Osteology - Introduction PDF

Osteology Dr. Incze-Bartha Zsuzsánna Anatomy - ways to approach gross anatomy: surface anatomy = the study of general form (morphology), and superficial anatomical markings regional anatomy = all the superficial and internal features in a specific area of the body systemi...

Osteology Dr. Incze-Bartha Zsuzsánna Anatomy - ways to approach gross anatomy: surface anatomy = the study of general form (morphology), and superficial anatomical markings regional anatomy = all the superficial and internal features in a specific area of the body systemic anatomy considers the structure of major organ systems (groups of organs that function together to produce coordinated effects) 11 organ systems The integumentary system Bones of the skeleton The skeletal system Joints The muscular system Connective tissues Bone marrow The nervous system The endocrine system homeostasis The cardiovascular system The lymphatic system - The respiratory system The digestive system The urinary system The reproductive system Disease Pathology The skeletal system bone + joints + connective tissue + bone marrow Structure and support, for the entire body provide a framework for the attachment of soft tissues and organs Movement muscles produce body movement via their attachment to the bones Storage of minerals the calcium salts reserve, that maintains normal concentrations of calcium (1–2 kg, 98% in bones) phosphate ions, magnesium ions in body; Blood cell production red blood cells, white blood cells, platelets are produced in the red marrow - hematopoiesis Protection delicate tissues and organs are often surrounded by skeletal elements Schuenke M, Schulte E, Schumacher U - Schuenke THIEME M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Atlas of Anatomy, 2nd edition, 2014, Thieme Osteology Bones of the skeleton are the organs of the skeletal system osseous tissue: calcified, living connective tissue ⟶ complex structure dynamic organs + connective tissues (covering) + smooth muscle tissue of the blood vessels + neural tissue high regenerative properties one-fifth of a body’s weight Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Osteology Bones of the skeleton Classification Macroscopical structure: compact, cancellous Microscopical structure = histology Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Development Adult and young bone Bone formation Bone regeneration Clinical examination Pathology Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Osteology Bones of the skeleton 206 The axial skeleton (80) The bones of the skull Vertebral column Thorax The appendicular skeleton (64+62) Girdles: the associated bones that connect the limbs to the trunk: at the shoulders and pelvis – pectoral and pelvic girdles – shoulder and hip The bones of the free limbs Teeth (32+20) Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Osteology Bones of the skeleton The axial skeleton (80) The bones of the skull Neurocranium: frontal, parietal, sphenoidal, occipital, temporal, ethmoidale Viscerocranium: maxilla, lacrimal, zygomatic, inferior nasal choncha, nasal, palatin, vomer, mandibula Vertebral column: cervical, thoracal, lumbar, sacral, coccygeal Thorax Sternum Ribs The appendicular skeleton (64+62) Pectoral girdle: clavicula, scapula Free upper limb: humerus, ulna, radius, carpals, metacarpals, phalanges Pelvic girdle: pelvis or hip bone Free lower limb: femur, tibia, fibula, patella, tarsals, metatarsals, phalanges Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Osteology Anatomical classification of bones Long bones - are tubular: diaphysis + epiphysis + metaphysis + canalis medullaris - surfaces, borders, bony features - central medullary cavity - nutrient foramen directed away from the growing end - typical: humerus, ulna, radius, femur, tibia, fibula - miniature long bones: one epiphysis: metacarpals, metatarsals, phalanges - modified long bones have no medullary cavity: clavicula Short bones - carpal bones (8) - tarsal bones (7) Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Osteology Anatomical classification of bones Flat bones - shallow plates - form boundaries of certain body cavities - consist of two compact bone plates separated by spongy bone - bones of the skull (diploë), ribs, sternum, scapula Irregular bones - are bones with various shapes - bones of the face, vertebra, hip bone - inner ear: mallet, incus, stapes - the smallest Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Osteology Anatomical classification of bones Pneumatic bones - contain large spaces of air - maxilla, sphenoid, ethmoid - make the skull light, help in voice resonance Sesamoid bones - are round or oval bones which are embedded in tendons or joint capsule - patella, fabella - no periosteum - to resist pressure, to minimize friction, alter the direction of the force Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Osteology Anatomical classification of bones Accessory, supernumerary bones: 20%, bilateral, (may result from the failure of fusion of certain adjacent ossification centers) Heterotopic bones: ossifications in the surrounding tissues; after surgeries, horse riders develop bones in adductor muscles Osteology Gross structure of the bones 1. Joint cartilage 2. Periosteum 3. Osseous tissue 4. Endosteum 6. Medullar cavity 7. Bone marrow 8. Vessels and nerves 9. Growth cartilage Anatomical position Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8th ed, 2015, Pearson Education Osteology Gross structure of the bones Parts Long bones - covered with periosteum - 3 parts: epiphysis + metaphysis + diaphysis - medullary cavity - 2 different texture: outer compact bone, spongy bone (epiphysis, diaphysis) - Endosteum - Medullar cavity - epiphyseal lines ← epiphyseal plate = growth plate Short bones - covered with periosteum - 2 different texture: outer compact bone, spongy bone, diploe - bone marrow - body, extensions Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8th ed, 2015, Pearson Education Osteology Gross structure of the bones Surface formations/ bone markings / bone features Smooth areas Caput → Head, prominent rounded surface Facies→ Flat surface Condilus → Rounded surface Elevations Protuberancia → Protruding Process → Prominence feature Spina → Sharp process Tuberculum → Small, rounded process Tuberositas → Rough surface Linea → Slight, elongated ridge Cresta → Ridge Depressions Fossa → Basin Fovea → Small pit Sulcus → Long groove Openings Canal → Passage in bone Fissura → Slit through bone Incisura → Notch, cleft Foramen →Hole through bone Meatus → Opening into canal Cavities Sinus → Air-filled space in bone Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8th ed, 2015, Pearson Education Osteology 2 forces: tensile force + compressive force pressure lamellae parallel + tension lamellae perpendicular Macroscopical architecture - 2 types - Substantia compacta = compact bone = cortical bone = cortex - Substantia spongiosa = spongy bone = trabecular = cancellous bone Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Osteology Structural classification Macroscopical architecture - 2 types Schuenke M, Schulte E, Schumacher U - Atlas of Anatomy, 2nd edition, 2014, Thieme Substantia compacta = compact bone = cortical bone = cortex Substantia spongiosa = spongy bone = trabecular = cancellous bone Osteology Structural classification Macroscopical architecture Substantia spongiosa = spongy bone = trabecular = cancellous bone Substantia compacta = compact bone = cortical bone = cortex loose, open network of struts and plates dense and solid stresses from many directions stresses arrive from a limited range of directions trabeculae forms the wall's high turnover rate, remodelling slow turnover rate surrounds the medullary, marrow cavity 80% of the skeleton contains bone marrow functional unit: Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme osteon = Haversian system lighter, reduces the weight of the Compact bone Cancellous bone skeleton Location diaphysis epiphysis Lamellae Haversian system meshwork Bone marrow yellow-adult, red-child red Nature hard, ivory spongy Osteology Macroscopical architecture Compact bone osteon = Haversian system - cylindrical, parallel with the long axis of the bone, 1cm x 250-300 micrometer - very thin layers of bone termed lamellae, concentric lamellae 5-20 - central Haversian canal: blood vessels, nerves, parallel to the long axis of the bone - collagen fibres spiral along the length of each lamella, of the adjacent lamellae run in opposite direction → twisting, bending - lacunae → osteocytes, 20,000–30,000 osteocytes and lacunae are found in each cubic millimeter of bone - canaliculi interconnect the lacunae of an osteon and form a branching network that reaches the central canal - perforating canals = Volkmann's canals, perpendicular Schuenke M, Schulte E, Schumacher U - Atlas - interstitial lamellae: between the osteons of Anatomy, 2nd edition, 2014, Thieme - circumferential lamellae: at the external and internal surfaces - stress forces Osteology Macroscopical architecture Cancellous bone trabeculae - meshwork of trabeculae - branching plates, with interconnecting spaces - between trabeculae bone marrow containing spaces - adaptation to compressive forces - pressure lamellae, tension lamellae - lined with endosteum thickness of the trabeculae: 200 micrometers Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Osteology Macroscopical architecture Cancellous bone trabeculae - meshwork of trabeculae - branching plates, with interconnecting spaces - between trabeculae bone marrow containing spaces - adaptation to compressive forces - pressure lamellae, tension lamellae - lined with endosteum - thickness of the trabeculae: 200 micrometers Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8th ed, 2015, Pearson Education Osteology Histology Osseous tissue - connective tissue: consists of specialized cell + extracellular matrix - separated from the other tissues by periosteum, inner endosteum Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8th ed, 2015, Pearson Education Osteology Osteocytes Osteoprogenitor cells Osseous tissue - maintain, monitor the protein and mineral content - periosteum, endosteum - communicate with blood vessels + one another with - from mesenchyme → osteoblasts the cells: 2% cytoplasmic extensions through canaliculi → a branching - environment will determine their function, role in repair network for the exchange of materials Osteoblasts th Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8 ed, 2015, Pearson Education - inner and outer layer of the bone - form bone by producing the organic components of the bone Osteoclasts matrix = osteoid witch will be mineralized - large, multinucleate: release acids dissolve matrix: release of the - osteogenesis: production of the new bone calcium and phosphate → osteolysis - differentiates into osteocyte Osteology Osseous tissue -the matrix (extracellular matrix): protein fibers (organic) + ground substance (inorganic) is solid due to the deposition of the calcium salts around protein fibers organic component = osteoid - consist of collagen fibers, non collagenous proteins: proteoglycans, osteocalcin, osteonectin, osteopontin - 1/3 of the weight - torsion, tensile strength inorganic component - calcium phosphate + calcium hydroxide → hydroxyapatite crystal (calcium salts: calcium carbonat, sodium, magnesium, fluoride) - 2/3 of the weight - resist compression Calcium phosphate crystals: strength Collagen fibres: tough, flexible The minerals are organized around the collagen fibers, Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8th ed, 2015, Pearson Education hydroxyapatite crystals form small plates that lie along the ground substance proteins ~ steel-reinforced concrete Osteology Structural classification Microscopical architecture - 5 types Lamellar bones – secondary bone - most of the mature bones - thin plates of bony tissue - compact or cancellous - secondary bone created by remodeling of the woven bone - organized and stress oriented - stronger, less flexible Woven bones – primary bone - immature bone - fetal bone, fracture repair, cancer of bones - characterized by the irregular arrangement of collagen fibres, large cell number (more osteocytes), reduced mineral content - not stress oriented - high rate of turnover - flexible Fibrosus bone - young fetal bones Dentine in teeth Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Cement in teeth Osteology Structure Periosteum - covers the cortex, outer surface of a bone - 2 layers: - outer fibrous layer - inner cellular layer: osteogenic layer containing osteoprogenitor (stem) functions in bone growth + participates in repairs after an injury - incomplete only at joints - assists in the attachment of a bone to surrounding tissues - collagen fibers of the periosteum are continuous with those of the bone, joint capsule, tendons, ligaments - connecting to the bone: perforating fibres or Sharpey's fibres - blood supply, sensitive innervation Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8th ed, 2015, Pearson Education Osteology Structure Endosteum - incomplete cellular layer - usually only one cell thick and incomplete layer, and the bone matrix is occasionally exposed - covers the trabeculae of spongy bone - osteoprogenitor cells, active during the growth of bone and repair or remodelling Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8th ed, 2015, Pearson Education Osteology Structure Bone marrow - gelatinous tissue, progenitor cells - medullary (marrow) cavity, cancellous bone - red marrow: consists of loose connective tissue supporting islands of blood-forming cells (hematopoietic) = progenitor and stromal cells, mature and immature red and white blood cells in all bones; - adult: cranium, vertebrae, scapula, sternum, ribs, pelvis, epiphysis - yellow marrow: with increasing age, in the long bones it gradually loses its blood-making capacity, a loose connective tissue dominated by adipocytes Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8th ed, 2015, Pearson Education Osteology Bone circulation - extensive blood supply - receives 5-10% of cardiac output - 5-29ml/min/100g of bone sources nutrient artery: through nutrient foramen, high pressure, 2/3 inner mature bone via haversian system, will divide into ascending and descending branches, which approach the epiphyses metaphyseal vessels: supply blood to the inner (diaphyseal) surface of each epiphyseal cartilage, where bone is replacing cartilage epiphyseal system: periarticular vascular plexus, the epiphyseal ends of long bones often contain numerous smaller foramina, the vessels that use these foramina supply the osseous tissue and medullary cavities of the epiphyses periosteal system: low pressure system, 1/3 outer of bone, connected by Volkmann artery (perpendicular), Haversian system (parallel) Direction of arterial flow Mature bone: centrifugal (inside to outside) Immature bone: centripetal (outside to inside, periosteal system predominates) Tenuous blood supply: scaphoid, talus, femoral head, odontoid Direction of venous flow: centripetal (outside to inside) Growth plate: perichondrial artery Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8th ed, 2015, Pearson Education Osteology Bone innervation - sensory nerves branch throughout the periosteum penetrate the cortex with the nutrient artery to innervate the endosteum, medullary cavity, epiphyses Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8th ed, 2015, Pearson Education Osteology Wolff`s law Bone formation directly proportional to stress and strain 2 forces: tensile force + compressive force pressure lamellae parallel + tension lamellae perpendicular To the stresses and exercise → grow thicker and stronger To inactivity → thin and brittle Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Osteology Bone development, growth - the growth of the skeleton determines the size and proportions of our body 11-week-old fetus ▪ Osteogenesis = the formation of an individual bone Schuenke M, Schulte E, Schumacher U - Atlas of Anatomy, 2nd edition, 2014, Thieme ▪ Ossification = the formation of bone tissue, mesenchyme or cartilage is replaced by bone ▪ Calcification = the deposition of calcium salts within a tissue Prenatal (6 weeks after fertilization) + postnatal (growth until 25 years of age) 10-week- old fetus 16-week-old fetus Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8th ed, 2015, Pearson Education Osteology Bone development, growth Prenatal (6 weeks after fertilization) - primordial skeleton: the supporting tissue of the human skeleton arises from embryonic connective tissue (= mesenchyme), derived from the mesoderm 11-week-old fetus - bones are first laid down as mesodermal (connective tissue) condensations Schuenke M, Schulte E, Schumacher U - Atlas of Anatomy, 2nd edition, 2014, Thieme - primordial skeleton: mesenchymal cells → chondroblasts → hyaline cartilage + mesenchymal tissue 2 types of bone ossification (8th week- 12th week) ossifaction centers Intramembranous (desmal) ossification: bone develops from mesenchyme or fibrous connective tissue, mesenchyme cells develop into osteoblasts (clavicle, mandible, the flat bones of the face and skull) endochondral ossification: bone replaces an existing cartilage model (bones 10-week- that bear weight, torso, limbs, and skull base) old fetus Birth 16-week-old fetus Martini FH, Timmons MJ, Tallitsch RB – Human anatomy, 8th ed, 2015, Pearson Education Osteology Bone development, growth Prenatal Intramembranous (desmal) ossification - clavicle, mandible, the flat bones of the face and skull - bone develops from mesenchyme or fibrous connective tissue - the structure of flat bones: between two layers of compact bone is the spongy bone - the inner spongy bone forms before the outer compact bone - ossification begins at a place called the primary ossification center: 1. Osteoblasts develop in the primary ossification center: mesenchymal cells differentiate first into osteogenic cells and then into osteoblasts. 2. Osteoblasts secrete organic matrix, which calcifies 3. Early spongy bone is formed: osteoblasts continue to lay down new bone, forming the trabeculae of the early spongy bone, some of the mesenchyme surrounding the developing bone differentiates into the periosteum other will become bone marrow 4. Early compact bone is formed: the spongy bone deep to the periosteum becomes more calcified, and its structure is rearranged to form immature compact bone. - larger bones have more than one primary ossification center, and so the resulting “pieces” of bone fuse together to form one complete bone - this process is often incomplete at birth: the fontanels in the skull of a newborn represent areas of incomplete fusion Amerman EC – Anatomy and physiology, Pearson Education, 2016 Osteology Bone development, growth Prenatal Endochondral ossification - bone replaces an existing hyalin cartilage model of the primordial skeleton - begins during the fetal period for most bones, some bones will ossify later in the postnatal period (until the age of 7 years) - ossification begins at primary ossification centers: primary bone, that is replaced with secondary bone - long bones also contain secondary ossification centers: after birth (exception: distal femur and proximal tibial epiphysis) 1. the chondroblasts in the perichondrium differentiate into osteogenic cells and then osteoblasts → periosteum 2. the bone begins to ossify from the outside: bone collar, osteoblasts begin to secrete the matrix, internal cartilage begins to die 3. in the primary ossification center, osteoblasts replace the calcified cartilage with early spongy bone; the secondary ossification centers and medullary cavity develop 4. the medullary cavity enlarges, the remaining cartilage is replaced by bone; the epiphyses finish ossifying Amerman EC – Anatomy and physiology, Pearson Education, 2016 Osteology Bone development, growth Prenatal Endochondral ossification - bone replaces an existing hyalin cartilage model of the primordial skeleton - begins during the fetal period for most bones, some bones will ossify later in the postnatal period (until the age of 7 years) - ossification begins at primary ossification centers: primary bone, that is replaced with secondary bone - long bones also contain secondary ossification centers: after birth (exception: distal femur and proximal tibial epiphysis) 1. the chondroblasts in the perichondrium differentiate into osteogenic cells and then osteoblasts → periosteum 2. the bone begins to ossify from the outside: bone collar, osteoblasts begin to secrete the matrix, internal cartilage begins to die 3. in the primary ossification center, osteoblasts replace the calcified cartilage with early spongy bone; the secondary ossification centers and medullary cavity develop 4. the medullary cavity enlarges, the remaining cartilage is replaced by bone; the epiphyses finish ossifying Birth https://www.istockphoto.com Osteology Bone growth Postnatal Schuenke M, Schulte E, Schumacher U - Atlas of Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Anatomy, 2nd edition, 2014, Thieme Growth in length from the division of chondrocytes in the epiphyseal plate = hyaline cartilage that does not ossify during endochondral ossification between the epiphysis and diaphysis the epiphyses become filled with spongy bone, osteoblasts invade the shaft side of the epiphyseal cartilage, replacing the cartilage with bone the epiphyseal cartilage enlarges through interstitial growth, the epiphysis is moves away from the diaphysis → length of the bone increases Growth in width as appositional growth, osteoprogenitor cells between the periosteum and the bone surface lay down new bone new circumferential lamellae are formed Osteology Bone growth Postnatal - 12–15 years of age, the rate of proliferation slows - at about age 18–21, the zone of proliferation completely ossifies Osteology Gross structure - Long bones Adult bone - Epiphysis: proximal + distal, cancellous bone, covered with hyaline cartilage - Diaphysis (shaft): periosteum + cortex (compact bone) + endosteum + medullary cavity - Metaphysis: epiphyseal line Young bone - ossification in three parts: 2 ends + shaft - Epiphysis - Diaphysis (shaft): periosteum + cortex (compact bone) + endosteum + medullary cavity – ossifies from a primary centre Metaphysis: epiphyseal growth plate of cartilage Source: Dr. Incze-Bartha Zsuzsánna Schuenke M, Schulte E, Schumacher U - Atlas of Anatomy, 2nd edition, 2014, Thieme Osteology Bone growth regulation - bone growth occurs when osteoblasts are creating more bone matrix than osteoclasts are removing - hormones regulate the pattern of growth by changing the rates of osteoblast and osteoclast activity: growth hormone (pituitary gland), and thyroxine (thyroid gland): stimulate bone growth parathyroid hormone: stimulates osteoclast and osteoblast activity, increases the rate of calcium absorption along the small intestine (in the presence of calcitriol), reduces the rate of calcium loss in the urine calcitonin (thyroid gland): inhibits osteoclasts and increases the rate of calcium loss in the urine the sex hormones (estrogen and testosterone) stimulate osteoblasts to produce bone faster than the rate of epiphyseal cartilage expansion. Over time, the epiphyseal cartilages narrow and eventually ossify or close. - factors regulating bone growth: normal diet, Vitamin A, C, Vitamin D Bone maintenance, remodeling, repair osteoblast activity and osteoclast activity are in balance, and the rate of bone formation is equal to the rate of bone reabsorption each year almost one-fifth of the adult skeleton is demolished and then rebuilt or replaced bones adapt to stress by altering the turnover and recycling of minerals the bones of the skeleton become thinner and relatively weaker as a normal part of the aging process osteopenia = inadequate ossification osteoporosis = reduction in bone mass, that compromise normal function and increase susceptibility to fracture fracture → repair Osteology Fracture Open Closed Simple Compound Adult Child Source: Dr. Incze-Bartha Zsuzsánna Osteology Fracture repair Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Direct (primary) fracture healing Indirect (natural or secondary) fracture healing Source: Dr. Incze-Bartha Zsuzsánna Osteology Bone development phylogenetic development , ontogenetic development Phylum Chordata (two subphyla invertebrate, vertebrata) Prenatal + postnatal climb and grasp upper limb → grasp, instrumental using limb climb and grasp lower limb → walking limb Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Schuenke M, Schulte E, Schumacher U - THIEME Atlas of Anatomy, 2nd edition, 2014, Thieme Osteology Examination of the skeletal system Clinical examination - physical signs + functional tests can assist in the diagnosis of a bone disorder abnormal posture a limitation of movement or stiffness the distribution of joint involvement and inflammation sounds associated with joint movement the presence of abnormal bone deposits - cannot be seen without relatively sophisticated equipment Diagnostic Procedure X-ray of bone and joint Bone Scans Arthrocentesis Arthroscopy MRI DEXA Source: Dr. Incze-Bartha Zsuzsánna Osteology Pathology Trauma - Fractures Source: Dr. Incze-Bartha Zsuzsánna Osteology Pathology Growth disturbances Source: Dr. Incze-Bartha Zsuzsánna Osteology Pathology Axial deviation Source: Dr. Incze-Bartha Zsuzsánna Osteology Pathology Axial deviation Source: Dr. Incze-Bartha Zsuzsánna Osteology Pathology Infection Tumors Source: Dr. Incze-Bartha Zsuzsánna Osteology anatomy = structures and the physical relationships between them physiology = the study of function, and physiological mechanisms physiology can be explained only in terms of the underlying anatomy https://www.zygote.com all specific physiological functions ⟶ anatomical structures connection between structure and function is always present https://www.zygote.com Osteology Andreas Vesalius “De humani corporis fabrica libri septem”, 1543 Thank You!