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19 Cards in this Set

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how much blood circulation does the bone have?
10 mL/min per 100g wet bone
what happens in bone when systemic BP rises? with EPI? whats the highest pressure part?
- riske in pulse pressure
- decrease in pulse pressure from constriction of the nutrient artery
- d>m>e
4 sources of blood for the bone
- nutrient artery
- periosteal
- small that enter met
- small that enter ep
perostial vessels supply what? nutruent artery?
- outer 1/3 of cortes
- inner 2/3 and haversian systems
what bloody supply goes thrgouth metaphyseal channes
- some vesses that enter marrow cavity to anasatomose w/ nutrient artery
- mainly veins to let blood leave marrow cavity
what bloody supply goes through epiphyseal channels
- passage of vessels to 2o oss centers
- isolated in child, join w/ met vessels in closure
why does bone necrosis look more dense?
- osteoclastic resorption + new bone formation
- compression of bone
what happes w/ loss of circulation of the terminal vessels in the nutrient artery in kids?
- interferes w/ enchondral oss
- new cartilage keeps forming, but it isn't ossified until circuation is restored
- this is usually really fast in kids
can adults have cortical bone death?
- no
- lots of ep-met collateral circulation
- makes an ASx infarct that heal by calcification
what does it mean if adults have pain w/ a met infarct?
- they can't necrose cortical bone
- so it means emboli of nutrient artery
- caisson disease (the bends) w/ nitrogen bubbels entraped
- this shouldn't impair function that much
Perthes disease
- osteochondrosis of the femoral head
- males 5-10
- long growth ceases, and if there isn't quick restoration of blood supply, the physis closes
Kohler disease
- osteochondrosis of the talar navicular
- long growth ceases, and if there isn't quick restoration of blood supply, the physis closes
Frieburg disease
- osteochondrosis of the 2nd metatarsal head
- long growth ceases, and if there isn't quick restoration of blood supply, the physis closes
where are adults at risk of osteonecrosis?
- femoral head
- talus (body w/ neck is fractured)
- lunate
- scaphoid (proximal)
tx of perthes disease
- protect it from localized stress by maintaining complete coverage of the head by the acetabulum
- keep it abducted and internally rotated
- takes 2-3 years
etiology of adult femoral head AVN
- aterial compromise (fracture of neck, arterial thrombosis from Sickle cell)
- high intraosseius P (steroids, alcohol, Gaucher glycogen storage disease) from increased marrow cellularity and fat
tx of adult femoral head AVN
- early intraosseous P, you can drill the head
- later, bone grafting
- after collapse, osteotomy
- even later, replacement
whats the deal with increased bone blood circulation in children?
- from fracture, infection, AV fistulae
- can cause overgrowth
whats the deal with increased bone blood circulation in adults?
- degenerative arthritis
- Pagets (can even compromise CO)