Bone tissue Flashcards

1
Q

State the functions of bone tissue

A
  • Structure
  • Mobility
  • Support
  • Protection
  • Store for minerals (mainly calcium)
  • Blood cell production
  • Fat production & storage
    (Many functions = lots to go wrong - needs good upkeep)
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2
Q

Common features of long bone

A

ends = epiphysis
middle = diaphysis
between these is a widening = metaphysis which separates growth plate from diaphysis

  • endosteum = inner layer
  • periosteum = 2 layers around outside
    - outermost is where tendons/ligs attach
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3
Q

What is the make-up of bone

A

Matrix of collagen fibres and ground substance that becomes calcified to give bones their firmness
(25% water, 25% collagen, 50% crystalized mineral salts - mainly calcium)
so bone is
- hard yet brittle
- light per unit of volume

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4
Q

Name the two types of bone tissue

A

Compact = 80% of bone mass

  • solid hard layer (strong in longitudinal axis)
  • external layer of all bones

Spongy = 20% of bone mass

  • honeycomb network
  • inner parts of axial skeleton + ephiphyses of long bones
  • light
  • good shock absorber
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5
Q

Describe Compact bone + its formation

A
  • dense + less flexible - hard external layer of all bones
    > Formation
  • osteoblasts lay collagen down in criss-cross around blood vessels
  • 1 ring = lamellae
  • many lamellae = osteon (a.k.a haversian system)
  • many osteons form to give compact bone its strength
  • between osteons = interstitial lamellae
  • between lamellae = lacuna of extracellular fluid & osteocytes
  • Osteocytes = mature bone cells (osteoblasts that have walled themselves in)
  • projections called canaliculi allow osteocytes to communicate & regulate bone tissue + nutrients
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6
Q

Describe Spongy bone and its formation

A

Spongy/ Trabecular/ Cancellous Bone
- Lattice-like
- Collagen fibres = laid down on stress lines = trabeculae (little beans)
- able to cope with multi-directional stress - distributes to longitudinal axis of compact bone
- light
- osteocytes reside in lacunae on surface of trabeculae
(gain nutrients via canaliculi = projections which pick up blood in medullary cavity)

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7
Q

what are the 4 bone cell types

A
> Osteogenic (osteoprogenitor) cell 
- undifferentiated 
- develops into osteoblast 
- found in endosteum + inner periosteum
> Osteoblasts
- builds matrix and collagen fibres (can't divide)
- generally on outside of bone
> Osteocytes = mature cells in lacunae
- maintain bone tissue 
> Osteoclasts 
- clear bone cells 
- developed from monocytes - phagocytosis (ruffled border to stick to edge + form seal, releases enzymes to kill bone cells, absorbs debris)
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8
Q

Define Remodelling and Coupling of bone

A
Remodelling =  constant process of building + destroying bone cells
Coupling = Balance between building and destroying (uncoupling = loss of balance)
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9
Q

Describe Bone growth

A
  • Cartilage grows at outer end of bone
  • cartilage on inner end is replaced by bone
  • remodelling - changes in width - resorbed at wider parts/ added at thinner parts (appositional growth)

Occurs in women til around 18-19 years
men til around 18-25 years

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10
Q

What can go wrong with bone growth

A
  1. Osteoporosis- low bone density
  2. Osteogenesis imperfecta - brittle bone disease (not enough collagen)
  3. Paget’s disease (bone = replaced faster than usual - doesn’t form as well so it weaker)
  4. Bone cancer
  5. Bone infection
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11
Q

Blood supply to the bones

A
> periosteal arteries
- periosteum and outer osteons of compact bone
> nutrient arteries via nutrient foramen
- medullary cavity and osteons of inner compact bone
> Metaphyseal arteries
- spongy bone and marrow in metaphysis
> Epiphyseal arteries
- spongy bone and marrow in epiphysis
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12
Q

Affectors of remodelling

A

> Age
- osetopenia = demineralisation of bone from 40 years on, accelerated by menopause
- osteoporosis = accelerated demineralisation
Mechanical stress
- weight bearing allows development + healing
- loss of activity = weaker bone (50% loss in 12 weeks)
Genetics
Environment
Nutrition - phospate + calcium = key in blood clotting so bone may be destroyed if levels in blood are low
Hormones - hgh, sex hormones, parathyroid hormone, calcitonin

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13
Q

Bone disorders - developmental

A

> Agenesis = limb doesn’t form/malforms
osteogenesis imperfecta = brittle bone disease
spina bifida = spinous processes malform - exposing spinal cord + fluid
achondroplasia = dwarfism

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14
Q

Bone disorders - remodelling + nutritional

A
Remodelling
> age 
> hormone levels
> calcium + phosphate levels
> Mechanical stress + activity

Nutritional
> rickets - lack of vit d
> osteomalacia
> scurvy - lack of vit c

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15
Q

Bone disorders - Endocrine

A

> Gigantism - too much hgh pre-puberty
acromegaly - over dense bone = >hgh post puberty
pituitary dwarfism = too little hgh
hyper/hypothyroidism = too much/little calcium
post-menopausal osteoporosis

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16
Q

Bone disorders - ageing

A

> osteopenia
- normal decrease in mineral levels due to osteoblast ability decreasing with age
osteoporosis = accelerated decrease in bone density
- Primary = high risk categories e.g women/elderly/non-weight bearers
- Secondary = due to disease/malnutrition
* Modifiable factors = smoking/alcohol/caffeine/protein/calcium/sunlight levels

17
Q

How are fractures named

A
  1. Severity
  2. Shape
  3. Position
  4. Name
18
Q

State the types of severity classification in fractures

A
  • open/compound = through skin
  • impacted = breaks forced into each other
  • comminuted = many pieces
  • closed/simple= skin is intact
  • displaced - fragments have moved usually due to muscle spasm
19
Q

State the types of shape classification in fractures

A
  • spiral - twisting forces
  • oblique - twisting with force applied
  • greenstick - splinters rather than breaks - usually kids
  • depressed - disappears down - usually in skull
  • transverse - straight across
20
Q

State the types of position and name classification of fractures

A

Position

  • distal/proximal
  • shaft
  • neck
  • epiphyseal

Name
Colle’s - distal radius
Potts - ends of malleoli

21
Q

Describe the bone healing after fracture

A
  1. hematoma formation (72 hours but clear up = 3/52)
    - bleeds - clots within 6-8 hours and cells die
    - inflammation - dead bone + debris is cleared by phagocytosis
    - ANGIOGENESIS - new capillaries grow into area
  2. Fibrocartilaginous callus forms (~3 weeks)
    - fibroblasts invade procallus and lay down collagen
    - chondroblasts produce fibrocartilage
  3. Formation of bony callus (takes 3-4 months)
    - osteoblasts create spongy bone that joins bone ends
    - fracture site = firmly held
  4. Bone remodelling (up to 1 year)
    - compact bone replaces spongy bone
    - surface = remodelled but lump may remain
22
Q

Rate of fracture healing is affected by:

A
> Type of fracture
> Site of fracture + vascular supply
> age
> movement
> separation of bony ends
> infection
> bone pathology 
Spiral fractures
UL = union in 3/52 and consolidated in 6/52
LL - union - 6/52, consolidated - 12/52
Transverse fractures
UL union - 6/52, consolidated - 12/52
LL union - 12/52, consolidated - 24/52
23
Q

Symptoms of fracture

A
> Pain + tenderness
> swelling + bruising
> deformity/angulation
> impaired function
> shock
24
Q

Treatment of different fractures

A
> Closed (simple)
- realigned  + immobilised
- rehab if necessary
> Open (simple)
- open reduction and internal fixation 
- rehab for damaged soft tissue
> Open (complex)
- open reduction + external fixation
- rehab for damaged soft tissue
25
Q

Complications of fracture healing

A

> delayed/mal-union
avascular necrosis
sudeck’s atrophy - disturbance to SNS
compartment syndrome -swelling cuts of blood
Volkmanns ichaemia - pressure in forearm
myositis ossificans = bone laid in muscle
blood vessel/nerve/visceral damage
tendon injury
fat embolus - yellow bone marrow in blood stream -stroke/heart attack risk
OA
growth impairment