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Pathophysiology
Exam 4 Chapter 42 Bone
22
Pathology
Undergraduate 1
06/24/2014

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Term
Osteoblasts
Definition
-Bone building cells that synthesize and secrete the organic matrix of bone. Osteoblast also participate in the calcification of the organic matrix. Are responsible for formation of bone matrix
-Two stages include ossification and calcification
-***Secrete alkaline phosphatase – useful blood test***
Term
Osteocytes
Definition
o Mature bone cells that function(actively involved) in the maintenance of bony matrix. Osteocytes also play an active role in releasing calcium into the blood.
Term
What cell builds bone matrix?
Definition
Osteocytes
Term
Osteoclasts
Definition
• Bone cells responsible for the resorption of bone matrix and the release of calcium and phosphate from bone.
Term
Role of growth plate?-
Definition
is a hyaline cartilage plate in the metaphysis at each end of a long bone.
• The plate is found in children and adolescents; in adults, who have stopped growing, the plate is replaced by an epiphyseal line.
Term
What is the growth place sensitive to?
Definition
Nutritional and Metabolic changes (thyroid, growth hormones),
Term
What is the impact of trauma in children?
Definition
cession of growth, shortened extremity, dwarf
Scury, (Vit-C deficiency) Rickets (Vit D)
Term
When does the epiphysis and metaphysis fuse
Definition
at Puberty
Term
What is the purpose of the growth plate?
Definition
•Growth in diameter occurs in concentric rings
•Long bones are provide with specializes structure called epiphyseal growth plate
•As long bones grow, deeper layers of cartilage cells in growth plate multiply and enlarge, pushing the articular cartilage farther away from the metaphysis and diaphysis of the bone
•Allows for bone growth without changing shape of bone or disrupting articular cartilage
Term
How does blood supply and innervation affect assessment?
Why is it important to examine both the joint below and above a musculoskeletal injury-hint peripheral nerve innervation and referred pain?
Definition
When talking about joints, bones and nerves. Make sure the fracture or dislocation did not impact the blood supply to the distal part of limb or nerve function to that distal part. “Distance away from” Check a lot of vessels and nerves in that vicinity.
They can become compromised at time of fracture. Have to check!
Is there referred pain? If so there can be a nerve injury. Is the limb distal to fracture pale? Pulses? Can they feel it when I touch it? If so there may be a disruption of blood flow or nerves and needs to be monitored.

•Blood supply to synovial membrane rich – healing and repair rapid and complete; innervated only by autonomic fibers, relatively free of pain fibers – local anesthesia
•As a rule, each joint of an extremity in innervated by all the peripheral nerves that cross the articulation – referral of pain from one joint to another
•Synovial membrane can form closed sacs that are not part of joint-bursae. Prevents friction on tendon. Bunion is inflamed bursa of metatarsophalaneal joint of great
Term
What Vitamin is important in bone metabolism?
Definition
Involves the interplay among PTH, Calcitonin & Vit D.

•PTH prevents serum calcium levels from falling below and phosphate levels from rising above physiologic conditions
•Calcitonin lowers blood calcium levels by inhibiting release of Ca from bone to ECF
•Vitamin D-actually steroid hormones increases intestinal absorption of Ca and promotes action of PTH
Term
Injury or Trauma Vocabulary= Things we can see

• Contusion
Definition
skin intact, ecchymotic “Bruise”
Term
Injury or Trauma Vocabulary= Things we can see

• Hematoma
Definition
large area of local hemorrhage “Subcatanous Hematoma
Term
Injury or Trauma Vocabulary= Things we can see

• Laceration -
Definition
skin torn, continuity disrupted
Term
Injury or Trauma Vocabulary= Things we can see

• Strain-
Definition
***stretching injury*** to muscle or musculotendinous unit from mechanical overloading
Term
Injury or Trauma Vocabulary= Things we can see

• Sprain
Definition
abnormal or excessive movement of joint with ***disruption to ligaments***
•Formation of new collagen within 4-5 days, may have original strength within 7 weeks, danger at disruption in healing
Term
RICE means
Definition
Rest, Ice, Compression, Elevation
Term
Dislocations-
Definition
***You have to Observe circulation with dislocations***
loss of articulation of the bone ends in the joint capsule caused by displacement or separation(congenital, pathological as well) Check the pulses to see if they are there.
Term
Shoulder
Definition
permits a wide range of motion, a factor that makes the joint relatively unstable; support and movement of shoulder joint relies heavily on support of four relatively small muscle-tendon groups collectively know as the rotator cuff. Most mobile joint, less injured, not a lot of load bearing.
Term
***Rotator cuff***
Definition
impingement tendonitis and tears are common among athletes(swimmers).
•***Commonly injured during repetitive movements*** that carry arm above shoulder-pitchers, swimmers, weight lifters. Functional immobility, can’t lift arm over head or behind back.
•Partial-non surgical. Need PT
•Full thickness-surgical. Need MRI to diagnose
Term
Knee injury
Definition
-***Runners, full contact sports. Most damage is at ligament & cartilage area & surrounding nerves and vessels. Check for sensation & pulse. Foot drop & can’t flex ankle.***
•Subject to abnormal twisting and compression
•Menisci are C-shaped plates of fibrocartilage superimposed on condyles of tibia and femur; stabilize, lubricate and load bear
•***Cruciate ligament*** secures femur to tibia in crossed position. Controls flexion and lateral rotation.
***ACL is weaker-often injured. Immediately disabling***
•Patellar subluxation and dislocation
Term
Hip Injuries
Definition
***high mortality due to inmobility in elderly***
•Ball/socket joint in which femoral head articulates deeply in acetabulum; vascular anatomy of femoral head is critical - viability of femoral head may lead to ***avascualar necrosis=W/o blood supply and tissue dies.***
•Fractures
–Major public health problem; falls most common cause
–Categorized by location; 90% are femoral neck and intertrochanteric fractures
–Location important to blood flow
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