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COM: MSK (Midterm) COPY > DSA: Bone > Flashcards

DSA: Bone Flashcards

1
Q

What are the 2 major functions of bone?

A

1) Support and protection of the body and its organ 2) A reservoir for calcium and phosphate ions

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2
Q

What type of bone is tubular?

A

Long bones

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3
Q

What type of bone is cuboidal and found only in the tarsus and carpus?

A

Short bones

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4
Q

What type of bone usually serves protective functions?

A

Flat bones

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5
Q

What type of bone are the bones of the face?

A

Irregular - Irregular bones are various shapes other than long, short or flat

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6
Q

What do sesamoid bones protect tendons from?

A

Excessive wear and other change the angle of the tendons as they pass to their attachments

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7
Q

_________ is a layer of specialized CT with osteopenia potential that surrounds most bones

A

Periosteum

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8
Q

________ is the marrow wall of the diaphysis and is lined with osteoprogenitor cells

A

Endosteum

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9
Q

What are the organic components of bone?

A

Type I collagen Proteoglycans Noncollagenous proteins

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10
Q

What are teh 3 main noncollagenous proteins found in bone?

A

Osteocalcin

Osteopontin

Osteonectin

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11
Q

What are the inorganic components of bone?

A

Calcium Hydroxyapatite

Magnesium

Potassium

Sodium

Fluoride

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12
Q

What classification of bone has an outer solid cortex of bone which encloses an inner layer of spongy bone, and is lamellar?

A

Compact bone

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13
Q

What classification of bone has an inner layer of spongy bone with spaces for bone marrow, is lamellar or woven, and contains trabeculae?

A

Spongy

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14
Q

Lamellar bone is also known as what classification of bone?

A

Compact

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15
Q

Trabecular or cancellous bone is also known as what classification of bone?

A

Spongy

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16
Q

________ bone is adult bone, where as _________ bone is immature bone.

A

Lamellar; woven (non-lamellar)

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17
Q

________ bone is mechanically strong and forms slowly, whereas ________ bone is mechanically weak and forms rapidly

A

Lamellar; woven

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18
Q

Is lamellar bone visible in H&E?

A

No -> dried or ground sections only

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19
Q

How are collagen fibers arranged in lamellar bone?

A

Regular parallel arrangement

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20
Q

How are collagen fibers arranged in woven bone?

A

Loose arrangement

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21
Q

What is woven bone replaced by?

A

Lamellar

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22
Q

What is the mineral and cell content like in woven bone?

A

Lower mineral content, more cells

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23
Q

What type of bone forms during fracture repair and remodeling?

A

Woven

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24
Q

________________ are observed between osteons and separated from them by a thin layer known as the cement line

A

Interstitial lamellae

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25
Q

_______________________ are visualized at the external surface of the compact bone under the periosteum

A

Outer circumferential lamellae

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26
Q

_________________ are seen on the internal surface of lamellar bone subjacent to the endosteum

A

Inner circumferential lamellae

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27
Q

_______________ is a longitudinal canal that houses capillaries and post capillary venules in the center of the osteon

A

Haversian canal

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28
Q

_________________ is a transverse or oblique canal connecting Haversian canals with one another, containing blood vessels derived from the bone marrow and some from the periosteum

A

Volkmann’s canal

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29
Q

__________ are trapped in the calcified matrix and occupies a lacuna and is responsible for maintenance and turnover of the bone matrix

A

Osteocytes

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30
Q

__________ are pockets in bone that contain osteocytes and are found between lamellae

A

Lacunae

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31
Q

___________ connect osteocytes to each other and to the Haversian canal

A

Canaliculi

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32
Q

___________ found in bone has a high binding affinity for hydroxyapatite and is a blood biochemical marker of osteogenesis

A

Osteocalcin

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33
Q

__________ found in bone binds to type I collagen and hydroxyapatite

A

Osteonectin

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34
Q

__________ found in bone participates in anchoring of osteoclasts to bone by formation of a sealing zone before resorption

A

Osteopontin

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35
Q

Osteocalcin and osteopontin increase following stimulation with what?

A

Active vitamin D

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36
Q

_____________ bones develop when additional ossification centers appear and form extra bones.

A

Accessory (supernumerary) bones - Many bones develop from several centers of ossification and the separate parts normally fuse. Sometimes one of these centers fails to fuse with the main bone, giving the appearance of an extra bone -> careful study shows that the apparent extra bone is a missing part of the main bone

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37
Q

Circumscribed areas of bone are often seen along the structures of the cranium where the flat bones abut, particularly those related to the parietal bone. These small, irregular, worm-like bones are _________ bones.

A

Structural bones (wormian bones)

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38
Q

It is important to know that accessory bones are common in what structure to avoid mistaking them for bone fragments in radiographs and other medical images?

A

The foot

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39
Q

Bones sometimes form in soft tissues where they are not normally present. Horse riders often develop _____________ bones in their thighs (rider’s bones), probably because of chronic muscle strain resulting in small hemorrhagic areas that undergo calcification and eventually ossification.

A

Heterotropic bones

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40
Q

Trauma to a bone may break it. For the fracture to heal properly, the broken ends must be brought together, approximating their normal position. What is this called?

A

Reduction of a fracture

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41
Q

During bone healing, the surrounding ____________ proliferate and secrete collagen which forms a collar of ________ to hold bones together

A

Fibroblasts; callus - Bone remodeling occurs in the fracture area and the callus calcifies

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42
Q

Why are fractures more common in children than adults?

A

Because of the combination of their slender, growing bones and carefree activities

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43
Q

Fractures are more common in children than in adults. Many fractures that occur in children are what type of fracture?

A

Green stick fractures -> incomplete breaks caused by bending of the bones **Fractures in growing bones heal faster than those in adults*

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44
Q

During the aging process, the organic and inorganic components of bone both decrease, often resulting in what?

A

Osteoporosis -> a reduction in the quantity of bone, or atrophy of skeletal tissue - Bone becomes brittle, loses its elasticity and fracture easily - Bone scanning is an imaging method used to assess normal and diminished bone mass

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45
Q

Examination of bone marrow provides valuable information for evaluating what kind of diseases?

A

Hematological (blood) diseases

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46
Q

Because it lies just beneath the skin and is easily accessible, the __________ is a commonly used site for harvesting bone marrow.

A

Sternum

47
Q

The age of a young person can be determined by studying the ________________ in bones

A

Ossification centers

48
Q

The fusion of epiphysis with the diaphysis occurs 1-2 years earlier in what gender

A

Girls

49
Q

How does starvation and illness affect growing bone?

A

Proliferation of cartilage at the metaphysics slows down but the degeneration of cartilage cells in the columns continues, producing a dense line of provisional calcification -> these lines later become bone with thickened trabeculae or lens of arrested growth

50
Q

Loss of arterial supply to an epiphysis or other parts of a bone results in avascular necrosis. After every fracture, small areas of adjacent bone undergo necrosis. In some fractures, avascular necrosis of a large fragment of bone may occur. In a number of clinical disorders of epiphyses in children result from avascular necrosis, these disorders are referred to as what?

A

Osteochondroses

51
Q

Label A-D

A

A) Interstitial lamellae

B) Outer circumferential

C) Osteon/Haversian system

D) Lacuna

52
Q

Label E-I

A
53
Q

What type of bone is found where tendons insert, such as teeth sockets?

A

Woven bone

54
Q

What is characteristic of the inner layer of periosteum?

A

Preosteoblasts (osteoprogenitor cells)

Osteogenic layer

55
Q

What is characteristic of the outer layer of periosteum?

A

Rich in blood vessels and nerves

Fibroblasts and collagen fibers

Sharpeys fibers

56
Q

What are sharpeys fibers?

A

Anchoring collagen fibers that penetrate the outer circumferential lamellae

57
Q

Which layer of the periosteum is highly innervated and is why breaking bones hurts?

A

Outer layer

58
Q

What part component of bone covers spongy walls, extends into all cavities of bones, and contains osteoprogenitor cells, reticular stromal cells of bone marrow and connective tissue fibers?

A

Endosteum

59
Q

What do osteoprogenitor cells give rise to?

A

Osteoblasts

60
Q

What are osteoprogenitor cells?

A

They are precursor cells that self-replicate, or differentiate into bone-forming cells

61
Q

What are osteoblasts?

A

Bone-forming cells that deposit osteoid and control subsequent mineralization

62
Q

What are osteocytes?

A

Modified osteoblasts that become surrounded by newly formed bone

63
Q

What are osteoclasts?

A

Macrophage-type cells that resorb bone in the remodeling process

64
Q

What do osteoclasts have high levels of?

A

Acid phosphatase and collagenase

65
Q

Where do osteoclasts come from?

A

Circulating monocytes

  • Will fuse together (multinucleated)
66
Q

When osteoclasts are attached to bone they have a ruffled edge called what?

A

Howship’s lacunae -> a small resorption bay/pit

67
Q

How are osteoblasts and osteoclasts different based on size?

A

Osteoclasts are much bigger/multinucleated

68
Q

Where do osteoclasts attach to the bone for resorption?

A

Howship’s lacunae

69
Q

_______________ is a disorder of bone, characterized by decreased mineralization of newly formed osteoid at sites of bone turnover (bone become soft)

A

Osteomalacia

**ONLY ADULTS**

70
Q

What 3 things cause osteomalacia?

A

Dietary vitamin D deficiency

Lack of sun exposure

In the US GI disease

71
Q

Bone and joint pain, muscle weakness, fracture, difficulty walking and waddling gait, and muscle spasms and cramps are all signs and symptoms of what bone related disorder?

A

Osteomalacia

72
Q

How does GI disease contribute to osteomalacia?

A

Unable to absorb Ca2+, PO4+ and vitamin D

73
Q

What cells are most affected in osteomalacia and why?

A

Osteoblasts because this is a problem with mineralizing the bone. You have osteocalcin binding Ca2+ and an osteonectin binding the type I collage in bone as well as Ca2+, both of these protein secreted by osteoblasts. To secrete these proteins you need vitamin D and here you have a deficiency so osteoblasts are most affected

74
Q

What lab values of calcium, phosphorus and alkaline phosphatase would be expected in osteomalacia?

A

Calcium = decreased or normal

Phosphorus = decreased or normal

Alkaline phsophatase = increased

75
Q

Why would alkaline phosphatase levels be increased in a pt with osteomalacia?

A

Osteoblasts are trying but cant mineralize bone

76
Q

What would you expect bone to look line on an X-ray of a pt with osteomalacia?

A

You will see a bunch of pseudofractures, not true fractures. Milkman pseudofractures

77
Q

What would restore the milkman pseudofractures seen in pts with osteomalacia?

A

Restoring vitamin D

78
Q

In what developmental stage is osteogenesis happening?

A

In embryo

79
Q

What form of ossification uses a mesenchymal template?

A

Intramembranous ossification

80
Q

What form of ossification uses a cartilage template?

A

Endochondral ossification

81
Q

What form of ossification forms the frontal and parietal bones and part of the occipital, temporal, mandible, maxilla and clavical?

A

Intramembranous ossification

82
Q

Which form of ossification forms the portions of the basicranium, long bones, pelvic and pectoral girdles and ribs?

A

Endochondral ossification

83
Q

During intramembranous ossification, mesenchyme will differentiate into __________, which will secrete osteoid, as osteoid becomes mineralized it will trap these cells now called ___________ and will start formation of _________ bone

A

Osteoblasts; osteocytes; woven

84
Q

During intramembraneous bone formation, at the same time osteoid deposition is occuring, the mesenchyme will start to condense to form the __________ and _______. This CT will be forming at the same time

A

Periosteum and endosteum

85
Q

Toward the end of intramembranous ossification, osteoid is continually laid down forming spongy bone trabeculae that will eventually convert the spongy bone to what?

A

Compact bone

86
Q

During intramembranous ossification, where do osteocytes become trapped?

A

within the calcified osteoid

87
Q

What are the 4 main steps of intramembranous ossification?

A

1) Condensation of mesenchyme into soft sheet permeated with blood capillaries
2) Deposition of osteoid tissue by osteoblasts on mesenchymal surface; entrapent of first osteocytes; formation of periosteum
3) Honeycomb of bony trabeculae formed by continued mineral deposition; creation of spongy bone
4) Surface bone filled in by bone deposition, converting spongy bone to compact bone; persistence of spongy bone in the middle layer

88
Q

What are the 6 main steps of endochondral ossification?

A

1) Mesenchum devleops into a body of hyaline cartilage covered with a fibrous perichondrium (will grow in thickness)
2) Perichondrium stops producing chondrocytes and starts producing osteoblasts
3) Blood vessels penetrate the bony collar and invade the primary ossification center
4) devleopment of the medullary cavity
5) Chondrocyte enlargement and death create a secondary ossification center in the epiphysis
6) The epipysis will fill with spongy bone

89
Q

Where do chondrocytes begin to die in endochondral ossification?

A

In the primary ossification center

  • This is where they are in the middle and enlarge and die
90
Q

What produces the primary marrow cavity during endochondral ossification?

A

Blood vessels penetrating the bony collar and invading the primary marrow cavity

91
Q

What cell type forms the thin collar of bone during endochondral ossification?

A

Osteoblasts

92
Q

During endochondral ossification, after the primary marrow cavity is formed ________ line the cavity and deposit osteoid and form the spongy bone. A wave of cartilage death progresses toward the endof the the bone and __________ follow the wave enlarging the marrow cavity of the diaphysis

A

Osteobasts; osteoclasts

93
Q

_________ growth happens at the epiphyseal plates in children. Only _________ growth can occur in adults

A

Interstitial; appositional

94
Q

During endochondral ossification, cartilage is limited to what?

A

The epiphyseal plate

95
Q

________ refers to deficient mineralization of cartilage at the growth plate, as well as architectural disruption of this structure

A

Rickets

96
Q

What type of rickets is caused by calcium deficiency?

A

Calcipenic rickets

97
Q

What are the 2 things that can cause calcipenic rickets?

A
  • Insufficient intake or metabolism of vitamin D
  • INsufficient intake or absorption of calcium in the setting of normal vitamin D levels
98
Q

Delayed closure of the fontanelles, parietal and frontal bossing, craniotabes (soft skul bones), widening of the wrist and bowing of the distal and radius ulna and progressive lateral bowing of the femur and tibia are all signs of what disease?

A

Rickets

99
Q

What cells would be most affected in rickets and why?

A

Chondrocytes because chondrocytes arent able to start the initial calcification in the zone of cell hypertrophy so they will be unable to move down into zones 4 and 5

100
Q

What lab values would you expect for calcium, phosphorus and alkaline phosphatase in patients with rickets?

A

Calcium = decreased or normal

Phosphorus = decreased or normal

Alkaline phosphatase = increased

101
Q

What is the most common skeletal dysplasia causing short-limb dwarfism?

A

Achondroplasia

102
Q

What type of bones are affected in achondroplasia?

A

Long bones are affected while the cranial and vertebral bones are spared

103
Q

What is the mutation causing achondroplasia?

A

FGFR3 (fibroblast growth factor receptor 3) mutation on chromosome 4

*normally controls as signal that stops chondrogenesis*

104
Q

How does the FGFR3 mutation lead to dwarfism?

A

FGFR3 becomes overactive -> inhibits cartilage synthesis resulting in decreased endochondral bone formation and premature ossification of the growth plates

105
Q

What zone of endochondral ossification is most affected in pts with achondroplasia?

A

Proliferative zone (zone 1)

  • stopped it from starting to stack into the columns
106
Q

What are the 4 steps in the conversion of trabecula into an osteon?

A

1) ridges in periosteum create groove for periosteal blood vessel
2) Periosteal ridges fuse, forming an endosteum-lined tunnel
3) Osteoblasts in endosteum build new concentric lamellae inward toward center of tunnel, forming new osteon
4) Bone grows outward as osteoblasts in periosteum build new circumferential lamellae. Osteon formation repeats as new periosteal ridges fold over blood vessels

107
Q

Why do we need to form an osteon from trabecula?

A

to develop lamellar bone so that its stronger, more mature, and more stable

108
Q

What are the 4 general steps of compact bone remodeling within an osteon?

A

1) activation
2) Resorption
3) Reversal
4) formation

109
Q

What bone disease is characterized by low bone mass, microarchitecture disruption, and skeletal fragility, resulting in decreased bone strength and an increased risk of fracture?

A

Osteoporosis

110
Q

What populations of individuals does osteoporosis commonly occur in?

A

Postmenopausal caucasian women and the elderly

111
Q

What are the signs of osteoporosis?

A

No clinical manifestations occur until there is a fracture

112
Q

What cells would be most affected in an individual with osteoporosis and why?

A

Osteoclast activity outplaces osteoblast activity

  • There is typically a balance between osteoblasts and osteoclasts, but the osteoclast activity is starting to be the primary mechanism, which will be breaking down more bone than is being formed
113
Q

What would the lab values of calcium, phosphorus, and alkaline phosphatase be in an individual with osteoporosis?

A

All normal!

114
Q
A

COM: MSK (Midterm) COPY (23 decks)

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