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CASE STUDY: 12 YR OLD BOY, BONE FRACTURE RIGHT ARM, RIGHT ELBOW FRACTURED

- - - - Condyle
        
        rounded articular projection; often articulates with a corresponding fossa
      - Facet
        
        smooth nearly flat articular (joint) surface
      - Head
        
        boney expansion carried by a narrow neck
    - - Notch
        
        indentation at the edge of a structure
      - Meatus
        
        canal-like passageway
      - Foramen
        
        round opening through a bone
      - Sinus
        
        cavity within bone, filled with air and lined with mucus membrane
      - Fissure
        
        narrow, slitlike opening
      - Fossa
        
        shallow, basinlike depression in a bone often serving as an articular surface
      - Groove
        
        furrow
    - - Epicondyle
        
        raised area on or above a condyle
      - Spine
        
        sharp, slender, often pointed projection
      - Tubercle
        
        small rounded projection or process
      - Process
        
        any boney prominence
      - Line
        
        narrow ridge of bone; less prominent than crest
      - Trochanter
        
        very large, blunt, irregularly shaped process
      - Crest
        
        narrow ridge; usually prominent
      - Tuberosity
        
        large rounded projections
  - - - run through spongy bone
        
        nutrient foramen
    - - endosteum
      - periosteum
    - - long axis of bone
      - contains medullary cavity
        
        no bone tissue
        
        yellow marrow (fat) in adults
        
        red bone marrow
        
        found in different location for adults and infants
        
        infants
        
        all areas of medullary cavity of diaphysis contain red bone marrow
        
        adults
        
        most red bone marrow is replaced with yellow marrow
        
        yellow marrow extends to epiphysis
        
        1 more item...
    - - these are the bone ends
      - epiphyseal plate
        
        growth plate
        
        turns into epiphyseal line after growth stops
    - - proximal epiphysis
        
        periosteum (surrounded by perforating fiber)
        
        compact bone
        
        spongy bone(in epiphysis)
        
        epiphyseal line
        
        medullary cavity line by endosteum
        
        1 more item...
  - - - cube shaped; vary in size
        
        sesamoid bones
        
        special bone that forms inside tendon
        
        bones of the ankle or wrist
    - - thin flattened usually slightly curved
        
        sternum, scapulae, most cranial bones
    - - longer than they are wide
        
        all limb bones except patella
    - - complicated shapes that do not fit into any classification above
        
        vertebrae and hip bones
  - - - appositional growth
        
        cartilage forming cells in the surrounded perichondrium secrete new matrix against the EXTERNAL face of existing cartilage tissue
      - interstitial growth
        
        lacunae-bound chondrocytes divide and secrete new matrix expanding cartilage from WITHIN
    - - matrix is made by chondroblasts
    - - hyaline cartilage
        
        provide support flexibility & resilience
        
        chondrocytes are spherical;
        
        matrix contains fine collagen fibers
        
        location
        
        costal cartilage
        
        connect ribs to sternum
        
        respiratory carilages
        
        form skeleton of the larynx; reinforces other respiratory passageways
        
        articular cartilage
        
        joints, point of connection
        
        nasal cartilage
        
        support external nose
      - elastic cartilage
        
        similar to hyaline cartilage but contain more ELASTIC fibers
        
        used for repeated bending
        
        location
        
        external ear
        
        epiglottis
        
        flat that bends to cover opening of larynx
      - fibrocartilage
        
        great tensile strength
        
        location
        
        between vertebrae
        
        knee
        
        thick collagen fibers
  - - - skeletal muscle which attach to bones by tendons
    - - reservoir for minerals like phosphate and calcium, withdrawals and deposits as needed
    - - fused bones of the skull and rib cage cradle soft organs
    - - hematopoeiesis occurs in red marrow of certain bones
    - - provide framework that supports the body
    - - energy source on stand by. stored as yellow marrow in the cavities of long bones
    - - bones produce osteocalcin
        
        regulates glucose homeostasis
        
        regulates energy expenditure
        
        regulates insulin secretion
  - - - periosteum
        
        made up of perforating fibers
        
        outermost layerer made up of dense connective tissue
        
        double layered membrane surrounds perimeter (outer)
        
        innermost layer contains OSTEOPROGENITOR cells (stem cells)
        
        contains
        
        OSTEOBLASTS
        
        matrix synthesizer
        
        responsible for bone growth
        
        OSTEOCLASTS
        
        bone reabsorbing cell
        
        breaks down with the help of lysosomal enzymes & acid
      - endosteum
        
        OSTEOCLASTS & OSTEOBLASTS PRESENT
        
        delicate connective tissue
        
        covers trabeculae of spongy bone
  - - - osteoblasts
        
        matrix synthesizing cell
        
        responsible for bone growth
        
        matrix secreted is 90% collagen
        
        become osteoclasts when they become surrounded by matrix
      - osteocyte
        
        mature bone cell
        
        retired osteoblasts
        
        live in lacunae
        
        monitors and maintains the mineralized bone matrix
        
        communicate with osteoblasts and osteoclasts for bone remodeling
      - osteoprogeniter cell
        
        stem cell
    - - osteoclasts
        
        bone reabsorbing cell
        
        have ruffled borders that directly contacts bone
        
        breaks down matrix with the help of lysosomal enzymes(protein) and acid (hydrogen ions)
  - - - bone collar forms around diaphysis of hyaline cartilage with the help of mesenchymal cells
        
        cartilage calcifies in the center of the diaphysis (break down of bone to make cavity)
        
        cartilage is replaced with spongy bone, periosteal bud invades causing veins and nerve fibers to wire through
        
        primary ossification elongates (diaphysis), secondary ossification forms (EPIPHYSIS)
        
        epiphysis ossify, only hyaline cartilage remains in plates and articular cartilage(epiphyseal surface) this happens from childhood to adolescence
  - - - proliferation zone; mesenchymal cells work to become osteoblasts and make an ossification center (MITOSIS)
        
        2.hypertropic zone; osteoblasts secrete osteoid(bone structure) then calcifies in a few days; OSTEOBLASTS become OSTEOCLASTS by getting trapped in calcified bone matrix
        
        3.calcification zone; immature spongy bone & periosteum is formed; honeycomb network is formed. blood vessels invade
        
        ossification zone; compact bone replaces immature spongy bone deep to the periosteum, red marrow develops
  - - - parathyroid hormone(PTH) controls blood calcium levels
      - calcitonin produced by thyroid gland regulates Ca^2+ levels
    - - wolff's law: bone grows or remodels in response to demands placed on it
  - - - completeness of break
        
        non complete
        
        complete fracture
      - whether bone penetrates skin
        
        open(compound) penetrating skin
        
        closed (simple) not penetrating
      - position of bone ends after fracture
        
        displaced; out of normal alignment
        
        nondisplaced; retain normal position
    - - depressed
        
        broken bones inward; typical skull fracture
      - compression
        
        bone is crushed; common in porous bones subject to trauma or a fall
      - spiral
        
        excessive twisting forces; common in athletes
      - epiphyseal
        
        epiphysis splits from diaphysis along the plate;
      - greenstick
        
        bone breaks incompletely only one side of shaft broken; common in children (more organic matrix)
      - comminuted
        
        bone fragments into 3 or more pieces; common in old folk because bones are more brittle
    - - fibrocartilage forms
      - bony callus forms
      - hematoma forms
      - bone remodeling occurs
- - - - displaced incomplete compound fracture to the humerous