Anatomy of bone system. The manual for medical students / Анатомия костной системы. Учебное пособие для медицинских вузов - Иван Васильевич Гайворонский 2 стр.


1.3. Internal Structure of Bones

The internal structure of bones essentially differs in a fetus and in a newborn child. Therefore two types of osseous tissue are distinguished reticulofibrous and lamellar. The reticulofibrous bone tissue is the basis of the embrional human skeleton. Its bony matrix is not arranged structurally, the bundles of collagen fibers are located in different directions, and they are directly connected with connective tissue surrounding the bone.

After birth, reticulofibrous tissue is replaced with lamellar tissue formed of osteal lamellae 4,5 11 mkm thick. There are osteal cells (osteocytes) in the smallest cavities (lacunae) between osteal lamellae. Collagen fibers in the bone lamellae are strictly arranged parallelly to their surfaces. They lose connection with the connective tissue surrounding the bone. They are connected with the periosteum only due to perforating (Sharpey`s) fibers running from the periosteum to the superficial layers of the bone. The lamellar bone is much more solid than the reticulofibrous bone. Substitution of one osseous tissue with another is caused by the influence of functional loads on the skeleton. On the section of a macerated bone (bone deprived of soft tissues), it is possible to see two types of the osseous tissue: compact and spongy. The compact bone, substantia compacta, is a solid bony mass located on the exterior of the bone. The osteal lamellae of the compact bone are very close to each other. The compact tissue coats the epiphyses of tubular and flat bones as a thin sheath. The diaphyses of tubular bones entirely consist of compact bone.

Spongy bone, substantia spongiosa, is formed by loosely located osteal lamellae. In the spaces between them there is red bone marrow. Spongy tissue forms epiphyses of tubular bones, bodies of vertebrae, ribs, sternum, pelvic bones and some hand and foot bones. Only the superficial cortical layer of such bones is comprised of the compact tissue. The spongy tissue of the skull bones has significantly smaller regularly shaped spaces in comparison with the trunk and limb bones. It has a specific name diploё.

The structural and functional unit of the bone is osteon or Haversian system. It is possible to see osteons on thin sections or on histological preparations. The osteon is formed of concentrically arranged osteal (Haversian) lamellae which surround the Haversian canal in the form of cylinders of various sizes nested into each other. The Haversian canal contains blood vessels and nerves. The majority of osteons are oriented parallelly to the axis of the bone joining with each other in many points. The number of osteons is individual for each bone. For example, in the femoral bone this number is 1,8 per 1 mm2. Meanwhile, the share of the Haversian canal is 0,2 0,3 mm2. Between the osteons there are insert or intermediate lamellae which run in all directions. The intermediate lamellae are the remnants of destroyed old osteons. Processes of new formation and destruction of osteons continuously occur in bones.

There is a layer of internal circumferential lamellae, lamina circumferentialis interna in tubular bones on the border with the medullary cavity. They are permeated with numerous canals widening to spaces. Several layers of general (or external) circumferential lamellae, lamina circumferentialis externa, surround the bone on the outside. The perforating canals (Volcmann`s canals) containing blood vessels with the same name pass through them.

There are three types of osteal lamellae in the diaphyses of tubular bones: Haversian, intermediate and general (external and internal). The lamellae lie close to each other, they are located parallelly to the axis of the bone and form quite a thick layer of only compact bone. It is 1,5 5 mm thick. Thus the diahysis of a long tubular bone is a hollow cylinder with walls formed of compact bone. The cavity of this cylinder is termed medullary canal. The latter is connected with spaces of the spongy tissue in the epiphyses of the bone. The Haversian lamellae form the basic mass of compact bone, thus making up osteons. The intermediate lamellae fill in the gaps between osteons. External and internal general (circumferential) lamellae form the most outer and the most inner layers of the compact bone, being located parallelly to the bone surface under the periosteum and endosteum respectively.

The epyphises of tubular bones consist of spongy tissue which is also formed of osteal lamellae. In structure, spongy bone may have large and small spaces. There are red bone marrow and vessels in these spaces. Compact bone covers epiphyses only on the outside with a comparatively thin layer. Flat and volumetric bones have a similar structure. Lamellae of spongy substance are strictly arranged in each bone. Their direction coincides with that of the maximum compression and stretching forces. The environment of each bone determines its structure. Trabeculae form an integral system in several adjacent bones, which characterizes the trabeculaes architectonics. Such structure of bones preconditions their maximum solidity. In vertebrae, the stretching and compression forces are perpendicular to the superior and inferior surfaces of the vertebral bodies. This corresponds to the fact that the trabeculae have mainly vertical direction in spongy substance (fig. 1.2). In the proximal epiphysis of the femoral bone there are arch-shaped systems of trabeculae which transfer pressure from the surface of the bone head to the walls of the diaphysis. Besides, there are trabeculae transfering the traction force of muscles attached to the greater trochanter (fig. 1.3).


Fig. 1.2. Orientation of trabeculae in the vertebral body (saggital section)


Fig. 1.3. Orientation of trabeculae in proximal epiphyses of tubular bones: a in femur; b in tibia


Trabeculae running in the radial direction are typical of the calcaneus. They distribute loads equally over the surface of the calcaneal tuberosity which serves as a foot support (fig. 1.4).


Fig. 1.4. Orientaton of trabeculae in calcaneus


Compact bone is formed in places of the highest concentration of force trajectories. It is clearly visible on the section of the femoral, tibial and calcaneal bones where the compact tissue is thickened in the areas of crossing between force lines and the bone surface. Thus we can say that compact bone is the result of compression of spongy bone, and vice versa, it is possible to consider spongy bone as sparse compact bone. It should be noted that if static and dynamic conditions are changed (increase or decrease in functional loads), the spongy bone architectonics changes too, a part of trabeculae disappear, or new systems of osteal trabeculae develop. The spongy bone structure changes in a special visible manner after fractures.

1.4. External Structure of Bones

While describing the external structure of bones, we should pay attention to the surfaces, facies, of the bones, which may be flat, concave or convex, smooth or rough. Articular surfaces facies articularis, involved in formation of joints, are the most smoothly polished ones. In some bones the end is rounded, forming a head caput; at the same time, the end of other bones has concavity, called articular fossa, or fossa articularis. The head may be separated from the bone body with a constricted part neck, collum. If the articular end is extensive but slightly curved surface, it is termed condyle, condilus. The processes located near the condyle are named epicondyles, epicondyli, they serve for attachment of tendons and ligaments (they may also be called apophyses).

The following surfaces are distinguished in bones (depending on theirlocation in the human body): internal or external, medial or lateral etc. The surfaces are separated by borders, margo. The borders, in turn, are known as superior or inferior, medial or lateral etc. They may be smooth or serrated, blunt or sharp, sometimes they have notches, incisurae, of different sizes.

On the surfaces of bones, there may be such formations as: processes, eminences, depressions, openings etc. (bone process, processus; elevation, eminence, eminentia; large rounded elevation or tuberosity, tuberositas; hillock, tuber; bulge, protuberance, protuberantia; tubercle, tuberculum; sharp process spine, spina; crest, crista; hollow in the bone, fossa; pit, foveola; groove, sulcus, opening, foramen; canal, canalis; small canal, canaliculus; fissure, fissura; cavity, cavitas).

1.5. Chemical Сomposition of Bone and its Properties

The chemical composition of a bone depends on the condition of the bone under examination, its age and individual characteristics. In a grown-up, a fresh bone which is not treated contains: water 50 %; fat 16 %; other organic substances 12 % and inorganic substances 22 %. A dehydrated and defatted bone contains approximately two-thirds of inorganic substances and one third of organic substances.

The inorganic substances are mainly represented by calcium salts in the form of submicroscopic crystals of hydroxyapatite. The microscopic examination shows that the axes of crystals are oriented parallelly to osteal fibers. The crystals of hydroxyapatite form mineral fibers.

The organic substance of the bone is called ossein. This protein is the type of collagen. It forms the basic substance of the bone. Ossein is contained in osteal cells osteocytes. There are osteal fibers containing protein collagen in the intercellular matrix of the bone. When bones are boiled, the proteins (collagen and ossein) form glutinous mass. It should be noted that the bony matrix contains mineral fibers, apart from collagen ones. The interlacement of organic and inorganic fibers determines the specific features of osseous tissue: durability and elasticity.

If a bone is treated by acid (decalcification), the mineral salts are removed. Such bone, containing only organic substance keeps its shape in all details, but becomes much more flexible and elastic. If the organic substance is removed from the bone through burning, the elasticity is lost. Such bone is very fragile.

The proportion of organic and inorganic substances in bones primarily depends on age, and it may change under the influence of various reasons (climatic conditions, nutrition, diseases). Thus in children, bones contain much less mineral (inorganic) substances, therefore they are more flexible and less solid. In elderly persons, vise versa, the amount of organic substances decreases. In such age, bones become more fragile and susceptible to fractures.

1.6. Mechanical Properties of Bones

The bone is a solid object, and its main properties are durability and elasticity. Durability is the ability to resist to the external destroying force. It depends on the macro- and microscopic structure, and on the osseous tissue composition. As for the macroscopic structure, each bone has its specific form which enables withstanding the maximal strain in a certain part of the skeleton.

The internal structure of the bone is also complicated. As already stated, the osteon is a hollow cylinder tube the walls of which are built of numerous lamellae. It is known that in architectural constructions, hollow (tubular) columns have greater durability per a unit of mass as compared to solid columns. Therefore, the osteon-based structure of the bone itself predetermines a high level of its durability. Groups of osteal lamellae, being arranged along the axes of maximal strains, form osteal trabeculae of spongy bone and terminal lamellae of compact bone. It should be noted that osteal trabeculae are archshaped in places of maximal strains. As well as tubular systems, arch-shaped systems are most durable. The arch principle in the structure of spongy bone trabeculae is typical of the proximal epiphysis of the femur, as well as of the calcaneus spongy tissue etc.

The bone composition significantly influences its durability. Decalcification causes a considerable decrease in the level of compression, tension and torsion strength. As a result, it is easy to bend, compress and twist the bone. If the calcium content increases, the bone becomes fragile.

Bone durability in a healthy adult is higher than the durability of some construction materials it is like a cast iron. The first examinations of bone durability were conducted in XIX century. According to Lesgaft`s researches, the human bone withstood tensile strain of 5500 N/cm2, compressive strain 7787 N/cm2. The tibia withstood compressive strain of 1650 N/cm2, whichis comparable to the weight of more than 20 men. These data show a high level of reserve capabilities of bones against various strains. Changes in the tubular structure of a bone (both macro- and microscopic) reduces its mechanical durability. For example, the tubular structure of bones is disrupted after fracture healing, and the durability of such bones significantly decreases.

Elasticity is the ability to regain the initial shape after cessation of an external impact. Bone elasticity is equal to that of hard tree species. Like durability, it depends on the macro- and misroscopic structure and the chemical composition of the bone.

Thus, the mechanical properties of bones durability and elasticity are predetermined by the optimal combination of organic and inorganic substances contained in them.

1.7. Functions of Skeleton

1. The bones serve as support for soft tissues (muscles, ligaments, fasciae, visceral organs).

2. Most of bones are leverages which are moved by attached muscles. According to these two functions, the skeleton may be considered to be the passive part of the musculoskeletal system.

3. The human skeleton is an antigravitational structure which counteracts the force of gravity. It prevents any changes in the body shape under the impact of gravitation pressing the human body to the ground.

4. Protective function: the skull, trunk and pelvis bones prevent any potential damage to the vital organs, major vessels and nerve trunks. For example, the skull encloses the brain, organs of vision, hearing and equilibrium. In the vertebral canal there is the spinal cord. The chest protects the heart, lungs, major vessels and nerve trunks. The pelvic bones protect the rectum, urinary bladder and internal genital organs against injuries.

5. Hematopoietic function: most bones contain red bone marrow which is the hematopoietic organ, as well asthe immune system organ. The bones protect the red bone marrow against damages, and provide favorable conditions for its trophism and for maturation of blood elements.

6. Involvement in mineral metabolism: bones deposit numerous chemical elements, predominantly calcium and phosphorus salts.

According to V. S. Speransky, the human skeleton is a perfect dynamic structure adapted to the motor function and human way of life; it is responsive to various changes which occur both in the body itself and in the environment.

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