2MBChB Musculoskeletal Physiology: Joint Physiology

Question 1

Types of joints

Answer 1

Fibrous, cartilaginous, synovial (For Christ’s Sake)

Question 2

Another name for fibrous joint

Answer 2

Synarthrosis

Question 3

Another name for cartilaginous joint

Answer 3

Amphiarthrosis

Question 4

Example of fibrous joint

Answer 4

Skull

Question 5

Example of cartilaginous joint

Answer 5

Intervertebral discs, pubic symphysis, costochondral joint

Question 6

Another name for synovial joint

Answer 6

Diarthrosis

Question 7

Tendons connect ___ to ___

Answer 7

Bone to muscle

Question 8

Ligaments connect ___ to ___

Answer 8

Bone to bone

Question 9

Joint lubrication is provided by ___, ___ and ___?

Answer 9

Cartilaginous interstitial fluid, synovium-derived hyaluronic acid (mucin), synovium-derived lubricin

Question 10

Normal synovial fluid is high / low viscosity? Why?

Answer 10

High viscosity = Less fluid; Due to hyaluronic acid (mucin)

Question 11

When joints are moved rapidly, how does synovial fluid change in viscosity and elasticity?

Answer 11

Less viscous (more fluid) and more elastic

Question 12

Which has a darker colour - normal or inflammatory synovial fluid?

Answer 12

Inflammatory synovial fluid is straw yellow; normal is colourless

Question 13

Normal vs Inflammatory synovial fluid: transparency?

Answer 13

Normal = Transparent
Inflammatory = Translucent

Question 14

Components and proportions of extracellular matrix of articular hyaline cartilage?

Answer 14

70% water
20% type II collagen
10% proteoglycans

Question 15

Name a type of proteoglycan

Answer 15

Glycosaminoglycan (GAG); e.g. chondroitin sulphate

Question 16

What comprises cartilage? Proportions?

Answer 16

98% extracellular matrix

2% chondrocytes

Question 17

What do catabolic factors of cartilage matrix turnover do?

Examples?

Answer 17

(a) Stimulate proteolytic enzymes
(b) Inhibit proteoglycan synthesis

Examples:

(a) Tumour necrosis factor (TNF)
(b) IL-1

Question 18

What do anabolic factors of cartilage matrix turnover do?

Examples?

Answer 18

(a) Stimulate proteoglycan synthesis
(b) Counteract effects of IL-1

Examples:

(a) Tumour growth factor, TGF-β
(b) Insulin-like growth factor, IGF-1

Question 19

Markers of keratin degradation / breakdown?

Answer 19

(a) Serum and synovial keratin sulphate

(b) Type II collagen in synovial fluid

Question 20

Due to age and repeated wear and tear, the composition and function of cartilage and synovium will deteriorate. This gives rise to?

Answer 20

Osteoarthritis

Question 21

Synovial cell proliferation and inflammation gives rise to?

Answer 21

Rheumatoid arthritis

Question 22

Deposition of salt crystals gives rise to?

Answer 22

Gouty arthritis

Question 23

Injury and inflammation to periarticular structures gives rise to?

Answer 23

Soft tissue rheumatism

Question 24

2 differences between gouty arthritis and pseudo-gout?

Answer 24

Gout has needle-shaped crystals of uric acid

Pseudo-gout has rhomboid-shaped crystals of calcium pyrophosphate