Vasculature and Innervation of bones

Refer for the textbook for further

details
• Nutrient arteries enters
through nutrient foramina.
divides into longitudinal
branches
• Periosteal arteries
• Havarsian systems or osteons
(microscopic canal systems)
compact bone small blood
vessels
• Metaphysial and epiphysial
arteries arise mainly from the
arteries that supply the joints.
 Vasculature and Innervation of bones

• In the limbs,
metaphysial and
epiphysial arteries are
typically part of a
periarticular arterial
plexus, which
surrounds the joint,
ensuring blood flow
distal to the joint
regardless of the
position assumed by
the joint.
 Vasculature and Innervation of bones
• Veins accompany arteries
through the nutrient foramina.
• Many large veins also leave
through foramina near the
articular ends of the bones.
• Bones containing red bone
marrow have numerous
large veins.
• Lymphatic vessels are also
abundant in the periosteum.
 Vasculature and Innervation of bones
• Nerves accompany blood vessels
supplying bones.
• The periosteum is richly
supplied with sensory nerves—
periosteal nerves—that carry
pain fibers. The periosteum is
especially sensitive to tearing or
tension, which explains the
acute pain from bone fractures.
• Bone itself is relatively sparsely
supplied with sensory endings.
Within bones, vasomotor
nerves cause constriction or
dilation of blood vessels,
regulating blood flow through
the bone marrow
Trauma to Bone and Bone Changes
Bones are living organs that cause pain when injured,
bleed when fractured, remodel in relationship to
stresses placed on them, and change with age. Like
other organs, bones have blood vessels, lymphatic vessels, and
nerves, and they may become diseased.
• Bone atrophy: decrease in size of unused bones, such as in a
paralyzed limb or in space. Bone may be absorbed, which
occurs in the mandible when teeth are extracted.
• Bones hypertrophy: bone enlargement when they support
increased weight for a long period
 Fractures
• A fracture is a break in the bone. Signs and Symptoms of a
bone fracture can vary wildly depending on the affected
region and severity. However, they often include some of the
following:
• pain
• swelling
• bruising and redness
• deformity
• Inability to move the affected area
• open fractures may be bleed
 Fracture healing
• For proper healing broken ends must
be brought together, approximating
their normal position. (Fracture
Reduction).
• During bone healing, the surrounding
fibroblasts (connective tissue cells)
proliferate and secrete collagen,
which forms a collar of callus to hold
the bones together
• Bone remodeling occurs in the
fracture area, and the callus calcifies.
Eventually, the callus is resorbed and
replaced by bone. After several
months, little evidence of the fracture
remains, especially in young people.
 Osteoporosis

• Osteoporosis is a reduction in the quantity of bone (or

atrophy of skeletal tissue) in which the organic and inorganic
components of bone both decrease.
• The bones become brittle, lose their elasticity, and
fracture easily.
• Bone scanning is an imaging method used to assess
normal and diminished bone mass
• Causes of Osteoporosis:
• Aging and lack of some hormones
• Some medications (corticosteroids)
• Thyroid problems,
• Lack of muscle use
 Sternal puncture
• Insertion of a wide-bore (large
diameter) needle through the thin
cortical bone into the spongy bone of
the manubrium of the sternum to
aspirate a sample of red bone
marrow.
• Laboratory examination of bone
marrow provides valuable
information for evaluating
hematological (blood) diseases.
Why is it common to use the sternum site for harvesting
bone marrow?
• Because it lies just beneath the skin (i.e., is subcutaneous)
and is easily accessible,
 Displacement and Separation of Epiphyses

• knowledge of bone growth and the appearance of bones and

the location of epiphyses in radiographic and other diagnostic
images at various ages is required in order not to
• Mistake a displaced epiphysial plate for a fracture,
• Interpret a separation of an epiphysis as a displaced piece of
a fractured bone.
• Differences and notes to keep in mind:
• The edges of the diaphysis and epiphysis are smoothly
curved in the region of the epiphysial plate.
• Bone fractures always leave a sharp, often uneven edge of
bone.
• An injury that causes a fracture in an adult usually causes the
displacement of an epiphysis in a child.
 Avascular Necrosis

• Death of bone tissue due to loss of arterial blood supply (G.

nekrosis, deadness).
• It may affect an epiphysis or other parts of a bone
• After every fracture, small areas of adjacent bone undergo
necrosis. In some fractures, avascular necrosis of a large
fragment of bone may occur.
• A number of clinical disorders of epiphyses in children result
from avascular necrosis of unknown etiology (cause). These
disorders are referred to as osteochondroses.
 Introduction To
Human Anatomy
7101101
Lecture 8 (2hrs): ‫تدرس من‬
‫الساليدات‬
Skeletal system 3:
• Axial skeleton
• Appendicular skeleton
• Bone markings
Axial and Appendicular Skeleton
The skeletal system is divided into two
functional parts:
• The axial skeleton consists of
the bones of the head (cranium
or skull), neck (hyoid bone and
cervical vertebrae), and trunk
(ribs, sternum, vertebrae, and
sacrum).

• The appendicular skeleton

consists of the bones of the
limbs, including those
forming the pectoral
(shoulder) and pelvic girdles
 The skull Bones
• The skull “cranium” is the skeleton of the head.
• A series of bones form the skull two parts,
1. The neurocranium: the braincase
2. The viscerocranium: the facial skeleton
 The neurocranium
• Formed by the superior aspect of the skull. It encloses and
protects the brain
• Composed of eight Immovable bones (Their borders meet to
form immovable joints “sutures"), two of them are paired
 The neurocranium
• The neurocranium can be subdivided into:
• Calvarium: The dome-like roof (skullcap)
comprised of regions of the frontal, occipital
and two parietal bones.
• Basicranium: the floor or the cranial base
comprised of regions of six bones: the
frontal, sphenoid, ethmoid, occipital, parietal
and temporal bones.
• Note: regions of the frontal, occipital and parietal
bones are found in both subdivisions
The viscerocranium (facial skeleton)
• Total of 14 bones, all are paired except the
mandibular and the vomer bones
• Two bones provide distinctive shape to face
– Maxillae (upper jaw bones)
– Mandible (lower jaw bone)
• All facial bones connected by immovable
joints (sutures)
– One exception (mandible)
 The Vertebral Column
• Protects the spinal cord and supports the head and
body
• 26 bones: 24 vertebrae, the sacrum, and the coccyx
• Cervical vertebrae (‫)العنقية‬
– Vertebrae of the neck (cervic/o = neck)
– Identified as C1 – C7
• Thoracic vertebrae (‫)الصدرية‬
– Vertebrae of the chest (thorac/o =
chest)
– Identified as T1 – T12
• Lumbar vertebrae (‫)القطنية‬
– Vertebrae of lower back (lumb/o =
lower back, loins)
– Identified as L1-L5
 The Vertebral Column
• Sacrum (‫)العجز‬
– 5 fused sacral bones
• Coccyx (‫)العصعص‬: Also called “tailbone”
– 4 fused coccygeal bones
 Bones of the Thorax
(The Thoracic Cage ; ‫)القفص الصدري‬
Consists of:
•Thoracic vertebrae
•Ribs
•Sternum
 The Pelvic Girdle
(‫)الزنار او الحزام الحوضي‬
Consists of:
• The two hip bones (also known as
coxal, innominate or pelvic bones)
which consist of three parts:
• ilium,
• ischium,
• and pubis
• The sacrum
• and the coccyx.
 The Pectoral Girdle
(‫)الزنار او الحزام الصدري‬
The pectoral girdle (also called: the shoulder girdle) consists of
the two clavicles and the two scapulae;
Segments
and Bones
of the
Upper Limb

Note: Three phalanges, a

proximal, a middle and a
distal phalanx (singular of
phalanges) are present in
each finger and toe, with
the exception of the
thumb and large toe,
which possess only two, a
proximal and a distal
phalanx
Segments
and Bones
of the
Lower Limb

Note: Three phalanges, a

proximal, a middle and a
distal phalanx (singular of
phalanges) are present in
each finger and toe, with
the exception of the
thumb and large toe,
which possess only two, a ‫عظام‬
proximal and a distal ‫الرصغ‬
phalanx
Bone Markings & Formations
Bone markings appear:
• wherever tendons, ligaments, and fascias are attached
• where arteries lie adjacent to or enter bones.
Other formations occur
• in relation to the passage of a tendon (often to direct the
tendon or improve its leverage), or
• to control the type of movement occurring at a joint.
Bone Markings & Formations
Some of the various markings and features of bones are:

1. Capitulum: small, round, articular

head (e.g., the capitulum of the
humerus).
2. Trochlea: spool-like articular process
or process that acts as a pulley (e.g.,
the trochlea of the humerus).
Bone Markings & Formations
3. Condyle: rounded,
knuckle-like articular area,
often occurring in pairs
(e.g., the lateral and
medial femoral condyles).

4. Crest: ridge of bone (e.g.,

the iliac crest).
5. Tuberosity: large rounded
elevation (e.g., the ischial
tuberosity).
6. Notch: indentation at the
edge of a bone (e.g., the
greater sciatic notch).
Bone Markings & Formations
7. Epicondyle: eminence
superior to a condyle (e.g.,
the lateral epicondyle of
the humerus).

8. Fossa: hollow or depressed area

(e.g., the infraspinous fossa of
the scapula, radial and coronoid
fossa)
9. Spine: thorn-like process (e.g.,
the spine of the scapula).
Bone Markings & Formations

10. Facet: smooth flat area, usually covered with cartilage,

where a bone articulates with another bone (e.g., the
superior costal facet on the body of a vertebra for
articulation with a rib).
Superior
Superior Costal
Articular
11. Spinous process: facet
facet
projecting spine- Articular facet for
like part (e.g., the tubercle of 6th rib
spinous process Crest of head
of a vertebra). Spinous
Vertebral body

process of
T6 vertebra

Right 7th rib

posterolateral
view
Bone Markings & Formations
12. Head (L. caput): large,
round articular end
(e.g., the head of the
humerus).
13. Groove: elongated
depression or furrow
(e.g., the radial groove
of the humerus).
14. Tubercle: small raised
eminence (e.g., the
greater tubercle of the
humerus).
Bone Markings & Formations
15. Line: linear elevation (e.g., the
soleal line of the tibia).
16. Malleolus: rounded process
(e.g., the lateral malleolus of
the fibula).

17. Protuberance: projection of bone (e.g.,

the external occipital protuberance).
Bone Markings & Formations
18. Trochanter: large blunt
elevation (e.g., the greater
trochanter of the femur).

19. Foramen: passage through a

bone (e.g., the obturator
foramen, the vertebral
foramen).
Accessory (supernumerary) bones
• Many bones develop from several centers of ossification,
eventually the separate parts normally merge.
• Sometimes, one of these centers fails to fuse with the main
bone thus giving the appearance of an extra bone. Examples:
• Wormian bones (sutural
bones): small, irregular,
wormlike bones
sometimes seen in the
cranium
• Foot accessory bones: common
and important to know to avoid
mistaking them for bone fragments
in radiographs and other medical
images.
Heterotopic Bones
• In medicine, heterotopia is the presence of a particular
tissue type at a non-physiological site, but usually co-existing
with original tissue in its correct anatomical location
• Bones that sometimes form in soft tissues where they are
not normally present (e.g., in scars, areas of recurrent
muscle injury). Examples:
• Rider's bones: Horse riders often develop heterotopic
bones in their thighs (rider's bones), probably because of
chronic muscle strain resulting in small hemorrhagic
areas that undergo calcification and eventual ossification.
• Shooter's bones: Heterotopic ossification located in the
deltoid muscle region probably due to recurrent muscle
injury. This is seen in soldiers undergoing military training
programmes