Exam 3 Flashcards
Spongy Bone
-Found inside & at the ends of bones
-Has more cavities in it that form a network of bony tissue
-Red blood cells are produced within red bone marrow located in the cavities between the trabeculae
-Red bone marrow forms the structural foundation of spongy bone
-20% of skeletal mass
-Predominant type of bone tissue in the axial skeleton
Compact Bone
-Hard, dense tissue that has less cavities as compared to spongy bone
-Forms the outermost layer of bones
-80% of skeletal mass
-Predominant type of bone tissue in the long bones & appendicular skeleton
Purposes of the Skeletal System
-Offers structural support to the body
-Provides attachments points for muscles & tendons
-Serves as a calcium reservoir
-Houses red bone marrow
Osteoblasts
Build bone in response to demands placed on them
Osteoclasts
Destroy bone to make way for new bone growth and help to maintain blood calcium levels
Estrogen & Testosterone
-Inhibits apoptosis of osteoblasts, increases apoptosis of osteoclasts & stimulates osteoblast activity promoting greater calcium deposition
-Almost 95% of peak bone mass achieved during childhood/adolescence is influenced by estrogen & testosterone
Bone Health in Childhood/Adolescence
-Osteoblast activity outpaces osteoclast activity resulting in longer, stronger, & denser bone
-Continues to the ages of 20 to 30
Bone Health in Early Adulthood
Process slows until osteoclast activity equals osteoblast activity
Bone Health in Middle Age
-Osteoclast activity outpaces osteoblast activity
-Results in a loss of bone tissue predisposing the bone to osteoporosis & risk of fracture
Bone Health in Old Age
Osteoblast activity decreases as the relative proportion of osteoclasts increases resulting in slow bone repair
Why do women have more bone related issues?
-Hormonal changes of menopause & decreased collagen synthesis
-Dramatic drop in estrogen production postmenopausal strips calcium from bone
-Women lose spongy & compact bone at a rate 3-4x faster than men & premenopausal women
-Men have greater peak bone mass
-Less dramatic drop in testosterone later in life
What causes people to lose height?
-Loss of bone mass, bone fracture, & intervertebral disc deterioration
-Decreases in bone mass & deteriorating discs lead to hunchback
Articular Cartilage (hyaline cartilage)
Covers the ends of articulating bones
Synovial Capsule
Two layered joint capsule that surrounds synovial joints
Synovial Joint Layers
-Fibrous Layer (outer)
-Synovial Membrane (inner)
What produces synovial fluid?
The Synovial Membrane
Joints
Exist anywhere two bones meet
Synovial Joints
-Freely moveable joints including hinge and ball and socket joints
-Prone to deterioration & disorder because they articulate
Aging Joints: Water
-Total body water decreases
-Pulls water out of the cartilage pads found between vertebrae (vertebral discs)
-Decreases flexibility & eventually stiffens the spine
Aging Joints: Collagen
-Structural component of cartilage, tendons, & ligaments
-Produce less collagen so articular cartilage begins to thin & wear away
-Joints lose cushioning & lubrication and become stiff & achy
-Ligaments & tendons become stiffer & more brittle decreasing flexibility & movement
Aging Joints: Blood Supply
-Capillary supply to the synovial membrane drops resulting in less synovial fluid produced
-Causes joint stiffness and immobility
-Allows debris & microbes to accumulate in the synovial cavity, further impairing mobility
-Though collagen production begins to slow around age 25, age-related changes in the joints usually aren’t apparent until age 40
What is the most common form of arthritis?
Osteoarthritis
What does osteoarthritis affect & what is it less common in?
-Affects small joints of the fingers, feet, & spine as well as weight bearing joints such as hips & knees
-Less common in wrists, elbows, & shoulders
Adding Stress on Osteoarthritis
-Discomfort develops over years resulting in varying degrees of pain as the joint is used
-Aging, obesity, diabetes, & joint trauma increase likelihood of OA
What is the rheumatoid arthritis major mechanism?
Synovial Membrane
When do symptoms of rheumatoid arthritis usually appear?
Between the ages 30 & 40
Rheumatoid Arthritis Active & Inactive Phase
-Active Phase: relapse resulting in inflammation, pain, limited ROM, & fatigue
-Inactive Phase: remission
Rheumatoid Arthritis Traits
-Bilateral in nature
-Generalized fatigue
-Auto-immune disease
-No cure
Age Related Injuries & Conditions: Sprains
-Active seniors & tend to sprain wrists & ankles more frequently than younger people
-Due to impaired balance, diminished muscle mass, weakened joints & shorter/tighter ligaments
-Ligaments are overstretched resulting in swelling, pain, & reduced range of motion
-Once a joint is sprained it is more susceptible to future injury
-Most sprains respond well to RICE though more serious sprains require medical attention
Exercise Precautions of Skeletal Disorders
-Be aware of comorbidities
-Avoid heavy weight-lifting
-Avoid high-impact activities
-Avoid explosive or twisting machines
-Balancing issues (avoid free weights)
How often is recommended for someone to stretch with skeletal disorders?
5-7 days per week
Benefits of Exercise with Skeletal Disorders
-Decrease bone loss & increase bone mass
-Maintains & increases joint function
-Preserves & increases muscle strength
-Controls weight
-Improves mood
When is the typical age for onset of Fibromyalgia?
Between the ages 20 & 40
Fibromyalgia Diagnosis
No clear cut diagnosis, typically attempts to rule out any other complications before diagnosing fibromyalgia
Who is more affected by Fibromyalgia, men or women?
90% of all cases occur in women
Fibromyalgia Tender Points Throughout the Body
-Bilateral tender points in at least 11 of 18 specified anatomical sites
-Neck, Chest, Back, Back of Head, Triceps, Buttocks, Knee area
Main Causes of Fibromyalgia
-Physical or Emotional Events
-Central Sensitivity Syndrome (CSS)
-Genetics
-Infections
-Pre-existing Conditions
Traits of Fibromyalgia Treatment
-No cure
-Only treatment & therapy
-Combination of both therapies is most effective strategy
Common Types of Medication for Fibromyalgia
-Anti-depressants
-Anti-seizures
-Muscle Relaxant
What is the primary barrier of exercise in Fibromyalgia?
Fear of worsening symptoms
Frequency, Intensity, & Rest Periods for those with Fibromyalgia
-Frequency & intensity reduced
-More effective with shorter interval for aerobic exercise
-Longer rest periods
-Lower frequency for resistance
How often should someone with Fibromyalgia do Flexibility Training?
Daily
Goldilocks Zone
-Find in fibromyalgia
-Not too strenuous but not too mild either
-Perfect condition/range for most effective exercise
Fibromyalgia can lead to Raynaud Syndrome Symptoms what does this include?
-Fingers turn pale or white then blue
-Triggers when exposed to cold, during stress, or emotional upset
Fibromyalgia Facts
-Constantly fatigued
-Easily depressed
-Suicide rate is up for this population
Why/How does Multiple Sclerosis Happen?
-Neurodegenerative autoimmune disease that attacks the myelin sheath surrounding nerve fibers
-Demyelination
Common Symptoms of Multiple Sclerosis
-Fatigue, muscular weakness, pain
-Numbness or tingling
-Muscle spasticity
-Lack of coordination/balance
-Dizziness
-Difficulty walking
-Bowel/Bladder Dysfunction
-Sexual Dysfunction
-Slurred Speech
-Memory problems
-Mood Swings/Depression
Multiple Sclerosis Diagnosis
-No diagnostic test
-Attempt to rule out any other health related issues before diagnosing Multiple Sclerosis
Common Testing for Multiple Sclerosis
-MRI
-Spinal Tap
-Evoked Potential Test
-Blood Tests
-Neuropsychological Tests
Non-Modifiable Risk Factors of Multiple Sclerosis
-Gender
-Age
-Heredity
-Ethnicity
Modifiable Risk Factors of Multiple Sclerosis
-Sunlight & Vitamin D
-Environment
-Health Habits
What ethnicity is most affected by multiple sclerosis?
Caucasians
Is there a higher risk in obese people of Multiple Sclerosis?
Yes
Relapsing-Remitting Multiple Sclerosis
Most common type affecting 85% of people with MS
Secondary-Progressive Multiple Sclerosis
50% of people with relapsing-remitting multiple sclerosis will eventually develop a steady progression of symptoms with or without periods of remission
Primary Progressive Multiple Sclerosis
Steady decline with no relapses or remissions
Progressive Relapsing Multiple Sclerosis
Marked by progressive deterioration
Is there a cure for Multiple Sclerosis?
-No cure
-Medications
-Only treatment & therapy
Common Medications of Multiple Sclerosis
-Immune System Modulators (immunomodulators) not over the counter
-Immune System Suppressants (immunosuppressants) not over the counter
-Anti-inflammatories, can be over the counter
What is the exercise goal for Multiple Sclerosis?
Improve functioning
What can exercise do for people with multiple sclerosis?
-Reduce fatigue levels
-Improve muscular strength, endurance, power, hypertrophy
-Enhance balance, coordination, functional mobility, & walking speed
-Reduce brain atrophy
-Physiologically helps to reduce stress
Main Barrier to Exercise for Multiple Sclerosis
Fear of worsening symptoms
Barriers to Exercise of Multiple Sclerosis
-Fatigue
-Tend to avoid activity
-Unpredictability of exacerbation
-May have to start over progress after exacerbation episode (frustrating)
-Lack of knowledge of issue from professionals
Frequency, Intensity, & Time Aerobic Recommendations for Multiple Sclerosis
-Start with one session per week & can progress to 2-3 sessions
-Decrease intensity, frequency, & time
Is there much difference for resistance recommendations for multiple sclerosis?
No, not much differences
Flexibility Training Recommendations for Multiple Sclerosis
-Daily flexibility & balance training
-Hold stretches 20-60 secs
-10-15 min per day on spastic muscles
True or False: Stress can make symptoms worse in Multiple Sclerosis
True
Exercise Precautions & Contraindications in Multiple Sclerosis
-Fatigue is common
-Exercise progressed slowly
-Cut down heat sensitivity
-Decreased sweating response
-Stay Hydrated
Should exercise during an exacerbation be discontinued?
-Yes
-Re-evaluate after
-Program flexibility is important
True or False: Gait issues are not common in Multiple Sclerosis
False
