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Physiotherpy > Bone Structure, Function And Healing > Flashcards

Bone Structure, Function And Healing Flashcards

1
Q

What do the bones of the skeleton provide?

A 
Structural formation 
Mobility 
Support
Protection of the body 
Storehouse
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2
Q

Describe bone

A

Connective tissue
Matrix of collagen fibres and a ground substance
Hard yet brittle
Consists of four types of cells
2 types of tissue in the bone - compact and spongy

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3
Q

What are the two types of bone tissue?

A

Compact and spongy

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4
Q

Describe characteristics of compact bone

A 
80% of our total bone mass
All cells squished together 
Solid hard layer 
Gives strength down the long axis of a bone - lateral impact could damage it 
Denser, less flexible - then spongy
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5
Q

Describe the appearance and structure on compact bone

A

Osteoblasts lay down collagen fibres in a criss cross fashion
Creates lots of ring like structures, around blood vessels = called lamellae.
You get lots of these side by side making a spiral like structure of rings and rings = Osteon aka. Haversian system.
Formed of concentric calcified rings, surrounding blood vessels
Lots of osteons lay next to each other along the long axis of your diaphysis. - can withstand great pressure
Between each osteon is more lamellae
Separating the lamellae is a Lacunae
A lake made of extracellular fluid and more cells known as osteocytes.

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6
Q

Describe characteristics of spongy bone

A

20% of a bones total mass
Composed of a honey comb network
Found in ends of all long bones - in the epiphseal where compressive forces are found
It redistributes the stress down the shaft
Light weight, good shock absorber
Distributes pressure and stress

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7
Q

Describe the appearance and structure of spongy bone

A

Laid down by osteoblasts in a lattice like structure along lines of stress
Beams and haphazard structure of the bone gives it this spongy look with gaps.
The gaps are filled with blood vessels, extracellular fluid, red and yellow bone marrow etc.
Nutrients are derived from the medullary cavities

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8
Q

What are the 4 types of bone cells?

A

Osteoprogenitor cells
Osteoblasts
Osteocytes
Osteoclasts

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9
Q

Describe osteoprogenitor cells

A

Undifferentiated cells
No distinguishing feature in this form
Sit and wait to receive information to be stimulated into making new bone
Once stimulated, they divide
The daughter cells produced are osteoblasts
Located in the endosteum and inner periosteum

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10
Q

Describe osteoblasts cells

A

Build the matrix and collagen fibres
Can’t divide
Come from osteoprogenitor cells
Once made, they remain in this form
Become trapped in their own system of bone.
Once trapped after being laid down, they are known as osteocytes
Located on the surface of bones and in the lacunae of built bone

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11
Q

Describe osteocyte cells

A

Mature cells
They maintain the bone
Have projections that communicate with other cells
Located in the lacunae, maintain the bone matrix
Provide information about how much building or breakdown of bone needs to be done
Also regulate nutrients

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12
Q

Describe osteoclast cells

A

Clear bone cells
A lot bigger than the other 3 types
Come from a monocytes
Clear up debris and dead bone
Have a ruffled border - easily stick to bone surface
Release enzymes and acids to destroy the bone underneath
Reabsorb this and release minerals back into the blood
Only respond to what osteocytes say
located on the surface of bones

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13
Q

What is Coupling?

A

The amount of bone being laid down and the amount broken down and reabsorbed is done at the right rate.

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14
Q

What is uncoupling?

A

Too much loss or gain of bone.

Osteoporosis is associated with this.

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15
Q

What is remodelling?

A

An ongoing process in the bone throughout our life.
Continually modelled throughout childhood and adolescence
Lots of removal and replacement at the same site.
Leads to strong, healthy bones.

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16
Q

What can go wrong with bone growth?

A

Low bone density - more brittle and weaker so more likely to break
Bone cancer
Bone infections - due to trauma or surgery
Osteogenesis imperfecta - an inherited disorder of extreme bone fragility, don’t produce enough collagen, very susceptible to fractures and don’t produce cartilage at the epiphyseal plates

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17
Q

What are the four arteries that supply bones with blood?

A

Periosteum arteries
Nutrient arteries
Metaphysical arteries
Epiphyseal arteries

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18
Q

Where does the periosteal arteries go?

A

Penetrates the periosteum through Vulcan canals

Supplies blood to the outer osteons of compact bone marrow

19
Q

Where does the nutrient arteries go?

A

Enters through the diaphysis, through the nutrient foramen

Supplies the medullary cavity and osteons of inner compact bone

20
Q

Where does the metaphyseal arteries go?

A

Enter the metaphysis

Supply spongy bone and bone marrow

21
Q

Where do the epiphyseal arteries go?

A

Enter your epiphysis

Supply spongy bone and bone marrow

22
Q

What can remodelling be affected by?

A 
Age 
Mechanical stress 
Genetics and environment 
Hormones 
Nutrition
23
Q

How does age affect remodelling?

A

Once at full height our bone density then begins to decrease.
Demineralisation from the age of 40
And continues to reduce at 1% each year
Due to menopause in women this can sometimes be worse
Remodelling in older people will take longer and may not heal properly or as fast

24
Q

How does mechanical stress affect remodelling?

A

Weight bearing is important for development and healing
As your muscle pulls on a bone it causes mechanical stress which means the bone will remodel.
Increases the mineral and collagen production to keep bones strong and healthy
Weight bearing builds bone
Lack of activity results in loss of bone and decrease in density

25
Q

How does genetics and the environment affect remodelling?

A

Genetically particular races such as black, have denser bones and are less likely to suffer from diseases such as osteoporosis.
Women’s bones are more affected than mens due to hormones
Cannot control genetics but can control environmental factors
Balanced diet, physical exercise

26
Q

How does nutrition affect remodelling?

A

Deficits in calcium will cause your osteoblasts to send signals that we need more calcium = bones are broken down to re absorb more calcium into the body.
Need around 800-1000 mg of calcium a day
Other vitamins such as D are needed to help calcium be absorbed and K
A lack of calcium causes bone deterioration and too much can causes lots of bone building

27
Q

How do hormones affect remodelling?

A

Menopause can cause women to become prone to uncoupling due to a change in hormone levels.

28
Q

What are some bone disorders of development?

A

Spina bifida
Osteogenesis imperfecta
Agenesis

29
Q

What are some bone disorders of remodelling?

A

Age
Hormone levels
Calcium levels
Mechanical stress

30
Q

What are some endocrine bone disorders?

A

Gigantism - too much growth hormone
Pituitary dwarfism
Postmenopausal osteoporosis

31
Q

What are some nutritional bone disorders?

A

Rickets - reduced amounts of vitamin D

Osteomalacia - bones become soft. Aka. Rickets in adults

32
Q

What is osteopenia?

A

Medical condition where proteins and mineral content of bone tissue is reduced.
Bones become thinner with age
Affects your jaw, vertebrae and limbs

33
Q

What is osteoporosis?

A

Medical condition in which the bones become brittle and fragile from loss of tissue.
Usually due to hormonal changes
More common in females
Over 70s
Early menopause or longer lasting menopause than normal can increase the risk.
More prone to fractures

34
Q

What scan can be done to check for osteoporosis?

A

A Bone Density scan aka. Dexa Scan
The scanner cannot easily pass through dense bone so a low reading indicates high bone density.
A high reading indicates low bone density, as the scanner can easily pass through.

35
Q

What are the two types of osteoporosis?

A

Primary and secondary

36
Q

What is primary osteoporosis?

A

Simple form
In the older generation, predicted
Or after menopause

37
Q

What is secondary osteoporosis?

A 
Not related to age or time of life. 
Relegated to other factors such as:
- bone diseases 
- cancerous illnesses 
- malnutrition 
- weightlessness 
- smoking 
- alcohol 
- lack of calcium 
All of the bottom 3 must be excessive and can be modified.
38
Q

What is a fracture?

A

Breaks caused by mechanical stress applied on a particular location where the bone cannot support it.

39
Q

What are some names of fractures?

A 
Open
Closed
Displaced
Comminuted 
Compressed 
Spiral 
Oblique 
Green stick 
Transverse 
Colle
Potts 
Boxer 
Pathological
40
Q

Describe the rate of healing

A

It depends on the type of fracture and where it is positioned - wither in the upper or lower limb.
Uber limb takes less time to heal than the lower as it is smaller.

41
Q

What can affect the rate of healing?

A 
Type of fracture 
Vascular supply 
Age 
Movement of fracture 
Infection 
Bone pathology
42
Q

What are some clinical features of a fracture?

A 
Pain and tenderness 
Swelling and bruising 
Deformity 
Impaired function 
Shock
43
Q

How might a fracture be treated?

A

Sling, cast, splint
Open reduction internal fixation
Open reduction external fixation
Rehabilitation may also be provided to help healing. But this tends to be after its fixed, to re gain movement and strength.

44
Q

What are some complication with fracture healing?

A

Delayed
Mal/non union - doesn’t heal in the correct alignment, may need to be re broke and re aligned
Compartment syndrome
Blood vessel damage
Fab embolus - causes a blockage of blood flow, preventing healing
Growth impairment
Osteoarthritis

Physiotherpy (7 decks)

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