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Pathophysiology II - MSK > Bones > Flashcards

Bones Flashcards

1
Q

What are the functions of the skeletal system?

A 
Support (Weight, teeth, organs) 
Protection (Skull, Ribs, Vertebrae) 
Movement 
Reservoir (Calcium, Phopsphorus)
Hematopoiesis
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2
Q

How many bones are in the body?

A

206

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3
Q

What bones compose the axial skeleton?

The rest of the bones are a part of the ____________ skeleton?

A

Skull, Vertebrae, Ribs

Appendicular

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4
Q

Bones of which TWO girdles attach the appendicular skeleton to the axial skeleton?

A

Pectoral

Pelvic

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5
Q

What are the FOUR types of bones?

A

Long
Short
Flat
Irregular

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6
Q

All limb bones are considered long bones except which bones?

A
  1. Patella
  2. Wrist Bones
  3. Ankle Bones
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7
Q

T/F: Finger bones are considered short bones

A

False

They are considered long bones

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8
Q

Bones of the hand/wrist and foot/ankle are considered _____ bones

A

Short Bones

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9
Q

The scapula, sternum, ribs, and most skull bones are considered ________ bones

A

Flat

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10
Q

Bones that have abnormal shapes and do not fit into the classification of either long, short, or flat would be considered what?

What are some examples of these?

A

Irregular bone

Scapula
Vertebrae
Hip Bones
Sphenoid
Ethmoid
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11
Q

The outer layer of bone is ________ (dense/spongy) and is referred to as ________ (compact/non-compact) bone

A

Outer layer…….

Dense

Compact bone

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12
Q

The inner layer of bone is ________ (dense/spongy) and has needle like projections called ________.

A

Inner Layer…..

Spongy

Trabeculae

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13
Q

What are the bone building cells?

A

Osteoblasts

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14
Q

T/F: Osteoblasts synthesize and secrete collagen

A

True

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15
Q

What cells are responsible for maintaining bone tissue?

HINT: These are also referred to as mature bone cells

A

Osteocytes

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16
Q

Osteocytes become trapped within the bone _____ in which they were secreted

A

Matrix

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17
Q

What HUGE cells of the bone are responsible for the digestion of the matrix (bone resorption)?

A

Osteoclasts

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18
Q

Where are osteoclasts primarily concentrated?

A

Endosteum

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19
Q

Osteoclasts are created through fusion of 50 or more ________.

A

Monocytes

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20
Q

Osteoclasts pump out ______ ions to create an _______ environment to eat away at the matrix

A

H+ Ions

Acidic

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21
Q

What mechanism do osteoclasts use to create the acidic environment?

A

Proton Pump:

Breaks down H2CO3- into H+ and HCO3-

Exports H+ with Cl-

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22
Q

What advantage does having a ruffled plasma membrane offer?

A

Increased Surface Area

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23
Q

Why is it important to have osteoclasts ‘eating’ away at the bone?

A

To allow for remodeling

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24
Q

Why are depressions often seen in the bone underneath an osteoclast?

A

Due to the acidic environment (H+ ions) eating away at the bone

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25
Q

1/3rd of the bone is made up of ________ (organic/inorganic) components while 2/3rds of the bone is made up of _________ (organic/inorganic) components

A

Organic

Inorganic

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26
Q

The organic material of bones consists primarily of _________ which is secreted by (osteoblasts/osteocytes/osteoclasts)

A

Proteins

Secreted by Osteoblasts

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27
Q

What is the ‘main protein’ in the organic material of bone?

What is this responsible for?

A

Collagen

Provides Resilience and ability to stretch
Resist over-stretching and twisting

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28
Q

What TWO salts compose the inorganic material in bones?

When these two salts interact, what do they form?

A

Calcium Phosphate
Calcium Hydroxide

Hydroxyapatite

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29
Q

Other than the calcium salts, what THREE ‘minerals’ can be found in the inorganic portion of bones?

A

Magnesium
Fluoride
Sodium

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30
Q

The inorganic components of bone allow for resistance to what?

A

Compression

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31
Q

The _________ of the bone consists of a thick collar of compact bone surrounding a central marrow cavity

A

Diaphysis

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32
Q

What collar is bone marrow in long bone in CHILD?

What color in ADULTS?

A

Children: Red

Adults: Yellow, Fatty

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33
Q

What is another name for the end of long bones?

A

Epiphyses

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34
Q

In the epiphyses, ________ (compact/spongy) bone covers _________ (compact/spongy) bone

A

Compact Bone covers Spongy Bone

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35
Q

Epiphyses are covered by ________ cartilage to reduce friction during movement

A

Articular Cartilage

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36
Q

What is the name of the double-layered membrane covering the external surface of a bone?

Does this cover joint surfaces?

A

Periosteum

No, the peristeum does not cover joint surfaces

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37
Q

What connects the periosteum to the bone matrix?

A

Collagen

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38
Q

T/F: The periosteum is POORLY supplied by nerve fibers, lymphatics, and blood vessels

A

False

It is richly supplied by those

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39
Q

Through what foramen do blood vessels enter the bone shaft?

A

Nutrient Foramen

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40
Q

What is the name of the delicate connective tissue that covers the internal surface of bones?

A

Endosteum

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41
Q

T/F: The endosteum covers the trabeculae of spongy bone in the marrow cavities

A

True

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42
Q

Endosteum contains both ________ and _________.

A

Osteoblasts

Osteoclasts

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43
Q

Do short, flat, and irregular bones have a diaphysis or epihysis?

A

No

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44
Q

Where do short, flat, and irregular bones contain bone marrow?

A

Trabeculae

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45
Q

In flat bones, what is the name of the internal spongy bone?

A

Diploe

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46
Q

Bone marrow occupies which cavity in long bones?

A

Medullary Cavity

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47
Q

T/F: Bone marrow exists in the larger haversian canal

A

True

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48
Q

What are the TWO main types of bone marrow?

A

Red

Yellow

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49
Q

Red bone marrow is also considered ________ tissue

A

Hematopietic Tissue

50
Q

Does bone marrow contain mature or immature RBCs?

Can bone marrow contain adipocytes?

A

Immature

Yes, scattered amounts

51
Q

T/F: Yellow bone is considered hematopietically active

A

False

It is hematopietically INACTIVE

52
Q

Under what circumstance could yellow bone marrow return to red marrow?

A

Anemia (Severe, Chronic)

53
Q

Where does red marrow exist in adults?

A

Pectoral Girdle
Pelvic Girdle
Head of the Femur
Head of the Humerus

54
Q

Compact bones contain what cylindrical structures which act as weight bearing pillars and are arranged parallel to one another?

A

Osteons (Harversian Systems)

55
Q

In a Osteons (Harversian System), what is the name of the central canal that is surrounded by bone matrix?

What are FOUR things that pass through the above canal?

A

Haversian Canal

Arteries
Veins
Lymphatics
Nerves

56
Q

What is the name of the concentric ‘tubes’ that surround the haversian canals?

A

Lamellae

57
Q

Collagen fibers in neighboring lamellae run in ________ (The same/Opposite) directions, helping bone to better withstand twisting forces.

A

Opposite

58
Q

What is the name of the canals that run perpendicular to the Haversian canals?

What are these responsible for?

A

Volkman’s Canal

They bring blood and nerve supply from the periosteum to the haversian canals and to the medullary cavity

59
Q

What is the name of the space that lies between intact osteons?

A

Interstitial Lamellae (Incomplete lamallae)

60
Q

Osteocytes occupy small cavities known as ________?

A

Lacunae

61
Q

What connects one lacunae to another one?

What type of ‘junctions’ allow for the exchange of nutrients, wastes, and chemical signals?

A

Canaliculi

Gap junctions

62
Q

Does spongy bone contain a haversian system?

A

No

63
Q

How does spongy bone get its blood supply if…..

the bone marrow is red?

the bone marrow is yellow?

A

Red: From the Marrow

Yellow: From Volkman’s Channels

64
Q

Prior to week 8, human embryonic skeleton ______ (fibrous/bony) membranes and cartilage

A

Fibrous

65
Q

After week 8, the fibrous membranes and cartilage of the embyronic skeleton begin to be replaced by what?

A

Bone

66
Q

____________ (Intramembranous/Endochondral) ossification involves the development of bone from fibrous membranes

A

Intramembranous Ossification

67
Q

____________ (Intramembranous/Endochondral) ossification involves the replacement of hyaline cartilage with bone

A

Endochondral Ossification

68
Q

What bones undergo intramembranous ossification ?

Prior to undergoing this what are these called?

A 
Skull Cap
Facial Bones
Clavicles
Pelvis
Scapulae
Mandible

These are called Mesenchyme

69
Q

What are the FOUR steps of intramembranous ossification?

A
  1. Create an Ossification center
  2. Create a bone maintenance mechanism
  3. Vascularization
  4. Maturation
70
Q

What is Step 1 of intramembranous ossification?

A

Mesenchymal Cells cluster together and secrete organic material for the bone matrix which become mineralized through the crystallations of calcium salts

Mesenchymal cells eventually differentiate into osteoblasts

71
Q

What is Step 2 of intramembranous ossification?

A

Osteoblasts differentiate into osteocytes

72
Q

What is Step 3 of intramembranous ossification?

A

Bone grows outward from the ossification center in SPICULES

Blood vessels branch from the spicules

73
Q

During what step of ossification does the periosteum form?

A

Step 3

74
Q

T/F: Compact bone forms around the spicules in step 4 of ossification

A

True

75
Q

During Step 4 of ossification what populates the spongy bone?

A

Red Bone Marrow

76
Q

Most bones in the body develop via the __________ (intramembranous/endochondral) ossification model

A

Endochondral

77
Q

How does endochondral ossification work?

A
  1. Large chondrocytes grow creating large spaces in the center of bones, when they dies large spaces remain
  2. Blood vessels fill those spaces brings in osteoblasts creating ossification centers
  3. Compact bone then forms around these centers to form the shaft of bones
  4. Bone replaces cartilage to form the epiphysis
  5. Secondary ossification centers are created in the epiphysis, and a cartilaginous area remains to become the epiphyseal growth plate
78
Q

T/F: Growth plates exist at primary ossification sites

A

False

Growth Plates exist at secondary ossification centers

79
Q

Epiphyseal cartilage (close to the epiphysis) of the epiphyseal plate _________ (Divides/Transforms) to create more ________(cartilage/bone)

While the diaphyseal cartilage (close to the diaphysis) of the epiphyseal plate is __________ (Divided/Transformed) into _________ (bone/Cartilage).

This __________ (increases/decreases) the length of the shaft.

A

Divides
Cartilage

Transformed
Bone

Increases

80
Q

Osteoblasts beneath the periosteum excrete bone matrix on the __________ (internal/external) surface of the bone making it thicker

Osteoclasts in the endosteum break bone on the ________ (internal/external) surface to widen the medullary cavity

What does this process result in?

A

External

Internal

This results in a increase shaft diameter without changing the relative amount of bone

81
Q

During puberty osteoblasts begin producing bone _______ (faster/slower) than the rate of epiphyseal expansion

A

Faster

This happens until the growth plate gets narrower and narrower until it finally closes

82
Q

What is precocious puberty?

What is this a risk factor for?

A

This occurs when the body goes into puberty to soon and can result in a shorter stature

83
Q

Proper healing of a fracture depends on what?

A

Blood Supply

Cellular Components of the bone

84
Q

A fracture is considered ______ when both ends penetrate the skin

A

Open

85
Q

A fracture is considered ________ when there are 3 or more bone fragments

Is this more common in children or the elderly?

A

Comminuted

Elderly

86
Q

What type of fracture is more common in children and is described as a bone bending but not completely breaking?

A

Greenstick Fracture

Bone in children has more collagen and is less mineralized

87
Q

A fracture is considered ________ one one bone fragment is driven into the medullary space or spongy area of another bone

A

Impacted

88
Q

In regards to bone healing after a fracture……

Immediately after a fracture extensive bleeding occurs, which will ultimately result in a _________.

What happens as a result of this?

A

Hematoma

Bone cells are deprived of nutrient and die resulting in pain, swelling, and inflammation

89
Q

In regards to bone healing after a fracture……

The hematoma will then be infiltrated by capillaries and _______ which gradually clean up debris to form _________ _______

A

Macrophages

Granulation Tissue

90
Q

In regards to bone healing after a fracture……

Once granulation tissue forms, fibroblasts will produce ________ to span across the break, which will differentiate into ________ and begin making the cartilage matrix

A

Collagen

Chondroblasts

91
Q

In regards to bone healing after a fracture……

Within the granulation tissue, osteoblasts will begin forming what?

A

Spongy Bone

92
Q

In regards to bone healing after a fracture……

The entire structure of granulation tissue, chondroblast, and osteoblasts is referred to as what?

A

Fibrocartilagenous Callus

93
Q

In regards to bone healing after a fracture……

Over 6-8 weeks following a fracture, the number of _________ increase converting the callus into a ______ callus

A

Trabeculae

Bony

94
Q

In regards to bone healing after a fracture……

In the late stages, ________ will dismantle the temporary structures while ________ will rebuild the compact bone

A

Osteoclasts

Osteoblasts

95
Q

What is the most common fracture that results in avascular necrosis of the hip?

What artery is interrupted in this case?

A

Femoral Neck Fx

Medial Femoral Circumflex Artery

96
Q

What fracture in the hand can commonly be complicated by AVN?

Which artery is involved in the case?

A

PROXIMAL Scaphoid Bone

Radial Artery

97
Q

In what “anatomical” location can the scaphoid be palpated?

A

Anatomical Snuffbox

98
Q

AVN of the scaphoid results in survival of the _______ (proximal/distal) portion of the scaphoid) and death of the ___________ (proximal/Distal) portion of the scaphoid

A

Distal (Survives)

Proximal (Dies)

99
Q

What is Wolff’s Law?

A

Bone will grow or remodel in response to the forces or demands placed upon it.

100
Q

Why might you suspect someone whose been a powerlifter for 15 years to have heavy, massive bones, especially at the point of muscle insertion?

A

Remember Wolff’s Law

Bone will continue to remodel in response to the force and demand placed on it

So in this case, bone will increase in size to meet the demands placed on it

101
Q

Astronauts tend to experience bone atrophy after they’re in space for an extended period of time. Why?

A

Remember Wolff’s Law

Bone will continue to remodel in response to the force and demand placed on it

So in this case, the bone will shrink because there is not a lot of force acting on it

102
Q

T/F: Normal bone growth/maintenance can occur w/o sufficient dietary intake of calcium and phosphate salts.

A

False

It will NOT occur

103
Q

Calcium and Phosphate are absorbed in the intestines through what hormone?

What vitamin is this hormone made from?

A

Calcitrol

Vitamin D

104
Q

Other than Vitamin D……

What vitamins are essential in bone growth?

A

Vitamin C, A, K, B12

105
Q

Growth hormone and thyroxine ____________ (Stimulate/Halt) bone growth

A

Stimulate

106
Q

How does GH influence bone growth?

Thyroxine?

A

GH Stimulates Protein synthesis and cell growth

Thyroxine stimulate metabolism and osteoblast activity

107
Q

Which hormone (estrogens or androgens) causes the faster closure of growth plates

A

Estrogens

108
Q

Is precocious puberty more common in men or women?

A

Women

109
Q

Insulin stimulates bone ________ (formation/degradation)

Glucocorticoids stimulate ___________ (osteoblasts/osteoclasts)

A

Formation

Osteoclasts

110
Q

Which TWO hormones antagonistically work to maintain Ca2+ levels in the blood?

Which one increases Ca2+ levels?

Decreases?

A

PTH (Increases Ca2+ levels)

Calcitonin (Decreases Ca2+ levels)

111
Q

Calcitonin is released by which cells in the thyroid?

A

C-Cells

112
Q

Calcitonin __________ (decreases/stimulates) osteoclast activity.

Calcitonin __________ (decreases/stimulates) osteoblast activity.

A

Decreases Osteoclast Activity (less bone breakdown = less Ca2+ in the blood)

Increases Osteoblast Activity (More Ca2+ from blood into bone matrix)

113
Q

PTH binds to __________ (Osteoblast/Osteoclasts)

What occurs because of this?

A

Osteoblasts

Decreases osteoblast activity
Osteoblsts will then release osteoclast stimulating factor increasing osteoclast activity

114
Q

PTH increases Ca2+ absorption by __________ (increasing/decreasing) calcitrol synthesis

A

Increasing

115
Q

PTH _________ (increases/decreases) Ca2+ excretion in the urine and ___________ (increases/decreases) phosphate excretion in the urine

A

Decreases Ca2+ Excretion

Increases Phosphate Excretion

116
Q

Osteomalacia is often referred to as “soft bones”.

What are common causes of this?

A

Insufficient Ca2+ in the diet
Insufficient Vitamin D
Insufficient exposure to sunlight

117
Q

What is the children’s form of osteomalacia referred to as?

What bones is this commonly seen in?

A

Rickett’s

Legs (Bowed)
Pelvis
Ribs
Skull

118
Q

___________ is described as inflammation of the bone and bone marrow by pus-forming bacteria that enter the body typically via a wound.

A

Osteomyelitis

119
Q

___________ is described as a group of diseases in which bone resorption occurs faster than deposition.

Bone becomes extremely porous?

A

Osteoporosis

120
Q

What types of fractures are common in patients with osteoporosis?

A

Compression
Colles
Femur Fractures

121
Q

When are women more likely to develop osteoporosis?

A

Post-Menopausal

Remember that estrogen stimulates osteoblasts and inhibits osteoclasts

Pathophysiology II - MSK (4 decks)

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