ZL

BONE HOMEOSTASIS

Bone Tissue Lecture Notes

Calcium Homeostasis

  • Day-to-Day Control of Calcium Regulation:

    • Involves several key hormones:

    • PTH (Parathyroid Hormone):

      • Stimulates osteoclastic activity, leading to an increase in serum calcium levels.

    • Critical for maintaining calcium homeostasis.

    • Works by acting on the bones, kidneys, and intestines.

    • Increased production of cyclic AMP in response to low blood calcium (Ca²+) levels.

    • Calcitonin (Thyrocalcitonin):

    • Stimulates osteoblastic activity, thereby lowering serum calcium levels.

    • Functions alongside hGH (human Growth Hormone) and sex hormones that have a lesser effect on calcium regulation.

    • Vitamin D:

    • Essential for the absorption of Ca²+ and PO₄³⁻ ions from the small intestine.

    • Necessary for the reabsorption of these ions from the kidneys, supporting overall calcium homeostasis.

    • Hormonal Control:

    • The regulation of serum Ca²+ levels and the process of mineralizing bone is tightly controlled and balanced by hormonal interactions.

Fracture and Repair

  • Fracture Classification:

    • Fractures can be categorized based on different criteria:

    • Anatomical Appearance:

      • Partial: Bone is not broken all the way through.

      • Complete: Fracture traverses through the entire bone.

      • Closed (Simple): Skin remains intact.

      • Open (Compound): Fracture punctures the skin.

      • Greenstick: A small linear break in the bone cortex, similar to breaking a green twig.

      • Impacted: The distal part of the bone is pushed into the proximal part.

      • Comminuted: Bone is shattered into several pieces.

      • Spiral, Transverse, Displaced: Describe specific fracture patterns based on the direction and placement of the fracture.

    • Disease or Mechanism of Injury:

      • Pathological Fracture: Results from cancerous processes or chronic diseases.

      • Compression Fracture: Caused by extreme forces, such as trauma.

      • Stress Fracture: Result of repetitive stress or activities, such as running.

    • Eponymous Fractures:

      • Named after individuals; includes:

      • Colles' Fracture: A fracture of the distal radius, often involving displacement.

      • Pott's Fracture: A fracture of the distal fibula, often accompanied by injury to the ankle.

  • Fracture Repair Process:

    • Phase 1: Formation of fracture hematoma

    • Occurs 6-8 hours post-injury.

    • Results from blood vessels breaking in the periosteum and osteons.

    • Phase 2-3: Formation of callus

    • Involves phagocytes cleaning up cellular debris.

    • Fibroblasts deposit collagen to form a fibro-cartilaginous callus which takes a few weeks to months to develop.

    • Phase 4: Formation of bony callus

    • Osteoblasts form new spongy bone over the fibro-cartilaginous callus.

    • Phase 5: Remodeling

    • Takes several months.

    • Spongy bone is replaced by compact bone, with visible signs of the fracture often disappearing but some evidence remaining.

Exercise and Bone Tissue

  • Mechanical Stress Effect on Bones:

    • Under mechanical stress (e.g., from muscle pull and gravity), bone tissue strengthens through the deposition of mineral salts and collagen fibers produced by osteoblasts.

    • Conversely, unstressed bones weaken as mineral deposits decrease.

  • Real-World Implication:

    • Astronauts in microgravity conditions suffer rapid loss of bone density due to the absence of mechanical stress.

Aging and Bone Tissue

  • Effects of Aging on Bone Mass:

    • A decrease in bone mass is observed as sex hormone levels decline during middle age, particularly in women after menopause.

    • This leads to an imbalance where bone resorption by osteoclasts surpasses bone deposition by osteoblasts.

    • Impact on Females:

    • Women typically have smaller bones than men, experiencing a more pronounced effect of aging on bone density.

  • Two Principal Effects of Aging on Bone Tissue:

    • Loss of Bone Mass:

    • The calcium loss from bones is a common symptom associated with osteoporosis.

    • Brittleness:

    • Collagen fibers are responsible for tensile strength in bone tissues.

    • As protein synthesis declines with age, tensile strength reduces, making bones more susceptible to fractures.

  • Osteoporosis:

    • A condition characterized by bone resorption outpacing deposition, often due to calcium depletion and inadequate intake.