PRELIMINARY EXAM

BIO 102
FUNDAMENTALS OF ANIMAL BIOLOGY
PART II
Name: Axle Brent A. Dayoc
Section: S45
Course: BS BIO- BOTANY -I

1. Explain the mechanism of osteoporosis and bone mass regulation, the genes and
environmental factors involved in the pathogenesis. ( 25 points)
Primary osteoporosis is a metabolic bone disease characterized by low bone mass and
microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and increased
fracture risk. It also has normal mineral-to-collagen ratio. Primary osteoporosis represents bone mass
loss that is unassociated with any other illness and is related to aging and loss of the gonadal
function in women and the aging process in men. Secondary osteoporosis can result from a variety of
the chronic conditions that significantly contribute to bone mineral loss, or it can result from the
effects of medications and nutritional deficiencies. Osteoporosis is the most common metabolic bone
disease. About 54% of postmenopausal white women in the United States have osteopenia and 30%
have osteoporosis. Men and nonwhite women at risk add 30 million to 54 million affected persons in
the United States. About 2.0 million osteoporotic fractures occur each year in the United States.
Approximately one half is vertebral fractures, one quarter is hip fractures, and one quarter is Colles
fracture. Significant ethnic and geographic differences exist in the prevalence of osteoporosis and
osteoporotic fractures. The risk of hip fracture is considerably higher in whites than in blacks. Two
factors contribute to this difference: higher peak bone mass (highest bone mass achieved by a
person in his or her lifetime) and slower postmenopausal bone loss in African American
women.4 Bone mineral density (BMD) is lower in Asians than in whites. However, when adjusted for
body size, most of the difference disappears, suggesting that the lower BMD in Asians is due to their
smaller body size. Decreased BMD and osteoporotic fracture rate increases with age. Wrist fracture
incidence starts increasing at about 50 years of age, vertebral fractures in the 60s, and hip fractures
in the 70s. Increased mortality rate associated with hip and vertebral fractures may be the worst
consequence, but the loss of independence and lowered quality of life of patients might be the
greatest burden of the osteoporosis. Osteoporosis in men has been recognized as an important
health problem. Incidence of hip fracture increases exponentially with age in men as well as in
women, although the incidence in men occurs about 5 to 10 years later than in women. Basic
mechanisms responsible for development of osteoporosis are poor bone mass acquisition during
growth and development and accelerated bone loss in the period after peak bone mass is achieved.
Both processes are modulated by environmental and genetic factors. About two thirds of the risk for
fracture in postmenopausal women is determined by premenopausal peak bone mass. Peak bone
mass is higher in blacks than in whites and Asians, and it is higher in men than women.
Approximately half of the bone mass is accumulated during pubertal development this is associated
with the increase in sex hormone levels and is almost completed with closure of the end plates. There
is only minimal additional accumulation of the bone minerals during the next 5 to 15 years (skeletal
consolidation). Peak bone mass is achieved during the third decade of life. Studies in twins and
mother-daughter pairs suggest that 40% to 80% of the variability in the bone mass is determined by
genetic factors. The genes implicated in osteoporosis include those for the estrogen receptor,
transforming growth factor-, and apolipoprotein E and collagen. Bone loss, in contrast, appears to
be mostly determined by environmental factors (nutritional, behavioral, and medications). However,
genetic factors also play a role, mostly acting on a person's estrogen status. Important nutritional
factors include dietary calcium intake, Vitamin D status, protein intake, and caloric intake.
Phosphorus, vitamins C and K, copper, zinc, and manganese also play a role. Low calcium intake
during childhood increases risk of fracture later in the life and is positively correlated with bone
mineral mass at all ages. Supplementation is shown to reduce rate of bone loss and decreases
incidence of fractures in calcium deficient elderly persons. Optimal calcium intake varies among

different age groups and is population specific. The typical U.S. diet is rich in sodium and protein,
both of which increase urinary calcium excretion, thus increasing dietary requirements. Vitamin D is
essential for bone mineral metabolism through its role in calcium absorption and osteoclast activity.
Vitamin D nutritional status is best assessed by measurement of serum 25(OH)-vitamin D levels.
Vitamin D levels decrease with increasing age. Supplementation reduces the rate of all fractures in
the elderly population. Protein or caloric malnutrition predisposes to falls and decreases soft tissue
cover over bony prominences. Protein intake is the major determinant of outcome after hip fracture,
and serum albumin level is the single best predictor of survival in these patients. The body weight
history of girls and women with anorexia nervosa is the most important predictor for the
development of osteoporosis. Behavioral factors important in pathogenesis of osteoporosis include
physical activity, smoking, and alcohol consumption. Bone mass is higher in top-level athletes than in
nonathletic. This is particularly pronounced in athletes engaging in strength training. The data are
hard to interpret because top athletes might have different skeletal and muscular characteristics than
the average population even before beginning training. However, mechanical loading is shown to
increases bone mass, and with decreasing mechanical load, bone mass is lost. The relationship
between load and BMD is curvilinear and much more pronounced at low levels of loads. In completely
immobilized patients, bone mass loss may be up to 40% in 1 year. On the other hand, active people
who further increase their levels of physical activity may expect only modest gains in BMD. Optimal
bone metabolism is the result of hormonal, nutritional, and mechanical harmony, and a deficit in one
area is usually impossible to overcome by improvements in others. Chronic alcohol use has been
associated with decreased BMD in the femoral neck and lumbar spine and is commonly listed as a
risk factor for osteoporosis. Prevalence of osteoporosis in alcoholics is 28% to 52%. Other nutritional
deficiencies associated with chronic alcohol abuse play an important role in development of
osteoporosis in alcoholics. Smoking is often associated with alcoholism and is an independent risk
factor for low bone mass. Smoking affects peak bone mass development and accelerates bone loss.
Among several medications, glucocorticoids are the most important cause of bone loss (mostly
trabecular). Fractures occur most commonly in vertebrae, ribs, and the ends of the long bones. Bone
loss occurs very rapidly and may be as high as 20% during the first year of steroid use. The incidence
of osteoporotic fractures in patients taking corticosteroids for more than 6 months is 30% to 50%.
The dose of steroid that is detrimental to BMD in most people appears to be more than 7.5 mg of
prednisone daily. Female sex hormones (estrogens) are mandatory for acquisition of the peak bone
mass and for maintenance of bone in women and men. Estrogen deficiency is considered a principal
cause of postmenopausal osteoporosis. It might play important role in male osteoporosis as well.
2. List 7 significant events in the study and history of orthopedics. (25 points)
Orthopedic surgery or orthopaedics (sometimes spelled orthopedic surgery and orthopedics) is
the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopaedic
surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, sports
injuries, degenerative diseases, infections, tumors, and congenital disorders.
a. Nicholas Andry coined the word "orthopaedics", derived from Greek words for "correct" or

"straight" ("orthos") and "child" ("paidion"), in 1741, when at the age of 81 he published
Orthopaedia: or the Art of Correcting and Preventing Deformities in Children. In the U.S. the
spelling orthopedics is standard, although the majority of university and residency programs,
and even the AAOS, still uses Andrys spelling. Elsewhere, usage is not uniform; in Canada,
both spellings are common; orthopaedics usually prevails in the rest of the Commonwealth,
especially in Britain.
b. In Egypt, splints have been found on mummies made of bamboo, reeds, wood or bark, padded
with linen. In ancient Greece, the works of Hippocrates detail the treatment for dislocations of
the shoulders, knees, and hips, as well as treatments for infections resulting from compound
fractures.
c. During the rise of Rome, Galen (129-199 BC), a Greek, became a gladiatorial surgeon. His

learning helped provide the best care possible for the Roman army. He is often referred to as
the father of modern medicine, and many of his techniques and teachings were standard
throughout the middle Ages. He studied the skeleton and the muscles that move it. He studied
the relationship of the brain' response from the nerves to the muscles.

"During this Graeco-Roman period, there were also attempts to provide artificial prostheses.
There are accounts of wooden legs, iron hands and artificial feet." - WorldOrtho.med
d. Jean-Andre Venel established the first orthopedic institute in 1780, which was the first hospital
dedicated to the treatment of children's skeletal deformities. He is considered by some to be
the father of orthopedics or the first true orthopedist in consideration of the establishment of
his hospital and for his published methods.
e. Antonius Mathysen, a Dutch military surgeon, invented the plaster of Paris cast in 1851.
f. Many developments in orthopedic surgery resulted from experiences during wartime. On the
battlefields of the Middle Ages the injured were treated with bandages soaked in horses' blood
which dried to form a stiff, but unsanitary, splint. Traction and splinting developed during World
War I...
g. Since WWII, treatments have evolved to include joint replacements, arthroscopy, and a whole
host of technologies.
3. Musculoskeletal disorders: types, causes, symptoms, treatment, and prevention. (25
points)
Musculoskeletal disorders (MSDs) consist of minor physical disabilities. This term is used to
describe a variety of conditions that affect the muscles, bones, and joints. The severity of the MSD
can vary. Pain and discomfort may interfere with everyday activities. MSDs are extremely common,
and your risk increases with age. Early diagnosis is the key to ease pain while potentially decreasing
further bodily damage.
a. TYPES:
MSDs can affect all major areas of the body, including the:

neck

shoulders

wrists

back (upper and lower)

hips

legs

knees

feet (American Academy of Orthopaedic Surgeons, 2009)

Given the different areas of the body that make up the musculoskeletal system, several other
diseases can produce significant musculoskeletal signs and symptoms. These other disorders
include:

low back pain

fibromyalgia

gout

osteoarthritis

rheumatoid arthritis

tendinitis
Some of these disorders can cause mild discomfort to debilitating pain.Low back pain is the most
common MSD.
b. CAUSES:
MSDs have a range of causes. The exact cause depends on your:

age

occupation

activity level

lifestyle
Certain types of activities can cause wear and tear overtime, which may lead to these types of
disorders. Just as frequent sports training can wear down a certain part of the body, so can sitting
down in the same position at a computer every day. Poor posture and lack of stretching can worsen
the effects of these types of activities.
According to the Bureau of Labor Statistics, the following professions experienced more
musculoskeletal problems than average in 2007:

attendants

delivery truck drivers

freight handlers

laborers

nursing aides

orderlies (BLS, 2008)

MSDs also increase with age. For this reason, many people believe that age directly causes these
types of conditions. Muscles, bones, and joints naturally break down with age, but getting old doesnt
mean youll automatically develop related medical disorders. In fact, according to the National
Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), low back pain typically starts
affecting adults in their 30s and 40s (NIAMS, 2012). By taking care of your body throughout
adulthood, you can potentially decrease your risk of developing musculoskeletal disorders as you
age.
c. SYMPTOMS:
Symptoms of musculoskeletal disorders can hamper everyday tasks, such as walking. You may notice
you have limited range of motion, as well as difficulties accomplishing your favorite activities. Call
your doctor if you experience:

recurrent pain

stiff, painful joints

swelling

dull aches
d. Treatment
Treating musculoskeletal disorders depends on the severity of your condition. Occasional pain may be
addressed with exercises as well as over-the-counter medications, such as ibuprofen or
acetaminophen. Never take these medicines without a doctors approval.
Advanced disorders may require different treatment approaches. Physical therapy and occupational
therapy can help you learn techniques to manage pain and discomfort during everyday activities.
Prescription medications may also be required to help reduce inflammation and pain.
e. Prevention

Preventive measures are the best ways to help prevent MSDs. These disorders arent common during
young adulthood, but your risk increases with age. This is why it is crucial to change your lifestyle
habits now to help avoid potential pain later. Regular strengthening exercises and stretching can help
keep bones, joints, and muscles strong. Also take care in the ways in which you complete everyday
activities. Maintain a tall posture to prevent back pain and be careful when picking up heavy objects.