Bone Health and Osteoblast Function
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Questions and Answers

What is the primary role of osteoblasts in bone health?

  • They regulate calcium absorption.
  • They deposit calcium salts to form bones. (correct)
  • They break down bone tissue.
  • They produce collagen.

Which vitamin is primarily necessary for enhancing calcium absorption in bones?

  • Vitamin A
  • Vitamin C
  • Vitamin K
  • Vitamin D (correct)

What leads to osteopenia?

  • Excess estrogen production.
  • High levels of physical activity.
  • Imbalance between bone formation and breakdown. (correct)
  • Increased sensitivity of osteoclasts to PTH.

Which hormone decreases osteoclast sensitivity to parathyroid hormone (PTH)?

<p>Estrogen (A)</p> Signup and view all the answers

Which elements are essential for the production of a healthy extracellular matrix in bones?

<p>Collagen and various vitamins (A)</p> Signup and view all the answers

Which bone is most commonly fractured in the event of a fall while rollerblading?

<p>Wrist (A)</p> Signup and view all the answers

What is a common characteristic of fractures among the elderly?

<p>The femur and pelvis are common fracture sites. (B)</p> Signup and view all the answers

What condition is commonly associated with fractures in undernourished individuals?

<p>Osteoporosis (A)</p> Signup and view all the answers

Which activity is most likely to result in a wrist fracture?

<p>Ice skating (B)</p> Signup and view all the answers

Vertebral fractures are most common in individuals engaged in what type of work?

<p>Physical intensive jobs (B)</p> Signup and view all the answers

In which direction does compact bone typically grow?

<p>Inward to outward (B)</p> Signup and view all the answers

Which site is a common fracture location for people who fall while extending their arms?

<p>Clavicle (C)</p> Signup and view all the answers

What is the typical outcome when a bone fractures?

<p>It can break inward or outward. (D)</p> Signup and view all the answers

What is the primary function of osteoblasts in bone structure?

<p>To build and maintain the bone matrix (A)</p> Signup and view all the answers

What condition can result from inflammation that cuts off the blood supply to the bone?

<p>Necrosis (C)</p> Signup and view all the answers

Which of the following is considered the fundamental unit of compact bone?

<p>Osteon (A)</p> Signup and view all the answers

What role do Haversian canals play in bone tissue?

<p>They contain blood vessels and nerves (D)</p> Signup and view all the answers

What is the external layer of the bone called?

<p>Periosteum (B)</p> Signup and view all the answers

Which dietary component is essential for bone density maintenance?

<p>Proteins and minerals (D)</p> Signup and view all the answers

Where are osteocytes found within the bone structure?

<p>In lacunae (D)</p> Signup and view all the answers

What is the function of canaliculi in bone tissue?

<p>To facilitate communication between osteocytes (C)</p> Signup and view all the answers

What happens to blood supply during inflammation in bone tissue?

<p>It may be cut off (A)</p> Signup and view all the answers

Which of the following structures is involved in the formation of new bone?

<p>Osteoblasts (B)</p> Signup and view all the answers

What characterizes reactive arthritis?

<p>It typically occurs after a gastrointestinal or genitourinary infection. (B)</p> Signup and view all the answers

In the context of psoriatic arthritis, which statement is true?

<p>It can involve the distal interphalangeal joints. (B)</p> Signup and view all the answers

Which joints are most commonly affected by rheumatoid arthritis?

<p>Fingers and wrists (A)</p> Signup and view all the answers

What is a significant complication of rheumatoid arthritis?

<p>Joint fusion leading to ankylosis (D)</p> Signup and view all the answers

Systemic lupus erythematosus (SLE) is primarily characterized by which type of immune response?

<p>Type III hypersensitivity reaction (C)</p> Signup and view all the answers

In systemic sclerosis, what is a primary pathological feature?

<p>Fibrosis of connective tissue (D)</p> Signup and view all the answers

What is the hallmark radiological finding in ankylosing spondylitis?

<p>Sacroiliitis (D)</p> Signup and view all the answers

Which medication class is typically used as a first-line treatment for rheumatoid arthritis?

<p>NSAIDs and COX-2 inhibitors (B)</p> Signup and view all the answers

Which condition is characterized by the crystallization of uric acid in joints?

<p>Gouty arthritis (A)</p> Signup and view all the answers

What is a characteristic symptom of juvenile idiopathic arthritis?

<p>Chronic joint pain and swellings (C)</p> Signup and view all the answers

Which form of psoriatic arthritis involves four or fewer joints?

<p>Oligoarticular form (D)</p> Signup and view all the answers

What is the typical inflammatory pattern seen in spondyloarthropathies?

<p>Inflammation at tendon and ligament insertions (A)</p> Signup and view all the answers

What is a common systemic effect of systemic lupus erythematosus?

<p>Cardiovascular diseases (D)</p> Signup and view all the answers

Which factor contributes to the autoimmunity seen in rheumatoid arthritis?

<p>Gene mutations and environmental triggers (D)</p> Signup and view all the answers

Which condition is characterized by reduced bone density and is most common in post-menopausal women?

<p>Osteoporosis (C)</p> Signup and view all the answers

What is the primary purpose of Dual Energy X-ray Absorptiometry (DEXA) in relation to bone health?

<p>To measure bone density (A)</p> Signup and view all the answers

Which treatment for osteoporosis inhibits bone resorption?

<p>Bisphosphonates (D)</p> Signup and view all the answers

What is a common complication associated with osteoporosis in the spine?

<p>Compression fractures (A)</p> Signup and view all the answers

Which of the following is a hallmark sign of Paget's Disease?

<p>Cotton wool patches (D)</p> Signup and view all the answers

What causes osteomalacia?

<p>Inadequate mineralization of bone (D)</p> Signup and view all the answers

Which lifestyle change is recommended for preventing osteoporosis?

<p>Smoking cessation (C)</p> Signup and view all the answers

Which of the following could lead to osteonecrosis?

<p>Compartment syndrome (A)</p> Signup and view all the answers

In which age group is osteosarcoma most commonly found?

<p>Teens and young adults (A)</p> Signup and view all the answers

What underlying condition might lead to osteomyelitis?

<p>Bacterial infections (A)</p> Signup and view all the answers

Which osteoporotic condition is characterized by an increase in bone resorption?

<p>Osteoporosis (D)</p> Signup and view all the answers

What is the principle deficit in osteogenesis imperfecta?

<p>Defective collagen gene (D)</p> Signup and view all the answers

What type of tumor is a chondroma?

<p>Benign cartilage tumor (B)</p> Signup and view all the answers

What is a characteristic feature of osteoclastomas?

<p>Resemble malignant tumors (A)</p> Signup and view all the answers

What role do vitamins C and D play in maintaining bone health?

<p>They assist in the production of connective tissue and calcium absorption. (A)</p> Signup and view all the answers

Which of the following correctly describes osteopenia?

<p>An imbalance leading to decreased bone formation relative to breakdown. (D)</p> Signup and view all the answers

What effect do hormones like estrogen and testosterone have on osteoclasts?

<p>They influence osteoclast sensitivity to parathyroid hormone. (B)</p> Signup and view all the answers

How does physical activity influence bone health?

<p>It stimulates osteoblast activity, aiding in bone formation. (A)</p> Signup and view all the answers

What is necessary for bone hardness to occur?

<p>The presence of calcium salts along with protein. (A)</p> Signup and view all the answers

What is a common fracture site for individuals who frequently participate in ice skating?

<p>Wrist (D)</p> Signup and view all the answers

Which individual is most likely to experience a vertebral fracture?

<p>An elderly person performing physical labor (C)</p> Signup and view all the answers

In what condition is osteoporosis primarily likely to develop?

<p>Individuals with inadequate nutrition (B)</p> Signup and view all the answers

What type of bone growth is described as bones growing inward to outward?

<p>Compact bone growth (B)</p> Signup and view all the answers

Which of the following activities poses a higher risk for femur fractures among the elderly?

<p>Falling from standing height (D)</p> Signup and view all the answers

Which characteristic of compact bone distinguishes it from spongy bone?

<p>Denser structure (B)</p> Signup and view all the answers

What mechanism typically leads to the fractures seen in people who fall while extending their arms?

<p>Pursuing body weight on arms (B)</p> Signup and view all the answers

Which of the following best describes a common reason for fractures in children?

<p>Sports-related accidents (A)</p> Signup and view all the answers

What is the layer of bone that contains blood vessels and nerves called?

<p>Haversian canal (D)</p> Signup and view all the answers

What cells are responsible for forming new bone tissue?

<p>Osteoblasts (C)</p> Signup and view all the answers

Which component is essential for the maintenance of normal bone density?

<p>Amino acids (B)</p> Signup and view all the answers

What happens to the blood supply in bone tissue during inflammation?

<p>It becomes cut off (B)</p> Signup and view all the answers

What is the primary cell type found in a lacuna of bone?

<p>Osteocytes (C)</p> Signup and view all the answers

What is the relationship between osteon and lamella?

<p>Osteon consists of concentric lamellae (D)</p> Signup and view all the answers

Which factor does NOT contribute to bone density?

<p>Hydration levels (D)</p> Signup and view all the answers

What is the primary role of the periosteum in bone health?

<p>To facilitate bone growth and repair (D)</p> Signup and view all the answers

What structure is involved in the transport of nutrients to osteocytes?

<p>Canaliculi (B)</p> Signup and view all the answers

What might occur if osteoblasts are deficient in their activity?

<p>Bone formation is impaired (C)</p> Signup and view all the answers

Which form of psoriatic arthritis is characterized by the involvement of four or fewer joints?

<p>Oligoarticular form (C)</p> Signup and view all the answers

What is the primary autoimmune process involved in rheumatoid arthritis?

<p>Inflammation of the synovial membrane (D)</p> Signup and view all the answers

Which joint is least commonly affected by rheumatoid arthritis?

<p>Shoulders (C)</p> Signup and view all the answers

Which medical treatment is not a typical first-line option for managing rheumatoid arthritis?

<p>Antibiotics (C)</p> Signup and view all the answers

Which condition is characterized by extensive fibrosis throughout the body?

<p>Systemic sclerosis (scleroderma) (C)</p> Signup and view all the answers

Which of the following is indicative of gouty arthritis?

<p>Presence of uric acid crystals (B)</p> Signup and view all the answers

What is a common symptom observed in systemic lupus erythematosus (SLE)?

<p>Butterfly rash (B)</p> Signup and view all the answers

Which is not a subtype of juvenile idiopathic arthritis?

<p>Spondylitis (A)</p> Signup and view all the answers

Which of the following conditions is known to lead to ankylosing spondylitis?

<p>Infection by enterogenic bacteria (A)</p> Signup and view all the answers

Which joint condition can lead to both arthritis and conjunctivitis as part of its symptoms?

<p>Reactive arthritis (B)</p> Signup and view all the answers

Which complication is commonly seen in rheumatoid arthritis?

<p>Muscle atrophy (C)</p> Signup and view all the answers

Which cytokine is primarily involved in the autoimmune response of rheumatoid arthritis?

<p>Tumor necrosis factor-alpha (C)</p> Signup and view all the answers

What is a defining feature of spondyloarthritis?

<p>Sacroiliitis (C)</p> Signup and view all the answers

What is a common systemic effect of systemic lupus erythematosus (SLE)?

<p>Renal involvement (B)</p> Signup and view all the answers

Which of the following conditions is characterized by increased bone remodeling leading to enlarged and softened bones?

<p>Paget's Disease (C)</p> Signup and view all the answers

What is the primary complication associated with osteoporosis in the hip?

<p>Hip fractures (D)</p> Signup and view all the answers

Which treatment for osteoporosis stimulates bone remodeling?

<p>Rh-PTH (C)</p> Signup and view all the answers

What is a common characteristic of osteomalacia?

<p>Inadequate mineralization of bone (A)</p> Signup and view all the answers

What is the most widely used screening tool for measuring bone density?

<p>DEXA (C)</p> Signup and view all the answers

Which of the following is a common non-pharmacological intervention for osteoporosis?

<p>Vitamin D supplements (A)</p> Signup and view all the answers

Which of the following conditions can lead to ischemic bone necrosis?

<p>Bone fracture (D)</p> Signup and view all the answers

What represents the hallmark sign of Paget's Disease on imaging?

<p>Cotton wool patches (D)</p> Signup and view all the answers

Which of the following is a common result of Osteomyelitis?

<p>Bone necrosis (A)</p> Signup and view all the answers

Which bone disease is primarily seen in post-menopausal women due to a loss of estrogen?

<p>Osteoporosis (C)</p> Signup and view all the answers

Which class of medication is primarily used to inhibit bone resorption in osteoporosis treatment?

<p>Bisphosphonates (D)</p> Signup and view all the answers

What dietary change is recommended to help prevent osteoporosis?

<p>Increase dietary calcium (A)</p> Signup and view all the answers

Which type of bone tumor is characterized by the presence of multiple nuclei and behaves like a malignant tumor?

<p>Osteo-clastoma (B)</p> Signup and view all the answers

Which of the following bone tumors is most commonly found in adolescents?

<p>Osteosarcoma (D)</p> Signup and view all the answers

Flashcards

Fracture

A break in a bone.

Common fracture sites

Areas of the body frequently affected by fractures, including the hand, clavicle, and humerus.

Elderly fracture sites

Fractures in the femur and pelvis are common among the elderly.

Vertebral fractures

Fractures in the vertebrae, common among those with physically demanding jobs.

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Osteoporosis

Bone disease, common in people who are not well-fed.

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Compact bone growth

Bone grows inward to outward.

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Bone Breaking

Bone breaks outward to inward.

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Activities causing fractures

Rollerblading, ice skating and falls from activities might result in wrist fracture.

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Bone Hardness

Bone hardness comes from calcium salts (crystals), primarily calcium carbonate and calcium phosphate.

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Bone Strength

The intracellular matrix (ICM) of protein (collagen) allows for calcium carbonate and phosphate deposition, making bone stronger.

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Vitamins for Bone

Vitamins C and D are essential for bone production and calcium absorption, respectively.

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Osteoblast vs Osteoclast

Osteoblasts build bone, while osteoclasts break it down.

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Osteopenia

Osteopenia is an imbalance between bone formation and breakdown, leading to decreased mineralization.

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Osteon

The fundamental unit of compact bone, a cylindrical structure.

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Periosteum

The external layer of bone, containing blood vessels and nerves.

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Osteoblasts

Bone-building cells located in the periosteum.

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Haversian Canals

Canals within osteons containing blood vessels and nerves.

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Lamellae

Rings of bone tissue surrounding Haversian canals.

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Osteocytes

Mature bone cells found in lacunae.

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Canaliculi

Tiny channels connecting lacunae to Haversian canals.

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Bone Matrix

The non-living, extracellular part of bone tissue.

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Bone Density Requirements

Bones need sufficient protein and minerals for healthy density.

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Dietary Proteins for Bone

Proteins from our diet are essential building blocks for bone cells.

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Osteoporosis causes

Reduced bone synthesis compared to bone resorption, commonly seen in post-menopausal women and people with poor nutrition.

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DEXA scan

A common screening tool to measure bone density.

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Osteoporosis prevention

Includes exercise, calcium-rich diet, reduced phosphate intake, and vitamin D supplementation, along with smoking cessation.

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Osteoporosis treatment

Involves medications like bisphosphonates (inhibit bone resorption), PTH (stimulates bone remodeling), SERMs, and calcitonin (inhibits osteoclastic activity).

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Osteomalacia

Inadequate bone mineralization, often due to Vitamin D deficiency.

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Paget's disease

Bone disease characterized by excessive bone remodeling (breakdown and formation) leading to enlarged and softened bones.

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Osteomyelitis

Bacterial infection of bone, commonly caused by Staphylococcus aureus.

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Benign Bone Tumors

Non-cancerous bone tumors, with limited growth potential.

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Malignant Bone Tumors

Cancerous bone tumors, which can spread to other parts of the body.

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Osteosarcoma

Most common malignant bone tumor in adolescents, often found in areas of fast bone growth.

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Scoliosis

Curvature of the spine.

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Osteoarthritis

Common form of arthritis characterized by cartilage erosion and bone changes.

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Ankylosing Spondylitis

A chronic inflammatory disease primarily affecting the spine, leading to fusing vertebrae, stiffening, and reduced mobility.

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Reactive Arthritis

A type of arthritis triggered by a previous infection, usually in the gastrointestinal tract or urinary tract.

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Psoriatic Arthritis

A form of arthritis associated with psoriasis, a skin condition characterized by scaly patches.

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Rheumatoid Arthritis

An autoimmune disease causing inflammation of the synovial membrane in joints, leading to pain, swelling, and stiffness.

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Pannus Formation

The formation of a thick, abnormal layer of tissue in the synovial membrane, destroying joint cartilage.

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Rheumatoid Nodules

Firm, painless lumps that can develop under the skin, particularly near joints, in people with rheumatoid arthritis.

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Systemic Lupus Erythematosus (SLE)

A systemic autoimmune disease characterized by autoantibodies attacking various self-molecules in the body.

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Antinuclear Antibodies (ANA)

Autoantibodies that target components within the cell nucleus, often present in patients with lupus.

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Systemic Sclerosis (Scleroderma)

A rare autoimmune disease causing extensive fibrosis, hardening of connective tissues, and affecting skin and organs.

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Spondyloarthropathies

A group of inflammatory disorders primarily affecting the spine and sacroiliac joints.

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Gouty Arthritis

A form of arthritis caused by a build-up of uric acid crystals in joints, leading to inflammation and pain.

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Hyperuricemia

High levels of uric acid in the blood, often associated with gout.

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Juvenile Idiopathic Arthritis

A group of inflammatory diseases affecting joints in children.

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Juvenile Dermatomyositis

A rare autoimmune disorder affecting muscles and skin, causing muscle weakness and a rash.

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What makes bone strong?

Bone strength comes from the intracellular matrix (ICM), composed of protein (collagen), which allows for the deposition of calcium carbonate and phosphate.

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Vitamins for Bone Health

Vitamins C and D are essential for bone health. Vitamin C is needed for the production of connective tissue, while Vitamin D helps the body absorb calcium.

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Osteoporosis & Nutrition

People with poor nutrition are more prone to osteoporosis, as their bones lack essential minerals like calcium.

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Risk Factors for Osteoporosis

Commonly seen in post-menopausal women due to estrogen decline, and in individuals with poor nutrition, lack of exercise, and smoking.

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Complications of Osteoporosis

Include fractures in the spine (compression fractures), hip (fractures of the neck of the femur), and other parts of the body. It can also lead to kyphosis (hunchback) and scoliosis (curvature of the spine).

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Causes of Osteomalacia

Include insufficient dietary intake of vitamin D, impaired intestinal absorption of vitamin D, and renal tubular disease, which leads to excessive vitamin D loss.

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Hallmark Sign of Paget's Disease

The presence of "cotton wool" patches on X-rays, which represent areas of bone that are porous and irregular.

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Common Sites of Osteoarthritis

Weight-bearing joints such as hips, knees, hands, and spine are frequent sites affected by osteoarthritis.

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Study Notes

Skeletal System Disorders

  • Chapter 43: Discusses trauma, infections, neoplasms, and childhood disorders of the skeletal system.
  • Chapter 44: Focuses on metabolic and rheumatic disorders of the skeletal system.

Fractures

  • Fractures are any discontinuity of the bone.
  • Common fracture sites include the hand, clavicle, and humerus.
  • Activities like rollerblading, ice skating, and falling can cause fractures, especially in the wrist.
  • Fractures are common among the elderly, particularly involving the femur and pelvis.
  • Vertebral fractures are common among those with physically intensive jobs.
  • Not well-nourished individuals are at an increased risk of osteoporosis-related fractures.

Compact Bone

  • Osteons are the fundamental units of compact bone.
  • They are cylindrical structures, with osteocytes found in lacunae.
  • Lamellae are concentric layers of calcified matrix that surround each osteon.
  • Haversian canals contain blood vessels and nerves, providing nutrients to osteocytes.
  • Volkmann's canals connect Haversian canals, facilitating blood supply throughout the bone.
  • The periosteum is the external layer of the bone, while the endosteum lines the medullary cavity.

Bone Density Requirements

  • Bone density requires protein, intercellular matrix (made of dietary proteins & amino acids building intracellular matrix), and calcium salts (calcium carbonate and calcium phosphate).
  • Calcium salts confer hardness to bone.
  • Without crystalization (from calcium salts), bone hardness would not form.

Bone Development

  • Bone formation involves mesenchymal condensation, chondrocytes, primary ossification, and secondary ossification.
  • Dietary protein and vitamin C are necessary for connective tissue formation.
  • Sufficient vitamin D ensures adequate calcium absorption from diet.

Requirements for Normal Bone Density

  • Hormones, including estrogen and testosterone, decrease osteoclast sensitivity to parathyroid hormone (PTH).
  • Vitamins C and D also play roles in bone health.
  • Physical activity stimulates osteoblast activity for bone production.

Osteopenia

  • Osteopenia results from an imbalance between bone formation and breakdown.
  • It describes low bone mass, increasing risk of fractures.
  • Decreased bone mineral density is a characteristic.
  • This contributes to other bone diseases if not rectified.
  • Bone replacement and maintenance of density are key functions of balanced formation and breakdown in healthy bones.
  • Postmenopausal women and undernourished individuals are at greater risk for osteopenia.

Osteoporosis

  • Osteoporosis is a disease of reduced bone density, making bones susceptible to fractures.
  • It's particularly prevalent in women with declining estrogen levels.
  • This metabolic condition is largely seen in older women.
  • Bone synthesis must outweigh bone resorption to prevent this condition.
  • The disease significantly impacts the hip and vertebral areas.

Complications of Osteoporosis

  • Spinal complications (fractures [compression fractures], kyphosis, scoliosis).
  • Hip fractures in the neck of the femur.
  • Reduced blood supply contributes to weakening and fractures in the hip (atherosclerosis).

Bone Thinning

  • Trabecular bone thinning is more prominent in women due to loss of connectivity and trabeculae rather than a decrease in formation in men.

Dual Energy X-ray Absorptiometry (DEXA)

  • DEXA is a widely used screening method for measuring bone density.
  • It's valuable for monitoring the effects of osteoporosis medications.

Osteoporosis Non-Pharmacological Treatments

  • Engage in regular exercise.
  • Increase calcium intake.
  • Minimize phosphate intake.
  • Take vitamin D supplements.
  • Quit smoking.

Osteoporosis Pharmacological Treatments

  • Bisphosphonates (alendronate, zoledronic acid) inhibit bone resorption.
  • Parathyroid hormone (PTH) stimulates bone remodeling.
  • Selective estrogen receptor modulators (SERMs, e.g., raloxifene) act on specific estrogen receptors.
  • Calcitonin, a naturally produced peptide, partially inhibits osteoclast activity.
  • Denosumab inhibits bone resorption and stimulates secondary bone formation as a RANKL inhibitor.

Osteomalacia

  • Osteomalacia is inadequate bone mineralization, leading to osteoid (soft bone)
  • Causes include vitamin D deficiencies (from decreased dietary intake, intestinal absorption problems, or renal tubular disease).

Rickets

  • Rickets is a childhood bone disorder resulting in skeletal malformations.
  • It stems from vitamin D deficiency and impairs bone mineralization during growth development.
  • Manifestations include short stature, odd-shaped skull, pigeon chest, wide joints, and bowlegs.

Paget's Disease

  • Paget's disease is a bone neoplasm characterized by increased bone remodeling and formation, leading to bone enlargement and softening.
  • Affected regions include the skull, vertebrae, sacrum, sternum, pelvis, and femur.
  • A hallmark sign is a cotton wool patch appearance.
  • It's the opposite of osteoporosis in that it is characterized by excessive formation and resorption of bone rather than reduced bone formation. It's a bone neoplasm with increased osteoclastic and osteoblastic activity.

Osteomyelitis

  • Osteomyelitis is a bacterial infection of bone and marrow, usually caused by Staphylococcus aureus.
  • Infections can be endogenous (spreading from another site) or exogenous (from an external source like a wound).
  • Inflammation can lead to thrombosing vessels, exudate filling canals, disrupting blood supply and leading to necrosis of underlying bone and sequestrum formation.
  • Complications include delayed wound healing and infections spreading to other body sites (septicimia).

Osteonecrosis

  • Osteonecrosis is a condition where bone dies due to a lack of blood supply.
  • Involves hypoxia, ischemia, and necrosis.
  • Causes include bone fractures, thrombosis or embolism, vessel injury, compartment syndrome, and steroid therapy.

Bone Tumors

  • A wide range of tumors can develop in bones, originating from various types of cells like osteoblasts, chondroblasts, and fibroblasts.
  • These develop into various types of bone tumors (e.g., osteosarcoma, osteoid osteoma).

Benign Bone Tumors: Chondroma, Osteochondroma, and Osteoclastoma

  • Chondromas are hyaline cartilage-derived tumors, including subgroups like enchondromas, subperiosteal/juxtacortical chondromas.
  • Osteochondromas are cartilage-capped tumors with bony stalks, typically forming in childhood or adolescence. They are usually benign exostoses.
  • Osteoclastomas are giant cell tumors, formed from mononuclear and osteoclast-type giant cells, exhibiting behavior similar to malignant tumors; the tumors are usually benign but may exhibit aggressive behavior.

Malignant Bone Tumors: Osteosarcoma, Chondrosarcoma, and Ewing Sarcoma

  • Osteosarcomas are the most frequent primary malignant bone tumors, typically showing up in adolescents.
  • Fast-growth areas are the typical locations.
  • Metastasis to the lungs is a common event after amputation.
  • Chondrosarcomas are malignant cartilage tumors arising from chondrocytes. They tend to occur in older adults and usually metastasize to the lungs, skeleton, and soft tissues.
  • Ewing Sarcomas are childhood malignant bone tumors originating from mesenchymal stem cells.
  • May involve pelvis, femur, humerus, ribs, and clavicle.
  • Some have a genetic linkage.

Variations in Growth & Development:

  • Angular and torsional deformities: include in toeing/out toeing.
  • Femoral torsion/tibial torsion
  • Genu varum-bowlegged
  • Genu valgum-knock-kneed

Congenital Disorders:

  • Osteogenesis imperfecta: a brittle bone disorder deriving from a collagen gene mutation affecting connective tissue synthesis.
  • Developmental dysplasia of the hip (DDH): a developmental disorder manifesting in hip subluxation or dislocation.

Juvenile Osteochondroses: Legg-Calvé-Perthes Disease, Osgood-Schlatter Disease

  • Legg-Calvé-Perthes disease: a disorder affecting the hip, leading to necrosis of the femoral head due to interrupted blood supply..
  • Osgood-Schlater disease: Inflammation of the area beneath the patellar tendon attaching to the tibia.

Scoliosis

  • Scoliosis is a misalignment of the spine, often requiring surgical intervention. Characterized by curvatures and possible rib deformities.

Arthritis

  • Umbrella term for joint inflammation.

Osteoarthritis

  • Common sites include weight-bearing joints like the hip, knee, hands, and spine.
  • Characterized by cartilage wear and tear, underlying bone sclerosis, and osteophyte formation.
  • Possible joint fusion.

Reactive Arthritis

  • Sterile joint inflammation stemming from previous infections (GI or STI).
  • Includes Reiter's syndrome (arthritis, urethritis, and conjunctivitis) and enteropathic arthritis (associated with inflammatory bowel disease).

Psoriatic Arthritis

  • Seronegative inflammatory arthropathy often associated with psoriasis.
  • Can have oligoarticular, spondylitis, polyarticular, distal interphalangeal, and mutilans forms.

Rheumatoid Arthritis

  • Autoimmune disease leading to joint inflammation with synovial membrane inflammation, and involvement of articular cartilage, joint capsules, ligaments, and tendons.
  • Common hand joint involvement & potential complications.

Systemic Lupus Erythematosus (SLE)

  • Type III hypersensitivity reaction.
  • Autoantibodies target self molecules (cells, plasma, cytoplasm).
  • Wide range of symptoms are possible, including arthralgia, skin rashes, kidney involvement, and cardiovascular issues.

Systemic Sclerosis (Scleroderma)

  • Autoimmune disease leading to widespread inflammation, fibrous tissue deposition, and hardening of connective tissue and internal organs.
  • Subtypes based on diffuse vs limited patterns.

Spondyloarthropathies

  • Multisystem inflammatory disorders.
  • Sacroilitis is a key diagnostic feature.
  • Inflammation begins at tendon and ligament insertions into bone.
  • Axial subtypes (e.g., ankylosing spondylitis) and peripheral subtypes (e.g., reactive arthritis).

Ankylosing Spondylitis

  • Axial spondyloarthropathy marked by spinal inflammation that may cause fusion of joints.
  • Affects various tissues/structures like enthesitis sites (tendons, ligaments).
  • Enthesitis regions include shoulders, hips, knees, and heels.
  • Possible spinal curvature (kyphosis).
  • Can affect eye (uveitis) health adversely.
  • Involves the costovertebral and costosternal joints.

Gouty Arthritis

  • Caused by uric acid crystallization in joints and tissues resulting from purine metabolism or excretion disorders.
  • This causes inflammation of joints.

Rheumatic Diseases in Children

  • Categories and specific illnesses targeting joints: Juvenile Idiopathic Arthritis (various types, oligo vs polyarticular), Juvenile Spondyloarthropathies (associations with inflammatory bowel diseases), and Juvenile Dermatomyositis (autoimmune disorder, proximal muscle weakness, rash).

Rheumatic Diseases in the Elderly

  • Common conditions that involve arthritis: Osteoarthritis, Rheumatoid Arthritis (older vs younger onset), Crystal-induced arthropathies (Gout, Pseudogout), and other inflammatory conditions like Polymyalgia Rheumatica (risk for giant cell arteritis).

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