ࡱ>  ]aPQRSTUVWXYZ[\za߀M'$,,G( ffffza5Oc}у%4( f3f3zayuIӘq( r?'NzaJJDT&+>LB( za`nxּfa( ~~za 1=<*I؜U( wwwwwwwwzaxQFoJl/I( ""za h>"f[g( za+.( % ( h/ 0DArialNew Romantt4x: 0"DTimes New Romantt4x: 0G . @n?" dd@  @@`` /m .     >  Q S;C56N1 ` !"y#$%&$',(O)>*|+g,)-.r$߀M'$,,Gijr$5Oc}у%4iir$yuIӘqi"r$JJDT&+>LBi/;r$`nxּfair$ 1=<*I؜Ui r$xQFoJl/Iivr$ h>"f[gi r$+.iHc AA1? ̙̙f___@mg4-d-dtx: 0ppp@  8ʚ;ʚ;<4dddd@U 0@r0___PPT10 pp2___PPT9/ 0?  5C    +    )A(B,; 1!9"<#*$-%/&0'2(4)6*8+:,=->.?/@   0` ̙33` 3` 3333f` 999MMM` f` f3` 3>?" dd@,|?" dd@   " @ `"  n?" dd@   @@``PR    @ ` ` p>> l(    Zgֳgֳ ?P  X Click to edit Master title style!! >  T$!Wgֳgֳ ? W RClick to edit Master text styles Second level Third level Fourth level Fifth level!    S    `)Wgֳgֳ ?`` W f** h   `X*Wgֳgֳ ?``  WH@___PPT9"@ p***f   `!Wgֳgֳ ?` ` WH@___PPT9"@ n*(*B  s *? ? ̙3380___PPT10.g? *5EJE 'A*1'6J  0  0(  H  0޽h ? 3380___PPT10.gR   0  5 E = 0  (   8 00  00  T 6 P(  V  T0 gֳgֳ?  (WHAT GUARANTEES Ca2+ STAYS AT THIS LEVELV)(*20    T gֳgֳ?| zA very large store bone is about half crystalline calcium salts (hydroxyapatite/bone mineral) A way to get Ca2+ out of storage cells that eat away bone & put its salts back into solution A way to get Ca2+ into storage cells that make bone and build in the calcium salts Ways to get Ca2+ for the body calcium in the diet; absorbed in the gut; not lost by the kidneys into the urine Ways to control the blood level hormones & helper materials (e.g. vitamin D, cytokines)|(*2 I  f f f f< f  f f f f5 f  f f f fT f$ : B     ` U     jB  Bf1? jB  Bf1?TjB  Bf1? jB  Bf1?  jB  Bf1?tH  0޽h ? ̙3380___PPT10.gt  0  5 `%(  8 |s |sR  T'gֳgֳ?  (WHAT GUARANTEES Ca2+ STAYS AT THIS LEVELJ)(*20  Q  TIgֳgֳ?|s A very large store bones are about half mineral To get Ca2+ out of storage cells that eat away bone & put its salts back into solution - OSTEOCLASTS To get Ca2+ into storage cells that make bone and build in the calcium salts - OSTEOBLASTS Ways to get Ca2+ for the body calcium in diet; absorbed in the gut; not lost by the kidneys To control the blood level hormones & helper materials (e.g. vitamin D, cytokines); use(*2   f f f f=f f     5   f f f f=f f @? P  E  N ?      2  C BqTENG IQ8c? qTqT`TqTqT`T`TqT`T`T` _p  2  C ENGHZJQ8c? `T`T`T`T`T`T`T`T`T`T0 @ 2  C CPTENG.JPTQ8c? `T6`TPT`T6`TPTPT6`TPTPT/@P 8 \  \rB  Bf1? rB   Bf1?drB   Bf1? rB   Bf1? , rB   Bf1?\ 2  C ENGHZJQ1? `T`T`T`T`T`T`T`T`T`T` 0@P H  0޽h ?O@ ̙3380___PPT10.gt  0  5 php(    T4}gֳgֳ?  h SOME IDEAS" (*2     T4gֳgֳ?0 ; P1 Construction/formation of bone is slower than destruction/resorption 2 Construction & destruction need to be in balance or bone is lost 3 Many organs have to work together: gut, bone, kidney, skin, endocrine glands, muscles & nerves 4 Complicated & vulnerable control systems 5 Some aspects under person s control -- exercise, diet, lactation; many things are not: genes, sex, age, size (*2JEf`̙-p . s  /  H  0޽h ? ̙3380___PPT10.g @  0  5   , (    Tऍgֳgֳ?0m  PURPOSE OF THE SKELETON.(*2 "   T4gֳgֳ?L  N1 Mineral store for Ca2+ 2 Protection skull - brain, eyes spine - spinal cord rib cage - heart lungs, great vessels bone - bone marrow 3 Support & leverage(*2 $  f $f     ̙ ̙ f                            T,gֳgֳ? ` kSKELETON -- many bones, connected by joints (with ligaments), pulled on by muscles, covered by skin & fat"l(*2l`     -   Tİgֳgֳ?h  8Calls for a living, hard, strong material with Ca in it"9(*298   Tgֳgֳ?P _}"(*2j X  Tgֳgֳ?` ^ENJOYABLE LIFE - - bones as the means to do things; extended by the use of tools & devices"_(*2_0 K H  0޽h ? ̙3380___PPT10.g/   0  5 - %  (   4  Tgֳgֳ?@G $ PURPOSE OF THE SKELETON: Correlates.%(*2$:      TH$gֳgֳ?PP# S1 Mineral store for Ca2+ 2 Protection skull etc 3 Support & leverageT(*2   f `     "  Z gֳgֳ ?"`0 W BONE MATERIAL/MATRIX"(*20     TDgֳgֳ?`O1 % STRONG - densely packed-in collagen fibrils HARD - calcium hydroxyapatite mineral crystals LIVING - osteocytes/bone cells living in spaces/lacunae & extending long processes in canaliculi(*2    ̙ ̙   U    3    3 [  T`Collagens I & XII bone proteoglycans bone glycoproteins mineral crystalsra(*2̙H0   jB  ( B1?DjB  ( B1?4  jB  ( B1?T  pB  ( H8c?` P pB ( H8c?`H ( 0޽h ? ̙3380___PPT10.g` Dž 0  5 #PP,(  ,  , C BCDE,F41?KK;6CW9x. <]} ,Xtx^SH>(=]~-Nyync(XSMt8"9Y3_sh]9RZ=' ) J k  $ xE mf b M 7 , , !@ a  \ |  , B W b+ m &}=]!s7Wx-CGchyBXy(>Si=^.89YCzNYouZ{)4J?I_ju$/:DOZep{`?p{DeD/uT3zYu8_T?4(cB"dNCs.R#' xW7iH>\3<  l yL c+ M 8 "  g ;      ~l ~K ~* ~ ~    f E $     U "-8{8OM.McyjI)(3H^oiNt#i>C.9NYoHcB!)h4G??II_jbA _?;;@  ,  xBClDEFA1? zY6NWNmomzY99&YGY]9h} #!,,7Xx'=iSIs3(3^ tS-(8Nn(H^cNNN9nYocC"">-I TTTj~~$$$~$]DHeH]~hH' ) J k ' H =   $ E P P P [ b| b b b B ! @ V ,V Wa x b B ! ! B b  0 mF Mg , , B b  6 W ' = ]s1h<H\2}22R --  ,Mm -Xync2>>3-MM(XIXiXcn(( (.=N^N9  .N#o-NozzdYNo3Ijuuu #9DD?D_Op_?4Tu4?`:Z{?v`Uk4k`U?*eD#>{pYO8D:^2cu8I?GxMY!9 }\t<S> (  b    y cr NQ C0 -     V 5    " C| NP c n  U 4  Z.3ITS)td9i#DNYozsS2xM, 4I_Ru&xW6u_TI?)zst@6 8 d \   ,d \ r2 , B1?dr2 , B1?d, r2 , B1?D|r2 , B1? r2 , B1?|\ r2  , B1?|<r2  , B1? ,   , S B CDE F(A1?6WxynXXM<B]7}7,,!m 'Hh8c3~Sssh]]RCGd<1&>_.O{xW6 4 U ` ` Ak bv  & G h      , M n      2 S t tk iJ S) = 222p2O2.222=uSTi3tdC> -CYnd~]=M!}]<3>I_jmL+ j I(     d6dWNxC8-"""s !Bc=]~-tii(^HHi=2'#No3TuyXjMIB)BBBMXznYy9>N ~'mM',= SithG&W6iH'@$ \  , S 4BCDEFfA1?uu6Wx~sh]G=h2'Bc2]~ 8XxHmtmbbXX#MNMoB7,!)I j!Bbm_>oN.'==^S>S]hs~~nN-~]= m M!"--]81CCCNXbnA yX8@P  8 ,  ,, r2 , B1?t r2 , B1?  r2 , B1?, r2 , B1?t,r2 , B1?4  r2 , B1?r2 , B1? , 8 t ,tr2 , B1?tTr2 , B1?tlr2 , B1? r2 , B1?Tr2 , B1?r2 , B1?|r2 , B1?lj , B1? l ,j , B1? Lj  , B1?  j !, B1?4tj ", B1?D, j #, B1?dD L $, S $B CDEF̙A1?ss yOcYC_8" d iIsh]HY2-iHcB!xbXhBG7&, bA  7+7AXbmx1],'M=nHS]h~=i"Cn(-t-8CNY#Yony4T_ju$/:DOZp{  @<v  %, S BCBDEF̙A1?eeM , ,M!cBnb'Rs'2"HM^yt~=^#Cd "-8>8_AAAAAA9AZA{AAAAA"pO.I(zN~-i^^S=t'H(yX8scRX27! @ @ &,  BCDEF̙A1?mm":! bA !A6LWWxbx<]~&1 G,RMhns~2St "-8CYdnIT^t^>y~Ys8h]RRG<t1S&2nM,~x]m":A+ @jB ', B)? @ pjB (, B)?` @ jB ), B)?  jB *, B)?0  j +, B1?Tlj ,, B1?DT -, TEgֳgֳ? `  {STRUCTURES OF A WORKING JOINT"(*2  ., T;gֳgֳ?P0 p |Articular cartilage ,(*2  /, TWgֳgֳ? bBone"(*2  0, T:gֳgֳ?  qMarrow .(*2f jB 1, Bf1?`@ jB 2, B1? 0 3, Togֳgֳ?  Periosteum dense irregular>(*2 0   jB 4, Bf8c?  5, T(xgֳgֳ?`P pTendon , (*2 jB 6, B1? j 7, B1?4 d  8, T膐gֳgֳ? 0P g Ligament " (*2   pB 9, H1?0 @ :, Tgֳgֳ?0  dMuscle"(*2 | ;,  TB&CDEF8c?669Yz)yIyunnnc9cZc{ccc c4c`cccXXX:X[XMMMM M*BK7l7,!!BMM%,!%7M, mp@& < <,  BCMDEF8c?..2S t +6686Y6y6666636_666++ +. Z z)Ju6LA+ +LL+  ]`@ y =,  BCDEF 8c?AA.~Nsoi^SSHH3=T=u22''9Z{?`$Ef@ax%mFXgB7!|!BM,MXrcrBr!@,  >, T(gֳgֳ?`  cNerve"(*2 c ?, Tgֳgֳ? Joint space with synoviumZ(*2  fH    2 @, 3 E$GH? I`TQ8c? `TOT`TOT`T`T`TOT`T`T  ,  A, S  B C|DE<FDA1? ?| 9[ #:    J  :iTIj3zZ9jI(ynYNyCY-8  iHs^SHy2X'7hG1&nM, ,MnxxmbbW2WsLLA 6-+N+n+!! >_ !Abs 7'H#.9O Z8oY3Tt )Z4?U4`uju:{* U v    0 /P Eq P e p { p e E $     f : j U J J ?? 4)eU4oZd.OD9._3yN ^t=i_I>3(n 7Xy2^(3N>oI_itItDoU #:.Z9OZz U     % E f        o ? ? @ = B, S B CDEFfA1? {Z9ncXMB7u,T!3 oN. ~ssh3hh]]yRXG8<1&h=mB!mbhLGA&6+! xW6+!Ab Ab&1G<h<GR ],h~2]8 y,7B>M^cny#Cd)T.'O2p=S^t  i H '     @ b   C, C BFCDE(F01?JJM?7Uv ,Mn2Ss$$/:::8:Y:y:::::(:I:i:EEEE $ iI(dC"~^=vvkkUJx@ F  D, C BFCZDE(F01?JJE Abxmbb1bRbsWWLA6!6B6c66,,,!'!H!i    -N!YAYbYN8- tS2yX7sR&bEE@K j E, B1? , j F, B1?T  G, Tdgֳgֳ? @ vJoint capsule ,(*2   , H,  BCDEFp?,, ,M m!7Lb2HH^1sRss~ 7X'Hi~^S82NozxM,0Y\@@ eQ , I,  BCDEFp?,, ,M m!7Lb2HH^1sRss~ 7X'Hi~^S82NozxM,0Y\@p eQ  jB J, B8c?0 p  j K, B1?T  L,  BACDEFfp?##.D6dLL+ AbbA 6Wm)L?+TLTmTjmL++LmbA  $ @GH@  0L M,  $BCDE@FHfp?Y!,! AL!m6m ,A!6Wx!$@w P A  jB N, B8c?@  O,  BCDEF)?6WyxcMC8-"< ]}!Bc=]~~~~~s h-hN]nRH=2'3St9Yzxm>b_WM77,!$D e      4 ,U 7v W b  : [ |  5 V w  ; b\ M| 7  A b ,&BGWmm,Mm2Rs2=HR]8hXss~(Ht d(T u "88ZM{Xny)JkKL@V H P,  BCDEF)?rAtbj_TI>3&(Gh ,Mm2]~ -Nyy>d^YCC--"N"o"  >_.Op~s^=' 4 ? ` n X 7 , !: [ |  @ a  ! ! , 7 B% MF Xg c x  + 'L Hl ^ i ~  1Rr !"B8bNYn'Gs -Mn(>I_(_HjiCo Tu#.9DZ#ZOepozJkKL@> H , 0޽h ?@, ̙3380___PPT10.g` o 0  5 ˊÊRR0C(  0  0 C B0CDE,F41?KK$:Pn-Cz`kwcTF>70!/E[ q"8NdzpiZZK3KHDf<5.' J`w.E[}qvngXQIB!37%NdzWm,:BI X4 gQ ng v}  6 D Z p . D Z i x   ) ? z     ! 0 ># M9 \O ke z       % ; X     *2'9<HiOV^et //////////////////%/,/4/;/B/I/Q/X/`/g/o/v/}////}gx`ZQ;,     X ; %      { tA m* e V H 9 * z \ F 0        rp kZ cD M 7 0 )  v ` J  pZ{K^5A'#   r] F0'5<KRRZajiLpxoYC,!)7mFWMAT$\ckrzs]1j6 #*2@oHYVC^&m|nWB+mV9# @0H  0  xB0CDEFA1?&$:IIW+n2|-<K`oww~k\\r z d/M>8S)j!)F\kU>! )1?FNdz3HWfupZZZZpxbK6 ,;J.YDoD~.~~~   .E[jngg}vXBB)B?vNdknkXkBk,k:QXB, , B X#X9IH4^t,BXn}n n; vv } } } g g }     6 K b x x' b= KS Ki D K b x           " 7 M \ \ 0r 0 )   ! 8 M d z     2 A A A O e {         # % ; Q n } } } +} A A +   # 9 O f ff5^DHR^ZuZZax//////4/J/`/w/////(pZD. ~ w} og hI `, Y C ; 4 e G 2       k u0 f W O A 2 +p S 6 '   z k U > 0n !Q %  fP9x#i bSSSSSzZ]b?p)jL6Y)8>U\kmzP3lU" jS>+(29HWfwm`uC-|fP:$|m^WOH&st@H 8 c    0 c r2 0 B1?c , r2 0 B1?c4  r2 0 B1? M r2 0 B1?& , r2 0 B1?U  r2  0 B1?  r2  0 B1?&4    0 S BCDE F(A1?$:Qf|~~w5wRohhhaZZ Z7ZLRcKyKD<5&& 9Vl:Pf}&<Yp|ufQ:$ !6LTT+[BcXjnrrxxxx5Kaw(>TrT[ME>//((((((h(<(&/>MTcj}yfP:N1 y[E"/*19@GoODV-^dssu_I3{dO9" $:Qf|-Yo/E[yqqqjc \9TNMdM{F7/( $ AXu}_I3sV9"[   w/a>DM&T\cjqynW:$ycM7  @  \  0 S 4BbCDEFfA1?uu#$:Qf|5Kh(}E}[uyunngg_*_?X]XsPIIBB;;$3A3W,n%-YaJ,;B&IX_nunWA+s]?*&q&[.E5/<CKRaahohDp&ww~u_B+~hR##@T y,  0 S  B9CaDE<FDA1?8E(yrkwca\KM5?7( u_I3{]GxiaRKy5c.M7 ~hR<&v_J3|gXX3XJQ_QvIBB::353K+a$x0F\r+BX_nr|\\\\ck&ra~ 7c  #"*92lHOV^lt{IDp0Mcy,; B#Q8X8`8X8Q8;8%8881j> {tlepVYODH.A9*# fI,dOyryk\cFT/MF70(!a5 &<Rh~(F q!(07F*MGTd\ckry;X&Yw  !M#y29AHV^el1l8V8A8*8888 @  H 0 S B(CdDEFfA1?'waJ4~voaYKC4n-W&A, l1jL/ugoXYXDI-B3+$fQ:$+BXn+BWnDaw  (-E4b<KRahh1vG~s$:Pf}- C Yp '/=ETc'c'L'6' ' ''  @! H 0 C BCDE(F01?JJU3*%9Oe{3J_v&=Rh!7Lcyle{ycL7! {leepeZ^D^.^^^^OOHH}9g2PUU@ +  ]  0 C BCDE(F01?JJug`+XBXXXnQIBBBB::&3<,Z$p$$$$ !7Mdy,BXo}g`r`U`>o(oouuu}hS<&nXB@| m 8  ;  0 ; r2 0 B1? xm r2 0 B1?u x r2 0 B1?4  r2 0 B1? ;m r2 0 B1?  r2 0 B1? , r2 0 B1?u ; 8  ,  !0 , r2 0 B1?R ! r2 0 B1? ! r2 0 B1?)r  r2 0 B1?R  r2 0 B1?) , r2 0 B1?) j r2  0 B1?  j "0 B1?. s j #0 B1? / J j $0 B1?o j %0 B1?  j &0 B1?4  j '0 B1?; 2 j (0 B1? j )0 B1?R L *0 S $B'CDEF̙A1?ss&b'~paYQC-&e* yM7}n_pXZPDB;,%nXB+%%+;BIXPn_gu} &DZw0Mcy&<CJY*YHheh{ww~%Xn 'bipx&&@z  +0 S BCDEF̙A1?eeW44B,JBXXgnn}'=Sq 0'F.]6z=ELSSZb+iHq_xt4KawqZSoLZECE-==66.'|'fP: kU7"iSDv.gXB;%}WW@; P@ ,0  BCKDEF̙A1?mm'uXB++$3::QBfP|X_n-Daw (>-U<jCJJJJJJJJJJJJJJJ JJ#J*J2J9JeJJJJJJJJJJ5--&t]H2  jU>(w|ZnDg-_XPI'+u_@w) jB -0 B)?w  jB .0 B)?  ^jB /0 B)?w B =jB 00 B)? + ^j 10 B1?R m j 20 B1? eM  30 T  | |?: | Joint capsule 0(*2   GG  " 40 Tpܐ | |?A< Articular cartilage 0(*2 GG   50 TD | |?J  Bone$(*2 GG   60 T  | |?d\& Marrow .(*2f GG  jB 70 Bf1?^! jB 80 B1?) < T 90 T | |?=G Periosteum dense irregularD(*2 0   GG  jB :0 Bf8c?~ ;0 T$  | |? Tendon 0 (*2 GG  jB <0 B1?Hj =0 B1? c , >0  BRC DEFp?,,3Ig%}3BXn&a~  6Li}!g)P83?Q Y\@  , ?0  BRC DEFp?,,3Ig%}3BXn&a~  6Li}!g)P83?Q Y\@  6  @0 T0 | |?8]  Ligament $ (*2   GG  pB A0 H1? jB B0 B8c? 8 { C0 T7 | |?R  Muscle$(*2 GG  j D0 B1?R 2  E0 T= | |?A absorbs & spreads the load"(*2 GG  | F0  TB'CDEF8c?66&|<uRnhf~__XQQII6IcBBBBBB B)BGBeBzB;;;;;3$3:3P3f3|,$$,33&&$3mp@>%L < G0  B]C5DEF8c?..!8Ndz$$$$$$+$I$f$|$$$$&DYp0$40,EM\\4E4>7!+]`@-  H0  BCDEF 8c?AA4Jaw'=Sj0F\r2H^t}ngQ$I;;Q,f%}}f_u,33n;XBX,Xnl@%  I0 TLW | |?  Nerve$(*2 GG   J0 T_ | |?d  Joint space with synoviumb(*2  fH    GG   K0  BCaDEFfp?## -$C3Y3YYppp+pBB+$:I33I`I3 !(3(I>BE+E[r GH@ 2 2 L0 3 E$GH I`TQ8c? `TFT`TFT`T`T`TFT`T`T  L M0  $BC^DE@FHfp?<+3I$I_g|,$;Q]!$@  y jB N0 B8c?% /  O0  B0CDEF)?$:Pf|xqbZSK-DC=Y6o.' / E[q)?Ul}3vHn_nug_XQIB:4&%;%Rh~  6L%b:xBXgnv})?zvg*XABW4m%  4 J ` v  , : I I X _= nS }i    0 F \ r  * A V t   ' . 6 =, DB DX Kn S S S b b i q.i !/KL@ H P0  B0C9DEF)?T+VBOWGn@81*"5K ` w(E[q1]sxxqAqWquiibb[LLE,=C6Y/o'  6=vSnj`xJ;%)?Uk%,24H;^BtQXn % ; Q g } / = E L [ b i6 qL a x        T k     " 1 8* GA GV Om ] d l {    4 I _ }     .Dax %!,/8KL@@ Hy \ Q0 Tt | |?(, * HARD/IMPOSSIBLE TO MOVE & ENJOY LIFE WHEN2+(*2*: $ GG   R0 Tgֳgֳ?0A OJoints get inflamed Cartilage wears out Bones break Bones grow out of shape Muscles weak or painful Brain, cord or nerves injured (paralysis)(*2| ̙          H 0 0޽h ?L0 ̙3380___PPT10.gP$ R 0  5 QQ::4>Q(  4,  4 S  BC" DE<FDfA1?c/wfC2A c   t v@ T 3 "   S   x f UA 3"vB1fDS3!T fCv#BvBwgwV23xDT!DxEwCvve3TfCCC333f""Dv3e22!vTvvvCw3v!e2C w!SCBUvf SA u  !u 3 UB f v1   A  R" 1 C e    Q   !     e 1 t@vtU@DD3s!  R   c 1   wu UB C 2 !u 0   c 1 fef C2!1SvCeTD"e13xD3Bv"3BDfCB" DSTevB R   u   u  ! 2c T w  R    02Cf0wb @tU! @s* 4 S BCgDE(F0A1?JJ.xbU"QbDtxttEwCwDwDx"T!TffbT/!!///T/"////U/"U!U#V"s@S  4 S BCDE(F0A1?JJ(uB1e2vCwve!TSTTTT DSDD33 3T" T3e1dO1C e1B uBBBSSdwdCdue2((@v j 4 B1?@N' 4 TO4O4?6  Joint capsule *(*2  &  ~FFj 4 B1?@mF 4  BCDEFfp?##G jTwwC2f6FfF2z zTzwCw5XwiCCwf2$XGH@=t   4 S L BCqDEFA8c?88cB!~z]o<dY N C 8 -x -W #6      r Q 0      l K + t i ^ S H| =[ 2: (     v U 5  pO/nXMB,j"J )eD#~~s_h>]RG'zdNm-b m  -C1dGohzY8~hRGGGtGSG2G'bA!!Ab'<yRXh7s hR]G<<111111bLLLLLbLbm1RsxW6 !,A7Wm1Rs,hBGc&n1RsynXX7XXXycn=^"Nz((2=H>S_^it9Zz_-:8ZC{NYdo z* J     0 P q      5 (V 3w 3 > I I T% _F _g _ j u  + L x     <]#7.X9yDOZepO.jI(qt@ *   4 S BCDE(F0A1?JJ,.No4T u,uMmjI)x)Ij'292ZG{]spZ{Z9_>~]]]]]]4=2oYC#b,,@d[|  4 S TBTCDEdFlA1?5cxbA6! =S!=AWmcB!5534@    4 S lBCDEpFxA1?B b)4J`k'Hhh]=xXv7k kJ9<@ F 4  4 S BCDE@FHA1?.0 Q q !AWxgF%m..!$@@ 4 S \BC`DEhFpfA1? . O!o7ALWbm4JU_?zxZm9L#L 58@e5 0  4  B1CDEFp?9Yzz0oPdq  6V)wIwjwaVw9Z{&& )J&UF`gggQFQr:[| ,5AV,w,W%xFmgr ALb'&&GG]gsssRG h ! 7 W x        ' H R s    7 X X 7 - B 7B XM yy    c M n  3 S t       - N d o  ( 2   2(SIS_2=^0GH@!A ^ 4 C 6BCDEF31?vviH'xxbbWXL7A777WxGs8BM X,cMnny'HitS2cB!yncsXRXB88"mA   Ab &G"h"~~~~]=xW7  7 Xy!!,,7A=A^L~WWbmx@k R  4  BjCDEF p?AAidLO,.! !Abb_LI,(!ALA!oN- 7WWL,tS2!'AWL77y7nWMx, mWAAWsx]<''x<m]b~A~!   @ 4 Z#gֳgֳ?  _}"(*2  4 Tgֳgֳ?@  g EPIPHYSIS" (*2     4 Tgֳgֳ?` DIAPHYSIS/SHAFT"(*20   p2 4 H31? <p2 4 H31?D L p2 4 H31?T p2 4 H31?D, p2 4 H31?4  p2 4 H31?  p2 4 H31?  p2 4 H31? p2 4 H31?$T |p2 4 H31?d p2 4 H&31?T p2  4 H31?\p2 !4 H31? L p2 "4 H431?$|p2 #4 H31? t, p2 $4 H31? < p2 %4 H31?T L  &4 Tԓgֳgֳ?0 w h Periosteum" (*2   jB '4@ Bfp?@  (4 Tߓgֳgֳ? Fibrous Osteoblastic<(*2 3 jB )4 B1?`P= *4 Tgֳgֳ?`  @ #Spongy bone with struts/ trabeculaeB$(*2   0   2 +4 3 ENGHZJQ38c? `T`T`T`T`T`T`T`T`T`T  2 ,4 3 ENGHZJQ38c? `T`T`T`T`T`T`T`T`T`T `p  -4 Tgֳgֳ? @  h Dense bone" (*2   jB .4 B38c?  [ /4 Tgֳgֳ?O iInner surfaces of both types lined by ENDOSTEUM of resting cells, active osteoblasts, & osteoclasts2j(*2\i > 04 Tgֳgֳ?@ 0 (Joint cartilage absorbs and spreads load>)(*2f0  jB 14 B8c?`  jB 24@ B1?0 ` 0jB 34 B8c?P 44  lBHCDEdFlp?0!Q!r ,MXX7,+M+nLmxcXy<G@34@p2 54 H31?Dp2 64 H31? < 74 T"gֳgֳ? ` @  ^marrow(*2  84 T\,gֳgֳ? P  svessels0(*233  94 T-gֳgֳ? pG  BONE COMPONENTS.(*2" 2 :4 3 BTENG IZQ8c? TT`TTT`TZ`TT`TZ`T0 p H 4 0޽h ??0+4,4:4 ̙3380___PPT10.g0)   0  5 l d 9 (  8 8 TFgֳgֳ? 0  evessels"(*23  8 C ^BCDElFt1?[[3 b   D a     : W t      0 L j      'DNkjL0:Wuj%WM:j&9VuiX}:}_C%ujlMl/bbbbXWX:NN::0'b;  33@B :  8  BC0DE F fA1?+000M0k0&&&&&&9&V&t&&&&&&.&L&j000000V000000.0J0h000000#0@0h000000,0J0g00000005N?u??5+++0+W+t++++%+t++55?L?i?????"qJ,rT6|^A$$r7VUBr8....B_#|-77777.7J@h@@JJJJ#J@J^J{JJJJJ"J@J]T{^^^+^S^p^^^^^T!T?TfTTTTT T* TG Te T J J J J J J= Je J J J J J3 JQ Jm J h      " @ ] {     < c    q S 6      { ^ T T T; TY Tv T T T T TT1TNTvTTJJJ J&h/////&6]{5S o&&&* &G &e & & & &= &G G =      v Xo 1e Q Q Q Q e c Y E 1         c = c [ m x w  P  ( E c '  v   1' E Y m v & C a     9 a }   %B_11'           v m c Y O E ;  } _ U U s  w Y <       c G = Z m i K /      j< MY /m w w w w w um Wc /O E < 2 )  k D  v Y m  c w = m  c  Z Q G Q G 3 3  )  e G )  3 Q d o [ G 4  3 Z w    f R 52 O m       ; pY ] ? 5 "  1NkuuguJ,{^T696W#u66%JCTa^}^6%B_|.rV8}`B$}siK./Lj}jC/$8VrW9$AThkrNr1rh ^ T J 7v .O $   Y 2     w P 3      d )     | _ B $      t V 8       j L /  ~ a C  y o e [ Q G > 4  y\>SgJ,7hAsL$jB`&k+0+@F 8  xBCBDEdFlfA1?,Jg " ? ]z +HfHe=Zw2Om1OwEl:Wu&Mk/Mj8AAxAoAeA[ARAHA>A*AA AAAAAAAAAAAAzAfA\AHA>A5A+A!AA AAAAAAAAAAAAzApAfA]AIA?A5A,AAAAAAAAAAAAAAA{AqAgA]ASAJA@A6A,A#AAA%`9uW9uW0 uX;c;cE) wZ=,+@  8  BmCDEF p?AA;,X6bSbqbD11"N?X]bzlllN15Rp'DXb b+bHNf1y ;*DHXebbX; 4[x1DXbl l>bZDd'   @^ 8  BmCDEF p?AA;,X5bSbqbD11!N?X]bylllN15Qo'DXb b*bGNe1y ;)DGXdbbX; 2Zw1DXbll<bYDb'   @ ^j2 8 B31?gj2  8 B31?gj2  8 B31?gj2  8 B31?gj2  8 B31?gj2  8 B31?gj2 8 B31?gj2 8 B31? g j2 8 B31? g j2 8 B31? g j2 8 B31? g j2 8 B31? gj2 8 B31?gj2 8 B31?g  8 C B%C DE F(31?;;;;8;V;t;;;;;;$;B;_;|;;;EEE.NKNhNXXu &k0Mt`~8Vt.Li|hK$_BtL.tV9&9`~8Vt8Vs.Kh7TrT{6Sz 5 S p      + H f  $ A ^ |      $      r T 8   * H e     [      = [ x     d G )      o Q 4      y R 4      z \ ? !      p S 5  z]@"qT6hJ7r-V-8-------j-L-.------j-L-----W-0---W-:----#u#b@b^b|bbbbbb,XJXhXX;qT6|^@#K| _ B $  jB$jL/W0lN011:1X1u111'''0Nj&'L1j1;;E;;@)z *8 ` 8`r2 8 B1? 8  BCDE F(8c?$ ; Sk @4ZK  8  BCDEF$8c?)Gd@pZ 8  BCDE F(8c?$;Sr@Z 8  BC#DE$F,8c? "$<Tk@`B8  ?  "8? r2 8 B___1?S Dn  8  BCDE F(___8c?$;Sk@   8  BCDEF$___8c?)Gd@    8  BCDE F(___8c? $;Sr @ x " !8  BC$DE$F,___8c? $;Sk#@ ? cB8 `j (8`jr2 #8 B___1?e $8  BCDE F(___8c?$ ; Sk @Z %8  BCDEF$___8c?)Gd@Z  &8  BCDE F(___8c?$;Sr@ Z1" '8  BC#DE$F,___8c? "$<Tk@G`jB8  .8r2 )8 B___1?Jd *8  BCDE F(___8c?# ; Sj @ +8  BCDEF$___8c?)Fc@ 1 ,8  BCDE F(___8c?#;Sq@HY" -8  BC#DE$F,___8c? "$;Sk@oB8 l8 48l8r2 /8 B___1?Jld3 08  BCDE F(___8c?# ; Sj @ 18  BCDEF$___8c?)Fc@ 28  BCDE F(___8c?#;Sq@" 38  BC#DE$F,___8c? "$;Sk@8B8  H L  :8 H L r2 58 B___1? G  68  BCDE F(___8c?$ ; Sk @ C  78  BCDEF$___8c?)Gd@ C  88  BCDE F(___8c?$;Sr@  C  " 98  BC$DE$F,___8c? #$;Sk@ ( H L B8  s ? @8s ?r2 ;8 B___1?S sn : <8  BCDE F(___8c?$ ; Sk @   =8  BCDEF$___8c?)Gd@   >8  BCDE F(___8c?$;Sr@  " ?8  BC#DE$F,___8c? "$;Sk@  ?B8  ;  F8; r2 A8 B___1?S @n  B8  BCDE F(___8c?$;Sk@   C8  BCDEF$___8c?)Gd@   D8  BCDE F(___8c? $;Sr @ u " E8  BC%DE$F,___8c? $;Sk$@ ; `B8 .c L8.cr2 G8 B___1?wc H8  BCDE F(___8c?#;Sj@..E I8  BCDEF$___8c?)Fc@.  J8  BCDE F(___8c? #;Sq @." K8  BC$DE$F,___8c? $;Sk#@.B8  R8r2 M8 B___1?Jd N8  BCDE F(___8c?#;Sj@ O8  BCDEF$___8c?)Fc@Rc P8  BCDE F(___8c? #;Sq @(9" Q8  BC$DE$F,___8c? $;Sk#@B8 R   X8R  r2 S8 B___1?JW d  T8  BCDE F(___8c?#;Sj@   U8  BCDEF$___8c?)Fc@   V8  BCDE F(___8c? #;Sq @  " W8  BC$DE$F,___8c? $;Sk#@R v B8 ?`  ^8?` r2 Y8 B___1?D  Z8  BCDE F(___8c?$;Sk@Z [8  BCDEF$___8c?)Gd@Z \8  BCDE F(___8c? $;Sr @xZ" ]8  BC$DE$F,___8c? $<Tk#@?`cB8 j   d8 j  r2 _8 B___1?   `8  BCDE F(___8c?$ ; Sk @j * @ a8  BCDEF$___8c?)Gd@j f w b8  BCDE F(___8c?$;Sr@j  " c8  BC#DE$F,___8c? "$;Sk@j  B8   c j8 cr2 e8 B___1?+ F _ f8  BCDE F(___8c?$ ; Sk @   g8  BCDEF$___8c?)Gd@   h8  BCDE F(___8c?$;Sr@  +" i8  BC$DE$F,___8c? #$;Sk@ ? cH8  q< p8q <x2 k8 H___1?  l8  B/CDE F(___8c?q$[)D.-+ @ q  m8  B)CDEF$___8c?~a E( (@ ~2) n8  B"CDE F(___8c?pY8  !@,N/" o8  BCDE$F,___8c? t\ E . @bz<B8    v8 r2 q8 B___1?W q  r8  BCDE F(___8c?$ ; Sk @  & s8  BCDEF$___8c?)Gd@ K \ t8  BCDE F(___8c?$;Sr@ r " u8  BC#DE$F,___8c? "$<Tk@  H8 QGs |8QGsx2 w8 H-___1?t; x8  B{C{DE F(___8c?# 3+J<[Lkbwzz@G y8  B{C{DEF$___8c?&<(O<ePzfyz@< z8  B{C|DE F(___8c?#'-7>SNd^uqz{@P" {8  BClDE$F,___8c? % <M)^9nIZkb@QsH8 }  8} x2 }8 H-___1?  ~8  B{C{DE F(___8c?# 3+J<[Lkbwzz@  8  B|C}DEF$___8c?&<)P=fR{gz|@]F  8  B{C{DE F(___8c?"',7=SNd^upzz@GZ " 8  BCmDE$F,___8c? % <M)^:nJ[lb@ /} H8  8x2 8 H-___1?Ke 8  B{C{DE F(___8c?# 3+J<[Lkbwzz@Dd 8  B{C|DEF$___8c?&<(O<eQzgy{@ 8  B|C|DE F(___8c?#'-8>TNe^vq{{@1v" 8  BClDE$F,___8c? % <M)^9nI~Zkb@d]H8 L   8L  x2 8B H___1?  x 8  BCDE F(___8c? oW@)@Y   8  BCDEF$___8c?fJ, @T   8  BCDE F(___8c? r Z :$ @R / H" 8  BC,DE$F,___8c? +u ] E /  @L V  8 C BkCDEF  A@1?hh31+'Qo3Qo  = [ y      3 Q n    ';YuwdG3;Wuo Q&=C)a %CyjeG=*!9B`jLe/ee[[[[~[/[[[[[[aQCQ&QHHH?a?;??55++!l!33+3+@"B  `|$ a H8 v5 U 85 vUx2 8B H___1?v ?  8  B0CDE F(___8c?*/&(=*V$l@5   8  B5CDEF$___8c?4$A]z @G   8  B0CDE F(___8c?*/&:Q m@N  " 8  BLCDE$F,___8c? K0#3Jbx @ _ UH8 '  8 'x2 8B H___1?'' 8  B1CDE F(___8c?+0&)=+V%m @1 b` 8  B5CDEF$___8c?4%A]z @p r 8  B0CDE F(___8c?*/&:R n@ x" 8  BLCDE$F,___8c? K0#3Jbx @ H8  _] 8 _]x2 8B H___1? H  8  B1CDE F(___8c?+0&)=+V%l @ 4 8  B5CDEF$___8c?4$A]z @ F 8  B0CDE F(___8c?*/&:R n@ M" 8  BLCDE$F,___8c? K0#3Jcx @ _]H8 c5 8c5x2 8B H___1? 8  B0CDE F(___8c?*/&(=*V$l@c  8  B5CDEF$___8c?4$A]z @&u[ 8  B/CDE F(___8c?).&:R n@M||%" 8  BKCDE$F,___8c? J0"3Jcx @p5H8    8  x2 8 H-___1?    8  B{C{DE F(___8c?# 3+J<[Lkbwzz@f   8  B|C|DEF$___8c?&<(P<fQ{gz{@1 I  8  B{C|DE F(___8c?#'-7>SNd^uqz{@ ^ " 8  BClDE$F,___8c? % <M)^9nIZkb@   H8 P^FE 8^PFEx2 8 H-___1?r9 8  B{C{DE F(___8c?# 3+J<[Lkbwzz@^F 8  B|C|DEF$___8c?&<(P<fQ{gz{@  8  B{C{DE F(___8c?"',7=SNd^upzz@"" 8  BCmDE$F,___8c? % <M)^:nJ[lb@PEH8  8x2 8 H___1?r 8  B/CDE F(___8c?q$[)D.-+ @ O 8  B)CDEF$___8c?~a E( (@b+ 8  B"CDE F(___8c?oX8  !@0" 8  BCDE$F,___8c? t\E . @4H8 m6 8m6x2 8 H___1?mr6 8  B/CDE F(___8c?q$[)D.-+ @} 8  B)CDEF$___8c?~a E( (@+ 8  B#CDE F(___8c?oX8  "@0" 8  BCDE$F,___8c? t\ E . @40j2 8 B31?J F 8 C BCQDEF31?333PmkW9 (FZwkO; 2PP;FO(k  'w9ZWFu( mZPF=3)gh@4F'  8 C ^BECNDEF1?;;%111~'aD&  'ElbNkD:'  : Wu '%D9bCMMMMC9:%Xtk0MD0DDDDDDDb%%wx@\'  8 C BCDEF1?..1 uX: &' 1 Ol &:Nk1NXk&9MajujXt:~~ltOj111]`@ j2 8 B1? Wj2 8 B1?1Cj2 8 B1?k j2 8 B1?;Tj2 8 B1?oj2 8 B1?.gj2 8 B1? ,Bj2 8 B1?0 p2 8 H?1?W p2 8 H?1?_  p2 8 H?1?  p2 8 H?1? 4/2 p2 8 H 1? vp2 8 H 1?'p2 8 H 1?Rp2 8 H 1?'p2 8 H?1?Rj2 8 B31?0  j2 8 B31?0  oj2 8 B31?w0  Gj2 8 B31?z\ Jj2 8 B31?0  W j2 8 B31?0  j2 8 B31?0  |p2 8 H231?t m j2 8 B31? 0  j2 8 B31?_ 0  / p2 8 H231?IA p2 8 H231?Gp2 8 H231?p2 8 H231?ovp2 8 H231? p2 8@ H31?  p2 8@ H31? # p2 8@ H31? N p2 8@ H31?V  p2 8@ H31?. }p2 8@ H31?Zp2 8@ H31?p2 8@ H31?p2 8@ H31?{9p2 8@ H31?\p2 8@ H31?  p2 8@ H31?  p2 8 H231?:Tp2 8 H231?1p2 8 H231?@\,p2 8 H231?* y p2 8 H231? Y p2 8@ H31?p2 8@ H31?P p B  8 Z,˕gֳgֳ ?"` PPg  h Osteoclast" (*2 ̙   8 TՕgֳgֳ?00P uCa 2+4(*2  2 8 C BcENGgGHۚ^I%OQ8c? "7cF"7cF%O`T"7cF%O`T`2 jB 8 B̙1? `P  8 Zߕgֳgֳ ?"`  pActive Osteoblasts"(*2 jB 8@ B8c?p2 8 3 E$GH I`TQ8c? `TJT`TJT`T`T`TJT`T`T AjB 8 Bwwwp?`pP 8 Tgֳgֳ?p  b Bone canal (*2    9 Zgֳgֳ ?"` @  k Resting cells"(*2  2 9 3 BTENG IZQ1? TT`TTT`TZ`TT`TZ`T1 !  9 Tgֳgֳ?@G i BONE CELLS" (*2    9 Thgֳgֳ?   h Periosteum" (*2   j2 9 B31?Lj2 9 B31? \j2 9 B31? < j2 9 B31?j2 9 B31?Lj2  9 B31?j2  9 B31?|j2  9 B31?\j2  9 B31? l j2  9 B31? | j2 9 B31?  j2 9 B31?  j2 9 B31?j2 9 B31?  j2 9 B31?lj2 9 B31?Q  j2 9 B31?;: j2 9 B31? J j2 9 B31? j2 9 B31?u j2 9 B31?K :  9 Z"gֳgֳ ?"`p g Osteocyte" (*2    9 Zh,gֳgֳ ?"```0 f 3Bone matrix = collagen fibrils + mineral crystalsZ4(*2 H    H 8 0޽h ??0889 ̙3380___PPT10.g0 3< 0  5 ;;BB<:(  <~2 < H p?"`@Z < Tgֳgֳ?0@P 4Osteoclasts as a team eating out a resorption tunnelN5(*2 f0  (  < TEgֳgֳ?` f >Osteon/Haversian system with concentric lamellar/layered bone>?(*2&`     +8 'P! 2<P'!(@ 'P! +<'P!@ 'P! <'P!F @ '!  <'!rB <B B1?p rB <B B1?  ` , <  BOCDEF1?++7M,BL7m,,!  2 Rs" B!c7Xx=]scB-   hG-'8NGWX@9p ! ~ < N3A1?t$  <  BzC DEhFp3A1?ZZy M, +Lb~hR<1'Rs ,MnxmWLA26S6t,,,! 8 Yz>_#!D,e,,6AAL4LUbvmx:[|1 G5 ]V sw      % F g ,} M I Xg @'  < C BzC DEhFp  A@1?ZZy M, +Lb~hR<1'Rs ,MnxmWLA26S6t,,,! 8 Yz>_#!D,e,,6AAL4LUbvmx:[|1 G5 ]V sw      % F g ,} M I Xg @"B  ` !@ tl <tl~2  < N3A1?tl~2  < N3A1?0~2 < N3A1?~ B~2 < N3A1?Z2 < H 1?"`_\@  E < E~2 < N3A1? E2 < H 1?"`W i z2 < < ?"`6 I:@ P  <P  <  |BC DEF  A@?oo S1eCvte11c 0cve/Bc /cvS!/au-Ua2-aweC-2_, vN T " UN 3 "P"Ua-a"-Cea/!R2CewR2RU uc11BSde@"B  `Qj rB < Bwwwp?+ PPx2 < HK31? @ ` r2 < B31?:   x2 < H;31? Y  < S lBUCjDEFPPA1?<<^2iS^tH'n"M-,N YohG&(m3L>+T 3 AbodNC&8G8h"  ,Mni^H=2^^y|@ "  < S BCDE FPPA1?CC+6L^W=mxyX7&1G]ssR1 b7AM c xAnbX7,&Ghsh G!1Bc'=^mWA6@l - At < S DB C DEFPPA1?77 ,LmyX7'1s<RR1hxW6 ! !AsbhR<1<]~m!bBWc7y7  op@P ] !  < S lBACDEFPPA1?<<k'J2)H H^iteD#_8>CYozzdC-"@338Yz>o_N-"#Dei ^)SJ=k'y|@p  x2 !< H1? T\ x2 "< H1? t\ ,x2 #< H1?D  \x2 $< H1?  x2 %< H1? $L x2 &< H1?  x2 '< H1? 4 x2 (< H1? d< x2 )< H1?t  rB *<B Bfp?`  x2 ,< HI1? 4 L x2 -< Hf1? x2 .< H&1? $ L x2 /< HP1?s $ x2 0< H1?t 4 x2 1< HW1?  \ ) 3< Ttmgֳgֳ?P <  New bone - start of new osteon2 (*2 PP0   7 4< T|sgֳgֳ?0 !Osteoblasts filling in the tunnel>"(*2 0   jB 5<@ Bf8c? ` 2 6< 3 BvTENG IQ8c? vTvT`TvTvT`T`TvT`T`T j2 7< Bf1?4 2 8< C ENGZHI`TJQ8c? `T`T`T`T`T`T`T`T`T`T!` 9< Tgֳgֳ?  sDENSE BONE REMODELING"(*2  2 :< 3 ENGHZJQ̙8c? `T`T`T`T`T`T`T`T`T`T  j2 ;< Bf1? 4  8 -t3l  A<t-3l ~2 << N3A1?-t3l ~2 =< N3A1?z ~2 >< N3A1?  ~2 ?< N3A1?Z H 2 @< H 1?"`> !_ j2 B< Bf1? t H < 0޽h ??06<8<:< ̙3380___PPT10.g<  0  5 $@(  @ @ T^gֳgֳ?PM >1 Everything has to be done by cells* 2 Organs & tissues need to grow & to change shape 3 Cells age , and control systems get out of balance 4 Bone is always at the mercy of body s need for calcium - nerve-muscle priority 5 Bone needs to be loaded every day: use is essential (*2%47̙=3339x%   4  d @ Z<gֳgֳ ?"` vBALANCE is vital in bone - bone destroyed by osteoclasts has to be replaced close by with new bone made by osteoblastsw(*2f$ ̙1      1   H @ 0޽h ? ̙3380___PPT10.g V  0  5  DB(  D D Tgֳgֳ?` ~ BONE S PROBLEMS"(*2   D Tʚgֳgֳ?@0  `21 Everything has to be done by cells* 2 Organs & tissues need to grow & to change shape 3 Cells age , and control systems get out of balance 4 Bone is always at the mercy of body s need for calcium - nerve-muscle priority 5 Bone needs to be loaded every day: use is essential(*2%25̙S37x%   4   D Tgֳgֳ? @ * Cells die & may not be replaced Cells cannot respond to signals Cells do not send signals Supplies, e.g. of Ca , not adequate Growth more demanding than staying the same (*2#/          / H D 0޽h ? ̙3380___PPT10.g 4 0  5 y3q3044H2(  H> 8 1 H1rB HB B1?Z rB HB B1?u  ` , H  B[CDEF1?++8N,CL8m,,!  2 Rs" B!c8Yz!CdzcB- h!G8'CZRWX@"p} ! ~ H N3A1?O$ H  BC DEhFp3A1?ZZ X6+ LbnXA1,R!s  ,MnzoXMB27S7t,,,! 8 Yz>_#!D,e,,7BBM4MUcvoz:[|!6 M5 cV zw      % F g 6} X T cg @} H C BC DEhFp  A@1?ZZ X6+ LbnXA1,R!s  ,MnzoXMB27S7t,,,! 8 Yz>_#!D,e,,7BBM4MUcvoz:[|!6 M5 cV zw      % F g 6} X T cg @"B  ` 18 tl Htl~2  H N3A1?tl~2  H N3A1? u~2  H N3A1?Z &~2  H N3A1?Z2  H H 1?"`_T8  E H  E~2 H N3A1? E2 H H 1?"`P l r2 H < ?"` I H  |BC DEF  A@?oo9n PCv1Pc> 0c/\c9/ci6/a-eaB-aqN-=_, ~N [ ( WN 4 #P#Wa-a(-Ila/+R=NqR BRe c$1FWize@"B  `Qxw jB H Bwwwp?P- Pp2 H HK31?@ w T j2 H B31?: l p2 H H;31? H  H S lBaCjDEFPPA1?<<^3iT^vH'n'M3,T _vhG&3m>LI+` > AbvkTI&>G>h' ,Mnk_I>2^^y|@"  H S BCDE FPPA1?CC+7M^X=ozyX7 +6McsyR1bAAW n AybcA6 &Ghyn M!6B c '=^oXB7@-l Al H S DBC DEFPPA1?77 ,MoyX7 !,6sBRX1nxW6!!AzbnXB6<]~o!cBXc8y8  op@P g ! H S lBLCDEFPPA1?<<k'J2)I I_kveD#_=>I_vzdC-'"K==8'Yz>v_T2'#Dek _)TJ>k'y|@ p p2 H H1?T ^ p2 H H1?t ^ ,p2 H H1?D \p2 H H1? p2  H H1?$ N p2 !H H1? p2 "H H1?4 p2 #H H1?d > p2 $H H1?t p2 %H HI1?4 N p2 &H Hf1?  p2 'H H&1?$ N p2 (H HP1?$ s p2 )H H1?4 t p2 *H HW1?  ^ j2 +H Bf1?^  ,H Thgֳgֳ? m (DENSE BONE at less risk than spongy bone")(*2) ( 8 -H TXgֳgֳ?`W 01 A lot of bone to start with (less in women)01(*2/0!   % .H T8#gֳgֳ?` 33 Tunnels filled in at least a little by new bone24(*2+ PP3 & /H T/gֳgֳ?`u  * 2 Only a few tunnels made by osteoclasts2+(*2 f") 2 0H S 6ENGZHI`TJQ̙8c? `T`T`T`T`T`T`T`T`T`T r jB 1H Bf8c?  2 2H C ENGHZJQ8c? `T`T`T`T`T`T`T`T`T`T @0 2 3H C ENGHZJQ8c? `T`T`T`T`T`T`T`T`T`T r j2 4H Bf1? 4  H H 0޽h ??00H2H3H ̙3380___PPT10.g R3 0  5 22@55L&2(  LjB L Bwwwp?P- P> 8 +Z   L+Z rB LB B1?P8~ rB LB B1? , L  BCDEF1?+++<!3:+S"m"6Wq+D]w"3MVoy`G.WX@'  ~ L N3A1?0  L  BCDEhFp3A1?ZZ!:xKpdVu=+ 6O`yxf^U*DC;]3u**""" &?Xr";Tm"" "&*?3Y3r;;LU^o x#;Un/#I4aE{MVpx@+ L C BCDEhFp  A@1?ZZ!:yKpdWu=, 6O`yxg^U*DC;]3u**""" &?Xr";Tm"" "&*?3Y3r;;MU^o x#;Un/#I5aF{NWpy@"B  `gZ   L  <BCDEF  A@?''u;dTKn)  9Sl)tB[u}t\J1eL3OP@"B  `7; r2  L < ?"`Rr2  L < ?"` + r2  L < ?"` UY r2 L < ?"`:C! r2 L < ?"` 8 j2 L B31? F[ j2 L B31?7j2 L B31? FY p2 L H^31?  p2 L H31?j1 p2 L HU31?O # p2 L HJ31?9Jp2 L H31?e# jB L Bp? ` 0 R8  . -L .F @  . L .rB LB B1?Z8 rB LB B1?1A , L  BCDEF1?++'6!.:'Sl5Vo'>Ul.6Mx\^dFt-t{WX@ 8# ~ L N3A1? L  BCDEhFp3A1?ZZr k:SJKd4u5M^w{{l\T M'=@5Y.r&&":Sm5Ng&8.Q.i55EMTdlt2Kd~ %>V%p,4KScr@  L C BCDEhFp  A@1?ZZr k:SJKd4u5M^w{{l\T M'=@5Y.r&&":Sm5Ng&8.Q.i55EMTdlt2Kd~ %>V%p,4KScr@"B  `m.  L  <BDCDEF  A@?'' Q}s]3) !Dg3Sr ##~-\89CCCCCChCFC## OP@"B  ` z2 !L < ?"` [z2 "L < ?"`5 ( z2 #L < ?"`%Mz2 $L < ?"`Vj z2 %L < ?"` # r2 &L B31?N x r2 'L B31?N w x2 (L H^31?  x2 )L H31?oQ x2 *L HU31?h w x2 +L H31?w+2 ,L BM ?"` &s r2 .L < ?"` 0 j2 /L B31? , p2 0L HJ31?/ ^  1L TTgֳgֳ?p @ j Larger holes" (*2    2L T^gֳgֳ?`@ fNarrower" (*2  jB 3L B8c?002 4L 3 BTENG~ I#Q8c? ëTT`TëTT`T#`TT`T#`T  5L Tjgֳgֳ?W TJDENSE BONE OSTEOCLAST-osteoblast imbalance leads to somewhat weaker boneK(*2 $      ( `      ' H L 0޽h ?4L ̙3380___PPT10.g n# 0  5 ""PP2"(  P^ P 6___?p $  P S B Cm DE8F@PPA1?L~%E!f,BMXc n+Kl0Qgg2rS}t} 8Yz(Ij .OO9r.Q.& V6 fE%9Z0eP{q6Vw;\})4!?LJmU`vv<]~,Mn$EyfXq7 @ a a a 7V XK y5   2H|i[[[[[ [-[N[nff|3Tt 9 Y  z * 5 5 @ @  @ ? @ _ @ K K K K  V $ V D V e a l l K *       |p qO q/ f f [ P P Ej EJ :) : / / $ z Y 9  `?{O. tttti_i>ii__TIzIYiNNdoz . O o      4 T u    ( ($ 3D >e > I I T 3      d C "  { Z :      T    D t# i ^^SHH_=>'Y8iH''c=BH!i ~]<-CNnybyA d C" Ab~tiS='&Gh yX,7,!  hG&bA!gF&a@ ~|s[s;hLL @ ~ P C VBCDEF___1?zz!2Ss  8Yy!!7AL(bImix .No>I<j]u~u"Bc(Ht#CduT4dzDo#odYNCi8I8(-#  cC"~^Ht=S22'nM- hG'b!!@ g  P S BCVDEFPPA1?$$O)"EcrY/LM&j ?e}aC&";UUUUvHYH;HOOIL@  p2 P H31?4 p2 P HP31? D  P  BCDEFfA1?::$4JkvxWB!/ P q!Bb2qRP]/hs~]=$'EfmLB7f7E7$7BbkJ0$ux@\ PD   P S BnCDE F(fA1?HHW2StmL6  #Cd Ab<RzsdC# ,MmcB!ttthG&-CdoozbAAdACA#bxiH2(W@ ) ~ @  P Tgֳgֳ?|  .2 Much surface area for attack by osteoclastsR/(*2  f.    P Tigֳgֳ?P '1 Struts are thin to start with ~ weak"((*2(' k  P Tgֳgֳ?0 a3 Gap in a strut/trabecula cut right through is usually too wide to be bridged by any new bone2b(*2Y f0 O    P T\gֳgֳ?0 (SPONGY BONE at more risk than dense bone")(*2) ( 2 P 3 ENGHZJQ1? `T`T`T`T`T`T`T`T`T`T  2 P C ENGZHI`TJQ̙1? `T`T`T`T`T`T`T`T`T`T 0` jB P B8c? H P 0޽h ?/ PP ̙3380___PPT10.gg  0  5 ^V`T (  T8  @  T @ rB T B3? @rB T B3? X@XrB T B3?@@ rB T B3? rB T B3?   rB T B3? h @h (8  p   T p rB  T B3p? prB  T B3p? rB  T B3p?88 rB  T B3p? h ph jB T Bfp?(` ( T Tgֳgֳ? 0 O  lThinner struts"(*2 N T T@Ŝgֳgֳ?8  Bigger holes Fewer strutsB(*2  H      T Tgֳgֳ?@  Q="(*20  T Tܜgֳgֳ? u smuch weaker framework"(*2  2 T 3 E$GH I`TQ8c? `TPT`TPT`T`T`TPT`T`T`  jB T B8c?pp8 jB T B8c? @@  T Tgֳgֳ?0 \RSPONGY BONE OSTEOCLAST- osteoblast imbalance & architecture lead to fragile boneS(*2 $      . `      - H T 0޽h ?T ̙3380___PPT10.gg X 0  5 WWpMMXtW(  Xe X T@ޜgֳgֳ?PG +MAINLY SPONGY BONE LOSS causes fractures inb,(*2 0  A X Ttgֳgֳ?P /1 Bones that are mostly spongy, e.g. vertebra"0(*20̙H#   & X Tgֳgֳ?k_P  D2 Spongy part of long bones, where leverage concentrates loading"E(*2ED jB X B8c?  X T$gֳgֳ?   rcompression fracture"(*2| 2 X 3 ENGHZJQ31? `T`T`T`T`T`T`T`T`T`T p  X Tt0gֳgֳ?P P V  > Hip fracture at neck of femur" (*2    X T;gֳgֳ?pPv  , Wrist end of radius 0(*2   X T4Ggֳgֳ? 0 vfrom falling on the hand"(*2    X  BBCVDEF1?7P@if 2)XCh$Kq5>Bc\ A h##(#M0t==Vc |4AZ33Z"4U ooogo3obU4II4U[o|@g '"""""""N"'Nu".;HT3nZZ3hiO({a!HUhUCUH.a;|U/pJ#\7pK$P7d>xrkLE%QT@Z K"  X NG  ?"` jB  X B? jB X B? jB X B?jB X B?jB X B?jB X B? jB X B?:@>jB X B?Z@^jB X B?jB X B?2``jB X B?jB X B?b@f" X NG  )?"`88 jB X B)?P jB X B)?1P 4jB X B)?4jB X B)?4jB X B)?4OOjB X B)?P jB  X B)?1jB !X B)?AjB "X B)?111jB #X B)?0P 4 $X  BBCDEF  A@p?@~h]]]]mRL<+ xW A++Lm 1Rs6~Wx<]~!Bn2St8d(Ij_>yY!8!!!!!!t!S!2!,MXc2nSntnx"Cd(Ij_>yY8iH'cB!~]<xXB!1RR@@IL@"B  ` P< %X  BCaDE8F@8c?-No#.39TDOZZ` @ aa D &X  B<CDE<FD8c?3St%%%%0080Y;z;;0 @    'X  BCDE F(8c?'}=\]Fs%@p P1 , (X  BC)DE0F88c? (!AWxxWA @ ga! 4 )X  BC:DE4F<8c? 009P#q##6Vw@ a: D *X  B!CDE<FD8c?8N#dDze )Jk  @ p 4 +X  BCDE4F<8c? 0Pq@Vv @l@0 n! t ,X  LBCDETF\8c?3 S77MXn.Yz>_+,@  | -X  TBCDEXF`8c?4U(u>Si:[{#.@C`Yo-0@ cV 4 .X  B>CDE4F<8c? =+3+S+t+ 8 d @ f , /X  B#CQDE0F88c? P2!H^~gF%" @p @c   0X  BlCDE F(8c? 0Q!r6AWk@p aa  1X  B.CDE(F08c? 2Ss^I( - @ @n l 2X  DBsC6DEPFX8c?0P q 6AWm6xVw0Qr&p5),@ c < 3X  B1CDE8F@8c?0#,#M#m##2 S s  @ E D 4X  BCDE<FD8c?.)O?pJUU`kv?` @ 1  5X  BCQDE$F,8c? P8GdrsM&@  d 6X  <BCDELFT8c?;9fOe6Vw?`'(@ ! l 7X  DB1CqDEPFX8c?5Uv;[| +Ll0p),@@ 0a  8X  B!CfDE(F08c? `4eUOuD9.  @ v < 9X  BnCDE8F@8c? ,+M+m6AALWb2bSbsm` @ a 4 :X  BCDE4F<8c?  L#,CNorQ1@` pa  ;X  BlCQDE(F08c? /5C\Wkkkkk@WP@ ,1  X C BCDEF1?//j,6M cm xAb&Ghxxmmm m,mMmnmmmM,n!M,,, ,hG& jj_`@v +G< ?X  BaCDE8F@8c? 3#S.t..88889NYNzY` @ p  @X  BCDEF1?""`6WxxW6AWmcBBxcWxA!`6xAXW7mdEH@  | AX  TBQCDEXF`1?PL#b^bB! i!H!(!L-0@D   BX  B'CDEF1?%%~^=bA 6W2xSs~&s&SH2mmbxbXb7bsKL@ Q d CX  <BCDELFT1?~]=vV55*B'(@0 p!* D DX  B!CDE<FD1? 0\}}zreQDF#1  @ !Z jB EX B)? 0 jB FX B)? "  GX  BCDEpFx8c?!7Mb2mSs'Hh~^=~]='xX79<@ @b  HX  BCDEF$1?kK * @ Q < IX  B!CRDE8F@1? PQ0pZO9`.@# @ 0Q"  JX  BnCDE(F03)? !A,L}W\W;md@ j  KX  BGCDE$F,3p? F+.!O!pp!{+@  \ LX  4BCMDEF3p?22L 7 W x 6AA 2Rs++ "+B6Mn ++ 'H S+t++ 8 Yz    36T6u  eh@ !pB MX H8c?P0PH X 0޽h ?X ̙3380___PPT10.g : 0  5 Q:I:00\9(  \ \ Zh_gֳgֳ ?"`R@ $ The anatomist can explain why any venous clot dislodged in the leg is likely to block vessels in the lung - a pulmonary embolism. B(*2n0j   \ Tgֳgֳ?0P qPULMONARY EMBOLISM"(*2  \ ZMgֳgֳ ?"`R f Blood clot (*2   p \ HG1?Y>p" \ HG 1?$w pr \ HG1? Spr \@ HG1? _8 =   \= ~"  \B NG 1?j ~  \ NGG1?=  \  rBCDEF1?99dLgAgtMt'tgZZZAZg4u4Z444 4   AgZ4  4ZgsMs' sL&&@ggL&dLdRst@  j2  \ B1?9WWj2 \ B1? j2 \ B8c?}p \ HGf1?q pR \ HG/*1?q^j2 \ B1?7 8 <=T  \=<T ~" \ NdG 1?j^ ~ \ NG1?<=^ \  rBCDEF1?99) L gAgM'&333A3gYuYZY4Y YAgZ4  4Z gM' AggM&gL&s) L)Rst@ T pR \ HG/*1?4u]pR \ HG/*1?4jB \ Bp? 1jB \ Bp? ! jB \ Bp? ! jB \ Bp? !` 8 xC &\xCz \ c JBCDEFfA?774'   '1;ENX_i r v!*3:C|LyUo[laed[jRnNwEz>74*'  } s ja[RI4'&op@T6r \ Bf1?/ef \ 6f?  \  BCDE FA?CC{rja[RI@8/)   !).6=EMU Zbint&y)~/5;CLU^addydqdifdj\mUoMrEx@x;~30)$@;l !\  BCjDEFfA? #(.6?AJRZb empx!),/44:?BEJPPSUX[```cc#f,f1f9iBiJiRiXi`ihipiyf|`[UPHB:1)! ~vp~h|`vXsPpGnBk9e4e.c&Z!UOGB <4,#  !&,17<DJJD<4.& ~vkbZU RLD?$9&6,1..4(9#?GPX`fn v ~KL@hC: "\ c BC0DE<FDfA?  !' -17<BHLRX^djnsy } !')/57=@DHNRV\`flruz !%+/,'%! ywqllhfb^ZVPJF{Bu<r8n5j/d+`%ZTPLH B >:51+% !  @x #\ TV1V1?&n zPT(*2 !HH   $\  BCDEtF|fp?]]  &,05;?CI O W[_`eg!h'l+r/x3~9=?CEGLQRVX\\^bhlnrx~!'-19=CIMSYaglrz@ov %\  dBC^DEFfp?xx4=AEIKOSWXZ]]]]]]]]]]]|]v]p]l]f]`]Z]UZQXKWEU=S5S-Q)O#MKIGEA=;753/-+'#!~xxtphfb`\VVRRNLKIDA;7~1|-x)v)r#njd`\ V QIC=73+'! @gCjB '\ B? P  (\ S BCDE F(A1?HH ['{aI$$^; 1InhRE/"@ e ~  +Ot  !F"k"E\t;^jjwj^w9hCq [ [@\jB )\ Bp? jB *\ Bp?AA< +\ S BCDEDFLA1?QQa$*  _<+$K k!7 W$w/HSl-Mbx*CCCCC.CNCnC7*Cg~nN.xbB"lL, ~`a$a$@PGfjB ,\ Bp?qj2 -\ B1?],j2 .\ B1?ejB /\ B8c?QV 0\ Z`gֳgֳ ?"` " 0As the clot passes through the venous drainage out of the leg, and up through the abdomen to the heart, it is in progressively wider vessels. The pulmonary arteries are also large. It is only when the clot reaches the narrow arterioles of the lungs that it is likely to be stopped, blocking blood flow."1(*21H % x H \ 0޽h ? ̙3380___PPT10.gI  0  5 bZ`(  `% ` Tpgֳgֳ?pm FRACTURES KILL>(*2  3  0    ` Ttןgֳgֳ?@p x Lung embolism - clot(s) not stopped until lungs arteries"=(*2= f`   #  ` Tgֳgֳ?p0m Infections - pneumonia, etc"(*2 f0   p ` Tgֳgֳ?p   Falls get Granma sent to a  home , where she is too depressed to live"H(*2H ̙G jB ` Bf1?T\ jB ` Bf1?dTjB ` Bf1?dTH ` 0޽h ? ̙3380___PPT10.g  0  5 QId(  d# d TDgֳgֳ? m )How to get a better cell-activity balance"*(*2* 30  ~ d T|gֳgֳ?0P ~1 Get more bone built when young food, exercise, vitamin D (sunlight) 2 Keep on eating properly, & boost needed nutrients when older, or pregnant 3 Exercise - high rapid loads (impact), as well as lengthy lower loadings 4 Correct hormone deficiences - older women especially 5 If at risk, have bone density measurements taken, with a view to special drug therapy(*2% &  N f   ' ; fZ B  \   F s H d 0޽h ? ̙3380___PPT10.g W 0  5 ;W3W__hSV(  hV8  _h h Tgֳgֳ?  tDENSE BONE REMODELING*"(*2  ~ h N|A1?dT \ 2 h  BTENG' I"Q 1? «TT`T«TT`T"`TT`T"`T"`] b @    h  v@     h  ~2 h N3A1?  f2 h 6f?0 P f2 h 6f?` P f2 h 6f? @ f2  h 6f?    h BCDE(F03?JJK  6VV+@K6KVKvkkKkk  +KVvv v  6kVvvk`VvKKkK+ 6  6kKK`+k vkK+ kVk@K K @E  2  h C 0BVENG IQ|)? ]VV`T]VV`T`TV`T`T 8 2  h C BVENG IQ|)? ]VV`T]VV`T`TV`T`T   h Z9gֳgֳ ?"`` h Osteoclast" (*2 3   h TBgֳgֳ?  1Ruffled border agitating released enzymes & acid 2(*221 J h TDgֳgֳ?`PV HEaten-out hole is a Howship s lacuna"%(*2%30  2 h 3 ENGHZJQ31? `T`T`T`T`T`T`T`T`T`T@0 E h  `Xgֳgֳ1?  GUn-mineralized OSTEOID between active osteoblasts & calcified boneH(*2f f3        h T8Ogֳgֳ?  sDENSE BONE REMODELING"(*2  2 h 3 ENGHZJQf8c? `T`T`T`T`T`T`T`T`T`T  b h T xgֳgֳ?  4Osteoclasts as a team eating out a resorption tunnelN5(*2 f0  ( ? h T܁gֳgֳ? Y !Osteoblasts filling in the tunnel>"(*2 0    h C BzC DEhFp  A@1?ZZy M, +Lb~hR<1'Rs ,MnxmWLA26S6t,,,! 8 Yz>_#!D,e,,6AAL4LUbvmx:[|1 G5 ]V sw      % F g ,} M I Xg @"B  `qF ~2 h N3A1? t2 h H p?"`-" 'z2 h < ?"` xx2 h HI1?c  x2 h Hf1? ;x2 h H&1?S  x2 h HP1?=S  x2  h H1?>c  x2 !h HW1?3  r2 "h Bf1? VL rB #hB Bf1? ! rB $h B1? rB %h B1?A 02 &h H p?"`pF @ XGR  -hXGR rB 'hB B1?!rB (hB B1?1 , )h  BOCDEF1?++7M,BL7m,,!  2 Rs" B!c7Xx=]scB-   hG-'8NGWX@jQ ~ *h N3A1?T  +h  BzC DEhFp3A1?ZZy M, +Lb~hR<1'Rs ,MnxmWLA26S6t,,,! 8 Yz>_#!D,e,,6AAL4LUbvmx:[|1 G5 ]V sw      % F g ,} M I Xg @XG ,h C BzC DEhFp  A@1?ZZy M, +Lb~hR<1'Rs ,MnxmWLA26S6t,,,! 8 Yz>_#!D,e,,6AAL4LUbvmx:[|1 G5 ]V sw      % F g ,} M I Xg @"B  ` GR @   3h ~2 .h N3A1? ~2 /h N3A1?aO~2 0h N3A1?=s~2 1h N3A1?&2 2h H 1?"`!\@ ; u 6h; u~2 4h N3A1?; u2 5h H 1?"` (z2 7h < ?"`g y 8h  |BC DEF  A@?oo S1eCvte11c 0cve/Bc /cvS!/au-Ua2-aweC-2_, vN T " UN 3 "P"Ua-a"-Cea/!R2CewR2RU uc11BSde@"B  `  x2 9h HK31?p  r2 :h B31?j @B x2 ;h H;31?J #  +T 3 AbodNC&8G8h"  ,Mni^H=2^^y|@R  =h S BCDE FPPA1?CC+6L^W=mxyX7&1G]ssR1 b7AM c xAnbX7,&Ghsh G!1Bc'=^mWA6@]! qt >h S DB C DEFPPA1?77 ,LmyX7'1s<RR1hxW6 ! !AsbhR<1<]~m!bBWc7y7  op@G Q ?h S lBACDEFPPA1?<<k'J2)H H^iteD#_8>CYozzdC-"@338Yz>o_N-"#Dei ^)SJ=k'y|@P x2 @h H1?5  <x2 Ah H1?5  \x2 Bh H1?ux2 Ch H1?- x2 Dh H1?% T} x2 Eh H1?  x2 Fh H1?d- x2 Gh H1?mLx2 Hh H1?$rB IhB Bfp? ! x2 Jh HI1?% d }  x2 Kh Hf1?5 <x2 Lh H&1?% T } x2 Mh HP1?T  x2 Nh H1?d  x2 Oh HW1?5 4 r2 Ph Bf1?%}L2 Qh 3 ENGHZJQ1? `T`T`T`T`T`T`T`T`T`T  Qr2 Rh Bf1?% } L @ $  Xh$ ~2 Sh N3A1?$ ~2 Th N3A1?kO ~2 Uh N3A1?=  ~2 Vh N3A1? 9 2 Wh H 1?"`/  r2 Yh Bf1?e L  Zh Ttgֳgֳ?  fNew bone" (*2 PP 2 [h 3 BvTENG IQ1? vTvT`TvTvT`T`TvT`T`Ta@" rB \h B31? p P ]h Txgֳgֳ?1   +Sealing ring of tight attachment to bone",(*2,|+ rB ^h Bf1? `0H h 0޽h ?ph h hhhQh[h ̙3380___PPT10.g  0  5 tll(  l l Tgֳgֳ?m i OSTEOCLAST*" (*2    " l Z΢   ?"` / Multinucleated"(*2f =ZZ  ff1 l TH  ?/ [  1Ruffled border agitating released enzymes & acid"2(*22̙1 =ZZ  ffb l T  ?   JEaten-out hole is a Howship s lacuna"&(*2&0  =ZZ  ffv l N|A1? 2 l  BwTENG% IQ 1? wTwT`TwTwT`T`TwT`T`T"`Dw v2 l NA1? ik^2  l 6f? ^2  l 6f?E ^2  l 6f? [^2  l 6f?[ )  l B&C6DE(F03?JJl.M||=\lMl|ll444bq)5I5WWw/^l|lll>.%M..M|lN g9 R$|\ll@8 ^2 l c C^TENGH/ I`TJ^TQ)? ^T.S^T.S`T^T^T.S`T^Tv 0 2 l S B UENGu} HGgIQ)? ` U US` U US`T US`T?I 2 l C CTENGgHZJQ̙8c? `TT`TT`TT`TT`TToM # jB l B8c?  `+ l T  ?0 +Sealing ring of tight attachment to bone",(*2,+ =ZZ  ffjB l@ Bf8c?` p  l Z   ?"`0`   Eosinophilic" (*2   =ZZ  ffjB l@ B8c? `p2 l 3 B"VENGw IQ8c? b"V"V`Tb"V"V`T`T"V`T`T  p  l Z   ?"`/` Large"(*2 =ZZ  ffH l 0޽h ?_Plllll ̙3380___PPT10.gN I 0  5 p (  pլ8 FP pFPrB pB B8c? @ rB p B8c?`pp@ F0` pF0`f p 6?`0` p C VBCDEhFp1?k1GQ[[[[fbA A|bfxGkk58@bK p C VBCDEhFp1?2H`S@]]]]@h`v ~hH58@! p C VBCDEhFp1?D3p1#-M{~bG++>ICV58@vJ p C VBCDEhFp1?:_s`w@&9zRg>M)41-W9~658@S   p C VBCDEhFp1?2H`S@]]]]@h`v ~hH58@gS  p C VBCDEhFp1?D3p1#-M{~bG++>ICV58@z  p C VBCDEhFp1?k1GR\\\\gbA A|bgxGkk58@s  p C VBCDEhFp1?2H`S@]]]]@h`v ~hH58@HsV  p C VBCDEhFp1?D3p1#-N{~bG++>ICW58@F p C VBCDEhFp1?k1GQ[[[[fbA A|bfxGkk58@l p C VBCDEhFp1?2H`S@]]]]@h`v ~hH58@  p C VBCDEhFp1?D3p1#-M{~bG++>ICV58@6: ! p C VBCDEhFp1?k1GR\\\\gbA A|bgxGkk58@hR p C VB CDEhFp1?lbO~6fOAO;]]bN5:Wfs}ll58@7@ p C VB*CDEhFp1?p:R]i)hijylG##Gj|Upp58@!YKp@  P Fp Pf p 6? PX@ $ \ "p$ \<@ l plr2 p B1?lr2 p B1?D<<@    p  r2 p B1?  r2 p B1?4 D <@  $  p $ r2 p B1? $ r2 p B1?4 T <@ \ !p\r2 p B1?\r2  p B1?l,X@ $ 4 l /p$ 4 l<@ T  | %pT  |r2 #p B1?T  |r2 $p B1?  L<@ D $  (pD $ r2 &p B1?D $ r2 'p B1?t T <@ D 4  +pD 4 r2 )p B1?D 4 r2 *p B1?t d <@ $  l .p$  lr2 ,p B1?$  lr2 -p B1?T  <<@ d  \ 2pd  \r2 0p B1?d  \r2 1p B1?  ,<@  <  5p < r2 3p B1? < r2 4p B1? 4 <@ d  | 8pd  |r2 6p B1?d  |r2 7p B1?  L6@ L  ?pL  9p C VBCDEhFp1?D3p1#-N{~bG++>ICW58@j<@  dL  ICW58@2 >p C VBCDEhFp1?D3p1#-N{~bG++>ICW58@  @p C VBCDEhFp1?D3p1#-N{~bG++>ICW58@ 2Z  Ap C VBCDEhFp1?D3p1#-N{~bG++>ICW58@2  Bp C VBCDEhFp1?D3p1#-N{~bG++>ICW58@6   Cp C VBCDEhFp1?D3p1#-N{~bG++>ICW58@   Dp C VBCDEhFp1?D3p1#-N{~bG++>ICW58@   Ep C VBCDEhFp1?D3p1#-N{~bG++>ICW58@V * @ p yppB@  Ipx2 Gp HC1?r2 Hp B1?\\f Jp 6?p<@ $ Mp$r2 Kp B1?$r2 Lp B1?4T<@ \ Pp\r2 Np B1?\r2 Op B1?,\<@ | Sp|r2 Qp B1?|r2 Rp B1?Ll<@ l Vplr2 Tp B1?lr2 Up B1?<\<@ \| Yp\|r2 Wp B1?\|r2 Xp B1?,L<@ << \p<<r2 Zp B1?<<r2 [p B1?  6@ l cpl ]p C VBCDEhFp1?D3p1#-N{~bG++>ICW58@<@ $l `p$lr2 ^p B1?$lr2 _p B1?T< ap C VBCDEhFp1?D3p1#-N{~bG++>ICW58@ bp C VBCDEhFp1?D3p1#-N{~bG++>ICW58@ dp C VBCDEhFp1?D3p1#-N{~bG++>ICW58@z ep C VBCDEhFp1?D3p1#-N{~bG++>ICW58@ fp C VBCDEhFp1?D3p1#-N{~bG++>ICW58@V* gp C VBCDEhFp1?D3p1#-N{~bG++>ICW58@& hp C VBCDEhFp1?D3p1#-N{~bG++>ICW58@6  ip C VBCDEhFp1?D3p1#-N{~bG++>ICW58@vJB@ F lpFx2 jp HC1?Fr2 kp B1?s<B@  opx2 mp HC1?r2 np B1?DDB@  rpx2 pp HC1?r2 qp B1?4\B@   up x2 sp HC1? r2 tp B1?T\<@ | xp|r2 vp B1?|r2 wp B1?$|L%@   p <@  4   |p 4  r2 zp B1? 4  r2 {p B1?D B@  d L  p d L x2 }p HC1? d L r2 ~p B1?4 f p 6? <@ 4 l p4 lr2 p B1?4 lr2 p B1?d <<@  4  p 4 r2 p B1? 4 r2 p B1?$ d | <@ 4   p4  r2 p B1?4  r2 p B1?Dd  <@  4  p 4 r2 p B1? 4 r2 p B1? d \ <@ T   pT  r2 p B1?T  r2 p B1?D   p C VBCDEhFp1?D3p1#-N{~bG++>ICW58@  <@  $ <  p $ < r2 p B1? $ < r2 p B1? T  p C VBCDEhFp1?D3p1#-N{~bG++>ICW58@v " J  p C VBCDEhFp1?D3p1#-N{~bG++>ICW58@f  :  p C VBCDEhFp1?D3p1#-N{~bG++>ICW58@f :j p C VBCDEhFp1?D3p1#-N{~bG++>ICW58@6 j p C VBCDEhFp1?D3p1#-N{~bG++>ICW58@ R Z : p C VBCDEhFp1?D3p1#-N{~bG++>ICW58@ b J B@ u T <  pu T < x2 p HC1?u T < r2 p B1? H B@ $  <  p$  < x2 p HC1?$  < r2 p B1? D B@  d  L  p d  L x2 p HC1? d  L r2 p B1?d B@  t  \  p t  \ x2 p HC1? t  \ r2 p B1?d <@  4   p 4  r2 p B1? 4  r2 p B1?T B p  BCIDEFff1?mm0]k8x`xxP((Pkx{S+%M+u+[@3p%H@.h0K0sK##0[X@@3 H    XK00k0C=X0(PxuM [3Nv[3 0Xf %33%.V ~x0P]8]`]P5 @ )i B@ $ <  p$ < x2 p HC1?$ < r2 p B1?  l B@ T 4 l   pT 4 l  x2 p HC1?T 4 l  r2 p B1? d <@  D  p D r2 p B1? D r2 p B1?4 t <@ t , L  pt , L r2 p B1?t , L r2 p B1?  f p 6?P \ p S ,BCDEPFXA31?*R%z%%xPC 5(]Pkx%Mujjjj=jexx]5 `E m;UU}mpEcp8``8}U-X+XSJ{JXX0"{m``Z`2` m]5m(E }(UP;x s K%#MuuhMh%hhhh%hMuu=e[e3e r %% Hp ),@; B@ U |  pU | x2 p HC1?U | r2 p B1? ( ~2 p NA1?r2 p B1?t2 p TCA1?T lr2 p B1? l<@ d4 pd4r2 p B1?d4r2 p B1?dB@ t$   pt$  x2 p HC1?t$  r2 p B1?T , 2 p TCA1?  r2 p B1?T$ | <@  ,  p , r2 p B1? , r2 p B1?4  2 p TCA1?t  r2 p B1?$ ,| B@ t\ pt\x2 p HC1?t\r2 p B1?<B@ , p,x2 p HC1?,r2 p B1?t,B@ ,| p,|x2 p HC1?,|r2 p B1?tB@ dd|L pdd|Lx2 p HC1?dd|Lr2 p B1?B@    p  x2 p HC1?  r2 p B1? \, <@ D l  pD l r2 p B1?D l r2 p B1?t < B@    p  x2 p HC1?  r2 p B1?T \ <@ D pDr2 p B1?Dr2 p B1?t$| p Zgֳgֳ ?"`` h Mesenchyme" (*2     p Zgֳgֳ ?"`  j Condensation" (*2 f    p Z8gֳgֳ ?"`0@`  mDifferentiation"(*2  p Zgֳgֳ ?"` P  pOsteoid deposition"(*2f  p  BCDE F()?%`8+(+Px@` !! T p  $B\CDE@FH?P[P[x[M%xP5 kC!$@P p  BdCDEF )?c^]6C( @- p  BCqDE$F,)? @;cC]kp@   p  BqCDE F()?p-5( Px(@@0 , p  BC$DE,F4)? @hh@# @  p Z gֳgֳ ?"`p uOsteocyte incorporation"(*2f  p Tgֳgֳ?    {INTRAMEMBRANOUS OSTEOGENESIS"(*2  p Z¤gֳgֳ ?"`` p@ h Osteoblast" (*2   2 p 3 BzTENG IQ38c? zTzT`TzTzT`T`TzT`T`Tp@2 p 3 BzTENG IQ8c? zTzT`TzTzT`T`TzT`T`TP  2 p H 3p?"` P2 p H 3p?"`P 2 p H 3p?"` @ 2 p H 3p?"`0p2 p H 3p?"`2 p H 3p?"` @ 02 p H 3p?"` @ p 2 p H 3p?"`@P 2 p H 3p?"`P @ 2 p H 3p?"`ppH p 0޽h ?/ pp ̙3380___PPT10.gN ^ 0  5 t"(  tjB t@ B8c? 0 jB t B8c?`pp8 F0` tF0`f t 6?`0` t C VBCDEhFp1?k1GQ[[[[fbA A|bfxGkk58@bK t C VBCDEhFp1?2H`S@]]]]@h`v ~hH58@! t C VBCDEhFp1?D3p1#-M{~bG++>ICV58@vJ t C VBCDEhFp1?:_s`w@&9zRg>M)41-W9~658@S   t C VBCDEhFp1?2H`S@]]]]@h`v ~hH58@gS  t C VBCDEhFp1?D3p1#-M{~bG++>ICV58@z  t C VBCDEhFp1?k1GR\\\\gbA A|bgxGkk58@s  t C VBCDEhFp1?2H`S@]]]]@h`v ~hH58@HsV  t C VBCDEhFp1?D3p1#-N{~bG++>ICW58@F t C VBCDEhFp1?k1GQ[[[[fbA A|bfxGkk58@l t C VBCDEhFp1?2H`S@]]]]@h`v ~hH58@  t C VBCDEhFp1?D3p1#-M{~bG++>ICV58@6: ! t C VBCDEhFp1?k1GR\\\\gbA A|bgxGkk58@hR t C VB CDEhFp1?lbO~6fOAO;]]bN5:Wfs}ll58@7@ t C VB*CDEhFp1?p:R]i)hijylG##Gj|Upp58@!YKp8  P Ft Pf t 6? PX@ $ \ "t$ \<@ l tlr2 t B1?lr2 t B1?D<<@    t  r2 t B1?  r2 t B1?4 D <@  $  t $ r2 t B1? $ r2 t B1?4 T <@ \ !t\r2 t B1?\r2  t B1?l,X@ $ 4 l /t$ 4 l<@ T  | %tT  |r2 #t B1?T  |r2 $t B1?  L<@ D $  (tD $ r2 &t B1?D $ r2 't B1?t T <@ D 4  +tD 4 r2 )t B1?D 4 r2 *t B1?t d <@ $  l .t$  lr2 ,t B1?$  lr2 -t B1?T  <<@ d  \ 2td  \r2 0t B1?d  \r2 1t B1?  ,<@  <  5t < r2 3t B1? < r2 4t B1? 4 <@ d  | 8td  |r2 6t B1?d  |r2 7t B1?  L6@ L  ?tL  9t C VBCDEhFp1?D3p1#-N{~bG++>ICW58@j<@  dL  ICW58@2 >t C VBCDEhFp1?D3p1#-N{~bG++>ICW58@  @t C VBCDEhFp1?D3p1#-N{~bG++>ICW58@ 2Z  At C VBCDEhFp1?D3p1#-N{~bG++>ICW58@2  Bt C VBCDEhFp1?D3p1#-N{~bG++>ICW58@6   Ct C VBCDEhFp1?D3p1#-N{~bG++>ICW58@   Dt C VBCDEhFp1?D3p1#-N{~bG++>ICW58@   Et C VBCDEhFp1?D3p1#-N{~bG++>ICW58@V * ^ Gt 6? P T Ht S ,BCDEPFXA31?*R%z%%xPC 5(]Pkx%Mujjjj=jexx]5 `E m;UU}mpEcp8``8}U-X+XSJ{JXX0"{m``Z`2` m]5m(E }(UP;x s K%#MuuhMh%hhhh%hMuu=e[e3e r %% Hp ),@ ;:8 U |  Kt U| x2 It HC1?U | r2 Jt B1? ( v2 Lt NA1?j2 Mt B1?t|2 Nt TCA1? Tlj2 Ot B1? l48 d4 Rt4dr2 Pt B1?d4r2 Qt B1?d:8 t$   Ut$ t x2 St HC1?t$  r2 Tt B1?T , |2 Vt TCA1?   j2 Wt B1?$ T| 48  ,  Zt , r2 Xt B1? , r2 Yt B1?4  |2 [t TCA1? t j2 \t B1?$ ,| :8 t\ _tt\x2 ]t HC1?t\r2 ^t B1?<:8 , bt,x2 `t HC1?,r2 at B1?t,:8 ,| et,|x2 ct HC1?,|r2 dt B1?t:8 dd|L htdd|Lx2 ft HC1?dd|Lr2 gt B1?:8    kt  x2 it HC1?  r2 jt B1? \, 48 D l  ntD l r2 lt B1?D l r2 mt B1?t < :8    qt   x2 ot HC1?  r2 pt B1?T \ 48 D ttDr2 rt B1?Dr2 st B1?t$| ut Zgֳgֳ ?"`` h Mesenchyme" (*2   M vt Zgֳgֳ ?"` WCondensations are widely dispersed and separated to commit a territory to becoming bone"X(*2XfW , wt Z gֳgֳ ?"`   6Continued division & recruitment to osteoblast numbers"7(*276   xt  BCDE F()?%`8+(+Px@ `!! L yt  $B\CDE@FH?P[P[x[M%xP5 kC!$@P zt  BdCDEF )?c^]6C( @- {t  BCqDE$F,)? @;cC]kp@    |t  BqCDE F()?p-5( Px(@@ 0$ }t  BC$DE,F4)? @hh@# @  ~t Z|gֳgֳ ?"`p  nVessels present "(*2f  t Tp gֳgֳ?    {INTRAMEMBRANOUS OSTEOGENESIS"(*2 2 t 3 BzTENG IQ38c? zTzT`TzTzT`T`TzT`T`T@p~2 t H 3p?"` P~2 t H 3p?"`P ~2 t H 3p?"`@  ~2 t H 3p?"`@P ~2 t H 3p?"`P @ ~2 t H 3p?"`pp2 t 3 ByTENG IQ38c? yTyT`TyTyT`T`TyT`T`T0'8  0 t 0%@   t <@  d L  t d L r2 t B1? d L r2 t B1? l  B@  |  t | x2 t HC1? | r2 t B1? \  f t 6?0 <@   t r2 t B1? r2 t B1?4  l<@  d |   t d |  r2 t B1? d |  r2 t B1? L <@  d   t d  r2 t B1? d  r2 t B1? l <@  d \   t d \  r2 t B1? d \  r2 t B1? , <@  <  t < r2 t B1? < r2 t B1? l  t C VBCDEhFp1?D3p1#-N{~bG++>ICW58@ <@ T T  tT T r2 t B1?T T r2 t B1?  t C VBCDEhFp1?D3p1#-N{~bG++>ICW58@F R  :  t C VBCDEhFp1?D3p1#-N{~bG++>ICW58@6 2   t C VBCDEhFp1?D3p1#-N{~bG++>ICW58@6  t C VBCDEhFp1?D3p1#-N{~bG++>ICW58@  t C VBCDEhFp1?D3p1#-N{~bG++>ICW58@V * j t C VBCDEhFp1?D3p1#-N{~bG++>ICW58@ jz B@ E l  tE l x2 t HC1?E l r2 t B1?  B@  D ,  t D , x2 t HC1? D , r2 t B1?T t B@  |  t | x2 t HC1? | r2 t B1?4  B@   t x2 t HC1? r2 t B1?4 , <@  d L  t d L r2 t B1? d L r2 t B1?$ |  B t  BCIDEFff1?mm0]k8x`xxP((Pkx{S+%M+u+[@3p%H@.h0K0sK##0[X@@3 H    XK00k0C=X0(PxuM [3Nv[3 0Xf %33%.V ~x0P]8]`]P5 @P B@     t   x2 t HC1?   r2 t B1?T D B@ $ d < L  t$ d < L x2 t HC1?$ d < L r2 t B1? <@ t ,  tt , r2 t B1?t , r2 t B1? \ <@ D |  tD | r2 t B1?D | r2 t B1?t L 2 t H 3p?"` @ 02 t H 3p?"` @ p rB t B8c?P p 0 rB t B8c? 0 H t 0޽h ?/ tt ̙3380___PPT10.gz  0  5 x>(  x x Z4Lgֳgֳ ?"`  eOSTEOID"(*2  x TRgֳgֳ?    {INTRAMEMBRANOUS OSTEOGENESIS"(*2 y8 \ x\f x 6?fr x C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@W$ x C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@S   x C VBCDEhFp1?@Uh*|1777|7h=[QUeUxNNxNeNQ:Q&QQQQ&K:=G*@@58@ -G  x C VBCDEhFp1?aL+:1&7777&>:RGfLyLSySfSRSRfRzRRRKz>f+Yaa58@ ba   x C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ:Q&QQQQ&J:=G*@@58@ g   x C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ;Q'QQQQ'J;=H*@@58@0c    x C VBCDEhFp1?@Uh*|1777|7h=[QUeUxNNxNeNQ;Q'QQQQ'K;=H*@@58@PS  x C VBCDEhFp1?@:`/L =/'/#77:L.Z bqh`#W4i={ENVNxK`NLY@@58@K    x C VBCDEhFp1?C["p18?>??qHd`^x_XWWxVa@a*bcdc*Z?JM3CC58@iU x C VBCDEhFp1?bM+:1&7777&>:RGfMyMSySfSRSRgR{RRRK{>g+Zbb58@1B x C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@{.  x C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@30  , x S B C#DE8F@Ap?0Pa0`!Q/`_ @ApPq0`/O q` A  /   p0 Q` 0 0 0 Q     O A ` p @    Ao q?  1aOQ`! Q    ""`0qQA_1@qA`? Q1p@@`qpa@PqpA_@/Q!Po@0@@p@?o @pP @\]  x S tB( CaDEtF|Ap?]]' P     @ p     p @ @ ` ` 000P00@PP `@ P0 @@P```@0 @pp@P P@ppp@pp``P@@0 0p @ ` p ` P 00 ` ' ' @ Q x C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@ = x C VBCDEhFp1?@Uh*|1777|7h=[QUeUxNNxNeNQ:Q&QQQQ&K:=G*@@58@A h  x C VBCDEhFp1?aL+:2&8888&>:RGfLzLSzSfSRSRfRzRRRLz>f+Yaa58@[   x C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@F h  x C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ:Q&QQQQ&J:=G*@@58@ , x C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ:Q&QQQQ&J:=G*@@58@u x C VBCDEhFp1?@Uh+|1777|7h>[RUfUyNNyNfNR:R&RRRR&K:>G+@@58@k x C VBCDEhFp1?A;`/L =/'/#78:L.Z cqi`#W4j=|ENVNyK`NMYAA58@ { 6  x C VBCDEhFp1?C["q18?>??rHd`^x_YWWxVaAa*bcdc*Z?JM3CC58@ U x C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@ =: x C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@/i x C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@c >  x C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@ 0   x C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@v   !x C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ:Q&QQQQ&J:=G*@@58@ [  "x C VBCDEhFp1?aL+:2&8888&>:RGfLzLSzSfSRSRfRzRRRLz>f+Yaa58@ X0  #x C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@OX $x C VBCDEhFp1?@Uh*|1777|7h=[QUeUxNNxNeNQ:Q&QQQQ&K:=G*@@58@d   %x C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ;Q'QQQQ'J;=H*@@58@H5 &x C VBCDEhFp1?@Uh+|1777|7h>[RUfUyNNyNfNR;R'RRRR'K;>H+@@58@i ^ 'x C VBCDEhFp1?A;`/L =/'/#78:L.Z cqi`#W4j=|ENVNyK`NMYAA58@M} (x C VBCDEhFp1?C["q18?>??rHd`^x_YWWxVaAa*bcdc*Z?JM3CC58@b ] )x C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@   *x C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@ v +x C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@ o2 N@ 3+ .x3+2 ,x TCA1?3+r2 -x B1?mN@ Z 1xZ2 /x TCA1?Zr2 0x B1?N@ kK 4xkK2 2x TCA1?kKr2 3x B1?2N@   q 7x  q2 5x TCA1?  qr2 6x B1?F x 8N@ z Q :xz Q2 8x TCA1?z Qr2 9x B1?N@ 6 =x62 ;x TCA1?6r2 x TCA1?kr2 ?x B1?92kN@ p Cxp2 Ax TCA1?pr2 Bx B1? RN@ 3  k Fx3  k2 Dx TCA1?3  kr2 Ex B1?m  1N@  >  Ix > 2 Gx TCA1? > r2 Hx B1?  QN@  e ~  Lx e ~ 2 Jx TCA1? e ~ r2 Kx B1?  + E N@  e  Ox e 2 Mx TCA1? e r2 Nx B1?@ r+ N@ sP   RxsP  2 Px TCA1?sP  r2 Qx B1?m  N@ S ~  UxS ~ 2 Sx TCA1?S ~ r2 Tx B1? E  Vx C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@ k  Wx C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@  >N@ f i  Zxf i 2 Xx TCA1?f i r2 Yx B1? N@ F i  ]xF i 2 [x TCA1?F i r2 \x B1? N@ f <  `xf < 2 ^x TCA1?f < r2 _x B1? Y N@  ^ X  cx ^ X 2 ax TCA1? ^ X r2 bx B1? %  N@ f 5  fxf 5 2 dx TCA1?f 5 r2 ex B1?  gx C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@ / +  hx C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@L S2 ix TY3A1?_ w l2 jx <Yf? 6 ll2 kx <Yf? @ l2 lx <Yf? + & l2 mx <Yf?x   <@ :1 px:1r2 nx B1?:1r2 ox B1?N@ S6 sxS62 qx TCA1?S6r2 rx B1?S<@ RK vxRKr2 tx B1?RKr2 ux B1?5.<@ 2 yx2r2 wx B1?2r2 xx B1?Pl zx  <BaCDELFT)?Iy 9i00OO)`YooI`'(@@ t {x  DB CDEPFX)?  R"R" 0@PSP#```c3),@ , |x  BCDE,F4)? Cs0`c9@z<@  E  x E r2 }x B1? E r2 ~x B1?C u ( <@  x  x x r2 x B1? x r2 x B1?* [ <@  %  x % r2 x B1? % r2 x B1?  <@ -  x- r2 x B1?- r2 x B1? <@  ~  x ~ r2 x B1? ~ r2 x B1?^9 e <@ : x:r2 x B1?:r2 x B1?<@ LT xLTr2 x B1?LTr2 x B1?6<@ < x<r2 x B1?<r2 x B1?Vv<@ @8 x@8r2 x B1?@8r2 x B1? x Zgֳgֳ ?"` @ pACTIVE OSTEOBLASTS"(*2  x Z쥩gֳgֳ ?"`!A h OSTEOCLAST" (*2 f  2 x 3 ENGHZJQf8c? `T`T`T`T`T`T`T`T`T`T@ 0 2 x 3 ENGHZJQ8c? `T`T`T`T`T`T`T`T`T`T jB x B8c?`  x Zgֳgֳ ?"`R r g TRABECULA" (*2 f  2 x 3 BTENGq I-Q38c? ͫTT`TͫTT`T-`TT`T-`T P  x Zgֳgֳ ?"`0`P h Mesenchyme" (*2   jB x B8c? @ x Zʩgֳgֳ ?"` oLESS ACTIVE CELLS"(*2 2 x 3 E$GH I`TQ8c? `TNT`TNT`T`T`TNT`T`T @~2 x H 3p?"` 0  ~2 x H 3p?"` pp ~2 x H 3p?"` @ ~2 x H 3p?"` H x 0޽h ?O@xxxx ̙3380___PPT10.g   0  5 f^|ބ(  | | T(gֳgֳ?0 P  sIM & EC OSTEOGENESIS"(*2 O | Zpgֳgֳ ?"`C  YTRABECULAE thicken by division & recruitment of more osteoblasts to increase bone density"Z(*2ZY ) | Zgֳgֳ ?"`0P 6 #Mesenchyme later turns into marrow2$(*2f# ^ | 6?zfr ~ | C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@qW~ | C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@C  ~ | C VBCDEhFp1?@Uh*|1777|7h=[QUeUxNNxNeNQ:Q&QQQQ&K:=G*@@58@ -7 ~  | C VBCDEhFp1?aL+:1&7777&>:RGfLyLSySfSRSRfRzRRRKz>f+Yaa58@ bQ ~  | C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ:Q&QQQQ&J:=G*@@58@ g ~  | C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ;Q'QQQQ'J;=H*@@58@S 0 ~  | C VBCDEhFp1?@Uh*|1777|7h=[QUeUxNNxNeNQ;Q'QQQQ'K;=H*@@58@PC ~  | C VBCDEhFp1?@:`/L =/'/#77:L.Z bqh`#W4i={ENVNxK`NLY@@58@;  ~ | C VBCDEhFp1?C["p18?>??qHd`^x_XWWxVa@a*bcdc*Z?JM3CC58@E i ~ | C VBCDEhFp1?bM+:1&7777&>:RGfMyMSySfSRSRgR{RRRK{>g+Zbb58@! B ~ | C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@ { ~ | C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@ 3 $ | S B C#DE8F@Ap?0Pa0`!Q/`_ @ApPq0`/O q` A  /   p0 Q` 0 0 0 Q     O A ` p @    Ao q?  1aOQ`! Q    ""`0qQA_1@qA`? Q1p@@`qpa@PqpA_@/Q!Po@0@@p@?o @pP @\]  | S tB( CaDEtF|Ap?]]' P     @ p     p @ @ ` ` 000P00@PP `@ P0 @@P```@0 @pp@P P@ppp@pp``P@@0 0p @ ` p ` P 00 ` ' ' @  A~ | C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@ = ~ | C VBCDEhFp1?@Uh*|1777|7h=[QUeUxNNxNeNQ:Q&QQQQ&K:=G*@@58@1 h ~ | C VBCDEhFp1?aL+:2&8888&>:RGfLzLSzSfSRSRfRzRRRLz>f+Yaa58@ [ ~ | C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@X F ~ | C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ:Q&QQQQ&J:=G*@@58@~ | C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ:Q&QQQQ&J:=G*@@58@e ~ | C VBCDEhFp1?@Uh+|1777|7h>[RUfUyNNyNfNR:R&RRRR&K:>G+@@58@[ ~ | C VBCDEhFp1?C["q18?>??rHd`^x_YWWxVaAa*bcdc*Z?JM3CC58@ U ~ | C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@ = *~ | C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@Y / ~ | C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@S > ~ | C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@0~  | C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@v~ !| C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ:Q&QQQQ&J:=G*@@58@[v~ "| C VBCDEhFp1?aL+:2&8888&>:RGfLzLSzSfSRSRfRzRRRLz>f+Yaa58@H0~ #| C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@?X~ $| C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ;Q'QQQQ'J;=H*@@58@85~ %| C VBCDEhFp1?@Uh+|1777|7h>[RUfUyNNyNfNR;R'RRRR'K;>H+@@58@Ni  ~ &| C VBCDEhFp1?A;`/L =/'/#78:L.Z cqi`#W4j=|ENVNyK`NMYAA58@Mm~ '| C VBCDEhFp1?C["q18?>??rHd`^x_YWWxVaAa*bcdc*Z?JM3CC58@bM~ (| C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@f  F8 3 +|32 )| TCA1?3r2 *| B1?mF8 Z .|Z2 ,| TCA1?Zr2 -| B1?F8 k; 1|k;2 /| TCA1?k;r2 0| B1?2F8  a  4| a 2 2| TCA1? a r2 3| B1?Fx( F8 zA 7|zA2 5| TCA1?zAr2 6| B1?F8 & :|&2 8| TCA1?&r2 9| B1?CKtF8  k =| k2 ;| TCA1? kr2 <| B1?)2[F8 ` @|`2 >| TCA1?`r2 ?| B1? |RF8 3  [ C|3 [2 A| TCA1?3  [r2 B| B1?m  !F8 >{ F|>{2 D| TCA1?>{r2 E| B1?AF8  e n  I| e n 2 G| TCA1? e n r2 H| B1?  + 5 F8  U L| U2 J| TCA1? Ur2 K| B1?@ rF8 s@ O|@s2 M| TCA1?s@r2 N| B1?]F8 S n  R| S n 2 P| TCA1?S n r2 Q| B1?  5 ~ S| C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@k }~ T| C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@.F8 fY  W|Y f 2 U| TCA1?fY r2 V| B1?v  F8 FY   Z|Y F 2 X| TCA1?FY  r2 Y| B1?v  F8  ^H  ]| ^H 2 [| TCA1? ^H r2 \| B1? % F8 f %  `| f % 2 ^| TCA1?f % r2 _| B1?  ~ a| C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@ + ~ b| C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@L C48 :  ! e|: !r2 c| B1?:  !r2 d| B1?  F8 S &  h|&S 2 f| TCA1?S & r2 g| B1? C t48  R ; k| R ;r2 i| B1? R ;r2 j| B1? 5 48  2  n| 2 r2 l| B1? 2 r2 m| B1? @ qd o|  <BaCDELFT)?Iy 9i00OO)`YooI`'(@@ l p|  DB CDEPFX)?  R"R" 0@PSP#```c3),@  $ q|  BCDE,F4)? Cs0`c9@ z 48  5  t| 5 r2 r| B1? 5 r2 s| B1?C u 48 s x  w|s x r2 u| B1?s x r2 v| B1?* [ 48 s %  z|s % r2 x| B1?s % r2 y| B1?  48 -s   }|s - r2 {| B1?-s  r2 || B1?  48  n  | n r2 ~| B1? n r2 | B1?^) U 48 v: |v:r2 | B1?v:r2 | B1?48 <T |<Tr2 | B1?<Tr2 | B1?p648 , |,r2 | B1?,r2 | B1?Vf48 @(  |@( r2 | B1?@( r2 | B1? jB | B8c?~2 | H 3p?"` ~2 | H 3p?"` 0` ~2 | H 3p?"` @  8 _{  |_{  | C VBCDEhFp1?A;`/L =/'/#78:L.Z cqi`#W4j=|ENVNyK`NMYAA58@ { &  | C VBCDEhFp1?@Uh*|1777|7h=[QUeUxNNxNeNQ:Q&QQQQ&K:=G*@@58@d  | C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@  w | C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@_2 N@ f,  |f, 2 | TCA1?f, r2 | B1?I{2 | TY3A1?_w l2 | <Yf? 6 \ l2 | <Yf? @ l2 | <Yf? & q l2 | <Yf?x  2 | H 3p?"`p 0 L | Z4gֳgֳ ?"`  >Vessels : incorporated from the start & remodel with the bone"?(*2?30 4 jB | B38c?P P7 | Zh?gֳgֳ ?"`  AOSTEOCLASTS active from the start to remodel & reshape the bone"B(*2BfA 8   | 2 | TY3A1? l2 | <Yf? <l2 | <Yf?kl2 | <Yf?pQl2 | <Yf?n2 | 3 BnTENG IQf8c? nTnT`TnTnT`T`TnT`T`T  jB | B8c? @`H | 0޽h ?| ̙3380___PPT10.g  0  5 ނv(  ^  6?zfr ~  C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@qW~  C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@C  ~  C VBCDEhFp1?@Uh*|1777|7h=[QUeUxNNxNeNQ:Q&QQQQ&K:=G*@@58@ -7 ~  C VBCDEhFp1?aL+:1&7777&>:RGfLyLSySfSRSRfRzRRRKz>f+Yaa58@ bQ ~  C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ:Q&QQQQ&J:=G*@@58@ g ~  C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ;Q'QQQQ'J;=H*@@58@S 0 ~  C VBCDEhFp1?@Uh*|1777|7h=[QUeUxNNxNeNQ;Q'QQQQ'K;=H*@@58@PC ~  C VBCDEhFp1?@:`/L =/'/#77:L.Z bqh`#W4i={ENVNxK`NLY@@58@;  ~  C VBCDEhFp1?C["p18?>??qHd`^x_XWWxVa@a*bcdc*Z?JM3CC58@E i ~  C VBCDEhFp1?bM+:1&7777&>:RGfMyMSySfSRSRgR{RRRK{>g+Zbb58@! B ~  C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@ { ~  C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@ 3 $  S B C#DE8F@Ap?0Pa0`!Q/`_ @ApPq0`/O q` A  /   p0 Q` 0 0 0 Q     O A ` p @    Ao q?  1aOQ`! Q    ""`0qQA_1@qA`? Q1p@@`qpa@PqpA_@/Q!Po@0@@p@?o @pP @\]   S tB( CaDEtF|Ap?]]' P     @ p     p @ @ ` ` 000P00@PP `@ P0 @@P```@0 @pp@P P@ppp@pp``P@@0 0p @ ` p ` P 00 ` ' ' @  A~  C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@ = ~  C VBCDEhFp1?@Uh*|1777|7h=[QUeUxNNxNeNQ:Q&QQQQ&K:=G*@@58@1 h ~  C VBCDEhFp1?aL+:2&8888&>:RGfLzLSzSfSRSRfRzRRRLz>f+Yaa58@ [ ~  C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@X F ~  C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ:Q&QQQQ&J:=G*@@58@~  C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ:Q&QQQQ&J:=G*@@58@e ~  C VBCDEhFp1?@Uh+|1777|7h>[RUfUyNNyNfNR:R&RRRR&K:>G+@@58@[ ~  C VBCDEhFp1?C["q18?>??rHd`^x_YWWxVaAa*bcdc*Z?JM3CC58@ U ~  C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@ = *~  C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@Y / ~  C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@S > ~  C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@0~  C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@v~  C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ:Q&QQQQ&J:=G*@@58@[v~  C VBCDEhFp1?aL+:2&8888&>:RGfLzLSzSfSRSRfRzRRRLz>f+Yaa58@H0~  C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@?X~ ! C VBCDEhFp1?@Uh*|1777|7h=[QUdUxNNxNdNQ;Q'QQQQ'J;=H*@@58@85~ " C VBCDEhFp1?@Uh+|1777|7h>[RUfUyNNyNfNR;R'RRRR'K;>H+@@58@Ni  ~ # C VBCDEhFp1?A;`/L =/'/#78:L.Z cqi`#W4j=|ENVNyK`NMYAA58@Mm~ $ C VBCDEhFp1?C["q18?>??rHd`^x_YWWxVaAa*bcdc*Z?JM3CC58@bM~ % C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@f  F8 3 (32 & TCA1?3r2 ' B1?mF8  ` n  +` n 2 ) TCA1? ` n r2 * B1? | 5 F8 #; .#;2 , TCA1?#;r2 - B1?@qL8 :Y 1Y:2 / T]A1?:Yx2 0 H1?ywF8 & 4&2 2 TCA1?&r2 3 B1?CKtF8  k 7 k2 5 TCA1? kr2 6 B1?)2[F8 0 [  :0 [ 2 8 TCA1?0 [ r2 9 B1?L "~ F8 3  [ =3 [2 ; TCA1?3  [r2 < B1?m  !L8 l @l2 > TeA1?lx2 ? H"1?;m4F8  e n  C e n 2 A TCA1? e n r2 B B1?  + 5 F8  U F U2 D TCA1? Ur2 E B1?@ rF8 s@ I@s2 G TCA1?s@r2 H B1?]F8 S n  L S n 2 J TCA1?S n r2 K B1?  5 ~ M C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@k }~ N C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@.F8 fY  QY f 2 O TCA1?fY r2 P B1?v  F8 FY   TY F 2 R TCA1?FY  r2 S B1?v  F8  ^H  W ^H 2 U TCA1? ^H r2 V B1? % F8 f %  Z f % 2 X TCA1?f % r2 Y B1?  ~ [ C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@ + ~ \ C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@L C48 :  ! _: !r2 ] B1?:  !r2 ^ B1?  F8 S &  b&S 2 ` TCA1?S & r2 a B1? C t48  R ; e R ;r2 c B1? R ;r2 d B1? 5 48  2  h 2 r2 f B1? 2 r2 g B1? @ qd i  <BaCDELFT)?Iy 9i00OO)`YooI`'(@@ l j  DB CDEPFX)?  R"R" 0@PSP#```c3),@  $ k  BCDE,F4)? Cs0`c9@ z 48  5  n 5 r2 l B1? 5 r2 m B1?C u 48 s x  qs x r2 o B1?s x r2 p B1?* [ 48 s %  ts % r2 r B1?s % r2 s B1?  48 -s   ws - r2 u B1?-s  r2 v B1?  48  n  z n r2 x B1? n r2 y B1?^) U 48 v: }v:r2 { B1?v:r2 | B1?48 <T <Tr2 ~ B1?<Tr2  B1?p648 , ,r2  B1?,r2  B1?Vf48 @(  @( r2  B1?@( r2  B1? ~2  H 3p?"` ~2  H 3p?"` 0` ~2  H 3p?"` @  8 _{  _{   C VBCDEhFp1?A;`/L =/'/#78:L.Z cqi`#W4j=|ENVNyK`NMYAA58@ { &   C VBCDEhFp1?@Uh*|1777|7h=[QUeUxNNxNeNQ:Q&QQQQ&K:=G*@@58@d   C VBCDEhFp1?bM+:2&8888&>:RGfMzMSzSfSRSRgR{RRRL{>g+Zbb58@  w  C VBCDEhFp1?(BXm ~m ]Q.UJ``orxiwZdKR:`*n| |%h+N(458@_2 N@ f,  f, 2  TCA1?f, r2  B1?I{2  TY3A1?_w l2  <Yf? 6 \ l2  <Yf? @ l2  <Yf? & q l2  <Yf?x  2  H 3p?"`p 0 jB  B38c?P P8    2  TY3A1? l2  <Yf? <l2  <Yf?kl2  <Yf?pQl2  <Yf?n  Tgֳgֳ?0w wENDOCHONDRAL OSTEOGENESIS"(*2 "   BvC{DEFff1?jj(@@@@b[:uM%]5 mEreX=0p"U-uZXM0% [3 jBk5 (P(jPxx   @ h3h0Ks"=JXe;rc+S{ -:CUkb}Em%zMzMR(MM[hphHh X-@C. ?  Z@gֳgֳ ?"`s P  IRecognizable, if some of the trabeculae have cores of calcified cartilage"J(*2JfI jB  Bf8c?p 0 H  0޽h ? ̙3380___PPT10.g J 0  5 II xxjI(     Tԣgֳgֳ?0w  SKELETAL DEVELOPMENT.(*2"   TXgֳgֳ? #Skeletal piece of hyaline cartilage"$(*2$# G8 PW xPW @ U* U*  S BQCDEF3A p?@@~^? 3Ss/ O o      @`4Ss1EPPPuPUP5PE::11o1O1/1:EEEEs:S13@U*~2  N3A p?~2  N3A p?~2  N3A p?>L~2  N3A p?ER~2   N3A p?lz ~2   N3A p?>L~2   N3A p?+9~2   N3A p?~2   N3A p?~2  N3A p?~2  N3A p?>ELR~2  N3A p?+9~2  N3A p?t@  0  + 0   S BCDEF3Ap?@@G uO' @h-T{    % M u  EmBh-T|`8uM%||||{|T-h|@G G @ 0 r2  B1?  Fr2  B1? u r2  B1?b  Fr2  B1? I nr2  B1?  %r2  B1?  Br2  B1?  r2  B1?  r2  B1? 2 Y@   " *  "~2  N3A p?  ~2  N3A p?@ N ~2  N3A p?n | ~2   N3A p? u ~2 ! N3A p? - ;~2 " N3A p?n | ~2 # N3A p? [ i~2 $ N3A p?  ~2 % N3A p?@ N "~2 & N3A p?@ N &~2 ' N3A p?n u| ~2 ( N3A p?@ [N i~2 ) N3A p?  : , Tήgֳgֳ?0 0Grows by internal expansion and from the surfaceB1(*2 0 @    M  r2 - B1?p 3  @    D   . S BCDEF3Ap?@@ G^/M|7f!^XBrN| 7fb3xIP!f7|M  @  r2 / B1?D l r2 0 B1?g  r2 1 B1?D j r2 2 B1? ( r2 3 B1?Y ~ r2 4 B1?r B r2 5 B1?G m r2 6 B1?w ? r2 7 B1?4 Z> r2 8 B1? " r2 9 B1?  r2 : B1?_  r2 ; B1?g2 Y r2 < B1?@ f r2 = B1? * r2 > B1?2p X r2 ? B1?Y ~ r2 @ B1?' *N r2 A B1? " r2 B B1?2Y X~ r2 C B1?  @ ,   L,   E BClDEF?--B b  ' G h .Op4UkhkGk'k`````b`B`!`kJ)eD[\@,  @ P   KP  r2 F B1?@  r2 G B1?@  r2 H B1?P  r2 I B1?P  r2 J B1?* )s  N Tgֳgֳ?   Cell enlargement/hypertrophy"(*20    O Thgֳgֳ? P  rMatrix calcification"(*2 2 P C ENGZHI`TJQ8c? `T`T`T`T`T`T`T`T`T`T  rB QB B8c?  &@ P9  uP9 @ 4(9  r4(9 r2 R B1?   @ 4(9  i4(9  S S BCDEF3Ap?@@ G^/M|7f!^XBrN| 7fb3xIP!f7|M  @4(9 r2 T B1?t$ L r2 U B1?p  r2 V B1?t5 Z r2 W B1?2@ Xf r2 X B1?  r2 Y B1?  r2 Z B1?w_  r2 [ B1?  r2 \ B1?d  r2 ] B1? * r2 ^ B1?i  r2 _ B1? % r2 ` B1?  r2 a B1? r2 b B1?4e Z r2 c B1?b 6 r2 d B1?  r2 e B1?4 Z r2 f B1? * r2 g B1?b  r2 h B1?2 Y @ \P   q\P   j BClDEF?--B b  ' G h .Op4UkhkGk'k`````b`B`!`kJ)eD[\@\P  @ j s  pj s r2 k B1?p* s r2 l B1?pj  r2 m B1?j  r2 n B1?* s r2 o B1? Y rB s Bf3p?P  rB tB Bf3p?   v T gֳgֳ? Q PW ,selective erosion into mineralized cartilage"-(*2-f3, 0 w Tgֳgֳ?  FCalcified cartilage can be resorbed like bone, and be attached to bone"G(*2GF H  0޽h ?P ̙3380___PPT10.go p 0  5 ZpRp0o(  Jc8 2 I 2 I`@ 2 I 2 Ir2  Bf1?  Y@ 2 I 2 IP@ 2 I {2 IrB  Bf3p?  N@ 2 I w2 Ir2  B1? $ t r2  B1? .   S BC DEF3Ap?@@&M1^/t3I//d///7//M / $ ; ^V u     4  O&   ~  h  M z7zOOdOOIOz3ztO&&@2 IP  BCDE\Fd?Lm0;;;;;1QR[s[[[[[[7[X[y[[[| nM, +Lslss7XywlLA'AHAiaiS21Fgn2,SLimiH'xbcbBb"mx'G]s~~""~]<xW6,,,],,,,,,b,!,,,},<,!!l L + qQ0/0@PR e 0  BkC'DELFT?0606Q6r66666666W6x+  !&AWxGh ,XySt"No3Tjj_IIx>W36rQ0%%%d0NQCrCCCC" +Lbt^^m^Lt+ tS2|gQ;%%n%XFXgc6WxnM!xW6rgsgRg1rrrg\Fm;L00'(@    `BC>DE|F?#WxxWL6==  xW 7! Ab ,##?@@l = G { r2   B1?\\ r2   B1?d  ,     B!CDExFfp?6W0m;;;;;F1FRQsQQQQQQ7QX[y[[fyX @=@@Pq |    LB1C|DETF\f?.No%%%4%T%u%%%%%%90Z0{0p+,@PP d   4BC!DEHFPfp? yygY\8\\\rrrtg^F=;0%(@ @    BC@DEFfp?((JW.AO o  )A)b)oO<9]Oho74X?y?yzZ`QT@0 p    dBCDEFfp?88mWA+xW7! Abm!,BWbm1xRx]]<&2Rh<RR2smL,!B c!Bb'Hh qt@    tBC DEhFpfp?2=St~ hG&bA 58@p R d   4B1C DEHFPf?0,0,Xx=^~  %(@  \   ,B1CDEDFLf?06Wx<]~ #$@`   \   ,B{CDEDFLf?,Lm#.9OZ2ZRdsdoo`z#$@    BCDE F(f?4U v@Q ` h Q    BCCDE$F,fp? #t^!HB'B, #@p - 1 p r2  B1?:@  :   : r2  B1? i r2  B1? : r2  B1? ) Cr2  B1?p r2  B1?P Z r2  B1?  r2  B1?p  @    '  r2   B1? JI r2 ! B1?  3r2 " B1?  r2 # B1?P J r2 $ B1?0 y Sr2 % B1? j r2 & B1?P : @ ` /`r2 ( B1?`*sr2 ) B1?9r2 * B1? ir2 + B1?*sr2 , B1?3r2 - B1?J9r2 . B1?c@ @  b 7@  br2 0 B1?@  r2 1 B1?  br2 2 B1? YI r2 3 B1?  r2 4 B1?p  Br2 5 B1?  r2 6 B1?  @    ?  r2 8 B1? 9 br2 9 B1? y r2 : B1?  r2 ; B1?@  br2 < B1? Yi r2 = B1?  Br2 > B1?@ ) rr2 @ B1? br2 A B1?p " r2 B B1? y r2 C B1? i "r2 D B1? I br2 E B1?`  r2 F B1? i 2@  ) r N ) rr2 G B1? r2 H B1? )irr2 I B1?Pi  r2 J B1? ) r2 K B1? R r2 L B1?  i r2 M B1? ) " r2 O B1? Y r2 P B1? Y #@ PJ  XPJ r2 Q B1?Pr2 R B1?J) r2 S B1? Y Sr2 T B1?  r2 U B1?jr2 V B1?) r2 W B1?  @  Z # ` Z #r2 Y B1? ir2 Z B1?Zr2 [ B1?) cr2 \ B1?p  r2 ] B1?Pzr2 ^ B1?#r2 _ B1?p  @ p  hp r2 a B1?p : r2 b B1? I # r2 c B1?0 y r2 d B1? : r2 e B1? Cr2 f B1? ZI r2 g B1? * sr2 i B1? y) r2 j B1?`r2 k B1?H q r2 l B1? q2 r2 m B1?a  r2 n B1? R [ f2 o 6?=ff2 p 6?D ] r2 q B1? $ t 0@  i #  v i # r2 r B1?` z r2 s B1?` z r2 t B1? i # r2 u B1? icrB x Bp?lErB y Bp?  rB z Bp? 0 r2 | Bf1?\ l x2 } HNf1? < r2 ~ Bf1?  , r2  Bf1?\  x2  H,f1? <L r2  Bf1? 4 r2  Bf1? T $ r2  Bf1? d x2  H;f1?L < r2  Bf1?  x2  H;f1?L , x2  H;f1? ,  x2  H;f1?\  , x2  HNf1?   x2  HNf1? L | x2  H,f1?|  x2  H,f1?L |    c BCDEF̙A?0RbRRR1<<<11Rs<]}!hBRXsXx2Ss~]<bA  AbmxW-xNnxxnN- &Gh"Cc nc!NBCc"ncMM7~7^B=MB!ncX7MXMyMMMncM,,!!!nM ,!77hG&7B!bA 6WxST@r x2  H,f1?L     BCDEFp?''6Wx<]~!B c      2 S t     8YzOP@:Q   T`Ygֳgֳ?  ~ EARLY ENDOCHONDRAL OSSIFICATION"!(*2!    T bgֳgֳ? P@ g EPIPHYSIS" (*2     Tngֳgֳ? @  _}"(*2   Twgֳgֳ? `  _}"(*2    Tgֳgֳ?0 0P  DIAPHYSIS/SHAFT"(*20     Thgֳgֳ? P xprimary ossification front"(*2  2  C ENGZHI`TJQ8c? `T`T`T`T`T`T`T`T`T`T   Tgֳgֳ? k perichondrium"(*2  jB  B8c?   TXgֳgֳ?0@ h periosteum" (*2    2  C BMTENG HQHdIQ1? zTMTNzTMTN`TMTN`TP Y  Tgֳgֳ?0   CBony collar provides support as mineralized cartilage is eaten away>D(*2 f80  7 jB  Bfp?0 ` H  0޽h ?/  ̙3380___PPT10.g*r 0  5 qq@Eq(  [  ZMgֳgֳ ?"`@@ MExpansive/interstitial growth by cartilage cell division and matrix synthesis"N(*2N0  C +  Tųgֳgֳ?  1 EARLY ENDOCHONDRAL OSSIFICATION: Cell activities"2(*220     Tгgֳgֳ? P xprimary ossification front"(*2   Tڳgֳgֳ?0`  i Bony collar" (*2 f    TLgֳgֳ? O  5;Chondroclasts & other cells eating into calcified cartilagev<(*2 ̙  f`         T8gֳgֳ?  ,2Hypertrophy of chondrocytes precedes calcificationv3(*2 f`        T@gֳgֳ?   dMarrow"(*2 c  Tgֳgֳ?` P YBone laid down as a seam on remnants of calcified cartilage by osteoblastsZ(*2f" f f  f "          j2  Bf1?  jB  Bf3p? j2  B1? $ t j2  B1? .   S BC DEF3Ap?@@&M1^/t3I//d///7//M / $ ; ^V u     4  O&   ~  h  M z7zOOdOOIOz3ztO&&@2 IH  BCDE\Fd?Lm0;;;;;1QR[s[[[[[[7[X[y[[[| nM, +Lslss7XywlLA'AHAiaiS21Fgn2,SLimiH'xbcbBb"mx'G]s~~""~]<xW6,,,],,,,,,b,!,,,},<,!!l L + qQ0/0@PR e (  BkC'DELFT?0606Q6r66666666W6x+  !&AWxGh ,XySt"No3Tjj_IIx>W36rQ0%%%d0NQCrCCCC" +Lbt^^m^Lt+ tS2|gQ;%%n%XFXgc6WxnM!xW6rgsgRg1rrrg\Fm;L00'(@    `BC>DE|F?#WxxWL6==  xW 7! Ab ,##?@@= l G { j2  B1?\\ j2  B1? d  ,    B!CDExFfp?6W0m;;;;;F1FRQsQQQQQQ7QX[y[[fyX @=@@Pq t   LB1C|DETF\f?.No%%%4%T%u%%%%%%90Z0{0p+,@PP \   4BC!DEHFPfp? yygY\8\\\rrrtg^F=;0%(@ @     BC@DEFfp?((JW.AO o  )A)b)oO<9]Oho74X?y?yzZ`QT@0  p    dBCDEFfp?88mWA+xW7! Abm!,BWbm1xRx]]<&2Rh<RR2smL,!B c!Bb'Hh qt@    tBC DEhFpfp?2=St~ hG&bA 58@p R \   4B1C DEHFPf?0,0,Xx=^~  %(@  T   ,B1CDEDFLf?06Wx<]~ #$@`  T   ,B{CDEDFLf?,Lm#.9OZ2ZRdsdoo`z#$@     BCDE F(f?4U v@` Q h Q    BCCDE$F,fp? #t^!HB'B, #@- p 1 p j2  B1?:8  :  ': r2   B1? i r2 ! B1? : r2 " B1? ) Cr2 # B1?p r2 $ B1?P Z r2 % B1?  r2 & B1?p  8    / r2 ( B1? JI r2 ) B1?  3r2 * B1?  r2 + B1?P J r2 , B1?0 y Sr2 - B1? j r2 . B1?P : 8 ` 7`r2 0 B1?`*sr2 1 B1?9r2 2 B1? ir2 3 B1?*sr2 4 B1?3r2 5 B1?J9r2 6 B1?c8 @  b ?@ br2 8 B1?@  r2 9 B1?  br2 : B1? YI r2 ; B1?  r2 < B1?p  Br2 = B1?  r2 > B1?  8    G r2 @ B1? 9 br2 A B1? y r2 B B1?  r2 C B1?@  br2 D B1? Yi r2 E B1?  Br2 F B1?@ ) rj2 H B1? bj2 I B1? p " j2 J B1?y j2 K B1? i "j2 L B1? I bj2 M B1?` j2 N B1? i 28  ) r V ) rr2 O B1? r2 P B1? )irr2 Q B1?Pi  r2 R B1? ) r2 S B1? R r2 T B1?  i r2 U B1? ) " j2 W B1? Y j2 X B1? Y #8 PJ  `JP r2 Y B1?Pr2 Z B1?J) r2 [ B1? Y Sr2 \ B1?  r2 ] B1?jr2 ^ B1?) r2 _ B1?  8  Z # hZ  #r2 a B1? ir2 b B1?Zr2 c B1?) cr2 d B1?p  r2 e B1?Pzr2 f B1?#r2 g B1?p  8 p  p p r2 i B1?p : r2 j B1? I # r2 k B1?0 y r2 l B1? : r2 m B1? Cr2 n B1? ZI r2 o B1? * sj2 q B1?y ) j2 r B1?`j2 s B1?qH j2 t B1?q 2 j2 u B1?a  j2 v B1? R [ ^2 w 6?=f^2 x 6?]D j2 y B1? $ t (8  i #  ~ i # r2 z B1?` z r2 { B1?` z r2 | B1? i # r2 } B1? icjB  Bp?lEjB  Bp? jB  Bp?0 j2  Bf1? \ l p2  HNf1? < j2  Bf1? \ p2  H,f1? <L j2  Bf1? 4 j2  Bf1? T $ j2  Bf1? d p2  H;f1? L < j2  Bf1?  p2  H;f1?, L p2  H;f1?,  p2  HNf1?   p2  HNf1? L | p2  H,f1? |  p2  H,f1? L |   c BCDEF̙A?0RbRRR1<<<11Rs<]}!hBRXsXx2Ss~]<bA  AbmxW-xNnxxnN- &Gh"Cc nc!NBCc"ncMM7~7^B=MB!ncX7MXMyMMMncM,,!!!nM ,!77hG&7B!bA 6WxST@r p2  H,f1? L    BCDEFp?''6Wx<]~!B c      2 S t     8YzOP@:Q  2  C ENGZHI`TJQ1? `T`T`T`T`T`T`T`T`T`T 2  3 E$GH8 I`TQ8c? `T7T`T7T`T`T`T7T`T`TP 2  3 E$GH I`TQ8c? `T:T`T:T`T`T`T:T`T`T0 jB  B38c?  j2  Bf1? , p2  H;f1?\ , ^B  6p?PP0jB  B8c?P @ jB  Bfp?` P 2  S B9SENGZHPI9SJQ8c? `T9S`T `T9S`T 9S9S`T 9S   jB  B8c?p PH  0޽h ?O@ ̙3380___PPT10.gpyi 0  5 hhP-h(    T&gֳgֳ?  ! MIDDLE ENDOCHONDRAL OSSIFICATION""(*2"!   Twgֳgֳ? @P@ g EPIPHYSIS" (*2     Ttgֳgֳ?@0P _}"(*2   TLgֳgֳ?p  _}"(*2   T쓶gֳgֳ?0 P  cSHAFT"(*2   T9gֳgֳ?   xprimary ossification front"(*2 j2  B1? i bj2  Bf1? 4 jB  Bf3p?` ` j2  B1?L j2  B1?9 g ^   S BC DEF3Ap?@@&M1^/t3I//d///7//M / $ ; ^V u     4  O&   ~  h  M z7zOOdOOIOz3ztO&&@yH  BCDE\Fd?Lm0;;;;;1QR[s[[[[[[7[X[y[[[| nM, +Lslss7XywlLA'AHAiaiS21Fgn2,SLimiH'xbcbBb"mx'G]s~~""~]<xW6,,,],,,,,,b,!,,,},<,!!l L + qQ0/0@   (  BkC'DELFT?0606Q6r66666666W6x+  !&AWxGh ,XySt"No3Tjj_IIx>W36rQ0%%%d0NQCrCCCC" +Lbt^^m^Lt+ tS2|gQ;%%n%XFXgc6WxnM!xW6rgsgRg1rrrg\Fm;L00'(@ 0    `BC>DE|F?#WxxWL6==  xW 7! Ab ,##?@@m  j2  B1? D j2  B1?  \    B!CDExFfp?6W0m;;;;;F1FRQsQQQQQQ7QX[y[[fyX @=@@  ! t   LB1C|DETF\f?.No%%%4%T%u%%%%%%90Z0{0p+,@ 1 \   4BC!DEHFPfp? yygY\8\\\rrrtg^F=;0%(@ `     BC@DEFfp?((JW.AO o  )A)b)oO<9]Oho74X?y?yzZ`QT@` 6    dBCDEFfp?88mWA+xW7! Abm!,BWbm1xRx]]<&2Rh<RR2smL,!B c!Bb'Hh qt@     tBC DEhFpfp?2=St~ hG&bA 58@  - \   4B1C DEHFPf?0,0,Xx=^~  %(@ 0 a T   ,B1CDEDFLf?06Wx<]~ #$@ A1 T   ,B{CDEDFLf?,Lm#.9OZ2ZRdsdoo`z#$@ @     BCDE F(f?4U v@     BCCDE$F,fp? #t^!HB'B, #@] j2  B1?j@ j2  B1?  j2  B1?j ` j2 ! B1?* sj2 " B1? ij2 # B1? I j2 $ B1?` 3j2 % B1? ij2 & B1?z j2 ' B1?@ cj2 ( B1?p #j2 ) B1?z I j2 * B1?: ) j2 + B1?j I j2 , B1?Z Y j2 - B1? Cj2 . B1?  j2 / B1?Z` j2 0 B1?@ cj2 1 B1?z j2 2 B1?J` j2 3 B1? 9 2j2 4 B1?I j2 5 B1?@ 2j2 6 B1?I j2 7 B1?0 y j2 8 B1?` 2j2 9 B1?I 9j2 : B1?  j2 ; B1?)0 y rj2 < B1?Y 9j2 = B1?Ip j2 > B1? iR j2 ? B1?@ j2 @ B1?   Rj2 A B1?I ) j2 B B1?  Rj2 C B1?  bj2 D B1? @ Bj2 E B1?Y  j2 F B1? I j2 G B1? Bj2 H B1?9 p j2 I B1?  " j2 J B1? R j2 K B1? j2 L B1?  Sj2 M B1? I #j2 N B1?z j2 O B1?: j2 P B1?P #j2 Q B1?0 y j2 R B1?  3j2 S B1?` j2 T B1?J j2 U B1? i 3j2 V B1? I j2 W B1? ` Sj2 X B1? i #j2 Y B1?j i j2 Z B1? S j2 [ B1? ) j2 \ B1?j p j2 ] B1?*P sj2 ^ B1?v = j2 _ B1?Zp j2 ` B1? j2 a B1? Y j2 b B1? ;j2 c B1?H ;j2 d B1? B + j2 e B1? h  ^2 f 6?mt  ^2 g 6? / j2 h B1?L j2 i B1? Y j2 j B1? Y j2 k B1?  S j2 l B1?J  jB m Bp?Q j ujB n Bp?` ` jB o Bp?` p p j2 p Bf1?, L p2 q HNf1? < j2 r Bf1?l \ j2 s Bf1? L L p2 t H,f1? | j2 u Bf1?$ 4 d j2 v Bf1?  T j2 w Bf1?  p2 x H;f1? < l j2 y Bf1? T p2 z H;f1?\ < p2 { H;f1?\ p2 | H;f1? L \ p2 } HNf1? L p2 ~ HNf1?< p2  H,f1? , l L p2  H,f1?< <   c BCDEF̙A?0RbRRR1<<<11Rs<]}!hBRXsXx2Ss~]<bA  AbmxW-xNnxxnN- &Gh"Cc nc!NBCc"ncMM7~7^B=MB!ncX7MXMyMMMncM,,!!!nM ,!77hG&7B!bA 6WxST@0 " p2  H,f1? < ,    BCDEFp?''6Wx<]~!B c      2 S t     8YzOP@@ !  2  C ENGZHI`TJQ1? `T`T`T`T`T`T`T`T`T`T 0 @  Tt߶gֳgֳ?`0p 9QSecondary ossification centers start by repeating the processes of the 1o center|R(*2)H  1   BC'DEF?##wG &  bA Ab+Lm&&&1RsmL+ wwGH@ j2  B1?1 " j2  B1?H ;j2  B1? b ;2  3 BtTENG IQ8c? tTtT`TtTtT`T`TtT`T`T j2  B1? [ 2  C ENGZHI`TJQ8c? `T`T`T`T`T`T`T`T`T`TP0p   Z ߶gֳgֳ ?"`` 5/Bone would be larger than in the previous view0(*2  `      H  0޽h ??0 ̙3380___PPT10.g` L 0  5 LL`##K(  18 sb  bs 6(@ sb   sb    BNCDEFp?bA!aA`5 #.jCJY4y /Pp41JQUru=^ J t**** 5+5l5555585X555555.5Z555555;5Z**    = \      H s    * J j  7 V w  7 jX `x U J J JJ.JOUou Kk+K 7WMw z"Y-9CM M M M 8x "X 7      l K ,     w aU W5 W M B 7 7 7^ ,3 , , , "g "G " """Z";""""""n"O"$xX-aAtU4",tBSW(lwgG&{[:yYCw#W  @s ~   NBC-DEFA?|| h G '  )?m`Wv6!!! : [ | *Kl     0 Q q   6!W!w!6Lm1Rs"w,W,A LllLALhaGAG GG'|\Q;''v'V5*'GG1<]]q]f<E'$<]$~~h]`G?G4h4444@b    TBC>DEF?66 xW0LFmfxb L+WLmlxwWw7!AbbA,&7FAgAA7  ,77W7x! ,LWWx'''<<]<=mp@R1    BtCDEF  A@fp?00;;;m[Wqx b6LVbwmWLLL+&+F+g+++ ,+L+m+x  +ALm1Rs1sR]s<sRx1xxxmmWmWLLLWW1WRWsWAs7R,1!}&&&Gh}Q1sR&1Qrm}m\Q1<]~~]<aaaall<l]l~llL66~6]6<6 ||&GGqh~~hRs|ffF;hRY\@"B  `$ u   BCyDE|F)?tS 2!!!n!M!-! !!!!!h!G!'!,7BMMbWBb!mx r?@@7=   S BCiDEFA1?hhQ6AWAxA6!<]~!Bc 2Ss!i6^WSx=2byccccmBb,!! xh]RRR11&&'G'<]hG'bLA+'+ QQ@n^    BCDEFp?>>Dx%xD;W\Lfmqqqm|L|,,LmmL,LLLL A6b6AVVbVAa!!!!AbA!& G G,GLGm\L\,\ }!,,LbA7}@     BlCDEFf?DD`U6`Wkxkkkkkk<k]k~kkkkk!kBkckkkkkk'kHkikkkkkk8kYkzkkkkkk>k_`UJJ??#?D?e??4444)4J4k4444)/Pq @po    B<CjDEFfp?;i,6 @e      BCDE F(fp?0bx0@ e      BCDEF$f?GG0 P q 6Vw&Fg ,Lm2Rs8Xy    =^     # C+d++6ALW)WIbjmx@_ ? -<   BgCDEFfp?--`\6fWfxffffff<f]f~fffff!fBfn\\\\\\=\^\\\\\\"\C\d\\\QF0(%Tu[\@_ 0    tBaCDEFfp?::4Uv$Ef5Vw% F r      A b      1 R s  ##.7.X.x.99DOO=Y^Y~`ux@@  t   DB4CDEPFXfp?TT]2]=<=====^^^^^^&^G^h~G~&tt~b<h ~-]8<888888b8A8 88 8A8bCCCCNN&n<nnnnnyxW6 AbmL+Lm3@ 4    B7C7DEF www)?6 6 640 @ _# 4  T0gֳgֳ?@%  Secondary ossification centers>(*20     dBaCDEFfp?882=!^ ~~X~~X7!y -X-78Y yy,cB37T_tyX77X#DYYY9y#X7.OY!`2qt@ 2  3 E$GH I`TQ8c? `TOT`TOT`T`T`TOT`T`T`p  T$%gֳgֳ?P  Growth/epiphyseal plate"(*20  jB  Bp? P   T85gֳgֳ? qArticular cartilage"(*2 jB @ B8c?? ?  Tl:gֳgֳ?0   xShaft bone grows by deposition on the outside, with mild resorption on the inside surface, plus osteonal remodelling in the interior(*2 f   0  {   S |B.CDEFA1?>>Lx  & G!B=]~!B"b-s2mB!hG&bA x+WA7LL}@9$R D  S BCDEHFPA1?RR*'m2St8Yy(Ii#Dd4Tu_6 )Q_m_{?dD#{^{>{{{{{{d{C{{{{{{t{Sm2_**@    BCDE Ffp?CCAb'22HbSAi iLtmt~xW66WxxW+ "W-8NNbY6dymL+Wx(3W>6I_AtbW++mmAE@j  E    BXCDE F(fp?0A1LQWrW6}`@/p  TdQgֳgֳ?@ `  Q+"(*2(   TZgֳgֳ??P  O- (*2<  2 ! C ENGZHI`TJQ8c? `T`T`T`T`T`T`T`T`T`T0 0 _ " Tcgֳgֳ?  ~ LATER ENDOCHONDRAL OSSIFICATION"!(*2!   # Zbgֳgֳ ?"`  -/Bone would be larger than in the previous viewz0(*2  `      H  0޽h ?/ ! ̙3380___PPT10.g`S 0  5 YSQSp++R(    Tgֳgֳ?P P Growth/epiphyseal plate"(*20    S |BmCDEFA1?>>P  7 ZAd'm== TA``l=b3dA}Z7gD!v-UD6PP}@9a 18 sb  bs 6(@ sb  sb    BNCDEFp?bA!aA`5 #.jCJY4y /Pp41JQUru=^ J t**** 5+5l5555585X555555.5Z555555;5Z**    = \      H s    * J j  7 V w  7 jX `x U J J JJ.JOUou Kk+K 7WMw z"Y-9CM M M M 8x "X 7      l K ,     w aU W5 W M B 7 7 7^ ,3 , , , "g "G " """Z";""""""n"O"$xX-aAtU4",tBSW(lwgG&{[:yYCw#W  @s ~   NBC-DEFA?|| h G '  )?m`Wv6!!! : [ | *Kl     0 Q q   6!W!w!6Lm1Rs"w,W,A LllLALhaGAG GG'|\Q;''v'V5*'GG1<]]q]f<E'$<]$~~h]`G?G4h4444@b    TBC>DEF?66 xW0LFmfxb L+WLmlxwWw7!AbbA,&7FAgAA7  ,77W7x! ,LWWx'''<<]<=mp@R1    BtCDEF  A@fp?00;;;m[Wqx b6LVbwmWLLL+&+F+g+++ ,+L+m+x  +ALm1Rs1sR]s<sRx1xxxmmWmWLLLWW1WRWsWAs7R,1!}&&&Gh}Q1sR&1Qrm}m\Q1<]~~]<aaaall<l]l~llL66~6]6<6 ||&GGqh~~hRs|ffF;hRY\@"B  `$ u   BCyDE|F)?tS 2!!!n!M!-! !!!!!h!G!'!,7BMMbWBb!mx r?@@7=    S BCiDEFA1?hhQ6AWAxA6!<]~!Bc 2Ss!i6^WSx=2byccccmBb,!! xh]RRR11&&'G'<]hG'bLA+'+ QQ@n^     BCDEFp?>>Dx%xD;W\Lfmqqqm|L|,,LmmL,LLLL A6b6AVVbVAa!!!!AbA!& G G,GLGm\L\,\ }!,,LbA7}@     BlCDEFf?DD`U6`Wkxkkkkkk<k]k~kkkkk!kBkckkkkkk'kHkikkkkkk8kYkzkkkkkk>k_`UJJ??#?D?e??4444)4J4k4444)/Pq @po    B<CjDEFfp?;i,6 @e      BCDE F(fp?0bx0@ e     BCDEF$f?GG0 P q 6Vw&Fg ,Lm2Rs8Xy    =^     # C+d++6ALW)WIbjmx@_ ? -<   BgCDEFfp?--`\6fWfxffffff<f]f~fffff!fBfn\\\\\\=\^\\\\\\"\C\d\\\QF0(%Tu[\@_ 0    tBaCDEFfp?::4Uv$Ef5Vw% F r      A b      1 R s  ##.7.X.x.99DOO=Y^Y~`ux@@  t   DB4CDEPFXfp?TT]2]=<=====^^^^^^&^G^h~G~&tt~b<h ~-]8<888888b8A8 88 8A8bCCCCNN&n<nnnnnyxW6 AbmL+Lm3@ 4    B7C7DEF www)?6 6 640 @ _# 3  Ttgֳgֳ?  Secondary ossification center>(*20     dBaCDEFfp?882=!^ ~~X~~X7!y -X-78Y yy,cB37T_tyX77X#DYYY9y#X7.OY!`2qt@ jB  Bp? P   T gֳgֳ? qArticular cartilage"(*2 jB @ B8c?? ?  Zdgֳgֳ ?"`0   }Shaft bone grows in width by deposition on the outside, & mild resorption on the inside surface, with osteonal remodelling in the interior(*2 f  0   &   BCDEHFPA?RR*'m2St8Yy(Ii#Dd4Tu_6 )Q_m_{?dD#{^{>{{{{{{d{C{{{{{{t{Sm2_**@    BCDE Ffp?CCAb'22HbSAi iLtmt~xW66WxxW+ "W-8NNbY6dymL+Wx(3W>6I_AtbW++mmAE@j  E    BXCDE F(fp?0A1LQWrW6}`@/p  Tͺgֳgֳ?@ `  Q+"(*2(   TӺgֳgֳ??P  O- (*2< jB  B8c?p " ! Zܺgֳgֳ ?"`00  ,No surface growth possible on loaded surface"-(*2-|,  2 " C BPENG, HVI Qf8c? TP+;TP+; `TP+; `T  # Zgֳgֳ ?"`| )Interstitial growth to elongate bone here"*(*2*) jB $ Bp?~ % Zxgֳgֳ ?"`p  Erosion matching cartilage s expansive growth keeps plate same width"E(*2E̙D 2 & 3 ENGHZJQ̙8c? `T`T`T`T`T`T`T`T`T`T Pj ' Zgֳgֳ ?"` P Pm DSeparation of function: articular cartilage is just for load-bearing"E(*2E|H $  . ( Z gֳgֳ ?"` ` 8Other growth plate doubles the ability to grow in length"9(*298 jB ) Bf8c? ` * TLgֳgֳ?  zSTRATEGIES FOR GROWTH WITH USE (*2 2 + 3 ENGHZJQ8c? `T`T`T`T`T`T`T`T`T`T0 H  0޽h ??0"&+ ̙3380___PPT10.g`?C 0  5 BBNNB(     T'gֳgֳ?G &ZONES/LAYERS OF THE GROWTH PLATE"'(*2'0   88 P EP&@ >  3> @ >  -> b   c 2 B_C DEPFXA?<?,,,,%,[,,,7,,,,e,, ]T=f&] * :* H T~2M[ iF ip i [ M [ " L t   i [ [B ^     w, T ~   b :     l )B S' S S S 7 )Z 0   7 a a~ aT a* a ao 8 b 0~ Y~    u L" >L Lt u    ' P z  u u u G p  b :     6 Rz `P `' ` ` ` R DZ D0 D D D 6 (b (8 ( (Rnyykk!!!! !8 .b . . < < <0 XZ X X t   4 P tz f X X X tG b b :     l 'B ' ' '   t L "    ' '~ 'T  5yCPC&CCCCtCKCCCCaCCC3CCC<CC}CCQ3Q QQQ^e^;^^^QC`C7C J)))6)))u)L)))))7))))2)7EbS:`,,<?{),@> r2  B1?]r2  B1?r2  B1? |r2  B1?Vr2  B1?lr2   Bf1?= r2   B1?  ]r2   B1?  r2   B1?  |r2   B1? V r2  B1?  lr2  Bf1?  r2  B1?*  ]r2  B1?*  r2  B1?*  |r2  B1?* V r2  B1?*  lr2  Bf1?* Q r2  B1?  ]r2  B1?  r2  B1?  |r2  B1? V r2  B1?  lr2  Bf1?  r2  B1?  >r2  B1? / zr2  B1?Q <@ Y   !Y  r2  B1?Y  rB  B8c?  <@    $  r2 " B1?  rB # B8c?' c <@  /  ' / r2 % B1? / rB & B8c?  r2 ( B1?  >r2 ) B1?  <@  ,r2 * B1?rB + B8c?ppH . BQC!DEXF`f? )E)n77EEE=EgE))))Q7{Saaa!EJ)s )&EPSzaaaa aVaaaa&aPPPBB/4Y44444(4R m.X&&&&&(&P&z ddd^d5 rXd.ddd:.m.D... uK!!zKPYP4444(4R4{4BP^ ^J^t^llP&5BlssszsP(X.e XXXmDX6.!!uYKKmummmm_D5_  55 CJCtCC5))B)l)  zP(u ugggfu<uuYYgmgDgYK/!uY==nY`7   g =  o ) )@ r2 / BA? r2 0 BA? r2 1 B1? ~ r2 2 B1? v r2 4 B1?H  r2 5 B1? F d 6  4B>CDEHFPf)?7,a,,.W,::,&N,x:=%(@   7  \BoCWDE\Fdf)?O`9`c6(DD#RL`u``nD 656_6666,VM/0@   8  lBC)DEdFlf)?7_4m]{Q))))79_G{p{mQ=CgC7Q_ (x34@ 7 l 9  <BTCDELFTf)?7 _ ).7WEEEES&SNSwS)'(@   :  dBCDE`Fhf)?>h''A O6]`]]y;yVkkk]]%]Miy14@ E S  ; TJgֳgֳ?   _}"(*20  < T,Sgֳgֳ? 1  _}"(*2u  = TZgֳgֳ?!P  _}"(*2H  > T]gֳgֳ?a P  _}"(*2<f  ? Togֳgֳ?q eRESTING"(*2  @ T|gֳgֳ?`P1 k PROLIFERATION"(*2   A T gֳgֳ?1  j HYPERYTROPHY" (*2    B Tgֳgֳ?1! !A  k CALCIFICATION"(*2   C Těgֳgֳ?R & _}"(*2`f  D TФgֳgֳ?   j OSSIFICATION" (*2 f  j2 F B1? D G Tgֳgֳ?0 g Expansion" (*2   ^B H 6p?  I Tgֳgֳ? n 6Osteoclasts stop the trabeculae from forever extending"7(*27f6 2 J 3 ENGHZJQ8c? `T`T`T`T`T`T`T`T`T`T@0 ! K T,ƽgֳgֳ?   nMatching erosion"(*2f 2 L 3 ENGHZJQ8c? `T`T`T`T`T`T`T`T`T`T ` j M Tѽgֳgֳ?  new bone on calcified cartilageZ!(*23fH   jB N B8c? @1H  0޽h ?/ JL ̙3380___PPT10.gPv3 0  5 22==J2(  28  0$ = 0$/@ ' :$ :' :$&@ ' :# 2' :#@ 0 :# ,0 :#b   c 2 B C DEPFXA?0#0#[#### #_######z##>]~  , L m      F q      ?.?9 Cd5Uv44$4D4e44I I> I^ > ) 4 I T u    i I )  pO/`? .De e*eJek$DZp 4 S t        i I 4> U4 k vvvvvpkO`/````UJkJJJ*J k *Jk$$$:/:O:pPqqP E4 :S :t : P q    i I )  {eD$`5qQ1W, ]Yj{[;     lL+ [/   U )    p O .     > +z6NA.L#l#00,),@0 :#r2  B1? ?L r2  B1? L &r2  B1? L Dr2  B1? ]L r2  B1? {L  r2  Bf1? : | ! r2   B1? ? r2   B1?  &r2   B1?  Dr2   B1? ] r2   B1? {  r2  Bf1? : ! r2  B1? ? r2  B1?  &r2  B1?  Dr2  B1? ] r2  B1? {  r2  Bf1? : ! r2  B1?$ ? r2  B1?$  &r2  B1?$  Dr2  B1?$ ] r2  B1?$ {  r2  Bf1?$ : ! r2  B1? a\ r2  B1? < r2  B1? L I<@  ||    || r2  B1? | rB  B8c? |P <@  |\  # |\ r2 ! B1? \ rB " B8c? |0 <@  |<  & |< r2 $ B1? < rB % B8c? | r2 ' B1?T a r2 ( B1?  I<@    +  r2 ) B1?  rB * B8c?  H - BCDEXF`f? !7!W,x,77777=!]~!!,BM7MXMy7! '!H7iBMMMM M8MYMzMMMm2Ss -Nn(IizdCCCtCTY3ozYNCCcCCC"" h H'ii2SSSsSSSSS^8iYtyttti>HT'^iI(yY8 yyhnHc'B"'Hh"CYy>^h G ====GiGI'3'''n'N- hH'WL2,H ] =  xX ! !@' % r2 . BA? &   r2 / BA? &  r2 0 B1?d  p r2 1 B1? t s r2 3 B1? m $r2 4 B1? $ C d 5  4B1CDEHFPf)? +#L#l# #0.Q.p##.0 %(@ Q  6  \BXCDE\Fdf)??L-LN+d 66AL'LHLgW6++++ +A+a/0@ t )  7  lBnCDEdFlf)?,L)WIbjAu!u!!!,Lb#mCmdbWA66,(AHLim`m34@  #l 8  <BCC>DELFTf)?+ K l!,707P7q7BBBB!5='(@z  R  9  dBCDE`Fhf)?1Rs4?JJ6JW`wv`UUU:J[J|Jk`14@ D  ; Tgֳgֳ?P 0 PCartilage is replaced by bone. There is no transformation of cartilage into bonebQ(*2  $ $' 0 1 2 < C ENGZHI`TJQp? `T`T`T`T`T`T`T`T`T`T`` H  0޽h ?< ̙3380___PPT10.g@] 0  5 ]]{{\(  5  Zgֳgֳ ?"`  Vitamin D & Ca2+ deficienciesD(*2̙̙̙  /8   ; &@   3 @    -  b   c 2 B C DEPFXA?0#0#[#### #_######z##>]~  , L m      F q      ?.?9 Cd5Uv44$4D4e44I I> I^ > ) 4 I T u    i I )  pO/`? .De e*eJek$DZp 4 S t        i I 4> U4 k vvvvvpkO`/````UJkJJJ*J k *Jk$$$:/:O:pPqqP E4 :S :t : P q    i I )  {eD$`5qQ1W, ]Yj{[;     lL+ [/   U )    p O .     > +z6NA.L#l#00,),@  r2  B1?m%wr2  B1?m%r2  B1?m%$r2  B1?m=%r2  B1?m[%r2   Bf1?mU r2   B1?uwr2   B1?ur2   B1?u$r2   B1?=ur2  B1?[ur2  Bf1? r2  B1?wr2  B1?r2  B1?$r2  B1?=r2  B1?[r2  Bf1? r2  B1?wr2  B1?r2  B1?$r2  B1?=r2  B1?[r2  Bf1? r2  B1?A5r2  B1?rr2  B1?%)<@ \U !\Ur2  B1?`UrB  B8c?\)<@ \5 $\5r2 " B1?`5rB # B8c?\ <@ \ '\r2 % B1?`rB & B8c?\r2 ( B1?-Ar2 ) B1?m)<@ i` ,i`r2 * B1?m`rB + B8c?iH . BCDEXF`f? !7!W,x,77777=!]~!!,BM7MXMy7! '!H7iBMMMM M8MYMzMMMm2Ss -Nn(IizdCCCtCTY3ozYNCCcCCC"" h H'ii2SSSsSSSSS^8iYtyttti>HT'^iI(yY8 yyhnHc'B"'Hh"CYy>^h G ====GiGI'3'''n'N- hH'WL2,H ] =  xX ! !@ r2 / BA?  r2 0 BA?y i r2 1 B1?= P r2 2 B1? MS r2 4 B1?M } r2 5 B1? # d 6  4B1CDEHFPf)? +#L#l# #0.Q.p##.0 %(@ *  7  \BXCDE\Fdf)??L-LN+d 66AL'LHLgW6++++ +A+a/0@T   8  lBnCDEdFlf)?,L)WIbjAu!u!!!,Lb#mCmdbWA66,(AHLim`m34@y  l 9  <BCC>DELFTf)?+ K l!,707P7q7BBBB!5='(@S 2  :  dBCDE`Fhf)?1Rs4?JJ6JW`wv`UUU:J[J|Jk`14@$   < S tB,C DEFA1?3>>>V>>>>336(Vv  6`v6Vv >]!@Vu/Nw (G f     J+++++#+9+w++++++2+Q+p+++++k++++& +y + + + + + +S +|      6 L k      % D m       = \ {   k `q VR V3 @ +      = \ { k K +     ` @     ` @  f G (   + + + +m N D : : Y x k ` Y :  L  +| 6S 6 @ @ @ @y @d @E K KKVVVk`L`#``````h`S`4``````p`Z`;``````XVBV#VKKKK~Ki@J@!@@@@f@(@666w6X696666~6_6@6!@@KVV`g33@5a lj2 = B1?4Lj2 > B1?LPj2 ? B1?@Lj2 @ B1?Lj2 A B1?Lj2 B Bf1?| j2 C B1?4j2 D B1?Pj2 E B1?@j2 F B1?j2 G B1?j2 H Bf1? j2 I B1?4 j2 J B1? Pj2 K B1?@ j2 L B1? j2 M B1? j2 N Bf1? j2 O B1?4$ j2 P B1?$ Pj2 Q B1?@$ j2 R B1?$ j2 S B1?$ j2 T Bf1?$ j2 U B1?N, j2 V B1?*<j2 W B1?cL 48  H|  ZH | r2 X B1? L| rB Y B8c? HP 48 H\  ]H\ r2 [ B1?L\ rB \ B8c? H0 48 H< `H<r2 ^ B1?L<rB _ B8c?Hj2 a B1?NT j2 b B1?c  48 L  eL r2 c B1?LrB d B8c? j2 f B1?Tj2 g B1? d < h S BCDEFfA1?11P+5K u +KU+k@u` @``K5uU5uk`@ PPcd@`A i S BCDEFfA1?$$`;K[5{ ;[p 5KkePu;U%@5++KkeEIL@0 Qj2 j Bf1?5  Q j2 k Bf1? t\ j2 l Bf1?U q j2 m Bf1?  j2 n Bf1? l! j2 o Bf1? $ ! j2 p Bf1?% |Aj2 q Bf1? D,  r  BC1DEF f?e%E%%%%0 @P0  s  BClDEFf?+Kk` @K\,^B t 61?p   u T Bgֳgֳ?0 $RICKETS - Expression in growth plate"%(*2% 0   v TMgֳgֳ? 0 P {CARTILAGE LENGTHENS & IS WEAK"(*2  w TUgֳgֳ?` f  yCartilage cannot mineralize"(*2  x Tbgֳgֳ?p@ `v %V. little erosion & bone substitutionb&(*2f`    jB y B1? j2 z Bf1? $  { Zhagֳgֳ ?"`  dNormal"(*2 H  0޽h ? ̙3380___PPT10.g@ 0  5 tlff(    TLKgֳgֳ?  .ENDOCHONDRAL vs INTRAMEMBRANOUS OSSIFICATION I"/(*2/. 8  ,    ,   BCcDE Ff?kWC/u `J*;=,P#cu ) =Qf{$/59EJU Z!^5dJo_tsy,AVk#7L`t%8K_s+?Ym+?s  $7!K"_$y&)+468:<1DEFYHmIKSUWXZ\^%`9bMVcDr2z p\H3vc~O|;{!x wtrqomjibU`'UMIGFDBAv?b=N5;3!1 /-,*(&%UA-vaM:% yeQ="nYD0 nZG80&.:,N*b"uvbN:  @ , H  BCvDEXF`?0DXlm(o<qPrcuxpz\{H}4 z gS> )-0@[@  BCxDETF\?qU@1 ,?Rg {0DXykdwPt=sq+,@@  BCwDETF\?qT@1 ,?Rg |/CWzkevQt=rq+,@-   B[CuDEDFL?g H3 ,@TZX-VATUKh6t"rg#$@d5  BQCxDE<FD?&)=Qes&u:wBdDPL=N)P& @(M    BcCvDEDFL?Y:&';Ob`&^:]NNaEt1rp uY#$@<XF    BCeDETF\fA?dJ7#}iUA,#6F(3=/Q0e2y4Cd+,@F %  Tgֳgֳ?P@ COnly a helpful dichotomy, when applied on the scale of whole bones."D(*2DB o  Tgֳgֳ?!P`  Spine, ribs, limb bones, & the cranial base form first from mesenchyme as small pieces of hyaline cartilage, which is mostly replaced by bone"(*2 ?8 KS "KS   B>C DEFp?E"       ^ E +     x ;  o$U6;G*az 'Hb|*;D^f1wJd~*n #Vx5Or&@b|0Jd}:\ " < V o  , F w` oz f U L D ; ; ;7 ;X ;r D ^ w  " ; ^      + o      4 p       { #a 5H =. = = = ,   z ` F ,       o V 3  xxpg__n_KV)VVVNNlN9NNNNN|NbN@N&N NNNEEzE`EFE-EEEEEEEgENE4EEEEEEEwE]ECE*EENVgxlS9bH/zaG6x E"  @K+~   NBCDEFA?||K  q2WLE^+w/Rl #>Wr)C]x+<Wq  )D]xxfox]oUf;o fL1)))z`O5~u[[[@'2;;2 gL2) );)U)o)oKK@Uk   TBCDEF?66 z ` E&<8WQ`lqhN<E W#`,E,,FX4iNN4#,444!,!:Uo,,#<E8EA`AzARRIc}mp@{   BCDEF  A@fp?&&//p/WHEZ`tpyhN<N+WEE`<y<<""""" "9Tn""""4<.W.p666?Ys|(b9H9.999B(pWp(B(eK0 9KT T99K KTTTB((0hWWhyyyqq1qKqeWKN1NNNNNN4y""""1"K"e eK1}cc}kZ t11 (B\w}cQnQT79/ Y\@"B  `| d   BCaDE|F)?sY?% mT9#,4=h=NE4NW`[?@@7  S BC!DEFA1?hh@+4E4_4y+1Je?Ys+E`z{aG?-h-NhqWNhvq\`Aq9999zqz yqqhN<3""h@@@Qr   B^CDEFp?>>6``6/EI<QWZqZZkkqkWc<c#}#<WqqW<#<<<<4NiiN44Nii4iNz4#<W<# 9#T#]<BN94 ,}@<O   BWCDEFf?DDMD+MEV_VyVVVVVVV1VKVeVVVVVVVV7VQVkVVVVVVV+VEV_VzVVVVVVV1VKMfD;;2222262Q)k)))))))")=)W q@,l    B0CUDEFfp?/T#+ @s   BCDE F(fp?&Nh_&@!    BC%DEF$f?GG &@Zt,Fi :To &@[t,F`{2Lf"""*83R<lEEMV_g g$ @n* <   BRCDEFfp?--LI+QEQ_QzQQQQQQQ1QKQeQQQQQII.IHIbI|IIIIIII4INIhIIII@7&B]v[\@;    tBNCDEFfp?::)D^x8Rl5Pi      * L g       ' A \ u $$$,$G-a-|6??GGMux@T t   DBC3DEPFXfp?TT(000000yKhKKKKKKK dd\\dvhNh 2hN44Nh  %%%%%%y.`?EH+Qkkk4kNkhkkkpW<"<Wp@L   B,C,DEF www)?+++)& @Dp   dBCDEFfp?88(0KddFdd~hF,`F,--#>zPPjhO4,q`F,3,DFDz^q`Fx,(qt@< .   B CDEHFPA?RR"W'xB\v-Ga|*Dg8[um L +  !ALW~bdmJm/m mmmmmmgmLm3mmbbbbbjbPb6bbbbbbbvb\bBW'L""@|wS   BhCDE Ffp?CC 3Nh''h9NB3SS<\W\qdvy~_~E++E_y_E"Eh h N+-h5Pajq|W<"E_yhE+3NhhE"!3";W;qDDU^Wg3e7@; = <    B~CDE4F<fp?MMckCh@(PxxCPx %3@M@MhMu[&^((uPMku#x=PK(Xe6e^eeess&NvvN&xP-HU&}@UN-Nc@ V !  BCQDEFfp?##  r J "  5]uM@k%CxP( Ck (B ]3MMMMPGH@P T #  ,BCDEFp?115(;c +S{Cx@h     0 X   H(p(((((8(`BPj(Pxcd@!Q F $ T츿gֳgֳ?!   dJaw, facial bones, & the clavicles start as mesenchyme, which turns directly into osteoblasts & bone"e(*2ed &8  d%@  a<@ a 'ar2 % B1?ar2 & B1?!IB@ i  *i x2 ( HC1?i r2 ) B1?f + 6?<@ Xq .Xqr2 , B1?Xqr2 - B1?1pY<@ Q 1Qr2 / B1?Qr2 0 B1?9<@ p 4pr2 2 B1?pr2 3 B1?0X<@ ip 7ipr2 5 B1?ipr2 6 B1?0X<@  :r2 8 B1?r2 9 B1? ; C VBjCuDEhFp1?!7I[ i[ MD'G>PQ]`drXdKT>E0Q#]hthW$B!+58@rZ<@  >r2 < B1?r2 = B1? ? C VBjCuDEhFp1?!7I[ i[ MD'G>PQ]`drXdKT>E0Q#]hthW$B!+58@8 @ C VBjCuDEhFp1?!7I[ i[ MD'G>PQ]`drXdKT>E0Q#]hthW$B!+58@r A C VBjCuDEhFp1?!7I[ i[ MD'G>PQ]`drXdKT>E0Q#]hthW$B!+58@0= B C VBjCuDEhFp1?!7I[ i[ MD'G>PQ]`drXdKT>E0Q#]hthW$B!+58@= C C VBjCuDEhFp1?!7I[ i[ MD'G>PQ]`drXdKT>E0Q#]hthW$B!+58@@% D C VBjCuDEhFp1?!7I[ i[ MD'G>PQ]`drXdKT>E0Q#]hthW$B!+58@`"B@ 9 G9x2 E HC1?9r2 F B1?pB@ x Jxx2 H HC1?xr2 I B1? HB@   M x2 K HC1? r2 L B1?1YB@ 8  P8 x2 N HC1?8 r2 O B1?Px<@ i Sir2 Q B1?ir2 R B1?)HQpB T  BCDEFff1?mm.5<0<D<X(ly(y5e<QP=V)dj~uuuua%M9 %    ,@Th|kdq|hT@,q%]I5! ,(<Pdqqqqqq,q3G[oxdP<(..0.D(Xei@1B@ ` W`x2 U HC1?`r2 V B1?Ai0B@ 1 Z1x2 X HC1?1r2 Y B1?<@  Yx ] Yxr2 [ B1? Yxr2 \ B1?8A`<@ 9  `9 r2 ^ B1?9 r2 _ B1?Qy2 b H 3p?"`L-t2 c H 3p?"` 4 e Zܿgֳgֳ ?"`P j ENDOCHONDRAL" (*2    f Zgֳgֳ ?"`  INTRA-MEMBRANOUS"(*230   H  0޽h ? ̙3380___PPT10.g@i)\ 0  5 [}[(([(    Tпgֳgֳ?  /ENDOCHONDRAL vs INTRAMEMBRANOUS OSSIFICATION II"0(*20/ 8  L   L  BCcDE Ff?kWC/u `J*;=,P#cu ) =Qf{$/59EJU Z!^5dJo_tsy,AVk#7L`t%8K_s+?Ym+?s  $7!K"_$y&)+468:<1DEFYHmIKSUWXZ\^%`9bMVcDr2z p\H3vc~O|;{!x wtrqomjibU`'UMIGFDBAv?b=N5;3!1 /-,*(&%UA-vaM:% yeQ="nYD0 nZG80&.:,N*b"uvbN:  @ LH  BCvDEXF`?0DXlm(o<qPrcuxpz\{H}4 z gS> )-0@[@  BCxDETF\?qU@1 ,?Rg {0DXykdwPt=sq+,@1@  BCwDETF\?qT@1 ,?Rg |/CWzkevQt=rq+,@-?   B[CuDEDFL?g H3 ,@TZX-VATUKh6t"rg#$@dU  BQCxDE<FD?&)=Qes&u:wBdDPL=N)P& @(m    BcCvDEDFL?Y:&';Ob`&^:]NNaEt1rp uY#$@<xF    BCeDETF\fA?dJ7#}iUA,#6F(3=/Q0e2y4Cd+,@F@   B>C DEFp?E"       ^ E +     x ;  o$U6;G*az 'Hb|*;D^f1wJd~*n #Vx5Or&@b|0Jd}:\ " < V o  , F w` oz f U L D ; ; ;7 ;X ;r D ^ w  " ; ^      + o      4 p       { #a 5H =. = = = ,   z ` F ,       o V 3  xxpg__n_KV)VVVNNlN9NNNNN|NbN@N&N NNNEEzE`EFE-EEEEEEEgENE4EEEEEEEwE]ECE*EENVgxlS9bH/zaG6x E"  @+Kv   NBCDEFA?||K  q2WLE^+w/Rl #>Wr)C]x+<Wq  )D]xxfox]oUf;o fL1)))z`O5~u[[[@'2;;2 gL2) );)U)o)oKK@Uk|   TBCDEF?66 z ` E&<8WQ`lqhN<E W#`,E,,FX4iNN4#,444!,!:Uo,,#<E8EA`AzARRIc}mp@{   BCDEF  A@fp?&&//p/WHEZ`tpyhN<N+WEE`<y<<""""" "9Tn""""4<.W.p666?Ys|(b9H9.999B(pWp(B(eK0 9KT T99K KTTTB((0hWWhyyyqq1qKqeWKN1NNNNNN4y""""1"K"e eK1}cc}kZ t11 (B\w}cQnQT79/ Y\@"B  `| d   BCaDE|F)?sY?% mT9#,4=h=NE4NW`[?@@7  S BC!DEFA1?hh@+4E4_4y+1Je?Ys+E`z{aG?-h-NhqWNhvq\`Aq9999zqz yqqhN<3""h@@@Qr   B^CDEFp?>>6``6/EI<QWZqZZkkqkWc<c#}#<WqqW<#<<<<4NiiN44Nii4iNz4#<W<# 9#T#]<BN94 ,}@<O   BWCDEFf?DDMD+MEV_VyVVVVVVV1VKVeVVVVVVVV7VQVkVVVVVVV+VEV_VzVVVVVVV1VKMfD;;2222262Q)k)))))))")=)W q@,l    B0CUDEFfp?/T#+ @s    BCDE F(fp?&Nh_&@!   BC%DEF$f?GG &@Zt,Fi :To &@[t,F`{2Lf"""*83R<lEEMV_g g$ @n* 4   BRCDEFfp?--LI+QEQ_QzQQQQQQQ1QKQeQQQQQII.IHIbI|IIIIIII4INIhIIII@7&B]v[\@;    tBNCDEFfp?::)D^x8Rl5Pi      * L g       ' A \ u $$$,$G-a-|6??GGMux@T l   DBC3DEPFXfp?TT(000000yKhKKKKKKK dd\\dvhNh 2hN44Nh  %%%%%%y.`?EH+Qkkk4kNkhkkkpW<"<Wp@L   B,C,DEF www)?+++)& @Dp   dBCDEFfp?88(0KddFdd~hF,`F,--#>zPPjhO4,q`F,3,DFDz^q`Fx,(qt@ <&   B CDEHFPA?RR"W'xB\v-Ga|*Dg8[um L +  !ALW~bdmJm/m mmmmmmgmLm3mmbbbbbjbPb6bbbbbbbvb\bBW'L""@w|S   BhCDE Ffp?CC 3Nh''h9NB3SS<\W\qdvy~_~E++E_y_E"Eh h N+-h5Pajq|W<"E_yhE+3NhhE"!3";W;qDDU^Wg3e7@ ;= 4   B~CDE4F<fp?MMckCh@(PxxCPx %3@M@MhMu[&^((uPMku#x=PK(Xe6e^eeess&NvvN&xP-HU&}@UN-Nc@ V   BCQDEFfp?##  r J "  5]uM@k%CxP( Ck (B ]3MMMMPGH@P .  T(gֳgֳ? ,Application to parts of bones starts troubleB-(*2, T !  ,BCDEFp?115(;c +S{Cx@h     0 X   H(p(((((8(`BPj(Pxcd@!Q  " Tgֳgֳ?q XSoon after the facial bones & clavicle have got going as bone, small regions of cartilage develop - secondary cartilages, which mostly or entirely experience endochondral replacement by boneB(*2hG0d Z jB # Bp?jB $@ Bp?jB %@ Bp?PjB & Bp?@ `@  ' T,gֳgֳ?1 6jBeresford WA. Chondroid bone, metaplasia, and secondary cartilage. Urban & Schwarzenberg: Baltimore, 1981 Hk(*23(`  3   jB ( Bp?I H  0޽h ? ̙3380___PPT10.g0,K 0  5 JJJ(    T$gֳgֳ?  0ENDOCHONDRAL vs INTRAMEMBRANOUS OSSIFICATION III"1(*210 .  Tgֳgֳ? ,Application to parts of bones starts troubleB-(*2,   TlNgֳgֳ?@ L lSome would maintain that parts of an endochondrally established long bone, e.g., the outer shaft, did not have cartilage preceding them at that site, and hence are  intra-membranous "(*2`L  [   B8 ]Y ]Y   B>C DEFp?E"       ^ E +     x ;  o$U6;G*az 'Hb|*;D^f1wJd~*n #Vx5Or&@b|0Jd}:\ " < V o  , F w` oz f U L D ; ; ;7 ;X ;r D ^ w  " ; ^      + o      4 p       { #a 5H =. = = = ,   z ` F ,       o V 3  xxpg__n_KV)VVVNNlN9NNNNN|NbN@N&N NNNEEzE`EFE-EEEEEEEgENE4EEEEEEEwE]ECE*EENVgxlS9bH/zaG6x E"  @Yv~   NBCDEFA?||K  q2WLE^+w/Rl #>Wr)C]x+<Wq  )D]xxfox]oUf;o fL1)))z`O5~u[[[@'2;;2 gL2) );)U)o)oKK@%];   TBCDEF?66 z ` E&<8WQ`lqhN<E W#`,E,,FX4iNN4#,444!,!:Uo,,#<E8EA`AzARRIc}mp@K   BCDEF  A@fp?&&//p/WHEZ`tpyhN<N+WEE`<y<<""""" "9Tn""""4<.W.p666?Ys|(b9H9.999B(pWp(B(eK0 9KT T99K KTTTB((0hWWhyyyqq1qKqeWKN1NNNNNN4y""""1"K"e eK1}cc}kZ t11 (B\w}cQnQT79/ Y\@"B  `LJ    BCaDE|F)?sY?% mT9#,4=h=NE4NW`[?@@   S BC!DEFA1?hh@+4E4_4y+1Je?Ys+E`z{aG?-h-NhqWNhvq\`Aq9999zqz yqqhN<3""h@@@    B^CDEFp?>>6``6/EI<QWZqZZkkqkWc<c#}#<WqqW<#<<<<4NiiN44Nii4iNz4#<W<# 9#T#]<BN94 ,}@ j    BWCDEFf?DDMD+MEV_VyVVVVVVV1VKVeVVVVVVVV7VQVkVVVVVVV+VEV_VzVVVVVVV1VKMfD;;2222262Q)k)))))))")=)W q@<     B0CUDEFfp?/T#+ @Csi   BCDE F(fp?&Nh_&@gux    BC%DEF$f?GG &@Zt,Fi :To &@[t,F`{2Lf"""*83R<lEEMV_g g$ @>u <   BRCDEFfp?--LI+QEQ_QzQQQQQQQ1QKQeQQQQQII.IHIbI|IIIIIII4INIhIIII@7&B]v[\@ \]    tBNCDEFfp?::)D^x8Rl5Pi      * L g       ' A \ u $$$,$G-a-|6??GGMux@$r t   DBC3DEPFXfp?TT(000000yKhKKKKKKK dd\\dvhNh 2hN44Nh  %%%%%%y.`?EH+Qkkk4kNkhkkkpW<"<Wp@XDw   B,C,DEF www)?+++)& @[@   dBCDEFfp?88(0KddFdd~hF,`F,--#>zPPjhO4,q`F,3,DFDz^q`Fx,(qt@ @  .   B CDEHFPA?RR"W'xB\v-Ga|*Dg8[um L +  !ALW~bdmJm/m mmmmmmgmLm3mmbbbbbjbPb6bbbbbbbvb\bBW'L""@L W   BhCDE Ffp?CC 3Nh''h9NB3SS<\W\qdvy~_~E++E_y_E"Eh h N+-h5Pajq|W<"E_yhE+3NhhE"!3";W;qDDU^Wg3e7@  s <   B~CDE4F<fp?MMckCh@(PxxCPx %3@M@MhMu[&^((uPMku#x=PK(Xe6e^eeess&NvvN&xP-HU&}@UN-Nc@} &)   BCQDEFfp?##  r J "  5]uM@k%CxP( Ck (B ]3MMMMPGH@ \   ,BCDEFp?115(;c +S{Cx@h     0 X   H(p(((((8(`BPj(Pxcd@[@ rB B Bp?`  h  THygֳgֳ? nThis need not confuse students of the skeleton & of instructors. It merely offers an example of hanging oneself with one s scheme of classification, by extending it beyond good sense."(*20? u H  0޽h ? ̙3380___PPT10.g0$5K 0  5 JJ!J(    T kgֳgֳ?  /ENDOCHONDRAL vs INTRAMEMBRANOUS OSSIFICATION IV"0(*20/ .  Tkgֳgֳ? ,Application to parts of bones starts troubleB-(*2,   TQgֳgֳ?@ L lSome would maintain that parts of an endochondrally established long bone, e.g., the outer shaft, did not have cartilage preceding them at that site, and hence are  intra-membranous  (*2`L  [      B>C DEFp?E"       ^ E +     x ;  o$U6;G*az 'Hb|*;D^f1wJd~*n #Vx5Or&@b|0Jd}:\ " < V o  , F w` oz f U L D ; ; ;7 ;X ;r D ^ w  " ; ^      + o      4 p       { #a 5H =. = = = ,   z ` F ,       o V 3  xxpg__n_KV)VVVNNlN9NNNNN|NbN@N&N NNNEEzE`EFE-EEEEEEEgENE4EEEEEEEwE]ECE*EENVgxlS9bH/zaG6x E"  @Yvv   NBCDEFA?||K  q2WLE^+w/Rl #>Wr)C]x+<Wq  )D]xxfox]oUf;o fL1)))z`O5~u[[[@'2;;2 gL2) );)U)o)oKK@]%;|   TBCDEF?66 z ` E&<8WQ`lqhN<E W#`,E,,FX4iNN4#,444!,!:Uo,,#<E8EA`AzARRIc}mp@K   BCDEF  A@fp?&&//p/WHEZ`tpyhN<N+WEE`<y<<""""" "9Tn""""4<.W.p666?Ys|(b9H9.999B(pWp(B(eK0 9KT T99K KTTTB((0hWWhyyyqq1qKqeWKN1NNNNNN4y""""1"K"e eK1}cc}kZ t11 (B\w}cQnQT79/ Y\@"B  `JL   BCaDE|F)?sY?% mT9#,4=h=NE4NW`[?@@  S BC!DEFA1?hh@+4E4_4y+1Je?Ys+E`z{aG?-h-NhqWNhvq\`Aq9999zqz yqqhN<3""h@@@   B^CDEFp?>>6``6/EI<QWZqZZkkqkWc<c#}#<WqqW<#<<<<4NiiN44Nii4iNz4#<W<# 9#T#]<BN94 ,}@ j   BWCDEFf?DDMD+MEV_VyVVVVVVV1VKVeVVVVVVVV7VQVkVVVVVVV+VEV_VzVVVVVVV1VKMfD;;2222262Q)k)))))))")=)W q@<    B0CUDEFfp?/T#+ @Csi    BCDE F(fp?&Nh_&@gux   BC%DEF$f?GG &@Zt,Fi :To &@[t,F`{2Lf"""*83R<lEEMV_g g$ @u> 4   BRCDEFfp?--LI+QEQ_QzQQQQQQQ1QKQeQQQQQII.IHIbI|IIIIIII4INIhIIII@7&B]v[\@\ ]    tBNCDEFfp?::)D^x8Rl5Pi      * L g       ' A \ u $$$,$G-a-|6??GGMux@$r l   DBC3DEPFXfp?TT(000000yKhKKKKKKK dd\\dvhNh 2hN44Nh  %%%%%%y.`?EH+Qkkk4kNkhkkkpW<"<Wp@DXw   B,C,DEF www)?+++)& @[@   dBCDEFfp?88(0KddFdd~hF,`F,--#>zPPjhO4,q`F,3,DFDz^q`Fx,(qt@@  &   B CDEHFPA?RR"W'xB\v-Ga|*Dg8[um L +  !ALW~bdmJm/m mmmmmmgmLm3mmbbbbbjbPb6bbbbbbbvb\bBW'L""@ LW   BhCDE Ffp?CC 3Nh''h9NB3SS<\W\qdvy~_~E++E_y_E"Eh h N+-h5Pajq|W<"E_yhE+3NhhE"!3";W;qDDU^Wg3e7@ s 4   B~CDE4F<fp?MMckCh@(PxxCPx %3@M@MhMu[&^((uPMku#x=PK(Xe6e^eeess&NvvN&xP-HU&}@UN-Nc@} &)   BCQDEFfp?##  r J "  5]uM@k%CxP( Ck (B ]3MMMMPGH@ T   ,BCDEFp?115(;c +S{Cx@h     0 X   H(p(((((8(`BPj(Pxcd@@[ jB  Bp? `` "  Txgֳgֳ??  For devotees of pedantry, the bone here is sub-periosteal, & not  intra-membranous in any early mesenchymal- membrane sense"}(*2}`.  $  B  Tgֳgֳ?1x `Where a scheme becomes unhelpful, don t use it."1(*21|/ H  0޽h ? ̙3380___PPT10.g0!r- 7(#.8\HxO[eO"ƭXp I{QZXM}oF>M*0Zi  $ kM a 4  qT /1Oh+'0h hp  No Slide TitleDr. Bill BeresfordZonaNet103Microsoft PowerPoint@5Dm@!*@y_;@$,gGHg   N  y--$xx--'--$66 P P6--'@"Arial-. 33 2 8BONE."System04-@"Arial-. 2  Bone is the .-@"Arial-.  2 +hard.-@"Arial-. 62 :supporting tissue that is used .-@"Arial-. H2 +to make the very many bones of the skeletonc.-@"Arial-.  2 : .-@"Arial-. E2 $)small, large; long, short; flat, roundedo.-@"Arial-. H2 .+Bones come together and are held at joints c.-@"Arial-. 2 5 which allow .-@"Arial-.  2 5.(J.-@"Arial-. 2 50 & restrict.-@"Arial-.  2 5I) .-@"Arial-. 2 5Mmovement.-@"Arial-. L2 A.Muscles act across joints to cause particular .-@"Arial-. N2 H/movements, which are classified in relation to .-@"Arial-. *2 Pthe planes of the body .-@"Arial-.  2 PL-J.-@"Arial-. %2 PPflexion, abduction, .-@"Arial-. 2 W rotation, etc.-@"Arial-.  2 W+. .-@"Arial-. 2 W/at that joint, e.-@"Arial-.  2 WX.J.-@"Arial-.  2 WZgJ.-@"Arial-.  2 W^.J.-@"Arial-. $2 W`, extension of the .-@"Arial-. 2 _ knee to kick.-@"Arial-. |2 iENJOYABLE LIFE .-@"Arial-. | 2 i5-J.-@"Arial-. | 2 i8-J.-@"Arial-. |-2 i<bones as the means to do .-@"Arial-. |L2 p.things; extended by the use of tools & devices.--- $--'-- $)+-+--'-- $:<><--'-- $dfhf--'D՜.+,0     ]e -,' /ArialTimes New Roman 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44    ,_9U ZonaNetZonaNet  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./012456789:;<=>?ABCDEFGIJKLMNO^_`cdefghijRoot EntrydO) 63bPicturesCurrent UserHSummaryInformation(3PowerPoint Document(]U DocumentSummaryInformation8@MsoDataStore 63 63RDOJSSS1==2  63 63Item  Properties7SXFDUZKICTC==2 63 63Item  ;Properties?  !"#$%&'()*+,-./012345689:<=>@AB This value indicates the number of saves or revisions. The application is responsible for updating this value after each revision. DocumentLibraryFormDocumentLibraryFormDocumentLibraryForm