Week 4 - Osteoporosis and Arthritis Flashcards
(36 cards)
1
Q
What is peak bone density determined by?
A
- Genetics
- hormones
- physical activity
- nutrition
2
Q
What is osteoporosis?
A
- critically low bone mass and density with loss of bony matric and mineralization
- cortical bone becomes porous and thin
- trabecular bone loss
3
Q
Bone mass
A
the amount of bone tissue in the skeleton
4
Q
Bone density
A
mineral mass per unit volume of bone
5
Q
Primary osteoporosis
A
age related
6
Q
Secondary osteoporosis
A
due to another disorder or issue
- diseases associated with bone loss
- prolonged use of certain drugs
- immobility
7
Q
Osteoporosis pathophysiology
A
bone resorption > bone formation
8
Q
Estrogen and control of bone remodeling
A
- inhibits expression of RANK-L
- increases production of OPG
result: inhibition of osteoclast formation
9
Q
OPG and control of bone remodeling
A
- decoy receptor
- blocks action of RANK-L by binding to it
- RANK-L cant bind to its receptor on osteoclast precursor cell
- Osteoclast differentiation is inhibited
10
Q
Osteoporosis signs and symptoms
A
- spontaneous fractures
- back pain from compression fractures
- abnormal spine curvature with loss of height
11
Q
Osteoporosis treatmetn
A
- dietary supplements
- pharmaceuticals
- estrogen replacement therapy
12
Q
Ways to diagnose osteoporosis
A
- bone mineral density testing
- fracture risk assessment
13
Q
Osteoporosis therapeutic goal
A
- prevent falls
- decrease fractures
14
Q
Osteoporosis exercise recommendations
A
- mod/vig aerobic exercise
- weight bearing activities
- resistance training
- exercises challenging balance and flexibility
- spine sparing strategies
15
Q
Osteoarthritis
A
- considered a disease of mechanical degeneration + inflammation of a synovial joint
- localized to affected joint
-favors breakdown of cartilage
16
Q
Osteoarthritis pathophysiology
A
- something triggers chondrocytes to release degradative enzymes
- favors breakdown of cartilage
- small pieces of cartilage break off into the joint space
- cells of the synovium try to remove debris; immune cells recruited; cytokine secretion; inflammation of the synovium
- cracks form in the cartilage; synovial fluid enters and widens cracks
- no longer have smooth articular surface with even load distribution; bone is eventually exposed and rubs against articulating bone
- bone eburnation; osteophytes and cysts develop
17
Q
Osteoarthritis signs and symptoms
A
- weight-bearing joints
- asymmetrical, <4 joints
- stiffness at beginning and end of day; increases with activity
- Limited ROM
- enlarged joint that can harden as osteophytes develop
18
Q
Osteoarthritis treatment
A
- minimize stress placed on joint
- exercise, physiotherapy
- medications
- surgery to repair or replace
19
Q
Rheumatoid Arthritis
A
- chronic inflammatory disease - autoimmune
- exacerbations and remissions
- slow onset, usually symmetrical (begins with small joints in the fingers)
- severity based on # of joints affected, degree of inflammation, rapidity of progression
20
Q
Rheumatoid arthritis pathophysiology
A
- autoimmune response
- inflammation of synovial membrane; vasodilation, increased capillary permeability, immune cells recruited, cytokine release, exudate
- cytokines trigger synovial cells to proliferate
- forms a pannus
- pannus releases proteolytic enzymes and cytokines
- destruction of the cartilage
- pannus becomes more fibrotic over time
- nutrient supply in joint is cut off
- articulating bone exposed
- antibodies continue to activate inflammatory mediators
21
Q
What is a Pannus?
A
thickened and inflamed synovial membrane with granulation scar tissue
22
Q
What is visible on an x ray of rheumatoid arthritis
A
- narrowing of the joint space
- decreased bone density around the affected joints
- soft tissue swelling around the joint
- bone erosion
23
Q
Rheumatoid arthritis signs and symptoms
A
- 3+ joints affected, symmetrically
- begins in fingers
- morning stiffness; better throughout the day
- decreased ROM
- joint deformities with progression
- blood markers
24
Q
Rheumatoid arthritis blood markers
A
- elevated blood CRP
- elevated erythrocyte sedimentation rate (ESR)
- elevated rheumatoid factor
25
Rheumatoid arthritis treatment
- "treat-to-target"
- symptom management
- multidisciplinary treatment to manage chronic pain and other symptoms
- OT, physiotherapy
- all exercise is safe
26
Ankylosing Spondylitis
- chronic inflammatory disease
- affects vertebral joints; makes them stiff
- thought to be autoimmune + genetic predisposition
27
Ankylosing spondylitis physiology
- inflammatory/immune response
- destroys the intervertebral, facet, and sacroiliac joints
- fibroblasts replace destroyed joints with fibrin
- eventually fibrous tissue ossifies through activation of osteoblasts
28
Ankylosing spondylitis symptoms
pain and mobility depends on location
29
Ankylosing spondylitis treatment
Meds, physiotherapy, OT, exercise to maintain/improve spinal mobility, postural and functional ability
30
Bursitis
- inflammation of bursae
- due to repetitive strain or physical irritation
31
Bursitis treatment
rest, cold, meds for pain and inflammation, physiotherapy, surgical drainage
32
Synovitis
- inflammation of the synovial membrane within joints
- due to infection or gout, or sing of OA or RA
33
Synovitis treatment
treat underlying cause
34
Tendinitis
- inflammation of the tendons
- usually a repetitive strain injury
35
Tendinitis treatment
rest, cold, meds for pain and inflammation, physiotherapy, surgery
36
