bone fractures and fracture repair - linn-benton …cf.linnbenton.edu/mathsci/bio/jacobsr/upload/16...
TRANSCRIPT
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Business
Reminder – bone quiz 1 in lab
Due in lab
Scientific America article summary
Priority registration for BI 232
Wednesday 11/14/12
You must fill out a registration form
Can’t have holds on your account
May register for one other student
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Disorders & Fractures
The Skeletal System
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Bone Disorders
Poor nutrition
Hormonal changes/imbalances
Trauma
Developmental errors
Infection
Tumors
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Nutritional Disorders
Rickets
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Nutritional Disorders
Osteomalacia
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Hormonal Disorders
Osteoporosis
Loss of bone mass Bone resorption ˃ deposit
Vertebral bodies and neck of femur
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Figure 6.16
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Hormonal Disorders
Osteoporosis
Risk factors
Lack of estrogen
Low calcium or vitamin D
Petite body form
Immobility
Low levels of TSH
Diabetes mellitus
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Hormonal Disorders
Osteoporosis
Treatment and prevention
Calcium, vitamin D, and fluoride supplements
Weight bearing exercise throughout life
Hormone (estrogen) replacement therapy
Drugs to increase bone mineral density
Fosamax, SERMs, statins
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Infections Osteomyelitis
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Bone Fractures
Incomplete
Does not cross entire bone
Complete
Bone is broken into two pieces
Comminuted
Three or more pieces
Open versus closed
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Bone Fractures
Transverse
Spiral
Impacted
Depressed
Greenstick
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Fractures
Pathological
Secondary to coexisting disease
Osteoporosis
Cancer
Malnutrition
Cushing’s syndrome
Osteogenesis imperfecta
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Fracture Repair
Local periosteum and surrounding blood vessels are torn
Inflammation
Open vs. closed
Swelling
Hemorrhage (bleeding)
Blood clots → fracture hematoma
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Fracture Repair
1. Fracture hematoma forms within 6-8 hrs
Torn blood vessels hemorrhage
Clot (hematoma) forms
Swollen, painful and inflamed
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Figure 6.15, step 1
A hematoma forms. 1
Hematoma
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Fracture Repair
2. Fibrocartilaginous callus forms
Capillaries grow into area
Osteoblasts begin forming spongy bone within 1 week
Fibroblasts secrete collagen fibers to connect bone ends
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Figure 6.15, step 2
Fibrocartilaginous
callus forms.
2
External callus
New blood vessels
Spongy bone trabecula
Internal callus (soft granulation tissue)
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Fracture Repair
3. Bony callus formation
New trabeculae form a bony (hard) callus
Continues until firm union is formed in ~2 months
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Figure 6.15, step 3
Bony callus forms. 3
Bony callus of spongy bone
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Fracture Repair
4. Bone remodeling
In response to mechanical stressors over several months
Final structure resembles original bone
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Figure 6.15, step 4
Bone remodeling
occurs.
4
Healed fracture
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Figure 6.15
Hematoma External
callus Bony
callus of
spongy
bone Healed
fracture New
blood
vessels
Spongy
bone
trabecula
Internal
callus
(fibrous
tissue and
cartilage)
A hematoma forms. Fibrocartilaginous
callus forms.
Bony callus forms. Bone
remodeling
occurs.
1 2 3 4
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Treatment of Fractures
Reduction
Realignment
Immobilization
Traction
Pathological fractures
Address underlying problem
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Developmental Errors
Skull
Microcephalus
Anterior fontanel closes early
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Developmental Errors
Skull
Hydrocephalus
Excess CSF causes pressure
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Developmental Errors
Skull
Cleft palate
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Disorders of the Spinal Column
Scoliosis
Lordosis
Kyphosis
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Figure 7.16
Cervical curvature
(concave)
7 vertebrae, C1–C7
Thoracic curvature
(convex)
12 vertebrae,
T1–T12
Lumbar curvature
(concave)
5 vertebrae, L1–L5
Sacral curvature
(convex)
5 fused vertebrae
sacrum
Coccyx
4 fused vertebrae
Anterior view Right lateral view
Spinous
process
Transverse
processes
Intervertebral
discs
Intervertebral
foramen
C1
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Scoliosis
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Lordosis
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Kyphosis
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Disorders of the Spinal Column
Herniated disc
Causes and risk factors
Location
Treatment
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Figure 7.17c
Vertebral spinous process
(posterior aspect of vertebra)
Spinal nerve root
Anulus fibrosus
of disc
Herniated portion
of disc
Nucleus
pulposus
of disc
Spinal cord
(c) Superior view of a herniated intervertebral disc
Transverse
process
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Questions?
Reminder: No school Monday
Office hour will be Tuesday 11/13/12 5-6pm