© Michie B.

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ANAPHY LECTURE: SKELETAL SYSTEM Long Bone Structures
• Diaphysis:
ANATOMY OF THE SKELETAL SYSTEM - shaft
- compact bone tissue (on outside)
The skeleton can be divided • Epiphysis:
into two parts: - ends
• Axial skeleton - spongy bone tissue
• Bones of the • Articular cartilage:
head, neck, and - covers epiphyses
trunk - reduces friction
• Appendicular • Epiphyseal plate:
skeleton - site of growth
• Bones of the - between diaphysis and epiphysis
arms and legs • Medullary cavity:
• Bones of the - center of diaphysis
girdles: attach - red or yellow marrow
arms and legs to • Periosteum: membrane around bone’s outer surface
trunk • Endosteum: membrane that lines medullary cavity

COMPONENTS OF SKELETAL SYSTEM

BONE
• Cartilage: reduce friction and model for bone formation
• Tendons: attach bone to muscle
• Ligaments: attach bone to bone

Background Information
• Bones, cartilage, tendons, and ligaments are connective
tissues.
• Proteoglycans: Compact Bone Tissue
- large polysaccharides attached to proteins Location: outer part of diaphysis (long bones) and thinner
- part of ground substance surfaces of other bones
- store water • Osteon:
- Bone’s extracellular matrix is collagen and - structural unit of compact bone
minerals (flexible and able to bear weight) - includes lamella, lacunae, canaliculus, central
- Cartilage’s extracellular matrix is collagen and canal, osteocytes
proteoglycans (good shock absorber) • Lamella: rings of bone matrix
- Tendons and ligaments’ extracellular matrix is • Lacunae: spaces between lamella
collagen (very tough) • Canaliculus: tiny canals, transport nutrients, remove waste
• Central canal: center of osteon, contains blood vessels
CLASSIFICATION OF BONES
Bones can be classified by shape:
• Long bones are longer than they are wide and have
clubby ends. Example: tibia.
• Short bones are cube-like. Example: carpal bones.
• Flat bones look like they are a sheet of clay that has
been molded. Example: parietal bone.
• Irregular bones have many projections and spines.
Example: vertebrae.
• Sesamoid bones grow in tendons where there is a lot
of friction. Example: patella.

Long Bones of the Hand and Flat Bones—Sternum and Ribs

Short Bones of the Wrist

Irregular Bone—A Typical Vertebra Sesamoid Bone—The Patella

Spongy Bone Tissue

• Cancellous bone
• Location: epiphyses of long bones and center of other bones
• Trabeculae: interconnecting rods, spaces contain marrow
• No osteons
Type of bone tissue:
compact and spongy (cancellous)
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Bone Cells
• Osteocytes: maintain bone matrix
• Osteoblasts: build bone
• Osteoclasts: carve bone

BONE MARKINGS
• Foramen: hole
• Fossa: depression
• Process: projection
• Condyle: smooth, rounded end
• Meatus: canal-like passageway
• Tubercle: lump of bone
Ex. Foramen magnum
Ex. Glenoid fossa
Ex. Mastoid process
Ex. Occipital condyle
Ex. Ext. auditory meatus
Ex. Greater tubercle

• Mastoid process: attached to neck muscles

• External auditory meatus: ear canal
• Nasolacrimal canal: ❖ VERTEBRAL COLUMN
- canal between nasal cavity and eye • 7 cervical vertebra
- conducts tears • 12 thoracic vertebra
• Styloid process: attachment site for tongue • 5 lumbar vertebra
• Mandibular fossa: depression where lower jaw & skull meet • 1 sacrum
• Glenoid fossa: where humerus meets scapula • 1 coccyx
• Hard palate: roof of mouth • Atlas:
• Foramen magnum: hole where spinal cord joins brainstem - 1st vertebra
• Zygomatic: cheek bone - holds head
• Mandible: lower jaw • Axis:
• Maxilla: upper jaw - 2nd vertebra
- rotates head
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Pectoral Girdle
• Scapula: shoulder blade
• Clavicle: collar bone

Upper Limb Bones

• Humerus: upper limb

• Ulna: forearm
• Radius: forearm
• Carpals: wrist
• Metacarpals: hand

Sacrum and Coccyx

Functions of Vertebral Column

• Support
• Protect spinal cord
• Movement

Thoracic Cage
• Protects vital organs
• 12 pair of ribs
• Sternum: breastbone
• True ribs: attach directly to sternum by cartilage
• False ribs: attach indirectly to sternum by cartilage
• Floating ribs: not attached to sternum
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Lower Limb Bones

• Femur: thigh
• Patella: knee cap
• Tibia: large lower
leg
• Fibula: small
lower leg
• Tarsals: ankle
Pelvic Girdle • Metatarsals: foot
• Where lower limbs attach to body • Phalanges: toes
• Pelvis: includes pelvic girdle and coccyx and fingers
• Ischium: inferior and posterior region
• Ilium: most superior region
• Acetabulum: hip socket (joint)
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Joints
- Joints can be classified based on their anatomy.

• Fibrous joints have fibrous tissue between bones.

→ Suture. This is formed by the membranes of
intramembranous ossification.
→ Gomphoses. This is formed by ligaments holding the
tooth in its socket.
→ Syndesmoses. This is formed by an interosseous
membrane.

• Cartilaginous joints have cartilage between the bones.

There are 2 types:
→ Symphyses. This is formed by fibrocartilage between
the pubic bones.
→ Synchondroses. This is formed by hyaline cartilage
between the diaphysis and the epiphyses of bones in
children.

• Synovial joints are lined by a synovial membrane and

have synovial fluid in the joint space.

Synovial Joint

→ The knee is a relatively unstable joint held together by

five ligaments:
• the medial and lateral collateral ligaments
• the anterior and posterior cruciate ligaments
• the patellar ligament
• It also contains fibrocartilage pads called menisci
that act as shock absorbers.

The Knee

Articulations
• What are they?
- where 2 bones come together (joint)

• Synarthrosis: Non-movable joint Ex. skull

• Amphiarthrosis: slightly movable Ex. Between vertebrae
• Diarthrosis: freely movable joint Ex. knee, elbow, wrist

→ There are six types of synovial joints: hinge, ball and

socket, saddle, gliding, ellipsoid, pivot

• Hinge Joints
- Allow movement in one direction only
- Example: knee and elbow joints
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• Ball-and-Socket Joints
- rounded head of 1 bone fits into a concavity on another bone
- Movement may be rotational or in any plane
- Example: hip and shoulder joint
• Saddle Joints
- Ends of each bone are saddle shaped
- Movement is side to side and back and forth
- Example: joint between trapezium and metacarpal of thumb
• Gliding Joints
- Involve sliding of bones across each other
- Example: carpal and tarsal bones
• Ellipsoid Joints
- Allow movement from side to side and back and forth
- Example: between carpals and bones of forearm
• Pivot Joints
- Allow rotational movement
- Example: atlas on the axis
PHYSIOLOGY OF THE SKELETAL SYSTEM
Functions of the Skeletal System
1. Support. Vertebral column allows the body to be erect.
2. Movement. The arrangement of bones and joints allows
a range of movements.
3. Protection. The cranial bones protect the brain. The
sternum and rib cage protect the lungs and heart.
4. Acid-base balance. Phosphate ions can bind to excess
hydrogen ions to buffer the pH of the blood.
5. Electrolyte balance. Bones serve as a reservoir for
calcium.
6. Blood formation. Red blood cells, white blood cells, and
platelets are produced in the red bone marrow.
Bone Formation
• Ossification: process of bone formation (occurs in utero)
• Osteoblast’s role:
- build bone
- after an osteoblast becomes surrounded by bone
matrix it becomes an osteocyte
Mineral Deposition
• Osteoblasts produce a chemical that allows calcium
phosphate crystals to be deposited. This is a positive
feedback mechanism starting with a seed crystal.
Bone Development
• Flat bones are formed through intramembranous
ossification.
• Long bones are formed through endochondral
ossification.
• Intramembranous Ossification
• Forms most skull bones
• Fontanelles present at birth
• Steps involved:
• Connective tissue membranes form at
sites of future intramembranous bones.
• Some cells become osteoblasts.
• Osteoblasts deposit spongy bone
beginning at center of bone.
• Osteoblasts form layer of compact bone
atop the spongy bone.
• Bone formation within connective tissue membranes
• Osteoblasts build bone
• Ex. Skull bones
Intramembranous Ossification of the Skull
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Endochondral Ossification • Infancy and youth:
• Bone formation inside cartilage • long bones lengthen at epiphyseal plate
• Cartilage models are replaced by bone • long bones widen by adding more lamella
• Ex. All bones (except skull) • End of bone growth (in length):
epiphyseal plate is replaced by an epiphyseal line
Steps in Endochondral Ossification
1. Chondroblasts build a cartilage model, the chondroblasts X-ray of a Child’s Hand
become chondrocytes.
2. Cartilage model calcifies (hardens).
3. Osteoblasts invade calcified cartilage and a primary
ossification center forms diaphysis.
4. Secondary ossification centers form epiphysis.
5. Original cartilage model is almost completely ossified
and remaining cartilage is articular cartilage.

Bone Remodeling
• What is it?
- removal of existing bone by osteoclasts and deposition of
new bone by osteoblasts
- occurs in all bones
- responsible for changes in bone shape, bone repair,
adjustment of bone to stress, and calcium ion regulation

Bone Repair
1. Broken bone causes bleeding and a blood clot forms.
2. Callus forms which is a fibrous network between 2
fragments.
3. Cartilage model forms first then, osteoblasts enter the callus
and form cancellous bone this continues for 4-6 weeks after
injury.
4. Cancellous bone is slowly remodeled to form compact and
cancellous bone.

Endochondral Ossification of a Long Bone

NUTRITIONAL REQUIREMENTS OF THE SKELETAL SYSTEM

• Calcium sources
• Dairy products, green leafy vegetables, broccoli,
collards, kale, turnip greens, and bok choy
• Phosphorus for phosphates found in dairy products and
Bone Growth meats
• Long bones continue to grow longer after birth through • Vitamin D needed for calcium absorption
endochondral growth until the epiphyseal plates are • Vitamin D is activated by the liver and kidneys
closed. to become calcitriol.
• Create epiphyseal line • Calcitriol increases calcium absorption
• Appositional growth makes bones more massive. It in the small intestines.
occurs along lines of stress.
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Bone and Calcium Homeostasis
• Bone is a major storage site for calcium
• Movement of calcium in and out of bone helps
determine blood levels of calcium
• Calcium moves into bone as osteoblasts build new bone
• Calcium move out of bone as osteoclasts break down
bone
• Calcium homeostasis is maintained by parathyroid
hormone (PTH) and calcitonin

Hormonal Regulation of Bone Deposition and

Reabsorption Herniated Disk
• Bone deposition and reabsorption are regulated by
hormones on the basis of blood calcium levels.
• If blood levels of calcium are too high, calcitonin tells
osteoblasts to deposit bone.
• If blood levels of calcium are too low, PTH tells
osteoclasts to reabsorb bone.

Joints
• Osteoarthritis is wear and tear on a joint. Most people
develop osteoarthritis as they age.
• Rheumatoid arthritis is an autoimmune disease.
Anyone, including children, can develop rheumatoid
arthritis.
• Joint replacement may be necessary with severe
arthritis.

Rheumatoid Arthritis

Hematopoietic Tissue
• What is it?
tissue that makes blood cells
• Red marrow: location of blood forming cells
• Yellow marrow: mostly fat
• Location of hematopoietic tissue in newborns:
most bones (red marrow)
• Location of hematopoietic tissue in adults:
- red is replaced with yellow marrow
- red marrow is mainly in epiphyses of femur and humerus

Effects of Aging on the Skeletal System and Joints Joint Replacement

1. Decreased Collagen Production

2. Loss of Bone Density
3. Degenerative Changes

The ratio of deposition to reabsorption changes as we age.

• Deposition > Reabsorption from Birth to age 25
• Increasing bone mass and density
• Deposition = Reabsorption from Ages 25 to 45
• Maintaining bone mass and density
• Deposition < Reabsorption at Age 45 and over
• Decreasing bone mass and density

Decreases in estrogen and testosterone levels are responsible for
the change.
• Vertebrae thin out, and the spinal column becomes
more curved and compressed
• The elderly are more prone to falls, resulting in fractures
• Joints stiffen and become less flexible
• Minerals may deposit in joints
• The best way to ensure good bone health in later life is
to build strong bones when deposition exceeds
reabsorption.
• Exercise and good nutrition, including calcium and
vitamin D, can minimize the effects of aging.
- Bone-softening disorders include osteoporosis, rickets,
and osteomalacia.
- Brittle bones is another name for osteogenesis imperfecta.
- Abnormal spinal curvatures include scoliosis, kyphosis, and
lordosis.
- Joint inflammations include osteoarthritis and rheumatoid
arthritis.
Osteoporosis
• Osteoporosis is a severe lack of bone density.

DISORDERS OF THE SKELETAL SYSTEM

Spinal Column
• Abnormal spinal curvatures
• Scoliosis: lateral curvature
• Kyphosis: hunchback
• Lordosis: swayback
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Osteomyelitis
• Osteomyelitis is a bone infection.
Gout
Cleft Palate
Mastoiditis
Fractures
• Fractures can be classified by using descriptive terms.
• Fractured bones can be set back into proper alignment
by closed or open reduction.
Types of Fractures
• Closed. A closed fracture (formerly called a simple
fracture) does not cause a break in the skin. A shattered
bone may not break through the skin, but it hardly
seems appropriate to refer to it as simple.
• Open. An open fracture (formerly called a compound
fracture) breaks through the skin.
• Complete. The bone is in two or more pieces.
• Displaced. The bone is no longer in proper alignment.
• Nondisplaced. The bone is in proper alignment.
• Hairline. There is a crack in the bone.
• Greenstick. The bone has broken through one side but
not completely through the other side.
• Depressed. The bone has been dented. This fracture is
found where there is cancellous bone, as in skull
fractures.
• Transverse. The bone is broken perpendicular to its
length.
• Oblique. The break in the bone is at an angle.
• Spiral. The break in the bone spirals up the bone.
• This type of break often results from twisting
the bone. This may occur when children fall
while kneeling on a chair at the table with their
feet sticking through the chair’s spokes.
• Epiphyseal. The break occurs at the epiphyseal plate in
a child.
• Comminuted. The bone (commonly referred to as
shattered) is broken into three or more pieces.
• Compression. Cancellous bone has been compressed.
This type of fracture may occur in the vertebrae.
X-Rays of Fractures
Open Reduction of an Ankle Fracture
Fracture Healing
1. Hematomas form due to bleeding.
2. The healing of a fracture starts with stem cells forming a soft
callus in a hematoma.
3. Osteoblasts deposit bone in the soft callus to form a hard
callus.
4. Osteoclasts finish the healing of the fracture by remodeling
the hard callus to reestablish the marrow cavity.
DIAGNOSTIC TESTS FOR SKELETAL SYSTEM DISORDERS
• BLOOD TESTS
• CALCIUM
• ALKALINE PHOSPHATASE
• C-telopeptide (C-terminal telopeptide of type 1
collagen (CTx)) – a marker for bone resorption.
• P1NP (Procollagen type 1 N-terminal propeptide) – a
marker for bone formation.
TABLE 4.4 Common Diagnostic Tests for Skeletal System
Disorders
Diagnostic Test or Screening Description
The use of low-dose radiation to
DEXA (dual-energy X-ray
measure bone
absorptiometry) scan
density in the hip and vertebrae
The use of electromagnetic radiation
that sends photons through the body
X-ray
to create a visual image of dense
structures such as bone
• Computed tomography (CT) scans
• CT scans are helpful in staging cancer. They help show if
the bone cancer has spread to your lungs, liver, or other
organs. The scans show the lymph nodes and distant
organs where there might be cancer spread.
• CT scans can also be used to guide a biopsy needle into
a tumor. This is called a CT-guided needle biopsy. For
this test, you stay on the CT scanning table while a
radiologist moves a biopsy needle toward the tumor. CT
scans are repeated until the tip of the needle is within
the mass.
• Magnetic resonance imaging (MRI) scans
• MRI scans are often the best test for outlining a bone
tumor. They are very helpful for looking at the brain and
spinal cord
• Needle biopsy
• There are 2 types of needle biopsies: fine (aspiration)
and core. For both types, a drug is first used to numb
the area for the biopsy.
• For fine needle aspiration (FNA), the doctor uses
a very thin needle and a syringe to take out a small
amount of fluid and some cells from the tumor.
• In a core needle biopsy, the doctor uses a larger
needle to remove a small cylinder of tissue (about
1/16 inch in diameter and 1/2 inch long).
• Surgical bone biopsy
• In this procedure, a surgeon needs to cut through the
skin to reach the tumor to remove a small piece of
tissue. This is also called an incisional biopsy. If the
entire tumor is removed (not just a small piece), it's
called an excisional biopsy