THE SKELETAL SYSTEM

The skeleton is the frame that supports the body. It really is a marvelous thing! Special bones of the skeletal system surround our organs and tissues giving them vital protection. For example: my skull protects my brain, my vertebral column protects my spinal cord and my rib cage protects my heart! I'm so glad. (When I was a little girl few things would frighten me more than the image of a skeleton. I have a skeletal replica I call Herbie Jr. And now with increased knowledge and understanding, "Herbie Jr." who is only 6" tall is like a buddy-he was with me throughout med school. Long bones of the body act as levers, so that as certain muscles contract and pull on them, movement is achieved. Red bone marrow is a source of red blood cells, white blood cells and platelets. In our bones and teeth
we find 95% of the calcium and 90% of the phospherous found in the body- they act to make our bones hard and strong. So, our skeletal system functions to support and protect us as well as achieve movement. It also stores minerals and produces blood cells. Wow! all that from that scary looking guy? Well there is more. Within this system bone remodeling occurs. What is that? It is a very precise function, a delicate balance between bone growth and bone breakdown.

MORE FACTS ABOUT BONES
Did you know that babies are born with over 300 bones (primarily composed of cartilage)? However, throughout normal development, various bones join to form single bones, thus we mature adults have a mere 206 bones! I will spare you, by not naming each bone, however, I will add that each bone is an organ consisting of osseous, nervous, vascular and cartilagenous tissues. Cartilage covers the ends of bones, (you guessed it) to cushion and protect the joints from friction.

COMMON DISORDERS OF THE SKELETAL SYSTEM:
OSTEOPOROSIS-Is a condition in which the bone matrix is lost, thus weakening the bones and predisposing them to fracture. Bone mineral density is 2.5 standard deviations below the peak bone density for a young adult (T score 2.5). A decrease in bone density of 1.5 to 2.5 below the young adult is called osteopenia (T score of
-1.5 to -2.5) In osteoporosis the Dual-energy X-ray absorbtiometry (DEXA) shows diminished bone mineral density (T score -2.5 or worse).
HALLUX VULGUS(BUNION)-Is a disorder of the foot, which involves the first metatarsal
and great toe. This disorder occurs in higher frequency in females and increases in incidence with age. Presents with pain, reduced range of motion, and callus of skin overlying the bunion.
LOWER BACK PAIN- Is characterized by an uncomfortable or acute pain in the lumbosacral area associated with severe spasms of the paraspinal muscles, often with pain radiating to lower extremeties.

MAINTAINING HEALTH OF THE SKELETAL SYSTEM:
Management of conditions such as osteoporosis is in prevention.
Calcium supplements 1-1.5 grams may be preventative. Vitamin D plays a vital role in the absorbtion of calcium and bone health in general: 400 to 800 IU is recommended. Also implement, weight-bearing exercises throughout life. Walking is a good example. Be vigilant to prevent falls with elderly family members. Medications your Primary Care Provider may recommend: Raloxifene (Evista)an estrogen receptor antagonist, Calcitonin (Miacalcin)a nasal spray, with side effects of runny nose and nasal burning. Biophosphonates such as Risedronate (Actonel) and Aledronate (Fosamax), will bind to bone cells inhibiting cell breakdown without inturrupting normal bone formation. (Must be taken with water not food; must remain upright for 30 minutes to prevent esophagitis.) Remember to wear good, well-fitted shoes for prevention of bunions. This condition has been linked to tight, pointed shoes. Mild to severe lower back pain is often associated with inactivity, obesity and poor posture. Recommended are 1.) an exercise program that involves stretching and toning the body; 2.) an eating plan which includes balanced meals in moderate amounts.
References: Anatomy Reference Guide, Lippincot,Williams & Wilkins
Lippincott Manuel of Nursing, Lippincott, Williams & Wilkins