lecture 9: osteoporosis Flashcards
can osteoporosis occur in young adults
yes
what is the relationship between osteopororsis and PA
stressing bones strengthens them and decrases chance of osteo
the use of what meds can LEAD TO osteoporosis
corticosteroisds (drugs used to decrease inflammation)
osteoporosis is what type of disease
metabolic disease od the bones
osteo means
bone
porosis means
pourous =cavities in bone
what does DEXA stand for
duel energy xray absorptiometry
what is DEXA used for
osteoporosis diagnosis
what does DEXA scan
Scans the entire body and measures the risk for fracture in
the hip, spine, and wrist
is the level of radiation high or low in DEXA
low
how long does dexa take
less than 5 min
DEXA provides what
provides 2d images of successive bone laters
what does (QCT) stand for
quantitative computed tomography
wha t does QCT measure
Measures BMD in the hip and spine and produces a threedimensional
(3-D) image that shows true volume density
QCT. Can isolate an area for testing
the QCT measures BMD in what part of the body
hip and spine
the DEXA measures the risk of fracture in what body part
hip spine and wristr
is the radiation level higher or lower in dexa or QCT
radiation is higher in QCT
the radiation level is BLANK times higher than in dexa
10x
what is the The only method capable of distinguishing BMD level between the exterior
cortical bone and the interior trabecular bone
quantitative computed tomophraphy
QCT is the only method capable of distringusihing BMD level between what
between the exterior
cortical bone and the interior trabecular bone
what is trabecular bone
where the bone loss begins
true or false: CT scan can measure BMD inside bones
true
true or false DEXA can measure BMD inside bones
false
where does osteoporosis begin
in the spongy bone
BMD is given as two scores, what are they
Tscore
Zscore
what is the Tscore
the deviation from the mean bone density of healthy young adults of the same
gender and ethnicity
what is the Z score
the deviation from the mean bone density of adults of the same age , gender
and ethnicity
which score is the BMD score compared with the score of healthy young adults
tscore
which score is the bmd score compared with the score of adults same age as you
z score
which score compares you to health young adults
t score
which score compares you with adults the same age as you
z score
which score gets rid of the age efect
z score
what t score defines osteoporosis
a t score of -2.5 sd and below
what t score indicares osteopenia and risk of osteo
between -1 and -2.5 sd
if your tscore is between -1.5 sd to -2.5 sd do you have osteopenia or osteoporosis
osteopenia
if your tscore is between 2.5 sd and below do you have osteopenia or osteoporosis
osteoporosis
KNOW HOW TO CALCULATE THE BMD VALUES (SLIDE 8)
.
WHAT IS establish osteoporsis
Preferred term for those with
osteoporosis and having one or more fragility fractures
what is a fragility fracture
A Fragility Fracture is any fall from a standing heigh or less, that results
in a fracture
true or false: A Fragility Fracture is any fall from jumping
false, standing beigh
a body should be able to wistand a fall from what heigh wihotut a fracture
standing heigh
what is the only reason you would get a fracture from standing hiegh
because of an underlying cause that makes the bones fragile
what are the most common areas of establish osteoporosis
wrist, hips and spine
every SD below normal BLANKS the risk for fracture
double
-1 standard deviation equals ______ the risk of fracture
2x
-2 standard deviation equals ______ the risk of fracture
4x
-3 standard deviation equals ______ the risk of fracture
8x
if you have -1 SD from mornal you have osteopenia or porosis
penia
if you have -3 SD from normal you have osteopenia or porosis
osteoporosis
what is used to used to determine whether the loss of bone
density is secondary to another disease or condition
z score
the z score is used to determinne what
whether the loss of bone
density is secondary to another disease or condition
if the z score is lower than expected for age than what does that mean
then there
must be something accelerating this loss beyond the
normal process of aging.
what are some things that then there
accelerating this bone loss beyond the normal process of aging.
drug use (corticosteroids,
anticonvulsants, antirejection drugs etc.), alcohol, tobacco,
eating disorders and others.
1 out of how many women over the age of 50 is affected with osteo
1/4
1/4 women over the age of what arte affected of osteoporosis
50
1 out of how many men over the age 50 is affected of osteroporis.
1/8
why is there more women who get osteoporosis instead of men
because of menopause (decreaes hormone level)
smaller bones
what are the most common fractures because of osteoprosis
vertebra
hip
wrist
Is the fall due to the femoral neck fracture (A) or is the fracture the result of the fall (B)?
the fracture is the result of the fall 80% of the time
over 60 years old BLANK are fracture of vertebra
18%
over 50 years old BLANK are hip fracture
15
over 60 years old, 18% of fracture are of what
vertebra
over 50 years old, 15% of fracture are of what
hip fracture
Women aged 65–69 who break a hip are 3 times more likely to what
to die within a year than women of the same age who don’t break a hip
Women aged BLANK who break a hip are BLANK more likely to die
within a year than women of the same age who don’t break a hip
65-69
3X
true or false: when you are youung you have 100% of bone density
false
as age increases, what is the effect of BMD
as age increases, BMD gets lower and lower
why does osteopenia istart to decrease near the age of 80
because those with osteopenia become osteoporotic
true or false: bones are not living tissue
false they are
what happens to our bones every 3-4 months
bone remodelling
every how long do we get bone remodlling
3-4 months
what does bone remodling mean
old bone is removed and replaced by new bones
what are the bone eroding cells
osteoclasts
what do osteoclasts do
dissolve the mineral and cause small
cavities
what are the bone forming cells
osteoblasts
what do osteroblasts do
fill in the cavitsuntil it is restored
decalcification =
bone resorption
calcification =
bone formation
what is the end product of osteoblasts and clasts
new meneralied bones
what are the 2 aging effects for osteo
1) unbalance in bone remodelling process
2) calcium is less effiencelty absorped
after the age of 20, there is a loss of what percentage of total bone mass
1%
what age is peak BMD
20
what is the percentage of total bone mass loss each year in women after menopause
2-3%
How can we positively
change/influence the BMD slope?
better nutrition
physical activtity
hormones in post menopausal women
bone remodelling is under the control of what 2 things
1) hormones
2) mechaninal loading
what are the homrones that affect bone remodelling
parathyroid hormones, estrogen, testosterone
what is the role of hormones in bone remodelling/BMD
to maintain the appropriate level of
calcium in the bone
what controls the activtity of bone cells
calcium
lack of hormones leads to =what
bone atro[hy
what are the general response of the skeletal system
hormone release
can you rely on only hormones or mechanical loading to maintain BMD
no
true or false: mecahnial loading is required to maintain adequate bone density
true
explai nwhy mecahnaial loading is improtant for maintaing BMD
contraction/loading =activation of bone cells = increase BMD
whta is the local response of the sketal system
mechanial system
where does degenration occur first
spongy bone
what happens to bone trabeculae in osteoporosis and what does this lead to
The bony trabeculae are thinned out and the mechanical strength of the vertebra
is reduced. This leads to compression fractures and flattening of the vertebra
for most fractures damages in the spine they are limited to where and what does that mean
lmited to the front of the vertebral column so there is rarely any spinal cord damages
where is there usually a fracture in the femur because of osteo
at the femoral head
which is easier to heal, hip or femur fracture and why
femor because it can be replaced by an articfiual head whereas hip you cannot
what are the risk factors for osteo that are beyond your control
family hisotru female small bones menopause caucasuion/asian prologngued hormonal imbalances removal of ovaries or prem menopause (before 45) prolongued med use over 50
prologunged hormonal imbalances are due to what gland
thyroid
what 4 factors have a direct effect on the bone remodelling process
menopausal
prolongued homronal imbalance
removal or ovaries or prem menopause
prolongued or heavy use of meds
if you checked off more than 5 risk facors than you should do what
consider consulting a health professional who can guide your course of prevention = Physician + Nutritionist + Kinesiologist
what are the risk factors you can control for osteoporosis
lack of PA diet poor in vit D and calcium smoking caffeine excessive alcohol consumption
lack of PA decreases what
decreases mechanial loading
bad diet, smoking, caffeine, and alcohol decrease what
decrease calcium i nthe bones
what are the 3 classficiations of osteoporosis
1) post menopausal (type 1)
2) senile osteoporosis (type 2)
3) secondary osteo
what is the most common type of osteopororis
postmenopausal
who is the target affected of postmenopausal osteoporir
mid sixties (=15 years post menopause)
what areas are most likely to get fractured in post menopausal osteipororis
vertebral and hip fractures
because of the decrease in estrogen after menopause causes what percent decrease in BMD
decrease 10-15% BMD in the first 5 years
senile osteropororis affects what age bracket
over 8- years
what percentage of peopel with senilie osteoporosis are men
30%
what areas are most commonly fractured due to senile osteroporis
forearm, pelvis, hip fractures
true or false: hip fractures are the most common in senile osteo
true
true or false: secondary osteoporosis cannot occur in young people
false, it can
what is secondary osteoporosis assocaitred with
Associated with calcitonin imbalance, malabsorption conditions
(e.g., celiac disease, cystic fibrosis, lactose intolerance),
alcoholism, smoking, and the use of certain medications (e.g.,
glucosteroids in arthritis)
what is celiac disease and what does it lead to
Inability to metabolize peptides in gluten
(wheat, oats, barley). Lead to muscle wasting
what is the prevention of osteoproris
hormone replacement therapy (estrogen)
what are the 2 pros of esttrogen therapy
1) Inhibit or slow down bone resorption
- decreases Effects of menopause (ex: hot flashes,
night sweats)
what are the 2 cons of estrogen thrapsy for osteoporosis
1) ↑ risk of blood clots, stroke and coronary
heart disease
2. Necessary or not?
what are the 2 types of PA for prevention of osteoporosis
weight bearing activities (walkingm running,dancing, soccer etc)
resistance traning (done with barbells, machines0
what is the special consideration for doing RT with osteoporosis
high intensities and
few repetitions to increase bone pressure
what is the effect of exercise on the bonens
increase pressure
on the bone = increase bone
mass
(site specific to the limbs used)
what are the 4 special considerations to exrecise for those with osteopenia/porosis
Avoid forward flexion of the spine
• Adapt equipment for decrease risk of falling (falls can =
fractures)
- Aerobic dance exercise = low impact
- Resistance training = decrase load and icrnease repetitions
