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BONE
JOINT
SOFT TISSUE
CELLS of BONE
- OSTEOPROGENITOR (“STEM”) (TGFβ)
- OSTEOBLASTS (surface of spicule ), under control of calcitonin to take blood calcium and put it into bone.
- OSTEOCYTES (are osteoblasts which are now completely surrounded by bone)
- OSTEOCLASTS (macrophage lineage), under control of PTH to chew up the calcium of bone and put it into blood
ADJECTIVES of BONE
- Compact
- Spongy
- Cancellous
- Membranous
- Endosteal
- Spicular
BONE DISEASES
- 1) MALFORMATIONS AND DISEASES CAUSED BY DEFECTS INTRANSCRIPTION FACTORS, polydactyly, syndactyly, absence of a bone NUCLEAR PROTEINS AND
- 2) DISEASES CAUSED BY DEFECTS INachondroplasia, thanatophoria HORMONES AND SIGNAL TRANSDUCTION MECHANISMS,
- 3) DISEASES ASSOCIATED WITH DEFECTS IN EXTRACELLULAR STRUCTURAL PROTEINS
- Type 1 Collagen Diseases (Osteogenesis Imperfecta)
- Types 2, 10, and 11 Collagen Diseases
- 4) DISEASES ASSOCIATED WITH DEFECTS INMACROMOLECULES FOLDING AND DEGRADATION OF
- 5) DISEASES ASSOCIATED WITH DEFECTS INAND TRANSPORTERS) METABOLIC PATHWAYS (ENZYMES, ION CHANNELS,
- 6) DISEASES ASSOCIATED WITH DECREASED BONE MASS
- 7) DISEASES CAUSED BY OSTEOCLAST DYSFUNCTION
- Paget Disease (Osteitis Deformans)
- 8) DISEASES ASSOCIATED WITH ABNORMAL MINERAL (Ca++) HOMEOSTASIS
- Ricketts and Osteomalacia
- Hyperparathyroidism
- Renal Osteodystrophy
2) DISEASES CAUSED BY DEFECTS IN
HORMONES AND SIGNAL TRANSDUCTION MECHANISMS
- Achondroplasia, dwarf (non-lethal)
- Thanatophoria, dwarf (lethal, FGF- mutations)
- a point mutation (usually Arg for Gly375) in the gene that codes for FGF receptor 3 (FGFR3), which is located on the short arm of chromosome 4. In the normal growth plate, activation of FGFR3 inhibits cartilage proliferation, hence the term “achondroplastic”;
- A MUTATION causes FGFR3 to be constantly activated.
3) DISEASES ASSOCIATED WITH DEFECTS IN
EXTRACELLULAR STRUCTURAL
PROTEINS
• OSTEOGENESIS IMPERFECTA TYPES
- (“Brittle” bone disease, too LITTLE bone), BLUE sclerae
- Mutations in genes which code for the alpha-1 and alpha-2 chains of COLLAGEN 1
- Mutations of COLLAGEN 2,10, 11 manifest themselves as CARTILAGE diseases, ranging from joint cartilage destruction to fatal sequelae
Categories of Generalized Osteoporosis Primary Postmenopausal (^) Idiopathic Senile Secondary Endocrine disorders (^) Rheumatologic disease Hyperparathyroidism (^) Drugs Hypo-hyperthyroidism (^) Anticoagulants Hypogonadism (^) Chemotherapy Pituitary tumors (^) Corticosteroids Diabetes, type 1 (^) Anticonvulsants Addison disease (^) Alcohol Neoplasia (^) Miscellaneous Multiple myeloma (^) Osteogenesis imperfecta Carcinomatosis (^) Immobilization Gastrointestinal (^) Pulmonary disease Malnutrition, Malbs., Hepatic Insuf., Vit C,D (^) Homocystinuria Anemia Docsity.com
7) DISEASES CAUSED BY OSTEOCLAST
DYSFUNCTION
Paget Disease (Osteitis Deformans)
- Matrix madness, Osteoblasts/-cytes gone wild
- THREE PHASES:
- 1) Increased osteoclast resorption
- 2) Increased “hectic” bone formation (osteoblasts)
- 3) Osteosclerosis
- ELEVATED ALKALINE-PHOSPHATASE
- ELEVATED urine HYDROXYPROLINE
RENAL OSTEODYSTROPHY
• PHOSPHATE RETENTION
• HYPOPHOSPHATEMIA
• HYPOCALCEMIA
• INCREASED PTH
• INCREASED OSTEOCLASTS
- METABOLIC ACIDOSIS release of HYDROXYAPATITES from matrix
FRACTURES, adjectives
- Complete, incomplete
- Closed, open (communicating)
- Communited (splintered, “greenstick”)
- Displaced (NON-aligned)
- PATHOGENIC, (non-traumatic, 2º to other disease, often metastases)
- “STRESS” fracture
OSTEONECROSIS
- Also called AVASCULAR necrosis
- Also called ASEPTIC necrosis
- CAUSE: ISCHEMIA
- Trauma
- Steroids
- Thrombus/Embolism
- Vessel injury, e.g., radiation
- INCREASED intra-osseous pressure vascular compression
- Venous hypertension too
OSTEONECROSIS
Disorders Associated with Osteonecrosis
Idiopathic Pregnancy
Trauma Gaucher disease
Corticosteroid administration
Sickle cell and other anemias
Infection (^) Alcohol abuse
Dysbarism Chronic pancreatitis
Radiation therapy Tumors
Connective tissue disorders
Epiphyseal disorders Docsity.com
OSTEOMYELITIS
- COMPLICATIONS
- Subperiosteal abscess
- Draining sinus
- Joint involvement
- SEQUESTRUM (dead bone)
vs.
OSTEOMYELITIS
- Tuberculous
- Usually blood borne
- TB of spine is known as POTTS disease
- Syphilis
- CONGENITAL
- TERTIARY, “SABRE” shins