Bone Anatomy and Growth
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Questions and Answers

Which layer of bone tissue is primarily responsible for providing strength and structural integrity?

  • Compact bone (correct)
  • Periosteum
  • Spongy bone
  • Bone marrow
  • What is the primary role of osteoclasts in bone remodeling?

  • Maturing into osteocytes
  • Breaking down and reabsorbing bone (correct)
  • Transporting nutrients to bone cells
  • Forming new bone tissue
  • During which phase of bone healing post-fracture does granulation tissue form?

  • Reparative phase
  • Reactive phase (correct)
  • Latent phase
  • Remodeling phase
  • What is a key consideration during the reactive phase of bone healing?

    <p>Ensuring adequate blood supply (B)</p> Signup and view all the answers

    Which of the following factors can negatively influence bone fracture healing?

    <p>Medical conditions like diabetes (B)</p> Signup and view all the answers

    What is a common treatment approach for an undisplaced, unstable fracture?

    <p>Positioning and immobilization (B)</p> Signup and view all the answers

    What is the main purpose of external fixation in orthopedic surgery?

    <p>To encircle the limb and attach to the bone for fracture treatment (D)</p> Signup and view all the answers

    What is a key characteristic of the Ilizarov procedure?

    <p>It includes inserting wires through the skin, muscle, and bone to lengthen a limb. (A)</p> Signup and view all the answers

    What is the primary purpose of the bone distraction process?

    <p>To generate bone growth through weight-bearing (C)</p> Signup and view all the answers

    Which method of implant fixation offers a higher stability and allows weight-bearing earlier post-surgery?

    <p>Cemented fixation (C)</p> Signup and view all the answers

    What is a common reason for patients to undergo arthroplasty?

    <p>Persistent pain and functional impairments from a compromised joint (B)</p> Signup and view all the answers

    What is the expected recovery weight-bearing status after a hybrid fixation procedure?

    <p>Partial weight-bearing for 2-4 weeks (B)</p> Signup and view all the answers

    Which of the following is a significant risk associated with the posterolateral approach to hip replacement?

    <p>Hip dislocation (D)</p> Signup and view all the answers

    What special consideration might be needed for a patient post-arthroplasty regarding dressing?

    <p>Clothing modifications for leg length discrepancies (D)</p> Signup and view all the answers

    Which muscle group is primarily incised during the posterolateral approach to hip replacement?

    <p>Hip abductors and external rotators (A)</p> Signup and view all the answers

    Which level of weight bearing allows a minimal amount of weight to be placed on the operated leg?

    <p>PWB (Partial weight bearing) (C)</p> Signup and view all the answers

    In the context of post-operative occupational therapy for hip arthroplasty, what is the PRIMARY focus on Post-Op Day 0 (POD 0)?

    <p>Initiating sit-to-stand and ambulation as early as 4 hours post-op, with pain management considered. (B)</p> Signup and view all the answers

    An adolescent patient is diagnosed with Slipped Capital Femoral Epiphysis (SCFE). What etiological factor is MOST associated with this condition?

    <p>Growth spurt leading to weakening of the growth plate combined with body weight. (C)</p> Signup and view all the answers

    What is a KEY aspect of the occupational therapist's role when addressing environmental factors for a patient with Slipped Capital Femoral Epiphysis?

    <p>Discussing safety in the home environment, including eliminating throw rugs and clutter. (C)</p> Signup and view all the answers

    During a knee replacement, how is the patella primarily addressed?

    <p>The patella is moved out of the way to access the damaged cartilage surfaces. (B)</p> Signup and view all the answers

    A patient presents with an ankle injury. Which of the following clinical findings is MOST indicative of a potential ankle fracture rather than a sprain?

    <p>Inability to bear weight, gross deformity, and bony tenderness. (A)</p> Signup and view all the answers

    According to the Weber classification, a Weber A ankle fracture involves which specific characteristic?

    <p>A fracture inferior to the syndesmosis, often with an intact medial malleolus. (D)</p> Signup and view all the answers

    A Weber C ankle fracture is characterized by:

    <p>Damage to the tibiofibular syndesmosis and potential medial malleolus fracture, leading to ankle instability. (B)</p> Signup and view all the answers

    What is a Pilon fracture?

    <p>A fracture of the distal tibia metaphysis combined with disruption of the talar dome. (D)</p> Signup and view all the answers

    A Maisonneuve fracture is described as:

    <p>A fracture of the proximal fibula coexisting with a medial malleolar fracture or disruption of the deltoid ligament. (D)</p> Signup and view all the answers

    A Tillaux fracture is caused by what MOI? and in which population is its highest incidence observed?

    <p>Eversion and lateral rotation; adolescents aged 12-14. (A)</p> Signup and view all the answers

    Flashcards

    Bone Distraction Rate

    The process of lengthening bone by 1 mm per day to promote healing.

    OT Role in Post-Surgery

    Occupational therapy tasks post-surgery include managing edema, wound care, and promoting ADLs.

    Arthroscopy

    A minimally invasive procedure using cameras for joint investigation or repair.

    Total Arthroplasty

    Surgical replacement of both surfaces of a compromised joint.

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    Cemented Implant Fixation

    Bone cement is used for stability, especially in patients with weak bones.

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    Weight Bearing (NWB)

    Non-weight bearing; the patient cannot put any weight on the affected limb.

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    Posterolateral Approach

    The most common hip replacement approach, sparing hip abductors.

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    Hip Precautions

    Guidelines to prevent dislocations after a hip replacement surgery.

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    Periosteum

    The outer membrane layer of bone that serves as an attachment for muscles and tendons.

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    Compact Bone

    The dense, mineralized part of the bone providing strength and integrity.

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    Spongy Bone

    The lighter part of the bone containing bone marrow and blood vessels.

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    Osteoblasts

    Bone-forming cells that help in the growth of bones.

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    Osteoclasts

    Cells responsible for breaking down and reabsorbing bone tissue.

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    Bone Healing Phases

    The phases post-fracture: reactive, reparative, and remodeling.

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    External Fixation

    A surgical method involving an external device attached to the bone for fracture treatment.

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    Ilizarov Procedure

    A leg lengthening procedure involving surgical cuts and wires to elongate bones.

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    Pre-op Education

    Teach clients precautions, functional implications, and equipment needs before surgery.

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    POD 0 Activities

    Patients start standing/walking as early as 4 hrs post-op, considering pain meds and precautions.

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    POD 1 Focus

    Teach correct transfers, confirm home support, and practice ADLs. Encourage walking and meals in a chair.

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    POD 3 Independence

    Patients should be independent in self-care and dressing, maintaining weight-bearing precautions.

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    Slipped Capital Femoral Epiphysis

    Condition where the femoral neck slips due to cartilaginous growth plate failure, often in obese adolescents.

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    Knee Replacement Procedure

    Damaged cartilage is removed and replaced with metal components, plastic spacer inserted for smooth movement.

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    Weber Classification A

    Fracture below the syndesmosis, intact syndesmosis, usually stable and treated with casting.

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    Weber Classification C

    Fracture above the ankle joint with syndesmosis damage, very unstable and usually requires surgery.

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    Pilon Fracture

    Fracture at distal tibia with talar dome disruption, common from falls, especially in males.

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    Tillaux Fracture

    Fracture caused by extreme eversion and lateral rotation in adolescents, treatment depends on displacement.

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    Study Notes

    Bone Anatomy

    • Periosteum: Outer layer of bone, serving as an attachment point for tendons, ligaments, and nerves.
    • Compact bone: Dense, strong, and mineralized outer layer of the bone, providing support and protection.
    • Spongy bone: Inner layer of bone, containing bone marrow (fat deposits), keeping the bones light while offering strength. Also contains blood vessels.
    • Long bone structure: Comprised of a shaft (diaphysis), and two ends (epiphyses). The diaphysis contains compact bone, while the epiphyses contain spongy bone.

    Bone Growth

    • Ossification: Begins at 8 weeks after conception. This ongoing process involves the development and formation of bone throughout life.
    • Cell types involved:
      • Osteoblasts: Bone-forming cells which build new bone tissue.
      • Osteocytes: Mature bone cells, maintaining bone tissue.
      • Osteoclasts: Bone-resorbing cells which break down existing bone tissue.
    • Bone growth is not uniform throughout the body
    • Excess bone that is removed to ensure growth is controlled

    Common Bone Disorders

    • Congenital disorders
    • Arthritic disorders : Soft tissue and autoimmune conditions, like inflammation of the bursae (fluid sacs), rheumatoid arthritis, gout and other conditions causing inflammation or damage.
    • Osteoporosis: A condition leading to the gradual loss of bone mass, resulting in decreased bone density and increased risk of fractures.
    • Degenerative Joint Disease (OA): Common condition causing cartilage damage and inflammation in joints.
    • Tumors: Cancers that affect bones.
    • Fractures: A break in the bone.

    Bone Growth Post-Fracture

    • Reactive phase: Inflammation and granulation tissue formation within 2–4 weeks post fracture. Key questions include immobilization needs, blood supply adequacy, and nutrition provision.
    • Reparative phase: Osteoblasts and new tissue formation 4 weeks to 8 months after fracture
    • Remodelling phase: Bone healing and remodelling 3 to 5 years after fracture, depending on age and health of the individual.

    Bone Treatment and Medical Conditions

    • Medical Conditions: Affecting bone growth and repair: diabetes, hormone imbalances, vascular diseases, and use of steroids.
    • Treatment Options:
      • Closed reduction: Aligning bone fragments without surgery
      • Open reduction internal fixation (ORIF): Using surgical plates, screws, wires to stabilize the bone.
      • External fixation: Using an external frame to stabilize broken bones.
      • Implantation: Using implants such as screws, plates, and nails.
      • Prostheses: A replacement for a dysfunctional joint or bone.

    OT Role

    • Pre-Op Assess client's environmental needs(home, school, leisure), safety, equipment, and implement strategies for mobility, self care and dressing, and transfers.
    • Post-Op: Provide education & demonstrate mobility, transfers, wound care, and ADLs.

    Orthopedic Equipment

    • Equipment like long handled reachers, shoehorns, raised toilet seats, grab bars, shower benches, tub transfer benches all help in effective mobility.

    Bed Mobility & Bathing Tips

    • Bed Mobility: Important to assist the patient in safe transfers, avoid injury by instructing on proper body mechanics for transfers.
    • Bathing: Implement proper techniques for bathing, assist in use of necessary equipment to prevent injury/fall, or difficulty performing the task.

    Car Transfers

    • Instruct on proper car transfer technique, using the appropriate equipment.

    Driving & House Work

    • Driving: Return to driving as indicated by the physician with safe practices.
    • House Work: Assist with light housekeeping, laundry, yard work based on the patient's needs and limitations.

    Medical Conditions

    • Slipped Capital Femoral Epiphysis (SCFE): A common condition in adolescents where the femoral head slips from its normal position. This occurs during periods of rapid growth, and it is often seen in overweight or obese children. This is typically a unilateral condition.
    • Knee Arthroplasty: The replacement of a damaged knee joint. This procedure has specific movement precautions.

    Knee Replacement

    • Techniques involving removing damaged cartilage and inserting metal components to restore knee function.
    • Movement and activity restrictions are essential for healing.

    Ankle Fractures

    • Classification such as Weber A, B, C based on location of fractures
    • Treatment options include immobilization, reduction, and surgery.
    • Pilon Fractures are fractures of the lower end of the tibia that often result from high impact trauma such as a fall from a height
    • Maisonneuve Fracture is a fracture of the lower end of the tibia in association with disruption of the syndesmosis.

    Shoulder

    • Rotator Cuff Review: Rotator cuff muscles include supraspinatus, infraspinatus, and teres minor, and subscapularis. These control the humeral head movement for abduction, external rotation and controlled internal rotation.

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    Description

    This quiz explores the key components of bone anatomy, including the periosteum, compact bone, and spongy bone, as well as the process of bone growth through ossification. It's designed to test your understanding of the various cell types involved in bone development. Dive into the intricate structures and functions of bones in this interactive quiz!

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