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2) Patho 2 > 9) Osteoporosis > Flashcards

9) Osteoporosis Flashcards

1
Q

Osteoporosis

A

Chronic, progressive disease characterized by low bone mass, decr bone strength, & incr fx risk

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2
Q

What is the most common metabolic bone disease?

A

Osteoporosis

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3
Q

What is OP the major cause of?

A

*Fx in elderly resulting in pain, disability, costly rehab, poor QOL, & premature death

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4
Q

True or False: OP occurs t/o the lifespan.

A

True

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5
Q

What happens to many pt’s w/OP-related fx’s?

A

Fx’s go un-dx’ed.

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6
Q

Qualities of OP in males:

A
  • Less common
  • Underdx’ed
  • Underreported
  • Higher m&m than women
  • Major public health concern
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7
Q

Collagen

A

Protein that provides a soft framework

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8
Q

CaP

A

Adds strength to & hardens bone

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9
Q

Where is cortical bone located?

A

Shafts of long bones

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10
Q

Where is trabeculated bone located?

A

Spine, pelvis, & ends of long bones

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11
Q

Osteoblasts

A

Build up bone

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12
Q

Osteoclasts

A

Break down bone

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13
Q

Osteocytes

A

Sense mechanical strain & respond to this train by stimulating osteoblasts & osteoclasts to do their thing

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14
Q

What type of bone cell makes up about 95% of adult bone?

A

Osteocytes

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15
Q

Generalized OP

A

Involves the entire skeleton

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16
Q

Regional OP

A

Involves a limb or region

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17
Q

Localized OP

A

Involves only focal areas; Sometimes the result of prolonged immobilization

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18
Q

Primary OP

A

Bone loss associated w/biological changes that take place t/o the lifespan

*Type 1 & Type 2

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19
Q

Type 1 OP

A

Occurs in post-menopausal women bc of decr estrogen

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20
Q

Type 2 OP

A

Associated w/the aging process

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21
Q

Secondary OP

A

Occurs at any age 2° to medical conditions, metabolic/nutritional disorders, meds, & immobilization

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22
Q

When do females & males hit peak bone mass?

A

Females=18y/o

Males=20y/o

23
Q

During the growth spurt, what % of total adult bone mass is acquired?

A

40%

24
Q

What is the critical period for building bone mass?

A

Growth spurt during puberty

25
Q

What influences peak bone mass?

A
  • Genetics
  • Nutrition
  • Physical activity
  • Hormones
  • Risk factors
26
Q

Non-modifiable risk factors of OP

A
  • Gender
  • Age
  • Body size
  • Ethnicity
  • FHx
  • Depression
  • Lactose Intolerance
  • Femoral Neck BMD
27
Q

Modifiable risk factors of OP

A
  • Sex hormones
  • Anorexia
  • Ca2+ & vitamin D intake
  • Too much protein, Na, & caffeine intake
  • Weight
  • Physical activity
  • Meds
  • Alochol
  • Smoking
28
Q

Risk factors of OP for women

A
  • White & Asian
  • Post-menopause
  • Early menopause/menstrual dysfxn
  • FHx of OP &/or fx
  • Lifestyle
  • Prolonged exposure to certain meds
  • Ca tx
  • Thin/small boned
  • Chronic diseases
29
Q

Risk factors of OP for men

A
  • White
  • Age
  • Lifestyle
  • FHx
  • Prostate CA w/bilateral orchiectomy
  • Undx’ed low testosterone
  • Hypogonadism
  • Chronic diseases
30
Q

FRAX

A

Evals 10-yr spine, UE, or hip fx risk

31
Q

FORE Test

A

Estimates 10yr fx risk for post-menopausal women & men >45y/o who aren’t getting tx for OP

32
Q

BMD

A

Avg concentration of mineral in a defined section of a bone; Correlates w/bone strength

33
Q

What is an excellent predictor of future fx?

A

BMD

34
Q

Who should have a BMD test?

A

Women >65y/o & men >70y/o

35
Q

Who should not have a BMD test?

A

Kids, healthy young men, & premenopausal women

36
Q

What is the gold standard for measuring BMD?

A

DEXA

37
Q

What areas does DEXA focus on?

A

Hip & spine

38
Q

Can an x-ray be used to determine BMD?

A

No

39
Q

What is the most common site for OP fx’s to occur?

A

The spine

40
Q

What are spine fx’s followed by?

A

Fx of the hip, rib, radius, & femur

41
Q

Sx’s of vertebral fx

A
  • Back pain
  • Loss of height
  • Postural change
  • Fxnl impairment
  • Disability
  • QOL
42
Q

What can be used to confirm vertebral fx?

A

Lateral spine x-ray & DEXA

43
Q

Can PT help prevent future OP fx?

A

Yes

44
Q

Medical & PT Management of OP

A
  • Tx should be pt-specific
  • Control pain w/moist heat, TENS, oral analgesics, positioning, & bracing
  • Assess diet
  • Postural education
  • Vertebroplasty or kyphoplasty
  • Meds
  • Counsel on risk
  • Check for 2° causes
  • Advise on Ca2+ & vitamin D intake
  • Design a regular exercise program
  • Advise against smoking & alcohol
  • Use guidelines
45
Q

Red Flags for OP

A
  • Height loss >1’’
  • Previous Fx
  • FHx
  • Kyphosis
46
Q

Top 11 Assessment Tests for OP

A
  • Balance
  • Standing Height
  • Occiput to wall distance
  • Flexibility
  • Kypholordosis
  • Prone Hip Extension
  • Supine to sit
  • STS
  • Floor to stand
  • Single leg stance
  • Hip hinge/spinal alignment
  • Slow gait speed (1m/s)
47
Q

Tx goals for OP

A
  • Decr fx risk
  • Decr pain
  • Incr mobility
  • Incr bmd
  • Strengthen
  • Optimize posture–>Neutral spine
  • Promote overall fitness
  • Balance, hip extension, thoracic extension, & thoracic mobes
48
Q

How is postural stabilization effective?

A

Via lengthening of the spine & contracting the deep stabilizers during abdominal & back exercises

49
Q

Programs for OP should be:

A
  • Population specific
  • Site specific
  • Novel
  • Intermittent
  • Progressive
  • Agreeable
  • Used in conjunction w/diet
  • Incorporate rxn forces
50
Q

Great activities for OP

A
  • Line dancing
  • Tai chi
  • Aquatics
  • Walking
  • Resistance exercise
  • High impact
  • Resistive back strengthening
  • Aerobics
  • WBV
51
Q

Strength training guidelines for OP

A
  • 1RM
  • Ideal intensity=70-80%
  • 8-12 reps for temporary fatigue
  • More reps is not as effective
  • Decompression exercises
52
Q

Other good interventions for OP

A
  • Jt mobes–>Use your own clinical decision making
  • Taping
  • Bracing
53
Q

Purpose of bracing

A
  • Strengthens back extensors & abs
  • Decr kyphosis
  • Decr pain
  • Decr sway
  • Incr vital capacity
54
Q

Exercise contraindications for OP

A
  • Trunk flexion
  • Trunk rotation
  • Side bending
  • Don’t test spine mobility
  • Certain yoga poses

2) Patho 2 (20 decks)

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