Task 1 Describe the Structure and Function Of the Musculoskeletal System

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ORTHOTICS & PROSTHETICS TASK 1 INTRODUCTION DESCRIBE THE STRUCTURE AND FUNCTION OF THE MUSCULOSKELETAL SYSTEM
PURPOSE

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In order for the orthotic-prosthetic technician to correctly fabricate orthoses and prostheses, it is necessary for him/her to have a basic knowledge of the muscles and bones of the human body. Given diagrams and charts, describe the structure and function of the musculoskeletal system with 80% accuracy on a written criterion exam.
1. Identify the Basic Systems of the Human Body 2. Describe the Terminology Used in Understanding the

PERFORMANCE OBJECTIVE

COMPETENCIES

Musculoskeletal System
3. Describe the Basic Musculoskeletal System of the Human

Body
CRITERION EXAM ESTIMATED COMPLETION TIME

142.1 Eighteen hours

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ORTHOTICS & PROSTHETICS

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COMPETENCY 1 IDENTIFY THE BASIC SYSTEMS OF THE HUMAN BODY

ASSIGNMENT

Read Information Sheet 1 to identify the basic body systems which an O&P technician needs to be aware of. Information Sheet 1 Basic Human Body Systems Medical textbooks in Orthotic Prosthetic Reference Library If you have any questions about this assignment please ask the instructor. Take Criterion Exam 142.1 when you have completed Task 1. You must pass this exam with 80% accuracy. Two hours

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ORTHOTICS & PROSTHETICS INFORMATION SHEET 1 BASIC HUMAN BODY SYSTEMS

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There are many complex systems that comprise the human body, many of which scientists scarcely understand. The orthotic-prosthetic practitioner needs to have a working understanding of many of these systems, with a strong comprehension of the musculoskeletal system. To a lesser extent, the technician should have a rudimentary understanding of some of the systems of the human body, with a reasonable understanding of the muscular and skeletal structure of the body. The following are the systems we will explore to a greater or lesser extent: 1. 2. 3. 4. 5. 6. The Integumentary System (skin) The Cardiovascular System The Respiratory System The Nervous System The Skeletal System The Muscular System

THE INTEGUMENTARY SYSTEM

The integumentary system, or integument, consists of the skin, hair, nails and glands of the skin. The integument is composed of three distinct layers. The visible skin layer on the surface is referred to as the epidermis (A). Immediately beneath the A epidermis lies the dermis (B). The dermis is the underlying layer of connective tissue, which contains sweat glands, touch B and pressure receptors, hair follicles, and nerve fibers. Beneath the dermis lies the subcutaneous tissue (C) that attaches the C integument to the muscles, fascia and bones of the body.

The integument provides five major functions: 1. It protects the body from infections, blunt force, foreign substances and the loss of body fluids. 2. It stores nutrients in the fat layers of the dermis. 3. It maintains body temperature by regulating heat retention and loss. 4. It provides sensory reception so the body can respond to touch, pressure, pain and temperature changes. 5. It excretes salts, water and organic wastes from the body.

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ORTHOTICS & PROSTHETICS INFORMATION SHEET 1 (CONTD) BASIC HUMAN BODY SYSTEMS

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The Cardiovascular System The cardiovascular system consists of the blood, heart, and blood vessels together. The main purpose of the cardiovascular system is to transport blood to all cells of the body. Blood delivers substances such as oxygen, nutrients, and hormones. It also removes carbon dioxide and organic wastes from cells.

Veins

Arteries

Blood is pumped from the heart to the body tissue through arteries. The large elastic arteries leave the heart and divide into medium sized muscular arteries, which in turn divide into still smaller arteries called arterioles. As the arterioles enter a tissue, they branch into microscopic vessels called capillaries. It is through the walls of the microscopic capillaries that oxygen, nutrients and waste products are exchanged between the blood and body tissues. As the capillaries leave the tissue laden with carbon dioxide and waste, they reunite with each other and form small veins called venules. These in turn merge with other venules to form veins, which transport the blood back to the heart.

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The Respiratory System The cells of our bodies require a continuous source of oxygen in order to function. As our cells metabolize the oxygen that is delivered to them by the cardiovascular system, they produce carbon dioxide as a by-product. The carbon dioxide is poisonous to the cells and must be removed promptly from the body. Both oxygen intake and carbon dioxide elimination are accomplished by the respiratory system, which consists of organs that exchange gases between the atmosphere and the blood. The respiratory exchange takes place inside the lungs where delicate tissues allow air and blood to exchange gases through diffusion across very thin membranes called alveoli. The cardiovascular system transports the gases in the blood between the lungs and the cells.

Respiratory System

Alveoli

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ORTHOTICS & PROSTHETICS INFORMATION SHEET 1 (CONTD) BASIC HUMAN BODY SYSTEMS The Nervous System The nervous system is a vast electrical network which acts as a communication center and control system for the body. It provides three main functions: First, it receives sensory input within the body and between the body and the outside environment. Second, it interprets the meaning of this sensory input, and third, it responds to the interpretation by initiating action resulting in a muscular contracture or a glandular secretion. The main components of the nervous system include the central nervous system which consists of the brain and the spinal cord, and the peripheral nervous system which consists of all the nerve tissue outside of the central nervous system. All body sensation must be relayed from receptors to the central nervous system if they are to be interpreted and acted upon. The CNS is also the seat of higher functions such as emotion, memory and intelligence.

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ORTHOTICS & PROSTHETICS COMPETENCY 2 BASIC MEDICAL TERMINOLOGY

ASSIGNMENT

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Study Information Sheet 2 to become familiar with the terminology used to describe musculoskeletal functions. Make a checklist of this information and include it in your lab manual. Information Sheet 2 Medical Terminology Medical textbooks in Orthotic Prosthetic Reference Library Go over any questions you may have with the Instructor. You must pass this exam with 80% accuracy. Take Criterion Exam 142.1 when you have completed Task 1. You must pass this exam with 80% accuracy. Six hours

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ORTHOTICS & PROSTHETICS INFORMATION SHEET 2 MEDICAL TERMINOLOGY

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ANATOMICAL POSITION

The anatomical position is the position that provides a reference point for describing the structures of the body. In this position, the body is erect and the face forward. The feet are together, flat on the floor and the toes pointing forward. The arms are down at the sides with the palms turned forward with the thumb side of the hand away from the body. When the body lying face down in the anatomical position, this is the prone position. When the body is lying face up, this is the supine position.

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CERVICAL DELTOID DELTOID DELTOID DELTOID

SCAPULAR PECTORAL

AXILLARY

THORACIC ABDOMINAL LUMBAR

SACRAL

PELVIC GLUTEAL
PUBIC

INGUINAL

FEMORAL

STERNAL

SCAPULAR PECTORAL

PATELLAR

POPLITEAL

SURAL TIBIAL

CALCANEAL

ANATOMICAL REGIONS

The body can be broken down by regions, or areas, that can be used to identify parts or features. For example, the area over the thigh is referred to as the femoral region.

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Saggital Plane
ANATOMICAL PLANES

Coronal Plane

Transverse Plane

There are three planes through the body that are used to describe the position and orientation of parts of the body. These are: Saggital (or median) plane - This plane runs through the body from the head to the feet, and divides the body into left and right halves. When this plane passes through the midline of the body it is known as the midsaggital plane. Any plane parallel to the mid-saggital plane through the body is known as a parasaggital plane. Coronal (or frontal) plane - This plane runs through the body from the head to the feet, and divides the body into front and rear halves. Transverse plane - This is any plane that runs left to right through the body and divides it into upper and lower sections.

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Anterior (ventral): of or relating to the front surface of the body or appendage. Examples: - The sternum is located on the anterior surface of the torso. - The quadriceps are located on the anterior surface of the thigh.

Posterior (dorsal): of or relating to the back surface of the body or appendage. Examples: - The scapula is located on the posterior surface of the torso. - The hamstrings are located on the posterior surface of the thigh.

Superior (cranial): towards the head. Superior Example: - The ribs are superior to the pelvis. Inferior (caudal): away from the head. Inferior Example: - The xiphoid process is inferior to the sternal notch.

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Flexion: Flexion occurs in the sagittal plane, when the angle of a joint decreased. It occurs in hinge joints and ball-and-socket joints. Flex: To bend a joint. Limbs cannot be flexed or bent, only joints. For example, in the act of touching ones nose the elbow is flexed. Flexor: A muscle that bends a joint.

Extension: Extension occurs in the sagittal plane, when the angle of a joint is increased. It occurs in hinge joints and ball-and-socket joints. Extend: To straighten a joint that has been flexed or bent. Joints can be extended or straightened, but limbs cannot. For example, in the act of straightening a leg while in a seated position the knee (joint) is extended. Extensor: A muscle that acts to straighten a joint.

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Abduct: To draw a limb away from a position near or parallel to the center line or median axis of the body. Standing erect with both feet together, you abduct your right arm by moving it sideways to your right. Abduction: The act of abducting a limb. Abductor: A muscle that abducts a limb.

Adduct: To draw a limb toward the centerline of the body. Standing erect with the feet apart, you adduct your left leg by moving it toward the right leg. Adduction: The act of adducting a limb. Adductor: A muscle that adducts a limb.

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ORTHOTICS & PROSTHETICS INFORMATION SHEET 2 (CONTD) MEDICAL TERMINOLOGY Neutral: Commonly usedLine to describe the position of the forefoot or hand. In this position: the forearm is in such a position that the closed hand is vertical with the thumb situated on top. The surface of the forefoot is perpendicular to the midsagittal line.
Midsaggital

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Pronation:
Line A rotation of the forearm that moves the palm from a neutral position to a position where the palm is facing down. Midsaggital

A rotation of the forefoot so that the sole of the foot is facing away from the midsagittal line.

Supination:
Line of pronation, the The opposite rotation of the forearm so that the palm is facing up. The hand is supine (facing anteriorly) in the anatomical position. Midsaggital

A rotation of the forefoot so that the sole of the foot is facing towards the midsagittal line.

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Dorsiflexion: Flexion of a joint in a dorsal direction or toward the back of the part. Refers usually to the foot or hand. Dorsal; Dorsum: Of or pertaining to the top of the foot or the back of the hand.

Plantar Flexion: Flexion of the ankle joint in the direction of the sole of the foot. Plantar: Of or pertaining to the sole of the foot.

Inversion: Inward rotation of the foot towards the midsagittal plane. Usually used only in reference to the foot and, like eversion, has no relation to toe-in or toe-out.

Lateral

Medial

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Lateral Medial Eversion: Outward rotation away from the mid-saggital plane. Usually used only in reference to the foot and is not related to toe-in or toe-out.

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Distal: Describing a position or direction farther from the trunk or point of origin. Example: The ankle is distal to the knee.

Proximal

Distal

Distal Proximal: Describing Proximal a position or direction closer to the trunk or point of origin.

Example: The hip is proximal to the knee.

Anterior

Anteroposterior: Extending from the front to the rear. Sometimes abbreviated "A-P." (Fig. A) Related to dimensions in the sagittal plane.

A-P Dimension

Mediolateral: Extending from the medial edge or side to the lateral edge or side. Sometimes abbreviated "M-L." Related to dimensions in the coronal M-L Dimension plane.

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MIDLINE

Lateral: Farther away from the midsagittal plane or midline of a structure. Examples: - The fibular head is on the lateral side of the lower leg. - The lateral malleolus is often more prominent with a varus deformity at the ankle.

LATERAL

MIDLINE

Medial: Closer to the midsagittal plane or midline of a structure. Examples: - The medial upright is usually edgebent when accommodating tibial torsion in an AFO. MEDIAL - With a valgus deformity the knee joint moves medially as body weight is applied.

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ORTHOTICS & PROSTHETICS INFORMATION SHEET 2 (CONTD) MEDICAL TERMINOLOGY Valgus: Bent outward. Denoting a deformity in which the angulation of the distal segment of a joint is away from Lateral Medial the midline of the body. An increase in the normal angle of a bone or joint structure.

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GENU VALGUS

CALCANEAL VALGUS

Varus: Bent inward. Denoting a deformity in which the angulation of the distal segment of a joint is towards the Lateral Medial midline of the body. A decrease in the normal angle of a bone or joint structure.

GENU VARUS

CALCANEAL VARUS

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COMPETENCY 3 DESCRIBE THE BASIC MUSCULOSKELETAL SYSTEM

ASSIGNMENT

Read Information Sheet 3 to recognize the features and names of both the skeletal structure and basic musculature of the human body. Information Sheet 3 The Skeletal System Information Sheet 4 Basic Musculature Medical textbooks in the Orthotic-Prosthetic Reference Library Skeleton Lab models Anatomical charts Bookstore study guides If you have any questions about this assignment please ask the instructor. Take Criterion Exam 142.1 when you have completed Task 1. You must pass this exam with 80% accuracy. Eight hours

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ORTHOTICS & PROSTHETICS INFORMATION SHEET 3 THE SKELETAL SYSTEM

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While the previous anatomical systems are relatively important to understand to a degree, the orthotic-prosthetic technician needs to be quite familiar with musculoskeletal anatomy, for the orthopedic appliances we provide must fit to and work with the muscular and skeletal systems of the body. Therefore, special emphasis will be placed on the presentation of these areas. The skeleton forms the framework to support the weight of the body. Without it, we would not be able to move about, grasp objects, or even breathe. The skeletal system includes all the bones in the body as well as cartilage and ligaments. Cartilage is a specialized tissue that provides support without being rigid. Imagine if your ears or the tip of your nose were hard and unable to yield to impacts from the environment. Ligaments are tough fibrous structures that connect bones to other bones so that there is stability to the framework. The skeletal system together provides the following major functions: Support the skeleton supports the soft tissues and provides a framework for the entire body. Protection the skeleton protects the soft tissues of the body from harm. For instance, the skull protects the brain from impact; the ribs protect the heart and lungs. Movement the skeleton provides a point of attachment for the muscles of the body so they have something to react against. When muscles contract, bones move and therefore provide the ability to ambulate, chew food, change position, grasp, etc. Storage the skeleton serves as a repository for calcium and other minerals essential to the health of the body. Blood cell production the marrow of the bone is responsible for producing red blood cells, white blood cells, and platelets. The lab skeleton: You will be responsible to know the names and locations of many of the skeletal bones, as well as their individual features. Use the skeleton to locate the bones of the body and bony features. We are fortunate to have an authentic skeleton in the lab. They are no longer available. It is fragile, and we insist that it be treated with respect since it is the remains of a living person. Other study aids: In the bookstore are many aids for studying anatomy. Many students find the anatomy coloring books very helpful. There are laminated charts, which are small duplicates of the charts we have in the lab, which can be purchased for a modest cost. There are anatomical models in the lab for you to disassemble and assemble. Be sure to ask the instructor for the booklet. The internet is a valuable resource for learning musculoskeletal anatomy. The instructors will make anatomy texts available to you if you ask. Many helpful references are located in the O&P Reference Library in the lab.

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ORTHOTICS & PROSTHETICS INFORMATION SHEET 3 (CONTD) THE SKELETAL SYSTEM

CRANIUM

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MANDIBLE

STERNUM

CLAVICLE

RIB CAGE HUMERUS

RADIUS ULNA

CARPALS METACARPALS PELVIS PHALANGES

FEMUR

PATELLA

FIBULA TIBIA

TARSALS METATARSALS PHALANGES

Skeleton Anterior View

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CERVICAL VERTERBRAE

SCAPULA THORACIC VERTERBRAE

HUMERUS

LUMBAR VERTERBRAE

ULNA

SACRUM COCCYX

RADIUS

FEMUR

TIBIA

FIBULA

TALUS

CALCANEUS

Skeleton Posterior View

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INFORMATION SHEET 3 (CONTD) THE SKELETAL SYSTEM

CLAVICLE

SCAPULA

HUMERUS

ULNA

RADIUS

CARPALS

METACARPALS

PHALANGES

Upper Extremity Anterior View

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ORTHOTICS & PROSTHETICS INFORMATION SHEET 3 (CONTD) THE SKELETAL SYSTEM

GREATER TROCHANTER FEMORAL HEAD

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FEMUR

FEMORAL CONDYLES

FIBULAR HEAD

PATELLA

FIBULA TIBIA

Lower Extremity Anterior View

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PHALANGES

METATARSALS

TARSALS

TALUS

CALCANEUS

Foot Dorsal View

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ORTHOTICS & PROSTHETICS INFORMATION SHEET 4 BASIC MUSCULATURE

ANTERIOR

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Upper Trapezius

Sternocleidomastoid

Pectoralis Major

Deltoid

Biceps

Brachii

Brachioradialis

Vastus Lateralis Satorius Rectus Femoris

Tibialis Anterior

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POSTERIOR

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Lower Trapezius

Deltoid Triceps Brachii Latissimus Dorsi Extensor Digitorum

External Oblique

Semitendinosis Semimembranosus

Gluteus Maximus Biceps Femoris

Gastrocnemius

Tendo Achilles