A CURA DEL DOTT. GUARDO S. RAUL

A CURA DEL DOTT. GUARDO S. RAUL
ONLUS (D.Lgs. 460/97)
1
BRITTLE BONES (osteoporosis)
Dr. Raul Guardo Salinas
Anatomy and Physiology
Bones are sturdy structures, whose shape, thickness, and size vary according to their function.
The skeletal system consists majorly of the bones which provide structural stability to the body.
Bones and body
The human body has approximately 212 bones, distributed as follows:
lower limbs: 60 bones;
upper limbs: 60 bones;
spine: 33 bones;
ribs: 24 bones;
skull: 22 bones;
ear : 6 bones;
girdle: 4 bones;
sternum: 3 bones;
pelvis: 2 bones connected to the vertebral column;
thyroid bone: 1 bone (this one is found at the root of the tongue, and is the only bone of the
human body that is not connected with any other bone.)
This list excludes the sesamoid bones (near certain joints. They contribute to the thickness of
tendons, ligaments, or joint capsules, particularly in those of the hands and feet.) and wormian
as they may vary in number in every individual or be absent altogether. Sesamoids improve
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ONLUS (D.Lgs. 460/97)
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muscle efficiency while the wormian are extra bone pieces that occur within a suture of the
cranium.
The number of bones varies according to the age of the individual, Wormian bones are found
most frequently in children at birth as the cartilagineous segments ossify and coalesce as the
child grows. This is a very important phase; the spaces separating the membranous bones of
the skull in infants, in fact, are flexible which avoids the child receiving excessive pressure from
to the brain during childbirth or further development. In adults, this type of cartilage (called
hyaline) is maintained only where ia high degree of flexibility is required, as in the case of the
nose, around the articular surfaces and the front ribs (which needs to be flexible in order to
allow the ribcage movement during breathing).
Small changes in the number of bones of the body are also found in individuals of the same
age.
Together with cartilage, bones form the skeleton, which alone accounts for less than 20% of
body weight (a percentage lower than that of the muscles, which in their totality cover 35 to
40% of body mass). The bones have four important characteristics: lightness, strength,
hardness and elasticity.
The skeleton
Appendicular: is composed of 126 bones in the human body. The word appendicular is the
adjective of the noun appendage, which itself means a part that is joined to something larger.
Functionally it is involved in locomotion (Lower limbs) of the axial skeleton and manipulation of
objects in the environment (Upper limbs). It is divided into 6 major regions: Pectoral girdles, arm
and forearm, hands, pelvis, thigh and leg, and feet.
The primary function of the skeleton is to support the structure of an organism.
Functions of Bones and Skeleton
Support
The skeleton is the framework of the body, it supports the softer tissues and provides points of
attachment for most skeletal muscles.
Protection
The skeleton provides mechanical protection for many of the body's internal organs, reducing
risk of injury to them.
For example, cranial bones protect the brain, vertebrae protect the spinal cord, and the ribcage
protects the heart and lungs.
Assisting in Movement
Skeletal muscles are attached to bones, therefore when the associated muscles contract they
cause bones to move.
Storage of Minerals
Bone tissues store several minerals, including calcium (Ca) and phosphorus (P). When
required, bone releases minerals into the blood - facilitating the balance of minerals in the body.
Production of Blood Cells
The red bone marrow inside some larger bones (including, for example, the ....) blood cells are
produced.
Storage of Chemical Energy
With increasing age some bone marrow changes from 'red bone marrow' to 'yellow bone
marrow'.
Yellow bone marrow consists mainly of adipose cells, and a few blood cells. It is an important
chemical energy reserve.
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What is osteoporosis
Osteoporosis is a bone disease characterized by lower calcium content and a deterioration of
the microscopic structure of bone; these factors determine an increase in fragility and the
possibility of fractures. Osteoporosis is not an acute illness, does not occur overnight, especially
not become osteoporotic month after having missed a period!
Why is it important to prevent
Is important to prevent the osteoporosis, because it is a factor of risk for the fractures: the
fractures of usual wrist are taken place in more juvenile age, that is between the 60-65 years, in
relation to the various modalities of fall of the young person regarding the old, which can more
easily suffer a fracture of the femur (85% after 75 years). The fractures of the vertebral column
instead can be postmenopausal or senile, be taken place that is before or after the 75 years.
Often they are asymptomatic: we can momentarily not notice any, but in the long run they carry
to an unavoidable deformation of the back which bends progressively. This can provoke
respiratory difficulties, that they are added to those already physiologically present in the old.
How you can prevent osteoporosis
Osteoporosis is a disease that can be prevented before starting, because the bone is influenced
by several factors
 physical activity
 nutritional factors
 Inheritance
 hormonal factors
 smoke
On some of these, such as inheritance, you cannot influence, but on others we can do much.
In a study conducted in Norway on women aged > 70 years the risk of hip fracture was
statistically correlated with reduced food intake and reduction of body weight in the previous
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ONLUS (D.Lgs. 460/97)
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year.
Moreover, the deficiency of vitamins and micronutrients (vitamin D, vitamin K) are associated
with accelerated bone loss age-dependent, increasing bone fragility and tendency to fall
(instability).
Decalogue osteoporosis
1. EATING AT LEAST 1,000 MG OF CALCIUM DAILY
These foods contain 500 mg of calcium:
500 ml of milk;
125 g di mozzarella di bufala o vacca;
100 g di stracchino
400 g yogurt;
50 g pecorino;
5 whole oranges (1 kg);
600 g spinach;
200 g of almonds;
It is advisable to divide the intake to improve calcium absorption and reduce its loss
It is better not to consume soft drinks containing caffeine because they cause a high urinary
calcium excretion
Water contains calcium. By drinking 2 liters of mineral water per day, you intake over 600
milligrams of calcium.
Acqua del rubinetto Brescia 82 mg/L;
acque oligominerali (Levissima, Panna, Vera, Rocchetta...) da 20 a 60 mg/L;
acque minerali:
Uliveto 190 mg/L;
Sangemini 328 mg /L;
Ferrarelle 360 mg /L.
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2. DOING MORE PHYSICAL ACTIVITY
Physical activity improves intake of calcium and increases bone mass, ie the maximum bone
mass is reached at 25. Vitamin D from the sun is also essential for bones.
The physical activities most recommended are:
walking;
running;
aerobics;
sports;
dancing outdoors.
3. SMOKING REDUCES THE ABSORPTION OF CALCIUM AND ANTICIPATES THE
AGE OF MENOPAUSE
4. MENSTRUATION SHOULD BE REGULAR
The prolonged lack of estrogen causes an increased absorption of calcium in the bones, which
are depleting and may become more fragile. You must avoid situations that cause a prolonged
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loss of the menstrual cycle at any age (for example, strict diets, excessive sports, drugs that
interfere with hormonal activities), and cure them if they occur.
5. NOT ALL WOMEN IN MENOPAUSE BECOME OSTEOPOROTIC
It is important to maintain an ideal calcium intake from when we are young to maintain strong
bones even when we are older.
6. THE MISCONCEPTION OF BEAUTY
Anorexia is a strong risk factor for osteoporosis. This does not mean becoming overweight but
the damage of being excessively skinny majorly increases the probability of bone fracture,
among other things.
7. MAMMA FRATTURATA? AHI AHI AHI
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If there were signs of osteoporosis between family members (mother or sisters), especially in
the years just after menopause, or if we already had a fracture, we are more likely to suffer
them again even from minor trauma. In this case, the best prevention is to avoid falling
altogether.
8. ESEGUIRE LA DENSITOMETRIA OSSEA NON PREVIENE L’OSTEOPOROSI
La densitometria ossea è un esame che valuta la densità minerale delle ossa. Non è
obbligatorio eseguirlo non appena si è in menopausa, ma è utile solo in certe circostanze che
già vi inquadrano in una situazione di rischio (per esempio la magrezza o una precedente
frattura).
Invece è consigliabile farla dopo i 65 anni, età già di per sè pericolosa per le fratture.
9. OTHER USEFUL TYPES OF OSTEOPOROSIS THERAPY
The choice whether to initiate therapy for osteoporosis is dependent on many factors that your
doctor will carefully consider as they extend over a lengthy period of time.
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