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Chapter 7 Skeletal System Bone Classification • Long Bones • Short Bones • Flat Bones • Irregular Bones • Sesamoid (Round) Bones 1 Skeletal System • Functions – Support – Protection • internal organs – Movement facilitation • Bones act as the levers • Articulations as the fulcrums • Muscles provide the force 2 Skeletal System • Functions – Mineral Storage • calcium and phosphorous – Storage of Blood Cell Producing Cells • red bone marrow – Storage of Energy • lipids stored in yellow bone marrow are important source of chemical energy 3 Bone Function • Support, Movement & Protection • gives shape to head, etc. • supports body’s weight • Inorganic Salt Storage • protects lungs, etc. • calcium • bones and muscles interact • phosphate when limbs or body parts move • magnesium • Blood Cell Formation • hematopoiesis • red marrow • sodium • potassium 4 Cells and Histology of Bone • Cartilage, Osseous and Dense CT • Osseous Tissue (4 cell types) – Osteoprogenitor • Found throughout the bone • Have mitotic potential • May differentiate into osteoblast 5 Cells and Histology of Bone • Osseous Tissue (4 cell types) – Osteoblast • No mitotic potential • Found on the surface of the bone • Secrete mineral salts and organic components for bone formation 6 Cells and Histology of Bone • Osseous Tissue (4 cell types) – Osteocytes • No mitotic potential • Found within the bone • Maintain daily cellular activities of bone tissue – Osteoclast • Found on the surface of bone • Function in the re-absorption of bone 7 Parts of a Long Bone • Epiphysis • distal end • proximal end • Articular Cartilage • Covers each epiphysis • Hyaline cartilage • Diaphysis • Shaft • Metaphysis • Area between diaphysis and epiphysis in mature bone 8 Parts of a Long Bone • Periosteum • Contains nerves, blood vessels, osteo cells • Attachment point for ligaments and tendons • Medullary cavity • contains yellow marrow • Endosteum • lines the medullary cavity 9 Parts of a Long Bone • Spongy Bone • Irregular lattice work of bone-trabeculae • Spaces filled with red marrow • produces RBCs 10 Parts of a Long Bone • Compact Bone • Tightly packed tissue • Parts • Concentric Lamellae • Concentric circles of tightly packed tissue • Volkmann’s Canals • Penetrate compact bone • Allow blood vessels and nerves into medullary cavity and other Haversian Canals 11 Parts of a Long Bone • Compact Bone • Haversian Canals • Run longitudinally through the compact bone • Concentric lamellae surround the canals • Lacunae • Open spaces between the concentric lamellae that contain osteocytes • Look like “little lakes” 12 Parts of a Long Bone • Compact Bone – Canaliculi • Tiny canals that radiate away from the lacunae – Osteon (Haversian System) • Central canal, surrounding lamellae, lacunae, osteocytes and canaliculi 13 Bone Development Intramembranous Ossification • bones originate within sheetlike layers of connective tissues • broad, flat bones • skull bones (except mandible) • intramembranous bones Endochondral Ossification • bones begin as hyaline cartilage • form models for future bones • most bones of the skeleton • endochondral bones 14 Endochondral Ossification • hyaline cartilage model • epiphyseal plate • primary ossification center • osteoblasts vs. osteoclasts • secondary ossification centers 15 Endochondral Ossification • Hyaline cartilage model • “bone” created by chondroblast • Actual ossification of this “bone” starts 6-7 weeks after conception 16 Endochondral Ossification • Interstitial and Oppositional Growth • Chondrocytes burst and trigger calcification • Capillaries and bone cells invade dying cartilage • Bone starts to calcify 17 Endochondral Ossification • Primary Ossification Center • Blood vessels in midregion produce ossification center • Osteoblast form spongy bone in the area of calcified cartilage, this causes the center to enlarge • Spongy bone is destroyed by osteoclast-forms medullary cavity 18 Endochondral Ossification • Secondary Ossification Centers • When blood vessels enter the epiphysis • Spongy bone created here will stay • Epiphyseal plate • Layer of hyaline cartilage between the 2 areas of growth • Stays until you reach maturity 19 Endochondral Ossification • Remnants of hyaline cartilage on the epiphysis becomes articulating cartilage 20 Growth at the Epiphyseal Plate First layer of cells • closest to the end of epiphysis • resting cells • anchors epiphyseal plate to epiphysis Second layer of cells • many rows of young cells • undergoing mitosis 21 Growth at the Epiphyseal Plate Third layer of cells • older cells • left behind when new cells appear • cells enlarging and becoming calcified Fourth layer of cells • thin • dead cells • calcified extracellular matrix 22 Homeostasis of Bone Tissue •Bone Re-absorption – action of osteoclasts and parathyroid hormone •Bone Deposition – action of osteoblasts and calcitonin 23 Factors Affecting Bone Development, Growth, and Repair • Deficiency of Vitamin A – retards bone development • Deficiency of Vitamin C – results in fragile bones • Deficiency of Vitamin D – rickets, osteomalacia • Insufficient Growth Hormone – dwarfism • Excessive Growth Hormone – gigantism, acromegaly • Insufficient Thyroid Hormone – delays bone growth • Sex Hormones – promote bone formation; stimulate ossification of epiphyseal plates • Physical Stress – stimulates bone growth 24 Superficial Bone Anatomy • Process • bony prominence “bump” • Condyle • rounded or knuckle like process • Tubercle • small process • Tuberosity • large process (tibial tuberosity) • Trochanter • huge process (located on the proximal end of the femur) 25 Superficial Bone Anatomy • Crest • narrow ridge of bone • Spine • sharp slender process (holes and/or depressions) • Fissure • narrow slit through which blood vessels or nerves pass • Foramen • opening through which blood vessels and nerves pass 26 Superficial Bone Anatomy • Meatus • tubelike passageway running within a bone • Sulcus or groove • furrow that accommodates a soft structure such as blood vessels, nerves or tendons • Fossa • depression in or on the surface of a bone 27 Skeletal Organization Axial Skeleton • head • neck • trunk Appendicular Skeleton • upper limbs • lower limbs • pectoral girdle • pelvic girdle 28 Skeletal Organization 29 Skeletal Organization • Hyoid Bone – Supports tongue – Attachment point for muscles that move tongue 30 Cranium Frontal (1) • Forehead • Roof of nasal cavity • Roofs of optical orbits • Frontal sinuses • Supraorbital foramen •Blood vessels and nerve • Coronal suture • Develops in two parts •Completely fused by age 5 or 6 31 Cranium Parietal (2) • Side walls of cranium • Roof of cranium • sagittal suture •Fuses two parietal bones together •Coronal suture •Fuses parietal bones to frontal bone 32 Cranium Occipital (1) • back of skull • base of cranium • foramen magnum •Inferior part of brain stem connects with spinal cord • occipital condyles •Either side of foramen magnum • lambdoid suture •Fuses parietal bones with occipital bone 33 Cranium Temporal (2) • side walls of cranium • floor of cranium • floors and sides of orbits • squamous suture •Fuses parietal with temporal • external acoustic meatus •Leads to inner ear • mandibular fossa •Where mandible meets temporal bone • mastoid process •Neck muscle attachment • styloid process •Tongue and pharynx attachment • zygomatic process 34 Cranium Sphenoid (1) • base of cranium • sides of skull • floors and sides of orbits • sella turcica •Indentation along midline within cranial cavity •Contains pituitary gland • sphenoidal sinuses 35 Cranium Ethmoid (1) • roof and walls of nasal cavity • floor of cranium • wall of orbits • cribriform plates •Join two parts of ethmoid on either side of nasal cavity • perpendicular plate •Forms most of nasal septum • superior and middle nasal conchae •Support mucous membranes of nasal cavity • ethmoidal sinuses • crista galli •Projects upward into cranial cavity •Attaches brain membranes 36 Facial Skeleton Maxillary (2) • upper jaw • anterior roof of mouth • floors of orbits • sides of nasal cavity • floors of nasal cavity • alveolar processes • maxillary sinuses • palatine process 37 Facial Skeleton 38 Facial Skeleton Palatine (2) • L shaped bones located behind the maxillae • posterior section of hard palate • floor of nasal cavity • lateral walls of nasal cavity 39 Facial Skeleton Zygomatic (2) • prominences of cheeks • lateral walls of orbits • floors of orbits • temporal process •Extends posteriorly to join zygomatic process of temporal bone 40 Facial Skeleton Lacrimal (2) • medial walls of orbits • groove from orbit to nasal cavity Nasal (2) • bridge of nose 41 Facial Skeleton Vomer (1) • inferior portion of nasal septum 42 Facial Skeleton Inferior Nasal Conchae (2) • extend from lateral walls of nasal cavity 43 Facial Skeleton Mandible (1) • Lower jaw • Body •Horseshoe shaped portion • Ramus •Flat, upward projections • Mandibular condyle •Fits into mandibular fossa • Coronoid process •Chewing muscle attachment • alveolar process • mandibular foramen • mental foramen 44 Infantile Skull Fontanels – fibrous membranes 45 Vertebral Column • cervical vertebrae (7) • thoracic vertebrae (12) • lumbar vertebrae (5) • sacrum • coccyx 46 Vertebral Column • cervical curvature •Smallest vertebrae •Most dense bone tissue • thoracic curvature • lumbar curvature • sacral curvature • rib facets • vertebra prominens •Long spinous process on 7th vertebra • intervertebral discs • intervertebral foramina 47 Cervical Vertebrae • Atlas – 1st; supports head • Axis – 2nd; dens pivots to turn head • transverse foramina •Blood vessels leading to the brain pass through • bifid spinous processes •Muscle attachment • vertebral prominens • useful landmark 48 Thoracic Vertebrae • long spinous processes • rib facets 49 Lumbar Vertebrae • large bodies •Support weight • thick, short spinous processes •Nearly horizontal 50 Sacrum • five fused vertebrae •Fuse between age 15 and 30 • median sacral crest •Fused spinous processes • posterior sacral foramina • posterior wall of pelvic cavity • sacral promontory •Body of the 1st sacral vertebra 51 Coccyx • tailbone • four fused vertebrae •Fuse by age 25 52 Thoracic Cage • Ribs • Sternum • Thoracic vertebrae • Costal cartilages • Supports shoulder (pectoral) girdle and upper limbs • Protects viscera • Role in breathing 53 Ribs • True ribs (7) •Attach to sternum by costal cartilage • False ribs (5) •Costal cartilage does not reach sternum •Top 3 join cartilage of 7th True rib •Bottom 2 don’t attach at all • floating (2) 54 Rib Structure • Shaft • Head •posterior end •articulates with vertebrae • Tubercle •articulates with vertebrae • Costal cartilage •hyaline cartilage 55 Sternum • Manubrium • Body • Xiphoid process 56 Appendicular Skeleton • Comprised of 2 parts – Pectoral girdle and upper extremity • Shoulders and arms – Pelvic girdle and lower extremity • Hips and legs 57 Pectoral Girdle • attach bones of the upper extremities to the axial skeleton •Shoulder Girdle •clavicles anterior • scapulae posterior • supports upper limbs 58 Clavicles •Long slender bone with double curvature •Sternal end •Rounded end •articulates with manubrium •Acromial end •Broad flat end • articulates with scapula (acromion process) 59 Scapulae •Triangular flat bone •Posterior part of the thorax •Between the 2nd and the 7th rib •Medial border •5 centimeters from the vertebral column • spine •Runs diagonally across body • supraspinous fossa • infraspinous fossa 60 Scapulae • acromion process • part of the spine that expands past the body • coracoid process • located at the lateral end of the superior ridge • glenoid cavity • fossa inferior to the acromian process • Articulates with the head of the humerus to make a ball and socket joint 61 Scapulae 62 Upper Limb • Consists of 60 bones • Each side contains 30 bones – – – – – – 1 humerus 1 radius 1 ulna 8 carpals 5 metacarpals 14 phalanges 63 Upper Limb • Humerus • Articulates proximally with the scapula and distally with both the radius and the ulna • Largest bone in the upper extremity 64 Humerus • Head •rounded proximal end, articulates with glenoid cavity •Anatomical neck •Slight groove below head •Epiphyseal plate • Greater tubercle •large lateral process below the anatomical neck 65 Humerus • lesser tubercle • anterior side • Intertubercular groove • Surgical neck • Constricted portion inferior to tubercles • Fractures likely here • Deltoid tuberosity • Slight bump on the anterior surface • Insertion point for deltoid muscle 66 Humerus • Capitulum • rounded knob • articulates with head of radius • Trochlea • Pulley-like surface that articulates with ulna • Coronoid fossa • Receives part of the ulna when elbow is flexed • On anterior, distal surface 67 Humerus • Olecranon fossa • posterior side • receives olecranon process of ulna when elbow is extended • Medial and Lateral Epicondyles • Found on either side of distal end of humerus • Serve as attachments of most forearm muscles 68 Humerus • Ulnar nerve • Lies over the posterior surface of the medial epicondyle • Can be rolled between the finger and the medial epicondyle 69 Ulna • medial forearm bone • trochlear notch •Curved area between olecranon and coronoid process •Articulates with trochlea of humerus •Allows for flexion and extension of elbow 70 Ulna • Olecranon process • posterior projection • proximal end • Coronoid process • anterior projectionlateral • Styloid process • posterior side of the head of the ulna • Head • distal end of the ulna 71 Radius • lateral forearm bone • Head •Disc like structure that articulates with capitulum of humerus and radial notch of ulna • Radial tuberosity •Proximal end inferior to head •Anterior surface • Styloid process •Distal end •Articulates with scaphoid bone 72 Wrist and Hand • Carpals (16) • trapezium • trapezoid • capitate • scaphoid • pisiform • triquetrum • hamate • lunate • Metacarpals (10) • Phalanges (28) • proximal phalanx • middle phalanx • distal phalanx 73 Pelvic Girdle •Provide a strong support for the lower extremities • Coxae (2) •Each is 3 bones fused together •Os coxa (1) •Sacrum • supports trunk of body • protects viscera 74 Coxae • hip bones •Acetabulum •lateral fossa of the os coxa where 3 pelvic bones merge • Ilium •Superior to other 2 portions •iliac crest •superior border •serves as insertion point for abdominal wall muscles 75 Coxae • Ilium • Iliac fossa • internal surface seen from the medial side • gives the pelvis a bowl shape appearance • Greater sciatic notch • Inferior to iliac crest • Posterior to acetabulum • Allows for major nerves and blood vessels to travel from sacrum to legs 76 Coxae • Ischium • inferior, posterior portion of the coxal bone • ischial spines • Posterior, superior to ischial tuberosity • lesser sciatic notch • Inferior to ischial spine • ischial tuberosity • tuberosity that we sit on 77 Coxae • Pubis • orbturator foramen • between ischium, pubic bone and acetabulum • symphysis pubis • Joins with other pubic bone at symphysis pubis • Hormone, relaxin, is released during child birth that allows greater flexibility of the fibrocartilage 78 Greater and Lesser Pelvis Greater Pelvis • lumbar vertebrae posteriorly • iliac bones laterally • abdominal wall anteriorly Lesser Pelvis • sacrum and coccyx posteriorly • lower ilium, ischium, and pubis bones laterally and anteriorly 79 Male and Female Pelvis Female • iliac bones more flared • broader hips • pubic arch angle greater • more distance between ischial spines and ischial tuberosities • sacral curvature shorter and flatter • lighter bones 80 Lower Limb • Femur (2) • Patella (2) • Tibia (2) • Fibula (2) • Tarsals (14) • Metatarsals (10) • Phalanges (14) 81 Femur • Longest & heaviest bone of body •Body of femur angles toward the midline •makes knees closer than hips •Degree is greater in females 82 Femur • Head • rounded end • articulates with acetabulum • Neck • Distal to the head • Elderly people break this area often • Greater trochanter & Lesser trochanter • large processes below the neck • serve attachment points for some thigh and buttock muscles 83 Femur • Shaft • diaphysis • Linea aspera • Posterior side of shaft • Serves as insertion point for adductor muscles of the leg • Medial & Lateral epicondyles • Distal end of femur • Articulates with proximal end of tibia 84 Femur • Intercondylar fossa • important area for the ligaments in the knee • Patellar surface • distal anterior surface between the condyles that forms a gliding joint with the patella 85 Patella • kneecap •Inferior end is called the Apex • anterior surface of knee • flat sesamoid bone located in a tendon 86 Tibia • shin bone •Large, medial, weight bearing bone of the lower extremity •Lateral & Medial Condyles •Articulate with epicondyles of femur •Inferior surface of the lateral condyle articulates with the fibula 87 Tibia • Tibial tuberosity • Anterior surface of the tibia • Surface serves as attachment point for the patellar ligaments and tendons • anterior crest • Extends downward from tibial tuberosity 88 Tibia • Intercondylar Eminence • Upward projection between the condyles of the tibia • Cruciate ligaments attach here • Medial malleolus • Medial projection on the distal end of the tibia • Provides medial supports to the hinge joint of your ankle 89 Fibula • Lateral to tibia • Non weight-bearing • Long, slender • Head •proximal end •more rounded • Lateral malleolus •Distal end •articulates with the tibia and talus •Lateral support to the ankle •Longer pointier end 90 Ankle and Foot • Tarsals (14) • Calcaneus •Largest and strongest tarsal •Supports body weight •Serves as lever attachment for gastrocnemius 91 Ankle and Foot • Talus • Uppermost tarsal • Only bone that articulates with the tibia and fibula • Initially bares all body weight, then transfers half to the calcaneus and half to the other tarsals 92 Ankle and Foot • Navicular • just anterior to the talus • cuboid • Lateral side of the foot • Articulates with calcaneus, the 4th and 5th metatarsal lateral cuneiform • intermediate cuneiform • medial cuneiform • • Each cuneiform that articulates with the corresponding metatarsal 93 Ankle and Foot • Metatarsals (10) • numbered from the medial to the lateral side • Phalanges (28) • proximal • middle • distal 94 Life-Span Changes • decrease in height at about age 30 • calcium levels fall • bones become brittle • osteoclasts outnumber osteoblasts • spongy bone weakens before compact bone • bone loss rapid in menopausal women • hip fractures common • vertebral compression fractures common 95 Clinical Application Types of Fractures • green stick • fissured • comminuted • transverse • oblique • spiral 96 Clinical Application: Fractures • Impacted • one fragment is firmly driven into the other • Displaced • anatomical alignment is NOT preserved • Non-displaced • anatomical alignment is preserved • Stress • partial fracture resulting in bones inability to withstand forces • About 25% involve distal end of the fibula 97 Clinical Application: Fractures • Pathologic • caused by weakening of the bone due to a disease • Pott’s • fracture of the distal end of the fibula with serious injury to the distal tibial articulation • Severe eversion sprain may lead to this • Colle’s • fracture at the distal end of the radius in which the distal end is displaced posteriorly • Occurs frequently when you try to stop yourself from falling 98 Clinical Application: Fracture Repair • Fracture breaks blood vessels found in the Haversian system • Blood clot forms at the site of the break within 6 to 8 hours (fracture hematoma) • Fracture hematoma • serves as the focus for cellular invasion 99 Clinical Application: Fracture Repair • Callus forms • New bone tissue developed around the fracture • Site of osteoblast activity 100 Clinical Application: Fracture Repair • Remodeling • Dead bone is absorbed by osteoclast • Compact bone replaces spongy bone in the fractured area 101 Clinical Application: Disorders • Osteoporosis • Age related disease characterized by decreased bone mass an increased chance of fractures • Decreased levels of estrogen (sex hormones that stimulate osteoblast) QuickTime™ and a decompressor are needed to see this picture. 102 Clinical Application: Disorders • Osteoporosis • White women more than men and people of color • Other factors linked to osteoporosis • Body build • short people have less bone mass • Weight • thin people have less adipose, which stores estrogen • Smokers• low estrogen levels • Calcium deficiency and mal-absorption • Vitamin D deficiency • Certain drugs• alcohol, cortisone, etc. • Premature menopause 103 Clinical Application: Disorders • Osteoporosis Prevention – Exercise • muscle action stimulates blood flow to bone tissue – Estrogen pills• for post menopause women – Calcium supplements/ vitamins – Prescription anabolic steroids• increase hormone levels – Sodium Fluoride stimulates oteoblast 104 Clinical Application: Disorders • Osteogenic Sarcoma • Malignant bone tumor that affects osteoblast • People between ages of 10-25 • Left untreated it will metasticize and lead to death • Treatment includes chemotherapy following amputation of affected area 105 Clinical Application: Disorders • Rickets – Vitamin D deficiency in children – Body can’t transport Ca+2 and P-3 from GI tract to blood – Osteoblasts in diaphysis don’t calcify causing bones to stay soft – Weight of body causes the legs to bow – Cure and prevention • Dietary- add vitamin D, calcium and phosphorus in large amounts • Exposing the skin to ultraviolet rays of light 106