elements of osteology dr.emmanuel m.d, msc, pgdgh

Elements of OsteologyElements of Osteology

DR .Emmanuel DR .Emmanuel M.D, MSc,M.D, MSc, PGDGH PGDGH

Session Objectives Session Objectives

Objectives is to able to Objectives is to able to – Use the anatomical terminology in osteology Use the anatomical terminology in osteology – State major bony structuresState major bony structures– Name and classify the bones of the bodyName and classify the bones of the body– Link bone structure and clinical conditionsLink bone structure and clinical conditions

– References:References:Frank Netter Atlas on OsteologyFrank Netter Atlas on Osteology

Common bone conditionsCommon bone conditions

OsteoporosisOsteoporosis

FracturesFractures

Dislocations/ subluxationDislocations/ subluxation

Cancer: Ostesarcoma,chondrosarcomasCancer: Ostesarcoma,chondrosarcomas

Founders of Founders of Anatomy Anatomy Hippocra

tesHippocrates----BC

460~377)

Father of MedicineMother of Nursing?...FNOther professions: Find out

Galen

Galen--------AD 130~200

Vesalius------(1514~1564) Founder of modern Anatomy

Andreas Vesalius

William William HarveyHarvey

Harvey------(1578~1657)

Described correctly the CVS

OsteologyOsteologyOsteology is the anatomical study of bonesOsteology is the anatomical study of bones

Conventionally we study the dry bones in Conventionally we study the dry bones in the anatomy classthe anatomy class

This sets the understanding of bones in This sets the understanding of bones in clinical settings e.g in Radiology, clinical settings e.g in Radiology, Orthopedics, Traumatolgy, Surgery etcOrthopedics, Traumatolgy, Surgery etc

Functions of the boneFunctions of the bone

Support and protectionSupport and protection The skeleton (bones, ligaments and tendons) The skeleton (bones, ligaments and tendons)

supports and protects soft tissuessupports and protects soft tissues

Muscle attachment and locomotion Muscle attachment and locomotion

Production of blood cells Production of blood cells

Mineral reservoir Mineral reservoir

Terms used in osteologyTerms used in osteology

Bone surface have structures e.g.:Bone surface have structures e.g.:

ElevationsElevations

FacetsFacets

Head and Condyle Head and Condyle

DepressionsDepressions

ForamenForamen

ElevationsElevationsLinear elevationsLinear elevations– Lines/ridgesLines/ridges e.g nuchal line, supracondylar e.g nuchal line, supracondylar

ridgesridges– CrestCrest is a prominent line/ridge is a prominent line/ridge

• Rounded elevations -Tubercle- small rounded elevation -Protuberance- knob-like elevation -Tuberosity- big rough elevation -Trochanter- rough elevation of femur -Malleolus- harmer like elevation

• Sharp elevation -Spinous process -Clinoid process

Facet:Facet: Small, smooth, flat articular Small, smooth, flat articular surface surface

Head and Condyle:Head and Condyle: Rounded articular Rounded articular surface normally covered by cartilage e.g surface normally covered by cartilage e.g head of humerus, condyles of femurhead of humerus, condyles of femur

EpicondyleEpicondyle--prominent process just --prominent process just above a condyleabove a condyle

DepressionsDepressions

SulcusSulcus: Shallow and long depression on the : Shallow and long depression on the bone surface.bone surface.FossaFossa: Deep depressions on the bone surface: Deep depressions on the bone surfaceNotch or IncisuraNotch or Incisura: Semicircular depressions : Semicircular depressions

ForamenForamen-Openings or holes-Openings or holesCanalCanal- A long foramen- A long foramenMeatus- Meatus- canal that enter the bone but does not go canal that enter the bone but does not go

through itthrough it

Types of bonesTypes of bonesClassificationClassification

Long bones-Long bones- humerus, radius, ulna, metacarpals, humerus, radius, ulna, metacarpals, femur, tibia, fibula, metatarsals, phalangesfemur, tibia, fibula, metatarsals, phalangesShort bones-Short bones- carpals and tarsal carpals and tarsalFlat bone-Flat bone- cranial bones, scapula, sternum, ribs and cranial bones, scapula, sternum, ribs and innominateinnominateIrregular bones-Irregular bones- vertebrae, temporal, sphenoid, vertebrae, temporal, sphenoid, ethmoid, zygomatic, maxilla, mandible, palatine and ethmoid, zygomatic, maxilla, mandible, palatine and inferior nasal conchainferior nasal conchaSesamoid bone-Sesamoid bone- bones embedded in a tendon e.g. bones embedded in a tendon e.g. patellapatellaPneumatic bones-Pneumatic bones- irregular bones with air filled irregular bones with air filled cavities/ sinuses e.g. maxilla, sphenoid, ethmoid, cavities/ sinuses e.g. maxilla, sphenoid, ethmoid, frontal and mastoid part of the temporal frontal and mastoid part of the temporal

Part of a long bonePart of a long bone

DiaphysisDiaphysis- has a thick outer compact - has a thick outer compact bonebone

MetaphysisMetaphysis- a thin part of diaphysis - a thin part of diaphysis adjoning epiphysisadjoning epiphysis

EpiphysisEpiphysis- proximal and distal rounded - proximal and distal rounded partpart

Long bonesLong bones (found in (found in limbs): limbs): – Diaphysis or shaft , Diaphysis or shaft ,

which is hollow (called which is hollow (called medullary cavity ), filled with medullary cavity ), filled with bone marrowbone marrow

– Two endsTwo ends －－ epiphysis epiphysis articular surface, articular surface, metaphysis, epiphysial metaphysis, epiphysial cartilage , and cartilage , and 　　　　　　epiphysial line epiphysial line

Short bonesShort bones: : cuboidal in cuboidal in shape, e.g. carpal bonesshape, e.g. carpal bones

Flat bonesFlat bones: thin : thin

Irregular bonesIrregular bones: : have any irregular or have any irregular or mixed shape, e.g. mixed shape, e.g. vertebrae, pneumatic vertebrae, pneumatic bonesbones

Sesamoid bones: Sesamoid bones: develop within tendondevelop within tendon

e.g patellae.g patella

General structures of boneGeneral structures of boneBone substance Bone substance

– compact bonecompact bone

– spongy bonespongy bone

trabeculaetrabeculae

In the flat bones of the skull, the In the flat bones of the skull, the layers of compact bone are layers of compact bone are called the outer plate and inner called the outer plate and inner plate while the layer of spongy plate while the layer of spongy bone is called the diploë bone is called the diploë

Periosteum :Periosteum :

– Outer or fibrous layer Outer or fibrous layer – Inner layer is vascular and Inner layer is vascular and

provides the underlying bone provides the underlying bone with nutrition. It also contains with nutrition. It also contains osteoblastsosteoblasts

EndosteumEndosteum is a single-cellular is a single-cellular osteogenic layer lining the inner osteogenic layer lining the inner surface of bone.surface of bone.Bone marrow Bone marrow – Red marrowRed marrow haematopoietic haematopoietic

centercenter– Yellow marrowYellow marrow: fatty : fatty

Chemical composition and Chemical composition and physical propertiesphysical properties

Organic materialOrganic material ：：

Inorganic saltsInorganic salts

Organic materialOrganic material Inorganic saltsInorganic salts

ChildrenChildren 11 11

Adult Adult 33 77

Old Old 11 44

The Bones of Limbs

Bones of upper limbsBones of upper limbs

Composition:Composition:

Should girdle: Should girdle: clavicleclavicle ，， scapulascapula

Bones of free upper limbBones of free upper limb

– HumerusHumerus in armin arm– RadiusRadius and ulnaand ulna in forearmin forearm– CarpalCarpal bonesbones, metacarpals, metacarpals

and phalangesand phalanges in handin hand

Clavicle Clavicle

““S” shaped, medial 2/3 S” shaped, medial 2/3 convex forward and lateral convex forward and lateral 1/3 convex backward1/3 convex backward

Sternal endSternal end medially and medially and acromial endacromial end laterally laterally

ScapulaScapula Three bordersThree borders– Superior: Superior: coracoid process coracoid process , , scapular notch scapular notch

– Lateral (axillary) borderLateral (axillary) border– Medial (vertebral) borderMedial (vertebral) border

Three anglesThree angles– Superior: opposite to the 2nd rib Superior: opposite to the 2nd rib – Inferior: opposite to the 7th rib or 7th intercostals Inferior: opposite to the 7th rib or 7th intercostals

spacespace– Lateral:Lateral: glenoid cavity, glenoid cavity, supra- and infraglenoid tubercles supra- and infraglenoid tubercles

Two surfacesTwo surfaces– Anterior surface concave: Anterior surface concave: subscapular fossasubscapular fossa– Posterior surface: Posterior surface: supra-supra- and and infraspinous infraspinous

fossae, fossae, spine of scapula spine of scapula , , acromion acromion

HumerusHumerus Proximal end: Proximal end: head of humerushead of humerus,, anatomical neckanatomical neck, , greatergreater and and lesser tubercleslesser tubercles, , crests of greater crests of greater and and lesser tuberclelesser tubercle, , intertubercular grooveintertubercular groove,, surgical surgical neckneckShaft: Shaft: deltoid tuberositydeltoid tuberosity on lateral on lateral surface, and a surface, and a groove for radial groove for radial nervenerve on posterior surfaceon posterior surfaceDistal end: Distal end: lateral and medial lateral and medial epicondylesepicondyles, , capitulum capitulum , , trochleartrochlear, , coronoidcoronoid fossa and fossa and radial fossa radial fossa (anteriorly) and (anteriorly) and olecranon fossaolecranon fossa (posteriorly), and (posteriorly), and sulcus for ulnar nerve sulcus for ulnar nerve

RadiusRadiusUpper end: Upper end: head of radiushead of radius, , neck of radiusneck of radius, , radial radial tuberositytuberosity, and articular , and articular circumferencecircumference

ShaftShaft ：： interosseous borderinterosseous border

Lower end: Lower end: styloid processstyloid process laterally, laterally, ulnar notchulnar notch medially, medially, and and carpal articular surfacecarpal articular surface inferiorlyinferiorly

Fracture of the distal end pf the Fracture of the distal end pf the radiusradius

RadiusRadiusProximal end: Proximal end:

olecranonolecranon

coronoid processcoronoid process

trochlear notchtrochlear notch

radial notchradial notch

ulnar tubersityulnar tubersity

Distal end Distal end

styloid process styloid process

head of Radius head of Radius

Carpal bonesCarpal bonesProximal row ― (lateral to medial) Proximal row ― (lateral to medial) scaphoidscaphoid,, lunate lunate, , triquetraltriquetral and and pisiformpisiformDistal row ― (lateral to medial) Distal row ― (lateral to medial) trapeziumtrapezium大大 , , trapezoidtrapezoid, , capitatecapitate andand hamate hamate

Metacarpal bonesMetacarpal bonesNumbered one to five from thumb to Numbered one to five from thumb to little fingerlittle fingerStructure of each―base (proximally), Structure of each―base (proximally), shaft, and head (distally)shaft, and head (distally)

Phalanges of fingersPhalanges of fingersConsist of 14 ―two for first digit Consist of 14 ―two for first digit (thumb) and three for each of other (thumb) and three for each of other four digitsfour digitsStructure of each ―base (proximally), Structure of each ―base (proximally), shaft, and trochlea of phalanx (distally), shaft, and trochlea of phalanx (distally), tuberosity of distal phalanxtuberosity of distal phalanx