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what do bones begin as?
cartilage
when does cartilage form?
third week of fetal development
when happens around the sixth week of fetal development?
ossification begins
when do bones stop growing?
at age 25
what is osteogenesis?
bone formation
what is ossification?
the process of replacing other tissues with bone
what is endochondral ossification?
when bone replaces existing hyaline cartilage
what is intramembranous ossification?
when bone develops directly from the stem cells of connective tissue
briefly describe the 6 steps of endochondral ossification
matrix thins, struts begin to calcify
osteoblasts begin producing a thin layer of bone around the shaft of the cartilage
bone develops begins at the primary ossification center
bones enlarge
capillaries and osteoblasts migrate into the secondary ossification center
epiphysis fills with spongy bone
growth plate begins to grow
how do bones lengthen in interstitial growth?
as long as epiphyseal cartilage continues to grow on the epiphyseal surface, bone continues to grow in length
osteoblasts in the shaft continuously invade cartilage and replaces it with bone
new cartilage is added in the epiphyseal
what does bone growth look like in the youth?
osteoblasts invade at the same rate as the epiphyseal cartilage expands
bones continue growing
what does bone growth look like in puberty?
rising levels of sex, growth, and thyroid hormones stimulate bone growth
bone-making osteoblasts produce faster than chondrocytes produce new epiphyseal cartilage
epiphyseal cartilage gradually decreases until it disappears
what does bone growth look like in adults?
epiphyseal closure
remnants of the end of epiphyseal growth creates the epiphyseal line
where does intramembranous ossification occur? what does it produce? give some examples
occurs in the deeper layers of the dermis
produces:
dermal bones (i.e. mandible, clavicle, cranial skull bones)
briefly describe the 3 steps of intramembranous ossification
stem cells differentiate into osteoblasts
developing bone grows outwards in small struts
spicules (bony spikes) fuse together
spongy bone in the intramembranous bone remodels around blood vessels to produce osteons of compact bone
what are the 3 blood supplies of mature bone?
nutrient artery and vein
metaphyseal vessels
periosteal vessels
describe the nutrient artery and vein: where is it located?
single pair of large blood vessels
enters the diaphysis through the nutrient foramen
what do the metaphyseal vessels supply blood to?
epiphyseal cartilage
what do periosteal vessels supply blood to?
superficial osteons
briefly describe 3 functions of the adult skeleton
maintains itself
replaces mineral reserves
recycles and renews bone matrix
involves osteocytes, osteoblasts, and osteoclasts
how does the turnover rate vary?
if deposition (osteoblasts) is greater than removal (osteoclasts), bones get stronger
if removal (osteoclasts) is faster than replacement (osteoblasts), bones get weaker
why is exercise important?
what are the effects of exercise? what about the lack of exercise?
bones adapt and change shape based on the stresses put on them
exercise allows osteoblasts and osteoclasts to break down “damaged” bone & replace it with healthy bone
exercise:
more stress leads to thicker bones
bumps and ridges at muscle attachment become more prominent
lack of exercise:
causes bones to become weak and brittle
after a few weeks, bones can lose up to a 1/3 of their mass
concerns astronauts and bedridden patients
how does the skeleton act as a calcium reserve? what parts of the body require calcium ions?
bones store calcium and other minerals
calcium ions are vital to:
membranes
neurons
muscles cells
especially heart cells
what is a bone fracture?
when the bone is cracked or splintered due to physical injury
what components are required to repair a fracture?
blood
periosteum and endosteum cells
osteoblasts
osteocytes
briefly describe the 4 steps of bone fracture repair
bleeding & clotting create a fibrous network
calluses stabilize the bone break
osteoblasts replace callusus with spongy bone
osteoblasts and osteocytes remodel
describe the 2 categories of fractures
open v. closed
open: projects through the skin (higher risk of infection)
closed: does not break the skin
displaced v. nondisplaced
displaced: obvious deformity
nondisplaced: bone is still inline
describe the 5 types of fractures
transverse: shaft breaks along the long axis
greenstick: one side frayed, the other twisted but not fractured (seen in children)
comminuted: one or more bones displaced or shattered
spiral: twisting force
epiphyseal: fracture where bone growth is still happening; can impact future growth
what is osteopenia? when does it occur?
when bones become thinner and weaker with age
(inadequate ossification) osteoblast activity declines while osteoclasts remain the same
begins between ages 30 and 40
why do we lose bone mass?
what percent do women lose bone mass per decade? what about men?
we produce less sex hormones as we age
women lose 8% bone mass/decade
menopause greatly impacts bone loss
men lose 3% bone mass/decade
what bones are most affected during aging bone loss?
epiphyses
vertebrae
jaws
what are the effects of aging bone loss?
fragile limbs
height reduction
tooth loss
what is osteoporosis? what does it affect? when does it occur? include what percentage men/women are affected
severe bone loss
affects normal function
occurs over the age of 45
29% of women
18% of men
what are the causes of osteoporosis?
malnutrition
low estrogen
lack of calcium/vitamin D
smoking
excessive drinking
lack of exercise
what does MCL mean? what is its function?
medial collateral ligament
function: prevents side-to-side knee movement
what does ACL mean? what are its functions?
anterior cruciate ligament
functions:
prevents excessive front-to-back sliding of the knee
prevents the tibia from sliding in front of the femur
what are the causes of ACL/MCL tears?
rapid direction change
sudden stopping
incorrectly landed jump
what are the symptoms of ACL/MCL tears?
“pop” noise
pain
swelling
loss in range of motion
tenderness
discomfort walking
what are the 2 types of treatments for ACL/MCL tears? describe them and their pros/cons
nonsurgical:
allows use during recovery; increases the chance of reinjury
brace
physical therapy
surgical:
high success rate, long-term treatment; longer and more painful recovery
ligament reconstruction
what can the ACL/MCL both do?
stretch and “loosen” knee