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A 12 year old boy with a bone fracture injury (Background (Bone Functions,…
A 12 year old boy with a bone fracture injury
Background
Bones
Grow
interstitial growth
growth in length
epiphyseal plate
proliferation zone
hypertrophic zone
rest zone
calcification zone
ossification zone
appositional growth
thickness
osteoblast secreting matrix in periosteum
osteoclast remove bone in endosteal surface
slight more building up than breaking down
Remodel
Resorption
osteoclasts
break down the bone matrix
secretes
acid (H+)
dissolve boone minerals
lysosomal enzymes
digest organic matrix
disolved matrix is transported by blood
depostion
osteoblast
deposit new bone matrix
osteoid seam
become calcified
secretes
alkaline phosphatase
removes phosphate ions from osteoid
osteoid bind calcium ions
raise Ca concetration
calcium phosphate crystals form
Form
endochondral ossification
develop by replacing hyaline cartilage
medullary cavity forms
epiphyses ossify
periosteal bud invades the internal cavities to form spongy bone
cartilage calcifies in the middle
bone collar around diaphysis
intramembranous ossification
develop from fibrous membrane
flat bones
ossification centers develop in fibrous connective tissue membrane
osteoid is secreted and calcifies
spongy bone and periosteum form
compact bone replaces immature spongy bone
Stages of Bone healing
fibrocartilaginous callus form
new blood vessels
new fibroblast
collegen fibers
new chondroblasts
secrete cartilaginous matrix
fibrocartilaginous callus
bony callus forms
form spongy bone
trabeculae
immature bone replaces fibrocariginous callus
hematoma forms
blood clot
cells deprived of nutrition die
bone remodeling occurs
bony callus is remodeled
compact bone reconstruct shaft walls
repair are resembles the original
mechanical stressors
excess material removed
Anatomy of long bones
Spongy Bone
internal layer
contains trabeculae
mesh of bony spines
Diaphysis
shaft, forms the long axis of the bone
Medullary Cavity
contains yellow marrow
Compact Bone
external layer
smooth and solid
osteon
group of hollow tubes of bone matrix
lamella
matrix tube
interstitial
between osteon
circumferential
deep to periosteum
central canal
run in the core of osteon
perforating canal
connect medullary cavity to central canal
Epiphyses
bone ends
exterior
compact bone
interior
spongy bone
Articular cartilage
cover joint surface
Epiphysis between diaphysis and epiphyses
epiphyseal line
when bone stops growing
epiphyseal plate
disc of hyaline cartilage
grows during childhood
Membranes
periosteum
covers external surface
outer layer
dense irregular connective tissue
inner layer
contains osteoprogenitor cells
has osteoclast and osteoblast
supplied with nerves & blood vessels
Endosteum
covers internal bone surfaces
Raw Materials for bone growth and repair
chemical composition
oraganic
osteoid
bone structure and flexibility
1/3 of matrix
ground susbstance
collagen fibers
osteoprogenitor cells
osteoblast
osteocytes
bone lining cells
osteoclast
inorganic
mineral salts
resist compression and tensiion
65% of bone tissue
hydroxyapatites
calcium
phosphate
Bone Fractures Classifications
depressed
bone portion is pressed inward
typical of skull fractures
compression
bone is crushed
common in porous bones
spiral
excessive twising forces
common sports fracture
epiphyseal
epiphysis separates from diaphysis
occur where cartilage cells are dying
comminuted
bone fragments
three or more pieces
bones are more brittle
greenstick
bones breaks incompletely
common in children
more organic matrix and flexible
Bone Functions
Anchorage
levers to move the body
Mineral Storage
Calcium
Phosphate
Protection
vertebrae
spinal cord
rib cage
organs of the thorax
skull
brain
Hematopoiesis
in red marrow
Support
framework that supports the body
Triglyceride storage
stored in yellow marrow
Hormone production
osteocalcin
glucose homeostasis
energy expenditure
regulate insulin secretion
Regions
Axial Skeleton
vertebral column
rib cage
skull
Appendicular Skeleton
upper limbs
lower limbs
girdles
sholder bones
hip bones
Bone Shapes
Short
cube shaped
Flat
thin, flattened, and usually a bit curved
spongy bone sandwiched between two thin layers of compact bone
long
longer than they are wide
Irregular
omplicated shapes
Bone cells
osteoblast
bone-forming cells
secrete bone matrix
become osteocytes when surrounded by matrix
osteocyte
mature bone cells
monitore and maintain bone matrix
communicate information to osteoblast and osteoclast
osteoprogenitor
stem cells
in the membranous periosteum and endosteum
can turn into osteoblast
osteoclast
break down bone
Downstream
bone remodeling
Adolescence
hormona regulation
sex hormones
high estrogen level
induce epiphyseal closure
low estrogen level
stimulate the growth spurt
pituitary gland
growth hormone
parathyroid gland
PTH
stimulates osteoclast
resorb bone
thyroid gland
calcitonin
produced by parafollicular cells
regulate blood Ca levels
longitudinal bone growth
epiphyseal plate
collagen still present
bone will regenerate more rapidly
more protein in bones
Location
joint
elbow joint
synovial;hinge
problem expanding foreman
flexion and extension
little or no movemnt allowed
radioous
head
humerus
capitulum
trochlea
ulna
olecranon process
coronoid process
trochlear notch
Fracture
Right Arm
Right Elbow
type of fracture
comminuted
bone fragments
three or more pieces
common in
brittle bones
fracture clacification
open( compound) fracture
bone ends penetrate the skin
treatment
immobilized
cast traction
reduction
open internal reduction
surgery required
Diet
Calcium leves
importance
muscle contraction
movement
resting membrane potential
nerves
hypocalcemia
low blood Ca levels
hyperexcitability
poor diet
withdrawal of Ca from bones
breakdown bone
for the body to use
Ca is not being replaced
bone can not calcified with out Ca
less bone matrix
more bone resorption
osteoporosis
less bone deposition
Upstream
indirect causes
poor diet
no dairy products
bone loss
eats nothing but junk food
no vitamins
no minerals
no nutrients
lactose intolerant
poor absorption of
vitamin D, k
phosphorus
calcium
neccesary for
muscle contractions
bones
make bone matrix
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nerve transmission
magnesium
Direct causes
running and fell
landed on his right arm
bone in upper arm protruded skin
bone fragments
broken elbow