Skeletal System Basics & Structure
Microscopic Anatomy & Cells
Cartilage
Bone Formation & Growth
Bone Remodeling, Hormones & Calcium Regulation
Clinical Views & Aging
100

If you broke down the skeletal system into its main components, what two general categories would you list?

→ Answer: The axial skeleton and the appendicular skeleton.

100

Which bone cell type actively builds new bone tissue?

→ Answer: Osteoblasts.

100

Which type of cartilage forms most of the fetal skeleton before bone takes over?

→ Answer: Hyaline cartilage.

100

Which bones of the skull are formed primarily by intramembranous ossification?

→ Answer: Flat bones of the skull (e.g., frontal, parietal) and parts of the mandible and clavicle.

100

Which process describes the continuous removal and deposition of bone tissue?

→ Answer: Bone remodeling.

100

What natural process causes bones to lose density as people age?

→ Answer: Decreased bone mass due to reduced osteoblast activity and loss of minerals.

200

Which function of bone is demonstrated when red blood cells are produced?

→ Answer: Hemopoiesis (blood cell production).

200

Which bone cell type is derived from white blood cells and dissolves bone tissue?

→ Answer: Osteoclasts.

200

What type of cartilage is found in the external ear and provides flexibility?

→ Answer: Elastic cartilage.

200

Which bones of the skeleton are formed primarily by endochondral ossification?

→ Answer: Most bones below the skull, especially long bones like the femur and humerus.

200

Which hormone stimulates osteoclast activity to increase blood calcium levels?

→ Answer: Parathyroid hormone (PTH).

200

Which gender is at higher risk for osteoporosis after menopause, and why?

→ Answer: Women, due to decreased estrogen which normally helps maintain bone density.

300

Which part of a long bone would you expect to find articular cartilage, and why?

→ Answer: The epiphyses, because they form joints and need cartilage to reduce friction and absorb shock.

300

What main structural difference makes compact bone denser than spongy bone?

→ Answer: Compact bone has tightly packed osteons; spongy bone has trabeculae with spaces.

300

Which type of cartilage is strongest and found in intervertebral discs?

→ Answer: Fibrocartilage.

300

During intramembranous ossification, which cell type differentiates first to initiate bone formation?

→ Answer: Mesenchymal cells differentiate into osteoblasts.

300

Which vitamin must be activated to calcitriol to effectively increase calcium absorption?

→ Answer: Vitamin D.

300

What is the first step in fracture healing?

→ Answer: Formation of a hematoma (blood clot).

400

What makes flat bones different from long bones in terms of shape, general role, and ossification type?

→ Answer: Flat bones are thin, often curved, and provide protection or muscle attachment, intramembranous ossification; long bones are elongated and act as levers for movement, endochondral ossification.

400

Why are canaliculi essential in compact bone, but less critical in spongy bone?

→ Answer: Compact bone cells are far from blood supply and need canaliculi for nutrient/waste exchange; spongy bone’s trabeculae are thinner and closer to marrow spaces.

400

Why does cartilage heal poorly after injury compared to bone?

→ Answer: It is avascular, so nutrients and cells required for repair diffuse slowly.

400

Why does endochondral ossification require a cartilage model first, unlike intramembranous ossification?

→ Answer: The cartilage provides a flexible template that is gradually replaced by bone.

400

Why would weightlifters have thicker bones compared to people who live sedentary lifestyles?

→ Answer: Mechanical stress stimulates osteoblast activity, increasing bone density.

400

Why does fracture healing slow down in elderly individuals?

→ Answer: Reduced cellular activity and decreased blood supply impair repair.

500

Why does the diaphysis of a long bone contain a medullary cavity, while the epiphysis does not?

→ Answer: The diaphysis provides space for marrow storage and lightens bone weight, while the epiphysis is filled with spongy bone to resist forces from many directions.

500

Which cell is considered the “mature” bone cell, and what is its main function?

→ Answer: Osteocytes; they maintain the bone matrix and act as mechanosensors.

500

In interstitial growth of cartilage, what do chondrocytes do inside their lacunae?

→ Answer: They divide and secrete new matrix internally, expanding the tissue from within.

500

In the epiphyseal plate, which zone is closest to the epiphysis, and what occurs there?

→ Answer: Zone of resting cartilage; it anchors the plate to the epiphysis.

500

Which hormone lowers blood calcium by inhibiting osteoclast activity?

→ Answer: Calcitonin.

500

During fracture healing, what tissue replaces the hematoma before bone forms?

→ Answer: A fibrocartilaginous (soft) callus.

600

Why does compact bone dominate the diaphysis, but spongy bone is found in greater proportion at the epiphyses?

→ Answer: Compact bone resists bending stress along the shaft, while spongy bone absorbs multidirectional forces at the ends of bones.

600

Why might spongy bone be more metabolically active than compact bone?

→ Answer: Its trabeculae are thinner and closer to marrow/blood vessels, allowing faster remodeling.

600

In appositional growth, which cell layer is responsible for adding new cartilage to the outside surface?

→ Answer: Chondroblasts in the inner layer of the perichondrium.

600

Which zone of the epiphyseal plate is responsible for pushing the epiphysis away from the diaphysis during growth in length?

→ Answer: Zone of proliferating cartilage (chondrocyte division).

600

Why does bone mass decrease in astronauts who spend long periods in zero gravity?

→ Answer: Lack of mechanical stress reduces osteoblast activity, shifting balance toward bone resorption.

600

What is the purpose of the bony callus formed during fracture repair?

→ Answer: It stabilizes the break with new trabeculae bridging the fracture site.

700

Which type of marrow would you expect to be more prominent in children, and what does this indicate about their physiology?

→ Answer: Red marrow, reflecting their higher demand for blood cell production during growth.

700

The bone matrix contains both organic and inorganic components. Which part provides flexibility, and which provides strength?

→ Answer: Organic (collagen/proteins) = flexibility; inorganic (calcium phosphate salts) = strength and hardness.

700

Why does hyaline cartilage appear smooth and glassy under the microscope?

→ Answer: Because it has fine, dispersed collagen fibers that aren’t easily visible.

700

In appositional growth, what role do osteoblasts in the periosteum play?

→ Answer: They add new bone layers to the external surface, increasing bone diameter.

700

Which two organs are most critical for converting vitamin D into calcitriol?

→ Answer: The liver and kidneys.

700

Why might long-term immobilization in a cast contribute to bone loss?

→ Answer: Lack of mechanical stress reduces bone remodeling and leads to resorption.

800

How do blood vessels and nerves inside bone contribute to maintaining homeostasis?

→ Answer: Blood vessels deliver nutrients and remove waste, while nerves detect stress or injury, ensuring proper growth, repair, and remodeling.

800

How does the arrangement of osteons in compact bone relate to resisting mechanical stress?

→ Answer: Concentric lamellae in osteons allow compact bone to resist compressive forces along the shaft.

800

What structural component of hyaline cartilage allows it to resist compressive forces?

→ Answer: Proteoglycans in the ground substance that trap water.

800

How is the medullary cavity enlarged during appositional growth?

→ Answer: Osteoclasts resorb bone on the internal surface as osteoblasts add bone externally.

800

How does calcitriol indirectly affect bone strength even though it doesn’t act primarily on bone tissue?

→ Answer: It promotes intestinal calcium absorption, providing minerals for bone mineralization.

800

Which step in fracture healing involves remodeling the callus to restore original bone shape?

→ Answer: Bone remodeling phase.

900

A patient has leukemia requiring a bone marrow transplant. Why would the physician be more concerned with red marrow location than yellow marrow?

→ Answer: Because red marrow is responsible for blood cell formation, while yellow marrow mainly stores fat.

900

A patient with brittle bone disease (osteogenesis imperfecta) often has normal calcium but defective collagen. Which part of the matrix does this affect, and how?

→ Answer: The organic portion; bones lose flexibility and become brittle.

900

A child with damage to the perichondrium has difficulty expanding cartilage width. Which type of growth is impaired?

→ Answer: Appositional growth.

900

If the zone of hypertrophic cartilage is damaged in the growth plate, what specific process is impaired?

→ Answer: Chondrocytes enlarging and preparing the matrix for calcification, which disrupts longitudinal growth.

900

A patient has low PTH levels. How would this affect both blood calcium and bone remodeling?

→ Answer: Blood calcium would fall; reduced osteoclast stimulation would impair normal remodeling balance.

900

A patient with osteoporosis fractures a hip after a minor fall. Why does this indicate a systemic, not just local, problem?

→ Answer: The fracture reflects weakened bone density throughout the skeleton, not just at the injury site.

1000

In cases of osteoporosis, which class of bones (by shape) is at the highest risk of fracture, and why?

→ Answer: Vertebrae (irregular bones) and long bones, especially the femur, because they bear weight and have high trabecular bone content that is vulnerable to loss.

1000

Why would an imbalance of osteoblast and osteoclast activity result in structural weakness, even if the total bone mass stayed the same?

→ Answer: If remodeling is unbalanced, bone structure becomes disorganized, weakening architecture regardless of mass.

1000

Why would fibrocartilage be more common in weight-bearing joints compared to hyaline cartilage?

→ Answer: Its dense collagen fibers provide tensile strength and resist compression better.

1000

In a child with rickets, the growth plate widens abnormally. Why does this happen in terms of ossification?

→ Answer: Mineralization of cartilage is impaired, preventing normal progression to bone.

1000

If calcitonin is overproduced, what change might occur in blood calcium, and how would this affect bone tissue?

→ Answer: Blood calcium would drop; osteoclast suppression could weaken remodeling and cause brittle bone.

1000

Why would a fracture that crosses the epiphyseal plate be treated differently in a child than in an adult?

→ Answer: In children it risks disrupting growth; adults no longer rely on epiphyseal plates for lengthening.

1100

Why might a fracture at the metaphysis of a child’s femur have a greater long-term consequence than a similar fracture in the shaft?

→ Answer: The metaphysis contains the growth plate; damage here can disrupt bone lengthening and cause deformities.

1100

In Paget’s disease, bone turnover is accelerated, producing disorganized tissue. Which microscopic difference between normal compact bone and Paget’s bone explains the higher fracture risk?

→ Answer: Loss of orderly lamellae in osteons; abnormal woven bone replaces organized compact bone.

1100

If hyaline cartilage in the trachea begins to calcify with age, how might this affect respiratory function?

→ Answer: Reduced flexibility could make the airway less able to expand, leading to breathing difficulties.

1100

Suppose an adolescent fractures through the epiphyseal plate. Why might this injury cause unequal limb length later on?

→ Answer: Because it disrupts the zones of cartilage growth, halting or altering longitudinal bone growth.

1100

Why might chronic kidney disease impair bone health even if dietary calcium is normal?

→ Answer: The kidneys cannot activate vitamin D to calcitriol, reducing calcium absorption and weakening bones.

1100

In older adults, vertebral compression fractures are common. Why does trabecular bone loss make these fractures more likely?

→ Answer: Vertebrae are rich in spongy bone, which is more vulnerable to age-related resorption.

1200

If an imaging scan reveals a loss of blood supply to part of a bone, what consequences could this have for both the bone’s structural integrity and systemic health?

→ Answer: Local bone death (avascular necrosis) can weaken structure and compromise marrow function, potentially affecting blood cell production.

1200

A patient has damage to osteoprogenitor cells in the periosteum. How would this impact both fracture healing and the long-term ability of bone to adapt to stress?

→ Answer: It would impair new osteoblast formation, limiting repair capacity and remodeling response to stress.

1200

Suppose a patient’s articular cartilage is wearing down (early osteoarthritis). How does the lack of perichondrium in this cartilage contribute to the poor repair capacity?

→ Answer: Articular cartilage has no perichondrium, so no chondroblasts are available for appositional growth, limiting regeneration.

1200

A researcher blocks blood vessel invasion during endochondral ossification in an animal model. Predict the outcome for long bone development.

→ Answer: Without vascular invasion, cartilage cannot be replaced by bone, leading to shortened or malformed long bones.

1200

In hyperparathyroidism, why would patients develop bone fragility despite high blood calcium levels?

→ Answer: Excessive PTH overstimulates osteoclasts, causing bone resorption that weakens skeletal structure.

1200

Suppose a patient’s fracture repair produces an unusually large callus that fails to remodel fully. What functional problem might this create?

→ Answer: Abnormal bone shape could impair joint movement or increase risk of re-injury.

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