Ppt- axial and appendicular skeleton, injection sites

Axial and appendicular skeleton; Injection safe sites

1. Axial and Appendicular Skeleton Presenter- Dr. Siddhartha Singh Senior resident, Orthopaedics , ATC

2. Introduction The skeleton is subdivided into two divisions: the axial skeleton, the bones that form the longitudinal axis of the body, and the appendicular skeleton, the bones of the limbs and girdles.

3. Axial Skeleton The axial skeleton, which forms the longitudinal axis of the body, is divided into three parts: the skull, the vertebral column, and the bony thorax.

4. Skull The skull is formed by two sets of bones: the cranium and the facial bones . The cranium consists of the following eight bones:- 1 ethmoid bone 1 frontal bone 1 occipital bone 2 parietal bones 1 sphenoid bone 2 temporal bones

5. Maxillae .  The two maxillae, or  maxillary bones , fuse to form the upper jaw; all facial bones except the mandible join the maxillae; thus, they are the main or “keystone”, bones of the face; the maxillae carry the upper teeth in the  alveolar margin . Palatine bones.  The paired palatine bones lie posterior to the palatine processes of the maxillae; they form the posterior part of the hard palate. Zygomatic bones.  The zygomatic bones are commonly referred to as the cheek bones; they also form a good-sized portion of the lateral walls of the orbits, or eye sockets. Lacrimal bones.  The lacrimal bones are finger-sized bones forming part of the medial walls of each orbit; each lacrimal bones has a groove that serves as a passageway for tears .

6. Nasal bones The small rectangular bones forming the bridge of the nose are the nasal bones. Vomer bone  The single bone in the medial line of the nasal cavity is the vomer ; the vomer forms most of the bony nasal septum. Inferior nasal conchae  The interior nasal conchae are thin, curved bones projecting medially from the lateral walls of the nasal cavity. Mandible  The mandible, or lower jaw, is the largest and strongest bone of the face; it joins the temporal bones on each side of the face, forming the only freely movable joints in the skull

7. Vertebral Column Serving as the axial support of the body, the vertebral column, or spine, extends from the skull, which it supports, to the pelvis, where it transmits the weight of the body to the lower limbs . In a human vertebral column, there are normally 33 vertebrae . 7 cervical, 12 thoracic, 5 lumbar, 5 sacrum (fused) and 4 coccyx (fused)

8. Appendicular Skeleton

9. 1.Shoulder girdle (4 bones):- Left and right clavicle and 2 scapula

10. 2. Arms and forearms (6 bones):- Humerus (arm, 2 ), ulna (2) and radius (2) [forearm]

11. 3.Hands (54 bones):- carpal bones (wrist, 16), metacarpals (10), proximal phalanges (10), intermediate phalanges (8) and distal phalanges (10)

12. 4. Pelvis (2)

13. 5. Thigh and legs (8 bones)- femur (2), patella (2), tibia (2) and fibula (2)

14. 6. Feet and ankle (52 bones)- left and right tarsals (14), metatarsals (10), proximal phalanges (10), intermediate phalanges (8) and distal phalanges (10)

15. Applications of musculoskeletal system in Nursing

16. Thorough assessment of musculoskeletal conditions is crucial in nursing practice as it serves as the foundation for providing effective and patient-centered care. Accurate assessment helps nurses identify underlying issues, develop appropriate care plans, and collaborate effectively with other healthcare professionals to ensure the best outcomes for patients with musculoskeletal conditions.

17. Common musculoskeletal conditions Fractures : A fracture is a broken bone resulting from trauma or injury. Fractures require proper immobilization, often through casts, splints, or surgery, depending on the severity. Nurses play a crucial role in assessing the fracture, monitoring healing progress, and educating patients about self-care during the recovery process.

18. Osteoarthritis: Osteoarthritis is a degenerative joint disease that occurs when the cartilage that cushions the ends of bones in the joints gradually wears away. This can lead to pain, swelling, and reduced range of motion. It's commonly seen in weight-bearing joints like knees, hips, and the spine . Management includes pain relief, exercise, physical therapy, and in severe cases, joint replacement surgery.

19. Rheumatoid Arthritis: Rheumatoid arthritis is an autoimmune disorder where the immune system attacks the synovium (lining of the membranes that surround the joints). This leads to inflammation, pain, swelling, and eventually joint damage . Treatment involves medications to suppress the immune response, reduce inflammation, and slow down the progression of the disease. Physical therapy and lifestyle modifications are also important for managing symptoms.

20. Sprains and Strains: Sprains involve ligament injuries, while strains involve muscle or tendon injuries. Both can result from sudden stretching or overuse of these tissues. Treatment includes rest, ice, compression, and elevation (RICE) along with pain management.

21. Intra-muscular injections Administration of the injectable drug into the muscular tissue. It has a high rate of absorption and muscle tissue can hold large volume of fluid. The injection is given at an angle range of 72-90 degree to the skin. However, it can be painful and is related with some complications such as abscess formation, nerve injury.

22. Sites for injection 1. Deltoid site:- The deltoid site is located by locating the lower edge of the  acromion process, and injecting in the area which forms an upside down triangle with its base at the acromion process and its midpoint in line with the  axilla.

23. 2. The Ventrogluteal site on the hip is used for injections which require a larger volume to be administered, greater than 1 ml, and for medications which are known to be irritating, viscous, or oily. It is located in a triangle formed by the anterior superior iliac spine and the iliac crest, and may be located using a hand as a guide .   It is less painful for injection than other sites such as the deltoid site.

24. 3. The   vastus lateralis  site is used for infants less than 7 months old and people who are unable to walk or who have loss of muscular tone .   The site is located by dividing the front thigh into thirds vertically and horizontally to form nine squares; the injection is administered in the outer middle square.

25. 4. The dorsogluteal site of the buttock site is not routinely used due to its location near major blood vessels and nerves, as well as having inconsistent depth of adipose tissue . This site is located by dividing the buttock into four using a cross shape, and administering the injection in the upper outer quadrant. 

26. Thank You