CHAPTER 2

Normal Structure and Function of Musculoskeletal Tissues

Bones as structures and bone as an organ

Bones:

1. Anatomical structures
a. Provide rigid framework for the trunk and
extremities
b. Locomotor function
c. Protect vulnerable viscera
2. Physiological organ
a. Hemopoietic tissue (RBC, granular leukocytes,
platelets)
b. Reservoir of Ca, Phosphor, Mg, Na.

Embryonic development of Bones

Mesoderm forms a mesenchyme, a diffuse cellular tissue that

pluripotent, differentiates into many connective tissue such as bone,
cartilage, ligament, muscle, tendon, fascia.

Ossification:

a. Endochondral (primary center) replacement of cartilage

bones
b. Intramembranous perichondrium becomes periosteum

6th month of embryonic development resorption central part of the

long bone results in the formation of medullary cavity, tubulation.

At the time of the birth distal femoral epiphysis forms the secondary
center of ossification, provides growth in the length of the bone.

2. Normal Structure and Function of Musculoskeletal Tissues 1

Short bones (ex. Carpal bones) are developed by endochondral
ossification length

Skull bones & clavicle are developed by intramembranous ossification

width

Warning: thalidomide and rubella infection affect the bones

development.

Endochondral ossification (Growth in length):

a. Articular cartilage (only in short bones)

b. Epiphyseal plate cartilage

Epiphyseal plate cartilage, provides growth of the metaphysis and

epiphysis, maintain the balance with 2 process:

1. Interstitial growth of the cartilage plate make bone thicker,

moving away the epiphyseal plate from metaphysis
2. Calcification death and replacement of cartilage on
metaphyseal through endochondral ossification

Zones in epiphyseal plate:

1. Resting cartilage
2. Young proliferative cartilage
3. Maturing cartilage
4. Calcifying cartilage

Hormonal control of the longitudinal bone growth: Growth hormone

a. produce insulin-like growth factor in the liver

b. Thyroxine
c. Sex hormones post-pubertal growth spurt
d. Glucocorticoid inhibition of growth, ex. Cushing syndrome

As the epiphyseal plate growth farther away, metaphysis should

remodeled continuously through deposition of osteoblast and
osteoclastic resorption.

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Wolffs law (cortical thickening on the concave site):

1. Positive bone balance (child, stress): deposition > resorption

2. Negative bone balance (elderly): resorption > deposition

Anatomical structures: Histological structures:

a. Long / tubular bones,
e.g. femur
b. Short / cuboidal bones,
e.g. carpal
c. Flat bones, e.g. scapula
1. Immature
bone/nonlamellar/woven/fiber
2. Mature bone/lamellar:
a. Cortical/compacta/dense
b. Cancellous/spongiosa/trabe
cular

! in children, fracture heals faster than adult because the covering

periosteum is thick and loosely attached to the cortex and it produces
new bone readily.

Blood supply to the long bone:

1. Afferent vascular system:

a. Metaphyseal arteries: 2/3 inner cortex
b. Periosteal arteries: 1/3 outer cortex
2. Efferent vascular system: conveys venous blood
3. Intermediate vascular system: capillary within cortex

Direction of blood flow: centrifugal from medullary cavity to periosteum.

Immature bone: first type of bone, never seen under normal condition
after 1 year. Exception: fracture healing, reaction to an infection, tumor.

Mature bone: haversian system/osteon, permit vascularization.

Cancellous bone has eight times greater surface area than cortical
bone.

Biochemistry of bones:

1. Organic substances: 30%

2. Inorganic substances: 60%
3. Water: 10%

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Organic substances: Bone cell & matrix (collagen, noncollagen)

Inorganic substances: Ca, phosphorus Na, Hydroxyl, carbonate,

fluoride

Enzymes: Bone alkaline phosphatase(produce matrix), produced by

osteoblast.

Ca & Phosphorus (Hydroxyapatite crystal) metabolism: regulate by 3

hormones:

1. Active metabolites of vitamin D

2. PTH
3. Calcitonin

Metabolically active tissues for those hormones: bones, kidney,

intestine.

Total Ca plasma: 9.0 10.4mg/100mL ( Ca2+ , albumin binded)

Pi plasma adult: 3mg/100mL

Pi plasma child: 5mg/100mL

PTH actions:

secretion stimulated by hypocalcemia

reabsorps bones and resorps Ca from renal tubule
inhibits Pi resorption from renal tubule
stimulate 1,25 (OH)2D

Calcitonin actions:

Produce by thyroid gland

stimulated by hypercalcemia
inhibited by hypocalcemia
decrease bone resorption, surpress osteoclastic activity
(th/ of Paget disease and osteoporosis)

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Vit D metabolites actions:

increase absorption of both Ca and Pi from intestine

mobilize Ca from bone
elevate Ca plasma
stimulated by hypoCa, HypoPi, PTH

2. Normal Structure and Function of Musculoskeletal Tissues 5

Joint and Articular Cartilage

Joint = simple junction between 2 / more bones

Classification:

1. Syndesmosis: bound together by fibrous tissue, e.g. skull

2. Synchondrosis: bound together by cartilage, e.g. epiphyseal
plate
3. Synostosis: obliteration of joint becomes bony union. Some
Syndesmosis and synchondrosis unite became this.
4. Symphysis: covered by hyaline cartilage & joined by
fibrocartilage and strong fibrous tissue. Ex: intervertebral
Less movement, more stability
5. Synovial joint: covered by hyaline cartilage, joined by fibrous
tissue capsule enclosing a joint cavity that contains synovial
fluid. Free movement, less stability

Once cartilage is damaged, its ability to heal is so limited, results

inevitably in progressive degenerative arthritis.

Anatomical structure:

The convex surface always > concave, thus provide gliding

motion
Articular cartilage has rubber consistency, also called hyaline
(frosted glass).
Lubricated by mucin (hyaluronate) fluid.
Synovial membrane
Menisci

Histological structure:

Has no vessels, nerve.

Matrix consist of 70-80% water, 10-15% collagen, 10-15%
proteoglycan
Proteoglycan glue collagen together

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 Chondrocytes produce proteoglycan and collagen, respond to
active / passive motion, substances such as growth factor,
interleukins, and drugs.
Chondrocytes get nutrient from synovial fluid.

Bone and cartilage, similarity and differences:

Similarity:

Derived from mesenchym

Have cells embedded in lacuna and have matrix

Differences:

Bone: Cartilage:
Collagen type I Collagen type II
Highly vascular Poorly vascular
Matrix are calcified

Structure and function of synovial membrane:

Consist of 2 layers: outer, inner.

Inner layer: produce macrophages, hyaluronate
Great surface area (because of enormous numbers of villi)

Synovial fluid:

Dyalisate of plasma
Clear, yellowish, vicous fluid
Contain glycoprotein and lubricant hyaluronic acid
Nourishing and lubricating joint
Adult: <5mL
Also contain in synovial burse and tendon sheath
Total cell count < 200/mL, predominantly MN macrophages &
lymphocytes
No fibrinogen thats way it wont clot

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