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Clinical Labs And Lectures > Cartilage Response To Injury Lecture > Flashcards

Cartilage Response To Injury Lecture Flashcards

1
Q

What type of cartilage is articular cartilage and where is it located

A

Joint surfaces, hyaline cartilage

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2
Q

Articular cartilage composition

A

70-80% water
Chondrocytes
Hyaline cartilage ECM

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3
Q

Type 2 collagen

A

Alpha chains are wound together in a triple helix
Large fibrilar structures
Arrange into arcade structure
Different that collagen in other locations

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4
Q

Normal cartilage is

A

Smooth, gray-white, glistening

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5
Q

Purpose of articular cartilage

A

Low friction gliding surface
Transmits weight bearing forces to underlying bone
Can withstand high cyclic loads

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6
Q

Injury to articular cartilage can be due to 2 things

A

Abnormal loading
Biochemical damage

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7
Q

Abnormal loading

A

Cyclic trauma
Direct, single overload trauma

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8
Q

Biochemical damage of articular cartilage

A

Joint inflammation, no direct trauma

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9
Q

Canine hip dysplasia

A

Improper alignment of the femoral head within acetabulum, increasing laxity

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10
Q

3 mutations in hip dysplasia

A

Mutations in formation of glycoprotein, proteoglycans, and fibrilar structure

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11
Q

Canine hip dysplasia is abnormal mechanical stress and vulnerability of tissues. This damages the …..

A

Articular cartilage

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12
Q

Joint homeostasis involves 2 processes

A

Anabolic synthesis and catabolic degradation

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13
Q

Injury starts cascade of inflammation and an increase in

A

Catabolism, degradation

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14
Q

In injury, chondrocytes are activated by

A

Stress

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15
Q

These cells act as their own inflammatory mediators

A

Chondrocytes

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16
Q

Injury causes the release of ……

A

Cytokines

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17
Q

Cytokines and examples

A

Modulate synthesis of catabolic enzymes
IL-1 beta, TNF alpha

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18
Q

Catabolic enzymes

A

MMP, Aggrecanase, IL-1

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19
Q

Catabolic enzymes are released by chondrocytes. The enzymes that breakdown collagen are

A

MMP which degrades the ECM

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20
Q

Chondrocytes release catabolic enzymes. The enzymes that break down proteoglycan are

A

Aggrecanase

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21
Q

Catabolic enzyme functions for cartilage injury

A

Collagen breakdown, proteoglycan breakdown, degradation of ECM

22
Q

Physical articular cartilage injury steps (5)

A

Abnormal stress to normal cartilage (trauma)
Direct damage to chondrocytes and collagen
Release of catabolic enzymes that degrade PG and collagen
Decreased synthesis of matrix (compaction)
Cartilage damage (degeneration and thinning)

23
Q

Biochemical articular cartilage steps (4)

A

Inflammation of surrounding tissues from age or use
Release of catabolic enzymes that degrade PG and collagen
Decreased synthesis of matrix
Cartilage damage

24
Q

Tissue repair involves 2 things

A

Replacement of damage cells and matrix
Regeneration

25
Q

General phases of tissue healing

A

Inflammation
Repair
Remodel

26
Q

Inflammation step of tissue healing
Type of response?
How long?
Infiltration of?
What repairs?

A

Vascular response
3-5 days
Cellular infiltration (debridement)
Scaffold for repair

27
Q

Repair step of tissue healing
Infiltration of?
What type of response?
How long?

A

Infiltration of cells, particularly fibroblasts
Local cellular response
2 days - 2 weeks

28
Q

Remodeling step of tissue healing
Removal of?
How long?

A

Removal of inferior tissue + replacement
2 weeks - 1 year +

29
Q

How is the inflammatory phase a problem for cartilage injury response

A

Cartilage is avascular, so there is no blood supply
No scaffold repair and no cellular infiltration

30
Q

How is repair phase limited in cartilage injury response

A

No he;p with matrix synthesis by cellular infiltration since it is avascular

31
Q

Larger defects of cartilage are filled with

A

Fibrocartilage

32
Q

Problems with large defects being filled with fibrocartilage in cartilage injury response

A

Fibrocartilage has less gag and mostly collagen 1 so it is biochemically inferior which reduces function

33
Q

Exclusive cartilage injury response step by step: trauma

A

Local death of chondrocytes and matrix loss

34
Q

Exclusive cartilage injury response step by step: inflammation

A

No vascular infiltration
No cellular infiltration
No fibroblasts response to help healing

35
Q

Exclusive cartilage injury response step by step: local repair

A

Local chondrocytes fill defect
Increased mitotic activity
Increased production of collagen and PG

36
Q

Exclusive cartilage injury response step by step: remodeling

A

Incomplete, lesion remains

37
Q

Complete repair in cartilage is …

A

Rare

38
Q

Intrinsic cartilage repair

A

No vascular ingrowth
Relies on chondrocytes

CARTILAGE ONLY

39
Q

Matrix flow

A

Forms lips of cartilage from perimeter that migrate towards center of defect
Can only heal small defects
Surface chondrocytes are more fibroblast-like
Fibrocartilage is added to large defects

CARTILAGE ONLY

40
Q

Extrinsic cartilage repair

A

Vascular ingrowth from surrounding tissue
Mesenchymal elements from subchondral bone
Helps form new connective tissues

41
Q

Articular cartilage repair 3 steps

A

Intrinsic repair
Matrix flow
Extrinsic repair

42
Q

2 main limitations of cartilage repair

A

Avascular
Inferior repair tissue

43
Q

Osteoarthritis

A

Articular cartilage damage and degeneration
Effects entire joint
Can start with injury to any part of the joint

44
Q

Cartilage is part of a joint and the joint is an …

A

Organ

45
Q

Gross features of early cartilage degeneration

A

Thinning, surface dullness and roughness

46
Q

Histological features of early cartilage degeneration

A

PG loss with matrix contraction and clefts
Chondrocyte necrosis and loss

47
Q

Progressive cartilage degeneration histological features

A

Larger areas of Chondrocyte loss
Development of Chondrocyte clones, chondrones
Loss of type 2 collagen in superficial to mid layers (goes to mid to deep layers)

48
Q

Advanced cartilage degeneration gross features

A

Severe thinning and score lines
Yellow discoloration
Erosion, ulcers, subchondral hemorrhage

49
Q

Advanced cartilage degeneration histological features

A

Matrix fibrillation (fraying)
Development of vertical fissures
Erosions
Loss of hyaline articular cartilage

50
Q

End stage cartilage degeneration histological and gross features

A

Ulcers and subchondral bone hemorrhage

Clinical Labs And Lectures (1 decks)

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