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APPENDICULAR SKELETON Dr. Mujahid Khan. Composition The appendicular skeleton consists of pectoral girdles and limb bones Mesenchymal bones form during

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  • CompositionThe appendicular skeleton consists of pectoral girdles and limb bones

    Mesenchymal bones form during the fifth week in the limb buds

    Chondrification of mesenchymal bone models occurs in the sixth week

    Clavicle initially develops from intramembranous ossification

    Later forms growth cartilages at both ends

  • CompositionThe models of pectoral girdle and upper limb bones appear slightly before those of the pelvic girdle and lower limbs

    The bone models appear in a proximodistal sequence

    Ossification begins in the long bones by the eighth week

    Initially occurs in the diaphysis

  • Primary OssificationBy 12 weeks primary ossification centers appear in almost all bones of the limbs

    The clavicle begin to ossify before any other bone in the body

    The femora are the next bones to show traces of ossification

    First indication of ossification in cartilaginous model appear in the center of the future shaft, called primary center of ossification

  • Primary OssificationPrimary centers appear at different times in different bones

    Most of them develop between 7 and 12 weeks

    Virtually all primary centers of ossification are present at birth

    The part of the bone ossified from a primary center is the diaphysis

  • Secondary OssificationSecondary ossification centers of the bones at knee are the first to appear

    The centers for the distal end of femur and proximal end of tibia appear during 34 to 38 weeks

    Consequently they are present at birth

    Most secondary centers of ossification appear after birth, called epiphysis

  • Secondary OssificationThe bone forms from the primary center in the diaphysis do not fuse with that formed from the secondary centers in the epiphysis until the bone grows to its adult length

    The delay enables lengthening of the bone to continue until the final size is reached

  • Secondary OssificationDuring bone growth, epiphysial plate intervenes between the diaphysis and epiphysis

    The epiphysial plate is eventually replaced by bone development on each of its two sides, diaphysial and epiphysial

    When this occurs, growth of the bone ceases

  • Limb DevelopmentThe limb buds appear as elevations of the ventrolateral body wall by end of 4th week

    The limb buds form deep to a thick band of ectoderm

    The upper limb buds are visible by 26 to 27 days

    Lower limb buds appear 2 days later

  • Limb BudEach limb bud consists of a mass of mesenchyme covered by ectoderm

    The mesenchyme is derived from the somatic layer of lateral mesoderm

    The limb buds elongate by the proliferation of the mesenchyme

    The upper limb buds appear low on the embryos trunk

  • Limb BudThe early stages of limb development are alike for the upper and lower limbs

    Development of upper limb buds occurs 2 days before that of lower limb buds

    The upper limb buds develop opposite the caudal cervical segments

    Lower limb buds form opposite the lumbar and upper sacral segments

  • Limb BudAt the apex of each limb bud the ectoderm thickens to form an apical ectodermal ridge (AER)

    AER exerts an inductive influence on the limb mesenchyme that initiates growth of limbs in proximal-distal axis

    Mesenchymal cells aggregate at the posterior margin of the limb bud to form the zone of polarizing activity (ZPA)

  • Digital RaysBy the end of 6th week, mesenchymal tissue in the hand plates has condensed to form digital rays

    These mesenchymal condensations or finger buds outline the pattern of the digits

    During the 7th week, similar condensations of mesenchyme form digital rays and toe buds in the foot plates

  • Digital RaysAER induces development of the mesenchyme into the mesenchymal primordia of the bones in the digits

    The intervals between the digital rays are occupied by loose mesenchyme

    Soon the intervening regions of mesenchyme break down forming notches between the digital rays

  • Digital RaysAs the tissue breakdown progresses, separate digits are formed by the end of 8th week

    Programmed cell death (apoptosis) is responsible for the tissue breakdown in the interdigital regions

    Blocking these cellular and molecular events could account for syndactyly, webbing or fusion of the fingers or toes

  • Final Stages of Limb DevelopmentAs the limbs elongate in the 5th week, chondrification centers appear

    By the end of 6th week, the entire limb skeleton is cartilaginous

    Osteogenesis of long bones begins in the 7th week from primary ossification centers in the middle of the cartilaginous models of long bones

  • Final Stages of Limb DevelopmentPrimary ossification centers are present in all long bones by the 12th week

    Ossification of the carpal (wrist) bones begins during the first year after birth

    As the long bones form, myoblasts aggregate and form a large muscle mass in each limb bud

    In general this muscle mass separates into dorsal (extensor) and ventral (flexor) components

  • Final Stages of Limb DevelopmentThe mesenchyme in the limb bud gives rise to bones, ligaments, and blood vessels

    From dermomyotome regions of somites, myogenic precursor cells also migrate into the limb bud

    Later they differentiate into myoblasts or precursors of muscle cells

  • Rotations of LimbsThe cervical and lumbosacral myotomes contribute to the muscles of the pectoral and pelvic girdles, respectively

    Early in the seventh week the limbs extend ventrally

    The developing upper limbs rotate in opposite directions and to different degrees

  • Rotations of LimbsThe upper limbs rotate laterally through 90 degrees on their longitudinal axis

    Now the future elbows point dorsally

    Extensor muscles lie on the lateral and posterior aspects of the limb

    The lower limbs rotate medially through 90 degrees

    Now the future knees face ventrally

    Extensor muscles lie on the anterior aspect of the lower limb

  • Cutaneous Innervation of LimbsMotor axons arising from the spinal cord enter the limb buds during the fifth week

    Grow into dorsal and ventral muscle masses

    Sensory axons enter the limb buds after the motor axons and use them for guidance

  • Cutaneous Innervation of LimbsNeural crest cells, the precursors of schwann cells, surround the motor and sensory nerve fibers in the limbs

    Form the neurolemmal and myelin sheaths

    A dermatome in this area of skin supplied by a single spinal nerve and its spinal ganglion

  • Cutaneous Innervation of LimbsDuring the 5th week, the peripheral nerves grow from the developing limb plexuses into mesenchyme of limb buds

    The spinal nerves are distributed in segmental bands, supplying both dorsal and ventral surfaces of the limb buds

    As the limbs elongate, the cutaneous distribution of the spinal nerves migrates along the limbs

  • Cutaneous Innervation of LimbsThe original dermatomal pattern changes during growth of the limbs

    An orderly sequence of distribution can still be recognized in the adult

    When the limbs descend they carry their nerves with them

    This explains the oblique course of the nerves arising from the brachial and lumbosacral plexuses

  • Blood Supply to LimbsThe limb buds are supplied by branches of the dorsal intersegmental arteries

    They arise from the aorta and form a fine capillary network in the mesenchyme

    The primordial vascular pattern consists of a primary axial artery and its branches

    The vascular pattern changes as the limbs develop

    This occurs by vessels sprouting from existing vessels

  • Blood Supply to LimbsThe new vessels coalesce with other sprouts to form new vessels

    The primary axial artery becomes the brachial artery and common interosseous artery in the forearm

    In the thigh the primary axial artery is represented by the profonda femoris artery

    In the leg it is represented by the anterior and posterior tibial arteries

  • Anomalies of LimbsMinor limb anomalies are common and can be corrected surgically

    The most critical period of limb development is from 24 to 36 days after fertilization

    Exposure to teratogen before day 33 may cause severe limb defects

    Major limb anomalies appear about twice in 1000 newborns