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Sports Medicine > Bone > Flashcards

Bone Flashcards

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1
Q

What tissues make up the musculo-skeletal system?

A
  • Bone
  • Cartilage
  • Muscles and tendons
  • Ligaments
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2
Q

Bone characteristics

A

Mechanical

Physiological

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3
Q

Mechanical structures

A

Structural

Protective

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4
Q

Physiological Structures

A

CA2+ Regulation

Blood Cell production in bone marrow

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5
Q

Components of bone

A

organic (35%) and inorganic (65%)

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6
Q

Organic

A
  • Cells
    • (osteoblasts, lining cells, osteocytes, osteoclasts)
    – Matrix (mostly type 1 collagen) – gives bone flexibility
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7
Q

Inorganic

A

– Mineral content – hydroxyapatite – makes bone strong

– Hydroxyapatite = complex salt of calcium and phosphate

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8
Q

Locations on a bone

A

Diaphysis

Two Epiphyses

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9
Q

Types of Bone

A

Cortical/Compact

Cancellous/ Trabecular

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10
Q

Characteristics of cancellous/trabecular

A
  • Lattice of fine bone plates
    – Epiphyses of long bones, vertebral bodies and flat
    bones
    – Intercommunicating spaces in mesh filled with bone
    marrow
    – Reduces skeletal mass without compromising strength
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11
Q

Physical properties of bone

A

Material

Structural

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12
Q

Material properties

A 
– Properties of the material itself independent of
specimen
– i.e. stress at which a sample of cortical bone breaks under
compression
• Density of bone
– Cortical bone 1700-2000 kg/m3
– Lumbar vertebra 600-1000 kg/m3
• Compressive strength of bone
– Femur (cortical) 131-224 MPa
– Wood (oak) 40-80 MPa
– Limestone 80-180 MPa
– Steel 370 MPa
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13
Q

Structural

A

– Properties of a specific specimen
i.e. breaking force for tibia
– Much more difficult to define

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14
Q

Bone Skeletal Processes

A

Longitudinal Growth
Circumferential Growth
Bone Remodelling

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15
Q

Longitudinal Growth

A

– Endochondral ossification
– Primary ossification centre
– Secondary Ossification centre (Epiphyseal plates)
– Ceases when secondary growth plates fuse at adulthood (~18yrs)

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16
Q

Circumferential Growth

A

– Diameter increases throughout lifespan

– Rapid prior to adulthood then very slow

17
Q

Bone Remodelling

A 
– Bone mass is maintained, increased and decreased
– Continuous repair of micro-damage
– Ensure that bone is fit for purpose
– Functional adaptation
Wolff’s Law (1882) - Structural and
Material properties of bone are
determined by forces acting on it
18
Q

What type of feedback informs the bone of microdamage

A

Sensory

19
Q

What is the bones response to the sensory feedback

A

2 types of cells

  • osteoblasts- bone formations
  • osteoclasts- resorption

in a coupled process

20
Q

Definition of Functional Adaptation

A

Bone adapts to the load placed upon it

21
Q

What is bone atrophy

A

if the load is reduced, reduction in bone mass.

  • decrease in activity
  • predominance in osteoclast activity
22
Q

What is bone hypertrophy

A

if the load is increased, increase in bone mass

  • increase in activity
  • trabeculae alignment can change to adapt new load
23
Q

Why can a bone fracture?

A

if the stress on the bone exceed the strength of the material.
e.g. excessive force, weak material, cumulative damage due to repetitive loading

24
Q

What is the formula for stress?

A

Force/Cross sectional area

25
Q

What can cause excessive stress?

A

Large external force

Inappropriate dimensions

26
Q

Types of fractures

A 
complete/incomplete
transverse
spiral
comminuted
avulsed
impacted
greenstick
compression
27
Q

What 2 types of xray can investigate fractures?

A

Plain Xrays

Computerised tomography

28
Q

What are the characteristics of a plain xray?

A
  • 2D imaging
  • High spatial resolution
  • Maneuvering of patient
  • Simple, available and affordable
  • Low radiation dose
29
Q

What are the characteristics of CT scan

A
  • 3D imaging
  • Very high resolution
  • Fast-20s for whole body scan
  • moderately expensive
  • High radition dose (200x that of a chest xray)
30
Q

Bone Repair

A
  • Haematoma leads to clot formation
  • cartilage fills gap which is ossified to form new woven bone (callous)
  • callous then remodels over time
31
Q

What is osteoporosis?

A

A common bone disease in post menopausal women

  • reduction in oestrogen levels disrupts bone remodelling
  • reduction in trabecular bone
  • reduction in bone mineral density –> increased risk of fracture
32
Q

how would you monitor Bone mineral density?

A

Dual energy X-ray Absorptiometry

33
Q

What are stress fractures?

A

When the remodelling process cannot keep up with damage

  • dependent on the magnitude of the load and number of cycles
  • common in metatarsals or tibia
34
Q

What way can you investigate stress fractures?

A

Bone scan (nuclear medicine)

  • Patient injected with radioactive tracking marker (technetium 99 bound to diphosphate)
  • Functional (identifies areas of remodelling)
  • Low spatial resolution/ high sensitivity
  • high dosage and moderately expensive
35
Q

Name 4 extrinsic risk factors of stress fractures

A

1) Specific sports
2) Change in training
3) Sudden increase in load
4) Change in equipment

36
Q

Name 3 intrinsic risk factors of stress fractures

A

1) small bone geometry
2) Relative energy deficiency syndrome
3) High load rate due to technique

37
Q

Name and describe bone injuries?

A
  • Osgood Schlatter Disease
  • Sever’s Disease

Repetitive tension on changing growth plates

Sports Medicine (6 decks)

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