PATH100 Review Theory Test #3

LP #52-54 (Functions, structure, composition, remodeling, Calcium the

wonderful ion!!!!)

I) FUNCTIONS OF BONE:
• Body shape
• Solid framework
• Support/anchor tissues/organs
• Protect internal organs
• Provide levers
• Store fat and mineral
• Hematopoeisis (blood cell formation)

II) FUNCTIONS OF MUSCLES:

• Movement
• Maintain posture
• Joint stability
• Heat generation

III) BONE STRUCTURE: (fig 6.3, 6.4)

• Compact bone
 Dense osseous tissue,
 Provide strength,
 Found in outer part of bone
 Made up of its structural unit, the osteon (fig 6.5, 6.6)
• Cancellous (spongy) bone
 Found in interior of long and flat bones
 Lightens bone

IV) BONE COMPOSITION:

• Organic
 Cells:
 Osteoblasts (bone builders)
 Osteocytes (mature cells)
 Osteoclasts (bone chewers)
 Ground substance
 Fibers (collagen)
• Inorganic
 Hydroxyapatite (calcium phostate)
V) BONE REMODELING:
• Continuous cycle of bone formation and bone resorption throughout life.
(Breaking down the older bone tissue to replace it with new and fresh bone tissue)
• Changes in bone mass with age (go over the 3 age groups and if there is more
bone formation or bone resorption, or if both processes are equal, and how that
affects overall bone mass.

A) Control of bone remodeling

• Mechanical Factors - Wolff’s Law: forces of stress placed on the bone stimulate
bone remodeling (physical activity will not only help to strengthen our muscles,
but our bones as well!!)
• Hormonal factors:
 Sex hormones, growth hormones
 The 2 main hormones to know are Calcitonin and Parathyroid hormone

B) Calcitonin:
• Produced by the thyroid
• Decreases calcium plasma levels when they rise above normal
• Stimulates calcium salts to be deposited in bone, therefore stimulating bone
formation

C) Parathyroid Hormone:
• Increases calcium plasma levels when they are below normal
• Stimulates calcium absorption from intestines
• Stimulates osteoclasts (therefore enhances bone resorption) to release the calcium
from bones into the blood

D) Calcium
• Role of calcium in our body:
 Muscle contraction
 Cardiac function
 Building bones and teeth (99% of our calcium is stored in our bones)
 Hemostasis = blood clotting
 Neural communication
• Since calcium is so important for many vital functions, Ca plasma levels must be
maintained within a narrow range before being able to store it or form new bone
tissue:
 If calcium plasma levels increase = bone formation will increase (excess is
stored)
 If calcium plasma levels decrease = bone resorption increases (the stored Ca is
needed)
• Calcium appears in the body in 2 forms:
  Ions (soluble – found in plasma)
 Salt crystals (insoluble – bone)
• Vit D is essential for absorbing calcium from intestines

LP #55,56 (Fractures)
• Go over the classifications of fractures (3) – type, location, pattern
• Common fractures:
 Colle’s: distal radius
 Pott’s: lower leg and ankle (wasn’t in your notes, but you’ll see it in CATS)
• Stages in fracture healing:
i. Hematoma (pooling of blood)
ii. Soft callus (fibrocartilage formation, fragile tissue)
iii. Hard callus (replacing soft fibrocartilage with hard bone tissue)
iv. Bone remodeling (polishing the hard callus)
• Complications of fractures (go over early complications of fractures and impaired
healing of fractures

LP #58,59 (Bone infections, Metabolic bone disorders)

I) BONE INFECTIONS
• Bone infections are uncommon
• Bacteria may infect bone tissue in two ways:
 Hematogenous (blood born)
 Trauma (from an open fracture, surgery/iatrogenic)
• The main treatment is antibiotics

II) METABOLIC BONE DISORDER (osteoporosis, Rickets, osteomalacia,

Paget’s)
A) Osteoporosis:
• Characterized by decreased bone mass and density (bone resorption > bone
formation)
• Both types of bone tissue (cancellous and compact) are affected
• Common fractures associated with osteoporosis:
 Vertebral compression
 Colle’s fracture (carpals may also be affected)
 Hip

B) Rickets:
• Seen in children
• Most common in northern climates
• Associated with lack of vit D and calcium, leading to deficient mineralization
(what gives bones their “hardness”), so become soft.
 C) Osteomalacia:
• Seen in adults
• Bones are demineralized, leading to brittle bones.

D) Paget’s:
• Excessive bone destruction and repair
• Bone formation cannot keep up with the rapid bone resorption; consequently,
destroyed bone is replaced with fibrous (scar) tissue.

LP #60-64 (Ossification, alterations in skeletal development, Juvenile Osteochondroses,

Scoliosis, Bone Neoplasms, Joint pathologies)

I) OSSIFICATION
A) Intra-membranous (fig 6.7)
• Initial supporting structure: fibrous CT
• 3 stages:
 Bone matrix is secreted within fibrous CT
 Woven bone forms (what forms the spongy bone) and the periosteum
(CT layer on the outer surface of the bone)
 Compact bone plates form
• Results in the production of flat bones

B) Endochondral (fig 6.8)

• Initial supporting structure: hyaline cartilage
• 5 stages:
 Formation of bone collar (ossification around the diaphysis/shaft)
 Cartilage in the center of the diaphysis calcifies and then forms a
cavity
 Blood vessel of the periosteal bud invades the internal cavities and
spongy bone starts to form
 Medullary cavity forms
 The epiphyses ossify
• Results in the ossification of long bones

II) ALTERATIONS IN SKELETAL DEVELOPMENT

• Make sure you know both names for all of these (ex: toeing in aka metatarsus
adductus)
• Know what they look like or what they present with on a postural
• Study what can cause these alterations (don’t worry about treatments)

III) JUVENILE OSTEOCHONDROSES

A) Legg-Calves-Perthes Disease
 • Osteonecrosis of the proximal femoral epiphysis

B) Osgood-Schlater Disease
• Abnormal endochondral ossification causing partial, or complete, avulsion of
the tibial tuberosity
• Caused by trauma prior to fusion of tibial tuberosity, or sudden/continued
strain on patellar tendon during periods of rapid growth

C) Scheurman’s Disease
• Inflammation of the spine in childhood
• Round back deformity

IV) SCOLIOSIS
• Any lateral deviation or curvature of the spine
• Mostly affects adolescent girls
• 2 types: functional and structural

A) Functional, or Postural
• Corrects on bending
• Could be due to leg length discrepancy
• Can be corrected with stretching and strengthening

B) Structural
• Structural change in bone
• Accentuated with bending
• May be corrected with surgery or brace

V) BONE NEOPLASMS
• Know the difference between a benign and malignant tumor
• Benign (encapsulated with defined borders, remains confined to bone, grow
slowly)
• Malignant (grow quickly, metastasize to other parts of the body, high mortality
rate)
• Primary bone tumor (originate in bone tissue)
• Secondary tumors – Metastatic bone disease (originating elsewhere in the body –
breast, lung, prostate…)

VI) JOINT PATHOLOGIES

• Go over the classification of joint pathologies
• Ex: trauma = sprain, dislocation; Inflammatory = tendonitis, bursitis
• Know the difference between the anatomical joint (articular structures) and the
physiological joint (articular structures + structures responsible for movement)
VII) FIBROMYALGIA
• Characterized by diffuse pain, acchiness, stiffness, fatigue, depression, mood swings
• Can be exacerbated by stress
• Idiopathic
• More common in adult women
LP #65, 66 (Autoimmune rheumatic disorders, hypermobility disorders, degenerative
disorders, joint pathologies associated with arthritis)

I) SYSTEMIC AUTOIMMUNE DISEASE

A) Rheumatoid Arthritis
• Cause is unknown
• WBC’s are attracted to area; release lysosomal enzymes, which will cause
erosion of articular surfaces
• Slow onset; joint on both sides of the body will be affected (symmetric =
note that this is one of the main differences with osteoarthritis)
• Frequently affected (hands/digits, feet, knees, wrists)

II) HYPERMOBILITY DISORDERS

• Know the names of the two syndromes (Marfan’s and Ehler-Danlos)
• Know that they affect the CT

III) DEGENERATIVE DISORDERS

A) Osteoarthritis
• Results in loss of articular cartilage
• Commonly affected: cervical, knee, sacroiliac, hip (weight bearing joints,
non-symmetrical)
• Enlargement of the joint

Read over the rest of LP 66 (other types of arthritis, gout, ankylosing spondylitis)