🏥- Bone Test Flashcards
Osteoclasts
Cells that help demineralize and destroy old bone
Osteoblasts
Cells that help form bone
Estrogen
Stimulates osteoblasts activity
Arthrogram
A series of images taken of a joint after contrast medium has been injected
Allows for visualization of soft tissue structures of a joint
Dexa scan
Assess bone density or the amount of calcium and other minerals in the bone
Bones most often used: spine, hip, hand, foot and forearm
Low bone density is an indicator for what
Presence of osteoporosis and increased fracture risk
Osteoporosis
Chronic condition that results in deterioration of bone tissue and density
Bone resorption (osteoclasts) exceeds bone formation (osteoblasts)
Primary risk factors for osteoporosis
Age Gender (female) Race (whites and asians) Family hx Small body frame (less than 58kg) Low Ca and vitamin D intake High K intake Sedentary lifestyle Smoking Excessive alcohol consumption
Secondary risk factors for osteoporosis
- medications (corticosteroids for more than 3 months, antiepileptics, heparin, thyroid hormones)
- disease (hypogonadism or early menopause, malabsorption issues, chronic liver disease, ibs, ra, hyper thyroid and parathyroid, previous fracture)
- other (family hx of hip fracture, recurrent falls, prolonged immobilization)
What is the gold standard for diagnosing and follow up with osteoporosis
Dexa scan
Gives precise measurements that highlights areas for future fracture risks
Treatment of osteoporosis
Prevention
Muscle-strengthening exercise
Healthy lifestyle
Foods high in vitamin d
Vitamin d fortified milk, cereals, egg yolks, saltwater fish and liver
How do bisphosphonates work
Impede bone resorption by inhibiting osteoclasts activity, thereby absorbing Ca phosphate in bone
What is teaching that should be done with all bisphosphonates
Take in the morning on an empty stomach
Can cause: gi disturbances, dysphagia and inflammation of esophagus
Clinical manifestations of osteoporosis
Dowagers hump Loss of height Back pain Restricting movement Previous fractures
Paget’s disease of the bone
Bone metabolism disorder associated with accelerated bone remodeling, resulting in bone that is structurally abnormal
bone excessively broken down and reformed
Type of patient most at risk for developing paget’s
15-40% linked to genetics
Over age 50
White
Males
Clinical manifestations of paget’s
Pain and deformity
Also fractures, bone tumors, neuro diseases, cardiac disease and Ca/Phos imbalance
Types of medications used to treat PDB
Analgesics
Calcitonin
Bisphosphonates (decrease osteoclast activity, which suppresses bone resorption)
What is the most serious complication of PDB
Development of primary bone tumors , osteosarcoma
Surgical treatment of PDB
Joint replacement
Spinal decompression and stabilization
Osteotomy
Varus vs valgus
Varus- bowleg knee
Valgus- knock knee
Surgical spinal decompression/spinal stabilization
Decompression- removal of bony substances that are causing nerve impingement
Stabilization- surgically inserted rods, pins and pedicle screws that maintain spinal column structure
Nursing diagnoses associated with PDB
Risk for trauma
Acute/chronic pain
Impaired mobility
Clinical manifestations of acute osteomyelitis
- fever
- swelling and tenderness at affected site
- erythema and heat
- pain (not relieved by rest)
Clinical manifestations of chronic osteomyelitis
- swelling, tenderness
- constant pain