A 12 year old boy is brought in with a bone fracture injury. Occured while running and then falling forward, landing on his right arm. Right elbow appears broken, and part of the bone in the upper arm appears to be protruding from the skin. There appears to be fragments of bone in the wound. We learn the child is lactose intolerant. He never consumes dairy and only eats burgers, hot dogs, spaghetti, and junk food.

upstream effect

downstream effects

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Background information

classifacation of bone fractures

raw materials needed for bone growth and repair

How bones...

location and rule of epiphyseal plate

anatomy of long bones from cells to organ level

direct

indirect

the fall the child takes

bones are weaker when not enough calcum is taken in

bones will be more likely to break in this type of intake

important factors for properly treating his injury

childs fracture

age of the boy

boys diet

location of break

grow

remodel

formation 5 stages

compressional compound fracture

the periosteal bud invades the internal cavities and spongy bone than forms

diaphysis elongates and medullay cavitiy forms

cartilage then calcifies in the center of the diaphysis and then develops cavities

epiphyses ossify

bone collar forms around the diaphysis of the hyaline cartilage model

secondary ossification centers appear in the epiphyses

when complete, hyaline cartilage remains only in epiphyseal plates and articular cartilage

part of bone in upper arm appears to protrude from skin

fragments of bone in the wound

right eblow breaks

12 year old boy

never consumes dairy

burgers

we learn he is lactose intolerant

hot dogs

spaghetti

junk food

Epiphysis

Diaphysis

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Distal

Proximal

causes more brittle bones

where bone growth occurs

plate thins, then is replaced by bone (epipyseal line)

this plate persist though childhood and adolesence

plate closure occurws when epiphysis and diahysis fuse

completeness of break

whether skin is penetrated

position of bone ends after fracture

non displaced

displaced

complete

incomplete

open (compound)

closed (simple)

ends retain normal position

ends are out of normal alignment

broken all the way through

not broken all the way through

skin penetrated

skin not penetrated

osteocytes

osteoclasts

osteoblasts

lining cells

osteogenic cells

tubular shaft that forms long axis of bone

ends of long bones that consist of compact bone externally and spongy bone internally

miotically active stem cells in periosteum and endosteum

bone formingcells secrete unmineralzed bone matrix called osteiod

mature bone cells in lacunae which no longer divide maintian bone matrix

breakdown of bone

regulate passage of calcium

bones increase in thicness through appositional growth

bones stop growing during adolecence

long bones grow in length wise by intersititial growth of epiphyseal plate

some facial bones continue to grow slowly through life

bone lengthining ceases around 18 in female 21 in males

bone resporption

bone deposit

osteoclasts breakdon tissue of bone then release minerals

osteoblasts depsit new bone matrix

stages of healing

  1. Fibrocartilaginous callus forms
  1. bony callus forms
  1. A hematoma forms

4.bone remodeling froms

magnesium

phosphorus

protien

vitamin D

calcium

flouride

potassium

bone formation exceeded resporation

heal quicker

skin penetrated

treatment: imobilization, medication to help with pain, maybe even surgery depending on break

right brachial region

not helping towards bone development

not enough calcium intake

bad eating habits cause bones to break because not enough nutrients