SKELETON
THE SKELETON
Bony &
cartilaginous frame
work of the body.
Latin: Os
Greek: Osteon
DEFINITION
BONE
It is a specialized, constantly changing
connective tissue and are composed of
cells, a dense intercellular substance
impregnated with calcium salts and
numerous blood vessels.
PECULIARITIES
Living tissue
Highly vascular tissue
High capacity of regeneration
Remoleded throughout life (constant turn over of calcium)
It can mould itself according to changes in stress and strain
It shows disuse atrophy and overuse hypertrophy
Subjective to disease, and heals after a fracture
FUNCTIONS
Provide shape & support to the body
Protect viscera
Provide surface for the attachment
Serve as levers for muscular actions
Storage of minerals (97% of body Ca & P)
Blood cell formation in bone marrow
Reticulo-endothelial cells and immune response
Paranasal air sinuses – resonance to the voice
CLASSIFICATION
ACCORDING TO POSITION (REGIONAL)
ACCORDING TO SHAPE
ACCORDING TO DEVELOPMENT
ACCORDING TO STRUCTURE
ACCORDING TO POSITION
Axial skeleton:
Skull, Vertebrae,
Ribs, Sternum
Appendicular skeleton:
Bones of limbs
TOTAL BONES OF THE BODY 206
AXIAL APPENDICULAR
Skull
Cranium 8 Pectoral girdles 4
Face 14
Pelvic girdles 2
Hyoid 1
Auditory ossicles6
Upper extremities 60
Vertebral column 26
Thorax Lower extremities 60
Sternum 1
Ribs 24
TOTAL 80 TOTAL 126
ACCORDING TO SHAPE
Long bones
Short bones
Flat bones
Irregular bones
Pneumatic bones
Sesamoid bones
Accessory bones(supernumerary bones)
Heterotopic bones
CLASSIFICATION OF BONES
Long bones
• They are much longer than wide
• Having elongated shaft & 2 ends
• The ends bear articular surface
• Shaft has 3 surfaces & 3 borders
• Shaft has a central medullary cavity
• Nutrient foramen directed away from the growing end
Examples of Typical Long Bone
FURTHER CLASSIFICATION OF LONG BONES
Typical long bones:
e.g. humerus, radius, femur
Miniature long bones:
one epiphysis e.g. metatarsals, metacarpals
Modified long bones:
no medullary cavity e.g. clavicle
CLASSIFICATION OF BONES
Short bones :
• Usually cuboid,cuneiform,trapezoid, scaphoid
in shape
• Examples: Carpals, tarsals
Flat bones :
• Thin and flattened - Plate like
• Form boundaries of certain body cavities
• Examples: Vault of Skull, scapula, sternum
CLASSIFICATION OF BONES
Irregular bones
• Irregular shape
• Do not fit into other bone
classification categories
• Example: Vertebrae and hip
CLASSIFICATION OF BONES
Pneumatic bones
Irregular bones contain large air spaces lined by epithelium
Make the skull light in weight
Help in resonance of voice
Acts as a air-conditioning chamber
CLASSIFICATION OF BONES
Sesamoid bones:
Sesame means ‘seed’
e.g. Patella, fabella,pisiform
Peculiarities:
• Develops in tendon of muscles
• Ossify after birth
• Devoid of periosteum
• Absence of Haversian system
Functions:
• To resist pressure
• To minimize friction
• To alter the direction of pull of the
muscle
• Act as pulley for muscle contraction
• To maintain local circulation
CLASSIFICATION OF BONES
Accessory (supernumerary) bones:
Not always present.
May occur as ununited epiphyses
Develop as extra centres of
ossification.
Medico-legal importance
e.g. Sutur bones,
Os trigonum
Os vesalianum
CLASSIFICATION OF BONES
Heterotopic bones:
Sometimes bones develops in soft
tissues.
“Rider’s bone”
Develops in adductor muscles
in horse riders.
“Os cordis”
DEVELOPMENTAL CLASSIFICATION
Membranous (Dermal) bones
Cartilaginous bones
Membrano-cartilaginous bones
Somatic bones:
Develop from somites or somatopluric mesoderm
eg most of the bones of the body
Visceral bones:
Develops from mesoderm of pharyngeal or branchial arches
e.g. hyoid bones,
part of mandible,
ear ossicles
MEMBRANOUS BONES
• Ossify in membrane
• Derived from
mesenchymal
condensation
• e.g.- bones of cranial
vault ,facial bones
• Defect in membranous
ossification cause
Cleidocranial dysostosis
CARTILAGINOUS BONE
Ossify in cartilage
(endochondral ossification)
Derived from preformed
cartilaginous model
e.g. - Bones of limbs
Bones of base of skull
Vertebral column
Thoracic cage
Defect cause - Achondroplasia
MEMBRANO - CARTILAGINOUS BONES
Partly ossify in membrane &
partly in cartilage
e.g. clavicle, mandible, occipital,
temporal, sphenoid bone
STRUCTURAL CLASSIFICATION
MACROSCOPICALLY:-
• Compact bone
• Cancellous (spongy) bone
MICROSCOPICALLY:-
• Lamellar bone
• Woven bone
• Fibrous bone
• Dentine
• Cement
•
COMPACT BONE
• Dense in texture
• Extremely porous
• Best developed in cortex
of the long bones
• Adaptation to bending &
twisting forces.
CANCELLOUS BONE
Open in texture
Made up of a meshwork of
trabeculae between which
there is space containing
marrow
Trabecular meshworks:
• Meshwork of rods
• Meshwork of rods and plates
• Meshwork of plates
Cancellous bone is an
adaption to compressive
forces
CANCELLOUS BONE
MICROSCOPICALLY
Lamellar bone:
Woven bone:
• foetal bone
• fracture repair site
• cancer of bone
Fibrous bone:
• young foetal bones
• reptiles and amphibia
Dentine:
Cement:
TRAJECTORY THEORY OF WOLFF
(WOLFF’S LAW)
Osteogenesis is directly proportional to
stress and strain.
Tensile force & Compressive force
favours bone formation
Pressure lamellae - parallel to line of
weight transmission
Tension lamellae - at right angle to
pressure lamellae
CLASSIFICATION
GROSS STRUCTURE OF A TYPICAL LONG
BONE
Two ends
Made up of cancellous bone
Covered with hyaline cartilage
Shaft
Periosteum, cortex, medullary cavity
PERIOSTEUM
• Two layers
• Thick fibrous membrane
• Sharpey’s fibre
• Rich nerve supply
• Absent on articular surface
FUNCTIONS
• Protects & Maintains shape
• Provide the attachment
• Give nutrition
CORTEX
• Made up of compact bone
• Gives strength to bone
MEDULLARY CAVITY
Filled with red or yellow marrow
At birth - red marrow
Advanced age - yellow marrow
Red marrow persist in
Cancellous end of long bones
Sternum
Ribs
Skull bones
PARTS OF A YOUNG (GROWING) LONG BONE
DIAPHYSIS
METAPHYSIS
EPIPHYSIS
EPIPHYSIAL PLATE OF CARTILAGE
DIAPHYSIS
• It is the elongated shaft of a long bone
which ossifies from a primary centre.
METAPHYSIS
• Epiphysial ends of diaphysis
• Zone of active growth
• Profuse blood supply
EPIPHYSIS
DEFINITION
The ends and tips of a bone which ossify from
secondary centres are called epiphysis.
Four types
• Pressure epiphysis
• Traction epiphysis
• Atavistic epiphysis
• Aberrant epiphysis
EPIPHYSIS
Pressure epiphysis
Articular
Takes part in transmission of weight
e.g. Head of femur, lower end of radius
Traction epiphysis
Nonarticular
Does not take part in transmission of weight
Provide muscle attachment
Ossifies later
e.g. Trochanters of femur
Tubercles of humerus
EPIPHYSIS
Atavistic epiphysis
• Phylogenatically - independed bone later fused
with another bone
• e.g. coracoid process of scapula, os trigonum,
lateral tubercle of talus
Aberrant epiphysis-
• Not always present
• e.g. head of first & base of other metacarpals
EPIPHYSIAL PLATE OF CARTILAGE
• It separates epiphysis from
metaphysis
• Responsible for lengthwise
growth of a long bone
• After the epiphysial fusion,
the bone can no longer grow
in length
LAW OF UNION OF EPIPHYSIS
‘The epiphyseal centre which appears first, unites last with
the diaphysis and vice versa’
Fibula is the bone violating the law of ossification
Growing end of the long bones
• It is that end where the secondary centre appears first and unites
last with the diaphysis.
• Knowledge of the growing ends is important in clinical practice.
CENTRES OF OSSIFICATION
The area of bone, where bone formation or ossification starts
in a cartilaginous model.
Primary centre:
• Area of bone which ossified before birth
• Exceptions- tarsal & carpal bones (except talus
calcaneum & cuboid bones).
Secondary centre:
• Area of bone which ossified after birth
• Exception: lower end of femur &
upper end of tibia
BLOOD SUPPLY
TYPICAL LONG BONES :-
Supplied by four sets of blood vessels
Nutrient artery
• Enters the middle of the shaft through the
nutrient foramen
• Supplies medullary cavity, inner 2/3 of cortex
and metaphysis
• Nutrient foramen: Directed away from the
growing end of the bone
‘TO THE ELBOW I GO, FROM THE KNEE
I FLEE’
BLOOD SUPPLY
Epiphyseal arteries
• derived from circulus vasculosus
Periosteal arteries
• Numerous beneath the muscular and
Ligamentous attachments
• Supply the outer 1/3 of the cortex
Metaphysial arteries
• Derived from the neighboring systemic vessels
‘HAIR –PIN’ BENDS -OSTEOMYLITIES
BLOOD SUPPLY
MINIATURE LONG
BONES
Nutrient artery breaks up in
to plexus immediately up on
reaching the medullarly
cavity.
Infection begins in middle of
the shaft, rather than
metaphysis.
In adults chances of infection
are less.
BLOOD SUPPLY
FLAT BONES
• Nutrient artery: pierce
compact part of flat
bones
• Periosteal artery: major
share in blood supply
SHORT BONES
• Supplied by numerous
Periosteal vessels
BLOOD SUPPLY
IRREGULAR BONES
One or more vessels entre the
body from basi-vertebral
foramen
Small vessels enters through
antero-lateral surface.
One vessel pierce root of
transverse process, and supply
vertebral arch.
Venous drainage:
• Veins are numerous and large in the cancellous ,red marrow
containing bones.
e.g. basi-vertebral veins.
• compact bones: veins accompany arteries in Volkmann's canals.
Lymphatic drainage:
• No existence of lymphatics.
• Although some of them accompany the periosteal blood vessels.
Nerve supply:
• Nerves accompany blood vessels
• Sympathetic or parasympathetic.
• Few of them are sensory- distributed to the articular ends and
periosteum of the long bones.
DEVELOPMENT AND OSSIFICATION
Bones fist lie down as mesenchymal condensation.
Mesodermal bones convert into calcified bones. This
process is called intramembranous ossification.
Such bones are called membranous bones. e.g. Clavicle,
Skull bones
Mesodermal stage may pass through cartilagenous stage
by chondrification during intrauterine life.
This is called endochondral ossification. Such bones are
called cartilagenous bones. Most of the bones are
cartilagenous.
DEVELOPMENT AND OSSIFICATION
The primary centers forms diaphysis and secondary
centers forms epiphysis.
Fusion of epiphysis with diaphysis starts at puberty and
complete at the age of 25 years.
LAW OF OSSIFICATION
‘The secondary center of ossification which appear
first are last to unite’
‘The end of long bone where epiphysial fusion is
delayed is called the growing end of the bone’
GROWTH OF BONES
Bone grows in length by multiplication of cells in
epiphysial plate of cartilage.
Bone grows in thickness by multiplication of cells in
deep layer of periosteum.
Removal of unwanted cells during the process of growth
is called remodelling.
Osteoclasts are cells responsible for remodelling.
FACTORS AFFECTING GROWTH OF
BONES
NUTRITIONAL
• Deficiency of vitamin A,D,C
• Disuse atrophy
HORMONAL
• Secretion of pituitary, parathyroid, thyroid gland and gonads
GENETIC
MECHANICAL
• Tensile force - Bone formation
• Compressive force - Bone resorption
CARTILAGE (GRISTLE)
Chondros in Greek
Connective tissue composed of cells & fibres embedded
in a firm, gel like matrix which is rich in
mucopolysacchaide.
CHARACTERISTICS
No blood vessels or lymphatics
No nerve supply. Insensitive to pain
Surrounded by perichondrium
When it calcifies, it replaced by bone tissue
TYPES OF CARTILAGE
Hyaline cartilage
Fibro cartilage
Elastic cartilage
HYALINE CARTILAGE
The word ‘hylos’ means Transparent stone.
Bluish white transparent cartilage.
It is made up of fine collagen fibers.
Widely distributed in body.
May calcify after age of 40 years.
All cartilaginous bones are preformed in hyaline
cartilage.
Examples : Articular cartilage
Embryonic cartilage
Costal cartilage
Cartilage of trachea, bronchus, larynx.
HYALINE CARTILAGE
FIBRO CARTILAGE
It is white and opaque cartilage.
Made up of aboundant dense collagen fibers.
It is tough, strong and resiliant.
Whenever any fibrous tissue is exposed to pressure it is
replased by fibro cartilage.
It lines certain grooves of strong joints.
Examples – Intervertebral disk,
Intra articular disk,
Menisci (Knee joint)
FIBROCARTILAGE
ELASTIC CARTILAGE
Pliable and Flexible as name suggests.
It is made up of rich network of yellow elastic
fibers and numerous cells.
Located in organs which are hard in consistency
and still compressible.
Examples – Cartilage of external ear, nose
Auditory tube
Epiglottis (leaf like cartilage of
larynx)
ELASTIC CARTILAGE
MEDICOLEGAL ASPECTS
TO KNOW
Weather the bones are of human or not
Weather they belong to one or more
persons
The age of person
The gender of person
The stature (height)of person
The race of person
The time and cause of death
APPLIED ANATOMY
APPLIED ANATOMY
Fracture is break in
continuity of bone.
Fractures may be open or
closed.
It requires restoration of
proper alignment of cut ends
for proper recovery.
This procedure is called
reduction of fracture.
APPLIED ANATOMY
RICKETS (VITAMIN D DEFICIENCY)
Calcification of cartilage is failed and
ossification of bone is disturbed.
Mineralization of bone does not take place
due to deficiency of calcium and vitamin
D.
It affects the growing bones and develops
during 3 months to 3 years of age.
APPLIED ANATOMY
OSTEOMALACIA
Deficiency of calcium,
vitamin D in adult life.
Bones on x-rays
examination do not reveal
enough trabeculae.
APPLIED ANATOMY
SCURVY (VITAMIN C DEFICIENCY)
Formation of collagenous fibres and matrix is impaired.
Rupture of capillaries and defective formation of new
capillaries.
Haematoma (collection of blood) in the muscles and bones.
Normal architecture at the growing ends is lost.
APPLIED ANATOMY
OSTEOPOROSIS
Deficiency of calcium in bones
in old age.
Seen both in females and males.
Forward bending of the vertebral
column, leading to kyphosis.
APPLIED ANATOMY
BONE MARROW APLASIA
When bone marrow stops the production of blood cells.
MULTIPLE MYELOMA
Tumors of plasma cells affecting bone marrow.
BONE MERROW TRANSPLANT
Defective bone marrow of person is replaced with healthy
and functioning bone marrow of other person.
APPLIED ANATOMY
BONE MARROW ASPIRATION (BIOPSY)
Bone marrow is aspirated with needle and examined
under microscope.
Done for the diagnosis of certain conditions like
Aplastic anemia, polycythemia vera, leukemia, Multiple
myeloma etc.
The sites commonly used are:-
In the adult:
Manubrium of sternum
Lumber spinous process
In the children:
Iliac crests of hip bones
