Skeletal Activities - Bone fracture, Healing, and Treatment

Question 1

bone grows in length via __________ and in width via __________

Answer 1

• endochondral ossification

- appositional growth

Question 2

7 stages in initial bone development through endochondral ossification

Answer 2

• hyaline cartilage model
• calcification of cartilage
• primary ossification center formation
• medullary cavity development
• secondary ossification centers formation
• formation of compact bone
• mature bone

Question 3

______ and ______ cartilage growth causes the cartilage model to lengthen and broaden

Answer 3

• interstitial

- appositional

Question 4

Does a medullary cavity occur in a secondary ossification center?

Answer 4

No

Question 5

During fetal bone development, cartilage is entirely replaced by bone except for __________ and __________

Answer 5

• epiphyseal growth plate

- articular cartilage

Question 6

In mature bone the only cartilage remaining is where?

Answer 6

on the articular suraces

Question 7

_________ spongiosa is made up of immature trabeculae

Answer 7

primary

Question 8

_________ spongiosa is made up of mature trabeculae

Answer 8

secondary

Question 9

________: the sculpting process that follows the elongation of growth. process by which the overall shape is changed in response to physiologic and/or mechanical influence

Answer 9

bone modeling

Question 10

during bone modeling, bone formation occurs at the ________ surface and bone resorption occurs at the ________ surface

Answer 10

• periosteal surface

- endosteal surface

Question 11

________: wherein old bone is resorbed by osteoclasts and replaced by new bone at the same surface

Answer 11

bone remodeling

Question 12

(bone modeling/bone remodeling) does NOT result in a change in the shape or position of bone

Answer 12

bone remodeling

Question 13

3 things that can shift the balance between bone formation and resorption

Answer 13

• drugs
• hormones
• mechanical forces

Question 14

What does BRU stand for?

Answer 14

Bone Remodeling Unit

Question 15

4 stages a BRU goes through

Answer 15

• resorption
• reversal
• formation
• resting

Question 16

_____: BRU stage where osteoclasts break down mineralized matrix, creating an erosion cavity

Answer 16

resorption

Question 17

_____: BRU stage where mononuclear cells prepare bone surface for new osteoblasts that will form bone

Answer 17

reversal

Question 18

_____: BRU stage where osteoblasts synthesize osteoid, which is then mineralized

Answer 18

formation

Question 19

_____: the BRU holding stage between remodeling cycles

Answer 19

resting

Question 20

_______ is a condition where bone resorption outweighs bone formation, commonly seen in human females following menopause

Answer 20

osteoporosis

Question 21

bone adapts to loading by modifying its ________ and/or ____________

Answer 21

• mass

- architecture

Question 22

_______: a break in the continuity of bone

Answer 22

fracture

Question 23

5 areas of fracture classification

Answer 23

• etiology
• displacement
• relation to the external environment
• pattern
• location

Question 24

3 etiological categories of fractures

Answer 24

• traumatic
• pathologic fracture
• stress fracture

Question 25

2 displacement categories for a fracture

Answer 25

- undisplaced | - displaced

Question 26

2 categories for a fracture's relation to the external environment

Answer 26

- simple/closed | - compound/open

Question 27

8 types of fracture patterns

Answer 27

- transverse - oblique - spiral - comminuated - avulsion - impacted - fissure - greenstick

Question 28

3 categories of fracture location

Answer 28

- growth plate - trabecular bone cortical bone

Question 29

3 signs of fracture

Answer 29

- lameness - pain - swelling

Question 30

Fracture treatment can depend on what 5 factors?

Answer 30

- type of fracture - age - health - owner's finances - surgeon's technical expertise

Question 31

6 factors that impair bone fracture healing

Answer 31

- advanced age - poor nutritional status - inadequate blood supply - soft tissue between fractured ends of bone - inadequate immobilization - infection at frature site

Question 32

4 arterial blood supplies to long bones

Answer 32

- nutrient artery (marrow cavity) - metaphyseal artery - epiphyseal artery - periosteal artery

Question 33

at heavy periosteal attachments, the outer 1/3 is supplied by branches of periosteal arteries (________) and the inner 2/3 is supplied by branches of the nutrient artery (________)

Answer 33

- centripetal flow | - centrifugal flow

Question 34

at sites of loose periosteal attachment, nearly the entire cortex is supplied by _________ flow from the _____________

Answer 34

- centrifugal flow | - nutrient artery

Question 35

centripetal flow to the cortical bone is supplied by the ______ arteries

Answer 35

periosteal

Question 36

centrifugal flow to the cortical bone is supplied by the _______ arteries

Answer 36

branches of the nutrient artery

Question 37

2 types of bone healing

Answer 37

- direct (primary) bone healing | - indirect (secondary) bone healing

Question 38

__________ bone healing accounts for 1 % of clinical cases and _________ bone healing accounts for the other 99%

Answer 38

- direct | - indirect

Question 39

Which type of bone healing does not require callus formation?

Answer 39

direct bone healing

Question 40

_______ bone healing only occurs under conditions of absolute fracture stability

Answer 40

direct

Question 41

_______ bone healing occurs via direct osteonal remodeling

Answer 41

direct

Question 42

________ bone healing occurs when fixation and stabilization are inadequate for direct osteonal remodeling

Answer 42

indirect

Question 43

_______ bone healing requires the formation of a fibrous/cartilaginous callus to proceed

Answer 43

indirect

Question 44

_________ occurs in areas of cortical bone by the energy of the trauma itself

Answer 44

necrotic bone

Question 45

necrotic bone removal is accomplished by _____

Answer 45

osteoclasts

Question 46

________: the unit that re-establishes the Haversian structure of the cortex during direct bone healing

Answer 46

cutter cone

Question 47

the 2 components of the cutter cone

Answer 47

- osteoclasts at the tip of a capillary bud that crosses the fracture site - behind the osteoclasts, a cuff of osteoblasts lays down concentric lamellae of bone (osteons)

Question 48

4 stages of indirect (secondary) bone healing

Answer 48

- inflammation - soft callus - hard callus - remodeling

Question 49

hematoma formation occurs during the _______ stage of indirect bone healing

Answer 49

inflammation

Question 50

the repair stage of indirect bone healing includes the formation of the ________ and _________

Answer 50

- soft callus | - hard callus

Question 51

In a fracture, the periosteum will be torn where?

Answer 51

Opposite the point of impact

Question 52

2 key components to management of bone fractures

Answer 52

- fixation | - stabilization

Question 53

_____: apposition of bone fragments

Answer 53

apposition

Question 54

______: preventing the movement of bone fragments

Answer 54

stabilization

Question 55

2 types of fracture nonunions

Answer 55

- vascular | - avascular (atrophic)

Question 56

______: type of nonunion in which a callus forms but the fracture fails to heal

Answer 56

vascular

Question 57

_______: type of nonunion where a bone callus fails to form

Answer 57

avascular (atrophic)

Question 58

which type of nonunion has a better chance at recovery?

Answer 58

vascular

Question 59

6 methods of stimulating bone fracture healing

Answer 59

- implantation of cancellous bone autograft - percutaneous injection of bone marrow cells - implantation of bone graft substitute - bone morphogenic protein (BMP) - electrical or ultrasound stimulation - shock wave treatment

Question 60

What is the most commonly used method of bone fracture stimulation used by veterinary orthopods?

Answer 60

implantation of cancellous bone autograft