The Skeletal System

 Connective tissue with a matrix hardened by minerals  Four components  Bones  Cartilage  Tendons  Ligaments
http://www.wpunj.edu/sec/APskel.htm

Functions of the Skeletal System

1. Support 2. Storage of minerals (calcium, phosphorus) 3. Storage of lipids (yellow marrow) 4. Blood cell production (red marrow) 5. Protection 6. Movement: provide levers for muscles

Bone
 Surrounded by periosteum  Membrane of tissue and cells essential for bone growth, repair and nutrition  Hard connective tissue  Living cells and dense mineralized matrix of calcium salt deposits around collagen fibers  Bone matrix  Inorganic (1/3 ): ):  Hydroxyapatite (calcium phosphate crystal) provides weightweight-bearing strength  Organic (2/3): (2/3):  Collagen provides flexible strength  Proteoglycans

Bone Matrix Changes

 Bone adapts to tension and compression by varying proportions of minerals and collagen fibers

Clinical Conditions
Osteomalacia  Soft bones  Causes can include  insufficient dietary calcium  Insufficient vitamin D  insufficient exposure to sunlight  Digestive disorders which prevent absorption of fat soluble Vitamin D Rickets  Signs include bowed legs and deformities of the pelvis, ribs and skull  More detrimental because bones are still growing

Osteoporosis
 Most common bone disease  Bones lose mass & become brittle due to loss of both organic matrix & minerals  risk of fracture of hip, wrist & vertebral column  fatal complications, ex. pneumonia  widows (dowagers) hump: deformed spine  Postmenopausal white women at greatest risk  by age 70, average loss is 30% of bone mass  Over age 45, occurs in:  29% of women http://www.youtube.com/watch?v=rHyeZhcoZc  18% of men Q&feature=related

http://pennhealth.com/health_info/animationplayer/osteoporosis.html

Effects of Osteoporosis

Risk factors include sedentary lifestyle, low calcium intake, being underweight  Best treatment: prevention -- exercise & adequate calcium (1000 mg/day) and Vitamin D intake throughout life


Bone Histology
 Bone can be classified according to amount of bone matrix relative to amount of space present within bone
 Cancellous bone  Inner layer of spongy bone with many spaces  Compact bone  Dense, solid outer layer with few spaces

BONE CELLS
 Make up only 2% of bone mass:  osteocytes  Osteoblasts  Osteoprogenitor cells  Osteocytes
      Mature bone cells Maintain bone matrix Help repair damaged bone Live in lacunae Between layers (lamellae) of matrix (lamellae) Connected by canaliculi  cytoplasmic extensions in lamellae

Osteoblasts
 Initiate process of calcification (ossification or osteogenesis) osteogenesis)  Surround themselves with bone matrix to become osteocytes  Osteoid
 Matrix produced by osteoblasts, but not yet calcified to form bone

Osteoclasts
 Break down bone  Secretes acids and protein-digesting enzymes proteinthat dissolves bone matrix and release stored minerals (osteolysis) for resorption (osteolysis)

Osteoprogenitor Cells
 Mesenchymal stem cells that divide to produce osteoblasts  Located in inner, cellular layer of periosteum  Assist in fracture repair

CompactBone

http://www.youtube.com/ watch?v=HUdwCvHZgu M&feature=related

 Cells and hard mineralized matrix surround vertically oriented blood vessels in osteons or Haversian canels in long bones  Lamellae combine to form trabeculae  Circumferential lamellae form outer surface of compact bones  Concentric lamellae surround central canals, forming osteons  Interstitial lamellae are remnants of lamellae left after bone remodeling

Osteons
 Haversian and other canals within compact bone provide means for exchange of gases, nutrients, and waste products
 Perforating canals  Carry blood vessels into bone and marrow
 From periosteum to central canals
http://www.youtube.com/watch?v=4qTi w8lyYbs&feature=related

 Extend between adjacent osteons  Canaliculi  Cytoplasmic extensions of cells

 connect central canals to osteocytes

Blood Vessels of Compact Bone

http://www.youtube.com/watch?v=c5zcGv8MvMc&feature=related

Spongy (Cancellous) Bone

 Formed by organized lamellae  Internal layer is honeycomb of trabeculae
 Beams of bone that interconnect to form a lattice-like structure latticespaces filled with red or yellow bone marrow and blood vessels  Found on the ends of long bones  Oriented along lines of stress and provide structural strength  No blood vessels  Osteocytes close to blood of bone marrow

Marrow
 Soft tissue that occupies medullary cavity of a long bone or the spaces within the trabeculae of spongy bone  Yellow Marrow  fatty marrow of long bones in adults  Gelatinous marrow of old age  yellow marrow replaced with reddish jelly  Red Marrow

Marrow
 Red marrow  looks like thick blood  mesh of reticular fibers and immature cells  Hemopoietic: produces blood cells  found in vertebrae, ribs, sternum, pelvic girdle and proximal heads of femur and humerus in adults  has blood vessels  supplies nutrients to osteocytes

Bone Anatomy
1. Long bones
  Longer than wide Upper & lower limbs

2. 3. 4. 5. 6.

Flat bones Sutural bones Irregular bones Short bones Sesamoid bones

Flat & Sutural Bones

 Flat Bones  Thin, flattened and slightly curved Sutural Bones  Scapulae, sternum, shoulder blades, ribs and Small, irregular most bones of skull bones  Resembles sandwich of Found between flat spongy bone between 2 bones of skull layers of compact bone

Irregular Bones
 Have complex shapes  Examples:
    vertebrae pelvic girdle Sphenoid Facial bones

Short and Sesamoid Bones

 Short Bones  Small and thick  As wide as they are long  Examples:  wrist bones  ankle Sesamoid Bones Small and flat Develop inside tendons near joints of knees, hands, and feet

Long Bone Structure

 Long bones consist of a diaphysis and an epiphysis  Epiphyseal plate or line separates diaphysis from epiphyses  Diaphysis  Tubular Shaft  Primarily dense compact bone that surrounds central cavity (medullary cavity)  Marrow contained in medullary cavity

Long Bone Structure

 Epiphysis
 Ends of long bone enlarged  strengthens joint  provides attachment for tendons & ligaments  Exterior is compact bone; interior is spongy bone  Epiphyseal plate is site of bone growth in length  Becomes epiphyseal line when its cartilage is replaced with bone  Joint surface covered with articular cartilage (hyaline)  Cushions bone ends  Reduces friction during movement

Cartilage
 Next to bone, firmest structure in body  Avascular - diffusion must bring in nutrients & remove wastes  injured cartilage heals slowly  Grows by appositional and interstitial growth  Matrix contains collagen fibers (for strength) and proteoglycans (trap water)  Covered by membrane, perichondrium: perichondrium:  outer, fibrous layer (for strength)
 contains fibroblasts

 inner, cellular layer (for growth and maintenance)

 contains chondroblasts

Cartilage
 Major types determined by fibers  Hyaline  Fibrocartilage  Elastic  Chondroblasts
 produce cartilage and become chondrocytes

 Cells (chondrocytes) surrounded by lacunae (chondrocytes) (chambers) surrounded by matrix

Hyaline Cartilage

Clear, glassy matrix; fine dispersed collagen fibers Forms most of skeleton before replaced by bone in embryo Involved in growth that increases bone length

Hyaline Cartilage

Found in areas for strong support and some flexibility Eases joint movements; ends of bones at movable joints, sternal ends of ribs Supportive material in airways, trachea and bronchi, fetal skeleton

Bone Membranes: Periosteum

 Double layer of protective membrane covering the outer surface of bone
 Outer fibrous layer is dense regular connective tissue that contains blood vessels and nerves  Inner osteogenic layer contains osteoblasts, osteoclasts, and osteoclasts, osteochondral progenitor cells

Contains collagen fibers continuous with ligaments, tendons, and fibers that penetrate bone matrix

Bone Membranes: Periosteum

 Functions: 1. Isolates bone from surrounding tissues 2. Provides a route for circulatory and nervous supply 3. Inner osteogenic layer important for growth and healing

Bone Membranes: Good review: Endosteum View at home

 Delicate membrane covering internal surfaces of bone  lines the marrow cavity  covers trabeculae of spongy bone  Contains osteoblasts, osteoprogenitor cells, and osteoclasts  Active in bone growth and repair
http://www.youtube.com/wa tch?v=d9owEvYdouk&featu re=related

Bone Histology
 Calcification:  Process of depositing calcium salts  Occurs during bone ossification and in other tissues

 Ossification:
 Process of replacing other tissues with bone

 (Osteogenesis) Osteogenesis)
1. Osteoblasts are on a preexisting surface, such as cartilage or bone. Cell processes of different osteoblasts join together 2. Osteoblasts produce bone matrix and become osteocytes

Fig. 6.3

Bone Development

Osteogenesis: bone formation Osteogenesis: Human bones grow until about age 25 Bones increase in length  by interstitial cartilage growth at epiphyseal plate & appositional bone growth on surface of cartilage width  by appositional growth beneath periosteum

Bone Development
 Begins at week 8 of embryo development  2 main forms of ossification:  intramembranous ossification
 bone develops from a fibrous membrane  Some skull bones, part of the mandible, and the diaphyses of the clavicles

 endochondral ossification  bone forms by replacing hyaline cartilage

 Bones of the base of the skull, part of the mandible, the epiphyses of the clavicles, and most of the remaining skeletal system

Bone Development
 Intramembranous Ossification
 Within the membrane, at centers of ossification, osteoblasts produce bone along the membrane fibers to form cancellous bone  Beneath the periosteum, osteoblasts lay down compact periosteum, bone to form the outer surface of the bone  Fontanels are areas of membrane that are not ossified at birth
Bones formed by intramembranous ossification are yellow and bones formed by endochondral ossification are blue Fig. 6.7

Endochondral Ossification
 Uses hyaline cartilage bones as models for bone construction  Requires breakdown of hyaline cartilage prior to ossification  The perichondrium covering the hyaline cartilage bone is infiltrated with blood vessels, converting it to a vascularized periosteum  The increase in nutrition transforms the underlying osteochondral progenitor cells into osteoblasts  Formation of bone collar around the diaphysis of the hyaline cartilage model

Bone Development
 Endochondral Ossification cont.  Blood vessels grow into the calcified cartilage, bringing osteoblasts and osteoclasts from the periosteum
 The primary ossification center formed as osteoblasts lay down bone matrix

 Medullary cavity forms  Appearance of secondary ossification centers in the epiphyses  Ossification of the epiphyses, with hyaline cartilage remaining only in the epiphyseal plates

BONE FORMATION

Bone

development begins in fetus at about 2 to 3 months of development Secondary ossification centers appear about 1 month before birth

Bone Growth
 Growth in Bone Length
 Bone length increases because of growth at the epiphyseal plate  Epiphyseal plate growth involves
 Interstitial growth of cartilage  Followed by appositional bone growth on the cartilage

 Epiphyseal plate growth results in an increase in the length of the diaphysis and bony processes

 Ossification of bone
 The calcified cartilage on the diaphyseal side of the plate is replaced by bone

Epiphyseal Lines
 Bone growth in length ceases when the epiphyseal plate becomes ossified and forms epiphyseal line - after puberty:  epiphyseal cartilage disappears  visible on X-rays as an epiphyseal line X-

Epiphyseal Plates

Bone Growth
 Growth at Articular Cartilage
 Involves the interstitial growth of cartilage followed by appositional bone growth on the cartilage  Results in larger epiphyses and an increase in the size of bones that do not have epiphyseal plates

Bone Growth

Bone Growth in Width

 Growth in Bone Width  Bone increases in diameter through appositional growth
 Appositional bone growth beneath periosteum increases diameter of long bones and size of other bones  Osteoblasts from periosteum form ridges with grooves between them  Ridges grow together, converting grooves into tunnels filled with concentric lamellae that form osteons  Osteoblasts from the periosteum lay down circumferential lamellae, which can be remodeled

Homeostasis
 Bone building (osteoblasts) and bone recycling (osteoblasts) (osteoclasts) must balance: osteoclasts)
 If more breakdown than building, bones become weak

Factors AffectingBone Growth

 Genetic factors determine bone shape and size HOWEVER  Expression of genetic factors can be modified  Factors can alter the mineralization process or the production of organic matrix  Physical Stress: stimulates bone growth  Nutrition  Hormones

Bone Remodeling
 Athletes bones visibly thicker and heavier than nonathletes  Up to 1/3 of bone mass can be lost in a few weeks of inactivity  Bone constantly removed by osteoclasts and new bone formed by osteoblasts  Remodeling converts woven bone to lamellar bone and allows bone to
    Change shape Adjust to stress Repair itself Regulate body calcium levels

http://www.youtube.com/watch?v=BrI7Ra5FTus&f eature=related

Bones and stress

 Spongy bone located where stresses are weaker or multi-directional multi Compact bone located where stresses are limited in direction
 Example: The femur transfers weight from hip joint to knee joint:  causing tension on the lateral side of the shaft and compression on the medial side

Factors Affecting Bone Growth

 Nutrients
 Vitamin D (fat soluble)
 Necessary for absorption of calcium from intestines  Since fat soluble requires sufficient fat intake  Insufficiency causes rickets and osteomalacia

 Vitamin A (fat soluble)

 Stimulates osteoblast activity  Deficiency retards bone development

 Vitamin K (fat soluble) & B12 (water soluble)

 Helps synthesize bone proteins

 Vitamin C (water soluble)

 Stimulates osteoblast activity  Necessary for collagen synthesis by osteoblasts  Deficiency results in scurvy & fragile bones

Factors Affecting Bone

 Hormones
 Hormones stimulate proliferation of osteogenic cells and chondrocytes in growth plate  Bone growth especially rapid at puberty  Growth hormone, estrogen, and testosterone stimulate bone growth  adolescent girls grow faster than boys & reach their full height earlier (18) (estrogen has stronger effect)  Males grow for a longer time (21)  Anabolic steroids may cause premature closure of growth plate producing short adult stature  Estrogen and testosterone cause closure of the epiphyseal plate
 Growth ceases when epiphyseal plate closes

Calcium Homeostasis
 Bone is the major storage site for calcium in body
 99% of bodys calcium is in skeleton

 Calcium ions in body fluids must be closely regulated

 Hypocalcemia  deficiency of blood calcium  causes excessive excitability of nervous system, leading to muscle spasms, tremors or tetany  Hypercalcemia  excessive calcium binding  depresses nervous system  Two major hormones regulate Ca2+ levels in the blood: parathyroid hormone (PTH) and calcitonin

 Produced by parathyroid glands in neck

 Falling blood Ca2+ levels signal the parathyroid glands to release PTH

Parathyroid Hormone (PTH)

 Increases blood calcium ion levels by:

 stimulating osteoclasts  increasing intestinal absorption of calcium via calcitriol stimulation  Reabsorption of Ca2+ from the urine

http://www.youtube.com/watch?v=xc8C5ECWPvI&feature=related

Hormonal Control of Calcium Balance

Calcitriol
 Hormonally active form of vitamin D
 made in kidneys  synthesis requires vitamin D3 (cholecalciferol)

 stimulates intestine to absorb calcium, phosphate & magnesium  weakly promotes urinary reabsorption of calcium ions  promotes bone resorption

Calcitonin
http://www.youtube.com/watch?v=yFJ4iswRiu4

 Secreted by thyroid  Rising blood Ca2+ levels trigger the thyroid to release calcitonin  Decreases blood calcium levels by:
 inhibiting osteoclast activity (by as much as 70% in 15 minutes)  increasing calcium excretion at kidneys  Decreasing calcitriol production reducing intestinal Ca absorption

Fractures and Their Repair

 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 bone ends penetrate the skin

 Stress fracture is a break caused by abnormal trauma to a bone  car accident, fall, athletics, etc  Pathological fracture is a break in a bone weakened by some other disease  bone cancer or osteoporosis

The Major Types of Fractures

Treatment of Fractures

 Closed reduction  fragments are aligned with manipulation & casted  Open reduction  surgical exposure & repair with plates & screws  Traction is not used in elderly due to risks of long-term longconfinement to bed  hip fractures are pinned & early walking is encouraged  Electrical stimulation is used on fractures that take longer than 2 months to heal  Orthopedics = prevention & correction of injuries and disorders of the bones, joints & muscles

Fracture Repair

Bone Repair
1. Hematoma formation
 Torn blood vessels hemorrhage  A mass of clotted blood (hematoma) forms at the fracture site  Site becomes swollen, painful, and inflamed

Fracture Repair: Step 2 Callus Formation

 Callus formation:
 Mass of tissue at fracture site connects broken ends of bone  Internal callus
 forms between ends of broken bone

 External callus
 forms collar around break

 Capillaries grow into the tissue and phagocytic cells begin cleaning debris

Fracture Repair: Step 3 Callus Ossification

 Osteoblasts and fibroblasts migrate to fracture zone and begin to reconstruct bone  The fibers and cartilage of the internal and external calluses ossify woven, cancellous bone replaces calluses
 Cancellous bone formation in the callus is usually complete 4-6 4weeks after the injury

Fracture Repair: Step 4 Bone Remodeling

 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  The remodeling process may take more than a year to complete
http://www.youtube.com/watch?v=qVougiCEgH8&feature=rec-LGOUT-real_rn-1r-2-HM

Skeletal System Divisions

There are 206 named bones in the human body. Each belongs to one of 2 large groups:
 Axial  Appendicular

Axial skeleton These bones protect, support and carry other body parts Appendicular skeleton Involved in movement and manipulation of the environment

Skeletal Organization
Axial Skeleton skull neck trunk Appendicular Skeleton  upper limbs  lower limbs  pectoral girdle  pelvic girdle

Axial Skeleton

Sinuses Air

spaces Make skull lighter Gives voice tone and resonance Lined with tissue that secretes mucus

Axial Skeleton
 Rib Cage:
 Sternumbreastbone is composed of the Sternum manubrium (the handle), the body (the blade), and the xiphoid process.  Twelve pairs of ribsconnect to the thoracic ribs vertebrae in the back.  Thoracic vertebraeprotects the spinal cord. vertebrae

10-15

The Vertebral Column

Vertebral

column consists of 33

vertebrae. Atlas1st cervical vertebrae & holds Atlas up the head. Cervical vertebraeseven neck vertebrae (cervical) vertebrae. Thoracic vertebraetwelve chest vertebrae vertebrae. Lumbar vertebraefive abdominal vertebrae vertebrae. Sacrumfive fused vertebrae. (solid Sacrum bone) Coccyxfour fused vertebrae forming Coccyx the tailbone.

Kyphosis

curvature becomes exaggerated posteriorly Causes include osteoporosis or compression fracture affecting anterior portions of vertebral bodies

Thoracic

Lordosis Swayback

abdomen and buttocks protrude abnormally due to anterior exaggeration of lumbar curvature

Both

Scoliosis

lateral curvature of spine Most common disorder of spinal curvature Causes include developmental problems,1-sided muscular problems,1paralysis Usually appears in girls during adolescence, when growth most rapid Treatment: exercises, braces, surgical modification

Abnormal

Appendicular Skeleton

Wide

range of movement Opposable thumb

Appendicular Skeleton
Supports

weight of

body Woman s pelvic girdle broader and shallower than male s

Remodeling

of pelvis triggered at puberty

Site

of attachment for

legs Protects organs

Effects of Aging on the Skeletal System

 With aging, bone matrix is lost and matrix becomes more brittle  Cancellous bone loss results from thinning and loss of trabeculae  Compact bone loss mainly occurs from inner surface of bones and involves less osteon formation  Loss of bone
      Increases the risk for fractures Causes deformity Loss of height Pain Stiffness Loss of teeth