) travel through the pharyngotympanic tubes. Middle ear infections can spread to the mastoid process called mastoiditis. Form there it can spread to nearby meninges, protective connective tissue coverings around the brain called meningitis. 2. Sinus inflammation and infections a. Paranasal sinuses, air-filled cavities in skull bones which are lined with mucous membranes are found in the frontal, sphenoid, ethmoid, and maxillary bones. Infectious organisms (bacteria, viruses, and fungi), allergens, and pollutants can pass the other direction- from the nasal cavity into the sinuses, causing sinus infection or sinusitis. i. Symptoms: pain,pressure, cough, fever, nasal discharge, inflammation, and swelling. In maxillary sinuses pain is in the upper jaw and upper teeth, and in the ethmoid bone pain is in the eye region or down the sides of nose ii. Tx: Antihistamines = decrease the inflammation and swelling and assists in opening and drainage of the sinuses, Decongestants = decrease swelling, Cortisone = (orally or nasal spray) reduce inflammation and swelling, Bacterial infections = antibiotics, Fungal = antifungal meds, and surgery may be preformed to remove infected and swollen mucous membrane which may be harboring microbes and preventing drainage of sinuses. 3. Cleft Lip and Cleft Palate a. Cleft Lip = Is one or more splits or openings in the upper lip resulting from failure of tissues to fuse normally during fetal development. Anterior part of the maxilla does not develop normally creating an opening the may extend into the nasal cavity b. Cleft palate = occurs when bones and or tissues of the palate do not join completely during fetal life. An opening in the roof of the mouth which may extend into the nasal cavity. c. More common in males d. Causes: i. Genetic or environmental factors/ disorder in development ii. Someone born with a cleft lip has a greater chance of having a baby with one iii. Occur at a greater rate with mothers who use certain meds or if she smokes or consumes alcohol or drugs during pregnancy e. Tx: repaired surgically after birth, several over the course of several years. Orthodontic problems may occur as teeth may never have formed or may be malformed. 4. Temporo-Mandibular Joint Disorder (TMJ)

a. This joint is the most used since it is in continuous motion when we speak,eat, or swallow. Pain can range in severity from mild to severe and occasionally a clicking noise can be heard as the jaw is opened or closed. It also causes ear pain, headaches, tenderness or pain in the nearby muscles, and a jaw that is difficult to open or “Locked” in place. b. Cause: i. Arthritis ii. Wear and tear on the joint iii. Misalignment of the teeth iv. Accidental injury v. Clenching and grinding of the teeth (stress related) c. Tx: over the counter pain and anti-inflammatory meds, limit jaw movement, heat therapy to relax jaw, splint or mouth guard for grinding, cortisone injections to the joint, dental treatment to correct misalignment of teeth, or surgery to replace TMJ with artificial joint occurs in only 1% of patients 5. Rhinoplasty (nose job) a. Reshaping of the nose and may be performed for cosmetic or medical reasons. Most are cosmetic, they are done to correct various structural defects within the nasal cavity which cause difficulties breathing b. Procedure: surgeon enters through the nostrils and makes incisions into the nasal mucosa to gain access to the nasal cartilage and nasal bones. Bone and cartilage are cut, broken, reshaped, and rebuilt as needed to reach desired outcome c. History: first performed in India about 600 BC by the father of plastic surgery. It was to repair or rebuild noses which had been injured or cut off which was common thing to do as criminal punishment 6. Abnormal Fontanels a. Anterior fontanels can be used as an indicator of the state of health of an infant. A sunken fontanel may indicate dehydration, while bulging fontanel may indicate an increased intracranial pressure in the infant. 7. Craniosynostosis a. Early or premature closure of one or more sutures. This restricts skull growth in the area of the closure and can result in abnormally shaped skull. This can cause pressure to be applied to the brain because the closed bones can’t make up for the rapid growth of the brain which can possibly led to brain damage. b. Causes: genetic defect, most cases occur in families with no history of the disorder and has no known cause c. Tx: require surgery to separate the bones, allowing the brain to grow. Cosmetic surgery for those that do not cause pressure to normalize the appearance of the skull

8. Ruptured Disc a. As individuals age, the fibrocartilage ring loses moisture, becoming thinner and

less flexible. These changes in the intervertebral discs make the fibrocartilage rings more likely to tear, allowing the gel-like material to ooze out, pressing on the spinal cord or nerves. Known as a ruptured or herniated disc 9. Abnormal curvatures of the spine a. Develop due to disease, developmental difficulties or poor posture. An exaggerated thoracic curvature = Kyphosis, which is most commonly seen in those with advanced causes of osteoporosis (compressed vertebrae). Exaggerated lumbar curvature = lordosis. A lateral curvature of the vertebral column = scoliosis, surgery is performed and limited movement of spine. 10. Spina Bifida a. Spinal cord defect, forms on outside of body in lesion b. Causes: not known, genetics, nutrition, environment play a role in it, lack of vitamin B, folic acid play significant role c. Tx: can be fixed with in utero surgery 11. Lumbar Puncture (Spinal Tap) a. Allows the withdrawal of cerebrospinal fluid or the addition of a substance into the CSF. Healthcare providers stick a large needle between L4 and L5 because spinal cord doesn’t extend to this level = no risk of injuring the spinal cord 12. Inward Xiphoid Process a. A blow to the chest in this region can force the xiphoid process into the underlying structures (heart), causing blood loss and death 13. Whiplash a. Occurs when the head is thrown suddenly and forcefully backward and then forward and may occur during auto accidents, contact sports(football), and physical abuse. Can cause fractures of cervical vertebrae, ruptured discs, muscle, tendon, or ligament injury (ALL can compress the spinal cord and nerves) b. Symptoms: neck pain, headaches, dizziness, ringing in the ears, blurred vision c. Tx: physical therapy combined with meds to decrease pain and inflammation and to relax muscles. People continue to feel pain for several months after injury. 14. Shaken Baby Syndrome a. Occurs when a child is forcefully shaken and may result in permanent brain injury or death, which can cause swelling, bruising, and bleeding inside the skull. Increased pressure in the skull and decreased blood supply to cells when vessels are torn, will quickly destroy brain cells. Usually in children younger than 2 but has occurred in 5 year olds. b. Symptoms: breathing problems, poor eating, vomiting, extreme irritability, tremors or seizures, extreme sleepiness, blue or pale skin, and coma. c. Tx: medical attention immediately, about half of all children who suffer from this will die 15. Dislocated shoulder a. Glenoid cavity is shallow, joint between the humerus and scapula is not well stabilized. Humerus is one of the most commonly dislocated bones in the body.

The humerus is forced anterior to the glenoid cavity in shoulder dislocations. 16. Deltoid IM Injections a. The acromion process of the scapula is used as a landmark for giving injections into the large shoulder muscle called the deltoid. Injections are given 2-5 cm below the greater tubercle. 17. Ulnar dislocation a. Medial epicondyle of the humerus, the olecranon process of the ulna, and the lateral epicondyle of the humerus should be in a direct line with each other. If not in line it’s dislocated. 18. Colles Fracture a. Is a fracture of the distal end of the radius and often occurs when an individual falls and tries to break their fall with outstretched arms. Happens to those with osteoporosis or other bone weakening disorders. 19. Appendicitis and McBurney’s Point a. McBurney’s point is located on the anterior abdominal wall which lies directly superficial to the appendix b. Pain which intensifies when the pressure is released is a common indicator of appendicitis, also where incision is made. 20. Inguinal canal and inguinal hernias a. Inguinal ligament travels from the anterior superior iliac spine to the pubis, and is marked externally by a groove in that area. The ligament forms part of the inguinal canal = opening between the abdominopelvic cavity and the external genitalia. The canal is larger in men than women due to all the things that travel through it. b. A hernia is a weakened area in a muscle wall through which internal organs protrude. In an inguinal hernia the small intestine may protrude through the inguinal canal and the hernia may present as a bulge in the groin region or the external genitals 21. Fetal Descent a. Comparing the baby’s head relative to the ischial spines provides info about the descent of the baby through the bony pelvis called the baby’s “station”. b. When the top of the head is even with the ischial spines = Zero station c. A minus one = head is one centimeter superior to the ischial spine d. A plus one = head is one centimeter inferior to the spines 22. Broken Hips a. Are breaks in the femur and most are either in the femoral neck or just below the neck region between greater and lesser trochanters. Most occur in older individuals who have osteoporosis, in younger individuals is trauma related. They require surgical repair (open reduction of the fracture) 23. Gluteal IM Injections a. Intramuscular injections into the gluteal muscles is given in a region to avoid the sciatic notch/nerve. The injection should be administered above an imaginary line which does from the greater trochanter of the femur to the posterior superior iliac

spine. Or in the upper, outer quadrant of the buttocks. b. Ventral gluteal muscles, to locate this site, place heel of hand on the greater trochanter of the femur and the index finger posterior to the anterior superior iliac spine. “V” shaped between the fingers.

Comparison of female to male pelvises Female

Male

False pelvis

Broader and flatter

Narrower and more upright

Pelvic inlet/ brim

Wider and more rounded

Narrower and more heart shaped

Subpubic angle

Rounder and greater than or equal to 90 degrees

Narrower, less round and 50-60 degrees

Ischial spines

Less prominent

More prominent

Ischial tuberosities

Farther apart, pointed more laterally, shorter

Closer together, pointed more medially, longer, sharper

Sacrum

Wider and directed in a more posterior direction

Narrower and directed in a more anterior direction

Coccyx

More mobile, more posterior

Less mobile, more anterior

Pelvic outlet

Wider due to less prominent ischial spines, tuberosities shorter and farther apart

Narrower due to prominent ischial spines and tuberosities closer together and more medial and longer...