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