FUNCTIONS OF THE SKELETON

1. Provides a framework that supports the body; the muscles that are attached to bones move the skeleton. 2. Protects some internal organs from mechanical injury; the rib cage protects the heart and lungs, for example. 3. Contains and protects the red bone marrow, the primary hemopoietic (blood-forming) tissue. 4. Provides a storage site for excess calcium. Calcium may be removed from bone to maintain a normal blood calcium level, which is essential for blood clotting and proper functioning of muscles and nerves.

TYPES OF BONE TISSUE

Bone was described as a tissue in Chapter 4. Recall that bone cells are called osteocytes, and the matrix of bone is made of calcium salts and collagen. The calcium salts are calcium carbonate (CaCO3) and calcium phosphate (Ca3(PO4)2), which give bone the strength required to perform its supportive and protective functions. Bone matrix is non-living, but it changes constantly, with calcium that is taken from bone into the blood replaced by calcium from the diet. In normal circumstances, the amount of calcium that is removed is replaced by an equal amount of calcium deposited. This is the function of osteocytes, to regulate the amount of calcium that is deposited in, or removed from, the bone matrix. In bone as an organ, two types of bone tissue are present (Fig. 61). Compact bone looks solid but is very precisely structured. Compact bone is made of osteons or haversian systems, microscopic cylinders of bone matrix with osteocytes in concentric rings around central haversian canals. In the haversian canals are blood vessels; the osteocytes are in contact with these blood vessels and with one another through microscopic channels (canaliculi) in the matrix. The second type of bone tissue is spongy bone, which does look rather like a sponge with its visible holes or cavities. Osteocytes, matrix, and blood vessels are present but are not arranged in haversian systems. The cavities in spongy bone often contain red bone marrow, which produces red blood cells, platelets, and the five kinds of white blood cells.

CLASSIFICATION OF BONES
1. Long bonesthe bones of the arms, legs, hands, and feet (but not the wrists and ankles). The shaft of a long bone is the diaphysis, and the ends are called epiphyses (see Fig. 61). The diaphysis is made of compact bone and is hollow, forming a canal within the shaft. This marrow canal (or medullary cavity) contains yellow bone marrow, which is mostly adipose tissue. The epiphyses are made of spongy bone covered with a thin layer of compact bone. Although red bone marrow is present in the epiphyses of childrens bones, it is largely replaced by yellow bone marrow in adult bones. 2. Short bonesthe bones of the wrists and ankles. 3. Flat bonesthe ribs, shoulder blades, hip bones, and cranial bones. 4. Irregular bonesthe vertebrae and facial bones. Short, flat, and irregular bones are all made of spongy bone covered with a thin layer of compact bone. Red bone marrow is found within the spongy bone. The joint surfaces of bones are covered with articular cartilage, which provides a smooth surface. Covering the rest of the bone is the periosteum, a fibrous connective tissue membrane whose collagen fibers merge with those of the tendons and ligaments that are attached to the bone. The periosteum anchors these structures and contains both the blood vessels that enter the bone itself and osteoblasts that will become active if the bone is damaged.

THE HIP AND LEG

The pelvic girdle (or pelvic bone) consists of the two hip bones (coxae or innominate bones), which articulate with the axial skeleton at the sacrum. Each hip bone has three major parts: the ilium, ischium, and pubis, and these are shown in Fig. 613, which depicts both a male and a female pelvis. The ilium is the flared, upper portion that forms the sacroiliac joint. The ischium is the lower, posterior part that we sit on. The pubis is the lower, most anterior part. The two pubic bones articulate with one another at the pubic symphysis, with a disc of fibrous cartilage between them. Notice the pubic angle of both the male and female pelvises in Fig. 613. The wider female angle is an adaptation for childbirth, in that it helps make the pelvic outlet larger. The acetabulum is the socket in the hip bone that forms a ball-and-socket joint with the femur. Compared to the glenoid fossa of the scapula, the acetabulum is a much deeper

socket. This has great functional importance because the hip is a weightbearing joint, whereas the shoulder is not. Because the acetabulum is deep, the hip joint is not easily dislocated, even by activities such as running and jumping (landing), which put great stress on the joint. The femur is the long bone of the thigh. As mentioned, the femur forms a very movable ball-andsocket joint with the hip bone. At the proximal end of the femur are the greater and lesser trochanters, large projections that are anchors for muscles. At its distal end, the femur forms a hinge joint, the knee, with the tibia of the lower leg. Notice in Fig. 614 that each bone has condyles, which are the rounded projections that actually form the joint. The patella, or kneecap, is anterior to the knee joint, enclosed in the tendon of the quadriceps femoris, a large muscle group of the thigh.

FRACTURE AND THEIR REPAIR

A fracture means that a bone has been broken. There are different types of fractures classified as to extent of damage. Simple (closed)the broken parts are still in normal anatomic position; surrounding tissue damage is minimal (skin is not pierced). Compound (open) the broken end of a bone has been moved and it pierces the skin; there may be extensive damage to surrounding blood vessels, nerves, and muscles. Greenstickthe bone splits longitudinally. The bones of children contain more collagen than do adult bones and tend to splinter rather than break completely. Comminutedtwo or more intersecting breaks create several bone fragments. Impactedthe broken ends of a bone are forced into one another; many bone fragments may be created. Pathologic (spontaneous)a bone breaks without apparent trauma; may accompany bone disorders such as osteoporosis. The Repair Process Even a simple fracture involves significant bone damage that must be repaired if the bone is to resume its normal function. Fragments of dead or damaged bone must first be removed. This is accomplished by osteoclasts, which dissolve and reabsorb the calcium salts of bone matrix. Imagine a building that has just collapsed; the rubble must be removed before reconstruction can take place. This is what the osteoclasts do. Then, new bone must be produced. The inner layer of the periosteum contains osteoblasts that are activated when bone is damaged. The osteoblasts produce bone matrix to knit the broken ends of the bone together. Because most bone has a good blood supply, the repair process is usually relatively rapid, and a simple fracture often heals within 6 weeks. Some parts of bones, however, have a poor blood supply, and repair of fractures takes longer. These areas are the neck of the femur (the site of a fractured hip) and the lower third of the tibia. Other factors that influence repair include the age of the person, general state of health, and nutrition. The elderly and those in poor health often have slow healing of fractures. A diet with sufficient calcium, phosphorus, vitamin D, and protein is also important. If any of these nutrients is lacking, bone repair will be a slower process.