Betty Burns Bone

Question 1

Bone - Characteristics

Answer 1

Mineralized
Vascularized
Nerve Supply
Dynamic
Interactive

Question 2

Types of Bone (+)

Answer 2

Trabecular (spongy, alveolar, cancellous - synonyms)

Compact (lamellar, haversian or cortical - synonyms)

Question 3

When Bone Fractured - steps

Answer 3

Hemotoma -> Fibrocartiligous callus (soft) -> Bony Callus (Hard) -> Bone Remodeling

Question 4

Soft Callus formation

Answer 4

new blood vessels formed within hematoma
Spongy bone trabeculae formed
Cells enter hematoma

Question 5

Possible Sources of back pain

Answer 5

Vertebral Joints
–Synovial joints are innervated
Nerves
–Impingement : Spinal nerve very close to disks as well as other things

Question 6

Epidural Space

Answer 6

External to dura
can be used for childbirth and pain
lower back, and neck, +

Question 7

Lumbar Puncture - where on spine

Answer 7

Subarachnoid space

Question 8

Central Cord Compression - causes

Answer 8

Metastatic Cancer (common), Herniated Disc, Spinal stenosis, etc

Question 9

Central Cord Compression - action

Answer 9

Lesion pushing directly on spinal cord

EMERGENCY b/c central spinal cord doesn’t really regenerate

Question 10

Central Cord Compression - result

Answer 10

pain, sensory disturbance (not necesarily dermatomal), weakness, hyperflexia

Question 11

Cauda Equina Syndrome - effect

Answer 11

compression of cauda equina/nerve roots (L1 and lower)
leg weakness and pain - weak plantar flexion
diminished Achilles reflex
Saddle Anesthesia (S)
Bowel and Bladder Dysfunction
Acute Sexual Dysfunction

Question 12

Osteoporosis - def

Answer 12

Decreased bone mass per volume (bone density)

OC>OB

Question 13

Classic osteoporosis effects

Answer 13

spinal compression fracture
hip fracture
SERIOUS - loss of independence

Question 14

Risk factors for osteoporosis

Answer 14

female, sex steroid deficiency (menopause), advanced age, ethnicity, glucocorticoid excess, smoking, caffiene

Question 15

Osteoporosis in men

Answer 15

often related to testosterone deficiency

Question 16

Osteoporosis - Dx

Answer 16

Dexa scan

Question 17

Osteoporosis - Tx

Answer 17

Smoking cessation, weight bearing exercise, Vit D and Calcium, Drugs

Question 18

Osteoporosis - Tx - Drugs, effect

Answer 18

Bisphosphanates
—Decrease osteoclast activity
Hormone Replacement Therapy (non standard)
—Increase OPG which down regulates osteoclasts
SERM
—like estrogen
PTH analog (Anabolic Therapy - injection 1/day)
—increases pre-osteoblast growth
—-hyperparathyroidism (constant elevated PTH) leads to osteoporosis though
Denosumab
—Monoclonal antibody against RANKL - down regulate osteoclast production