00:01
So, I want to walk you through
the inside of a bone.
00:04
It is amazing
what is going on in there.
00:07
Now, you look at the screen
you see the pelvic bone.
00:09
Do you see that you have
the hip sockets?
And you've got the femurs.
That's where we're going to zero in.
00:15
So you've got a close up shot
because I wanted to make sure
you're aware
that this is one of the
most vulnerable areas
in our geriatric population.
00:23
When a geriatric client has a fall
and they damage a hip,
they break their hip
that can start a really difficult
series of events with bad outcomes.
00:34
They're not the kind of outcomes
we want for our geriatric clients.
00:37
So keep at the
forefront of your mind,
safety and falls
are really important
that we help educate
family members,
and the geriatric clients
themselves
and how to keep themselves safe.
00:49
Now, after that
public service announcement,
I want to show you a deeper
look into our long bones.
00:55
So take a look at the
difference now
of the bone on the right,
and the bone on the left.
01:00
Okay, we wanted that there.
01:01
So you saw that this is we're
looking at the inside of the bone.
01:05
So that's why you see
on the right side, it's all solid.
01:08
Remember we said that bones
turn from cartilage with calcium,
they get ossified.
01:13
Ossification is a process of
making it much harder and stronger.
01:17
The bone on the left is like
we've taken an inside view for you.
01:22
So same bone,
but one side is how it looks
on the outside,
the left is how it looks
on the inside.
01:30
So, let's pull that bone up
and really dig down.
01:33
Now, you've got different types here
of material in the bone.
01:37
Spongy bone, as you see
we have that highlighted.
01:40
It's found in the long bones,
and it's surrounded by compact bone.
01:44
So the first things
we want you to understand
is that you have
different types of let's call them
material in the bone.
01:51
Now, this is a femur.
It's considered a long bone.
01:54
So see the spongy bone and how
it is surrounded by compact bone,
because that's heavy, tough,
and kind of dense and compact.
02:03
That's what keeps you safe,
and allows you to support
your body weight
when you have that compact bone.
02:09
So let's show you once again,
where is the spongy bone.
02:13
Got it?
Good.
02:14
Where is the compact bone?
Excellent.
Now, we've got some other layers
that we're going to introduce.
02:21
Look at the yellow bone marrow.
02:24
Okay, now you've heard the term
bone marrow, right?
A lot of things that go on in there.
It's pretty cool.
02:30
Another layer is the periosteum.
02:33
Now, at the bottom,
we've got the red bone marrow.
02:36
So you have two different types
of bone marrow:
Yellow bone marrow,
and red bone marrow.
02:42
Now on the outside,
we have the term cartilage.
02:45
And that's what helps keep your
bone staying together, right?
I have cartilage that keeps that
femur bone in my hip socket,
so I can move my leg,
and I can walk,
and I can take steps.
02:57
So cartilage is really important,
and you want to keep that healthy.
03:01
Now, let's talk about
something like smoking.
03:03
I know it's a pretty
personal topic.
03:05
And we've covered that
in lots of our videos.
03:07
But did you know that smoking
is really hard on cartilage?
So if someone has a
lifetime habit of smoking,
while they're cartilage is
going to be really delicate.
03:18
So if your cartilage is not good,
you have an increased
risk for falling
or really having severe damage
when you do.
03:26
So just a side note,
keep that in mind,
that smoking doesn't
just damage your lungs,
it also is very difficult
on your cartilage.
03:37
Now, we've got a more detailed
kind of anatomical breakdown
of what a bone is
really comprised of.
03:43
Please don't let this
overwhelm you.
03:46
We were very particular and
what we chose to illustrate here,
so that you get a good understanding
of your bone tissue.
03:53
So let's take a look
at the big picture first.
03:57
Now, when you start on the inside,
you'll see we've got
the spongy bone.
04:00
It's got that different web
kind of look.
04:03
When you're moving to the outside
in the middle of the bone,
you see we've got some
blood canals there
like Volkmann's canal.
04:10
So, many times students don't think
about the circulatory system
being inside the bone,
but it is.
04:16
I mean, even in
a crisis or an emergency,
if we couldn't get a vein
in a patient's arm,
we couldn't start a peripheral IV,
we can do a pretty traumatic entry
into their thigh bone or their femur
and access their
circulatory system right there.
04:30
So we can enter IV fluids and
medications in an emergency.
04:34
So we've got this bone.
04:36
Pull back a little bit
what's in the middle?
Yeah, right. In this picture,
you've got the spongy bone.
04:42
And then we talked about,
on the outside,
we've got blood supplies
going in there.
04:48
Now, I want to focus
on the osteons.
04:51
These are the parts that
make up the compact bone.
04:54
So we're going to highlight
those just for a minute
because I really wanted
to point out to you,
there's a lots of them.
There's not just one in the bone,
there are many osteons.
05:04
Okay, so before we go on,
I want you to point out,
where's this spongy bone?
Good.
05:10
Where's the blood supply?
Excellent.
05:15
And do you have
one osteon or many osteons?
Yes, you've got several.
Like lots and lots and lots of them.
05:25
Now, we're going to show you
a big blown up picture
of just a single osteon.
Right.
05:30
I want you to understand
what's going on there.
05:32
See that how you have
the different labels there?
Got those different levels
and right in the middle,
you've got your capillaries,
which is your arteries,
and your venules,
which is your veins.
05:43
So in the middle of every osteon
is where we have that blood supply.
05:47
Okay, I promise we're going to
continue to break this down.
05:51
But it's critically important
all healthcare workers understand
this part of their bone.
05:59
So, you see our previous drawing
on one side of your screen
and you see spongy bone.
06:04
Then we show you on the part
that's in the shape of a femur,
where the spongy bone is.
06:09
Compact bone. We show it's all
made up those osteons. Right?
And now you see it in the
other picture on a femur bone.
06:17
So we're helping you visualize
the different types of tissue.
06:20
In this picture, we're featuring
spongy bone and compact bone.
06:26
Now, I'm going to help you
compare the difference between
compact bone and spongy bone.
06:32
Now, in compact bone,
the Lamellae are arranged
in this regular kind of pattern
right the Haversian systems.
06:38
They've got canaliculi,
and you see Volkmann's canal,
they're all present.
06:43
But if you look at the spongy bone,
the Lamellae arranged kind of like
this interfacing network, right?
They've got Haversian systems
are not in this type of bone
in the spongy bone.
06:55
So, what are some
differences between
the compact bone and a spongy bone
right now that you could write down
in regards to Lamellae
and Haversian canals.
07:06
Okay,
now let's talk about the gaps.
07:08
In compact bone, there are no gaps
in between the lamellae.
07:12
That's why we call it compact bone
and why it is so much stronger.
07:17
In spongy bone, you can see
you've got some small spaces
between the lamellae.
07:22
That's why we call it spongy bone
because it's got kind of holes
like you see in a sponge.
07:28
Now compact bone,
it's in the shaft, right?
So you saw when
we looked at that femur,
the compact bone is in the shaft.
07:35
Sometimes you heard that called
the diaphysis of long bones.
07:40
Spongy bone forms the
epiphysis of long bones.
07:44
Besides forming skull bones,
and vertebra and ribs.
07:47
So they're actually in kind
of different locations.
07:51
Compact bone has a marrow
and has a cavity for marrow.
07:56
Spongy bone does not
have a cavity for marrow.
08:00
So when you're looking at
those pictures, you can see
we haven't noted any marrow
area in the spongy bone.
08:06
You see it in the compact bone.
08:08
That's why if we were accessing,
right, a thigh bone,
we would do it right in the middle.
08:13
We wouldn't do it at the
top or bottom of the femur.
08:17
Now, marrow cavity and compact bone
has yellow bone marrow.
08:23
So keep that in mind.
08:24
But in spongy bone,
the spaces between the lameliae
they have the red marrow.
08:30
So we'll talk
a little bit more about
red marrow versus
yellow bone marrow.
08:34
But remember that you have both.
08:36
So wow,
we've given you a lot of facts.
08:39
Pause for just a minute
without looking at your notes
and see if you can make
a quick chart
that compares
compact bone to spongy bone
and see what you can remember.
08:56
Now, let me have a time.
08:58
Just to give you a chance
to answer some questions.
09:01
Let's see how you do with these.
09:03
So which type of bone?
Spongy bone or compact bone
has a cavity for marrow?
The answer is compact bone.
09:17
Where is red bone marrow located?
Spongy bone or compact bone?
Spongy bone. Good.
09:27
Who has lamellae? Now, who?
Compact bone or spongy bone?
Where are the lamellae
arranged in a regular system?
And where are they more
of an interlacing network?
Spongy bone is interlacing
and therefore compact bone
is the one that's more in order.
09:47
Okay, are you staying with us?
Keep in mind when you're going
over this much information,
especially with terms that
you may not be familiar with yet,
you need to pause and quiz yourself,
and ask questions.
10:00
Look for ways that you can
personally write out the information
in your own handwriting,
because that really helps
your brain encode things
in a much more efficient manner.
10:12
And two more fun facts.
Let's talk about marrow.
10:16
Now, in compact bone,
the bone marrow stores fat.
10:22
Listen, we need it to survive.
10:24
But some of us wish
we can have a little less storage.
10:26
Don't you? Right.
10:28
But look at the spongy bone.
10:30
This is something
I really want to focus on.
10:32
Now, I know it is easy
when we're going through
all this content
in terms you may not know
to feel kind of overwhelmed
or think,
why do I need to memorize this?
Well, in your classes
before your nursing program,
you may have had the opportunity
to take a chart like this,
memorize it, and you could get
a great grade on your test.
10:53
And that's fine.
10:54
That was appropriate for
that part of your program.
10:56
But now, we're teaching you
to be a nurse
and develop
clinical nursing judgment.
11:02
So it's never enough for you
just to memorize something.
11:04
You have to think two things.
11:06
Why would a nurse
need to know this?
How would it keep a patient safe?
So let's take a look at what
happens in your spongy marrow,
and I'll give you an example.
11:15
Remember,
nursing is an applied science.
11:18
Memorizing is the first baby step,
but always asking,
Why do I need to know this
as a nurse in my practice?
How can I use it to
keep patients safe?
Now, you're doing
what a professional nurse does.
11:30
You're on your way to developing
your clinical nursing judgment.
11:34
Because what the
spongy marrow does,
it actually produces your
red cells and your white cells,
and we're talking
about blood cells.
11:42
So, it produces your red blood cells
and your white blood cells.
11:47
If that bone marrow is
damaged or suppressed,
you're not going to have enough
red cells or white cells.
11:53
So, when would this
type of thing happen?
We'll see,
That's why you need to think about
why do I need to know this?
Because there's certain medications
that can suppress bone marrow.
12:05
Now, it seems weird,
but oftentimes, in healthcare,
we have to weigh out the risk of
a treatment versus the benefits.
12:12
I know you've probably heard
of patients on chemotherapy.
12:15
That's going to have a really
significant impact on bone marrow.
12:19
So you end up with
less white cells,
which diminishes a patient's ability
to fight off infection.
12:25
White blood cells,
there are fighters, right?
They're the ones that keep us safe.
12:30
Red blood cells are the ones that
promote oxygen
moving around in your body.
12:35
So without those, you're not
going to be as well perfused.
12:38
So, bone marrow matters.
12:41
You understanding where
red cells and white blood cells
are created matter.
So when you're studying your drugs,
and you see that this drug
causes bone marrow suppression,
you immediately know,
"Oh, that's gonna be a problem with
my white cells, and my red cells."
So keep going stick with us.
12:59
Remember, you're not just studying
to pass a test.
13:02
You're studying to be
the kind of nurse you would want
taking care of you or
someone you really care for.