Musculoskeletal System

Question 1

Physical and social impacts of age-related conditions of the musculoskeletal system include…

Answer 1

• Pain
• Limited mobility
• Reduced quality of life
• Direct expenditure on diagnosis and treatment
• Indirect cost from loss of labour force

Question 2

What is osteopenia?

Answer 2

A loss in bone density with bone mass 1 - 2.5 standard deviations below mean peak bone mass.

Question 3

What is osteoporosis?

Answer 3

A loss in bone density with bone mass at least 2.5 standard deviations below mean peak bone mass.

Question 4

What are the risk factors for osteoporosis?

Answer 4

Age, physical activity, calcium nutritional state, hormones and genetic factors.

Question 5

Imbalance between what can lead to bone loss?

Answer 5

Imbalance between rates of resorption and formation can lead to bone mass.

Question 6

What is the function of an osteoclast?

Answer 6

Osteoclasts are key to resorption (the breakdown of the bone matrix).

Question 7

What is the function of an osteoblast?

Answer 7

Osteoblasts form the bone matrix.

Question 8

How does age increase risk of osteoporosis?

Answer 8

As we age, osteoblast numbers decreased. There is a reduced proliferative and biosynthetic potential and cellular response to growth factor is reduced.

Question 9

What effect does physical activity have on osteoporosis?

Answer 9

Physical activity stimulates bone remodelling. Physical activity decreases with age with links to a decrease in skeletal muscle mass as we age.

Question 10

Which has a greater influence on bone density: load magnitude or number of load cycles?

Answer 10

Load magnitude has a greater influence on bone density than number of load cycles.

Question 11

What does Wolff’s Law state?

Answer 11

Wolff’s Law states that bones will adapt to loads they are placed under.

Question 12

What is bone comprised of?

Answer 12

Bone comprises cells in a mineralised matrix.

Question 13

What two components make up the mineralised matrix in bone and what is the function of each?

Answer 13

The organic portion of the bone matrix is made up of protein fibres and provides flexibility.
The inorganic portion of the bone matrix is made up of calcium and phosphate salts and provides strength.

Question 14

Which vitamin and mineral do the NHS recommend for a bone-friendly diet?

Answer 14

Vitamin D and calcium are important for a bone-friendly diet.

Question 15

What affect does Vitamin D have on calcium levels?

Answer 15

Vitamin D promotes absorption of calcium from the GI tract and reabsorption of calcium in the kidneys. It also decreased calcium release from bone.

Question 16

What are the main sources of Vitamin D?

Answer 16

The main source of Vitamin D is sunlight. Food sources include oily fish, eggs and fortified foods.

Question 17

What effect does ageing have on gut absorption of Vitamin D?

Answer 17

Gut absorption of Vitamin D decreases with age.

Question 18

What may a Vitamin D deficiency in adolescence lead to?

Answer 18

A Vitamin D deficiency in adolescence can lead to low peak bone mass.

Question 19

How much bone do women lose after the onset of menopause?

Answer 19

After the onset of menopause women lose an average of 2.5% of bone per year.

Question 20

What effect does menopause have on bone?

Answer 20

Decreases in oestrogen production and increased osteoclast activity inhibit bone remodelling.

Question 21

Which hormones regulate bone calcium?

Answer 21

Calcitonin and parathyroid hormone regulate bone calcium.
- Increases in parathyroid hormone in older age is associated to osteoporosis.

Question 22

Which hormones increase bone resoprtion?

Answer 22

Glucocorticoids increase bone resorption.

Question 23

Glucocorticoid medications may lead to which age related disease?

Answer 23

Steroid induced osteoporosis can be caused by glucocorticoid medications.

Question 24

What percentage of variance in bone loss may be attributable to genes?

Answer 24

Up to 40% of variance in bone loss may be genetic.

Question 25

Genes associated with osteoporosis have been linked to which other conditions?

Answer 25

Genes associated with osteoporosis have been linked to sarcopenia, osteoarthritis and obesity.

Question 26

Which joints are affected by osteoarthritis?

Answer 26

Synovial joints are affected by osteoarthritis.

Question 27

What effects does osteoarthritis have?

Answer 27

Synovial joints permit free movement of bones. This flexibility can decline with age as the articular cartilage of the joint thins and changes.

Question 28

What changes happen in the cartilage in osteoarthritis?

Answer 28

In osteoarthritis, there is a decrease in water content in the cartilage. There are changes to matrix proteins such as collagen, and senescence in chondrocytes.

Question 29

Osteoarthritis affects almost half of those over 75 and is more prevalent in women. Which other factors are associated with osteoarthritis?

Answer 29

Osteoarthritis is associated with obesity, genetics and occupation.

Question 30

What is sarcopenia?

Answer 30

Sarcopenia is a loss of skeletal muscle mass and function.
- It is a reduction in both size and number of muscle fibres.

Question 31

What infiltrates the muscle in sarcopenia?

Answer 31

Fibrous and adipose tissue infiltrate the muscle in sarcopenia.

Question 32

What type of cells are reduced in those affected by sarcopenia?

Answer 32

Sarcopenia leads to a reduction in satellite cells.

Question 33

What is sarcopenia associated with?

Answer 33

Sarcopenia is associated with disease, insulin resistance, fatigue, falls and mortality.

Question 34

How does exercise prevent age-related diseases of the musculoskeletal system?

Answer 34

Exercise helps maintain muscle mass, increases bone density and increases number of mitochondria.