GERIATRICS MUSCOLOSKELETAL

THE MUSCULOSKELETAL SYSTEM

• Changes reflect the aging process.

• A decline in muscle mass and a reduction in muscle strength leading to risk of fractures, frailty, reduction in the quality of life and loss of independence.

Bones

• consists of protein and the mineral (calcium and phosphorus).

Calcium

Bones

• necessary for bone strength, muscle contraction, myocardial contraction, blood clotting, and neuronal activity.

• Cardiovascular

Hormones

Bones

also play an important role in bone maintenance.

o Calcitonin

o Parathyroid hormone

o Insulin and thyroxine

o Estrogen and testosterone

Calcitonin

Hormones

• hormone produced by the thyroid gland

• helps to lower blood calcium levels

Parathyroid hormone

Hormones

• a hormone secreted by the parathyroid glands

• primarily regulates blood calcium and phosphate levels by acting on the bones, kidneys, and intestines

Insulin

Hormones

• produced by the pancreas

• helps regulate blood sugar (glucose)

thyroxine

Hormones

• produced by the thyroid gland,

• helps regulate metabolism, growth, development

• controls how much energy your body uses (the metabolic rate).

Estrogen and testosterone

Hormones

essential sex hormones found in both males and females, though in different concentrations

Vertebrae

• The _____ supports the head and allows for flexible movement of the back.

• The spinal cord, the nerve tissue that extends downward from the brain, passes through the vertebral canal

Joints

are the places where bones meet

Cartilage

allows free movement of the joint surfaces

Bursa

Many of these joints contain a ____, which is a fluid sac that provides lubrication to enhance joint mobility

Tendons

are structures that connect the muscles to the bone

Ligaments

are structures that connect bones to other bones

Muscle strength

• is an important determinant of functional capacity in older people.

• Types of muscles:

o Cardiac - heart

o Smooth–hollow organs

o Skeletal - largest

Sarcopenia

EXPECTED AGE-RELATED CHANGES

• increased risk of disability, falls, unstable gait

• Decreased muscle mass, muscle strength & function.

osteoporosis

EXPECTED AGE-RELATED CHANGES

• Decreased myosin adenosine triphosphatase activity

• Excessive loss of calcium from bone combined with insufficient replacement.

• It is characterized by porous, brittle, fragile bones that are susceptible to breakage.

Osteoarthritis

EXPECTED AGE-RELATED CHANGES

• Deterioration and drying of joint cartilage

• Limited range of motion, joint instability

• Most common form

• Not a normal part of aging.

• The cartilage within a joint begins to break down & the underlying bone begins to change.

OTHERS:

• Death of chondrocytes leads to degeneration of articular cartilage

• Loss of cartilage leads to eburnation of bone

• Affects weight bearing joints

• Asymmetric (may only affect 1 hand)

• Swelling of DIP and PIP joints DIP (Distal Interphalangeal) and PIP (Proximal Interphalangeal) are medical terms for two specific joints in each finger

• Synovial fluid enters bone fractures leading to subchondral cysts

• Osteophytes form at margins of cartilage

Muscle weakness/ muscle fatigue

EXPECTED AGE-RELATED CHANGES

Decreased bone mass and osteoblastic activity

Rheumatoid Arthritis

is a collagen disease that results from an autoimmune process, affecting more women than men.

OTHERS:

• Proliferation and inflammation of synovium creates panni

• Pannus: finger-like projections that grow it joint space

• Affects hands and feet

• Symmetric (affects both hands)

• Ulnar deviation of MCP joints

• Swelling of MCP and PIP joints

• Subcutaneous nodules