Clinical Case Study: Look out Below: A Case on Bone Tissue Structure and Repair
Mrs. Debbie Morgan is a 45-year-old female who works as a stocking clerk for a local home improvement store. While she was at work today a large box of metal rivets fell from a 20-ft.-high overhead shelf, striking her outstretched arm and knocking her to the ground. The ambulance personnel reported that she had lost quite a bit of blood at the accident scene and was unconscious when they arrived. To minimize further hemorrhage, the paramedics applied a pressure bandage to her arm.
You meet the paramedics as they bring Mrs. Morgan into the emergency room and begin to assess her for injuries. She is awake and alert, but complaining of severe left arm and back pain, plus she has a "killer headache." To fully examine her injuries you remove four blood-soaked bandages from her arm. You notice a large open wound on her arm with what appears to be bone tissue sticking out of the skin. She also has bruises covering her left shoulder, left wrist, and lower back. To determine the extent of her injuries Mrs. Morgan undergoes several x-rays, which reveal the following: 1) fracture of the left humerus at the proximal diaphysis, 2) depressed fracture of the occipital bone, 3) fracture of the 3rd lumbar vertebral body.
Part A
Mrs. Morgan has an occipital bone fracture. Select the correct classification for this bone.
Mrs. Morgan has an occipital bone fracture. Select the correct classification for this bone.
flat
irregular
long
short
Part B
One of Mrs. Morgan's fractures is described as being located on the proximal diaphysis. Which of these phrases best describes the anatomical location of this fracture?
One of Mrs. Morgan's fractures is described as being located on the proximal diaphysis. Which of these phrases best describes the anatomical location of this fracture?
expanded end closest to the shoulder joint fractured
expanded end closest to the elbow joint fractured
shaft of the bone closest to the elbow joint
shaft of the bone closest to the shoulder joint
Part C
Mrs. Morgan's fracture is described as having "bone tissue sticking out of the skin." This could make her susceptible to which of the following complications?
Mrs. Morgan's fracture is described as having "bone tissue sticking out of the skin." This could make her susceptible to which of the following complications?
osteomalacia
osteomyelitis
osteosarcoma
osteoporosis
Part D
Mrs. Morgan's fracture has not developed a soft callus. Which type of cartilage is her body having trouble forming?
Mrs. Morgan's fracture has not developed a soft callus. Which type of cartilage is her body having trouble forming?
hyaline cartilage
fibrocartilage
elastic cartilage
compact cartilage
Part E
A depressed fracture is _______.
one due to weakening of the bone structure by pathologic processes such as cancer, osteomalacia, or osteomyelitis
one in which the bone has been twisted apart
one in which broken bone fragments are displaced inward
a term used to describe a fracture site that lacks ossification
Part F
Define the following terms, used in the case and also in associated questions. a. hemorrhage b. fracture c. proximal d. diaphysis
Essay answers are limited to about 500 words (3800 characters maximum, including spaces).
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Part G
One way bones are classified is by their shape. How would you classify the bones fractured by Mrs. Morgan?
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Part H
The body of Mrs. Morgan's vertebra is fractured. What type of bone tissue makes up the majority of the vertebral body? Describe the structure and function of this type of bone.
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Part I
The diaphysis of Mrs. Morgan's humerus is fractured. What type of bone makes up the majority of the diaphysis of long bones like the humerus? Describe the layers of bone tissue found here.
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Part J
Most connective tissue, including bone, is highly vascular. Which anatomical structures in Mrs. Morgan's compact bone house blood vessels? What sign or symptom in Mrs. Morgan's case is directly related to disruption of these structures by her bone fractures? How is the sign or symptom related to these anatomical structures?
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Part K
Within days after a fracture, a "soft callus" of fibrocartilage forms. What fibers are found in this type of cartilage? Identify the cells required for fibrocartilaginous callus formation and list their functions.
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Part L
As a fracture is repaired, new bone is added to the injury site. What term is used to describe the addition of new bone tissue? Identify which bone cell is responsible for this process and explain how it occurs.
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Part M
In the final stage of bone repair, some of the osseous tissue must be broken down and removed. What term is used to define the breaking down of osseous tissue? Which bone cell would be best suited for this task?
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Part N
The extracellular matrix (ECM) of bone is considered to be a composite material made up of organic and inorganic matter. What makes up the organic and inorganic portions of the matrix? Describe the cellular mechanism involved in breaking down this matrix; include the bone cell required for the process.
Essay answers are limited to about 500 words (3800 characters maximum, including spaces).
Which cartilage attaches the ribs to the sternum?
hyaline
elastic
fibrocartilage
areolar cartilage
Part A
https://session.masteringaandp.com/problemAsset/2126553/1/7870008007_u8a1_postlab.jpg Identify the structure labeled "b."
vertebra
appendicular bone
sternum
rib
Diagram show a section of spongy bone.
The bony plates visible in this figure are called _____.
canaliculi
trabeculae
osteons
lamellae
Which tissue lines the medullary cavity?
spongy bone
endosteum
periosteum
epiphysis
What is found within the osteon's lacunae?
chondrocytes
osteocytes
osteoblasts
oxygenated blood
What cells build the bone?
chondroblasts
osteoclasts
osteoblasts
fibroblasts
Which component of bone is dissolved by acids like vinegar?
calcium minerals
osteocytes
collagen
organic matrix