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Niu0gf5ny Chapter+6+-+Skeletal+System
Niu0gf5ny Chapter+6+-+Skeletal+System
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Chapter 6
Skeletal System:
Bones and Joints
ANA101:
ANATOMY & PHYSIOLOGY
WITH PATHOPHYSIOLOGY
LEARNING OBJECTIVES:
• Explain the functions of the skeletal system.
• Describe the components of the extracellular matrix and explain the
function of each.
• Explain the structural differences between compact bone and spongy
bone.
• Outline the processes of bone ossification, growth, remodeling, and
repair.
• Explain the role of bone in calcium homeostasis.
• Describe how parathyroid hormone and calcitonin influence bone
health and calcium homeostasis.
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LEARNING OBJECTIVES:
• List and define the major features of a typical bone.
• Name the bones of the skull and describe their main features as seen
from the lateral, frontal, internal, and inferior views.
• List the bones that form the majority of the nasal septum.
• Describe the locations and functions of the paranasal sinuses.
• List the bones of the braincase and the face.
• Describe the shape of the vertebral column and list its divisions.
• Discuss the common features of the vertebrae and contrast vertebrae
from each region of the vertebral column.
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LEARNING OBJECTIVES:
• List the bones and cartilage of the rib cage, including the three types of
ribs.
• Identify the bones that makeup the pectoral girdle and relate their
structure and arrangement to the function of the girdle.
• Name and describe the major bones of the upper limb.
• Name and describe the bones of the pelvic girdle and explain why the
pelvic girdle is more stable than the pectoral girdle.
• Name the bones that make up the coxal bone. Distinguish between the
male and female pelvis.
• Identify and describe the bones of the lower limb.
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LEARNING OBJECTIVES:
• Describe the two systems for classifying joints.
• Explain the structure of a fibrous joint, list the three types, and give examples of
each type.
• Give examples of cartilaginous joints.
• Illustrate the structure of a synovial joint and explain the roles of the components
of a synovial joint.
• Classify synovial joints based on the shape of the bones in the joint and give an
example of each type.
• Demonstrate the difference between the following pairs of movements: flexion and
extension; plantar flexion and dorsiflexion; abduction and adduction; supination
and pronation; elevation and depression; protraction and retraction; opposition
and reposition; inversion and eversion.
• Describe the effects of aging on bone matrix and joints.
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Extracellular Matrix
• Bone, cartilage, tendons, and ligaments of the skeletal system
are all connective tissues.
• Their characteristics are largely determined by the
composition of their extracellular matrix.
• The matrix always contains collagen, ground substance, and
other organic molecules, as well as water and minerals.
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Extracellular Matrix
• Collagen is a tough, ropelike protein.
• Proteoglycans are large molecules consisting of many
polysaccharides attaching to and encircling core proteins.
• The proteoglycans form large aggregates and attract water.
• The extracellular matrix of tendons and ligaments contains
large amounts of collagen fibers, making these structures very
tough, like ropes or cables.
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Bone Marrow
• Bones contain cavities, such as the large medullary cavity in
the diaphysis, as well as smaller cavities in the epiphyses of
long bones and in the interior of other bones.
• These spaces are filled with soft tissue called marrow.
• Red marrow is the location of blood forming cells.
• Yellow marrow is mostly fat.
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Bone Marrow
• In newborns most bones have blood making red bone
marrow.
• In adults red marrow in the diaphysis is replaced by yellow
bone marrow.
• In adults most red bone marrow is in the flat bones and the
long bones of the femur and humerus.
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Bone Cells
• Osteoblasts: responsible for the formation of bone and the
repair and remodeling of bone.
• Osteocytes: cells that maintain bone matrix and form from
osteoblast after bone matrix has surrounded it.
• Osteoclasts: contribute to bone repair and remodeling by
removing existing bone, called bone reabsorption.
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Bone Formation
• Ossification is the formation of bone by osteoblasts.
• Bone formation that occurs within connective tissue
membranes is called intramembranous ossification.
• Bone formation that occurs inside hyaline cartilage is called
endochondral ossification.
• Both types of bone formation result in compact and spongy
bone.
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Bone Formation
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Intramembranous Ossification
• Intramembranous ossification occurs when osteoblasts begin
to produce bone within connective tissue.
• This occurs primarily in the bones of the skull.
• Osteoblasts line up on the surface of connective tissue fibers
and begin depositing bone matrix to form trabeculae.
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Intramembranous Ossification
• The process begins in areas called ossification centers and the
trabeculae radiate out from the centers.
• Usually, two or more ossification centers exist in each flat skull
bone and mature skull bones result from fusion of these
centers as they enlarge.
• The trabeculae are constantly remodeled and they may
enlarge or be replaced by compact bone.
Intramembranous Ossification
Bone Formation in the Fetus
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Endochondral Ossification
• Endochondral bone formation is bone formation within a
cartilage model.
• The cartilage model is replaced by bone.
• Initially formed is a primary ossification center, which is bone
formation in the diaphysis of a long bone.
• A secondary ossification center is bone formation in the
epiphysis.
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Bone Remodeling
• Bone remodeling involves:
• removal of existing bone by osteoclasts and
• deposition of new bone by osteoblasts
• occurs in all bones
• responsible for changes in bone shape, bone
• repair, adjustment of bone to stress, and
• calcium ion regulation
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Bone Repair
1. Broken bone causes bleeding and a blood clot forms.
2. Callus forms which is a fibrous network between 2
fragments.
3. Cartilage model forms first then, osteoblasts enter the callus
and form cancellous bone this continues for 4-6 weeks after
injury.
4. Cancellous bone is slowly remodeled to form compact and
cancellous bone.
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Bone Repair
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Cranial Bones
Frontal bone
• Anterior part of cranium
Parietal bones
• Sides and roof of cranium
Occipital bones
• Posterior portion and floor of cranium
Temporal bones
• Inferior to parietal bones on each side of the cranium
• Temporomandibular joint
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Cranial Bones
Sphenoid bone
• Forms part of cranium floor, lateral posterior portions of eye
orbits, lateral portions of cranium anterior to temporal bones
• Sella turcica
Ethmoid bone
• Anterior portion of cranium, including medial surface of eye
orbit and roof of nasal cavity
• Nasal conchae
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Facial Bones
Maxillae
• Form upper jaw, anterior portion of hard palate, part of
lateral walls of nasal cavity, floors of eye orbits
• Maxillary sinus
Palatine bones
• Form posterior portion of hard palate, lateral wall of nasal
cavity
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Facial Bones
Zygomatic bones
• Cheek bones
• Also form floor and lateral wall of each eye orbit
Lacrimal bones
• Medial surfaces of eye orbits
Nasal bones
• Form bridge of nose
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Facial Bones
Vomer
• In midline of nasal cavity
• Forms nasal septum with the ethmoid bone
Inferior nasal conchae
• Attached to lateral walls of nasal cavity
Mandible
• Lower jawbone
• Only movable skull bone
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Bones of the Nasal Cavity
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Paranasal Sinuses
• Several of the bones associated with the nasal cavity have
large cavities within them, called the paranasal sinuses which
open into the nasal cavity.
• The paranasal sinuses are:
• Frontal
• Ethmoid
• Sphenoid
• Maxillary
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Hyoid Bone
• The hyoid bone is an unpaired, U-shaped bone that is not part
of the skull and has no direct bony attachment to the skull or
any other bones.
• The hyoid bone has the unique distinction of being the only
bone in the body that does not articulate with another bone.
• The hyoid bone provides an attachment for some tongue
muscles, and it is an attachment point for important neck
muscles that elevate the larynx.
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Vertebral Column
• The vertebral column, or spine, is the central axis of the
skeleton, extending from the base of the skull to slightly past
the end of the pelvis.
• In adults, it usually consists of 26 individual bones, grouped
into five regions.
• The adult vertebral column has four major curvatures:
cervical, thoracic, lumbar and sacrococcygeal.
• The cervical region curves anteriorly.
• The thoracic region curves posteriorly.
• The lumbar region curves anteriorly
• The sacral and coccygeal regions together curve posteriorly
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Vertebral Column
• 7 cervical vertebra
• 12 thoracic vertebra
• 5 lumbar vertebra
• 1 sacrum
• 1 coccyx
• Atlas:
• 1st vertebra
• holds head
• Axis:
• 2nd vertebra
• rotates head
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Thoracic Cage
• Protects vital organs
• 12 pair of ribs
• Sternum:
• breastbone
• True ribs:
• attach directly to sternum by cartilage
• False ribs:
• attach indirectly to sternum by cartilage
• Floating ribs:
• not attached to sternum
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Pelvic Girdle
• Where lower limbs attach to the body
• Pelvis:
• includes pelvic girdle and coccyx
• Ischium:
• inferior and posterior region
• Ilium:
• most superior region
• Acetabulum:
• hip socket (joint)
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Hip Bones
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Articulations
• Articulations (joints) are where two bones come together.
• Joints can be classified structurally as fibrous, cartilaginous, or
synovial, according to the major connective tissue type that
binds the bones together and whether a fluid-filled joint
capsule is present.
• Joints are also be classified in functional categories according
to their degree of motion as synarthroses, amphiarthroses, or
diarthroses.
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Types of Movement
• Flexion: bending
• Extension: straightening
• Abduction: movement away from midline
• Adduction: movement toward the midline
• Pronation: rotation of the forearm with palms down
• Supination: rotation of the forearm with palms up
• Rotation: movement of a structure about the long axis
Types of Movement
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Clinical Impact
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Osteogenesis Imperfecta
• Osteogenesis imperfecta is also known as brittle bone
disorder.
• This connective tissue disease is caused by mutations that
yield reduced or defective type I collagen.
• Type I collagen is the major collagen of bone, tendon, and skin
• There is considerable variability in the appearance and
severity of OI symptoms, which is partially explained by
different types of mutations.
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Osteogenesis Imperfecta
• The mildest and most common form of OI is called type I. It is
caused by too little formation of normal type I collagen.
• The majority of patients have a mutation in a type I collagen
gene that creates a stop codon, so that the gene no longer
encodes a functional protein.
• The more severe types of OI occur when mutated collagen
genes are transcribed and the resulting mRNA codes for a
defective protein.
• The more defective the protein, the weaker the collagen fiber
and the more severe the disorder.
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Osteogenesis Imperfecta
• Thus, the most severe forms of OI are defective-collagen and
collagen-deficiency disorders.
• Patients may exhibit any of the following characteristics:
bones predisposed to fracture, especially before puberty; a
tendency to develop spinal curvature; loose joints; brittle
teeth; hearing loss; and a blue tint to the whites of the eyes.
• There is no cure for OI, and treatments are primarily directed
at reducing the risk for fractures.
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Osteogenesis Imperfecta
• Thus, the most severe forms of OI are defective-collagen and
collagen-deficiency disorders.
• Patients may exhibit any of the following characteristics:
bones predisposed to fracture, especially before puberty; a
tendency to develop spinal curvature; loose joints; brittle
teeth; hearing loss; and a blue tint to the whites of the eyes.
• There is no cure for OI, and treatments are primarily directed
at reducing the risk for fractures.
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Gluteal Injections
• The large gluteal muscles (hip
muscles) are a common site for
intramuscular injections.
• Gluteal injections are made in the
superolateral region of the hip
because a large nerve (the sciatic
nerve) lies deep to the other gluteal
regions.
• The landmarks for such an injection
are the anterior superior iliac spine
and the tubercle of the iliac crest,
which lies about one-third of the way
along the iliac crest from anterior to
posterior.
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Broken Hip
• A femoral neck fracture is commonly,
but incorrectly, called a broken hip.
• Femoral neck fractures are among the
most common injuries resulting in
morbidity (disease) and mortality
(death) in older adults.
• Despite treatment with anticoagulants
and antibiotics, about 5% of patients
with femoral neck fractures develop
deep vein thrombosis (blood clot),
and about 5% develop wound
infections; either condition can be life-
threatening.
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Spina Bifida
• Sometimes vertebral laminae
partly or completely fail to fuse
(or even fail to form) during fetal
development, resulting in a
condition called spina bifida
(split spine).
• This defect is most common in
the lumbar region. If the defect
is severe and involves the spinal
cord, it may interfere with
normal nerve function below the
point of the defect.
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Gingivitis
• The gingiva, or gums, are the soft tissues covering the alveolar process.
• Neglect of the teeth can result in gingivitis, an inflammation of the
gingiva that is often caused by bacterial infection. Left untreated,
gingivitis can spread to the tooth socket, resulting in periodontal
disease.
• In periodontal disease, plaque and bacteria accumulate, resulting in
inflammation that gradually destroys the periodontal ligaments and the
bone. Teeth may become so loose that they come out of their sockets.
• Proper brushing, flossing, and professional cleaning to remove plaque
can usually prevent gingivitis and periodontal disease.
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Rheumatoid Arthritis
• Rheumatoid arthritis (RA) is the second most common type of
arthritis.
• RA is a general connective tissue disorder that affects the skin,
vessels, lungs, and other organs, but it is most pronounced in
the joints.
• RA is severely disabling and most commonly destroys small
joints, such as those in the hands and feet.
• The initial cause of RA is unknown but may involve a transient
infection or an autoimmune disease that develops against
collagen.
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Rheumatoid Arthritis
• People with classic RA have a protein, rheumatoid factor, in
their blood.
• In RA, the synovial fluid and associated connective tissue cells
proliferate, forming a pannus(clothlike layer), which causes
the joint capsule to become thickened and destroys the
articular cartilage.
• In advanced stages, opposing joint surfaces can become fused.
• Juvenile rheumatoid arthritis is similar to the adult type in
many ways, but no rheumatoid factor is found in the serum.
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Systems Pathology
Osteoporosis
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Osteoporosis
• Osteoporosis, or porous bone, is a loss of bone matrix.
• The loss of bone mass makes bones so porous and weakened
that they become deformed and prone to fracture.
• The occurrence of osteoporosis increases with age. In both
men and women (although it is 2.5 times more common in
women), bone mass starts to decrease at about age 40 and
continually decreases thereafter.
• Women can eventually lose approximately one-half, and men
one-quarter, of their spongy bone.
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Osteoporosis
• 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.
• Collapse of the vertebrae can cause a decrease in height or,
in more severe cases, kyphosis in the upper back.
• Estrogen levels decrease after menopause, removal of the
ovaries, amenorrhea (lack of a menstrual cycle) due to
extreme exercise or anorexia nervosa (self-starvation), and
cigarette smoking.
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Osteoporosis
• 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.
• 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.
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Osteoporosis
• Early diagnosis of osteoporosis can lead to more preventive
treatments. Instruments that measure the absorption of photons
(particles of light) by bone are used; of these, dual-energy x-ray
absorptiometry (DEXA) is considered the best.
• Supplementation with dietary calcium and vitamin D and exercise
are the best preventive and rehabilitory measures to prevent bone
loss or regain mild bone loss. Calcitonin (Miacalcin) inhibits
osteoclast activity, as does alendronate (Fosamax), which binds to
hydroxyapatite. Although osteoporosis is linked to estrogen loss,
estrogen therapy has been associated with many side eff ects,
including breast cancer, and is no longer recommended as a
treatment.
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Osteoporosis
Interactions Among Organ Systems and Osteoporosis
Representative Diseases and Disorders: Skeletal System
Representative Diseases and Disorders: Skeletal System
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THANK YOU!
• REFERENCES:
• Seeley’s Essentials of Anatomy and Physiology 10th Edition By Cinnamon
VanPutte and Jennifer Regan and Andrew Russo, 2019
• Seeley’s Laboratory Manual Essentials of Anatomy & Physiology 8th Edition By
Kevin Patton