Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BRS MUSCULOSKELETAL > Injury and Healing- Bones > Flashcards

Injury and Healing- Bones Flashcards

1
Q

What makes up the musculoskeletal system?

A

Musculoskeletal system–> bone, muscle, connective tissue

connective tissue–> tendon, ligaments, cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a joint?

A

a junction between 2 or more separate bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How many bones in the skeleton?

A

206 bones (+sesamoids)
270 in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 2 skeletons in the body?

A

axial and appendicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the axial skeleton?

A

vertebral column, cranium, rib cage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the appendicular skeleton?

A

pectoral girdle, upper and lower limbs, pelvic girdle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the functions of the skeleton?

A
  1. support- helps you stand up
  2. protection- protects your vital organs
  3. movement- works with muscles so you can get around
  4. mineral storage- stores calcium and phosphate
  5. produces blood cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do flat bones develop in utero?

A

Intramembranous mesenchymal cells&raquo_space; bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do long bones develop in utero?

A

Endochondral mesenchymal&raquo_space; cartilage&raquo_space; bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is intramembranous ossification?

A

When mesenchymal cells turn to bone

  • forms flat bones of skull, clavicle and mandible
  • bone development from fibrous membranes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the template for mesenchymal cells?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is osteoid?

A

Unmineralized organic tissue that eventually undergoes calcification and is deposited as lamellae or layers in the bone matrix.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the process of intramembranous ossification?

A

Condensation of mesenchymal cells which differentiate into osteoblasts – Ossification centre forms

Secreted osteoid traps osteoblasts which become osteocytes

Trabecular matrix and periosteum form

Compact bone develops superficial to cancellous bone. Crowded blood vessels condense into red bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is endochondral ossification?

A

mesenchymal to cartilage bone
Development of long bone from a hyaline cartilage model

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the process of endochondral ossification?

A
  1. Bone collar formation
  2. Cavitation
  3. Periosteal bud invasion
  4. Diaphysis elongation
  5. Epiphyseal ossification
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is diaphysis?

A

the shaft or central part of a long bone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the primary ossification centre in endochondral ossification?

A

diaphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the secondary ossification centre in endochondral ossification?

A

epiphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the epiphysis?

A

The ends of long bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are bones made of?

A

cells and matrix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the bone cells?

A

Osteogenic cells
Osteocyte
Osteoblast
Osteoclasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are osteogenic cells?

A

Bone stem cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are osteocytes?

A

‘Mature’ bone cell

Formed when an osteoblast becomes imbedded in its
secretions

Sense mechanical strain to direct osteoclast and
osteoblast activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are osteoblasts?

A

‘Bone forming’ think BLAST BUILDING

Secretes ‘osteoid’

Catalyse mineralisation of osteoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are osteoclasts?

A

Bone breaking’

Dissolve and resorb bone by phagocytosis

Derived from bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where are osteogenic cells found?

A

Deep layers of periosteum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where are osteoblasts found?

A

Growing portions of bone, including periosteum and endosteum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Where are osteocytes found?

A

Entrapped in matrix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Where are osteoclasts found?

A

Bone surfaces and at sites of old, injured or unneeded bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the bone matrix composed of?

A

Organic component (40%)= type I collagen and ground substance

ground substance= proteoglycans, glycoproteins, cytokine and growth factors

Inorganic component (60%)= calcium hydroxyapatite and Osteocalcium phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the different types of bone?

A

Immature bone
Mature bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is immature bone?

A

Woven. immature/ disorganised

First bone that is produced
Laid down in a ‘woven’ manner – relatively weak
Mineralized and replaced by mature bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is mature bone?

A

Mineralized woven bone
Lamellar (layer) structure – relatively strong

Can be split into cortical and cancellous bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is cortical bone?

A

Cortical/ compact/ lamellar

‘Compact’ – dense
Suitable for weight baring

35
Q

What is cancellous bone?

A

cancellous/ spongy

‘Spongy’ – honeycomb structure
Not suitable for weight baring

36
Q

What is the parietal bone of the skull made of?

A

Cortical and cancellous bones
cortical outside, cancellous inside

37
Q

How is compact/ cortical bone organised?

A

Into osteons

Compact bone: has osteons
Few spaces
Provides protection, support and resists stresses produced by weight of movement

38
Q

What are osteons?

A

Repeated structural units ‘Osteons’ – concentric ‘Lamellae’ around a central ‘Haversian Canal’

‘Haversian Canal’ – contain blood vessels, nerves and lymphatics.

Lacunae – small spaces containing osteocytes Tiny Canaliculi radiate from lacunae filled with extracellular fluid.

Volkmans canal – transverse perforating canals

39
Q

What is the structure of long bones?

A

Periosteum – Connective tissue covering
Outer Cortex – compact bone
Cancellous bone
Medullary cavity - contains yellow bone marrow (and sometimes red bone marrow)
Nutrient Artery
Articular cartilage: on surface of bone at a joint only

40
Q

How do bones grow?

A

Interstitial and appositional

41
Q

What is interstitial growth?

A

increase in length
in long bones

42
Q

What is appositional growth?

A

increase thickness and diameter

43
Q

Where does interstitial growth occur?

A

physis (physeal plate)

44
Q

What is the physis?

A

physis (physeal plate)

Zone of elongation in long bone
Contains hyaline cartilage
Epiphyseal side – hyaline cartilage active and dividing to form hyaline cartilage matrix
Diaphyseal side – Cartilage calcifies and dies and then replaced by bone

45
Q

What are the steps of appositional growth?

A

Appositional growth – deposition of bone beneath the periosteum to increase thickness

  1. Ridges in periosteum create groove for periosteal blood vessel
  2. Periosteal ridges fuse, forming an endosteum-lined tunnel
  3. Osteoblasts in endosteum build new concentric lamellae inward toward center of tunnel, forming a new
    osteon
  4. Bone grows outwards as osteoblasts in periosteum build new circumferential lamellae. Osteon formation repeats as new periosteal ridges fold over blood vessel.
46
Q

What is the role of bone in calcium homeostasis?

A

Bone – Stores 99% of total body calcium

Calcium hydroxyapatite – structural support

Calcium is deposited and withdrawn during bone remodelling

Regulated by PTH and Calcitriol (Kidneys)

Calcitonin (Thyroid) – stimulates calcium uptake into bone

Vitamin D – helps the body absorb and use calcium

47
Q

What are the mechanisms of bone fracture?

A

Trauma= low or high E
Stress
Pathological

48
Q

What is an example of low and high E trauma mechanisms of fracture?

A

low E= stairs
high E= car accident

49
Q

Do stress fractures always show on x-rays?

A

No

50
Q

How does a stress fracture when it is a abnormal stress on normal bone?

A

overuse–>
Stress exerted on bone> bones capacity to remodel–>
Bone weakening–>
Stress fracture–>
Risk of complete fracture

51
Q

What are our weight bearing bones?

A

femur, tibia, metatarsals, navicular

52
Q

What activities are related to stress fractures?

A

athletes, occupational, military, female athlete triad

53
Q

What is the mechanism of fracture when it is a normal stress on abnormal bone?

A

Pathological

54
Q

What are the pathological reasons for abnormal bone?

A

Osteoporosis
Malignancy (eat at bone)
Vitamin D deficiency
Osteomyelitis
Osteogenesis imperfecta
Paget’s

Infection of bone, so puss in bone= weaker

55
Q

What changes in osteoporosis?

A

Bone size doesn’t change, there is just a thinner cortex

56
Q

What is osteopenia?

A

The stage before osteoporosis is called osteopenia. This is when a bone density scan shows you have lower bone density than the average for your age, but not low enough to be classed as osteoporosis. Osteopenia does not always lead to osteoporosis.

57
Q

What happens during osteopenia and osteoporosis?

A

Osteoclast activity > Osteoblast activity -> Disrupted microarchitecture

Female > Male 4:1

Postmenopausal Osteoporosis – Women 50-70

Senile Osteoporosis - > 70

Secondary osteoporosis: Any age, 60% Male
Hypogonadism
Glucocorticoid excess
Alcoholism

Associated with ‘fragility fractures’ – hip, spine, wrist

Low energy trauma-> fracture

58
Q

What happens during vitamin D deficiency?

A

Vitamin D facilitates calcium, magnesium and phosphate absorption

Dietary or synthesized from the sun

Inadequate Calcium or Phosphate-> Defect in osteoid matrix mineralization

Paeds – Rickets, Adults - Osteomalacia

59
Q

What happens during congenital osteogenesis imperfecta?

A

‘Brittle Bone Disease’

Hereditary – autosomal dominant or recessive

Decreased Type I Collagen due to:
Decreased secretion
Production of abnormal collagen

->Insufficient osteoid production

Effects:
Bones
Hearing
Heart
Sight

60
Q

What happens in paget’s disease?

A

Genetic & Acquired factors

Excessive bone break down and disorganized remodeling-> deformity, pain, fracture or arthritis

May transform into a malignant disease

4 stages:
1. Osteoclastic Activity
2. Mixed osteoclastic-
osteoblastic activity
3. Osteoblastic activity
4. Malignant degeneration

Can become cancer (not sure why)

61
Q

What are the primary bone cancers?

A
62
Q

What are the types of malignancies that cause fractures?

A

Blastic (bone forming)

Lytic (bone eating)

63
Q

What are the general principles of tissue healing?

A

Bleeding-> inflammation -> new tissue formation -> remodelling

blood -> neutrophils, macrophages-> -BLASTS (fibro-, osteo-, chondro)-> macrophages, osteoclasts, osteoblasts

64
Q

What are the 3 steps that fracture healing?

A

Inflammation

repair

Remodelling

65
Q

What happens during inflammation of fracture healing?

A

Haematoma formation
Release of Cytokines
Granulation tissue and blood vessel formation

66
Q

What happens during repair of fracture healing?

A

Soft Callus formation (Type II Collagen - Cartilage)
Converted to hard callus (Type I Collagen - Bone)

67
Q

What happens during remodelling of fracture healing?

A

Callus responds to activity, external forces, functional demands and growth
Excess bone is removed

68
Q

What is Wolff’s law?

A

Bone Grows and Remodels in response to the forces that are placed on it

69
Q

What are the two different types of bone healing?

A

Primary and secondary bone healing

70
Q

What is primary bone healing?

A

Intramembranous healing
Absolute stability
Direct to woven bone

71
Q

What is secondary bone healing?

A

Endochondral healing
Involves responses in the periosteum and external soft tissues
Relative stability
Endochondral ossification: more callus

72
Q

How long does it take for a fracture to heal?

A

3-12 weeks depending on site

Phalanges: 3 weeks
Metacarpals: 4-6 weeks
Distal radius: 4-6 weeks
Forearm: 8-10 weeks
Tibia: 10 weeks
Femur: 12 weeks

73
Q

When do you start seeing healing on XR from a fracture?

A

Signs of healing are visible on XR from 7-10 days

74
Q

What are the principles of management of a fracture?

A
75
Q

What are the ways of healing a fracture?

A

reduction
hold
fixation
rehabilitate

76
Q

How does reduction work?

A

Children remodel faster

77
Q

How does hold work?

A
78
Q

How does fixation work?

A
79
Q

How does rehabilitation work?

A
80
Q

When can a patient have fusion?

A

If the broken bones are very close together

81
Q

How would you get more information about an accident of damage/ fracture to leg?

A

Get a history from the patient and a bystander if possible

Do an examination of the patient’s leg looking for skin integrity, deformity, function, tenderness and neurovascular status (they do not need to learn the full form examination)

Request an x-ray with 2 views (AP and lateral)

82
Q

What might you expect when examining a patient from an accident with a fracture?

A

Inability to weight bear
Severe pain
Swelling and point tenderness
Deformity
Scrapes / abrasions
Wound if open fracture
Loss of movement
Loss of sensation if nerve injury

83
Q

What is the difference between open and closed fractures?

A

open the skin has been penetrated and vice versa

BRS MUSCULOSKELETAL (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions