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Describe the process of endochondral ossification. Discuss how bone growth is regulated from the fetus to complete ossification. Mention where cartilage remains in the adult. Identify THREE examples of skeletal system disorders. Your response can include disorders of the spinal column, nutritional deficiencies, genetic conditions, and conditions of growth and development. Describe possible causes of each of these conditions. Your answer may not include traumatic conditions (i.e., broken bones). Distinguish the mechanisms of injury and the affected anatomy in a shoulder dislocation versus a shoulder separation. Distinguish the mechanisms of injury and the affected anatomy in a broken ankle versus a sprained ankle. Describe the mechanism of injury and results of an "Unhappy Triad" injury to the knee joint. Be sure to diagram the mechanism of injury and identify all relevant anatomical landmarks. A synovial joint (diarthrosis) has three major structural components. Identify each of these components. Be sure to discuss the structure and function of each of the components. Your answer should include a sketch of a typical synovial joint.

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Endochondral ossification is a fundamental process in skeletal development, where cartilage is gradually replaced by bone tissue. It begins with a cartilage model derived from mesenchymal cells that differentiate into chondrocytes, forming a hyaline cartilage scaffold. Primary ossification centers develop in the diaphysis (shaft) of long bones, where nutrient arteries invade the cartilage, stimulating osteoblast activity that replaces cartilage with woven bone. As development progresses, secondary ossification centers form in the epiphyses, enabling further growth. The process continues into adolescence, regulated by hormones such as growth hormone, sex hormones, and thyroid hormone, which influence cartilage proliferation, ossification, and epiphyseal plate activity. In adults, although most cartilage is replaced by bone, remnants such as articular cartilage at joints and epiphyseal plates remain, allowing for movement and growth respectively.

Several skeletal system disorders can impact bone development and health. For example, scoliosis is a lateral curvature of the spine that can be congenital, caused by vertebral anomalies during development, or idiopathic with unknown origins. Nutritional deficiencies like rickets, caused by vitamin D deficiency, result in weak, deformed bones in children due to impaired calcium absorption and mineralization. Osteogenesis imperfecta, a genetic disorder, affects collagen synthesis leading to brittle bones prone to fractures, and can be inherited in dominant or recessive patterns. These conditions often stem from genetic mutations, nutritional deficits, or developmental anomalies, and they impair normal growth and structural integrity of the skeleton.

A shoulder dislocation involves the displacement of the humeral head from the glenoid cavity, typically caused by excessive external rotation and abduction of the arm, affecting the glenohumeral joint's capsule, labrum, and surrounding ligaments. In contrast, a shoulder separation involves injury to the acromioclavicular joint, often caused by a fall directly on the shoulder, resulting in ligament damage between the acromion and clavicle. Thus, a dislocation affects the ball-and-socket joint, while a separation impacts the joint between the acromion and clavicle, with different mechanisms and affected tissues.

In a broken ankle (fracture), injury occurs when the force exceeds the bone’s structural capacity, typically from a fall or twisting injury, affecting the tibia, fibula, or both. A sprained ankle involves ligament overstretching or tearing, often caused by rolling or twisting the ankle during activity, affecting ligaments such as the anterior talofibular ligament. The fracture affects the bone’s integrity, whereas a sprain impacts soft tissue stability around the joint. Both injuries compromise ankle function but differ in mechanism and affected structures.

The "Unhappy Triad" injury involves simultaneously tearing the ACL (anterior cruciate ligament), MCL (medial collateral ligament), and medial meniscus, often resulting from a lateral blow to the knee with the foot planted. The injury mechanism involves excessive valgus force and rotational stress, leading to instability and knee pain. Anatomically, the force disrupts the medial structures and the supportive ligaments and menisci, often depicted in diagrams showing the valgus stress and rotational component. The result is significant joint instability, swelling, and a high chance of long-term joint degeneration if untreated.

A synovial joint, or diarthrosis, comprises three major components: (1) the articular cartilage, which covers the ends of bones and reduces friction during movement; (2) the synovial cavity, a fluid-filled space that lubricates the joint; and (3) the synovial membrane, which lines the cavity and produces synovial fluid. The articular cartilage provides a smooth surface for articulation; the synovial fluid nourishes cartilage and lubricates joint movement; and the synovial membrane maintains the environment within the cavity. A typical synovial joint, such as the knee, allows for extensive movement and is critical for mobility and stability.

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