CHAPTER 6

The Skeletal
System: Bone
Tissue

Dr. Jody Ralph

NURS 1210
Land Acknowledgement:

 The University of Windsor sits on the

traditional territory of the Three Fires
Confederacy of First Nations, which includes
the Ojibwa, the Odawa, and Potawatomie.
 We respect the longstanding relationships
with First Nations people in this place in the
100-mile Windsor-Essex peninsula and the
straits of Detroit.
Learning Objectives

 Describe the functions of the skeletal system.

 Describe the structure and functions of each
part of a long bone.
 Describe common types of fractures and the
process of fracture repair.
 Describe the importance and regulation of
calcium in the body.
FUNCTIONS OF BONE
AND THE SKELETAL
SYSTEM
Bone
 Bone is an organ made up of several different
tissues (bone, cartilage, dense connective
tissue, adipose, and nervous tissue) working
together
 The entire framework of bones and their
cartilages constitute the skeletal system
Functions of the Skeletal System
1. Provides support
2. Protects the internal organs (brain, heart,
etc.)
3. Assists body movements (in conjunction
with muscles)
4. Mineral homeostasis - stores and releases
calcium and phosphorus
5. Participates in blood cell production
(hemopoiesis)
6. Stores triglycerides in adipose cells of
yellow marrow
Which two minerals are stored in major
quantities in bone tissue?

a) calcium and phosphorus

b) calcium and iron
c) iron and phosphorus
d) calcium and iodine
e) calcium and sodium
STRUCTURE OF BONE
Structure of Bone
A long bone consists of several parts:
 Diaphysis (bone shaft)
 2 epiphyses (both ends of the bone at the joints)
 2 metaphyses (region between diaphysis and
epiphysis)
 Articular (hyaline) cartilage covering both
epiphyses
 Periosteum (connective tissue surrounding the
diaphysis)
 Medullary cavity (hollow space within diaphysis)
 Endosteum (thin membrane lining the medullary
cavity)
Structure of Bone

 Bone Structu
re and Tissue
s
Structure of Bone
In which region of a long bone, such as the humerus,
would you find the epiphyseal plate (growth plate)?

a) epiphysis
b) diaphysis
c) metaphysis
d) periosteum
e) endosteum
HISTOLOGY OF BONE
Histology of Bone

 Bone contains an abundant extracellular

matrix that surrounds widely separated cells
 The extracellular matrix is about 15% water, 30%
collagen, and 55% crystalized mineral salts
 Mineral salts calcium phosphate and calcium
hydroxide combine to form crystals called
hydroxyapatite
Histology of Bone

 Mineral salts confer hardness on bone

while collagen fibers give bone its great
tensile strength.
 These salts are deposited in a framework
of collagen fibers, a process called
calcification or mineralization.
 The process of calcification occurs only in
the presence of collagen fibers.
Histology of Bone
Bone contains 4 types of cells:
 Osteoprogenitor cells (bone stem cells able
to differentiate into the other types of cells)
 Osteoblasts (bone-building cells that secrete
matrix; initiate calcification)
 Osteocytes (mature bone cells)
 Osteoclasts (remodel bones and cause them
to release calcium; bone resorption)

 osteoBlasts Build bone, while osteoClasts Carve

out bone
Histology of Bone
Histology of Bone
 Compact bone is
good at providing
protection and
support
 Few spaces
 Strongest bone
tissue
 Found beneath
periosteum of all
Compact Bone
bones
Histology of Bone
 Spongy bone is
lightweight and provides
tissue support
 Located in interior of
bone
 Also called trabecular or
cancellous bone tissue
 Red bone marrow in
bones that produce red
blood cells
 Yellow bone marrow in Spongy (Cancellous)
other bones Bone
Histology of Bone
Histology of Bone
Which structure in the image below
represents an osteon, the structural
units of compact bone?
a) A
b) B
c) C
d) D
e) E
Blood and Nerve Supply of Bone

 Blood vessels, which are especially abundant

in portions of bone containing red bone
marrow, pass into bones from the periosteum
 The arterial supply to bone involves several
vessels
 Veins that carry blood away from long bones
 Nerves follow vessels into bone tissue and
the periosteum where they sense damage
and transmit pain messages
Blood and Nerve Supply of Bone
BONE FORMATION
Bone Formation

 Ossification (osteogenesis) is the process

of bone formation.
 Ossification takes place in 2 forms:
Intramembranous and endochondral
Bone Formation
 Intramembranous ossification occurs in flat
bones when a connective tissue membrane
is replaced by bone
Bone Formation
Endochondral ossification replaces cartilage
with bone in the developing embryo and fetus
Growth of bones during infancy, childhood, and
adolescence until adulthood
Bone Formation

 Endochondral
ossification also occurs
in epiphyseal plates of
long bones as they grow
in length
 The activity of the
epiphyseal plate is the
only means by which the
diaphysis can increase
in length.
Bone Formation

 When the epiphyseal plate closes, is

replaced by bone, the epiphyseal line
appears and indicates the bone has
completed its growth in length.
Bone Formation
Bones thicken thanks to the cooperative action
of osteoblasts and osteoclasts
Bone Formation

 Bone can grow in thickness or diameter only

by appositional growth at the periosteum
 Bone grows in diameter as a result of
interstitial and appositional addition of new
bone tissue by osteoblasts around the outer
surface of the bone and to a lesser extent
internal bone dissolution by osteoclasts in the
bone cavity
Bone Formation
As osteoblasts deposit bone on the outer
surface, osteoclasts widen the medullary cavity
from within
Bone Growth and Remodeling
Interactions Animation:
Bone Growth and Remodeling – necessary
nutrients
Bone Growth and Remodeling – maintenance
of bone thickness

You must be connected to the Internet and in Slideshow Mode to run this animation.
Bone grows in diameter by adding new layers to
the outside surface of the bone, while the
medullary cavity is enlarged by the activity of
cells on the inside surface.

a) True
b) False
Most of the bones of the skull are formed
by this process.

a) interstitial growth
b) growth at the epiphyseal plate
c) intramembranous ossification
d) endochondral ossification
e) appositional growth
Bone Remodeling

 Remodeling is the ongoing replacement of

old bone tissue by new bone tissue.
 Old bone is constantly destroyed by
osteoclasts, whereas new bone is
constructed by osteoblasts.
Bone Remodeling

 Adequate dietary intake of minerals and

vitamins is necessary for growth and
maintenance of bone.
 Calcium and phosphorus are needed for bone
growth in large concentrations, with other minerals
(magnesium, fluoride, manganese) needed in
smaller amounts.
 Vitamins C, D, K, B12, and A are needed for bone
growth.
Bone Remodeling

 The most important hormones for stimulation

of bone growth during childhood are the
insulin-like growth factors (IGFs), which are
stimulated by human growth hormone (hGH).
 Thyroid hormones and insulin are also necessary
hormones for bone growth.
 At puberty, the sex hormones (estrogen and
testosterone) stimulate sudden growth and
modifications of the skeleton to create the male
and female forms.
FRACTURE AND REPAIR
OF BONE
Fracture and Repair of Bone

 A fracture is a break in a bone. Many different

types of fractures may occur.
 The healing process involves 3 different
phases in 4 steps.
 The reactive phase is an early inflammatory phase
 The reparative phase includes formation of a
fibrocartilaginous callus first and a bony callus
second
 The bone remodeling phase is the last step as
the bony callus is remodeled
Fracture and Repair of Bone
Fracture and Repair

 Treatments for fractures include the anatomic

realignment of the bone fragments,
immobilization to maintain realignment, and
restoration of function.
Common Fractures
Fracture Description Illustration Radiograph
Open The broken ends of the bone
(Compound) protrude through the skin.
Conversely, a closed (simple)
fracture does not break the skin.

Comminuted The bone is splintered, crushed, or

(KOM-i-noo- broken into pieces at the site of
ted; com- = impact, and smaller bone fragments
together; - lie between the two main
minuted = fragments.
crumbled)

Greenstick A partial fracture in which one side

of the bone is broken and the other
side bends; similar to the way a
green twig breaks on one side while
the other side stays whole, but
bends; occurs only in children,
whose bones are not fully ossified
and contain more organic material
than inorganic material.
Common Fractures
Fracture Description Illustration Radiograph

Impacted One end of the fractured bone

is forcefully driven into the
interior of the other.

Pott Fracture of the distal end of the

lateral leg bone (fibula), with
serious injury of the distal tibial
articulation.
Common Fractures
Fracture Description Illustration Radiograph

Colles (KOL-ēz) Fracture of the distal end of the

lateral forearm bone (radius) in
which the distal fragment is
displaced posteriorly.

Vertebral The vertebral body of one or more

compression vertebrae fractures and becomes
fracture compressed into a wedge-shape.
May be caused by injury, trauma, or
more commonly in individuals with
osteoporosis.
 BONE’S ROLE IN
CALCIUM HOMEOSTASIS
Bone’s Role in Calcium Homeostasis
 Bone is the major reservoir for calcium ions (Ca2+) in the
body; the level of blood calcium ions (Ca2+) are very
closely regulated due to calcium’s importance in
cardiac, nerve, enzyme, and blood physiology.
 An important hormone regulating Ca2+ exchange
between bone and blood is parathyroid hormone (PTH).
It increases blood calcium ion levels
 PTH also stimulates the production of calcitriol (vitamin
D) to increase calcium absorption in the intestine
 Another hormone that contributes to the homeostasis of
blood Ca2+ is calcitonin. It decreases blood Ca2+ levels.
Bone’s Role in
Calcium
Homeostasis

Calcium Homeo
stasis
Which of the following is a function of
calcium in the body? Select all that apply.

a) nerve cells require extracellular calcium ions

(Ca2+) for proper functioning
b) Ca2+ is a cofactor needed for many enzymes to
function properly
c) Ca2+ is required for the process of blood clotting
d) Ca2+ is needed by muscle cells for contraction
EXERCISE AND AGING IN
BONE TISSUE
Exercise
 Under stress, bone tissue becomes stronger
 Increased deposition of mineral salts and
production of collagen fibers
 Weight-bearing activities- walking or
moderate weight lifting, build/retain bone
mass
 All ages can and should strengthen their
bones by engaging in weight-bearing
exercise
Effect of Exercise on Bone
Aging and Bone Tissue

 From birth through adolescence, more bone

is produced than is lost during remodeling.
 In adults, the rates are the same.
 Older individuals, especially post-
menopausal women, experience a decrease
in bone mass when resorption outpaces
deposition.
Aging
 The two principal effects of aging on bone
are:
 The loss of calcium and other minerals from bone
matrix (demineralization), which may result in
osteoporosis
 The decreased rate of protein synthesis, resulting
in decreased production of matrix components
(mostly collagen) and increased susceptibility to
bone fracture
 Factors That Affect Bone Growth
Factor Comment
MINERALS
Calcium and Make bone extracellular matrix hard.
phosphorus
Magnesium Helps form bone extracellular matrix.
Fluoride Helps strengthen bone extracellular matrix.
Manganese Activates enzymes involved in synthesis of bone extracellular matrix.
VITAMINS
Vitamin A Needed for the activity of osteoblasts during remodeling of bone; deficiency
stunts bone growth; toxic in high doses.
Vitamin C Needed for synthesis of collagen, the main bone protein; deficiency leads to
decreased collagen production, which slows down bone growth and delays repair
of broken bones.
Vitamin D Active form (calcitriol) is produced by the kidneys; helps build bone by
increasing absorption of calcium from gastrointestinal tract into blood; deficiency
causes faulty calcification and slows down bone growth; may reduce the risk of
osteoporosis but is toxic if taken in high doses. People who have minimal
exposure to ultraviolet rays or do not take vitamin D supplements may not have
sufficient vitamin D to absorb calcium. This interferes with calcium metabolism.
Vitamins K and Needed for synthesis of bone proteins; deficiency leads to abnormal protein
B12 production in bone extracellular matrix and decreased bone density.
Factors That Affect Bone Growth
Factor Comment
HORMONES
Growth hormone Secreted by the anterior lobe of the pituitary gland; promotes general growth
(GH) of all body tissues, including bone, mainly by stimulating production of
insulin-like growth factors.
Insulin-like Secreted by the liver, bones, and other tissues on stimulation by growth
growth factors hormone; promotes normal bone growth by stimulating osteoblasts and by
(IGFs) increasing the synthesis of proteins needed to build new bone.
Thyroid hormones Secreted by thyroid gland; promote normal bone growth by stimulating
(T3 and T4) osteoblasts.
Insulin Secreted by the pancreas; promotes normal bone growth by increasing the
synthesis of bone proteins.
Sex hormones Secreted by the ovaries in women (estrogens) and by the testes in men
(estrogens and (testosterone); stimulate osteoblasts and promote the sudden "growth spurt"
testosterone) that occurs during the teenage years; shut down growth at the epiphyseal
plates around age 18-21, causing lengthwise growth of bone to end;
contribute to bone remodeling during adulthood by slowing bone resorption
by osteoclasts and promoting bone deposition by osteoblasts.
Parathyroid Secreted by the parathyroid glands; promotes bone resorption by
hormone (PTH) osteoclasts; enhances recovery of calcium ions from urine; promotes
formation of the active form of vitamin D (calcitriol).
Calcitonin (CT) Secreted by the thyroid gland; inhibits bone resorption by osteoclasts.
Factors That Affect Bone Growth
Factor Comment

EXERCISE Weight-bearing activities stimulate osteoblasts and, consequently, help

build thicker, stronger bones and slow loss of bone mass that occurs as
people age.

AGING As the level of sex hormones diminishes during middle age to older
adulthood, especially in women after menopause, bone resorption by
osteoclasts outpaces bone deposition by osteoblasts, which leads to a
decrease in bone mass and an increased risk of osteoporosis.
Males generally have lower rates of developing
osteoporosis because, on average, they enter
adulthood with a heavier bone mass than
women and they don’t experience the same
dramatic decline in sex hormones as women do
with aging.

a) True
b) False
DISORDERS
Homeostatic Imbalances
 Bone Scan
 Osteoporosis
 Ricketts
 Osteomalacia
Bone scan

 A bone scan is a nuclear

medicine imaging test
 A bone scan looks at the
bones to see if there are
any abnormalities, such as
a fracture, tumour or
infection.
Bone scan showing
multiple bone metastases
from prostate cancer
Osteoporosis

 Condition of porous bones- low bone mass

(osteopenia)
 Bone resorption (breakdown) outpaces bone
deposition (formation)
 Bone mass becomes so depleted that bones
fracture, with stresses of daily living
Ricketts and Osteomalacia

 Inadequate calcification of the extracellular

bone matrix, usually caused by a vitamin D
deficiency
Summary

 Skeletal system functions

 Parts of a long bone
 Cell types in bone tissue
 Compact and spongy bone tissue
 Intramembranous and endochondral ossification
 Bone growth length and thickness
 Fracture repair
 Blood calcium level regulation
 Exercise and aging