Development of Bones

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Study Tools For Development of Bones

Bone Formation (Image)
Macroscopic Bone Structure (Picmonic)
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Outline

Overview

  1. Intramembranous → cranium & splanchnocranium
    1. Begins with flat sheets of CT (“Mesenchyme”)
    2. Primary ossification center forms (POC)
      1. Fibroblasts → osteoblasts
      2. Osteoblasts → trabecular bone
      3. Blood vessels grow into POC
      4. Marrow precursors enter
        1. Will become red bone marrow in spaces of trabecular bone
      5. Surface membrane → periosteum
      6. Produces thin layer of compact bone over POC
      7. Steps of ossification expand to edges of the membrane model
    3. 6 Fontanels @ birth
      1. Membrane spaces between fetal cranial bones
      2. Ossify this way
      3. At birth, cranial bones overlap one another to allow the skull to adapt to the birth canal
      4. See Peds 01.04 for timing of closures
  2. Intracartilaginous → long, short, irregular
    1. Ossification of long bone diaphysis
      1. All begin as hyaline cartilage
      2. Perichondrium → periosteum @ POC
      3. Periosteum → osteoblasts → thin compact bone
      4. “Bony collar” formed @ POC
      5. Cartilage inside bony collar grows and expands → compressing the matrix into flat plates
      6. Blood vessels grow in and bring calcium
        1. Cartilage becomes calcified
        2. Cartilage cells begin to die
      7. Osteoblasts and bone marrow precursors enter
        1. Osteoblasts → trabecular bone
        2. Precursors produce Red Marrow
      8. Process extends to ends to complete diaphysis
      9. Periosteum produces more compact bone at edges
      10. Osteoclasts from Red Bone Marrow break down spongy bone to create the Bone Marrow cavity of long bones
    2. Ossification of long bone epiphyses
      1. Secondary ossification center (SOC) forms in epiphyses
      2. Same steps as for diaphysis
      3. No bone marrow cavity
      4. Condition of epiphysis
        1. Articular cartilage
        2. Thin compact bone surrounds epiphyses underneath articular cartilage
        3. Central spongy bone containing red bone marrow
        4. Epiphyseal plate (disc)(growth plate)
          1. Hyaline cartilage
          2. Between epiphysis and diaphysis

Nursing Points

General

  1. Growth of bone through adolescence
    1. Length
      1. Intracartilaginous
      2. Site: epiphyseal plate
      3. Cartilage cells divide and grow next to epiphysis
      4. Old cartilage cells die → spongy bone
      5. Osteoclasts expand BM cavity to new areas
      6. Occurs simultaneously at both ends
    2. Circumference
      1. Intramembranous
      2. Site: Periosteum
        1. Osteoblasts →  compact bone at out surface of bone
      3. Endosteum
        1. Osteoclasts → expand BM cavity
  2. Factors affecting growth
    1. Thyroxine (thyroid gland)
      1. Metabolism of cartilage cells in epiphyseal plate
      2. Lack of thyroxine after birth
        1. Long bones shorter than normal
        2. Dwarfism
    2. Somatotropic hormone (anterior pituitary gland)
      1. Growth hormone → to liver
      2. Hypersecretion before closure = gigantism (8’ tall)
      3. Hyposecretion before closure = dwarfism (3’-3’6”)
    3. Estrogens and testosterone
      1. Affect closure
      2. Epiphyseal plate disappears, forming the epiphyseal line
        1. Stops growth in length of long bones
      3. Females→ 17-19
      4. Males → 19-21
      5. Everyone → by age 25
    4. Vitamin A Deficiency
      1. Reduces rate of cartilage cycle in epiphyseal plate
        1. Length = short
        2. Diameter = not affected
        3. Short and stubby
  3. Calcification = addition of calcium and phosphate to organic matrix (i.e. making the bone harder)
    1. Hormonal control
      1. Calcitonin (thyroid gland)
        1. Inhibits osteoclasts
        2. Favors production of new bone
      2. Parathormone (parathyroid gland)
        1. Stimulates osteoclasts
        2. Favors breakdown of bone
        3. Destroys inorganic matrix of bone
          1. Removes calcium and phosphate
    2. Vitamins
      1. Vit. A
        1. Excess → ↑ osteoclastic activity
        2. Bone breaks down and becomes brittle
      2. Vit. C
        1. Deficiency = abnormal proteoglycans in organic matrix
        2. Lack calcium and phosphate therefore bones are soft
      3. Vit. D
        1. Stimulates uptake of calcium and phosphate  from small intestine
        2. Deficiency = low calcium and phosphate
        3. Less calcification
        4. Soft bones
          1. Rickets in young
          2. Osteomalacia in aged

References
Betts, J.G., et al. (2017). Anatomy and physiology. Houston, TX: OpenStax, Rice University. Retrieved from https://openstax.org/details/books/anatomy-and-physiology?Book%20details

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Transcript

In this lesson we’re going to take a look at the development of bones.

In bone development we have two ways that it happens. The first one is called intramembranous bone development and the second one is called intracartilaginous bone development.

Intramembranous bone development is responsible for the flat bones so these are things like skull bones, clavicle, and the ribs. These are all flat bones and and they’re develop differently than things like long bones. So before we get into the intracartilaginous bone development let’s first look at the intramembranous bone development.

In utero you have these group of cells called mesenchymal stem cells and they all come together and they form something called the primary ossification center. These mesenchymal stem cells are turned into osteoblasts and osteoblasts begin to lay down new layers of bone tissue around the primary ossification center. These layers will eventually spread to the edges of whatever bone they’re forming but a couple of things happen during this process. First off any osteoblast to get trapped inside of the osteoid or the central location are turn into osteocytes. The other thing that happens is that blood vessels are formed into the primary ossification center. As this expansion occurs this osteoid forms this network called woven bone which is eventually turned into trabecular bone or spongy bone. And as it gets to the edge it begins to lay down the periosteum and underneath the periosteum will eventually be a layer of thin compact bone. And this process happens in sheets so you’ll have one layer that is going and you’ll have another layer that’s going at the same time until the entire bone is formed, and then it’s hardened over time.

Now that we’ve looked at intramembranous bone development let’s take a look at intracartilaginous bone development.

Alright so this process is really complicated so stick with me. In long bone, you have the diaphysis. It’s the shaft of the bone, and this is where all of this begins. You initially start with something call the hyaline cartilage and in the middle is the primary ossification center. At the primary ossification center the periosteum begins to form and it creates this thing around the bone called the bony collar. The cartilage inside the bony collar grows and expands, and it compresses all of the cells into these flat plates and it begins to harden. But it can’t do it without blood vessels. So the blood vessels grow in and they bring in the calcium and that’s when the ossification occurs. The osteoblasts begin to work on building the hard bone and the osteoclast begin to carve out in the middle of the bone known as the medullary cavity. That’s really how it works along the middle of the bone, so let’s check out what it looks like on the ends of the bone.

Intracartilaginous bone development in the epiphyses are not very different from the diaphysis. Instead of having a primary ossification center, you have something known as a secondary ossification center and it’s at the end of each bone. It’s the essential same concept as the diaphysis. However no bone marrow cavities are formed in each epiphysis.

But here’s some really interesting characteristics of the epiphysis that happened as a result of the bone development. First off there covered in articular cartilage. Then underneath it is a thin layer of compact bone than most of that after that is comprised primarily of central spongy bone. However a really unique characteristic of bone development is that the epiphysis has to meet the diaphysis. And this happens it’s something called the epiphyseal plate, or something we commonly known as a growth plate. And now we’ll look at how bone growth actually occurs.

Okay so let’s take a look at bone growth especially through adolescence. What we’re talking about right now is a length of the bone.

So you have the diaphysis and you have the epiphysis and then you have the epiphyseal plate here.

As cartilage cells come in they lie next to the epiphyseal plate and the bone gets longer. These cartilage cells did generate, and are converted into spongy bone. As the bone lengthens the osteoclasts will come in and break down areas Within the bone to lengthen the diaphysis.

So this is what it would look like in terms of length. You have your epiphysis which grows new cartilage and then you have your medullary cavity. As a bone gets longer do you have more layers of cartilage that is converted into spongy bone. Well your medullary cavity needs to increase so the osteoclasts come in and cave out more medullary cavity.

When we talk about circumference, especially in flat bone, this happens underneath the periosteum. The osteoblasts put down new bone cells at the outer surface of the bone. Inside the bone, the endosteum expands the bone marrow cavity when osteoclasts break down bone tissue to allow for bone marrow cavity formation as the bone grows larger.
So now let’s take a look at different types of factors that will affect the growth of the bone.

Thyroxine is the thyroid hormone, and what we’re looking at is that when you have decreased thyroxine you’re going to have decreased bone growth.

The somatotropic hormone is produced in the anterior pituitary gland and if you have an overproduction of the somatotropic, and you’re going to have increased bone growth and if you have a decreased secretion you’re going to have decreased bone growth.

Estrogen and testosterone also affect bone growth. They affect closure of the epiphyseal plates are the growth plates, and this is related to puberty. Because of this bone development stops around 17 to 19 in females, and males around the ages of 19 to 21.

Vitamin A deficiency also affect bone growth. Reduced vitamin A intake causes a reduced rate of the cartilage cycle, and the length of the overall bones are shortened.

Now what kind of things affect calcification of the bone?

Well calcitonin which is produced in the thyroid gland that inhibits osteoclasts. And that in turn favors production of new bone.

Parathormone or the parathyroid hormone is produced in the parathyroid gland. It stimulates osteoclasts and that favors the breakdown a bone. What happens is it destroys the inorganic Matrix of the bone and removes calcium and phosphate from the bone. This is important in the regulation of calcium in the blood, but problems with the parathyroid gland can actually cause changes in overall calcium levels in can lend itself to conditions like osteoporosis.

Let’s take a look at how vitamin intake effects bone production.

Vitamin A is really important for bone development. However excess vitamin A actually increases osteoclast activity meaning that you’re going to have an excess breakdown on that bone. So too much vitamin A causes bones to break down and become brittle.

Vitamin C is important because vitamin C deficiencies cause an abnormal matrix and that and causes decreases in the calcium and phosphate.

And then there’s vitamin D. Vitamin D is responsible for stimulating the uptake of calcium from the small intestine. So if you don’t have enough vitamin D, you can’t stimulate that process and calcium is not deposited into bones.

Okay so let’s recap.

Intramembranous bone development is formed in sheets and it starts from one primary ossification center and moves outward until the entire bone is formed.

Intracartilaginous bone development starts centrally and grows outward but it also text in the process of making that medullary cavity. There’s also the secondary ossification centers in the epiphyses which are important for those ends of the bone growth.

When we are talking about bone growth, especially through adolescence, this growth happens along the epiphyseal plate, then the medullary cavity expands.

Calcification of bone is influenced by both calcitonin and parathormone. Calcitonin impedes osteoclasts, and parathormone promotes osteoclasts.

Vitamin intake is vitally important for bone growth. Vitamin A, C and D all impact how bones develop.

That’s it for our lesson on bone development. Make sure you check out all the resources attached to this lesson. Now go out and be your best I was today, and as always happy nursing.

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Anatomy & Physiology Course Introduction
Blood Pressure (BP) Control
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Bone Structure
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Inserting a Foley (Urinary Catheter) – Male
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Development of Bones
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Human Biology Course Introduction
Infection or Inflammation? The Quick & Dirty on CBCs – Live Tutoring Archive
Infection or Inflammation? The Quick & Dirty on CBCs 2 – Live Tutoring Archive
Infection Stages
Infectious Diseases: Multidrug-Resistant Organisms (MRSA, VRE, CRE, ESBL) for Progressive Care Certified Nurse (PCCN)
Inflammation- Signs and Symptoms Nursing Mnemonic (HIPER)
Intro to Cell Metabolism
Intro to Ions & Molecules
Key Nutrients in the Prevention of Chronic Disease
Lipids, Carbohydrates & Proteins
Macro and Micronutrients
Mechanisms of Antimicrobial Agents
Meiosis & Mitosis
Membranous Organelles
Molecular vs Serological Diagnosis
Multi-Drug Resistant Organisms (MRSA, VRE) for Certified Emergency Nursing (CEN)
Mycotoxins and Mycotoxicosis
Needle Safety
Non-Membranous Organelles
Nursing Care Plan (NCP) for Infection
Nursing Care Plan (NCP) for West Nile Virus
Nutrition Course Introduction
Nystatin (Mycostatin) Nursing Considerations
Parasites and Parasite Replication
Protein Synthesis & Nucleic Acids
Tonicity of Solutions – Live Tutoring Archive
Viral Reproduction
Viruses & Fungi
12 Points to Answering Pharmacology Questions
6 Rights of Medication Administration
ACLS (Advanced cardiac life support) Drugs
Adenosine (Adenocard) Nursing Considerations
Amiodarone (Pacerone) Nursing Considerations
Anesthetic Agents
Anti-Infective – Antifungals
Anti-Platelet Aggregate
Antianxiety Meds
Antidepressants
Atenolol (Tenormin) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Barbiturates
Bariatric: IV Insertion
Basics of Calculations
Benztropine (Cogentin) Nursing Considerations
Bisacodyl (Dulcolax) Nursing Considerations
Buspirone (Buspar) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Codeine (Paveral) Nursing Considerations
Combative: IV Insertion
Complex Calculations (Dosage Calculations/Med Math)
Cyclosporine (Sandimmune) Nursing Considerations
Dark Skin: IV Insertion
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Drawing Blood from the IV
Drawing Up Meds
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Epoetin Alfa
Eye Prophylaxis for Newborn
Fentanyl (Duragesic) Nursing Considerations
Geriatric: IV Insertion
Giving Medication Through An IV Set Port
Glipizide (Glucotrol) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Hanging an IV Piggyback
How to Remove (discontinue) an IV
How to Secure an IV (chevron, transparent dressing)
Hydralazine
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
Hydromorphone (Dilaudid) Nursing Considerations
IM Injections
Injectable Medications
Insulin
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin Drips
Insulin Mixing
Interactive Pharmacology Practice
Interactive Practice Drip Calculations
IV Catheter Selection (gauge, color)
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
IV Infusions (Solutions)
IV Insertion Angle
IV Insertion Course Introduction
IV Placement Start To Finish (How to Start an IV)
IV Pump Management
IV Push Medications
Ketorolac (Toradol) Nursing Considerations
Labeling (Medications, Solutions, Containers) for Certified Perioperative Nurse (CNOR)
Lidocaine (Xylocaine) Nursing Considerations
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Maintenance of the IV
Mannitol (Osmitrol) Nursing Considerations
MAOIs
Medication Errors
Medication Reconciliation Review for Certified Perioperative Nurse (CNOR)
Medications in Ampules
Meds for Postpartum Hemorrhage (PPH)
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Methylergonovine (Methergine) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Mood Stabilizers
Nalbuphine (Nubain) Nursing Considerations
Needle Safety
Neostigmine (Prostigmin) Nursing Considerations
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Nitro Compounds
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
Nystatin (Mycostatin) Nursing Considerations
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Olanzapine (Zyprexa) Nursing Considerations
Opioid Analgesics in Pregnancy
Oral Medications
Oxycodone (OxyContin) Nursing Considerations
Pain Management for the Older Adult – Live Tutoring Archive
Pain Management Meds – Live Tutoring Archive
Parasympathomimetics (Cholinergics) Nursing Considerations
Patient Controlled Analgesia (PCA)
Pediatric Dosage Calculations
Pentobarbital (Nembutal) Nursing Considerations
Pharmacodynamics
Pharmacokinetics
Pharmacokinetics Nursing Mnemonic (ADME)
Pharmacology Course Introduction
Phenobarbital (Luminal) Nursing Considerations
Phytonadione (Vitamin K) for Newborn
Pill Crushing & Cutting
Positioning
Procainamide (Pronestyl) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Rh Immune Globulin in Pregnancy
Sedatives-Hypnotics
Sedatives-Hypnotics
Selecting THE vein
Spiking & Priming IV Bags
Starting an IV
Streptokinase (Streptase) Nursing Considerations
Struggling with Dimensional Analysis? – Live Tutoring Archive
SubQ Injections
Supplies Needed
Tattoos IV Insertion
TCAs
The SOCK Method – C
The SOCK Method – K
The SOCK Method – O
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method of Pharmacology 1 – Live Tutoring Archive
The SOCK Method of Pharmacology 2 – Live Tutoring Archive
The SOCK Method of Pharmacology 3 – Live Tutoring Archive
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Verapamil (Calan) Nursing Considerations