Pathology and Abnormalities Flashcards

1
Q

CHALLENGES TO IDENTIFYING PATHOLOGIES ON BONE

A
  • No symptoms are identified on the living body- only evidence are bony lesions
  • Only chronic/longstanding diseases affect bone, not all
  • individuals w/ lesions: people who lived long enough to have disease affect the bone (were more healthy/strong)
  • individuals w/ no lesions: people who may have died quickly from a disease
  • Different diseases can have similar bony responses
  • Postmortem/taphonomic changes may mimic disease => pseudopathology
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2
Q

RESPONSES BY BONE TISSUE TO PATHOLOGY

A
  • Lytic lesions: removal of bone/necrosis
  • Proliferation: addition of bone
  • Combination of the two
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3
Q

FACTORS AFFECTING THE EXPRESSION OF DISEASE ON BONE

A
  • Age
  • Sex and gender
  • Nutritional status
  • General health & stress level
  • Portal of entry (of pathogen)
  • Exposure
  • Environmental conditions
  • Efficacy of treatment
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4
Q

STRATEGY: DIFFERENTIAL DIAGNOSIS

A
  • *Describe lesions
  • if lytic, proliferation, or combination
  • precise location on body
  • distribution on body*
  • Other things to consider: geographic limits/locations of a particular pathogen
  • The spread of lesions can often eliminate/bring into consideration certain diseases as possibilities
  • Differential diagnosis: hypothetico-deductive reasoning
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5
Q

WHY IS CONSIDERATION OF ABNORMALITIES AND PATHOGENS SO IMPORTANT?

A
  • Need to differentiate disease trauma from assailant trauma
  • Can help in ID’ing individual
  • Pathology knowledge can also differentiate peri- ante- and postmortem damage to the bone
  • Can help distingusish normal variation of the skeleton from pathological damage.
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6
Q

CLASSES OF PATHOLOGY

A
  • Congenital or developmental abnormalities
    -genetically influenced disorders
    -can include: -underdeveloped structures
    -accessory structures
    -fusion abnormalities
    -absence of structures
    Eg: Congentital dislocation, cleft palate
  • Metabolic abnormalities:
    -reduced bone mass due to:
    -inadequate bone production
    -excessive remodelling
    -mineralization
    Eg: Rickets/osteomalacia: can lead to kyphosis, scoliosis, bowing, fractures=>inadequate mineralization of the bone, osteoporosis: change in bone quality and quantity
  • Inflammatory abnormalities:
    -from infection of microorganisms
    -responses can either be: -non-specific: periostitis: inflammation due to infection of the inner layer of periosteum
    -osteomyletis: infection of bone by a particular pathogen
    -specific: at a specfic area in the skeleton, for eg syphilis affects skull vault + tibia
  • Degenerative abnormalities:
    -can be either: chronic- due to excessive wear and tear
    -acute - result of trauma
    eg: osteoarthiritis: eburnation, lipping, osteophyte formation due to extensive degeneration of articular cartilage
  • Endocrine abnormalities:
    -resulting from abnormal hormonal production
    eg: pituitary dwarfism leads to pronounced inhibition of longitudunal growth, hyperparathyroidism leads to cysts on interior surface of bones
  • Dental abnormalities:
    Can result from dietary excesses or infection
    -caries or cavities: destruction of tooth structure due to bacterial attack
    -hypoplasias: abnormalities in enamel quality due to disturbances in development
    -abcesses: pus cavities caused due to infection
    -alveolar resorption/antemortem teeth loss (edentulism): wasting of bony socket in jaw due to loss of teeth
    -calculus/tartar: hardened dental plaque
  • Circulatory or Hematological:
    -due to disorders related to blood or blood-forming tissues
    eg: anemia:
    -cribra orbitalia: porous bone deposited in eye sockets
    -porotic hyperostostis: diploe swelling, surface of cranial vault starts to appear porous as well
  • Neoplasia/tumor formation:
    -abnormal growth in bone tissue
    -Types: -malignant: progressive
    -benign: localized
    -primary (osteoma): arises in bones and joints
    -metastasus (carcinoma): spread of tumors from soft tissue to bone
    -quite rare archaeologically
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7
Q

ACTIVITY RELATED CHANGES IN BONES:

WAYS OF LOOKING FOR ACTIVITY

A
  • Cross-sectional geometry
  • Musculo-skeletal markers
  • Degenerative changes/wear and tear
  • Histology of trabecular bone
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8
Q

MUSCULOSKELETAL MARKERS

(MSMs)

A

Some terms:

  • Entheses: Insertion site for tendons (muscles)
  • Syndesmoses: Insertion site for ligaments (bones)
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9
Q

CONFOUNDING FACTORS WITH MSMs

aka

THESE ARE REALLY HARD TO READ

A
  • Larger bones/joints = larger MSMs
  • MSM relationship to muscle mass (unclear if linear or threshold)
  • Preservation of MSMs
  • Measuring MSMs, repeatability, as well as ordinal system of scoring
  • MSM can’t tell us about specific activities: specific activities use several types of muscles, and diff activities can produce similar MSMs
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10
Q

ARTHRITIC OR DEGENERATIVE WEAR:

What do we examine?

Causes of osteoarthritis?

A
  • Temporomandibular junction in cranium
  • Post cranial bones
  • Vertebral bones
  • Age
  • Weight
  • Mechanical loading ( especially repetitve usage)
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11
Q

PROBLEMS WITH USING OA

A
  • effect of age on OA, some areas seem to be more affected than others (such as the spine)
  • multifactorial etiology: multiple causes aside from age and repetitive use:
    -genetics
    -BMI
    -individual anatomical variation
  • force on bones depends upon anatomical variations (for example arthiritis in knees depends on tibia length)
    -also depends on weight, genes, sex
  • OA is dependent on weight – heavier people have more OA in both weight bearing AND non-weight bearing joints (does more fat/leptin cause osteophyte formation)
  • OA is dependent on activity as well: not just LEVEL of activity but also AGE OF ONSET
  • Very poor indicator of SPECIFIC activities, only indicative of a general level of activity
  • Need more consistent and standard reporting language
  • Better engagement with clincal lit
    *
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12
Q

SO WHAT IS OA GOOD FOR?

A
  • Useful for indication of general level of activity
  • Assymetry shows promise
  • Animal studies have potential
  • CS geometry + MSMs <=> OA’s
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13
Q

SKELETAL ANATOMIES

A
  • Variation can be both environmental as well as genetic
  • Can be adaptive => responding to particular environments (but not always straightforward!)
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14
Q

WHY IS IT IMPORTANT TO REMEMBER THINGS ABOUT SKELETAL ANOMALIES?

A
  • Can be useful for distinguishing anomalies from trauma
  • Can help to ID individuals
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15
Q

TYPES OF DIFFERENCES STUDIED

A
  • Metric: Cranial or dental length/width measurements; looks at shape and size, continuous traits
  • Non-metric: Discrete traits => present//absent
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16
Q

NON METRIC TRAITS

A
  • Minor variations in ossification
  • Correlates with soft tissue variation during development
17
Q

CATEGORIES OF NONMETRIC VARIATIONS

A
  • Foramen variation: trait expression depends on surrounding soft tissue (arteries, veins, neural)
  • Variation in number of bones and teeth:
    -extra ossicles within the sutures of the cranium
    -supernumerary ossification centers
    extra teeth
  • Articular facet variation: -extensions
    -extra facets
    -different position of joint surface: often activity related
  • Variation in tooth crown: -minor pits and fissures
    -entire crown shape difference
  • Hyperostotic: Excesses: proliferations, bony spurs, bridges
  • Hypostotic: Deficiencies (eg: metopic suture)
18
Q

SEX RELATED DIFFERENCES IN HYPEROSTOTIC AND HYPOSTOTIC VARIATION

A
  • Females: hypostotic traits
    more towards the right
    decrease with age
  • Males: hyperostotic traits
    more towards the left
    increase with age
  • Causes:
    gendered activity differences
    possibly genetic differences as well
19
Q

MEANING OF NM TRAITS

A
  • Genetic control, as well as environmental cues
  • Population specific heritability of some traits
  • Some are purely environmental: eg: squatting facets
20
Q

HALTSTATT COLLECTION

A
  • 700 skeletons, known identities + family relationships
  • some traits under significant genetic control: metopic suture, certain ossicles, palatine torus, parietal foramena
  • remember that heritability is population specific! so more research needs to be done with different pop.s
21
Q

SOME FUN NON-METRIC TRAITS TO REMEMBER

  • Metopic Suture
  • Parietal Foramena
  • Palatine Torus
  • Os Japonicum
  • Wormian bones
  • Spondylolysis
  • Squatting facets
  • Enamel pearls
  • Infraorbital suture
  • Trochlear spur
  • Pterionic bone
A
  • Suture present b/w orbits, splits frontal bone into two
  • Apertures present in parietal bones
  • Bony protusion on palates
  • Extra zygomatic bone
  • Extra bones present along lamboidal suture
  • Verterbral defect
  • Facets formed on tibia due to excessive squatting
  • Droplets of enamel present on teeth where they should not be present
  • Suture present underneath eye orbits
  • Bony spur present from upper portion of eye orbit
  • Bone where frontal, parietal, lamboidal and sphenoid join together