1. An individual has a broken humerus that requires a cast and immobilization fo
ID: 3512402 • Letter: 1
Question
1. An individual has a broken humerus that requires a cast and immobilization for 6 weeks. At the end of treatment, an X-ray reveals that the injury has healed very nicely but that the overall mass of the entire bone is less when compared to the other arm. The patient has consumed adequate calcium and vitamin D during recovery. Given this fact, why is the bone mass reduced? 2. Ten year old Sally, playing on her swing set, falls and breaks her right leg. At the emergency room doctors tell her parents that the proximal end of the tibia (shin bone) where the epiphyses meet the diaphysis is fractured. The fracture is properly set and heals well. When she is eighteen, Sally begins to have problems with her hip. When she goes to an orthopedic physician she learns her right leg is slightly shorter than her left. Explain what might account for this difference. 3. Sherry is a pregnant teenager. Her diet consists largely of junk food. Approximately 12 -14 weeks into her pregnancy she falls and breaks her arm. She doesn't understand why the bone broke because it was not a hard fall. Test results show a significant amount of bone demineralization is occurring in her skeleton. Cite two different causes for this demineralization in Sherry and explain how each is producing its effect.Explanation / Answer
1) The mass of the entire bone even after remodelling is less than the normal bone due to the following reasons:
a) The hormones affecting the metabolism of calcium and phosphate such as parathromone, calcitrol, calcitonin and hormones like estrogen, growth hormone, thyroid hormone and insulin could be under imbalance.
b) Genetic factors could also play a role in the bone density.
c) Gender of the person could also contribute to bone density.
2) Sally's right limb is shorter than the left, because at the age of 10 years Sally had her right tibia fractured at the meeting point of epiphysis and diaphysis, where metaphysis is present. Metaphysis is also known as the growing part of the bone, it consists of growth plate. Since Sally had the region of metaphysis fractured, the growth of the tibia is affected and it lead to her right limb shorter than the left limb.
3) Two reasons for having bone demineralization for a pregnant teenager includes:
a) Since the uptake of dietary calcium is less, the body reacts to the requirement of the baby by absorbing calcium from the pregnant mother's bones. This leads to fragility of the bones.
b) Teenage is the critical time where the body accumulates bone for peak bone mass. Factors that interfere during this period can result in increased risk of osteoporosis in the llter age. Several studies have shown that adoloscence pregnancy has detrimental effects of bone mass measurements.
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