Skeletal System provides rigid framework to support the soft tissues of the body.

It has a system of joints

and levers to allow the body to move. It consists of bones as well as their associated connective tissue which
includes cartilages, tendons and ligaments.
The term skeleton is derived from a Greek word meaning “dried”, but skeleton is far from being dried and
non-living, rather it has a dynamic living tissue that are able to grow, detect pain stimuli, adapt to stress, and
undergo repair after injury.
A joint or an articulation is a place where two bones come together. Many joint are movable, some only
allows limited movements, others have no apparent movements.

Physiology of the Skeletal System

Body Support come together, allow movement between

 Rigid, strong bone is well suited for
bearing weight and is the major
supporting tissue of the body. Cartilage
provides a firm yet flexible support
within certain structures, such as the
nose, external ear, thoracic cage, and
trachea. Ligaments are strong bands of
fibrous connective tissue that hold bones
together.
Organ Protection
 Bone is hard and protects the organs it
surrounds. For example, the skull encloses
and protects the brain, and the
vertebrae surround the spinal cord. The
rib cage protects the heart, lungs, and
other organs of the thorax.
Body Movement
 Skeletal muscles attach to bones by
tendons, which are strong bands of
connective tissue. Contraction of the
skeletal muscles moves the bones,
producing body movements. Joints, which
are formed where two or more bones
bones. Smooth cartilage covers the ends
of bones within some joints, allowing the
bones to move freely. Ligaments allow
some movement between bones but
prevent excessive movements.
Mineral Storage
 Some minerals in the blood are stored in
bone. If blood levels of these minerals
decrease, the minerals are released from
bone into the blood.
 The principal minerals stored are calcium
and phosphorus, two minerals essential
for many physiological processes. Adipose
tissue is also stored within bone cavities.
If needed, the lipids are released into the
blood and used by other tissues as a
source of energy.
Blood Cell Production
 Many bones contain cavities filled with
red bone marrow, which gives rise to
blood cells and platelets

MNEMONIC TO REMEMBER THE FUNCTIONS OF
THE SKELETAL SYSTEM
“SOME MEN PREFER MINI-SKIRTS BUT
CAN’T FINF ENOUGH SKIN”
 S – SUPPORT
 M – MOVEMENT
 P – PROTECTION
 M – MINERAL STORAGE
 B – BLOOD CELL PRODUCTION
 E – ENERGY STORAGE
Extracellular Matrix
 The matrix always contains collagen,
ground substance and other organic
molecules, as well as water and minerals.
 COLLAGEN: a tough, rope-like protein
 PROTEOGLYCANS: large molecules
consisting of many polysaccharides
attaching to and encircling core proteins;
can attract and retain large amount of
water between polysaccharides.
 The ECM of tendons and ligaments
contains a large amount of collagen fibers
making their structure tough.
 ECM of cartilage contains collagen and
proteoglycans.
 Collagen makes the cartilage
tough and proteoglycans make it
smooth and resilient.
 Cartilages are relatively rigid and
it springs back to its original form
after being bent or compressed.
 ECM contains collagen and minerals
(Calcium, Phosphate)
 Collagen fibers add flexible strength to
the bone.
 Minerals give the bone compression
strength.
 HYDROXYAPATITE: calcium phosphate
crystals found in bones.
 BRITTLE BONE DISEASE (OSTEOGENESIS
IMPERFECTA): a rare disorder caused by
a faulty genes that results in either too
little collagen or poor quality collagen
formation, the bone matrix decreases its
flexibility, and becomes more easily
broken down.
General Features of Bone
Classification of Bones
Long Bones
 Longer than they are wide.
 Enhances the function in appendages
movement.
 Have a shaft with enlarged ends
 Mostly compact bone, but also contains
spongy bone at the end
 Examples: Bones of the upper
and lower limbs.
Long bone: HUMERUS
Short Bones
 Wide as they are long
 Helps transfer force between long bones.
 Contain mostly of spongy bone with an
outer layer of compact bone
 Example: Bones of the wrist and
ankle.
SHORT bone: TALUS
  A long bone that is still growing has an
Flat Bones epiphyseal plate or growth plate that
consists of cartilage, between each
 Have relatively thin, flattened shape
diaphysis and epiphysis.
 Provide barrier around soft organs (brain
 As bones stopped growing, cartilages are
and heart)
replaced by bones and epiphyseal plate is
 Have two thin layer of compact bone
replaced by an epiphyseal line.
sandwiching a layer of spongy bone
 Bones contain a cavity called medullary
between them.
cavity in the diaphysis, as well as smaller
 Example: certain skull bones, the
cavities in the epiphysis.
ribs, scapulae, sternum
 These spaces are filled with soft tissues
called marrow.
 YELLOW MARROW: storage area for
adipose (fat) tissue.
 RED MARROW: consists of blood forming
FLAT bone: STERNUM cells and is only the site for blood
formation in adults. It is contained in the
spongy bone of the epiphysis.
 Children have more red marrows, as a
person ages, red marrow is being
replaced by a yellow marrow.
Irregular Bones
 Have specialized functions
 Providing protection while allowing bending
and flexing
 Has a spongy bone with an outer layer of
compact bone.
 Example: spine

Irregular bone: vertebra

Structure of a Long Bone

 Each long bone consist a central shaft
called diaphysis and two ends called
epiphysis.
 A thin layer of articular cartilage covers
the ends of the epiphysis where the
bone articulates (joins) with other bone.
  All terms beginning with T are
projections
 All terms beginning with F
(except facet) are depressions.
Bone Markings
Projections (Muscle and Ligament
Attachments)
NAME OF BONE MARKING DESCRIPTION
Large, rounded projection;
TUBEROSITY
may be roughened
Narrow ridge of bone, usually
CREST
prominent
Very large, blunt, irregularly
TROCHANTER
shaped process (femur)

Narrow ridge of bone; less

LINE
prominent than a crest
Small rounded projection or
TUBERCLE
process
Raised are on or above the
EPICONDYLE
condyle
Sharp, slender, often pointed
SPINE
projection
PROCESS Any bony prominence

 PERIOSTEUM: A dense connective tissue

that covers the outer surface of the
bone; consists of two layers and contains
blood vessels and nerves.
 ENDOSTEUM: A thinner connective tissue
membrane that lines the surface of the
medullary cavity.
 BONE MARKINGS: the surface of bones
are not smooth but scarred with bumps,
holes, and ridges; these bone marking
reveals the muscles, tendons, and
ligament that are attached; it determines
the passage of blood vessels and nerves.
 PROJECTIONS OR PROCESSES: grows out
from the bone surface.
 DEPRESSION: indentations in the bone
 Projections (helps to form joints)
NAME OF BONE MARKING DESCRIPTION
Bony expansion carried on
HEAD
a narrow neck
Smooth, nearly flat
FACET
articular surface
Rounded articular
CONDYLE
projection
RAMUS Armlike bar of bone

Histology of Bone
Depressions and Openings
 The periosteum and endosteum contains
For passage of blood vessels and nerves osteoblasts which functions in the
formation as well as repair and
NAME OF BONE MARKING DESCRIPTION
remodelling of bones.
GROOVE Furrow  OSTEOCYTES: osteoblasts that are
FISSURE Narrow, slitlike opening surrounded by matrix.
Round or oval opening  OSTEOCLASTS (BONE-DESTROYING
FORAMEN
through a bone CELLS): contributes to bone repair and
Indentation at the end of a
NOTCH remodelling by removing existing bones
structure called bone reabsorption.
OTHERS
 LAMELLAE: bones that are formed in
Cana or tunnel-like
MEATUS thin sheets of ECM; lacunae arranged in
passageway
concentric circular around central canals
Cavity within a bone, fil ed
(Haversian canals)
SINUS with air and lined with
 LACUNAE: osteocytes located between
mucous membrane
lamellae.
Shallow, basin-like
depression in a bone, often  OSTEON (HAVERSIAN SYSTEM): consisting
FOSSA of central canals and matrix rings;
serving as an articular
opening structural and functional unit of compact
bone.
 CANALICULI: tiny canals that radiate
outside the central canal to all lacunae;
forms a transport system that connects
all the bone cells to the nutrient supply
through the hard bone matrix.
  PERFORATING CANALS: Communication
pathways from outside of the bone to its
interior are completed by perforating
(Volkmann’s) canals, which run into the
compact bone at right angle to the shaft.
Spongy Bone
Major Types of Bone Tissues
Compact Bone
 Otherwise known as cortical bone.
 Forms the parameter of the diaphysis of
a long bone and the thinner surfaces of
all other bones.
 Has more matrix and is denser with
fewer pores.
 Has a predictable pattern of repeating
units (osteons)
 Each osteon consists of concentric
lamellae surrounding a central canal or
Haversian canal.
 Osteocytes are located in lacunae
between the lamellae of each osteon.
 Blood vessels that run parallel to the long
axis are located in the central canals.
 Osteocytes are connected to one another
by cell processes in canaliculi, it gives the
osteon the appearance of having tiny
cracks within the lamaellae.
 Nutrients leave the blood vessels of the
central canal and diffuse to the
osteocytes in canaliculi.
 Waste products diffuse in different
directions.
 Blood vessels of central canal are
connected to the blood vessel in the
periosteum and endosteum.
 Porous and located in the epiphysis of the
long bone and lines the medullary cavity.
 Has less bone matrix and are more open
spaces.
 TRABECULAE: delicate interconnecting
rods or plates of bone.
 add strength to the bone
without the added weight that
would be present if the bone is
solid mineralized matrix.
 The spaces between the trabeculae are
filled with marrow.
 Each trabeculae has lamellae with
osteocytes between them.
 No blood vessels penetrate the
trabeculae and has no central canal.
 Nutrients exit vessels in the marrow by
diffusion through canaliculi to the
osteocytes of the trabeculae.
Bone Ossification
 Formation of bones by osteocytes
 After an osteoblast becomes completely
surrounded by bone matrix it becomes a
mature bone cells or osteocytes.
 In fetus, bone develop by two processes:
 Bone formation within the
connective tissue
(Intramembranous Ossification)
  Bone formation that occurs in
the Hyaline cartilage
(Endochondral Ossification)
Intramembranous Ossification
 Occurs when the osteoblasts began to
produce bone within the connective
tissue membrane.
 Primarily occurs in the bone of the skull.
 Osteoblasts line up to the surface of
connective tissues fiber and begin
depositing bone matrix to form
trabeculae.
 It begins on the area called ossification
center, and the trabeculae radiates out
from the centers.
 Two or more ossification centers exists
in each flat bones.
Endochondral Ossification
 This process develops the bone of the
base of the skull, and most remaining
skeletal system.
1. Chondrocytes (cartilage cells)
increase in number causing the
cartilage model to increase in size.
2. Chondrocytes in the center of
the model absorb some of the
cartilage matrix and enlarge.
3. Chondrocytes release matrix
vesicles which initiates the
formation of hydroxyapatite
crystals. This causes the cartilage
matrix to become calcified.
4. Blood vessels accumulate in the
perichodrium
 The presence of blood vessels in the
outer surface of the future bone causes
some of the connective tissue cells to
differentiate into osteoblasts.
 Osteoblasts produce a collar of bone
around part of the surface of the
diaphysis.
 The perichondrium becomes periosteum in
that area.
 Blood vessels grow into the center of the
diaphysis, bringing in osteoblasts and
stimulating ossification.
 PRIMARY OSSIFICATION CENTER: center
part of the diaphysis where bone first to
appear.
 Osteoblast invades the spaces in the
center of the bone left by the dying
cartilage cells.
 Calcified cartilage matrix is removed by
osteoclasts and the osteoblasts line up on
the remaining calcified matrix and begin to
form trabeculae.
 Medullary cavity forms in the center of
the diaphysis as osteoclasts remove
bones and calcified cartilage are replaced
by bone marrow.
 Secondary Ossification Center forms the
diaphysis.
Bone Growth
 Occurs by the deposition of new bone
lamellae into existing bone and other
connective tissues
 Appositional Growth: the depositing of a
new bone matrix on the surface of
bones between the periosteum and the
existing bone matrix by the osteoblasts
thereby increasing its width.
 Growth in bone length results in height
increase.
 Chondrocytes increases in number in
epiphyseal side of the epiphysial plate.
 It lines up in columns parallel to the long
axis causing bone to elongate. Then,
chondrocytes enlarge and die.
 The cartilage matrix becomes calcified.
 Cartilages that forms around the
enlarged cells are removed by osteoclasts
and the dying chodrocytes are replaced
by osteoblasts.
 Osteoblast start forming bone by
depositing bone lamellae on the surface
of the calcified cartilage.
 This process produces bone on the
diaphyseal side.
Bone Remodelling
 The removal of existing bone by
osteoclasts and the deposition of new
bone by osteoblasts.
 Responsible for changes in bone shape,
adjustment of bone to stress, bone
repair and calcium ion regulation.
 Involved in bone growth when newly
formed spongy bone in the epiphyseal
plate forms compacy bone.
 Long bone increases in length and
diameter as new bone is deposited on the
outer surface and growth occurs in the
epiphyseal plate.
 At the same time, bone is removed from
the inner medullary cavity.
 Bone diameter increases -
thickness of the compact bone
relative to the medullary cavity
remain fairly constant.
 Bone size increases - medullary
cavity did not increase - the
component of the diaphysis
would become thick and heavy.
 Important to maintain blood calcium level
within normal range.
 Ca2+ is removed from bones when blood
Ca2+ levels decreases and it is deposited
when dietary Ca2+ is adequate.
 Too much deposited - bone
thickness; development of
abnormal spurs or projections.
 Too little bone formation/removal
- osteoporosis; weakened bones
and it makes them susceptible to
fracture.
Bone Repair
 Bones is sometimes fractured and needs
to be repaired.
 The blood vessel bleed and form a
hematoma (clot) in the damaged area.
 2-3 DAYS AFTER INJURY:
 Blood vessels begin to invade the
clot
 Cells produce are fibrous
connective tissue that holds the
bone fragments together and fill
the gap between them.
 Others form callus (network of
fibers and islets of cartilage
between two bone fragments)
 4-6 WEEKS AFTER INJURY:
 Spongy bone formation
(osteoblasts enters the callus and
begin forming the spongy bone)
 Immobilization is still crucial
because movement can
refracture the new matrix.
 The spongy bone is slowly
remodelled to form compact
bone and spongy bone and the
repair is complete.
Classification of Bone Fractures
Severity of Injury
Open Fracture
 Occurs when an open wound extends to
the site of the fracture or when a
fragment of bone protrudes through skin.
Closed Fracture
 Skin is not perforated
Complicated Fracture
 Soft tissues around a closed Fracture are
damaged
Incomplete Fracture
 Does not extend completely across a
bone
Complete Fracture
  Bone is broken into at least two
fragments
Greenstick Fracture
 Incomplete fracture on the convex side
of the curve of the bone
Hairline Fracture
 Incomplete fracture in which two
sections of the bone do not separate;
usually happens in the skull
Comminuted Fracture
 Complete Fracture in which the bone
breaks into more than two fragments
Impacted Fracture
 One fragment is driven into the spongy
portion of the other fragment.
Classification According to
Direction
Linear Fracture
 Run parallel to the length of the bone
Transverse Fracture
 At right angles to the length of the bone
Spiral Fracture
 Make a helical structure around the bone
Oblique Fracture
 Run obliquely in relative to the length of
the bone
Dentate Fracture
 Have rough, toothed ends
Stellate Fracture
 Have a breaking line radiating from the
central point
Bone and Calcium
Homeostasis
 Bone is the major storage site of calcium
in the body.
 Calcium movement into and out of the
body helps to determine the blood calcium
levels.
 Ca2+ moves into bone as osteoblast make
new one and out of the bone as
osteoclasts break down bones
 Blood calcium decreases, osteoclasts
activity increases, therefore, osteoclast
release calcium from bones to the blood.
 Blood calcium increases, osteoclasts
activity decreases, blood calcium level
decreases, therefore the osteoblasts
remove calcium from blood to produce a
new one.
 Calcium homeostasis is maintained by
three hormones:
 Parathyroid Hormone (PTH) from
the parathyroid gland
 Vitamin D from skin or diet
 Calcitonin from thyroid gland
 Blood calcium is too low, PTH and Vit. D is
secreted
 Blood calcium is high, Calcitonin is secreted
 PTH works through three simultaneous
mechanism to increase blood calcium
levels
 PTH indirectly stimulates
osteoclasts to break down bone
and release stored calcium into
the blood.
 PTH stimulates the kidney to take
up calcium from urine and return
it to the blood.
 PTH stimulates the active Vitamin
D formation that promotes
increase in calcium absorption
from the small intestine.
 PTH and Vitamin D causes blood level to
incerase, thereby maintaining
homeostasis.
 Calcitonin causes to decrease blood General Considerations of Bone
calcium level by inhibiting osteoclast
activity. Anatomy

Pathology: Osteomyelitis Anatomical Terms for Bone

 A bacterial infection in the bone caused Features
by the aggressive pathogen
TERM DESCRIPTION
Staphylococcus Aureus. MAJOR FEATURES
 This bacterium is found in skin but can BODY, SHAFT Main portion
enter the bone in three major ways: HEAD Enlarged (often rounded) end
 Spreads through bloodstream Constricted area between
NECK
from another infected location head and body
e.g. abscerred tooth Smooth, rounded articular
CONDYLE
 Penetrates the bone through an surface
open wound Small, flattened circular
FACET
 Introduced into a joint or bone surface
CREST Prominent ridge
during surgery
PROCESS Prominent projection
 Osteoblasts are copted to overactivate TUBERCLE OR
osteoclasts. Knob or enlargement
TUBEROSITY
 The bacteria has cell wall that contains Large tuberosity found only on
cell merkers that alter signalling dynamics. TROCHANTER
proximal femur
 Production of osteoclasts increases, but Enlargement near or above a
EPICONDYLE
osteoblasts decreases. condyle
 Common Treatment: OPENINGS OR DEPRESSIONS
 4-8 weeks antibiotics FORAMEN Hole
 IV dosing with antibiotics, thus CANAL, MEATUS Tunnel
FISSURE Cleft
patients are often fitted with a
SINUS Cavity
peripherally inserted central
FOSSA Depression
catheter (PICC) line
 Debridement (removal of infected  Adult skeleton has an average of 206
tissues) bones.
● The number varies from person to
person and decreases with age as some
bones fuse.
● The skeleton is divided into axial and
appendicular portions.