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Flashcards in Bone Healing Updated Deck (60):
1

Two types of bone

Cortical and cancellous

2

Describe cortical bone

Dense and compact

3

Describe cancellous bone

less dense, lattice-like bone

4

What is cortical bone arranged in units of?

Osteons aka haversian systems

5

Osteonic consist of ______ layers of bone arranged around a central ___________ ___________

concentric, haversian canal

6

What does the haversian canal contain?

Blood vessels and nerves

7

What are interspersed between the concentric layers of bone in the osteons?

Osteocytes

8

What connect the haversian system together?

Volkmann's Canals

9

Channels that run perpendicular to the haversian canals allowing blood vessels to travel from the outside of the bone to the center

Volkmann's Canals

10

Cancellous bone consists of interconnected bands of tissue called ______

Trabeculae

11

Thicker trabeculae may contain _______

Osteons

12

Cancellous bone typically contains more irregularly arranged _________

Lamellae

13

Another term for cancellous bone

Trabecular bone

14

Bone building cells

Osteoblasts

15

Bone removing cells

Osteoclasts

16

Cells that reside in cavities within bone and reach through to network with other cells of the same type

Osteocytes

17

These cells within the bone transfer nutrients and wastes and send signals based on stress and strain

Osteocytes

18

Develop from osteoblasts that get trapped in mineralized bone

Osteocytes

19

Line the outer surface of bone

Bone lining cells

20

These cells direct mineral update and release in bone

Bone lining cells

21

Send signals to initiate bone removal and formation

Bone lining cells

22

What mineral is deposited into collagen during bone growth?

Hydroxyapatite

23

A soft tissue that contains stem cells

Bone marrow

24

The two types of stem cells in bone marrow

Mysenchymal and hematopoietic

25

What 5 things do mysenchymal stem cells create?

Cartilage, bone, blood vessel, nerve, and fat cells

26

What do hemapoietic stem cells create?

Blood cells

27

Define remodeling

The process by which the body continually replaces areas of old necrotic bone with new bone tissue

28

Bone remodeling steps

1. Body identifies areas of bone that need replacement
2. Bone lining cells signal osteoclasts and recruit them
3. Osteoclasts arrive, attach to bone, create acid environment and create a void
4. Osteoblasts are recruited after sufficient bone removed
5. Osteoblasts fill void with osteoid
6. Osteoid mineralized to become new bone
7. Some osteoblasts encased in mineralized bone and become osteocytes, others finish filling void and remain outside of the new bone as bone lining cells

29

The remodeling of old necrotic bone or bone grafts

Creeping substitution

30

Following the bone remodeling cycle, the mineral density of the region will continue to increase over the next ______ years

2-3

31

The term creeping substitution is most commonly used when referring to the incorporation of a ______ ______ into _____ _______

Bone graft into living bone

32

Define Wolff's Law

Bone is built where stresses require it and resorbed where stresses are absent

33

What are the three stages of bone repair?

Inflammation Phase (0-3 weeks)
Repair Phase (3 weeks to 4 months)
Remodeling Phase (4 months to 7 years)

34

Difference between fracture healing and fusion

In fracture healing, you are taking two bone fragments that were once united and putting them back together

In a fusion, two or more separate individual bones are induced to grow together

35

Bone that is removed from one place and transferred to another

Bone graft

36

Three stages of bone graft incorporation

Inflammation
Repair
Remodeling

37

Lifestyle factors that impact fusion

Poor nutrition
Tobacco
Diabetes
Rheumatoid Arthritis
Steroids
Cytotoxic Drugs
Radiation

38

Bone relocated from elsewhere in the patient's body

Autograft

39

Bone taken from another member of the same species

Allograft

40

Bone taken from a member of a different species

Xenograft

41

Substitute for bone graft artificially created to mimic bone in body

Synthetic

42

Ability to provide framework (scaffold) for new bone growth

Osteoconductive

43

Ability to induce bone growth (satisfies chemical requirements for a fusion)

Osteinductive

44

Ability to grow into bone (contains live bone cells) and satisfies the biologic requirements for a fusion

Osteogenic

45

The gold standard in bone grafting

Autograft

46

Bone marrow removed surgically from the inside of bones

Bone Marrow Aspirate

47

Grafts designed to be implanted without any modification by the surgeon

Machined Grafts

48

When the mineral content is removed from allograft, this material remains osteoinductive

Demineralized Bone Matrix

49

Usually consists of a power mixed with a carrier that facilitates deliver of the demineralized bone into the surgical site

Demineralized Bone Matrix

50

Demineralized Allograft

Osteoconductive, Osteoinductive

51

B-TCP

Osteoconductive

52

Hydroxyapatite

Osteoconductive

53

BMP

Osteoinductive

54

Has the ability to provide the framework (scaffold) for new bone growth (satisfies structural requirements for a fusion)

Osteoconductive

55

Has the ability to induce bone growth (satisfies the chemical requirements for a fusion)

Osteoinductive

56

Has the ability to grow into bone (satisfies the biologic requirements for a fusion)

Osteogenic

57

Bone is ___% organic

30%

58

Bone is ___% inorganic

70%

59

Autograft

Osteoconductive, osteoinductive, osteogenic`

60

What are four things a surgeon can do to create a good environment for fusion?

Bony apposition (tight fit on bone graft)
Maximize surface area
Bloody pathway
Stable fixation