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Chapter 6 Bones and Skeletal Tissue

front 1

Using Figure 6.1, match the following bone types with the numbered structure:

1) Bone 1
2) Bone 2
3) Bone 3
4) Bone 4
5) Bone 5
6) Bone 6
7) Bone 7

A. Long
B. Short
C. Flat
D. Irregular
E. Sesamoid

back 1

1) Bone 1 C
2) Bone 2 A
3) Bone 3 C
4) Bone 4 D
5) Bone 5 A
6) Bone 6 E
7) Bone 7 B

front 2

Using Figure 6.2, match the following:

8) Compact bone
9) Location of the epiphyseal line
10) Area where yellow marrow is found
11) Area with articular cartilage

back 2

8) C
9) B
10) D
11) A

front 3

Bones are porous and thin but bone composition is normal.

A) Osteomalacia
B) Paget's disease
C) Osteoporosis

back 3

C) Osteoporosis

front 4

Bone formed is poorly mineralized and soft. Deforms on weight bearing.

A) Osteomalacia
B) Paget's disease
C) Osteoporosis

back 4

A) Osteomalacia

front 5

Abnormal bone formation and reabsorption.

A) Osteomalacia
B) Paget's disease
C) Osteoporosis

back 5

B) Paget's disease

front 6

An incomplete fracture or cracking of the bone without actual separation of the parts. Common in children.

A) Comminuted
B) Spiral
C) Greenstick

back 6

C) Greenstick

front 7

Bone fragments into many pieces.

A) Comminuted
B) Spiral
C) Greenstick

back 7

A) Comminuted

front 8

Common sports fracture resulting from a twisting force.

A) Comminuted
B) Spiral
C) Greenstick

back 8

B) Spiral

front 9

The lining of the marrow cavity.

A) Endosteum
B) Canaliculi
C) Osteoblasts
D) Osteoclasts
E) Lamellae

back 9

A) Endosteum

front 10

Cells that can dissolve the bony matrix.

A) Endosteum
B) Canaliculi
C) Osteoblasts
D) Osteoclasts
E) Lamellae

back 10

D) Osteoclasts

front 11

Layers of bone matrix.

A) Endosteum
B) Canaliculi
C) Osteoblasts
D) Osteoclasts
E) Lamellae

back 11

E) Lamellae

front 12

Small channels that radiate through the matrix of bone.

A) Endosteum
B) Canaliculi
C) Osteoblasts
D) Osteoclasts
E) Lamellae

back 12

B) Canaliculi

front 13

Cells that can build bony matrix.

A) Endosteum
B) Canaliculi
C) Osteoblasts
D) Osteoclasts
E) Lamellae

back 13

C) Osteoblasts

front 14

The cells responsible for the early stages of endochondral ossification.

A) Chondrocytes
B) Appositional growth
C) Epiphyseal line
D) Diaphysis
E) Epiphyseal plate

back 14

A) Chondrocytes

front 15

The growth pattern of bone in which matrix is laid down on the surface.

A) Chondrocytes
B) Appositional growth
C) Epiphyseal line
D) Diaphysis
E) Epiphyseal plate

back 15

B) Appositional growth

front 16

The area of long bones where cartilage cells are replaced by bone cells.

A) Chondrocytes
B) Appositional growth
C) Epiphyseal line
D) Diaphysis
E) Epiphyseal plate

back 16

D) Diaphysis

front 17

The appearance of this structure signals the end of bone growth.

A) Chondrocytes
B) Appositional growth
C) Epiphyseal line
D) Diaphysis
E) Epiphyseal plate

back 17

C) Epiphyseal line

front 18

Area where bone longitudinal growth takes place.

A) Chondrocytes
B) Appositional growth
C) Epiphyseal line
D) Diaphysis
E) Epiphyseal plate

back 18

E) Epiphyseal plate

front 19

Radius.

A) Short bone
B) Long bone
C) Irregular bone
D) Flat bone
E) Sesamoid bone

back 19

B) Long bone

front 20

Carpals.

A) Short bone
B) Long bone
C) Irregular bone
D) Flat bone
E) Sesamoid bone

back 20

A) Short bone

front 21

Patella.

A) Short bone
B) Long bone
C) Irregular bone
D) Flat bone
E) Sesamoid bone

back 21

E) Sesamoid bone

front 22

Scapula.

A) Short bone
B) Long bone
C) Irregular bone
D) Flat bone
E) Sesamoid bone

back 22

D) Flat bone

front 23

Hip bones.

A) Short bone
B) Long bone
C) Irregular bone
D) Flat bone
E) Sesamoid bone

back 23

C) Irregular bone

front 24

True/False?

1) Hematopoiesis refers to the formation of blood cells within the red marrow cavities of certain
bones.

back 24

TRUE

front 25

True/False?

Compact bone is replaced more often than spongy bone.

back 25

FALSE

front 26

True/False?

Bones are classified by whether they are weight bearing or protective in function.

back 26

FALSE

front 27

True/False?

The periosteum is a tissue that serves only to protect the bone because it is not supplied with
nerves or blood vessels.

back 27

FALSE

front 28

True/False?

Short, irregular, and flat bones have large marrow cavities in order to keep the weight of the
bones light.

back 28

FALSE

front 29

True/False?

In newborn infants, the medullary cavity and all areas of spongy bone contain yellow bone
marrow.

back 29

FALSE

front 30

True/False?

The structural unit of compact bone (osteon) resembles the growth rings of a tree trunk.

back 30

TRUE

front 31

True/False?

The term osteoid refers to the organic part of the matrix of compact bones.

back 31

TRUE

front 32

True/False?

Sixty-five percent of the mass of bone is a compound called hydroxyapatite.

back 32

TRUE

front 33

True/False?

All bones formed by intramembranous ossification are irregular bones.

back 33

FALSE

front 34

True/False?

An osteon contains osteocytes, lamellae, and a central canal, and is found in compact bone
only.

back 34

TRUE

front 35

True/False?

The trabeculae of spongy bone are oriented toward lines of stress.

back 35

TRUE

front 36

True/False?

Bone tissue in the skeleton of a human fetus is completely formed at six months' gestation.

back 36

FALSE

front 37

True/False?

Each consecutive bone lamella has collagen fibers that wrap in alternating directions.

back 37

TRUE

front 38

True/False?

Cartilage has a flexible matrix that can accommodate mitosis of chondrocytes.

back 38

TRUE

front 39

True/False?

Closure of the epiphyseal plate stops all bone growth.

back 39

FALSE

front 40

The structure of bone tissue suits the function. Which of the following bone tissues is adapted to support weight and withstand tension stress?

A) spongy bone
B) irregular bone
C) compact bone
D) trabecular bone

back 40

C) compact bone

front 41

Yellow bone marrow contains a large percentage of ________.

A) fat
B) blood-forming cells
C) elastic tissue
D) Sharpey's fibers

back 41

A) fat

front 42

The cell responsible for secreting the matrix of bone is the ________.

A) osteocyte
B) osteoblast
C) osteoclast
D) chondrocyte

back 42

B) osteoblast

front 43

What kind of tissue is the forerunner of long bones in the embryo?

A) elastic connective tissue
B) dense fibrous connective tissue
C) fibrocartilage
D) hyaline cartilage

back 43

D) hyaline cartilage

front 44

What can a deficiency of growth hormone during bone formation cause?

A) inadequate calcification of bone
B) decreased osteoclast activity
C) decreased proliferation of the epiphyseal plate cartilage
D) increased osteoclast activity

back 44

C) decreased proliferation of the epiphyseal plate cartilage

front 45

A fracture in the shaft of a bone would be a break in the ________.

A) epiphysis
B) metaphysis
C) diaphysis
D) articular cartilage

back 45

C) diaphysis

front 46

The term diploƫ refers to the ________.

A) double-layered nature of the connective tissue covering the bone
B) fact that most bones are formed of two types of bone tissue
C) internal layer of spongy bone in flat bones
D) two types of marrow found within most bones

back 46

C) internal layer of spongy bone in flat bones

front 47

Which of the following is a bone marking name that indicates a projection that helps to form
joints?

A) meatus
B) ramus
C) foramen
D) fossa
E) epicondyle

back 47

B) ramus

front 48

Factors in preventing (or delaying) osteoporosis include ________.

A) drinking fluoridated water
B) decreasing weight-bearing exercise
C) increasing dietary vitamin C
D) decreasing exposure to the sun

back 48

A) drinking fluoridated water

front 49

Ossification of the ends of long bones ________.

A) is a characteristic of intramembranous bone formation
B) involves medullary cavity formation
C) is produced by secondary ossification centers
D) takes twice as long as diaphysis

back 49

C) is produced by secondary ossification centers

front 50

Which structure allows the diaphysis of the bone to increase in length until early childhood,
as well as shaping the articular surfaces?

A) lacunae
B) Haversian system
C) epiphyseal plate
D) epiphyseal line

back 50

C) epiphyseal plate

front 51

The most abundant skeletal cartilage type is ________.

A) hyaline
B) elastic
C) fibrocartilage
D) epiphyseal

back 51

A) hyaline

front 52

Which of the following is not a function of the skeletal system?

A) support
B) storage of minerals
C) production of blood cells (hematopoiesis)
D) communication

back 52

D) communication

front 53

What is the structural unit of compact bone?

A) osseous matrix
B) spongy bone
C) lamellar bone
D) the osteon

back 53

D) the osteon

front 54

Bones are covered and lined by a protective tissue called periosteum. The inner (osteogenic)
layer consists primarily of ________.

A) cartilage and compact bone
B) marrow and osteons
C) osteoblasts and osteoclasts
D) chondrocytes and osteocytes

back 54

C) osteoblasts and osteoclasts

front 55

The periosteum is secured to the underlying bone by dense connective tissue called
________.

A) Volkmann's canals
B) a bony matrix with hyaline cartilage
C) perforating (Sharpey's) fibers
D) the struts of bone known as spicules

back 55

C) perforating (Sharpey's) fibers

front 56

The canal that runs through the core of each osteon (the Haversian canal) is the site of
________.

A) cartilage and interstitial lamellae
B) osteoclasts and osteoblasts
C) yellow marrow and spicules
D) blood vessels and nerve fibers

back 56

D) blood vessels and nerve fibers

front 57

What are the small spaces in bone tissue that are holes in which osteocytes live called?

A) lacunae
B) Volkmann's canals
C) Haversian canals
D) trabeculae

back 57

A) lacunae

front 58

For intramembranous ossification to take place, which of the following is necessary?

A) A bone collar forms around the cartilage model.
B) An ossification center forms in the fibrous connective tissue.
C) The cartilage matrix begins to deteriorate.
D) A medullary cavity forms.

back 58

B) An ossification center forms in the fibrous connective tissue.

front 59

The process of bones increasing in width is known as ________.

A) closing of the epiphyseal plate
B) long bones reaching adult length and width
C) appositional growth
D) concentric growth

back 59

C) appositional growth

front 60

Bones are constantly undergoing resorption for various reasons. Which of the following cells
accomplishes this process?

A) osteoclast
B) osteocyte
C) osteoblast
D) stem cell

back 60

A) osteoclast

front 61

Which hormone increases osteoclast activity to release more calcium ions into the bloodstream?

A) calcitonin
B) thyroxine
C) parathyroid hormone
D) estrogen

back 61

C) parathyroid hormone

front 62

The universal loss of mass seen in the skeleton, which begins about the age of 40, ________.

A) is slower in females than in males
B) is absolutely uniform throughout the skeleton
C) reflects incomplete osteon formation and mineralization
D) is greater in African Americans than in Northern Europeans

back 62

C) reflects incomplete osteon formation and mineralization

front 63

Wolff's law is concerned with ________.

A) vertical growth of bones being dependent on age
B) the thickness and shape of a bone being dependent on stresses placed upon it
C) the function of bone being dependent on shape
D) the diameter of the bone being dependent on the ratio of osteoblasts to osteoclasts

back 63

B) the thickness and shape of a bone being dependent on stresses placed upon it

front 64

Cranial bones develop ________.

A) from cartilage models
B) within fibrous membranes
C) from a tendon
D) within osseous membranes

back 64

B) within fibrous membranes

front 65

Which of the following glands or organs produces hormones that tend to decrease blood
calcium levels?

A) pineal gland
B) thyroid
C) parathyroid
D) spleen

back 65

B) thyroid

front 66

Osteomyelitis is ________.

A) partially due to insufficient dietary calcium
B) literally known as "soft bones"
C) due to pus-forming bacteria
D) caused by altered vitamin D metabolism

back 66

C) due to pus-forming bacteria

front 67

Cartilage grows in two ways, appositional and interstitial. What is appositional growth?

A) growth at the epiphyseal plate
B) the secretion of new matrix against the external face of existing cartilage
C) along the edges only
D) the lengthening of hyaline cartilage

back 67

B) the secretion of new matrix against the external face of existing cartilage

front 68

Which of the following statements best describes interstitial growth?

A) Growth occurs in the lining of the long bones.
B) Fibroblasts give rise to chondrocytes that differentiate and form cartilage.
C) Unspecialized cells from mesenchyme develop into chondrocytes, which divide and form
cartilage.
D) Chondrocytes in the lacunae divide and secrete matrix, allowing the cartilage to grow from
within.

back 68

D) Chondrocytes in the lacunae divide and secrete matrix, allowing the cartilage to grow from
within.

front 69

In the epiphyseal plate, cartilage grows ________.

A) by pulling the diaphysis toward the epiphysis
B) by pushing the epiphysis away from the diaphysis
C) from the edges inward
D) in a circular fashion

back 69

B) by pushing the epiphysis away from the diaphysis

front 70

Spongy bones are made up of a framework called ________.

A) osteons
B) lamellar bone
C) trabeculae
D) osseous lamellae

back 70

C) trabeculae

front 71

Osteogenesis is the process of ________.

A) making a cartilage model of the fetal bone
B) bone destruction to liberate calcium
C) bone formation
D) making collagen fibers for calcified cartilage

back 71

C) bone formation

front 72

Lengthwise, long bone growth during infancy and youth is exclusively through ________.

A) interstitial growth of the epiphyseal plates
B) the secretion of bone matrix into the medullary cavity
C) differentiation of osteoclasts
D) calcification of the matrix

back 72

A) interstitial growth of the epiphyseal plates

front 73

Growth of bones is controlled by a symphony of hormones. Which hormone is important for bone growth during infancy and childhood?

A) thyroid hormone
B) somatomedins
C) growth hormone
D) prolactin

back 73

C) growth hormone

front 74

In some cases the epiphyseal plate of the long bones of children closes too early. What might
be the cause?

A) overproduction of thyroid hormone
B) elevated levels of sex hormones
C) too much vitamin D in the diet
D) osteoblast activity exceeds osteoclast activity

back 74

B) elevated levels of sex hormones

front 75

Normal bone formation and growth are dependent on the adequate intake of ________.

A) calcium, phosphate, and vitamin D
B) potassium, phosphate, and vitamin D
C) sodium, calcium, and vitamin E
D) vitamin D, phosphate, and chloride

back 75

A) calcium, phosphate, and vitamin D

front 76

Ostealgia is ________.

A) a defect called clubfoot
B) a disease of the bone
C) pain in a bone
D) fractured bone

back 76

C) pain in a bone

front 77

Blood cell formation is called ________.

back 77

hematopoiesis

front 78

A bone embedded in a tendon is called a(n) ________ bone.

back 78

sesamoid

front 79

A central (Haversian) canal may contain arteries, veins, capillaries, lymph vessels, and
________ fibers.

back 79

nerve

front 80

A long bone forms by a process known as ________ ossification.

back 80

endochondral

front 81

________ growth is growth in the diameter of long bones.

back 81

Appositional

front 82

________ are multinucleated cells that destroy bone.

back 82

Osteoclasts

front 83

________ is a disease of the bone in which bone reabsorption outpaces bone deposit, leaving the person with thin and often very fragile bones.

back 83

Osteoporosis

front 84

A round or oval hole through a bone that contains blood vessels and/or nerves is called a(n)
________.

back 84

foramen

front 85

List the steps in the repair process of a simple fracture.

back 85

Hematoma formation, fibrocartilaginous callus formation, bony callus formation, and
remodeling.

front 86

What is found in a Haversian canal?

back 86

Blood vessels and nerve fibers.

front 87

Several hormones control the remodeling of bones. Which two respond to changing blood calcium levels?

back 87

To keep bones in proper dimensions, PTH and calcitonin are the major determinants of whether and when remodeling will occur in response to changing blood calcium.

front 88

Why are the bones of young children much more flexible than those of the elderly?

back 88

Bones of children are not completely calcified, with a higher ratio of more flexible organic fibers. Bones in the elderly are more completely calcified, which gives the characteristic of rigidity.

front 89

Inflammation of bony tissue is called ________.

back 89

osteitis

front 90

Bones appear to be lifeless structures. Does bone material renew itself?

back 90

Bone only appears lifeless in gross anatomy. Microscopically, bone is full of cells and blood vessels that maintain and renew bone tissue. Approximately 5% to 7% of our bone mass is recycled each week. Up to 0.5 g of calcium may enter or leave the bones each day, depending on the negative feedback hormonal mechanism and gravitational forces.

front 91

Compare the function of the organic materials in the bone matrix with the function of the
inorganic materials in the matrix.

back 91

The organic matrix contributes to the bone structure and its tensile strength, while the
inorganic matrix contributes to hardness and resistance to compression.

front 92

What are the differences between the diaphysis and the epiphyses of long bones?

back 92

The diaphysis bone is composed almost entirely of compact bone (except in irregular and short bones), while the epiphyses are composed almost entirely of spongy bone. The epiphyses are on the ends of the bone; the diaphysis is the "shank" of the bone. The diaphysis in long bones has a large medullary cavity, whereas the epiphyses do not.

front 93

Describe how oxygen is carried from outside a bone to an individual osteocyte.

back 93

Blood vessels enter through the periosteum into a perforating canal. The vessel may follow along the axis of the bone through a central canal. Osteocytes have long, almost dendritic-like extensions or arms that reach out through tiny holes called canaliculi. The canaliculi connect one cell to another and to the central canal. Oxygen would leave the blood vessel in the central canal and travel through the canaliculi from cell to cell until it reaches the
cell in question.

front 94

How is the beginning of intramembraneous ossification different from endochondral
ossification?

back 94

Intramembraneous ossification starts in connective tissue from mesenchymal cells that become osteoblasts. These osteoblasts cluster together into an ossification center. Endochondral
ossification starts with a hyaline cartilage "template." Mesenchymal cells become osteoblasts
and begin forming bone around the cartilage.

front 95

If your doctor notices a marked decrease in calcium ion levels in your blood, what gland
might he suspect is not functioning properly and why?
Answer: T

back 95

The parathyroid gland normally responds to low calcium ion levels in the blood and releases PTH, which mobilizes osteoclasts to step up bone destruction, releasing more calcium into the bloodstream. If the parathyroid is not functioning properly it may release too much PTH or not respond at all, which seems to be the case here.

front 96

Clinical Questions
While on vacation last spring, June fell on the pavement and broke her wrist. At the emergency room, a resident placed a cast on her wrist after manipulating the bones. It seemed to heal within a few months. However, recently she has noticed lumps in the area where the break happened and she has been complaining of pain. What could be causing the lumps and the pain?

back 96

June probably has "bony spurs," which are abnormal projections from a bone due to bone overgrowth.

front 97

Clinical Questions
Alice and James adopted a 3-year-old child from a developing country. They noticed that her legs were bowed and there were some deformities in her cranial and pelvic bones. They brought her to a physician for a diagnosis. What was the diagnosis, and what was the treatment for the
disorder?

back 97

The child most likely has rickets, a condition caused by poor diet, especially one deficient in vitamin D. The parents were told to increase her intake of calcium and vitamin D and to make sure that she gets some sunshine every day.

front 98

Clinical Questions
Emily, a 64-year-old obese woman, was brought to the hospital suffering pain in her legs, and an X ray revealed that she had a simple fracture in her right femur and a crack in her left tibia. Other tests revealed that her bones were brittle and porous. What might have happened to Emily, and what advice would she have been given by the physician?

back 98

Emily has osteoporosis, a debilitating bone disease that strikes more women than men after age 45-50. The bones become weak and brittle due to leaching of calcium from the bone. Emily has been told that she needs to lose weight because her bones may not have the strength to support her body mass.

front 99

Clinical Questions
A 75-year-old woman and her 9-year-old granddaughter were victims of a train crash. In both cases, trauma to the chest was sustained. X rays of the grandmother revealed several fractured
ribs, but her granddaughter had none. Explain these different findings.

back 99

The child had more organic material in her bones, which allows them to bend, while her grandmother's bones are extensively calcified, with little organic material, and are probably thin due to osteoporosis.

front 100

Clinical Questions
Johnny fractured the lower third of his right tibia in a skiing accident. The soft tissues in the
area were severely damaged and their surgical removal was necessary. After prolonged
immobilization, it was found that Johnny was healing very poorly. The explanation offered by
the orthopedic surgeon was that vascularization of the fracture site was still inadequate and good
healing was absolutely dependent upon an adequate blood supply. Describe how a long bone receives its blood supply and trace the path of nutrient delivery to the osteocytes.

back 100

Long bones are nourished by nutrient arteries that frequently enter the shaft. Removal of the soft tissues probably reduced the flow of blood to the affected area. The pathway would include diffusion of nutrients from blood vessels to periosteum to Volkmann's canals to Haversian canals to canaliculi to lacunae.

front 101

Clinical Questions
People who live in the north should take supplemental calcium with vitamin D. Explain why.

back 101

Vitamin D is manufactured by sunlight and is needed for absorption of dietary calcium. People who live in the north where the winter months are severe may need supplemental vitamin D because of the decreased amount of sunlight exposure.

front 102

Clinical Questions
When does prevention of osteoporosis start?

back 102

The prevention of osteoporosis should begin with children. Parents need to provide children with the opportunity to develop as much bone as they have inherited the ability to develop. If people increase their peak bone mass as young adults, they will have additional protection from osteoporotic fractures in the future.

front 103

Clinical Questions
If your elderly patient's blood calcium level is normal, does that mean the patient does not
have osteoporosis? Explain.

back 103

No. The level of calcium in the blood is expected to be normal, even in advanced cases of osteoporosis. The calcium in the bones will be low, but that is not indicated by the blood nourishment.

front 104

Clinical Questions
Mrs. Brown was outside on her patio cleaning windows when she fell off her step ladder and
fractured her right hip. She had emergency surgery for an open reduction and internal fixation of
the right hip. Three days postoperative, she asks you if she will have trouble going through
airport security. What has prompted her concern?

back 104

Open reduction is the correction of the bone alignment through a surgical incision. It may include internal fixation of the fracture with the use of rods, wire, screws, pins, or nails, metal items that may trigger security alarms.

front 105

Clinical Questions
How can a tooth be moved in a bony socket during orthodontic treatment?

back 105

Because bone deposition and reabsorption can occur, and because bone responds to mechanical stress (Wolff's law), a tooth can be moved. By applying slight pressure to a tooth, the bone on the forward side will reabsorb, while the bone on the reverse side will be reformed.

front 106

Clinical Questions
Explain why swimming is not generally recommended as an exercise to prevent osteoporosis.

back 106

Mechanical stress and gravity help to promote skeletal remodeling. Swimming is not considered a weight-bearing exercise. The water, not bones, supports the body's weight while swimming.