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العظم ويسمى النسيج العظمي : يشكل الدعامة الهيكلية الداخلية لجسم الإنسان.

العظم في الجسم البشري يضم نوعان اثنان من أنواع النسيج العظمي: المكتنز والإسفنجي. تشير الأسماء ضمنا إلى أن الإثنان من أنواع تختلف في الكثافة، أَو مقدار اكتظاظ النسيج داخل العظم. هناك ثلاثة من أنواع الخلايا التي تساهم في عملية نمو العظم. أوستيوبلاستس Osteoblasts وهي خلايا إنتاج العظم, أوستيوكلاستس osteoclasts وهي خلايا ماصة أَو محطمة للعظم، وأوستوسايتس osteocytes وهي خلايا عظمية بالغة. التوازن بين الأوستيوبلاستس والأوستيوكلاستس يحافظ على النسيج العظمي.

وظيفة العظم

العظام الطويلة تكون متصلة بالعضلات الهيكلية بلأوتار. ترتيط العظام بعضها ببعض بواسطة المفاصل والتي ترتبط بلأربطة. يوجد نخاع العظم الاحمر في المادة الخلوية للعظم الاسفنجي، مما يسمح للعظم من إنتاج خلايا الدم الحمر. وأيضاً يوجد نخاع العظم في ساق العظام، ويقوم بتوليد خلايا الدم البيضاء.

 أمراض العظام

كسر العظم من الإصابات الشائعة التي تصيب العظم. تُشفى العظام بطريقة طبيعية، لكن إذا لم يُراقب العظم أثناء مرحلة الشفاء، سينتج خلل في نموالعظم مرة ثانية.

هناك امراض أخرى كهشاشة العظام وسرطان العظام، وتصاب المفاصل بمرض المفاصل.

 تركيب العظم

تركيب العظم

ان العظم هو صلب نسبياً وخفيف، وتدخل مواد عديدة في تركيبه، حيث يتكون وبشكل رئيسي من فوسفات الكالسيوم.

يكون العظم على نوعين : صلب " مضغوط" وأسفنجي. تتكون قشرة العظم من العظم الصلب. العظم المُكون للقشرة يشكل 80% من كتلة العظم الكلية للهيكل العظمي في الإنسان البالغ. بسبب كثافة القشرة العالية تُعد نسبتها 10% من مساحة الجسم السطحية. اما العظم الاسفنجي فيحتل مساحة سطحية كبيرة أكثر بعشرة مرات من العظم المكون للقشرة، ويشكل 20% من المساحة السطحية لجسم الإنسان.

 العظم الكثيف

العظم الكثيف يشمل osteons مكتظة بشدة أَو أنظمة haversian. الosteon تشمل قناة وسطى تدعى قناة osteonic أو قناة(haversian)، والتي تكون محاطة بحلقات مركزية (lamellae) من الهيكل الشبكي. تقع الخلايا العظمية (أوستوكيتس) بين حلقات الهيكل، في فراغات تدعى الفجوات (lacunae). تتفرع قنوات صغيرة (canaliculi) من الفجوات إلى قناة osteonic لإنشاء الممرّات خلال الهيكل الصلب. في العظم الكثيف، تكتظ أنظمة haversian باحكام مشكلة ما يبدو كالكتلة الصلبة. تحتوي قنوات osteonic على الأوعية الدموية والتي تسير بصورة متوازية مع محور العظم الطويل. هذه الأوعية الدموية ترتبط، عن طريق قنوات ثاقبة عرضية، بالشراين على سطح العظم.

 العظم الإسفنجي

العظم في كتاب تشريح غراي"بحاجة للترجمة على فوتوشوب"

العظم الإسفنجي، (Cancellous)، أخف وأقل كثافة من العظم الكثيف. العظم الإسفنجي يشمل صفائح (trabeculae) ودعامات من العظم مجاورة للتجاويف متناثرة صغيرة تي تحتوي نخاع العظم الأحمر. تتصل canaliculi مع التجاويف المجاورة، بدلا من قناة haversian المركزية، للحصول على حاجتها من الدم. قد يبدو بأن trabeculae مرتبة بطريقة عشوائية، لكنها منظمة لإعطاء أقصى صلابة بصورة مشابهة للشيّالات التي تستعمل لدعم البناء. يتبع trabeculae العظم الإسفنجي خطوط الإجهاد ويمكن أن يعاد ترتيبها إذا تغير إتجاه الإجهاد.

 تطور ونمو العظم

المصطلحين osteogenesis والتعظّم (ossification) يستعملان في أغلب الأحيان بشكل مرادف للإشارة إلى عملية التشكيل العظمي. أجزاء من الهيكل العظمي تتشكل أثناء الأسابيع القليلة الأولى بعد الإخصاب. بحلول نهاية الإسبوع الثامن بعد الإخصاب، يتكون شكل الهيكل من الغضاريف والأنسجة الرابطة وتبدأ عملية التعظّم.

يستمر تطور العظم في أثناء فترة البلوغ. وحتى بعد البلوغ يستمر تطوير العظم لإصلاح الكسور ولإعادة القولبة. خلايا الأوستيوبلاستس, الأوستوسايتس والأوستيوكلاستس تشترك في تطوير، نمو وإعادة قولبة شكل العظام. هناك نوعان للتعظّمِ: intramembranous و endochondral.

[ Intramembranous

. وتشمل بعض العظام المستوية في الجمجمة وبعض العظام الغير منتظمة. عظام المستقبل تشكّل أولا كأغشية من أنسجة رابطة. تهاجر خلايا الأوستيوبلاستس إلى هذه الأغشيةِ وتحيط نفسها بهيكل شبكي عظمي. خلايا الأوستيوبلاستس المحاطة بالهيكل الشبكي تسمى أوستوسايتس.

 Endochondral

طريقة تعظّم Endochondral تتم عن طريق استبدال الغضاريف بالنسيج العظمي. أغلب العظام في الهيكل العظمي تتشكّل بهذا الإسلوب. تدعى هذه العظام بعظام endochondral. في هذه العملية، العظام تشكّل أولا كقوالب من الغضاريف. أثناء الشهرِ الثالث بعد التلقيح، الأوعية الدموية وخلايا الأوستيوبلاستس تخترق perichondrium المحيط بقوالب الغضاريف وتتحول perichondrium إلى periosteum. حيث تشكل خلايا الأوستيوبلاستس ياقة من العظم المضغوط حول diaphysis. في نفس الوقت، الغضروف في مركز diaphysis يبدأ بالتحلل. وتخترق خلايا الأوستيوبلاستس الغضروف المتحلل وتستبدله بعظم الإسفنجي. هذا يشكّل نواة أساسية للتعظّم. تنتشر عملية التعظّم من هذه النواة إلى نهايات العظام. بعد تشكل العظم الإسفنجي في diaphysis، تقوم خلايا أوستيوكلاستس بتحطيم قسم من العظمَ المشكل حديث لفتح تجاويف medullary.

الغضروف في epiphyses يواصل النمو لإعطاء المجال للعظم النامي لأخذ مزيد من الطول. لاحقاً، عادة بعد الولادةِ، تنشأ مراكز تعظّم ثانويَة في epiphyses. التعظّم في epiphyses مشابه للذي يحصل في diaphysis إلا أن العظمِ الإسفنجيِ لا يحطّم لتَشكيل تجاويف medullary. عندما يكتمل التعظّم الثانوي، الغضاريف تستبدل بالعظم كليا ماعدا في منطقتين. مساحة من الغضروف تبقى على سطح epiphysis مشكلة الغضروف المفصلي، أما المنطقة الأخرى من بقايا الغضروف فتقع بين epiphysis وdiaphysis. وهذه تسمى طبقة epiphyseal أو منطقة النمو.

 نمو العظام

مراحل نمو العظام

تنمو العظام طوليا إنطلاقا من طبقة epiphyseal بواسطة عملية مشابهة لتعظّم endochondral. الغضروف الموجود بمنطقة طبقة epiphyseal بجانب epiphysis يواصل النمو. chondrocytes بجانب diaphysis، يهرم ويتحلّل. تدخل خلايا الأوستيوبلاستس وتُعظّم الهيكل لتشكيل العظم. تستمر هذه العملية في فترة الطفولة وسنوات المراهقة إلى أن يتباطأ نمو الغضروف ومن ثم يتوقف. عند توقف نمو الغضروف، في أوائل العشرينات، تتحجّر طبقة epiphyseal بالكامل ويبقى خط رقيق جدا من epiphyseal، وعليه لا تستطيع العظام النمو طوليا. يتم التحكم بنمو العظام بواسطة هورمون النمو المفرز في الغدّة النخامية، وهورمونات الجنس المفرزة في المبايض والخصيات.

على الرغم من توقف نموالعظام طوليا، إلا أنه يمكنها أن تواصل زيادة سماكتها (القطر) في فترة حياتها وذلك كرد فعل على الإجهاد بسبب نشاط العضلات المتزايد أَو زيادة الوزن. إن زيادة القطرِ تدعى نموا عطفي. خلايا الأوستيوبلاستس في periosteum تشكل طبقة عظمية كثيفة حول السطح العظمي الخارجي. وفي نفس الوقت، تقوم خلايا أوستيوكلاستس في endosteum بتحطيم قسما من العظم على السطح العظمي الداخلي، حول تجويف medullary. تزيد هذه العمليتين قطر العظم، وفي نفس الوقت، تمنع العظم من أن يصبح ثقيلا وضخما.

 


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الكاتب: احمد  ابوسمرة التاريخ: 2010/05/04
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