ch. 6 bones tissues Flashcards

1
Q

Cartilage

A
•	Skeletal cartilage
–	Water lends resiliency
–	Contains no blood vessels or nerves
–	Perichondrium surrounds
•	Dense connective tissue girdle
–	Contains blood vessels for nutrient delivery
–	Resists outward expansion
•	All contain chondrocytes in lacunae and extracellular matrix
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2
Q

Hyaline cartilage

A
  • Provides support, flexibility, and resilience
  • Collagen fibers only; most abundant type
  • Articular, costal, respiratory, nasal cartilage
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3
Q

Elastic cartilage

A
  • Similar to hyaline cartilage, but contains elastic fibers

* External ear and epiglottis

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4
Q

Fibrocartilage

A
  • Thick collagen fibers—has great tensile strength

* Menisci of knee; vertebral discs

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5
Q

Appositional growth

A

– Cells secrete matrix against external face of existing cartilage

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6
Q

Interstitial growth

A

– Chondrocytes divide and secrete new matrix, expanding cartilage from within

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7
Q

Classification of Bones

A
•	206 named bones in skeleton
•	Divided into two groups
–	Axial skeleton
•	Long axis of body
•	Skull, vertebral column, rib cage
–	Appendicular skeleton
•	Bones of upper and lower limbs
•	Girdles attaching limbs to axial skeleton
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8
Q

Classification of Bones by Shape

A
•	Long bones
•	Short bones
•	Flat bones
•	Irregular bones
Classification of Bones by Shape
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9
Q

Long bones

A

– Longer than they are wide

– Limb, wrist, ankle bones

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10
Q

Short bones

A

– Cube-shaped bones (in wrist and ankle)
– Sesamoid bones (within tendons, e.g., Patella)
– Vary in size and number in different individuals

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11
Q

Flat bones

A

– Thin, flat, slightly curved

– Sternum, scapulae, ribs, most skull bones

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12
Q

Irregular bones

A

– Complicated shapes

– Vertebrae, coxal bones

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13
Q

Seven important functions of bone

A
–	Support
–	Protection
–	Movement
–	Mineral and growth factor storage
–	Blood cell formation
–	Triglyceride (fat) storage
–	Hormone production
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14
Q

Bones

A
•	Are organs
–	Contain different types of tissues
•	Bone (osseous) tissue, nervous tissue, cartilage, fibrous connective tissue, muscle and epithelial cells in its blood vessels
•	Three levels of structure
–	Gross anatomy
–	Microscopic
–	Chemical
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15
Q

Gross Anatomy

A
•	Bone textures 
–	Compact and spongy bone
•	Compact
–	Dense outer layer; smooth and solid
•	Spongy (cancellous or trabecular)
–	Honeycomb of flat pieces of bone deep to compact called trabeculae
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16
Q

Structure of Short, Irregular, and Flat Bones

A

• Thin plates of spongy bone covered by compact bone
• Plates sandwiched between connective tissue membranes
– Periosteum (outer layer) and endosteum
• No shaft or epiphyses
• Bone marrow throughout spongy bone; no marrow cavity
• Hyaline cartilage covers articular surfaces

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17
Q

Structure of Typical Long Bone

A

• Diaphysis
– Tubular shaft forms long axis
– Compact bone surrounding medullary cavity
• Epiphyses
– Bone ends
– External compact bone; internal spongy bone
– Articular cartilage covers articular surfaces
– Between is epiphyseal line
• Remnant of childhood bone growth at epiphyseal plate

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18
Q

Membranes: Periosteum

A

• White, double-layered membrane
• Covers external surfaces except joint surfaces
• Outer fibrous layer of dense irregular connective tissue
– Sharpey’s fibers secure to bone matrix
• Osteogenic layer abuts bone
– Contains primitive stem cells – osteogenic cells
• Many nerve fibers and blood vessels
• Anchoring points for tendons and ligaments
Membranes: Endosteum
• Delicate connective tissue membrane covering internal bone surface
• Covers trabeculae of spongy bone
• Lines canals that pass through compact bone
• Contains osteogenic cells that can differentiate into other bone cells

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19
Q

Hematopoietic Tissue in Bones

A

• Red marrow
– Found within trabecular cavities of spongy bone and diploë of flat bones (e.g., Sternum)
– In medullary cavities and spongy bone of newborns
– Adult long bones have little red marrow
• Heads of femur and humerus only
– Red marrow in diploë and some irregular bones is most active
– Yellow marrow can convert to red, if necessary

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20
Q

Bone Markings

A
  • Sites of muscle, ligament, and tendon attachment on external surfaces
  • Joint surfaces
  • Conduits for blood vessels and nerves
  • Projections
  • Depressions
  • Openings
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21
Q

Bone Markings

A

• Projections
– Most indicate stresses created by muscle pull or joint modifications
• Depressions and openings
• Usually allow nerves and blood vessels to pass

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22
Q

Microscopic Anatomy of Bone: Cells of Bone Tissue

A
•	Five major cell types
•	Each specialized form of same basic cell type
–	Osteogenic cells
–	Osteoblasts
–	Osteocytes
–	Bone lining cells
–	Osteoclasts
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23
Q

Osteogenic Cells

A

• Also called osteoprogenitor cells
– Mitotically active stem cells in periosteum and endosteum
– When stimulated differentiate into osteoblasts or bone lining cells
• Some persist as osteogenic cells

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24
Q

Osteoblasts

A

• Bone-forming cells
• Secrete unmineralized bone matrix or osteoid
– Includes collagen and calcium-binding proteins
• Collagen = 90% of bone protein
• Actively mitotic

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25
Q

Osteocytes

A

• Mature bone cells in lacunae
• Monitor and maintain bone matrix
• Act as stress or strain sensors
– Respond to and communicate mechanical stimuli to osteoblasts and osteoclasts (cells that destroy bone) so bone remodeling can occur

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26
Q

Bone Lining Cells

A
  • Flat cells on bone surfaces believed to help maintain matrix
  • On external bone surface called periosteal cells
  • Lining internal surfaces called endosteal cells
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27
Q

Osteoclasts

A

• Derived from hematopoietic stem cells that become macrophages
• Giant, multinucleate cells for bone resorption
• When active rest in resorption bay and have ruffled border
– Ruffled border increases surface area for enzyme degradation of bone and seals off area from surrounding matrix

28
Q

Compact Bone

A

• Also called lamellar bone
• Osteon or haversian system
– Structural unit of compact bone
– Elongated cylinder parallel to long axis of bone
– Hollow tubes of bone matrix called lamellae
• Collagen fibers in adjacent rings run in different directions
– Withstands stress – resist twisting

29
Q

Lamellae

A

– Incomplete lamellae not part of complete osteon
– Fill gaps between forming osteons
– Remnants of osteons cut by bone remodeling
• Circumferential lamellae
– Just deep to periosteum
– Superficial to endosteum
– Extend around entire surface of diaphysis
– Resist twisting of long bone

30
Q

Spongy Bone

A

• Appears poorly organized
• Trabeculae
– Align along lines of stress to help resist it
– No osteons
– Contain irregularly arranged lamellae and osteocytes interconnected by canaliculi
– Capillaries in endosteum supply nutrients

31
Q

Chemical Composition of Bone: Organic Components

A

• Includes cells and osteoid
– Osteogenic cells, osteoblasts, osteocytes, bone- lining cells, and osteoclasts
– Osteoid—1/3 of organic bone matrix secreted by osteoblasts
• Made of ground substance (proteoglycans and glycoproteins)
• Collagen fibers
• Contributes to structure; provides tensile strength and flexibility
• Resilience of bone due to sacrificial bonds in or between collagen molecules
– Stretch and break easily on impact to dissipate energy and prevent fracture
– If no addition trauma, bonds re-form

32
Q

Chemical Composition of Bone:

Inorganic Components

A

• Hydroxyapatites (mineral salts)
– 65% of bone by mass
– Mainly of tiny calcium phosphate crystals in and around collagen fibers
– Responsible for hardness and resistance to compression

33
Q

Bone

A

• Half as strong as steel in resisting compression
• As strong as steel in resisting tension
• Last long after death because of mineral composition
– Reveal information about ancient people
– Can display growth arrest lines
• Horizontal lines on bones
• Proof of illness - when bones stop growing so nutrients can help fight disease

34
Q

Bone Development

A
•	Ossification (osteogenesis)
–	Process of bone tissue formation
–	Formation of bony skeleton
•	Begins in 2nd month of development
–	Postnatal bone growth
•	Until early adulthood
–	Bone remodeling and repair
•	Lifelong
Two Types of Ossification
•	Endochondral ossification
–	Bone forms by replacing hyaline cartilage
–	Bones called cartilage (endochondral) bones
–	Forms most of skeleton
•	Intramembranous ossification
–	Bone develops from fibrous membrane
–	Bones called membrane bones
–	Forms flat bones, e.g. clavicles and cranial bones
35
Q

Endochondral Ossification

A

• Forms most all bones inferior to base of skull
– Except clavicles
• Begins late in 2nd month of development
• Uses hyaline cartilage models
• Requires breakdown of hyaline cartilage prior to ossification

36
Q

Intramembranous Ossification

A
  • Forms frontal, parietal, occipital, temporal bones, and clavicles
  • Begins within fibrous connective tissue membranes formed by mesenchymal cells
  • Ossification centers appear
  • Osteoid is secreted
  • Woven bone and periosteum form
  • Lamellar bone replaces woven bone & red marrow appears
37
Q

Postnatal Bone Growth

A

• Interstitial (longitudinal) growth
– Increase in length of long bones
• Appositional growth
– Increase in bone thickness

38
Q

Growth in Length of Long Bones

A

• Requires presence of epiphyseal cartilage
• Epiphyseal plate maintains constant thickness
– Rate of cartilage growth on one side balanced by bone replacement on other
• Concurrent remodeling of epiphyseal ends to maintain proportion
• Result of five zones within cartilage
– Resting (quiescent) zone
– Proliferation (growth) zone
– Hypertrophic zone
– Calcification zone
– Ossification (osteogenic) zone
• Resting (quiescent) zone
– Cartilage on epiphyseal side of epiphyseal plate
– Relatively inactive
• Proliferation (growth) zone
• Calcification zone
– Surrounding cartilage matrix calcifies, chondrocytes die and deteriorate
• Ossification zone
– Chondrocyte deterioration leaves long spicules of calcified cartilage at epiphysis-diaphysis junction
– Spicules eroded by osteoclasts
– Covered with new bone by osteoblasts
– Ultimately replaced with spongy bone

–	Cartilage on diaphysis side of epiphyseal plate •	Near end of adolescence chondroblasts divide less often
•	Epiphyseal plate thins then is replaced by bone
•	Epiphyseal plate closure
–	Bone lengthening ceases
•	Requires presence of cartilage
–	Bone of epiphysis and diaphysis fuses
–	Females – about 18 years
–	Males – about 21 years

– Rapidly divide pushing epiphysis away from diaphysis  lengthening
• Hypertrophic zone
– Older chondrocytes closer to diaphysis and their lacunae enlarge and erode  interconnecting spaces

39
Q

Growth in Width

A

• Allows lengthening bone to widen
• Occurs throughout life
• Osteoblasts beneath periosteum secrete bone matrix on external bone
• Osteoclasts remove bone on endosteal surface
• Usually more building up than breaking down
–  Thicker, stronger bone but not too heavy

40
Q

Hormonal Regulation of Bone Growth

A

• Growth hormone
– Most important in stimulating epiphyseal plate activity in infancy and childhood
• Thyroid hormone
– Modulates activity of growth hormone
– Ensures proper proportions
• Testosterone (males) and estrogens (females) at puberty
– Promote adolescent growth spurts
– End growth by inducing epiphyseal plate closure
• Excesses or deficits of any cause abnormal skeletal growth

41
Q

Bone Homeostasis

A
•	Recycle 5-7% of bone mass each week
–	Spongy bone replaced ~ every 3-4 years
–	Compact bone replaced ~ every 10 years
•	Older bone becomes more brittle
–	Calcium salts crystallize
–	Fractures more easily
•	Consists of bone remodeling and bone repair
42
Q

Bone Remodeling

A

• Consists of both bone deposit and bone resorption
• Occurs at surfaces of both periosteum and endosteum
• Remodeling units
– Adjacent osteoblasts and osteoclasts

43
Q

Bone Deposit

A

• Evidence of new matrix deposit by osteoblasts
– Osteoid seam
• Unmineralized band of bone matrix
– Calcification front
• Abrupt transition zone between osteoid seam and older mineralized bone
• Trigger not confirmed
– Mechanical signals involved
– Endosteal cavity concentrations of calcium and phosphate ions for hydroxyapatite formation
– Matrix proteins bind and concentrate calcium
– Enzyme alkaline phosphatase for mineralization

44
Q

Bone Resorption

A

• Is function of osteoclasts
– Dig depressions or grooves as break down matrix
– Secrete lysosomal enzymes that digest matrix and protons (H+)
– Acidity converts calcium salts to soluble forms
• Osteoclasts also
– Phagocytize demineralized matrix and dead osteocytes
• Transcytosis allow release into interstitial fluid and then into blood
– Once resorption complete, osteoclasts undergo apoptosis
• Osteoclast activation involves PTH and T cell-secreted proteins

45
Q

Control of Remodeling

A

• Occurs continuously but regulated by genetic factors and two control loops
– Negative feedback hormonal loop for Ca2+ homeostasis
• Controls blood Ca2+ levels; Not bone integrity
– Responses to mechanical and gravitational forces

46
Q

Importance of Calcium

A
•	Functions in
–	Nerve impulse transmission
–	Muscle contraction
–	Blood coagulation
–	Secretion by glands and nerve cells
–	Cell division
•	1200 – 1400 grams of calcium in body
–	99% as bone minerals
–	Amount in blood tightly regulated (9-11 mg/dl)
–	Intestinal absorption requires Vitamin D metabolites
–	Dietary intake required
47
Q

Hormonal Control of Blood Ca2+

A

• Parathyroid hormone (PTH)
– Produced by parathyroid glands
– Removes calcium from bone regardless of bone integrity• Calcitonin may be involved
– Produced by parafollicular cells of thyroid gland
– In high doses lowers blood calcium levels temporarily

48
Q

Calcium Homeostasis

A

• Even minute changes in blood calcium dangerous
– Severe neuromuscular problems
• Hyperexcitability (levels too low)
• Nonresponsiveness (levels too high)
– Hypercalcemia
• Sustained high blood calcium levels
• Deposits of calcium salts in blood vessels, kidneys can interfere with function

49
Q

Other Hormones Affecting Bone Density

A
•	Leptin
–	Hormone released by adipose tissue
–	Role in bone density regulation
•	Inhibits osteoblasts in animals
•	Serotonin
–	Neurotransmitter regulating mood and sleep
–	Most made in gut
–	Secreted into blood after eating
•	Interferes with osteoblast activity
•	Serotonin reuptake inhibitors
50
Q

Response to Mechanical Stress

A

• Bones reflect stresses they encounter
– Long bones thickest midway along diaphysis where bending stresses greatest
• Bones stressed when weight bears on them or muscles pull on them
– Usually off center so tends to bend bones
– Bending compresses on one side; stretches on other

51
Q

Results of Mechanical Stressors:

Wolff’s Law

A

• Bones grow or remodel in response to demands placed on it
• Explains
– Handedness (right or left handed) results in thicker and stronger bone of that upper limb
– Curved bones thickest where most likely to buckle
– Trabeculae form trusses along lines of stress
– Large, bony projections occur where heavy, active muscles attach
– Bones of fetus and bedridden featureless

52
Q

How Mechanical Stress Causes Remodeling

A

• Electrical signals produced by deforming bone may cause remodeling
– Compressed and stretched regions oppositely charged
• Fluid flows within canaliculi appear to provide remodeling stimulus
Results of Hormonal and Mechanical Influences
• Hormonal controls determine whether and when remodeling occurs to changing blood calcium levels
• Mechanical stress determines where remodeling occurs

53
Q

Bone Repair

A
•	Fractures
–	Breaks
–	Youth
•	Most result from trauma
–	Old age
•	Most result of weakness from bone thinning
54
Q

Fracture Classification

A

• Three “either/or” fracture classifications
– Position of bone ends after fracture
• Nondisplaced—ends retain normal position
• Displaced—ends out of normal alignment
– Completeness of break
• Complete—broken all the way through
• Incomplete—not broken all the way through
– Whether skin is penetrated
• Open (compound) - skin is penetrated
• Closed (simple) – skin is not penetrated
• Also described by location of fracture
• External appearance
• Nature of break

55
Q

Fracture Treatment and Repair

A

• Treatment
– Reduction
• Realignment of broken bone ends
• Closed reduction – physician manipulates to correct position
• Open reduction – surgical pins or wires secure ends
– Immobilization by cast or traction for healing
• Depends on break severity, bone broken, and age of patient

56
Q

Stages of Bone Repair: HEMATOMA Forms

A
  • Torn blood vessels hemorrhage
  • Clot (hematoma) forms
  • Site swollen, painful, and inflamed
57
Q

Stages of Bone Repair:

Fibrocartilaginous Callus Forms

A

• Capillaries grow into hematoma
• Phagocytic cells clear debris
• Fibroblasts secrete collagen fibers to span break and connect broken ends
• Fibroblasts, cartilage, and osteogenic cells begin reconstruction of bone
– Create cartilage matrix of repair tissue
– Osteoblasts form spongy bone within matrix• Mass of repair tissue called fibrocartilaginous callus

58
Q

Stages of Bone Repair:

Bony Callus Forms

A
  • Within one week new trabeculae appear in fibrocartilaginous callus
  • Callus converted to bony (hard) callus of spongy bone
  • ~2 months later firm union forms
59
Q

Stages of Bone Repair:

Bone Remodeling Occurs

A
  • Begins during body callus formation
  • Continues for several months
  • Excess material on diaphysis exterior and within medullary cavity removed
  • Compact bone laid down to reconstruct shaft walls
  • Final structure resembles original because responds to same mechanical stressors
60
Q

Homeostatic Imbalances

A
•	Osteomalacia
–	Bones poorly mineralized
–	Calcium salts not adequate
–	Soft, weak bones
–	Pain upon bearing weight
•	Rickets (osteomalacia of children) 
–	Bowed legs and other bone deformities
–	Bones ends enlarged and abnormally long
–	Cause: Vitamin D deficiency or insufficient dietary calcium
61
Q

Osteoporosis

A

– Group of diseases
– Bone resorption outpaces deposit
– Spongy bone of spine and neck of femur most susceptible
• Vertebral and hip fractures common
Risk Factors for Osteoporosis
• Risk factors
– Most often aged, postmenopausal women
• 30% 60 – 70 years of age; 70% by age 80
• 30% caucasian women will fracture bone because of it
– Men to lesser degree
– Sex hormones maintain normal bone health and density
• As secretion wanes with age osteoporosis can develop
Additional Risk Factors for Osteoporosis
• Petite body form
• Insufficient exercise to stress bones
• Diet poor in calcium and protein
• Smoking
• Hormone-related conditions
– Hyperthyroidism
– Low blood levels of thyroid-stimulating hormone
– Diabetes mellitus
• Immobility
• Males with prostate cancer taking androgen-suppressing drugs
Treating Osteoporosis
• Traditional treatments
– Calcium
– Vitamin D supplements
– Weight-bearing exercise
– Hormone replacement therapy
• Slows bone loss but does not reverse it
• Controversial due to increased risk of heart attack, stroke, and breast cancer
• Some take estrogenic compounds in soy as substitute

62
Q

New Drugs for Osteoporosis Treatment

A

• Bisphosphonates
– Decrease osteoclast activity and number
– Partially reverse in spine
• Selective estrogen receptor modulators
– Mimic estrogen without targeting breast and uterus
• Statins
– Though for lowering cholesterol also increase bone mineral density
• Denosumab
– Monoclonal antibody
– Reduces fractures in men with prostate cancer
– Improves bone density in elderly

63
Q

Preventing Osteoporosis

A

• Plenty of calcium in diet in early adulthood
• Reduce carbonated beverage and alcohol consumption
– Leaches minerals from bone so decreases bone density
• Plenty of weight-bearing exercise
– Increases bone mass above normal for buffer against age-related bone loss

64
Q

Paget’s Disease

A

• Excessive and haphazard bone deposit and resorption
– Bone made fast and poorly – called pagetic bone
• Very high ratio of spongy to compact bone and reduced mineralization
– Usually in spine, pelvis, femur, and skull
• Rarely occurs before age 40
• Cause unknown - possibly viral
• Treatment includes calcitonin and biphosphonates

65
Q

Developmental Aspects of Bones

A
  • Embryonic skeleton ossifies predictably so fetal age easily determined from X rays or sonograms
  • Most long bones begin ossifying by 8 weeks
  • Primary ossification centers by 12 weeks
  • At birth, most long bones well ossified (except epiphyses)
  • At age 25 ~ all bones completely ossified and skeletal growth ceases
66
Q

Age-related Changes in Bone

A

• Children and adolescents
– Bone formation exceeds resorption
• Young adults
– Both in balance; males greater mass
• Bone density changes over lifetime largely determined by genetics
– Gene for Vitamin D’s cellular docking determines mass early in life and osteoporosis risk as age
• Bone mass, mineralization, and healing ability decrease with age beginning in 4th decade
– Except bones of skull
– Bone loss greater in whites and in females
– Electrical stimulation; Daily ultrasound treatments hasten repair