Skeleton: Bone Fracture
child is lactose intolerant
never consumes dairy which contains calcium
calcium is crucial for the formation of strong bones.
not consuming enough calcium causes your bones to be brittle
anatomy of long bones
grater in length than width
elongated
most common come shape
cylindrical shaft(Diaphysis)
used for leverage
Epiphysis
found in upper and lower limbs as well as feet and hands
thin spicules of spongey bone extending in ward
compact bone
metaphysis
medullary cavity(inner region)
contains red bone marrow in kids
yellow blood marrow in adults
hollow
outer thin layer; compact bone
inner region; spongy bone
knobby region at end of each long bone
articular cartilage
cover joint surface
think layer of hyaline cartilage
reduces friction
absorbs shock in movable joints
region of bone between diaphysis and epiphysis
contains epiphyseal plate/disk
thin layer of hyaline cartilage
known as growth plate, lengthwise bone growth
epiphyseal line in adults is the remnant of the epiphyseal plate in children.
Periosteum
Cellular layer
Fibrous layer
forms the outer surface of bone
cells
anchored to bone by collagen fibers
dense irregular connective tissue
outer layer
contains blood, lymph vessels, nerved that nourish compact bone
osteogenic
osteoclast
osteoblasts
attachment site for ligaments and tendons
bones formation(Ossification) and growth.
osteoclast
osteoblast
osteogenic cells
osteocyte
regulates matrix
rebuilds
shaves off/ eat
stem cells
derived from mesenchyme
will mature and become osteoblast
in periosteum and marrow
growth in width
periosteum and endosteum
can be trapped in matrix and become osteocytes
secretes gooey collagen matrix(organic) and calcium salts (inorganic) attract, forming new bone.
on bone surfaces, involved with bone resorption
derived from fused blood stem cells
large, multinuclear, phagocytic
entrapped in bone
mature bone cells that regulate bone health. derived from osteoblast
detects mechanical stress
send signals for formation of new bone matix
maintains mineral concentration of the bone matrix by secretion of enzymes.
begins as an embryo but we are majority cartilage. 7th week skeleton starts forming
2 types
bone is a replacement tissue
endochondral
intramembraneous
formation and development of bone ct
continues through childhood and adolescence
fracture type
bone develops directly from mesenchymal not from cartilage
takes place in sheets of mesenchymal tissue
flat bones of the skull(last to stop growing) and clavicle
allows shoulder and skull to fit trough birth canal
some mesenchymal cells will become capillaries, other eventually osteoblast
bone replacing cartilage
takes longer then intamembranous ossification
long bones
1: mesenchymal cell differentiate into chondrocytes
2: the cartilage model of the future boney skeleton and the perichondrium form
3: capillaries penetrate cartilage. perichondrium transforms into periosteum, periosteal collar develops.primary ossification center develops.
4: cartilage and chondrocytes continue to grow at the epiphyseal plate.
5: secondary ossification centers develop at center of epiphyseal region. cartilage remains at epiphyseal (growth )plate and at joint surface as articular cartilage.
Appositional growth
growth in length in epiphyseal plate
growth in length happens here(epiphyseal plate)
growth in diameter
occurs in periosteum
osteoclast resorb bone on the endosteum
osteoblast produce new bone tissue beneath the periosteum.
bone growth in diameter and increased diameter of medullary cavity.
modeling not remodeling
endosteum
osteogenic cells
osteoblasts
lines the medullary cavity :
osteoclasts
bone remodeling
resorption of old damage bone by osteoclast
lay new bone to replace by osteoblast
continues thought adulthood, after bone growth
5-10% of skeleton replace yearly, even without injury
influenced by hormones and mechanical stress and injury
bone fractures
result of unusual stress or sudden impact
increase risk with age, due to normal thinning and weakening of bone
break in bone
stress fracture
bone experiences repetitive loads ex. runners
thin break caused by increased physical activity
pathological fracture
simple fracture (closed)
compound fracture(open)
occurs in bone weakened by disease
broken bone not penetrating skin
one or both ends of the bone pierce overlying skin
2-3 months to heal depending on age
longer to heal depending in age
requires surgery most of the time
transvers fracture
straight across
spiral fracture
comminuted fracture
impacted fracture
greenstick fracture
oblique fracture
fissured fracture
often from a twisting action
broken into more than 3 fragments
one fragment driven(compressed/crushed) into another
incomplete break with splintering
incomplete fracture longitudinally (hairline fracture)
bone fracture repair
2: fibrocartilagenous internal and external callus formation
3: cartilage replaced by trabecular bone
1: fracture hematoma
4: remodeling
forms from clotted blood within 6-8 hrs, blood vessels are everywhere due to fracture
within 48 hrs. chondrocytes in the endosteum and periosteum secrete a fibrocartilaginous matrix between 2 broken ends creating hyaline cartilage and bone around break, stabilizing the fracture.
osteoclast reobsorm bead bone at site of the fracture
oseogenic cells become active and divide into osteoblast
osteoblast adjacent to callus produce trabeculae via endochondrial ossification
compact bone replaced trabecular/spongy bone on the outer surface of the bone. internal and external calli unite
there might be a bump present, but with time it will be remodeled almost completely away.
process takes several weeks
epiphyseal plate
in metaphysis
becomes line in adults when they are done growing
known as growth plate
materials needed for bone growth and repair
fluoride
omega 3 fatty acids
Magnesium
calcium
Vitamin K
vitamin D
bi=one growth longitudinally
potassium
conserves the calcium inn your body
reduced the amount of calcium you lose during urination
supports bone mineralization
green leafy veggies
action of sunlight on skin triggers the body to produce
not found naturally in many foods
added to milk and orange juice
the liver converts to a circulating form, calcidiol and kidneys transform it into its useable form calcitriol(D3)
calcium cannot be absorbed from our food with out vitaminD
strengthen bones
without calcium bones become brittle
in dairy, green leafy veggies; broccoli. also in intact salmon and canned sardines with their soft bones
in structure of the bones
also in bone structure, strengthens bones and enamel of teeth
decreases inflammation that may interfere with osteoblast function
compound (open)
comminuted
protruding the skin
multiple pieces of bone
healing
children's bones don't break as easily as adults
healing will be longer bc his bones are brittle
due to the lack of calcium in his diet his body gets the calcium it needs from his bones, causing the bones too become brittle
kids have more cartilage in their bones
surgery will be needed
worry about infection since the bone opened the skin to the outside world
increase calcium in diet using a supplement
wont heal fast like normal 12 year olds.
location
elbow/ olecranon; ulna, trochlear notch
upper part of humerus
slanted fracture
angles fractre
humerous
elbow