Tree diagram
Skeletal system Skeleton
Axial skeleton
Facial bones
Skull
Nasal bones
Bone Physiology
www.ama-assn.org
www.eskeletons.org
Bone cells
As for all connective tissue, bone consists of cells and extracellular matrix. There are three types of cells in mature bone tissue: Osteoblasts Osteocytes Osteoclasts
Function
Osteoblasts and osteocytes are involved in deposition of bone matrix Osteoblasts are located at the surface of bone tissue, whereas osteoclasts are located within the calcified matrix Osteoclasts are involved in the resorption of bone tissue.
An osteoclast cell attached to the bone surface. Where it is in contact with the bone it forms a ruffled zone under which resorption takes place.
Bone structure
A typical long bone (greater length than width) consists of the following parts: The diaphysis. The bones shaft or body The epiphyses. The distal and proximal ends of the bone The metaphyses. Regions in a mature bone where the diaphysis joins the epiphyses The articular cartilage. This is a thin layer of hyaline cartilage
Support
The skeleton is a structural framework for the body supporting soft tissues and provides attachment points for the tendons of most skeletal muscles
Protection
The skeleton protects many internal organs from injury. For example, the skull (cranial bones) protects the brain and the vertebrae protect the spinal cord.
Movement
As skeletal muscles attach to bones, when muscles contract they pull on bones. Thus, muscles and bones can produce movement
Mineral homeostasis
Bone tissue stores important minerals, especially calcium and phosphorus. Bone releases these minerals (on demand) to different parts of the body to maintain homeostasis
Parathyroid hormone and 1,25-dihydroxyvitamin D3 stimulate bone resorption. Calcitonin inhibits bone resorption.
Triglyceride storage
Triglycerides stored in the adipose cells of yellow bone marrow form an important energy reserve Yellow bone marrow consists mostly of adipose cells, which store triglycerides In the newborn, all bone marrow is red and is involved in haemopoiesis As we age, much of the bone marrow changes from red to yellow
Bone pathologies
Primary bone cancer: the cancer started in the bone. Metastatic or secondary bone cancer: did not start in the bone but has spread to the bone from other organs. E.g. when lung cancer spreads to the bones.
Osteoporosis
Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures of the hip, spine, and wrist. Men as well as women suffer from osteoporosis, a disease that can be prevented and treated.
Risk factors
Gender women have more chance. Age - bones become less dense and weaker with age. Body size - Small, thin-boned women are at greater risk. Family history - Susceptibility to fracture may be, in part, hereditary.
Prevention of osteoporosis
Calcium needs change during one's lifetime. It is greater during childhood and adolescence, when the skeleton is growing rapidly, and during pregnancy and breastfeeding. Postmenopausal women and older men also need to consume more calcium.
Continued
Vitamin D plays an important role in calcium absorption from the GIT. Exercise makes bones stronger, especially weight-bearing exercise, that forces you to work against gravity. Smoking lowers oestrogen levels. Medications glucocorticoids (for arthritis, asthma, Crohn's disease, lupus, and other diseases of the lungs, kidneys, and liver) can lead to a loss of bone density and fractures.
Pathogenesis of RA
Fibroblasts and lymphocytes are white blood cells that attack the joint. The synovium becomes thickened and irregular. Swelling, stiffness and pain.
Infection
Types of pathogens
Bacteria
Fungi
Pathogens continued
Pathogens continued
Protozoa
Spread of infection
Direct Contact Transmission (DCT): This involves the direct contact of the person with the infected material such as touching, kissing or sexual contact. Infections can also be spread directly coming into contact with infected droplets produced during sneezing. This only occurs if the droplets are large enough to carry the infection and only travel over short distances of less than a meter.
Spread continued
Indirect contact or Vehicle Transmission (VT): - Here inanimate objects are involved in the spread of the disease and are called vehicles. Examples of vehicles include money, drinking and eating utensils, books and bedding. Vector Borne Transmission (VBT): Vectors are animals that carry the infection. They can be insects, ticks, fleas and mites, but can also be dogs, cats, skunks and bats.
Nature of pathogens
Toxins interfere with normal cellular functions. Toxins from outside the body are called exogenous. Toxins produced by microorganisms (bacteria, fungi, protozoa) are endogenous.
Immune System
[a] [b] [c] Defence System Extremely adaptable Generates a variety of cells and molecules
Immune Response
Two interrelated activities [1] [2] Recognition Response
Recognition
Remarkably Specific
Discriminate between foreing pathogen Distinguish one pathogen from another and own cells and proteins
Response
Also known as effector function.
Eliminate or neutralize foreign organisms.
Later exposure to same foreign organism memory response heightened immune reactivity.
Immunity
State of protection from infectious diseases
Immunity
Specific (Aquired) Nonspecific (Innate)
Nonspecific Immunity
Basic resistance to disease that a species possesses
Anatomic Barriers
Skin Sebaceous Glands secrete sebum low pH (3-5) Inhibitory to growth of most microorganisms. Mucous membranes of the respiratory/GI/Urogenital tracts
Secrete mucuc traps microorganisms and expels them by movement of celia.
Physiological barriers
Temperature
pH
Soluble factors
Gastric juice acidic organisms cant survive. Newborns less acidic gastric juice more susceptible to infections.
Soluble factors
Complement = serum proteins that are non active. when pathogen enters activated membrane damaging reactions clear infections
Inflammatory Response
Signs Redness Swelling Heat Pain Three major events (1) Vadodilation (2) Increased capillary permeability (3) Influx of phagocytic cells (chemotaxis)
Specific Immunity
Reflecting the presence of a specific and functional immune system Properties of self immunity SPECIFICITY DIVERSITY
MEMORY
SELF/NONSELF RECOGNITION
Autoregulation of pressure
ICP is maintained within a normal range. This is called autoregulation. If the process continues the increase in volume will be associated with gradual rise in ICP.This continues up to an ICP of about 50mm Hg when the pattern changes and the intracranial cavity loses its stretchability and behaves as a solid box. There will be steep rise in the curve and incremental rise of the intracranial pressure.
Cerebral oedema
Because the brain is enclosed in a rigid box, any increase in volume compresses vessels and tissue, reducing perfusion and killing the tissue. Brain oedema is caused by increased vascular pressure or increased permeability. Hypertensive crisis, concussion (mechanical damage with capillary fluid leaking into the brain). 1. Brain oedema => compresses vessels (capillaries) => reduced flow => ischemia => arteriolar dilatation => increased capillary pressure => increased oedema 2. Reduced oxygen => increased capillary permeability and shuts off sodium/potassium pump => cellular swelling
Types of Fractures
Simple - bone breaks cleanly and does not penetrate the skin. Compound (open) - broken ends of bone protrude through soft tissues and the skin. Comminuted - bone breaks into many fragments. Compression - bone is crushed. Depressed - broken portion is pressed inward. Impacted - broken ends are forced into each other. Spiral - ragged break caused by excessive twisting force. Greenstick - Bone breaks incompletely.
Vertebral fractures
Advanced Osteoporosis and 'Dowager's Hump'
Loss of height Spine deformity Often severe pain, Loss of mobility
Pain pathway
Physiology of pain
Harmful stimuli activate the peripheral endings of primary sensory neurons, called nociceptors, whose cell bodies lie in the dorsal root ganglia (DRG) of the spinal cord. Nociceptive input is conveyed from the peripheral receptors to the central nervous system predominantly by two classes of primary afferent fibres. Of these, the slowly-conducting, thinly-myelinated Afibres mediate thermal and mechanical nociception whereas the non-myelinated, C-fibres are activated by a variety of high-intensity mechanical, chemical, hot and cold stimuli.