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child with broken humerus and elbow (anatomy of long bone (diaphysis…
child with broken humerus and elbow
lactose intolerant
calcium deficiency caused the bones to be brittle and break easily
blunt force trauma to bone and joint
stress on the bones caused the breaks
two broken bones
humerus broken
compound fracture
could result in bone infection or compartment syndrome
bone must be stabilized to heal properly
skin compromised so bacteria may be present
wound needs to be cleaned out and surgery needs to be performed
will require antibiotics to treat infection
comminuted fracture
will need cast so bones can heal properly
part of bone might not get proper blood supply
bone might be seen as foreign object
parts of bone fragments might try to reject from the body
surgery will be needed
could affect bone growth
elbow broken
surgery will most likely be required due to extremity
damage to tendons, muscles and ligaments most likely occurred and will be a lengthy recovery process
will require a sling or cast to immobilize the joint
long recovery due to damaging surrounding tissue
classifications of fractures
completeness of the break
bone broken all the way through is complete
bone not broken all the way through is incomplete
whether bone ends penetrate the skin
closed fractures dont penetrate the skin
open fractures penetrate the skin
position of the bone ends after the fracture
bone ends out of normal position are displaced
bone ends retain normal position is nondisplaced
how bones form
intramembranous ossification
osteoid is layed between embryonic blood vessels and form immature spongy bone
vascularized mesenchyme condenses and becomes periosteum
osteoblasts secreate osteoid and calcify. trapped osteoblasts become osteocytes
trabeculae below periosteum remodeled and replaced with compact bone
mesenchymal cells form ossification centers in the fibrous connective tissue membrane
immature spongy bone remodeled into mature spongy bone and fills with red marrow
endochondral ossification
osteoblasts secrete osteoid and encase it into the bone collar and chondrocytes begin to enlarge
chondrocytes calcify matix and then begin to die and matrix starts to deteriorate (cartilage model begins to elongate)
mesenchymal cells specialize into osteoblasts. Perichondrium becomes periosteum
periosteal bud forms earliest version of spongy bone
diaphysis elongates and forms medullary cavity secondary ossification centers appear in epiphyses
epiphyses ossify hyaline cartilage only remains in epiphyseal plates and articular cartilages
materials needed for bone growth and repair
bone growth
matrix becomes calcified and chondrocytes die
cartilage cells die and blood vessels invade
old cartilage cells enlarge
matrix begins deteriorating
cartilage cells under go mitosis
they push the epiphysis away from the diaphysis and cells lengthen the bone
new bones forms
osteoclast erode cartilage spicules and osteoblasts cover them with new bone
bone repair
bone resorbtion
materials are endocytosed and transported to opposite side
they enter the blood and interstitial fluid
osteoclasts secrete acid that desolve bone material and lysosomal enzymes that digest organic matrix
osteoclasts eat dead osteocytes and once resorbed into area of bone undergo apoptosis
osteoclasts dig depressions along bone surface and break down matrix
bone deposition
when concentration of calcium and phosphate are high enough then calcium phosphate crystals form
proteins bind calcium ions and trigger osteoblasts to release matrix vesicles studded with alkaline phosphate
hydroxyapatites form around calcium salts and then create a calcified bone matrix
between osteoid seam and older mineralized bone. forms calcification front
osteoblasts deposit new bone matrix
stages of bone healing
fibrocartilaginous callus forms
new blood vessels grow into clot
fibroblasts and chondroblasts produce collagen and cartilaginous matrix that calcifies
bony callus forms
osteoblasts begin forming spongy bone
fibrocartilaginous callus replaced by immature bone and endochondral ossification repeats
trabeculae layed down by osteoblasts unite the fragments of broken bone
a hematoma is formed
blood vessels are torn
clotted blood forms at fracture site
bone remodeling occurs
extra material of diaphysis and medullary cavity is removed
bony callus remodeled
compact reconstructs shaft walls
epiphyseal plate
located between the diaphysis and each epiphysis of adult bone
disc of hyaline cartilage that grows during childhood to lengthen bone
growth plate
anatomy of long bone
epiphyses
spongy bone
hyaline cartilage
compact bone
epiphyseal line
inorganic components
hydroxyapatites
diaphysis
yellow marrow
spongy bone
red marrow
compact bone
medullary cavity
membranes
periosteum
perforating fibers
endosteum
cells
osteoclasts
bone lining cells
osteocytes
osteoblasts
osteoprogenitor cells
organic components
osteoid
all cells
blood vessels and nerves
epiphyseal arteries
nutrient arteries
epiphyseal veins
nutrient veins