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“

"POROUS BONES“

from Greek: οστούν/ostoun meaning "bone"
and πόρος/poros meaning "pore"

”

KERSTIN KAREN VICENTE, RN
A condition of
skeletal fragility
characterized by
compromised bone
strength predisposing
to an increased risk
of fracture
ASSESSMENT
Age/Gender
Race
Lifestyle/
Diet
Personal/
family
history of
fractures
Height
Spinal curves
DIAGNOSTICS
Dual-Energy X-Ray Absorptiometry (DEXA)

Measures bone mineral
density which can be
determined from the
absorption of each
beam by bone
Ultrasound

Transmits painless sound waves
through the heel of the foot to
measure bone density. Heel
bone - a weight bearing bone
with a high incidence of
trabecular bone and is on the
same axis as the hip joint.
Alkaline phosphatase (AST)
Elevates

following a fracture, and serum
bone Glaprotein (osteocalcin), marks of
osteoclastic activity.
This test is most useful to evaluate the
effects of treatment, rather than as
indicator of the severity of the disease.
INCIDENCE
Incidence
Awareness

of osteoporosis in the
Philippines was one of the lowest when
compared to other Asian countries in
the mid 1990s.
Ten years later, awareness of the
disease has moved one level higher.
Incidence

The National Osteoporosis
Foundation (2006)
10M people have osteoporosis
34M have low bone mass
80% are women

Phil.Population: 96M.
Over 60 yo: 6.0 to 6.7%
(6M) of population
It is expected to
increase to 110 million
by 2020 and 146 million
by 2050.
Incidence
1:2

women
1:4 men
Over age 50 will have an
osteoporosis related fracture
PATHOPHYSIOLOGY
Male

Female

↓Testosterone

Menopause
↓ Estrogen

↓Thyroid stim
↓Calcitonin
↑Osteoclast

↓Ca
absorption

↓Osteoblast
Race

↓Pigmentation
↓Bone mass
↓

Asians

Europeans

Americans
Endocrine Disorders
Hyperthyroidism

Hyperparathy

Cushing’s
↓Bone minerals

DM
Age

↓BMD
Smoking
Vasoconstriction
↓Blood supply
↓Osteoblast

Impaired cell
absorption
↓Bone density
Lifestyle
Female athletes

Sedentary

Eating
disorders

Amenorrhea

Minimal
blood flow
to bones

↓Estrogen

Nutritional
deficiency

↓Nutrients
Alcohol
Moderate

Intoxication

↑Estrogen&Calcium

Suppressed
bone
formation

↑Bone mineral
content
Diet

↓ Ca

↑ Protein

Removal
of ca from
skeleton

Acidosis

Weakened
bone tissue

Attempts to
buffer
excess acid

↑ Phosphate
Osteoclast
formation
Medication
Corticosteroids
Affects
calcium & sex
hormones

Bone
density
loss

Aluminum
containing
antacids,
Anticonvulsants
↑Ca excretion

Heparin

↑ Resorption
↑BONE RESORPTION

↓BONE FORMATION

Diameter of bone
enlarges

Wedging & collapse
of vertebrae

Thinner outer
supporting cortex

↓Height

Susceptible to
fractures

Kyphosis

Dowager’s hump
Post

TYPE I
PRIMARY

menopausal
Senile
TYPE II
SECONDARY
Drugs

Diseases
NURSING DX
Acute pain
related to
compression of
vertebral spine
secondary to
osteoporosis
Imbalanced
nutrition: less
than body
requirements
related to
inadequate
calcium intake
Risk for injury
related to bone
fragility
secondary to
osteoporosis
Osteoporosis by Kerstin Karen Vicente, RN

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Osteoporosis by Kerstin Karen Vicente, RN

Notes de l'éditeur

  1. he Cuba Clinical Ultrasound ScanIS AN ADVANCED BONE DENSITOMETRY INCORPORATING BUA and has been regarded as a major stride forward in the diagnosis and monitoring of osteoporosisCubaclinical draws on 11 years of technical development with clinical assessment trials and is the most sophisticated implementation yet of ultrasound technology.Cubaclinical uses a non-ionising, non-invasive approach to bone densitometry. Researches suggest that Broadband Ultrasonic Attenuation (BUA) gives not only information on bone density but also structure. This indicates that it may be a superior predictor of fracture risk than other forms of bone densitometry.The Cubaclinical machine beams ultrasound through the heel bone. The less sound that comes out of the heel bone, the denser the heel bone is. If the heel bone is good quality bone then it indicated that bones elsewhere in the body, for instance in the back and in the hip, are also of good quality. The heel bone has been selected as it is a weight bearing bone with a high incidence of trabecular bone and is on the same axis as the hip joint.