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12yo boy with bone break in elbow and humerus (Background Info (Anatomy of…
12yo boy with bone break in elbow and humerus
Upstream cause
Direct cause : Fall while running
Indirect cause: lack of proper nutrition
lactose intolerant
calcium deficiency
unbalanced diet
excessive junk food
lacking vitamins and nutrients
fell on arm
Background Info
Anatomy of the long bone
longer than wide
Diaphysis
compact bone
contains the medullary cavity
filled with yellow bone marrow
fat storage
Epiphysis
proximal an distal ends
epiphysial plate (aka growth plate)
surrounded by compact bone
contains spongy bone
red bone marrow
blood cell production
blood forming tissue
trabeculae
surrounded by periosteum
inside of bone has endosteum
dense irregular connective tissue
cellular level
osteogenic cells
mitotically active stem cells
endosteum and periosteum
osteocytes
mature bone cells in lacunae
maintain bone matrix
osteoclasts
become macrophages
bone resorption
osteoblasts
bone forming cells
secretes osteoid
collagen - 90% bone protein
microscopic anatomy of compact bone
osteons
structural unit of compact bone
weight bearing pillars
consists of lamelle
contains collagen
withstands stress
canals and canaliculi
central canal
contains blood vessels and nerve fibers
perforating canals
connects blood vessels and nerves to periosteum, medullary cavity and central canal
lacunae
contains osteocytres
canaliculi
connect lacunae to each other and central canal
interstital and circumferential lamelle
interstital lamelle
not part of osteon
circumferential lamelle
helps resist twisting
micorscopic anatomy of spongy bone
contains trabeculae
no osteons
chemical composition
organic components
osteoid
organic part of matrix
inorganic components
hydroxyappetites
mineral salts
Bone development
ossification
endochondral ossification
replace hyaline cartilage
forms almost all bones
5 major steps
bone collar forms around diaphysis
cartilage calcifies and dies
periosteal bud invades cavity, makes spongy bone
diaphysis elongates, medullary cavity forms
epiphysis ossify
intramembranous ossification
develops from fibrous membrane
forms cranial and clavicle bones
four major steps
ossification centers are formed
osteoid is created, then calcified
trabeculae is formed
compact/pongy bone form
red marrow appears
epiphysial plate
interstitial growth
between the diaphysis and epiphysis
hardens in epiphysial line after adolenscence
bone remodeling
bone resorption
bone deposits
osteoblasts
requires vitamin D and C, calcium and phosphates
osteoclasts
surface of periosteum and endosteum
osteoblasts and osteoclasts coordinate remodeling
Breaks
nondisplaced/displaced
complete/incomplete
open/closed
Downstream effects
Open displaced compound comminuted fracture the right humerus
possible break along the epiphyseal plate on the humerud due to fractured elbow.
possible stunted growth of right arm due to the boy being 12 and still growing
patient needs a better balanced diet to heal the bone break and prevent future trauma