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Flashcards in Musculoskeletal System Deck (68)
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1

The outer layer of bone is called___________. It makes up __% of the bone mass and is very______and _________

Cortical bone
Makes up 80%
Very dense and compact

2

The inner layer of bone is called ___________ or _________ bone. It is less _______ and _________ than the outer layer

Cancellous or trabecular
Stiff and Strong

3

Joints are composed of 3 parts.......

Fibrous capsule
Cartilage
Synovial Membrane

4

Intramembranous Ossification is a model of __________. It occurs when.......

Bone Formation
It occurs when mesenchymal cells differentiate into osteoblasts which form bone

5

Endochondral Ossification is a model of __________. It occurs when

Bone formation
It occurs when a cartilage model, created by chondrocytes, is converted to bone by mineral deposition

6

What is bone remodeling?

The process by which old bone is resorped and new bone is layed down

7

What are osteoclasts?

Osteoclasts are multi-nucleated cells that resorp bone
They connect to bone via the protein integrin
When attached they become polarised

8

What are osetoblasts?

Active bone forming cells that produce a collagenous bone matrix

9

What is osetoporosis?

A systemic skeletal disease characterized by low bone mass and micro-architectural deterioration of bone tissue. This causes an increased susceptibility to fracture

10

What are the risk factors for osteoporosis

Female Gender
Low Ca intake/absorption
Renal Disease
White/Asian
Sedentary Lifestyle
Alcohol and Drug use
Low body weight

11

What are the 2 major pathogenic processes for osteoporosis?

Poor bone mass acquisition in adolescence
Accelerated bone loss during the 6th decade

12

What causes poor bone mass acquisition?

Hormone deficiencies and malnutrition along with decreased physical activity

13

What causes accelerated bone loss?

Increased activity of osteoclasts without the same increase in osteoblast activity. Bone is being broken down faster than it is being formed

14

What chemicals increase Bone formation?

Growth Hormone
Vitamin D metabolites
Gonadal steroids

15

What chemicals decrease Bone formation?

Glucocorticoids

16

What chemicals increase Bone resorption?

Glucocorticoids
Thyroid Hormone
High doses of Vitamin D metabolites

17

What chemicals decrease Bone resorption?

Calcitonin
Gonadal Steroids

18

What is BDM?

Bone Density Measurement, the lab test for determining if a patient has osteoporosis. Low BDM and many remodeling markers indicate higher incidence of fractures

19

What are some initial tests for osteoporosis?

Blood cell count
Ca and PO4 levels
Kidney and Liver Function tests
TSH, Oestrogen and Testerone levels

20

What are some additional tests undertaken to screen for osteoporosis?

Screening for Hyperparathyroidism
24 hour urine test to rule our hypo/hypercalciuria
Serum Protein electrophoresis to rule out multiple myeloma

21

What is a urinary marker to show bone resorption has occurred?

Collagen cross-link fragments found in urine

22

What is DEXA and what does it stand for?

The most popular BDM test, Dual-Energy X-ray absorptiometry

23

Even though CT scans are more sensitive they aren't used as much to screen for osteoporosis because........

They expose the patient to more radiation

24

What is a T-score?

The result given by DEXA, it is the number of standard deviations above or below the the mean BDM for a given race/gender

25

What factors influence who should be treated for osteoporosis ?

Increasing age
Declining BDM
Prior fractures
Family history of osteoporosis
Risk factors for boneless (hyperparathyroidism, immobilisation etc)
Lots of bone remodeling markers

26

Should you treat a women with osteoporosis and no fractures?

Yes

27

Should you treat a women with osteoporosis and fractures

Yes

28

Should you treat a women with osteopenia and a fracture?

Yes

29

Should you treat a women with osteopenia and no fractures?

No, however, follow up check should be done in 1-3 years

30

What are some overall stratagies for treating osteoporosis?

Increase calcium intake (diet or supplements)
Oestrogen Replacement Therapy
Bisphophonate use
Selective Oestrogen Receptor modulators
Weight bearing excercise
Reduce consumption of drugs and alcohol