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Bone Fracture Injury (Anatomy of Long Bones (Osteoblasts (BONE BUILDER,…

- - - - Cyte=MATURE
      - Derived from osteoblasts
      - Maintain mineral concentration of bone matrix by secretion of enzymes
      - Detect mechanical stress on bones
      - SIGNALS for new bone matrix
      - THE REGULATORY CELL
      - Diaphysis
        
        Cylindrical shaft
        
        Runs from proximal to distal part of bone
        
        Leverage and weight support
        
        Compact bone with spongy bone extending inwards
        
        Covered with periosteum
        
        Central part of long bone
        
        Medullary Cavity
        
        Hollow space inside the diaphysis (INNER REGION)
        
        Bone Marrow
        
        Red BM in children
        
        Yellow BM in adults
        
        Epiphysis
        
        Rounded region at end of long bones
        
        Proximal=Closest to body trunk
        
        Distal=Farthest from body trunk
        
        Outer Layer= thin layer of compact bone
        
        Inner Layer= Inner region of spongy bone
        
        Articular Cartilage
        
        Covers joint surface
        
        THIN LAYER OF HYALINE CARTILAGE
        
        Reduces friction
        
        Absorbs shock in moveable joints
        
        Metaphysis
        
        Region of bone between diaphysis and epiphysis
        
        EPIPHYSEAL PLATE/DISK (Growth plate)
        
        Present in children to provide lengthwise bone growth
        
        In adults, EPIPHYSEAL LINE is the remnant of epiphyseal plate
        
        Thin layer of hyaline cartilage
        
        Periosteum
        
        Tough membranous sheath covering outer surface of bone
        
        Anchored to bone by collagen fibers
        
        Outer layer
        
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        Inner layer
        
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        Endosteum
        
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  - - - Types
        
        Intramembranous
        
        FLAT BONES OF SKULL AND CLAVICLE
        
        Bone developing directly forming from mesenchymal connective tissue
        
        Begins as fetus, not stopping until adolescence
        
        Takes place in sheets of MESENCHYMAL TISSUE
        
        Allows shoulders and skull to fit through birth canal
        
        Flat bones of skull are last to stop growing
        
        Some mesenchymal cells become capillaries, some osteoblasts
        
        Steps
        
        Osteoblasts cluster together= Ossification center
        
        Osteoblasts secrete osteoid, which will entrap some osteoblasts --> BECOME OSTEOCYTES
        
        If osteoid secreted around capillary--> TRABECULA, mesenchyme becomes periosteum
        
        Compact bone formed around trabecula which protects it, crowded blood vessels get squished, become RED BONE MARROW
        
        Endochondral
        
        LONG BONES
        
        REPLACES HYALINE CARTILAGE
        
        Most bones below skull, except clavicle
        
        Steps
        
        Mesenchymal cells differentiate into chondrocytes
        
        Cartilage Model for future skeleton/Perichondrium form
        
        Capillaries penetrate cartilage, Perichondrium--> Periosteum, Periostial Collar develops, PRIMARY OSSIFICATION CENTER DEVELOPS
        
        Cartilage and chondrocytes continue to develop at end of bones
        
        SECONDARY OSSIFICATION CENTER DEVELOPS
        
        Cartilage stays at epiphyseal plate and joint surface as articular cartilage
        
        Secondary Ossification Center
        
        HOW BONES GROW IN LENGTH
        
        Epiphyseal Plate
        
        Present in children and adolescents
        
        Area of hyaline cartilage in IMMATURE bone where ossification occurs
        
        Epiphyseal side: Cartilage grows
        
        Diaphyseal side: bone grows, therefore shaft grows in length
        
        Becomes Epiphyseal line when done growing
        
        IN METAPHYSIS
        
        4 zones of Epiphyseal Plate
        
        Proliferative Zone
        
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        Hypertrophic Zone
        
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        Calcification Zone
        
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        Ossification Zone
        
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        Location/Role of Epiphyseal Plate
        
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        Stages of bone healing
        
        Fracture Hematoma
        
        Form from clotted blood within 6-8 hours, as blood vessels are torn by fracture
        
        Hematoma forms
        
        Internal/External callus formation
        
        Forms within 48 hours
        
        From chondrocytes in endosteum and periosteum
        
        These chondrocytes secrete fibrocartilaginous matrix between 2 broken ends
        
        Create hyaline cartilage around break, stabilizing the fracture
        
        Cartilage replaced by trabecular bone
        
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        Fibrocartilaginous callus forms
    - - Skeleton begins forming
- - - - Compound
        
        Part of bone in right upper arm is protruding through skin
      - Comminuted
        
        Appears to be fragments of bone in wound
        
        Not common with young age, more common in older age
    - - Right elbow is broken
  - - - Due to being such a young age, these breaks should heal in about 6 weeks
      - Bone can readily bounce back to normal when we are so young
      - BONE REBUILDS AND RESTORES QUICKLY
  - - - May take longer to heal, due to being in such an awkward area
      - Trochlear notch
      - Ulna
    - - Compound fracture
- - - - Stress Fracture
        
        Thin break caused by increased physical activity
        
        Bone experiences repetitive pounding (ex: runners)
      - Pathologic Fracture
        
        Occurs in bone weakened by disease
      - Simple/Closed Fracture
        
        Broken bone not penetrating skin
        
        Takes 2-3 months to heal
      - Compound/Open Fracture
        
        One or both ends of bone penetrate overlying skin
        
        Takes longer to heal than simple fracture
      - Transverse Fracture
        
        Break straight across
        
        Occur as result of strong force applied perpendicular to long axis of bone
      - Spiral Fracture
        
        AKA TORSION FRACTURE
        
        Bone breaks due to a rotating or twisting force
      - Comminuted Fracture
        
        Break or splinter of bone in MORE THAN 2 FRAGMENTS
        
        Usually caused by high-impact trauma
        
        Shatter
      - Impacted Fracture
        
        One fragment of bone driven (pushed/forced) into another
      - Greenstick Fracture
        
        Incomplete break with splintering
        
        Occurs in young, soft bone
        
        One side of bone broken, other side is bent
      - Oblique Fracture
        
        Slanted fractures
        
        Occurs when force is applied at any angle other than a right angle to the bone
      - Fissure Fracture
        
        HAIRLINE FRACTURE
        
        Incomplete break
        
        Not broken all the way through bone
        
        Longitudinal
      - Complete Fracture
        
        Bone breaks through completely
      - Incomplete Fracture
        
        Bone does not break through completely