Bone and Cartilage Healing

Bone Composition

osteoblasts derived from

osteoblasts line the ____ of bone and produce _____

osteocytes are former ____
trapped in ____
function to ______ bone
regulating bone ___ in response to stress

osteoclasts derived from ______ _____ _____
multinucleated giant cells whose function is ______ _______
Parathyroid hormone (PTH) stimulates _________ ____ ___________ that activate osteoclatic bone resorption

Woven Bone

Lamellar bone

Cortical bone ____ of skeleton
comprised of ______ packed ____
contains

osteon

Haversian system

mechanisms of bone formation

endochondral bone formation
bone development from ___________ ____________
mechanism by which a long bone grows in _______
osteoblasts line a _________ _______
the chondrocytes __________, _________ and _______
__________ ___________ of the cartilage occurs followed by __________

Intramembranous ossification

mechanism by which a long bone grows in ______
bone development from _______ ____________
it is involved in the formation of _____ bones
ossification begins as ______ cells form a template of the future bone
Osteoblasts differentiate directly from ___________ and lay down seams of _______.
Does not involve _______ _______, which is important in __________ ________

Fracture healing occurs through a process of ________, either endochondral or intramembranous
depends on the ________

Prerequesites for bone healing
Adequate ______ ________ and __________ ________

2 Types of fracture healing

Indirect fracture healing
what types?
does not require anatomical _____ or ______ conditions
enhanced by ________ and _________

Direct Fracture healing
types?
can only occur when repair of the ________ ________ is achieved and ______ ______ is provided resulting in a substantial _____ in interfragmentary strain
______ stability

does surgical fixation always lead to direct healing?

Direct bone healing is possible only when the fracture ends are _________ ________ and ______ __________ isused to decrease strain

_________ __________ and __________ ____________ at the fracture site stimulate _______
Inadequate stabilization may result in ________ ________ at the fracture site interrupting _______ __________ to bone
Over stabilization _______ periosteal bone formation

3 stages of Indirect Fracture Healing

Inflammation

tissue disruption results in ________ at the fracture site
Local vessels _________ causing ________ ________ at the edges of the fracture
_________ capillary permeability results in a ________ __________ ________
osteoinductive growth factors stimulate the ______ and ________ of mesenchymal cells

Repair

periosteal _____ forms along the periphery of the fracture site
intramembranous ossification initiated by ________
Intramedullary callus forms in the ______ of the fracture site
endochondral ossifiction at the site of the fracture _________
chemical and mechanical factors stimulate ______ ________ and _________

remodeling

woven bone is gradually converted to ______ _____
Need to apply _______ _____ __
medullary cavity is _________
bone is restructured in response to ______ and _______

bridge plating

Intramedullary nail

no motion at the fracture site =

direct healing does not involve formation of

in direct healing onsteoblasts originate from _______ and ______ cells

Delayed Or non Union

Failure to reach bony union by ___ ______

Types of non unions

septic non union

hypertrophic non union

atrophic non union

treatments of non union

Growth factors

malunion

local anatomic factors that influence fracture healing

cartilage is a ____ _______ type of connective tissue

cartilage is ____ _____ than bone

healing rate for cartilage

cartilage cell

Cartilage Layers

outer fibrous layer

inner cellular layer

types of cartilage

Hyaline

_____ surface
contains _____ ______ collagen fibers ->
elastic material?

Fibrocartilage

_____ of the three
no _______ and a matrix with bundles of collagen fibers embedded with ________
fosters _____
provides ______ and ________

Elastic Cartilage

provides ____
_______ color and is surrounded by a ________
network of _______ elastic fibers
makes it ________ and _______

Hyaline cartilage properties

solid phase

low permeability to ______ _______
high ______ resistance contributes to load _________
Type II collagen lines up to form _____ and encases Aggrecan
Resists ________

Fluid phase

provides the _____
_________ derformability
ability to _____ _______

ECM
Type ____ collagen provides the tensile strength
Embedded in _______
__________ _____ chains with links
________ and _______ ________
Protects chondrocytes from _______ ________

Proteoglycans provde the _______ ______

microarchitecture - 4 Zones

superifical structure
resists ______

middle structure
higher _______ content

deep structure
Lowest ____ and highest _______
prevent _________

Tidemark in Deep Layer

Calcified cartilage structure
violated during _______