servical, lumbar, thoracic

V - Skeletal System ○ vertebral column - 26 bones

including coccyx and sacrum
The Skeletal System ○ thoracic cage - 12 pairs of ribs
● composed of bones and cartilage and 1 sternum
● bones - “osseous tissue” ○ ear ossicles (6) - 3 each ear
○ hard, dense connective
tissue that forms most of
the adult skeleton
● cartilage
○ semi-rigid form of
connective tissue
○ flexibility and smooth
surface for movement
usually found within joints

Functions of the Skeletal System

1. Support - bones provides a framework
that supports and anchors all organs
(e.g. pelvic girdle) for upper extremities
2. Movement - levers for muscle
3. Protection - protects soft organs (e.g.
rib cage & skull) for heart, lungs, brain
4. Blood cell production - hematopoiesis lateral of
B. Appendicular Skeleton axial skeleton
5. Storage - calcium, phosphorus, fats
● upper and lower limbs plus the
marrow
bones that attach each limb to the
Composition of the Bone
axial skeleton
Component (% by Composition ● consists of 126 bones
weight) ○ shoulder girdle (4) - left and
right clavicle (2), scapula (2)
Organic (30%) Cells (~2%)
Type I collagen has
○ arms and forearms (6) -
thumb pinky

(~93%) 4 ypes
+
humerus (2), ulna (2), radius (2)
wrist

Ground substance ○ hands (54) - carpals LR (16),

(~5%) metacarpals (10), proximal
phalanges (10), intermediate
Inorganic (70%) Ca2+ and (PO4)3-
phalanges (8), distal phalanges
crystals calcium t
phosphate (10)
○ pelvis (2)
Divisions of the Skeletal System ○ thighs and legs (8) - femur (2),
A. Axial Skeleton patella (2), tibia (2), fibula (2)
● midline ankle

○ feet and ankles (52) - tarsals LR

● consists of 80 bones: (14), metatarsals (10), proximal
○ skull - 22 bones (8 cranial, 14 phalanges (10), intermediate
facial) phalanges (8), distal phalanges
○ 1 hyoid bone (10)

Total # of bones:206
 2. Short bones
● cube shaped (equal in length,
width, and thickness)
● stability and support and some
limited motion
● carpals & tarsals
ankle

wrist

3. Flat bones
● thin, flat, and curved
● two thin layers of compact bone
sandwiching spongy bone
● cranial (skull) bones, scapulas,
sternum, and ribs

Common Bones in the Body

1. Long bones
● cylindrical; longer than wide
● has shaft and heads (both ends)
● mostly compact
● all bone of the limbs except wrist
and ankle bones
● function as levers and move when
muscle contract 4. Irregular bones
● have complex shapes
thumb
● vertebra, hip bones, and many
facial bones (sinuses)

digits
5. Sesamoid bones 4. Medullary Cavity
● small, round bone ● storage area for adipose tissue
● shaped like a sesame seed ● yellow marrow
● forms in the tendons - protects the
tendons by helping them overcome 5. Endosteum
compressive forces ● membranous lining of medullary
● vary in number and placement cavity
● found in tendons associated with ● bone growth, repair, and
the feet, hand, and knees remodelling
● patella - sesamoid bone common
with every person 6. Periosteum
● outer surface of the bone except
epiphysis
● contains blood vessels, nerves, and
knee cap
lymphatic vessels that nourish the
compact bone

thicker
thin

Anatomy of a Long Bone

1. Diaphysis
● compact bone, makes up most of
the length of the bone
● covered by periosteum
● secured by CT fibers called
Sharpey’s fibers

2. Epiphysis
● end of long bones
● consists of mainly of spongy bone
covered with a thin layer of
compact bone Types of Osseous Tissues
● covered by articular cartilage 1. Compact bone
● dense, smooth, and homogenous
3. Metaphysis growth plate ● diaphysis yellow marrow
● epiphyseal plate, flat plate of
hyaline cartilage, responsible for 2. Spongy bone
the lengthwise growth of bones, ● small needle pieces
● replaced by bone by the end of ● lots of open spaces
puberty ● epiphysis
red marrow

Type of Bone Marrow
1. Yellow marrow
● contains adipose tissue
● triglycerides stored in the
adipocytes of the tissue
● can serve as source of energy
2. Red marrow
● hematopoiesis - production of
blood cells (RBC, WBC, and
platelets)
Bone Development
1. Osteoprogenitor cells
● unspecialized cells in the inner part
of the periosteum, endosteum,
central canal of compact bone
2. Osteoblasts
● bone forming cells
● secreting the matrix characteristic
of the bone
3. Osteocytes
● mature bone cells
● osteoblasts surrounded by matrix
4. Osteoclasts "Kalas-Kalas"
● perform bone resorption
● break down bone and assist in
depositing Ca and PO4 in the
blood
● important to the growth and repair
of bone
Two Types of Bone Development
1. Intramembranous Ossification
● compact and spongy bone
develops directly from sheets of
mesenchymal (undifferentiated) CT.
● e.g. flat bones of the face, most of
the cranial bones, clavicles (collar
bones)
 ● cartilages serves as a template to
be completely replaced by new
bone
● e.g. long bones

● begins in utero during fetal

development and continues on into
adolescence
● at birth, the skull and clavicles are
not fully ossified nor are the sutures
of the skull closed *fontanelle bunbunan
=

● this allows the skull and shoulders

to deform during passage through
the birth canal
● the last bone to ossify via
intramembranous ossification are
the flat bones of the face, which
reach their adult size at the end of
the adolescent growth spurt Ossification Timetable

Age Occurrence

third month of ossification in long

prenatal bones is beginning
development

fourth month most primary

ossification centers
have appeared in the
diaphyses of bones
2. Endochondral Ossification birth to 5 secondary ossification
● bone develops by replacing hyaline years centers appear in the
cartilage epiphyses
● cartilage does not become bone
primary:diaphysis
secondary:epiphysis
 bone
kapagtapos
* na ossification, tapos no and
development. nag go-grow lang because of muscle
growth
● this determines where bone matrix
5 to 12 years ossification spreads
in female, or 5 rapidly from the to be lay down or formed
to 14 years in ossification centers,
males and various bones are Modeling
becoming ossified ● process in which matrix is resorbed
on one surface of a bone and
17 to 20 years bones of the upper
deposited on another
limbs and scapulae
become completely ● primarily takes place during bone
ossified growth

18 to 23 years bones of the lower Remodeling

limbs and coxal bones ● happens during adult life
become completely
● resorption of old or damaged bone
ossified
takes place on the same surface
23 to 25 years bones of the sternum, where osteoblasts lay new bones
clavicles, and vertebrae to replace that which is resorbed
become completely ● injury, exercises, and other
ossified activities
by 25 years nearly all bones are
completely ossified Causes of Bone Remodeling
a. Mechanical stress - low bone
stress = low bone mass
What do you call the type of bone cell
b. Microdamage - micro-fissure &
that is responsible for bone resorption?
microscopic cracks -> fracture ->
OSTEOCLAST
remodeling
c. Hormones - PTH (parathyroid) &
Failure of what type of bone
calcitonin (thyroid) & vitamin D ->
development?
balance bone resorption &
ENDOCHONDRAL OSSIFICATION
for achondroplasia failure of
deposition; bone reservoirs of Ca2+
long bones to & (PO4)3-
Bone Remodeling develop
hyperthyroidism
* -
can cause premature
● bone formation and bone Osteoporosis
resorption
● response to certain changes in the
body

Two factors of Bone Remodeling

1. Calcium levels in the blood
● PTH determines when bone is to be
Joints and Articulations
broken down or formed in response
Functional Classification of Joints
to calcium levels
1. Synarthrosis (fibrous joints)
parathyroid hormone
● immobile or nearly immobile joint
2. Pull of gravity and muscles on the
skeleton
weak bones
>
sedentary person:
 ● important locations where the Synovial Joints (Diarthrosis)
bones provide protection for Components
internal organs 1. joint capsule
● e.g. coronal suture, lambdoid ● seals the joint space and provides
suture, manubriosternal joint stability by restricting the range of
possible movements
2. Amphiarthrosis (Cartilaginous joints)
● has limited mobility 2. cartilage
● e.g. joints connecting rib and ● lines the bone surface to facilitate
sternum (costal cartilage), pubic smoother movement, as well as
symphysis (pubic bones), absorbing shock and distributing
intervertebral disc (bodies of load
adjacent vertebrae)
3. synovial fluid
3. Diarthrosis (synovial joints) ● provides oxygen and nutrition to
● freely mobile joint the cartilage
● mostly found in the appendicular ● lubrication (reduces friction)
skeleton (giving limbs wide range of
motion) Stabilization of joint
● bones do not come in contact with 1. joint capsule which is a sleeve like
each other extension of the periosteum of
● e.g. knee joint each articulating bone
2. ligaments - composed of dense
siS
regular connective tissue binding 2
synartho bones BBL
3. tendons - cords of dense
fibroconnective tissues that
sutures
·
of the skull connect muscle to bone MBT
.

pubic symphysis
Types of Synovial Joint
medial/ lateral
Type of Movement rotation
Joint movement

pivot joint uniaxial pronation and

Elbow joint - HINGE JOINT
radius -
In a supination,
a 19s -axis
rotational
+

movement

hinge joint uniaxial flexion and

elbow joint, knee, ankle,
interphalangeal joints of extension
finger and to es

condyloid biaxial flexion/

joint extension
knuckle, outwards
radio carp al abduction/
joint of the
adduction,
wrist towards

circumduction

saddle biaxial flexion/

joint extension
Radio-ulnar Joint - PIVOT JOINT
abduction/
adduction

circumduction
towards
plane joint multiaxial inversion/ the inside
(gliding eversion
towards the
joint) outside

flexion/
extension
Bone Fracture and Repair
lateral flexion
of vertebral
column
I
At

sliding =

movement -
I
He

ball-and-s multiaxial flexion/

->
⑧y
Socket joint extension

abduction/
adduction Types of Bone Fractures
1. Transverse - straight across the
circumduction long axis of the bone entire width
2. Oblique - at an angle (not 90)
 3. Spiral - bone segments are pulled
apart (twisting motion)
4. Comminuted - several breaks
result into small pieces between
two large segments i pira-piraso
5. Impacted - one fragment is driven
to the other, compression idurog
6. Greenstick - partial fracture ; one side
7. Open (or compound) - tears only
through the skin; carries a high risk
of infection
8. Closed (or simple) - skin remains
intact
2. Fibrocartilaginous callus
● 3 weeks
● tissue repair begins and
fibrocartilage fills the spaces
between the ends of the broken
bone
3. Bony callus
● 3-4 months
● osteoblasts produce trabeculae of
spongy bone & convert the
fibrocartilaginous callus to a bony
callus that joins broken bones

4. Remodeling
● osteoblasts build new compact
bone at the periphery, and
osteoclasts resorb the spongy
bone, creating new medullary
cavity

A - Transverse
B - Oblique
C - Spiral
D - Segmental
E - Comminuted
F - Greenstick
G - Compression
H - Avulsion
I - Stress
J - Pathological

Bone Repair
"Pasa"
1. Hematoma
● 6-8 hrs of fracture
for
* bone remodelling of astronauts:
● blood escapes from ruptured blood
ADVANCED RESISTIVE
EXERCISEDEVICE
vessels & forms a mass of clotted
blood between spaces of broken
bones
Bone Nutrition
Calcium
E
● critical component of the bone à
calcium phosphate and calcium
carbonate
● not readily available in our body;
should be obtained from the diet
● milk, dairy products, green leafy
vegetables, broccoli, intact salmon,
sardines with their soft bones, nut,
beans, seeds, and shellfish
● it cannot be absorbed from the
small intestine without Vit D
Vitamin D
● not found naturally in many foods
● through the action of sunlight on
the skin that triggers the body to
produce Vit. D
● in cases of deficiency -> Vit. D
supplement
Vitamin K
● has synergistic role with Vit D in the
regulation of bone growth (green
leafy vegetable)
Magnesium
● mostly found in the skeleton and
plays a role in the structure of the
bone
Fluoride
● displaces the hydroxyl group in
bone’s hydroxyapatite crystals à
fluorapatite which stabilize and
strengthen bone mineral
Omega-3 fatty acids
● helps reduce inflammation and
helps enhance production of new
osseous tissue
Hormonal Influences on the Skeletal
System
1. Growth Hormone (somatotropin)
● composed of 191 amino acids
secreted by the anterior pituitary
gland
● secreted in a rhythmic fashion with
a dominant 2-hr periodicity
● highest levels of growth hormone
are achieved during sleep
● no direct effect on cartilage and
bone growth
● GH stimulate the production of
small proteins in the liver called
insulin-like growth factor or IGF
(formerly called somatomedins)
● IGF may also be produced locally
in mesodermal and ectodermal
cells and growth plate of children
Functions of IGF in bone growth
1. act on cartilage and bone to
promote growth
2. IGF is required for deposition of
collagen and ground substance of
the extracellular matrix
2. Testosterone and Estrogen
● asteroid compound synthesized
from cholesterol or acetylCoA
● testosterone is produced in the
Leydig’s Cells of the testes while
estrogen is produced in the ovaries
Functions in bone growth
1. increase in size and strength of the
bone through:
a. increased total quantity of
bone matrix secondary to
the general protein
anabolic function of
testosterone
b. calcium retention since
more bone matrix is
available for calcification
When increased quantities
of testosterone is secreted
in a growing child, the rate
of bone growth increases
markedly
2. causes epiphyses of long bones to
unite with the shaft at an early age
epiphyseal closure effect stronger
in the female à growth of the
female ceases earlier
3. Thyroxine calcitonin
● secreted by the thyroid gland
● promotes osteoblastic activity and
the synthesis of the bone matrix
rate and strength of contraction,
blood coagulation, contraction of
smooth and skeletal muscle cells,
and regulation of nerve impulse
conduction
● normal level : 10mg/dL
● Hypocalcemia – abnormally low
levels of calcium (can have an
adverse effects on diff body
systems including circulation,
muscles, nerves, and bone) à
difficulty in coagulation, skipped
heartbeat or even stopped,
difficulty in muscle contraction,
problem with nerve impulse
conduction, bones may become
brittle. Causes can be hormonal
imbalance or improper diet
● Hypercalcemia – abnormally high
levels of calcium à nervous system
is underactive à lethargy, sluggish
reflexes, constipation, loss of
appetite, confusion, or even coma.

4. PTH
● composed of 84 amino acids
secreted by the parathyroid gland
● primarily responsible for the control
of calcium concentration
● increases plasma calcium
concentration through absorption
of calcium from the bones and
increase absorption of calcium 0
D

from the intestinal tract by

activating Vit D in the kidneys

Roles of Bones in Calcium Regulation

● most abundant mineral in the bone
and in the human body
● needed in : bone mineralization
including teeth, regulation of heart
Effects of Aging
● chemical nature of cartilage ->
changes
● bluish color of typical cartilage ->
opaque, yellowish
● cartilage calcifies -> chondrocytes
die -> resorption -> hard, brittle
● calcification interferes with the
ready diffusion of nutrients and
waste products through the matrix
● articular cartilage may no longer
function properly -> arthritis
Common Bone Disorders
1. Osteoporosis
● most common of all bone disease
in adults, especially in old age
● results from diminished organic
bone matrix due to decreased
osteoblastic activity and
consequently decreased rate of
bone osteoid deposition
● trabecular (spongy bone) loses
mass & interconnections despite
normal bone mineralization &
serum Ca2+ & (PO4)3-
● histologically: reduction in the
thickness of compact bone and the
number and size of trabeculae in
the cancellous bone
● overall prevalence of osteoporosis
in adult Filipinos 60 to 69 years of
age was 0.8% while those older
than 70 years old was 2.5%
● overall prevalence of fractures was
11.3% in females and 9.0% in
males.
Causes of Osteoporosis
1. inactivity
2. malnutrition
3. postmenopausal lack of sex
hormones
4. old age
5. Cushing’s Syndrome
Presentation of Osteoporosis
● acute back pain secondary to
vertebral crush or fracture
● hip bone fracture
● loss of height or kyphosis
● women are more likely to suffer
fracture than men
Diagnosis
● Bone Mineral Density Test or DXA
Scan with a T-score of -2.5
 ● osteoblast try to compensate but
the new bone formed is weak and
brittle à prone to fracture

Risk factors
1. increased age
2. family history
3. previous bone fracture (>50y.o)
Presentation
4. medications
● asymptomatic, others experience
5. decrease sex hormones
pain, bone fractures, and bone
deformities
Prevention
● commonly affected bones: pelvis,
1. calcium supplement ↑stress
skull, spine, and legs
2. vitamin D supplement ↓ remodelling

3. high intensity resistance exercise

Diagnosis
4. weight bearing exercise
● x-rays
5. moderate levels of walking
● bone scans
6. stop smoking and limit alcohol
consumption
Management
7. natural food supplements ->
● bisphosphonates -> decreases the
isoflavones
activity of osteoclasts
Management
3. Achondroplasia
1. calcium + vitamin D
● common cause dwarfism
2. bisphosphonates, calcitonin,
● short limbs: failure of the
hormonal replacement therapy, longitudinal bone growth
selective estrogen receptor (endochondral ossification)
modulator (SERM) ● large head relative to limbs:
Membranous ossification not
affected
2. Paget’s Disease ● inhibition of chondrocyte
● disorder of the bone remodeling proliferation
● associated with advanced paternal
process that begins with overactive
age
osteoclasts ● autosomal dominant inheritance
● more bone is resorbed than is ● normal lifespan & fertility
formed -mental ability is notdelayed
head
* circumference should be

normal, if not, hydrocephalus

a cerebrospinal fluid
in the head
 2. Rheumatoid arthritis - synovial
membrane becomes inflamed and
same size
grows thicker cartilage due to an
ofthe head
autoimmune reaction
3. Gouty Arthritis - excessive build-up
of uric acid (metabolic waste) in the
blood, instead of being excreted in
urine, the acid is deposited as
crystals in joints -> inflammation
and pain

4. Arthritis
● disease that affects the joints;
involves inflammation or
degeneration of the joints

Presentation
● joint pain
● swelling
● stiffness
● reduced mobility

Three common Types of arthritis

1. Osteoarthritis - associated with
deterioration of the articular
cartilage
 no, kasi tapos no and bone ossification

yes, sedentary people have weaker bones

Yes. Vit.D!!