DR. PARMESHWAR G.

KENDRE
( Junior resident )
Gross Anatomy of a Long Bone
1. Shaft
• Diaphysis
• Compact bone
• Contain medullary cavity
2. Knobby Ends
• Epiphysis
• mostly spongy bone
3. Periosteum
• Outside covering except at
articular surface
• Fibrous connective tissue
membrane
• Outer fibrous layer & inner
cellular layer
4. Endosteum
-Thin fibrous cellular membrane
-Lines medullary cavity
5.Sharpey’s fibers
• Secure periosteum to bone
• Extrinsic collagen fibers
6. Arteries & nutrient foramen
• Supply bone cells with
nutrients
7. Articular cartilage
• Covers the articular surface
• Hyaline cartilage
• Decreases friction
8. Medullary cavity
• Cavity of shaft contains
• Yellow marrow (mostly fat) in
adults
• Red marrow (blood cell
formation) in infants
Blood supply of bones
Epiphyseal artery
Long bones: supplied by
1) Nutrient artery:
- Enter through nutrient foramen at diaphysis
- Tortuous form ‘hair pin loops’ in metaphysis Metaphyseal
artery
(osteomylitis)
- femur has several , tibia has only one which is Nutrient artery

largest nutrient artery in the body

2) Periosteal arteries:
- supply outer 1/3 cortex

3) Metaphyseal (juxta- epiphyseal) arteries:

4) Epiphyseal arteries:
Parts of growing (young) long bone:

Before completion of ossification

young bone has
-Epiphysis
-Epiphyseal plate
-Metaphysis
-Diaphysis
Diaphysis:
- Develop from primary ossification
center
- Appears before birth
-Elongated bone between two epiphysis
forms shaft of long bone.
 Epiphysis
• Ossify from secondary centers
• Appears after birth, except that of
Lower end of femur & Upper end of tibia
• More than one epiphysis may be present
at one or both ends of long bone.
Types:
1) Pressure epiphysis
- covered by articular cartilage
- involved in weight
transmission
ex. Head of femur, humerus
2) Traction epiphysis
- produced by pull of muscle
- always nonarticular
- ossify later than pressure epiphysis
ex. Greater & lesser trochanters of
femur
3) Atavistic epiphysis:
-independent bone that get fused to nearest
bone
-to get nutrition (like parasite)
ex. Coracoid process of scapula,
os trigonum
(posterior tubercle of talus )

4) Aberrant epiphysis:
-at unusual end of short long bones
ex. Epiphysis at head of first metacarpal
Epiphyseal plate:

-Plate of hyaline cartilage remains in between epiphysis &

diaphysis
-Responsible for lengthwise growth of long bone
-After puberty, cartilagenous plate replaced by bone
-Ossification start earlier in females, and fusion with
diaphysis completed as much as 2-3 yrs earlier.
Metaphysis:
-End of diaphysis towards epiphyseal cartilage.
-Most actively growing area of bone
-Bone grows in length at the expense of
metaphysis
-Profuse blood supply, nutrient artery form
hair- pin like capillary loops
-Sometimes it may be intracapsular
• Growing end of the bone:
-Epiphysis of both ends does not fuse simultaneously
-The epiphysis unites last with diaphysis, grows for
longer period before union. Hence known as
growing end of the bone
• Law of union of epiphysis:
-The epiphyseal end appears first, unites last with the
diaphysis and vise versa.
Except that of fibula
• Nutrient foramen and it’s direction:
-Conveys nutrient vessel
-Situated near the middle of shaft of long bone
- Direction can be remembered by
“ To the elbow I go, from the knee I flee.”
• Growing end is situated against the direction
of nutrient foramen.

• Clinical importance:
An injury or infection of this end in young
age , makes the bone stunted in growth
 Bone Formation
•All embryonic connective tissue begins as mesenchyme.
•Bone formation is termed osteogenesis or ossification
Mesenchymal cells provide the template for subsequent
ossification.
•Two types of ossification occur.
1. Intramembranous ossification is the formation
of bone directly from or within fibrous connective
tissue membranes.
2. Endochondrial ossification is the formation of
bone from hyaline cartilage models.
Intramembranous Ossification

•Also called dermal ossification

•Occurs in the deeper layers of connective tissue of the
dermis of the skin.
Ex. All roofing bones of the Skull
1. Frontal bone
2. Parietal bones
3. Occipital bone
4. Temporal bone
5. Mandible
6. Clavicle
Intramembranous Ossification
Endochondral Ossification
•Developing bones are deposited as
a hyaline cartilage model and then this cartilage is
replaced by bone tissue.
• All bones of the body except:
-All roofing bones of the Skull
-Mandible
-Clavicle
Endochondral Ossification
Endochondral Ossification
Growth at epiphyseal plates: Zones of Growth in
Epiphyseal Plate
▪Zone of resting cartilage
-anchors growth plate to bone
▪Zone of proliferating cartilage
-rapid cell division (stacked coins)
▪Zone of hypertrophic cartilage
-cells enlarged & remain in
columns
▪Zone of calcified cartilage
-thin zone, cells mostly dead since
matrix calcified
-osteoclasts removing matrix
-osteoblasts & capillaries move in
to create bone over calcified
cartilage
Zones of epiphyseal
plates

-Zone of Resting Cartilage

-Zone of Proliferating
Cartilage
-Zone of Hypertrophic
Cartilage
-Zone of Calcified
Cartilage
 Growth in Thickness
Bone can grow in thickness or diameter only by
appositional growth.
Steps:
-Periosteal cells differentiate into osteoblasts which
secrete collagen fibers and organic molecules to form the
matrix.
-Ridges fuse and the periosteum becomes the
endosteum.
-New concentric lamellae are formed.
-Osteoblasts under the periosteum form new
circumferential lamellae.
 cont….

Periosteal cells differentiate into osteoblast

Appositional growth at the bone’s surface and form bony ridges and then a tunnel
around periosteal blood vessel.

Concentric lamellae fill in the tunnel to form an osteon.

Factors That Affect Bone Growth

1. Minerals
2. Vitamins
3. Hormones
4. Exercise
 Minerals

Calcium -Makes bone matrix hard

-Hypocalcemia:
low blood calcium levels.
-Hypercalcemia:
high blood calcium levels.
Phosphorus -Makes bone matrix hard
Magnesium -Deficiency inhibit osteoblasts
Manganese -Inhibits formation of new
bone tissue
 Vitamins
Vitamin A -Controls activity, distribution, and
coordination of osteoblasts/osteoclasts
Vitamin B12 -May inhibit osteoblast activity
Vitamin C -Helps maintain bone matrix,
-deficiency leads to decreased collagen
production which inhibits bone
growth and repair
(scurvy) disorder due to a lack of Vitamin C
Vitamin D -(Calcitriol) Helps to build bone by
increasing calcium absorption.
-Deficiencies result in “Rickets” in
children
 Hormones

Human Growth Hormone: -Promotes general growth of

all body tissue and normal
growth in children
Insulin-like Growth Factor: -Stimulates uptake of amino
acids and protein synthesis
Insulin: -Promotes normal bone growth and
maturity
Thyroid Hormones: -Promotes normal bone growth and
maturity
Estrogen and -Increases osteogenesis at puberty
Testosterone: and is responsible for gender
differences of skeletons
 Repair of Bone Fractures
1. Hematoma (blood-filled swelling) is formed
2. Break is splinted by fibrocartilage to form a
cartilaginous callus
3. Fibrocartilage callus is replaced by a bony callus
4. Bony callus is remodeled to form a permanent patch
 Bone Disorders

Osteomalacia: -Loss of bone salts but not collagen

due to poor diet, decreased
absorption of calcium, and vitamin
D deficiency.
-Basically a demineralization of bone

Example: -Rickets in young children

Osteomyelitis: Infection of bone most commonly by

Staphylococcus aureus
Paget’s Disease: Abnormal bone remodeling
resulting in irregular
thickening and thinning of
bone through remodeling

Osteogenic sarcoma: Bone cancer that affects

osteoblasts at the
metaphysis of long bones.
Most common in teenagers
 Arthritis:
Osteoarthritis: “DJD” degenerative joint
disease
Inflammatory Joint Disease:
Rheumatoid arthritis: Initially may be
caused by transient infection that results
in autoimmune attacks against collagen
in the bones at joints.
Gouty Arthritis: Build-up of uric acid in the joints due to
metabolic problems with handling the amino
acid cystine.
Thanks…