Growth and Development of the Human Skeleton Flashcards

1
Q

give an overview of bone development

A
  • begins as cartilaginous analage
  • periosteum forms
  • primary ossification centre forms and ossification begins
  • primitive joint begins to develop
  • more blood supply forms alongside secondary ossification centre
  • growth plate eventually disappears, bone and cartilage left
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2
Q

what layer is bone derived from

A

mesoderm

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3
Q

when to limb buds begin to develop

A

week 4

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4
Q

what layers are the limb buds made of

A

mesoderm covered with ectoderm

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5
Q

in limb development what forms the (a) bone (b) muscle

A

(a) lateral mesoderm (b) somatic mesoderm

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6
Q

what is the apical ectodermal ridge important in

A

ensuring proper limb development

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7
Q

what gene controls the apical ectodermal ridge

A

sonic hedgehog gene

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8
Q

what can go wrong during skeletal development

A

failure of formation or separation, hypo/hyperplasia, duplication, constriction ring syndromes, skeletal dysplasia

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9
Q

what are constriction ring syndromes

A

abnormal tissue forms around growing limbs

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10
Q

what are cartilaginous analages

A

small areas of cartilage

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11
Q

by when are primary ossification centres in all long bones

A

12 weeks

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12
Q

where and when do secondary ossification centres first appear

A

distal femur at 36 weeks

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13
Q

describe the zones of the growth plate and what occurs in each

A
  • zone of reserved cartilage
  • zone of proliferating cartilage (proliferation begins)
  • zone of hypertrophic cartilage (becomes swollen)
  • zone of calcified matrix (bone)
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14
Q

where can appositional growth of bone occur

A

through the perichondrium and perichondrial ring

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15
Q

what is the Heuter-Volkmann Law

A

distraction across the plate increases growth whereas compression suppresses growth

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16
Q

what, besides the Heuter-Volkmann Law, stimulates the growth plate

A

increased blood flow, fractures, releasing periosteum

17
Q

what methods can be used to predict growth

A

height on 2nd birthday x2
menelaus - after age 10 grow 10mm from distal femoral plate and 6mm from proximal tibial plate each year
bone age
Paley multiplier

18
Q

what percentage of femur growth comes from the (a) proximal plate (b) distal plate

A

(a) 30% (b) 70%

19
Q

what percentage of tibial growth comes from the (a) proximal plate (b) distal plate

A

(a) 60% (b) 40%

20
Q

what is used to calculate bone age

A

x-ray of L wrist

21
Q

what can the menelaus method be used for

A

to calculate how much growth is left and when to stop for treatments, etc

22
Q

when does the spine grow until

A

late teens

23
Q

why is menarche useful in spinal growth

A

signals 18 months until end of spinal growth

24
Q

what is the Risser score

A

check iliac apophysis on x-ray, this shows the degree of ossification and the spinal maturity left

25
Q

what is the seleneas curve

A

natural varus valgus of a child’s tibia and femur

- bow legs from birth - 2, straightens then is slightly valgus 3 - 5 before settling into physiological adult valgus

26
Q

why might the growth plate die therefore causing deformity/destroying joints

A

physeal injury - trauma, infection, tumour, radiation, surgery, compression

27
Q

how might we control growth using Heuter-Volkmann Law

A

plates and screws

28
Q

what is the Salter Harris Classification used for

A

breaks surrounding growth plate