PATH100 Review Theory Test #3

LP #52-54 (Functions, structure, composition, remodeling, Calcium the wonderful ion!!!!) I) FUNCTIONS OF BONE:
• • • • • • • • • • • • Body shape Solid framework Support/anchor tissues/organs Protect internal organs Provide levers Store fat and mineral Hematopoeisis (blood cell formation)

Movement Maintain posture Joint stability Heat generation

III) BONE STRUCTURE: (fig 6.3, 6.4)
Compact bone  Dense osseous tissue,  Provide strength,  Found in outer part of bone  Made up of its structural unit, the osteon (fig 6.5, 6.6) • Cancellous (spongy) bone Found in interior of long and flat bones Lightens bone

 

    • Organic Cells: Osteoblasts (bone builders) Osteocytes (mature cells) Osteoclasts (bone chewers)  Ground substance  Fibers (collagen) • Inorganic Hydroxyapatite (calcium phostate)

• • Continuous cycle of bone formation and bone resorption throughout life. (Breaking down the older bone tissue to replace it with new and fresh bone tissue) Changes in bone mass with age (go over the 3 age groups and if there is more bone formation or bone resorption, or if both processes are equal, and how that affects overall bone mass.

A) Control of bone remodeling • Mechanical Factors - Wolff’s Law: forces of stress placed on the bone stimulate bone remodeling (physical activity will not only help to strengthen our muscles, but our bones as well!!) • Hormonal factors:  Sex hormones, growth hormones  The 2 main hormones to know are Calcitonin and Parathyroid hormone B) Calcitonin: • Produced by the thyroid • Decreases calcium plasma levels when they rise above normal • Stimulates calcium salts to be deposited in bone, therefore stimulating bone formation C) Parathyroid Hormone: • Increases calcium plasma levels when they are below normal • Stimulates calcium absorption from intestines • Stimulates osteoclasts (therefore enhances bone resorption) to release the calcium from bones into the blood D) Calcium • Role of calcium in our body:  Muscle contraction  Cardiac function  Building bones and teeth (99% of our calcium is stored in our bones)  Hemostasis = blood clotting  Neural communication • Since calcium is so important for many vital functions, Ca plasma levels must be maintained within a narrow range before being able to store it or form new bone tissue:  If calcium plasma levels increase = bone formation will increase (excess is stored)  If calcium plasma levels decrease = bone resorption increases (the stored Ca is needed) • Calcium appears in the body in 2 forms:

 Ions (soluble – found in plasma)  Salt crystals (insoluble – bone) Vit D is essential for absorbing calcium from intestines

LP #55,56 (Fractures)
• • Go over the classifications of fractures (3) – type, location, pattern Common fractures:  Colle’s: distal radius  Pott’s: lower leg and ankle (wasn’t in your notes, but you’ll see it in CATS) • Stages in fracture healing: i. Hematoma (pooling of blood) ii. Soft callus (fibrocartilage formation, fragile tissue) iii. Hard callus (replacing soft fibrocartilage with hard bone tissue) iv. Bone remodeling (polishing the hard callus) • Complications of fractures (go over early complications of fractures and impaired healing of fractures

LP #58,59 (Bone infections, Metabolic bone disorders) I) BONE INFECTIONS
• • Bone infections are uncommon Bacteria may infect bone tissue in two ways:  Hematogenous (blood born)  Trauma (from an open fracture, surgery/iatrogenic) • The main treatment is antibiotics

II) METABOLIC BONE DISORDER (osteoporosis, Rickets, osteomalacia,
Paget’s) A) Osteoporosis: • Characterized by decreased bone mass and density (bone resorption > bone formation) • Both types of bone tissue (cancellous and compact) are affected • Common fractures associated with osteoporosis:  Vertebral compression  Colle’s fracture (carpals may also be affected)  Hip B) Rickets: • Seen in children • Most common in northern climates • Associated with lack of vit D and calcium, leading to deficient mineralization (what gives bones their “hardness”), so become soft.

C) Osteomalacia: • Seen in adults • Bones are demineralized, leading to brittle bones. D) Paget’s: • Excessive bone destruction and repair • Bone formation cannot keep up with the rapid bone resorption; consequently, destroyed bone is replaced with fibrous (scar) tissue.

LP #60-64 (Ossification, alterations in skeletal development, Juvenile Osteochondroses,
Scoliosis, Bone Neoplasms, Joint pathologies)

A) Intra-membranous (fig 6.7) • Initial supporting structure: fibrous CT • 3 stages:  Bone matrix is secreted within fibrous CT  Woven bone forms (what forms the spongy bone) and the periosteum (CT layer on the outer surface of the bone)  Compact bone plates form • Results in the production of flat bones B) Endochondral (fig 6.8) • Initial supporting structure: hyaline cartilage • 5 stages:  Formation of bone collar (ossification around the diaphysis/shaft)  Cartilage in the center of the diaphysis calcifies and then forms a cavity  Blood vessel of the periosteal bud invades the internal cavities and spongy bone starts to form  Medullary cavity forms  The epiphyses ossify • Results in the ossification of long bones

• • • Make sure you know both names for all of these (ex: toeing in aka metatarsus adductus) Know what they look like or what they present with on a postural Study what can cause these alterations (don’t worry about treatments)

A) Legg-Calves-Perthes Disease

Osteonecrosis of the proximal femoral epiphysis

B) Osgood-Schlater Disease • Abnormal endochondral ossification causing partial, or complete, avulsion of the tibial tuberosity • Caused by trauma prior to fusion of tibial tuberosity, or sudden/continued strain on patellar tendon during periods of rapid growth C) Scheurman’s Disease • Inflammation of the spine in childhood • Round back deformity

• • • Any lateral deviation or curvature of the spine Mostly affects adolescent girls 2 types: functional and structural

A) Functional, or Postural • Corrects on bending • Could be due to leg length discrepancy • Can be corrected with stretching and strengthening B) Structural • Structural change in bone • Accentuated with bending • May be corrected with surgery or brace

• • • • • Know the difference between a benign and malignant tumor Benign (encapsulated with defined borders, remains confined to bone, grow slowly) Malignant (grow quickly, metastasize to other parts of the body, high mortality rate) Primary bone tumor (originate in bone tissue) Secondary tumors – Metastatic bone disease (originating elsewhere in the body – breast, lung, prostate…)

VI) JOINT PATHOLOGIES • Go over the classification of joint pathologies • Ex: trauma = sprain, dislocation; Inflammatory = tendonitis, bursitis • Know the difference between the anatomical joint (articular structures) and the physiological joint (articular structures + structures responsible for movement)

VII) FIBROMYALGIA • Characterized by diffuse pain, acchiness, stiffness, fatigue, depression, mood swings • Can be exacerbated by stress • Idiopathic • More common in adult women LP #65, 66 (Autoimmune rheumatic disorders, hypermobility disorders, degenerative disorders, joint pathologies associated with arthritis) I) SYSTEMIC AUTOIMMUNE DISEASE A) Rheumatoid Arthritis • Cause is unknown • WBC’s are attracted to area; release lysosomal enzymes, which will cause erosion of articular surfaces • Slow onset; joint on both sides of the body will be affected (symmetric = note that this is one of the main differences with osteoarthritis) • Frequently affected (hands/digits, feet, knees, wrists) II) HYPERMOBILITY DISORDERS • Know the names of the two syndromes (Marfan’s and Ehler-Danlos) • Know that they affect the CT III) DEGENERATIVE DISORDERS A) Osteoarthritis • Results in loss of articular cartilage • Commonly affected: cervical, knee, sacroiliac, hip (weight bearing joints, non-symmetrical) • Enlargement of the joint Read over the rest of LP 66 (other types of arthritis, gout, ankylosing spondylitis)

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