Quiz 6: Osteoporosis & Arthritis Flashcards
What is osteoporosis?
loss of bone mass due to calcium and bone protein depletion
- results in skeletal structural weakness
What is osteopenia?
thinning with bone mass reduction, due to reduced calcium and bone protein
- occurs when new bone formation cannot offset bone mass
Which is less severe? Osteoporosis or osteopenia?
osteopenia
The degree of _____ _________ ______ is the diagnostic difference between osteoporosis and osteopenia
bone mineral density
What is bone mineral density BMD?
a measure of bone density represented by calcium content
Over __% of women and __% of men over the age of 50 are at risk of bone fracture
50% W and 20% M
What types of exercises are good to offset osteo?
weight bearing resistance
What are the key risk factors for osteoporosis?
- post menopause
- low estrogen
- low testosterone
- deficient calcium intake
- nutrient mal absorption
- excessive alch
- smoking ciggies
Where do majority of hip fractures result from?
osteoporosis
Where are the most frequen osteoporotic fracture sites?
- prox femur
- vertebrae
- wrist (distal end)
What is hip fracture repair and what else is it known as?
ORIF
- involves pinning screws nails or plates at the fracture site
_____ is indicated once the fracture site is properly aligned
pinning
What is the other option as opposed to ORIF?
THA
What are some horomones that influence bone density?
- estrogen
- progesterone
- test
- growth hormone
- insunlin-like growth factor (IGF-1)
- corticosteroids
- thyroid hormone
What is the parathyroid hormone? (PTH)
a hormone produced by the parathyroid glands and regulates the body’s level of calcium and phosphorus
- PTH combines with calcitonin to produce vitamin D
True or False:
When blood plasma has a low calcium level, hypocalcemia), the parathyroid gland releases PTH causing calcium levels to rise and restore serum calcium concentration to normal
True
______ _______ increases bone resorption, decreases the amount of calcium your bones absorb, and interferes with vitamin D reglation
cig smoking
What increases urinary excretion of calcium, but any detreminal effect can be offset by calcium intake
caffine
Do light or darker soda beverages contain higher phosphorus levels?
dark
What is the gold standard for measuring bone density?
dexa
- QUS and QCT also good too
What are the advantages of DEXA?
- low radiation exposure
- high accuracy
- can measure small changes in bmd over time
True or False:
QUS and QCT measure less acurately and have higher radiation lvls?
true
To enhance bone density, maintain…
- calcium intake at 1000-1200mg per day
- vitamin D intake at 200-600 IU per day
Other than regular weight bearing exercise, what else has shown to have a positive impact on bone density
high impact resistance exercise
-aquatic is minimal impact
When is the skeleton most responsive to bone-loading?
during preadolescence
When designing a client’s program, what all should you assess ab the client?
- current fitness status
- joint concerns
- med use
- functional ability
When working with a client, what all should you focus on
weight training with progressive resistance
stair climbing
running and jumping activities
Which is better for osteoporosis? OCK or CKC
CKC
True or False:
Plyometrics are effective but should be used with caution for older adults
True
What are plyometrics?
specialized exercises that are associated with high-impact loads specifically designed to increase muscular strength and power
- assure strength and balance are adequate before attempting this
What is arthritis?
deterioration resulting in inflammation, swelling, stiffness, and structural changes to a joint
- can result from disease, injury, or infection
What are the two types of arthitis?
OA = muskuloskeletal
RA = autoimmune
What are the joint structure components and what are they?
joint capsule - encloses joint to keep fluid
synovial membrane - lining of the joint capsule
synovial fluid - flows within the membrane and provides lubrication essential to healthy joint function
Arthritis breaks down the _______ ______ (articular cartilage) that covers the articulating bone surfaces within a joint
hyaline cartilage
What is hyaline cartilage?
a dense, elastic, fibrous conn tissue that has no blood supply and thus cannot heal
What is OA?
a chronic degenerative form of arthritis that primarily affects articular cartilage
- results in bone remodeling and overgrowth (lipping and spurs) at the joint margins
What is bone lipping?
the formation of lip like structures at the articular end of a bone
What is a bone spur?
(osteophyte)
- a tiny projected outgrowth of bone that develop in areas of inflammation and injury
What is ankylose?
to unite or fuse together (bamboo)
What does OA result from?
wear and tear
- modifed activity can slow the progression
What joint do OA primarily affect?
knee, hip, and fingers
What do symptoms of OA include?
- pain and stiffness
- progressive loss of flexibility and development of bone spurs
- gradual reduced tolerance to pain associated with joint degeneration
- thinning of articular cartilage that transmits force to bone
- eventual bone on bone contact resulting in constant pain
True or False:
Symptoms of OA may not appear until significant degenerative changes have occurred, and at this stage surgery is the only viable treatment
True
OA is ______ and RA is ________ (sides of how it affects the body)
OA = unilateral or bilateral
RA = bilateral
What factors lead to accelerated deterioration?
- obesity
- poor nutrition
- lack of joint movement
- excessive repetitive joint movement
- surgical intervention
What are the risk factors for developing OA
- aging
- overweight or obesity
- previous joint surgery
- altered gait pattern often linked to prev injury
OA can lead to ___, ________, and ____
CAD, diabetes, and HTN
True or False:
Exercise will not cure OA but low impact, moderate resistance exercise can reduce the pain and rate of decline in functional capacity
True
What is RA?
an autoimmune disorder that results in inflammation and thickening of the joint capsule
What is autoimmune disorder?
a failure of the body’s immune system causing it to attack itself
True or False:
RA is systemic
True
RA results in. ____ _______ and joint deformity
bone erosion
Inflammatory damage from RA occurs in the _______ _______
tendon sheath (tenosynovitis)
Where is tenosynovitis most common?
hands, wrists, feet, ankles
- long tendons = increase chance to occur
What is DeQuervain tenosynovitis?
- pain around base of thumb
- caused by overuse
- Finkelstein test (paper pinch index and thumb, pos if pain)
What is Trigger finger?
- finger gets stuck in bent position
- ring and index commonly
- tendon cannot glide smoothly
Where is the intial onset of RA?
joints of hands and feet, specifically the PIP joints
For RA, what should you do for periods of remission?
- encourage active movement through ROM, but avoid stretching activity
- apply moderate resistance exercise during, but avoid over exertion
True or False:
Functional loss from RA is irreversible, so when exercise
tolerated can minimize functional loss
True
Common things to know about OA
- degenerative joint disorder
- most common
- larger joint
- pain/stiff/weak
- crepitus
- stiffness under 30 min
- unilateral
Common things to know about RA
- autoimmne disorder
- smaller joints
- prolonged stiffness over 1 hr
- pain/inflamation
- fever/loss appetite
- visible deformity
- bilateral
