SKELETAL SYSTEM

SKELETAL SYSTEM
FUNCTIONS BONE MATRIX
1. Support • By weight, mature bone matrix is
normally about 35% organic and 65%
 rigid strong bone supports the inorganic material.
tissue weight of the body.
 The vertebral column’s • The organic material consists primarily
curvatures play a key role in of collagen and proteoglycans.
supporting the entire body’s • The inorganic material consists
weight. As do the arches formed primarily of a calcium phosphate crystal
by the bones of the feet. called hydroxyapatite.
2. Protection • The collagen and mineral components
are responsible for the major functional
 The skeleton encases and
characteristics of bone.
shields delicate internal organs.
• If all the mineral is removed from a
3. Movement
long bone, collagen becomes the
 Contraction of the skeletal primary constituent and the bone is
muscles moves the bones, overly flexible.
producing body movements.
• if the collagen is removed from the
 Joints, which are formed where
bone, the mineral component becomes
two or more bones come
the primary constituent and the bone is
together, allow movement
very brittle.
between bones.
 Ligaments allow some
movement between bones but
BONE CELLS
prevent excessive movements. • Osteoblasts, are bone forming cells,
have an extensive endoplasmic
4. Storage-Some minerals in the blood are
reticulum and numerous ribosomes.
taken into bone and stored.
They produce collagen and
 Should blood levels of these proteoglycans, which are packaged into
minerals decrease, the vesicles by the Golgi apparatus and
minerals are released released from the cell by exocytosis.
from bone into the blood.
• Osteocytes is a mature bone cells that
 Adipose tissue is also stored
maintain bone matrix and form from
within bone cavities. If needed,
osteoblast after bone matrix has
the lipids are released into the
surrounded it.
blood and used by other tissues
as a source of energy. • Osteoclasts are bone-destroying cells.
The osteoclasts are multi-nucleated
5. Blood cell production- Many bones
cells that contain numerous
contain cavities filled with red bone
mitochondria and lysosomes.
marrow, which gives rise to blood cells
and platelets. • These cells perform reabsorption, or
breakdown, of bone that mobilizes
crucial Ca2+ and phosphate ions for use
in many metabolic processes.
 SHAPE CLASSIFICATION
OF BONES
1. Long bones are longer than they are
wide; examples are upper and lower
limb bones.
BONE TISSUES 2. Short bones are approximately as wide
• Spongy bone consists of as they are long; examples are the
interconnecting rods or plates of bone bones of the wrist and ankle.
called trabeculae. Between the
3. Flat bones have a relatively thin,
trabeculae are spaces, which in life are
flattened shape.
filled with bone marrow and blood
vessels.  Examples of flat bones include
certain skull bones, the ribs,
• Compact bone is denser and has fewer
the breastbone (sternum),
spaces than spongy bone.
and the shoulder blades
(scapulae).
BONE SUPPLY TO THE
4. Irregular bones include the vertebrae
BONE
and facial bones, which have shapes
Blood reaches bones through three paths: that do not fit readily into the other
three categories.
• Haversian canals, minute channels that
lie parallel to the axis of the bone and LONG BONE STRUCTURES
are passages for arterioles.
The structure of long bone has 2 parts:
• Volkmann’s canals, which contain
vessels that connect one haversian canal  Diaphysis is the tubular shaft that runs
to another and to the outer bone. between the proximal and distal ends of
the bone
• Vessels in the bone ends and within the
marrow.  Epiphysis is the end part of a long bone

BONE MARROW  The epiphyses are covered with

articular cartilage, a thin layer of
• Red marrow consists of blood forming cartilage that reduces friction
cells and is the only site of blood and acts as a shock absorber.
formation in the adult.
 Medullary cavity- is the hollow region
• Yellow marrow consists mostly of in the diaphysis filled with red or yellow
adipose tissue. marrow.

• In the fetus, the spaces within bones are  Metaphysis is the narrow portion of a
filled with red marrow. long bone between the epiphysis and
the diaphysis.
• Yellow marrow completely replaces the
red marrow in the long bones of the  The epiphyseal plate, or growth plate,
limbs, except for some red marrow in separates the epiphysis from the
the proximal part of the arm bones and diaphysis.
thighbones.
 Epiphyseal plate has a layer of hyaline
• In adults most red bone marrow is in cartilage in a growing bone and a site
the flat bones, in the central axis of the of growth between diaphysis and
body and the epiphyses long bones of epiphysis
the femur and humerus.
BONE FORMATION multiply rapidly, pushing the epiphysis
away from the diaphysis.
• Ossification is the formation of bone by
• This new cartilage ossifies, creating
osteoblasts.
trabeculae on the medullary side of the
• Bone formation that occurs within epiphyseal plate.
connective tissue membranes is called
• This type of bone growth occurs through
intramembranous ossification.
endochondral ossification
• Bone formation that occurs inside
hyaline cartilage is called BONE GROWTH IN WIDTH
endochondral ossification.
• Bone growth occurs by the deposition
of new bone lamellae onto existing
bone or other connective tissue.

• As osteoblasts deposit new bone matrix

on the surface of bones between the
INTRAMEMBRANOUS periosteum and the existing bone
matrix, the bone increases in width, or
OSSIFICATION
diameter.
• Intramembranous ossification occurs
• This process is called appositional
when osteoblasts begin to produce bone
growth.
within connective tissue. This occurs
primarily in the bones of the skull.
FACTORS AFFECTING
• Intramembranous Ossification occurs BONE GROWTH
in a 12 week old fetus at ossification
centers in the flat bones of the skull. 1. NUTRITION
• Endochondral ossification occurs in  Calcium is implicated in the
the bones forming the inferior part of process of bone mineralization,
the skull by the formation of
hydroxyapatite crystals.
ENDOCHONDRAL  Vitamin D is necessary for the
normal absorption of calcium
OSSIFICATION from the intestines. The body
can either synthesize or ingest
• Endochondral bone formation is bone
vitamin D. Its rate of synthesis
formation within a cartilage model.
increases when the skin is
• The cartilage model is replaced by bone. exposed to sunlight.
 Insufficient vitamin D in
• Initially formed is a primary children causes rickets, a
ossification center, which is bone disease resulting from reduced
formation in the diaphysis of a long mineralization of the bone
bone. matrix. Children with rickets
may have bowed bones and
• A secondary ossification center is bone
inflamed joints
formation in the epiphysis.
2. RICKETS
BONE LENGTH GROWS  Insufficient vitamin D in
children causes rickets, a
• Cartilage is replaced by compact bone disease resulting from reduced
near the outer surfaces of the epiphysis. mineralization of the bone
matrix. Children with rickets
• Only cartilage cells on the upper surface may have bowed bones and
of the epiphyseal plate continue to inflamed joints
 3. NUTRITION • It will heal whether or not a physician
 Vitamin C is necessary for resets it in its anatomical position.
collagen synthesis by • If the bone is not reset correctly, the
osteoblasts. Normally, as old healing process will keep the bone in its
collagen breaks down, new deformed position.
collagen is synthesized to
replace it. Vitamin C deficiency CLASSIFICATION OF
results in bones and cartilage
that are deficient in collagen FRACTURE
because collagen synthesis is
impaired. • An open fracture (formerly called a
compound fracture) occurs when an
4. HORMONES open wound extends to the site of the
 Growth hormone from the fracture or when a fragment of bone
anterior pituitary increases protrudes through the skin.
general tissue growth, including
overall bone growth, by • If the skin is not perforated, the fracture
stimulating interstitial cartilage is called a closed fracture (formerly
growth and appositional bone called a simple fracture)
growth.
 Excessive growth hormone • If the soft tissues around a closed
secretion results in pituitary fracture are damaged, it is called a
gigantism, whereas insufficient complicated fracture.
growth hormone secretion
results in pituitary dwarfism. TYPES OF BONE
 Thyroid hormone is also FRACTURE
required for normal growth of
all tissues, including cartilage; • Incomplete fracture does not extend
therefore, a decrease in this completely across the bone, whereas in
hormone can result in a smaller a complete fracture the bone is broken
individual. into at least two fragments.
 Sex hormones also influence
• Greenstick fracture is an incomplete
bone growth. Estrogen and
fracture on the convex side of the curve
testosterone initially stimulate
of the bone.
bone growth, which accounts
for the burst of growth at • Hairline fractures are incomplete
puberty when production of fractures in which the two sections of
these hormones increases. bone do not separate; hairline fractures
 Both estrogen and testosterone are common in the skull.
stimulate ossification of
epiphyseal plates, and thus the • Comminuted fracture is a complete
cessation of growth. fracture in which the bone breaks into
more than two pieces—usually two
FRACTURE AND BONE major fragments and a smaller
fragment.
REPAIR
• Impacted fracture, one fragment is
• Fracture is a break in the driven into the spongy portion of the
continuity of bone and is defined other fragment.
according to its type and extent.
Fractures are also classified according to the
• Fractures occur when the bone is direction of the fracture within the bone
subjected to stress greater than it can
absorb • Linear fractures run parallel to the
long axis of the bone.
 • Transverse fractures are at right • Closed reduction is accomplished by
angles to the long axis. bringing the bone fragments into
apposition through manipulation.
• Spiral fractures take a helical course
around the bone • The extremity is held in the desired
position while the physician applies a
• Oblique fractures run obliquely in cast, splint, or other device.
relation to the long axis.
OPEN REDUCTION
BONE REPAIR
• Open Reduction is through a surgical
• When a bone breaks, blood flows from approach, the fracture fragments are
any vessel torn by the fracture. These reduced.
vessels could be in the periosteum,
osteons, and/or medullary cavity. • Internal fixation devices (metallic pins,
wires, screws, plates, nails, or rods)
• Within about 48 hours after the fracture, may be used to hold the bone
chondrocytes from the endosteum have fragments in position until solid bone
created an internal callus by secreting a healing occurs.
fibrocartilaginous matrix between the
two ends of the broken bone. BONE AND CALCUIM
• While the periosteal chondrocytes and HOMEOSTASIS
osteoblasts create an external callus of
hyaline cartilage and bone, respectively, • Bone is a major storage site for calcium
around the outside of the break, this
• Movement of calcium in and out of bone
will stabilize the fracture.
helps determine blood levels of calcium
• Osteoblasts enter the callus and begin
• Calcium moves into bone as osteoblasts
forming spongy bone.
build new bone
• Spongy bone formation in the callus is
• Calcium move out of bone as osteoclasts
usually complete after 4-6 weeks after
break down bone
the injury.
• Calcium homeostasis is maintained by
• Immobilization of the bone is critical up
parathyroid hormone (PTH) and
to this time because movement can
caShlercwyintHoatanb in
refracturate the delicate matrix.

• Eventually, the internal and external OSTEOPOROSIS

calli unite, compact bone replaces
spongy bone at the outer margins of the • Osteoporosis or porous bone, is a loss
fracture, and healing is complete. of bone matrix. The loss of bone mass
makes bones so porous and weakened
TREATMENT OF that they become deformed and prone
to fracture.
FRACTURE
• The occurrence of osteoporosis
• Reduction of a fracture refers to increases with age. In both men and
restoration of the fracture fragments to women (although it is 2.5 times more
anatomic alignment and rotation. common in women)

• Either closed reduction or open • Bone mass starts to decrease at about

reduction may be used to reduce a age 40 and continually decreases
fracture. thereafter.

CLOSED REDUCTION
 • Women can eventually lose
approximately one-half, and men one-
quarter, of their spongy bone.

• In women, decreased production of the

female reproductive hormone estrogen
can cause osteoporosis, mostly in
spongy bone, especially in the vertebrae
of the spine and the bones of the
forearm.

• Estrogen levels decrease after

menopause, removal of the ovaries,
amenorrhea due to extreme exercise or
anorexia nervosa, and cigarette
smoking.

• In men, reduction in testosterone levels

can cause a loss of bone tissue.
However, this is less of a problem in
men than in women because men have
denser bones than women, and
testosterone levels generally don’t
decrease significantly until after age 65.

FACTORS THAT CAN

CAUSE OSTEOPOROSIS
• Inadequate dietary intake or absorption
of calcium, sometimes due to certain
medications, can also contribute to
osteoporosis.

• Absorption of calcium from the small

intestine decreases with age.

• Finally, too little exercise or disuse from

injury can also cause osteoporosis.

• Significant amounts of bone are lost

after 8 weeks of immobilization.

OSTEOPOROSIS CLINICAL
MANIFESTATION
• Pain and stiffness especially in spine

• Easily fractured bones

• Loss of height

• Progressive kyphosis