Pathophysiology Osteoporosis

Increased acceleration in bone loss because of the loss of natural estrogen

Women whose ovaries have stopped functioning, such as women being treated for the  prevention and treatment of  ovarian and  breast cancer 

Declining testosterone levels

Genetic factors (60% - 80%)

Thyrotoxicosis Hyperparathyroidism Anorexia nervosa Cushing’s syndrome Long term use of  medications such as thyroid hormone, anticonvulsants, furosemide and corticosteroids History of low-trauma fracture in a 1 st degree relative

Low body weight (less than about 128 lbs) Current cigarette smoking Impaired vision Dementia Poor health/frailty Recent falls Inadequate physical activity Low intake of dietary calcium (lifelong) Suboptimal levels of serum vitamin D Alcohol in amounts of more than two drinks per day Personal Personal histor histor of fracture fracture

Increased duration of bone loss

Change in bone architecture

Aging of bone tissue

Accumulation of  microdamage

Thinning of bone cortex

Marked weakness of bones

Progressive bone deformities

Fracture

Functional disability

Physical immobility Shortened stature

Compression fracture for  vertebral deformities

Progressive dorsal kyphosis Pain accompanied by skeletal fractures Resting of lower ribs on iliac crest

Downward  pressure on viscera

Restricted lung expansion

Impaired respiration

Abdominal distention and  bloating

Pain Generalized hypoxia

Anoxia

DEATH

DEVELOPMENT OF DECUBITUS ULCERS

Aging

Osteoporosis

Physical immobility

Aging

Decrease in circulation

Incontinence

Decreased nutrients to  periphery

Moisture

Skin maceration Restricted movements Fixed position Displacement of tissue

External pressure Friction Shearing force Skin breakdown

Disruption of blood flow to capillary  beds and arterioles Stretching or rupture to blood vessels

Edema, autolysis of cells

Tissue ischemia

Decubitus ulcer 

Worsening of tissue injury

Increased depth of wound Tunneling / fistulas

Infection

Systemic sepsis

DEATH

Decubitus ulcer