Skeletal System Anatomy of Bone Histology of Bone Haversian

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Skeletal System
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Anatomy of Bone
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Histology of Bone
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Haversian System
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Cartilage
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Age Related Changes (Cartilage)
1. Looses Translucence- 2. Decrease in
Chondrocyte Number 3. Matrix Changes - fibers and
GAGs asbestos formation chemically altered
chondroitin sulfate 4. Calcification e.g.
costal cartilage intervertebral discs
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Age Related Changes (Bone)
1. Loss of Calcium 2. Decline in Osteoblasts 3.
Decrease Collagen Synthesis makes bones
brittle 4. Haversian Canals Increase in Diameter
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Age Related Dysfunctions
Arthritis Osteoarthritis- chronic
degenerative 30-40 million Americans 90 of
pop. By age 40 chronic inflammation of
articular cartilage normal age-dependent change
vs. pathology due to ? Age-related
changes decrease blood supply trauma
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Osteoarthritis
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Arthritis (cont.)
Rheumatoid Age-related, peaks 40-60 chronic
inflammation of synovial membrane autoimmune
(women 2-3X men) Gouty Accumulation of Uric
Acid Sodium urate crystals Inflammation,
Swelling Affects men 201
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Osteoporosis
Affects 10 million Americans Eight million
women, two million men. Decline in Bone
Density Bone Resorption gt Bone
Deposition Increase Risk for Fracture 1.5
million fractures annually, including over
300,000 hip fractures 700,000 vertebral
fractures 250,000 wrist fractures and
300,000 fractures at other sites. Role of
calcium, vitamin D, estrogen, exercise Calcitonin
vs. Parathyroid Hormone
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Osteoporosis
National Osteoporosis Foundation
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Detection

• Specialized test (Dual Energy X-Ray
  Absorptiometry or DXA) can measure bone mineral
  density (BMD) in various sites of the body.  A
  BMD test can
• Detect osteoporosis before a fracture occurs
• Predict chances of fracturing in the future
• Determine rate of bone loss and/or monitor the
  effects of treatment if a DXA BMD test is
  conducted at intervals of one year or more 

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Treatment

• The following medications are approved by the FDA
  for postmenopausal women to prevent and/or treat
  osteoporosis
• Bisphosphonates (inhibit bone resorption)
• Alendronate and alendronate plus vitamin D (brand
  name Fosamax and Fosamax plus D)
• Ibandronate (brand name Boniva)
• Risedronate and risedronate with calcium (brand
  name Actonel and Actonel with Calcium)
• Calcitonin (brand name Miacalcin)
• Estrogen/Hormone Therapy
• Estrogens (brand names, such as Climara,
  Estrace, Estraderm, Estratab, Ogen,
  Ortho-Est, Premarin, Vivelle and others)
• Estrogens and Progestins (brand names, such as
  Activella, FemHrt, Premphase, Prempro and
  others)
• Selective Estrogen Receptor Modulators (SERMs)
• Raloxifene (brand name Evista)

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Prevention
Exercise- Use it or Lose it Estrogen- Bone
Resorption Accelerates after Menopause estrogen
reduces bone resorption enhances dietary use of
calcium Calcium Supplements ? Little evidence
it is effective post-menopausal