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HES 383 > Bones and Joints > Flashcards

Bones and Joints Flashcards

1
Q

why is bone continuously remodeling

A

based on our body’s need to maintain homeostasis

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2
Q

what are involved in bone remodeling

A

osteoblasts and osteoclasts

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3
Q

what are osteoblasts

A

create bone formation

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4
Q

what are osteoclasts

A

create bone resorption

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5
Q

when does peak bone mass occur

A

in early 20s

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6
Q

what is peak bone mass highly determined by

A

genetics

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7
Q

what are the 2 prominent modifiable predictors of peak bone mass

A

physical activity level and nutrient intake

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8
Q

what is age-related bone loss tightly linked to

A

sex-hormone decline

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9
Q

what causes the decline in sex-hormones

A

the decrease production of sex-hormones causing a decrease in osteoblasts and an increase in osteoclast activity

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10
Q

what are the intrinsic effects of aging on bone

A

impaired osteoblast production from osteogenic stem cells and a decerased ability for cells to sense and respond to mechanical forces

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11
Q

what are the morphological changes of bone with age

A

loss of bone mass and mineral content, altered bone shape and geomtry, and an increase in yellow bone marrow/decrease in red bone marrow

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12
Q

what percent of red bone marrow do we have at birth vs at 70 years old

A

~90% at birth and ~30% at 70 years old

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13
Q

what is the pattern of age-related bone loss in men

A

theres a steay decline of cortical and trabecular bone

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14
Q

what is the pattern of age-related bone loss in women

A

over 10 year menopausal time period there is ~30% loss of trabecular bone mass and ~10% loss of cortical bone loss

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15
Q

what is osteoporosis

A

when theres trabecular bone loss and thinning and cortical bon becomes porous and this

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16
Q

what percentage of men and women who suffer a hip fracture will die within one year

A

37% of men and 28% of women

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17
Q

what are the non-modifiable risk factors of osteoporosis

A

age (>65YO), genetics, sex, and caucasian or asian decent

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18
Q

what are the modifiable risk factors of osteoporosis

A

low Ca2+ and/or vitamin D, tabacco use, alcohol inake, inactivity/sedentary lifestyle, prolonged use of certain drugs

19
Q

falls are the leading cause of what among older adults

A

hip fractures

20
Q

what are spinal compression fractures

A

source of chronic pain and are difficult to rehabilitate

21
Q

what are ways to rehab spinal compression fractues

A

back brace, osteoporosis meds to strengthen bone, cement injections, spinal fusion surgery

22
Q

what are signs/symptoms of osteoporosis

A

abnormal curvature of the pine, height decrease, and fragility/spontaneous fractures of the spine

23
Q

what are fragility fractures

A

any falls from standing height or less that resukt in a fracture

24
Q

what are treatment options for osteoporosis

A

dietary supplements, exercise, and pharmaceuticals that inhibis bone resorption or promotes bone formation

25
Q

what are ways to diagnose osteoporosis

A

bone mineral density testing like a DXA scan usually of the femur or spine

26
Q

what are the 2 fracture risk calculator assessments

A

CAROC and FRAX

27
Q

what is CAROC

A

the Canadian Association of Radiologist & Osteoporosis Canada that assesses any fracture after 40, that includes age, sex and BMD measurement

28
Q

what is FRAX

A

the Fracture Risk Assessment System that is a computer-based questionnarie

29
Q

what is the vicious cycle

A

when there is muscle and bone loss, and visceral fat accumulation with aging, comboned with an increase of total adiposity resulting in chronic inflammation

30
Q

what can the vicious triad lead to

A

osteosarcopenic obesity sydrome

31
Q

what is the osteosarcopenic obesity syndrome

A

a multimorbid state that predisposes an individual to morbidity

32
Q

what are the increase risks of osteosarcopenic obesity syndrome

A

weakness and imbalance, falls, fracutres, further decline in function, frailty and disease

33
Q

what exercise would prevent/treat osteoporosis

A

weight-bearing activity, resistance training, balance training, and functional training

34
Q

what are the 4 F-words when prescribing exercise for someone with osteopososis

A

Functional (movements that reflect ADL), Fun (enjoyable activities), Free (or low cost if applicable) and Fall (consider the fall risk)

35
Q

what joints our our weight-bearing joints

A

knees, hips, spine, and big toes are the most prone to wear and tear

36
Q

what occurs to joints with age

A

articular cartilage thins, decreases tensile stiffnes, reduced water content, and an increase in fibrous growth

37
Q

what is osteoarthrisis

A

a progressive degradation of articular cartilage along with synovitis and bone remodeling

38
Q

what areas are the most common for osteoarthritis to occur

A

hands, knees, hips, and spine

39
Q

what are the primary risk factors of osteoathritis

A

age, family history, inflammation, overuse/disuse, overweight and obesity

40
Q

what is the pathophysiology of osteoarthritis

A
  1. articular cartilage is structuraly damaged and eroted
  2. proteolytic enzymes are released from chondrocyctes which further degrades the cartilage
  3. bone becomes exposed and damaged causing cracks to form
  4. cysts and osteophytes develop
  5. pieces of osteophytes and damaged cartilage break off and float around in the synovil cavity
41
Q

what are signs/symptoms of osteoartheritis

A

pain with movement and weight bearing, swelling, limtied ROM, crepitus may be heard, deformity, and can affect other joints and body alignment

42
Q

how can osteoarthritis be diagnosed

A

seeing inflammation or changes in the joint with an X-Ray

43
Q

what is the osteoarthritis treatment regime

A
  1. surgery (top of pyramid)
  2. COX2 inhibitors, high dose NSAIDs, corticosteriods, hyaluronic acid, DMOADs
  3. simple analegsics, low dose Non-steroidal anti-inflammatory drugs (NSAIDs)
  4. exercise, weight loss, diet, physiotherapy, brace (bottom of pyramid)
44
Q

what are exercises to prevent/treat osteroarthritis

A

low impact exercises, flexibility/strength/aerobic exercises, and muslce strengthening exercuses

HES 383 (15 decks)

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