DOCSLIB.ORG

The Periosteum Part 1: Anatomy, Histology and Molecular Biology

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Periosteum Part 1: Anatomy, Histology and Molecular Biology Injury, Int. J. Care Injured (2007) 38, 1115—1130 www.elsevier.com/locate/injury REVIEW The periosteum Part 1: Anatomy, histology and molecular biology Goran Augustin *, Anko Antabak, Slavko Davila Clinical Hospital Center Zagreb, Kisˇpatic´eva 12, 10000 Zagreb, Croatia Accepted 21 May 2007 KEYWORDS Summary The periosteum is a thin layer of connective tissue that covers the outer Periosteum; surface of a bone in all places except at joints (which are protected by articular Fibrous layer; cartilage). As opposed to bone itself, it has nociceptive nerve endings, making it very Cambium layer; sensitive to manipulation. It also provides nourishment in the form of blood supply to Sharpey’s fibres; the bone. The periosteum is connected to the bone by strong collagenous fibres called Periosteal circulation; Sharpey’s fibres, which extend to the outer circumferential and interstitial lamellae Bone formation; of bone. The periosteum consists of an outer ‘‘fibrous layer’’ and inner ‘‘cambium Bone resorption; layer’’. The fibrous layer contains fibroblasts while the cambium layer contains Perichondrial progenitor cells which develop into osteoblasts that are responsible for increasing ossification groove bone width. After a bone fracture the progenitor cells develop into osteoblasts and chondroblasts which are essential to the healing process. This review discusses the anatomy, histology and molecular biology of the periosteum in detail. # 2007 Elsevier Ltd. All rights reserved. Contents Historical aspects . 1116 Anatomical considerations . 1116 Microscopic features . 1116 Periosteal circulation . 1120 Intrinsic periosteal system . 1121 Periosteocortical (cortical capillary) anastomoses . 1122 Musculoperiosteal system . 1122 Nutritive periosteal system (fascioperiosteal system) . 1122 Periosteal bone formation during growth . 1123 Periosteal bone formation in adulthood . 1124 Periosteal bone resorption. 1125 The perichondrial ossification groove . 1126 * Corresponding author. Tel.: +385 915252372. E-mail addresses: [email protected] (G. Augustin), [email protected] (A. Antabak), [email protected] (S. Davila). 0020–1383/$ — see front matter # 2007 Elsevier Ltd. All rights reserved. doi:10.1016/j.injury.2007.05.017 1116 G. Augustin et al. Extrinsic mechanical effects of the periosteum on the growth plate . 1126 Conflict of interest statement . 1127 References. 1127 Historical aspects chanical features: bone fractures without the dis- ruption of the periosteum (subperiosteal fractures) Since the time of Duhamel and John Hunter it has or intact periosteum on the concave side of the 59 been the belief of anatomists and surgeons that the fracture (greenstick fracture). With growth, the periosteum is osteogenic. In 1757 Duhamel and periosteum becomes thinner and loses elasticity and 91 Monceau reflected the periosteum from the bone firmness. It is especially compliant on tensile and fitted around it a silver ring, over which the forces and tearing which results in the disruption periosteum was sewed. After a period of several of the periosteum in the level of bone fracture in months the ring was completely covered with bone adults. The periosteum is highly vascularised and and from this observation they concluded that the innervated and contains large amounts of lymphatic 53 periosteum secreted bone.35 In the mid 1800s, vessels. It contains different types of nerves: sen- Dupuytren proposed that the cartilage of fracture sory and vasomotor nerves. These vasomotor nerves callus originated from periosteum and bone mar- regulate vessel tone by regulation of precapillary row.36 In 1867 Ollier proved that the deep cellular or sphincters and capillary blood flow. Pain fibres with osteogenic layer of a free periosteal graft is able to nociceptors are highly expressed which explains the 74 produce bone. This view was not disputed until in intense pain that follow periosteal injuries. 1912 when Sir W. Macewan published his work The Growth of Bone in which he described many experi- ments which seemed to demonstrate that the peri- Microscopic features osteum cannot be considered osteogenic, and that it must be viewed merely as a limiting membrane of Generally, periosteum is composed of an outer much the same nature as the sheath of a muscle or fibrous and inner cellular layers and does not the capsule of one of the viscera. This observation of supply epithelial cells, though periosteum has a periosteum as merely a limiting membrane was the potential to produce collagen.25 The structure confirmed by the Gallie and Robertson in 1914.44 of the periosteum in terms of ultrastructure and Then Lacroix in 1945 demonstrated the osteogenic functional organisation was not definitively under- capability of mature periosteum.65 stood until recently. The original division into two anatomical layers was made by Tonna in 1965, and only in 1986 Tang and Chai clearly delineated Anatomical considerations osteogenic cells of the cambium from fibroblasts (fibrous layer).124,128 The periosteum is specialised fibrous tissue in a form of fibro-vascular membrane. This well vascularised fibrous sheath, covers the external surface of most bones and is absent from articular surfaces, tendon insertions, or sesamoid bone surfaces.60 The peri- osteum and bones are bound together by collagen fibres called Sharpey’s fibres that penetrate into bone. The direction of collagen fibres is determined by tension forces (Fig. 1). These fibres penetrate entire cortex at the sites exposed to the high tension forces and the results are tight junctions of tendons and bones.136 In the region of the diaphyses of long bones the periosteum is thicker (2—3 mm) and easily separated from the underlying bone. It is strongly fused with bones in the metaphyseal and epiphyseal region where it is thinner. The main feature of children’s bone is to grow, Figure 1 Cortex (K), periosteum (P) and muscle (M). wrapped with elastic, firm periosteum. This explains Collagen fibres (Sharpey’s fibres, blue arrows) penetrate why childrens’ fractures have some specific biome- from periosteum to bone matrix. The periosteum 1117 Figure 2 The periosteum of sheep tibia. (a) Magnification 250Â and (b) magnification 25Â. Photomicrograph of normal periosteum attaching to bone. Periosteum consists of two clearly divided layers: osteogenic, cambium (K) and fibrous (F) layer. Periosteal surface (P) adjacent to the cortex. Microscopically (Fig. 2), the periosteum consists of analysis of periosteal morphology of the dog with an outer, fibrous, firm layer (collagen and reticular light and electron microscopy. fibres) and an inner, proliferative layer (cambium) Zone I consists mainly of osteoblasts arranged in which lies adjacent to bone and contains osteoblast the layer adjacent to the bone surface in a form of and osteoprogenitor cells (Fig. 3). Cambium is cap- simple epithelium and a supraosteoblast layer of able of: (a) forming normal lamellar bone apposition smaller,compact cells.6 Adjacent to primary (imma- on cortical bone that grows in width and (b) forming ture) bone, during intense synthesis of extracellular primary, woven bone after a fracture.54,103,124,129 matrix, osteoblasts are cuboidal, arranged as stra- The outer fibrous layer provides elasticity and flex- tified epithelium, with basophilic cytoplasm with ibility, whereas the inner cambium is the osteogenic high levels of alkaline phosphatase (Fig. 4).38 With layer and contains three or four cell layers, including the decrease of activity, osteoblasts elongate osteoblasts and preosteoblastic cells.24,27,119 and basophilic characteristics of the cytoplasm The first division of the periosteum into three decrease. The layer over the osteoblasts consists layers was made by Squier et al.119 in 1990 with the of small, spindle cells with scarce endoplasmic reti- Figure 3 Periosteal covering of the human femoral midshaft. Note the abundance of cells (arrowheads) near the periosteal surface comprising the cambium layer stained with Masson trichrome. Magnification 400Â, bar = 25 mm. From Ref. [3]. 1118 G. Augustin et al. Figure 4 Periosteum of the sheep tibia. Zone I: basophilic osteoprogenitor cells (red arrows) of germinative layer in transition to Zone II (blue line). Zone II: transparent zone with capillaries (yellow arrows) consists of extracellular matrix and fibroblasts. Magnification 25Â, bar = 15 mm. Hemalaun-eosin. Imunohistochemical staining with CD 31 and CD 34 (von Willenbrand factor). culum that are similar to fibroblasts. These are tially surround capillaries. Pericytes are found in the osteogenic progenitor cells which differentiate into microvasculature of connective tissue, nervous tis- osteoblasts. Fibrous tissue consists mainly of col- sue, muscle tissue and the lungs.115 These cells have lagen and small amount of elastic fibres.125 Fibro- the ability to contract and hence may regulate blood blasts are scarce and blood vessels are almost flow in the microvasculature.23 Pericytes may also completely lacking.114 This is the thinnest part of function as resting stem cells and differentiate into the periosteum (also called germinative layer). smooth muscle cells.81 They may also play a regu- Zone II is a relatively transparent zone with latory role in controlling capillary proliferation dur- capillaries and amorphous extracellular matrix mak- ing wound healing,31 and support capillaries in ing the most voluminous part (Figs. 5 and 6). The maintaining structural rigidity of the micro-vessel fibroblasts constitute most of the cellular compo- wall.29 Pericytes are cells in physical contact
Load more

Recommended publications
  • Autologous Matrix-Induced Chondrogenesis and Generational Development of Autologous Chondrocyte Implantation
    Autologous Matrix-Induced Chondrogenesis and Generational Development of Autologous Chondrocyte Implantation Hajo Thermann, MD, PhD,* Christoph Becher, MD,† Francesca Vannini, MD, PhD,‡ and Sandro Giannini, MD‡ The treatment of osteochondral defects of the talus is still controversial. Matrix-guided treatment options for covering of the defect with a scaffold have gained increasing popularity. Cellular-based autologous chondrocyte implantation (ACI) has undergone a generational development overcoming the surgical drawbacks related to the use of the periosteal flap over time. As ACI is associated with high costs and limited in availability, autologous matrix-induced chondrogenesis, a single-step procedure combining microfracturing of the subchondral bone to release bone marrow mesenchymal stem cells in combination with the coverage of an acellular matrix, has gained increasing popularity. The purposes of this report are to present the arthroscopic approach of the matrix-guided autologous matrix-induced chondrogenesis technique and generational development of ACI in the treatment of chondral and osteochon- dral defects of the talus. Oper Tech Orthop 24:210-215 C 2014 Elsevier Inc. All rights reserved. KEYWORDS cartilage, defect, ankle, talus, AMIC, ACI Introduction Cartilage repair may be obtained by cartilage replacement: (OATS, mosaicplasty) or with techniques aimed to generate a hondral and osteochondral lesions are defects of the newly formed cartilage such as microfracture or autologous Ccartilaginous surface and underlying subchondral bone of chondrocyte implantation (ACI).9-17 the talar dome. These defects are often caused by a single or Arthroscopic debridement and bone marrow stimulation multiple traumatic events, mostly inversion or eversion ankle using the microfracture technique has proven to be an 1,2 sprains in young, active patients.
    [Show full text]
  • GLOSSARY of MEDICAL and ANATOMICAL TERMS
    GLOSSARY of MEDICAL and ANATOMICAL TERMS Abbreviations: • A. Arabic • abb. = abbreviation • c. circa = about • F. French • adj. adjective • G. Greek • Ge. German • cf. compare • L. Latin • dim. = diminutive • OF. Old French • ( ) plural form in brackets A-band abb. of anisotropic band G. anisos = unequal + tropos = turning; meaning having not equal properties in every direction; transverse bands in living skeletal muscle which rotate the plane of polarised light, cf. I-band. Abbé, Ernst. 1840-1905. German physicist; mathematical analysis of optics as a basis for constructing better microscopes; devised oil immersion lens; Abbé condenser. absorption L. absorbere = to suck up. acervulus L. = sand, gritty; brain sand (cf. psammoma body). acetylcholine an ester of choline found in many tissue, synapses & neuromuscular junctions, where it is a neural transmitter. acetylcholinesterase enzyme at motor end-plate responsible for rapid destruction of acetylcholine, a neurotransmitter. acidophilic adj. L. acidus = sour + G. philein = to love; affinity for an acidic dye, such as eosin staining cytoplasmic proteins. acinus (-i) L. = a juicy berry, a grape; applied to small, rounded terminal secretory units of compound exocrine glands that have a small lumen (adj. acinar). acrosome G. akron = extremity + soma = body; head of spermatozoon. actin polymer protein filament found in the intracellular cytoskeleton, particularly in the thin (I-) bands of striated muscle. adenohypophysis G. ade = an acorn + hypophyses = an undergrowth; anterior lobe of hypophysis (cf. pituitary). adenoid G. " + -oeides = in form of; in the form of a gland, glandular; the pharyngeal tonsil. adipocyte L. adeps = fat (of an animal) + G. kytos = a container; cells responsible for storage and metabolism of lipids, found in white fat and brown fat.
    [Show full text]
  • Nomina Histologica Veterinaria, First Edition
    NOMINA HISTOLOGICA VETERINARIA Submitted by the International Committee on Veterinary Histological Nomenclature (ICVHN) to the World Association of Veterinary Anatomists Published on the website of the World Association of Veterinary Anatomists www.wava-amav.org 2017 CONTENTS Introduction i Principles of term construction in N.H.V. iii Cytologia – Cytology 1 Textus epithelialis – Epithelial tissue 10 Textus connectivus – Connective tissue 13 Sanguis et Lympha – Blood and Lymph 17 Textus muscularis – Muscle tissue 19 Textus nervosus – Nerve tissue 20 Splanchnologia – Viscera 23 Systema digestorium – Digestive system 24 Systema respiratorium – Respiratory system 32 Systema urinarium – Urinary system 35 Organa genitalia masculina – Male genital system 38 Organa genitalia feminina – Female genital system 42 Systema endocrinum – Endocrine system 45 Systema cardiovasculare et lymphaticum [Angiologia] – Cardiovascular and lymphatic system 47 Systema nervosum – Nervous system 52 Receptores sensorii et Organa sensuum – Sensory receptors and Sense organs 58 Integumentum – Integument 64 INTRODUCTION The preparations leading to the publication of the present first edition of the Nomina Histologica Veterinaria has a long history spanning more than 50 years. Under the auspices of the World Association of Veterinary Anatomists (W.A.V.A.), the International Committee on Veterinary Anatomical Nomenclature (I.C.V.A.N.) appointed in Giessen, 1965, a Subcommittee on Histology and Embryology which started a working relation with the Subcommittee on Histology of the former International Anatomical Nomenclature Committee. In Mexico City, 1971, this Subcommittee presented a document entitled Nomina Histologica Veterinaria: A Working Draft as a basis for the continued work of the newly-appointed Subcommittee on Histological Nomenclature. This resulted in the editing of the Nomina Histologica Veterinaria: A Working Draft II (Toulouse, 1974), followed by preparations for publication of a Nomina Histologica Veterinaria.
    [Show full text]
  • Bone Cartilage Dense Fibrous CT (Tendons & Nonelastic Ligaments) Dense Elastic CT (Elastic Ligaments)
    Chapter 6 Content Review Questions 1-8 1. The skeletal system consists of what connective tissues? Bone Cartilage Dense fibrous CT (tendons & nonelastic ligaments) Dense elastic CT (elastic ligaments) List the functions of these tissues. Bone: supports the body, protects internal organs, provides levers on which muscles act, store minerals, and produce blood cells. Cartilage provides a model for bone formation and growth, provides a smooth cushion between adjacent bones, and provides firm, flexible support. Tendons attach muscles to bones and ligaments attach bone to bone. 2. Name the major types of fibers and molecules found in the extracellular matrix of the skeletal system. Collagen Proteoglycans Hydroxyapatite Water Minerals How do they contribute to the functions of tendons, ligaments, cartilage and bones? The collagen fibers of tendons and ligaments make these structures very tough, like ropes or cables. Collagen makes cartilage tough, whereas the water-filled proteoglycans make it smooth and resistant. As a result, cartilage is relatively rigid, but springs back to its original shape if it is bent or slightly compressed, and it is an excellent shock absorber. The extracellular matrix of bone contains collagen and minerals, including calcium and phosphate. Collagen is a tough, ropelike protein, which lends flexible strength to the bone. The mineral component gives the bone compression (weight-bearing) strength. Most of the mineral in the bone is in the form of hydroxyapatite. 3. Define the terms diaphysis, epiphysis, epiphyseal plate, medullary cavity, articular cartilage, periosteum, and endosteum. Diaphysis – the central shaft of a long bone. Epiphysis – the ends of a long bone. Epiphyseal plate – the site of growth in bone length, found between each epiphysis and diaphysis of a long bone and composed of cartilage.
    [Show full text]
  • The Female Pelvic Floor Fascia Anatomy: a Systematic Search and Review
    life Systematic Review The Female Pelvic Floor Fascia Anatomy: A Systematic Search and Review Mélanie Roch 1 , Nathaly Gaudreault 1, Marie-Pierre Cyr 1, Gabriel Venne 2, Nathalie J. Bureau 3 and Mélanie Morin 1,* 1 Research Center of the Centre Hospitalier Universitaire de Sherbrooke, Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; [email protected] (M.R.); [email protected] (N.G.); [email protected] (M.-P.C.) 2 Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3A 0C7, Canada; [email protected] 3 Centre Hospitalier de l’Université de Montréal, Department of Radiology, Radio-Oncology, Nuclear Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada; [email protected] * Correspondence: [email protected] Abstract: The female pelvis is a complex anatomical region comprising the pelvic organs, muscles, neurovascular supplies, and fasciae. The anatomy of the pelvic floor and its fascial components are currently poorly described and misunderstood. This systematic search and review aimed to explore and summarize the current state of knowledge on the fascial anatomy of the pelvic floor in women. Methods: A systematic search was performed using Medline and Scopus databases. A synthesis of the findings with a critical appraisal was subsequently carried out. The risk of bias was assessed with the Anatomical Quality Assurance Tool. Results: A total of 39 articles, involving 1192 women, were included in the review. Although the perineal membrane, tendinous arch of pelvic fascia, pubourethral ligaments, rectovaginal fascia, and perineal body were the most frequently described structures, uncertainties were Citation: Roch, M.; Gaudreault, N.; identified in micro- and macro-anatomy.
    [Show full text]
  • Kumka's Response to Stecco's Fascial Nomenclature Editorial
    Journal of Bodywork & Movement Therapies (2014) 18, 591e598 Available online at www.sciencedirect.com ScienceDirect journal homepage: www.elsevier.com/jbmt FASCIA SCIENCE AND CLINICAL APPLICATIONS: RESPONSE Kumka’s response to Stecco’s fascial nomenclature editorial Myroslava Kumka, MD, PhD* Canadian Memorial Chiropractic College, Department of Anatomy, 6100 Leslie Street, Toronto, ON M2H 3J1, Canada Received 12 May 2014; received in revised form 13 May 2014; accepted 26 June 2014 Why are there so many discussions? response to the direction of various strains and stimuli. (De Zordo et al., 2009) Embedded with a range of mechanore- The clinical importance of fasciae (involvement in patho- ceptors and free nerve endings, it appears fascia has a role in logical conditions, manipulation, treatment) makes the proprioception, muscle tonicity, and pain generation. fascial system a subject of investigation using techniques (Schleip et al., 2005) Pathology and injury of fascia could ranging from direct imaging and dissections to in vitro potentially lead to modification of the entire efficiency of cellular modeling and mathematical algorithms (Chaudhry the locomotor system (van der Wal and Pubmed Exact, 2009). et al., 2008; Langevin et al., 2007). Despite being a topic of growing interest worldwide, This tissue is important for all manual therapists as a controversies still exist regarding the official definition, pain generator and potentially treatable entity through soft terminology, classification and clinical significance of fascia tissue and joint manipulative techniques. (Day et al., 2009) (Langevin et al., 2009; Mirkin, 2008). It is also reportedly treated with therapeutic modalities Lack of consistent terminology has a negative effect on such as therapeutic ultrasound, microcurrent, low level international communication within and outside many laser, acupuncture, and extracorporeal shockwave therapy.
    [Show full text]
  • Patell O Medical Term
    Patell O Medical Term Delightful and shadowing Brooks respect, but Aube sigmoidally remainders her nankeen. Valedictory Rene nuts some correcting after connectible Micah sliced intransitively. Correctional Richy never summersault so thievishly or hulls any nannies interchangeably. See intracardiac electrophysiological is called a smoothing action to move from the medical term many nurses have a list of a sonogram definitely showed far vision is Medical Language University of Phoenix. Medical Terminology YouScience. Medical Terminology Simplified 4th Edition Gylys Masters Test. Patello-femoral Pain Syndrome OnePointHealth. In medical terminology roots usually indicate a piece part cardio dento pulmono. Definition of PE definition of RO definition of patello difference between WR and. Algeso algesia excessive sensitivity to pain alveolo alveolus. What does in robe in medical terms? QuickStudy Medical Terminology Basics. The term and the right tube in the glans penis is located on. Meaning of Medical Term Medical Term myoso inflammation of muscle 1 cranio surgical repair her skull 2 patello excision of patella 3 teno suture of tendon. Medical Terminology Quiz By melissa91 Sporcle. What the the medical term SARC o mean? Presentation on theme Medical Terminology Get Connected. The term is. Word parts ortho osteo parieto patello pedo petro phalango physo. -ous pertaining to pancreato pancreas para- near camp around patello. What treatment of terms related to proceed with england with greek term for below are called _______________________, or more roots for partial or prone to and contempt. Talo-patello-scaphoid osteolysis is an extremely rare form is primary osteolysis see no term described in two. Medical word analyze the jury terms contract the letter Example.
    [Show full text]
  • Autologous Chondrocyte Implantation
    ARTIGO DE REVISÃO Transplante Autólogo DE Condrócitos AUTOLOGOUS CHONDROCYTE IMPLANTATION RONALD BISPO BARRETO, JOSÉ RICARDO PÉCORA, RICCARDO GOMES GOBBI, MÁRCIA UCHÔA DE REZENDE, GILBERTO LUIS CAMANHO RESUMO ABSTRACT: Esta revisão da literatura descreve o processo do transplante autólogo This literature review article describes the autologous chondrocyte de condrócitos em todas as suas etapas, indicações clínicas, técni- implantation (ACI) process – its stages, clinical indications, sur- ca operatória, técnica laboratorial, reabilitação e resultados clínicos. gical technique, laboratory protocol, rehabilitation and clinical Desde 1994, quando a técnica de ACI foi descrita pela primeira vez, outcomes. Since 1994, when the ACI was described for the first este procedimento foi aprimorado e tornou-se uma das mais impor- time, the procedure has improved to become one of the most tantes alternativas cirúrgicas para o tratamento das lesões condrais important surgical alternatives for the treatment of chondral lesions do joelho. Nivel de Evidência II, Prospectivo Comparativo. of the knee. Descritores: Traumatismos do Joelho. Condrócitos. Transplante Keywords: Knee trauma. Chondrocytes. Autologous transplant. autólogo. Humanos. Cultura celular. Humans. Cell culture. Citação: Barreto RB, Pécora JR, Gobbi RG, Rezende MU, Camanho GL. Transplante Citation: Barreto RB, Pécora JR, Gobbi RG, Rezende MU, Camanho GL. Autologous autólogo de condrócito. Acta Ortop Bras. [online]. 2011;19(4)X219-25. Disponível em chondrocyte implantation. Acta Ortop Bras.
    [Show full text]
  • Aandp1ch07lecture.Pdf
    Chapter 07 Lecture Outline See separate PowerPoint slides for all figures and tables pre- inserted into PowerPoint without notes. Copyright © McGraw-Hill Education. Permission required for reproduction or display. 1 Introduction • In this chapter we will cover: – Bone tissue composition – How bone functions, develops, and grows – How bone metabolism is regulated and some of its disorders 7-2 Introduction • Bones and teeth are the most durable remains of a once-living body • Living skeleton is made of dynamic tissues, full of cells, permeated with nerves and blood vessels • Continually remodels itself and interacts with other organ systems of the body • Osteology is the study of bone 7-3 Tissues and Organs of the Skeletal System • Expected Learning Outcomes – Name the tissues and organs that compose the skeletal system. – State several functions of the skeletal system. – Distinguish between bones as a tissue and as an organ. – Describe the four types of bones classified by shape. – Describe the general features of a long bone and a flat bone. 7-4 Tissues and Organs of the Skeletal System • Skeletal system—composed of bones, cartilages, and ligaments – Cartilage—forerunner of most bones • Covers many joint surfaces of mature bone – Ligaments—hold bones together at joints – Tendons—attach muscle to bone 7-5 Functions of the Skeleton • Support—limb bones and vertebrae support body; jaw bones support teeth; some bones support viscera • Protection—of brain, spinal cord, heart, lungs, and more • Movement—limb movements, breathing, and other
    [Show full text]
  • Structure and Function of Periosteum with Special Reference to Its Clinical Application Review Article Hany K
    Structure and Function of Periosteum with Special Reference to its Clinical Application Review Article Hany K. K. Mostafa Faculty of Medicine, Ain Shams University – Fakeeh College of Medical sciences FCMS. ABSTRACT This review summarizes the structure of periosteum in relation to clinical applications.. It shows the structure of periosteum as outer fibrous and inner osteogenic layers. Bone lining cells were used recently to describe inactive osteoblasts. The review also discussed the role of periostin protein, its higher concentration in periosteum than bone. Periostin is high early in fracture while decrease after stoppage of cellular differentiation so figure out the stem cell as the main source of periostin. Also in this review the structure of bone niche was described as formed of cellular part and non cellular part. Stem cell niche is very important to regulate stem cell division and direct differentiation to bone growth or bone healing and regeneration of damaged bone. This review also reported the blood supply of periosteum. Blood supply from periosteum is divided into four vascular systems. It sheds a light on morphology of osteoblasts and mechanism of mineralization. osteoblast has specific receptors in the cell membrane and contains a magic structure called matrix vesicle which plays the key role in bone mineralization. Moreover, the review discusses the role of periosteum in bone remodeling. Periosteal bone formation is described in different ages: fetal, childhood and adulthood. It also reported on osteoblastic activation of osteoclasts and its role in bone structure. The review explained the new term of bone remodeling unit which is formed of cutting cone and closing cone so confirm the importance of exercise for healthy bone formation.
    [Show full text]
  • Musculoskeletal System
    4 Musculoskeletal System Learning Objectives Upon completion of this chapter, you will be able to • Identify and define the combining forms, prefixes, and suffixes introduced in this chapter. • Correctly spell and pronounce medical terms and major anatomical structures relating to the musculoskeletal system. • Locate and describe the major organs of the musculoskeletal system and their functions. • Correctly place bones in either the axial or the appendicular skeleton. • List and describe the components of a long bone. • Identify bony projections and depressions. • Identify the parts of a synovial joint. • Describe the characteristics of the three types of muscle tissue. • Use movement terminology correctly. • Identify and define musculoskeletal system anatomical terms. • Identify and define selected musculoskeletal system pathology terms. • Identify and define selected musculoskeletal system diagnostic procedures. • Identify and define selected musculoskeletal system therapeutic procedures. • Identify and define selected medications relating to the musculoskeletal system. • Define selected abbreviations associated with the musculoskeletal system. 83 M04_FREM0254_06_SE_C04.indd 83 18/12/14 10:12 pm Section I: Skeletal System at a Glance Function The skeletal system consists of 206 bones that make up the internal framework of the body, called the skeleton. The skeleton supports the body, protects internal organs, serves as a point of attachment for skeletal muscles for body movement, produces blood cells, and stores minerals. Organs Here
    [Show full text]
  • A Randomized Controlled Trial Demonstrating Sustained Benefit of Autologous Matrix-Induced Chondrogenesis Over Microfracture at Five Years
    International Orthopaedics (SICOT) DOI 10.1007/s00264-016-3391-0 ORIGINAL PAPER A randomized controlled trial demonstrating sustained benefit of Autologous Matrix-Induced Chondrogenesis over microfracture at five years Martin Volz1 & Jens Schaumburger 2 & Hubert Frick1 & Joachim Grifka2 & Sven Anders 2 Received: 9 August 2016 /Accepted: 26 December 2016 # The Author(s) 2017. This article is published with open access at Springerlink.com Abstract Introduction Purpose Autologous Matrix-Induced Chondrogenesis (AMIC®) utilizing a type I/III collagen membrane was com- Cartilage has a low intrinsic regenerative and reparative capac- pared with microfracture (MFx) alone in focal cartilage le- ity, and cartilage defects can potentially lead to severe osteoar- sions of the knee at one, two and five years. thritis in the long term. A variety of surgical techniques that aim Methods Forty-seven patients (aged 37 ± 10 years, mean de- to resurface and repair the damaged articular cartilage include fect size 3.6 ± 1.6 cm2) were randomized and treated either perforation of the subchondral bone, mosaicplasty, and autolo- with MFx, with sutured or glued AMIC® in a prospective gous chondrocyte transplantation. Marrow stimulation multicentre clinical trial. methods, such as microfracturing (MFx), involve penetration Results After improvement for the first two years in all sub- of the subchondral bone plate to access the bone marrow com- groups, a progressive and significant score degradation was partment. The resulting blood clot enriched with bone marrow observed in the MFx group, while all functional parameters elements is thought to provide a favourable microenvironment remained stable for least five years in the AMIC® groups.
    [Show full text]