The skeletal system In this unit Bones of the human skeleton: medical and common names t Plural nouns of Latin origin ¢ Describing bones Adjectives describing anatomical position Bone structure © Osteoporosis ¢ Warm-up Working in pairs, list the functions of the human skeleton, Listening Bones of the human skeleton Exercise 1 Listen and identify the bones in the picture below.7 cervical vertebrae 12 thoracic vertebrae 4 5 lumbar vertebrae ~ Tail bone (coccyx) wrist bones (arpa) Palm bones (metacarpals) Finger bones (phalanges) < & ‘Ankle bone (talus) Collarbone (clavicle) 1— shoulder blade (scapula) | — Breastbone (sternum) Humerus Uina Radius Thigh bone (femur) Kneecap (patella) Shin bone (tibia) Calf bone (fibula)Over ninety per cent (90%) of technical terms in anatom, clinical medicine and laboratory medicine are of Greek 1 Steen, Greco-Latin origin. Many of them have their English 7 atta ang The technical terms are used in the literature and between 4 professionals, but when you talk to patients, the rule is a alt please!’ Tish, Exercise 2 4 ® Listen and repeat technical and common names of the bo, Follow them in the picture. . Vocabulary building Complete the table giving medical and common names of the following bones. How many can you name without referring to the picture in Exercise 1? Can you remember more medical terms or more common names? Kosé Medical English name Common name ezaszka kogé krzyzowa kogé tokciowa koSé piszczelowa koS¢é promieniowa ko$¢ ramienna kosé strzatkowa koS¢ udowa kosci Srédstopia koSci stepu oy kregostup Fetopatka mostek obojozyk paliczki rzepka zebra zuchwa Read the description of the human skeleton adding the missing names of the bones, either common or technical. The skeleton of an adult human is formed by 206 bones. The bones are organised into two groups known as the axial skeleton and the appendicular skeleton. The axial skeleton includes the skull and the bones of the trunk (the vertebral column, rib cage and sternum, or ). The skull is made up of eight bones which form the cranium and fourteen bones which make the skeleton of the face. The only movable bone is the ?. or lower jaw bone. The spinal column consists of 33 vertebrae. The rib cage (thoracic cage) is formed of twelve pairs of ribs with the top seven pairs of ribs attached directly to the * and known as true ribs. The next five pairs are called false ribs because they are not joined to the sternum directly. The 8", 9° and 10" ribs are fused with the rib above, but the 11" and 12", called floating ribs, are unattached in front. The appendicular skeleton consists of the bones of extremities ‘ vssssses.) and the bones that attach them to the axial skeleton. The shoulder girdle is formed by the °. collarbones and the scapulae, or °......+ It supports the axial skeleton. The bone of upper limb attaching its skeleton to the the upper arm is called the 7........::01+8 + The®... is the outer and shorter bone of the forearm. The other bone, ‘The wrist contains eight bones ones inner and longer, is the °. called the '° ., each hand is formed of five b(Ma. ...) and each set of «has known as phalanges. 4 bong The pelvic girdle consists of the right hip bone and hip bone and connects the lower limbs to the axial skelery lower limb has four bones. These are the femur, or 3, "0 Each bone, the '*. -» or kneecap, and two bones in thei leg which are the tibia, or '°. - bone and the fir" » the foot has fy. ji 6 ankle contains seven bones (" bones ('” ..) and each set of ®. one 14 bones. tag The bones are connected by joints (articulations) with tog bands of white fibrous connective tissue known as ligament Tendons, which are fibrous cords or bands attach the skeleta muscles to the bones. The skeleton, which is strong, movable and flexible, forms the framework of the body and is responsible for movement (locomotion). Its parts also protect soft tissues and internal organs, The skull protects the brain, the rib cage protects the heart and the lungs, the vertebral column protects the spinal cord and the pelvic bones give some protection to the viscera. In the bone marrow within bones blood cells are produced. The bones store calcium and other minerals which are released into the bloodstream when needed. In the text above, what bones do these numbers refer to? Example: 1. There is only one (1) movable bone in the facial skelet™ It is the mandible, or lower jaw. 2.2 7.8 3.3 8.12 4.4 9:14 5.5 10. 33 6.7 11. 206 NOTE: | seh some With many foreign nouns the original plural is use¢> with jue! it is either the original plural or the more recently if hs anglicised plural, e.g. one scapula but two scapulae oF ©?Listening Exercise 6 5 ® Listen and repeat the names of the bones with their plurals. singular original plural regular English plural alcaneus calcanei fibula fibulae fibulas humerus humeri phalanx phalanges radius radii scapula scapulae scapulas sternum sterna tibia tibiae tibias ulna ulnae ulnas vertebrae vertebrae Vocabulary building Complete the table with appropriate nouns or adjectives. Noun Adjective axis bony cranial ulna tibial radial humerus. femoral vertebra clavicular sternum Patella rib costal coccygeal sacralComplete the table with the names of the bones 7 appropriate heading. You may add your own example, “te calcaneus metacarpals femur humerus Pay ‘sternum tarsal vertebra facial bones Vert ., metatarsals radius scapula carpal bones tibia rae Bone(s) short flat long sesamoid_| triangular Tinegug 1. A paired long slender curved bone which forms the front pat of the shoulder girdle is called the clavicle, or collar bone. 2. A flat bone which forms the front part of the thoracic cage’s known a8 oes eesesseeseeees POT eee 3. The bone of the upper arm is named . 4. The outer and shorter of the two bones of the foream referred £0 88 cee-ccesseeessess 7 5. The small bone situated in front of the knee is cll Bs ed 8. The five bones in the hand between the fingers and the wrist are referred to as EG 9. Bones in fingers and toes are called . is called 10. One of the ring-shaped bones which form the spi deatysreledesl 7 «che body ® 11. The longest, and the largest and strongest bone is the namedExercise 10 Make your own descriptions of these bones. Work in pairs. Jake turns reading the descriptions to a partner, whose task is qa guess what bone you have described. ulna fibula calcaneus metatarsals humerus patella Adjectives describing anatomical position ‘The adjectives below are used to describe the relative position of the body parts. Match each adjective (1-10) with its meaning @-j)- Posterior = w=» Anterior ‘\ Proximal {Distal ral1. superior a. inside the body, further fro, 1m the sk; 2. inferior b. above another part, higher up skin part, closer to the head another 3. anterior c. at the back, behind 4. posterior d. in front 5. proximal e. below another part, lower down, clog the feet ai 6. distal £. closer to a point of attachment 7. medial g. towards or nearer to the midline of th body 8. lateral h. towards or nearer the side 9. superficial i. located on or near the surface 10. deep j. farther away from the point of attachment 1 2 3 4 5 6 7 8 9 10 Exercise 12 Use the adjectives to describe the position of these parts/organs in relation to each other. 1. sternum/heart The sternum is anterior to the heart. The heart is posterior 1th sternum. . vertebral column/sternum . wrist/elbow . muscles/skin . radius/ulna fingers/wrist . chest/abdomen NAWRWNne structure id Look at the figure showing a long bone and Laok a th ig bone and repeat the names Epiphysis - — Epiphyseal plate Metaphysis Medullary cavity Diaphysis ~ (shaft) War Endosteum ie" 8 = —— Bone marrow yd Bea / Epiphysis] piphysis G Complete the sentences describing the parts of a long bone: Compare your answers with those of your partner. 1. The long central part of a long bone is referred wo the .. ., OF and the is the central cavity which contains yellow bone marrow. 2. The expanded end ofalong bone iscalled ... 4 3. The growing portion of a long bone, between the epiphyses an the diaphysis is known as «+++ + i is named 4, The membrane that lines the marrow cavity of a bone i the veeeeeeeseeeeeeees : ¢ covers the surface of @ 5. A layer of dense connective tissue tha bone is called :OSS. lo This table is a mi i-glossary of terms related to structure. Complete the table by choosing the right a.v* be (a-f). The first line has been done for you. Finitions 1. | bone matrix f | substancja migdzyko; koSci, macierz kos" 2. | compact bone koSé zbita 3. | osteoblast komérka koSciotworcza 4. | osteoclast komérka kosciogubna, osteouay 5. | osteocyte komérka kostna, osteocyt 6. | cancellous (spongy) bone kosé gabozasta a. cells that break down bone b. cells that build bone c. less dense, second layer of bone d. mature bone cells e. outer hard layer of bone £. the material between bone cells; it stores calcium and phosphorus for the body to use as needed Listening i Osteoporosis owa a Exercise 16 76 You will hear a journalist at the local radio station interviewing a or physiotherapist for their weeldy programme “In Good Shape”. Today's topic is osteoporosis. Listen to the conversation and note down answers to the questions below. Listen to the recording again to check the answers. 1. Whar is the role of osteoblasts and of osteoclasts?ae does Tomek mean when he says “Bone is not static’? at imbalance between bone formation and bone loss oes osteoporosis Produce? * Cadjectives can you use to describe osteoporotic bone? Mi what bones do osteoporosis-associated fractures usually cour? vu sign of advanced osteoporosis is shown in the picture? at are the two general terms for the physical activity which stimulates bone growth? What activities in particular can stimulate bone growth? | Translation Exercise 17 fanslate the sentences into English. Then compare your aswers with the Answer Key. | Osteoporoza, nazywana réwnied choroba kruchych kosci, powoduje zmniejszenie sig ggstosci kostnej i zmniejszenie | wytrzymatosci (strength) koséca. | Dotknigte osteoporoza kosci — zwhaszcza kr¢ | i nadgarstek — moga tatwo ulegaé zlamaniu. | Osteoporoza moie ted. prowadzié do proksymalnego zamania | kogci ramiennej i koSci piszczelowe} oraz miednicy. | Osteoporozie mozna zapobiegaé przez éwiczenia wzmacniajace , kogé biodrowa Ficta pestctni kosci i migSnie. § Obcigéenie jest konieczne do wzrostu tkanki kostnej i dlatego unieruchomienie powoduje utratg tej tkanki. Codzienne éwiczenia w obciaieniu, ktére kazdy mote stosowac, to szybki spacer, bieganie, jazda na rowerze, gimnastyka lub éwiczenia sitowe, a nawet wehodzenie po schodach.The joints | In this unit rs Types of joints ' Synovial joint structure Osteoarthritis: changes in the joints Range of motion (ROM) movements: evaluation and exercises Osteoarthritis: patients’ complaints ¢* Exercises to prevent joint stiffness and maintain function ® Warm-up Work in pairs. Make a list of joints in the human body and 7 problems they may cause. Compare your answers with those o other students. Reading Types of joints oot the text and find answers to these questions: she? ° 1. What does ROM stand for? What does it describe! he 2. What terms can be used to describe the joints bones of the skull?hat range of motion is possible in the sacro- i 3. Sphich joins allow the greatest range of movement eine? 5, What movement is possible in the hinge joint? % Can you extend, flex and rotate the ellipsoidal joint? 7, Where are the saddle joints situated in the body? §, Which of the joints do we use when we shake our head answer ‘no”? ead to joint, also known as an articulation, is the point where two or a vre bones are joined. For example, the knee connects the fers and the tibia. One of the criteria used to classify joints is their mobility or che range of motion (ROM). Itis the range, measured in degrees through which the joint can be extended and flexed. According to this criterion joints may be divided into three categories: immovable (with no ROM), slightly movable (with limited ROM) and freely movable (with full ROM). “The sutures between the bones of the skull are an example of fixed joints also known as synarthroses. The joints at both ends of the clavicle or the sacro-coccygeal joint are slightly movable and the term for such joints is amphiarthroses or cartilaginous joints. The knees, elbows, wrists, shoulder and ankles are examples of joints with full ROM and they are called diarthroses or synovial ‘Another classification of movable joints is based on the way they move.-A ball-and-socket joint, like the hip and the shoulder, allows the greatest range of movement. In health, a person may bend, straighten, move sideways and rotate the hipsand shoulders. A hinge joint, like the elbow or finger joints, allows bending and straightening. The elbow joint is in fact a und hingesmnovi joint which consists of the humeroradial articulation and the humeroulnar articulation which function as a unit. Ap lee joint, like the one between the forearm and the wrist» can a any . : 7 ; freely bent and straightened with only limited F080" the saddle joint js situated at the base of the thumb, We ean move thumbe backwards and forwards and from side to sis ny rotation is limited, Gliding joints, like che joints Im Tt Ft ang wrist, allow limited movement. The joint beweet td and second vertebrae ica pivot joint, It allows roranon & its movement from side to side.Synovial joints Read these descriptions of parts of the synovial join, the diagram of the knee joint. Use the labelled pithy describe the synovial joint structure to a partner, “8 ty A. Articular cartilage Hyaline cartilage covers the ends of bones. In the the ends of the femur and tibia. Hyaline cartilage strong. It is wear-resistant and reduces friction duri B. Bursa (p/, bursae) ‘The fluid-filled sac which provides cushioning and protec ih joint against pressure and rubbing. kn . af these ate is smooth ang Ng Movement, C. Joint capsule Fibrous tissue which completely surrounds a joint. It holds the joint together but is flexible enough to allow movement. D. Ligaments Strong bands of fibrous connective tissue which strengthen joints ‘The cruciate ligaments of the knee stabilize the joint and prevent dislocation of the tibia. E. Meniscus (p/. menisci) Two pads of cartilage (lateral meniscus and medial meniscus) between the femur and the tibia in the knee joint. They act cushions and shock absorbers. F Synovial fluid 4 Secreted by the synovial membrane (synovium), it fils a lubricates the joint space and is essential to proper functioning the joint. G. Synovial membrane (synovium) Smooth lining of the capsule covering a joint. It secretes © which lubricates the joint. he fluidMuscle Bone Osteoarthritis Read this brief description of osteoarthritis and complete the notes below. Osteoarthritis is a common form of joint degeneration caused by natural wear and tear and it affects many patients as they age. Mild osteoarthritis may be seen in people over the age of 60. A familial susceptibility, injury, infection and obesity may be also responsible. When the articular cartilage is damaged or worn down, it becomes rough and thin. The bone at the edge of the joints grows outwards forming bony spurs called osteophytes. In advanced arthritis very little cartilage remains and the bone starts to wear away as the bone surfaces touch and rub. The joint space becomes increasingly reduced. The inflamed synovium is thickened and may produce extra fluid which makes the joint swell. The capsule and ligaments thicken and contract. Muscles that move the joint may weaken or become thin and wasted. The shape of the joint 1s likely to change, which leads to deformities. Osteoarthritis usually affects the cervical and lumbar vertebrae, shoulders, knees and hips as well the base of the thumb, big 6 and the knuckles. Typical symptoms include pain and swelling of the affected joint, worsened by activity, joint stiffness for some tim after a period of inactivity, limited activity in the affected jointyf epitus, i.e. a crackling sound produced by bone ru crepitus, i. bbin, ! i joints’ Bon or roughened cartilage (‘creaky joints’). bone 1, Causes of osteoarthritis 4. Joint space becomeg b 5. Synovium become, c. : d. I d fren c. i ost o| 3 os . 2. Joints affected m 6 edie. bh become c. : , : 7 3, Articular cartilage becomes 8. Typical symptoms and signs a. . ; b.. c. d.. Speaking severe Label the diagram showing a joint affected By sot osteoarthritis. Use the labelled diagram to explain with ost" his/her problems to a partner acting as a patient arthritis, inflamed synovium roughened, thinning cartilage, little remaining cartilage thickened bone ends with no cartilage reduced joint space osteophytes thickened capsule changed shape eoevvcceGrammar reminder Complete the table supplying appropriate nouns, adjectives, verbs and past participles used as adjectives. Noun ‘Adjective Verb Past participle length long lengthen lengthened redness red redden roughness straight strength strengthen thickness tightness toughness weaknessThe spine (also known as the spinal column, the verre column or the backbone) consists of 33 bones called the vertehy Seven vertebrae are in the neck (cervical vertebrae), twelve © the chest (thoracic vertebrae), seven in the lower back (lum : i f at vertebrae), five are fused into a single unit the sacrum (saee) vertebrae) and four are fused into another single unit called the coccyx or tail bone (coccygeal vertebrae). The first cervical verteby, is called the atlas and the second cervical vertebra is called the axic Each vertebra is a ring-like bone enclosing a central canal called the spinal canal as the spinal cord passes through it. Spinal nerves branching out of the cord pass between the vertebrae. Intervertebral discs are pads of fibrous cartilage with a gelatinous (elly-like) centre. They are situated between all the vertebrae with the exception of the atlas and axis and the fused vertebrae in the sacrum and the coccyx. They act as flexible cushions and help absorb shocks. A herniated disc which protrudes into the intervertebral foramen may compress a nerve root and cause considerable pain. Seen from the back, the spine looks straight. Viewed from the side, it curves in the shape of an S. The main function of the spine is to support the head and torso upright. Yer, it isa flexible column which can bend forwards and backwards and twist on its axis. Thanks to the cervical vertebrae the head may move backwards, forwards, sideways and around. The thoracic vertebrae support the ribs while the ribs stabilize the spine. The lumbar vertebrae are1 EE Spinous process Facets for articulation with ribs Transverse process Articulating process Vertebral canal Intervertebral disc Body quite mobile. They allow turning, twisting and bending. They also bear the weight of the upper body and are used in all activities of daily living. Pain in this area can limit many activities and lower the quality of life. The sacrum and the coceyx protect the internal organs in the lower part of the body. 1. What are the names for the series of 33 vertebrae that extend from the cranium to the coccyx? 2. What are the five regions of the spine? 3. How many vertebrae are there in the neck? What do you think the symbol C3 stands for? 4. How many vertebrae are there in the upper body? What do you think the symbol T12 stands for? What is the number of the vertebrae in the lower back? What do you think the symbol L2 stands for? . What is the topmost vertebra called? Can you explain why? Where is the spinal cord found? . Which parts of the spine are formed by the fusion of Why is the spine said to be a flexible column? What structure may be described as a shock absorber? w f vertebrae? SyaengnMusculoskeletal injuries In this unit vs Fractures Taking care of a cast and rehabilitation Dislocations, sprains and strains Sports injuries * Ambulation exercises and walking aids A “smart” crutch ¢ Warm-up § What injuries may be caused by a bad fall? Work in pairs and make alist of the most common ones. Compare your answers with thot of other students. Reading Fractures Re: ad the text and answer the questions. Fractui es are breaks (cracks) in bones and their most comm cause is trauma lik in ike idents 5 falls on level ground, car acciden® © i. accidents or falls from heights. A radiological view (8: X-ray)described by the type of fracture line (e.g. transverse or oblique), location of fracture line, (e.g. the proximal third of the tibial shaft), angulation, (i.e. the broken fragment is on an angle), and displacement, (i.e. the broken parts deviate from a straight line). Another classification is into simple and compound fractures. ‘A simple fracture also known as closed is not associated with soft- tissue injury. In a compound or open fracture the skin is broken. ‘The usual symptoms and signs of fracture include immediate pain, swelling increasing for several hours, bone tenderness, ecchymosis, reduced or abnormal motion, deformity and crepitus. Fractures hurt and the patient is not able to move an arm, stand ona leg or grip with a hand. The treatment is by open reduction or by closed reduction. Open reduction and internal fixation (ORIF) is surgical treatment. The fracture fragments are stabilized by direct fixation to one another with surgical hardware such as wires, screws, pins, plates or external fixators. In closed reduction, the broken bones are brought into normal position without surgery, by stretching, traction or external manipulation. The set bones are immobilized by applying a splint or a cast. Casts and splints or “half casts” are made of plaster or fibreglass. Aluminium splints covered with foam are used for finger fractures. ‘The patient has to wear the cast for weeks or months just as fracture healing time varies from weeks to months. With a walking cast he or she may walk on it using a cast shoe on the cast. A sling is used to provide support for a cast or splint on the arm. 1. Which of the accidents described above are likely to result in minor fractures and which usually cause severe fractures of several bones? . How are fractures classified? (By ...) . What does a broken limb usually look like? What are the signs showing that the limb is not functioning properly? 5. What is surgical hardware and why is it used? 6. Why is a cast or a splint used? What is the difference between the two? AWNComp! supplying : reading the defini Stable presenting different fracture i i "Ypes the English terms and definitions. The, by Cee ons aloud with a partner,” “¢ tun, English term Definition | Zamanie patologiczne Ziamanie Colles (z. w nadgarstku) Ztamanie mnogie (wielokrotne) Ztamanie zupeine Ziamanie otwarte Ztamanie poprzeczne Ztamanie skosne 2|afolola Ztamanie skretowe (spiraine) Ztamanie wewnatrzstawowe 10. Ziamanie wieloodtamowe () a comminuted fracture (C) the bone is broten| into many pieces 11. Ztamanie niezupetne, z.. typu zielonej gatazki 12. Ztamanie kompresyine 13. Ziamanie Zewnatrzstawowe .| Ztamanie z przemieszezeniem ew mean ge a compound (open) fracture a multiple fracture a complete fracture an incomplete (greenstick) fracture an extra-articular fracture a transverse fracture an oblique fracturea spiral fracture acomminuted fracture acompression fracture a displaced fracture a pathological fracture .a Colles’ fracture an intra-articular fracture | the fractured bone or bones are not properly aligned . a partial crack and a bend in the bone; the fracture does not extend through the width of the shaft the bone is broken into many pieces the bone is broken completely the bone is broken at an angle a fracture which involves the bones of the joint a fracture near a joint but not involving the bones which form it a break in the radius, usually caused by a fall onto the outstretched hand _ a fracture going round and down the length of the bone |. broken bone breaks through the skin and is visible on the surface K. the bone is broken straight across L. fractures caused by an underlying disease which has weakened the bones M.due to hyperflexion of the spine, usually occurs in the lumbar region N. more than one break in the same bone e> pacers mOmmgOO oe