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5th yr- CMS2- Musculoskeletal disorders > bone and joints > Flashcards

bone and joints Flashcards

1
Q

Name the different types of bone

A
  1. Woven
  2. Cortical
  3. Cancellous
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2
Q

What is cortical bone also known as

A

Compact or lamellae

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3
Q

What does cortical bone make up

A

Forms the shaft of long bones
Outlier or covering of flat bones

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4
Q

What is cortical bone made up of

A

Rings of typ 1 collagen

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5
Q

What is cancellous bone also known as

A

Trabecular

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5
Q

What is cancellous bone also known as

A

Trabecular

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6
Q

Where is cancellous bone found

A

Found inside flat bones and at the end of long bones

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7
Q

What is cancellous bone made up of

A

Network of non collagen proteins

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8
Q

Where does woven bone form

A

In early years of non development and at fracture sites

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9
Q

What is woven bone made up of

A

It is disorganised nd made up of bone mineral

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10
Q

Name the cells involved with bone

A
  1. Osteoblasts
  2. Osteoclasts
  3. Osteocytes
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11
Q

What are osteoblasts derived from

A

Local mesenchymal stem cells

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12
Q

What do osteocytes do

A

Regulate mineralisation and bone resorption
Synthesis collagen matrix

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13
Q

What do osteoblast do

A

Activate bone formation

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14
Q

What do osteoclasts do

A

Resorb bone

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15
Q

List teh stages of bone healing following fracture

A

1, Cellular stage
2. Vascular stage
3. Primary callus
4. Bony callus
5. Mature callus

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16
Q

Give examples of genetic bone diseases

A
  1. Osteogenesis imperfecta
  2. Cleidocranial dysplasia
  3. Osteopetrosis
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17
Q

What is Osteogenesis imperfecta due to

A

It is an autosomal dominant condition that leads to collagen defects

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18
Q

List some characteristic presentation of Osteogenesis imperfecta

A
  1. Blue sclera
  2. Deafness
  3. Bruising easily
  4. Loose joints/ tendons
  5. +/- Cardiac complications
  6. Fracture easily
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19
Q

What is Osteogenesis imperfecta also known as

A

Brittle bone disesse

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20
Q

What is Osteogenesis imperfecta also known as

A

Brittle bone disesse

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21
Q

As a dentist what consideration should you make if a patient has Osteogenesis imperfecta

A
  1. Take care with extractions due to fracture risk
  2. GA risk - chest deformity and cardiac issues
  3. Teeth may be brown/purple or worn
  4. Soft dentine
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22
Q

What is cleidocranial dysplasia due to

A

Autosomal dominant condition that is rare and mainly involves the skull and clavicle

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23
Q

List some clinical signs of cleidocranial dysplasia

A
  1. Clavicles absent or defective
  2. Brachycepalic (broad short skull)
  3. Hypoplastic midface= mandibular protrusion
  4. +/- Clefts
  5. Other skeletal defects
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24
Q

List some dental features of cleidocranial dysplasia

A
  1. Hyperdontia
  2. Supernumeraries
  3. Retained deciduous dentition
  4. Abnormalities with dentition
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25
Q

What is osteopetrosis also known as

A

Albers schonberg disease

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26
Q

What is osteopetrosis due to

A

A rare disorder leading to a defect in osteoclastic activity and bone remodelling leading to excessive bone density

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27
Q

What are some clinical signs of osteopetrosis

A
  1. Often no symptoms
  2. Incidental finding on a radiograph following pt complaining of ‘bone pain’
  3. Patient may be anaemic or susceptible to infections
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28
Q

List some dental signs of osteopetrosis

A
  1. Fractures of the jaw/ osteomyelitis
  2. Difficulty in irradiating infection
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29
Q

Give examples of acquired bone Disorders

A
  1. Rickets/ osteomalacia
  2. Osteoporosis
  3. Fibrous dysplasia
  4. Pagets disease
  5. primary Hyperparathyroidism
  6. secondary Hyperparathyroidism
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30
Q

What is rickets

A

A childhood disease leading o inadequate skeletal mineralisation due to lack of vitamin D or calcium

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31
Q

What is teh treatment fro rickets

A

Vitamin supplements and dietary advice

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32
Q

What is osteoporosis

A

A disease lading to diminished bone mass and low bone density which causes fragile bones

33
Q

What factors can effect or increase the risk of osteoporosis

A
  1. Calcium intake
  2. Reproductive hormones
  3. Parathyroid gland
  4. physical activity
34
Q

Is osteoporosis more common in men or women

A

Women over the age of 50 (post menopausal)

35
Q

What are the symptoms of osteoporosis

A
  1. Usually asymptotic in early stages
  2. Back pain
  3. Reduced height
  4. Stooped posture
  5. Unexpected fractures
36
Q

What is teh treatment for osteoporosis

A
  1. Hormone replacement
  2. Bisphosphoantes
  3. PTH
  4. Floride
  5. Vitamin D Supplements
  6. Calcitonin
  7. Exercise
37
Q

What is fibrous dysplasia

A

A benign chronic fibro osseous lesion frequently found in the craniofacial region
Scar like tissue grows in the place of normal bone

38
Q

What is pagets disease

A

A common disorder that causes changes int eh balance of remodelling of bone

39
Q

What might a patient with pagets disease complain of

A
  1. Bone pain
  2. Fractures
  3. Hearing loss
40
Q

What is teh treatment fro pagets disease

A

bisphosphonates
calcitonin for pain relief

41
Q

What dental considerations should we make if we treat a patient with pagets disease

A
  1. Enlargement of maxilla seen
  2. Bulging in the zygomatic area
  3. Hypercementosis of teeth sometimes
  4. PT may have an increased risk of bleeding or osteomyelitis post surgery
42
Q

Which body system regulates blood calcium

A

The parathyroid and vitamin D levels

43
Q

What are teh parathyroids

A

4 small glands foudn on teh posterior aspect of the thyroid glands

44
Q

What happens when there is a low calcium level in the blood

A

The parathyroid releases calcitonin which increases the resorption of calcium from the gut and promotes osteoclastic bone resorptions
This increases calcium levels int eh blood

45
Q

List some of the signs and symptoms of primary hyperparathyroidism

A
  1. 50% asymptomatic
  2. Hypercalcaemia
  3. Bone pain
  4. Pathological fracture
  5. Giant cell tumours
  6. Peptic ulcers
  7. Pancreatitis
  8. Local swelling in teh mandible
46
Q

What is hyperparathyroidism caused by

A

Usually a single parathyroid adenoma that can be removed as treatment

47
Q

What is secondary hyperparathyroidism ALSO known as

A

Parathyroid hyperplasia

48
Q

What is secondary hyperparathroyism caused by

A

Due to a response to persistently low calcium levels
may be due to chronic renal failure or malabsorption

49
Q

Give examples of joints disorders

A
  1. Marfarns
  2. Ehlers-danlos
  3. Recurrent TMJ dislocation
50
Q

What is marinas syndrome

A

An autosomal dominent connective tissue disorder

51
Q

How might marinas syndrome present

A

Long/tall thin body
huge arm span

52
Q

Name the 3 key areas that are defected in Marfan syndrome

A
  1. Skeletal
  2. Cardiovascular
  3. Neuro-ocular
53
Q

list the key features of marfins

A

Mitral valve prolapse
Aortic dissection
Retinal detachment
Fibrillin 1 mutation
Arachnodactyly (long spider like fingers)
Near sighted
Scoliosis

54
Q

What is Ehlers dances syndrome

A

A group of rare disorders fo collagen formation
It is an autosomal dominant condition

55
Q

List some of the characteristic features of Ehlers dances syndrome

A
  1. Hyperextensible skin
  2. Bruise
  3. Loose joints
  4. Recurrent spontaneous dislocations
  5. Poor healing
56
Q

What are some issues associated with ehlers danlos syndrome

A
  1. Mitral valve prolapse
  2. Haematological issues- bleeding
  3. TMJ
  4. Short teeth/ abnormal roots/ pulp stones
  5. Micrognathia
  6. AOB
  7. Gingival hyperplasia
57
Q

Give examples of arthritides

A
  1. Osteoarthritis
  2. Rheumatoid arthritis
  3. Felty sun
  4. Juvenile arthritis
  5. Ankyosing spondylitis
  6. Infective arthritis
  7. Gout
58
Q

what Is osteoarthritis

A

Degenerations of articular cartilage and proliferation of new bone, cartilage and CT

59
Q

What might patents complain of if they have osteoarthritis

A

Pain stiffness and swelling in weight baring joints
more common in women

60
Q

What is the management of osteoarthritis

A

Analgesia
Joint replacement

61
Q

What is a key difference between osteoarthritis and rheumatoid arthritis

A

Osteoarthritis does not have any systemic symptoms whereas rheumatoid arthritis does

62
Q

What is rheumatoid arthritis

A

Most commonest form of chronic inflammatory joint disease leadign to symmetrical destruction
more common in women

63
Q

List some of the clinical features of rheumatoid arthritis

A
  1. Stiffness of hands/feet
  2. Usually worse in the morning
  3. Redness, tenderness and swelling over joints if acute
  4. Ulnar deviation usually symmetrical
  5. Increased disability in teh wrists, elbows, ankles and knees
  6. C spine involvement
64
Q

List the radiographic features of rheumatoid arthritis

A

Initially widening of joint space followed by narrowing erosion and destruction

65
Q

What is the management for rheumatoid arthritis

A
  1. Supportive measures
  2. Analgesics
  3. Corticosteroids into joint space
  4. DMARDs and biologic agens
66
Q

What dental issues may be seen in patients with rheumatoid arthrits

A
  1. Often associated with sjogrens syndrome
  2. Some changes on an OPT within TMJ
  3. Increased risk of bleeding, infection and mRONJ due to medication
67
Q

What is felty syndrome

A

Patients with rheumatoid arthritis, splenomegaly and neutropenia (it is very rare)

68
Q

List the different types of juvenile arthritis

A
  1. Systemic
  2. Polyarticular
  3. Pauciarticular
69
Q

Who is more commonly affected by juvenile arthritis

A

Girls in their late childhood

70
Q

What is juvenile arthritis assicted with

A

Fever
Nodules
Malaise
Anaemia

71
Q

What is ankylosing spondylitis

A

A form of chronic inflammatory arthritis that affects the sacroiliac and spinal joints
Mainly seen young males

72
Q

What can ankylosing spondylitis cause overtime

A

Fusion of vertebrae

73
Q

What issues can ankylosing spondylitiscauwe

A

Back pain
Stiffness
Eye lesions
Cardiac disease

74
Q

How is ankylosing spondylitis trearted

A

Physiotherapy
Exercises
NSAIDS

75
Q

How is ankylosing spondylitis trearted

A

Physiotherapy
Exercises
NSAIDS

76
Q

What is gout

A

A form of chronic inflammatory arthritis where crystals of monosodium urate monohydrate form in teh joints

77
Q

What can build up of monosodium urate monohydrate crystals int eh joint cause

A
  1. Inflammtory arthritits
  2. Tenosynovitis
  3. Bursitis or cellulitis
  4. Tophaceous deposits
  5. Urolithiasis
  6. Renal disease
78
Q

What can build up of monosodium urate monohydrate crystals int eh joint cause

A
  1. Inflammtory arthritits
  2. Tenosynovitis
  3. Bursitis or cellulitis
  4. Tophaceous deposits
  5. Urolithiasis
  6. Renal disease
79
Q

What is gout caused by

A

High uric acid from breakdown of purines
High blood pressure, diabetes and obesity

80
Q

What is the treatment for gout

A

NSAIDS
Allopurinol

5th yr- CMS2- Musculoskeletal disorders (4 decks)

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