(A Project of National Medical Centre Karachi)

2/14/2019 1
 Describe the physical agents responsible for soft tissue
trauma.
 Differentiate among the three types of soft tissue injuries.
 Compare muscle strains and ligamentous sprains
 Describe the healing process of soft tissue injuries
 Differentiate open from closed fractures
 List the signs and symptoms of a fracture
 Explain the measures used in treatment of fractures
 Describe the fracture healing process
 Differentiate the early complications of fractures from
 later complications of fracture healing
 Composed of axial (skull, thorax, vertebral column)
and appendicular (upper and lower extremities)
skeletons.
 Ligaments: connect bones to bones
 Tendons: connect muscles to bones
 Connective tissue (bone and cartilage) are made up
of:
◦ Living cells
◦ Non-living intracellular protein fibers
◦ Shapeless ground substance
 Intracellular fibers:
◦ Collagen: inelastic, fibrous, high tensile strength, white
◦ Elastic fibers: contain elastin -able to repeatedly stretch then
return to normal shape and length. Ligaments contain a lot
of elastic fibers
 Firm but flexible connective tissue
 Weight bearing capacity exceeded only by bone
 Embryonic skeleton is mostly cartilage then replaced
by bone
 Chondrocytes are cartilage cells
 Does not contain blood vessels or nerves
 65-80% water weight in a gel matrix
 Allows diffusion of gases, nutrients and wastes

Important - takes a very long time to heal because

there is no blood supply. Gets nutrients through
the gel matrix instead
 Elastic cartilage: contains some elastin(ear)

 Hyaline cartilage: pure cartilage, white (fetal skeleton,

joint surfaces, costochondral junctions)
◦ Most surfaces are covered by perichondrium (fibrous
connective tissue)

 Fibrocartilage: intermediate between hyaline cartilage

and dense connective tissue (intervertebraldisks)
 Connective tissue which is strong but compressible and
light

 Intracellular matrix contains

◦ Organic matter (1/3): cells, vessels, nerves
◦ Inorganic matter (2/3): hyroxyapatite-insoluble structure of
calcium salts Mixture of Calcium salts
◦ May also take up lead and other heavy metals and the
antibiotic tetracycline in newly formed bones
As bones are forming they are more likely to take up the
heavy metals - like tetracycline, like lead, etc. that's why
kids are more susceptible to lead poisoning.
 Two types of mature bone:

 1. Cancellous (spongy): interior of bones

◦ Trabeculae Interior of long bones. have
◦ Filled with red or yellow bone marrow more cancellous material than
small bones or skull.
◦ Compressible
 2. Compact (cortical): outer shell of bones
◦ More rigid Cortical gives bones and
bodies stability.
 Classified as
◦ Long (upper & lower extremities)
◦ Short (ankle, wrist)
◦ Flat (skull, ribcage)
◦ Irregular (vertebrae, jaw)
 Red bone marrow contains red blood cells and blood
cell formation. Present in nearly all marrow in young
children, in adults it exists in vertebrae, ribs, sternum,
ilia (Pelvis).
 Yellow marrow composed of adipose
Kids have more bone marrow and produce
more cells - that's why kids are more
likely to have leukemia and bone
cancers.
LONG BONE ANATOMY

•Diaphysis: shaft
•Compact bone with
marrow in the
medullarycavity
•Epiphysis: the ends

•Metaphysis: part of the

shaft that fans out as it
approaches the epiphysis,
contains bony trabeculae
with cartilage