Anatomy and Physiology

Chapter 1 - The Human Body: An Orientation

Anatomy: the study of the bodys structures and their relationships to one
another
Physiology: the study of the bodys function.

Topics of Anatomy
Gross/macroscopic anatomy: the study of large body structures (ex.
kidneys, lungs)
Regional anatomy: all the structures of the body (muscles, bones, blood,
etc.) in a particular region (legs, abdomen, etc.) are studied at one time
Systemic anatomy: body structure is studied system by system.
Surface anatomy: the study of internal structures as they relate to the
overlying skin surface.
Microscopic anatomy: the study of structures too small to be seen with the
naked eye (ex. cells). Subdivisions include cytology (cells of the body) and
histology (study of tissues)
Developmental anatomy: studies changes in the body throughout the life
span, a subdivision being embryology, the study of developmental changes
before birth.

Topics of Physiology
Has many different subdivisions, mostly concerning specific body systems.
For example, renal physiology concerns kidney function and urine production.
Often focuses on events at cellular or molecular level.
Complementarity of Structure and Function
Definition: The principle of complementarity of structure and function states
that what a structure can do depends on its specific form.
Function always reflects structure and anatomy and physiology is
inseparable.

Levels of Structural Organization

Chemical level: atoms combine to form molecules such as water and
proteins.
Molecules associate to form organelles, the basic components of living cells.
This is the cellular level.
Tissue level: groups of similar cells that have a common function. Four basic
types: epithelium, muscle, connective tissue, and nervous tissue.
Organ: a discrete structure composed of at least two tissue types that
perform a specific function for the body.
At the organ level, extremely complex functions become possible.
Organ system level: organs that work together to accomplish a common
purpose make up an organ system.
The organismal level represents the sum total of all structural levels working
together to keep us alive.

Maintaining Life

Maintaining boundaries: an organism must keep its internal environment

distinct from its external environment. All the cells of our body are
surrounded by a selectively permeable membrane. The body as a whole is
protected by the intergumentary system or skin.
Movement: the activities promoted by the muscular system, such as
propelling ourselves from one place to another such as running or swimming.
As well, movement also occurs when substances are propelled through the
internal organs. This is called contractility, the ability to move by shortening.
Responsiveness: the ability to sense changes in the environment and then
respond to them. The nervous system is most involved with responsiveness.
Digestion: the breaking down of ingested food to simple molecules that can
be absorbed by the blood, then distributed by the cardiovascular system.
Metabolism: a broad term that includes all chemical reactions that occur
within our body cells.
Catabolism: breaking down substances
Anabolism: synthesizing more complex cellular structures
Excretion: the process of removing wastes (excreta) from the body.
Reproduction: occurs at cellular and organismal level
Cellular reproduction: the original cell divides producing two identical
daughter cells that may e used for body growth and repair.
Reproduction of the human organism is the major task of the reproductive
system,
Growth: an increase of the size of a body part or the organism.
Survival Needs
Nutrients: chemical substances used for energy and cell building. Taken in
via the diet.
Oxygen and water: molecules required for most chemical reaction in the
body.
Normal body temperature: needed for continued chemical reactions (37
degrees Celcius)
Atmospheric pressure: the force that air exerts on the surface of the body.
Breathing and gas exchange rely on appropriate atmospheric pressure.

Homeostasis

Definition: The bodys ability to maintain a relatively stable internal

condition even though the outside world is changing constantly.
Dynamic state of equilibrium refers to the fact that internal conditions vary
but always within relatively narrow limits.
Virtually every organ system plays a role in maintaining homeostasis.
Homeostatic control
Communication is essential for homeostasis. All homeostatic control
mechanisms involve at least three components that work together.
The receptor is some type of sensor that monitors the environment and
responds to changes called stimuli by sending information to the control
centre along the afferent pathway.
The control centre determines the set point (the level or range at which a
variable is to be maintained). It also analyzes the input it receives and

determines the appropriate response. Information then goes to the effector

along the efferent pathway.
The effector provides the means for the control centres response to the
stimulus.
The results of the response then feed back to influence the effects of the
stimulus.
In negative feedback, the response is reduced. In positive feedback the
response is increased.
Negative feedback mechanisms: in these systems, the output shuts off
the original effect of the stimulus or otherwise reduces its intensity.
Positive feedback mechanisms: in these systems the result or response
enhances the original stimulus so that the result is accelerated. Often
referred to as cascades.
Homeostatic imbalance: most diseases can be regarded as a result of
homeostatic disturbance. Sometimes occurs when negative feedback cycles
are overwhelmed.

The Language of Anatomy

Superior: towards the head end, or upper part of a body structure; above
Inferior: towards the lower end (away from the head end) of a body
structure; below
Ventral: towards or at the front of the body; in front of
Dorsal: towards or at the back of the body; behind
Medial: towards or at the midline of the body; on the inner side of
Lateral: away from the midline of the body; on the outer side of
Intermediate: between a more medial and lateral structure
Proximal: closer to the origin of the body part or to the point of attachment
of a limb to the body trunk
Distal: farther away from the origin of the body part
Superficial (external): towards or at the body surface
Deep (internal): away from the body surface, more internal
Anatomical position: the body is erect with feet slightly apart. Palms face
forward and the thumbs point away from the body.
Directional terms: allow us to explain where one body structure is in
relation to another
Regional terms
Axial part: includes the head, neck, and trunk.
Appendicular part: consist of appendages, or limbs, which are attached to the
bodys axis.
Regional terms: used to designate specific areas within these division.
Body Planes and Sections
For anatomical studies, the body is often sectioned along a plane.
Sagittal plane: a vertical plane that divided the body into its right and left
parts.

Frontal plane: divide the body into anterior and posterior (front and back)
parts
Transverse plane: runs horizontally from right to left, divided body into
superior and inferior parts
Oblique sections: cuts made diagonally between horizontal and vertical
planes

Body Cavities and Membranes

Dorsal body cavity: two subdivisions, cranial cavity (in the skull encasing
the brain) and vertebral or spinal cavity (enclosing the spinal cord)
Ventral body cavity: the more anterior and closer body cavities. Houses
internal organs collectively called the viscera or visceral organs
Two major subdivisions, the thoracic cavity and the abdominopelvic cavity
The thoracic cavity is superior to the abdominopelvic cavity. It is surrounded
by the ribs and muscles on the chest. It is further subdivided into lateral
pleural cavities, each enveloping a lung, and the medial mediastinum.
The mediastinum contains the pericardial cavity which encloses the heart and
it also surrounds the remaining thoracic organ (esophagus, trachea, etc.)
The abdominopelvic cavity is inferior to the thoracic cavity, separated by the
diaphragm
The abdominal cavity contains the stomach, intestines, spleen, and other
organs.
The pelvic cavity (inferior) lies in the pelvis and contains the urinary bladder,
some reproductive organs, and the rectum.
Membranes in the Ventral Body Cavity
The walls of the ventral body cavity and the outer surfaces of the organs it
contains are covered by a thin, double-layered membrane called the serosa
or the serous membrane.
The part lining the cavity walls is the parietal serosa and it folds in on itself to
form the visceral serosa.
Separated by a thin layer of lubricating fluid: the serous fluid
This fluid allows the organs to slide without friction across other surfaces
The parietal pericardium lines the pericardial cavity and folds back as the
visceral pericardium. The parietal pleurae line the walls of the thoracic cavity
and the visceral pleurae cover the lungs.
The parietal peritoneum is associated with the walls of the abdominopelvic
cavity while the visceral peritoneum covers most of the organs within that
cavity.

Chapter 4 - Tissue: The Living Fabric

Preparing Human Tissue for Microscopy
All specimens must be fixed (preserved), cut into thin sections and stained
The stains used in light microscopy are dyes; the stains in electron
microscopy are heavy metal salts
Artifacts: minor distortions that alter the tissues original condition

Epithelial Tissue

Definition: a sheet of cells that cover a body surface or line a body cavity
Covering and lining epithelium: forms the outer layer of the skin, lines the
open cavities of many systems and covers the walls of the closed ventral
cavity
Glandular epithelium: fashions the glands of the body
Special Characteristics of Epithelium
1. Polarity: all epithelia contain an apical surface and a basal surface. All
epithelia exhibit apical-basal polarity, i.e. the cell regions near the
apical surface differ from those near the basal surface in structure and
function
Most apical surfaces have microvilli (for absorption) and some have
cilia (to propel substances along their free surface)
Basal lamina: noncellular, adhesive sheet consisting largely of
glycoproteins plus some fine collagen fibres lying adjacent to the basal
surface. Acts as a selective filter or as a scaffolding along which
epithelial cells can migrate to repair a wound
2. Specialized contacts: epithelial cells fit close together by tight
junctions and desmosomes to form continuous sheets. These tight
junctions help keep proteins in the apical layer from migrating to the
basal layer and thus help to maintain epithelial polarity
3. Supported by connective tissue: all epithelial sheets rest upon and
are supported by connective tissue. The basal lamina and the reticular
lamina form the basement membrane which helps the epithelia resist
stretching and defines its boundaries
4. Avascular but innervated: epithelia have nerve fibres but no blood
vessels. They are nourished by substances diffusing from the blood in
the underlying connective tissue
5. Regeneration: epithelium has a high regenerative capacity. As long
as epithelia receive adequate nutrition, they can replace lost cells by
cell division
Classification of Epithelia
Two names: the first indicates the number of cell layers and the second
describes the shape of its cells
Simple epithelia has one layer of cells, stratified has two or more
All epithelia have six sides which allows the cells to be closely packed. But
they do vary in height:
Squamous cells are flattened and scale like, cuboidal cells are box-like and as
tall as they are wide, and columnar cells are tall and rectangle shaped
Stratified cells are named according to the cell shape in the apical layer
Simple Epithelia
Most concerned with absorption, secretion and filtration NOT protection
Simple Squamous Epithelium
Flattened laterally, cytoplasm is sparse

Thin and permeable, found where filtration or rapid diffusion is a priority (ex.
the kidneys)
Endothelium: slick, friction reducing simple squamous epithelium lining
found in lymphatic vessels and in all the hollow organs of the cardiovascular
system (blood vessels and heart)
Mesothelium: found in serous membranes lining the ventral body cavity
Simple Cuboidal Epithelium
Consists of a single layer of cells as tall as they are wide
Functions to secrete and absorb, forms the walls of the smallest duct glands
and kidney tubules
Simple Columnar Epithelium
A single layer of tall, closely packed cells
Lines the digestive tract, associated with absorption and secretion
Dense microvilli are found on the apical surface of absorptive cells and cells
secrete protective mucus
Some simple columnar epithelium display cilia on their free surfaces
Pseudostratified Columnar Epithelium
Cells vary in height, all of its cells lie on the basement membrane but many
do not reach the free surface
A ciliated version lines most of the respiratory tract
Stratified Epithelium
Two or more cell layers that regenerate from below with the basal cells
pushing apically as they divide to replace older surface cells
Protection is their major role
Stratified Squamous Epithelium
Most widespread, composed of several layers and is very thick
Its free surface cells are squamous while its basal cells are cuboidal or
columnar
Forms the skin surface
Stratified Cuboidal and Columnar Epithelium
Stratified cuboidal epithelium is quite rare and is found in the ducts of some
of the larger glands. Usually only two layers of cuboidal cells
Stratified columnar epithelium is also rare, small amounts are found in the
pharynx, the male urethra, and in transition areas between cells. Only its
apical surface is columnar
Transitional Epithelium
Forms the lining of the hollow urinary organs, and can change shape to
accommodate a greater volume of urine. Very useful in the bladder as it
allows more urine to be stored
Resembles both stratified squamous and stratified cuboidal; basal cells are
cuboidal or columnar, surface cells dome shaped or squamous-like depending
on degree of organ stretch

Glandular Epithelia
Gland: one or more cells that make and secrete a particular product
(secretion)
Endocrine: internally secreting
Exocrine: externally secreting
Unicellular (scattered within epithelial sheets) or multicellular (have ducts at
least initially)
Endocrine Glands
Called ductless glands and produce hormones
Hormones: regulatory chemicals secreted into the extracellular space that
act to stimulate some specific target organ in a characteristic way
Exocrine Glands
Secrete their products onto body surfaces or into body cavities
Unicellular Exocrine Glands
Consist of mucous cells and goblet cells sprinkled in the epithelial linings of
the intestinal or respiratory tract amid columnar cells with other functions
Produce mucin that dissolves in water to form mucus
In goblet cells, the cuplike accumulation of mucin distends the top of the cell
so it looks like a goblet
Multicellular Exocrine Glands
Two basic parts: a duct and a secretory unit (acinus)
Supportive connective tissue surrounds the secretory unit to supply it with
blood vessels and nerves
Forms a fibrous capsule that extends into the gland to divide the gland into
lobes
Structural classification: either simple (unbranched duct) or
compound (branched duct). Tubular if the secretory cells form tubes or
alveolar if the secretory cells form small flask-like sacs. Called
tubuloalveolar if they have both secretory units
Modes of secretion: merocrine secrete their products by exocytosis
while holocrine glands accumulate their products within themselves
until they rupture. Apocrine cells pinch off a part of their apex releasing
the secretion as well as a small amount of cytoplasm. Debate as to
whether this is found in humans

Connective Tissue

Found everywhere, most abundant and widely distributed primary tissue type
Common Characteristics of Connective Tissue
1. Common origin: all connective tissue arises from mesenchyme
2. Degrees of vascularity: wide variety, from avascular cartilage to
poorly vascularized dense connective tissue to well vascularized bone

3. Extracellular matrix: connective tissue is composed mostly of

extracellular matrix which allows it to bear weight, withstand great
tension, and so on and so forth.
Structural Elements of Connective Tissue
Three main elements: ground substance, fibres, and cells
Ground substance and fibres make up the extracellular matrix
Areolar connective tissue is used as a model for this group of tissues
Ground Substance
Definition: unstructured material that fills the space between the cells and
contains the fibres
Composed of interstitial (tissue) fluid, cell adhesion proteins, and
proteoglycans
Cell adhesion proteins serve as connective tissue glue that allows the
connective tissue cells to attach themselves to matrix elements
Proteoglycans consist of a protein core to which glycosaminoglycans (GAGs)
are attached
GAGs (chondroitin sulphate and hyaluronic acid) are large negatively charged
polysaccharides that make the ground substance viscous
The ground substance holds large amounts of water and functions as a
molecular sieve
Fibers
Provide support: three types are collagen, elastic, and reticular fibers
Collagen fibers: most abundant, extremely tough and provide high tensile
strength
Elastic fibers: long, thin fibers that form a branching network in the
extracellular matrix. Can stretch and recoil, snap connective tissue back into
normal length and shape after stretching
Reticular fibers: short, fine, collagenous fibers continuous with collagen
fibers. Branch extensively and form delicate networks around small blood
vessels and support the soft tissue of organs
Cells
Blast cells: undifferentiated, actively mitotic calls that secrete the ground
substance and fibers characteristic of their particular matrix
Connective tissue proper has fibroblasts, cartilage has chondroblasts, and
bone has osteoblasts
Once they have synthesized the matrix, they become cyte cells
Connective tissue also contains fat cells, immune cells (like white blood cells
and macrophages)
Mast cells: cluster along blood vessels to detect foreign microorganisms and
initiate the inflammatory response against them
Macrophages: large irregular cells that phagocytize foreign material from
bacteria to dust particles

Types of Connective Tissue

Connective Tissue Proper Loose Connective Tissue

Areolar Connective Tissue
Supports and binds other tissue (fibers), holds body fluids (ground
substance), defends against infection (white blood cells and macrophages),
and stores nutrients as fat (fat cells)
Fibroblasts predominate but other cell types are also present
Most obvious characteristic is the loose arrangement of its fibers
Because of its loose nature, it provides a reservoir of water and salts
Hyaluronic acid makes its ground substance quite viscous and when a body
region is inflamed the areolar tissue in the area soaks up excess fluid, so the
area become puffy (edema)
Most widely distributed, serves as packing material between other tissues
Present in all mucous membranes as lamina propria
Adipose (Fat) Tissue
Stores nutrients in adipocytes, cells are packed close together and there is
little matrix
Usually accumulates in subcutaneous tissue to act as a shock absorber, as
insulation, and as an energy storage site. Helps prevent heat loss from the
body
Reticular Connective Tissue
Resembles areolar connective tissue but the only fibers in its matrix are
reticular fibers
Reticular cells are scattered throughout the reticular fiber network, supports
other cell types
Found only in lymph nodes, the spleen, and in bone marrow
Connective Tissue Proper Dense Connective Tissues
Often referred to as fibrous connective tissues
Dense Regular Connective Tissue
Contains closely packed bundles of collagen fibers running parallel to the
direction of pull
Results in white, flexible structures with great resistance to tension where the
tension is exerted in a single direction
Collagen fibers are slightly wavy allowing the tissue to stretch a little
This tissue has few cells other than fibroblasts and is poorly vascularized
Forms tendons that attach muscle to bone and aponeuroses which attach
muscle to muscle
It also forms fascia and ligaments
Dense Irregular Connective Tissue
Same structural elements as the regular variety except the bundles of
collagen fibres are much thicker and run in more than one direction
This type of tissue forms sheets in body areas where tension is exerted in
many directions like in the dermis or in fibrous joint capsules
Elastic Connective Tissue

A few ligaments connecting adjacent vertebrae are very elastic so that the
dense connective tissue found in those structures is referred to as elastic
connective tissue
Cartilage
Stands up to both tension and compression, has qualities intermediate
between dense connective tissue and bone
Tough but flexible and provides a resilient rigidity
Lacks nerve fibers and is avascular, receives nutrients through diffusion from
perichondrium
Ground substance contains large amounts of GAGs, hyaluronic acid, and
firmly bound collagen fibers
Cartilage is 80% water which allows it to rebound when compressed and
helps nourish the cartilage cells
Chondroblasts: predominant cell type in growing cartilage produces new
matrix until skeleton stops growing. Mature chondrocytes are usually found in
lacunae
Three types of cartilage:
1. Hyaline Cartilage: most abundant cartilage type, contains large
numbers of collagen fibers. Provides firm support with some pliability,
covers ends of long bones as articular cartilage
2. Elastic Cartilage: nearly identical to hyaline cartilage but with many
more elastic fibers. Found where strength and stretchability is needed:
in the external ear and epiglottis
3. Fibrocartilage: rows of chondrocytes alternate with rows of collagen
fibers. Compressible and resists tension well, found where strong
support and the ability to withstand heavy pressure is needed: in the
intervertebral discs and in the menisci of the knee

Muscle Tissue

Highly cellular, well-vascularized tissues that are responsible for body

movement
Myofilaments: bring about movement or contraction in all cell types
Skeletal muscle: these muscles form the flesh of the body and as they
contract, they pull on bones or skin to cause body movement. Skeletal
muscle cells (muscle fibers) are long cylindrical cells that contain many
nuclei. Their striation reflects the precise alignment of their microfilaments
Cardiac muscle: only found in the wall of the heart and help propel blood
throughout the body. Are striated but uninucleate and are branching cells that
fit together tightly at unique junctions called intercalated discs
Smooth muscle: have no visible striations, spindle shaped, and only have
one nucleus. Mainly found in the walls on hollow organs except the heart and
acts to squeeze substances through these organs (peristalsis and such)

Covering and Lining Membranes

Three types, all are continuous multicellular sheets with an epithelium bound
to an underlying layer of connective tissue proper

Cutaneous Membrane
The skin: see chapter 5 notes
Mucous Membranes
Line body cavities that open to the exterior, such as the organs of the
digestive system
All are wet or moist membranes bathed in secretions
Most mucosae contain either stratified squamous or simple columnar
epithelia directly underlain by a layer of loose connective tissue called the
lamina propria
Mucous membranes are adapted for absorption and secretion, some secrete
mucus
Serous Membranes
Moist membranes found in closed ventral cavities
Consists of simple squamous epithelium (mesothelium) resting on a thin layer
of areolar connective tissue. The mesothelial cells add hyaluronic acid to the
fluid that filters from the capillaries in the associated connective tissue. The
result is thin, clear serous fluid
Tissue Repair
Repair occurs in two major ways: by regeneration and by fibrosis
Regeneration is the replacement of the destroyed tissue with the same kind
of tissue whereas fibrosis involves proliferation of fibrous connective tissue
called scar tissue
Steps of Tissue Repair
1. Inflammation occurs: tissue trauma causes injured tissues,
macrophages, mast cells and other tissues to release inflammatory
chemicals which cause the capillaries to become very permeable. This
allows white blood cells and plasma to seep into the area. This
produces a clot and eventually forms a scab.
2. Organization restores the blood supply: this is the first part of
tissue repair. The blood clot is replaced by granulation tissue (a
delicate pink tissue containing capillaries proliferating fibroblasts).
Some of the fibroblasts within the granulation tissue produce growth
factors and new collagen fibers while others pull the edges of the
wound together. As organization continues, macrophages digest the
original blood clot and collagen fiber deposit continues. The
granulation tissue is destined to become scar tissue and is highly
resistant to infection because it produces bacteria-inhibiting
substances
3. Regeneration and fibrosis effect permanent repair: during
organization the surface epithelium start to regenerate until it finally

resembles that of the adjacent skin. The end result is fully regenerated
epithelium and an underlying area of scar tissue which may be visible
or not
This repair process follows healing of a wound. In simple infection, healing is
by regeneration only

Regenerative Capacity of Different Tissues

Epithelial tissues, bone, areolar connective tissue, dense irregular connective
tissue, and blood-forming tissue regenerate extremely well
Smooth muscle and dense regular connective tissue regenerate moderately
well but skeletal muscle and cartilages have a weak regenerative capacity
Cardiac muscle and the nervous tissue of the brain and spinal cord have
virtually no functional regenerative capacity
In nonregenerative tissues and in exceptionally severe wounds, fibrosis totally
replaces lost tissue

Developmental Aspects of Tissues

The first events of embryonic development is the formation of three primary
germ layers: the ectoderm, mesoderm, and endoderm
These primary germ layers then specialize to form the four primary tissues:
epithelium, nervous tissue, muscle, and connective tissue
In adults, only epithelia and blood-forming tissues are highly mitotic

Chapter 5 - The Integumentary System

Two distinct regions: the epidermis and the dermis
Epidermis: composed of epithelial cells, outermost protective shield of the
body
The underlying dermis makes up the bulk of the skin and is a tough, leathery
layer composed mostly of fibrous connective tissue. Vascularized
Nutrients reach the epidermis by diffusing through the tissue fluid from blood
vessels in the dermis
Hypodermis: the subcutaneous tissue just deep to the skin, is not part of the
skin but shares some protective functions. Also called the superficial fascia, it
is superficial to the skeletal muscles and is composed mostly of adipose
tissue
The hypodermis anchors the skin to the underlying structures but loose
enough so it can still slide freely (this ensures that many blows just glance off
our body). Also acts as a shock absorber and an insulator

Epidermis

Definition: A keratinized stratified squamous epithelium consisting of four

distinct cell types and four or five distinct layers
Cells of the Epidermis
Keratinocytes: chief role is to produce keratin, are tightly connected by
desmosomes and arise in the deepest cell layer known as the stratum basale.
These cells undergo almost continuous mitosis; as the cells are pushed
upwards by the new cells being produced beneath them, they make the
keratin that eventually dominates their cell contents.
By the time the keratinocytes reach the free surface of the skin, they are little
more than keratin filled plasma membranes. Millions of these dead cells rub
off every day
Melanocytes: spider-shaped epithelial cells that synthesize the pigment
melanin. Found in the deepest layer of the epidermis and melanin
accumulates in melanosomes that are moved along to the ends of the
melanocytes process. From there, they are taken up by the keratinocytes
The melanin granules accumulate on the superficial side of the keratinocytes
and form a pigment shield to protect against UV rays
Epidermal dendritic cells (Langerhans cells): arise from bone marrow
and migrate to the epidermis. They ingest foreign substances and are key
activators of our immune system.
Tactile (Merkel) cells: present at the epidermal-dermal junction and
function as a sensory receptor for touch
Layers of the Epidermis
Thick vs. thin skin: five layers in thick skin (extra stratum lucidum) and
only four in thin skin (layers are also significantly thinner)
Stratum Basale (Basal Layer)
Deepest epidermal layer, attached to the underlying dermis along a wavy
borderline, consisting of a single layer of stem cells representing the
youngest keratinocytes.
Also called the stratum germinativum because of the rapid division of cells.
Each time one basal cell divides, one daughter cell is pushed into the cell
layer above to begin the process of becoming a mature keratinocyte while
the other stays behind to continue the process of producing new
keratinocytes
Some melanocytes present in the stratum basale and occasional tactile cells
Stratum Spinosum (Prickly Layer)
Several cell layers thick; cells contain intermediate filaments (mainly tensionresistant bundles of pre-keratin filaments) which span their cytosol to attach
to desmosomes

As well as keratinocytes, there are melanin granules and epidermal dendritic

cells (most abundant here)
Stratum Granulosum (Granular Layer)
Three to five cell layers in which keratinization begins. Keratinocytes flatten,
their nuclei and organelles begin to disintegrate, and they accumulate two
types of granules.
Keratohyaline granules: help to form keratin in the upper layers
Lamellated granules: contain a water-resistant glycolipid that is spewed
into the extracellular space that helps slow water loss across the epidermis
Keratinocytes become more resistant to destruction as their plasma
membranes thicken and lipids released by the lamellated granules coat their
external surface
Note: above the stratum granulosum, the epidermal cells are too far from
the dermal capillaries and get cut off from nutrients and so they die
Stratum Lucidum (Clear Layer)
Two or three rows of clear, flat, dead keratinocytes with indistinct boundaries;
visible only in thick skin
Here, the gummy substance of the keratohyaline granules clings to the
keratin filaments in the cells, causing them to integrate into cable-like,
parallel arrays
Stratum Corneum (Horny Layer)
Outermost layer and is a broad zone of 20 to 30 cell layers. Accounts for up
to three quarters of the thickness of the epidermis
Keratin and the thick plasma membranes of the cells in this layer protect the
skin against abrasion and penetration. The glycolipid between its cells
waterproofs this layer
The cell remnants of the stratum corneum are referred to as cornified or
horny cells

Dermis
Definition: Second major skin region, is made up of strong, flexible
connective tissue
Its cells are typical of any connective tissue proper and include: fibroblasts,
macrophages, and occasional mast cells and white blood cells
Richly supplied with nerve cells, blood vessels, and lymphatic vessels
Hair follicles, oil, and sweat glands are derived from the epidermis but reside
in the dermis
Two layers: the papillary layer and the reticular layer
The thin superficial papillary layer is areolar connective tissue in which
fine, interlacing collagen and elastic fibres are mixed with small blood

vessels. Phagocytes and other defensive cells wander freely through this
layer looking for bacteria and other foreign substances
Dermal papillae: peg like projections on the superior surface of the papillary
layer that indent the overlying dermis. Most contain capillary loops but some
house free nerve endings and touch receptors (Meissners corpuscles)
On the palms of the hands and soles of the feet, these papillae lie atop
dermal ridges, causing the epidermis to form epidermal ridges. Called friction
ridges, these increase gripping ability
Sweat pores open along their crests (this is what creates fingerprints)
The deeper reticular layer is coarse, irregularly arranged, dense fibrous
connective tissue
Cutaneous plexus: the network of blood vessels, lying between the reticular
layer and the hypodermis, which nourishes the reticular layer
The extracellular matrix of the reticular layer contains pockets of adipose
cells and thick bundles of collagen fibres, mostly running parallel to the skins
surface. Separations between these bundles form cleavage, or tension, lines
in the skin.
An incision is usually made parallel to these externally invisible cleavage lines
The collagen fibres of the dermis give skin strength and prevent most scrapes
and jabs from penetrating the dermis. Collagen also binds water and elastic
fibres provide the stretch-recoil properties of the skin
Flexure lines: dermal folds that occur at or near joints where the dermis is
tightly secured to deeper structures and so cannot slide easily, causing deep
skin creases to form

Skin Colour
Melanin: a polymer made of tyrosine amino acids, ranges in colour from
yellow to tan to reddish brown to black. Made by melanocytes and based on
to the keratinocytes. Eventually, the melanosomes are broken down by
lysosomes so it can only be found in the deeper layers of the epidermis.
Protects DNA against the damaging effects of UV radiation
Carotene: a yellow to orange pigment found in certain plant products (such
as carrots), tends to accumulate in the stratum corneum and in the fatty
tissue of the hypodermis. May pigment skin
The pinkish hue of fair skin is due to the colour of haemoglobin. Caucasian
skin does not contain much melanin pigment and so allows haemoglobins
crimson colour to show through

Appendages of the Skin

A key step in forming a skin appendage is the formation of an epithelial bud.
The process is stimulated by reduced production of cell adhesion factor
(cadherin). Once the cell-to-cell attractions are broken, the cells can move
about and rearrange themselves, allowing an epithelial bud to form.

Sweat (Sudoriferous) Glands

Two types: eccrine and apocrine
Both types are associated with myoepithelial cells: specialized cells that
contract when stimulated by the nervous system to force sweat to the skin
surface
Eccrine (or merocrine) sweat glands: numerous simple, coiled, tubular
glands. The secretory part lies coiled in the dermis and the duct opens in a
funnel shaped pore at the skin surface
Eccrine gland secretion: a hypotonic filtrate of the blood that is released
through exocytosis by the secretory cells of the sweat glands
Sweating is regulated by the sympathetic division of the autonomic nervous
system. Its major role is to prevent overheating of the body.
Apocrine sweat glands: found on axillary and anogenital regions and
secretes a thick, milky or yellowish version of sweat. Contains all the
components of regular sweat plus some fatty substances and proteins
Ceruminous glands: modified apocrine glands whose product mixes with
sebum to produce earwax

Sebaceous (Oil) Glands

Definition: Simple, branched alveolar glands that secrete sebum (an oily
substance)
Holocrine glands: the central cells accumulate sebum until they burst and
these lipids and cell fragments constitute sebum. Sebum is usually secreted
into a hair follicle
Sebum softens and lubricates hair and skin, prevents hair from becoming
brittle, and slows water loss in skin. Also, has bactericidal properties
The arrector pili contractions force sebum out of the hair follicles to the skin
surface

Hairs and Hair Follicles

Definition: Hairs or pili are flexible strands produced by hair follicles and
consist largely of dead, keratinized cells
Hair senses insects on the skin before they bite or sting us, hair on the scalp
guards against trauma, heat loss, and sunlight. Eyelashes shield the eyes,
and nose hairs filter large particles from the air we inhale
Structure of a Hair
Hard keratin: dominated hair and nails (vs. soft keratin found in skin cells)
and is tougher and more durable and does not flake
Shaft: portion of hair where keratinization is complete
Root: portion of hair where keratinization is still ongoing
Three concentric layers of keratinized cells:

Medulla: the central core consists of large cells and air spaces. Only part of
hair with soft keratin
Cortex: the bulky layer surrounding the medulla, consists of several layers of
flattened cells
Cuticle: outermost layer, formed from a single layer of flattened cells that
overlap like shingles on a roof. It is the most keratinized part of the hair and
provides strength and keeps the inner layers compacted
Hair pigment is made by melanocytes at the base of the hair follicle and
transferred to the cortical cells
Structure of a Hair Follicle
Hair follicles fold down from the epidermis into the dermis
Hair bulb: the deep end of the follicle; is extended. A hair follicle receptor or
root hair plexus wraps around the hair bulb so it serves a sensitive touch
receptor
Hair papilla: contains a knot of capillaries that supply nutrients to the hair
and signal it to grow
The wall of a hair follicle is composed of an outer connective root sheath, a
thickened basement membrane called the glassy membrane, and an inner
epithelial root sheath
Hair matrix: actively dividing area of hair bulb that produces the hair,
originates in the hair bulge (located close to the hair bulb)
The arrector pili is attached so that its contraction pulls the hair upwards and
dimples the skin
Types and Growth of Hair
Vellus: pale, fine body hair of females and children
Terminal: coarse, long hair of eyebrows, scalp, axillary and pubic regions
Each follicle goes through a growth cycle, in each cycle an active phase is
followed by a regressive phase
During the regressive phase, the hair matrix cells die and the follicle base
and hair bulb shrivel somewhat and the follicle enters a resting phase of one
to three months
After the resting phase, the follicle regenerates and new hair growth starts

Nails
Definition: a scalelike modification of the epidermis that forms a protective
layer over the dorsal surface of the distal part of a finger or toe. Nails contain
hard keratin
Each nail has a free edge and a body (the visibly attached portion) and a
proximal root (within the skin)
The nail matrix is the thickened proximal position of the nail bed (the deeper
layers of epidermis that extend beneath the nail) that is responsible for nail
growth

The hyponychium is the region below the free edge, informally called the
quick

Functions of the Integumentary System

Protection
The skin constitutes three types of barriers: chemical, physical, and
biological
Chemical
Include skin secretions and melanin, the acid mantel stops bacteria
multiplication, and many bacteria are killed by dermcidin in sweat and
bactericidal substances in sebum
Defensins are natural antibiotics secreted by the skin
Cathelicidins are protective peptides that prevent infection by Group A
streptococcus bacteria
Melanin shields skin cells from UV rays
Physical/Mechanical Barriers
Provided by the continuity of the skin and the hardness of its keratinized cells
and the water resistant glycolipids of the epidermis block most diffusion of
water and water soluble substances between cells
Some things do penetrate skin cells though (ex. Fat soluble substances)
Biological Barriers
Include the dendritic cells of the epidermis, macrophages within the dermis,
and DNA itself
The dendritic cells activate the immune system by presenting antigens to the
lymphocytes
The dermal macrophages are the second line of defense and they too act as
antigen presenters
DNA converts potentially destructive radiation into harmless heat

Body Temperature Regulation

Sweat glands secrete insensible perspiration daily to maintain body
temperature homeostasis
Sensible perspiration is activated in response to vigorous physical activity or
high heat levels
When the external environment is cold, dermal blood vessels constrict to
allow blood to bypass the skin surface temporarily thus slowing passive heat
loss

Cutaneous Sensation
Cutaneous sensory receptors are found throughout the skin and they respond
to stimuli outside the body (exteroceptors)

Meissners corpuscles in the dermal papillae and tactile discs allow us to feel
something like a caress, while Pacinian corpuscles in the deeper dermis or
hypodermis alert us to contact with deeper pressure
Hair follicle receptors report on things like wind blowing though our hair
Free nerve endings sense painful stimuli

Metabolic Functions
Skin modifies cholesterol in the blood to a vitamin D precursor when hit by
sunlight
The precursor is then transported to other body systems which activate it.
Vitamin D plays a role in calcium metabolism and absorption
Skin cells also activate some steroid hormones and make several biologically
important enzymes

Blood Reservoir
The dermal vascular supply is extensive and can hold large volumes of blood
When other body organs require a greater blood supply, the dermal blood
vessels constrict to shunt more blood into the general circulation

Excretion
Limited amounts of nitrogen wastes are eliminated through sweat
Sweating is also an important avenue for water and sodium chloride loss

Chapter 6 - Bones and Skeletal Tissues

Skeletal Cartilages

Bone Structure, Types, and Locations

Skeletal cartilage: made up of some variety of cartilage tissue consisting
primarily of water. The high water content of cartilage accounts for its
resilience
The cartilage contains no nerves or blood vessels. It is surrounded by
perichondrium, a layer of dense irregular connective tissue.
The perichondrium acts as to resist outward expansion of the cartilage and it
contains the blood vessels from which nutrients diffuse to reach the cartilage
There are three types of cartilage in the body. All contain chondrocytes
encased in lacunae with an extracellular matrix containing ground substance
and fibers.
Hyaline cartilages: provide support with flexibility and resistance, most
abundant skeletal cartilage. Only have fine collagen fibers. Skeletal hyaline
includes articular cartilages (covering ends of most bones and joints), costal
cartilages (connecting the ribs to the sternum), respiratory cartilages
(forming the skeleton of the larynx and reinforcing other respiratory
passageways), and nasal cartilages (supporting the nose)
Elastic cartilages: contain more stretchy elastic fibers and are better able
to stand up to repeated bending. They are found in the external ear and in
the epiglottis

Fibrocartilages: highly compressible and have great tensile strength.

Consist of parallel rows of chondrocytes alternating with thick collagen fibers.
Found in sites subjected to heavy pressure and stretch, like the knee and the
disks between the vertebrae

Growth of Cartilage

Flexible matrix can accommodate mitosis. Grows in two ways:

Appositional growth: cartilage-forming cells in the surrounding
perichondrium secrete new matrix against the external face of the existing
cartilage
Interstitial growth: the lacunae-bound chondrocytes divide and secrete
new matrix, expanding the cartilage from within
Cartilage growth usually ends during adolescence

Classification of Bones

The axial skeleton forms the long axis of the body and includes the skull,
vertebral column, and rib cage. Involved in protecting, supporting, or carrying
other body parts
The appendicular skeleton consists of the bones of the upper and lower limbs
and the bones that attach the limbs to the axial skeleton (shoulder and hip
bones). These bones help us move and manipulate our environment.
Long bones: considerably longer than they are wide. Has a shaft plus two
ends. All the limb bones except the wrist and ankle bones are long bones.
Short bones: roughly cube shaped. Include the bones of the wrist and ankle.
Sesamoid bones: a special type of short bone found in a tendon
Flat bones: thin, flattened, usually a bit curved. The sternum, scalpulae,
ribs, and skull bones are flat bones.
Irregular bones: have complicated shapes that fit none of the other classes.
Include vertebrae and hip bones.

Functions of Bones

Support: bones provide a framework that supports the body and cradles its
soft organs
Protection: the fused bones of the skull protect the brain, the vertebrae
surround the spinal column, the rib cage protects the vital organs of the
thorax, etc.
Movement: skeletal muscles use the bones as levers to move the body and
its parts. Joints determine the range of movement possible
Mineral and growth factor storage: bone is a reservoir for minerals, esp.
calcium and phosphate. The stored minerals are released into the
bloodstream as needed. Additionally, bone matrix stores important growth
factors
Blood cell formation: most hematopoiesis (blood cell formation) occurs in
the marrow cavities of certain bones
Triglyceride (fat) storage: fat is stored in bone cavities as a source of
stored energy

Bone Structure

Gross Anatomy
Bone Markings

Bones display projections, depressions, and openings that serve as the site of
muscle, ligament, and tendon attachment, or as conduits for blood vessels
and nerves
Projections: grow outward from the bone surface, and are usually an
indication of the stresses created by muscles attached and pulling on them or
are modified surfaces where bones meet and form joints
Projections That Are Sites of Muscle and Ligament Attachment
Tuberosity: large rounded projection, may be roughened
Crest: narrow ridge of bone, usually prominent
Trochanter: very large, blunt, irregularly shaped process (only found on
femur)
Line: narrow ridge of bone, less prominent than a crest
Tubercule: small rounded projection or process
Epicondyle: raised area on or above a condyle
Spine: sharp, slender, often pointed projection
Process: any bony prominence
Projections That Help to From 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: usually serve to allow passage of nerves and
blood vessels
Depressions For Passage of Blood Vessels and Nerves
Groove: furrow
Fissure: narrow, slitlike opening
Foramen: round or oval opening through a bone
Notch: indentation at the edge of a structure
Others
Meatus: canal-like passageway
Sinus: cavity within a bone, filled with air and lined with mucous membrane
Fossa: shallow, basinlike depression in a bone, often serving as an articular
surface

Bone Textures: Compact or Spongy Bone

The external layer is compact bone and internal to this is spongy bone
Spongy bone is a honeycomb of small needle-like or flat pieces of trabeculae
The open spaces between trabeculae are filled with yellow or red bone
marrow
Structure of a Typical Long Bone
Same general structure: shaft, bone ends, and membranes
Diaphysis: shaft, forms the long axis of the bone. Constructed of a relatively
thick collar of compact bone that surrounds a central medullary cavity or

marrow cavity (in adults, this contains fat and is called the yellow marrow
cavity)
Epiphysis: bone ends. Compact bone forms the exterior and the interior
contains spongy bone. The joint end is covered by a thin layer of articular
(hyaline) cartilage.
Between the diaphysis and the epiphysis of an adult long bone in an
epiphyseal line (a remnant of the epiphyseal plate, a disk of hyaline cartilage
that grows during childhood to lengthen the bone)
Metaphysis: the region where the diaphysis and epiphysis meet
Membranes
The external surface of the bone (except the joint surface) is covered by a
glistening white, double-layered membrane called the periosteum
Periosteum: has two layers, the outer fibrous layer (dense irregular
connective tissue) and the inner osteogenic layer, abutting the bone surface
(consists primarily of bone forming cells called osteoblasts and bone
destroying cells called osteoclasts). In addition, there are primitive stem cells
called osteogenic cells that give rise to osteoblasts
The periosteum is supplied with nerve endings, lymphatic vessels, and blood
vessels entering through the nutrient foramina
Perforating (Sharpeys) fibers: secure the periosteum to the underlying
bone. Consist of tufts of collegen fibers that extend from its fibrous layer into
the one matrix
Endosteum: delicate connective tissue covering the internal bone surfaces.
Covers the trabeculae of spongy bone and lines the canals that pass through
compact bone. Contains both bone-forming and bone-destroying cells

Structure of Short, Irregular, and Flat bones

All share a simple design: consist of thin plates of periosteum-covered

compact bone on the outside and endosteum-covered spongy bone on the
inside. Do not have a shaft or epiphysis. They contain bone marrow, but no
marrow cavity is present
In flat bones, the spongy bone is called the diplo
Location of Hematopoietic Tissue in Bones
Hematopoietic tissue (red marrow) is typically found in the trabecular cavities
of spongy bone in long bones and in the diplo of flat bones
Both cavities are often referred to as red marrow cavities
In newborns, the medullar cavity of the diaphysis and all areas of spongy
bone contain red bone marrow. In adult long bones, however, the fatcontaining medullary cavity extends well into the epiphysis and little red
marrow is present in spongy bone cavities
Most blood cell production in adult long bones occurs only in the head of the
femur and humerus
The red marrow found in the diplo of flat bones and in some irregular bones
is much more active in hematopoiesis

Microscopic Anatomy of Bone

Four main cell types populate bone: osteogenic cells, osteoblasts, osteocytes,
and osteoclasts. These are surrounded by an extracellular matrix of their own
making
Compact Bone
Osteon (or Haversian system): the structural unit of compact bone. Each
osteon is an elongated cylinder oriented parallel to the long axis of the bone.
Functions as a weight-bearing pillar
An osteon is a group of hollow tubes of bone matrix, each one placed outside
the next
Each matrix tube is called a lamella (compact bone is often called lamellar
bone)
In each lamella, the collagen fibers fun in a single direction, opposite to the
direction of the adjacent lamella. This helps reduce torsion stress
Tiny crystals of bone slats also align with the collagen fibers and thus also
alternate their direction in the adjacent lamella
Central canal (or Haversian canal): a canal running through the core of
each osteon, containing small blood vessels and nerves
Perforating canals (or Volkmanns canals) lie at right angles to the long
axis of the bone and connect the blood supply of the periosteum to those of
the central canal and medullary cavity
These canals are lined with endosteum
Osteocytes occupy lacunae at the junctions of lamellae. Canaliculi connect
the lacunae to one another and to the central canal
Canaliculi form when bone matrix hardens and the osteocytes become
trapped within it. Tiny canals, formerly tentacle-like extensions containing
gap junctions of the osteocytes, are thusly formed
The canaliculi tie all the osteocytes in an osteon together, permitting nutrient
and wastes to be relayed from one osteocyte to the next throughout the
osteon. It also permits cell-to-cell relays through its gap junctions to allow
bone cells to be well-nourished
Osteocytes maintain the bone matrix and act as stress or strain sensors in
cases of bone deformation or other damaging stimuli. They also communicate
with osteoblasts and osteoclasts
Interstitial lamellae: incomplete lamellae lying between intact osteons.
They either fill gaps between forming osteons or are remnants of osteons cut
through by bone remodeling
Circumferential lamellae: extend around the entire surface of the
diaphysis and resist twisting of the long bone

Spongy Bone

The trabeculae in spongy bone align to resist stress as much as possible

Trabeculae contain irregularly arranged lamellae and osteocytes
interconnected by canaliculi. No osteons are present. Nutrients reach the
osteocytes by diffusion

Chemical Composition of Bone

Organic compounds include the cells and osteoid (the organic part of the
matrix)
Osteoid includes ground substance and collagen made by the osteoblasts

Sacrificial bonds: between collagen molecules, break easily on impact to

dissipate energy and prevent the bone from fracturing
Hydroxyapatites (mineral salts): largely calcium phosphates present in
the form of tiny crystals in and around collagen fibers in the extracellular
matrix. Account for the bones exceptional hardness which allows it to resist
compression

Bone Development

Ossification (osteogenesis): the process of bone formation

Formation of the Bony Skeleton
The skeleton of a human embryo before week 8 is constructed entirely from
fibrous membrane and hyaline cartilage
Bone tissue eventually replaces most of the fibrous or cartilage structures
Structure (membranes and cartilage) that are flexible and resilient are able to
accommodate mitosis so make growth easier
Intramembranous Ossification
Developed from a fibrous membrane and results in the formation of the skull
and the clavicles (membrane bones); most bones formed by this process are
flat bones
Four steps:
1. Ossification centers appear in the fibrous connective tissue
membrane. Selected mesenchymal cells cluster and differentiate into
osteoblasts, forming and ossification center
2. Bone matrix (osteoid) is secreted by osteoblasts within the
fibrous membrane and calcifies. Trapped osteoblasts become
osteocytes
3. Woven bone and periosteum form. Accumulating osteoid is laid
down in a random manner between embryonic blood vessels, forming
a network of trabeculae called woven bone. Vascularized mesenchymal
condenses on the external face of the woven bone and becomes
periosteum
4. Lamellar bone replaces woven bone, just deep to the
periosteum. Red marrow appears. Trabeculae just deep to the
periosteum thicken and are later replaced with mature lamellar bone,
forming compact bone plates. Spongy bone (diplo), consisting of
distinct trabeculae, persist internally and its vascular tissue becomes
red marrow

Endochondral Ossification

Bone development by replacing hyaline cartilage; essentially all bones of the

skeleton below the base of the skull are formed like this.
Begins in the centre of the hyaline cartilage at a region called the primary
ossification centre
First, the perichondrium covering the hyaline cartilage bone in infiltrated
with blood vessels, converting in into a vascularized periosteum. As a result
of this, the underlying mesenchyme cells specialize into osteoblasts. Now
ossification can begin.

1. A bone collar is laid down around the diaphysis of the hyaline

cartilage model. Osteoclasts secrete osteoid against the hyaline
cartilage diaphysis, encasing it with bone. This is called the periosteal
bone collar.
2. Cartilage in the centre of the diaphysis calcifies and then
develops cavities. As the bone collar forms, chondrocytes within the
shaft enlarge and signal the surrounding cartilage matrix to calcify. The
chondrocytes deteriorate due to lack of nutrients diffusing from the
blood and this deterioration opens up cavities. Elsewhere, the cartilage
grows briskly, causing the cartilage model to elongate
3. The periosteal bud invades the internal cavities and spongy
bone forms. The periosteal bud contains a nutrient vein and artery,
lymphatic vessels, nerve fibers, red marrow elements, osteoblasts, and
osteoclasts. The osteoclasts partially erode the calcified cartilage
matrix and the osteoblasts secrete osteoid around the remaining
fragments of hyaline cartilage, forming bone-covered cartilage
trabeculae (the earliest version of spongy bone)
4. The diaphysis enlarged and a medullar cavity forms. As the
primary ossification enlarges, osteoclasts break down the newly
formed spongy bone and open up a medullar cavity in the centre of the
diaphysis. The rapidly growing epiphysis still contains only cartilage,
and the hyaline cartilage models continue to elongate by the division
of viable cartilage cells at the epiphysis. Ossification chases cartilage
formation along the length of the shaft as cartilage calcifies, is eroded,
and then is replaced by bony spicules on the epiphyseal surfaces
facing the medullar cavity.
5. The epiphysis ossifies. After birth, secondary ossification centers
appear in one or both epiphyses and the epiphyses gain bony tissue.
The cartilage in the centre of the epiphysis calcifies, opening up
cavities that allow a periosteal bud to enter. The bony trabeculae form,
just like in the diaphysis.
Secondary ossification is almost the exact same as primary ossification,
except the spongy tissue is retained and no medullar cavity is formed in the
epiphysis. After secondary ossification, hyaline cartilage remains only on the
epiphyseal surfaces as articular cartilage and at the junction between the
epiphysis and the diaphysis (the epiphyseal plate)

Postnatal Bone Growth

Long bones lengthen entirely by interstitial growth of the epiphyseal plate

cartilage and its replacement by bone. All bones grow in thickness by
appositional growth. Most bones stop growing in adolescence

Growth in Length of Long Bones

Longitudinal bone growth mimics endochondral ossification.

Resting or quiescent zone: the relatively inactive part of the cartilage
facing the epiphysis

Proliferation or growth zone: cells abutting the diaphysis, dividing rapidly,

pushing the diaphysis way from the epiphysis thus allowing the whole bone to
lengthen.
Hypertrophic zone: older chondrocytes close to the diaphysis hypertrophy,
leaving large interconnecting spaces.
Calcification zone: area where the cartilage surrounding the hypertrophic
zone calcify so the chondrocytes die and deteriorate
Long, slender spicules of calcified cartilage is left at the epiphysis-diaphysis
junction
Ossification or osteogenic zone: the area where the calcified spicules are
partly eroded then quickly covered by new bone (woven bone) and ultimately
replaced by spongy bone. The spicule tips are eventually digested by
osteoclasts so the medullar cavity also grows longer as the bone lengthens.
Longitudinal growth is accompanied by remodeling of the epiphysis to
maintain proper bone proportions
As adolescence ends, the epiphyseal plate stops dividing and eventually gets
replaced by bone tissue. The epiphysis and the diaphysis fuse, ending
longitudinal bone growth in a process called epiphyseal plate closure.

Growth in Width (Thickness)

Growing bones widen as they lengthen by appositional growth

Osteoblasts beneath the periosteum secrete bone matrix while osteoclasts on
the endosteal surface of the diaphysis remove bone
There is slightly less breaking down than building up, creating a thicker,
stronger bone

Hormone Regulation of Bone Growth

Regulated by growth hormone released by the anterior pituitary gland, by

thyroid hormones, and by male and female sex hormones (in puberty, leading
to a growth spurt and masculinization/femininization of certain parts of the
skeleton)

Bone Homeostasis: Remodeling and Repair

Bone Remodeling

Bone depositing and bone resorption occurs at the surface of the periosteum
and the endosteum. The two processes constitute bone remodeling.
Remodeling units: packets of adjacent osteoblasts and osteoclasts that
couple and coordinate bone remodeling
Bone deposit: occurs wherever bone is injured or added bone strength is
required
Osteoid seam: an unmineralized band of gauzy looking bone matrix,
marking the presence of new matrix deposits by osteoblasts
Calcification front: an abrupt transition between the osteoid seam and the
older mineralized bone
The trigger for calcification of the osteoid seam is the local concentrations of
phosphate ions and calcium ions and the presence of the enzyme alkaline
phosphatase
Bone resorption: accomplished by osteoclasts as they digest the bones
surface

Osteoclasts secrete lysomal enzymes to digest the organic matrix and

hydrochloric acid to convert calcium salts into soluble forms
The dissolved matrix end products, growth hormones, and dissolved minerals
are endocytosed, transported across the osteoclasts by transcytosis, and
released into the blood by way of the interstitial fluid

Control of Remodeling

Regulated by two control loops: a negative feedback hormonal loop that

maintains Ca2+ levels in the blood and another that involves responses to
mechanical and gravitational forces acting upon the skeleton
Hormonal Controls
Parathyroid hormone (PTH) and calcitonin regulate the amount of calcium in
the blood
PTH secretion is stimulated by decreased calcium levels in the blood to cause
osteoclasts to resorb bone and boost blood calcium levels
Increased blood calcium causes PTH to stop being secreted in a negative
feedback cycle
Response to Mechanical Stress
Wolffs law: a bone grows strong or remodels in response to the demands
placed upon it.
A bones anatomy reflects the common stresses in encounters
As a result of bending caused by weight bearing down on a bone, long bones
are thickest midway along the diaphysis where the stress is the greatest.
Both compression and tension are minimal towards the center of the bone so
a bone can hollow out for lightness
Bone Repair
Bones are susceptible to fractures. They may be classified by:
Position of the bone ends after fracture: nondisplaced fractures vs. displaced
fracture: whether bones are in their original alignment or not
Completeness of the break: complete vs. incomplete: whether the bone is
broken through or not
Orientation of the break relative to the long axis of the bone: linear fractures
run parallel to the long axis, transverse run perpendicular to it.
Whether the bone end penetrates the skin: open (compound) fractures vs.
closed (simple) fractures
Reduction: realignment of the broken ends of a bone. In a closed (external)
reduction, the physician coaxes it into position with his hands. In an open
(internal) reduction, the bone ends are secured together surgically with pins
or wires. It is then immobilized by a cast
Repair in a simple fracture involves four main stages:
1. A hematoma (a mass of clotted blood) forms at the fracture
site. Soon, bone cells deprived of nutrition die and the area becomes
swollen, painful, and inflamed
2. Fibrocartilaginous callus forms. Capillaries grow into the
hematoma and phagocytic cells invade the area begin cleaning up
debris. Meanwhile, fibroblasts and osteoblasts invade the fracture site

and begin reconstructing the bone. The fibroblasts create collagen

fibers that connect the broken bone ends. Some differentiate into
chondroblasts and begin secreting cartilage matrix. This entire mass of
repair tissue, now called the fibrocartilaginous callus, splint the bone
3. Bony callus (the new bone trabeculae that appear in the
fibrocartilaginous callus to convert it to spongy bone) forms.
4. Bone remodeling occurs. The bony callus is remodeled so the
excess material on the diaphysis exterior is removed and compact
bone is laid down to reconstruct the shaft walls. The final structure of
the remodeled area looks like the original unbroken bone because it
withstands the same mechanical stressors

Homeostatic Imbalances of Bone

Osteomalacia and Rickets
Osteomalacia includes a variety of disorders in which the bones are
inadequately mineralized. Bones are soft and weak because calcium salts are
not deposited in the osteoid
Rickets is the analogous disease in children
Both are caused by insufficient calcium in the diet or by a vitamin D
deficiency
Osteoporosis
Refers to a group of diseases in which bone resorption outpaces bone
deposit. The bones become excessively fragile and break very easily. The
composition of the bone matrix is reduced and the bones become porous and
light.
Occurs most often in the aged, especially women
Treated by calcium and vitamin D supplements, weight-bearing exercise, and
certain drugs that mimic estrogen or otherwise decrease osteoclasts activity
Pagets Disease
Characterized by excessive and haphazard bone deposit and resorption. The
newly formed Pagetic bone is hastily made and has an abnormally high ratio
of spongy bone to compact bone.
Drug therapies have shown success in preventing bone breakdown.