Bone

Gray's Anatomy illustration of a human femur.

Bones are rigid organs that form part of the endoskeleton of vertebrates. They function to move, support, and protect the various organs of the body, produce red and white blood cells and store minerals. Because bones come in a variety of shapes and have a complex internal and external structure, they are lightweight, yet strong and hard, in addition to fulfilling their many other functions. One of the types of tissues that makes up bone is the mineralized osseous tissue, also called bone tissue, that gives it rigidity and honeycomb-like three-dimensional internal structure. Other types of tissue found in bones include marrow, endosteum and periosteum, nerves, blood vessels and cartilage. There are 206 bones in the adult body and about 300 bones in the infant body.

Functions

Bones have eight main functions:

• Protection — Bones can serve to protect internal organs, such as the skull protecting the brain or the ribs protecting the heart and lungs.
• Shape — Bones provide a frame to keep the body supported.
• Blood production — The marrow, located within the medullary cavity of long bones and the interstices of cancellous bone, produces blood cells in a process called haematopoiesis.
• Mineral storage — Bones act as reserves of minerals important for the body, most notably calcium and phosphorus.
• Movement — Bones, skeletal muscles, tendons, ligaments and joints function together to generate and transfer forces so that individual body parts or the whole body can be manipulated in three-dimensional space. The interaction between bone and muscle is studied in biomechanics.
• Acid-base balance — Bone buffers the blood against excessive pH changes by absorbing or releasing alkaline salts.
• Detoxification — Bone tissues can also store heavy metals and other foreign elements, removing them from the blood and reducing their effects on other tissues. These can later be gradually released for excretion.^{[citation needed]}
• Sound transduction — Bones are important in the mechanical aspect of hearing.

Characteristics

The primary tissue of bone, osseous tissue, is a relatively hard and lightweight composite material, formed mostly of calcium phosphate in the chemical arrangement termed calcium hydroxylapatite (this is the osseous tissue that gives bones their rigidity). It has relatively high compressive strength but poor tensile strength, meaning it resists pushing forces well, but not pulling forces. While bone is essentially brittle, it does have a significant degree of elasticity, contributed chiefly by collagen. All bones consist of living cells embedded in the mineralized organic matrix that makes up the osseous tissue.

Masto-structure

Gross anatomy

See also: Human skeleton and List of bones of the human skeleton

Individual bones

Bone is not a uniformly solid material, but rather has some spaces between its hard elements.

Compact bone

The hard outer layer of bones is composed of compact bone tissue, so-called due to its minimal gaps and spaces. This tissue gives bones their smooth, white, and solid appearance, and accounts for 80% of the total bone mass of an adult skeleton. Compact bone may also be referred to as dense bone or cortical bone.

Trabecular bone

Filling the interior of the organ is the trabecular bone tissue (an open cell porous network also called cancellous or spongy bone) which is composed of a network of rod- and plate-like elements that make the overall organ lighter and allowing room for blood vessels and marrow. Trabecular bone accounts for the remaining 20% of total bone mass, but has nearly ten times the surface area of compact bone.

Cellular structure

There are several types of cells constituting the bone;

• Osteoblasts are mononucleate bone-forming cells which descend from osteoprogenitor cells. They are located on the surface of osteoid seams and make a protein mixture known as osteoid, which mineralizes to become bone. Osteoid is primarily composed of Type I collagen. Osteoblasts also manufacture hormones, such as prostaglandins, to act on the bone itself. They robustly produce alkaline phosphatase, an enzyme that has a role in the mineralisation of bone, as well as many matrix proteins. Osteoblasts are the immature bone cells.

• Bone lining cells are essentially inactive osteoblasts. They cover all of the available bone surface and function as a barrier for certain ions.
• Osteocytes originate from osteoblasts which have migrated into and become trapped and surrounded by bone matrix which they themselves produce. The spaces which they occupy are known as lacunae. Osteocytes have many processes which reach out to meet osteoblasts probably for the purposes of communication. Their functions include to varying degrees: formation of bone, matrix maintenance and calcium homeostasis. They possibly act as mechano-sensory receptors—regulating the bone's response to stress. They are mature bone cells.

• Osteoclasts are the cells responsible for bone resorption (remodeling of bone to reduce its volume). Osteoclasts are large, multinucleated cells located on bone surfaces in what are called Howship's lacunae or resorption pits. These lacunae, or resorption pits, are left behind after the breakdown of bone and often present as scalloped surfaces. Because the osteoclasts are derived from a monocyte stem-cell lineage, they are equipped with engulfment strategies similar to circulating macrophages. Osteoclasts mature and/or migrate to discrete bone surfaces. Upon arrival, active enzymes, such as tartrate resistant acid phosphatase, are secreted against the mineral substrate.

Molecular structure

Matrix

The matrix is the major constituent of bone, surrounding the cells. It has inorganic and organic parts.

Inorganic

The inorganic is mainly crystalline mineral salts and calcium, which is present in the form of hydroxyapatite. The matrix is initially laid down as unmineralized osteoid (manufactured by osteoblasts). Mineralisation involves osteoblasts secreting vesicles containing alkaline phosphatase. This cleaves the phosphate groups and acts as the foci for calcium and phosphate deposition. The vesicles then rupture and act as a centre for crystals to grow on.

Organic

The organic part of matrix is mainly composed of Type I collagen. This is synthesised intracellularly as tropocollagen and then exported. It then associates into fibrils. Also making up the organic part of matrix include various growth factors, the functions of which are not fully known. Other factors present include glycosaminoglycans, osteocalcin, osteonectin, bone sialo protein and Cell Attachment Factor. One of the main things that distinguishes the matrix of a bone from that of another cell is that the matrix in bone is hard.

Woven or lamellar

Bone is first deposited as woven bone, in a disorganized structure with a high proportion of osteocytes in young and in healing injuries. Woven bone is weaker, with a small number of randomly oriented collagen fibers, but forms quickly. It is replaced by lamellar bone, which is highly organized in concentric sheets with a low proportion of osteocytes. Lamellar bone is stronger and filled with many collagen fibers parallel to other fibers in the same layer. The fibers run in opposite directions in alternating layers, much like plywood, assisting in the bone's ability to resist torsion forces. After a break, woven bone quickly forms and is gradually replaced by slow-growing lamellar bone on pre-existing calcified hyaline cartilage through a process known as "bony substitution."

Five types of bones

There are five types of bones in the human body: long, short, flat, irregular and sesamoid.

• Long bones are characterized by a shaft, the diaphysis, that is much greater in length than width. They are comprised mostly of compact bone and lesser amounts of marrow, which is located within the medullary cavity, and spongy bone. Most bones of the limbs, including those of the fingers and toes, are long bones. The exceptions are those of the wrist, ankle and kneecap.

• Short bones are roughly cube-shaped, and have only a thin layer of compact bone surrounding a spongy interior. The bones of the wrist and ankle are short bones, as are the sesamoid bones.
• Flat bones are thin and generally curved, with two parallel layers of compact bones sandwiching a layer of spongy bone. Most of the bones of the skull are flat bones, as is the sternum.
• Irregular bones do not fit into the above categories. They consist of thin layers of compact bone surrounding a spongy interior. As implied by the name, their shapes are irregular and complicated. The bones of the spine and hips are irregular bones.
• Sesamoid bones are bones embedded in tendons. Since they act to hold the tendon further away from the joint, the angle of the tendon is increased and thus the force of the muscle is increased. Examples of sesamoid bones are the patella and the pisiform

Formation

The formation of bone during the fetal stage of development occurs by two processes: intramembranous and endochondral ossification.

Intramembranous ossification mainly occurs during formation of the flat bones of the skull; the bone is formed from mesenchyme tissue. The steps in intramembranous ossification are:

1. Development of ossification center
2. Calcification
3. Formation of trabeculae
4. Development of periosteum

Endochondral ossification

Endochondral ossification, on the other hand, occurs in long bones, such as limbs; the bone is formed from cartilage. The steps in endochondral ossification are:

1. Development of cartilage model
2. Growth of cartilage model
3. Development of the primary ossification center
4. Development of medullary cavity
5. Development of the secondary ossification center
6. Formation of articular cartilage and epiphyseal plate

Endochondral ossification begins with points in the cartilage called "primary ossification centers." They mostly appear during fetal development, though a few short bones begin their primary ossification after birth. They are responsible for the formation of the diaphyses of long bones, short bones and certain parts of irregular bones. Secondary ossification occurs after birth, and forms the epiphyses of long bones and the extremities of irregular and flat bones. The diaphysis and both epiphyses of a long bone are separated by a growing zone of cartilage (the epiphyseal plate). When the child reaches skeletal maturity (18 to 25 years of age), all of the cartilage is replaced by bone, fusing the diaphysis and both epiphyses together (epiphyseal closure).

Bone marrow

There are two types of bone marrow, yellow and red, most commonly seen is red Bone marrow can be found in almost any bone that holds cancellous tissue. In newborns, all such bones are filled exclusively with red marrow , but as the child ages it is mostly replaced by yellow, or fatty marrow. In adults, red marrow is mostly found in the flat bones of the skull, the ribs, the vertebrae and pelvic bones.

Remodeling

Remodeling or bone turnover is the process of resorption followed by replacement of bone with little change in shape and occurs throughout a person's life. Osteoblasts and osteoclasts, coupled together via paracrine cell signalling, are referred to as bone remodeling units.

Purpose

The purpose of remodeling is to regulate calcium homeostasis, repair micro-damaged bones (from everyday stress) but also to shape and sculpture the skeleton during growth.

Calcium balance

The process of bone resorption by the osteoclasts releases stored calcium into the systemic circulation and is an important process in regulating calcium balance. As bone formation actively fixes circulating calcium in its mineral form, removing it from the bloodstream, resorption actively unfixes it thereby increasing circulating calcium levels. These processes occur in tandem at site-specific locations.

Repair

Repeated stress, such as weight-bearing exercise or bone healing, results in the bone thickening at the points of maximum stress (Wolff's law). It has been hypothesized that this is a result of bone's piezoelectric properties, which cause bone to generate small electrical potentials under stress.^[1]

Paracrine cell signalling

The action of osteoblasts and osteoclasts are contolled by a number of chemical factors which either promote or inhibit the activity of the bone remodelling cells, controlling the rate at which bone is made, destroyed or changed in shape. The cells also use paracrine signalling to control the activity of each other.

Osteoblast stimulation

Osteoblasts can be stimulated to increase bone mass through increased secretion of osteoid and by inhibiting the ability of osteoclasts to break down osseous tissue.

Bone building through increased secretion of osteoid is stimulated by the secretion of growth hormone by the pituitary, thyroid hormone and the sex hormones (estrogens and androgens). These hormones also promote increased secretion of osteoprotegerin.^[2] Osteoblasts can also be induced to secrete a number of cytokines that promote reabsorbtion of bone by stimulating osteoclast activity and differentiation from progenitor cells. Vitamin D, parathyroid hormone and stimulation from osteocytes induce osteoblasts to increase secretion of RANK-ligand and interleukin 6, which cytokines then stimulate increased reabsorbtion of bone by osteoclasts. These same compounds also increase secretion of macrophage colony-stimulating factor by osteoblasts, which promotes the differentiation of progenitor cells into osteoclasts, and decrease secretion of osteoprotegerin.

Osteoclast inhibition

The rate at which osteoclasts resorb bone is inhibited by calcitonin and osteoprotegerin. Calcitonin is produced by parafollicular cells in the thyroid gland, and can bind to receptors on osteoclasts to directly inhibit osteoclast activity. Osteoprotegerin is secreted by osteoblasts and is able to bind RANK-L, inhibiting osteoclast stimulation.^[2]

Disorders

See also: List of skeletal disorders

There are many disorders of the skeleton. One of the more prominent is osteoporosis.

Osteoporosis

Main article: Osteoporosis

Osteoporosis is a disease of bone - leading to an increased risk of fracture. In osteoporosis, the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. Osteoporosis is defined by the World Health Organization (WHO) in women as a bone mineral density 2.5 standard deviations below peak bone mass (20-year-old sex-matched healthy person average) as measured by DXA; the term "established osteoporosis" includes the presence of a fragility fracture.^[3] Osteoporosis is most common in women after the menopause, when it is called postmenopausal osteoporosis, but may develop in men and premenopausal women in the presence of particular hormonal disorders and other chronic diseases or as a result of smoking and medications, specifically glucocorticoids, when the disease is called steroid- or glucocorticoid-induced osteoporosis (SIOP or GIOP).

Osteoporosis can be prevented with lifestyle advice and medication, and preventing falls in people with known or suspected osteoporosis is an established way to prevent fractures. Osteoporosis can be treated with bisphosphonates and various other medical treatments.

Other

Other disorders of bone include:

• Bone fracture
• Osteomyelitis
• Osteoporosis
• Osteosarcoma
• Osteogenesis imperfecta
• Arthritis

Osteology

The study of bones and teeth is referred to as osteology. It is frequently used in anthropology, archeology and forensic science for a variety of tasks. This can include determining the nutritional, health, age or injury status of the individual the bones were taken from. Preparing fleshed bones for these types of studies can involve maceration - boiling fleshed bones to remove large particles, then hand-cleaning.

Typically anthropologists and archeologists study bone tools made by Homo sapiens and Homo neanderthalensis. Bones can serve a number of uses such as projectile points or artistic pigments, and can be made from endoskeletal or external bones such as antler or tusk.

Alternatives to bony endoskeletons

There are several evolutionary alternatives to mammilary bone; though they have some similar functions, they are not completely functionally analogous to bone.

• Exoskeletons offer support, protection and levers for movement similar to endoskeletal bone. Different types of exoskeletons include shells, carapaces (consisting of calcium compounds or silica) and chitinous exoskeletons.
• A true endoskeleton (that is, protective tissue derived from mesoderm) is also present in Echinoderms. Porifera (sponges) possess simple endoskeletons that consist of calcareous or siliceous spicules and a spongin fiber network.

Exposed bone

Bone penetrating the skin and being exposed to the outside can be both a natural process in some animals, and due to injury:

• A deer's antlers are composed of bone
• The extinct predatory fish Dunkleosteus, instead of teeth, had sharp edges of hard exposed bone along its jaws
• A compound fracture occurs when the edges of a broken bone puncture the skin
• Though not strictly speaking exposed, a bird's beak is primarily bone covered in a layer of keratin

Terminology

Several terms are used to refer to features and components of bones throughout the body:

Several terms are used to refer to specific features of long bones:

See also

• List of bones of the human skeleton
• Terms for anatomical location
• Orthopaedics
• Chiropractic

Footnotes

References

• Katja Hoehn; Marieb, Elaine Nicpon. Human Anatomy & Physiology (7th Edition). San Francisco: Benjamin Cummings. ISBN 0805359095. 
• Netter, Frank H. (1987), Musculoskeletal system: anatomy, physiology, and metabolic disorders. Summit, New Jersey: Ciba-Geigy Corporation ISBN 0914168886
• Bryan H. Derrickson; Tortora, Gerard J. (2005). Principles of anatomy and physiology. New York: Wiley. ISBN 0471689343. 

External links

• Review (including references) of piezoelectricity and bone remodelling
• A good basic overview of bone biology from the Science Creative Quarterly
• Bone Health at Got Bones?
• Osteopathic physicians

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