Transcription
Hello, ladies and gentlemen, to Real in Partition Moments on Tuesday nights. Anatomy with dialogue. Today's section, we continue with the skeletal system. Inside that, we have already begun, of course. There's going to be the 10 parts of the series, okay? So kindly get the video links of the first two parts. If not, I mean, why them already up today? Because last Sunday was Father's Day, I want to use this opportunity to wish all male individuals, okay, especially fathers among you who have been, I mean, watching this video, okay? And not only those individuals, I mean, all males across the globe, okay? I want to wish you happy, you know, fathers, you know, the celebration. A belated one, of course.
Now, especially to, of course, my father, Mr. Daniel, a very great teacher, someone I describe as the brain behind the camera. Now, the reason is that, you know, some people think I've had some training in education, okay? I've gone for some special training regarding teaching. No, I don't have any obsiders, but my father has been a very good teacher, okay? I have, you know, that kind of traits, a chip off the whole block, okay? So if you see me teaching, yes, I'm trying to walk in the footsteps of my father. For that reason, this Ted video regarding the series of skeletal system inside, I dedicate fully, you know, for my father, or to my father, okay?
Now, similarly, I have some important teachers, okay, in my life over the years that I would wish, you know, to mention their names. Yet, yes, I want to talk about Mr. Raymond Attubani, okay? I want to talk about Mr. I mean, Artificial, okay? These are some great teachers, okay, that I've met, you know. Not forgetting, okay, some male teachers. I still want to, you know, say that I'm very, I mean, grateful for all that you did for me at the various levels.
But today, too, I want to do something for the first time. I want to start acknowledging, okay, individuals who, one way or the other, you know, they are, I mean, so excited about whatever message they receive over here, okay? Through their comments. When I see their comments, they are so encouraging and they push me to do more, okay? More of these important videos. Yes, I want to mention three names today, okay? Now, in future, I'll be mentioning them. Once I see people doing distance, I'll mention names, okay? And then I'll acknowledge you. Write it on this channel of mine, okay? I'll do that over here.
So I want to mention one guy, I mean, Caleb. He's in first-year medicine at KNUST, okay? Even this guy has not met me, but he had already fallen in love with me, the way I teach, okay? Right here on this channel, okay? So I want to appreciate you. Yes, similarly, I have what you call Stephanie Edu, okay? Has also been a very, you know, I'm a wonderful person, okay? And not forget an important individual. Don't forget. Now, if you go to Christian Service University, there is one lady over there, also first year in Nelson, okay? Enjoys the way I teach, okay? Yes, you know, enjoys my company that, yes, I'm able to help her impact, you know, knowledge, okay? In here, right here on this channel. She's also been doing very great. So these are the videos I want to acknowledge.
But let's quickly get into what we have to do today, okay? In future, we mentioned other names. Let me see you so that I do seem for you. And so, without much at all, let's set the world ruling. Now, during the second, you know, episode regarding the series of skeletal system inside, we looked at, of course, I mean, the various types of wounds. We talked about them. We talked about, you know, the fact that we looked at the long wound, I mean, bring out some areas by way of the epiphysis of the bone, the metaphysis of the bone. We talked about the diaphysis of the wound, okay? So please, if not watch these videos, all the important details are there. Kind of get the video links and watch them.
But today, what I want to really, you know, tackle today is that I told you something, okay? That supplies, you know, what you call the medullary cavity of what we call the bone, the diaphysis of the bone, alongside the inner two-thirds portion of the cortical bone. I told you about something that there will be an artery doing that. That is called the nutrient artery. We are going to see it again here. Yes.
Now, for this nutrient artery to run through, there's one important thing that you've got to know, and that is something we call nutrient foramen. Nutrient foramen. So if you are an artery, you are called nutrient artery, then you traverse through what we call nutrient foramen. That's an important thing that I want you to know, okay?
Now, for that reason, one thing I want you to be aware of is that I want to talk briefly about this nutrient, nutrient artery, okay? Now, this nutrient artery, why is it important? Okay? One important thing that I want you to recognize is that those nutrient arteries, the nutrient foramen we are talking about, will take an oblique course. Oblique course. Now, it's not taking, you know, horizontal course or transverse course, no vertical or no. It is taking an oblique course. Either oblique course downwards towards the the distal aspect, the distal epiphysis of the bone, or an oblique course towards the proximal, I mean, end of the bone. That is what we have to understand here, okay?
Now, the question that we need to look at is that why is it important that we study this nutrient foramen? This nutrient foramen, yes, there isn't a sum for number one, so that we know how this nutrient artery traverses through this bone. And why is this important? Now, sometimes there's that kind of orthopedic surgery which will be indicated, it has to be performed. So knowledge of this nutrient foramina, and for that matter, what distribution through them by way of the nutrient arteries, then you don't cause iatrogenic injury to these, I mean, vessels, okay? So that kind of surgery, what is taking place because of the surgical procedure that we are doing, that injury we call it iatrogenic injury. A sorry, I-A-T-R-O-G, you know, uh, G-E-N-I-C, iatrogenic, you know, this kind of injury. That's what we are talking about. We want to prevent that.
Number two, once we are aware of this, I mean, what do you call nutrient foramen, then we go to also understand that it will help us to know what we call the growing end of the bone. The growing end of the bone. Now, when you were young, your bones were relatively perhaps shorter, okay? But with time, they became longer. Which portion will continuously increase in length? Okay? One question was stop growing, I mean, increasingly land, but the other will continue to increase in length. Either it's just increasing in length to lower the distal portion, or it may be increasingly towards the proximal portion. It means that this time around, the proximal end, okay, will be at the stationary at a point, and then the distal end will continue to increase in length. That is also very useful, okay? So that is what we want to demonstrate over here.
So what we are talking about is we are talking about nutrient foramina. Nutrient foramina. So whenever we talk about nutrient foramen, okay, what you should understand is that the plural of foramen becomes foramina. Now, another principle, what you usually find is that one bone, one long bone, one nutrient foramen. Yes, that's what we see. Normal case scenario, okay? So one village, one town, one district, one party, one student, one laptop. This time, we are talking about one bone, one nutrient foramen, okay? That is what we see.
But my friends, there's a catch. What we find is that there are some bones, okay, or some individuals, they may present for double nutrient foramina. Double nutrient foramina. So all these anatomical variations, okay, you need to be aware of them so that you know the deviations, okay? You attend to them, you know, I mean, very well, okay? Otherwise, maybe cause iatrogenic injury to some of these things, okay? So that is, I mean, one thing you should be aware of, especially we find this double nutrient foramina, okay, regarding the males. So sometimes the tibia, the fibula, represent with a double nutrient foramen, especially for the males. And what's the reason? I told you that the nutrient foramen will be allowing nutrient arteries, which are very important blood supply to the bone. And you know that generally males, we tend to be involved more in this kind of, I mean, I mean, manual work. So it makes sense that giving the bone nutrients by way of this, I mean, arterial blood supply, nourishing the the what do you call it, this bone, okay? Because males are more involved in this kind of, I mean, loading activities, traders activities, then it makes sense that God equips some of the bones of such individuals, okay, with double nutrient foramina, okay? That's what we see, okay? So that is that one.
Now, for us to understand it again, one lesson two that will help you, okay? All these things, they are helping you to prevent or to minimize the occurrences of iatrogenic injuries during orthopedic surgeries when they are indicated, okay? Is that normal one for the upper limb bones? Upper limb bones. What you find is that normally the nutrient foramen, we tend to see them, okay, anteriorly oriented. Anteriorly. Most of the upper limb, okay? And when we talk about bones of the upper limb, we are talking that of the humerus, radius, all that. They tend to be directed, okay? They can replace more anteriorly in the bone, the diaphysis of the bones. However, in the case of the lower limb, we tend to be displaced at the crucial aspect, especially at the crucial aspect of these bones, by way of the femur, you know, the tibia and fibula. That's what generally we see. And why? Why are we saying this? Because during development, there's some kind of rotation about 90 degrees rotation of the bones of the upper limb towards the lateral aspect. But in the case of the lower limb, there's about 90 degrees rotation, okay, medially. That is why some of these, you know, turns we talked about them, okay? So that's also another thing that I want you to be aware of. Good.
So now, once you understand this, then what we are saying is that in the case, now there are some important facts that we should be aware of. Number one, in the case of long bones of the upper limb, okay, they are nutrient. This is my elbow joint. The anterior has been over here. I have the elbow joint over here, okay? Between the arm and the forearm. What we are saying is that the bones of the upper limb, their nutrient foramina are directed obliquely towards the elbow joint. That's what we see. So there's a simple mnemonic that goes this way: "To the elbow, I go. To the elbow." Now, this guy, that is for what you call the upper limb, okay? So we are moving towards the elbow joint. Now, what do I mean by this? What I mean is that, for instance, if I take, now, that's the elbow. Thus, the humerus. Now, we are going, the upper limb bones, okay? We are going towards the elbow joint. So there's an oblique, okay? So it will be going this way, obliquely downwards in the case of the humerus, towards the elbow joint. Now, however, for the radius and the ulna, they will take an oblique course rather towards what we call the elbow joint. That is what we are going to see, okay? So if I'm having the radius, the radius, so the nutrient foramen, okay, will be oriented downwards, this obliquely towards the elbow joint. Now, for the radius, as well as of course, the ulna, what we will see, okay, is that rather they will be going towards the elbow joint. So it means that now the elbow joint will be here, so the nutrient foramen will be directed upwards towards the elbow joint. That is what we see, okay? Good.
Now, in the case of the lower limb, that is not what we see. Now, in the case of the lower limb, by way of the tibia, what will happen is that they also related to a joint. So that's the knee joint. So the knee joint, they are rather moving away from the knee joint. So from the lower limb, okay, that mnemonic goes this way: "From the knee, I flee. From the knee, I flee." And that is for bones of the lower limb, the long bones of the lower limb, okay? So that is another useful point you should be aware of. Okay? So what it means is that in the case of the tibia, of the femur, okay, this is the area of the knee joint. Now, we are feeling, we are moving away. So it means that the nutrient foramen will be directed obliquely upwards, away from this, I mean, knee joint over here. Now, in the case of the fibula, yes, the same way. This time around, does that the distal portion of the, this is the distal portion of the fibula, that's unfortunately it's over here. Now, it is also related to what we call the knee joint. Although it's a non-weight-bearing portion, that I mean, contribute to knee going from it, it is important in its stability over there. So what we are saying is that because there's the medial, we are clean, we are moving away from the knee joint, it means that the nutrient foramen in the case of the tibia, yes, so the knee joint to be here, the proximal aspect of the tibia, means that the nutrient foramen will be moving away from it, so it will be obliquely oriented downwards. Now, if you take a very close look at this guy over here, you will see there's this foramen over here. If you take a closer look, it's not going upwards, it's flowing away from this knee joint. Therefore, it's obliquely directed downwards. It means that I mean, the nutrient artery will also be obliquely downwards in this manner. So these are the nutrient foramina that I want you to be aware of.
Now, once I'm aware of the nutrient foramen, then I'm also aware of the direction of what we call the growing end of the bone. But I'll probably tell you about that one again. If I look at the clavicle, the collarbone. Now, the last time to do that is a special long bone because all other long bones, they are vertically oriented in the body. This is the only long bone which is horizontally, you know, placed in the body. Horizontally placed. So this is the clavicle. Now, the clavicle, rather, the direction of its nutrient foramen is directed towards the lateral end of the bone, towards the lateral end of the bone, obliquely. It means that towards the medial end of the bone will be the growing end. So whenever you have, you know, the direction of the nutrient foramen going, then the opposite end becomes the growing end of the bone, okay? So that was one useful term that I want you to be aware of.
Now, you've seen that. Let me just sketch out something and then show you something briefly. Now, assuming I have this to be a long bone. So take it that there's a long bone. Now, once there is a long bone, okay, what we will see is that at a point, what do you see? We will see a foramen in the diaphysis. Or we call this foramen, okay? This is what we are calling nutrient foramen. Nutrient foramen. Okay? Now, look at it. What are the directions? It is obliquely directed. It's going downwards. Now, what it means is that the nutrient artery will also be running downwards in this manner. But what we will see is that it means that now I'm supposed to have epiphyseal plates. Now, you see that what will happen is that this one fuses early. Okay? So this one, okay, because this, okay, you're trying to actually die at the time because and I'm having to epiphyseal plates, one of them will fuse earlier. One of them will fuse earlier. Now, whenever the epiphyseal plate fuses, the name becomes what? Epiphyseal line. The last time I explained that. So that's why I'm at this point here is epiphyseal line. Epiphyseal line. And whenever you talk about epiphyseal line, it means that there has been something called synostosis. Synostosis has taken place, you know, synostosis. In other words, initially it was hyaline cartilage, which, you know, of it already, that this is the epiphyseal plate. Epiphyseal plate, which I told you that is the same as growth plate, the same as physis, and this is made of hyaline cartilage, not a sports fiesta, the last time. Now, he said that initially we were having two ends of the bone, but one fuses earlier than the other, okay? That is what we see. And this fusion, we call it now, over here, this one has fused. Why? Because so growth is going to take place. So for us to predict which one fused earlier, the knowledge of this, the direction of the nutrient artery becomes important because now I know that there's the growing end of the bone. Now, the activities in those, the cartilage cells over here, will help you what we call elongation of these bones. Elongation of these bones. And that elongation of these bones, the growth of that bone, increasing in length, is something that is worth mentioning. It's one of the ways in which bones grow, and they grow in length. We call it interstitial growth of the bone. Interstitial growth, okay? That is what we see. So it has taken place where in these epiphyses. And once the growth has reached at mass, okay, yes, these, I mean, chondroblasts, all these, they become exhausted, and they bone, yes, everything will become one like this. One becomes an epiphyseal line. So whenever the fusion of an epiphysis, we get an epiphyseal line, okay? That is what we see. And that is because it has become bone, okay? So that is one thing you should be aware of.
Now, once you've seen the direction of the nutrient foramen, then I know the growing end of the bone. It means that this bone will be growing in this manner. The opposite direction opens it to the direction of this nutrient foramen. This one is going downwards, okay? So that is, I mean, what do we see? Now, the last time to also told you that yes, I mean, it's not only cartilage that we have, but yeah, we have cartilage plates also lining the articular areas where they are going to make joints. And these are what you call, I mean, because they are making joints, that becomes articular. Articular. Last time I told you that, I mean, whenever we are making joints, it's also called articulation, or actresses to articular cartilage over here. So that is one thing I want you to understand, okay? So regarding the direction of these kind of nutrient, I mean, foramina, and therefore the nutrient artery. So we want to look at, if you've seen those nutrient foramina, importantly, I want to explain something regarding the blood supply, arterial supply to the bone, and bring an important clinical scenario in here. Why we tend to see osteomyelitis, inflammation of the bone, caused by a bacterial infection, okay? Happening more in children than in adults. So we want to explain that basis over here.
So the topic, the next one I'm going to look at is the arterial blood supply. We don't want to see that arterial supply to the bone. So blood supply to the bone, that's what we want to look at. Now, for that reason, draw this diagram exactly the way I'm going to draw it for you. Draw it exactly the same way I'm going to draw it, okay? So okay, so that's the diagram that we have now. Okay, just throw it exactly, you know, the same way.
Now, you are aware that, of course, I'm having the epiphyses. These are the proximal epiphyses, those are the distal epiphyses. Then, of course, I will have what we call the intermediate, that's the shaft. Now, the last time, before I told you that these areas which which column the what you call it, metaphysis, okay? They are what we call the epiphyseal ends of the diaphysis. The epiphyseal ends of the diaphysis. This is what we are going to see now. First, just draw this. Let's have the nutrient foramen in the nutrient foramen is over here, okay? Which is directed obliquely downwards. It means that the growing end of the bone is here. Now, that is the reason why, okay, this one is okay, but that's why I still have it exactly the one, you know, over here is the epiphyseal, okay? You get to understand that. So it means that the growing end of the bone is the epiphyseal end. So it will be increasing in length in this manner, interstitial growth. Now, once you've done that, there will be an artery, okay, which will be entering this bone, okay? So that's the artery, okay? Because it's running through the nutrient foramen, then of course, we will call it nutrient artery. Nutrient artery. Very important. And one thing I want you to write there, right now, yes, is to indicate that this nutrient artery supplies. Now, it is going in here, into the medullary cavity. Supplies the medullary cavity, number one. Then it's also supplies what we call the inner two-thirds portion of the cortical bone of the diaphysis. So put those two points on. Yes, the supply in the medullary cavity, and again, it will be supplying what we call the inner two-thirds portion of the cortical bone of the diaphysis, okay? That is good. That's the nutrient artery.
Now, immediately this nutrient artery enters the bone, what happens is that it will divide into two, okay, to give two branches. Well, last time I told you that artists who have branches, they will divide, giving us branches. So we have branches of arteries. So this artery, the branches that we are talking about is that one is moving upwards from it. Therefore, this one becomes the ascending branch. Ascending branch of the nutrient artery. Ascending branch of the nutrient artery. Then, I mean, but the one which is going down becomes, of course, the descending branch. Descending branch of the nutrient artery. Of this nutrient artery, okay? So that is what we see.
Now, what happens is that, yes, the epiphyses, okay, it's also going to get blood supply from neighboring, you know, vessels. It will give us some branches to it. So these epiphyses too, there will be some branches, okay, coming in from either side. So what do you think that we call epiphyseal arteries? So these arteries will be called epiphyseal arteries, okay? So that's what we see.
Now, once you've seen these epiphyseal arteries, then the next to the last, even this area, what is the metaphysis, okay? We also be receiving some branches, okay, from neighboring vessels. You just want to give us some branches, some branches, okay? So that is what we see over here. So it means that these arteries will be called metaphyseal arteries. Metaphyseal arteries, okay? Good.
Now, what do we see over here? Now, I'll have the same epiphysis from here. Metaphyseal. Yes, I also have one in here, in here. So this one should be called metaphyseal, metaphyseal arteries, okay? So that is, I mean, what we find over here. Of course, I've told you that this guy is what we call the epiphyseal plate, okay? Because that's the growing end of the bone. The epiphyseal plate is a solid that's in children. Okay? Maintaining this week. In adults, you have been a similar term, just like this one, okay? But that's what we see. I also told you.
Now, in the second video of Orientation to Anatomy, or in the chat video, I explained to you something on anastomosis. Now, I told you whenever we have structures around, okay, like that, okay, they can communicate through anastomosis. They form that connection. If they are veins, they will do so. They are arteries, they usually, okay? So the same way, now, because these arteries, they anastomose, what I want you to be aware of is that the anastomosis is going to be between this kind of metaphyseal arteries, uh, what do you call it, these nutrient arteries, with what we call the epiphyseal arteries. Very important. So now, observe here, because of that, these epiphyseal arteries, yes, they are coming down, okay? They want to form that kind of an anastomotic connection, okay? So they come down. The metaphyseal arteries, yes, I've seen it, which will form their anastomotic connection, okay? Should be able to form this kind of anastomotic connection over here. That is normal case scenario, okay? In case there's no growth plate in there, the epiphyseal plate in there, okay? Then anastomosis goes on correctly, no problem. In children, where we still have epiphyses, yes, I just like what do we find out that, yes, this, I mean, epiphyseal arteries, these arteries try to come down, okay, to come and anastomose with the metaphysis. It's unable to meet them over there, okay? Because there's a growth plate in here already. If you have already told you that cartilages are avascular, okay? Importantly, so you have this growth plate in there, and it means that, I mean, there's no, I mean, way that blood flows here. Now, from here, okay, this one, yes, it wants to anastomose with it, but it fails to meet it. Therefore, it makes a sharp bend, and I just want to try is to meet, but it's only going to meet it. So it also makes a sharp bend. So they are unable to communicate with these epiphyseal arteries up there, okay? And therefore, they form something more happy bends. Happy bends. Now, so this is distance before the happy bends. Happy bends before these happy bends. Why? Because of favor of anastomosis will be epiphyseal, you know, arteries. Now, where are where are the happy bends produced? They are produced at the level of the metaphysis, okay? The epiphyseal ends of the diaphysis. That is where we have these happy bends, you know, formed over there.
Now, you might have heard of, you know, sometimes you may have bacterial infection, okay? Say that it will be so overwhelmed, they will get into your bloodstream and form something for septicemia, okay? Overperforming, you know, bacterial infection, affecting your blood services. Now, sometimes we say that septicemia is synonymous with sepsis, yes. In the world, we tend to use them interchangeably, but there's a term line, okay? Infection, okay? Invasion in your bloodstream, that is called septicemia. And it's anemia has to do their blood. But this time around, what we are saying is that your immune system also responds, and it may respond excessively. Exaggerated immune response to septicemia will be toxic to your own body, and that's what we call sepsis, okay? Bye-bye. Like we can use them to change them anyway. So what we are saying is that what will happen is that, yes, it's in the blood. So what about blood can go? These arteries are taking blood to the bone. So it means that blood will be running through them, and this blood has been infected with a lot of bacteria. So what is going to happen? What is going to happen is that, yes, because now they can come out, these arteries, some of them can come up because they are not forming this kind of anastomosis. It means that these arteries, value of these metaphyseal arteries, these, I mean, this in this case, they are celebrating making this kind of happy bends, they become what we call end arteries, okay? I mean, structurally, because they are not able to anastomose, structurally end arteries in this case, okay? So those bacteria sometimes they may come out, and this bacteria, they may get lodged, okay, in these happy bends areas, okay? They may get lodged in these happy bends areas. So in this week, okay, and whatever we have such, the bacteria will be eroded in the bone, and that is what we call osteomyelitis. Osteomyelitis, that is inflammation of these bones we are talking about. Osteomyelitis, okay? So that is, I mean, one thing you should be aware of. What's your my life? And so that explains the reason why osteomyelitis is more common in children and where they're going to take this in their metaphyses, okay? So that is one thing you should be aware of.
Now, the next, now, having seen this, the next thing we have to understand is that last time I told you, you're not done with the blood supply. Those cartilages, how will it receive its nourishment? Now, it's going to be through diffusion, okay? From here, from these metaphyseal arteries into the bone, okay? From these epiphyseal arteries into the bone, into this cartilage, okay? All these, they will keep that nourishment to this, I may have epiphyseal plates, okay? That is what is going to happen. But there's one more thing that we told you the last time, that this bone, okay, that fuses over here, will be having this density recognition from outside. And I told you that that guy was the periosteum, around the bone. Periosteum. Against the vascular tissue. But even that one, I want to tell you that that one will be differentiated into two. Be differentiated into two. I'll tell you that one. Now, this growth, which we need that cartilage, we told you that one is called interstitial growth, okay? For this one, wanted before I even talk about that one, just want to have some arteries, okay, in there. Several arteries in there. And because this is through what you call the periosteum, that means that these arteries will be called periosteal arteries. Periosteal arteries. Now, this periosteal arteries are worth mentioning. Why? Because what you are going to do is that we say that the inner two-thirds portion of the cortical bone will be supplied by our water's nutrient. Now, the outer one-third portion, the supply will be received, you know, from what we call this kind of periosteal arteries. Yes. Now, also importantly, whenever someone gets, okay, okay, at your point, then what is happening is that the healing of the bone mainly depends on the nourishment coming from the periosteal arteries. Yes. For that same reason, if someone gets bumping, the pain fibers, okay, in here, they detect the pain. In their periosteum, they detect the pain, okay? That is very important.
Now, there's one more thing that I want you to, you know, tell you over here, that even the periosteum is having two layers. Periosteum is having two layers. So assuming the periosteum, okay, if I want to see the layers, then we are saying that this periosteum is finally, it is having two layers, okay? Now, the first layer, which is the one which is very close, cellular, and one thing that we find is that those cells, we have some mesenchymal cells which have permitted themselves, okay, to becoming bone cells. So we call that osteoprogenitor or osteogenic cells. That's what we see. It means that the one outside, really, the outer, full of organization. So you call it outer fibrous layer, okay? The fibrous layer. Outer fibrous layer of the periosteum. Now, the inner cellular, because they'll be committed to making the bone cell by way of the osteoblasts, we're going through that one, secreting this extracellular matrix, okay? It means that that one will help deposit ossification towards the size of the bone. So that when we're young, your bone's diameter was smaller, but as you grew, they became larger and larger, okay? In terms of diameter. So for increase in diameter of the bone, you need the activity of, you know, these osteogenic cells, okay? In that kind of inner layer, okay? Increasing the diameter of the bone. That one, we call it appositional growth. So it means that others, appositional, okay? So that is one useful thing you should be aware of, okay? So that is the blood supply to, of course, this bone that we've looked at, okay?
So we quickly look around at them, which is very important. Okay? We want to talk about types of epiphyses. Types of epiphyses. We've learned about these epiphyses. Might have types which we have to differentiate the types of epiphyses. So the topic is types of epiphyses. Types of epiphyses. I should put that point now. I remember that the plural of epiphysis makes it epiphyses. Types of epiphyses.
One thing I want you to be aware of is that we have four types of epiphyses. Four types. Just only four types that we'll be looking at. Now, the first type that we have, okay, is known as pressure epiphysis. Pressure epiphysis. Pressure epiphysis. Now, for pressure epiphysis, one thing that you should be aware of is that there are those ones which form joints with neighboring bones, okay? Now, it means that whenever you are one form joints, okay, we said that your ends of these bones will be covered by what we call hyaline cartilage. Anything which forms joints, we use the word articular for it, because I've told you articulation is joint. So it means that this type of epiphyses, one of them, because they are going to form joints, they will bear weight, number one. They will bear weight, okay? And they are going to be articular. They are going to form joints. And because they are going to form joints, they will be covered by what we call hyaline cartilage. So we are talking about they will bear weight, usually they will bear weight, okay? They will be articular, means that you form joints, and because they will form joints with hyaline cartilage, that's articular cartilage. So that's the important thing that I want you to be aware of.
Now, what are some of these examples? If I take, for instance, the humerus, then this rounded portion that we have, okay, through the humerus, it's able to, you know, articulate with this glenoid cavity. So they tend to be covered with hyaline cartilage and bear weight. So this head of the humerus is an example. So put this point down. One, head of the humerus, okay? Now, when you look at the distal end over here, we have what we call condyles. We have elbow joints over here. These areas, they articulate with hyaline cartilage by way of the lateral modified condyle of the humerus being capitulum, the medial one being trochlea. The articular end, and therefore they become what we call, I mean, pressure epiphyses. Pressure epiphyses. Yeah. If I look at the head of the radius, pressure epiphysis. Distal end, pressure epiphysis. Okay? Now, if I look at the femur, pressure epiphysis. The condyles of the femur, pressure epiphysis, okay? By way of the, I mean, lateral condyle of the femur, medial condyle of the femur, pressure epiphysis, okay? That is what we see. The articular. The same way, if I look at the tibia, the tibia, these areas, the condyles of the tibia, they are going to form pressure epiphyses. Examples like these ones, okay? So these are the ones I want you to be aware of, okay? The same way, if I look at, for instance, the, I mean, if there's the coronoid process or the condylar, these are the condylar processes of what mandible, for instance, okay? Fitting in the mandibular fossa, okay? In what you call the, okay, this one is going to bear weight, it won't be articulate, it will be covered by what we call hyaline cartilage, okay? So it means that it becomes an example of pressure epiphysis, okay? So that's one thing you should be aware of, okay?
So once you have seen pressure epiphysis, then there's a second type of epiphysis which is very close to where the pressure epiphysis is, but that one is not weight-bearing. Rather, tendons of muscles were attached on these areas by the tendons of these muscles, okay? So what one key thing is that they are more articular. They will not form joints. They rather provide surfaces for these muscles' tendons or muscles to attach or ligament attachment. And those ones that will be the number two. The number two is what we call traction epiphysis. Traction has to do with pull, so they will develop an attraction, okay? So it means that they are normally buried. They are not articular. They are not covered by hyaline cartilage, but the key to is that they are very close to these pressure epiphyses. What are these examples? You've been talking about one of them. Now, we've seen this, this guy over here, does the head of the humerus, pressure epiphysis. But I'm having these epicondyles. These what you call two tubercles. So I have one greater tubercle of the humerus, lesser tubercle of the humerus, pressure epiphysis. Muscles, tendons of muscles were attached there. I have what you call the, what you call medial epicondyle, I have lateral epicondyle. These are pressure, so traction epiphyses, okay? That is what we see. Now, I have these ones towards the femur. I have greater trochanter of the femur, lesser trochanter of the femur, I have what you call, I mean, medial epicondyle, I have lateral epicondyle. These become what they call traction epiphyses. Traction epiphysis, okay? For instance, these are the medial malleolus over here. Very close to them, I have, you know, tibial tuberosity. Traction, you know, epiphysis. Develop an attraction, okay? These are some examples that you should be aware of. Foreign attraction, okay? That's one thing I want you to be aware of. So whenever we give you the scenario, look at it and then you tell us, you know, what it's going to be.
Now, number three, with the third type of epiphysis that we have is known as atavistic epiphysis. Atavistic epiphysis. Now, I'm sure you learned some biology and came across the word atavism. Now, there are some structures we find them in human beings to be underdeveloped, but in other primates, in other quadruplets, they are well developed. That is why human beings, we see them to be, I mean, tied to enlargeable, so to speak. So that in the other quadruplets, there are separate bones on their own. So that becomes an example of what we call traction epiphysis, sorry, atavistic epiphysis. So what are these examples? The typical example that I want to show you is this one. Now, that's the scapula. They should have did. I have the superior border over here, presented an indentation, and then from there, we see this process coming out, which is shaped like the peak of a hook. The beak of a hook. The beak of a hook. Now, this guy we find over here, in other quadruplets, there are separate bones on its own. We call it coracoid bone. But this one is part of this main bone. So we call the coracoid process. So the coracoid process becomes an example of what we call atavistic epiphysis of what you call the scapula. Atavistic epiphysis.
Now, if you look at this guy, I mean, I'm looking at the middle ear. In the middle ear, we have three bones in each of the ears, okay? We call them ossicles of the ear. And those ones, you know, we have the malleus, incus, stapes. Hammer, anvil, stirrup, okay? These are the things we have. But one thing we will see is that now this one, we don't have the, I mean, malleus or hammer is not here. So I'm having rather the incus or the anvil over here, and then I have what we call the stapes, okay? Having a recess over here. So now, what we see is that if you look at the stapes, okay, represents. Now, this, I mean, longer process of the stapes over here, presents the process over here, which I'm running my finger on, we call it lenticular process of incus. Lenticular process of incus. In other animals, there are separate bones on their own, but in those human beings, it is tied to what we call the, I mean, the incus. Something that other anatomists believe that it should be separate, but it should be the fourth ossicle of the ear. That lenticular process of incus, it is an example of atavistic epiphysis.
Now, not only that, even the talus, the tarsal bones are the ankle region, okay? The talus and the calcaneus. The best and process, okay, which you call it posterior tubercle of talus, and that posterior tubercle sometimes we call it os trigonum, or trigonum, okay? So these are examples of what we call the atavistic epiphysis. That have been, we've discussed.
Now, the fourth type of epiphysis, which you should be aware of, we call it aberrant epiphysis. Aberrant epiphysis. Now, the name is aberrant. So if you are calling it aberrant, then what does it mean? It is not supposed to be there, but it finds itself there. Are those where you find the other parent ossification. Classically, the last time when I was teaching you the types of bones, we came across one bone type which morphologically appears long, but we told you that yes, that is no longer, rather call it miniature long bone. And the reason was that all the result was this long bone in several respects, having a shaft, having two ends, so to speak, but I told you that instead of saying that we are having two epiphyses, no, one of them is functional, the other is non-functional. And what we mean by that in the diaphysis. So let me demonstrate that one to you. In the diaphysis, especially something to be called primary ossification center, which is common in all these, I mean, long bones, by way of the metacarpals, by way of the metatarsals, by way of the phalanges, they are there. But the only thing is that there will be only and only one secondary center of ossification. Where is normally present, it will either be present at the head region or to be present at the proximal base. We are going to see that. So that if you are supposed to be present at the head and it goes to the base, then that epiphysis, which are the base, becomes aberrant, abnormal. One is not supposed to be present. Okay? So let's look at that. Now, assuming I have this, let me just sketch out something for you. So those are generally these miniature long bones appear. That's how they appear. Now, these miniature long bones, what we see is that they present with a proximal portion and this proximal portion, unfortunately, call it base. This is the base aspect. Then at a distal portion, they have with the head. Then at the middle portion, okay, which I want to indicate something over here, in the middle portion, we call it shaft, intermediate shaft, or body. Now, remember, you have to understand this, that in the level of the shaft, I'm trying to do something here, that is where the bone is going to develop. In the shaft, we have primary ossification center in the diaphysis. So in the shaft, normally you want to see what? One primary center of ossification, which is normal, normally present for whichever miniature long bone we are talking about. What we see is that now, does the base? Now, doesn't come. And then for the first metacarpal, the second metacarpal, third, fourth, and of course, fifth. So we come from where the term is. Okay? Now, take this first metacarpal out. The remaining metacarpals, that is one, sorry, two, three, four, and five. As well as when you come here, these are what you call metatarsals. Metatarsals. Those metatarsals, one, we come from where the metatarsals, two, three, four, and five. Now, this time also, take the first metatarsal out. So we have two, three, four, and five. Just like the metacarpals, two, three, four, and five. One thing I want you to be aware of is that there's another center of ossification. So that one, the center of ossification is with the head. Now, I get to know that is in case of volleyball. So the point over here is that in the head, that is for, there's one secondary center, and therefore this becomes the functional epiphysis of the bone. There's only one epiphysis, okay? That is for normal. So let me know where normal, normal epiphysis for who? So I told you this time we say what? Metacarpal, metacarpal, or metatarsal is that true? All the way to five. To all the way to five. So that is, I mean, one thing you should be aware of, two, all the way to five. That's the normal case you want to see, okay? Over there.
But what if something happens? Rather, the same two, three, four, and five, rather, if you go and find the metatarsal center, didn't happen in the head and it came to the base, or any of the epiphyses of them. If it happened this way, then what is going to happen is that that's why there's one secondary ossification center here. It should have epiphysis or it can be happening at both ends. Then the one happening in the base over here becomes an abnormal one, okay? That becomes an abnormal, okay? In this case, you say aberrant epiphysis for who? We are talking about metacarpal, metacarpal, or metatarsal, you see, through all they need to fight. Aberrant epiphysis. The first, in the case of the first metacarpal, in the case of the first metatarsal, and in the case of the phalanges, okay? Of either the hand, okay? So in this case, then what we are going to see is that we are talking about whether is the proximal, distal, intermediate, whichever. The same way.
For that of the tools, as well, the flange is over there. They will still have one primary center qualification in their offices. No problem, they will have it in there. No problem. Is that okay? That is over the ones friends is normal by the case of the epithesis. The normal one is actually yes, in the proximal base. So thus, okay, I'm having one secondary center of education over here. Okay. And this time, what are you talking about? We are talking about that it is normal. So that black is for normal. Normal for who? For metacarpal or metatarsal one? Very importantness. [Music] Normal key scenario. Okay. However, if it doesn't happen over here and then it comes down here, or it can be happy again, happy, not the same point, then what is happening is that yes, I'm gonna have one secondary center of auspension in the head, but this time it's abnormal. So you see, it's unbalance. Okay. Apparent every faces for women. This time, now we are talking about meta cap or one or meta tassel one. And who? And of course, the far line is okay. So please understand this. Okay. For us, so these are the types of emphasis that we have. Okay. That is all that you need to be aware of. So [Music] the next thing that I'm going to look at, okay, is look at some bits of this board histology that we have. I'm just introducing you to that one. Then we'll do, I mean, the major part of it in our next meeting and we delve into ossification of these bulls we're talking about. Okay. So that is what you are going to do. So now you want to do a big orientation, a quick, you know, introduction bits to bone tissue. Bone tissue.
Bone tissue. Another way that is synonymous to it, which you should be aware of, is osteous tissue. Osteous bone tissue or osteous tissue. Yes, that is what we see. Now keep an eye on this guy. What's your station? Now remember that whenever we talk about the bone tissue, the name is a tissue, but precisely what basic shoe does it fall under? There are four basic tissues. You have epithelial tissue, apparently, if you have muscles, you have no tissue. Now this guy, which is the bone, is an example of connective tissue. But it's not just connective tissue, it's a special type of connective tissue for the reason that it has happened. It's something we call extracellular matrix to be mineralized. Okay. So it becomes hard. That's why bones are hard. Okay. It's not like the other common connective shoes that we have. It's special. Yes. Now because the tissue, then it means that we are made up of similar cells, so to speak. So you have to also understand these cells of the bone tissue. Now remember those connective tissue, in addition to cells, the cells will make another product, and that product, because they are found outside the cell, they form something called extracellular matrix of the bone. So I'm going to have the living components by way of the cells, and I will have what you call, I mean, the products that the cells will make. So just for now, I want to introduce you a bit to it so that we can really delve in our in our future. Okay. So that's what we are going to do.
Now if I'm having this bone tissue, what are you saying? What we are saying is that this bone tissue will be having cells. I will see if I can do it the cells today, and then we can, we also have those products made by the cells, and that is called extracellular matrix. That's extracellular matrix. Extra cellular matrix. Now I want to spend my energy over here called the cells. I need to get time and then explain it better for you. So let's first do this one. Now if you look at the extracellular matrix, the matrix we are having, okay, we have what we call the inorganic component and the organic component. Inorganic and organic. Now when you are the senior high school, you learned about this organic and inorganic. Yes, we are applying them here. So inorganic component, that is what we call the mineral component. So I have what you call the inorganic component of the bone extracellular matrix, then I also have the organic components of the bone. Okay. Now this inorganic component of the bone, one thing is that our tea Canada component, I'll take another term which is also inorganic. So let me just put it over here like this, and my friends, that guy is water. You know, water is inorganic. So let me bring it this way. Now it is wet separating it from the inorganic components because the water proportion is very important. Okay. That way we get to know those inorganic components. We also call it mineral component. Mineral. Mineral components. Now keep an eye on this guy, which is the mineral component. Now this mineral component is very important because it consists of about 40 percent of what you call the extracellular matrix of the bone. About 40 percent of the extracellular matrix is the mineral component. Okay. Importantly, you have to understand that. Now before I will lay the mineral components, I need the organic component to be laid. Without the mineral organic components, the mineral component cannot be laid over there. The mineral component is needed in the hardness of the bone. By the mineral, cause your phosphorus, what have you, they'll be there. Okay. So if you are not having this mineral component, okay, that is something you need a condition we call it osteomalacia. So deficiency of this, I mean, on inorganic component, what is the mineral component, to lead to something called osteomalacia. Now those of you, if you, I mean, you remember at a senior high school, we learned about rickets. The rickets, you know, is caused by deficiency of vitamin D, but I'm talking about the active vitamin D, calcitriol. If you don't have it, why? Because when you don't have it, then when you eat the calcium in the diet, okay, it will go to waste. You will not be mercifully able to absorb them. And this calcium is part of the mineral component, which is needed in the bone. Okay. It means that in your development, you have such a case, you saw from multiple rickets, that's the bow leg that you are talking about. In the case of the adults, we don't call it rickets, we call it osteomalacia. When osteo has to remove, and malaysia has to do with softening, you are not having the mineral, I mean, matrix. So how can your bone be hard? And therefore, they will bend regardless, especially the weight that is exerted on it. So that is what we see. Okay. Osteomalacia.
Now this mineral matrix that we are talking about, mineral component, I want you to know the name. Yes, it may be giving you an exam, you have to be aware of this one. We call it hydroxyapatite. Hydroxyapatite. Hydroxyapatite formula, which we have, is this. Okay. Hydroxyapatite. Now some people called calcium hydrogen phosphate. Now if you remember molecular formula, you know empirical formula. So I can get a broken formula, CA five PO four, then three. They know each. Okay. That would be the empirical form in this case. Okay. Now remember, in the fraction of metals, you hear something like magnetite, hematite, and what have you. This one is the ore. The minerals in the bone. So in the bone can harvest this kind of minerals, that is hydroxyapatite in there. Okay. So that is one thing. Now the water is important. The water, yes, contributes about 25 percent. Okay. Matrix. Important. Then this organic component, one thing I want you to be aware of is that now water is important for metabolic activity. You know, the cells are going to be there. Okay. All those kind of movement, yes, making, I mean, the bone, okay, be able to perform all its metabolic, you know, processes needs water media for all these things. Now the organic components, one condition their way, okay, and that's we have two main components. We have one called collagenous components, and then you have the non-collagenous, non-collagenous parts. Okay. So please understand this one. Collagenous and non-collagenous components of the organic parts. Remember that collagen is the most abundant protein that we have in the human body. The most abundant protein. So that's quality we are talking about. Precisely, it is collagen type one. Collagen type one that is very important. Now keep an eye over here that collagen, then you have other proteins which are non-collagenous. So your organic components can also be called the protein components. So that if you have seen that they organize a 40 percent, water is 26 is 25, together about 65 percent, so it means that this one will be protein, I mean, contribution about 35 percent. Two of us, the bone extracellular matrix. Okay. That is what we see over here. Now this organic program, which I'm saying protein, keep an eye on the P, the protein. Okay. Now the non-collagenous components, the main ones I want you to be aware will be these three things I want you to be, I mean, aware of. Now we have what you call. Now whenever we talk about extracellular matrix, we are talking about fibers, and the fibers knows what you're talking about. And also have something called ground substance, which will be classified later. Okay. By the inorganic components. So the ground substance, the glycoproteins, proteoglycans, there are certain things in there. They are those ones I want you to be aware of. This one we have already called osteonexin and yes, maybe right osteopontin. Okay. These are parts of what you call the non-collagenous components of the extracellular matrix of the bone. Okay. So that is, I mean, one thing that you should be aware of.
Now I told you that this, keep an eye on it, especially those components. So what it means is that without what assuming you have a condition which is not implementing you to make this collagen fibers or these bridges are not there, then what will happen is that you suffer rather from osteoporosis. Now studies have shown, okay, that yes, I mean, your bone become very light. I mean, because you are having osteoporosis, then it means what? It means that you are not getting organic components. Means you cannot also lay enough inorganic because we need this one so that we can lay the inorganic components. Okay. That's what we see. So it means that now one thing is that, you know, especially in postmenopausal women, they tend to suffer from this kind of osteoporosis because the most functional estrogen, which is estradiol, okay, after menopause becomes very limited. Cannot produce it. Although it may be producing estrone or estrogen, okay, by what we call the adrenal cortex, the zona glomerulosa over there, you may be doing that, but that one will not really help you out so much. Okay. Sometimes estrogen therapy to help them with some of these things. So if you have any old woman out there, osteoporosis, they don't take care, they may get a fractured bone which may take very long time to heal. So that's what I have for you today. The next time we see the cells for another convention. That's cells. You want of them will be osteoprogenitors, which have committed themselves to making the bone matrix. They will talk about osteoblasts, talk about osteocytes and mature bone. The blast won't make the extracellular matrix. Then we're also going to talk about what we call the, I mean, osteocytes, the mature bone, which will maintain the matrix. Then you have some kind of cell which will be coming from the bone marrow, monoblastic level of peripheral blood will be monocyte, okay, able to fuse activities so that they can resolve the bone. Now as you are there, there's bone formation and bone resorption, that bone breakdown taking place in you at the moment as you stand now. Yes, that is what is happening. So be explained all those concepts. Now introduce you to the two kinds of, you know, I mean, bone tissue by when you're off the spongy bone and the compact bone. Okay. I believe you are going to make a date with me and then from there we look at multiplication by way of intramembranous ossification and endochondral ossification. If you look at the systematic mechanism, okay, involved in all these things. I'm very grateful for your time this evening. Have a good night all of you and may the good Lord richly bless you. Amen.