Micro/Path: Bone Disorders Flashcards
The most common bone lesion is a __
fracture
Healing of a fracture involves what 3 phases
Inflammatory phase
Reparative phase
Remodeling phase
- Which phase in the healing of a bone fracture does a BLOOD CLOT FORM
- Which phase does a CALLUS of CARTILAGE + CALLUS OF COMPACT BONE/BONY CALLUS FORM
- in the remodeling phase, the __ is revitalized
- inflammatory phase
- reparative phase
- cortex
Non union of fractures means that the fracture?
Failed to heal
There are 4 reasons for non union/failure of a bone fracture to heal. What are they?
- Infection
- Ischemia
- Excessive mobility
- Interposition of soft tissue-between the fractured ends
- bone fragments usually protrude in this kind of fracture
2. what is the most likely reason a compound fracture does not heal (non -union)
- compound fracture
2. infection
Pseudoarthrosis or pseudojoint may occur when a fracture fails to heal due to?
excessive mobility.
Pseudarthrosis = is a fracture that has not united in the stipulated time in which such fractures usually unite and has no chance of union without intervention.
There is movement of a bone at the location of a fracture resulting from inadequate healing of the fracture
fractures in which bones may fail to heal (non-union) due to ischemia? (3)
neck of femur (thigh bone), navicular bone of the wrist, and lower third of tibia (lower leg bone) b/c they are poorly vascularized = subject to coagulation necrosis after a fracture
___ is a pathological condition resulting from a disease, injury, therapy, or other trauma
sequela
____ is most often a sequel of fractured bones due to the mechanical disruption of bone marrow fat and by alterations in plasma lipids
fat embolism
Osteochondroma:
- benign/malignant tumor
- it is made of?
- found most frequently near the end of __ bones
- most common in patients aged _ -___
- benign
- bone and cartilage
- long bones
- 10-25years
- ___ = a group of disease that affects the growth plate during childhood, resulting in abnormal bone growth and deformity.
- affects different bones initially characterized by __ and __ followed by regeneration and ossification
- Osteochondroses
2. aseptic necrosis and degeneration
- osteochondro-ma =
2. osteochondro-ses =
- benign tumor of long bones made of cartilage and bone
2. group of diseases that affects the growth plate in CHILDHOOD
Osgood-Schlatter Disease - a type of osteochondroses
- _____of bone and cartilage at the ___
- usually develops b/w ages __ and more common in athletic boys/girls
- major symptoms
- usually involves the __ of the knee
- inflammation , top of the SHINBONE
- 10-15 athletic boys
- pain, swelling, tender knee.
- tibial tubercle (tibial tuberosity) of knee
Legg-Calve Perthes Disease- a type of osteochondroses 1. it is the destruction of the growth plate in the ___ caused by __
- develops between ages ___ and more common in boys/girls
- symptoms?
- neck of thigh bone (femur), poor blood supply to thighbone
- 5-10 years, boys
- hip pain and problems walking
___ is a bone condition that results from poor blood supply to an area of bone, causing LOCALIZED bone death.
Aseptic necrosis
Schuermann’s Disease: a type of osteochondroses
- a common condition in which changes in ___ cause ___
- Affects mostly boys/girls?
- symptoms?
- humpback (kyphosis) and backache due to changes in the vertebrae.
- boys
- rounded shoulders and PERSISTENT MILD BACKPAIN
Kohler’s bone disease - a type of osteochondroses:
- a rare form of __ of bone and cartilage
- it affects which bones
- usually affects g/b
- symptoms -
- inflammation (osteochondritis)
- small bones (navicular bones) in the foot
- boys
- swollen foot and limping
Identify the osteochondroses disease based on the symptoms:
- mild pain in back that is persistent, shoulders rounded, kyphosis
- swollen foot and limping
- hip pain and problems walking
- pain, swelling, and tenderness in shin
a. Osgood-schlatter disease
b. legg-calve perthes disease
c. scheuermann’s disease
d. kohler’s bone disease
- scheuremann’s disease (C)
- Kohler’s bone disease (D)
- Legg-Calve-Pertes disease (B)
- Osgood-schlatter disease (A)
Osteomalacia-
- is caused by __ deficiency in adults/youth?
- bones ___ b/c the bones contain osteoid tissue that failed to ___ due to lack of Vitamin __
- are all or some bones affected? where in the bone?
- Identified radiographically as?
- Characterized by gradual ___ of bones with ___ pain
- vitamin D, adults
- soften, calcify, D
- ALL bones affected at their epiphyseal growth plates.
- diffuse radiolucency that mimics osteoporosis
- softening and bending of bones with varying severity of pain.
- Osteomalacia often looks like what other disease on radiographs?
- What is the only way to differentiate bw the two
- Osteoporosis (diffuse radiolucency)
2. bone biopsy
- Osteomalacia is the ADULT form of ___
- OSteomalacia occurs more in W/M?
- T/F it may be asymptomatic until a fracture occurs
- Rickets
- WOMEN
- true
- Rickets is ___ in children that causes skeletal __
- it is usually accompanied by listlessness, irritability and general muscle weakness. In Rickets the bone becomes ___ because of failure of osteoid tissue to ___
- osteomalacia, deformities
2. bowed, calcify
TEETH IN CHILD WITH RICKET’S:
- Eruption is early/delayed
- occlusion?
- which dental tissues have developmental abnormalities?
- Is the caries rate affected?
- Eruption is delayed
- malocclusion
- dentin and enamel have abnormal development
- caries rate increases
- __________ - a bone infection usually caused by BACTERIA introduced by trauma/surgery/or nearby infection via bloodstream
- It is an acute/chronic pyogenic/non pyogenic infection of bone?
- which bacteria causes it
- common infection sites? (3)
- symptoms of?
- Osteoyelitis
- acute pyogenic
- Staphylococcus Aureus
- distal femur, proximal end of tibia, proximal end of humerus (upper arm bone)
- pain, redness, swelling, fever, malaise (feeling of general discomfort or uneasiness)
- ____ is a decrease in BONE MASS caused by impaired synthesis or increased resorption of bony matrix protein.
- It results in a predisposition to ___
- Common in what people and in what stage of life?
- treatment?
- Osteoporosis
- pathologic fractures
- thin, elderly white women, associated with postmenopausal bc estrogen deficiency, physical inactivity, hyperthyroidism, and calcium deficiency.
- estrogen therapy, calcium supplemets, vitamin D
____ = osteonecrosis
bone death
- OsteopeTrosis (NOT OSTEOPEROSIS) is aka (2)
- It is an uncommon__ bone disorder of marked ____ in density of bones, causing skeletal abnormalities
- begins at what age
- symptoms:
- What organs may enlarge?
- progressive __ and __ may occur
- marble bone disease, Albert-Schonberg Disease
- hereditary, increase
- infancy
- poor growth and poor weight gain (failure to thrive), easy bruising, abnormal bleeding, and anemia.
- Kidneys and liver may enlarge
- blindness and deafness
- neoplasm is a
- tumor = abnormal mass of tissue as a result of abnormal growth or division of cells
Metaplasia =
(Greek: “change in form”) is the reversible replacement of one differentiated cell type with another mature differentiated cell type
(conversion in cell type)
____(increase in the volume of cells)
Hypertrophy
___(reduced functionality of an organ, with decrease in the number or volume of cells)
Atrophy
___ (connective tissue growth)
Desmoplasia
___ (abnormal proliferation)
Neoplasia
___ (proliferation of cells)
Hyperplasia
____ (congenital below-average number of cells, especially when inadequate)
Hypoplasia
__ (organ or part of organ missing)
Aplasia
___ (structural differentation loss within cell or group of cells)
Anaplasia
NON-NEOPLASTIC BONE DISEASE
- Achondroplasia: one of the most common causes of
- It is genetically an x-linked/autosomal dominant/recessive disorder
- characterized by __ limbs with __ sized head and trunk
- Dwarfism
- autosomal dominant
- short limbs, normal sized head and trunk
NON-NEOPLASTIC BONE DISEASE
- Osteogenesis imperfect: a rare __ disorder that demonstrates the effect of inadequate osteoid production.
- bones are brittle/soft?
- OI results in skeletal fragility, __ skin, poor teeth.
- affect on eyes?
- affect on joints?
- the teeth are poor bc of malformation of ____
- patients have a history of multiple ___
- hereditary
- brittle
- thin
- thin sclera with a blue appearance
- Hypermobility of joints
- dentin (dentinogenesis imperfecta)
- multiple fractures
NON NEOPLASTIC BONE DISORDERS:
- Fibrous dysplasia is when normal bone is __
- there are 3 classifications depending on extensiveness of skeletal movement: name them
- if polyostotic AND endocrine disturbance it is called ___ syndrome
- replaced by fibrous tissue
- Monostotic: one bone
Polyostotic: more than one bone - Albright’s Syndrome
Osteoarthritis = aka (2)
degenerative arthritis
degenerative joint disease
- The most common joint disorder is
2. The most common bone lesion is
- osteoarthritis
2. fracture
- Osteochondroma
- Ostechondroses
- Ostemalacia
- Rickets
- Osteomyelitis
- Osteoperosis
- Osteornecrosis
- Osteropetrosis
- Osteoarthritis
- benign tumor of bone and cartilage (10-25yr athletic boys), long bone ends
- group of diseases that affects growth plate during CHILDHOOD = abnormal bone growth and deformity
- Vit D deficiency = adults bones failed to calcify. all bones
- Vit D def in kids. Same as osteomalacia but in kids, higher caries, dentin and enamel abnormal, delayed eruption of teeth, malocclusion
- Bone infection, staph aureus, distal femur, prox tibia, prox humerus. acute pyogenic
- loss of bone mass, assoc with menopause, age, hyperthyroid, inactivity
- bone death
- increase in bone density, begins in infancy, poor weight and development anemia, liver kidney enlarge, blind, deaf
- chronic joint disorder: degeneration of joint cartilage and adj bone
- Osteoarthritis: chronic/acute joint disorder
- ___ degeneration
- osteoarthritis is classified as primary when?
- It is classified as secondary when?
- Has a higher incidence in w/m over the age of
- chronic
- cartilage and adjacent bone degenerates -can cause pain and discomfort
- when cause is unknown
- when it is caused by another disease (ex Paget’s disease), or an infection, deformity, injury, or overused joint.
- women over 50
Osteoarthritis morphological changes:
- Eburnation of bone =
- Osteophyte
- Heberden’s nodes
- Bouchar’s nodes
- joints most often affected?
- polished ivory like appearance of bone
- bony spur formation that can fracture and float into the synovial fluid along with fragments of separated cartilage called JOINT MICE)
- osteophytes (bone spurs) found in DISTAL interphalangeal joints of fingers
- osteophytes (bone spurs) found in PROXIMAL interphalangeal joints of fingers
- intervertebral joints of the spine, phalangeal joints of fingers, knees, hips
- Rhueumatoid arthritis (RA) = a severely damaging form of arthritis affecting certain bones especially in the
- Begins at ___ age, but first symptoms occur
- w/m affected more?
- __ is a classis microscopic lesion of RA
- hands, feet, knees, ankles, elbows, wrists.
- any age, BEFORE the age of 50
- women
- pannus = tissue formed in the joint affected by the disease, causing loss of bone and cartilage
Still’s Disease is a type of __ in __ people
RA in young people
- Cause of RA?
- But it may be initiated by a __
- some people have a __ tendency to develop the disease
- Research suggests it may be a ___ disease
- unknown
- bacterial/viral infection
- genetic tendency
- autoimmune
- RA is marked by proliferative inflammation of the __ causing deformity, ankylosis, and invalidism.
- the earliest changes in RA occur in the __
- synovial membranes
2. synovia
___ = stiffness of a joint due to abnormal adhesion and rigidity of the bones of the joint, which may be the result of injury or disease.
Ankylosis
RA characteristics:
- serum immunoglobins?
- subcutaneous ___
- symmetric ___
- other symptoms
- anti-IgG antibodies = rheumatoid factor
- rheumatoid nodules
- polyarthritis
- fatigue, malaise, anorexia, weight loss, fever, myalgias
Rheumatoid arthritis (RA) is a ____, inflammatory, peripheral polyarthritis
symmetric