Bones Chapter 7 Pre bone Cartilage All bone

Bones Chapter 7

Pre bone Cartilage • All bone starts out as cartilage. • Contains no blood vessels or nerves • Surrounded by the perichondrium (dense irregular connective tissue) that resists outward expansion • Three types – hyaline, elastic, and fibrocartilage

Hyaline Cartilage • Provides support, flexibility, and resilience (due to water) • Is the most abundant skeletal cartilage • Is present in these cartilages: – Articular – covers the ends of long bones – Costal – connects the ribs to the sternum – Respiratory – makes up the larynx and reinforces air passages – Nasal – supports the nose

• Similar to hyaline cartilage but contains elastic fibers • Found in the external ear and the epiglottis • Highly compressed with great tensile strength • Contains collagen fibers • Found in menisci of the knee and in intervertebral discs

Growth of Cartilage Appositional – cells in the perichondrium secrete matrix against the external face of existing cartilage Interstitial – lacunae-bound chondrocytes inside the cartilage divide and secrete new matrix, expanding the cartilage from within Calcification of cartilage occurs During normal bone growth During old age

Skeletons • Axial skeleton – bones of the skull, vertebral column, and rib cage • Appendicular skeleton – bones of the upper and lower limbs, shoulder, and hip

Classification of bones • • • Long Bones Short Bones Flat Bones Irregular Bones Sesamoid Bones

Classification by shape • Long bones – • longer than • they are wide (e. g. , humerus

By shape: • Short bones – Cube-shaped – bones of the – wrist and ankle – Bones that form within tendons (e. g. , patella)

By Shape: • Flat bones – • thin, flattened • , and a bit curved (e. g. , sternum, and most skull bones)

By Shape: • Irregular bones • – bones with complicated shapes (e. g. , vertebrae and hip bones)

Functions of Bones • Support – form the framework that supports the body and cradles soft organs • Protection – provide a protective case for the brain, spinal cord, and vital organs • Movement – provide levers for muscles • Mineral storage – reservoir for minerals, especially calcium and phosphorus • Blood cell formation – hematopoiesis occurs within the marrow cavities of bones

Bone Markings • Bulges, depressions, and holes that serve as: – Sites of attachment for muscles, ligaments, and tendons – Joint surfaces – Conduits for blood vessels and nerves

Projections: Sites of Muscle and Ligament Attachments • • Tuberosity – rounded projection Crest – narrow, prominent ridge of bone Trochanter – large, blunt, irregular surface Line – narrow ridge of bone Tubercle – small rounded projection Epicondyle – raised area above a condyle Spine – sharp, slender projection Process – any bony prominence

Projections That Help Form Joints • Head – bony expansion carried on a narrow neck • Facet – smooth, nearly flat articular surface • Condyle – rounded articular projection • Ramus – armlike bar of bone

Depressions and Openings • • • Meatus – canal-like passageway Sinus – cavity within a bone Fossa – shallow, basinlike depression Groove – furrow Fissure – narrow, slitlike opening Foramen – round or oval opening through a bone

Bone Textures Compact bone – dense outer layer Spongy bone – honeycomb of trabeculae filled with yellow bone marrow

Structure of a Long Bone • Long bones consist of a diaphysis and an epiphysis • Diaphysis – Tubular shaft that forms the axis of long bones – Composed of compact bone that surrounds the medullary cavity – Yellow bone marrow (fat) is contained in the medullary cavity

• Epiphyses – Expanded ends of long bones – Exterior is compact bone, and the interior is spongy bone – Joint surface is covered with articular (hyaline) cartilage – Epiphyseal line separates the diaphysis from the epiphyses

Bone Membranes • Periosteum – double-layered protective membrane – Outer fibrous layer is dense regular connective tissue – Inner osteogenic layer is composed of osteoblasts and osteoclasts – Richly supplied with nerve fibers, blood, and lymphatic vessels, which enter the bone via nutrient foramina – Secured to underlying bone by Sharpey’s fibers • Endosteum – delicate membrane covering internal surfaces of bone

Structures of Short, Flat and Irregular Bones Thin plates of periosteum-covered compact bone on the outside with endosteum-covered spongy bone (diploë) on the inside Have no diaphysis or epiphyses Contain bone marrow between the trabeculae

Structure of a Flat bone

Hematopoetic tissue Red Marrow Formation • In infants – Found in the medullary cavity and all areas of spongy bone • In adults – Found in the diploë of flat bones, and the head of the femur and humerus

Compact Bone Structure • Haversian system, or osteon – the structural unit of compact bone – Lamella – weight-bearing, column-like matrix tubes composed mainly of collagen – Haversian, or central canal – central channel containing blood vessels and nerves – Volkmann’s canals – channels lying at right angles to the central canal, connecting blood and nerve supply of the periosteum to that of the Haversian canal

Microscopic structures of bone • Osteocytes – mature bone cells • Lacunae – small cavities in bone that contain osteocytes • Canaliculi – hairlike canals that connect lacunae to each other and the central canal • Osteoblasts – bone-forming cells and secretes matrix • Osteocytes – mature bone cells • Osteoclasts – large cells that resorb or break down bone matrix • Osteoid – unmineralized bone matrix composed of proteoglycans, glycoproteins, and collagen

Compact Bone

Inorganic Composition • Hydroxyapatites, or mineral salts – Sixty-five percent of bone by mass – Mainly calcium phosphates – Responsible for bone hardness and its resistance to compression

Bone Development • Osteogenesis and ossification – the process of bone tissue formation, which leads to: – The formation of the bony skeleton in embryos – Bone growth until early adulthood – Bone thickness, remodeling, and repair

Formation of the Skeleton • Begins at week 8 of embryo development Intramembranous ossification – bone develops from a fibrous membrane Endochondral ossification – bone forms by replacing hyaline cartilage • Formation of most of the flat bones of the skull and the clavicles • Fibrous connective tissue membranes are formed by mesenchymal cells

Ossification • An ossification center appears in the fibrous connective tissue membrane • Bone matrix is secreted within the fibrous membrane • Woven bone and periosteum form • Bone collar of compact bone forms, and red marrow appears

Endochondral Ossification • Begins in the second month of development • Uses hyaline cartilage “bones” as models for bone construction • Requires breakdown of hyaline cartilage prior to ossification • Formation of bone collar • Cavitation of the hyaline cartilage • Invasion of internal cavities by the periosteal bud, and spongy bone formation • Formation of the medullary cavity; appearance of secondary ossification centers in the epiphyses • Ossification of the epiphyses, with hyaline cartilage remaining only in the epiphyseal plates

Stagesof of. Endochondral. Ossification Deteriorating cartilage matrix Hyaline cartilage Primary ossification center Bone collar 1 Formation 1 of Formation bone of bone collar around hyaline cartilage model. Spongy bone formation Secondary ossification center Epiphyseal blood vessel Medullary cavity Articular cartilage Spongy bone Epiphyseal plate cartilage Bloodof vessel of periosteal bud 2 Cavitation 2 of Cavitation the of the hyaline cartilage within the within cartilage the cartilage model. 3 Invasion of 3 internal Invasion of cavities byinternal the by the periosteal bud periosteal and spongy bud and spongy bone formation. 4 Formation of the 4 medullary Formation of the cavity as medullary continues; cavity as ossification appearance of continues; appearance of secondary ossification centers in the centers in epiphyses inthe epiphysesfor in stage 5. preparation for stage 5. 5 Ossification of the 5 epiphyses; Ossification of the when epiphyses; when completed, hyaline cartilage remains only in the epiphyseal plates epiphyseal and articular plates and articular cartilages 38 6. 8 Figure 6. 8

Postnatal bone growth • Growth in length of long bones – Cartilage on the side of the epiphyseal plate closest to the epiphysis is relatively inactive – Cartilage abutting the shaft of the bone organizes into a pattern that allows fast, efficient growth – Cells of the epiphyseal plate proximal to the resting cartilage form three functionally different zones: growth, transformation, and osteogenic

Growth in Long Bones • Growth zone – cartilage cells undergo mitosis, pushing the epiphysis away from the diaphysis • Transformation zone – older cells enlarge, the matrix becomes calcified, cartilage cells die, and the matrix begins to deteriorate • Osteogenic zone – new bone formation occurs • Growth in length – cartilage continually grows and is replaced by bone as shown • Growth in width (Remodeling) – bone is resorbed and added by appositional growth as shown

i

Appositional. Growthof of. Bone Periosteal ridge Periosteum Penetrating canal Artery 1 Osteoblasts beneath Osteoblasts 1 the periosteumbeneath the periosteum secrete bone matrix, secrete bone that matrix, forming ridges follow the course that of follow the course of periosteal blood vessels. latio 2 As the bony ridges As theand bony ridges 2 enlarge meet, theenlarge grooveand meet, the groove containing the containing blood vessel the blood vessel becomes a tunnel. Central canal of osteon 3 The periosteum The the periosteum 3 lining tunnel is lining the tunnel transformed into anis transformed endosteum andinto the an endosteum and the osteoblasts just deep to the tunnel endosteum secrete endosteum bone matrix, secrete bone matrix, narrowing the canal. 4 As the osteoblasts 4 beneath As the osteoblasts endosteum beneath the endosteum form new lamellae, a new osteon is created. osteon isnew created. Meanwhile new circumferential lamellae are elaborated beneath the periosteum and the process is repeated, continuing to enlarge bone diameter. 42 6. 11 Figure 6. 11

Hormone Regulation of Bone Growth • During infancy and childhood, epiphyseal plate activity is stimulated by growth hormone • During puberty, testosterone and estrogens: – Initially promote adolescent growth spurts – Cause masculinization and feminization of specific parts of the skeleton – Later induce epiphyseal plate closure, ending – longitudinal bone growth Therefore, a deficiency of growth hormone will cause a decrease proliferation of the epiphyseal plate cartilage Remodeling units – adjacent osteoblasts and osteoclasts deposit and resorb bone at periosteal and endosteal surfaces

How Bone is Deposited • Occurs where bone is injured or added strength is needed • Requires a diet rich in protein, vitamins C, D, and A, calcium, phosphorus, magnesium, and manganese • Alkaline phosphatase is essential for mineralization of bone • Sites of new matrix deposition are revealed by the: – Osteoid seam – unmineralized band of bone matrix – Calcification front – abrupt transition zone between the osteoid seam and the older mineralized bone

How Bone is Reabsorbed • Accomplished by osteoclasts • Resorption bays – grooves formed by osteoclasts as they break down bone matrix • Resorption involves osteoclast secretion of: – Lysosomal enzymes that digest organic matrix – Acids that convert calcium salts into soluble forms • Dissolved matrix is transcytosed across the osteoclast’s cell where it is secreted into the interstitial fluid and then into the blood

Calcium for Bones? • Calcium is necessary for: – Transmission of nerve impulses – Muscle contraction – Blood coagulation – Secretion by glands and nerve cells – Cell division – Remodeling of bone

Remodeling • Two control loops regulate bone remodeling – Hormonal mechanism maintains calcium homeostasis in the blood – Mechanical and gravitational forces acting on the skeleton • Rising blood Ca 2+ levels trigger the thyroid to release calcitonin • Calcitonin stimulates calcium salt deposit in bone • Falling blood Ca 2+ levels signal the parathyroid glands to release PTH • PTH signals osteoclasts to degrade bone matrix and release Ca 2+ into the blood

Response to Mechanical Stress • Wolff’s law – a bone grows or remodels in response to the forces or demands placed upon it • Observations supporting Wolff’s law include – Long bones are thickest midway along the shaft (where bending stress is greatest) – Curved bones are thickest where they are most likely to buckle • Trabeculae form along lines of stress • Large, bony projections occur where heavy, active muscles attach

Fractures • Bone fractures are classified by: – The position of the bone ends after fracture – The completeness of the break – The orientation of the bone to the long axis – Whether or not the bones ends penetrate the skin

Fractures Nondisplaced – bone ends retain their normal position Displaced – bone ends are out of normal alignment Complete – bone is broken all the way through Incomplete – bone is not broken all the way through Linear – the fracture is parallel to the long axis of the bone Transverse – the fracture is perpendicular to the long axis of the bone Compound (open) – bone ends penetrate the skin Simple (closed) – bone ends do not penetrate the skin

Fractures Comminuted – bone fragments into three or more pieces; common in the elderly Spiral – ragged break when bone is excessively twisted; common sports injury Depressed – broken bone portion pressed inward; typical skull fracture Compression – bone is crushed; common in porous bones Epiphyseal – epiphysis separates from diaphysis along epiphyseal line; occurs where cartilage cells are dying Greenstick – incomplete fracture where one side of the bone breaks and the other side bends; common in children

Healing a bone fracture • Hematoma formation – Torn blood vessels hemorrhage – A mass of clotted blood (hematoma) forms at the fracture site – Site becomes swollen painful, and inflamed

Stages in the Healing of a Bone Fracture • Fibrocartilaginou s callus forms • Granulation tissue (soft callus) forms a few days after the fracture • Capillaries grow into the tissue and phagocytic cells begin cleaning debris External callus Internal callus (fibrous tissue and cartilage) New blood vessels Spongy bone trabeculae 2 Fibrocartilaginous callus formation Figure 58 6. 14. 2

Healing of Fracture The fibrocartilaginous callus forms when: Osteoblasts and fibroblasts migrate to the fracture and begin reconstructing the bone Fibroblasts secrete collagen fibers that connect broken bone ends Osteoblasts begin forming spongy bone Osteoblasts furthest from capillaries secrete an externally bulging cartilaginous matrix that later calcifies

Stages in the Healing of a Bone Fracture • Bony callus formation – New bone trabeculae appear in the fibrocartilaginous callus – Fibrocartilaginous callus converts into a bony (hard) callus – Bone callus begins 3 -4 weeks after injury, and continues until firm union is formed 2 -3 months later Bony callus of spongy bone 3 Bony callus formation Figure 60 6. 14. 3

Stages in the Healing of a Bone Fracture • Bone remodeling – Excess material on the bone shaft exterior and in the medullary canal is removed – Compact bone is laid down to reconstruct shaft walls Healing fracture 4 Bone remodeling Figure 61 6. 14. 4

Factors Affecting Bone Growth and Development • • 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

Homeostasis? • Osteomalacia – Bones are inadequately mineralized causing softened, weakened bones – Bone formed is poorly mineralized and soft. • Deforms on weight-bearing – Main symptom is pain when weight is put on the affected bone – Caused by insufficient calcium in the diet, or by vitamin D deficiency

Rickets Bones of children are inadequately mineralized causing softened, weakened bones Bowed legs and deformities of the pelvis, skull, and rib cage are common Caused by insufficient calcium in the diet, or by vitamin D deficiency

• Osteoporosis – Group of diseases in which bone reabsorption outpaces bone deposit – Spongy bone of the spine is most vulnerable – Bones are porous and thin but bone composition is normal – Occurs most often in postmenopausal women – Bones become so fragile that sneezing or stepping off a curb can cause fractures

• Calcium and vitamin D supplements • Increased weight-bearing exercise • Hormone (estrogen) replacement therapy (HRT) slows bone loss • Natural progesterone cream prompts new bone growth • Statins increase bone mineral density

Paget’s Disease • Characterized by excessive bone formation and breakdown – Abnormal bone formation and reabsorption • Pagetic bone with an excessively high ratio of woven to compact bone is formed • Pagetic bone, along with reduced mineralization, causes spotty weakening of bone • Osteoclast activity wanes, but osteoblast activity continues to work • May be prevented by increasing dietary vitamin C • Usually localized in the spine, pelvis, femur, and skull • Unknown cause (possibly viral) • Treatment includes the drugs Didronate and Fosamax

Developmental Aspects Mesoderm gives rise to embryonic mesenchymal cells, which produce membranes and cartilages that form the embryonic skeleton The embryonic skeleton ossifies in a predictable timetable that allows fetal age to be easily determined from sonograms At birth, most long bones are well ossified (except for their epiphyses)

By age 25, nearly all bones are completely ossified In old age, bone resorption predominates A single gene that codes for vitamin D docking determines both the tendency to accumulate bone mass early in life, and the risk for osteoporosis later in life

What bones do we need to know?

Skull Frontal (1) • forehead • roof of nasal cavity • roofs of orbits • frontal sinuses • supraorbital foramen • coronal suture

Skull Parietal (2) • side walls of cranium • roof of cranium • sagittal suture

Skull Occipital (1) • back of skull • base of cranium • foramen magnum • occipital condyles • lambdoidal suture

Skull Ethmoid (1) • roof and walls of nasal cavity • floor of cranium • wall of orbits • cribiform plates • perpendicular plate • superior and middle nasal conchae • ethmoidal sinuses • crista gallis

Facial 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

Frontal Palatine (2) • posterior roof of mouth • floor of nasal cavity • lateral walls of nasal cavity

Facial Zygomatic (2) • prominences of cheeks • lateral walls of orbits • floors of orbits • temporal process

Facial Lacrimal (2) • medial walls of orbits • groove from orbit to • nasal cavity Nasal (2) • bridge of nose

Facial Vomer (1) • inferior portion of nasal septum

Facial Inferior Nasal Conchae (2) • extend from lateral • walls of nasal cavity

Facial Mandible (1) • lower jaw • body • ramus • mandibular condyle • coronoid process • alveolar process • mandibular foramen • mental foramen

Infantile skull

Vertebral Column • cervical vertebrae (7) • thoracic vertebrae (12) • lumbar vertebrae (5) • sacrum • coccyx

Vertebral Column • cervical curvature • thoracic curvature • lumbar curvature • pelvic curvature • rib facets • vertebra prominens • intervertebral discs • intervertebral foramina

• five fused vertebrae • median sacral crest • dorsal sacral foramina • posterior wall of pelvic cavity • sacral promontory Coccyx: Tailbone 4 Fused Vertebrae Sacrum

Thoracic cage Ribs • Sternum • Thoracic vertebrae • Costal cartilages • Supports shoulder girdle • Protects viscera • Role in breathing

Ribs • True ribs (7) • False ribs (5) • floating (2)

Sternum • Manubrium • Body • Xiphoid process

Pectoral girdle

Clavicles • articulate with manubrium • articulate with scapulae (acromion process articulate with manubrium) • articulate with scapulae (acromion process)

Upper Limb • Humerus • Radius • Ulna • Carpals • Metacarpals • Phalanges 7 -45

Pelvis Coxae (2) • supports trunk of body • protects viscera •

Male and Female Pelvis Female • iliac bones more flared • broader hips • pubic arch angle greater • more distance between ischial spine and ischial tuberosity • sacral curvature shorter and flatter • lighter bones

Lower body Femur • longest bone of body • head • fovea capitis • neck • greater trochanter • lesser trochanter • linea aspera • condyles • epicondyles

Patella • kneecap • anterior surface of knee • flat sesmoid bone located in a tendon

Tibia • shin bone • medial to fibula • condyles • tibial tuberosity • anterior crest • medial malleolus

Fibula • lateral to tibia • long, slender • head • lateral malleolus • does not bear any body weight

Ankle and Foot • Tarsals (14) • calcaneus • talus • navicular • cuboid • lateral cuneiform • intermediate cuneiform • medial cuneiform • Metatarsals (10) • Phalanges (28) • proximal • middle • distal

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