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Bones and Muscles
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Fig 77 The four general types of bone fractures (Note: Only the rst box or cell
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contains an illustration The reader is asked to ll in the other 3 boxes in the gure)
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In real life, we usually deal with some particular combination of fracture types In the rst square cell shown in Figure 77, speci cally, we see drawn a simple complete fracture This type involves a break entirely through the bone, but with no damage to the skin overlying the bone [Study suggestion: Now, you go ahead and name the other three broad combinations of fracture types Make a quick sketch of each in the cells of Figure 77, then check your answers with a friend]
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As you read the preceding material about bone fractures, you may have asked yourself this question: Why do some elderly people get fractures so much easier than younger people Part of the answer comes from a single medical term: osteoporosis (ahs-tee-oh-por-OH-sis) This word literally translates to mean an abnormal condition of (-osis) pores or holes (por) in bones (oste) Figure 78 (A) reveals the normal microanatomy of bone connective tissue Three Haversian (hah-VER-shun) systems or osteons (AHS-tee-ahns) are
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A Haversian system (osteon)
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Central (Haversian) canal Amount of bone matrix is greatly reduced
Haversian canals ("pores") greatly enlarged
Fig 78 Holes in normal bone tissue versus osteoporotic bone tissue (A) Normal bone
matrix showing three Haversian systems (osteons) (B) Abnormal bone matrix showing dramatic effects upon the same three Haversian systems in osteoporosis: Greatly enlarged pores (Haversian canals), with some merging together
pictured These Haversian systems (osteons) are the repeating structural units that make up dense bone tissue Observe that a large black hole, called a central or Haversian canal, is found in the middle of each Haversian system These Haversian or central canals are completely normal In fact, they serve as the vital channels through which nutrient or feeder blood vessels pass Figure 78 (B) demonstrates the dramatic difference in a bad case of osteoporosis The Haversian canals have greatly enlarged in some cases to the extent of even merging with one another! The result is a very hole-ridden bone tissue Very little hard, white, calcium-rich bone matrix still remains Thus, osteoporotic (ahs-tee-oh-por-AH-tik) bones are very weak, brittle, and easily fractured One potentially valuable prophylactic behavior to protect
PART 3
Bones and Muscles
yourself from osteoporosis is to take a large oral dose of calcium (about 1,000 milligrams per day) This simple daily ritual helps retard the breakdown and dissolving of the calcium-rich bone matrix
Bursitis versus arthritis
There are several different types of -itis or in ammations of tissues that lie in or around the joints Let us consider two types: bursitis (bur-SIGH-tis) versus arthritis (arth-RYE-tis) of the shoulder joint A bursa (BUR-sah) is a uid lled sac or purse (burs) present (-a) between skeletal muscles and their tendons and the underlying bones The bursas themselves are not part of the freely movable joint Rather, they often lie around one The bursas serve to reduce friction between muscles and bones, especially in body areas that perform a lot of movement, such as the shoulder The shoulder joint, for instance, has a group of four small bursas around it (Figure 79, A) One of the most prominent of these is the subdeltoid (subDEL-toyd) bursa It lies just below (sub-) the deltoid muscle, which forms the eshy pad of the shoulder It is the outer purse-like sac on the lateral surface of the head of the humerus A frontal section cut through the shoulder (Figure 79, B) displays the associated internal anatomy Note that, in addition to being lined by a synovial membrane and containing synovial uid, the shoulder joint contains a good deal of articular (ar-TIK-you-lar) cartilage This is literally soft, rubbery gristle (cartilag) that is present (-e) to help make a little joint (articul) The articular cartilage softens the otherwise rock hard, bony contact surfaces between the head of the humerus and the shoulder socket of the scapula Figure 79 (C) shows the very unpleasant effects associated with a chronic overuse syndrome of the shoulder joint After long hours of pitching, a professional baseball player may suffer this type of disorder The bursas around the joint become severely swollen, reddened, and in amed This is bursitis The bursal (BUR-sal) wall also secretes a watery serous (SEER-us) uid into the surrounding tissues There is severe pain, tenderness, and limitation of motion of the shoulder Abnormal calcium deposits may be present beneath the subdeltoid bursa The most frequent type of arthritis an in ammation of the joints themselves is called osteoarthritis (ahs-tee-oh-arth-REYE-tis) or OA This is common wear-and-tear arthritis, often resulting from chronic overuse, or improper use, of particular joints When joints such as the shoulder are used excessively over a long time, the articular cartilage wears down and the underlying bony tissue becomes eroded and in amed (That s why it s called osteoarthritis, rather than just plain arthritis) It is also called degenerative joint
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