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23 spring: ortho > Test 1 bone healing > Flashcards

Test 1 bone healing Flashcards

1
Q

osteoblasts are made from

A

mesenchymal stem cells

make osteoid (make bone)

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2
Q

osteoclasts are made from

A

hematopoietic stem cells

eat bone

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3
Q

cortical bone is also called

A

lamellar bone

(strong dense on outside of long bones)

made of columns of osteons

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4
Q

spongy bone is also called

A

cancellous/trabecular/medullary/woven bone

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5
Q

— form during primary bone growth. Forming new lamellae of bone

A

primary osteon

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6
Q

— are formed during remodeling. Osteoclastic resorption followed by osteoblasts

A

secondary osteons

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7
Q

what is a cutting cone

A

primary bone healing and remodeling

lead by osteoclasts eating away at bone, followed by osteoblasts

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8
Q

where does IO take place

A

flat bones

inner and outer surfaces of long bones

NO cartilage precursor- increases width of bone

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9
Q

— ossification will increase width of bone

A

IO

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10
Q

— ossification will increase length of bone

A

EO

cartilage precursor

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11
Q

where does EO take place

A

cartilage precursor

in the epiphysis (end of bone)
and the physis (growth plate)

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12
Q

what is needed for bone healing

A

blood supply
stability
no/mild infection

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13
Q

explain strain

A

the change in length/ original length

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14
Q

how much strain allowed for bone healing

A

2% to make lamellar bone

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15
Q

10% strain will form

A

cartilage

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16
Q

100% strain will form

A

granulation/fibrosis tissue

17
Q

how does indirect bone healing work

A

inflammation
repair
remodeling

18
Q

how to have primary bone healing

A

pieces must be perfectly together (anatomic reduction) with rigid stability

<2% strain
<1mm fracture gap

repair by cutting cone
No callus formed

19
Q

how does contact healing work

A

has to be <0.01 mm gap
cutting cones come in and remodel

direct formation of lamellar bone in axial direction

20
Q

how does gap healing work

A

type of primary healing with <1mm gap

gap filled with loose connective tissue then osteoblasts lay down new lamellar bone

cutting cone formed longitudinally

will go through secondary osteonal reconstruction

21
Q

indirect bone healing occurs with

A

less stable fractures

forms callus to decrease strain, then EO remodelling with cartilage then bone

22
Q

bone heals in — weeks

A

6

nutrition, stability, age, infection, size/strain will take longer

23
Q

what happens during inflammatory phase

A

1st phase of healing (0-7 days)

hematoma forms
revascularization
resorption of bone fragments and hematoma

24
Q

what happens in repair phase

A

2nd stage of bone healing
soft callus (1-3 weeks)
bony callus (3-6 weeks)

hematoma → granulation tissue → fibrocartilage

mesenchymal cells differentiate into chondrocyte and osteoblasts

goes through EO

25
Q

remodeling phase

A

last phase
>8 weeks to years

forms secondary osteons
external callus disappears
reestablish medullary cavity

26
Q

what happens during secondary remodeling

A

woven bone remodeled using cutting cones to make lamellar bone

27
Q

osteogenesis

A

osteoblasts in bone graft material contribute to new bone growth

28
Q

bone graft recruits osteoprogenitor cells and induces them to form new bone

A

osteoinduction

29
Q

bone graft serves as a scaffold for osteoprogenitor cells

A

osteoconduction

30
Q

enhancement of osteoinduction without the prossession of osteoinductive properties

A

osteopromotion

enamal matrix

31
Q

when to use bone graft

A

help repair, speed healing and promote healing or non-unions and infected fractures

32
Q

type of bone graft sources

A

auto- from self
allo- from another person
xeno- from a different species

33
Q

where do you get cancellous bone graft

A

(spongy bone) end of bones- where marrow is

is osteogenic, osteoinductive and osteoconductive

34
Q

cortical bone graft is —

A

osteoconductive (gives a structure for bone to grow on)

35
Q

where can you harvest cancellous bone graft in small animals

A

lateral tubercle of the proximal humerus
proximomedial tibia
craniodorsal iliac spine
subtrochanteric region or medial condyle of femur

36
Q

where to harvest cancellous bone in large animals

A

ilium
sternum

not proximal tibia- will break leg

37
Q

synthetic bone grafts are

A

osteoconductive- gives scaffold for new bone growth

osteoinductive if there is growth factors added

38
Q

assessment of healing, looking for bridging callus on —

A

3/4 of the cortices (sides of bone)

39
Q

what are you looking for when assessing bone healing

A

callus formation
appearance of fracture site
bone opacity/density
periosteal/endosteal reaction
pain-free weight bearing
no movement at fracture site

23 spring: ortho (27 decks)

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