Bone path 1 Flashcards

1
Q

What are the functions of bone?

A
  • Rigidity
  • protection
  • haematopoiesis
  • resovoir for minerals (calcium and phosphorus)
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2
Q

What are the cellular components of bone?

A

Make bone or cartilage
- osteoblasts -> osteocytes
- line bone trabeculae
- produce osteoid
- once they are mineralised bone matrix = osteocytes

Remove bone (remodelling)
- Osteoclasts - multinucleate phagocytic cells that sit in Howships lacunae and secrete acid and proteinase. Increase PTH -> increase in osteoclast numbers and activity . Osteoclasts have calcitonin receptors, calcitonin inhibits osteoclasts and causes them to detatch from bone surgaces

Bone marrow
- stromal cells
- adipocytes
- erythroid and myeloid precursors

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3
Q

What are the matrix components of bone?

A

Cone extracellular fluid (bone tissue fluid)
- Functional membrane (osteoblasts and osteocytes) separates bone ECF from general ECF
- Allows regulation of Ca2+ and PO4- ion flow into and out of bone ECF

Lining tissues
- Periosteum
- endosteum

Vascular supply
- Provides nutrients, growth factors/hormones, mineral ions
- Removes waste, mineral ions

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4
Q

Key components of calcium homeostasis

A
  • ## tightly regulated - particularly extracellular calcium (kept in a very narrow range). This is critical to cell signalling
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5
Q

How is calcium regulated?

A

o Parathyroid hormone
 Bone
* ↑Ca2+ transfer across cellular barrier
* ↑Ca2+ resorption
 Kidney
* ↑Ca2+ absorption in DCT
* ↓ Pi absorption in PCT
* Activation of Vit D
o Calcitonin
 ↓ Bone resorption
 ↓Ca2+ transfer across cellular barrier
o 1,25(OH)2 Vitamin D
 GIT: ↑Ca2+ absorption
 Bone: ↑Ca2+ resorption
 Kidney: Activation of Vitamin D
 Skin: Formation of Vitamin D (UV dependent)

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6
Q

What are the causes of hyperparathyroidism?

A
  • Reaction to persistently high serum PO4 (renal failure, vit D toxicity)
  • Persistent secretion of PTH or related proteins (lymphoma, anal sac adenocarcinomas)
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7
Q

What could lead to pathological fractures?

A

Osteodystrophy - sacrifice of skeletal calcium

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8
Q

How does parathyroid hormone influence calcium homeostasis?

A

Parathyroid hormone
- BONE: ↑Ca2+ transfer across cellular barrier and ↑Ca2+ resorption
- KIDNEY: * ↑Ca2+ absorption in DCT, ↓ Pi absorption in PCT and activation of Vit D

Calcitonin: ↓ Bone resorption and ↓Ca2+ transfer across cellular barrier

1,25(OH)2 Vitamin D
- GIT: ↑Ca2+ absorption
- Bone: ↑Ca2+ resorption
- Kidney: Activation of Vitamin D
- Skin: Formation of Vitamin D (UV dependent)

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9
Q

How does calcium flow between bone and extracellular fluid TO ADD

A
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10
Q

What might happen if damage occurs to the growth plate?

A
  • Stunted bone growth
  • Malformation
  • If you get damage to only one section of the growth plate, you might see malformations/deviations in the growth of the bone
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10
Q

What might happen if damage occurs to the growth plate?

A
  • Stunted bone growth
  • Malformation
  • If you get damage to only one section of the growth plate, you might see malformations/deviations in the growth of the bone
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11
Q

What could lead to imparied osteoclastic activity?

Think viral or toxic causes

A
  • Canine distemper virus
  • Bovine viral diarrhoea
  • Lead poisoning
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12
Q

Explain Wolffs law

A
  • Bone is deposited at sites where its needed and reabsorbed where it isnt. The abnormal use of a bone can result in a change in shape. Removal of mechanical forces can cause localised osteopenia.
  • Net bone formation at sites of compression, net bone resorption at sites of tension. Trabecular bon aligns along the lines of stress
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13
Q

What is osteochondrosis?

A

disorder resulting from abnormal growth, injury, or overuse of the developing growth plate and surrounding ossification centers

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14
Q

What is osteonecrosis?

A

The death of bone cells due to decreased blood flow. Generally as a reslt of trauma/fractures, pressure from tumours or inflammatory lesions or mechanical pressure, and lastly vasoconstriction from cold or ergotism.

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15
Q

What response do we see in periosteal injury?

A

Injured periosteum often forms bone. Usually see spicular bone that is orientated perpendicular to the log axis of the cortex (nodular lesions = osteophytes, osteophytes at insertions or tendons or ligaments are referred to as enthesiophytes). This spicular bone may be admixed with cartilage (esp. under low oxygen tension).

16
Q

What is ectopic mineralisation/ossification?

A

Ectopic mineralisation: Mineralisation in areas of the body outside of the skeletal system

Ectopic ossification: Ectopic ossification is a biologic process in which new bone is formed in tissues which normally do not ossify.

17
Q

What are the forms of ectopic mineralisation?

A

Metastatic and dystrophic

18
Q

Give an examle of metastatic forms of ectopic mineralisation

A
  • Hypercalcaemia or hyperphosphataemia
19
Q

Give an examle of dystrophic forms of ectopic mineralisation

A
  • Calcinosis cutis - Mineralisation of collagen fibres in the skin, strongly assoicated with cell injury
  • Tumouralcalcinosis/calcinosis crcumscripta - often near joints, mass lesion due to depostiion of chalky accumulation of calcium salts
20
Q

What can cause bone fractures?

A

Either
- Traumatic fractures - excessive force on NORMAL bone
- Pathological fractures - abnormal bone, minimal trauma as a result of neoplasia, inflammatory disease, osteodystrophies

21
Q

What are the types of fractures?

A
  • Transverse/oblique/spiral
  • comminuted
  • greenstick
  • physeal (salter-harris I-V) - refer to image
22
Q

Why is the distal ulnar physis easy to damage?

A

Because its conically shaped

23
Q

What are the stages of healing following a fracture?

A

→ Haematoma
→ Local ischaemic necrosis of bone ends and local tissues
→ Acute inflammation, fibrinolysis, phagocytosis
→ Proliferation of mesenchymal cells (periosteal, endosteal) -> dominated by periosteal proliferation in the beginning stages
→ Loose connective tissue callus
→ Mesenchymal cells differentiate into chondroblasts
→ Cartilaginous callus, while osteoclasts remove dead bone
→ Osteoblasts proliferate and make woven bone
→ Bony callus (primary callus)
→ Modelling to mature lamellar bone (secondary callus)
→ remodolling continues for the remainder of the animals life

24
How would you promote high vascularity to promote bone formation?
- Minimise dead space - Minimise dead tissue present
25
What are the aims of the treatment of fractures?
aimed at ensuring stability, maintaining blood supply, removing infectious agents and promoting normal function to optimise the healing process
26
In fracture repair, what does poor oxygen tension promote?
Poor oxygen tension promotes increased cartilage in the callus -> ont as strong as woven bone but will eventually form bone via endochondrial ossification
27
What would a lack of stabilisation mean in fracture repair?
↑ movement & tension, promoting development of mature fibrous tissue in the callus and may lead to non-union Infection
28
What diseases might impact fracture repair?
Neoplasia and or degenerative bone disease
29
List some adverse outcomes of fractures
o Delayed union o Non-union o Malunion o Osteomyelitis o Disuse atrophy of bone and musculature o Physical disruption of surrounding tissue by the callus o Angular limb deformity
30
How can inflammation induce a pathological fracture?
Exudate may accumulate in the medullary cavity - Increased intramedullary pressure - Compression of vessels - Thrombosis and infarction Stimulation of bone resorption - Inflammatory mediators stimulate bone resorption by osteoclasts - Enzymes from inflammatory cells and activation of matrix metalloproteinases promote matrix resorption
31
In a pathological fracture, what would cause a change to the matrix?
- Cellular infiltration from inflammation or neoplasia - Change to the composition/amount of matrix as a result of osteodystrophies or congenital abnormalities of the bone or cartilage
32
Name some specific diseases that can result in a pathological fracture?
- Osteoporosis - legg-calve-perthes disease in small dogs -> ishaemic necrosis of the femoral head - Slipped capital physis in cats -> usually in overwight males, disorganised cartilage with delayed physeal closure - Bucked shins -> dorsal cortex of MCIII in horses, repetative stress may cause periosteal damage, microfractures are in cortical bone