Bones & Cartilages By Chaman Lal Karotia (CK)

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Bones and cartilages basic anatomy

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Federal Institutes of Health Sciences, Multan:

Bones & Cartilages Federal Institutes of Health Sciences, Multan By: Chaman Lal -B.S.PT, DPT, Dip. in sports Injuries, MPPS(PAK), -PG in Clinical Electroneurophysiology (AKUH), -Registered.EEGT (USA), -Member of AANEM & ASET (USA).

Study Outlines:

Study Outlines Introduction to Bone tissue, its composition Functions of skeletal system Classification of bone by: Shape, Region, Development, Structure Gross structure of long bone Cartilages, its types & functions 2/1/2014 Bone & Cartilages By:CK (FIHS) 2

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Bone tissue In simplified terms, bone itself is composed of: Cells Osteoblasts (bone making cells) Osteocytes (Mature bone cells, , maintain bone matrix) Osteoclasts (bone destroying cells) Collagen fibers that contribute to hardness of the bone Matrix (cement) mostly calcium phosphate, calcium carbonate & other salts that give bone it’s strength & structure Together, collagen & matrix act as reinforcement Bone is constantly turning over (old bone replaced by new bone) Bone density changes as with age Weight bearing activity increases bone density (stimulates osteoblasts) Two types of bone tissue: spongy compact 2/1/2014 3 Bone & Cartilages By:CK (FIHS)

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Bone tissue Spongy bone forms flat and short bones as well as ends (epiphyses) of long bones Compact bone solid, dense bone compact bone forms external shell of all bones and shafts (diaphyses) of long bones 2/1/2014 4 Bone & Cartilages By:CK (FIHS)

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Supports soft tissues of the body for the maintenance of the body’s form and posture. Provides an attachment point for skeletal muscles, tendons, ligaments etc. They serve as levers for muscular actions. Protects vital organs (brain, heart, lungs, bladder etc). Storing important minerals, e.g. calcium and phosphorus (97% of the body calcium & phosphate). Bone marrow manufactures blood cells. The larger paranasal air sinuses affect the timber of the voice. Functions of the Skeletal System 2/1/2014 6 Bone & Cartilages By:CK (FIHS)

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Long Bones - mainly compact bone with spongy bone at the ends. Examples: -Humerus -Femur -Ulna -Radius -Tibia -Fibula Flat Bones - protective bones for soft organs such as the lungs. Example: -Sternum -Scapula -Ribs & Skull CLASSIFICATION OF BONES (1-Shape) 2/1/2014 7 Bone & Cartilages By:CK (FIHS)

Types of Bones…..cont’d:

Types of Bones…..cont’d

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Short Bones - cube like bones, provide stability and strength. Example: -Trapezoid-finger -Carpal & tarsal bones Irregular bones - Various functions including protection, stability and strength. Example: - Vertebrae -Pelvis or hip bone CLASSIFICATION OF BONES 2/1/2014 9 Bone & Cartilages By:CK (FIHS)

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Pneumatic Bones - Certain irregular bones contain large air spaces lined by epithelium. Examples: -Maxilla, Sphenoid,Ethmoid etc They make the skull light in weight, help in resonance of voice, and act as air conditioning chambers for the inspired air. Sesamoid Bones - These are the bony nodules found embedded in the tendons or joint capsules. They have no periosteum & ossify after birth. Example: -Patella, Pisiform etc Accessory (supernumerary) Bones:- These are not always present. They may occur as ununited epiphyses developed from extra centres of ossification., e.g sutural bones etc. These are often bilateral and have smooth surfaces without any callus. CLASSIFICATION OF BONES 2/1/2014 10 Bone & Cartilages By:CK (FIHS)

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DIAPHYSIS - shaft of a long bone, constructed mainly of compact bone. EPIPHYSIS - end of the long bone, exterior is formed by compact bone & interior is formed by spongy bone. Medullary cavity – storage area for yellow bone marrow (red bone marrow in infants, in adults red marrow confined to spongy bone) Articular cartilage covers epiphysis providing a smooth, slippery surface decreasing friction at joints Structure of a Long Bone 2/1/2014 11 Bone & Cartilages By:CK (FIHS)

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Anatomy of a Long Bone:

Anatomy of a Long Bone Diaphysis Medullary Cavity Nutrient Art & Vein 2 Epiphyses Epiphyseal Plates Epiphyseal Art & Vein Periosteum Outer: Dense irregular CT Inner: Osteoblasts, osteoclasts Does not cover epiphyses Attaches to bone matrix via collagen fibers Endosteum Osteoblasts, osteoclasts Covers trabeculae, lines medullary cavity 2/1/2014 13 Bone & Cartilages By:CK (FIHS)

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14 Structure of a Long Bone Bone markings Projections & indentations Where muscles, tendons & ligaments attach and where nerves and blood vessels pass Examples: Tuberosity Trochanter Process Facet Condyle Fossa 2/1/2014 Bone & Cartilages By:CK (FIHS)

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15 Growth & development of bone tissue Epiphyseal line remnant of epiphyseal plate: In embryos skeleton made of hyaline cartilage By birth all replaced by bone except articular cartilage & epiphyseal plates in children (growth plate) Epiphyseal plate cause lengthwise growth - cells divide quickly pushing plate away from diaphysis. Too much stress can cause injury hindering growth Hyaline cartilage is replaced by bone BW 16-25 years leaving epiphyseal line 2/1/2014 Bone & Cartilages By:CK (FIHS)

CLASSIFICATION OF BONES (2-Regional):

1-Axial skeleton ( 80 bones) Skull=8, Facial =14 Vertebrae=26 Ribs=24 Sternum=1 Hyoid=1 Auditory ossicles (3 in each ear) =6 2-Appendicular skeleton 126 bones upper & lower limbs and Pelvic & pectoral girdles CLASSIFICATION OF BONES (2-Regional) 2/1/2014 Bone & Cartilages By:CK (FIHS) 16

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Cranial bones=8 & Facial=14 Frontal Parietal Temporal Occipital 2/1/2014 17 Bone & Cartilages By:CK (FIHS)

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Spine built of 26 vertebrae Five vertebral regions cervical vertebrae (7) in the neck thoracic vertebrae (12) in the thorax lumbar vertebrae (5) in the low back region sacrum (5, fused) coccyx (4, fused) Vertebral column 2/1/2014 19 Bone & Cartilages By:CK (FIHS)

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Thorax Sternum (breast bone) =1 Ribs 1-7 are true ribs (join sternum directly) 8-12 are false ribs (do not join sternum directly but via 7 th rib) 11-12 are floating (not bound anteriorly) 2/1/2014 20 Bone & Cartilages By:CK (FIHS)

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21 Pectoral (shoulder) girdle Bones Clavicle Scapula 2/1/2014 Bone & Cartilages By:CK (FIHS)

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Bones Humerus ulna & radius carpal bones metacarpal bones phalanges Upper extremity 2/1/2014 22 Bone & Cartilages By:CK (FIHS)

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Lower extremity Bones femur and patella tibia & fibula tarsal bones metatarsals phalanges 2/1/2014 23 Bone & Cartilages By:CK (FIHS)

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Pelvic girdle Bones of Pelvis Coxal (Hip) bones (2) Sacrum Coccyx 2/1/2014 24 Bone & Cartilages By:CK (FIHS)

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25 3 parts Ilium Ischium Pubis 3 separate parts in childhood Fused into single bone in adults Hip bones 2/1/2014 Bone & Cartilages By:CK (FIHS)

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1) Intramembranous Ossification Membrane bones: most skull bones and clavicle Osteoblasts in membrane secrete osteoid that mineralizes Osteocytes maintain new bone tissue Trabeculae forms between blood vessels Grows into thickened plates at periphery = compact bone Periosteum forms over it CLASSIFICATION OF BONES (3-Developmental) Bone & Cartilages By:CK (FIHS) 2/1/2014 27

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2) Endochondral Ossification : All other bones Begins with a cartilaginous model Perichondrium becomes replaced by periosteum Cartilage in diaphysis calcifies Trabeculae forms from Periosteal bud Periosteal bud = arteries & veins, cells forming bone marrow, osteoblasts, osteoclasts Medullary cavity is formed by action of osteoclasts Epiphyses grow and eventually calcify Epiphyseal plates remain cartilage for up to 20 years CLASSIFICATION OF BONES (3-Developmental) Bone & Cartilages By:CK (FIHS) 2/1/2014 28

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3) Membrano-cartilaginous bones : Ossify partly in membrane and partly in cartilage. Example:- Clavicle, Mandible, Occipital, Temporal, sphenoid etc. CLASSIFICATION OF BONES (3-Developmental) Bone & Cartilages By:CK (FIHS) 2/1/2014 29

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A- Macroscopically the architecture of bone may be ; 1- Compact Bone 2- Cancellous spongy/trabecular bone 1-Compact Bone:- - Compact bone is dense in texture like ivory, but is extremely porous. It is best developed in the cortex of the long bones. - These have adaptation of bending and twisting by force. 2/1/2014 Bone & Cartilages By:CK (FIHS) 30 CLASSIFICATION OF BONES (4-Structure)

Structural classification. . . Cont’d:

2- Cancellous Spongy, or Trabecular Bone:- It is open in texture and is made up of a meshwork of trabeculae (rods & plates). This meshwork is of 3 types; 1- Meshwork of rods 2- Meshwork of plates 3- Meshwork of rods & plates - Cancellous bone is an adaptation to compressive forces. 2/1/2014 Bone & Cartilages By:CK (FIHS) 31 Structural classification. . . Cont’d

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Microscopically, the bone is of 4 types; 1. Lamellar bone:- -Most of mature human bones (compact/spongy) -These are composed of thin plates of bony tissue called lamellae. -These are arranged in piles in a cancellous bone, but in concentric cylinders (Haversian system or secondary osteon) in compact bone. Fibrous bone:- -in young fetus, common in reptiles & amphibian 3&4. Dentine & Cement in teeth. 2/1/2014 Bone & Cartilages By:CK (FIHS) 32 Structural classification. . . Cont’d

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Bone Growth & Remodeling:

Bone Growth & Remodeling GROWTH Appositional Growth = widening of bone Bone tissue added on surface by osteoblasts of periosteum Medullary cavity maintained by osteoclasts Interstitial Growth =Lengthening of Bone Epiphyseal plates enlarge by chondroblasts Matrix calcifies (chondrocytes die and disintegrate) Bone tissue replaces cartilage on diaphysis side REMODELING Due to mechanical stresses on bones, their tissue needs to be replaced Osteoclasts -take up bone ( = breakdown) release Ca 2++ , PO 4 to body fluids from bone Osteoblasts -lay down bone formation secrete osteoid to form new bone Ideally osteoclasts and osteoblasts work at the same rate! 2/1/2014 Bone & Cartilages By:CK (FIHS) 34

Growth and Remodeling:

Growth and Remodeling Bone & Cartilages By:CK (FIHS) 35

Bone Anatomy and Stress:

Bone Anatomy and Stress Wolff’s law holds that a bone grows or remodels in response to the forces which act upon it. Changes in bone density in response to exercise. Tension and compression forces must balance . 2/1/2014 Bone & Cartilages By:CK (FIHS) 36

Healing of a Bone Fracture:

Healing of a Bone Fracture 2/1/2014 Bone & Cartilages By:CK (FIHS) 37

Cartilages:

Cartilages One of the most remarkable tissues of the human body. Its inert and lifeless, bones are living, dynamic structures. Weaker than bone More flexible than bone Cells in an abundant matrix. Cell Types Chondroblasts Chondrocytes in lacunae Bone & Cartilages By:CK (FIHS) 2/1/2014 38

Skeletal Cartilages:

Skeletal Cartilages Initially our skeleton is made up of cartilages and fibrous membranes. Gradually our skeletal cartilages are replaced by bone. Upon reaching adulthood the skeleton becomes almost fully ossified. Only a few cartilages remain in the adult skeleton. Bone & Cartilages By:CK (FIHS) 2/1/2014 39

Basic structure, type & location:

Basic structure, type & location A skeletal cartilage is made of some variety of cartilage tissue Each type contains a high proportion of water which makes them resilient Cartilage has no nerves or blood supply It is surrounded by a dense tissue membrane called a perichondrium. Bone & Cartilages By:CK (FIHS) 2/1/2014 40

Basic structure, type & location :

Basic structure, type & location There are three types of cartilage tissue: 1. Hyaline Cartilage 2. Elastic Cartilage, and 3. Fibrocartilage Each contains a matrix of jellylike ground substance and fibers. Bone & Cartilages By:CK (FIHS) 2/1/2014 41

Cartilages:

Cartilages Bone & Cartilages By:CK (FIHS) 42

1.Hyaline cartilages:

1.Hyaline cartilages Greek  Hyalos= transparent stone Its bluish white and translucent in color The most prevalent type of cartilage Its high proportion of collagen fibers give it flexibility and resilience while providing support Upon examination the tissue appears white, frosted, and smooth. Bone & Cartilages By:CK (FIHS) 2/1/2014

Hyaline cartilage locations:

Hyaline cartilage locations Articular - covers the end of bones Costal - connect ribs to breastbone Laryngeal - skeleton of larynx Tracheal & bronchial - reinforce the respiratory passages Nasal - support the external nose Bone & Cartilages By:CK (FIHS) 2/1/2014

2.Elastic cartilage:

2.Elastic cartilage Elastic cartilage is similar to hyaline cartilage but with more elastic fibers Its elastic fibers enable it to withstand repeated bending Found only in the external ear and the epiglottis Bone & Cartilages By:CK (FIHS) 2/1/2014

3.Fibrocartilage:

3. Fibrocartilage The tissue contains parallel rows chondrocytes alternating with collagen fibers. Tissue is highly compressible and has great tensile strength. Found in thick pad-like structures like the menisci of the knee or the discs of the vertebral column. Bone & Cartilages By:CK (FIHS) 2/1/2014

Growth of cartilage:

Growth of cartilage Cartilage grows in two ways Appositional growth occurs when cells in the surrounding perichondrium secrete new matrix next to existing cartilage tissue (growth from the outside). Interstitial growth occurs when the chondrocytes within the cartilage divide and secrete new matrix, expanding the cartilage (growth from within). Bone & Cartilages By:CK (FIHS) 2/1/2014 47

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