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PATHO 2 > Osteoporosis > Flashcards

Osteoporosis Flashcards

1
Q

Osteoporosis: chronic or acute?

A

CHRONIC, PROGRESSIVE DISEASE

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2
Q

Osteoporosis characteristics

A
  • low bone mass
  • impaired bone quality
  • decreased bone strength
  • enhanced risk of fractures
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3
Q

Osteomalasia

A

soft bone

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4
Q

osteopenia

A

low bone mass

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5
Q

What does osteoporosis translate to?

A

“porous bone”

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6
Q

Incidence of osteoporotic fracture increases with?

A

AGE

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7
Q

Osteoporosis and women

A
  • more common
  • estrogen deficient women
  • postmenopausal women have higher risk
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8
Q

Osteoporosis and men

A
  • less common
  • under diagnosed
  • under treated
  • underreported
  • higher morbidity and mortality than women
  • major public health problem
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9
Q

What is bone composed of?

A
  • mostly collagen
  • collagen = protein
  • calcium phosphate
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10
Q

Two types of bone

A
  1. Compact cortical bone – outer shell, shaft, 80%

2. Cancellous/ spongy– inner parts of bone, 20%

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11
Q

Bone remodeling

A

resorption and formation of bone

occurs from the interaction of:

  • osteocytes
  • osteoclasts
  • osteroblasts
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12
Q

Osteoclasts

A

cells that break down bone

life span of about 3 weeks

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13
Q

Osteoblasts

A

cells that form new bone

life span of about 3 months

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14
Q

Osteocytes

A

cells buried in bone, comprise 95% of bone cells

sense mechanical strain by sending signals to osteoblasts to increase bone formation or osteoclast to remove existing bone

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15
Q

Normal bone remodeling

A 
Activation of osteoclasts
Bone breakdown by osteoclasts
Transition phase
Bone formation by osteoblasts
New bone matches amount broken down, hardens via MINERALIZATION PROCESS
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16
Q

How does osteoporosis occur?

A

mismatch between osteoclast and osteoblast activity

commonly a result of:

  • aging
  • change in hormones post menopause
  • diets low in calcium and vitamin D
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17
Q

The more active you are…

A

the more DENSE your bones are

18
Q

Peak bone mass

A

largest amount of bone tissue a person has at any point in their life

most people reach by the age of 30

19
Q

Peak bone mass (girls)

A

Attained at age 18

20
Q

Peak bone mass (boys)

A

Attained at age 19-20

21
Q

Growth spurt ages

A

Girls: 11-14
Boy: 13-17

Adult bone mass is accumulated in this period of rapid growth

Build strong bones during this window of time!

22
Q

Determinants of peak bone mass

A 
Physical Activity
Hormones
Risk Factors
Genetics 60-80%
Nutrition: Calcium, Vitamin D
23
Q

Two types of osteoporosis

A

primary

secondary

24
Q

Three types of osteoporsis

A

Generalized– whole skeleton

Regional– limb/ region

Localized– only focal areas of bone (cast)

25
Q

Primary osteoporosis

A

Due to biological changes:

  1. menopause
  2. aging
26
Q

Secondary osteoporosis

A

Can occur at any age, M=W

  • medical conditions
  • metabolic/ nutritional disorders
  • medications
  • immobilization with loss of function
27
Q

RISK FACTORS

A

ACCESS: leads to osteoporosis

  • Alcohol use
  • corticosteroid use
  • calcium low
  • estrogen low
  • smoking
  • sedentary lifestyle
28
Q

FRAX

A

evaluates fracture risk: 10 year probability

29
Q

FORE

A

10 year fracture risk calculator – post menopausal women and men 45 and older, NOT receiving treatment for osteoporosis

30
Q

Bone mineral density

A

Average concentration of mineral in a define section of bone

correlates with bone strength

predicts future fracture risk

31
Q

Gold standard for diagnosing osteoporosis

A

DEXA: Dual energy x ray

  • assesses BMD
  • hip and spine
  • predicts fractures at other locations as well
32
Q

Can x rays detect osteoporosis?

A

YES, but cannot determine BMD and 30% loss of bone mass

33
Q

Most common osteoporotic fracture

A 
vertebral 
hip
rib
radius
femur
34
Q

Are vertebral factors often recognized?

A

NOPE, often silent

increases likelihood of subsequent fractures

35
Q

Role of PT

A 
Comprehensive evaluation
Counsel
Check for secondary causes
Advise on adequate calcium and vitamin D
Advise avoiding smoking/ alcohol consumption
36
Q

RED FLAGS you may see during a PT assessment

A

Height loss of more than 1”
Previous fracture
Family history
Presence of kyphosis

37
Q

Top Tests for Assessment

A 
Balance
Standing height
occiput to wall distance
rib to pelvis distance
kypholordosis
prone hip extension
supine to sit
floor to stand
SLS
Hip hinge/ alignment
SIT TO STAND
38
Q

PT Treatment goals

A

REDUCE FRACTURE RISK!

Decrease pain and increase mobility
Increase bone density via joint reaction forces/ ground reaction forces
Strengthen areas at risk 
Optimize posture 
Home modification-- reduce fall risk
Promote overall fitness
39
Q

Intervention focus

A 
FRACTURE PREVENTION
leg strength
balance
thoracic extension
hip extension
thoracic mobilization
40
Q

T/F: People with osteoporosis are encouraged to perform trunk flexion.

A

FALSE!!

Trunk flexion is CONTRAINDICATED
Avoid flexion and rotation (crunches)
Do not test spine mobility

41
Q

Optimal position

A

EXTENSION

Increase length of spine and strength of stabilizers
alignment is key

42
Q

Sara Meeks

A

Realignment routine exercises for postural correction, specific to patients with osteoporosis

PATHO 2 (4 decks)

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