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Semester 2 systems > Bone growth > Flashcards

Bone growth Flashcards

(51 cards)

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1
Q

When does bone growth start?

A

Before birth

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2
Q

When does bone growth end?

A

Puberty

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3
Q

Which part of bone is very poorly vascularised?

A

The hyaline cartilage

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4
Q

What effect do sex steroids have on bone?

A

They stimulate bone growth spurt but also promotes the closure of epiphyseal plates

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5
Q

What happens to the growth plate towards the end of bone growth?

A
  • Growth in cells ceases, cell proliferation slows and the plate thins
  • The plate is invaded by blood vessels, epiphyseal and diaphysial vessels unite
  • A visible line may be left on an X ray
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6
Q

Which bones have one ossification centre

A
  • Capals
  • Tarsals
  • Ear ossicles
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7
Q

How many ossification centres do most bones have?

A

More than 2

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8
Q

How many ossification centres does the humerus have?

A

3

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9
Q

What are the effects on bone growth caused by having multiple ossification centres?

A
  • Rate of bone growth varies both bone to bone and within the same bone
  • Weak points within the bone change
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10
Q

What are the zones of the epiphyseal plate?

A
  • Ossification zone
  • Calcification zone
  • Hypertrophic zone
  • Growth (proliferating) zone
  • Resting zone
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11
Q

What happens in the resting zone?

A

Matrix production

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12
Q

What are the defects associated with the resting zone?

A

Diatrophic dysplasia: defective collagen synthesis/processing of proteaglycans
Results in shortened stature and shorter arms and legs

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13
Q

What happens in the Growth zone?

A

Cell proliferation

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14
Q

What are the defects associated with the growth zone?

A 
• Achondroplasia
• Malnutrition 
• Irradiation injures
All above result from the deficiency of proliferation and/or matrix synthesis 
• Gigantism: Increased proliferation
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15
Q

What happens in the hypertrophic zone?

A

Calcification of the matrix

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16
Q

What are the defects associated with the hypertrophic zone?

A

• Rickets
• Osteomalacia
Both caused by an insufficiency of calcium or phosphate for normal calcification

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17
Q

What is the difference between rickets and osteomalacia?

A
  • Rickets is more paediatrics related because of the growth plates
  • Osteomalacia involves the periosteum
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18
Q

What happens in the Metaphysis?

A

Bone formation and vascularisation

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19
Q

What are the defects associated with the metaphysis?

A
  • Osteomyelitis: bacterial infection
  • Osteogenesis imperfecta: Abnormalities with the osteoblasts and collagen synthesis (brittle bone disease)
  • Scurvy: Inadequate collagen turnover(which is why it also affects the skin)
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20
Q

What does bone growth and development require?

A
  • Calcium
  • Phosphorus
  • Vitamins A, C and D
  • Balance between growth hormone, thyroid and parathyroid hormones, oestrogen and androgens
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21
Q

What percentage of bone is cortical bone?

22
Q

Where is cortical bone found?

Study These Flashcards
A

In the shafts of long bones

23
Q

Describe the structure of cortical bone

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A

Concentrically arranged in lamellae- Haversian system

24
Q

What is the function of cortical bone?

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A

Mechanic strength

25
What may cause damage to the bone/ cause the bone to fracture?
Direct or indirect violence may result in deficits at the fracture sit leading to non-union
26
What percentage of bone is cancellous/trabecular bone?
20%
27
Where is cancellous/trabecular bone located?
At the ends of long bones, vertebral bodies and flat bones
28
Describe the structure of cancellous/trabecular bone
Meshwork of trabecular with intercommunicating spaces
29
What is the function of cancellous/trabecular bone?
Metabolic
30
How would cancellous/trabecular bone likely be damaged?
Honeycomb structure fails as the result of compression
31
In cortical and cancellous bone, what are the differences between: 1) The periosteum 2) Cell turnover 3) Blood supply
1) Cortical bone has a thicker periosteum, Cancellous bone has a thin periosteum 2) Cortical bone has a slow turnover, Cancellous bone has a rapid turnover 3) Cortical bone has a slow blood supply and Cancellous bone has a rich blood supply
32
What needs to be thought about in the mechanism of injury of a fracture?
Direction of force: • Direct vs angular? • Rotational? • Was there compression? Energy transfer: • Cause? • Site? (how close was it to other tissues?)
33
What is imaging used for in fracture treatment?
* Site and the bones involved * Clues on any soft bone injury (e.g. are there fragments? Can it be realigned? etc.) * Clues on energy transfer: Wide displacement? Comminuted? Multiple fracture sites? * Pathological bone? * Paediatric bone: What are the effects on the growth plates and bone density
34
What are the different definitions of a fracture?
* Complete or incomplete * Site * Open to surface * Contaminated * Soft tissue injury * Joint involvement * No. of pieces * Alignment * Degree of separation
35
What are the types of fracture?
* Transverse- across the bone horizontally * Linear - across vertically * Oblique non displaced - Diagonally * Oblique displaced - Diagonally and separated * Greenstick (mainly in children) chunk on side of bone * Communited - broken into fragments * Spiral - Around the bone and twisted
36
What are avulsion fractures?
Fragment of the bone is separated from the main mass
37
What is a buckled fracture?
* Otherwise known as an impacted fracture, torus fracture | * Ends are driven into each other, commonly seen in arm fractures in children
38
What is a compression/ wedge fracture?
Usually involves vertebrae (seen more commonly in patients with osteoporosis or in cancer patients)
39
What is a pathologic fracture?
Caused by a disease that weakens the bones
40
What is a stress fracture?
Hairline crack
41
What complications are limb threatening/ a non-union risk?
* Dislocation * Comminuted * Compound * Compartment syndrome * Vascular/nerve injury * Soft tissue injury * Pathological bone
42
How long does a fracture take to heal and what is the healing time dependent on?
* 2-10 weeks * Severity and position * Age
43
What effect on bone cells does age have?
• Decrease of osteoblasts
44
What effect on bone cells does osteoporosis have?
• Increases osteoclasts
45
What are the 3 major phases of fractures and callus formation?
1) Reactive phase 2) Reparative phase 3) Remodelling phase
46
What happens in the reactive phase of callus formation ?
* Fracture and inflammatory phase (haematoma) | * Fibroblasts in the periosteum proliferate to form granulation tissue around fracture site
47
What happens in the reparative phase of callus formation?
30-40% of callus formation • Callus formation: osteoblasts quickly form woven bone to bridge the gap • Woven bone is weak as the collagen fibres are arranged irregularly • Lamellar bone is laid down - collagen is organised in regular sheets to give strength and resilience
48
What determines if osteoblast or chondroblasts are the main cell in callus formation?
* Osteoblasts = loading/ forces being applied | * Chondroblasts = less weight bearing
49
What happens in the remodelling phase?
Remodelling by osteoclasts restore original bone shape
50
What is conservative treatment?
* Simple fracture with low risk of non-union * Dependent on natural healing process * +/- immobilisation * Rehabilitation
51
What happens in intervention?
* Fractures with limb threat or risk of non union * Augment natural healing with replacement or strengthening * +/- immobilisation * Rehabilitation

Semester 2 systems (6 decks)

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