Functions of the Bones:

A. Support: Rigid framework for the body (ribs, pelvis, lower limbs), and attachment points for
tendons and ligaments
B. Protection: forms rigid walls of the cavities (cranial cavity protects brain, and the vertebral
encloses the spinal cord)
C. Movement: bones serve as levers to which muscles are attached by tendons, when muscles
contract they pull on levers and movement is produced
D. Mineral Storage: calcium, phosphorus, sodium, potassium and other minerals (in pregnant
female calcium is reabsorbed from mothers bones to provide for baby)
E. Hematopoiesis: (blood cell formation) mostly RBCs, with some WBCs and platelets. Following
birth, red marrow (consists of immature blood cells, fat cells and macrophages) with certain
bones produced blood cells
F. Triglycerides (fat) storage: (yellow marrow) used as an energy source
Perichondrium:

a layer surrounding cartilage (no nerves or BV) made of dense irregular connective tissue
resists outward expansion when the cartilage is compressed
contains BV from which nutrients diffuse through the matrix to reach the cartilage cells

Classification of Bones (by shape and tissue type)

A. Shape
1. Long Bone:
longer then they are wider (upper and lower limbs, metacarpals, phalanges)
has a shaft plus two ends
named for their elongated shape not overall size
2. Short Bone:
Roughly cubed shaped (wrist/ carpals and ankle/tarsals)
3. Sesamoid Bone:
Special type of short bone that form in a tend (patella)
Vary in size and number in different individuals
Some sasamoid bones act to alter the direction of pull of a tendon
4. Flat Bone:
Think, flattened, and usually a bit curved (sternum, scapulae, ribs, skull)
5. Irregular Bones:
Have complicated shapes that fit none of the preceding classes (vertebrae and hip)
B. Tissue Type
1. Compact:
Dense outer layer that looks smooth and solid to the naked eye
Consists of very few tiny spaces, provides protection and support for stress
Thicker in diaphysis than epiphysis

2. Spongy:
Aka cancellous bone
Honeycomb of small needle-like or flat pieces called trabeculae
In living bones the open spaces between trabeculae are filled with red or yellow
bone marrow
Trabeculae function to lighten the total amount of bone weight
Bone Structure:
Diaphysis: (shaft)

Long axis of the bone

Constructed of thick collar compact bone that surrounds a central medullary cavity (marrow
cavity). In adults it contains fat (yellow marrow) and is called yellow marrow cavity

Epiphyses:

Two expanded ends of a long bone (proximal and distal)

Compact bone forms the exterior of epiphyses, and interior contains spongy bone
Articulates with other bones (forms joints)
Join surface of each epiphysis is covered with a thin layer of articular (hyaline) cartilage, which
cushions the opposing bone ends during joint movement and absorbs stress
Between diaphysis and each epiphysis is an epiphyseal line, remnant of epiphyseal plate
(females at 18, males at 20)
Epiphyseal plate: (disc of hyaline cartilage that grows during childhood to lengthen the bone)

Periosteum:

A glistening white, double-layered membrane that covered the external surface of the entire
bone except the joint surface
Essential for protection, growth, repair, and nutrition of bone
Provides an insertion and anchoring point for tendons and ligament
Richly supplied with nerve fibers, lymphatic vessels, and BV, which enter diaphysis via nutrient
foramina
Fibrous Layer: (outer)
Dense irregular CT, BV, lymph vessels and nerves these vessels enter through nutrient
canals (nutrient foramina) into bone
Osteogenic Layer: (inner)
Against the bones outer surface
Contains MOSTLY bone-forming cells (osteoblasts) which secrete bone matrix elements
Osteoclasts (bone breakers/reabsorb)
Elastic fibers, nerves, BV, which enter diaphysis via nutrient foramina

Sharpeys fibers:
Tufts/strands of collage fibers that extend from its fibrous layer into the bone matrix (penetrates
through the osteogenic layer into bone)
Secure periosteum to the underlying bone
Increase in numbers at muscle/tend/capsule attachment
Endosteum:

Thin CT membrane that lines the medullary cavity surface of diaphysis

Covers the trabeculae of spongy bone and lines the canals (medullary cavity) that pass through
the compact bone
Contains osteoblasts but MOSTLY osteoclasts

Metaphysis: region between the diaphysis joins epiphysis (not in adults)

Location of hematopoietic tissue (red marrow)

Typically found within trabecular cavities of spongy bone of long bones and in the dipole of flat
bones
In children: found in spongy bone in the long bones
In adults:
Dipole (spongy bone) of flat bones in red marrow cavities.
Only in the epiphysis in red marrow cavities. (spongy bone)
Yellow marrow can revert to red marrow if necessary (with increased blood loss)

Cells: 4 basic types

1. Osteogenic Stem Cells
Found in the periosteum and endosteum and central canal
Mitotically active stem cells (produce osteoblasts)
2. Osteoblasts:
Non-mitotic (differentiate from osteogenic cells)
Bone forming cells, synthesize the organic matter of bone matrix
Stress (fractures, pressure) stimulate an increase in numbers
3. Osteocytes:
Former osteoblasts now trapped in the matrix they synthesized
Found in little cavities called lacunae (canaliculi connect lacunae)
Maintain bone matrix, if they die surrounding matrix is reabsorbed
Also act as sensors in cases of bone deformation or damaging stimuli
Processes of neighboring osteocytes are joined by gap junctions within canaliculi,
allowing them to share nutrients and chemical signals coming from the central canal
4. Osteoclasts:
Bone-dissolving cells

Come from the same bone marrow stem cells that produce monocytes (blood); these
cells are also believed to be macrophages in the tissue
Made by the fusion of several very large cells

Compact Bone

Haversian System (Osteon): (smallest functional unit)

Elongated cylinder with a central canal (tiny weight-bearing pillars)
Runs along axis of the bone
Contain lamellae, lacunae, osteocytes, canaliculi

Central Canal (Haversian canal)

runs longitudinally through each osteon and connects with perforating canal (Volkmanns canal)
contains small BV and nerve fibers that serve osteons cells

Perforating canals (Volkmanns canal)

runs horizontally (at right angles to the central canal)

connect blood and nerve supply from periosteum to those in central canal and medullary cavity
lined with endosteum

Interstitial lamellae:

incomplete lamella not part of osteon

fill the gaps between forming osteons or are remnants of osteons that have been cut through by
bone remodeling

Circumferential lamellae:

deep to the periosteum and superficial to endosteum, (most superficial layer of bone, next to
periosteum)
surrounds all bone tissue completely (extends around entire circumference of diaphysis
resists twisting of the long bone

Spongy Bone:
Trabeculae:

thin plates of bone forming a lattice work

lad down according to stresses (specifically to resist stress as much as possible)
few cells thick; contain irregularly arranged lamellae and osteocytes interconnected by canaliculi
No osteons are present

Nutrients reach osteocytes by diffusing through canaliculi from capillaries in the endosteum
surrounding the trabeculae

Chemical Composition of Bone:

1. Organic components (living tissue)
Structures:
Osteogenic cells, osteoblasts, osteocytes, and osteoclasts and osteoid (organic part of
the matrix)
Osteoid makes up one third of the matrix, includes ground substance (composed of
proteoglycans and glycoproteins) and collage fibers, made and secreted by osteoblasts
Function: gives bone flexibility and tensile strength to resist twisting and stretching
1/3 of the total bone weight
2. Inorganic components (salts)
Structure:
Hydroxyapatite: calcium phosphate, calcium hydroxide, calcium carbonate
Present in the form of tiny, tightly packed, needle-like crystals in and around the collage
fibers in the extracellular matrix
Function: Account for hardness and resist in compression
These salts cause bone to ossify
2/3 of the bone weight
Bone Development (osteogenesis)
Bone develops by transformation of embryonic connective tissue. There are two different processes in
bone formation:

It ossifies from either fibrous membrane to bone (directly)- intramembranous ossification

Or from embryonic CT to hyaline cartilage indirectly- endochondral ossification

Intramembranous Ossification:

Results in formation of cranial bones of the skull and clavicle

Before 8 weeks
Most bones formed by this process are flat bones
1. Mesenchymal cells cluster and differentiate into osteoblasts
2. They then form centers for ossification (clusters of osteoblasts) from within fibrous
membrane and throughout the structure
Osteoblasts then secrete osteoid (cellular substance) will calcify within a few days
(become true bone) as calcium and salts are added

3. Developing woven bone around different ossification centers will all fuse together and form
a bony lattice work (trabeculae) which entraps BV
4. With this ongoing ossification of fibrous membrane (now woven bone), osteoblasts will
become trapped in lacunae (and become osteocytes)
5. Simultaneously, mesenchymal tissue surrounding growing mass of woven bone becomes
the periosteum
The inner osteogenic layer, along with superficial trabeculae, will produce
compact/laminar bone (replaces woven bone)
Outer fibrous layer will serve to protect and support
6. With appearance of red marrow within spongy bone, and when compact bone completely
encloses trabeculae (diploe), process is complete
Endochondral Ossification:
Forms long and short bones (most bones of the body)
Beginning in the 2nd -3rd month of development:
1. Perichondrium covering hyaline cartilage bone is infiltrated with BV converting it to
vascularized periosteum
2. As a result, mesenchyme cells specialize into osteoblasts
3. These new osteoblasts secrete osteoid against the hyaline cartilage diaphysis, encasing it in
bone. Forming a layer of bone called periosteal bone collar.
4. Cartilage in the center of the diaphysis calcifies and then develops cavities
5. As the bone collar forms:
1. Chondrocytes within the shaft hypertrophy (enlarge) until they burst; their contents will
increase alkalinity (secrete alkaline phosphate) into the matrix. This will cause
2. Calcification of cartilage which will stop diffusion of blood and nutrients to chondrocytes,
and this will cause the cells to die
3. Deterioration of matrix occurs; leaving cavities and broken cartilage, but the hyaline
cartilage is supported by bone collar. Cartilage remains healthy and continues to grow
briskly, causing cartilage model to elongate
6. The remaining cavities fill with components of periosteal bud (nerves, arteries, veins,
lymphatics, osteoblasts, and osteoclasts); this will cause remaining fragments of hyaline
cartilage to calcify and deteriorate completely
7. Primary ossification center will continue to enlarge into the growing medullary cavity due to
osteoclastic activity
8. Eventually a periosteal bud will enter the epiphysis, and secondary ossification center will
appear, starting the same type of cycle again
Growth in length of long bones (after both secondary ossification centers have formed, and all cartilage
has been replaced) two regions remain cartilage:
Articular cartilage: epiphyseal surfaces (both ends) as
Epiphyseal plate: between epiphysis and diaphysis

 As long as the epiphyseal plate remains present, bone can and will continue to lengthen
o Cartilage cells undergo mitosis and increase the size of the epiphyseal plate
o Simultaneously, chondrocytes/cartilage on the side nearest the medullary cavity
(diaphysis) will ossify. Longitudinal growth is accompanied by remodeling process by
means of selective bone reabsorption and formation
o This will maintain epiphysis at a relatively constant size
Epiphyseal plate has 4 zones and a resting zone:
1. Zone of served (quiescent) cartilage:
Consists of small chondrocytes irregularly scattered; it does not function in bone
growth
Anchors epiphyseal plate to the bone
BV from here also provide nutrients to other zones of epiphyseal plate
2. Proliferating (growth) zone:
Ongoing rapid chondrocyte mitosis
Chondrocytes arranged in coin-like stacks, due to rapid growth
These cells divide quickly pushing the epiphysis away from diaphysis, causing entire long
bone to lengthen
3. Hypertrophic zone:
Chondrocytes are maturing and are getting extremely large as they move toward the
diaphysis
Still arranged in columns
Hypertrophy, and their lacunae erode and enlarge, leaving large interconnecting spaces
4. Calcification-Ossification:
Only a few cells thick
Mostly dead cartilage because the intercellular matrix around them has chemically
changed and hardened-> calcified
Bone tissue and vascularization laid down by osteoblasts
5. Resorption zone:
Osteoclasts breakdown and remove excess cartilage and bone
Appositional growth (growth from the outside):

Process by which bone increase in thickness/diameter

Osteoblasts in osteogenic layer of the periosteum secrete bone matrix onto outside
surface of the bone
Osteoclasts destroy bone lining the marrow cavity causing increase in the diameter of
cavity and maintaining relatively thin diaphyseal wall

Interstitial growth (growth from within)

Osteocytes from within the lacunae secret matrix (osteoid), expanding the cartilage from within

Hormonal Regulation of Bone Growth during Youth

Growth hormone (GH):

Released by anterior pituitary gland->
->Liver(kidneys) release IGF-1 aka (somatomedins-cell growth and division), for
cartilage formation, skeletal growth by stimulating the epiphyseal plate and protein
synthesis.
Thyroid hormones (T3 and T4)
Modulate activity of GH
Help with development of proper proportions
Sex hormones:
Both male testosterone and female estrogen and progesterone cause initial growth
spurt at puberty and secondary sex characteristic changes (masculine and femininebreasts, facial hair, Adams apple)
They will also stop growth by causing closure of epiphyseal plates
Proper amounts of vitamins, minerals and hormones
Calcium and phosphorus, salts (make bone hard)
Vitamin A, C, D (vit. D for proper utilization of Ca and P)
Other hormones (calcitonin, parathyroid hormone, GH, thyroid, sex hormones)

Hyposecretion of GH or thyroid hormone leads to dwarfism before

Hypersecretion of GH or thyroid hormone in a child leads to increased height (gigantism)
Homeostatic Imbalances of Bone
A. Osteoporosis: bone resorption outpaces bone deposit
1. It was not precisely defined as a disease until 1994
2. A disease which causes the density and quality of bone to be reduced, leading to weakness
of the skeleton with an increased risk of fracture (spine (vertebral body compression)
fractures, wrist, hip, pelvis and upper arm)
3. Bone loss can occur gradually without signs or symptoms until the disease is advanced
4. Known as an old womans disease
Most commonly seen in old people (sedentary white females, post-menopausal,
with long-term dietary calcium deficiency)
Seen in younger aged persons (bone loss in women can begin as early as age 25)
Genetics, people with slight body build, or with eating disorders (anorexia) ,
smokers
5. Estrogen in females:
Decreased estrogen causes increased chance of osteoporosis
Decreased estrogen (female athletes; due to decreased adipose tissue->decreased
menses due to decreased estrogen release from the ovaries)

 Estrogen decreases sensitivity of osteoclasts to parathyroid hormone (PTH)

decreased (PTH) leads to increased bone resorption. (without estrogen, osteoclasts
eat more)
6. Risk for a female to have osteoporotic fracture is 30-40%. In male it is about 13%
In several European countries, osteoporosis is responsible for more hospital days for
women over 45 than any other disease
7. Diagnosis (Dx) & Treatment (Tx): NO cure
Dx:
Early detection of bone loss is key to the prevention of suffering
Bone mineral density (BMD) measurements are effective in assessing fracture risk,
conforming a diagnosis of osteoporosis
Tx:
There are medications for prevention and the treatment (may not be reimbursed)
Rehabilitation to regain mobility and reduce pain
Non-medical therapy, healthy balanced diet high in Ca++ and Vitamin D, regular
exercise, no smoking and limited alcohol intake
B. Demineralization disease: osteomalacia (adults), rickets (children)
1. Due to deficiency or abnormal metabolism of Vitamin D, or excretion of inorganic
phosphates, with subsequent demineralization (Ca++) and softening of bones
2. A number of disorders in which the bones are inadequately mineralized
3. Symptoms :pain when weight is put on affected bones
4. Due to deficiencies of calcium, phosphorus, vitamin D or sunlight (all of which contribute
to hardening of bone)
5. Osteomalacia:
A condition marked by softening of the bones (due to impaired mineralization, with
excess accumulation of osteoid), with pain, tenderness, muscular weakness,
anorexia, and loss of weight, resulting from deficiency of vitamin D and calcium.
Osteomalacia is seen in adults (after epiphyseal plate is closed); reduction of
inorganic components leads to softening bones, e.g. bowed leg and coxa vera
6. Rickets:
A condition caused by deficiency of Vitamin D, especially in infancy and childhood,
with disturbance of normal ossification. The disease is marked by bending and
distortion of the bones under muscular action, by the formation of nodular
enlargements on the ends and sides of the bones, by delayed closure of the
fontanels, pain in the muscles, and sweating of the head. Vitamin D and sunlight
together with an adequate diet are curative, provided that the parathyroid glands
are functioning properly.
Can be more severe (developmental delays, long-term effects)
Epiphyseal plate lacking calcification; plate will noticeably widen
Bone is appositionally enlarged

 May stunt longitudinal growth

Craniotabes: softening and flattening of skull bones, bowing of the limbs and coxa vera