骨与关节骨与关节BoneandarthrosisBoneandarthrosis正常人骨全貌正常人全身共有骨207块，婴儿期270块，至青春期可增至350，包括骨骺、腕骨和跗骨。骨的解剖骨的解剖anatomyanatomy•一、骨的形态长管状骨短管状骨扁骨flat异型骨atypical二、骨组织结构二、骨组织结构(structure)(structure)组织学上骨可分为板层骨和非板层骨。一岁后全部骨均由板层骨组成。成熟的骨组织常成板层状，称骨板（bonelamella）。由纤维连接支持。骨组织结构（骨组织结构（bonestructurebonestructure））（1）板层骨（lamellabone）皮质骨由不同的骨板组成。•1）哈氏骨板:同心骨板和中央的管腔，包括血管、淋巴管和神经组成哈佛氏系统（Haersiansystem）。哈佛管之间有交通管相连接称福克曼氏管（Volkmanncanal）,并与骨皮质内外表面相通。2）骨间板（intermediatelamella）:3）内、外环骨板（2）非板层骨（wovenbone）--编织骨•Periosteum骨膜•metaphysis[mitafisisi]干骺端•Diaphysis[dai’afisis]骨干•Medullacavity骨髓腔•Marrow骨髓•Epiphysealcartilage骺软骨•Cortical（hard）bone骨密质•Spongybone骨松质•Trabeculae骨小梁•Cortex骨皮质BasicPathologicChangesBasicPathologicChangesofboneofbone•1.Osteoporosis:骨质疏松•2.Osteomalacia：骨质软化•3.Osteosclerosis骨质硬化•4.Periostealnewboneformation骨膜•5.sequestrum:死骨•6.bonedestruction骨质破坏1.Osteoporosis:Acommonmetabolicdisorderofbonecharacteredbyqualitativelynormalbutquantitativelydeficientbone.Dividedintogeneralized,regionalandlocalizedtypesandaccompaniesavarietyofdiseaseprocesses.2.OsteomalaciaAgroupofdisordersresultingfrominadequateofdelayedmineralisationofosteoidinmaturecorticalandspongybone.Characterisedbyabnormalquantitiesofosteoidcoatingthesurfacesoftrabeculaeandliningthehaversiancanalsinthecortex.UsuallyassociatedwithabnormalityofVitaminDmetabolism•Reason:DeficiencyofVitaminD;Gastrointestinalmalabsorption;Liverdisease;Drugtherapy;Renalosteo-dystrophy;Aluminiumpoisoning.VitaminDdeficiency3.OsteosclerosisAnabnormalhardeningorincreaseddensityofboneonradiographs.•Reason:hyperparathyoidism;renalosteosclerosis;osteoarthritis;sicklecellanaemia;Pager’sdisease;skeletalmetastasis;……•Osteopetrosis:---marbleboneathymic(胸腺的）defectresultingindefectiveosteoclasticandchondroclasticresorption.Theresultisgeneralisedosteosclerosiswithdense,thick,brittlebone.4.PeriostealnewboneformationNonspecificresponseoftheperiosteumtoavarietyofcauses;mayfocalordiffuse.•Reason:physiological;congenital;infective;inflammatory;traumatic;metabolic;neoplasticidiopathicType:sunburst;spiculate（针状）;onionskin……AcuteosteomyelitisSubacuteosteomyelitisSarcoma5.sequestrum:afragmentofnecroticbonethatbecomesseparatedfromhealthybone.mayoccurinvariousconditions,suchas:osteomyelitis,tuberculous,arthritis,tropicalulcerandnon-Hodgkin’sdiseaselymphoma6.BonedestructionInfectiousdiseases;tumor…BasicPathologicChangesBasicPathologicChangesofjointofjoint•1.swellingofjoint•2.destructionofjoint•3.degenerationofjoint•4.Ankylosisofjoint•5.dislocationofjointBasicPathologicChangesBasicPathologicChangesofsofttissueofsofttissue1.Softtissueswelling2.Softtissuemass3.Calcificationinsofttissue4.Gasinsofttissue5.AtrophyofmuscleOsteoarticularTraumaOsteoarticularTraumaThetypeoffractureThetypeoffracture1.GreenstickfractureAfractureoccurringintheimmatureskeleton,whichtypicallyresultsinincompletebreaksintheshaftofabone.Commonsites:Thetibia(proximalmetaphysisordiaphysis)andmiddlethirdoftheradiusorulna2.Transversefracture3.Obliquefracture4.Spiralfra...
