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HES 311: Pathophysiology 2.0 > Week 4 - Bone Physiology, Fractures, Healing > Flashcards

Week 4 - Bone Physiology, Fractures, Healing Flashcards

1
Q

What are the 4 types of bone cells?

A
  1. osteocytes
  2. osteoblasts
  3. osteoclasts
  4. osteogenic cells
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2
Q

Compact bone

A
  • ~80% of bone mass
  • dense outer layer
  • allows bone to resist bending and otrsion
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3
Q

Spongy bone

A
  • ~20% of bone mass
  • deep to compact bone, mesh-like trabeculae
  • allows bone to resist forces in many directions
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4
Q

Bone marrow

A
  • found in medullary cavity and within spongy bone
  • yellow and red marrow
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5
Q

Yellow bone marrow

A
  • found in long bones of adults
  • adipose tissue
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6
Q

Red bone marrow

A
  • site of hematopoiesis
  • cranium, vertebral body, ribs, sternum, ilium, proximal epiphyses of humerus and femur
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7
Q

Bone remodeling: formation and reabsorption

A
  • balanced activity between osteoclasts and osteoblasts
  • modulated by hormones and physical stress
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8
Q

What is a fracture

A

a complete or partial break in a bone

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9
Q

4 Types of bone fracture classifications

A
  1. complete or incomplete
  2. open or closed
  3. number of fracture lines
  4. direction of fracture lines
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10
Q

Complete bone fracture

A

bone is broken to form 2+ pieces

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11
Q

Incomplete bone fracture

A
  • bone only partially severed
  • more common in children because of softer bone (e.g. greenstick fracture - bending of softer bone)
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12
Q

Open (compound) bone fracture

A
  • skin is broken
  • bone fragments may protrude through skin
  • usually more damage to soft tissue surrounding the bone
  • higher risk of infection
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13
Q

Closed bone fracture

A
  • skin not broken through
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14
Q

Simple bone fracture

A
  • single break
  • bone ends maintain alignment and position
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15
Q

Comminuted bone fracture

A

multiple fracture lines and bone fragments

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16
Q

Compression fracture

A

bone is crushed into smaller pieces and collapses

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17
Q

Spiral bone fracture

A

angles around the bone

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18
Q

Transverse bone fracture

A

across the bone

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19
Q

Oblique bone fracture

A

at an angle with respect to the diaphysis

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20
Q

longitudinal (linear) bone fracture

A

along the axis of the bone

21
Q

Impacted bone fracture

A

one end forced into the other at the location of the break

22
Q

Stress fracture

A

repeated excessive stress

23
Q

Pathologic bone fracture

A
  • weakness in bone structure due to other conditions
  • can cause spontaneous fractures
  • e.g. osteoporosis, bone tumor
24
Q

Fracture signs and symptoms

A
  • pain, swelling, bruising, altered sensation, inability to move limb or bear weight
  • affected area may look misaligned, shortened, deformed
25
Q

Fracture treatments

A
  • immediate immobilization
  • surgery if needed
  • exercise to maintain range of motion, muscle mass, circulation
26
Q

3 steps to broken bone healing process

A
  1. inflammatory phase
  2. reparative phase
  3. remodeling phase
27
Q

Bone healing - inflammatory phase

A
  • hematoma & edema
  • immune cells recruited
28
Q

bone healing - reparative phase

A
  • granulation tissues -> procallus -> callus
29
Q

Bone healing - remodeling phase

A
  • Callus -> remodeling -> healed bone
30
Q

Bone healing - hematoma formation physiology

A
  • bone breaks
  • bleeding from blood vessels in bone and periosteum
  • bleeding around bone from soft tissue damage
  • clot forms in the medullary cavity, under the periosteum and between bone fragments
  • hematoma
31
Q

Bone healing - inflammatory response and granulation tissue physiology

A
  • bone cell necrosis because of halted nutrient delivery
  • inflammatory response due to cell damage and presence of debris at the site
  • part of hematoma includes fibrin network formation
  • growth of granulation tissue (new connective tissue) within the fibrin network
  • new capillaries form, phagocytes remove debris and fibroblasts migrate here
32
Q

bone healing - Procallus (fibrocartilage) formation physiology

A
  • fibroblasts and chondroblasts lay down new collagen to produce cartilage matrix
  • the two bones become splinted together by a fibrocartilaginous procallus (not strong enough to bear weight but acts as a preliminary bridge repair
33
Q

bone healing - bony callus formation and remodeling physiology

A
  • osteoblasts generate new bone over the fibrocartilage model (procallus)
  • procallus is replaced by bone (bony callus)
  • during the following months, in response to mechanical stresses on the bone, repaired bone is remodeled by osteoblasts and osteoclasts activity. excessive callus removed and more compact bone laid down
34
Q

How does age affect bone healing timeline?

A

Kids: 1-2 months
Adults: 2+ months

35
Q

Factors that can impair bone healing

A
  • extent of damage
  • systemic factors
  • other complications
36
Q

Complications of fractures

A
  • broken ends of bone can damage surrounding structures
  • compartment syndrome
  • fractures of long bones
  • ischemia due to cast compression
  • infection
37
Q

Complication of fractures - compartment syndrome

A

bleeding or edema -> increased pressure inside limb -> impaired blood supply and potential for tissue necrosis

38
Q

Complications of fractures - long bone fractues

A

potential for release of adipose from fractured area and enters the blood stream (obstruction of blood flow to the lungs and/or brain)

39
Q

Long-term complications of fractures

A
  • healing abnormalities
  • mobility complications
  • side-effects of long-term immobilization
40
Q

Malunion bone healing

A

healing with a deformation

41
Q

Delayed union bone healing

A

requires time to heal

42
Q

Nonunion bone healing

A

failure to heal

43
Q

Lumbar Lordosis

A

spine curves inwards at lower back

44
Q

Common risk factor of Lumbar Lordosis

A

central obesity

45
Q

Kyphosis

A

‘hunchback’; rounded upper back

46
Q

Common risk factor of kyphosis

A

poor posture

47
Q

Scoliosis

A

S or C shaped sideways curvature of the spine

48
Q

Common risk factor of scoliosis

A

genetics

49
Q

Lumbar lordosis and exercise treatment

A
  • results in anterior pelvic tilt
  • build strength in hip extensors
  • build strength in abdominals

HES 311: Pathophysiology 2.0 (11 decks)

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