bone growth and fractures
DESCRIPTION
hGH- (from Pituitary Gland) BONE GROWTH - hGH hGH- (from Pituitary Gland) Increases size of all organs (including brain) Increases Protein Synthesis: Builds up Body Affected by exercise, nutrition, sleep Increases osteoblast activity Stimulates growth of cartilage in the epiphyseal plateTRANSCRIPT
![Page 1: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/1.jpg)
Bone Growth and Fractures
![Page 2: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/2.jpg)
BONE GROWTH - hGH
• Increases size of all organs (including brain)
• Increases Protein Synthesis: Builds up Body
• Affected by exercise, nutrition, sleep
• Increases osteoblast activity• Stimulates growth of
cartilage in the epiphyseal plate
1.hGH- (from Pituitary Gland)
![Page 3: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/3.jpg)
Disorder: Gigantism- excess growth from too much hGH during childhood, before epiphyseal plates have closed
BONE GROWTH
![Page 4: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/4.jpg)
BONE GROWTH
![Page 5: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/5.jpg)
Bone GrowthAcromegaly- adult condition, ↑ hGH
after Epiphyseal plate closure, disfigured face, pronounced jaw and brow, swelling of internal organs
• most common cause: benign tumor of pituitary gland
• treatment: surgery
![Page 6: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/6.jpg)
![Page 7: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/7.jpg)
BONE GROWTH -
Causes elongation of bones through chondrocytes cell division at the epiphyseal plate and stimulates osteoblast activity
2. Thyroid Hormone (from Thyroid Gland)
![Page 8: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/8.jpg)
• Estrogen and Testosterone (Male and Female Sex hormones – from ovaries /testes + adrenal glands )-at puberty released in larger quantities-increasing osteoblast activity and synthesis matrix-responsible for “growth spurts” teen yrs.- Levels of Estrogens (♀)/Androgens(♂) at the end of puberty cause epiphyseal plate to close (epiphyseal line)
BONE GROWTH
![Page 9: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/9.jpg)
FACTORS AFFECTING NORMAL BONE GROWTH A. DIET
1. Minerals• CALCIUM & PHOSPHORUS (& traces of fluoride,
magnesium, iron, manganese) for deposition into matrix
Broccoli, Nuts, Seeds, Legumes, Grains, Dairy, Garlic, Chicken and Turkey
![Page 10: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/10.jpg)
FACTORS AFFECTING NORMAL BONE GROWTH
A. DIET
2. vitamins• VITAMIN D stimulates
absorption & transport of Ca2+ into blood - can be synthesized by skin in presence of UV light or taken in through diet
(10-15 mins 2X/week on face, arms + hands)
(4 glasses milk/day or 1 serving fatty fish)
![Page 11: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/11.jpg)
FACTORS AFFECTING NORMAL BONE GROWTH A. DIET• VITAMIN D: Deficiency Rickets
in Children/ Osteomalacia in Adults-Affects long bones: Bowed Legs, Fragile bones, Impaired growth, Dental problems, Bone pain, Muscle weakness
![Page 12: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/12.jpg)
Rickets
![Page 13: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/13.jpg)
Rickets• Caused by Vitamin D deficiency in childhood• Vit D crucial for calcium and phosphorus absorption in
digestive tract• Not enough minerals so bones are too flexible• During Industrial Revolution, a lot of children who
worked in factories (little exposure to sunlight and malnourished)
• Starting to increase again in urban US because spending so much time in doors and drinking soda instead of milk
![Page 14: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/14.jpg)
FACTORS AFFECTING NORMAL BONE GROWTH
A. DIET
VITAMIN A balance between deposition and resorption, stimulates osteoblast activity liversweet potatoscarrotsmangoesspinachcantaloupedried apricotsmilkegg yolksmozzarella cheese
![Page 15: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/15.jpg)
FACTORS AFFECTING NORMAL BONE GROWTH
A. DIET• VITAMIN C necessary for collagen synthesis,
normal bone growth, maintenance, & healing
SCURVYSymptoms – spots on skinspongy gumsbleeding from mucous membranes
![Page 16: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/16.jpg)
BONE REMODELING- continual trading of Ca2+ between blood & bones;
bones are continually remodeled with spongy bone being replaced every 3-4 years and compact bone every 10 years
![Page 17: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/17.jpg)
BONE REMODELINGA. BONE DEPOSITION: osteoblasts build
bone & deposit Ca2+ and collagen
![Page 18: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/18.jpg)
BONE REMODELINGB. BONE RESORPTION: osteoclasts break
down bone (acids and enzymes) & release Ca2+ into blood
![Page 19: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/19.jpg)
BONE REMODELING*TOO MUCH Dietary Ca2+ can lead to “bone spurs”
(Ca2+ deposits) and muscle weakness, heart failure*TOO LITTLE Dietary Ca2+ can lead to brittle,
weakened bones, muscle spasms
![Page 20: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/20.jpg)
BONE REMODELING- *Major Factors Influencing Remodeling:A. STRESS RESPONSE • osteoblast formation stimulated by physical stress
(exercise) from gravitational and mechanical forces
![Page 21: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/21.jpg)
BONE REMODELING- *Major Factors Influencing Remodeling:A. STRESS RESPONSE • CALCITONIN (thyroid gland) is released and inhibits
osteoclast activity and encourages osteoblast’s activity and calcium deposition from blood into bone
![Page 22: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/22.jpg)
BONE REMODELING- *Major Factors Influencing Remodeling:A. STRESS RESPONSE
B. BLOOD CALCIUM & PHOSPHORUS CONCENTRATION HOMEOSTASIS
• P5+ needed for phosphates (PO43-) which
contribute to ATP, DNA, & RNA
![Page 23: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/23.jpg)
BONE REMODELING- *Major Factors Influencing Remodeling:B. BLOOD CALCIUM & PHOSPHORUS CONCENTRATION HOMEOSTASIS
• Ca2+ needed for normal functioning in:MUSCLES & NERVES BLOOD CLOT RESPONSEGLANDULAR SECRETIONS CELL DIVISION
![Page 24: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/24.jpg)
Ca2+ Regulation Flow Chart:• (bones = storage tank for Calcium (Ca2+))• CALCITONIN (THYROID GLAND) secreted when
blood calcium– inhibits osteoclasts– Stimulates osteoblasts
• PARATHYROID HORMONE (PARATHYROID GLANDS) secreted when blood calcium – stimulates osteoclasts– Inhibits osteoblasts
![Page 25: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/25.jpg)
Thyroid and Parathyroid Glands
![Page 26: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/26.jpg)
Blood Calcium Level
Low
Calcitonin
High
Parathyroid hormone
Ca2+ added to blood
Ca2+ remains in bones Osteoclasts inhibited
Osteoclasts stimulated
![Page 27: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/27.jpg)
AGINGloss of Ca2+ over time (mostly due to hormonal changes)• -in females age ~ 30 (accelerates 40-45)• -in males age ~ 60
loss of protein (organics) from bone matrix = overall weakening of bone tissue
![Page 28: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/28.jpg)
Bone Density• Some studies show peak bone density may be
reached by age 15– After age 15 bone density only slightly increases
• Mid 30’s bone density begins to decline 1% /year – menopause ↓ (decreases osteoblast activity) – impact activities stimulate osteoblasts ↑
-soccer + basketball better than running-strength training – great-swim/cycle need to do other activities if possible-walking pretty good*don’t specialize in one sport
• Need sex hormones for osteoblast activity
![Page 29: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/29.jpg)
OSTEOPOROSISRISK FACTORS• AGE (Dec. Hormones)
-Bones need sex hormones (stimulate osteoblasts) to maintain density-estrogen drops dramatically ♀, in ♂ testosterone declines gradually male menopause
• EATING DISORDERS• LACK OF EXERCISE• Ca2+ Deficiency• VITAMIN D Deficiency• DRUGS (Alcohol, Smoking, some
Diuretics, etc.)
![Page 30: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/30.jpg)
Bone Fractures and Healing
![Page 31: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/31.jpg)
![Page 32: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/32.jpg)
![Page 33: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/33.jpg)
1. If it is a fracture, what type is it? If it’s not a fracture, what’s the injury?
2. List ALL of the bones present in the x-ray and underline which, if any, are the fractured bone
Answer these questions for each patientCan work in groups of 1-3
![Page 34: Bone Growth and Fractures](https://reader036.vdocuments.us/reader036/viewer/2022062905/5a4d1acd7f8b9ab05997009e/html5/thumbnails/34.jpg)
Bone Healing Stages