SKELETAL SYSTEM: BONE TISSUE
It
Introduction
1. A bone is made up of several different tissues:
bone or osseous tissue, cartilage,
dense connective tissue, epithelium, adipose tissue,
and nervous tissue.
2. The entire framework of bones and their
cartilages constitutes the skeletal
system.
6.1 Functions of Bone and the Skeletal
System
1. The skeletal system functions in support,
protection, movement, mineral
homeostasis, blood cell production, and
triglyceride storage.
6.2 Structure of Bone
1. Parts of a typical long bone are the diaphysis
(shaft ), proximal and distal
epiphyses (ends), metaphyses, articular cartilage,
periosteum, medullary
(marrow) cavity, and endosteum.
6.3 Histology of Bone Tissue
1. Bone tissue consists of widely separated cells
surrounded by large amounts
of extracellular matrix.
2. The four principal types of cells in bone tissue
are osteoprogenitor cells, osteoblasts (bone-
building cells), osteocytes (maintain daily activity
of bone), and osteoclasts (bone-destroying cells).
3. The extracellular matrix of bone contains
abundant mineral salts (mostly
hydroxyapatite) and collagen fibers.
4. Compact bone tissue consists of osteons
(haversian systems) with little space between
them.
5. Compact bone tissue lies over spongy bone
tissue in the epiphyses and
makes up most of the bone tissue of the diaphysis.
Functionally, compact bone
tissue is the strongest form of bone and protects,
supports, and resists stress.
6. Spongy bone tissue does not contain osteons.
consists of trabeculae surrounding many red bone
marrow–filled spaces.
7. Spongy bone tissue forms most of the structure
of short, flat, and irregular bones, and the interior
of the epiphyses in long bones. Functionally,
spongy bone tissue trabeculae off er resistance
along lines of stress, support and protect
red bone marrow, and make bones lighter for
easier movement.
6.4 Blood and Nerve Supply of Bone
1. Long bones are supplied by periosteal, nutrient,
metaphyseal, and epiphyseal arteries; veins
accompany the arteries.
2. Nerves accompany blood vessels in bone; the
periosteum is rich in sensory neurons.
6.5 Bone Formation
1. The process by which bone forms, called
ossification, occurs in four principal
situations:
(1) the initial formation of bones in an embryo and
fetus;
(2) the growth of bones during infancy, childhood,
and adolescence until their adult sizes are reached;
(3) the remodeling of bone (replacement of old
bone by new bone tissue throughout life); and
(4) the repair of fractures (breaks in bones)
throughout life.
2. Bone development begins during the sixth or
seventh week of embryonic development. The two
types of ossification, intramembranous and
endochondral, involve the replacement of a
preexisting connective tissue with
bone. Intramembranous ossification refers to bone
formation directly within mesenchyme arranged in
sheetlike layers that resemble membranes.
Endochondral ossification refers to bone formation
within hyaline cartilage that develops from
mesenchyme. The primary ossification center of a
long bone is in the diaphysis. Cartilage
degenerates, leaving cavities that merge to form
the medullary cavity. Osteoblasts lay down bone.
Next, ossification occurs in the epiphyses, where
bone replaces cartilage, except for the epiphyseal
(growth) plate.
3. The epiphyseal plate consists of four zones:
zone of resting cartilage, zone
of proliferating cartilage, zone of hypertrophic
cartilage, and zone of calcified
cartilage. Because of the cell division in the
epiphyseal (growth) plate, the diaphysis
of a bone increases in length.
4. Bone grows in thickness or diameter due to the
addition of new bone tissue by
periosteal osteoblasts around the outer surface of
the bone (appositional growth).
5. Bone remodeling is an ongoing process in
which osteoclasts carve out small tunnels in old
bone tissue and then osteoblasts rebuild it.
6. In bone resorption, osteoclasts release enzymes
and acids that degrade collagen fibers and dissolve
mineral salts.
7. Dietary minerals (especially calcium and
phosphorus) and vitamins (A, C,
D, K, and B12) are needed for bone growth and
maintenance. Insulin-like
growth factors (IGFs), growth hormone, thyroid
hormones, and insulin stimulate
bone growth.
8. Sex hormones slow resorption of old bone and
promote new bone deposition.
6.6 Fracture and Repair of Bone
1. A fracture is any break in a bone. Types of
fractures include closed (simple),
open (compound), comminuted, greenstick,
impacted, stress, Pott, and Colles.
2. Fracture repair involves formation of a fracture
hematoma during the reactive
phase, fibrocartilaginous callus and bony callus
formation during the
reparative phase, and a bone remodeling phase.
6.7 Bone’s Role in Calcium Homeostasis
1. Bone is the major reservoir for calcium in the
body.
2. Parathyroid hormone (PTH) secreted by the
parathyroid glands increases
blood Ca2+ level. Calcitonin (CT) from the thyroid
gland has the potential to
decrease blood Ca2+ level. Vitamin D enhances
absorption of calcium and
phosphate and thus raises the blood levels of these
substances.
6.8 Exercise and Bone Tissue
1. Mechanical stress increases bone strength by
increasing deposition of mineral
salts and production of collagen fibers.
2. Removal of mechanical stress weakens bone
through demineralization and
collagen fiber reduction.
6.9 Aging and Bone Tissue
1. The principal eff ect of aging is
demineralization, a loss of calcium from
bones, which is due to reduced osteoblast activity.
2. Another eff ect is decreased production of
extracellular matrix proteins
(mostly collagen fibers), which makes bones more
brittle and thus more susceptible
to fracture.
THE AXIAL SKELETON
Introduction
1. Bones protect soft body parts and make
movement possible; they also
serve as landmarks for locating parts of other body
systems.
2. The musculoskeletal system is composed of the
bones, joints, and muscles
working together.
7.1 Divisions of the Skeletal System (see
Table 7.1)
1. The axial skeleton consists of bones arranged
along the longitudinal axis. The parts of the axial
skeleton are the skull, auditory ossicles (ear
bones), hyoid bone, vertebral column, sternum,
and ribs.
2. The appendicular skeleton consists of the bones
of the girdles and the upper
and lower limbs (extremities). The parts of the
appendicular skeleton are the
pectoral (shoulder) girdles, bones of the upper
limbs, pelvic (hip) girdles, and
bones of the lower limbs.
7.2 Types of Bones
1. On the basis of shape, bones are classified as
long, short, flat, irregular, or sesamoid. Sesamoid
bones develop in tendons or ligaments.
2. Sutural bones are found within the sutures of
some cranial bones.
7.3 Bone Surface Markings
1. Surface markings are structural features visible
on the surfaces of bones.
2. Each marking—whether a depression, an
opening, or a process—is
structured for a specific function, such as joint
formation, muscle attachment,
or passage of nerves and blood vessels (see Table
7.2).
7.4 Skull: An Overview
1. The 22 bones of the skull include cranial bones
and facial bones.
2. The eight cranial bones are the frontal, parietal
(2), temporal (2), occipital,
sphenoid, and ethmoid.
3. The 14 facial bones are the nasal (2), maxillae
(2), zygomatic (2), lacrimal (2),
palatine (2), inferior nasal conchae (2), vomer, and
mandible.
7.5 Cranial Bones
1. The frontal bone forms the forehead (the
anterior part of the cranium).
2. The frontal bone also forms the roofs of the
orbits and most of the anterior
part of the cranial floor.
3. The parietal bones form the greater portion of
the sides of the cranial cavity.
4. The parietal bones also form most of the roof of
the cranial cavity.
5. The temporal bones form the inferior lateral
aspects of the cranium.
6. The temporal bones also form part of the
cranial floor.
7. The occipital bone forms the posterior part of
the cranium.
8. The occipital bone also forms of the base of the
cranium.
9. The sphenoid bone lies at the middle part of the
base of the skull.
10. The sphenoid bone is known as the keystone
of the cranial floor because it articulates with all
the other cranial bones, holding them together.
11. The ethmoid bone is located in the anterior
part of the cranial floor medial
to the orbits.
12. The ethmoid bone is anterior to the sphenoid
and posterior to the nasal bones.
7.6 Facial Bones
1. The nasal bones from the bridge of the nose.
2. The lacrimal bones are posterior and lateral to
the nasal bones and form a part of the medial wall
of each orbit.
3. The palatine bones form the posterior portion of
hard palate, part of the floor and lateral wall of the
nasal cavity, and a small portion of the floors of
the orbits.
4. The inferior nasal conchae form a part of the
inferior lateral wall of the nasal cavity and project
into the nasal cavity.
5. The vomer forms the inferior portion of the
nasal septum.
6. The maxillae form the upper jawbone.
7. The zygomatic bones (cheekbones) form the
prominences of the cheeks
and part of the lateral wall and floor of each orbit.
8. The mandible is the lower jawbone, the largest
and strongest facial bone.
7.7 Special Features of the Skull
1. The nasal septum consists of the vomer,
perpendicular plate of the ethmoid,
and septal cartilage. The nasal septum divides the
nasal cavity into left and right sides.
2. Seven skull bones form each of the orbits (eye
sockets).
3. The foramina of the skull bones provide
passages for nerves and blood vessels.
4. Sutures are immovable joints that connect most
bones of the skull. Examples are the coronal,
sagittal, lambdoid, and squamous sutures.
5. Paranasal sinuses are cavities in bones of the
skull that are connected to the nasal cavity. The
frontal, sphenoid, and ethmoid bones and the
maxillae contain paranasal sinuses.
6. Fontanels are mesenchyme-filled spaces
between the cranial bones of fetuses and infants.
The major fontanels are the anterior, posterior,
anterolaterals (2), and posterolaterals (2). After
birth, the fontanels fill in with
bone and become sutures.
7.8 Hyoid Bone
1. The hyoid bone is a U-shaped bone that does
not articulate with any other bone.
2. It supports the tongue and provides attachment
for some tongue muscles and for some muscles of
the pharynx and neck.
7.9 Vertebral Column
1. The vertebral column, sternum, and ribs
constitute the skeleton of the
body’s trunk.
2. The 26 bones of the adult vertebral column
are the cervical vertebrae (7),
the thoracic vertebrae (12), the lumbar vertebrae
(5), the sacrum (5 fused vertebrae), and the coccyx
(usually 4 fused vertebrae).
3. The adult vertebral column contains four normal
curves (cervical, thoracic,
lumbar, and sacral) that provide strength, support,
and balance.
4. Each vertebra usually consists of a body,
vertebral arch, and seven processes. Vertebrae in
the different regions of the column vary in size,
shape, and detail.
7.10 Vertebral Regions
1. The cervical vertebrae (C1–C7) are smaller than
all other vertebrae except those that form the
coccyx.
2. The first two cervical vertebrae are the atlas
(C1) and the axis (C2).
3. The thoracic vertebrae (T1–T12) are
considerably larger and stronger than
cervical vertebrae.
4. The thoracic vertebrae articulate with the ribs.
5. The lumbar vertebrae (L1–L5) are the largest
and strongest of the unfused bones in the vertebral
column.
6. The various projections of the lumbar vertebrae
are short and thick.
7. The sacrum is a triangular bone formed by the
union of the five sacral vertebrae (S1–S5).
8. The coccyx is formed by the fusion of usually
four coccygeal vertebrae
(Co1–Co4).
7.11 Thorax
1. The thoracic skeleton consists of the sternum,
ribs, costal cartilages, and thoracic vertebrae.
2. The thoracic cage protects vital organs in the
chest area and upper abdomen.
Sternum
3. The sternum (breastbone) is located in the center
of the anterior thoracic
wall.
4. The sternum consists of the manubrium, body,
and xiphoid process.
Ribs
5. The twelve pairs of ribs give structural support
to the sides of the thoracic
cavity.
6. The three types of ribs are the true
(vertebrosternal) ribs, vertebrochondral,
ribs, and floating (vertebral) ribs.
THE APPENDICULAR SKELETON
8.1 Pectoral (Shoulder) Girdle
1. Each of the body’s two pectoral (shoulder)
girdles consists of a clavicle and
scapula.
2. Each pectoral girdle attaches an upper limb to
the axial skeleton.
3. The clavicle (collarbone) lies horizontally
across the anterior part of the thorax superior to the
first rib.
4. The medial end of the clavicle articulates with
the manubrium of the sternum; the lateral end of
the clavicle articulates with the acromion of the
scapula.
5. The scapula (shoulder blade) is situated in the
superior part of the posterior
thorax between the levels of the second and
seventh ribs.
6. The scapula articulates with the clavicle and the
head of the humerus.
8.2 Upper Limb (Extremity)
1. Each of the two upper limbs (extremities)
contains 30 bones.
2. The bones of each upper limb include the
humerus, the ulna, the radius, the
carpals, the metacarpals, and the phalanges.
3. The humerus (arm bone) is the longest and
largest bone of the upper limb.
4. The humerus articulates proximally with the
scapula and distally with the ulna and radius.
5. The ulna is located on the medial aspect of the
forearm and is longer than the radius.
6. The radius is the smaller bone of the forearm
and is located on the lateral aspect of the forearm.
7. The eight carpals are located in the proximal
region of the hand.
8. The five metacarpals are located in the
intermediate region of the hand.
9. The 14 phalanges are located in the distal part
of the hand (fingers).
8.3 Pelvic (Hip) Girdle
1. The pelvic (hip) girdle consists of two hip
bones.
2. Each hip bone consists of three parts: the ilium,
pubis, and ischium.
3. The hip bones, sacrum, and pubic symphysis
form the bony pelvis. It supports the vertebral
column and pelvic viscera and attaches the free
lower limbs to the axial skeleton.
4. The ilium is the superior portion of the hip
bone.
5. The ischium is the inferior, posterior portion of
the hip bone.
6. The pubis is the anterior and inferior part of the
hip bone.
8.4 False and True Pelves
1. The false pelvis is separated from the true pelvis
by the pelvic brim.
2. The true pelvis surrounds the pelvic cavity and
houses the rectum and
urinary bladder in both genders, the vagina and
cervix of the uterus in females,
and the prostate in males.
3. The false pelvis is the lower portion of the
abdomen that is situated superior
to the pelvic brim. It contains the superior portion
of the urinary bladder
(when full) and the lower intestines in both
genders and the uterus, uterine
tubes, and ovaries in the female.
8.5 Comparison of Female and Male
Pelves
1. Bones of the male skeleton are generally larger
and heavier than bones of
the female skeleton. They also have more
prominent markings for muscle
attachments.
2. The female pelvis is adapted for pregnancy and
childbirth. Sex-related
diff erences in pelvic structure are listed and
illustrated in Table 8.1.
8.6 Lower Limb (Extremity)
1. Each of the two lower limbs (extremities)
contains 30 bones.
2. The bones of each lower limb include the
femur, the patella, the tibia, the
fibula, the tarsals, the metatarsals, and the
phalanges.
3. The femur (thigh bone) is the longest, heaviest,
and strongest bone in the body.
4. The patella (kneecap) is a small, triangular bone
located anterior to the
knee joint.
5. The tibia (shin bone) is the larger, medial,
weight-bearing bone of the leg.
6. The fibula is parallel and lateral to the tibia, but
is considerably smaller.
7. The seven tarsal bones are located in the
proximal region of the foot.
8. The five metatarsals are located in the
intermediate region of the foot.
9. The 14 phalanges are located in the distal part of
the foot (toes).
10. The bones of the foot are arranged in two
arches, the longitudinal arch and the transverse
arch, to provide support and leverage.
8.7 Development of the Skeletal System
1. Most bones form from mesoderm by
intramembranous or endochondral
ossification; much of the skeleton of the skull
arises from ectoderm.
2. Bones of the limbs develop from limb buds,
which consist of mesoderm
and ectoderm.
JOINTS
Introduction
1. A joint (articulation or arthrosis) is a point of
contact between two bones,
between bone and cartilage, or between bone and
teeth.
2. A joint’s structure may permit no movement,
slight movement, or free
movement.
9.1 Joint Classifications
1. Structural classification is based on the
presence or absence of a synovial
cavity and the type of connective tissue.
Structurally, joints are classified as
fibrous, cartilaginous, or synovial.
2. Functional classification of joints is based on
the degree of movement permitted. Joints may be
synarthroses (immovable), amphiarthroses
(slightly movable), or diarthroses (freely
movable).
9.2 Fibrous Joints
1. The bones of fibrous joints are held together by
dense irregular connective
tissue.
2. These joints include immovable or slightly
movable sutures (found between
skull bones), immovable to slightly movable
syndesmoses (such as roots of
teeth in the sockets in the mandible and maxilla
and the distal tibiofibular
joint), and slightly movable interosseous
membranes (found between the
radius and ulna in the forearm and the tibia and
fibula in the leg).
9.3 Cartilaginous joints
1. The bones of cartilaginous joints are held
together by cartilage.
2. These joints include slightly movable to
immovable hyaline cartilage
synchondroses (cartilaginous junction of first rib
with manubrium of sternum), slightly movable
fibrocartilage symphyses (pubic symphysis), and
immovable hyaline cartilage epiphyseal cartilages
(epiphyseal or growth plates between
the diaphysis and epiphysis and epiphyses of
growing bones).
9.4 Synovial Joints
1. Synovial joints contain a space between bones
called the synovial cavity. All synovial joints are
diarthroses.
2. Other characteristics of synovial joints are the
presence of articular cartilage and an articular
capsule, made up of a fibrous membrane and a
synovial membrane.
3. The synovial membrane secretes synovial fluid,
which forms a thin, viscous film over the surfaces
within the articular capsule.
4. Many synovial joints also contain accessory
ligaments (extracapsular and
intracapsular) and articular discs (menisci).
5. Synovial joints contain an extensive nerve and
blood supply. The nerves convey information
about pain, joint movements, and the degree of
stretch at a joint. Blood vessels penetrate the
articular capsule and ligaments.
6. Bursae are saclike structures, similar in
structure to joint capsules, that alleviate friction in
joints such as the shoulder and knee joints.
7. Tendon sheaths are tubelike bursae that wrap
around tendons where there is considerable
friction.
9.5 Types of Movements at Synovial
Joints
1. In a gliding movement, the nearly flat surfaces
of bones move back and forth and side to side.
2. In angular movements, a change in the angle
between bones occurs. Examples are flexion–
extension, lateral flexion, hyperextension, and
abduction– adduction. Circumduction refers to
the movement of the distal end of a body part in a
circle and involves a continuous sequence of
flexion, abduction, extension, adduction, and
rotation of the joint (or in the opposite direction).
3. In rotation, a bone moves around its own
longitudinal axis.
4. Special movements occur at specific synovial
joints. Examples are elevation–
depression, protraction–retraction, inversion–
eversion, dorsiflexion–plantar
flexion, supination–pronation, and opposition.
5. Table 9.1 summarizes the various types of
movements at synovial joints.
9.6 Types of Synovial Joints
1. Types of synovial joints are plane, hinge,
pivot, condyloid, saddle, and ball-and-socket.
2. In a plane joint the articulating surfaces are flat,
and the bones primarily glide back and forth and
side to side (many are biaxial); they may also
permit rotation (triaxial); examples are joints
between carpals and tarsals.
3. In a hinge joint, the convex surface of one bone
fits into the concave surface of another, and the
motion is angular around one axis (uniaxial);
examples are the elbow, knee (a modified hinge
joint), and ankle joints.
4. In a pivot joint, a round or pointed surface of
one bone fits into a ring formed by another bone
and a ligament, and movement is rotational
(uniaxial); examples are the atlanto-axial and
radioulnar joints.
5. In a condyloid joint, an oval projection of one
bone fits into an oval cavity of another, and motion
is angular around two axes (biaxial); examples
include the wrist joint and metacarpophalangeal
joints of the second through fifth digits.
6. In a saddle joint, the articular surface of one
bone is shaped like a saddle and the other bone fits
into the saddle like a sitting rider; movement is
biaxial. An example is the carpometacarpal joint
between the trapezium and the metacarpal of the
thumb.
7. In a ball-and-socket joint, the ball-shaped
surface of one bone fits into the cuplike depression
of another; motion is around three axes (triaxial).
Examples include the shoulder and hip joints.
8. Table 9.2 summarizes the structural and
functional categories of joints.
9.7 Factors Aff ecting Contact and Range
of Motion at Synovial Joints
1. The ways that articular surfaces of synovial
joints contact one another
determine the type of movement that is possible.
2. Factors that contribute to keeping the surfaces in
contact and aff ect range of
motion are structure or shape of the articulating
bones, strength and tension
of the joint ligaments, arrangement and tension of
the muscles, apposition of
soft parts, hormones, and amount of use.
9.8 Selected Joints of the Body
1. A summary of several selected joints of the
body, including articular
components, structural and functional
classifications, and movements, is
presented in Tables 9.3 and 9.4.
2. The temporomandibular joint (TMJ), shoulder
joint, elbow joint, hip joint,
and knee joint are described in Sections 9.9
through 9.13.
9.9 Temporomandibular Joint
1. The temporomandibular joint (TMJ) is
between the condyle of the mandible and
mandibular fossa and articular tubercle of the
temporal bone.
2. The temporomandibular joint is a combined
hinge and plane joint.
9.10 Shoulder Joint
1. The shoulder (humeroscapular or
glenohumeral) joint is between the head
of the humerus and glenoid cavity of the scapula.
2. The shoulder joint is a type of ball-and-socket
joint.
9.11 Elbow Joint
1. The elbow joint is between the trochlea of the
humerus, the trochlear notch of the ulna, and the
head of the radius.
2. The elbow joint is a type of hinge joint.
9.12 Hip Joint
1. The hip (coxal) joint is between the head of the
femur and acetabulum of the hip bone.
2. The hip joint is a type of ball-and-socket joint.

9.13 Knee Joint

1. The knee (tibiofemoral) joint is between the
patella and patellar surfaceof the femur; the lateral
condyle of the femur, the lateral meniscus, and the
lateral condyle of the tibia; and the medial condyle
of the femur, the medial
meniscus, and the medial condyle of the tibia.
2. The knee joint is a modified hinge joint.
9.14 Aging and Joints
1. With aging, a decrease in synovial fluid,
thinning of articular cartilage, and
decreased flexibility of ligaments occur.
2. Most individuals experience some degeneration
in the knees, elbows, hips,
and shoulders due to the aging process.
9.15 Arthroplasty
1. Arthroplasty refers to the surgical replacement
of joints.
2. The most commonly replaced joints are the hips,
knees, and shoulders.