Physiology of Bone and Calcium Homeostasis Flashcards
How is soft tissue growth measured?
Weight
How is bone growth measured?
Height
What are growth hormone and insulin-like growth factors needed for in tissue and bone growth?
Protein and cell division
What is thyroid hormone’s role in growth?
Permissive role
Directly contributes to nervous system development
What is the role of insulin in growth?
Supports growth
Provides glucose energy
Of what adequate dietary requirements needed for bone growth?
Calcium
Protein
What happens to long bones as they grow in length?
Bone diameter increases as matrix deposits on outer surface
Epiphyseal plate site of linear growth of long bones
When is the epiphyseal plate active?
Childhood and adolescence
Between what does hormonal control exchange calcium?
ECF and bone, kidneys, and intestine
What is calcium important in?
Intracellular signalling
Structural
- Physical strength to bone matrix
- Helps hold cells together at tight junctions
Cofactor in blood coagulation
Normal excitability of neurons and muscle
What are the three pools of calcium, and what proportion of total body calcium do they store?
Bone matrix = 99%
Extracellular fluid = 0.1%
Intracellular fluid = 0.9%
Which pool of calcium can move to other locations?
That in extracellular fluid
How much calcium is absorbed from the small intestine?
1/3
What regulates calcium absorption?
Hormones
How is calcium excreted?
Most through urine
Some through faeces
Where in the nephron is calcium reabsorbed?
Distal tubule
What regulates calcium excretion?
Hormones
What secretes parathyroid hormone?
Parathyroid glands
Is parathyroid hormone essential for life?
Yes
In response to what is parathyroid hormone secreted?
Decreased plasma calcium
What effect does parathyroid hormone have on the plasma?
Increases calcium
Decreases phosphate
What are parathyroid hormone’s actions on bone?
Increases calcium and phosphate release from bone into plasma
Favours bone resorption via indirect action on osteoclasts
What are parathyroid hormone’s actions on the distal nephron?
Increases calcium reabsorptuon
Decreases phosphate reabsorption
What are parathyroid hormone’s actions on the intestine?
Indirectly increases calcium and phosphate reabsorption by activating vitamin D
What is the chemical nature of parathyroid hormone?
Peptide
What is the half-life of parathyroid hormone?
Less than 20 min
What is the onset of action of parathyroid hormone?
2-3 hours for bone
- Increased osteoclast activity in 1-2 hours
1-2 days for intestinal absorption
Minutes for kidney transport
What produces calcitonin?
C cells of thyroid gland
When is calcitonin released?
Plasma calcium is high
What does calcitonin do?
Decreases plasma calcium and phosphate
What effect does calcitonin have on bone?
Decreases release of calcium from bone
Decreases bone resorption
What effect does calcitonin have on the kidneys?
Increases calcium excretion
When is calcitonin physiologically useful?
No role normally
Only works with extreme hypercalcaemia
What is the effect of calcitonin on the gut?
None
What is the chemical nature of calcitriol?
Steroid
How is calcitriol transported in circulation?
Bound to plasma proteins
What is the stimulus for synthesis of calcitriol?
Decreased calcium
Indirectly via parathyroid hormone
Prolactin
Where is the target receptor for calcitriol?
Nuclear
What are the roles of phosphate?
Energy transfer and storage - ATP - cAMP Control of - Enzymes - Transporters - Ion channels Part of DNA and RNA backbone
What can cause hyperparathyroidism?
Tumour
What can cause hypoparathyroidism?
Rare
Autoimmune attack of glands
Inadvertent parathyroidectomy during thyroid surgery
What happens to calcium and phosphate levels in hyperparathyroidism?
Hypercalcaemia
Hypophosphataemia
What happens to calcium and phosphate levels in hypoparathyroidism?
Hypocalcaemia
Hyperphosphataemia
What can a vitamin D deficiency cause?
Impaired intestinal calcium absorption
Parathyroid hormone maintains calcium levels at expense of bones
Bone demineralisation
What is bone demineralisation due to a vitamin D deficiency in children called?
Rickets
What is bone demineralisation due to a vitamin D deficiency in adults called?
Osteomalacia
What are the preventable risk factors for osteoporosis?
Low dietary calcium
Lack of exercise
Smoking