bone and joints Flashcards
(81 cards)
1
Q
Name the different types of bone
A
- Woven
- Cortical
- Cancellous
2
Q
What is cortical bone also known as
A
Compact or lamellae
3
Q
What does cortical bone make up
A
Forms the shaft of long bones
Outlier or covering of flat bones
4
Q
What is cortical bone made up of
A
Rings of typ 1 collagen
5
Q
What is cancellous bone also known as
A
Trabecular
5
Q
What is cancellous bone also known as
A
Trabecular
6
Q
Where is cancellous bone found
A
Found inside flat bones and at the end of long bones
7
Q
What is cancellous bone made up of
A
Network of non collagen proteins
8
Q
Where does woven bone form
A
In early years of non development and at fracture sites
9
Q
What is woven bone made up of
A
It is disorganised nd made up of bone mineral
10
Q
Name the cells involved with bone
A
- Osteoblasts
- Osteoclasts
- Osteocytes
11
Q
What are osteoblasts derived from
A
Local mesenchymal stem cells
12
Q
What do osteocytes do
A
Regulate mineralisation and bone resorption
Synthesis collagen matrix
13
Q
What do osteoblast do
A
Activate bone formation
14
Q
What do osteoclasts do
A
Resorb bone
15
Q
List teh stages of bone healing following fracture
A
1, Cellular stage
2. Vascular stage
3. Primary callus
4. Bony callus
5. Mature callus
16
Q
Give examples of genetic bone diseases
A
- Osteogenesis imperfecta
- Cleidocranial dysplasia
- Osteopetrosis
17
Q
What is Osteogenesis imperfecta due to
A
It is an autosomal dominant condition that leads to collagen defects
18
Q
List some characteristic presentation of Osteogenesis imperfecta
A
- Blue sclera
- Deafness
- Bruising easily
- Loose joints/ tendons
- +/- Cardiac complications
- Fracture easily
19
Q
What is Osteogenesis imperfecta also known as
A
Brittle bone disesse
20
Q
What is Osteogenesis imperfecta also known as
A
Brittle bone disesse
21
Q
As a dentist what consideration should you make if a patient has Osteogenesis imperfecta
A
- Take care with extractions due to fracture risk
- GA risk - chest deformity and cardiac issues
- Teeth may be brown/purple or worn
- Soft dentine
22
Q
What is cleidocranial dysplasia due to
A
Autosomal dominant condition that is rare and mainly involves the skull and clavicle
23
Q
List some clinical signs of cleidocranial dysplasia
A
- Clavicles absent or defective
- Brachycepalic (broad short skull)
- Hypoplastic midface= mandibular protrusion
- +/- Clefts
- Other skeletal defects
24
List some dental features of cleidocranial dysplasia
1. Hyperdontia
2. Supernumeraries
3. Retained deciduous dentition
4. Abnormalities with dentition
25
What is osteopetrosis also known as
Albers schonberg disease
26
What is osteopetrosis due to
A rare disorder leading to a defect in osteoclastic activity and bone remodelling leading to excessive bone density
27
What are some clinical signs of osteopetrosis
1. Often no symptoms
2. Incidental finding on a radiograph following pt complaining of 'bone pain'
3. Patient may be anaemic or susceptible to infections
28
List some dental signs of osteopetrosis
1. Fractures of the jaw/ osteomyelitis
2. Difficulty in irradiating infection
29
Give examples of acquired bone Disorders
1. Rickets/ osteomalacia
2. Osteoporosis
3. Fibrous dysplasia
4. Pagets disease
5. primary Hyperparathyroidism
6. secondary Hyperparathyroidism
30
What is rickets
A childhood disease leading o inadequate skeletal mineralisation due to lack of vitamin D or calcium
31
What is teh treatment fro rickets
Vitamin supplements and dietary advice
32
What is osteoporosis
A disease lading to diminished bone mass and low bone density which causes fragile bones
33
What factors can effect or increase the risk of osteoporosis
1. Calcium intake
2. Reproductive hormones
3. Parathyroid gland
4. physical activity
34
Is osteoporosis more common in men or women
Women over the age of 50 (post menopausal)
35
What are the symptoms of osteoporosis
1. Usually asymptotic in early stages
2. Back pain
3. Reduced height
4. Stooped posture
5. Unexpected fractures
36
What is teh treatment for osteoporosis
1. Hormone replacement
2. Bisphosphoantes
3. PTH
4. Floride
5. Vitamin D Supplements
6. Calcitonin
7. Exercise
37
What is fibrous dysplasia
A benign chronic fibro osseous lesion frequently found in the craniofacial region
Scar like tissue grows in the place of normal bone
38
What is pagets disease
A common disorder that causes changes int eh balance of remodelling of bone
39
What might a patient with pagets disease complain of
1. Bone pain
2. Fractures
3. Hearing loss
40
What is teh treatment fro pagets disease
bisphosphonates
calcitonin for pain relief
41
What dental considerations should we make if we treat a patient with pagets disease
1. Enlargement of maxilla seen
2. Bulging in the zygomatic area
3. Hypercementosis of teeth sometimes
4. PT may have an increased risk of bleeding or osteomyelitis post surgery
42
Which body system regulates blood calcium
The parathyroid and vitamin D levels
43
What are teh parathyroids
4 small glands foudn on teh posterior aspect of the thyroid glands
44
What happens when there is a low calcium level in the blood
The parathyroid releases calcitonin which increases the resorption of calcium from the gut and promotes osteoclastic bone resorptions
This increases calcium levels int eh blood
45
List some of the signs and symptoms of primary hyperparathyroidism
1. 50% asymptomatic
2. Hypercalcaemia
3. Bone pain
4. Pathological fracture
5. Giant cell tumours
6. Peptic ulcers
7. Pancreatitis
8. Local swelling in teh mandible
46
What is hyperparathyroidism caused by
Usually a single parathyroid adenoma that can be removed as treatment
47
What is secondary hyperparathyroidism ALSO known as
Parathyroid hyperplasia
48
What is secondary hyperparathroyism caused by
Due to a response to persistently low calcium levels
may be due to chronic renal failure or malabsorption
49
Give examples of joints disorders
1. Marfarns
2. Ehlers-danlos
3. Recurrent TMJ dislocation
50
What is marinas syndrome
An autosomal dominent connective tissue disorder
51
How might marinas syndrome present
Long/tall thin body
huge arm span
52
Name the 3 key areas that are defected in Marfan syndrome
1. Skeletal
2. Cardiovascular
3. Neuro-ocular
53
list the key features of marfins
Mitral valve prolapse
Aortic dissection
Retinal detachment
Fibrillin 1 mutation
Arachnodactyly (long spider like fingers)
Near sighted
Scoliosis
54
What is Ehlers dances syndrome
A group of rare disorders fo collagen formation
It is an autosomal dominant condition
55
List some of the characteristic features of Ehlers dances syndrome
1. Hyperextensible skin
2. Bruise
3. Loose joints
4. Recurrent spontaneous dislocations
5. Poor healing
56
What are some issues associated with ehlers danlos syndrome
1. Mitral valve prolapse
2. Haematological issues- bleeding
3. TMJ
4. Short teeth/ abnormal roots/ pulp stones
5. Micrognathia
6. AOB
7. Gingival hyperplasia
57
Give examples of arthritides
1. Osteoarthritis
2. Rheumatoid arthritis
3. Felty sun
4. Juvenile arthritis
5. Ankyosing spondylitis
6. Infective arthritis
7. Gout
58
what Is osteoarthritis
Degenerations of articular cartilage and proliferation of new bone, cartilage and CT
59
What might patents complain of if they have osteoarthritis
Pain stiffness and swelling in weight baring joints
more common in women
60
What is the management of osteoarthritis
Analgesia
Joint replacement
61
What is a key difference between osteoarthritis and rheumatoid arthritis
Osteoarthritis does not have any systemic symptoms whereas rheumatoid arthritis does
62
What is rheumatoid arthritis
Most commonest form of chronic inflammatory joint disease leadign to symmetrical destruction
more common in women
63
List some of the clinical features of rheumatoid arthritis
1. Stiffness of hands/feet
2. Usually worse in the morning
3. Redness, tenderness and swelling over joints if acute
4. Ulnar deviation usually symmetrical
5. Increased disability in teh wrists, elbows, ankles and knees
6. C spine involvement
64
List the radiographic features of rheumatoid arthritis
Initially widening of joint space followed by narrowing erosion and destruction
65
What is the management for rheumatoid arthritis
1. Supportive measures
2. Analgesics
3. Corticosteroids into joint space
4. DMARDs and biologic agens
66
What dental issues may be seen in patients with rheumatoid arthrits
1. Often associated with sjogrens syndrome
2. Some changes on an OPT within TMJ
3. Increased risk of bleeding, infection and mRONJ due to medication
67
What is felty syndrome
Patients with rheumatoid arthritis, splenomegaly and neutropenia (it is very rare)
68
List the different types of juvenile arthritis
1. Systemic
2. Polyarticular
3. Pauciarticular
69
Who is more commonly affected by juvenile arthritis
Girls in their late childhood
70
What is juvenile arthritis assicted with
Fever
Nodules
Malaise
Anaemia
71
What is ankylosing spondylitis
A form of chronic inflammatory arthritis that affects the sacroiliac and spinal joints
Mainly seen young males
72
What can ankylosing spondylitis cause overtime
Fusion of vertebrae
73
What issues can ankylosing spondylitiscauwe
Back pain
Stiffness
Eye lesions
Cardiac disease
74
How is ankylosing spondylitis trearted
Physiotherapy
Exercises
NSAIDS
75
How is ankylosing spondylitis trearted
Physiotherapy
Exercises
NSAIDS
76
What is gout
A form of chronic inflammatory arthritis where crystals of monosodium urate monohydrate form in teh joints
77
What can build up of monosodium urate monohydrate crystals int eh joint cause
1. Inflammtory arthritits
2. Tenosynovitis
3. Bursitis or cellulitis
4. Tophaceous deposits
5. Urolithiasis
6. Renal disease
78
What can build up of monosodium urate monohydrate crystals int eh joint cause
1. Inflammtory arthritits
2. Tenosynovitis
3. Bursitis or cellulitis
4. Tophaceous deposits
5. Urolithiasis
6. Renal disease
79
What is gout caused by
High uric acid from breakdown of purines
High blood pressure, diabetes and obesity
80
What is the treatment for gout
NSAIDS
Allopurinol
