Cartilage & Bone Flashcards

1
Q

Differences between cartilage and CT

A

Cartilage, compared to CT, is harder due to chondromucoid in the matrix, avascular, and cells (chondrocytes) lie in lacuna.

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2
Q

Cartilage Types

A

Hyaline, elastic, and fibrous

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3
Q

Hyaline

A

Most common. Skeletal model for most bones.

In adults replaced by bone except for articular surfaces, costal cartilage, larynx, nose, trachea and bronchi.

Does not calcify under normal conditions in the adult.

Chondrocytes are in “cell nests”

Matrix has collagen fibers (Type II) that cannot be seen
- White glassy appearance covered by perichondrium

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4
Q

Hyaline in depth

A

covered by perichondrium that consists of an outer fibrous layer and an inner cellular layer called chondrogenic that contains stem cells, which, in the absence of blood vessels (in an environment of low oxygen tension), differentiate into chondroblasts. The latter cells synthesize cartilage matrix that is rich in chondromucoid (proteoglycan and glycoprotein), in which are embedded type II collagen fibrils (also synthesized by chondroblasts). The chondroblast entrapped in its own matrix is called chondrocyte, which lies in a space (just like the space surrounding a candle in a cake) called lacuna. Nests of chondrocytes (all originate by division of the same chondrocyte) surrounded by large lacunae and dense matrix called territorial matrix are the hallmarks of hyaline cartilage in H&E-stained section. Type II collagen fibrils are not visible in these sections because they have the same refractive index as that of the matrix in which they are embedded. Examples of hyaline cartilage include most long bones in the fetus and young animals until they are ossified, articular cartilage in adult bones (note, articular cartilage is not covered by perichondrium), and walls of respiratory passages (nose, trachea, larynx, bronchus).

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5
Q

Elastic

A

Like hyaline cartilage, except the matrix contains elastic fibers that impart flexibility and yellowish color to it; examples: pinna of the ear, auditory tube, epiglottis.

Has elastic fibers, perichondrium highly flexible.

Yellow in color and more resilient

Found in external ear, auditory canal, laryngeal cartilages.

Chondrocytes are arranged in cell nests.

 - Elastic fibers are more apparent in the matrix. Identical to hyaline cartilage except for the presence of elastic fibers.
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6
Q

Fibrous cartilage

A

Essentially like dense connective tissue because it contains type I collagen fibers, which are densely packed and longitudinally arranged as in the tendon, except that chondrocytes lies in lacunae and are arranged in rows; examples: intervertebral disks, pubic symphysis, and insertions of some tendons.

Irregular layers of collagenous fibers and very little matrix.
Acts as an intermediate between tendon and cartilage.

Found in Intervertebral discs acts a mechanical shock absorbers

Other examples: ligaments, tendon bone junctions, cardiac skeleton, menisci.

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7
Q

Growth of cartilage

A

Interstitial : Results from cell division of preexisting chondrocytes and occurs in early stages of cartilage formation, articular cartilage, and epiphyseal plates of long bones.

Appositional: results from differentiation of chondrogenic cells in the perichondrium to form new chondroblasts, which lay down a new layer of cartilage matrix at the periphery.

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8
Q

Interstitial Growth of Cartilage

A

New tissue is created within the matrix of existing cartilage
- Cartilage grows from within

Chondrocytes in matrix divide (mitotically), lacunae may possess two, four, eight daughter chondrocytes - isogenous or nest cells.

Increase in matrix volume.

Occurs in existing cartilage and results in growth of cartilage

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9
Q

Appositional Growth of Cartilage

A

New tissue is laid down on the outside of the existing structure
- Cartilage grows from the outside

Mesenchymal cells are found in special aggregates called chondrogenic centers.

Chondroblasts form from these centers. Chondroblasts differentiate into chondrocytes

Chondrocytes deposit matrix (territorial and inter territorial).

Includes new matrix formation on existing cartilage.

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10
Q

Degeneration of Cartilage

A

Chondrocytes hypertrophy and matrix becomes calcified; normal process in endochondral ossification (replacement of cartilage by bone), but it can abnormally occur in an environment of hypercalcemia. Regeneration: very poor, except in young animals, results from the activity of chondrogenic cells in the perichondrium.

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11
Q

General Function of Bone

A

Support, protection, movement, electrolyte balance, and blood formation. Differences between cartilage and bone: Compared to cartilage, bone is harder due to calcification, vascular, canalicular, and grows only by appositional mechanism.

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12
Q

Macroscopic structure of a long bone

A

Shaft, diaphysis; extremities, proximal and distal epiphyses; epiphyseal plate or growth plate, located between epiphysis and diaphysis; metaphysis, a small actively growing area between epiphysis and diaphysis; marrow cavity, a central space that contains bone marrow cells; articular cartilage, the joint surface between two bones; periosteum, an outer covering that consists of an outer fibrous layer and an inner osteogenic layer of stem cells; and endosteum, a layer of bone cells that lines bone marrow, as well as all marrow spaces within a bone.

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13
Q

Epiphyses

A

Trabeculae of spongy bone

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14
Q

Macroscopic structure of a cranial bone

A

Consists of three parts: outer plate( compact), middle diploe (spongy bone), and inner plate (compact)

the outer surfaces of both plates are covered with periosteum, although the periosteum of the inner plate is fused with the dura-mater of the cranial cavity

Inner periosteum is thicker

the inner surfaces of both plates face marrow spaces of the diploe and thus are lined by endosteum.

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15
Q

Microscopic structure of a typical compact bone

A

Consists of ground substance containing inorganic calcium and phosphate salts;

four cell types: osteoprogenitor, osteoblasts, osteocytes, and osteoclasts;

Type I collagen embedded in the matrix, which is arranged in the form of lamellae, which, based upon their location, are classified as: outer circumferential, under the periosteum; inner circumferential, under the endosteum; concentric, a part of osteons (also called Haversian systems); and interstitial, between osteons.

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16
Q

Structure of an Osteon (Haversian system) in depth

A

These are cylinders that run parallel to the diaphysis, just like pillars in a house; have a central space called Haversian canal (also called central canal) that contains blood vessels and is surrounded by 4-20 circumferential lamellae, which contains bone cells, osteocytes; adjacent Haversian canals are connected with each other by Volkmann’s canals, which also connect to the periosteum and endosteum and thus bring blood vessels and nerves to the bone. Three types of osteons, depending upon the type of bone cells that line the Haversian canal: mature osteons are lined by osteoprogenitor cells, forming osteons are lined by osteoblasts, and resorption osteons (also called resorption cavities) are lined by osteoclasts.

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17
Q

Bone cells

A

Osteoprogenitor
Osteoblasts
Osteocytes
Osteoclasts

Osteoprogenitor cells are in the periosteum, endosteum, osteons, and perforating canals

Osteoblasts are on the bone surfaces and synthesize osteoid matrix

Osteocytes are mature osteoblasts, are branched, are in lacunae, and use canaliculi for communication and exchange
Osteocytes maintain homeostasis of bone and blood concentrations of calcium and phosphate

Osteoclasts are multinucleated cells responsible for resorption, remodeling, and bone repair
Osteoclasts belong to the mononuclear macrophage-monocyte cell line and are found in enzyme-eroded depressions (Howship’s lacunae)

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18
Q

Osteoprogenitor

A

stem cells, found in the endosteum, inner layer of periosteum, and Haversian canal; they multiply and some of them become osteoblasts at sites where new bone must be synthesized; may become chondroblasts in an environment of low oxygen tension.

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19
Q

Osteoblasts

A

Bone forming cells, found in the same locations where osteoprogenitor cells are; synthesize osteoid (uncalcified matrix made of type I collagen and osseomucoid) that is subsequently calcified; stress and fractures stimulate osteoprogenitor cells to differentiate into osteoblasts, which build new bone.

Produce Bone Matrix

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20
Q

Osteocytes

A

mature osteoblasts surrounded by their own matrix, therefore, osteocytes do not line the bone surface; like chondrocytes, they also lie in tiny cavities called lacunae, which are interconnected by slender channels called canaliculi; thus neighboring osteocytes in a mature osteon connect with each other via cytoplasmic processes that lie in canaliculi; this canalicular arrangement allows osteocytes to get nutrients from distant vessels (for example, vessels of the central canal), which cannot penetrate the calcified matrix.

Lie in lacunae

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21
Q

Functions of osteocytes:

A

maintenance of bone density and blood concentration of calcium and phosphate; calcium is continuously renewed by osteocytes (osteolytic homeostasis, do not confuse this with bone resorption that occurs at the level of osteoclasts).

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22
Q

Osteoclasts

A

bone eating cells, found on the bone surface (periosteum, endosteum, central canal), multinucleated cells that are derived from monocytes, often lie in pits called Howship’s lacunae, the side of osteoclasts facing the bone surface has ruffled border that is composed of finger-like projections of the cell membrane extending into the Howship’s lacunae, thus increasing the surface area of bone resorption.

reabsorb bone

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23
Q

Spongy bone

A

is composed of interconnected trabeculae, which surround cavities filled with bone marrow. Each trabecula is lined by endosteum containing osteoprogenitor cells, osteoblasts, and osteoclasts (remember all marrow spaces are lined by endosteum); the bony matrix contains osteocytes and may or may not form osteons (note, only thicker trabeculae have osteons).

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24
Q

Immature bone or woven bone

A

it is the primary bone formed for the first time, regardless of when and where; contains more osteocytes and irregularly arranged collagen bundles; is remodeled and replaced by mature bone with time.

First bone tissue to appear in embryonic development and in fracture repair.

Random disposition of fine collagen fibers ( woven bone)

Temporary, replace secondary by bone(adults) except places; tooth sockets, insertions of some tendons.

Lower mineral content (easily penetrated by x-rays)

Higher proportion of osteocytes than in secondary bones.

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25
Q

Bone Marrow

A

is a general term for soft tissue present in the marrow cavity of a long bone and in the spaces of a spongy bone; two types: red and yellow; red: marrow cavity of all bones in young animals are filled with red marrow (myeloid tissue, also called hematopoietic tissue); in adults, however, red marrow turns into fatty yellow bone marrow, except in the skull, vertebrae, sternum, pelvic girdle.

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26
Q

Ossification

A

The bone formation is called ossification, which is two types: intramembranous and endochondral.

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27
Q

Intramembranous

A

bones develop in fibrous sheets called trabeculae; mesenchymal cells lining the trabecula in the presence of blood vessels differentiate into osteoblasts, which synthesize osteoid, which is subsequently calcified. The trapped osteoblasts in a calcified matrix are called osteocytes. Adjacent trabeculae join and form a spongy bone consisting of many trabeculae separated by wide spaces. Trabeculae at the surface of the bone continue to grow and calcify until the spaces between them are filled in, converting the spongy bone to compact bone; examples of intramembranous ossification include flat bones of the skull, part of the scapula and pelvic girdle.

28
Q

Endochondral

A

bone develops from a preexisting model of hyaline cartilage; steps include: formation of periosteal collar in the periphery (note, with the invasion of blood vessels in the perichondrium, chondrogenic cells become osteoblasts and synthesize bone, the perichondrium is now called periosteum), hypertrophy of cartilage cells in the center of the cartilage models, calcification of cartilage matrix, degeneration of cartilage cells, infiltration of periosteal bud carrying blood vessels and osteoblasts in the middle of the cartilage matrix (establishment of primary ossification center in the diaphysis), deposition of woven bone on the calcified cartilage matrix, replacement of woven bone by lamellar bone, repetition of the above sequence of events until the entire cartilage is replaced by bone, except the epiphyseal plate (growth plate), which is responsible for growth in length of the bone. Different zones of the epiphyseal plate are zone of reserve cartilage cells (resting), zone of cell proliferation, zone of hypertrophy, zone of calcification, and zone of ossification. Thus, bone elongation is really the result of interstitial growth of hyaline cartilage, which is continuously replaced by bone until the epiphyseal plate fuses (in other words, becomes bone). Note, bone cannot grow by interstitial mechanism because cells cannot multiply in a calcified matrix; however, bone grows by appositional mechanism, where new bone is formed under the periosteum or endosteum; appositional growth allows bone to grow in width.

29
Q

Bone remodeling

A

In addition to growth, bone is continuously remodeled throughout life by the absorption of old bone and deposition of new bone. Remodeling does not cause any significant changes in its structure, geometry, or size.

Conversely, modeling determines the size, shape and structure of the bone and is limited to the growing bone, no modeling after maturity.

Resorption of osteons involves erosion of parts of lamella leading to a resorption cavities.

After resorption, osteoblasts appear in the resorption cavity and start building a new generation of osteons.

At the completion of the new osteon, remnants of the previous osteon forms an interstitial system.

Remodeling continues throughout life.

30
Q

Role of hormones in bone formation/resorption

A

Parathyroid hormone: activates osteoclastic activity and thus elevates blood calcium level; excess calcium loss renders bone susceptible to fracture, and the resulting hypercalcemia can calcify arteries and certain organs such as the kidney. Calcitonin: produced by parafollicular cells of the thyroid gland, inhibits osteoclastic activity, and stimulates osteoblastic activity and thus prevents the release of calcium from the bone. Growth hormone: produced by the anterior pituitary gland, stimulates overall growth of the body, especially that of the epiphyseal plate; excess growth hormone during growing years causes gigantism and in adult causes acromegaly; deficiency of growth hormone during growing years causes dwarfism.

31
Q

Clinical considerations: Osteoporosis

A

Osteoporosis: decrease in bone mass associated with a normal ratio of mineral to matrix, results from decreased bone formation, increased bone resorption, or both; commonly occurs in old age, postmenopausal women, and immobile patients.

32
Q

Clinical considerations:Osteomalacia

A

Results from calcium deficiency in adults, is characterized by deficient calcification of newly formed bone and decalcification of already formed bone.

33
Q

Clinical considerations: Rickets:

A

Rickets: results from calcium deficiency (vitamin D deficiency is the common cause) in children, characterized by deformed epiphyseal plates.

34
Q

Clinical considerations:Osteopetrosis

A

is a genetic disorder characterized by heavy bones due to defective osteoclastic activity. Acromegaly, dwarfism, and gigantism are discussed above.

35
Q

Cartilage

A

Develops from mesenchyme, consists of cells, connective tissue fibers, and ground substance

36
Q

Cartilage Consists of

A

Cells : Chondrogenic, Chondroblasts and Chondrocytes cells
Fibers : Collagen fibers and Elastic fibers
Matrix : Proteoglycans and Glycosaminoglycans

37
Q

Functions of Cartilage

A

Is strong and rigid but also flexible

Made of cells Chondrogenic (chondroblasts and chondrocytes) and extracellular matrix

Forms supporting framework of some organs

Lines the surface of articulating bones

Forms the template for growth and development of long bones

38
Q

Cartilage Extracellular Matrix (ECM)

A

Cartilage ECM is composed of:

Glycosaminoglycans (GAGs) and proteoglycans
Collagen and/or elastic fibers
These substances make the ECM firm and resistant to mechanical forces.

39
Q

Perichondrium

A

Covers surface of hyaline and elastic cartilage (but not fibrocartilage).
Dense connective tissue composed of fibroblasts and type I collagen fibers.
Contains blood vessels.

40
Q

Mesenchymal stem cells

A

Reach the inner perichondrial layer differentiate into chondroblasts.

41
Q

Chondroblasts

A

Mature, secrete cartilaginous matrix, get trapped in it and become chondrocytes.

42
Q

Chondroclasts

A

Are multinucleated cells that may be involved in lysis of cartilage. Not commonly seen.

43
Q

Cartilage Formation

A

Mesenchyme is the precursor tissue of all types of cartilage.

Mitotic proliferation of mesenchymal cells gives rise to a highly cellular tissue.

Chondroblast are separated from one another by the formation of a great amount of matrix.

Multiplication of cartilage cells gives rise to isogenous groups, each surrounded by a condensation of territorial( capsular) matrix

44
Q

Secondary or Mature Bone

A

Found in adults.

Multiple layers of calcified matrix (each 3-7micrometer) thick –lamellar bone.

Concentric bony lamellae surround small canal with blood vessels, nerves, and loose connective tissue is called an osteon ( haversian system)

Lacunae with osteocytes found between the lamellae

Outer boundary of each osteon is more collagen-rich layer (cement line).

45
Q

Osteons( Haversian Systems)

A

Cylindrical structures (diameter 40-200μm)

Each osteon has a single trophic unit- Haversian canal

Haversian canal involves in the common nutrition of the osteon.

Blood from the periosteum, penetrates the osteons in a transverse direction - Volkmann’s canals.

46
Q

Mature Compact Bone

A

Interstitial Systems
Remodeling of bone is a continuous process involving resorption of osteons and the rebuilding of new osteons.

Interstitial systems represent the remnants of osteons after remodeling.

They are present between regular osteons and can be identified as irregular lamellar structures without central Haversian canal.

47
Q

Types of Osteons and their Morphological Characteristics

A

A. Mature Osteon
- Haversian canal is narrow
- Haversian canal is lined by osteoprogenitor cells
- Lamelle are regular. React to stain

B. Resorption Osteon
- Haversian canal is wide and irregular
- Haversian canal is lined by osteoclast

C. Forming Osteon
- Haversian canal is lined by osteoblast
- Lamelle is closer to the Haversian canal . Take fuchsin/ PAS

48
Q

Appositional growth of Bone

A

Appositional growth occurs when new bone tissue is deposited on the surface of the bone, resulting in bone thickening.

Addition to surface
Osteoprogenitor cells
Bone
Solid matrix
Increases in thickness

49
Q

Interstitial growth of Bone

A

Interstitial growth produces longer bones as the cartilage lengthens and is replaced by bone tissue.,

Addition within
Chondroblasts
Cartilage
Denser Matrix
Increases the length

50
Q

Location of cells in the bone

A

Osteogenic cells
Mesenchymal stem cells in the periosteum and endosteum
Small oval/elongated , pale cytoplasm and oval nuclei.

Osteoblasts
Bone forming cells, found on growing surface bone
Large rounded branched cells, deep basophilic cytoplasm,

Osteocytes - Principal cells of mature bone. Maintain bone matrix.
In small cavities, lacunae, and their processes (branches) extend into canaliculi in the hard matrix.

Osteoclasts - Large multinucleated cells , acidophilic cytoplasm, and brush border (Ruffled border) facing the bone marrow.
Bone eating cells (resorption). Are in bony surfaces in shallow depression called HOWSHIP`S lacunae.

51
Q

Functional correlates:

A

Bones are dynamic structures
There is continuous remodeling and renewal.
Calcium and phosphate are stored and released depending on the activity of hormones.
Calcitonin decreases serum calcium levels and deposits it in bone through a reduction in osteoclastic activity.
Osteoporosis literally means porous bone, a disease in which the density and quality of bone are reduced. (normal ratio of mineral to matrix); occurs in old age and post-menopausal women. Bone resorption increases than bone formation.
Calcitonin encourages bone tissue formation and can be used in clinical treatment of osteoporosis.

52
Q

Osteogenesis

A

Bone can be formed initially by either of two ways

Intramembranous ossification- osteoblasts differentiate directly from mesenchyme and begin secreting osteoid

Endochondral ossification- matrix of preexisting hyaline cartilage is eroded and replaced by osteoblasts producing osteoid.

53
Q

Intramembranous Ossification

A

Bone develops directly from osteoblasts that produce the osteoid matrix

Initially form spongy bone that consists of trabeculae

Mandible, maxilla, clavicle, and flat skull bones are formed by this process

Fontanelles in newborn skull represent areas where intramembranous ossification is occurring

54
Q

slide 49

A
  1. Condensation of mesenchymal tissue and appearance of ossification center
  2. Formation of osteoid and its mineralization
  3. Formation of trabecular bone (spongy bone)
  4. Formation of periosteum and compact bone at the periphery
55
Q

Steps in intramembranous Ossification

A

Occurs in embryonic development- flat bones of the skull (“membrane bones”) and jaw.
1. Capillaries grow into mesenchyme & release oxygen.
2. Surrounding mesenchymal cells round up, differentiate into osteoblasts and form osteoid.
3. Osteoid mineralizes. Osteoblasts become osteocytes.
4. Bone spicules form and enlarge to form trabeculae of immature bone.
5. A single plate (table) of bone is formed.
6. Immature bone is replaced by mature bone.
7. Remodeling continues, and 2 tables of bone are formed.
8. The two tables are separated by diploe:
- Tables represent compact bone
- Diploe represents spongy bone with marrow

56
Q

Endochondral Ossification

A
  1. Hyaline cartilage model calcifies and cells die
  2. Mesenchyme cells in periosteum differentiate into osteoprogenitor and form osteoblasts cells.
  3. Osteoblasts synthesize osteoid matrix, this calcifies, traps osteoblasts in lacunae as osteocytes
  4. Osteocytes establish cell-to-cell communication via canaliculi
  5. Primary ossification center forms in diaphysis and Secondary center of ossification in epiphysis
  6. Epiphyseal plate between diaphysis and epiphysis allows for growth in bone length
    7.Bone marrow cavity forms in the diaphysis as a result of osteoclastic activity furthered by vascularization.
  7. All cartilage is replaced except the articular cartilage
57
Q

Epiphyseal Plate

A
  1. Normally appearing hyaline cartilage
  2. cartilage with proliferating chondroblasts aligned in lacunae as axial aggregates
  3. Degenerating cartilage with hypertrophic cells and condensed matrix
  4. Chondrocyte disappeared area where matrix is undergoing calcification
  5. Blood vessels and osteoblasts have invaded the lacunae of the old cartilage, producing marrow cavities and osteoid for new bone
58
Q

Functi

A
59
Q

Bone Fracture Healing

A

Blood vessels torn bleed which clots to produce a large hematoma.
Clot is gradually removed by macrophages and replaced by a soft fibrocartilage-like mass ( procallus tissue) rich in collagen and fibroblasts. If broken, the periosteum re-establishes continuity over this tissue.
Procallus tissue is invaded by regrowing blood vessels and osteoblasts.
Later( few weeks) fibrocartilage is gradually replaced by trabeculae of primary bone, forming a hard callus throughout the original area of fracture.
Primary bone is remodeled as compact and cancellous bone in continuity with the adjacent uninjured areas and fully functional vasculature is re-established.

60
Q

Role of Parathyroid hormone in Bone Formation/Resorption and Clinical Considerations

A

Increases osteoclastic activity, leads to hypercalcemia; hypocalcemia stimulates parathyroid hormone secretion from parathyroid gland.

61
Q

Role of Calcitonin Hormones in Bone Formation/Resorption and Clinical Considerations

A

Inhibits osteoclastic activity, stimulates osteoblastic activity; hypercalcemia stimulates calcitonin secretion from parafollicular cells of thyroid gland.

62
Q

Role of Growth Hormones( GH) in Bone Formation/Resorption and Clinical Considerations

A

Stimulates growth at the epiphyseal plate; increased secretion of GH leads to giantism in young animals and acromegaly (thickening of extremities) in adult animals; decreased GH secretion leads to dwarfism.

63
Q

Role of Osteoporosis:Clinical Considerations

A

Decrease in bone mass (thin bone) associated with a normal ratio of mineral to matrix; occurs in old age and post-menopausal women (estrogen deficiency). Bone resorption increases than bone formation.

64
Q

Osteomalacia: Clinical Considerations

A

Soft bone due to calcium and vitamin D deficiency in adults, resulting in poor calcification of newly formed bone and decalcification of the already formed bone (impairment of mineralization).

65
Q

Rickets: Clinical Considerations

A

Soft bone, especially enlarged growth plates (cartilage matrix fails to calcify properly) in children due to calcium and Vitamin D deficiency (Vitamin D is needed to absorb calcium in the intestine.

66
Q

Role of Osteopetrosis and Clinical Considerations

A