Clinical Disorders and Diseases of the Skeletal System

Cleft Palate• Occurs when the roof of a baby's mouth doesn't

fully develop (palatine bones fail to fuse) leaving an opening (cleft) in the palate that may go through to the nasal cavity.

• It is a birth defect that happens during pregnancy and can affect either the soft or hard palate.

• Cleft palate is treatable, and surgery is usually recommended.

Cleft Palate

Vertebral Column: CurvaturesScoliosis: abnormal lateral curvature of the spine– Occurs most often in the thoracic region

• Most common during adolescence and girls are more prone to developing the condition

• If muscles on one side of the body are not functioning properly, those on the opposite side tug on the spine and force it out of alignment

Scoliosis

Clinical Conditions• Osteomalacia

– Literally “soft bones.”– Includes many disorders in which

osteoid is produced but inadequately mineralized.• Causes can include insufficient dietary

calcium• Insufficient vitamin D fortification or

insufficient exposure to sun light.• Rickets

– Children's form of osteomalacia– More detrimental due to the fact that

their bones are still growing.– Signs include bowed legs, and

deformities of the pelvis, ribs, and skull.

Age and Bones

• Bone loss outpaces bone regeneration

• Bones weaken and lose mass

• Bones become brittle and fractures occur more often

• Found most often in women

Clinical Conditions

Fractures

• A break in the bone• Simple – bone breaks cleanly• Compound – the broken bone ends have

broken through the skin• Greenstick – bone splits and bends, does

not break (seen only in children)

Common fracture types (cont’d)

Common fracture types

• Comminuted fractures

• Spiral fractures

Figure 6–16 (4 of 9)

Figure 6–16 (7 of 9)

• Greenstick fracture

Figure 6–16 (9 of 9)

• Compression fractures

Depression fracture of the skull

X-ray & MRI

How do they work???

Steps in the Repair of a FractureStep 1 – • Immediately after the fracture, extensive

bleeding occurs. • A large blood clot, or fracture hematoma,

soon closes off the injured vessels and leaves a fibrous meshwork in the damaged area.

• The disruption of the circulation kills osteocytes around the fracture.

• Dead bone soon extends along the shaft.

Steps in the Repair of a Fracture

Step 2 – • The cells of the endosteum and periosteum

undergo cell division and the daughter cells migrate into the fracture zone.

• An external callus forms and encircles fracture• An internal callus organizes within the cavity

and between the broken ends of the shaft

Steps in the Repair of a Fracture

Step 3 – • Osteoblasts replace the central cartilage of the

external callus with spongy bone• Calluses form a brace at the fracture site• Spongy bone now unites the broken ends• Fragments of dead bone are removed and

replaced

Steps in the Repair of a Fracture

Step 4 – • Osteoclasts and osteoblasts continue to

remodel the region of the fracture (4 months to 1 year)

• When remodeling is complete, the bone of the calluses is gone and only living compact bone remains.

• The bone could be slightly thicker and stronger than normal at the fracture site

Fracture repair

Fracture repair (cont’d)

Treatment of a Fracture

• Initial treatment for fractures of arms, legs, hands, and feet include splinting the extremity in the position it is found, elevation, and ice.

• Edema (what does this have to do with splinting and casting?)

• Closed Reduction – manual realignment