Flashcards in Bones Deck (22)
What are the major proteins making up the bone matrix?
Type 1 collagen. Also proteoglycans and phosphoproteins.
What is the mineral found in the bone matrix called?
Hydroxyapatite - calcium phosphate crystals.
Name the cell involved in bone resorption.
Osteoclast, derived from monocytes.
Name the cell involved in bone formation.
Which hormone stimulates osteoclastic activity, and which cell does it act through?
Where is it released from?
Parathyroid hormone (acts via PTH receptors on osteoblasts).
Released from chief cells in the parathyroid glands.
Which hormone inhibits osteoclasts and where is it released from?
Calcitonin, released from parafollicular cells in the thyroid gland.
What is another name for the bone matrix?
Which hormones promote bone growth?
Growth hormones, male and female sex hormones (oestrogen and androgens), thyroid hormones.
How does calcium exist in circulation?
Ionic form - Ca2+
Bound to plasma proteins
Combined in unionised salts with citrate and phosphate
Name the hormones that regulate calcium levels.
Parathyroid hormone, calcitonin.
Name three physiological processes requiring calcium.
Nerve impulse transmission (exocytosis in presynaptic terminal)
Muscle contraction (excitation-contraction coupling)
Where is calcium absorbed from?
The duodenum and jejunum, stimulated by 1,25-(OH)2 vitamin D3.
State three factors which can alter calcium absorption.
A deficiency of vitamin D (osteomalacia).
A decrease in oestrogen levels due to the menopause.
Age-related decrease in Ca2+ absorption from the gut.
How is vitamin D synthesised?
7-dehydrocholesterol in the skin is converted to vitamin D3 (cholecalciferol), which is the converted to 25-(OH) vitamin D3 in the liver by 25-hydroxylase. This is then converted to 1,25-(OH)2 vitamin D3 in the kidneys by 1alpha- hydroxylase.
It is broken down to 1,24,25-(OH)3 vitamin D3 by 24-hydroxylase in the liver.
What are the physiological actions of parathyroid hormone?
PTH increases Ca2+ levels in the plasma by:
Increasing osteoclastic activity to increase Ca2+ and (HPO4)2- in the blood.
Increasing Ca2+ reabsorption by the kidneys, and increasing phosphate excretion by kidneys.
Increasing the formation of vitamin D3, which increases the absorption of Ca2+ from the duodenum and jejunum.
What are the physiological actions of calcitonin?
Calcitonin decreases plasma Ca2+ by increasing mineralisation of bone.
Calcitonin stimulates osteoblastic activity.
Increases Ca2+ excretion by kidney.
What are the physiological actions of vitamin D3?
Increases absorption of Ca2+ and (HPO4)2- from the intestine.
It induces marrow monocytes to form osteoclasts.
High 1,25-(OH)2 vitamin D3 levels stimulate 24-hydroxylase activity in the liver so vitamin D toxicity is prevented.
What is secreted cancer cells and causes hypercalcaemia?
Parathyroid hormone-related protein.
What's the difference between primary hyperparathyroidism and secondary hyperparathyroidism?
Primary hyperparathyroidism is too much secretion of parathyroid hormone (e.g due to a parathyroid adenoma) which causes hypercalcaemia.
Secondary hyperparathyroidism is a physiological response to hypocalcaemia and produces similar symptoms.
What elevates alkaline phosphatase levels?
Osteomalacia and rickets.
Name some treatments of osteoporosis.
Selective oestrogen receptor modulators - SERMs (which only bind to oestrogen receptors in bone