12 year old boy with a bone fracture, elbow appears broken, and part of the bone in the upper arm appears to be protruding from the skin. Found fragments of bone in the wound. Also the child is lactose intolerant.
Anatomy of Long
Epiphysis
Diaphysis
tubular shaft
runs proximal and distal of bone
hollow region
Called medullary cavity
filled with yellow marrow
walls of the diaphysis composed of dense and hard compact bone.
wider section at each end of the bone
filled with spongy bone.
Red marrow fills the spaces in the spongy bone
epiphysis meets the diaphysis at the metaphysis
narrow area that contains the epiphyseal plate
Growth plate
bone stops growing in early adulthood
cartilage is replaced by osseous tissue
epiphyseal plate becomes an epiphyseal line.
Forming, Growth, Remodeling of bones
Osteocyte
Regulates Bone Health
Boss Man
Osteoclast
Osteoblast
Shaves on bone
Macrophage
(builds bone) lays down osteoids
which are mostly collagen
Protein(organic)
Osteoid
which attracts inorganic
Stages of bone Healing
Calcium
Medullary
Bone is composed of small cells
In Matrix of collagen cells
the periosteum forms the outter Surface of bone
collagen fibers lay on rings of Lamella
in opposite direction
Elasticy and flexibility
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Hemotopoises
blood cell production
occurs in red bone marrow (CT)
stem cells form red, and whitee blood cellsalso platelets
proximal and distal
articular cartilage
Hematoma Formation
endosteum lines the medullary cavity
fibrous layer and cellular layer
-mass of clotted blood forms at fracture site
-torn blood vessels hemorrhage
-site becomes swollen, painful, and inflamed
Fibrocartilaginous Callus Formation
-fibrocartilaginous callus forms
-granulation tissue/soft tissue forms a few days after fracture
-capillaries grow into tissue and phagocytic cells (WBCs) begin cleaning derbis
fibroblasts secrete collagen fibers that connect broken bone ends
Bony Callus Formation
-new bone trabeculae appears in fribrocartilaginous callus
-fibrocartilaginous callus converts into bony/hard callus
-bone callus begins 3-4 weeks after injury and continues until firm union is formed 2-3 months later
Bone Remodeling
Open Reduction
-excess material on bone shaft exterior and in the medullary cavity is removed
-compact bone is laid down to reconstruct shaft walls
surgery is required to align bones... screws, plates, and rods may be used to hold bones in place
Factors of Healing Time
reduction in which fractured bones are realigned by manipulation rather than surgery
nonsurgical
-painful
-age
-if patient is smoker...
oxygen provides energy to heal but smokers have a decreased level of oxygen
Inorganic part:Calcium Phosophate (what our bone is made of)
proliferation zone
hypertrophic zone
calcification zone
the line in the adult bone that stoops growth
disc of hyline cartilage
that grow during childhood
ossification zone
side of the epiiphyseal plate facing the epiphisis contains resting cartilage
Eli. proximal to the resting cartilage area are arranged form the earliest stage of growth
to region where bone is replacing the cartilage
Long one is Endochondral
Mesynchyme
Aerolar dense
12 year old vitamin D defficient
Classification of bone fractures
simple: closed fracture
compound: open fracture
transverse: straight across
spiral: often from twisting
comminuted fracture: more than two pieces
impacted fracture: one fragment driven into another
greenstick fracture: incomplete fracture with splintering
oblique fracture
Vitamin C deficient
Poor diet
brittle bone from lack of nutrients
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compound fracture
humerous and epicondile
olecranon
medial condyle
boy was running and fell
scapula and clinical area
younger children have smaller bones than adults
if treated properly it should heal well and keep growing