The Skeletal system (I) Speaker: 許書豪 解剖學科助理教授
Why do we need bones? Functions of bones: 1.Support 2.Protection
3. Movement 4. Source of Ca++ that induces muscle contraction
5. Source of blood cells https://commons.wikimedia.org/wiki/file:hematopoesis_en.svg
Types of bones:
Bone tissue 1. Compact bone tissue 緻密骨組織 2. Spongy bone tissue 海綿骨組織
Compact bone tissue 緻密骨組織 LM, 100x LM, 400x
Compact bone tissue 緻密骨組織 Haversian system 哈氏系統 * 組成單元 :Osteon Lamellae 骨板, lacuna 陷窩, canaliculi 骨小管 Central (Haversian) canal 哈氏管, Perforating (Volkmann) canal 佛克曼氏管
Spongy bone tissue 海綿骨組織 * 組成單元 :trabeculae (spicules) ; 骨小樑
Bone cells Ossification: Osteogenic cells 骨原性細胞 Osteoblasts 骨母細胞 Osteocytes 成骨細胞 Bone resorption: Osteoclasts 噬骨細胞 ( 多核 )
Osteoblasts 成骨細胞 Bone-building cells. Synthesize and secrete collagen fibers/organic components. Trapped by their own secretion and become osteocytes. Osteoclasts 噬骨細胞 ( 多核 ) Huge multinucleated cells. Crawls along bone surfaces. Resorption: breaks down bone tissue with lysosomal enzyme and acids.
Bone development Ossification (Osteogenesis) 骨化 : the process of new bone formation. Intramembranous ossification 膜內性骨化 Endochondral ossification 軟骨性骨化
Intramembranous ossification 膜內性骨化 額骨 頂骨 顳骨 上頷骨 梨骨 下頷骨
Intramembranous ossification 膜內性骨化 2 4
Endochondral ossification 軟骨性骨化
Bone growth in length Epiphyseal plate cartilage ( 骨骺 ) *primary endochondral ossification completes by birth. *epiphyseal plate cartilage is continuously ossified before age of 25.
Resting cartilage Proliferating cartilage Hypertrophic (maturing) cartilage Calcified cartilage epiphysis
*Extra slide 1 http://www.easynotecards.com/uploads/62/89/_4a88b4c5_140c98ff4b1 8000_00007046.PNG
Bone growth in thickness
Bone remodeling Reshaping or replacement of of bone during growth and following injury (e.g., fractures). Bone responds to functional demands and muscle attachments. With remodeling, bone will be added where needed and removed where it is not required.
Bone remodeling during bone growth or reshaping
Bone remodeling after injuries
What if bone remodeling has defect? Example: Osteoporosis 骨質疏鬆 :
骨質疏鬆症 (Osteoporosis) 其原因為年紀增大以後骨頭 ( 主要是海綿骨 ) 的鈣質流失, 使得內部骨小樑變少, 造成許多孔隙, 呈現中空疏鬆的現象, 換句話說, 即是骨骼密度變小, 單位體積內骨骼所含的礦物質量減少 退化性骨質疏鬆症, 又可分為 Type I- 由於停經後所引起, 稱之為停經後骨質疏鬆症 (post-menopausal osteoporosis); 與 Type II- 由於年紀老邁引起, 稱之為老年型骨質疏鬆症
Axial skeleton 中軸骨 skull 頭骨 29 vertebral column 脊柱 26 thorax 胸 25 80 Appendicular skeleton 四肢骨 upper extremities 上肢 64 lower extremities 下肢 62 126
Skull: 頭骨 Cranium (8) 顱骨 Face (14) 顏面骨 Sphenoid
Facial bones (14) 顏面骨 Auditory ossicles (3)
Cranial bone (Cranium) 顱骨 1) Frontal bone 額骨 2) Parietal bone 頂骨 (2) 3) Occipital bone 枕骨 4) Temporal bone 顳骨 (2) 5) Sphenoid bone 蝶骨 6)Ethmoid bone 篩骨
1) Frontal bone 額骨 : Supraorbital foramen (notch) 眶上孔 (supraorbital nerve (CN V1), artery pass) Frontal sinus
3) Occipital bone 枕骨 foramen magnum, 大孔 (CN IX, CN X, & CN XI and vertebral pass) occipital condyles, 枕骨髁 ( ㄎㄜ )
3) Occipital bone 枕骨 hypoglossal canals, 舌下神經管 (CN XII and ascending pharyngeal artery pass) jugular foramen 頸靜脈孔 (Jugular vein passes) Jugular foramen
4) Temporal bone 顳骨 squamous portion: 鱗部 tympanic portion: 鼓部 external auditory canal (meatus). 外耳道 mastoid portion: 乳突部 ; petrous portion: 岩樣部
4) Temporal bone 顳骨 squamous portion: 鱗部 zygomatic process, 顴突 (forms zygomatic arch with temporal process of zygomatic bone 顴骨 ) mandibular fossa, 下頷窩 (articulate with mandible to form temporo-mandibular joint, TMJ)
4) Temporal bone 顳骨 mastoid portion: 乳突部 mastoid process 乳突 stylomastoid foramen 莖突乳突孔 : (CN VII (facial N.) and stylomastoid artery pass) carotid canal 頸動脈管 : (internal carotid artery pass) Mastoid air cells
*Extra slide 2 Carotid foramen Jugular foramen http://img2.tfd.com/mk/j/x2604-j-05.png
4) Temporal bone 顳骨 petrous portion: 岩樣部 (contains middle and inner ear) ossicles of ear 耳小聽骨 internal auditory canal (meatus) 內耳道 (CN VII and VIII pass)
4) Temporal bone 顳骨 tympanic portion: 鼓部 external auditory canal (meatus). 外耳道
5) Sphenoid bone 蝶骨 body: sella turcica 垂骨鞍 (*Turkish Settle) -----protect pituitary gland
5) Sphenoid bone 蝶骨 Medial and lateral pterygoid processes: 翼突 lesser wings: 小翼 optic foramen 視神經孔 (CN II) greater wings: 大翼 superior orbital fissure 眶上裂 (CN III, IV, *V1 & VI)
foramen rotundum 圓孔 : CN V2 foramen ovale 卵圓孔 : CN V3 foramen spinosum 棘孔 : middle meningeal artery
6) Ethmoid bone 篩骨 crista galli 雞冠 cribriform plate 篩板 Median perpendicular plate 中垂直板 superior nasal concha 上鼻甲 middle nasal concha 中鼻甲
6) Ethmoid bone 篩骨 crista galli 雞冠 cribriform plate 篩板 Median perpendicular plate 中垂直板 superior nasal concha 上鼻甲 middle nasal concha 中鼻甲
6) Ethmoid bone 篩骨 crista galli 雞冠 cribriform plate 篩板 Median perpendicular plate 中垂直板 superior nasal concha 上鼻甲 middle nasal concha 中鼻甲
Paranasal Sinus 副鼻竇 : frontal, ethmoidal, shenoidal, and maxillary sinus
Paranasal Sinus 副鼻竇 : frontal, ethmoidal, shenoidal, and maxillary sinus
Paranasal Sinus 副鼻竇 : frontal, ethmoidal, shenoidal, and maxillary sinus
(B) Bones of the face 1) Inferior nasal concha 下鼻甲 2) Vomer 犁骨 3) Nasal bones 鼻骨 4) Lacrimal bones 淚骨
(B) Bones of the face 1) Inferior nasal concha 下鼻甲 2) Vomer 犁骨 3) Nasal bones 鼻骨 4) Lacrimal bones 淚骨
5) Palatine bones 腭骨 horizontal plate, 橫板 vertical plate 垂直板
6) Maxilla 上頷骨 alveolar process 齒槽突 infraorbital foramen 眶下孔 CN V2 7) Zygomatic bones 顴骨 Aveolar process
8) Mandible 下頷骨最大 最強壯, 也是頭顱骨中唯一能動者 coronoid process, 冠突 condylar process, 髁突 mandibular notch, 下頷切跡 alveolar process, 齒槽突 mental foramen, 頦孔 CN V3 mandibular foramen 下頷孔 CN V3
*Orbital Bones 眼眶七骨 : 1. Maxilla 上頷骨, 2. Palatine bones 腭骨, 3. Lacrimal bones 淚骨, 4. Ethmoid bone 篩骨, 5. Zygomatic bones 顴骨, 6. Frontal bone 額骨, 7. Sphenoid bone 蝶骨
(C) Ossicles of the ear malleus, 鎚骨 incus, 砧 ( ㄓㄣ ) 骨 stapes 鐙 ( ㄉㄥ ) 骨
(D) Hyoid bone 舌骨 : Free, No articulation
Fontanels ( 囟 ) of the skull at birth: 1. Anterior 2. Posterior, 3. Anterolateral, 4. Posterolateral Fontanels
Fontanels ( 囟 ) of the skull at birth: 1. Anterior 2. Posterior, 3. Anterolateral, 4. Posterolateral Fontanels
2. Vertebral Column 脊柱 cervical vertebrae 頸椎 (7) thoracic vertebrae 胸椎 (12) lumbar vertebrae 腰椎 (5) sacrum 薦椎 (1) coccyx 尾椎 (1)
* Cervical, Thoracic, Lumbar and Sacral curves
Typical vertebra (horizontal) body spinous process 棘突 transverse process 橫突 superior articular process 上關節突 inferior articular process 下關節突 lamina 板 (*laminetomy) Pedicle 椎弓板 vertebral arch 椎弓 vertebral foramen 脊椎孔
(A) Cervical vertebrae 頸椎 : C1-C7 Transverse foramen 橫孔 ; Atlas 寰椎 (C1); Axis 樞椎 (C2); Vertebra prominens 脊椎隆起 (C7)
(A) Cervical vertebrae 頸椎 : C1-C7 Transverse foramen 橫孔 Atlas 寰椎 (C1): superior articular facet 上關節面 (atlanto-occipital joint) 寰椎枕骨關節 facet for dens 齒狀接面 YES action--nodding Axis 樞椎 (C2): dens 齒突 (odontoid process), (atlanto-axial joint) 寰椎 - 樞椎關節 NO action shack one s head
*Extra slide 3 Body of atlas moves down and fuse with Axis to become Dens left posterior Anterior right ID4 UFO! http://www.spineuniverse.com/anato my/vertebral-column
(B) Thoracic vertebrae: T1--T12 胸椎 transverse costal facet 橫胸骨面 : tubercle of rib 肋骨結節 sup. and inf. costal demifacet 上下關節面 : head of rib 肋骨頭
(C) Lumbar vertebrae: L1--L5 腰椎
(C) Lumbar vertebrae: L1--L5 腰椎 heart Big, kidney
坐骨神經痛 坐骨神經痛是一個通俗名稱, 用來描述一種神經痛的方式, 不是指一個特定的病 通常發生於椎間盤突出壓迫腰椎神經引起的痛 坐骨神經坐骨神經痛的方式有一定的特色 : 從後背部沿著臀部, 再順著大腿的後側到小腿的側面或腿肚 好像是順著一條神經的走向痛下來的
(D) Sacrum: S1--S5 薦椎 sacral foramina, 薦孔 sacral promotary, 薦岬 auricular surface, 耳狀接面 sacral canal, 薦道 sacral hiatus. 薦裂孔 (Caudal anesthesia) injection site Auricular surface Sacral promontary Sacral foramina Sacral foramina Sacral hiatus Sacral canal
(E) Coccyx (3 to 4 fused bones) 尾椎 Tail bone