Term
| A metabolically active organ system undergoing continuous remodeling throughout life with 10% annual turnover of cortical and trabecular bone. |
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Definition
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Term
| The result of the activities of the following two types of cells: osteoblasts and osteoclasts |
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Definition
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Term
| Bone-forming cells that form an osseous matrix in which it becomes enclosed as an osteocyte |
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Definition
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Term
| Large multinucleated cells specializing in bone absorption and removal |
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Definition
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Term
| This process is important in maintaining structural integrity, metabolic functions; acts as a storehouse for calcium and phosphorous and regulates the concentration of calcium and phosphorous |
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Definition
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Term
| Can be affected by changing mechanical forces or by metabolic and nutritional stresses. |
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Definition
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Term
| Most of these are manifested by diffuse loss of bone density and bone strength with one exception; Paget's disease- increased bone density and decreased bone strength |
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Definition
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Term
| Porous bones resulting from decreased bone density and microdamage to the bone structures that result in a susceptibility to fracture; this is the most common metabolic bone disease |
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Definition
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Term
| What are the incidence rates for osteoporosis? |
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Definition
-10 million in US have been diagnosed
-18 millionmore have osteopenia (low bone mass or density); at increased risk of osteoporosis
-Women>men 5:1
-Onset age of bone loss: women earlier than men |
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Term
| How can primary osteoporosis start and what are the risk factors? |
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Definition
-Hormonal deficiency: estrogens or androgens
-Nutritional deficiency: inadequate ca and vitamin D, impaired absorption of calcium; excessive alcohol, caffeine consumption
-Decreased physical activity
-Inadequate mechanical loading
-Additional risk factors: family history, Caucasion/Asian race, early menopause, being of a thin-small build, smoking |
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Term
| What is the etiology and risk factors for secondary osteoporosis? |
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Definition
-Diseases that affect bone loss: hyperthyroidism, diabetes, hyperparathyroidism, rheumatoid arthritis, liver dz, Paget's dz, certain types of cancer.
-Medications that affect bone loss: corticosteroids, thyroid hormone, anticonvulsants, catabolic drugs, some estrogen antagonists, chemotherapy |
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Term
| Describe the pathogenesis of osteoporosis? |
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Definition
| Etiological factors can cause bone loss greater than bone formation resulting in weakened tabeculae and increasing risk for fracture |
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Term
| What are the clinical manifestations for osteoporosis? |
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Definition
-Loss of height
-Postural changes: increased kyphosis
-Back pain: chronic or acute onset
-Fracture
>chronic site of fracture incluse verteral bodies, hip, ribs, distal radius/wrist, and femoral neck
>vertebral compression fractures are the most common osteoporosis-related spinal fractures (usually spontaneous; prevalence increases with age: 20% for 50 year old postmenopausal women; 64% for older women
>Pain located at the site of fracture |
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Term
| How can osteoporosis be diagnosed? |
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Definition
-Medical history, physical exam, nutritional history, physical activity/ fall history
-Bone density test
-X-rays for known or suspected fractures |
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Term
| Is there a cure for osteoporosis? |
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Definition
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Term
| How can osteoporosis be prevented? |
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Definition
-Educate pt on osteoporosis risk and risk management; complication prevention
-Daily Ca and Vitamin D intake
-Adequate nutrition and calories
-Maintain bone mass: exercise
-Postural/balance training
-Safety education/fall prevention |
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Term
| What exercises would help to maintain bone mass? |
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Definition
-Weight bearing exercises: walking (30 min/day); stair climbing; use of weight belts to increase loading
-Resistance exercises of hip and knee extensors, and triceps |
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Term
| What type of postural/balance training helps prevent osteoporosis? |
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Definition
-Postural reeducation, postural exercises to reduce kyphosis, forward head position
-Flexibility exercises
-Functional balance exercises; chair raises, standing/kitchen sink exercises (toe raises, unilateral stance, hip extension, hip abduction, partial squats)
-Tai Chi
-Gait Training |
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Term
| What types of safety education and fall prevention can help to prevent osteoporosis? |
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Definition
-Proper shoes: thin soles, flate shoes enhance balance abilities (no heels)
-Assistive devices: cane, walker, etc.
-Fracture prevention |
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Term
| What are some early intervention and treatment techniques for osteoporosis? |
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Definition
-Patient osteoporosis education on nutrition, lifestyle, and exercise
-Medications: bisphosphonates, hormonal therapy (estrogen/progestin for women, testosterone for men), evista/raloxifene, calcitonin, PTH
-Balance assessment, fall and fracture prevention |
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Term
| Another term for adult rickets |
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Definition
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Term
| The softening of bone without loss of bone matrix, resulting from insufficient mineralization of bone matrix due to calcium and/or phosphate deficiency |
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Definition
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Term
| What is the etiology of osteomalacia? |
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Definition
-Insufficient intestinal calcium absorption either due to a lack of calcium or a resistance to vitamin D
-Increased renal phosphate losses due to chronic renal failure or renal tubular insufficiency
-Hyperparathyroidism |
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Term
| What is the clinical manifestation of osteomalacia? |
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Definition
-Bone pain
-Postural deformities: increased thoracic kyphosis, marked bowing of the femur and tibia
-Muscle weakness
-Waddling gait and difficulty with transitional movements such as from sitting to standing, climbing stairs |
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Term
| A generalized skeletal disease of older people; characterized by excessive bone resorption and formation, resulting in thickened and weak bones that lack structural stability and strength; Normal boneis replaced with disorganized fibrous connective tissue |
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Definition
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Term
| The second most common metabolic bone disease after osteoporosis; Leads to complications such as bone deformities, fracture, arthritis and pain |
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Definition
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Term
| What is the incidence rates for Paget's dz? |
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Definition
-Affects 2-5% of people older than 50
-10% of people older than 70
-Rarely presenting before age 35
-Cause of Paget's dz is unknown
-Frequently familial |
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Term
| There are 2 phases of the pathogenesis of Paget's dz what are they? |
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Definition
Osteoclastic/osteoplastic sclerotic phase
Sclerotic phase |
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Term
| Rapidly resorbed bone is replaced with abnormal regenerated fibrous connective tissue |
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Definition
| Osteoclastic/Osteoplastic sclerotic phase |
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Term
| The normal bone is replaced by coarse, thickened, brittle new bones that are enlarged but weakened. |
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Definition
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Term
| What are the clinical manifestations of Paget's Disease? |
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Definition
-Silent until advanced; may be found incidentally in x-rays
-Primary affects axial skeleton
-Multiple lesion sites: skull, spine, pelvis, femur, lower leg are most often affected
-Signs and symptoms: deep bone pain, arthritis, deformtities (increased kyphosis and bowing femur and tibia, and fracture |
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Term
| what are the neurologic effects of Paget's Dz? |
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Definition
-Nerve compression syndromes including cranial, spinal, and peripheral nerves
-Most commonly affected is the eigth cranial nerve resulting in hearing loss
-Brain ischemia
-Decreased cognitive function, mental confustion and deterioration |
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Term
| What are the cardiovascular effects of Paget's dz? |
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Definition
-Increased vascularity and skin temperature over the affected bone
-Congestive heart failure, which is the most common cause of death in advanced Paget's |
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Term
| How can Paget's dz be diagnosed? |
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Definition
Bone scan
Radiography
Test for alkaline phosphatase
Genetic predisposition indicated pro-active testing |
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