Bones and Joints Flashcards
why is bone continuously remodeling
based on our body’s need to maintain homeostasis
what are involved in bone remodeling
osteoblasts and osteoclasts
what are osteoblasts
create bone formation
what are osteoclasts
create bone resorption
when does peak bone mass occur
in early 20s
what is peak bone mass highly determined by
genetics
what are the 2 prominent modifiable predictors of peak bone mass
physical activity level and nutrient intake
what is age-related bone loss tightly linked to
sex-hormone decline
what causes the decline in sex-hormones
the decrease production of sex-hormones causing a decrease in osteoblasts and an increase in osteoclast activity
what are the intrinsic effects of aging on bone
impaired osteoblast production from osteogenic stem cells and a decerased ability for cells to sense and respond to mechanical forces
what are the morphological changes of bone with age
loss of bone mass and mineral content, altered bone shape and geomtry, and an increase in yellow bone marrow/decrease in red bone marrow
what percent of red bone marrow do we have at birth vs at 70 years old
~90% at birth and ~30% at 70 years old
what is the pattern of age-related bone loss in men
theres a steay decline of cortical and trabecular bone
what is the pattern of age-related bone loss in women
over 10 year menopausal time period there is ~30% loss of trabecular bone mass and ~10% loss of cortical bone loss
what is osteoporosis
when theres trabecular bone loss and thinning and cortical bon becomes porous and this
what percentage of men and women who suffer a hip fracture will die within one year
37% of men and 28% of women
what are the non-modifiable risk factors of osteoporosis
age (>65YO), genetics, sex, and caucasian or asian decent
what are the modifiable risk factors of osteoporosis
low Ca2+ and/or vitamin D, tabacco use, alcohol inake, inactivity/sedentary lifestyle, prolonged use of certain drugs
falls are the leading cause of what among older adults
hip fractures
what are spinal compression fractures
source of chronic pain and are difficult to rehabilitate
what are ways to rehab spinal compression fractues
back brace, osteoporosis meds to strengthen bone, cement injections, spinal fusion surgery
what are signs/symptoms of osteoporosis
abnormal curvature of the pine, height decrease, and fragility/spontaneous fractures of the spine
what are fragility fractures
any falls from standing height or less that resukt in a fracture
what are treatment options for osteoporosis
dietary supplements, exercise, and pharmaceuticals that inhibis bone resorption or promotes bone formation
what are ways to diagnose osteoporosis
bone mineral density testing like a DXA scan usually of the femur or spine
what are the 2 fracture risk calculator assessments
CAROC and FRAX
what is CAROC
the Canadian Association of Radiologist & Osteoporosis Canada that assesses any fracture after 40, that includes age, sex and BMD measurement
what is FRAX
the Fracture Risk Assessment System that is a computer-based questionnarie
what is the vicious cycle
when there is muscle and bone loss, and visceral fat accumulation with aging, comboned with an increase of total adiposity resulting in chronic inflammation
what can the vicious triad lead to
osteosarcopenic obesity sydrome
what is the osteosarcopenic obesity syndrome
a multimorbid state that predisposes an individual to morbidity
what are the increase risks of osteosarcopenic obesity syndrome
weakness and imbalance, falls, fracutres, further decline in function, frailty and disease
what exercise would prevent/treat osteoporosis
weight-bearing activity, resistance training, balance training, and functional training
what are the 4 F-words when prescribing exercise for someone with osteopososis
Functional (movements that reflect ADL), Fun (enjoyable activities), Free (or low cost if applicable) and Fall (consider the fall risk)
what joints our our weight-bearing joints
knees, hips, spine, and big toes are the most prone to wear and tear
what occurs to joints with age
articular cartilage thins, decreases tensile stiffnes, reduced water content, and an increase in fibrous growth
what is osteoarthrisis
a progressive degradation of articular cartilage along with synovitis and bone remodeling
what areas are the most common for osteoarthritis to occur
hands, knees, hips, and spine
what are the primary risk factors of osteoathritis
age, family history, inflammation, overuse/disuse, overweight and obesity
what is the pathophysiology of osteoarthritis
- articular cartilage is structuraly damaged and eroted
- proteolytic enzymes are released from chondrocyctes which further degrades the cartilage
- bone becomes exposed and damaged causing cracks to form
- cysts and osteophytes develop
- pieces of osteophytes and damaged cartilage break off and float around in the synovil cavity
what are signs/symptoms of osteoartheritis
pain with movement and weight bearing, swelling, limtied ROM, crepitus may be heard, deformity, and can affect other joints and body alignment
how can osteoarthritis be diagnosed
seeing inflammation or changes in the joint with an X-Ray
what is the osteoarthritis treatment regime
- surgery (top of pyramid)
- COX2 inhibitors, high dose NSAIDs, corticosteriods, hyaluronic acid, DMOADs
- simple analegsics, low dose Non-steroidal anti-inflammatory drugs (NSAIDs)
- exercise, weight loss, diet, physiotherapy, brace (bottom of pyramid)
what are exercises to prevent/treat osteroarthritis
low impact exercises, flexibility/strength/aerobic exercises, and muslce strengthening exercuses
