Chapter 7

Bone Tissues
and the
Skeletal System
Jahangir Moini, MD, MPH
 Overview (1 of 2)
• Skeletal system consists of:
– Bone tissue
– Cartilage
– Blood
– Dense connective tissue
– Nervous tissue
 Overview (2 of 2)
• Bones
– Attach to muscles
– Help maintain position
– Control precise movements
– Store salts
– Protect softer tissues
– Support body weight
– Have blood-producing cells
– Form blood vessels, nerve passageways
• 206 named bones in the skeleton
 Classifications of Bones
• Axial skeleton
– Skull, vertebral column, rib cage
– Long axis of body
– Protects and supports various body parts
• Appendicular skeleton
– Upper and lower limbs
– Girdles attaching limbs to the axial skeleton
 Classifications of Bones by Shape
• Flat: ribs, shoulder bones, some skull bones
• Irregular: many facial bones, spinal/pelvic
vertebrae
• Short: wrist and ankle bones
• Long: arm, forearm, thigh, leg, palms, soles,
fingers, toes
• Sutural (Wormian): between flat skull bones
• Sesamoid (round): inside tendons near joints in
knees, hands, and feet
 Carpal Tunnel Syndrome
• Carpal tunnel = narrow passageway formed
from ligament and bones at base of hand
– Contains median nerve, various tendons
– Tendon irritation from overuse narrows this
tunnel, compressing median nerve
• Tingling, numbness, then sharp pain
(greatest at night)
– Grasping objects becomes difficult
Figure 7-1 Anterior and posterior
views of the human skeleton
showing the normal position of
each bone.
 Long Bones
• Have shafts with expanded ends
• Located in arms, legs, palms, soles, fingers
• Femur bone is an example of a long bone
Figure 7-2 Anatomy of long bones. (A) Drawing of the humerus.
Notice the long shaft and dilated ends. (B) Longitudinal section of
the humerus showing compact bone, spongy bone, and marrow.
 Structures of Bones
• Dominated by osseous tissue
• Contain:
– Nervous tissue
– Cartilage
– Fibrous connective tissue
 Gross Anatomy
• Bone textures
– Compact bone and spongy bone
• Compact
– Dense outer layer; solid
• Spongy
– Needle-like pieces called trabeculae
Figure 7-3 Spongy bone.
© Photo Insolite Realite/Science Source, Inc.
 Long Bone Structures
• Diaphysis
– Connected to epiphysis; walls of compact or
dense bone
• Compact bone
– Solid, contains central space, marrow cavity
– Layer lining endosteum filled by soft marrow
• Diaphysis forms a tube with hollow medullary cavity
• All bones covered by superficial periosteum
• Bony processes = where ligaments and tendons
can attach
 Bone Markings
• Depressions, projections, openings
• Where ligaments, muscles, tendons attach—or
may occur at joint surfaces:
– Fissures—narrow, slit-like openings
– Fossae—deeper depressions; articular surfaces
– Foramina—oval or round openings through bones
– Meatuses—passageways that resemble canals
– Grooves—shallow depressions
– Sinuses—air-filled cavities
– Notches—indentations at edges of structures
 Bone Projections (1 of 2)
• Allow for passage of nerves and blood vessels, and
are where muscles and ligaments attach:
– Crests—narrow, prominent ridges
– Spines—pointed, sharp, slender
– Epicondyles—raised areas on or above
condyles
– Trochanters—large, blunt (only on femurs)
– Lines—narrow ridges, not as prominent
– Tubercles—small, rounded
– Processes—bony prominences
– Tuberosities—large, rounded; may be
rough
 Bone Projections (2 of 2)
• Those that help to form joints include:
– Condyles—rounded, articular
– Facets—smooth, almost flat, articular
– Heads—expansions on narrow necks
– Rami—arm-like bars
Microscopic Anatomy (Bone Cells)
(1 of 2)

• Osteogenic cells
– Active stem cells
– May differentiate into osteoblasts or
bone lining cells
• Osteoblasts
– Produce bone matrix
– Related to osteoprogenitor cells and
osteocytes
• Osteocytes
– Mature osteoblasts in bone matrix
Microscopic Anatomy (Bone Cells)
(2 of 2)

• Bone lining cells

– Help maintain bone matrix
• Osteoclasts
– Multinucleated bone cells
– Also known as osteophages
Figure 7-4 Types of bone cells.
 Microscopic Anatomy
of Compact Bone (1 of 5)
• Also called lamellar bone
• Osteon or Haversian system
– Structural unit of compact bone
– Cylinder parallel to long axis of bone
– Hollow tubes of bone matrix called lamellae
o Collagen fibers in adjacent rings run in
different directions
Figure 7-5 The microscopic structure of a long bone.
 Microscopic Anatomy
of Compact Bone (2 of 5)
• Canals and canaliculi
– Central (Haversian) canal runs through core
of osteon (contains blood vessels, nerve
fibers)
• Perforating (Volkmann’s) canals
– Lined with endosteum at right angles to
central canal
– Connect blood vessels, nerves of periosteum
 Microscopic Anatomy
of Compact Bone (3 of 5)
• Lacunae
– Small cavities containing osteocytes
• Canaliculi
– Hair-like canals
– Connect lacunae to each other and central
canal
 Microscopic Anatomy
of Compact Bone (4 of 5)
• Lamellae
– Interstitial lamellae
o Incomplete lamellae not part of complete
osteon
o Fill gaps between forming osteons
o Left over structure of osteons cut by
bone remodeling
 Microscopic Anatomy
of Compact Bone (5 of 5)
• Lamellae
– Circumferential lamellae
o Just deep to periosteum, superficial to
endosteum
o Extend completely around the diaphysis
o Resist twisting of long bone
 Microscopic Anatomy
of Spongy Bone
• Appears poorly organized
• Trabeculae
– No osteons
– Contain irregularly arranged lamellae,
osteocytes interconnected by canaliculi
Chemical Composition of Bone (1 of 2)
• Organic components
– Osteogenic cells
– Osteoblasts
– Bone lining cells
– Osteocytes
– Osteoclasts
– Osteoid
Chemical Composition of Bone (2 of 2)
• Inorganic components
– Hydroxyapatites or 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
 Bone
• Half as strong as steel in resisting compression
• As strong as steel in resisting tension
• Last long after death (mineral composition)
• Proof of illness
Growth and Development of Bones
(1 of 3)

• In embryos:
– Ossification and osteogenesis lead to
formation of skeleton
– Nearly all bones below base of skull, except
clavicles, are formed by endochondral
ossification
– Bone collars form around diaphysis of hyaline
cartilage models
– By third month, cavities in diaphysis invaded
by periosteal bud
Figure 7-6 Intramembranous ossification results in
the development of flat bones. Endochondral
ossification results in the production of long bones.
Photo: © Ralph Hutchings/Visuals Unlimited.
Growth and Development of Bones
(2 of 3)

• Osteoclasts break down new spongy bone as

primary ossification center enlarges
• Most long bones, at birth, have:
– Bony diaphysis surrounding spongy bone
remnants
– A widening medullary cavity
– Two cartilage epiphyses
Growth and Development of Bones
(3 of 3)

• Secondary ossification like primary

ossification, but
– Interior spongy bone is retained
– No medullary cavity formed in the epiphyses
– Begin forming in first eight weeks after fertilization
• Intramembranous bones
– Originate between “sheet-like” connective tissues
– Examples: flat, broad bones of the skull
• Bone-forming osteoblasts develop
– Deposit bony matrix around them to become
osteocytes
Figure 7-7 The major stages in the development of an
endochondral bone.
Adapted from Shier, D. N., Butler, J. L., and Lewis, R. Hole’s Essentials of Human Anatomy & Physiology,
Tenth edition. McGraw Hill Higher Education, 2009.
Figure 7-8 Lengthwise growth (A) occurs in the epiphyseal plate until
puberty when the epiphyseal plate closes, becoming the epiphyseal
line. Growth in diameter (B) involves altered rates of osteoclast and
osteoblast activity at the periosteum and endosteum.
 Functions of Bones
• Hemopoiesis: begins in embryo yolk sac
• Movement: via skeletal muscles
• Support and protection: of vital organs
• Storage of minerals: calcium, phosphorus
• Fat storage: for energy
• Hormone production: osteocalcin
Figure 7-9 Bones and muscles form lever systems when
they interact to move body parts.
 Bone Homeostasis
• Bone self-repair
• 5% to 7% of bone mass recycled every week
• Compact bone replaced every 10 years
• Spongy bone replaced every 3 to 4 years
• Bone fracture: most common disorder of
bone homeostasis
 Bone Remodeling
• Made up by bone deposit and resorption
• Remodeling units are assisted by osteocytes
– Normally, rates of bone deposit and
resorption are in balance
 Bone Fracture (1 of 3)
• Classified by:
– Positioning
– Completeness of fracture
– Penetration of skin by bones
• Nondisplaced: bone ends stay in normal
position
• Displaced: out of alignment
• Complete: broken completely through
• Incomplete: not broken completely through
Figure 7-10 Complete fracture.
Courtesy of Dr. Kirkland W. Davis, MD, Department of Radiology,
University of Wisconsin School of Medicine and Public Health.
 Bone Fracture (2 of 3)
• Open or compound: bone penetrates skin
• Closed or simple: does not penetrate skin
• Other descriptions include:
– Comminuted
– Epiphyseal
– Compression
– Greenstick
– Depressed
– Spiral
Figure 7-11 Open fracture.
Courtesy of Rhonda Beck.
Figure 7-12 Types of fractures.
 Bone Fracture (3 of 3)
• Treatment:
– Reduction (realignment of broken bone
ends)
– Then, immobilization by cast or traction
• Fractures take longer to heal in older adults
 Skull Fracture
• A break in one or more of the bones that form
the cranium
• Usually because of blunt force trauma
• May damage the brain, rupture blood vessels,
result in severe hemorrhage
 Bone Repair (1 of 2)
• Hematoma formation: bone cells die due to lack
of nutrients, followed by:
– Inflammation
– Pain
– Swelling
• Fibrocartilaginous callus formation
– Capillaries grow into hematoma
– Phagocytes engulf debris
– Bone reconstruction begins
Figure 7-13 Stages in fracture repair.
 Bone Repair (2 of 2)
• Bony callus formation
– Within 1 week, new bone trabeculae appear
– Slow conversion to hard, bony callus of
spongy bone
– In 2 months, it has become firm
• Bone remodeling
– Over several months, excess materials
removed
– Compact bone rebuilds bone shaft walls
 Bone Deposition
• New bone matrix deposits signified by osteoid
seams (unmineralized sections)
• Calcification occurs after about 1 week
• Calcium salts deposited throughout matured
matrix
 Bone Resorption
• Due to osteoclasts
– Which cling to bone and seal off areas of
destruction
• Calcium salts converted to soluble forms
• Osteoclasts:
– Phagocytize dead osteocytes and
demineralized matrix
– These are released into interstitial fluid and
blood, and osteoclasts die
 Control of Bone Remodeling (1 of 2)
• Genetic factors
• Negative feedback hormonal loop
– Maintains calcium ion homeostasis in the
blood
• Gravitational and mechanical forces
• Parathyroid hormone
– Main hormonal controller
– Aided by calcitonin, leptin, serotonin
 Calcium Ion Disorders
• Calcium ion levels must be strictly controlled
– If increased by 35%, convulsions occur
– If increased by 30%, muscle cells, neurons
become unresponsive
– If they reduce to 50%, death usually occurs
• Hypercalcemia can lead to:
– Dangerous calcium salt deposition
– Kidney stones and damage
 Control of Bone Remodeling (2 of 2)
• Wolff’s law
– Bones grow or remodel in response to
demands on them
• Curved bones
– Thickest where most likely to break
• Most-used limbs have thicker bones
• Projections develop where heavy, active
muscles attach
• Spongy bone trabeculae form supportive
framework along compression lines
 Bone Homeostatic Imbalance (1 of 2)
• Rickets
– Bowing of a child’s legs
– Deformities of pelvis, rib cage, skull
– Due to deficiency of calcium or vitamin D
• Osteomalacia
– Poor bone mineralization in adults
– May cause abnormal gait, decreased muscle
tone, weakness, immobility
 Bone Homeostatic Imbalance (2 of 2)
• Osteoporosis
– Bone resorption is quicker than bone
deposition
– Spongy bone of spine is most vulnerable
– Most common in postmenopausal women
Figure 7-14 Rickets.
© DR LR/age fotostock.
Figure 7-15 Osteoporosis with a compression
fracture of the vertebral body. Vertebral bodies
are less dense than normal, and the front of one
vertebral body has collapsed (arrow). Compare
the compression fracture in this vertebral body
with the vertebra above in which the anterior and
posterior surfaces are the same height.
Courtesy of Leonard V. Crowley, MD, Century College.
Figure 7-16 Major bones of the axial skeleton.
 Skull
• 22 firmly interlocked bones, divided into
cranium (brain case) and facial bones
• Sutures: lines where skull bones lock together
• Only movable bone the mandible (lower jaw),
attached to cranium by ligaments
• Paranasal sinuses
– Air-filled spaces in cranial bones
– Help voice to resonate
– Reduce weight of skull
Figure 7-17A Lateral, midsagittal, and posterior
views of the skull.
Figure 7-17B Anterior, inferior, and superior
views of the skull. (Continued)
 Bones of the Cranium
• Frontal: forms anterior skull above eyes
• Parietal: form sides and roof of cranium
• Occipital: forms back of skull and base of cranium
• Temporal: form parts of sides and base of cranium
• Sphenoid: forms part of base of cranium, sides of
skull, floors and sides of eye orbits
• Ethmoid: forms mass on each side of nasal cavity
joined by cribiform plates, which help form roof of
nasal cavity
Figure 7-18 The sphenoid bone.
Figure 7-19 The ethmoid bone.
© Jones & Bartlett Learning. Specimen courtesy of the Biology Department, Northeastern University.
 Fontanels
• In infants, cranial bones are connected by
fibrous membranes through soft spots
(fontanels)
– Fontanels eventually close as cranium
ossifies and bones grow together
• There are two types of fontanels:
– Anterior (closes at 18 months of age)
– Posterior (closes at 2 months of age)
Figure 7-20 The hyoid bone, superior view.
 Facial Skeleton (1 of 2)
• 14 bones
– Maxillae: form upper jaw, anterior roof of
mouth, floors of eye orbits, nasal cavity sides
and floor
– Zygomatic: form cheek prominences below
eyes, lateral walls and floors of eye orbits
– Nasal: form bridge of nose
– Vomer: forms nasal septum
– Inferior nasal conchae: support mucous
membranes of cavity
 Facial Skeleton (2 of 2)
– Lacrimal: in medial wall of eye orbits,
between maxillae and ethmoid bone
– Palatine: form posterior hard palate and
nasal cavity floor, nasal cavity lateral walls
– Mandible: lower jaw bone
 Mastoiditis
• Inflammation of mastoid process of temporal
bone
• A complication of otitis media
• Mastoid process contains sinuses (mastoid air
cells)
– Due to lack of blood circulation:
o Antibiotic treatments in this area are
difficult
– Surgery may be needed to remove part of the
bone and drain the mastoid
 Spine
• Vertical axis formed by vertebral column
– From skull to pelvis
• 26 vertebrae
– Separated by intervertebral discs of
cushioning cartilage, connected by ligaments
• Head and trunk supported by vertebral column
• Spinal cord passes through vertebral canal
– Created by openings in vertebrae
• At bottom, some vertebrae fuse
– Form sacrum and coccyx (tailbone)
Figure 7-21 The vertebral column
and features of skeletal vertebrae.
 Vertebrae (1 of 2)
• Cervical: 7 structures of neck
– Atlas (1st vertebra) supports head
o With two kidney-shaped facets
– Axis (2nd vertebra) has a process (dens) that
it pivots around
• Thoracic: 12 structures that increase in size,
moving down spine, articulating with ribs
 Vertebrae (2 of 2)
• Lumbar: five structures in lower back
– Larger than thoracic vertebrae, support more
weight
• Sacrum: triangular structure of five fused
vertebrae, form vertebral column’s base
• Coccyx (tailbone): lowest part of vertebral
column
– Composed of four fused vertebrae
Figure 7-22 Sacrum and coccyx, posterior aspect.
Figure 7-23 Normal curvatures of the
human spinal column.
 Intervertebral Disc Herniation
• Common in lumbar spine
• Herniation: outward bulging
– Intervertebral discs dry out with age
o Become prone to herniation
– Severe lower back pain, nerve pressure
o Causes radiculopathy
 Abnormal Spinal Curvatures
• Kyphosis: exaggeration of dorsal curvature in
thoracic region (often due to osteoporosis)
• Lordosis: inward lumbar curvature
– Linked to osteomalacia or spinal tuberculosis
• Scoliosis: abnormal lateral curvature, usually
thoracic
– Mostly in females
 Thorax
• Composed of thoracic cage
– 12 pairs of ribs
– Sternum (breastbone
– Costal cartilages attaching ribs to sternum
anteriorly
– Thoracic cage supports pectoral girdle,
upper limbs
– Also protects visceral organs in thoracic and
upper abdominal cavities
Figure 7-24 The ribcage, anterior view.
 Sternum and Ribs
• Breastbone (sternum) in middle anterior
thoracic cage
• One pair of ribs attach to each of 12 thoracic
vertebrae, totaling 24 in all
– First seven are true ribs
– Last five are false ribs (do not reach sternum
directly)
o With final two called floating ribs
Figure 7-25 Sternum, anterior view.
Figure 7-26 Sixth rib, inferior view.
 Pectoral Girdle
• Also known as shoulder girdle
– Made up of clavicle (collarbone) and scapula
(shoulder blade) on each side
– Actually an incomplete ring that opens in
back between the scapulae
– Connects upper limb bones to axial skeleton
Figure 7-27 Right clavicle.
Figure 7-28 The scapulae showing (A) the anterior view of the
right scapula and (B) the posterior view of the right scapula.
 Clavicles and Scapulae
• Clavicles: shaped like rods with an elongated
“S” shape
– Located at base of neck, bracing scapulae to
hold shoulders in place
• Scapulae: slightly triangular bones
– On either side of upper back
 Upper Limbs
• These bones include arms, forearms, and
hands
• Provide muscle attachments, function to move
limb parts
 Arm Bones
• Humerus: upper arm bone, extends from
scapula to elbow
• Lower humerus has two smooth condyles
articulating with ulna and radius
• Radius is located on thumb side of forearm
• Ulna is longer than radius, overlaps end of
humerus
Figure 7-29 (A) Anterior and (B) posterior aspect
of the right humerus.
 Forearm
• Antebrachium: formed by radius and ulna
– Proximal ends of these bones articulate with
humerus
– Distal ends form joints with the wrist bones
– Radius and ulna articulate with each other at
radioulnar joints
– They are connected all along their lengths by
the interosseous membrane
Figure 7-30 (A) Anterior and (B) posterior views of the
right radius and ulna.
 Hand
• Consists of wrist, palm, and fingers
• Wrist contains eight bones called carpals
• Five bones called metacarpals form the palm
• Metacarpals articulate with carpals and
phalanges (finger bones)
Figure 7-31 Anterior view of the bones of
the left hand.
 Marfan’s Syndrome
• Due to gene mutation
• Tall, thin stature
• Abnormally long limbs, fingers
• Skeletal abnormalities from excessive cartilage
formation at epiphyseal cartilages
• Connective tissue throughout body affected,
may result in life-threatening cardiovascular
problems
 Pelvic Girdle
• Made up of the two hipbones
– Which articulate with each other and sacrum
• Attaches lower limbs to axial skeleton
• Sacrum, coccyx, and pelvic girdle form the
pelvis
Figure 7-32 The pelvic girdle.
 Pelvic Bones
• Ilium: largest portion of hipbone, forms
prominence of hip
• Ischium: L-shaped, lowest portion of hipbone,
supports body weight when sitting
• Pubis: anterior portion of hipbone, forms angle
known as the pubic arch
 Lower Limbs
• Consist of bones of thigh, leg, and foot
• Femur (thighbone) = longest bone in body
• Patella (knee cap) = in a tendon passing over
the knee
• Tibia (shinbone) = larger of the two leg bones
– Located on medial side
• Fibula = slender bone
– Located on lateral side of tibia
Figure 7-33 (A) Anterior and (B) posterior
aspect of the right femur.
Figure 7-34 Anterior aspect of the right
fibula and tibia.
 Foot
• Consists of ankle, instep, and toes
• Ankle (tarsus): seven tarsal bones; talus bone
moves freely where it joins leg bones
• Largest tarsal bone is the calcaneus (heel bone)
• Metatarsus (instep): made of five metatarsal
bones
• Bones of toes are, like fingers, called phalanges,
– Each toe has three bones, except great toe,
which has only two
Figure 7-35 Bones of the right foot (superior view).
 Pott’s Fracture
• Common sports-related injury
• Occurs at distal end of fibula, tibia, or both
• Similar to ankle sprain; hard to distinguish
• Immediate, severe pain
• Weight cannot be put on the leg
• Followed by swelling, bruising
 Effects of Aging on the
Skeletal System
• Bone mass decreases and bones become
weaker
• Every adult has inadequate ossification
(osteopenia)
• Common sites of fracture:
– Hips, neck of femur, and vertebrae of spine
• Several centimeters in height lost by the age of
55 years
– Vertebral column resumes arc-like shape it
had as a newborn
Figure 7-36 The vertebral column has a marked
convex deformity on lateral X-ray.
Courtesy of Dr. Kenneth Noonan, Department of Pediatric Orthopedics, University of
Wisconsin School of Medicine and Public Health.