Week 6 Case Study

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Chamberlain College of Nursing *

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251X

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Anatomy

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Apr 3, 2024

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docx

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1 Case Study: Bone Christiana Sodeke Nursing, Chamberlain University BIOS251X-16854: Anatomy & Physiology I with Lab Dr. Justin Wiethop February 18, 2024

2 Case Study: Bone Describe the bone cells that are involved in the generation of bone tissue. There are 4 primary bone cells that are responsible for the generation of bone tissue. These cells are called: osteogenic cells, osteoblasts, osteocytes, and osteoclasts. Osteogenic cells are the only cells that divide and are the stem cells of the bone cells. Osteogenic cells will differentiate into bone cells such as osteoblasts and osteoclasts. Osteoblasts are responsible for the synthesis of bone formation from organic matter and this process is called osteogenesis. Osteocytes are cells that are deposited and trapped in the cellular matrix and mature osteoblasts. Osteocytes act as strain sensors and produce biochemical signals that are responsible for the regulation of bone formation and remodeling. Osteoclasts are the cells responsible for the breakdown and reabsorption of bone. Osteoclasts carry out bone-dissolving functions and are also essential in bone remodeling along with osteoblasts. Describe the steps of fracture repair. There are four stages in the repair of a broken bone, the formation of hematoma at the break, the formation of a fibrocartilaginous callus, the formation of a bony callus, and the remodeling and addition of compact bone. Step 1: Hematoma formation: occurs immediately after the fracture. The blood vessels supplying the bone and periosteum are ruptured during the fracture. This causes a hematoma to form around the fracture. As the hematoma clots it forms the temporary frame for the next healing steps (Sheen, 2023). Step 2: Fibrocartilaginous callus formation: mesenchymal stem cells at the site of fracture start to differentiate into fibroblasts, chondroblasts, and osteoblasts. As this

3 occurs a collagen-rich fibrocartilaginous network is laid across the fracture site with a hyaline cartilage sleeve (Sheen, 2023). Step 3: Bony callus formation: then the cartilaginous callus starts the process of endochondral ossification. The cartilaginous callus is resorbed and begins to calcify. As this occurs woven bone continues to be laid down. New blood vessels emerge allowing. migration of mesenchymal stem cells. As this ends a hard calcified callus of immature bone is formed (Sheen, 2023). Step 4: Bone remodeling: the hard callus continues remodeling as the migration of osteoblasts and osteoclasts occurs. This is known as coupled remodeling where a balance of resorption by osteoclasts and new bone formation by osteoblast. The callus center is replaced by compact bone and the edges become lamella bone. This can last many months with a conclusion of regeneration of the normal bone structure (Sheen, 2023). The physician indicated that Kyndall was lucky because the fracture occurred about 3 inches below the epiphyseal plate. Why is this important? What are some possible outcomes if the epiphyseal plate had been damaged? It is important that Kyndall’s fracture occurred about 3 inches below the epiphyseal plate because this is the primary area of longitudinal growth for the long bones. According to an article by Hospital for special surgery, it states that the epiphyseal plate is where new bone develops and adds length as the child gets older. As the child grows into an adult these plates close and form solid bones. If the epiphyseal plate is damaged it could cause growth deformities in children and teens. Injury to this area could cause the plate to close early and stop bone growth.

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