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MD2002 > Bone Growth and Fractures > Flashcards

Bone Growth and Fractures Flashcards

1
Q

what is the role of sex steroids in bone growth?

A

stimulate bone growth spurt but promote close of epiphyseal plates

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2
Q

what happens to bone growth at end of puberty?

A
  • growth in length ceases
  • cell proliferation slows and plate thins
  • plate invaded by blood vessels
  • epiphyseal and diaphyseal vessels unite
  • may leave visible line on x-rays
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3
Q

which bones have only one ossification centre?

A
  • carpals
  • tarsals
  • ear ossicles
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4
Q

which bones have 2+ ossification centres?

A

head of humerus has 3

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5
Q

what are the zones of the epiphyseal plate?

A
  • ossification (osteogenic)
  • calcification
  • hypertrophic
  • growth (proliferation)
  • resting zone
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6
Q

what is the function of the resting zone?

A

matrix production

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7
Q

what is the function of the growth zone?

A

cell proliferation

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8
Q

what is the function of the hypertrophic zone?

A

calcification of matrix

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9
Q

what is the function of the metaphysis zone?

A
  • bone formation

- vascularisation

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10
Q

what are examples of diseases due to defects in resting zone?

A

diastrophic dwarfism:

- defective collagen synthesis/processing of proteoglycans

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11
Q

what are examples of diseases due to defects in growth zone?

A

achondroplasia; malnutrition; irradiation injury:
- deficiency in cell proliferation and/or matrix synthesis

gigantism:
- increased cell proliferation

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12
Q

what are examples of diseases due to defects in hypertrophic zone?

A

rickets; osteomalacia:

- insufficiency of calcium or phosphate for normal calcification

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13
Q

what are examples of diseases due to defects in metaphysis zone?

A

osteomyelitis:
- bacterial infection

osteogenesis imperfecta:
- abnormality

scurvy:
- inadequate collagen turnover

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14
Q

what are the requirements of normal growth and bone development?

A
  • calcium
  • phosphorus
  • vitamin A, C, D
  • balance between growth hormone, thyroid/parathyroid, oestrogen/androgens
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15
Q

what is the ratio of cortical/compact bone to cancellous/trabecular bone?

A

8:2

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16
Q

what is the location of cortical/compact bone?

A

shaft of long bones

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17
Q

what is the location of cancellous/trabecular bone?

A
  • ends of long bones
  • vertical bodies
  • flat bones
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18
Q

what is the structure of cortical/compact bone?

A

concentrically arranged lamellae - haversian systems

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19
Q

what is the structure of cancellous/trabecular bone?

A

meshwork of trabeculae with intercommunicating spaces

20
Q

what is the function of cortical/compact bone?

A

mechanically strong

21
Q

what is the function of cancellous/trabecular bone?

A

metabolic

22
Q

what is turnover like in cortical/compact bone?

A

slow

23
Q

what is the turnover like in cancellous/trabecular bone?

A

fast

24
Q

what is the periosteum like in cortical/compact bone?

A

thick

25
Q

what is the periosteum like in cancellous/trabecular bone?

A

thin

26
Q

what is blood supply like in cortical/compact bone?

A

slow

27
Q

what is blood supply like in cancellous/trabecular bone?

A

rich

28
Q

what is the fracture pattern of cortical/compact bone?

A

direct or indirect violence may result in deficits at the fracture site leading to non-union

29
Q

what is the fracture pattern of cancellous/trabecular bone?

A

honeycomb structure fails as the result of compression ( e.g. fall from height compacts bone)

30
Q

what information does x-ray imaging provide?

A
  • site and bones involved
  • clues on soft tissue injury
  • clues on energy transfer e.g wide displacement, comminuted, multiple fracture sites
31
Q

what is a fracture?

A

a complete or incomplete break in a bone

32
Q

what ways are there to describe a fracture?

A
  • site
  • open to surface
  • contaminated
  • associated soft tissue injury
  • joint involvement
  • number of pieces
  • alignment
  • degree of separation
33
Q

what are some types of fracture patterns?

A
  • transverse
  • linear
  • oblique non-displaced
  • oblique displaced
  • spiral
  • greenstick
  • comminuted
34
Q

avulsion fracture

A

a fragment of bone is separated from main mass

35
Q

buckle fracture

A
  • a.k.a impacted fractur, torus fracture
  • ends are driven into each other
  • commonly seen in arm fracture in children
36
Q

compression or wedge fracture

A

usually involves vertebrae

37
Q

pathological fracture

A

caused by a disease that weakens the bones

38
Q

stress fracture

A

a hairline crack

39
Q

what types of fracture are limb threatening/non-union risk?

A
  • dislocation
  • comminuted
  • compound
  • compartment syndrome
  • vascular/nerve injury
  • significant soft tissue injury
  • pathological bone
40
Q

what are the 3 major phases of fracture healing?

A
  1. reactive phase
  2. reparative phase
  3. remodelling phase
41
Q

what is involved in the reactive phase of fracture healing?

A
  • fracture and inflammatory phase (haematoma)

- fibroblasts in periosteum proliferate to form granulation tissue around fracture site

42
Q

what is involved in the reparative phase of fracture healing?

A
  • callus formation: osteoblasts quickly form woven bone to bridge gap
  • woven bone is weak as collagen fibres arranged irregularly
  • lamellar bone laid down, collagen organised in regular sheets to give strength and resilience
43
Q

what is involved in the remodelling phase of fracture healing?

A

remodelling by osteoclasts to restore original bone shape

44
Q

when are conservative forms of fracture treatment used?

A

simple fracture with low risk of non-union:

  • dependent on natural healing process
  • +/- immobilisation
  • rehabilitation
45
Q

when are forms of intervention treatment used for fractures?

A

fractures with limb threat or risk on non-union:

  • augment natural healing with replacement of strengthening
  • +/- immobilisation
  • rehabilitation

MD2002 (85 decks)

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