16-09-21 - MS System: Bones Flashcards

1
Q

What are the functions of bones?

A
  • Enables movement through attachment of muscles
  • Provides protection
  • Structural support
  • Storage of minerals – primary calcium, phosphate, and magnesium
  • Bone marrow is the site of haematopoiesis (blood cell formation)
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2
Q

What does bone consist of? And what gives it its strength?

A
  • Collagen fibre framework in mucopolysaccharide-rich semisolid gel (ground substance) – gives bone tensile strength (ability to withstand tension)
  • Bone is hardened by precipitation of Calcium Phosphate (hydroxyapatite) crystals within its matrix – this gives bone its compressional strength (ability to withstand compression)
  • Bone is made from osteoblasts, osteoclasts, and osteocytes (cells)
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3
Q

What are the different parts of the long bone in this diagram?

What is each part made of?

What is each part for?

A
  • Medullary cavity at the centre of the bone
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4
Q

What are the 2 major kinds of bone found in the long bones?

What do they do?

A
  • Trabecular/cancellous (spongy/porous) – Gives supporting strength to the ends of the weight-bearing bone.
  • Cortical (solid) – Runs down the outside of the bone and forms the shaft of the long bone.
  • Provides stiffness and strength
  • Transfers forces generated on the weight surface of the long bones
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5
Q

Where are trabeculae found?

What do they do?

How are they generated?

A
  • Trabeculae are laid along the lines of stress in the head of long bones
  • They allow for the distribution of stresses on the bone heads to the shaft (diaphysis)
  • Without them, bone heads would succumb to forces placed on them and shatter.
  • They are generated as the bone grows and is stresses through activity
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6
Q

How is blood supplied to and from bones and why?

How close are cells to these blood supplies?

A
  • Haversian canals carry blood along the axis of the bone (parallel)
  • Volksman canals carry blood perpendicularly
  • Majority of the cells in the bone are in close contact to the blood supply, but osteocytes are not.
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7
Q

Cortical bone:

  • What are its anatomical/functional units?
  • What runs through it?
  • How are its cells arranged?
  • What is its structure like and what minerals does it require to stay strong?
A
  • The anatomical/functional units of cortical bone are osteon
  • Haversian canals contain blood vessels that carry blood along the bone
  • Osteocytes are arranged in concentric circles (like onions) around blood vessels in haversion canal
  • Each layer contains collagen fibres, which can be oriented differently for each layer, making the structure flexible.
  • Hydroxyapatite is needed to add strength to the bone
  • It is now strong and flexible enough
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8
Q

Trabecular/cancellous bone:

  • What are its anatomical/functional units?
  • Composition compared to cortical bone
  • Function
A
  • Anatomical/function units: Trabeculae
  • Fewer lamellar layers in trabecular region than cortical
  • Weaker and more flexible than cortical bone
  • More open, less dense and site of haematopoiesis in bone marrow
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9
Q

What is the composition of bone matrix?

A
  • Organic matrix
  • Mostly made from protein fibres called collagen
  • The collagen is organised in parallel arrangement in both cortical and trabecular bones
  • Inorganic matrix
  • Made from crystallised mineral salts like hydroxyapatite
  • Made from water
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10
Q

What are common disorders regarding the bones?

What causes them?

What does this lead to?

A
  • Rickets – caused by a vitamin D deficiency.
  • The body can’t absorb Calcium and form hydroxyapatite.
  • Scurvy – Vitamin C deficiency – lack of proper collagen formation
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11
Q

What are osteoblasts?

How are they formed?

What do they do?

What can be their fate?

A
  • Mononucleate cells, derived from osteoprogenitor cells (stem cells).
  • Line the surface of the bone
  • When stimulated to form bone, will deposit organic matrix (collagen) and then hydroxyapatite
  • Some osteoblasts become entombed in the matrix during this process and turn into osteocytes (mature bone cells)
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12
Q

What are osteoclasts?

What do they do?

How are they controlled?

A
  • Multinucleate cells created by individual cells fusing
  • Forms a sealing zone on the edge of the bone matrix, releases H+ ions and hydrolytic enzymes in order to dissolve the material, liberate calcium and break down the extracellular matrix.
  • Regulated by hormones (e.g oestrogens) and osteoblasts.
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13
Q

What are Osteocytes?

How are they formed?

How do they communicate?

What do they do when these structures are damaged?

A
  • Osteocytes are mature bone cells.
  • They are formed when osteoblasts become entombed in the matrix during bone formation
  • They communicate via finger like structures in the canaliculi
  • If the canaliculi become damaged, osteocytes will attract the attention of osteoblasts to repair them.
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14
Q

Why is bone described as being a dynamic tissue?

A
  • It is dynamic because it cycles through being reduced to its primary components via resorption to being built back up again from these components by osteoblasts
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15
Q

How is bone formation and resorption balanced?

What can cause this to become unbalanced?

A
  • Equilibrium between osteoblast and osteoclast activity is controlled by signalling between the different cells in bone and via the actions of hormones such as Calcitonin and Parathyroid Hormone (PTH)
  • Calcitonin – Reduces activity of Osteoclasts and reduces Calcium blood levels
  • PTH – Increases activity of Osteoclasts which increases Calcium blood levels
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16
Q

What is the trabecular bone remodelling for?

How is it triggered?

Describe the process. QRRO

A
  • The trabecular bone remodel cycle is triggered by microdamage or hormonal responses
  • It is generally scheduled repair/turnover
  • The 4 stages of the cycle are:
  • Quiescence
  • Resorption by osteoclasts
  • Reversal
  • Osteoblasts laying down new bone
17
Q

Give a description of the cortical bone remodelling cycle and how it relates to the trabecular bone remodelling cycle. => builders with waterworks

A
  • The remodelling cycle for cortical bone is more complex than the remodelling cycle for trabecular bone as cortical bone is more solid.
  • To start, a cutting cone is developed by osteoclasts at the resorption front.
  • The osteoclasts tunnel into remote regions of bone via haversion canals
  • Osteoclasts than then drill down behind haversion canals and surface cells
  • The release H+ ions and hydrolytic enzymes to dissolve the bone matrix (broken down components released into extracellular fluid)
  • Osteoblasts will then rebuild and lay down new matrix
  • Some osteoblasts will become entombed in the new matrix and become osteocytes.
  • A closing cone is formed by red stained osteoid lined with osteoblasts.
18
Q

What can cause bone mass and density to increased = 1

decreased = 4

What is Wolffs law?

A
  • Bones mass and density can be increased by excessive mechanical stimulation and increased stresses, such as running.
  • Bone mass and density can decrease because of non-weight bearing (immobilisation from injury ie atrophy)
  • Sex-hormone deficiency (e.g menopause)
  • Endocrine/nutritional deficiency (inability to absorb calcium because of lack of vitamin D, can’t form hydroxyapatite – rickets)
  • Natural aging process
  • Wollf’s law – Bone adapts to load under which its placed (ie more load placed on bone, the more bone will form within limits)
19
Q

Describe the age-related change in bone mass graph for men and women.

A
  • Ages 1-27 – Attainment of peak bone mass
  • Ages 27-40 Consolidation of peak bone mass
  • More than 40 – Age related bone loss
  • Woman go through menopause at around 50, which leads to an accelerated decrease in bone mass.
  • At around 60, women will pass the fracture threshold for bone mass, which makes them more susceptible to fractures/breaks.
  • This is indicated when they suffer a fracture or break from a relatively minor fall
20
Q

What are the differences between normal and osteoporotic trabecular bone?

What are consequences.

A
  • In Osteoporotic bone, there are significant breakages and gaps between the trabeculae compared to the normal bone
  • If trabeculae are not present, or are weak and thin, they will not direct stress well away from the head of bones, making them more susceptible to fractures and breaks.
21
Q

How does bone initially grow in foetuses?

What is it replaced by?

NAME OF OSSIFICATION FOR LONG VS FLAT BONES

Where is the primary centre of growth?

A
  • Initially a cartilage model is formed by chondroblasts and reshaped by chondrocytes (mature cartilage cells)
  • This cartilage model is replaced by bone via ossification
  • Endochondral ossification for long bones and intermembranous ossification for flat bones
  • During foetal endochondral ossification, the primary centre of ossification is in the bony shafts known as diaphysis
  • This primary centre is active before birth.
22
Q

How does bone growth change after birth?

What is the secondary center of growth?

What is between the primary and secondary centers of growth?

Under what circumstances will growth continue?

A
  • After birth, bone begins to develop in the ends of long bones in the epiphysis
  • The epiphysis is the secondary center of ossification
  • The epiphyseal plate is cartilage that exists between the primary and secondary centers of ossification and is located in the metaphysis of long bones,
  • Bone is laid down in the diaphysis and the epiphysis
  • As long as the epiphyseal plate of cartilage is between the 2 centers and active, and new bone is laid down at the centers of ossification, the bone will increase in length
23
Q

Describe the process of bone growth at the epiphyseal plate.
RGHCO

A
24
Q

What occurs to bones by the end of puberty and why?

A
  • At the end of the puberty, the epiphyseal growth plates fuse, leaving the epiphyseal line
  • The epiphyseal growth plate of cartilage is no longer active and the bone forms.
25
Q

How long do fractures take to heal?

What does a fracture lead to?

What is the proces of fracture healing?

A
  • Fractures take 2-4 weeks to heal, depending on age, severity and position of fracture
  • A fracture leads to inflammation and an increase in blood flow
  • This leads to callus formation – osteoblasts quickly form woven bone to bridge the gap, which is weak as the collagen fibres are not organised or mineralised well.
  • Lamellar bone is then laid down – collagen is now organised in regular sheets to give strength and resilience
26
Q

What are the 6 different types of bones? What are examples of each?

A
27
Q

At the time of birth, what stage of growth in long bones has typically been achieved?

A

Mineralisation in the diaphysis only