Medical Physics

CHAPTER 3

Physics Of the Skeleton

There are 206 bones in the body, as shown in figure-1.

Figure-1: Skeleton of human.

The bones are designed and oriented to suit their functions. The
bones have at least seven functions which are:
 1- Supporting: e.g. legs support the body, neck vertebrae
support the head and the back bone vertebrae support the track
and the body.
2- Locomotion: legs, hands, and bone joints are contributed in
locomotion.
3- Protection of organs: e.g.: the skull protects the brain, chest
ribs and sternum protect the heart and lungs; the back bone
protects the spinal cord, and the tympanic bone protects the
inner ear.
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4- Storage of chemicals:- bones are Ca bank of the body. It
stores the excess of calcium from the blood and gives it back to
the blood when it is needed.
5- Nourishment: the teeth in the upper and lower jaws used for
cutting chewing and grinding the food. Incisors: cutting, Canines:
tearing, Molars: grinding.
There are two kinds of teeth: deciduous teeth (baby) and
permanent teeth.
6- Sound transmission: the ossicles in the middle ear transmit the
sound vibrations to the inner ear.
7- Breathing: ribs and muscles increase or decrease the chest
volume to maintain breath, i.e. inspiration and expiration.
Muscles are attached to the bones, by tendons and ligaments to
support the body and for locomotion and some other functions
of the bones.
Bones are living tissues has blood supply and nerves. Most of
the bone tissue is inert but about 2% of the bone cells maintain
the bone in a healthy condition. These cells are called
osteocytes, which is distributed through the bone.
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 Bone remodeling:

The bone of the body contains about 1000 gm. of calcium. In

childhood the body builds more calcium than it consumed. At
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youth the body destroys about 0.5 gm. of Ca each day (this
process is called osteoclast) and built up about the same amount
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of Ca (this process is called osteoblast). These processes are
called bone remodeling. In youth: osteoblast and osteoclast are
nearly equal. In elderly: osteoblast is less than osteoclast which
reduce the mass and volume of the bone. This process is called
osteoporosis (porous bones) (see figure-2) which results in bone
fracture (mainly in the hips of old women). The osteoporic bone
is weaker than the normal bone.

Figure- 2: Porous bone ( Osteoporic bone) of an old woman.

Example: Suppose that the mass of your bones equals 1.2 kg,
calculate the time required for your bones to be completely
remodeled?
Solution:
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 Since our body build 0.5 gm per day, therefore the time required
to build 1.2 kg is equal:
1.2 x 1 / (0.5x10-3 ) = 2400 days.
Composition of the bone:
The bone is composed from two quite different materials plus
water:
1-Collagen: it is organic material forms about 40% of the weight
of solid bone and 60% of its volume. It is different from the other
collagen in the skin and other parts of the body.
2- Bone minerals: it is the inorganic parts of the bone. It forms
about 60% of the weight of solid bone and 40% of its volume. It
is made mainly of calcium.
When the collagen is separated from bone minerals it is flexible
like rubber while bone minerals are fragile and can be crushed
with the fingers like chalk.
Bones are formed from very small crystals which are made from
minerals and fitted in the template of collagen. The crystals are
rod shaped of diameters range 20 to 70 Aº and lengths of 50 to
100 Aº. Each crystal is surrounded by a layer of water contains
many nutrients and chemicals needed by the bone which are the
same of that normally supplied to the body by the blood.
The bone contains a large amount of Ca and because Ca is a
heavy material (atomic mass=40), therefore it normally absorbs
X-rays when it is irradiated by this kind of radiation. The color
of bones images in X-ray film will be more white after
irradiation. See figure-3 below.

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 Figure-3: absorption of X-ray by the bones

Types of bones:
There are two types of bones which are:
1- Compact bone: it is solid bone which normally forms the
shaft of the bone and it is thicker at the middle of the bone to
withstand more pressure and thinner at the two ends ,in order
to withstand more weights.
2- Trabecular bone (cancellous bone ): it is a spongy bone and
considerably weaker than compact bone due to the reduced
amount of bone material in a given volume.
Even the osteoporotic bones are weaker than the healthy
bone, the density of the bone is constant which equals1.9
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gm/cm . But the strength of the osteoporic bone is reduced
because it becomes thinner, (see figures - 4a, b).
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Figure-4a: Complete femur bones, left and right showing both
compact and trabecular parts.

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 Figure- 4b: Trabecular bone (head of femur).

Elasticity of the bone:

Even the bone is very hard and solid material, it is an elastic
material which can be elongated or shortened due to the applied
force, and it follows Hook's law of elasticity, which states that: the
force needed to extend or compress a spring by some distance is
proportional to that distance.
According to Hooke’s law, the strain is proportional linearly with
stress ( Stress is the pressure in solids which is equal to the force F
per unit area A). As the force applied on the bone increases, the
length of the bone increases more rapidly. The bone breaks at
stress of about 120 N/mm2 ( see figures -5a, b ).

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 Figure - 5a: Stress – Strain relationship.

Figure – 5b: Effect of force direction on types of fractures.

Young Modulus: is dealing with stress and strain and given by:
Y = stress / strain
Y = ( F / A ) / (Δ L / L )
Where:
Y : Young Modulus for bone = 1.8 x 10^10 N/m^2

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 F: force applied A: cross-section area of the bone
Δ L: difference between the original and fractured length of the
bone ( L – L0 )
L: fractured length of the bone L0: original length of the
bone.
This equation is valid for both tension and compression. The
bones don’t normally break due to compression; they usually
break due to shear or under tension. The shear is happened by
catching the foot and twisting the bone while falling. A shear
fracture often results in spiral break in which the bone punctures
the skin. This kind of fracture is called compound fracture and it
is become more infected than simple fracture in which the bone
does not puncture the skin. The body can repair bone fracture
rapidly if the bone region is immobilized(‫(تجبير‬. Even at elderly
ages the healing process is effective.
Example: a patient had a car accident which caused a breakage
in his leg bone of 1m in length and 4cm2 average cross sectional
area. This results in a shortening of 0.2 mm in his leg bone.
Calculate the balance (weight) should be hanged on his leg
bone to maintain its original length?
Solution:
we have: Y = ( F / A ) / (Δ L / L )
Y = (L x F) / ( A x ΔL )
the: 1.8x1010 = ( 1 x F ) / ( 4x10-4 x 2x10-4 )
or: F = 1440 N
therefore; the weight should be hanged is equal to:
W = F / 9.8
= 1440 / 9.8
= 147 Kg.

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 Fracture in elderly or in the back bone requires long time to
repair, depends on the age of the patient, and the patient stays
lying in bed for few months which results in bed ulcers. The
patient should stand as soon as he can. Bed ulcers can be treated
by ultraviolet rays.
The patient should have X-ray image for his bone fracture before
any surgical involvements. Another X-ray should be taken
immediately after the medical treatment of the bone to make sure
that the parts of the broken bones are treated perfectly.
Medically, the parts of the breakage bone should not put
correspond to each other(end-to-end) because when these parts
are growing up they will meet each other and make a bent in the
growing parts of the bone.
The two ends should be put in a way that fulfill two important
things:
First: there should be a small gap between the two ends of the
bone depending on the age of the patient, and the kind of
breakage: the gap is inversely proportional with the age.
Second: the two ends should not correspond to each other.

Metal prosthetic hip joints, pins, nails and so forth are often used
to repair such damaged bones.
Local electrical fields in the bone may play a role in growth and
repair of the bone because the bone generates electric charge on
its surface when the bone is bent.
Lubrication of bone joints:
A bone joint composed from synovial membrane incased two
bone ends and synovial fluid (see figures- 6: a, b; figure- 7).
The surfaces of the joint are articular cartilage; the surface of the
cartilage is enough which plays a useful role in joint lubrication by
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trapping some of the synovial fluid. This fluid squeezed in the joint
according to the stress applied on the on the joint. The viscosity of the
synovial fluid changes according to the applied stress.
When a continuously squeezed in the joint, this will result in swollen
in the joint.
It is advised that the synovial fluid in a swollen joint should not be
drained out, only when all the medical treatments are not useful.
When compression on the joint is relieved, synovial fluid sweeps back
into the articular cartilage like water into sponge. This mechanism
lubricates the free surfaces of the cartilage and nourishes their cells.
This mechanism is called “weeping lubrication”.
Synovial fluid reduces the friction coefficient to 0.01, compared with
that of the lowest friction in nature, which is between a steel blade and
ice, equals 0.03.

Fig (6 –a )

Figure – 6a: Showing the anatomy of the right knee.

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 Fig . ( 6 –b )

Figure – 6b: Showing synovial fluid in the knee (yellow color).

Figure – 7: Showing the Temporomandibular joint (TMJ).

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END OF CHAPTER

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