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Bone Break (Background (Epiphyseal Plate (4 Zones (Hypertrophic Zone…

- - - - Medullary Cavity
        
        Hollow
        
        Cylindrical Space
        
        Within Diaphysis
        
        Red Bone Marrow in Children
        
        Yellow Bone Marrow In Adults
      - Diaphysis
        
        Elongated
        
        Cylindrical Shaft
        
        Proximal to Distal End
        
        Leverage
        
        Weight Support
        
        Compact Bone
        
        Thin Spicules
        
        Spongy Bone
      - Epiphysis
        
        Knobby Region
        
        End of Long Bone
        
        Proximal Epiphysis
        
        End of Bone
        
        Closest to body trunk
        
        Distal Epiphysis
        
        Farthest from Trunk
        
        Composed of
        
        Outer thin layer
        
        Compact Bone
        
        Inner Region
        
        Spongy Bone
        
        Articular Cartilage
        
        Covers Joint Surface
        
        Thin Layer
        
        Hyaline Cartilage
        
        Reduces Friction
        
        Absorbs Shock
      - Metaphysis
        
        Between Diaphysis & Epiphysis
        
        Contains Epiphyseal Plate/Disk
        
        Growth Plate
        
        Provides Lengthwise Bone Growth
        
        Thin Layer
        
        Hyaline Cartilage
        
        Adults
        
        Epiphyseal Line
        
        Remanent of Epiphyseal Plate
    - - Periosteum
        
        Tough Membranous Sheath
        
        Covers outer surface
        
        Anchored to bone
        
        Collagen Fibers
        
        Double layer membrane
        
        Peri = Around
        
        Osteo = bone
      - Outer Fibrous Layer
        
        Protects Bone
        
        From Surrounding Structures
        
        Contains
        
        Blood Vessels
        
        Lymph Vessels
        
        Nerves
        
        Provide nourishment to Compact Bone
        
        Attachment site
        
        Ligaments
        
        Tendons
        
        Dense Irregular CT
      - Inner Cellular Layer
        
        Osteogenic Cells
        
        Osteoblasts
        
        Osteoclasts
      - Endosteum
        
        Covers all internal surface of Bone
        
        Within Medullary Cavity
        
        Contains
        
        Osteogenic Cells
        
        Osteoblasts
        
        Osteoclasts
    - - Osteogenic Cells
        
        Stem Cells
        
        Located
        
        Periosteum
        
        Marrow
      - Osteoblasts
        
        Form from Osteogenic Cells
        
        Growth in Width
        
        Cell layer
        
        Periosteum/Endosteum
        
        Make & Secrete
        
        Collagen Matrix
        
        Calcium Salts
        
        Become Entrapped
        
        Within Matrix
        
        Then Becomes Osteocytes
        
        Bone Formation
      - Osteocytes
        
        Regulator Cell
        
        Cell Layer
        
        Mature Bones
        
        Maintain
        
        Mineral Concentration
        
        In Bone Matrix
        
        Secretion of Enzymes
        
        Sends Signals
        
        Trigger Deposition
        
        New Bone in Matrix
        
        Detects
        
        Mechanical Stress of Bone
      - Osteoclasts
        
        Bone Polisher
        
        Large, Multinuclear
        
        Phagocytic Cells
        
        Derived from
        
        Fused Blood Stem Cells
        
        Found on Bone Surface
        
        Regulate Bone Health
        
        Breaks Down
        
        Old & Damaged Cells
        
        Releases Calcium into Blood
        
        Bone Resorption
        
        Cell Layer
        
        Periosteum/Endosteum
  - - - Ossification/Osteogensis
        
        Intramembranous
        
        Flat bones of Skull
        
        Last to stop growing
        
        Flat bone of Clavical
        
        Developed directly from
        
        Mesenchyme
        
        Undifferentiated Stem CT
        
        NOT formed from Cartilage
        
        Begins as Fetus
        
        Stops at Adolesence
        
        Mesenchymal Cells
        
        Osteogenic
        
        Osteoblasts
        
        Cluster Together
        
        1 more item...
        
        Secrete Osteoid
        
        1 more item...
        
        Secreted around Capillaries
        
        1 more item...
        
        Compact Bone
        
        1 more item...
        
        Endochondral
        
        Long Bones
        
        Bone Replacing
        
        Hyaline Cartilage
        
        Cartilage Template
        
        Longer Process
        
        Endochondral Ossification
        
        Mesenchymal Cells
        
        Chondrocytes
        
        Cartilage model - Step 1
        
        Future bony skeleton
        
        Perichondrium Form
        
        Capillaries penetrate cartilage - Step 2
        
        Perichondrium Transforms
        
        Periosteum
        
        Periosteal Collar Develops
        
        Primary Ossification Center Develops
        
        Grow - Step 3
        
        Chondracytes keeps grow
        
        Cartilage keeps growing
        
        Secondary Ossification Center Develops - Step 4
        
        Cartilage - Step 5
        
        Remains at Epiphyseal Plate
        
        Joint Surface
        
        Articular Surface
        
        Formation of bone CT
        
        Begins in Embryo
        
        7th week
    - - Epiphyseal Plate
        
        Area of Hyaline Cartilage
        
        Immature Bone
        
        Ossification Occurs
        
        Epiphyseal side
        
        Cartilage Grows
        
        Diaphyseal Side
        
        Bone Grows
        
        4 zones
        
        Proliferative zone
        
        Mitosis Happens here
        
        Chondracytes
        
        Make new Chondrocytes
        
        Replace dying Chondrocyes
        
        1 more item...
        
        Hypertrophic Zone
        
        Chondrocytes Mature
        
        Older/Larger Chondrocytes
        
        Lacuna starts eroding
        
        Calcification Zone
        
        Mostly dead Chondrocytes
        
        Calcified
        
        Penetration Capillaries
        
        From Diaphysis
        
        Connects Plate
        
        To Diaphysis
        
        Via "Calcified cartilage stalactites"
        
        Ossification Zone
        
        Osteoblast
        
        Secrete Bone Tissue
        
        Remaining Calcified Cartilage
        
        Bone Grows
        
        Length
        
        Osseous tissue
        
        1 more item...
        
        Epiphyseal LIne
      - Rate of Growth
        
        Controlled by hormones
      - Appositional Growth
        
        Growth in Diameter
        
        Occurs in Periosteum
        
        Osteoclasts resorb bone
        
        Endosteum
        
        Osteoblasts
        
        Produce new bone tissue
        
        Increased Diameter
        
        Medullary Cavity
        
        Modeling
    - - Continues throughout adulthood
        
        After bone growth
      - Resorption of old/damaged bone
        
        5-10% skeleton replaced yearly
        
        Influence
        
        Mechanical stress
        
        Hormones
        
        Injury
      - Mechanical Stress
        
        Lift weights
        
        Exercise
        
        Results from
        
        Skeletal contraction
        
        Gravitational forces
        
        Required
        
        Normal Bone Remodeling
        
        Increases bone strength
        
        Resistance Training
        
        Important
        
        Slow down bone loss
        
        Due to aging
        
        Help prevent Osteoporosis
  - - - Fracture Hematoma
        
        Blood Clot forms
        
        6-8 hours
        
        Blood vessels torn in
        
        Periosteum
        
        Osteons
        
        Medullary Cavity
      - Fibrocartilagenous
        
        Internal/External Callus Forms
        
        Within 48 hours
        
        Chondrocytes
        
        Endosteum
        
        Periosteum
        
        Chondrocytes Secrete
        
        Fibrocartilaginous Matrix
        
        Between 2 broken ends
        
        Create Hyaline Cartilage
        
        Bone
        
        Around break
        
        Stabilizing Fracture
      - Cartilage Replaced
        
        Trabecular Bone
        
        Osteoclasts resorb dead bone
        
        At fracture site
        
        Osteogenic Cells
        
        Become Active
        
        Divide
        
        Osteoblasts
        
        Osteoblasts
        
        Adjacent to Callus
        
        Produce Trabeculae
        
        Via Endochondral Ossification
      - Remodeling
        
        Compact bone
        
        Replaces trabecular/spongy bone
        
        Outer surface of bone
        
        Internal Calli Unite
        
        External Calli Unite
        
        Bump may be present
        
        Often w/time goes away
        
        Process takes several weeks
      - Nutrition
        
        Need Vitamin D
        
        Calcium
        
        Get from food
        
        Get from Vit. D
        
        Most abundant mineral
        
        Required for bone
        
        Required for smooth, cardiac, and skeletal muscle contractions
        
        Regulates nerve impulse
        
        Stimulates heart rate
        
        Strength of contraction
        
        Required for blood clotting
        
        Get from Sun
        
        Magnesium
        
        Structure in bone
        
        Vitamin K
        
        Supports bone mineralization
        
        Green leafy veggies
        
        Fluoride
        
        In bone structure
        
        Strengthens bone
        
        Strengthens Enamel of teeth
        
        Omega 3 FA
        
        Decrease Inflammation
      - Hormones
        
        Endocrine System
        
        Controls Bone Growth
        
        Maintaining bone health
        
        Remodeling Bone
        
        Growth Hormone
        
        Indirect
        
        Stimulates growth
        
        Cartilage
        
        Epiphyseal plate
        
        Increases Calcium retention
        
        Increases Amino Acids
        
        Thyroid Hormone
        
        Secreted by thyroid gland
        
        Promotes Osteoblastic activity
        
        Synthesis of bone matrix
        
        Sex Hormone
        
        Estrogen
        
        Testosterone
        
        Secreted in large amounts
        
        At Puberty
        
        Accelerates bone growth
        
        Promotes Osteoblastic Activity
        
        Synthesis of bone matrix
        
        Conversion of Epiphyseal Plate
        
        Epiphyseal Line
        
        Parathyroid Hormone
        
        Release
        
        Stimulated by
        
        Low Blood Calcium
        
        Stimulates Osteoclasts Proliferation
        
        Promotes Calcium
        
        Reabsorbed in kidney
        
        Rather than lost in Urine
        
        Calcitriol - Vit D
        
        Promotes Absorbed Calcium
        
        Phosphate from GIT
  - - - Unusual stress
      - Sudden impact
      - Increase w/age
    - - Stress Fracture
        
        Thin break
        
        Increased physical activity
        
        Bone experience repetitive loads
        
        Closed Fracture
      - Pathologic Fracture
        
        Bone weakened by disease
      - Simple Fracture
        
        Broken bone not penetrating skin
      - Compound Fracture
        
        One or both ends
        
        Bone pierce overlaying skin
        
        Open Fracture
        
        broken ends penetrate the skin
      - Transverse Fracture
        
        Break straight across
      - Spiral Fracture
        
        Twisting Action
        
        Torsion fracture
      - Comminuted Fracture
        
        2 or more pieces
      - Impacted Fracture
        
        One fragment of bone driven into another
      - Greenstick Fracture
        
        Incomplete break with splintering
      - Oblique Fracture
        
        Slanted fractures
      - Fissure Fracture
        
        Hairline fracture
        
        incomplete longitudinal break
      - Incomplete fracture
        
        bone is not broken through
      - Complete Fracture
        
        Bone broken through
    - - Simple Fracture
        
        2-3 months
      - Compound Fracture
        
        Longer to heal
      - Healing slows w/age
      - Some requires surgery
  - - - Cartilage Grows
    - - Bone Grows
    - - Proliferative Zone
        
        Mitosis happens here
        
        Chondrocytes
        
        Make new chondrocytes
        
        Replace dying chondrocytes
        
        Diaphyseal end
      - Hypertrophic Zone
        
        Chondrocytes mature
        
        Older/larger chondrocytes
        
        Lacuna starts eroding
      - Calcification Zone
        
        Mostly dead chondrocytes
        
        Calcified
        
        Penetration capillaries
        
        From diaphysis
        
        Connects plates
        
        To Diaphysis
        
        Via "Calcified cartilage stalacities"
      - Ossification Zone
        
        Osteoblasts
        
        Secrete bone tissue
        
        Remaining calcified cartilage
        
        Bone grows
        
        Length
        
        Osseous tissue
        
        Added to diaphysis
        
        Interstitial growth
        
        Epiphyseal Line
- - - - Will take longer to heal
        
        Open to outside world
    - - Bone fragments
        
        2 or more pieces
        
        Not common in kids
        
        Common in aged
        
        Bones more brittle
  - - - Olecranon fossa
      - Upper Humerus
        
        Compound fracutre
    - - Olecranon Process
        
        Comminuted