Ch. 11, 12, 13 Skeletal Tissues, Axial and Appendicular Skeleton-3

CHAPTER 11, 12, 13 SKELETAL SYSTEM Copyright © 2022, Elsevier Inc. All Rights Reserved. 1     OBJECTIVES    List and discuss the five homeostatic functions of bones. List the four types of bones and give examples of each. Identify the six major structures of a typical long bone and the parts of flat bone. Identify each of the major constituents of bone as a tissue and discuss how structural organization contributes to function. Identify by name and discuss each of the major components of a haversian system. Compare and contrast cancellous bone and compact bone. List and describe the functions of the three major types of cells found in bones. 2 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Discuss the two types of bone marrow.  Identify the three specialized types of cartilage, give examples of each, and summarize the structural and functional differences among them.  Explain the role bones play in maintaining homeostasis of blood calcium levels in the body.  Compare and contrast the development of intramembranous and endochondral bone.  Describe the process of bone remodeling and the steps involved in bone fracture repair.  Discuss the diseases of skeletal tissues. OBJECTIVES Copyright © 2022, Elsevier Inc. All Rights Reserved. 3   OBJECTIVES Identify the two main subdivisions of the skeleton and the primary subdivisions of the axial skeleton. Do the following regarding the bones of the skull:  Distinguish between the bones of the skull and those of the face.  List the sutures and fontanels of the skull.  Discuss the clinical significance of the cribriform plate of the ethmoid bone. 4 Copyright © 2022, Elsevier Inc. All Rights Reserved. OBJECTIVES  Identify the hyoid bone.  Name the regions of the vertebral column and give the number of vertebrae in each segment.  Discuss the bony components of the rib cage, or chest.  Discuss disorders of the axial skeleton and the three primary types of abnormal vertebral curvatures 5 Copyright © 2022, Elsevier Inc. All Rights Reserved.     OBJECTIVES      List the primary subdivisions of the appendicular skeleton. List the bony components of the shoulder. Discuss the structures and functions of the arm, forearm, and hand. List the bony components of the pelvic girdle. Discuss the structures and functions of the thigh and leg. Discuss the structural components and functional significance of the arches of the foot. List the skeletal differences between men and women. Discuss age-related changes in the skeleton. Define the different types of bone fractures. 6 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Skeletal system organs  Bones and ligaments  Ligaments  Hold bones together  Bones  Five major roles 7 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Support Support  Provides structural support for the entire body  Bones provide attachments for soft tissues and organs  Protection  Soft tissues and organs are surrounded by skeletal structures  The skull encloses the brain  The ribs protect the heart and lungs  Movement  Bones function as levers  Change size and direction of force generated by skeletal muscles  Result is body movement Copyright © 2022, Elsevier Inc. All Rights Reserved. 8  Mineral storage  Mineral reserves for calcium and phosphate ions held in calcium salts in bone  Yellow bone marrow stores lipids for energy reserves  Hematopoiesis  Blood cell production  Red blood cells, white blood cells, and other blood elements produced in the red bone marrow 9 Copyright © 2022, Elsevier Inc. All Rights Reserved. 10 Copyright © 2022, Elsevier Inc. All Rights Reserved. Long bones • Cylindrical Short bones • Box-like Flat bones • Flat, sheet-like Irregular bones • Varied shapes Sesamoid bones • Seed-like 11 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Diaphysis  Main shaft of a long bone  Hollow, cylindrical shape and thick compact bone  Epiphyses  Both ends of a long bone; made of cancellous bone filled with marrow  Bulbous shape Copyright © 2022, Elsevier Inc. All Rights Reserved. 12  Articular cartilage  Layer of hyaline cartilage covering articular surface of epiphyses  Periosteum  Dense, white fibrous membrane that covers bone  Contains cells that form and destroy bone  Contains blood vessels that send branches into bone  Medullary cavity  Tubelike, hollow space in diaphysis of a long bone  In adults, filled with connective tissue (yellow marrow)  Endosteum  Thin, fibrous membrane that lines the medullary cavity 13 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Internal table and  Covered with periosteum and external table  Compact bone lined with endosteum  Red marrow  Spaces inside cancellous  Diploe  Between internal and external tables bone of short, flat, irregular, and sesamoid bones 14 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Extracellular components  Hard and calcified  Composition of Bone Matrix  Inorganic salts  Calcification  Rigidity of bone  Supportive and  Hydroxyapatite protective functions  Tensile strength  Nearly equal to that of cast iron, at less than ⅓ the weight  Also magnesium, sodium, sulfate, fluoride  Organic matrix  Ground substance  Collagenous fibers 15 Copyright © 2022, Elsevier Inc. All Rights Reserved.  About 80% of total bone mass in adult  Osteon is basic unit  Lamellae  Concentric, interstitial, circumferential  Lacunae  Canaliculi  Central canal  Connected to parallel central canals by transverse canals 16 Copyright © 2022, Elsevier Inc. All Rights Reserved.  About 20% of total bone mass in adult  Spongy bone  Trabeculae  Fractal organization  Found between flat bones, in short and irregular bones, inside the epiphyses, and lining medullary cavities of long bones  Blood supply 17 Copyright © 2022, Elsevier Inc. All Rights Reserved. B: Dennis Strete. Copyright © 2022, Elsevier Inc. All Rights Reserved. 18  Osteoblasts  Formed from osteogenic stem cells  Secrete osteoid and build bones  Osteoclasts  Giant, multinucleated cells  Collagenase and hydrochloric acid erode bone  Osteocytes  Mature, nondividing osteoblasts 19 Copyright © 2022, Elsevier Inc. All Rights Reserved. BONE MARROW  Soft, diffuse connective tissue  Also called myeloid tissue  Two types of marrow over lifetime  Red marrow  Functions to produce red blood cells  Yellow marrow  Marrow cells that become saturated with fat and are no longer active in blood cell production 20 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Collagenous fibers embedded in gel  Avascular  Diffusion from perichondrium or synovial fluid  Embryonic development  Later replacement with bone  Some cartilage remains in body throughout life 21 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Hyaline cartilage  Formation: chondrification centers  Locations  Fibrocartilage  Abundant fibrous elements within matrix  Strong and rigid  Elastic cartilage  Locations 22 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Sustains great weight  When covering articulating surfaces of bones  Shock-absorbing pads  Between articulating bones in spine  Provides strong yet pliable support structure  External ear, nose, and respiratory passages  Permits growth  Long bones 23 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Interstitial growth  Cartilage cells within the substance of the tissue mass divide and begin to secrete additional matrix  Appositional growth  Occurs when chondrocytes in the deep layer of the perichondrium begin to divide and secrete additional matrix 24 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Helps maintain constancy of blood calcium levels:  Osteoblasts remove calcium from blood and lower circulating levels  Osteoclasts release calcium into blood and increase circulating levels  Homeostasis of calcium ion concentration essential for:  Bone formation, remodeling, and repair  Blood clotting  Transmission of nerve impulses  Maintenance of skeletal and cardiac muscle contraction 25 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Parathyroid hormone  Primary regulator of calcium homeostasis  Stimulates osteoclasts to initiate breakdown of bone matrix and increase blood calcium levels  Increases renal absorption of calcium from urine  Stimulates vitamin D synthesis  Calcitonin  Protein hormone produced in thyroid gland  Produced in response to high blood calcium levels  Stimulates bone deposition by osteoblasts  Inhibits osteoclast activity 26 Copyright © 2022, Elsevier Inc. All Rights Reserved. 27 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Embryonic development of bone  Begins at week 6 as a cartilaginous formation  Replaced with bone, a process called ossification  Two types 1. Intramembranous ossification 2. Endochondral ossification  Calcification occurs during ossification  Can also occur in other tissues besides bone 28 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Intramembranous ossification  Flat bones begin to take shape when groups of cells differentiate into osteoblasts  Clusters of osteoblasts: ossification centers  Collagenous fibers become embedded in ground substance  Bone matrix  Trabeculae appear and join in network  Spongy bone 29 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Also called intracartilaginous ossification  Primary ossification center  Diaphysis toward each epiphysis  Interstitial growth  Secondary ossification centers 30 Copyright © 2022, Elsevier Inc. All Rights Reserved. From Patton KT, Thibodeau G: Human body in health & disease, ed 7, St. Louis, 2018, Mosby. 31 Copyright © 2022, Elsevier Inc. All Rights Reserved. From Patton KT, Thibodeau G: Human body in health & disease, ed 7, St. Louis, 2018, Mosby. 32 Copyright © 2022, Elsevier Inc. All Rights Reserved. Ed Reschke. 33 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Four layers of epiphyseal plate  “Resting” cartilage cells  Zone of proliferation  Zone of hypertrophy  Zone of calcification  Potential for epiphyseal fracture 34 Copyright © 2022, Elsevier Inc. All Rights Reserved.  At puberty, bone growth accelerates due to increased sex hormone production  Osteoblasts produce bone faster than the  epiphyseal cartilage can expand  Epiphyseal cartilages get narrower until disappear  Called epiphyseal closure = end of growth  Varies from bone to bone and person to person  X-rays of adult bones show former location of epiphyseal cartilage as epiphyseal line 35 Copyright © 2022, Elsevier Inc. All Rights Reserved. From Booher JM, Thibodeau Ga: Athletic injury assessment, St. Louis, 1985, Mosby. Copyright © 2022, Elsevier Inc. All Rights Reserved. 36 37 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Growth in diameter of bones occurs along with growth in length = appositional growth  Periosteum cells develop into osteoblasts  Produce more matrix on the outer surface of the bone  Osteoclasts erode the inner surface  Marrow cavity enlarges as a result 38 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Early woven bone replaced by lamellar bone  Primary osteons created  Replaced by secondary osteons  Osteoclasts and osteoblasts  Work together for growth and blood calcium homeostasis  Changes in balance of formation and destruction  Childhood, adolescence, early adulthood, aging  Stressors  Wolff’s law of bone 39 Copyright © 2022, Elsevier Inc. All Rights Reserved. 40 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Initiated by bone death or damage to blood vessels  Influenced by age and underlying conditions  Process  Fracture hematoma, then granulation tissue, then procallus 41 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Protective and supportive  Skeleton fully ossified by  Shape, alignment,  Adults: Changes occur as a functions positioning  Purposeful and coordinated movement  Homeostatic function  Mineral storage and release  Hematopoiesis mid-20s result of specific conditions  Decreased density and strength result from pregnancy, nutritional deficiencies, and illness  Advanced adulthood: Apparent degeneration  Exercise can counteract degeneration 42 Copyright © 2022, Elsevier Inc. All Rights Reserved. Axial skeleton DIVISIONS OF THE SKELETON • 80 bones Appendicular skeleton • 126 bones 43 Copyright © 2022, Elsevier Inc. All Rights Reserved. 44 Copyright © 2022, Elsevier Inc. All Rights Reserved. 45 Copyright © 2022, Elsevier Inc. All Rights Reserved. 46 Copyright © 2022, Elsevier Inc. All Rights Reserved.  28 irregularly-shaped bones  Cranium  8 bones  Face  14 bones  Frontal and ethmoid not  Frontal bone  Frontal, or paranasal,  Sphenoid bone  Anchors frontal, parietal,  Temporal bones  Mastoid sinuses numbered occipital, and ethmoid bones  Sphenoid sinuses  Ethmoid bone  Irregular  Ethmoid air cells sinuses  Coronal suture  Parietal bones  Lamboid, squamous, and coronal sutures  Occipital bone  Immovable joints  Parietal, temporal, sphenoid  Movable joint  First cervical vertebra Copyright © 2022, Elsevier Inc. All Rights Reserved. 47 48 Copyright © 2022, Elsevier Inc. All Rights Reserved. 49 Copyright © 2022, Elsevier Inc. All Rights Reserved. 50 Copyright © 2022, Elsevier Inc. All Rights Reserved. 51 Copyright © 2022, Elsevier Inc. All Rights Reserved. 52 Copyright © 2022, Elsevier Inc. All Rights Reserved. 53 Copyright © 2022, Elsevier Inc. All Rights Reserved. 54 Copyright © 2022, Elsevier Inc. All Rights Reserved. 55 Copyright © 2022, Elsevier Inc. All Rights Reserved. 56 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Maxillae (upper jaw)  Articulate with nasal,  Zygomatic bone (cheek zygomatic, inferior conchae, and palatine bones  Form parts of orbital floor, roof of mouth, and floor and sidewalls of nose  Maxillary sinus  Mandible (lower jaw)  Only movable joint of the skull bone, or malar bone)  Forms outer margin of the orbit  Forms zygomatic arch  Nasal bones  Form upper part of bridge of nose  Articulate with perpendicular plate of ethmoid bone, cartilaginous part of nasal septum, frontal bone, maxillae, each other 57 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Lacrimal bones  Paper-thin  Just posterior and lateral to  Inferior nasal conchae  Palatine bones  Two Ls facing each other in  Vomer bone  Completes the nasal septum each nasal bone  Form nasal cavity and medial wall of orbit  Contain groove for nasolacrimal duct the midline  Form posterior part of hard palate, lateral wall of posterior part of nasal cavities  Orbital process (turbinates)  Form lower edge projecting into nasal cavity  Also form the nasal meatus  Articulate with the ethmoid, lacrimal, maxillary, and palatine bones posteriorly  Articulates with the sphenoid, ethmoid, and palatine bones and also the maxillae Copyright © 2022, Elsevier Inc. All Rights Reserved. 58 59 Copyright © 2022, Elsevier Inc. All Rights Reserved. 60 Copyright © 2022, Elsevier Inc. All Rights Reserved. 61 Copyright © 2022, Elsevier Inc. All Rights Reserved. 62 Copyright © 2022, Elsevier Inc. All Rights Reserved. 63 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Contain  Eyes and associated muscles  Lacrimal apparatus  Important blood vessels and nerves  Often fragile 64 Copyright © 2022, Elsevier Inc. All Rights Reserved. From Williams P: Gray’s anatomy, ed 38, Philadelphia, 1996, Churchill Livingstone. Copyright © 2022, Elsevier Inc. All Rights Reserved. 65  U-shaped  Muscle attachments  No articulation with other bones 66 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Forms flexible longitudinal axis of the skeleton  7 cervical vertebrae  Including atlas  Anterior and posterior arches  Including axis  Dens  12 thoracic vertebrae  5 lumbar vertebrae  Including sacrum and coccyx  Fusions with age  No vertebral foramen in sacrum and coccyx Copyright © 2022, Elsevier Inc. All Rights Reserved. 67 From Gosling J, Harris P, Whitmore I, Willan P: Human anatomy, ed 4, Philadelphia, 2002, Mosby. 68 Copyright © 2022, Elsevier Inc. All Rights Reserved. From Gosling J, Harris P, Whitmore I, Willan P: Human anatomy, ed 4, Philadelphia, 2002, Mosby. 69 Copyright © 2022, Elsevier Inc. All Rights Reserved. From Gosling J, Harris P, Whitmore I, Willan P: Human anatomy, ed 4, Philadelphia, 2002, Mosby. 70 Copyright © 2022, Elsevier Inc. All Rights Reserved. From Gosling J, Harris P, Whitmore I, Willan P: Human anatomy, ed 4, Philadelphia, 2002, Mosby. Copyright © 2022, Elsevier Inc. All Rights Reserved. 71  Convex (kyphotic) curvatures  Thoracic  Sacral  Concave (lordotic) curvatures  Cervical  lumbar 72 Copyright © 2022, Elsevier Inc. All Rights Reserved.  12 pairs of ribs  Ribs  Vertebral column  Elongated flat bones  Sternum  Manubrium  Articulations  Body and transverse  Body  Xiphoid process processes of corresponding vertebrae  True ribs  First seven pairs  False ribs  Pairs 8 through 10  Floating ribs  Pairs 11 and 12 73 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Mastoiditis  Otitis media  Abnormal spinal curvatures  Lordosis  Kyphosis  Treatment  Scheuermann disease  Scoliosis  Treatment 74 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Shoulder girdle  Made of scapula and clavicle  Articulations  Identifying structures  Arm  Humerus  Identifying structures  Articulations  Forearm  Radius and ulna  Identifying structures  Articulations Copyright © 2022, Elsevier Inc. All Rights Reserved. 75 76 Copyright © 2022, Elsevier Inc. All Rights Reserved. Photo courtesy Vidic B, Suarez FR: Photographic atlas of the human body, St. Louis, 1984, Mosby. 77 Copyright © 2022, Elsevier Inc. All Rights Reserved. Photo courtesy Vidic B, Suarez FR: Photographic atlas of the human body, St. Louis, 1984, Mosby. 78 Copyright © 2022, Elsevier Inc. All Rights Reserved. Photo courtesy Vidic B, Suarez FR: Photographic atlas of the human body, St. Louis, 1984, Mosby. 79 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Hand  8 carpal bones (upper hand)  Ligaments: proximal and distal rows  Four in each  5 metacarpal bones  Significance of thumb  Articulations 80 Copyright © 2022, Elsevier Inc. All Rights Reserved. Photo courtesy Vidic B, Suarez FR: Photographic atlas of the human body, St. Louis, 1984, Mosby. 81 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Pelvic girdle  Coxal bones  Each is ilium, ischium, and pubis fused  Bound to sacrum posteriorly and to each other anteriorly  Pelvic inlet and pelvic brim  False pelvis  True pelvis and pelvic outlet  Significance in childbirth 82 Copyright © 2022, Elsevier Inc. All Rights Reserved. Photo courtesy Vidic B, Suarez FR: Photographic atlas of the human body, St. Louis, 1984, Mosby. Copyright © 2022, Elsevier Inc. All Rights Reserved. 83 From Abrahams P, Marks S, Hutchings R: McMinn’s color atlas of human anatomy, ed 5, Philadelphia, 2003, Mosby. Copyright © 2022, Elsevier Inc. All Rights Reserved. 84  Thigh  Femur  Markings  Patella  Universally present sesamoid bone  Leg  Tibia and fibula  Articulations  Markings 85 Copyright © 2022, Elsevier Inc. All Rights Reserved. 86 Copyright © 2022, Elsevier Inc. All Rights Reserved. Courtesy Vidic B, Suarez FR: Photographic atlas of the human body, St. Louis, 1984, Mosby. 87 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Foot  7 tarsal bones  Arch construction  Longitudinal arch  Medial longitudinal arch  Lateral longitudinal arch  Transverse arch  Support functions (vs manipulation in the hand) 88 Copyright © 2022, Elsevier Inc. All Rights Reserved. Photo courtesy Vidic B, Suarez FR: Photographic atlas of the human body, St Louis, 1984, Mosby. 89 Copyright © 2022, Elsevier Inc. All Rights Reserved. Drawings from Yvonne Wylie Walston. Photo inset from Seidel HM, Ball JW, Dains JE, Benedict GW: Mosby’s guide to physical examination, ed 5, St. Louis, 2003, Mosby. 90 Copyright © 2022, Elsevier Inc. All Rights Reserved.  General: size and weight  Specific: pelvic bones and cavity  Male pelvis: Deep, funnel-shaped, with a narrow pubic arch  Female pelvis: Shallow, broad, and flaring, with a wider pubic arch  Subtle differences in axial skeleton 91 Copyright © 2022, Elsevier Inc. All Rights Reserved. Drawings From Patton KT, Thibodeau G: Human body in health & disease, ed 7, St. Louis, 2018, Mosby. Photos from Abrahams P, Marks S, Hutchings R: McMinn’s color atlas of human anatomy, ed 5, Philadelphia, 2003, Mosby. Copyright © 2022, Elsevier Inc. All Rights Reserved. 92  Mature at 25 years  Maintenance until 50, then density decreases  Nutrition  Calcium and vitamin D  Exercise  Applications 93 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Increasing structural hierarchy in the body  Chemical level of organization  Cells and tissues of bone and cartilage  Discrete organs (bones)  Complex operational units 94 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Structural changes in bone, cartilage, muscle  Bone age vs chronological age  Risks of density loss 95 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Malignant tumors of bone and cartilage  Osteosarcoma and chondrosarcoma  Metabolic bone diseases  Diseases of bone remodeling, such as osteoporosis  Rickets and osteomalacia  Demineralization of bone due to vitamin D deficiency  Osteitis deformans and osteomyelitis 96 Copyright © 2022, Elsevier Inc. All Rights Reserved.  Bone fracture  Definition  Causes  Mechanical stress  Pathological or spontaneous  Types  Stress fracture  Displaced, open , or compound fracture  Nondisplaced or closed  Impacted fracture  Complete  Incomplete 97 Copyright © 2022, Elsevier Inc. All Rights Reserved. 98 Copyright © 2022, Elsevier Inc. All Rights Reserved.