bone Flashcards
What is the concept of mechanostat?
- concept of bone density regualtion according to certain thresholds
- groups of cells within the bone work together to keep bone strain at an optimal level
What is bone mechanotransduction?
- physiologic process that permits mechanstat
- four stages
- mechanocoupling
- biomechanical coupling
- transmission of biochemical signals
- the effector response
What is the first stage of bone mechanotransduction?
mechanocoupling
- bone defomation causes changes in pressure gradients
- as fluid flows past the osteocytes it shears the cell membrane creating a cellular response
- degrees of deformation have different cellular responses
What is the second stage of bone mechanotransduction?
biochemical coupling
- it is the coupling between bone and collagen matrix
- integrins connect the cell membrane to the collagen matrix
- the integrins transmit the biochemical force to the cytoskeleton and nucleus to alter gene expression
What is the third stage of bone mechanotransduction?
- transmission of the biochemical signal
- mechanical strain through bone directly activates osteoblasts and bone lining cells
- intermediary biochemical compounds also work to communicate to osteoblasts
What are some different theories of cellular mechnosensors?
- mechanically gaited ion channels
- integrens and focal adhesion
- G proteins
- linkage between cytoskeleton and certain phospholipase C isoforms
What is the fourth stage of mechanotransduction?
The effector response
- the effector is the term for the portion of the bone that produces new bone in response to mechanical strain
- may be osteoblast or osteoclast that responds
What is the time frame for cellular effector response?
- mechanical strain osteocytes and bone lining cells release prostacyclin
- after 5 minutes increased glucose 6-phosphate dhydrogenase
- 6-24 hours increased RNA synthesis and IGF-1 message of osteocytes
- 1-2 days osteoblast appears
- 3-5 days increased collagen and mineral apposition on bone surface
- 5-12 bone formation rate is increased
What are the two types of stress generated electrical potentials in bone metabolism?
- piezoelectric potential- stretch or strain produces electrical potentials within the collagen and proteglycans (positive charges lead to regeneration and negatives lead to remodeling)
- streaming potentials- potential produces by electolyte fluid flow
how do the electromechanical modeling mechanism for bone work?
- piezoelectric effect and streaming potentials convert mechanical energy to electrical energy
- (+) charged side bone under goes regeneration (-) side of the bone under goes remodeling
- positive chemical charge stimulates the osteoblastic activity
What chemicals contribute to the bone modeling mechanism?
- vitamin D metabilities
- parathyroid hormone
- calcitonin
What organ plays a role in the chemical modeling mechanism?
- kidney contributes to secretion and resorption of calcium and phophorus
- thyroid
What are some intrinsic or extrinsic factots effecting bone synthesis?
- amount of weight bearing and use of antigravity muscles
- muscle contraction force on bone
- estrogen levels
- testosterone levels
- HGH
- thyroid hormone
- calcitonin levels
- androgens
- gludocorticoids
- nutrition levels (vitamin D)
What factors are associated with bone disoluation or aborption?
- lack of weight bearing and decreased use of wt bearing muscles
- lack of stress to bone from muscle contraction
- glucocorticoids are produced by the adrenal cortex and fucntion to decrease absorption of calcium ions from the intestine
- excessive thryroid hormone
- levels of PTH which produce in response to low calcium and acidosis
What does PTH do?
- enhances release of calcium from the large reservoir contained in the bones. Bone resorption is the normal destruction of bone by osteoclasts, which are indirectly stimulated by PTH. Stimulation is indirect since osteoclasts do not have a receptor for PTH; rather, PTH binds to osteoblasts, the cells responsible for creating bone.
- effects calcium absorption in the kidney to increase blood calcium levels
- Increases production of activated vitamin D for improving abrosption of Ca from the intestine
What are the two basic phases of STEP?
- phase 1; pain free stage focusing on coordination and mobility around the physiologic axis throughout the ROM
- phase 2: restoration of function focusing on increasing tissue tolerances to demand of ADLs
What is bone composed of?
5% water
70% mineral (Ca hydroxiapatite with phosphorus, magnesium, sodium and potassium)
30% organic compounds (type I collagen 5-10% non-collagenous protien)
What are the three typs of bone cells?
osteocytes
osteoblasts
osteoclasts