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Anatomy Of Bone and CarDFGFHGJKL;JHtilage.pptx
- 1. Dr. M. SajjadHassan BSc, Pharm D, RPh M.Phil Pharmacology ( University of Sargodha) PhD Scholar , Assistant Professor ICPS Hospital Pharmacist AMC Sargodha
- 2. CONTENTS FORMATION OFBONE CLASSIFICATION OF BONES STRUCTURE OF BONE BLOOD SUPPLY COMPOSITION OF BONE FRACTURE HEALING CARTILAGE TYPES OF CARTILAGE
- 3. BONE (syn –Os; Osteon) Osseous tissue, a specialised form of dense connective tissue consisting of bone cells (osteocytes) Embedded in a matrix of calcified intercelluar substance Bone matrix contains collagen fibres and the minerals calcium phosphate and calcium carbonate
- 4. FORMATION OF BONE The process of bone formation - ossificatiom All bone is of mesodermal origin Two types of ossification 1. Intramembranous ossification 2. Endochondral ossification
- 5. INTRAMEMBRANOUS OSSIFICATION Development ofbones in membranous sheets Mesenchymal (immature connective tissue) condensation. Bone layers, membranes formation begins Highly vascular, Laying down of bundles of collagen fibres in themesenchymalcondensation Osteoblast formation – osteoid(unmineralized) Calcium phosphate salts deposition – lamellus of bone . Calcification occurs in
- 6. BONE FORMATION- Intramembranousossification
- 7. BONE FORMATION -Intramembranous ossification
- 8. BONE FORMATION -Intramembranous ossification
- 9. BONE FORMATION -Intramembranous ossification
- 10. ENCHONDRAL OSSIFICATION Intracartilaginous osteogenesis Ossifiesbones that originate as hyaline cartilge Most bones originate as hyaline cartilage E.G, bones of limbs, ribs , vertebrae. Growth and ossification of long bones occurs in 6 steps
- 11. STEP 1 Chondrocytesin the center of hyaline cartilage: – enlarge – form struts and calcify – die, leaving cavities in cartilage
- 12. STEP 2 Bloodvessels grow around the edges of the cartilage • Cells in the perichondrium (connective tissue that envelope cartilage) change to osteoblasts: – producing a layer of superficial bone around the shaft which will continue to grow and become compact
- 13. STEP 3 •Blood vessels enter the cartilage: –bringing fibroblasts that become osteoblasts –spongy bone develops at the primary ossification center
- 14. STEP 4 Remodeling createsa marrow cavity: – bone replaces cartilage at the metaphyses
- 15. STEP 5 Capillaries and osteoblasts enterthe epiphyses: – creating secondary ossification centers
- 16. STEP 6 Epiphysesfill with spongy bone: –cartilage within the joint cavity is articulation cartilage – cartilage at the metaphysis is epiphyseal cartilage
- 17. Endochondral ossification Stages 1-3 duringfetal week 9 through 9th month Stage 4 is just before birth Stage 5 is process of long bone growth during childhood &
- 18. SKELETAL ORGANIZATION • Theactual number of bones in the human skeleton varies from person to person • Typically there are about 206 bones • For convenience the skeleton is divided into the: • Axial skeleton • Appendicular skeleton
- 19. DIVISION OF SKELETON •Axial Skeleton • Skull • Spine • Rib cage • Appendicular Skeleton • Upper limbs • Lower limbs • Shoulder girdle • Pelvic girdle
- 20. CLASSIFICATION OF BONESBY SHAPE Long bones Short bones Flat bones Irregular bones Pneumatize d bones Sesamoid bones (Short bones include sesmoid bones)
- 21. LONG BONES Diaphysis– shaft Epiphysis – expanded ends Shaft – 3 surfaces, 3 borders, medullary cavity and a nutrient foramen directed away from the growing end Ex – humerus, radius, ulna,
- 22. SHORT BONES Aresmall and thick Their shape is usually cuboid, cuneifrom, trapezoid or scaphoid Ex – carpal and tarsal bones
- 23. FLAT BONES Arethin with parallel surfaces • Are found in the skull, sternum, ribs,and scapula • Form boundaries of certain body cavities • Resembles a sandwich of spongy bone • Between 2 layers of compact bone
- 24. PNEUMATIC BONES (Gr.– pert. to air) Certain irregular bones contain large air spaces lined by epithelium Make the skull light in weight, help in resonance of voice, and act as air conditioning chambers for inspired air Ex – maxilla, sphenoid, ethmoid, etc
- 25. SESAMOID BONES Resemblinga grain of sesame in size or shape Bony nodules found embedded in the tendons or joint capsules No periosteum and ossify after birth Related to an articular or nonarticular bony surface Ex – patella, pisiform, fabella,
- 26. IRREGULAR BONES Havecomplex shapes Examples: – spinal vertebrae – pelvic bones
- 28. DEVELOPEMENTAL CLASSIFICATION Membrane(dermal) bones Cartilaginous bones Membrano-cartilagenous bones
- 29. Membrane (dermal) bones Ossify in membrane (intramembranous of mesenchymal) Derived from mesenchymal condensations Ex – bones of the vault of skull and facial bones Defect – cleidocranial dysostosis
- 30. Cartilaginous bones Ossifyin cartilage (intracartilagenous or endochondral) Derived from preformed cartilaginous models Ex – bones of limbs, vertebral column and thoracic cage Defect – common type of dwarfism called achondroplasia
- 31. Membrano-cartilaginous bones Ossifypartly in cartilage and partly in membrane Ex – clavicle, mandible, occipital, etc
- 33. BONE CELLS ELEMENTSCOMPRISING BONE TISSUE 1. It consists of bone cells or osteocytes – separated by intercellular substance 2. Osteoblasts – bone producing cells 3. Osteoclasts – bone removing cells 4. Osteoproginator cells – from which osteoblasts and osteoclasts derived
- 34.
- 35. OSTEOPROGENITOR CELLS Mesenchymalstem cells that divide to produce osteoblasts • Are located in inner, cellular layer of periosteum (endosteum) • Assist in fracture repair
- 36. OSTEOBLASTS (Gr.- osteon-bone,blastos – germ) Immature bone cells that secrete matrix compounds (osteogenesis) Osteoid •Matrix produced by osteoblasts, but not yet calcified to form bone •Osteoblasts surrounded by bone become osteocytes
- 37. OSTEOCYTE Mature bonecells that maintain the bone matrix • Live in lacunae • Are between layers (lamellae) of matrix • Connect by cytoplasmic extensions through canaliculi in lamellae • Do not divide
- 38. OSTEOCLAST (Gr.- osteon–bone,+klan-to break) •Secrete acids and protein digesting enzymes • Giant, mutlinucleate cells •Dissolve bone matrix and release stored minerals (osteolysis) • Are derived from stem cells
- 39. STRUCTURAL CLASSIFICATION Macroscopically 1.Compact bone 2. Cancellous bone
- 40. COMPACT BONE Strongdense – 80% of the skeleton Consists of multiple osteons (haversian systems) with intervening interstitial lamellae Best developed in the cortex of long bones Osteons are made up of concentric bone lamellae with a central canal (haversian canal) containing osteoblasts and
- 42. Contd. Lamellae areconnected by canaliculi Cement lines mark outer limit of osteon (bone resorption ended) Volkmann’s canals: radially oriented, have arteriole, and connect adjacent osteons This is an adaptation to bending and twisting forces (compression,
- 43. OSTEON The basicunit of mature compact bone • Osteocytes are arranged in concentric lamellae • Around a central canal containing blood vessels
- 47. CANCELLOUS BONE (SPONGY ORTRABECULAR) Open in texture – meshwork of trabeculae (rods and plates) Crossed lattice structure, makes up 20% of the skeleton High bone turnover rate Bone is resorbed by osteoclasts in Howship’s lacunae and formed on the opposite side of the trabeculae by osteoblasts Osteoporosis is common in cancellous bone, making it susceptible to fractures Commonly found in the metaphysis and epiphysis of long bones
- 48. Contd. Does nothave osteons • The matrix forms an open network of trabeculae • Trabeculae have no blood vessels
- 51. Microscopicall y 1. Lamellar bone 2.Woven bone
- 52. LAMELLAR BONE Boneis made up of layers or lamellae Lamellae – is a thin plate of bone consisting of collagen fibres and mineral salts, deposited in gelatinous ground substance Between adjoining lamellae we see small flattened spaces – lacunae
- 53.
- 54. Contd. Lacunae 1. Containsone osteocyte 2. Have fine canals or canaliculi that communicate with those from other lacunae Fibers of one lamellus run parallel to each other, but those of adjoining lamellae run at varying angles to each other.
- 55. WOVEN BONE Foundin all newly formed bone – later replaced by lamellar bone Collagen fibres are present in bundles - run randomly – interlacing with each other Abnormal persistence – paget’s disease
- 56.
- 58. GROSS STRUCTURE OFAN ADULT LONG BONE Shaft Two ends
- 59. SHAFT Composed of 1.periosteum, 2. cortex and 3. medullary cavity
- 60. PERIOSTEUM External surfaceof any bone covered by a membrane – periosteum Two layer Outer – fibrous membrane, inner – cellular In young bones – inner layer – numerous osteoblasts – osteogenitic layer In adults – osteoblasts are not conspicuous, but osteoprogeniter cells present here can form osteoblasts when need arises
- 61.
- 62.
- 63. FUNCTIONS Medium throughwhich mucles, tendons and ligaments are attached Forms a nutritive function Can form bone when required Forms a limiting membrane that prevents bone tissue from ‘spilling out’ into neighbouring tissues
- 64. CORTEX Is madeup of a compact bone which gives the desired strength Can withstand all possible mechanical strains
- 65. ENDOSTEUM • Anincomplete cellular layer: – lines the marrow cavity – covers trabeculae of spongy bone – lines central canals • Contains osteoblasts, osteoprogenitor cells, and osteoclasts • Is active in bone growth and repair
- 66. MEDULLARY CAVITY Filled withred or yellow bone marrow 1. Red – at birth – haemopoiesis 2. Yellow – as age advance – atrophies – fatty 3. Red marrow persists in the cancellous ends of long bones
- 68. PARTS OF YOUNGBONE It ossifies in 3 parts The two ends from the secondary centers Intervening shaft from a primary center
- 69. EPIPHYSIS (Gr., a growingupon) The ends of a bone which ossify from secondary centers Types 1. Pressure epiphysis – transmission of the weight . Ex- head of femur, etc 2. Traction epiphysis – provides attachment to one or more tendons which exerts a traction on the epiphysis. Ex- trochanters of femur,et
- 70. 3. Atavistic epiphysis– phylogenitically an independent bone , which fuses to another bone. Ex- coracoid process of scapula,etc 4. Aberrant epiphysis – not always present. Ex- head of the 1st metacarpal and base of other metcarpal
- 71. DIAPHYSIS (Gr., a growingthrough) It is the elongated shaft of a long bone which ossifies from a primary center Made of thick cortical bone Filled with bone marrow
- 72. METAPHYSI S (Gr. meta, after,beyond, + phyein, to grow) Epiphysial ends of a diaphysis Zone of active growth Typically made of cancellous bone Hair pin bends of end arteries
- 73. EPIPHYSIAL PLATE OFCARTILAGE It separates epiphysis from the metaphysis. Proliferation – responsible for lengthwise growth of the long bone Epiphysial fusion – can no longer grow Nourished by both epiphysial and metaphysial arteries
- 77. BLOOD SUPPLY OF BONES LONG BONES – derived from 1. Nutrient artery 2. Periosteal artery 3. Epiphysial artery 4. Metaphysial artery
- 78. Nutrient artery 1. Entersthrough the nutrient foramen 2. Divides into ascending and descending branches in the medullary cavity 3. Branch divides – small parallel channels – terminate in adult metaphysis 4. Anastomosing with the epiphysial, metaphysial and periosteal arteries 5. Supplies the medullary cavity , inner 2/3 of the cortex and metaphysis 6. Nutrient foramen is directed away
- 80. Periosteal arteries 1.Numerous beneath the muscular and ligamentous attachments 2. Ramify beneath the periosteum and enter the volkmann’s canals to supply the outer 1/3 of the cortex
- 82. Epiphysial arteries 1.Derieved from periarticular vascular arcades (circulus vasculosus) 2. Out of the numerus vascular foramina in this region – few admit arteries and rest venous exits 3. Number size – idea of the relative vascularity of the two ends of long bone
- 83. Metaphysial arteries 1.Derived from the neighbouring systemic vessels 2. Pass directly into the metphysis and reinforce the metaphysial branches from the primary nutrient artery
- 85. HOMEOSTASIS OF BONETISSUE • Bone Resorption – action of osteoclasts and parathyroid hormone aka parathormone aka PTH • Bone Deposition – action of osteoblasts and calcitonin • Occurs by direction of the thyroid and parathyroid glands MC OC
- 86. FACTORS AFFECTING BONETISSUE • Deficiency of Vitamin A – retards bone development • Deficiency of Vitamin C – results in fragile bones • Deficiency of Vitamin D – rickets, osteomalacia • Insufficient Growth Hormone – dwarfism • Excessive Growth Hormone – gigantism, acromegaly • Insufficient Thyroid Hormone – delays bone growth • Sex Hormones – promote bone formation;
- 88.
- 89. APPLIED ANATOMY Periosteumis particularly sensitive to tearing or tension – 1. Drilling into the compact bone without anaesthesia causes only dull pain 2. Drilling into spongy bone is much more painful 3. Fractures, tumours and infections of the bone are very painful Blood supply of bone is so rich that it is very difficult to sufficiently to kill the bone
- 90. Contd. In rickets– calcification of cartilage fails and ossification of the growth zone is disturbed 1. Osteoid tissue is formed normally and the cartilage cells proliferate freely , 2. Mineralization does not takes place Scurvy – formation of collagenous fibres and matrix is impaired Osteoporosis - Bone resorption proceeds faster than deposition
- 91. FRACTURE HEALING STAGESOF FRACTURE HEALING 1. Stage of inflammation 2. Stage of soft callous formation 3. Stage of hard callous formation 4. Stage of remodelling
- 92.
- 93. STAGE OF SOFTCALLUS FORMATION
- 94. STAGE OF HARDCALLUS FORMATION
- 95.
- 96. MECHANISM OF BONEHEALING Direct (primary) bone healing Indirect (secondary) bone healing
- 97. DIRECT BONE HEALING Mechanism of bone healing seen when there is no motion at the fracture site (i.e. absolute stability) Does not involve formation of fracture callus Osteoblasts originate from endothelial and perivascular cells A cutting cone is formed that crosses the fracture site Osteoblasts lay down lamellar bone behind the osteoclasts forming a secondary osteon Gradually the fracture is healed by the formation of numerous secondary osteons A slow process – months to years
- 99. INDIRECT BONE HEALING Mechanism for healing in fractures that have some motion, but not enough to disrupt the healing process Bridging periosteal (soft) callus and medullary (hard) callus re-establish structural continuity Callus subsequently undergoes endochondral
- 100. BONE REMODELLING WOLFF’sLAW – remodeling occurs in response to mechanical stress 1. Increasing mechanical stress increases bone gain 2. Removing external mechanical stress increases bone loss which is reversible on (to varying degrees) on remobilzation
- 101. Contd. PIEZOELECTERIC REMODELING– occurs in response to electric charge 1. The compression side of bone is electronegative stimulating osteoblasts 2. Tension side of the bone is electropositive, stimulating osteoclasts
- 103. CARTILAGE (L.-cartilago –gristle) It is a connective tissue composed of cells (chondrocytes) and fibres (collagen) in matrix, rich in mucopolysaccarides smooth type of connective tissue it covers and protects the ends of long bones at the joints as articular cartilage. structural component of many body parts including the rib cage, the neck and the bronchial tubes, and the intervertebral discs. It is not as hard and rigid as bone, but it is much stiffer and much less flexible than muscle.
- 104. CARTILAGE Groung substance– chemically GAG Core protein – aggrecan Collagen – type 2 Fibrocartilage and perichondrium – type 1 Cartilage is composed of specialized cells called chondrocytes that produce a large amount of collagenous extracellular matrix, abundant ground substance that is rich in proteoglycan and elastin fibers.
- 105. cartilage cartilage does notcontain blood vessels or nerves. Some fibrocartilage such as the meniscus of the knee does however have blood supply in part. Nutrition is supplied to the chondrocytes by diffusion. The compression of the articular cartilage or flexion of the elastic cartilage generates fluid flow, which assists the diffusion of nutrients to the chondrocytes. Compared to other connective tissues, cartilage has a very slow turnover of its extracellular matrix and is documented to repair at only a very slow rate relative to other tissues.
- 106. General features Hasno blood vessels or lymphatics Nutrition is by diffusion through matrix No nerves – insensitive Surrounded by a fibrous membrane – perichondrium Articular cartilage has no perichondrium – regeneration after injury inadequate When calcifies – chondrocytes die – replaced by bone
- 107. TYPES HYALINE CARTILAGE FIBROCARTILAGE ELASTIC CARTILAGE
- 109. HYALINE CARTILAGE (G. hyalos- transparent stone) Bluish white and transparent due to very fine collagen fibres Abundantly distributed – tendency to calcify after 40yrs of age All cartilage bones are preformed in hyaline cartilage Ex – articular cartilage, costal cartilage
- 112. FIBROCARTILAGE White andopaque due to abundance of dense collagen fibres Whenever fibres tissue is subjected to great pressure – replaced by fibrocartilage Tough, strong and resilient Ex – intervertebral disc, intraarticular disc
- 113.
- 114. ELASTIC CARTILAGE Madeof numerous cells and Rich network of yellow elastic fibres pervading the matrix – so that it is more pliable Cartilage in the external ear, auditory tube
- 115.
- 116. REFERENCES: -GRAY’s ANATOMY FORSTUDENTS -Google images -BRS Anatomy -Netter’s Atlas of Anatomy -Snell Clinical Anatomy 9th Edition -Atlas Anatomy