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Anatomy and Physiology I – Fall 2014 The Skeletal System – Part 2 Physiology of Osseous Tissue I. Mineral Deposition – mineralization begins in fetal development A. B. Why does bony tissue usually develop only in bone? 1. Calcium phosphate crystals 2. Inhibitors of crystallization 3. Osteoblasts and crystallization Ectopic calcification 1 Arteriosclerosis II. Mineral Resorption – dissolves bone; release of minerals A. Osteoclast activity and HCl B. III. Osteoclasts and acid phosphatase Calcium & Phosphate (PO4) Homeostasis – mineral/ion reservoir A. PO4 – what contains it: blood acid:base imbalances B. Ca+2 - 99% Ca+2 in bones Neurons, muscles, blood clotting, signaling 1. Hypocalcemia a. Effects on nervous system b. Effects on muscles - spasms, tetany, suffocation 2 2. C. c. Effects on bone - rickets and osteomalacia d. Causes of hypocalcemia a. Low levels of vitamin D b. Underactive parathyroid glands c. Thyroid tumors d. Pregnancy/lactation Hypercalcemia – effects on nervous/muscular systems a. Effects of the nervous system Emotional disturbances, lethargy, depression b. Effects on muscles Weakness, sluggishness, cardiac arrest Hormonal Regulation of Ca+2 homeostasis Calcitriol (vitamin D), parathyroid hormone, calcitonin, estrogen/testosterone 3 1. Calcitriol a. Production (skin, liver, and kidney) b. Functions 1) Ion absorption 2) 2. Stimulation of osteoclasts Parathyroid Hormone and parathyroid gland a. Production of osteoclasts b. Ca+2 resorption c. Inhibits collagen synthesis d. Promotes excretion of PO4 by kidneys 4 3. Calcitonin and Thyroid a. Functions 1) Inhibits osteoclasts 2) b. 4. Osteoblasts Role in children, adults, pregnant/lactating women Estrogen Source: Science Daily http://www.sciencedaily.com/releases/2011/04/110411163910.htm How Estrogen Protects Bones - Mar. 25, 2007 Researchers at the University at Buffalo described how estradiol, the primary estrogen in humans, aids in maintaining bone density, a function critical to avoiding osteoporosis. Estrogen is essential for healthy bone. When production of estrogen is reduced, as occurs normally in postmenopausal women or after exposure to radiation or chemotherapeutic drugs, bones become brittle and break easily. Their study found that estradiol helps maintain bone density by stopping activity of the enzyme caspase-3, which initiates apoptosis (programmed cell death) of osteoblasts, bone cells that aid in growth/development of bones. Estrogens prevent bone loss and bone fractures by preventing apoptosis in osteoblasts by inhibiting caspase-3 activity. 4. Role of obesity in bone density Effects of obesity on bone metabolism, Jay J Cao, Cao J. Orthopaedic Surgery and Res. 2011, 6:30 Obesity is traditionally viewed as beneficial to bone health due to the positive effect of mechanical loading conferred by body weight on bone formation, despite being a risk factor for many other chronic health disorders. Although body mass has a positive effect on bone formation, whether the mass derived from obesity or excessive fat accumulation is beneficial to bone remains controversial. Underlining relationships between obesity and bone are complex and continue to be an active research area. 5 Recent data strongly support that fat accumulation is detrimental to bone mass. Obesity affects bone metabolism through several mechanisms. Because both adipocytes and osteoblasts are derived from a common stem cell, obesity may increase adipocyte differentiation and fat accumulation while decreasing osteoblast differentiation and bone formation. Obesity is associated with chronic inflammation. Increased proinflammatory messengers in obesity may promote osteoclast activity and bone resorption. Furthermore, excessive secretion of leptin and/or decreased production of adiponectin by adipocytes in obesity may affect bone formation/resorption by increasing proinflammatory messenger production. Highfat intake may also block intestinal Ca+2 absorption and decrease Ca+2 availability for bone formation. Obesity and bone metabolism are interrelated. First, both osteoblasts and adipocytes (fat storing cells) are derived from a common stem cell and agents that inhibit adipogenesis stimulate osteoblast differentiation and agents that inhibit osteoblastogenesis increase adipogenesis. Second, decreased bone marrow osteoblastogenesis during aging is usually accompanied by increased marrow adipogenesis. Third, chronic use of steroid hormone, such as glucocorticoid, results in obesity and rapid bone loss. Fourth, both obesity and osteoporosis are associated with increased production of proinflammatory messengers. BONE DISORDERS I. Fractures A. Several Types of Fractures 1. Closed vs. open 2. Complete vs. incomplete 3. Comminuted 4. Spiral 6 II. 5. Epiphyseal 6. Colles Other Bone Disorders A. Osteoporosis Breaks of femur, hips, distal forearm bones, compression fractures of vertebrae Who’s affected? Estrogen and osteoclasts – covered above Other factors – smoking; diabetes; diets low in Ca+2, protein, vitamins C and D; genetics Role of exercise Supplemental calcitonin 7 B. Osteosarcoma (males between 10-25 years) JOINTS (Articulations) – Chapter 8 Contact areas between bones I. Types A. Sutures - fibrous connective tissue between skull bone B. Syndesmosis - sheet or bundle of dense connective tissue (between tibia and fibula) C. Gomphosis – socket in which teeth fit 8 D. Synchondrosis –united by hyaline cartilage. Permanent example = first rib and manubrium E. Symphysis – fibrocartilage pad – shock absorber. Pubic symphysis; intervertebral discs C. Synovial Joints - diarthrosis (freely movable) Articular cartilage, fibrous capsule, synovial fluid, synovial membrane, ligaments Types of Synovial Joints – see Table 8.1 and figure below 1. Ball-and-socket joints – globular head with cupshaped cavity Head of humerus or femur with glenoid cavity or acetabulum 9 2. Condyloid joint – oval condyle into elliptical cavity Metacarpals and phalanges 3. Gliding joints – flat surfaces slide past each other Joints between carpal/tarsal bones 4. Hinge joints – convex and concave surfaces meet Joints between phalanges; between olecranon process and olecranon fossa in elbow 5. Pivot joints – cylindrical surface rotates within ring Proximal ulna and radius; atlas and dens of axis 6. Saddle joints – both bones have convex and concave regions Trapezium and thumb metacarpal 10 II. Types of Joint Movements A. Flexion – decreases angle of joint Example: B. Extension – increases angle of joint Example: C. Dorsiflexion Example: D. Plantar flexion Example: E. Rotation – spinning joint around another Example: F. Circumduction – move part in circle Example: G. Abduction – moves part away from midline Example: 11 H. Adduction – moves part towards midline Example: I. Supination Example: J. Pronation Example: K. Eversion Example: L. Inversion Example: M. Protraction – moves part forward Example: N. Retraction – moves part backwards Example: 12 O. Elevation – raising a part Example: P. Depression – lowering a part Example: 13