OSTEOLOGYOSTEOLOGYBone-a-fideBone-a-fide

THE BARE BONES OF ITTHE BARE BONES OF IT

STRUCTURESTRUCTURE FUNCTIONFUNCTION TYPESTYPES IDENTIFICATIONIDENTIFICATION GROWTH, DEVELOPMENT & HEALINGGROWTH, DEVELOPMENT & HEALING

THE BONE CELLTHE BONE CELL The osteocyte is surrounded by matrix The osteocyte is surrounded by matrix 35% protein collagen for hardness and flexibility35% protein collagen for hardness and flexibility 65% mineral salts – mostly Calcium and 65% mineral salts – mostly Calcium and

PhosphorusPhosphorus Precursor – cells that manufacture the bone cells Precursor – cells that manufacture the bone cells

– Osteoblasts– Osteoblasts Cells that erode the bone matrix – Osteoclasts – Cells that erode the bone matrix – Osteoclasts –

these constantly remodel the bones according to these constantly remodel the bones according to the force of muscles.the force of muscles.

Outer covering is a thin membrane called Outer covering is a thin membrane called Periosteum Periosteum - encloses the bone - fibrous - encloses the bone - fibrous connective tissue - contains blood vesselsconnective tissue - contains blood vessels

OSSEOUS/BONY TISSUEOSSEOUS/BONY TISSUE

COMPACT BONE Usually found on the

outside where there is more stress

They are parallel cylinders called Osteons, which are concentric tubes of matrix, with a central canal that carries blood vessels.

Tiny spaces within this contain isolated osteocytes

SPONGY or CANCELLOUS bone

It has a honeycomb structure and bony struts with spaces called trabeculae

Jelly like yellow marrow that stores fat

Red marrow that produces blood cells

OSSIFICATIONOSSIFICATION

In embryonic development the bones In embryonic development the bones arise from the mesoderm.arise from the mesoderm.

They are usually either Fibrous They are usually either Fibrous connective tissue or Cartilage.connective tissue or Cartilage.

The fibrous tissue ossification is The fibrous tissue ossification is called INTRAMEMBRANOUScalled INTRAMEMBRANOUS

The cartilaginous ossification is The cartilaginous ossification is called ENDOCHONDRAL.called ENDOCHONDRAL.

Bone OssificationBone Ossification Skeleton begins as cartilage in prenatal development Skeleton begins as cartilage in prenatal development At fetal age 2 months: - osteoblasts begin to deposit calcium At fetal age 2 months: - osteoblasts begin to deposit calcium

(ossification) - first begins in the center of the long bones - called (ossification) - first begins in the center of the long bones - called primary ossification points - ossification extends along the shaft - primary ossification points - ossification extends along the shaft - at birth, shaft is fully ossified at birth, shaft is fully ossified

Postnatal bone growth occurs at secondary ossification points - Postnatal bone growth occurs at secondary ossification points - called "epiphyseal plates" or "growth plates" called "epiphyseal plates" or "growth plates"

The epiphyseal plate has four layersThe epiphyseal plate has four layers : : 1) Zone of resting cells - serves as reservoir for future growth 1) Zone of resting cells - serves as reservoir for future growth 2) Proliferative zone - cartilage cells increase in size 2) Proliferative zone - cartilage cells increase in size 3) Hypertrophic zone - cartilage cells arrange themselves in 3) Hypertrophic zone - cartilage cells arrange themselves in

vertical columns vertical columns 4) Calcified cartilage zone - cartilage cells erode and bone is 4) Calcified cartilage zone - cartilage cells erode and bone is

deposited by osteoblasts deposited by osteoblasts

Ossification of short bones ossify from the center outward At birth, Ossification of short bones ossify from the center outward At birth, about 400 ossification centers exist. After birth, another 400 more about 400 ossification centers exist. After birth, another 400 more develop. After puberty, growth plates ossify and bone stops growth develop. After puberty, growth plates ossify and bone stops growth –there is evidence that excessive stress can cause premature –there is evidence that excessive stress can cause premature ossification. ossification.

Bone is constantly being broken down (osteoclasts) - rebuilt again by Bone is constantly being broken down (osteoclasts) - rebuilt again by osteoblasts - else, we could not recover from a broken bone. osteoblasts - else, we could not recover from a broken bone.

GROWTH PATTERN OF BONESGROWTH PATTERN OF BONES

GROWTH – our bones are growing all GROWTH – our bones are growing all the time. Maximum growth happens the time. Maximum growth happens within 18 yrs. Then mainly reshuffling within 18 yrs. Then mainly reshuffling esp of face, vertebrae, ribs and hips.esp of face, vertebrae, ribs and hips.

LONG bones grow most and skull LONG bones grow most and skull bones least.bones least.

Growth in long bones takes place at Growth in long bones takes place at the Epiphysis, at the ends.the Epiphysis, at the ends.

FUNCTIONFUNCTION

Strong, lightweight frame work, dynamic Strong, lightweight frame work, dynamic and flexible.and flexible.

SUPPORTSUPPORT SHAPING BODYSHAPING BODY ANCHORAGE OF SKELETAL MUSCLESANCHORAGE OF SKELETAL MUSCLES SURROUNDS AND PROTECTS INTERNAL SURROUNDS AND PROTECTS INTERNAL

ORGANSORGANS MOVEMENTMOVEMENT STORES FATSTORES FAT PRODUCES Red Blood CellsPRODUCES Red Blood Cells STORES CALCIUMSTORES CALCIUM

THE TYPES OF BONESTHE TYPES OF BONES

TYPES

FLAT IRREGULAR

LONG SHORT

LONG BONESLONG BONES

LIMBSLIMBS ACT as LEVERS – responsible for movement.ACT as LEVERS – responsible for movement. Weight BearingWeight Bearing LENGTH IS MORE THAN WIDTH – LENGTH IS MORE THAN WIDTH – The Diaphysis or shaft is longer than the Epiphysis or end, which is The Diaphysis or shaft is longer than the Epiphysis or end, which is

usually rounded and expanded.usually rounded and expanded.

EpiphysisEpiphysis - expanded portion at the end - made of spongy - expanded portion at the end - made of spongy bone mostly with compact bone at the end bone mostly with compact bone at the end

DiaphysisDiaphysis - between the epiphysis's - made of compact bone - between the epiphysis's - made of compact bone Medullary CavityMedullary Cavity - cavity in center of the bone - contains the - cavity in center of the bone - contains the

yellow marrow yellow marrow Articular CartilageArticular Cartilage - connection between bones - connection between bones

SHORT BONESSHORT BONES Cube like shapeCube like shape Form connective bridgeForm connective bridge Limited movementLimited movement Stability is essential- Stability is essential- predominantly in hands in feetpredominantly in hands in feet Facilitate movement by elasticity, shock absorpbtion Facilitate movement by elasticity, shock absorpbtion The CARPALS & TARSALSThe CARPALS & TARSALS

FLATFLAT

Usually thin, Usually thin, flattened and flattened and slightly curvedslightly curved

Mostly protective Mostly protective in functionin function

Includes STERNUM, Includes STERNUM, RIBS, SCAPULAE & RIBS, SCAPULAE & CRANIAL bonesCRANIAL bones

IRREGULARIRREGULAR

Those that don’t Those that don’t have a symmetrical have a symmetrical shapes or those shapes or those which don’t fall into which don’t fall into any other categoryany other category

Includes the FACIAL Includes the FACIAL bones, PELVIS & bones, PELVIS & VERTEBRAEVERTEBRAE

IDENTIFICATIONIDENTIFICATION Bones are identified by shape, position in body, Bones are identified by shape, position in body,

function and in relation to its surrounding function and in relation to its surrounding structures.structures.

WHY DO WE NEED TO KNOW THIS ?WHY DO WE NEED TO KNOW THIS ? When there is an injury/trauma to any bone When there is an injury/trauma to any bone

structure, we must know what else could have structure, we must know what else could have been affected – muscle, ligament, tendon, artery, been affected – muscle, ligament, tendon, artery, vein or nerve. We need to assess short term and vein or nerve. We need to assess short term and long term damage along with choosing right long term damage along with choosing right remedies to promote healing.remedies to promote healing.

Specific bone diseases including Arthritis, Specific bone diseases including Arthritis, Rheumatism, etcRheumatism, etc

Also to predict healing patterns in case of Also to predict healing patterns in case of fracture.fracture.

HEALINGHEALING Bones heal by producing extra osteocytes that Bones heal by producing extra osteocytes that

occupy deficient area.occupy deficient area. Then the dead tissue trapped within is either Then the dead tissue trapped within is either

completely re-absorbed or turned into a fibrous completely re-absorbed or turned into a fibrous scar over which the bone unites.scar over which the bone unites.

Long bones require to be set if healing needs to Long bones require to be set if healing needs to take place. take place.

The ability to produce RBC is usually lost or The ability to produce RBC is usually lost or diminished in the area of the healing.diminished in the area of the healing.

Remedies like Symphytum, Ruta, Calc Phos aid in Remedies like Symphytum, Ruta, Calc Phos aid in the healing by speeding up the process.the healing by speeding up the process.

Complete immobility of the area is essential.Complete immobility of the area is essential.

AXIAL SKELETONAXIAL SKELETON

It consists of - It consists of -

The Skull – 22 bones – 8 Cranial and 14 The Skull – 22 bones – 8 Cranial and 14 FacialFacial

The Vertebrae – 24The Vertebrae – 24

The Ribs – 12The Ribs – 12

The SternumThe Sternum

THE SKULLTHE SKULLThe skull has cavities – CRANIAL , NASAL , ORBITAL, ear.

It also has foramina- for blood vessels and nerves, the biggest being foramen magnum – for the spinal cord.

It develops intramembranously and ossification is complete at 1.5 yrs when the fontanells disappear.

Remedies for fontanelle ossification – Calc Carb, Calc Phos, Sil

Bones of Face and SkullBones of Face and Skull Bones not in diagram – Ethmoid (behind nasal) Lacrimal (part of orbit), Palatine (rear of hard palate), inferior

nasal concha, Vomer (nasal septum)

Other Facial Bones- Other Facial Bones- mandiblemandible hyoid bone hyoid bone Middle ear bones – malleus , incus stapes Middle ear bones – malleus , incus stapes

The VertebraeThe VertebraeThis surrounds and protects the spinal cord. The structure is a short pillar like body – centrum with projections called spinous and transverse processes, which attach to ligaments and back muscles. The body and the neural arch make the vertebral foramen.Between each vertebrea- are intervertebral discs- cartilage pads with jelly like filling.

Ribs and SternumRibs and Sternum The ribs are attached to The ribs are attached to

vetrebrae at the back and to vetrebrae at the back and to cartilage in front, which is cartilage in front, which is then attached to the then attached to the sternum. They are called sternum. They are called costo-chondral cartilages. costo-chondral cartilages.

The last 2 ribs are called The last 2 ribs are called floating ribs as they are not floating ribs as they are not attached to anything in the attached to anything in the front. front.

The sternum is held up by The sternum is held up by the cartilages, its ends are the cartilages, its ends are attached to muscles of the attached to muscles of the neck and abdomen.neck and abdomen.

Occasionally an extra Occasionally an extra cervical rib is present, cervical rib is present, hampering neck movement.hampering neck movement.

The sternum is fused from 3 The sternum is fused from 3 parts (body, manubrium, parts (body, manubrium, and xyphoid process)and xyphoid process)

APPENDICULAR SKELETONAPPENDICULAR SKELETON

It consists of - It consists of - PECTORAL GIRDLE –SCAPULA + PECTORAL GIRDLE –SCAPULA +

CLAVICLE and the Upper LimbsCLAVICLE and the Upper Limbs

PELVIC GIRDLE – ILLIUM, Ischium, PELVIC GIRDLE – ILLIUM, Ischium, Sacrum, Pubis and the Lower LimbsSacrum, Pubis and the Lower Limbs

THE PELVISTHE PELVIS THE MALETHE MALE Thick and Thick and

heavyheavy DeepDeep Narrow and Narrow and

deepdeep Heart shapedHeart shaped SmallerSmaller NarrowNarrow

RoundRound

LargeLarge

THE FEMALETHE FEMALE Thin and lightThin and light

ShallowShallow Wide and Wide and

shallowshallow Oval/roundOval/round LargerLarger WideWide

OvalOval

SmallSmall

Structure

P major

P minor

P inletP outlet-P arch + suprapubic angle

-ObturatorForamen

-Acetabulum

The Hip BonesThe Hip Bones

IlliumIllium IschiumIschium SacrumSacrum Pubis Pubis

LOWER LIMBSLOWER LIMBS THE FEMURTHE FEMUR Articulates with the Articulates with the

Illium via the obturator Illium via the obturator foramen proximally and foramen proximally and to the Tibia and Patella to the Tibia and Patella via the condyles distally via the condyles distally (at the bottom)(at the bottom)

Most common injury is Most common injury is fracture at the neck fracture at the neck which is mostly in the which is mostly in the elderly and a hip elderly and a hip replacement surgery is replacement surgery is performed where the performed where the head is replaced.head is replaced.

If break anywhere else If break anywhere else – then usually – then usually associated with major associated with major muscle damage and muscle damage and blood loss – which can blood loss – which can be fatal if the femoral be fatal if the femoral artery is cut.artery is cut.

TIBIA & TIBIA & FIBULAFIBULA

The head of the fibula fits just under the lateral condyle of the Tibia.

The inner edges of the distal ends of the bones articulate with each other,

The Tibia articulates with the Femoral condyles and Patella proximally- forming the Knee Jt and the Calcaneous bone distally to form the Ankle Jt.

THE PECTORAL GIRDLETHE PECTORAL GIRDLE

THE SCAPULATHE SCAPULA The Glenoid The Glenoid

fossa fossa articulates with articulates with the head of the the head of the HumerousHumerous

The Acromion The Acromion process process articulates with articulates with the clavicle the clavicle absorbs shock absorbs shock of shoulder of shoulder impact, impact,

THE CLAVICLETHE CLAVICLE

Acromial endAcromial end- is flat and has a small facet for articulation with - is flat and has a small facet for articulation with the acromion; the acromion;

Sternal endSternal end- has a large facet for articulation with the - has a large facet for articulation with the manubrium, and first costal cartilage; manubrium, and first costal cartilage;

Conoid tubercleConoid tubercle- conoid ligament of the coracoclavicular - conoid ligament of the coracoclavicular ligament attaches here; ligament attaches here;

Trapezoid lineTrapezoid line- trapezoid portion of the coracoclavicular - trapezoid portion of the coracoclavicular ligament attaches here. ligament attaches here.

THE HUMEROUSTHE HUMEROUS It is part of the It is part of the

shoulder joint or shoulder joint or rotator cuff.rotator cuff.

Attached by the head Attached by the head to the scapula at the to the scapula at the proximal end and to proximal end and to the Radius at the the Radius at the Capitulum-head of Capitulum-head of radius- and the Radial radius- and the Radial fossa in flexionfossa in flexion

Ulna- Coronoid fossa Ulna- Coronoid fossa in flexion and in flexion and Olecrenon fossa in Olecrenon fossa in extension extension

Most common injury Most common injury to the bone is fracture to the bone is fracture at the surgical neck.at the surgical neck.

RADIUS & ULNARADIUS & ULNA They are the most They are the most

commonly fractured commonly fractured bones.bones.

Called Colles #,the other Called Colles #,the other being Barton’s #.being Barton’s #.

The The trochlear notch trochlear notch is is the point where the the point where the humerous articulates with humerous articulates with the ulna and the the ulna and the radial radial notchnotch is the point where is the point where the ulna articulates with the ulna articulates with the head of the radius the head of the radius

The The styloid processstyloid process of of the the radius radius forms the forms the medial margin of the wrist medial margin of the wrist while the while the styloid processstyloid process of the of the ulnaulna forms the forms the lateral margin of the wrist.lateral margin of the wrist.

The HandThe Hand

Attachments – to Attachments – to various muscles of the various muscles of the forearm and ligaments forearm and ligaments that hold all these that hold all these small bones together.small bones together.

Carpals articulate with Carpals articulate with metacarpals which in metacarpals which in turn articulate with turn articulate with the fingers or the fingers or phalanges.phalanges.

Special movement – Special movement – opposable thumbopposable thumb

Other movements- Other movements- holding, tearing, holding, tearing, pincer actionpincer action

The FootThe Foot Attachments – to Attachments – to

various muscles of various muscles of the ankle and the ankle and ligaments that hold ligaments that hold all these small bones all these small bones together.together.

TarsalsTarsals articulate articulate with with metatarsalsmetatarsals which in turn which in turn articulate with the articulate with the fingers or fingers or phalangesphalanges- - proximal, proximal, intermediate and intermediate and distal.distal.

Special movements- Special movements- balance of entire balance of entire body weight across body weight across the arch/bonesthe arch/bones

Stretch Up…Stretch Up…

Dr Anjali HariharanDr Anjali Hariharan