Development Of The Skeletal System Flashcards
Development of the skeletal system
.Develop from the mesodermal and neural crest cells of the developing embryo
- 4th week; development of the vertebrae of the axial skeleton
- Late in 4th week: the paddle-shaped limb buds of the lower extremities make their appearance
- 9th week: ossification begins with the appearance of ossification centers in the lower thoracic and upper lumbar vertebrae
Bone growth
. Normal bone growth
- As long bones grow in length, the deeper layers of cartilage cells in the growth plate multiply and enlarge, pushing the articular cartilage farther away from the metaphysis and diaphysis of the bone
- Separation of the epiphyseal growth plate ruptures the blood vessels that nourish the epiphysis
- Causes cessation of growth and shortened extremity length
Bone growth and remodeling
. Embryonic and fetal
. Bone growth in childhood
Alterations During Normal Growth Periods
. Torsional deformities
- Toeing- in and toeing-out
- Tibial torsion
- Femoral torsion
. Genu Varun and genu Valgum
. Flatfoot
Congenital Deformities
. Mild Limb deformities
- syndactyly: simple webbing of the fingers or toes
- polydactyl: presence of an extra digit
- Absence of a bone such as the phalanx, rib, or clavicle
. Major limb malformations
- Joint contractures and dislocations
- Absence of entire bones, joints, or limbs
Hereditary and Congenital Defoe
. Osteogenesis imperfects
- hereditary disease characterized by defective synthesis of type 1 collagens
. Developmental dysplasia of the hip
- Abnormal in hip development that leads to a wide spectrum of hip problems in infants and children
. Club foot or talipes
- Congenital deformity of the foot that can affect one or both feet
Treatment of Clubfoot
. When treatment is initiated during the first few weeks of life, a nonoperative procedure may be effective. Serial manipulations and casting are used gently to correct each component of the deformity
. Surgery may be required for severe deformities or when nonoperative treatment methods are unsuccessful
Juvenile Osteochondrosis
. Definition
- a group of children’s disease in which one or more growth ossification centers undergoes a period of degeneration, necrosis, or inactivity that is followed by regeneration and usually deformity
Types
- leg Calve Pethes disease: osteonecrosis of an apophyseal or epiphyseal center of the femoral head
- osgood- Schlatter disease: involves microfractures in the area where the patellar tendon inserts into the tibial tubercle
. Slipped capital femoral epiphysis
Scoliosis
. Definition
- lateral deviation of the spinal column that may or may not include rotation or deformity of the vertebrae
. Classification
- Postural scoliosis: a small curve that corrects with bending
- Structutal scoliosis: fixed deformity that does not correct with bending
Classification of sclerosis
. Idiopathic sclerosis
-structural spinal curvature for which no cause has been established
. Congenital sclerosis
- caused by disturbances in vertebral development during the 6th to 8th week of embryologic development
. Neuromuscular scoliosis
- develops from neuropathic or myopathic diseases
Major influences on equilibrium of bone tissue
. Mechanical stress
. Calcium and phosphate level in the extracellular fluid
. Hormones and local growth factors
. Cytokines
Types of bone remodeling
. Osteoblasts and osteoclasts in homeostatic balance in normal tissues
- RANK/ RANKL
- Osteopeotegerin
. Structural remodeling
- involves deposition of new bone on the out respect of the shaft at the same time that bone is reabsobed from the inner aspect of the shaft
. Internal bleeding
- largely involves the replacement of trabecular bone
- continuous during adulthood
Osteopenia
. Definition
- reduction in bone mass greater than expected for age, race, or sex
. Causes
- decrease in bone formation
- inadequate bone mineralization
- excessive bone deossification
Risk factors Associated with Osteoporosis
. Personal characteristics
- white, aging female, small bone structure, postmenopausal, family history
. Lifestyle
- sedentary, calcium deficient , high protein diet, excessive alcohol and caffeine intake , smoking
. Drug related
. Disease related
Osteoporosis
Definition
. Skeletal disorder characterized by loss of bone mass and deterioration of the architecture of cancellous bone with a subsequent increase in bone fragility and susceptibility to fractures
- Loss of mineralized bone mass causes increased porosity of the skeleton
. Causes
- can occur as the result of an endocrine disorder or malignancy
- Most offers associated with the aging process
Diagnosis and treatment of osteoporosis
Diagnosis
- BMD assessment
- Dual- energy x ray absorptiometry of the spine and hip
.Treatment
- regular exercise and adequate calcium intake are important factors in preventing osteoporosis
- weight- bearing exercises such as walking, jogging, rowing
. Drug treatment
- anabolic agents
- Antireeorptive agents
Disorders Invoving Softening of the bones
- Osteomalacia
- A generalized bone condition in which inadequate mineralization of bone results from a calcium or phosphate deficiency, or both
. Rickets
- A disorder of vitamin D deficiency, inadequate calcium absorption, and impaired mineralization of bone in children
Definition
- A progressive skeletal disorder that involves exercise bone destruction and repair
Etiology
. Clinical manifestations
- characterized by increasing structural changes of the long bones, spine, pelvis and cranium
Diagnosis
Treatment
Activity Intolerance and Fatigue
. Mechanisms of fatigue
Acute physical fatigue
. Chronic fatigue
. Management of chronic fatigue
. Myalgic encephalmyelitis/ chronic fatigue syndrome
Myalgic Encephalomyelitis/ chronic fatigue syndrome
. Assessment
. Presenting symptoms
. Laboratory values
Assessment of Activity and exercise tolerance
. Assessment tolerance and fatigue
. Aerobic fitness
