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Musculoskeletal Physiopathology > Bone Development and CT > Flashcards

Bone Development and CT Flashcards

1
Q

What are the primary functions of bone tissue?

A
  • Structure
  • Locomotion
  • Protection
  • Calcium homeostasis
  • Hematopoietic
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2
Q

What is the name for the shaft of a long bone?

A

Diaphysis

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3
Q

What is physis?

A

A growth plate

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4
Q

What is the name for the secondary ossification center on the non-weight bearing part of a long bone?

A

Apophysis

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5
Q

What are some examples of apophyses?

A

Trochanters, tuberosities, etc.

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6
Q

Where is the metaphysis of a long bone?

A

Next to the most metabolically active part of the bone, between diaphysis and epiphysis

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7
Q

What is the name of the expanded end of a long bone?

A

Epiphysis

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8
Q

Where is cortical bone found?

A

The outer shell of the bone

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9
Q

What is trabecular bone?

A

Thin bone/cancellous bone

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10
Q

What is the name of the less dense center of a long bone?

A

Medullary cavity

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11
Q

Where does bone pain come from? Why?

A

Pain comes from periosteum because it is innervated

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12
Q

When a physis fuses, what is left behind on the bone?

A

Physeal scar

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13
Q

What percentage of bone composition is made up of cells?

A

About 10%

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14
Q

What are four cells found in bone?

A
  • Osteoprogenitor cells
  • Osteoblasts
  • Osteoclasts
  • Osteocytes
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15
Q

What percentage of bone is organic?

A

About 30%

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16
Q

What is the primary organic component in bone tissue?

A

Type I collagen (about 88%)

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17
Q

What is the function of type I collagen in bone?

A

Resists tensile forces

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18
Q

Osteocalcin is a byproduct of…

A

osteoblasts

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19
Q

What is the function of osteopontin and sialoprotein?

A

Anchor cells to matrix, work to adhere things

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20
Q

What are the organic components of bone?

A
  • Type I collagen
  • Osteocalcin
  • Osteopontin and sialoprotein
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21
Q

What is the function of the organic components of bone?

A
  • Contribute to tensile strength
  • Make bone more elastically and/or plastically responsive to stress
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22
Q

What constitutes the inorganic component of bone tissue?

A
  • Hydroxyapatite: Ca10(PO4)6(OH)2
  • Carbonate, citrate, flouride, chloride, sodium, magnesium, potassium, and strontium
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23
Q

What is the function of the inorganic components of bone?

A
  • Contributes to rigidity of bone tissue
  • Lends compressive strength to bone tissue
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24
Q

What do osteoprogenitor cells develop into?

A

Osteocytes or osteoblasts

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25
Q

Where are osteoprogenitor cells found?

A

Bone marrow and periosteum

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26
Q

What is produced by osteoblasts?

A
  • Produces and mineralizes bone tissue
  • Alkaline phosphatase and osteocalcin
  • Several growth factors
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27
Q

What growth factors are produced by osteoblasts?

A
  • IL-1
  • FGF
  • IGF-1
  • IGF-2
    (and others)
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28
Q

What is the function of osteoblasts?

A

Controls the differentiation and maturation of osteoclasts (production of RANKL)

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29
Q

What are osteoclasts?

A

Multi-nucleated cells in the monocyte/macrophage cell family

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30
Q

What is the function of osteoclasts?

A

Bone resorption using lysosomes and hydrolytic enzymes

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31
Q

What substances increase osteoclastogenesis?

A

Rank and RankL

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32
Q

What is the ratio of organic to inorganic bone components in children?

A

1:1

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33
Q

What is the ratio of organic to inorganic bone components in adults?

A

1:4

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34
Q

What is the ratio of organic to inorganic bone components in elderly?

A

1:7

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35
Q

How do changes in organic to inorganic components affect the properties of bone?

A

Decreased elasticity over time

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36
Q

A greater relative organic component produces…

A

increased elasticity and plasticity in response to stress

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37
Q

Where is the para-physiological space in the stress/strain curve?

A

Elastic region

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38
Q

Where does permanent deformity occur in the stress/strain curve?

A

Plastic region (after yield point)

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39
Q

When does failure/fracture occur in the stress/strain curve?

A

After the plastic region (ultimate yield point)

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40
Q

Which type of bone is most responsible for preventing fractures?

A

Trabecular/spongy bone

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41
Q

How does cortical/compact bone present in a stress/strain curve?

A

High stress with little strain percentage

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42
Q

Does bone have more tensile or compressive strength?

A

More compressive strength than tensile

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43
Q

Unmineralized bone is called…

A

osteiod

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44
Q

Compact and spongy bone are both ___ bone

A

lamellar (layered)

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45
Q

What are three types of compact bone?

A
  • Circumferential bone
  • Concentric lamellar bone
  • Interstitial lamellar bone
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46
Q

What is the histology of woven bone?

A
  • Irregular arrangement of type I collagen fibers
  • Many osteocytes of different size and shape
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47
Q

What is the nature of woven bone?

A
  • Deposits rapidly
  • Low tensile strength
  • Response to stress in adults
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48
Q

A tissue histologically presents with an irregular arrangement of type I collagen fibers among many osteocytes of different size and shape
What type of bone is this?

A

Woven bone

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49
Q

What gives rise to bone?

A

Mesenchymal condensation

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50
Q

In what two ways does mesenchymal condensation give rise to bone?

A
  • Intramembranous ossification
  • Endochondral ossification
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51
Q

During intramembranous ossification, how does mesenchyme give rise to bone?

A

Direct transition from mesenchyme to bone
Grows via accretion, outward from a primary center of ossification (adding bone to the surface and edges)

52
Q

The closure of the fontanels is an example of what type of ossification?

A

Intramembranous ossification

53
Q

During endochondral ossification, how does mesenchyme give rise to bone?

A

A cartilage model forms from mesenchyme, then is ossified

54
Q

When do physes close?

A

Toward the end of puberty, varies by joint

55
Q

How does the growth plate close in endochondral ossification?

A

Rate of ossification exceeds epiphyseal cartilage proliferation

56
Q

When do females’ bones stop growing in comparison to males’?

A

About 3 years earlier in females than males

57
Q

What is bone modeling?

A

The process of original bone development

58
Q

What is bone remodeling?

A

The continual process of bone turnover

59
Q

What theory guides bone remodeling?

A

Wolff’s Law:
Increased compressive forces = increased deposition
Decreased compressive forces/increased tensile forces = resorption

60
Q

What are the requirements for remodeling bone?

A
  • Maintain an equilibrium of calcium and other metabolites in blood and bone
  • Viable blood supply to oxygenate bone cells
  • Stress, pressure, or load on the bone
61
Q

Without loading stresses, osteoclastic activity ___ and osteoblastic activity ___

A

osteoclastic activity increases and osteoblastic activity decreases

62
Q

Which cells initiate bone remodeling?

A

Osteoclasts

63
Q

Unmineralized bone tissue is called…

A

osteoid

64
Q

During endochondral ossification, what step is required for ossification of cartilage to occur?

A

Vascularization

65
Q

Collagen comprises ___ of all mammalian protein

A

25%

66
Q

Which organs contain collagen?

A

Nearly all organs

67
Q

What is the function of collagen in organs?

A
  • Holds cells together
  • Gives tissue structural integrity
68
Q

What are the types of collagen and where are they found?

A
  • Type I - bone
  • Type II - cartilage
  • Type III - reticular (skin, muscles, blood vessels, along with type I)
  • Type IV - basement membrane
69
Q

What cells produce collagen?

A

All cells of the fibroblast family:

  • bone cells (osteoblast/osteocyte)
  • cartilage cells (chondrocyte)
  • fat cells (adipocyte)
  • smooth muscle cells
70
Q

Fibroblasts are derivative of…

A

mesoderm

71
Q

How are fibroblasts classified?

A

Staining, morphology, and function

72
Q

What is the least specialized cell in the body?

A

Fibroblasts, the most versatile of connective tissue cells, able to differentiate into others

73
Q

Which components of the extracellular matrix are secreted by fibroblasts?

A
  • Collagen
  • Proteoglycans
  • Elastin
  • Fibronectin and other structural proteins
74
Q

What is the name for inactive fibroblasts?

A

Fibrocytes

75
Q

Describe intracellular collagen synthesis

A
  • Amino acid synthesis –>
  • Alpha chain formation –>
  • Procollagen formation –>
76
Q

Describe extracellular collagen synthesis

A
  • Tropocollagen formation –>
  • Organization and mature collagen arrangement
77
Q

What are some possible signs/symptoms a patient may have if they suffer from a collagen synthesis disorder?

A
  • Ligamentous laxity
  • Joint hypermobility
  • Vessel fragility
  • Compromise of bone structural integrity
  • Tooth loss/developmental issues
78
Q

What are signs that a collagen synthesis disorder is causing vessel fragility?

A

Bleeding and/or bruising

79
Q

The signs/symptoms of collagen synthesis disorders and their severity depends on…

A

where the disruption/problem occurs in collagen synthesis

80
Q

Many will have a ___ etiology that will lead to disruption of normal collagen synthesis

A

genetic

81
Q

What is Ehler’s-Danlos?

A

“Rubber band syndrome”
Problem with procollagen peptidase (inability to cleave off terminal extensions)
This is a contraindication to manipulation

82
Q

Which collagen disorder possesses a problem with procollagen peptidase leading to inability to cleave off terminal extensions?

A

Ehler’s-Danlos

83
Q

What is Marfan’s syndrome?

A

Hereditary issue affecting cross-linking in collagen synthesis
Not an adjusting candidate

84
Q

Which collagen disorder is a hereditary issue affecting cross-linking in collagen synthesis?

A

Marfan’s syndrome

85
Q

What is osteogenesis imperfecta?

A

Messenger RNA transcription deletion error

86
Q

Which collagen disorder possesses a messenger RNA transcription deletion error?

A

Osteogenesis imperfecta

87
Q

What are some genetic etiologies of collagen synthesis disorders?
Which of these are more common?

A

Ehlers-Danlos and Marfan’s syndrome are very common
A less common etiology is osteogenesis imperfecta

88
Q

What is an example of an environmental etiology of collagen synthesis disorders?

A

Scurvy: hydroxylation step interrupted

89
Q

Which collagen disorder involves the hydroxylation step being interrupted?

A

Scurvy

environmental etiology

90
Q

Collagen is a major fibrous element in…

A
  • Bone
  • Skin
  • Teeth
  • Tendons
  • Cartilage
  • Blood vessels
91
Q

alignment

What are some terms relating to peripheral alignment?

A
  • Subluxation
  • Dislocation
92
Q

alignment

What are some terms relating to spinal alignment?

A
  • Lordosis
  • Kyphosis
  • Anterolisthesis
  • Scoliosis
  • Etc.
93
Q

View:
Anatomy:
Skeletally young/mature:

A

View: AP knee
Anatomy: femure, patella, tibia, fibula
Skeletally young/mature: mature

94
Q

What is the alignment of this knee?

A

Lateral and superior (proximal) dislocation of tibia (in relation to femur)

95
Q

What notes can be made about the bones in this knee?
Connective tissue?

A

Bone: missing medial condyle of femur, spines of tibia, and patella; some bones are more radiolucent than others
CT: cartilage not visualized; none left after dislocation

96
Q

What notes can be made about the soft tissue in this knee?

A

Radiodense soft tissue superior to patella; mineral composition or edema/debris

97
Q

What does radiodensity in this knee suggest?

A

Usage (Wolff’s law)

98
Q

Does this patient likely feel pain when walking on this knee?

A

Likely can’t feel the knee

99
Q

View:
Anatomy:
Skeletally young/mature:

A

View: lateral knee
Anatomy: femur, tibia, fibula, patella (yet to form)
Skeletally young/mature: young (growth plates observed)

100
Q

Is this knee lesion local or systemic?

A

Local

101
Q

What notes can be made about alignment of this knee?

A

Normal alignment

102
Q

What notes can be made about the bones of this knee?

A

Extremely radiodense/osteoblastic in inferior diaphysis of femur

103
Q

What notes can be made about connective tissue in this knee?
Soft tissue?

A

No observations about cartilage or soft tissue

104
Q

What are the primary growth centers of a long bone?

A

Diaphysis & metaphysis

105
Q

What are the secondary growth centers of a long bone?

A

Epiphysis & apophysis

106
Q

What is the most metabolically active part of a long bone?

A

Metaphysis

107
Q

Is the diaphysis of a long bone metabolically active?

A

No, inactive

108
Q

Is the epiphysis of a long bone metabolically active?

A

Yes, but less active than metaphysis

109
Q

What is the dense fibrous membrane covering the surface of bones (except at their extremities) and serving as an attachment for tendons and muscles?

A

Periosteum

110
Q

What is the inner membrane layer separating the marrow cavity and the cortical bone?

A

Endosteum

111
Q

What percentage of bone is composed of inorganic material?

A

60%

112
Q

What bone cell is found in the marrow and periosteum and can develop into osteocytes or osteoblasts?

A

Osteoprogenitor cell

113
Q

What is the term for an osteoblast embedded in bone matrix (lacunae) that maintains bone tissues?

A

Osteocyte

114
Q

stress strain curve

Compared to normal adult bone, what bones would have a more gradual slope, with a longer plastic phase?

A

Bones of children
(more organic material)

115
Q

stress strain curve

Compared to normal adult bone, what bones would have a more gradual slope, with a shorter plastic phase?

A

Bones with osteoporosis
(more inorganic material, likely older)

116
Q

What are the major passageways running in the direction of the length of long bones, providing paths for blood vessels?

A

Haversian canals

117
Q

What are the connections between Haversian canals that runs in a perpendicular fashion?

A

Volkmann’s canals

118
Q

According to Wolff’s law, what type of force will increase bone resorption?

A

Increased tensile force (less compressive)

119
Q

According to Wolff’s law, what type of force will increase bone deposition?

A

Increased compressive force (less tensile)

120
Q

What is the term for the remodeling unit of bone?

A

Cutting cone

121
Q

What is the structural organization of collagen?

A

Fibrils within fibers within bundles

122
Q

Fibroblasts will differentiate into ____ when the environment is anoxic

A

chondrocytes (cartilage cell)

123
Q

During collagen synthesis, what materials are necessary for hydroxylation to occur?

A

Iron, oxygen, and vitamin C

124
Q

What must occur in order to turn procollagen into tropocollagen?

A

Cleavage of terminal extensions of procollagen

125
Q

What enzyme is responsible for the creation of tropocollagen?

A

Procollagen peptidase

Musculoskeletal Physiopathology (13 decks)

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