Bones and Joints

SAMAN SAJID
(Lecturer)
ILM College of Pharmaceutical Sciences, Sargodha.

1
Contents
• Classification of bones
• Structure of bones
• Formation of bones
• Composition of bones
• Blood supply
• Fracture healing

2
 BONE (syn – Os;
Osteon)
Osseous tissue, a specialised form of dense
connective tissue consisting of bone cells
(osteocytes)
Embedded in a matrix of calcified
intercelluar substance
Bone matrix contains collagen fibres and the
minerals calcium phosphate and calcium
carbonate

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4
FORMATION OF
BONE
 The process of bone formation -
ossification
All bone is of mesodermal origin
Two types of ossification
1. Intramembranous ossification
2. Endochondral ossification

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Intramembranous Ossification
Mesenchymal condensation
Highly vascular
Laying down of bundles of collagen
fibres in the mesenchymal
condensation
Osteoblast formation – OSTEOID
Calcium salts deposition – lamellus of
bone

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BONE FORMATION- Intramembranous
ossification

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BONE FORMATION - Intramembranous
ossification

8
BONE FORMATION - Intramembranous
ossification

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BONE FORMATION - Intramembranous
ossification

10
Endochondral OSSIFICATION
Ossifies bones that originate as hyaline
cartilge
Most bones originate as hyaline
cartilage
Growth and ossification of long bones
occurs in 6 steps

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STEP
1
Chondrocytes in the
center of hyaline
cartilage:

– enlarge

– form struts and

calcify

– die, leaving
cavities in 12
 STEP 2
Blood vessels grow
around the edges of the
cartilage

• Cells in the
perichondrium change
to osteoblasts:

– producing a layer of
superficial bone around
the shaft which will
continue to 13
STEP
3
• Blood vessels
enter the cartilage:

– bringing fibroblasts
that become
osteoblasts

–spongy bone develops

at the primary
ossification center
14
STEP
4
Remodeling
creates a
marrow cavity:

– bone replaces
cartilage at the
metaphyses

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STEP
5
Capillaries
and
osteoblasts
enter the
epiphyses:

– creating
secondary
ossification
centers

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STEP
6
Epiphyses fill
with spongy
bone:

– cartilage within
the joint cavity is
articulation
cartilage

– cartilage at the
metaphysis is
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epiphyseal cartilage
Endochondral
ossification

Stages 1-3 during fetal week 9

through 9th month Stage 5 is
Stage 4 is process of long
just bone growth
before during 18
SKELETAL
ORGANIZATION
• The actual number of bones in the
human skeleton varies from person to
person

• Typically there are about 206 bones

• For convenience the skeleton is divided

into the:
• Axial skeleton
• Appendicular skeleton
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DIVISION OF
SKELETON
• Axial Skeleton
• Skull
• Spine
• Rib cage
• Appendicular
Skeleton
• Upper limbs
• Lower limbs
• Shoulder girdle
• Pelvic girdle
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 CLASSIFICATION OF BONES
BY
LongSHAPE
bones
Short bones
Flat bones
Irregular
bones
Pneumatiz
ed bones
Sesamoid
bones

(Short bones include sesmoid

bones)
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LONG
BONES
Diaphysis – shaft
Epiphysis –
expanded ends
Shaft – 3 surfaces,
3 borders,
medullary cavity
and a nutrient
foramen directed
away from the
growing end
Ex – humerus,
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SHORT
BONES
Are small and
thick
Their shape is
usually cuboid,
cuneifrom,
trapezoid or
scaphoid
Ex – carpal and
tarsal bones

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 FLAT
BONES
Are thin with parallel
surfaces

• Are found in the skull,

sternum, ribs,and scapula

• Form boundaries of certain

body cavities
• Resembles a
sandwich of spongy
bone

•Between 2 layers of 24
compact bone
PNEUMATIC BONES (Gr. – pert.
to air)
Certain irregular bones contain large air
spaces lined by epithelium
Make the skull light in weight, help in
resonance of voice, and act as air
conditioning chambers for inspired air
Ex – maxilla, sphenoid, ethmoid, etc

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 SESAMOID
BONES a
Resembling
grain of sesame in
size or shape
Bony nodules found
embedded in the
tendons or joint
capsules
No periosteum and
ossify after birth
Related to an
articular or
nonarticular bony
surface 26
IRREGULAR
BONES

Have complex
shapes
 Examples:
– spinal vertebrae
– pelvic bones

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DEVELOPEMENTAL
CLASSIFICATION
Membrane (dermal) bones
Cartilaginous bones
Membrano-cartilagenous
bones

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Membrane (dermal)
bones
Ossify in membrane
(intramembranous of
mesenchymal)
Derived from mesenchymal
condensations
Ex – bones of the skull and facial
bones
Defect – cleidocranial dysostosis

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Cartilaginous
bones
Ossify in cartilage
(intracartilagenous or
endochondral)
Derived from preformed
cartilaginous models
Ex – bones of limbs, vertebral column and
thoracic cage
Defect – common type of dwarfism
called achondroplasia

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Membrano-cartilaginous
bones
Ossify partly in cartilage and partly in
membrane
Ex – clavicle, mandible, occipital, etc

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BONE
CELLS
 ELEMENTS COMPRISING BONE TISSUE
1. It consists of bone cells or osteocytes –
separated by intercellular substance
2. Osteoblasts – bone producing cells
3. Osteoclasts – bone removing cells
4. Osteoprogenitor cells – from which
osteoblasts and osteoclasts derived

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CELLS OF BONE
TISSUE

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 OSTEOPROGENITOR
CELLS
• Mesenchymal stem cells that
divide to produce osteoblasts

• Are located in inner, cellular

layer of periosteum
(endosteum)

• Assist in fracture repair

36
 OSTEOBLASTS (Gr.- osteon-bone,
blastos – germ)

Immature bone cells that secrete

matrix compounds (osteogenesis)

•Matrix produced by osteoblasts,

but not yet calcified to form bone

•Osteoblasts surrounded by bone

become osteocytes

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 OSTEOCYT
Ecells that maintain the bone matrix
Mature bone

• Live in lacunae Between the rings of matrix, (the bone

cells (osteocytes) are located in spaces called lacunae).

•Are between layers (lamellae) of matrix

•Connect by cytoplasmic extensions through canaliculi in

lamellae

•Do not divide (They are derived from osteoprogenitor

cells, some of which differentiate into active osteoblasts
(which may further differentiate to osteocytes).
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OSTEOCLAST (Gr.- osteon–bone,
+klan-to break)

•Secrete acids and

protein digesting
enzymes

•Giant, mutlinucleate
cells

•Dissolve bone matrix

and release stored
minerals (osteolysis)

•Are derived from 39

stem cells
STRUCTURAL
CLASSIFICATION
Macroscopicall
y
1. Compact
bone
2. Cancellous
bone

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 COMPACT
BONE
Strong dense – 80% of the skeleton
Consists of multiple osteons (haversian systems) with
intervening interstitial lamellae
Haversian canals are microscopic tubes or channels in cortical
bone that consist of nerve fibers and a few capillaries.
This allows bone to get oxygen and nutrition without being
highly vascular. These canals also communicate with bone cells
using special connections, or canaliculi.
Best developed in the cortex of long bones
Osteons are made up of concentric bone lamellae with a central
canal (haversian canal) containing osteoblasts and an arteriole
supplying the osteon.

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42
 Contd
.
Lamellae are connected by canaliculi
 Cement lines mark outer limit of osteon (bone
resorption ended)
Volkmann’s canals: radially oriented, have
arteriole, and connect adjacent osteons
Volkmann’s canals are small channels in bone that
transmit blood vessels from the periosteum into the
bone and that lie perpendicular to and communicate
with the haversian canals.
This is an adaptation to bending and twisting forces
(compression, tension and shear)
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 OSTEO
N
The basic unit of mature
compact bone

• Osteocytes are arranged in

concentric lamellae

• Around a central canal

containing blood vessels

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45
46
 CANCELLOUS BONE
(SPONGY OR
TRABECULAR)
Open in texture – meshwork of trabeculae (rods and plates)
Crossed lattice structure, makes up 20% of the skeleton
Bone is resorbed by osteoclasts in Howship’s lacunae( a groove or cavity
usually containing osteoclasts that occurs in bone which is undergoing
reabsorption) and formed on the opposite side of the trabeculae by
osteoblasts
Osteoporosis is common in cancellous bone, making it susceptible to
fractures
 Commonly found in the metaphysis and epiphysis of long bones
 Adaptation to compressive forces
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Contd
.
Does not have
osteons

• The matrix forms

an open network
of trabeculae

• Trabeculae have
no blood vessels

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49
50
Microscopica
lly
1. Lamellar
bone
2. Woven bone

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 LAMELLAR
BONE
Bone is made up of layers or lamellae
Characterized by a haphazard organization of collagen fibres and is
mechanically weak.
Lamellae – is a thin plate of bone consisting of collagen fibres and
mineral salts, deposited in gelatinous ground substance
Between adjoining lamellae we see small flattened spaces – lacunae

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LAMELLAR BONE

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Contd
.
Lacunae
1. Contains one osteocyte
2. Have fine canals or canaliculi that
communicate with those from other
lacunae

 Fibers of one lamellus run parallel to each

other, but those of adjoining lamellae run
at varying angles to each other.

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 WOVEN
BONE
Found in all newly formed bone – later replaced by lamellar bone
 Characterized by a regular parallel alignment of collagen into sheets
(lamellae) and is mechanically strong.
Collagen fibres are present in bundles - run randomly
– interlacing with each other

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MICROSCOP
MACROSCOP
IC
IC

Primary
Immature
Woven

Secondary
Mature
Lamellar

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57
GROSS STRUCTURE OF AN
ADULT LONG BONE
Shaft
Two
ends

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SHAF
T
Composed of
1. periosteum,
2. cortex and
3. medullary
cavity

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PERIOSTEU
M
External surface of any bone covered by a
membrane – periosteum
Two layer
Outer – fibrous membrane, inner – cellular
In young bones – inner layer – numerous
osteoblasts – osteogenitic layer
In adults – osteoblasts are not conspicuous,
but osteoprogenitor cells present here can
form osteoblasts when need arises

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PERIOSTEU
M

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PERIOSTEU
M

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FUNCTION
S
Medium through which mucles,
tendons and ligaments are attached
Forms a nutritive function
Can form bone when required
Forms a limiting membrane that prevents
bone tissue from ‘spilling out’ into
neighbouring tissues

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CORTE
X
 Is made up of a compact bone which
gives the desired strength
 Can withstand all possible mechanical
strains

64
 ENDOSTEU
•MAn incomplete cellular
layer:
– lines the marrow cavity
– covers trabeculae of
spongy bone
– lines central canals
• Contains osteoblasts,
osteoprogenitor cells,
and osteoclasts
• Is active in bone growth
and repair
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MEDULLARY
CAVITY
Filled with red or yellow bone marrow
1. Red – at birth – haemopoiesis
2. Yellow – as age advance – atrophies – fatty
3. Red marrow persists in the cancellous
ends of long bones

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67
PARTS OF YOUNG
BONE
It ossifies in 3 parts
The two ends from the secondary
centers
Intervening shaft from a primary
center

68
EPIPHY
SIS
(Gr., a growing upon)
The ends of a bone which ossify from
secondary centers
Types
1. Pressure epiphysis – transmission of the
weight . Ex- head of femur, etc
2. Traction epiphysis – provides attachment
to one or more tendons which exerts a
traction on the epiphysis. Ex- trochanters
of femur,et

69
3. Atavistic epiphysis – phylogenitically an
independent bone , which fuses to another
bone. Ex- coracoid process of scapula,etc
4. Aberrant epiphysis – not always present.
Ex- head of the 1st metacarpal and
base of other metcarpal

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DIAPHY
SIS
(Gr., a growing through)
It is the elongated shaft of a long bone
which ossifies from a primary center
Made of thick cortical bone
Filled with bone marrow

71
METAPHY
SIS
(Gr. meta, after, beyond, + phyein, to grow)
Epiphysial ends of a diaphysis
Zone of active growth
Typically made of cancellous bone
Hair pin bends of end arteries

72
EPIPHYSIAL PLATE OF
CARTILAGE
It separates epiphysis from the metaphysis.
Proliferation – responsible for lengthwise
growth of the long bone
Epiphysial fusion – can no longer grow
Nourished by both epiphysial and
metaphysial arteries

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BLOOD
SUPPLY OF
BONES
LONG BONES – derived
from
1. Nutrient artery
2. Periosteal artery
3. Epiphysial artery
4. Metaphysial artery

77
Nutrient artery

1. Enters through the nutrient foramen

2. Divides into ascending and descending
branches in the medullary cavity
3. Branch divides – small parallel
channels – terminate in adult
metaphysis

4. Anastomosing with the epiphysial,

metaphysial and periosteal arteries
5. Supplies the medullary cavity , inner
2/3 of the cortex and metaphysis
6. Nutrient foramen is directed away 78
79
Periosteal arteries

1. Numerous beneath
the muscular and
ligamentous
attachments

2. Ramify beneath
the periosteum
and enter the
volkmann’s canals
to supply the
outer 1/3 of the
cortex 80
81
Epiphysial arteries
1. Derieved from periarticular
vascular arcades (circulus
vasculosus)
2. Out of the numerus vascular
foramina in this region
– few admit arteries and rest venous
exits
3. Number size – idea of the relative
vascularity of the two ends of long bone
82
Metaphysial arteries
1. Derived from the neighbouring systemic
vessels
2. Pass directly into the metphysis and
reinforce the metaphysial branches from
the primary nutrient artery

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84
 HOMEOSTASIS OF BONE
TISSUE
• Bone Resorption –
osteoclasts
action of and M
parathyroid hormone C

aka parathormone aka

PTH
O
• Bone Deposition – C
action of osteoblasts
and calcitonin
• Occurs by direction
of the thyroid and
parathyroid glands
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FACTORS AFFECTING BONE
TISSUE
• Deficiency of Vitamin A – retards bone
development
• Deficiency of Vitamin C – results in fragile
bones
• Deficiency of Vitamin D – rickets,
osteomalacia
• Insufficient Growth Hormone – dwarfism
• Excessive Growth Hormone – gigantism,
acromegaly
• Insufficient Thyroid Hormone – delays bone
growth 86
CHEMICAL ANALYSIS OF
BONE

87
APPLIED
ANATOMY
Periosteum is particularly sensitive to
tearing or tension –
1. Drilling into the compact bone without
anaesthesia causes only dull pain
2. Drilling into spongy bone is much more
painful
3. Fractures, tumours and infections of the
bone are very painful

 Blood supply of bone is so rich that it is

very difficult to sufficiently to kill the bone
88
Contd
.
In rickets – calcification of cartilage
fails and ossification of the growth
zone is disturbed
1. Osteoid tissue is formed normally and the
cartilage cells proliferate freely ,
2. Mineralization does not takes place

 Scurvy – formation of collagenous fibres

and matrix is impaired
 Osteoporosis - Bone resorption proceeds
faster than deposition 89
FRACTURE
HEALING
 STAGES OF FRACTURE
HEALING
1. Stage of inflammation
2. Stage of soft callous
formation
3. Stage of hard callous
formation
4. Stage of remodelling

90
STAGE OF
INFLAMMATION

91
STAGE OF SOFT
CALLUS
FORMATION

92
STAGE OF HARD
CALLUS
FORMATION

93
STAGE OF
REMODELLING

94
MECHANISM OF BONE
HEALING
Direct (primary) bone
healing
Indirect (secondary) bone
healing

95
 DIRECT BONE
HEALING
Mechanism of bone healing seen when there is no
motion at the fracture site (i.e. absolute stability)
Does not involve formation of fracture callus
Osteoblasts originate from endothelial and
perivascular cells

A cutting cone is formed that crosses the fracture site

Osteoblasts lay down lamellar bone behind the
osteoclasts forming a secondary osteon
Gradually the fracture is healed by the formation of
numerous secondary osteons
A slow process – months to years
96
97
 INDIRECT BONE
HEALING
Mechanism for
healing in fractures
that have some
motion, but not
enough to disrupt the
healing process

Bridging periosteal (soft)

callus and medullary
(hard) callus
re-establish
structural
continuity

Callus subsequently 98
BONE
REMODELLING
WOLFF’s LAW – remodeling occurs in
response to mechanical stress

1. Increasing mechanical stress increases

bone gain
2. Removing external mechanical stress
increases bone loss which is reversible on
(to varying degrees) on remobilzation

99
Contd
.
PIEZOELECTERIC REMODELING –
occurs in response to electric charge
1. The compression side of bone is
electronegative stimulating osteoblasts
2. Tension side of the bone is
electropositive, stimulating
osteoclasts

100
• REFERENCES:
-GRAY’s ANATOMY FOR STUDENTS
-Google images
-BRS Anatomy
-Netter’s Atlas of Anatomy
• -Snell Clinical Anatomy 9th Edition
• -Atlas Anatomy

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