From which germ layer is bone formed?
What kind of cartilage does long bone develop from?
What is the name for a primary center of ossification?
What is the name of the secondary ossification center?
In the first stage of the ossification process, what transforms into bone?
Embyronic connective tissue (NOT cartilage).
What kind of bone involves intramembranous ossification?
What else does intramembranous ossification participate in?
In the second stage of the ossification process, where does the ossification take place?
Within the cartilage.
Primary endochondral ossification transforms what into bone?
Cartilagenous tissue: which lengthens the bone.
Where does secondary endochondral ossification take place?
Within epiphyses & apophyses.
Where is the growth plate located?
Between the primary & secondary growth centers, as a thing plate of cartilage.
What 4 types of bone is secondary ossification associated with?
- 1. Tubular bone.
- 2. Vertebrae.
- 3. Ethmoids.
- 4. Inferior conchae.
Name the 4 steps for bone growth.
- 1. Resting zone: attaches the growth plate to the epiphysis.
- 2. Zone of Proliferation: bone is lengthened via active chondrocytes.
- 3. Zone of Hypertrophy: chondrocytes mature.
- 4. Zone of Degeneration/ossification: dying chondrocytes = ossification.
Which zone of bone growth is affected by injury?
Step #1: Resting Zone... if injured, growth stops.
Which growth zone is affected by cell death?
Step #2: the zone of proliferation: if cell death occurs, growth stops.
Which growth zone is the weakest portion, and does not have active growth?
- Step #3: zone of hypertrophy.
- Salter-Harris fractures may occur.
What is a Salter Harris Fracture?
- A fracture involving the growth plate or epiphyseal plate.
- Common in children.
In which zone does the growth plate attach to the metaphysis?
Step #4: the zone of degeneration/ossification.
Bone is 70% what?
What are osteoblasts?
Bone forming cells.
What are osteoclasts?
Bone remodeling & reabsorption cells.
What are osteocytes?
- Living cells of bone.
- Within lamellar bone.
What are the 2 types of bone?
- 1. Compact.
- 2. Cancellous.
What percentage of bone is compact bone?
Name 3 a/k/a's for cancellous bone.
- 1. Trabecular.
- 2. Spongy.
- 3. Medullary.
- Internal cavity of bone.
Phosphorus levels are inversely related to what?
Which hormone is involved with bone growth?
- Gigantism: increased somatotropin before physeal closure.
- Acromegaly: increased somatotropin after physeal closure.
What are the 2 main functions of parathormone?
- 1. Stimulate & control the rate of bone remodeling.
- 2. Influence the control of the plasma level of calcium.
What is an apophysis?
- Secondary growth center.
- Attachment site for ligaments & tendons.
What is an enthesis?
- Site of attachment of tendons & ligaments.
- Highly vascularized, high metabolic activity.
Name a tubular bone with 3 epiphyses.
Humerus: head, trochlea, & capitulum.
Name a tubular bone with 2 apophyses.
Femur: greater & lesser trochanter.
What are the 4 functions of periosteum?
- 1. Attaches to cortex (via sharpey's fibers).
- 2. Maintains bone by appositional bone growth.
- 3. Provides a transitional zone of attachment for muscles, tendons, & ligaments.
- 4. Source for vascularization.
What does CATBITES stand for?
- Soft tissue.
Which type of lesion is destructive, has sharp borders, is less aggressive, is slow growing, & has a narrow zone of transition?
What are the 3 types of lytic lesions?
- 1. Geographic.
- 2. Moth-eaten.
- 3. Permeative.
What is the diameter for a moth-eaten lytic lesion?
What are the 3 examples of moth-eaten lytic lesions?
- 1. Myeloma.
- 2. Mets.
- 3. Lymphoma.
What is an a/k/a for osteoblastic lesions?
If the mitchell marker is behind the spinous, is it an anterior or posterior view?
Behind the spinous = anterior.
Is the film anterior or posterior if the film is behind the body?
Closer to body = posterior.
3 things to remember with a solid periosteal reaction?
- 1. Slow growing.
- 2. Uninterrupted.
- 3. Thickening.
Which type of periosteal response grows unevenly?
- Lamellated or onion-skin.
- New layer forms when the tumor stops growing.
Which type of response grows fast & evenly?
Sunburst or hair-on-end or spiculated.
Which year did Roentgen discover x-rays?
- Same year as chiropractic.
What percentage of bone loss to you need for x-rays to pick it up?
What does DEXA stand for?
NEED TO COMPLETE CARDS FOR IMAGING.... CARDS FOR METABOLIC DISORDERS ARE DONE.
With osteoporosis is the quantity or quality of bone affected?
- Quantity decreased.
- Quality normal.
What is the name of the descriptive term which means poverty of bone?
Osteopenia: general radiolucent bone.
Which 3 areas of the body are affected by Generalized Osteoporosis?
- 1. Axial skeleton.
- 2. Pelvis.
- 3. Proximal long bones.
What is the cause of Generalized Osteoporosis?
Decrease in bone density.
What is Generalized Osteoporosis most commonly due to?
- 1. Postmenopausal females.
- 2. Aging.
Which age does bone loss begin at?
35 years of age.
Bone loss stimulates which bone cell activity?
Osteoclastic activity: bone remodeling & resorption.
What is the percentage for bone loss with cortical bone? And trabecular?
- Cortical bone: 1% per year... stronger bone.
- Trabecular bone: 2% per year.
Name 3 complications of osteoporosis.
- 1. Spinal compression fractures: mostly undiagnosed.
- 2. Increased thoracic kyphosis (= spinal stenosis).
- 3. Other fractures: proximal femur, humerus, radius.
What is the hallmark sign on radiograph for a compression fracture?
The anterior height is less than the posterior height in the vertebral body.
What are the names of the 3 vertebral changes in regards to osteoporosis?
- 1. Vertebra plana: flat like pancake.
- 2. Wedged vertebrae.
- 3. Biconcave deformity.
What are the names of the 3 trabecular patterns associated with Ward's Triangle?
- 1. Principal compressive group.
- 2. Secondary compressive group.
- 3. Principal tensile group.
Which group is the last to be obliterated?
- The principal compressive group.
- Strongest type: thickest & most densely packed.
- Weight bearing.
- From the medial metaphsyeal cortex to the superior femoral head.
Which group is thin & widely separated?
- The secondary compressive group.
- Begins at the lesser trochanter & curves toward the greater trochanter.
Which group extends in an arch like pattern medially?
- The principal tensile group.
- From the lateral cortex, inferior to the greater trochanter.
- Terminates in the inferior portion fo the femoral head.
Name 3 other fractures associated with osteoporosis.
- 1. Distal radius.
- 2. Humeral neck.
- 3. Ankle malleoli.
Insufficiency fractures occur when bone is not strong enough to withstand normal physiological stress. Where are the 3 most common locations?
- 1. Spine.
- 2. Hip.
- 3. Distal radius.
Which type of osteoporosis results from immobilization?
- Regionalized osteoporosis.
- Post traumatic.
- RSDS: overactive sympathetic system.
What causes Transient Osteoporosis of the hip?
Pregnancy: left hip always.
Which type of osteoporosis is idiopathic, localized, occurring in lower extremities, & skips joints?
Regional migratory osteoporosis.
Which form of osteoporosis results from infection?
Localized osteoporosis: focal, infection, inflammatory arthritis, neoplasm.
Softening of the bone describes which condition?
- Osteomalacia: caused by a lack of Ca++ deposited in osteoid tissue.
- Rickets in children.
With osteomalacia the quantity of bone decreases. True or false?
False: QUALITY decreases.
The Spine Radiographs article proves what?
That radiology specialists get more specific results.