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A 12 year old boy fell and landed on his right arm which caused a break to…

- - - - Limb bones
        
        ex: humerus, tibia, fibula
  - - - bone ends (epiphyses)
        
        and membranes
        
        two types of membranes (periosteum and endosteum)
        
        periosteum
        
        is a white,double-layered membrane covering external surfaces except joints
        
        covers Fibrous layer- outer layer of dense irregular connective tissue
        
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        peri- covers
        
        oste- bone
        
        endosteum
        
        is a delicate connective tissue membrane covering internal bone surface
        
        Covers trabeculae of spongy bone
        
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        endo- within
        
        oste-bone
      - ends of long bones that consist of compact bone externally and spongy bone internally
        
        Articular cartilage covers articular (joint) surfaces
        
        Between diaphysis and epiphysis is epiphyseal line
        
        Remnant of childhood epiphyseal plate where bone growth occurs
    - - Consists of compact bone surrounding central medullary cavity
        
        medullary cavity is
        filled with yellow bone marrow (fat) in adults
  - - - Osteogenic cells
        
        aka osteoprogenitor cells
        
        Mitotically active stem cells in periosteum and endosteum
        
        when stimulated they turn into osteoblasts
      - Osteoblasts
        
        Bone-forming (makes bone) cells that secrete unmineralized bone matrix called osteoid
        
        osteoid is made of collagen and calcium binding proteins
        
        collagen is make up 90% of bone protein
      - Osteocytes
        
        cyte = mature cells
        
        Mature bone cells in lacunae that no longer divide but instead maintain bone matrix
        
        Respond to stimuli such as increased force on bone or weightlessness
        
        Communicate to osteoblasts and osteoclasts so bone remodeling can occur
      - Osteoclast
        
        Breaks down bone
        
        Derived from same hematopoietic stem cells that become macrophages
  - - - made up of two components
        
        organic component
        
        allow it to resist tension
        
        (stretch)
        
        includes its cells and osteoid
        
        Contributes to high tensile strength and flexibility
        
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        osteoid- organic part of matrix,is secreted by osteoblasts and consists of ground substance and collagen fibers
        
        inorganic component
        
        allows it to resist compression
        
        Hydroxyapatite
        
        Lasts long after death because of mineral composition
        
        Can reveal information about ancient people
        
        mineral salts
        
        Makeup 65%of bone by mass and consist mainly of tiny calcium
        phosphate crystals in and around collagen fibers
        
        Responsible for hardness and resistance to compression
- - - - Postnatal bone growth occurs until early adulthood
        
        Bone remodeling and repair are lifelong
        
        Long bones grow lengthwise by interstitial (longitudinal) growth of epiphyseal plate
        
        Bones increase thickness through appositional growth
        
        Some facial bones continue to grow slowly through life
      - Near end of adolescence, chondroblasts divide less often
      - Epiphyseal plate thins, then is replaced by bone (epiphyseal line)
      - Epiphyseal plate closure occurs when epiphysis and diaphysis fuse
      - Bone lengthening ceases around 18 in females and 21 in males
  - - - Intramembranous ossification
        
        Bone develops from fibrous membrane
        
        Bones are called membranous bones
      - Intramembranous ossification
        
        Begins within fibrous connective tissue membranes
        formed by mesenchymal cells
        
        Forms cranial bones of skull (frontal, parietal, occipital,
        and temporal) and clavicle bones
      - Endochondral ossification
        
        Bone forms by replacing hyaline cartilage
        
        Bones are called endochondral bones
        
        Form most of skeleton
        
        chon- cartilage
    - - 1st: Ossification centers are formed when mesenchymal cells cluster and become osteoblasts
        
        2nd: Osteoid is secreted, then calcified
        
        3rd: Woven bone is formed when osteoid is laid down around blood vessels, resulting in trabeculae
        
        4th: Compact and spongy bone form, and red marrow appears
        
        Outer layer of spongy bone forms periosteum
    - - 1st: Bone collar forms around the diaphysis of the hyaline cartilage model
        
        2nd: Cartilage calcifies in the center of the diaphysis and then developed cavities
        
        3rd: The periosteal bud invades the internal cavities and spongey bone forms
        
        4th: The diaphysis elongates and a medullary cavity forms, Secondary ossification centers appear in the epiphyses
        
        5th: The epiphyses ossify. When ossification is complete, hyaline cartilage remains only in the epiphyseal plates and articular cartilages
- - - - Completeness of break
        
        Complete: broken all the way through
        
        Incomplete: not broken all the way through
      - Whether skin is penetrated
        
        Open(compound):skin is penetrated
        
        Closed(simple):skin is not penetrated
        
        Kevin ware incident google it
      - Position of bone ends after fracture
        
        Nondisplaced: ends retain normal position
        
        Displaced: ends are out of normal alignment
  - - - Immobilization of bone by cast or traction is needed for healing
      - Time needed for repair depends on break severity, of patient
      - open fracture takes longer to heal than simple
      - generally,healing slower with age
    - - Hematoma formation
        
        Torn blood vessels hemorrhage, forming mass of clotted blood called a hematoma
      - Fibrocartilaginous callus formation
        
        Capillaries grow into hematoma
        
        Fibroblasts, cartilage, and osteogenic cells begin reconstruction of bone
        
        This mass of repair tissue is called fibrocartilaginous callus
        
        Create cartilage matrix of repair tissue
        
        Osteoblasts form spongy bone within matrix
      - Bony callus formation
        
        Within one week, new trabeculae appear in fibrocartilaginous callus
        
        Callus is converted to bony (hard) callus of spongy bone
      - Bone remodeling
        
        Osteoclasts remove excess bony material
        
        Compact bone is laid down to reconstruct shaft walls
        
        Final structure resembles original structure because responds to same mechanical stressors
- - - - The boy fell
  - - - The boy is lactose intolerant so he can't drink milk or diary products
        
        The boy has a poor diet in general
        
        lack of fruits and vegetables
        
        fruits and vegetables are good sources of needed vitamins of the body that builds bones
      - insufficient dietary calcium level
      - milk is a great source of calcium which build/strengthens bones
- - - - VitaminC which is needed for collagen formation
        
        Calcium and phosphate for calcification