Osteoporosis Flashcards
(82 cards)
1
Q
Trabeculae ____ are thin and narrow
A
rods
2
Q
Trabeculae ______ are thick and flat
A
plates
3
Q
Trabeculae is ____ affected by OP
A
most
4
Q
In the ______ stage, osteoclasts break down and remove old bone
A
resorption
5
Q
In the ______ stage, osteoblasts build new bone
A
formation
6
Q
Peak bone mass occurs around age ___
A
30
7
Q
4 determinants of peak bone mass?
A
- genetics
- hormones
- lifestyle
- nutrition
8
Q
______ is a critically important time for bone building
A
puberty
9
Q
____% of adult bone mineral is accrued in the 2 years around puberty
A
26
10
Q
_______ is associated with a rapid decline in bone mass
A
menopause
11
Q
Bone strength reflections the integration of which two main features?
A
- bone density
2. bone quality
12
Q
A __score shows how much your bone density is higher or lower than the bone density of a healthy 30 year old.
A
T
13
Q
A HCP looks at ___ T-sore to dx OP
A
lowest
14
Q
A t-score of -__ or above is normal
A
1
15
Q
A t-score between -__ and -__ means you have lower bone density or osteopenia
A
1;2.5
16
Q
A t-score of -____ or below is a dx of OP
A
2.5
17
Q
____ is a term reserved for men and premenopausal women
A
LBM/D
18
Q
______ is reserved for postmenopausal women
A
osteopenia
19
Q
Several studies have shown that many #’s occur in people with only moderately decreased BMD (T/F)
A
TRUE
20
Q
1/3 of all postmenopausal #s occur in women with BMD that don’t categorize them as having OP (T/F)
A
FALSE ; 1/2!
21
Q
Bone quality is related to _______ architecture
A
architecture
22
Q
More trabecular ___ vs ____ = better quality
A
plates; rods
23
Q
Currently there is no standard dx practice of assessing bone quality (T/F)
A
TRUE
24
Q
Primary type 1 OP?
A
women post menopause
25
Primary type 2 OP?
people over 70 years of age,
26
Primary type 2 OP occurs _______ in men and women
equally
27
Secondary OP?
A result of other medical conditions or rx
28
Secondary OP affects more women than men (T/F)
FALSE (equally)
29
____% of hip #'s are result of OP
90
30
An individual with a hip # has a ___% risk of death in following year
25
31
______ # = # occurring spontaneously or from a minor trauma such as a fall from standing height or less
fragility
32
4 common OP # sites ?
1. spine
2. wrist
3. hip
4. humerus
33
OP consumes the most hospital beds (T/F)
TRUE
34
OP has a greater impact on QOL than COPD, heart disease or diabetes (T/F)
TRUE
35
Dx of OP?
DXA (assesses bone density)
36
2 common # risk assessment tools?
1. CAROC
| 2. FRAX
37
CAROC uses age, sex and ___ BMD to ID preliminary # risk
hip
38
DEXA scans give no info on bone _____
quality
39
2 types of pharmaceuticals that may be prescribed to people with high risk of OP?
1. antiresorptive agents
| 2. anabolic/bone formation agents
40
OP meds can reduce #s by __ -__ % depending on medication, pt age and site of bone loss
30-70
41
3 types of surgical rx?
1. joint fixations
2. joint replacements
3. vertebral surgeries
42
2 types of vertebral surgeries?
1. vertebroplasty
| 2. kyphoplasty
43
10 things to include in PT assessment of pt with OP?
1. subjective hx
2. height and weight
3. posture
4. breathing pattern
5. movement patterns
6. strenght
7. flexibility
8. aerobic capacity
9. balance assessment
10. functional assessment
44
4 health and activity questionnaires you may use for subjective hx?
1. OPAQ-PF
2. BPAQ
3. OFDQ
4. COPA
45
______ _____ loss = different between the tallest recalled heigh by the pt and the current measured height
historical height loss (HHL)
46
Vertebral compression # is suspected if HHL is >__cm
6
47
_____ _______ loss = difference between 2 measurements up to 3 years apart
prospective height
48
Vertebral compression # is suspected if prospective height loss is > __ cm
2
49
2 ways to measure cervicothoracic and / or lumbar deformities ?
1. wall-occiput test > 0 cm
| 2. rib/pelvis different ≥ 2 fingerbreadths
50
Looking at ____ ____ is also a good assessment tool for posture
plumb line
51
3 things to assess for breathing?
1. chest expansion
2. breathing pattern
3. IMT
52
5 mms to focus on for strength/flexibility/special tests ?
1. gastroc
2. soleus
3. pecs
4. lat
5. hip flexors
53
2 ways to measure aerobics capacity in OP pts?
1. adapted shuttle walking test
| 2. two minute step test
54
4 OM to use for measuring balance in OP pts?
1. one-leg stand test (b/w parallel bars)
2. Tinetti balance assessment tool
3. Berg balance
4. Fullerton advance balance scale
55
6 OM for functional assessment of OP pts?
```
1. OP functional disability questionnatie
(OFDQ)
2. Timed chair sit to stand
3. Elderly mobility scale
4. TUG
5. Senior fitness test
6. 20 m timed walk
```
56
What 4 domains does the seniors fitness test include?
1. upper and lower body strength
2. aerobic endurance
3. upper and lower body flexibility
4. mobility
57
Senior fitness test is standardized testing for performance standards from ___ - ___ years of age
60-94
58
Osteogenesis is specific to the site of the _____
strain
59
What type of exercise has the greatest potential to affect bone?
high impact
60
____ loads and _____ patterns are more important than number of loading cycles
peak; novel
61
Research suggests it takes ~ __ months to see results for exercise in pt's with OP
9
62
3 movements to focus on for strength / flexibility ?
1. spinal extension and rotation
2. hip flexion
3. shoulder elevation
63
Our primary concern is that they use movement strategies that don't overload the ______ _____ _____ and put them at risk for VCF
anterior vertebral bodies
64
When getting up/down from floor / bed, tell pts with OP to ____ on to their _____
roll; side
65
How often each week for postural training?
5-10 mins daily
66
Falls often associated with ____ perturbation
lateral
67
Control of ____ stability/ _____ stepping is of particular importance for preventing #'s
lateralx2
68
VCF = ___% asymptomatic
50
69
___ of pt's with VCF require treatment
1/3
70
Treatment for VCF?
back extensor strengthening
71
CIs/precautions post VCF?
1. no external resistance exercise or manual therapy to the spine for 3 months post-VCF
2. precaution/CI to many PT treatments, including general screen for OP
72
Prescription parameters for back extension exercise post VCF?
hold for 5 s, 10s rest, 10 reps per set, 3-5 mins to complete, 1 set per day, 5x a week
73
3 exercises for low risk fracture pts?
High impact WB exercises that include:
1. acceleration / deceleration
2. jumping
3. variety
74
3 examples of exercises for mod risk # pts?
1. run
2. hike
3. circuit training
75
No ____ sports for mod risk # OP pt.
contact
76
3 exercise for high risk # OP pts?
1. brisk walk
2. swimming /pool exercise
3. stair climbing
77
Exercises to avoid for the spine for OP pts?
1. flexion with resistance, rotation, side-bending and combinations
2. high compressive forces
78
Exercises to avoid for the hip for OP pts?
1. forced rotation
| 2. mindful of surgeons orders
79
For CV fitness, encourage exercises that have max bone _______ effect but are safer _____ risk zone
building; fracture
80
Use ____ and ____ as targets for CV fitness
RPE; HR
81
5 aspects of fall prevention?
1. medication
2 footwear
3. awareness of postural hypotension
4. consideration of vision deficits, multifocal glasses
5. environment modification tp reduce tripping hazards
82
Pharmaceuticals do a very good job of building bone ______ but exercise does a better job of building bone ______
density; quality
