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Little boy sustains bone fractures to right arm (Classification of…
Little boy sustains bone fractures to right arm
Running and fell forward onto his right arm
Diet is hot dogs and junk food
Lactose Intolerant/Calcium deficiency
Anatomy of Long Bones
Regions
Diaphysis
the shaft of the long bone
Medullary Cavity
hollow, cylindrical space within diaphysis
Epiphysis
Distal
farthest away from trunk
Proximal
closest to thrunk
each end of long bone
Linings/Coverings
Periosteum
tough sheath two layers
perforating fibers
anchoring the periosteum made of collagen fibers
Endosteum
incomplete layer covers all internal surfaces in the medullary cavity
Compact Bone Anatomy
Central Canal(CC)
lets blood vessels and nerves run through lying in the middle of a osteon
Concentric Lamellae
rings of bone connective tissue(CT) surround central canal gives strength and resilience
Lacunae
small spaces that hold osteocytes
Canaliculi
tiny interconnected channels letting osteocytes share nutrients
Osteons
small cylindrical structures subunit of compact bone
Perforating Canals
run perpendicular holds blood vessels and nerves help connect several CC within osteons
Circumferential Lamallae
rings of bones internally or externally
Interstitial Lamallae
incomplete leftovers
Anatomy of Spongy Bone
Trabeculae
open lattice of narrow rods and plates
Parallel Lamallae
bone matrix
Cells of Bones
Osteoprogenitor
stem cells derived from mesenchyme mature into osteoblasts
Osteoblasts
synthesizing and secreting osteoids
Osteoid
semisolid organic form of bone matrix
Osteocytes
lost bone making ability maintain bine matrix and detect mechanical stress
Osteoclasts
break down bone material
Bone Formation
Endochondral Ossification
1.) the fetal hyaline cartilage model develops
chondroblasts secret cartilage matrix and HC model forms Chondrocytes trapped in lacunae and perichondrium surround cartilage
Hyaline cartilage(HC) becomes bones in the body except flat bones
2.) Cartilage calcifies, and a periosteal bone collar forms
chondrocytes start hypertrophy and resorb some cartilage starts to calcify blood vessels start to grow osteoblast start secreting osteoid. osteoid hardens
3.) The primary ossification center forms in the diaphysis
periosteal bud extends from periosteum into cartilage shaft primary ossification centers remains of calcified cartilage are blueprints
4.) Secondary ossification centers form in the epiphysis
Secondary Ossification centers are created calcified cartilage pushed out creates a hollow cavity
5.) Bone replaces almost all cartilage, except the articular cartilage and epiphyseal cartilage
almost all HC turns to bone excepts some cartilage stays behind in joints
6.) Lengthwise growth continues until the epiphyseal plates(EP) ossify and form epiphyseal line(EL)
bones grow into puberty until EP turns into EL
Bone Growth
Interstitial Growth
1.) Zone of resting cartilage
composed of small chondrocytes distributed throughout resembles mature HC secures the epiphysis to EP
2.) Zone of proliferating cartilage
chond. undergo rapid mitotic cell division aligned in stacks parallel to diaphysis
3.) Zone of hypertonic cartilage
Chond. cease dividing & begin to hypertrophy wall of lacunae thin b/c chind. resorb matrix
4.) Zone of calcified cartilage(c.c)
composed of 2-3 layers of chond. Minerals deposited b/t columns of lacunae calcification destroys chond. and make matrix appear opaque
5.) Zone of ossification
walls break down b/t lacunae in the columns forming longitudinal channels spaces invaded by capillaries and osteoprogenitor cells new matrix is deposited on remaining c.c matric
Appositional Growth
occurs within periosteum osteoblasts produce and deposit bone matrix within layers parallel to surface external circumferential lamellae they increase # structure increases in diameter
Bone Remodeling
adding on new bone tissue and removal of old bone tissue throughout life
1.) A fracture hematoma forms
fracture tears blood vessels causing bleeding-fracture hematoma(fh) blood is clotted in the space
2.) A fibrocartilaginous (soft) callus forms
FH is reorganized into active growing CT fibroblasts create collagen fibers that help connect broken ends Chondroblasts from dense regular CT forming a fibrocartilaginous callus(FC) lasts 3 weeks
3.) A hard(bony) callus forms
osteoprogenitor cells in areas adjacent to FC become osteoblasts and produce primary bone forms hard callus grow and thicken over few months
4.) The bone is remodeled
final phase hard callus lasts 3-4 months osteoclasts remove excess bony material compact bone replaces primary bone fracture usually leaves thickening some do not
Raw Materials
Hormones
these help grow/repair or inhibit growth
Growth Hormone
stimulates liver for IGF causes cartilage proliferation at EP resulting in bone elongation
Thyroid Hormone
stimulates bone growth by stimulating metabolic rate of osteoblasts
Calcitonin
promotes calcium deposition and inhibits osteoclast activity
Calcitriol
stimulates absorption of calcium ions from SI into blood
Parathyroid Hormone
increases blood calcium levels by encouraging bone resorption by osteoclasts
Sex Hormones
stimulates osteoblasts; promote EP growth and closure
Glucocorticoids
increase bone loss impair bone growth when chronically high levels of glucocorticoids
Serotonin
inhibits osteoprogenitor cells from differentiating into osteoblasts when chronically high levels of serotonin
Epiphyseal Plate
Location
Metaphysis
sandwiched b/t the diaphysis and epiphysis
growing bone thing layer of HC provides continued lengthwise growth
Epiphyseal Line
thin defined area of compact bone
Classification of Fractures
Fractures
breaks in a bone
Stress Fractures
thin breaks
Pathologic Fracture
weakened by disease
Simple fracture
broken bone does not break skin
Compound Fracture
one or both ends break the skin
Avulsion
complete severing of a body part
Colles
fracture of distal end of lateral forearm
Comminuted
bone splintered into several small pieces b/t main parts
Complete
bone broken into two or more pieces
Compound (open)
broken ends of bone protrude through skin
Compression
bone is squashed
Depressed
broken part forms a concavity
Displaced
fractured bone parts are out of anatomic alignment
Epiphyseal
epiphysis is separated from diaphysis at the EP
Greenstick
partial fracture; outside breaks other side is bent
Hairline
fine crack in which sections are aligned
Impacted
one fragment of bone firmly driven into other
Incomplete
partial fractures extend only partway across bone
Linear
parallel to long axis of bone
Oblique
diagonial fracture
Pathologic
weakened by disease
Pott
fracture is at distal ends of tibia and fibula
Simple (closed)
does not break the skin
Spiral
spiral around axis of long bone
Stress
thin fractures due to repeated stressful impact
Transverse
at a right angle to the long axis of bone
Right elbow
Fracture
just needs to be reset/ a cast put on
needs calcium and Vitamin D supplements/change in diet to help with regrowth
couple of weeks to heal
Right Upper Arm
Comminuted Compound Fracture
needs surgery to reset bones in proper alignement
change in diet to aid in regrowth
age may play in not letting the bone grow completely
may take a month or two to heal