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TSM 97
Bone growth and remodelling
19
Medical
Undergraduate 2
01/07/2013

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Term
What are the 4 cell types present in bone?
Definition
1) Osteoprogenitor cells: Stem cells
2) Osteoblasts: Synthesise the organic bone matrix
3) Osteocytes: Mature osteoblasts. Inactive
4) Osteoclasts: Erode mineralised bone and remodel. Their activity is regulated by osteocytes.
Term
Which hormones stimulate the osteoclasts (via osteoblasts)?
Definition
1) Parathyroid hormone: stimulates
2) Calcitonin: inhibits.
Term
Which 2 processes are involved in the production of bone?
Definition
1) Ossification: bone formation
2) Mineralisation: addition of a hydroxyapatite.
Term
What are the 2 methods of ossification?
Definition
1) Intramembraneous: The formation of bone from connective tissue
2) Endochondral: The formation of bone from cartilage.
Term
Describe the process of intramembraneous ossification.
Definition
1) Mesenchymal cells differentiate to osteoblasts
2) Ossification centre forms in membrane
3) Osteoblasts secrete osteoid
4) Forms mineralised bone matrix in spicules
5) Osteoid laid down between blood vessels fuse spicules and form the trabeculae of woven bone
4) Mesenchyme forms periosteum
5) Woven bone is remodelled to haversian bone.
Term
Describe the process of endochondral ossification.
Definition
1) Hyaline cartilagte generated from mesenchyme
2) Cartilage deposited in the shape of future bone
3) Chondroblasts form perichondrium and then periosteum
4) Formation of bone collar
5) Cavitation of template
6) Chondrocytes proliferate
7) Calcium deposited in the cartilage matrix in the primary ossifcation centre
8) Bone deposited in diaphysis
9) Capillaries penerate periosteum and grow into diaphysis
10) Osteoprogenitor cells form osteoblasts in the primary ossification centre
11) Osteoblasts secrete osteoid bone matrix to form trabecular bone
12) Osteoid is mineralised
13) Collar and trabecular bone merge
14) Hyaline cartilage only remains in epiphyseal plate
15) Secondary ossification centre ossifies epiphyses.
Term
What does the secondary ossification centre form from?
Definition
Blood vessels and osteoprogenitor cells.
Term
How do long bones grow?
Definition
1) New cartilage added to the ends of diaphysis due to chondrocyte division in the epiphyseal plate
2) Osteoblasts produce osteoid on new cartilage
3) Cartilage converted to bone by endochondral ossification.
Term
How is long bone growth regulated?
Definition
Androgens
Term
What kind of disorder is osteogenesis imperfecta?
Definition
An autosomal dominant genetic disorder.
Term
What causes the symptoms of osteogenesis imperfecta?
Definition
An abnormality of connective tissue- collagen improperly formed (not type 1).
Term
What are the observations you would make about a patient with osteogenesis imperfecta?
Definition
1) Sclera has a blue, purple or gray tint
2) Hearing loss may be present
3) Triangular face.
Term
Describe the stages of fracture healing.
Definition
1) Haematoma and inflammation, granulation tissue forms
2) Cartilage and osteoid laid down by osteoblasts to make a 'provisional callus'
3) Bone is remodelled by the action of osteoblasts and osteoclasts.
Term
What is the difference between acromegaly and gigantism and what underlies these conditions?
Definition
Gigantism and acromegaly involve the excessive growth of bones and other tissues due to abnormal levels of growth hormone. Gigantism occurs in children before the epiphyseal closure. Acromegaly occurs in adults after the closure.
Term
What causes osteoporosis?
Definition
A decrease in bone calcium (menopause: reduced estrogen).
Term
What are the results of osteoporosis?
Definition
Fewer and narrower trabeculae.
Term
What is fibodysplasia ossificans progressiva?
Definition
'Stone man syndrome'.
Term
What is osteomalacia?
Definition
A failure of mineralisation which can be caused by a high intake or low excretion of calcium/ phosphate ions. It results in the softening of bone leading to an increased susceptibility to fractures.
Term
What is osteomalacia called in children?
Definition
Rickets.
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