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00:05 Okay. What good? Okay. looks like everything's working here. Um

00:11 we're looking at up here on the is the distribution for the first exam

00:16 was a 60, a little bit than I wanted. I like a

00:19 for 65 but it's better than the . So yeah, you're like yeah

00:25 like really the spring was worth. the spring was worse. Oh uh

00:31 . Uh So you can see the grade 90 for the low grade of

00:35 22 18 grade runs 60. This actually a really interesting curve because normally

00:41 not this clean of a distribution. you get kind of some sort of

00:44 fin, it looks like a fish along. But this is actually you

00:49 kind of what you expect for a classes to have this kind of

00:54 Remember this just first exam? So just kind of shows you where everyone

00:57 of went. So you just kind think about what was a great I

01:00 and then just kind of put yourself there and you kind of get a

01:02 notice there's no A B. D. S. And stuff like

01:04 because it doesn't matter. It's just do I stand relative to the rest

01:09 the class? You're better than half class. Good if you're better worse

01:12 half the class. Do better. right. I think we care about

01:17 stupid things. Thing we care about really this now remember this is a

01:23 average. So every time after each is going to change a little bit

01:27 don't just sit there and go this is how it's going to be

01:29 the end of the semester. All . Now, what this does.

01:33 shows you what grade is after 25% the great coming in. Right?

01:38 you have your test, you have homework that you've done. This does

01:41 include extra credit. I don't do credit until the end of the

01:45 right? And we have the second of the extra credit which was supposed

01:49 close today. But I'm gonna extend because you still haven't had a chance

01:52 look at your exams, right? , there's a couple people that have

01:56 related stuff. They'll take their exams thursday. I'll open them up and

02:00 you'll have until Tuesday to do the credit next week. So, I'm

02:04 to try to fix that right after if I can not get distracted.

02:08 , anyway, coming back to All right. So, you can

02:10 now these are representing the ones that taken the exams. This includes people

02:14 have dropped but haven't told Uh You know those people they basically

02:18 you don't know. I know these they take like the whole class.

02:21 don't see any great. They're great and then like the day before the

02:25 and they drop. So they screw up. But So So that's what

02:30 are. So you can ignore those hard failing my class is always a

02:34 , I don't adjust that. So we start moving towards that 50,

02:39 50 just becomes that hard line. ? But the good news is that's

02:42 what's gonna happen. So this group people right here, they're gonna freak

02:47 and panic. And what they're gonna is we're gonna work hard and they're

02:49 go this direction and then this group here, they're gonna do better because

02:54 like, oh, I figured this . And so they'll do better people

02:57 here. They'll probably do better people here, we'll start doing better as

03:00 . And if you're not going to better than well, we've got to

03:02 a conversation. All right. what you can do with this is

03:07 panic. Who's panicking? Yeah, you. Going Douglas Adams. Um

03:15 don't panic. All right. We 75% of our grade left. Would

03:19 quit a basketball game after the first ? Yeah. All right. Now

03:30 have to have the conversation on saturday played the the midshipmen. Did you

03:37 watch that game? People like? . Yeah. All right. They

03:41 down 17-7 at the half. Did just go on the thing up?

03:47 done, yep. We're gonna keep our coach a ridiculous amount of

03:51 We're done. Know what they They scored 21 straight points embarrassed.

03:58 midshipmen, you know, their coach now in the locker room that after

04:02 game going, no, no, , no, no, we don't

04:05 this and all we did was allow to have a field goal. That's

04:12 we do stuff. We self We look, what did I do

04:17 get the grade that I got And you're not happy with your grade,

04:21 don't just keep going well, I'll keep doing the same thing because hopefully

04:24 will change because that will never Yeah. What you need to do

04:30 you need to look at that extra that I gave you. Maybe you

04:33 have looked at did the first one free points Did you answer truthfully or

04:38 you just kind of go through and because I'm not looking at your

04:40 I'm just looking to see who did , right. This is how you

04:44 assessed. Am I prepared for the ? Did I study everything that I

04:48 I should do? I feel What do I expect to do?

04:51 well do I expect to do then go take the exam in, you

04:54 your grade, you forgot the You want your like a high,

04:56 did everything I was supposed to And if you didn't get the

05:00 you want, you asked the why did I study, right?

05:06 I ignore material? I can look my exam. I can see that

05:09 can't right now, but in two you'll be able to look at your

05:13 and say did I do the things did I learn the things that I

05:16 I learned. And if the answer no. Figure out why you didn't

05:20 that? Make adjustments change fix come in the second quarter kick. But

05:27 things. I want every one of to get into the program of your

05:33 . I want everyone at the University texas. Everyone at the texas

05:36 And M. Everyone at Ut Which is actually the premier health school

05:39 texas to have to wait after a . That's unfair. That sounds

05:46 You guys want that. You roll eyes at me. I saw that

05:50 really know that's my job is to you achieve your goals. But you're

05:55 going to achieve your goals. Watching else do the work. All

05:59 I asked the other day how many want to go to nursing school?

06:02 about 70% of you raise your All right. You want to hear

06:06 heart? Yes. You don't want hardback. Okay? You do.

06:12 . The number of slots in nursing are almost equivalent to the number of

06:17 in this room. Yeah. So if you want to go to

06:24 school, you got to be better everybody else who do I want to

06:27 to nursing school? You guys, don't want the people at U.

06:31 . To go to nursing school. I've seen Longhorns there. You

06:37 my wife's naggy. We can put with her the rest of them.

06:42 right. I want you guys to the ones. All right. So

06:46 gonna have to work a little bit . You have to be a little

06:48 smarter. And because we're the underdog , no one treats us.

06:52 Right. Right. We've got to got to prove it to them.

06:56 right. So don't be daunted by . If you find yourself over

07:00 come and see me. All If you're gonna do it online,

07:04 fine. If you have to walk to my office, cover yourself in

07:07 tape to pretend like you're not going get some sort of virus. That's

07:11 as well. We will fix the and we will make you succeed.

07:15 help you succeed. How's that? sounds good. All right.

07:19 if you don't know how to calculate grade, this is how you calculate

07:22 great I'm not gonna spend a lot time on that because you can go

07:24 that up and remember here is the . Right? Some of you are

07:30 to email me and say Doctor Doctor a blackboard doesn't have my

07:33 Right. Yeah. I know. sucks. All right. The sinking

07:39 blackboard and um uh achieved doesn't always . Just make sure your chief grades

07:45 correct on achieved. That's where I your grades from. All right.

07:49 will move things over to blackboard. sure that I've moved the correct grade

07:54 the blackboard for you. Because some you have different names listed officially on

07:58 roster versus another. And it might flop. Especially some of you who

08:02 the double last names. You you have the maternal the maternal last

08:06 . Sometimes they flip those people So there's a couple of you and

08:10 try to mark them and make sure see him. But I have 400

08:13 you. So sometimes I miss one two. So double check that.

08:18 notice with this there is a curve now in a is an 88.

08:24 right. That's an a minus. ? Alright. That's probably not going

08:27 change, but you might probably go other direction. This will probably go

08:32 direction. This will probably move in direction. Alright. Historically, that's

08:36 they do. But for the first , that's not surprising. So,

08:39 see, I'm not panicking if I'm panicking. Should you panic?

08:43 When you see the captain panic, when you panic. I'm the

08:47 All right. With that in I'm going to stop before we go

08:53 . I'm going to stop before we here, are there any questions you

08:59 ask? It's okay. All Is that right? So there's two

09:08 to This is a good question there always gonna be two parts to

09:12 There's gonna be one for each Alright for exams, there's that means

09:16 a total of eight little things. first one is always gonna be before

09:20 exam. It opens at 6:00 before exam. Why 6:00? Because I

09:24 you've been studying since then and then closes right before the exam because we

09:28 do extra credit because we blew the . We do extra credit because it's

09:31 points. I'm dealing with two kids now. I am I going to

09:35 the extra credit and strangle my Children someone said here's $10 and put it

09:41 the table and said that's yours, you gotta do is walk over and

09:45 it up, would you come and it up? Yes, that's what

09:49 credit is. If you're sitting there well, you know, that's like

09:52 steps. Okay? We're gonna have have a conversation. Free money is

09:58 money. So, that's the first . Right? And it's just asking

10:00 you study? You don't have to it correctly. I recommend that you

10:06 . I don't have the correct answer only you do right? The second

10:10 is after the exam. Now. theory everyone should have take the exam

10:13 the exam day. Right? But doesn't always happen. So what happens

10:18 is presuming presuming everyone did it on exam day. As soon as I

10:22 up the exam you go and look your exam. Then you go and

10:24 the extra credit and it's open for long we need to allow you to

10:27 at your example. All right. then what you do is you self

10:32 1st 1 2.5 points, 2nd 1 points on your exam. So if

10:36 got a 70 just using that your exam is now worth 75

10:41 And you do that four times, ? That's five extra points on your

10:47 grade. Almost. Well it's not four points on your extra great.

10:50 simple math. Does that sound Because you're like oh yeah that $10

10:55 now start worth walking up to. . It's not like it's a

11:00 There's big money. You can like a pizza cheap pizza. All

11:09 That's a good question. Alright, again I will extend the time for

11:12 second part of the first extra If you miss the extra credit,

11:17 say I missed it. Can I it? I'm not going to reopen

11:20 credit. There's a point where I'm go take my money. I'm gonna

11:23 it back in my pocket. Extra credits. Extra credit. All

11:29 . Any other questions about test Anything else? Alright. If you're

11:34 about dropping the class Talk to Me . I have seen students who don't

11:42 grades. All right. I've seen dropped the B plus, you do

11:48 drop the B plus after the first . Talk to me 1st. I'll

11:52 you off the cliff. We'll pull away from the cliff. I'm paying

11:58 it's better for you to drop the , I'm not going to keep you

12:01 the class. I'm going to tell it's in your best interest to go

12:04 else. Wait another semester together. right. That's my job. I'm

12:08 to help here to help today and Tuesday. Make sure you get the

12:16 days right today, Tuesday. And following day is all about skeletons.

12:21 . When we think about anatomy, is what we think about. All

12:24 . What I told you because we that day because that horrible horrible hurricane

12:29 came through. Remember that one when got to sleep in And I didn't

12:32 that it was happening right? I'm to speed up a little bit to

12:37 able to cover the stuff in All right. In terms of what's

12:41 to be uh you know, part your great stuff in terms of top

12:46 and stuff. I'm going to make small adjustments to make your life

12:49 Like I might not count one or like that. The idea, but

12:54 have to cover the material because it's of understanding anatomy. Alright. And

12:58 good news is like one lecture is like 45 minutes. So, we

13:02 plenty of room. All right. , what we're gonna do is we're

13:05 talk about skeleton. Skeleton is an system. A larger organ system consisting

13:10 bones. Okay. That's what we about. But it's more than just

13:13 . It actually has cartilage and ligaments other connective tissues. And it allows

13:18 to move. It serves as the of the body. It's on this

13:24 that muscles pull and tug to allows . It also plays an important role

13:29 protecting many of our internal organs. right. So, the primary organ

13:36 going to be the bones. that's what we're going to talk

13:38 is bone. We're going to look structurally what bone is. And then

13:42 going to go in over the next maybe a little bit today on what

13:46 bones actually are. Which by name how to identify the All right.

13:51 , when you hear the word bone of the term odysseus tissue. All

13:55 . That's the tissue that's part of organs. All right. So,

13:58 gonna make these organs out of this material. Austria's tissue. Now,

14:04 are two types of bones. One called compact one that's called spongy.

14:09 names should already kind of give you sense what looks kind of like a

14:13 . One is very, very All right. And so you can

14:16 both of these types. So, compact is fairly dense. When you

14:20 bone this is what you're looking It's about 80% of the total bone

14:25 . It's the stuff that makes it the outside, we'll see this very

14:28 , very smooth and of course it's . All right. Now the spongy

14:34 is typically internal to the compact So if you took a bone and

14:38 it and you look at it, see, oh it looks kind of

14:40 a sponge on the inside. So very porous appearing and that's just structurally

14:46 it looks like. It's not actually . And this makes up the remaining

14:51 . All right. So you've got thick, hard, dense bone.

14:56 then you have this lighter bone that's on the inside. So on the

15:03 picture, the grand scale when you up a bone you're going to see

15:07 a couple of features that all bones on the outside of the bone.

15:11 this very, very thin layer of tissue. It's a dense irregular connective

15:17 . All right. It's not always apparent if you pick up a bone

15:21 see it, you know, like fresh bone. But if you've ever

15:24 ribs, you guys ever eaten ribs you kind of get that bike,

15:27 get that thin tissue, you bite and it just keeps coming off.

15:32 the perry Osti um All right. Osti um is simply this connective tissue

15:38 underneath on the other side of that tissue is where you're gonna find these

15:43 progenitor cells. Alright now osteopenia. you ever see the word osteo just

15:47 bone and then progenitor means making or creator of. Right. So,

15:52 are the cells are these are the stem cells and their job is to

15:56 bone And they're really what they're doing they're giving rise to the osteoblasts.

16:02 are the immature bone making cells. then the osteoclasts we're going to see

16:06 are the cells that break down So, really what you have here

16:11 you have the hard substance the Then you have a thin layer of

16:16 and then on top of that you connective tissue, kind of like a

16:19 . All right. And that's gonna on the outside. Now, also

16:22 , this is where you're going to some blood vessels. So, you

16:24 see blood vessels are anchored in That's also where nerves are gonna be

16:28 . This is where the tendons All right. This is where ligaments

16:33 . So, it's not just this kind of little coating that's been shrink

16:37 around the bone. It actually serves greater purpose than that. All

16:41 And the way that you hold on is it has these perforating fibers that

16:45 into the bone. They're actually called fiber. That's their technical name.

16:49 right. So, that's what they're to show you. So, that's

16:51 when you pull on it, you to use your teeth and you can

16:54 feel that, right? Makes that then, if you break open the

16:59 of freshmen look on the inside, going to be a covering on the

17:02 as well. That's similar to the is called the industry um indo meaning

17:07 . All right. And again, primarily layers of cells and there's not

17:13 connective tissue layer. And so, they're doing is they're creating the bone

17:17 the inside and breaking the bone on inside. All right. So,

17:21 not a really good picture of a picture, more of the same stuff

17:25 the inside. All right. we like to look at long bones

17:30 they're the easiest ones to kind of our minds around the structure of the

17:34 . All right. So, here a long bone you can see in

17:38 of its feature. It's long, , longer than it is wide.

17:43 right. So, it has some to it. The shaft portion is

17:48 the diagnosis. The end up here the end down there is called the

17:54 If Asus And then the picture is . So, you see how it

17:58 epiphanies goes up here, this region here, see that little line right

18:03 . That line right there. That right there. That area that contains

18:07 line is called the metamorphosis. All . So, the diagnosis is the

18:13 , yep. If Asus r that and then the region in between the

18:17 and, yep. If Asus is metamorphosis. Alright, so what do

18:21 have here? Well, when you're about a long bone, the outside

18:25 going to be compact and then there's to be this thin layer of

18:30 Um So the spongy bone and covered a little tiny sales. And then

18:34 the dye opposition are going to have big giant cavity that's gonna be filled

18:38 marrow of some sort. There's two types of marriage and we'll get to

18:41 a little bit later. Alright, say it right there when you're young

18:46 a child, it's gonna be red when you get older it's yellow marrow

18:50 I'm just going to think there's a 22 away, I guess maybe

18:54 So yellow marrow is more fatty. a lot of fat cells in

18:58 So, basically, I like to the older you get the fatter you

19:01 . So that's it's easy for me understand. Right, So, all

19:08 , the nabe ends. Those are epiphany sees that's plural epithets is's

19:13 Alright, So, typically on the of the epithets is's where you're gonna

19:17 cartilage and it's a smooth protective layer allows for the two bones to rub

19:23 each other and slide over each other than grinding each other down? All

19:27 , so it's articular cartilage. why is it articular? Because an

19:32 is a joint? Hence the word . So it's joint cartilage is the

19:36 that they're using here. All right look here inside the epiphany sis

19:41 You can see right there versus here you have that cavity here.

19:45 don't have a cavity. It's all bone. So still you have this

19:50 compact bone. On the outside and the inside is the spongy bone.

19:55 right. And the diagnosis spongy bone in the middle of big large

19:59 So, that's clarifying. I All right now, how you identify

20:05 metastases? Just look for the epithelial plate. Um You can see right

20:10 . And so this is going to typical in the longboat. All

20:14 Now, the other bones still have . So here, you can see

20:20 a flat bone that we're looking So, you can see here is

20:24 compact bone. There's compact bone. then on the inside you have spongy

20:28 noticed, you see a cavity no . All right. So, there

20:32 no Dionysus. There's no purpose is bone, compact bone in the middle

20:36 . Spongy bone. We have a name for the spongy bone we call

20:39 diplomacy. Alright, so no medullary diplo is what we call the spongy

20:45 , but otherwise pretty simple. bones are classified in a couple different

20:51 . It's always gonna be on This is what we're looking at so

20:54 bones. Or start we're gonna start flat bones. They have flat thin

20:58 . All right now, this is it gets kind of complicated because what

21:01 looking for here is a flat If you curve that's still a flat

21:07 like. So, right. Because like this that's flat. So for

21:12 , your ribs are flat bones. if you look at a rib you

21:15 but wait a second, that's Right? Wouldn't you think a rib

21:19 kind of long? Yeah, but again. See this is where if

21:23 really like meat, this is where go home for homework and say I'm

21:27 ribs tonight. All right. And you do is you go get a

21:30 and you eat that rib. Um then look at it from the side

21:33 you're gonna see that it has this to it. That's why it's a

21:37 . Okay. Some other examples are bones of the skull, your

21:41 which is the bone back here that for this particular articulation, It looks

21:47 of like a shovel. Hence named . The sternum, that's your breast

21:51 on the front. It's a flat . All right. So, their

21:55 flat bones because they're flat and kind big is their job is to protect

22:01 underlying surfaces. Now they're also going have very large surface areas on which

22:06 are going to change. But you think of it. They're flat,

22:08 must be protecting something like a shield protect what's underneath it. Okay,

22:16 bones are weird bones. I put on the front plate or the front

22:19 . Just because All right. So these are found within your tendons.

22:24 what they do is they increase muscle . We have lots of sesamoid bones

22:29 our bodies. Everyone has different sesamoid except for one that we all have

22:34 common, which is the patella. your kneecap. Okay, So when

22:39 think sesamoid bone, when you hear , what do you think of?

22:41 you hear that word? Sesame? like a sesame seed. That's why

22:45 he got his name? It's like little tiny. Itsy bitsy bones that

22:48 of appear in places. It's like . Some of them have actually have

22:54 . But really the big one is patella. All right now. I

22:59 on yours I have in the short . I think I had patella listed

23:04 here. And sesamoid bones just cross off. Okay, so it's not

23:07 short bone. It's kind of set . All right, long bones.

23:11 just saw those there longer than they wide. They typically have a cylindrical

23:15 and those two ends. So there's of long bones in the body.

23:21 This what we when we think of bone, this is what we think

23:23 it as the most common bone So think of your limbs,

23:28 Upper and lower limbs. Even your and your toes or long bones.

23:31 right. Even the bones in your or long bones. All right.

23:34 really the risks and the ankles that not. They're actually short bones and

23:39 short bones because they're lengthened with with roughly the same. They're not square

23:45 when I hear roughly the same, means sounds like square. But

23:49 it means that they're kind of compact they have that that shape, they're

23:53 of like, oh well you can't which side is longer. All

23:58 Lastly after we put everything into the , we're left with a bunch of

24:01 left over. We don't know what do with them. So we just

24:03 them irregular bones. They have these , really complex shapes. And so

24:08 like would be the vertebrae. There some bones of the school that fall

24:11 this, not the bones of the . Um and your hip bones are

24:15 to fall in this category. It's easy to look at the hip bones

24:18 , well, those look like flat , but they have these really,

24:21 funky shapes that go with them. , um, that's why they throw

24:24 that category. So, we categories based on change. Now bones have

24:34 . Now I'm going to just put time out here for a second.

24:38 is electric course. I'm pointing at . I'm not going to sit there

24:42 say identify these things other than some really obvious things like I'm going to

24:47 for example, a couple slides here a picture of a long bone.

24:50 , the parts of the long All right. But I'm not going

24:52 say I be able to identify these of of a bone, right?

24:59 really the best way to identify bones how hold them in your hands,

25:03 them over, taste them. I'm kidding. Seeing if you're paying

25:09 right? But to look at them them, that's how it has to

25:13 kind of experiential. Alright. And it's hard to see for example,

25:18 costal groove in a picture like All right. It's just there's a

25:22 arrow pointing and saying that's the costal and you have to take my word

25:25 it. All right. So, idea here is understanding that bones have

25:30 that allow us to identify them. , that's kind of key thing.

25:35 first type of bone marking that we to identify stuff or depressions. Depression

25:41 is a structure on a bone that another tissue or another structure to run

25:46 it. All right. So, are just examples. Facets,

25:51 phobias and grooves are examples. All . And so, for example,

25:57 the costal groove. This is where costal artery in the costal veins and

26:03 costal nerves travel. They travel right to go along the length of these

26:09 . So there's a little tiny groove these things sit in. All

26:15 Things like a facet, which we'll more of when we talk about the

26:19 bones. Things like a phobia or fossa, allow to bones to

26:24 Again, we can see the word . That doesn't mean they talk although

26:28 guess it kind of is it's two moving against each other. All

26:32 It's a joint. So it creates joints. There's openings and an opening

26:38 as a whole in the bone. there's some really obvious ones. There's

26:41 right there. You can see it's of small and really when you see

26:44 opening something has to travel through, are we traveling through? Well,

26:47 usually a nerve or blood vessel. right. So again, we here's

26:53 one of the meet us. If hear the word meet us. It's

26:57 actually me. Oddest but pronounce it like a Miata. The Lieutenant Cars

27:07 . All right. So Miatas is canal that basically allows something to pass

27:11 it? A fissure? It's kind like a whole right? And Foramen

27:19 means hole and we have a big in our brain called the Foramen

27:25 The big hole. Yeah, it's stupid, right? You can pick

27:32 bunch of really, really brilliant people cut up a cadaver and they're looking

27:35 it. What do you want to that? That's a big hole.

27:40 then it is the big hole. of course you're all speaking in

27:43 So its frame and magnus sounds much peace. The purpose of the german

27:49 noticeable. Your brain. All So, so the question is what

27:53 the purpose? Right. And so what is the point where the spinal

27:57 exits out of the cranium? And you can imagine your brains in the

28:02 and then so the spinal cord comes through that we'll get there when we

28:06 about the parts of the skull. . And if your brain wasn't supported

28:11 a whole bunch of stuff, they just lose out that hole.

28:15 Well, you know in peace. , just like brain is like

28:20 It's like soft butter. Yeah, kind of cool. Alright,

28:26 projections are things that extend outward, ? So they come in lots of

28:30 of shapes and sizes. That's where , ligaments and muscles attached to the

28:34 . Because remember bones are where you to so that you can create

28:37 So, here's an example of the . I'll This is uh kind of

28:41 up and allows articulation between the mandible the skull. A crest for

28:47 You can all feel that that's this right here. That's that higher into

28:50 hip. So, the you have that are called heads. Epic

28:55 which is next to the con dial barasa et tube recalls. These are

29:01 identify iRS for where things are are outwards or something's attached spines,

29:08 Protuberances. Trow cancers lines when you these names. Don't get frightened by

29:13 or or think, oh, this getting complicated. It's just a name

29:17 identifies the type of extension rejection that taking place. All right. Not

29:25 . Now. When you go to , you will need to know

29:29 All right. So if you're taking p lab, their likelihood is that

29:33 going to pick up a bone and gonna have you identify this type of

29:36 . Okay. And here less. Alright, it's more gonna be do

29:41 know this bone and what it does thing? And I'm again we're gonna

29:44 through remember we're just kind of laying groundwork and then we'll start diving into

29:47 specifics. Do you guys know how bones are? Thank you.

29:52 you have to know them all. huh. But it's scary,

29:56 That that sounds scary when you put number like that. It's like that's

30:00 . But think about this take your and divided in half, right.

30:05 is your left and your right half similar. So do you have to

30:08 is Yeah. So you can see the things like, okay, there's

30:12 lot of double bones, right? about fingers, right. Are they

30:17 they pretty pretty similar? Yeah. basically you got a lot of multiples

30:20 your hands and your feet. So scary to give the big number.

30:26 the truth is there's a lot less you think there are. Yes.

30:30 a better way to think. It's lot like you got to think in

30:32 of of groups and what the names these things are. All right.

30:36 , here's marrow, Right? So got red marrow. Yellow marrow,

30:40 marrow is hematopoietic. Very fancy That means makes blood cells okay,

30:45 doesn't mean yellow doesn't have a home a poetic potential. But really what

30:51 is, yellow marrow is kind of down the matter poetic activity. The

30:55 marrow is in an active state of seen blood cells. Red blood cells

31:01 white blood cells. All right in the adults, we find these

31:06 the spongy bone of long bones. do we say the spongy bone was

31:11 ? And the heads, right? epiphany sees. So those are not

31:15 really easy place to get bone And then the other place is going

31:19 be in the diplomacy of the flat . So, the flat bones

31:21 remember we said the cranium and there's ribs which are not easy to get

31:26 . And so there's a sternum and you actually have the flat ends of

31:31 hip bones, which is an irregular , but it's flat ended. So

31:34 you're thinking of bone marrow donation, have to go to some pretty hard

31:39 to get this stuff right. That's it's really amazing when people do those

31:44 because that's not a lot of fun drilling for red bone marrow hard

31:49 Children on the other hand everywhere. right. The maid gallery cavities of

31:54 long bones is filled with red red cells. Or sorry, with red

31:58 marrow. All right. So it's a hard place to go to,

32:02 know? But it's also where there's lot of activity going on. All

32:06 . And really when you're a kid a lot of activity going on everywhere

32:09 all sorts of things. So as age, red marrow becomes yellow marrow

32:16 say it replaces it changes. So can kind of see here here's red

32:22 and then deep down here you can we're starting to see that trans transition

32:25 this yellow marrow. So there's lots lots of fat cells there. So

32:30 it's out of the sites but not out of sight but you can say

32:33 example let's say your body is struggling know in terms of um producing red

32:41 cells. For whatever reason let's say drained a couple pints of blood from

32:45 and or your something along those right? You've lost red blood

32:49 So what's gonna happen is you're going ramp up the production of red blood

32:54 . And so what happens is is that yellow marrow then converts back over

32:58 red blood cell. Right? It a little bit of time. The

33:01 is long but it's an amplification. you basically replace again and revert back

33:07 in times of emergency. All So anemia is the condition. What

33:12 say when you're not producing the red cells. No, that's not

33:18 Yeah, that's the point. If was too much, they wouldn't let

33:21 out of the building. Right. makes sense. They what do they

33:24 ? They give you a cookie and glass of orange juice and send you

33:26 your way? Right. And they let you donate one pipe every 30

33:31 . That right? 45 days. . I mean, right, if

33:35 clever you can go to place to to place to place. But

33:40 Yeah, it's it's it's bad. don't want to lose that much

33:45 All right. So moving on, are four basic types of cells.

33:51 , remember how we kind of organize . We said cells make tissues tissue

33:54 make organs and so odysseus tissues. making these organs which are called

33:59 But we need to know which cells there. Okay, so there's four

34:02 types. We have the osteoclasts. genic osteo site and osteoblasts. And

34:07 can see in very general terms what do. Osteoclasts. Reabsorb estrogenic cells

34:12 stem cells. Osteoblasts make bone Osteo maintain bone. So that's a real

34:18 way to look at things. And if you if you have that.

34:20 everything else going for is pretty All right. So first we're gonna

34:26 with these osteogenesis sells the major one not. The major won. The

34:31 one is the osteoporosis senator. This the stem cell that gives rise to

34:36 cells, gives rise to the You know, it's on this,

34:40 only three slides and then we're gonna a special one for osteoclasts.

34:44 so here we are making bone. is very early on, this is

34:48 perry Osti um right here, these those differentiating cells. And what they

34:53 is they divide. So these cells dividing and what they do is when

34:57 divide some of them differentiate and become osteoblasts. And the osteoblasts job is

35:03 produce new bone. And that's what it starts secreting matrix. And that

35:09 is the bone in which it's going live. And then that is doing

35:12 . It's not secretive and necessarily in direction. It's secreted in multiple

35:17 Right? And so you can have you ever painted a room?

35:21 . Can you matt, you've heard term painted myself into a corner,

35:25 ? It's like I'm starting at the end of the room. Like,

35:27 the door over there. And so where I start painting and I moved

35:30 way away from the door and now stuck in the corner, right?

35:34 what osteo blast do is they make and it just kind of exudes from

35:42 and they get stuck in their own . All right. And then what

35:46 do is they differentiate again and they Osteo site. So the osteoblasts makes

35:52 gets stuck in it. And then it's stuck, it doesn't die.

35:56 a job is to maintain matrix, sure the matrix is doing what it

36:01 designed to do. And so you see here here's an osteo site.

36:05 been stuck in the matrix that And you can see if you look

36:08 , you can see these little tiny into these little tiny structures called

36:13 which is a fancy word for saying little tiny canal. Right? And

36:17 they're doing is they are in contact other Osteo sites and they're talking to

36:23 other and they're looking at the matrix saying, is it maintaining the structural

36:28 that we designed it to do And it is awesome. And if it's

36:33 we got to rebuild. Yes. . We'll get to that in a

36:40 slides, right? The question what is the matrix made out of

36:44 ? No, it's We will get because I want to paint the

36:48 And then let's build the cells All right. So, their job

36:53 to detect mechanical stress. All There's a rule. I don't know

36:59 I even talk about this, but just gonna say it here. There's

37:02 rule or Law called Wolff's Law. guess it be better call the law

37:06 Law. And Wolff's Law says a of the strong as it be.

37:12 right. In other words, the that you impart on a bone is

37:16 to be detected and it's going to the bone to structure itself so that

37:22 can do the work that it's designed do. That kind of makes

37:26 She's looking to go what? All . If you sit around all day

37:32 T. V. And never moved your so far, you're gonna have

37:34 bones? No. Because the job you've designed your bones to do is

37:39 support me on the couch, But if your job is to go

37:44 carry bricks all day long, are bone is going to be strong so

37:48 you can maintain that sort of Yes. All right. Now,

37:52 that mean you can overstress the No. No. So if I'm

37:57 show you right? So if my is always to carry £100 of

38:00 my bones are gonna get strong to £100 of books. But if I

38:03 and say it now, I'm gonna pick up £250 of bricks. You

38:07 , is my bone will be able maintain do that? The answer is

38:09 . You're gonna overstress it's gonna Right? But can you work it

38:14 a point where it can lift a amount of uh breaks? Right?

38:20 say 2 50 is reasonable, then answer is yes. You can work

38:24 it. But you can't just super it, right? You're gonna vote

38:28 say I'm gonna bend you. It's break. But if all you do

38:32 the time. So, I'm gonna a little bit of stress, a

38:33 bit of stress, a little bit stress, a little bit stress.

38:35 gets strong enough to to fight that gets stronger. Like that's what we're

38:40 to get at here. All So, the osteo class is a

38:47 of fig acidic cell. Alright. job is derived from a different type

38:52 progenitor. So, it doesn't come the osteoporosis. The osteoporosis,

38:55 it comes from a different group. actually a little bit bigger. And

38:59 job is to break down bone Have you what? I'm going to

39:03 down my bones. Yes. If not doing the job they need to

39:07 . I'm gonna remodel though. this is kind of a remodeling

39:11 right? I've got cells that make bone and I've got cells that break

39:16 the bone. It kind of looks this. And this is probably the

39:20 way to kind of think about how deal with the matrix. And you

39:23 pick anywhere. All right. We're start here. All right. Rather

39:26 starting over here. All right. look at these and I just see

39:30 man there's inky blinky and Clyde. right. So here we have matrix

39:39 is not doing its job Alright. not strong enough. And so,

39:43 arrived, they build up bone and structure. So now we have matrix

39:49 is designed to do what it was to do. That's called formation basically

39:53 basically take the asteroid the materials that play down with calcium. Fire it

39:59 is capable of dealing with the stress this bone is designed to do or

40:03 the mechanical stress that it's detecting. right, then off they go and

40:08 go do some other stuff or they and rest. All right. And

40:11 what happens is is that if we're needing the bone right here? In

40:15 words, the stress at this particular , isn't uh is it or the

40:21 of this location? Isn't there to the right amount of stress?

40:24 why don't we just go ahead and rid of that and we can go

40:27 that someplace else. So, and comes along and basically breaks down the

40:33 and then uh that material can then used by osteoblasts. Remodel someplace

40:38 All right. So, there's this remodeling of your bone. I like

40:42 way that this this number. If kind of think about this. Your

40:45 mass Changes roughly 5-7% every. All . That means in roughly 20 weeks

40:54 recycled all your bone mass now. that mean you completely remodel your

40:59 No. Right. But let's see let's say you decided after a year

41:05 a half of sitting at home watching meetings all week long. You said

41:09 am done with this. I want go work out now. And so

41:13 started leaving the house and you started . All right. Are you putting

41:18 stress on your legs? Right. all of a sudden now your body's

41:22 . This is this is new. don't want to break anything.

41:25 it starts remodeling the bone structure that with the stress that you're putting on

41:30 . And you start going lifting All right. It's gonna start doing

41:34 . But then you start sitting, know, you change your mind after

41:37 week because it hurts. See And so then it's like the body

41:41 making adjustments and modifications. So, always this constant modification. The larger

41:47 stays more or less constant. But micro structures where you're starting to see

41:51 change. All right. Now, bone we're gonna see here is structurally

41:57 different than spongy bone. So, rate at which it replaces much,

42:01 slower than the rate at which spongy is. But spongy bone is kind

42:04 arranged in such a way that is long stressor lines. All right.

42:08 , you're detecting where the stresses and you're building bones. So it kind

42:11 looks like a web because you're really of dealing with stress to answer your

42:18 . What's the Matrix? All The matrix is two parts. There's

42:23 organic part in an inorganic part. organic part is what's called osteo And

42:28 basically collagen and some other ground substance proto glide hands. So remember here's

42:34 . You get them put them together you get all this structure is basically

42:37 bunch of strings that have been wrapped or arrange together. All right.

42:42 so there's some cells that are going be located in there as well.

42:46 , right? And eventually they'll become site and this organic material is what

42:52 rise to the strength of bone. . It resists stretching. It doesn't

42:57 to be twisted. So basically what is, it's structurally sound but it's

43:03 particularly strong. It's very much like . What can I do with

43:07 Well, I can do a lot cartilage is pretty movable, isn't

43:11 So, what the difference is between and bone? Is this inorganic

43:15 This is calcium phosphate. Alright. called hydroxy appetite. Alright. Not

43:22 isn't hungry, but that's how it's . Alright. And what it is

43:25 these calcium phosphate crystals are embedded on surface of these fibers. And in

43:32 matrices. So what you now have this hard matrix that's even more rigid

43:38 when you began. It's not So you can see again using my

43:43 . The cartilage of my nose is . All right. If that was

43:47 , it would just sit there. could break it which would not be

43:53 but it wouldn't move until I broke . All right, cartilage, you

44:01 squeeze and water comes out. It's , but in this you no longer

44:07 compressibility. And so what this is kind of showing this is a collagen

44:12 or you get a whole bunch of put that calcium salt. And what

44:15 gonna do is you're gonna end up these structures called austrians. And so

44:20 going to see and look at this to see how this compact bone is

44:26 . And so that's what's making up matrix. It is basically a bunch

44:31 collagen with salt on it. so what we've done in this particular

44:39 is we've taken a cross section of long bone. So you can see

44:43 our long bone up here. I'm sorry, I take that.

44:48 , that's right. And so here are. Is we're just taking a

44:52 at that little a portion of that section. So this would be the

44:56 cavity out here would be the outside the bone. Here you can see

44:58 periodicity um pulled away. There is little perforating fibers. Here's the endoscopy

45:03 over here, that kind of spongy . And so we're looking solely at

45:07 compact bone of a small portion of long bone. And so what you

45:12 see here is that they have all little tiny rings that make up the

45:17 bone. These ring structures, which you look from the top look kind

45:21 like a bull's eye is called an ? All right. And you can

45:26 it's like a bunch of pencils that good took and kind of pulled together

45:30 are holding together like So if you're down down from the top and this

45:35 what they've done. This isn't a showing you. And you can see

45:39 is the rings. There's like one . There's another ring. It's kind

45:42 identified by these little dots. And the middle of that is a is

45:46 structure called the central canal which we'll to in a minute. That's not

45:50 . It's filled with other stuff. right. So, the Austrian is

45:57 structural unit. There are lots and of austrians. So don't confuse the

46:04 structure with the micro structure. What looking at. All right now,

46:09 are weight bearing pillars because they have multiple concentric rings. That means they

46:17 capable of resisting torshavn alright towards you basically twist. All right. And

46:23 you look at the fibers here and think in the next slide a little

46:26 better, you can see that the run in opposite directions. All

46:31 So look at this. The picture left, picture top left. The

46:36 , one's going this way and then next ring. The fibers are going

46:39 way and then the next ring, fibers are going this way. So

46:42 you do is you basically your cross or having crisscross. Now, I

46:47 all of you here too young to seen this. But did you guys

46:50 the movie the blind side? All . Do you remember the opening scene

46:54 the blind side? It's a football with Sandra, Bullock narrating what's going

47:00 ? And it's a football game between new york giants and the Washington Redskins

47:06 are no longer the Washington Redskins Theismann rolls out. Lt the biggest

47:13 nastiest linebacker on the planet, awesome comes in leaps at Heisman grabs him

47:23 the ankle and like linebackers roles very and twists, causing his lower leg

47:32 literally twist and snap. Now, knew what he did because he immediately

47:37 up and starts pointing at the I've broken somebody's leg, right?

47:43 a horrific And the whole thing about whole narration there is basically how the

47:47 side is very important to protect That right? There is supposed to

47:52 origin. So, when I go grab your legs go like this nothing

47:55 going to happen because I'm not lt probably could twist the truck in

48:00 Right? That's Lawrence taylor by the . All right. So that's the

48:06 of those structures Now that rotation. , if you think of that

48:10 So there's a big Austin you can there's a series of concentric rings.

48:14 concentric rings are called Lamela. So concentric Lamela's at the boundary of each

48:22 these Lamelas. So here's ring number . Ring number to ring number

48:25 Ring number one. Ring number to number three. You can see the

48:29 of each of those. That's where gonna find the osteo sites. The

48:35 are there because they were osteoblasts and built the ring on either side of

48:41 . That makes sense. And they stuck and then it became ostracized,

48:45 in their matrices. Alright, now Osteo sites are located in a little

48:52 little tiny pool or lake. That a name called the Lacuna. All

48:59 , so here is an electron You can see it three dimensionally.

49:02 here is Laguna Laguna. Laguna Laguna . I'm sorry. That was

49:08 All right. But Laguna and that's the osteo site lives. The osteo

49:12 is there monitoring each of the are out at each other, particularly each

49:17 the Lomeli on either side of Now these are concentric Lomeli. You

49:22 to understand concentric versus some other ones we're going to see here in a

49:25 . All right now, in order these Osteo sites to survive, they

49:31 to have some sort of access two or the materials that are being transported

49:35 blood and other cells. And so they have our little tiny canals called

49:42 that allow them to interconnect with each . So bone is a hard,

49:48 tissue based on collagen with salt. ? These calcium phosphate crystals with live

49:56 stuck in their matrices that are in with each other. So there's living

50:01 in contact that can actually transfer Transfer ways and monitor the surrounding environment

50:10 far. You with me. So that is a single asan.

50:18 you can see there are lots of here. Again, lots of different

50:23 . Now, if you take a of round things and put them

50:26 you're gonna have space in between. you're going to fill those up as

50:30 . All right. That would be interstitial Lomeli. All right. So

50:37 little space that you see inside there inside there and over there and so

50:40 and so forth. That's interstitial Now, how do we get

50:44 We'll bone we said is broken down rebuilt. So sometimes what you'll do

50:49 you'll break down in austin and you in Austin and it's placed and so

50:53 ever left over that would cause or as or service interstitial Emily.

50:59 if there's just a gap you're going fill that up with bones. So

51:02 would also would be another way that going to do that. All

51:06 on the outside. You can see a ring there and you can see

51:11 kind of a ring. They're not really strong one. Those are called

51:16 Lomeli. Not to be confused with concentric rings which are the concentric Lomeli

51:21 the asean. All right. So circumferential surround the entire structure. That's

51:28 to be built by the cells of Osti. Um And by the cells

51:33 the indo Austrian. All right now blood vessels are going to be located

51:41 . So, I guess if I at the previous slide, I've had

51:43 central canals. So you can see the Charlestown you have the central

51:47 That's where the blood vessels are and nerves are located. All right,

51:51 , how do they get their well the length of the bone? You're

51:54 to have uh these canals that move just as the central canals move

52:01 And those are called perforating canals. if you want to look at the

52:05 who discovered them, Volkmann canals, we'll just refer to as perforating.

52:10 ? So you have a perforating Central canal, perforating canal. Central

52:13 . And this is how you get nutrients to the cells within the austin

52:17 through the central canal. But they there via the perforating canal. Any

52:27 about the Austin and the structure? ma'am. All the bones. So

52:34 one of your bones is very much . This is a really important thing

52:37 understand. Your bones are very much . They have blood and they have

52:41 if you ever been kicked in the , you know that your legs are

52:44 much alive. Your bones are very alive. Right. Right. So

52:47 blood is penetrating through, you have these life cells, are there structurally

52:53 in these austrians monitoring the austrians to that the bone is strong enough to

52:58 what is designed to do? Kind cool. Huh? So very much

53:03 . Not dead bone is alive. . Three lamelo. All right.

53:11 the Lomeli, So depending on which you're looking at is gonna be there

53:15 gonna be osteoblasts are producing the lamelo . Right? So, if you're

53:22 the outside, remember you have osteoblasts this side of the periodicity. Um

53:27 they're making the circumferential ones, you osteoblasts here that are making up that

53:34 uh the internal right circumferential. But you're talking about an Austrian, what

53:41 doing is you're building each of those , kind of like in this

53:45 So you have osteoblasts there that build then you have other ones that are

53:48 and that's why you end up with on the outsides. So they're always

53:52 be osteoblasts. So this is a good uh demonstration here. So you

53:57 see here the curriculum, so those osteoblasts that we're laying down matrix on

54:01 sides of themselves and they just got in it. So basically you can

54:06 I'm growing this way to build the and as I'm growing, I'm I'm

54:11 those osteoblasts stuck in there now, it's not like entertaining. This is

54:16 of you're looking at a final You're not looking at initial product,

54:19 ? We're gonna talk about how bone made, which is kind of interesting

54:23 well. Okay. But did I you still have that look on your

54:29 ? Like I'm not certain. All . Let's go back and look

54:33 Okay, it's fine. If it's fine, you stopped me.

54:41 it's fine. Okay, it's Spongy bones easier. All right.

54:48 are no Austin's so see no All right. You have no um

54:55 . That's kind of the same Again, you're still kind of creating

54:58 concentric rings but it's not an actual is what is called a parallel lamelo

55:05 ? Or Lomeli. There's no blood because basically, you're opened up to

55:09 environment that has all the materials you in order to survive. In other

55:15 , the nutrients and materials that would carried in the blood are kind of

55:18 surrounding inside that matrix. These structures make up the webbing of the spongy

55:26 , it's called a trip Picula us try particularly as plural. All

55:30 So they're kind of you can think as raj or whatever and what they

55:33 is they are lying along stress So you can think of it is

55:37 building to counter some sort of And so that's why they kind of

55:43 in all these different directions. All . And so what they're doing is

55:47 say we're just looking at this. stress is coming this way, that

55:50 is being distributed along those lines. if it's too much for this thing

55:54 bear, then something else would be to ensure that the stress is being

55:58 appropriately. All right. Usually this where the engineers in the class get

56:03 excited and jittery. All right. you're not an engineer, I

56:07 All right. So, it's kind this open matrix that just kind of

56:11 in all these different directions. All . And so there's no blood

56:16 And if you look at this here's the what they would call the parallel

56:21 . Right? You can see here an osteo site. It's stuck in

56:25 . And these little lines they represent curricula and you can see that they're

56:28 of open to the outside so I gather nutrients from here, transfer to

56:32 environment which can transfer to their which transfer down to there and so on

56:36 so on. So, the cells are deep aren't being deprived. They

56:40 need a blood vessel traveling through the of the Asean because there's plenty of

56:45 that they can transfer internally via the . All right. It's just a

56:57 . So that is the basic structure bones. All right. It's a

57:03 tiny cells that create matrix that has to it that is there to oppose

57:10 . And then what you do is just you macro that stuff out and

57:12 of a sudden now you have structure . How do we get it?

57:16 process is called ossification or osteogenesis. . It's going to begin during embryo

57:22 while you're forming in the womb. . It continues on through childhood up

57:27 its adolescence. And here's the scary . I don't have it up

57:30 It continues on as you get They're part of your body that continue

57:36 . That would normally be thought. , if you're Well, we'll get

57:40 I'll talk about it. So, have the the boy process that's part

57:44 the sternum. All right. When about 20, it's still cartilaginous.

57:49 you get my age, it turns hard bone. All right.

57:53 you can actually break it and and greater harm than you could if you

57:57 younger. All right. So, are two different types of formation.

58:02 have something that's called intra member this saying anything about it. What do

58:06 what can you interpret? Think when hear it? Remembrance inside membranes.

58:11 . Right. So, there's got be some sort of membrane that's going

58:14 be there that we're going to do . And then the other one is

58:17 con droll Condra We said has a to it. Let's see if you

58:21 remember you got remote control is condo . So indo con dro. What

58:29 that now mean? Inside cartilage? right. So one there's gonna be

58:34 membrane that's not really well organized in , there's going to be something that's

58:39 that's organized that we're gonna replace. really what those two to meet.

58:44 , when you think about them, think, okay, lack of

58:49 And I'm going to create organization. There's already organization. And I'm going

58:52 use it as a as a framework which I'm gonna build bone. All

58:57 . So, your long bones and pelvis, vertebrae and clavicle all uses

59:02 mitochondrial. So, we're gonna start the intra member in us because it's

59:05 nebulous thinking. All right. And , what we have here is we

59:10 Mesen kind now, Mesen kind is just uh it's the progenitor tissue that

59:17 rise to a whole bunch of different of tissue in the body. All

59:22 . And so it's it's not formed a formal tissue yet. It's an

59:28 tissue is really what it is. right. And so that's where you

59:32 . And so, you can see it's a matrix, right? You

59:34 see there's fiberglass and other mesenchymal cells there. And what we have is

59:39 have a series of cells that have differentiation to become osteoblasts. Right?

59:44 , one day they just change and here we are. We are now

59:47 producing cells. All right. If ask me how that happens, it's

59:51 . Don't worry about it right It's part of the developmental process.

59:56 , So, they start producing Osti . Remember? They don't produce in

60:01 direction. They're producing in all So they're just basically I put it

60:05 all around me and it kind of the cells apart. Some get stuck

60:09 this poor soul right here would be in the middle and but it's still

60:13 matrices and gets stuck. And once gets stuck in that matrix, it

60:17 and becomes an osteo site. All . And so what they're doing is

60:20 these cells, in the sense, the center are gonna be monitoring the

60:24 . But you can see what am doing? I start off producing my

60:28 and I start building out that matrix it kind of lacks any sort of

60:35 to it. All right. that's step one is the formation of

60:39 uh ossification center here. We're starting lay down the calcium phosphate. So

60:45 start seeing calcification and then as it bigger and bigger where you get this

60:51 that's pushing out on that medicine comes look to see how it's kind of

60:55 in two different directions. So this why it's intra member innocents creating a

60:59 on either side and then what you is you have structure that's organized but

61:04 quite as organized as it should All right. It doesn't have the

61:07 sort of organization against stress lines because is no stress. It's just kind

61:12 put together it's called woven bone, vessels are penetrating in your building and

61:20 and breaking. You can see the sites on the inside. And so

61:24 fairly unorganized as blood vessels penetrate It provides nutrients for the cells.

61:30 then finally you're going to start replacing Weldon bone with the LaMICtal uh similar

61:36 , which is basically those structures that on the uh working along stress

61:41 And why are you getting compact bone the outside? Well, because as

61:44 pushing that mesen kim you're now starting produce perry Osti um Melancon is compressing

61:50 creating that connective tissue. You've got underneath it that are putting out

61:56 And so you're building matrix in this . You're growing outward in that

62:02 away from the away from the How's that? And that's why you're

62:06 that compact pounds. So that's intra anus. It's pretty report. Mostly

62:13 and basically inside the uh Mesen com is flat bones so far.

62:20 A little bit more confusing I think the other type. Even though it's

62:23 little bit simpler. Yeah. Um . And how a little bit similar

62:33 . Only in the sense that an bone is replaced by organized mint that

62:38 . Okay. Mhm. Oh, PT Okay. Into control uses a

62:50 skeleton to build the actual bones All right, So here we

62:58 young fetus around week 6 to week , basically, you can see here

63:03 the skeleton being formed. All what are we gonna do? We

63:07 this cartilaginous model. Alright, so your cart So the big joke I

63:12 when I was when I had very Children is you know, moms are

63:16 very concerned. When Children fall like they fall down the stairs, they

63:20 , you know? Yeah, they . And if you watch a child

63:24 falls down the stairs. The first a child does when he falls is

63:27 looks up at his mother to see he's supposed to respond or she is

63:31 to respond. Right? So, mom has this look on her

63:33 like the baby goes, ha get now watch and it just starts bawling

63:41 . Child falls down the stairs, at dad. Dad says get up

63:44 brush it off. Mom looks at and gives you the side stink

63:49 right? But child gets up and just goes off and runs in

63:54 Right? I had a child fall of a tree. Mm You will

64:00 . I mean, it's inevitable Trees hit by cars. You know

64:07 ? Okay. See it's the 1, 2, 3.

64:11 Right. I had a child followed . Come to my research.

64:15 we'll walk it off. Two weeks . My wrist hurts. We took

64:18 in compression fracture. Okay. but it was cartilage. Young Children

64:24 cartilage. That's the way I remember , there's cartilage and you're going to

64:27 the cartilage with bone bone is what . Alright, so, very early

64:33 in field development that cartilage undergoes You can see right here, here's

64:37 calcification, right? And then you're to get these primary ossification centers.

64:43 it's kind of the same thing where have that woven bone type thing.

64:46 get ossification of something that's already there it starts hardening and then you start

64:53 that material. All right. And where you're gonna get the diagnosis.

64:56 is when the blood vessels start penetrating and then you start seeing the formation

65:00 a secondary ossification center. Alright, an idea. The idea here is

65:05 have the cartilage in place. Remember doesn't have blood vessels penetrating through And

65:10 you start getting ossification. The cells the inside are gonna die. So

65:13 blood vessels penetrate through and what they're do is they're starting to create an

65:19 to allow for the sells the Aasif sells the osteoblasts to survive. All

65:26 . That's in essence what's going Yes. Mission of us.

65:31 ossification is simply there's a real what's definition of ossification. The definition of

65:36 of the formation of bone technically. right now, what is actually going

65:40 here is you have cartilage which is replaced. The matrix is basically being

65:47 with new matrix with that calcium All right. So it's it's structurally

65:54 similar cartilage and bone are very But you're adding in that calcium on

66:00 . So, it knows what we've here. Primary and then secondary.

66:03 so you can see now you're starting see those ossification centers penetrating the

66:09 All right. Now, what you're going to see is the formation of

66:13 medullary cavity. All right. Basically inside of the bone is being denied

66:20 . And so it basically kind of its way out. Osteoclasts are breaking

66:24 down. And so the bone kind Hollows out in the center by the

66:31 you are a child, basically bonus all of the cartilage. The differences

66:36 some very specific places. We have cartilage. Mentioned that that would be

66:41 cartilage on the outside of the on the ends of the epiphany sees

66:45 that the two bones can roll against another without damaging each other. And

66:50 you're gonna have cartilage also like located in the epithelial plate, within the

66:56 . All right. So, this the end diagnosis is a shaft.

67:00 area in between them is the This is where the epithelial plate is

67:05 and the epithelial plate is what's going allow that bone to elongate. All

67:11 . So, when you were how big were you guys know like

67:15 right? A lot of changes But one of the major changes to

67:19 you to where you are is the elongated and part of that is because

67:24 still have cartilage in those particular And so bone and cartilage are gonna

67:30 laying themselves down and allowing the bones extend at the end of your growth

67:37 Usually around the age of 20. are earlier, some are later.

67:43 cartilage gets caught up by the bone the bone multiplies and divides faster than

67:49 cartilage does and he catches up. I want to focus here on that

67:54 just a second. All right. we're going to deal with this interstitial

67:59 growth. All right. And we're to look at this a little bit

68:03 closely. So interstitial bone growth is growth in length. Alright meaning the

68:09 elongate. All right. So this due to this cartilage growth plate.

68:17 there is living cells in the It is laying down new cartilage on

68:22 top side, on the epiphany. the epiphany seal up. If come

68:28 epiphany seal epiphany, I can't even it anymore. Epithelial is the word

68:32 looking for epithelial side. All so you're laying new cartilage, cartilage

68:37 pushing the epithet Asus further and further . Bone on the other hand is

68:42 on the back side. So bone chasing after the cartilage. So the

68:47 villages pushing the Epp if Asus the bone is trying to catch up

68:51 the epithet sis and that is how get this growth eventually the bone is

68:58 to catch up because it's being laid faster than the cartilage is laying itself

69:03 . All right. And so that's you see the fusion of the epithelial

69:08 plates now show you humans are sexually or fake meaning males and females have

69:18 different features. One of the examples this is that on average, if

69:23 took all the women in this class all the men in this class and

69:26 measured them, who would be On average man? Alright. The

69:32 for that is women enter into puberty men do on average. All

69:39 And what happens is is the hormones puberty caused growth spurts. So,

69:44 have twin twin boy and girl, ? They were the exact same size

69:49 until about the age of eight. my daughter started growing faster. All

69:54 . Now, I've said it is growing but not at the same

69:57 So, she was going through this still is I mean, they're

70:01 So, they still in the midst their fun years. Right? And

70:05 what happens is is that she's growing and earlier. But then that epithelial

70:12 closes because the bone catches up and stops growing and then a boy who

70:19 hits puberty a little bit later, already started growing at a larger

70:25 So, remember my daughter started my son started here when he hit

70:29 , right? So he grows But she's already stopped. And so

70:33 keeps growing and that's why he becomes and larger. All right. So

70:39 enters puberty later. And here's the part, estrogen plays a major role

70:45 that epithelial plate closure. So that's women don't typically grows tall now.

70:50 that mean women can't be as No, I've seen girls on the

70:54 team. I'm sure there's one in and they're like this to me.

70:59 , yes, But on average, that's an example. All right.

71:06 part of the reason you get the because you're further and further away from

71:09 source of blood. So the converse to die off. This is just

71:13 at this. All right. you can see up here this is

71:17 the resting cartilage is. So, they're doing is they're laying down

71:21 which pushes the epithet Asus. So pushing this way, in essence right

71:25 , pushing in this way. So moving in that way. All

71:29 And you get further and further away your source of nutrients. So,

71:32 cells kind of die off and then takes place. And so that's where

71:37 get that calcification of the bone, sorry, of the cartilage. And

71:41 basically you go back to remodel it that would be where ossification takes

71:44 So the ossification is slowly, well slowly but very quickly catching up until

71:51 we'll catch up here and you'll ossified this stuff up there. So you

71:57 imagine this is in motion. It's now if you're growing long, you

72:05 want to keep a thin bone. mean, think about how thin your

72:08 is when your baby It's like like . Imagine if all you did was

72:13 in one direction. Think of thin how it would just be a useless

72:18 , Right? So you're going to what is called oppositional? That's the

72:22 of the bone. All right. , again, remember underneath the periodicity

72:28 Right, we have bones that's lying matrix, that's going to make the

72:31 fatter on the outside, on the , we have bone that's being laid

72:37 . But it's also being broken down you don't want to have too much

72:40 because then you're doing too much work move around, it gets too

72:43 All right. So, on the , you're breaking down bone alright,

72:47 your bone gets wider and fatter. right. But the rate at which

72:51 laying down bone on the outside is than the rate at which I'm breaking

72:55 bone. And so what ends up is that you grow thicker from the

73:02 to the inside relative to when you off. So thicker, stronger bones

73:08 a structure that can support what you're . So oppositional growth in width.

73:16 then we have sorry, interstitial which growth in like Yeah. Why is

73:26 called oppositional because in my mind I and positional for Yeah, I honestly

73:33 don't know That's that's that's fair and can see that as well now many

73:37 you guys are stopping. Well we're . And what time is it?

73:42 ? Yeah. One slide. know how we'll stop here. All

73:46 , So why not? I mean it's like seven minutes. Right,

73:50 how far am I gonna get It's not going to do like

73:52 Here we go. We're just gonna through the different we're not gonna do

73:55 . So, when we come what we're gonna do is we're gonna

73:58 with the bones All right. Be to go beyond what's already there in

74:03 slides. I will have those slides for you. Okay, Because this

74:07 really the need bones are connected to the hip bone type, you

74:11 so and so forth. Mhm. a great weekend stage. It is

74:16 right now. It's Tuesday. Oh goodness. I wanted it to be

74:22 . Have a great

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