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140 . Foundations of Anatomy and Clinical Practice > Osteology, Fractures and Fracture Healing > Flashcards

Osteology, Fractures and Fracture Healing Flashcards

1
Q

How many bones are in the human skeleton?

A

206

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2
Q

Which is the largest and smallest bone in the human body?

A 
Largest = femur
Smallest = stapes
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3
Q

What are the different bone types in the human body?

A 
Long
Short
Flat
Irregular
Sesamoid
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4
Q

Classify each of the following bones:

  • Cuboid
  • Humerus
  • Patella
  • Vertebrae
  • Sternum
A 
Cuboid = Short
Humerus = Long
Patella = Sesamoid
Vertebrae = Irregular
Sternum = Flat
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5
Q

What is the main function of flat bones?

A

Protecting organs in the body especially vulnerable ones such as the lungs

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6
Q

List some of the functions of bones:

A 
Protection
Locomotion and Support
Through muscle attachment
Storage of Mineral Salts
Production of Red Blood Cells (RBC)
Secretory endocrine organ
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7
Q

Bones are important in storage of mineral salts, specifically which of these are important in the bones?

A

Calcium and Phosphate

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8
Q

Certain bones are hemopoietic, what does this mean?

A

They contain stem cells which specialise into red blood cells

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9
Q

Explain the function of bone as a secretory endocrine organ

A

Osteocalcin which has a regulatory effect on insulin

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10
Q

What gives bones a smooth, white outer appearance?

A

The compact / cortical bone

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11
Q

What is the function of compact / cortical bone

A

Protection, support and movement

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12
Q

In which bones is cancellous / spongy bone found?

A

Short, Flat and Irregular bones (and the ends of long bones)

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13
Q

Describe the structure of compact / cortical bone:

A

Compact bone is densely structured and incredibly hard

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14
Q

Describe the structure of cancellous / spongy bone:

A

Open cell, porous network with trabeculae

likened to the structure of honeycomb

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15
Q

What are trabeculae?

A

Stress lines in cancellous / spongy bone which withstand force in certain directions

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16
Q

Describe the structure of a long bone:

A 
The shaft is comprised entirely of compact / cortical bone to provide resistance to compression
The epiphysis (ends) are comprised mainly of cancellous / spongy bone to provide multi-directional force resistance
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17
Q

Describe the structure of a flat bone:

A

Cancellous / spongy bone sandwiched between a thick layer of compact / cortical bone to provide protection whilst remaining light

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18
Q

Describe the structure of a short bone:

A

Cancellous / spongy bone surrounded by a very thin layer of compact / cortical bone, cancellous / spongy bone allows absorption of a variety of force directions

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19
Q

Describe the structure of an irregular bone:

A

Cancellous / spongy bone surrounded by a very thin layer of compact / cortical bone, cancellous / spongy bone allows absorption of a variety of force directions

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20
Q

What are the three main parts of a long bone?

A

Epiphysis – upon
Metaphysis – after
Diaphysis – through

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21
Q

What is the epiphysis?

A

The end of a long bone
Forms articulation with another bone at a joint
Receives pressure and bears weight

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22
Q

What is the metaphysis?

A

The neck of a long bone

Contains growth plates in U25s

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23
Q

What is the diaphysis?

A

The shaft of a long bone
Made of compact / cortical bone
Contains the bone marrow cavity

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24
Q

In which section of a long bone is the bone marrow cavity?

A

Diaphysis (shaft)

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25
Q

Where in a long bone are the growth plates found?

A

Metaphysis (neck)

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26
Q

What is the periosteum?

A

The most external structure of a long bone, formed of two layers: the outer fibrous layer and inner osteogenic layer

27
Q

What is the most external layer of a long bone?

A

Periosteum (two layers - the outer layer is more external, this is called the outer fibrous layer)

28
Q

What is the most internal layer of a long bone?

A

Haversian systems (osteons) and interstitial lamellae

29
Q

What are the different transverse layers of a long bone?

A

Periosteum is the most external structure
Circumferential lamellae
Compact bone

30
Q

What is the Volkmann’s canal?

A

A structure in the circumferential lamellae which allows the neurovascular bundle to pass through a bone

31
Q

What separates the Haversian systems from the Endosteum and Marrow cavity?

A

Inner circumferential layers (onion layers)

32
Q

What is Endosteum?

A

A single layer of connective tissue in long bones which contains Osteoprogenitor (stem) cells

33
Q

What is the structure of woven bone?

A

A haphazard arrangement of collagen fibres

34
Q

Where is woven bone found

A

Fetal bones and Calluses (fracture healing)

35
Q

What are the 3 main components of bone?

A 
Extracellular matrix (type I collagen, protein gel)
Inorganic mineral salt (calcium, phosphate)
Bone cells (osteoblasts, osteocytes, osteoclasts, osteogenic cells)
36
Q

What are the different bone cells?

A

Osteocyte (maintains bone tissue)
Osteoblast (form bone matrix)
Osteogenic cell (stem cell)
Osteoclast (reabsorbs older bone)

37
Q

Explain why bone is not an inert tissue:

A

When a bone is subject to stress, small electrical signals stimulate osteocytes for bone growth. Cells respond to strengthen the region along the line of stress

38
Q

What is a fracture?

A

A loss of continuity within the substance of a bone

39
Q

What can cause a fracture?

A

Trauma, pathology or prolonged exposure to high force (a rather all-encompassing definition)

40
Q

What is the different between a bone fracture and a bone break?

A

There is no difference between a fracture and a break

41
Q

What is a stress fracture?

A

Where a bone has a prolonged exposure to a high force

42
Q

Through what means can fractures be classified?

A

Mechanism (traumatic / pathologic)
Open or closed
Joint involvement
Displacement (displaced / non-displaced)
Pattern (linear / spiral / oblique / wedge / avulsed / segmental)
Fragmentation (complete / incomplete / communited)

43
Q

What is meant by a traumatic fracture?

A

A fracture arising from a high force, e.g. a car crash

44
Q

What is meant by a pathologic fracture?

A

A fracture arising from a smaller force but the bone is weakened, e.g. the bone has a tumour present so content is less

45
Q

What is meant by a closed fracture?

A

A fracture where the skin is still intact, the fracture occurred within the body

46
Q

What is meant by an open fracture?

A

A fracture where the bone fragment has penetrated the skin

47
Q

What is meant by a fracture with joint involvement?

A

A fracture located at the articulating part of a bone

48
Q

What is meant by a fracture with no joint involvement?

A

A fracture located not at the articulating part of a bone

49
Q

What is meant by a displaced fracture?

A

A fracture where bones can be translated, rotated, angulated or overlapping

50
Q

What is meant by a non-displaced fracture?

A

A fracture where the bone remains in its relative anatomical position

51
Q

What is meant by the pattern of a fracture?

A

A descriptive of a fracture from a radiograph, such as linear, spiral, oblique, wedge, avulsed or segmental

52
Q

What is meant by a complete fracture?

A

A fracture where bones remain in contact, e.g. a hairline fracture

53
Q

What is meant by an incomplete fracture?

A

A fracture where bones are separated

54
Q

What is meant by a communited fracture?

A

A fracture where the bone has been fractured into multiple fragments (often specular on an x-ray

55
Q

What type of fracture are amongst the hardest to resolve?

A

Open and Communited sue to the complexity of piecing bones back together and the risk of infection inevitably lead to surgery

56
Q

Is fracture healing a repair or regeneration process?

A

Regeneration process

57
Q

What is the difference between repair and regeneration?

A 
Repair = tissue formed in healing is different to what was there before
Regeneration = tissue formed in healing is same as what there was before
58
Q

What are the two main types of fracture healing?

A

Primary and Secondary

59
Q

What are the different stages of secondary fracture healing?

A
  1. Haematoma
  2. Cellular proliferation and cartilage model formation
  3. Callus formation
  4. Consolidation of callus
  5. Remodelling
60
Q

Explain the formation of a haematoma:

A

Trauma to the structure of bone disrupts blood vessels causing a bleed
Undamaged periosteum will prevent blood regress
Clotting factors and platelets stimulate clotting of blood
Torn blood vessels lead to necrosis at bone ends
New blood vessels, stimulated by acidic conditions of cellular breakdown and VGF sprout from undamaged vessels and grow towards site
Cellular proliferation occurs as stem cells begin differentiation into osteoblasts and chondroblasts

61
Q

Describe fracture healing in cancellous bone:

A

Same 5 stages as secondary healing
Outer layer healing lags behind cancellous healing and no callus formation occurs, overall the fracture heals quickly with few complications

62
Q

What local factors may affect the rate of healing of a fracture?

A

Fracture characteristics
Infection
Blood supply

63
Q

What systemic factors may affect the rate of healing of a fracture?

A 
Age
Obesity
Anaemia
Endocrine conditions
Steroid use
Malnutrition
Smoking
64
Q

Give a very rough guide to time taken for fracture healing:

A

Bones join in 8 weeks:
Double this for the lower limbs
Half this for children

140 . Foundations of Anatomy and Clinical Practice (12 decks)

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