GENERAL

A N AT O M Y
OF
 GENERAL ANATOMY OF BONES
Definition: 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.
 Components …… cells & matrix.
• cells:-
osteoblasts bone production

osteocytes bone maintenance

osteoclasts bone resorption

• Matrix:-
1/3 Inorganic calcium salts-

calcium phosphate
calcium carbonate

2/3 Organic connective tissue – collagen fibres

 FUNCTIONS OF
BONES ?
 Shape & Support to the body
 Protection of soft organs.
 Provides surface for muscle
attachment.
 Serves as levers for muscle actions
 Storage of minerals (97% of body ca
& p)
 Bone marrow…Blood cell formation
 Reticulo-endothelial cells-immune
response
 Para nasal air sinuses – resonance to
the voice
 PECULIARITIES OF BONE

 living tissue….. ?
 Highly vascular, with constant turn over of its calcium
content;
 Shows a characteristic pattern of growth;
 Subjective to disease, and heals after a fracture;
 Greater regenerative power than any other tissue of the
body, except blood;
 It can mould itself according to changes in stress and
strain;
 It shows disuse atrophy and overuse hypertrophy.
 CLASSIFICATION

According to
According to According to According to
Developmen
shape : Region : structure :
t:
long Membrane
Macroscopically

Short bones
Axial • Compact
• cancellous
Flat
Irregular Cartilaginou Appendicula
Pneumatic s bones r
Microscopically
Sesamoid
• Lamellar
Accessory Membrano- • Woven
Heterotopic cartilaginous • Fibrous
• Dentine
• Cement
 ACCORDING TO POSITION

 Axial skeleton
-
Skull,vertebrae,ribs,sternum

 Appendicular skeleton
- limbs and girdle
 AXIAL SKELETON APPENDICULAR SKELETON
Skull Pectoral girdles 4
Cranium 8
Face 14 Pelvic girdles 2
Hyoid 1
Auditory ossicles 6 Upper extremities 60
Vertebral column 26
Thorax Lower extremities 60
Sternum 1
Ribs 24 TOTAL
TOTAL 80 126

TOTAL BONES OF THE BODY 206

AXIAL SKELETON
APPENDICULAR SKELETON
APPENDICULAR SKELETON
APPENDICULAR SKELETON
 ACCORDING TO SHAPE
 Long bones:

 Short bones:

 Flat bones:

 Irregular bones:

 Pneumatic bones:

 Sesamoid bones:

 Accessory
(supernumerary)
bones:
 CLASSIFICATION OF BONES
 Long bones:
 Elongated shaft
 Two expanded ends
 Examples:
 A) typical long bones -
Femur, humerus
B) miniature long bones-
Metatarsals,
Metacarpals
C) modified long bones-
Clavicle,
Body of a vertebra
 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
 Thin layers of compact bone around a
 layer of spongy bone

Examples: Vault of Skull, ribs, 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 bone 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:
Derived from Arabic word-
sesame….. ‘seed’
• Patella, fabella pisiform,etc
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 imp.
– e.g. Sutural 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”
Bone develops in cardiac muscles.
-seen in pigs.
 (C) DEVELOPMENTAL CLASSIFICATION
1.Membranous (Dermal) bones

2.Cartilaginous bones

3.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
1. Membranous bones:
• Ossify in membrane
 Derived from mesenchymal condensation
 e.g.- bones of cranial vault
 - facial bones
 Defect in membranous ossification cause

 Cleidocranial dysostosis
2.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

3. Membrano - cartilaginous bones:
 Partly ossify in membrane & partly in cartilage

 e.g. – clavicle, mandible, occipital, temporal, sphenoid

bone

temporal sphenoid

occipital

mandible
 (D)STRUCTURAL CLASSIFICATION

 Macroscopically:-
1.Compact bone
2.Cancellous (spongy) bone
 Microscopically:-
1.Lamellar bone
2.Woven bone
3.Fibrous bone
4.Dentine
5.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(rods and plates)
between which are marrow
containing spaces.
• Trabecular meshworks:
1. Meshwork of rods
2. Meshwork of rods and
plates
3. Meshwork of plates
 Cancellous bone is an
adaption to compressive
forces
• Microscopically:
1.Lamellar bone:
-most mature human bones
2. Woven bone:
- foetal bone
-fracture repair site
-cancer of bone
3. Fibrous bone:
-young foetal bones
-reptiles and amphibia

4.Dentine:

5.Cement:
 Trajectory theory of Wolff
Wolff’s Law

• Osteogenesis is directly proportional to stress

and strain.
• Tensile force favours bone formation
• Compressive force favours bone resorption
• Lamellae ……
• Pressure lamellae….parallel to line of weight
transmission

• Tension lamellae … at right angle to

pressure lamella
GROSS STRUCTURE OF A TYPICAL LONG BON

 Three parts:
Shaft
Two ends

SHAFT :
From outside inwards

A. Periosteum
B. Cortex
C. Medullary cavity
D. Endosteum
A) PERIOSTEUM

 Thick fibrous membrane

 Two layers
 Sharpey’s fibre
 Rich nerve supply

 Functions
 Protects
 Receives the
attachment
 Maintains shape
 Give nutrition
 Help in bone formation
during growth & repair.
• Cortex
– Compact bone
– Strength
 M E D U L L A RY C AV I T Y

• Bone marrow
– 2 forms

1) RED
2) Yellow
• Red Marrow

• New born
• After 20 years
• Skull
• Sternum, ribs
• Vertebrae, Iliac cresst
• Ends of long bones
• Some short bones
• Yellow Marrow
• Fat
• Some Hemopoietic
elements
 D) ENDOSTEUM:
 Lines the medullary cavity
• Have role in bone remodeling
and repair

 TWO ENDS :
• Made up of cancellous bone
covered by thin shell of
compact bone.
• Articular hyaline cartilage
DEVELOPMENT &
OSSIFICATION
BONE CELLS
From mesenchymal Osteoprogenitor cell

Osteoblast

Organic material

Alkaline phosphatase

Osteocytes

Woven bone

Remodeling

Mature bone
T Y P E S O F O SS I F I C AT I O N

Intramembranous ossification
I N T R A C A RT I L A G I N O U S O SS I F I C AT I O N
 CENTER OF OSSIFICATION
The area of bone, where bone formation or ossification
starts in a cartilaginous model.
Primary centre:
Main part - Shaft
Before birth
e.g. : Shaft of long bones
Exceptions- Carpals & Tarsals, except
talus, calcaneus & cuboid bones.

Secondary centre:

Accessory parts - Ends

After birth

Exceptions: Lower end of femur &

upper end of tibia.
PA R T S O F A Y O U N G L O N G B O N E

 DIAPHYSIS

 METAPHYSIS

 EPIPHYSIS

 EPIPHYSIAL PLATE OF
CARTILAGE
 DIAPHYSIS :-
 From a primary
centre.
 Shaft of a long bone

 METAPHYSIS :
 Epiphysial ends of diaphysis
 Zone of active growth
 Profuse blood supply
 E P I P H Y S I S *Most IMP

The ends and tips of a bone which ossify from secondary centres
are called epiphyses.

 Mostly having spongy bone.

• Four types:

1) Pressure epiphysis;

2) Traction epiphysis;

3) Atavistic epiphysis;
 Pressure epiphysis
Articular
Transmission of weight
e.g. Head of femur, lower end of radius

Traction epiphysis-
Nonarticular
Provide muscle attachment
e.g. Trochanters of femur
Tubercles of humerus

Pressure epiphysis always appear before Traction epiphysis*

Atavistic epiphysis-
Coracoid process of
scapula
Posterior tubercle of talus

Aberrant epiphysis-
Not always present
Appears at unusual end
Head of first metacarpal
When more than one epiphysis present at one or both ends:

• Simple Epiphysis
• Compound Epiphysis
 EPIPHYSIAL PLATE OF CARTILAGE :-
 Separates epiphysis from metaphysis
 Lengthwise growth of a long bone
 After fusion - no longer growth in length
 B LO O D S U P P LY O F B O N E S
• TYPICAL LONG BONES :-
Supplied by four sets of blood vessels

• (1) Nutrient artery

 Middle of the shaft through the nutrient

foramen

 Medullary cavity, inner 2/3 of cortex and

metaphysis

‘HAIR –PIN’ BENDS AND OSTEOMYLITIES

(2) Epiphyseal arteries
from circulus vasculosus
(3) Periosteal arteries:-
 Outer 1/3 of the cortex

(4) Juxta-epiphyseal or
Metaphysial arteries

• SHORT BONES

• By numerous periosteal vessels

which enter their nonarticular surface
• MINIATURE LONG BONES

 Nutrient artery breaks up

in to plexus

 Infection begins in middle

of the shaft, rather than
metaphysis.

 In adults chances of
infection are less

 Because NA is replaced by
periosteal arteries.
 F L AT B O N E S
 Nutrient Artery:-
pierce compact part
of flat bones.

 Periosteal Artery:-
major share in blood
supply.
RREGULAR BONES (VERTEBRA)
From basi-vertebral
foramen

 Through antero-
lateral surface.

 Pierce root of
transverse process,
and supply vertebral
arch.
 Venous drainage:
– Cancellous & red marrow containing
bones- Large and Numerous
• e.g.-basivertebral veins.

– Compact bones: Accompany blood

vessels

 Nerve supply:
– Accompany blood vessels
– Sympathetic and vasomotor
– Periosteum – reach nerve supply
 L AW O F U N I O N O F E P I P H Y S I S

The epiphyseal center which appears first , unites last with

the diaphysis and vice – versa.

Bone violating the law

of ossification……

Fibula….
Lower end
Appear first
also
Fuses first
 GROWING END OF THE LONG BONES:

• The end where the secondary centre appears first

and unites last with the diaphysis.

• Increase length of bone

 Knowledge of the growing ends is important in clinical

practice.

– Fracture at growing end Stunted growth

Nutrient foramen: Directed away from the
growing end of the bone
‘TO THE ELBOW I GO,
FROM THE KNEE I FLEE’
 GROWTH OF LONG BONE
IN LENGTH: Epiphysial plate of
cartilage

IN WIDTH: Supperiosteal
deposition

Appositional Growth or
Surface Accretion

Remodelling
 FACTORS AFFECTING GROWTH OF
BONES
 NUTRITIONAL
Deficiency of vitamin A,D,C
Disuse atrophy

 HORMONAL
Secretion from Pituitary, Parathyroid, Calcitonin

 GENETIC
Chondrodystrophia Foetalis
 MECHANICAL
Tensile force…..Bone formation
Compressive force…..Bone resorption
MEDICOLEGAL AND ANTHROPOLOGICAL
ASPECTS

 Weather the bones are

human or not;
 Weather they belong to
one or more persons;
 The age of individual;
 The sex;
 The stature;
 The time and cause of
death
 CLINICAL ANATOMY

• Atrophy and Hypertrophy • Osteomalasia

• Periosteum • Osteoporosis
• Cleidocranial dysostosis • Bone marrow aspiration
• Achondroplasia • Bone tumour
• Fracture • Bone graft
• Rickets • Bone bank
• Scurvy
1. Atrophy , if not used i.e. become thinner and weakened
Hypertrophy
– overuse

2. Periosteum

Very sensitive to pain, particularly to tearing and tension.

Therefore drilling into the bone without anaesthesia is very
painful.
CLEIDOCRANIAL DYSOSTOSIS
 Defect in membranous

ossification.
• It may be hereditary or
environmental in origin.

 Three cardinal features:

(i) Aplasia of the clavicles
(ii) Increase in the transverse

diameter of cranium
(iii) Retardation in fontanelle
ossification
 ACHONDROPLASIA

 Defect in endochondral
ossification.

 Limbs are short ,but the

trunk is normal.

 Transmitted as a Mendelian
dominant character
 FRACTURE
 It is the break in the continuity of a bone.
 Simple(closed) fracture
 Compound(open) fracture
HEALING (REPAIR) OF A FRACTURE
 Fracture hemetoma
 Repair by granulation tissue
 Union by callus
External callus
Internal callus
 Remodelling by mature bones
SCURVY ( DEFICIENCY OF VITAMIN
C )
• Formation of collagenous fibres and
matrix is impaired

• Rupture of capillaries and defective

formation of new capillaries

• Haematoma in the muscles and

bones

• Normal architecture at the growing

ends is lost
 RICKETS
( DEFICIENCY OF VITAMIN D in
children)
• Defective mineralization of bone in
children usually as a result of
insufficient sunlight or vitamin D ––
causes bone softening and deformity

• Calcification of cartilage fails and

ossification of growth zone is
disturbed.

• Affects growing bone; 3 months to

3 years
 OSTEOMALACIA
 Deficiency of calcium, vitamin D in adult life.
 Bones on x-rays examination do not reveal
enough trabeculae
 OSTEOPOROSIS
• The most common bone disease –
characterized by low bone mass,
increased skeletal fragility, and
susceptibility to fractures
• –Associated with lack of exercise or
estrogen deficiency
• – Estrogen inhibits osteoclast activity –
Loss of organic matrix and minerals –
Affects spongy bone in particular
– Frequently involves the hip, wrist
and vertebra

• Seen both in females and males

• Forward bending of the vertebral

column, leading to kyphosis
BONE MARROW ASPIRATION
• Done for the diagnostic purpose
• The sites commonly used are:-

Manubrium of sternum
Iliac crests of hip bones
Lumber spinous process
 BONE TUMOUR
 Benign tumour:Osteoma

 Malignant:Osteosarcoma
BONE BANKS , BONE GRAFTS
The Bone Bank is a facility for collecting, storing and freezing
human bone for use in patients requiring a bone allograft (the
transplantation of bone between two unrelated people).
 SUMMARY
• INTRODUCTION
• FUNCTIONS OF BONES
• CLASSIFICATION
• CENTER OF OSSIFICATION
• PARTS OF A YOUNG(GROWING) LONG BONE
• GROSS STRUCTURE OF A TYPICAL LONG BONE
• LAW OF UNION OF EPIPHYSIS
• BLOOD SUPPLY OF BONES
• FACTORS AFFECTING GROWTH OF BONES
• MEDICOLEGAL AND ANTHROPOLOGICAL ASPECTS
• CLINICAL ANATOMY