Please enable JavaScript.

Coggle requires JavaScript to display documents.

A 12-year-old boy landed on his right arm after a fall. His right elbow…

- - - - Impaired growth
        
        Limb deformity
        
        Bone can grow crooked or short
        
        Growth Arrest
        
        Permanent stoppage of bone's development
        
        Decreased function and range of motion
      - Bony Bridge forms across fracture line
      - Stimulate excessive bone growth
        
        Unequal limb size
        
        May require surgery
    - - Infection
        
        Bone Infection
        
        Sepsis
        
        Amputation of limb in rare, severe bone infections
        
        Long-term antibiotic treatment
    - - Motor weakness
        
        Permanent Paralysis
        
        Pinch deformity & inability to make fist
      - Chronic forearm pain
        
        Numbness, tingling, & paresthesia (abnormal dermal sensation)
    - - Damaged cartilage lining
        
        Inflammation of joints
        
        Decreased range of motion, stiffness, and pain
    - - Joint instability, joint stiffness
      - Nerve damage
        
        Chronic Pain
      - Bone misalignment
    - - Cannot reach full elbow extension
- - - - Infection
      - Damage to nerves & blood vessels
        
        Stretching of ulnar nerve
        
        Weakness in hand & wrist
        
        Temporary numbness & tingling
      - Nonunion (fracture does not heal)
        
        Due to failure to heal, more surgical intervention
    - - Hypovolemic Shock
        
        Possible Death
    - - Decreased range of motion
      - Edema & localized fever
        
        Increased pain, possible posttraumatic arthritis
      - Increased muscle spasms in joint
      - Joint Rigidity
        
        Rough & bumpy movements
    - - Joint stiffness, swelling, & pain
- - - - Found in upper & lower limbs; most common bone shape; vary in size
    - - Diaphysis: elongated, cylindrical part of long bone between its 2 ends
        
        Provides leverage & major weight support of a long bone
        
        Medullary Cavity: extends internally from compact bone along length of diaphysis are spicules of spongy bone (Hollow,cylindrical spce within diaphysis)
        
        Contains red bone marrow in children, replaced by yellow bone marrow in adults.
        
        Epiphysis: expanded, knobby region at end of a long bone; composed of an outer, thin layer of compact bone & inner region of spongy bone
        
        Spongy bone resists stress applied from multiple directions.
        
        Proximal Epiphysis (end of bone closest to the body) & Distal Epiphysis the end farthest from the trunk.
        
        Articular Cartilage: hyaline cartilage covering the joint surface of an epiphysis
        
        Cartilage helps reduce friction & absorbs shock in moveable joints.
        
        Metaphysis: region of mature bone sandwiched between the diaphysis & epiphysis; contains epiphyseal plate (growth plate)
        
        Epiphyseal Plate: thin layer of hyaline cartilage that provides lengthwise growth of bone
        
        1 more item...
        
        Epiphyseal Line: remnants of the epiphyseal plate in adults; thin, defined area of compact bone
    - - Vascularized: supplied w/ many blood vessels in regions of spongy bone
        
        Blood vessels enter bones from periosteum; 1 nutrient artery enters & 1 nutrient vein exits bone through nutrient foramen.
        
        Supply nutrients & oxygen required by cells to remove waste products from bone cells.
        
        Nerves accompany blood vessels through nutrient foramen & are found in the bone periosteum, endosteum, & marrow cavity
        
        Sensory nerves that signal injuries to skeleton
      - Cells of Bone Connective Tissue
        
        Osteoprogenitor: stem cells derived from mesenchyme; located in periosteum & endosteum
        
        When they divide, another stem cell is produced along with a committed cell that matures to become an osteoblast.
        
        Osteoblasts: formed from osteoprogenitor stem cells; perform important function of synthesizing & secreting initial semisolid organic form of bone matrix called osteoid
        
        Osteocytes: mature bone cells derived from osteoblasts that have lost their bone-forming ability when enveloped by calcified osteoid
        
        Maintain bone matrix & detect mechanical stress on bone; if stress found, osteoblasts signaled to decompose new bone matrix at the surface
        
        Osteoclasts: phagocytic cells that are involved in the breaking down of bone (resorption)
        
        Compact Bone Anatomy
        
        Osteons: small, cylindrical structures that make up compact bones; parallel to diaphysis of long bone
        
        Basic functional & structural unit of mature compact bone
        
        Central Canal: cylindrical channel that lies in the center of the osteon; where blood vessels & nerves are found
        
        Concentric Lamellae: rings of bone connective tissue that surround the central canal & form bulk of osteon
        
        Alternating pattern of collagen fibers give bone its strength & resilience
        
        Osteocytes: Mature bone cells found in small spaces btwn adjacent concentric lamellae
        
        1 more item...
        
        Spongy Bone Anatomy
        
        Trabeculae: an open lattice of narrow rods and plates of bones; bone marrow fills in btwn
        
        Parallel Lamellae: composed of bone matrix; btwn adjacent lamellae are osteocytes, lacunae, with numerous canaliculi
    - - Bone Marrow: soft connective tissue of bone that includes both red & yellow bone marrow
        
        Red Blood Marrow: Myeloid tissue, is hemopoietic (blood cell-forming) and contains reticular connective tissue, developing blood cells, & adipocytes.
        
        Location in Children: Spongy bone of most bones as well as medullary cavity of long bones
        
        Location in Adults:selected portions of axial skeleton; flat bones of the skull, vertebrae, ribs, sternum, ossa coxae, & proximal epiphysis of humerous & femur
        
        Yellow Bone Marrow: progressive decrease in developing blood cells & increase in adipocytes
        
        Anemia can cause conversion of yellow bone marrow back to red bone marrow due to insufficient oxygen supply.
      - Composition of Bone Matrix
        
        Bone Matrix: connective tissue that has both organic & inorganic components
        
        Organic Component = Osteoid; composed of both collagen and semisolid ground substance of proteoglycans * glycoproteins that suspends/supports collagen fibers
        
        Inorganic Component = Salt Crystals; salt crystals deposit around long axis of collagen fibers in the extracellular matrix; account for the rigidity/inflexibility of bone; provides compressional strength
  - - - Bone formation is dependant upon growth of hyaline cartilage
        
        Cartilage Development: during embryonic development
        
        Interstitial Growth: length
        
        A chondrocyte within a lacuna begins to exhibit mitotic activity
        
        2 cells (now chondroblasts) are produced by mitosis from 1 chondrocyte and occupy 1 lacuna
        
        Each cell produces new matrix & begins to separate from its neighbor. Each cell is now a chondrocyte
        
        1 more item...
        
        Appositional Growth: width
        
        Mitotic activity occurs in stem cells within the perichondrium
        
        Undifferentiated stem cells & committed cells form into chondroblasts. Chondroblasts produce new matrix at the periphery.
        
        Matrix formation results; chondrocytes push apart and become chondrocytes; chondrocytes continue to produce more matrix
      - Bone Formation
        
        8-12 weeks of embryonic development
        
        Intramembranous Ossification: thickened condensation of mesenchyme
        
        Bone Growth within a membrane
        
        Ossification centers form within thickened regions of mesenchyme beginning at the eighth week of development
        
        Osteoid undergoes calcification: calcium salts are deposited into osteoid & solidify, osteoblasts become osteocytes
        
        1 more item...
        
        Committed cells turn into osteoprogenitor cells, which then become osteoblasts.
        
        Endochondral Ossification: thickened condensation of hyaline cartilage model of bone
        
        The fetal hyaline cartilage model develops: chondrocytes secrete cartilage matrix; chondrocytes trapped in lacunae; perichondrium surrounds cartilage
        
        2.Cartilage calcifies, and a periosteal bone collar forms: Chondrocytes enlarge & eat away cartilage matrix; matrix calcifies; stem cells divide into osteoblasts
        
        Primary ossification center forms in the diaphysis: Growth of capillaries & osteoblasts (periosteal bud) extend. Bone dev. extends in both directions toward epiphysis
        
        1 more item...
        
        Bone Growth
        
        Interstitial Growth: dependent upon growth of cartilage within epiphyseal plate
        
        5 Distinctive Microscopic Zones
        
        Zone of Resting Cartilage: Zone farthest from the medullary cavity, composed of chondrocytes throughout cartilage matrix. This region secures epiphysis to the epiphyseal plate.
        
        Zone of Proliferating Cartilage: Chondrocytes under rapid mitotic division; become aligned into longitudinal columns of flat lacunae
        
        1 more item...
        
        Growth in bone length occurs within zone 2 & 3 as chondrocytes undergo mitotic division (2) & hypertrophy (3)
        
        These processes push the zone of resting cartilage toward the epiphysis.
        
        Once growth in length has occurred, new bone connective tissue is produced in zone 5.
        
        1 more item...
        
        Appositional Growth: occurs within the periosteum
        
        Osteoblasts in inner layer of periosteum produce/deposit bone matrix in layers parallel to surface
        
        Creates external circumferential lamellae
        
        As lamellae increase, diameter increases = bone grows wider
        
        New bone forms & osteoclasts resorb bone matrix, expanding medullary cavity
        
        1 more item...
    - - Constant process of addition of new bone & removal of old bone
        
        Occurs @ periosteal & endosteal surfaces of bone
        
        Mechanical stress: required for normal bone remodeling
        
        Mechanical stress is detected by osteocytes & communicated to osteoblasts
        
        Osteoblasts increase production of osteoid & depositing of mineral salts
        
        Bone strength increases as a response to mechanical stress
        
        Decrease of mechanical stress weakens the bone due to reduction in collagen production & demineralization
        
        Strength of fractured bone decreases due to immobilization
        
        Hormones & Bone Maintenance
        
        Growth Hormone: causes cartilage proliferation at epiphyseal plate & results in bone elongation
        
        Thyroid Hormone: stimulates bone growth by increasing rates of osteoblasts
        
        1 more item...
        
        Calcitriol: stimulates absorption of calcium ions from small intestine into blood
        
        2 more items...
  - - - A fibrocartilaginous callus forms (3 weeks)
        
        A hard/bony callus forms (3-4 months)
        
        Osteoprogenitor cells turn into osteoblasts around fibrocartilage & produce primary bone
        
        Bone is remodeled
        
        Osteoclasts remove excess bony material; some obvious thickening
        
        Blood capillaries regenerate inside fracture hematoma & fibroblasts connect broken ends of bone
      - Broken blood vessels bleed and form a clot within periosteum
  - - - Colles: fracture of distal end of lateral forearm bone; diner fork deformity
        
        Comminuted: bone splintered into several small pieces
        
        Complete: bone broken into 2 or more pieces
        
        Compound/Open: broken ends of bone protrude through skin
        
        Compression: bone is squashed
        
        Depressed: broken part of bone forms concavity
        
        1 more item...
    - - Hairline: fine crack in which sections of bone remain aligned
        
        Impacted: one fragment of bone is firmly driven into the other
        
        Incomplete: partial fracture extends only partway across the bone
        
        Linear: fracture is parallel to the long axis of bone
        
        Oblique: diagonal fracture is at an angle
        
        Pathologic: weakening of a bone caused by disease process
        
        1 more item...
  - - - Calcitonin: regulates blood calcium levels
        
        Adequate Hormone levels
        
        Osteoprogenitor Cells: stem cells of bone that form osteoblasts
        
        Hyaline Cartilage: helps in formation of bone & holding body together
        
        Calcium from plant sources: enough calcium in food to encourage bone growth in addition to hormones & other chemical processes of the body
        
        Stress: needed in order to inhibit process of bone resorption and creation
        
        2 more items...
        
        Osteoblasts: secrete matrix for bone formation
        
        Osteoclasts: bone cells that absorb bone tissue during growth & healing
        
        Osteocytes: mature bone cells
      - Daily sunlight
- - - - Osteopenia
        
        Bone deterioration
        
        Osteoporosis
      - Brittle Bones
        
        Increased risk of fractures & injury
      - Hypocalcemia
        
        Tingling
        
        Muscle spasms
        
        Irregular heart rhythm
        
        Seizures