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Spinal Anatomy > Bone Healing Updated > Flashcards

Bone Healing Updated Flashcards

1
Q

Two types of bone

A

Cortical and cancellous

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2
Q

Describe cortical bone

A

Dense and compact

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3
Q

Describe cancellous bone

A

less dense, lattice-like bone

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4
Q

What is cortical bone arranged in units of?

A

Osteons aka haversian systems

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5
Q

Osteonic consist of ______ layers of bone arranged around a central ___________ ___________

A

concentric, haversian canal

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6
Q

What does the haversian canal contain?

A

Blood vessels and nerves

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7
Q

What are interspersed between the concentric layers of bone in the osteons?

A

Osteocytes

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8
Q

What connect the haversian system together?

A

Volkmann’s Canals

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9
Q

Channels that run perpendicular to the haversian canals allowing blood vessels to travel from the outside of the bone to the center

A

Volkmann’s Canals

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10
Q

Cancellous bone consists of interconnected bands of tissue called ______

A

Trabeculae

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11
Q

Thicker trabeculae may contain _______

A

Osteons

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12
Q

Cancellous bone typically contains more irregularly arranged _________

A

Lamellae

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13
Q

Another term for cancellous bone

A

Trabecular bone

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14
Q

Bone building cells

A

Osteoblasts

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15
Q

Bone removing cells

A

Osteoclasts

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16
Q

Cells that reside in cavities within bone and reach through to network with other cells of the same type

A

Osteocytes

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17
Q

These cells within the bone transfer nutrients and wastes and send signals based on stress and strain

A

Osteocytes

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18
Q

Develop from osteoblasts that get trapped in mineralized bone

A

Osteocytes

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19
Q

Line the outer surface of bone

A

Bone lining cells

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20
Q

These cells direct mineral update and release in bone

A

Bone lining cells

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21
Q

Send signals to initiate bone removal and formation

A

Bone lining cells

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22
Q

What mineral is deposited into collagen during bone growth?

A

Hydroxyapatite

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23
Q

A soft tissue that contains stem cells

A

Bone marrow

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24
Q

The two types of stem cells in bone marrow

A

Mysenchymal and hematopoietic

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25
Q

What 5 things do mysenchymal stem cells create?

A

Cartilage, bone, blood vessel, nerve, and fat cells

26
Q

What do hemapoietic stem cells create?

A

Blood cells

27
Q

Define remodeling

A

The process by which the body continually replaces areas of old necrotic bone with new bone tissue

28
Q

Bone remodeling steps

A
  1. Body identifies areas of bone that need replacement
  2. Bone lining cells signal osteoclasts and recruit them
  3. Osteoclasts arrive, attach to bone, create acid environment and create a void
  4. Osteoblasts are recruited after sufficient bone removed
  5. Osteoblasts fill void with osteoid
  6. Osteoid mineralized to become new bone
  7. Some osteoblasts encased in mineralized bone and become osteocytes, others finish filling void and remain outside of the new bone as bone lining cells
29
Q

The remodeling of old necrotic bone or bone grafts

A

Creeping substitution

30
Q

Following the bone remodeling cycle, the mineral density of the region will continue to increase over the next ______ years

A

2-3

31
Q

The term creeping substitution is most commonly used when referring to the incorporation of a ______ ______ into _____ _______

A

Bone graft into living bone

32
Q

Define Wolff’s Law

A

Bone is built where stresses require it and resorbed where stresses are absent

33
Q

What are the three stages of bone repair?

A 
Inflammation Phase (0-3 weeks)
Repair Phase (3 weeks to 4 months)
Remodeling Phase (4 months to 7 years)
34
Q

Difference between fracture healing and fusion

A

In fracture healing, you are taking two bone fragments that were once united and putting them back together

In a fusion, two or more separate individual bones are induced to grow together

35
Q

Bone that is removed from one place and transferred to another

A

Bone graft

36
Q

Three stages of bone graft incorporation

A

Inflammation
Repair
Remodeling

37
Q

Lifestyle factors that impact fusion

A 
Poor nutrition
Tobacco
Diabetes
Rheumatoid Arthritis
Steroids
Cytotoxic Drugs
Radiation
38
Q

Bone relocated from elsewhere in the patient’s body

A

Autograft

39
Q

Bone taken from another member of the same species

A

Allograft

40
Q

Bone taken from a member of a different species

A

Xenograft

41
Q

Substitute for bone graft artificially created to mimic bone in body

A

Synthetic

42
Q

Ability to provide framework (scaffold) for new bone growth

A

Osteoconductive

43
Q

Ability to induce bone growth (satisfies chemical requirements for a fusion)

A

Osteinductive

44
Q

Ability to grow into bone (contains live bone cells) and satisfies the biologic requirements for a fusion

A

Osteogenic

45
Q

The gold standard in bone grafting

A

Autograft

46
Q

Bone marrow removed surgically from the inside of bones

A

Bone Marrow Aspirate

47
Q

Grafts designed to be implanted without any modification by the surgeon

A

Machined Grafts

48
Q

When the mineral content is removed from allograft, this material remains osteoinductive

A

Demineralized Bone Matrix

49
Q

Usually consists of a power mixed with a carrier that facilitates deliver of the demineralized bone into the surgical site

A

Demineralized Bone Matrix

50
Q

Demineralized Allograft

A

Osteoconductive, Osteoinductive

51
Q

B-TCP

A

Osteoconductive

52
Q

Hydroxyapatite

A

Osteoconductive

53
Q

BMP

A

Osteoinductive

54
Q

Has the ability to provide the framework (scaffold) for new bone growth (satisfies structural requirements for a fusion)

A

Osteoconductive

55
Q

Has the ability to induce bone growth (satisfies the chemical requirements for a fusion)

A

Osteoinductive

56
Q

Has the ability to grow into bone (satisfies the biologic requirements for a fusion)

A

Osteogenic

57
Q

Bone is ___% organic

A

30%

58
Q

Bone is ___% inorganic

A

70%

59
Q

Autograft

A

Osteoconductive, osteoinductive, osteogenic`

60
Q

What are four things a surgeon can do to create a good environment for fusion?

A

Bony apposition (tight fit on bone graft)
Maximize surface area
Bloody pathway
Stable fixation

Spinal Anatomy (12 decks)

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