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Equine BCM Lecture > DJD > Flashcards

DJD Flashcards

1
Q

(T/F) Normal joint motion is pain-free, follows a prescribed range of motion, and is virtually frictionless.

A

(T)

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2
Q

(T/F) Normal joint motion is controlled by muscles and tendons and is repeatable.

A

(T)

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3
Q

In what two locations of the body are menisci used in joints?

A

(The stifle and the TMJ)

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4
Q

The term osteoarthritis is a term that represents a group of disorders that are characterized by what three things?

A

(Deterioration of articular cartilage, changes in the subchondral bone, and changes in soft tissue of joints)

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5
Q

(T/F) Natural repair processes of articular cartilage by adjacent tissues are incapable of producing tissue with morphological, biochemical and biomechanical properties of articular cartilage.

A

(T, cartilage defect → fibrous tissue → fibrocartilage (not the same as original cartilage))

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6
Q

The chondrocyte response to biomaterial failure as a result of trauma is to degrade a repair what they can but that results in what pathology?

A

(Chronic synovitis)

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7
Q

A joint will form enthesophytes and osteophytes to try to fuse a joint that is causing pain due to injury but that only works in high/low (choose) motion joints.

A

(Low)

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8
Q

What histopathologies occur in the synovial membrane in osteoarthritis?

A

(Synovial lining hyperplasia, villous hyperplasia, inflammatory cell infiltration of subintima, and fibrosis)

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9
Q

If a synovial insult or injury occurs, synoviocytes will release what substances?

A

(Lysosomal enzymes, PGE2, free radicals, and cytokines)

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10
Q

What are the sources of pain associated with synovial insults/injuries?

A

(There are pain receptors in the capsule itself so triggering of those leads to pain but also the increase in intraosseous pressure leads to pain)

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11
Q

Why is articular cartilage that is undergoing degradation discolored?

A

(Because of the loss of proteoglycan, instead of nice pale white it will start to turn yellow)

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12
Q

What types of strength that articular cartilage provides a joint are reduced when that cartilage is degraded?

A

(Compressive and tensile strength)

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13
Q

What is the main purpose of chondrocytes in the joint?

A

(Controlling the turnover over the extracellular matrix of articular cartilage)

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14
Q

The turnover of the extracellular matrix of articular cartilage by chondrocytes is controlled by what?

A

(The local environment so cytokines present and mechanical stimuli)

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15
Q

Pair the following cytokines to the metabolic pathway they trigger when present in the joint:

IGF and TGF

A - Anabolic
B - Catabolic
C - Regulation of catabolism

A

(A)

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16
Q

Pair the following cytokines to the metabolic pathway they trigger when present in the joint:

IL-1, TNF-a, IL-17 and prostaglandins

A - Anabolic
B - Catabolic
C - Regulation of catabolism

A

(B)

17
Q

Pair the following cytokines to the metabolic pathway they trigger when present in the joint:

IL-10, IL-4, IL-6, IL-13

A - Anabolic
B - Catabolic
C - Regulation of catabolism

A

(C)

18
Q

How does subchondral bone adapt to repetitive cyclic loading?

A

(By becoming thicker)

19
Q

What subchondral bone changes are seen in relation to osteoarthritis?

A

(Subchondral bone sclerosis, subchondral cystic lesions (d/t vascular infiltration or focal osteonecrosis), and periarticular osteophyte formation)

20
Q

What are the two essential clinical features of osteoarthritis that are the main reason it is treated?

A

(Pain and loss of function)

21
Q

What are nonsteroidal anti-inflammatory options for treatment of inflammation secondary to trauma or degraded cartilage products in osteoarthritis?

A

(Phenylbutazone, flunixin meglumine, firocoxib, diclofenac sodium, acetaminophen)

22
Q

What is the purpose of Adequan (an IM injectable polysulfated glycosaminoglycan)?

A

(Stimulates synoviocytes to produce hyaluronic acid, stimulates chondrocytes to produce proteoglycans and collagen, and inhibits metalloproteases)

23
Q

Why is pain relief associated with corticosteroid intra-articular injections both an advantage and a disadvantage?

A

(Pain relief is an advantage but also a disadvantage because it can hides big issues like fractures)

24
Q

How does intra-articular corticosteroid usage improve cartilage nutrition?

A

(By controlling severity of synovitis → enables return of normal synovial fluid properties and improves fluid exchange within the joint)

25
Q

What is an important differential diagnosis for post-injection flare symptoms (heat, pain, swelling, and lameness that occurs 8-24 hours post-injection of corticosteroids)?

A

(Joint infection)

26
Q

What is thought to enhance the positive effects of corticosteroid intra-articular injections so they are often combined (though this has not been studied)?

A

(Hyaluronic acid)

27
Q

What is the primary adverse effect of IA polysulfated glycosaminoglycans that IA HAs do not have?

A

(Increased chance of infection → increased minimum inhibitory concentration of abx effective in vitro against S. aureus, don’t use with steroids)

28
Q

What does IRAP stand for?

A

(Interleukin-1 receptor antagonist → competes with IL-1 for binding and IL-1 is one of the main actors for bad OA)

29
Q

The primary goal of arthroscopic techniques for repairing cartilage is enhancement of what the body is already doing to repair the tissue either by increasing the quantity or quality of the repair tissue, how is that accomplished?

A

(Local manipulation or cell/tissue transplantation)

30
Q

What are the advantages and disadvantages of a chondroplasty for partial thickness defects?

A

(Advantages → removal of loose tissue and reduction of further exfoliation which will prevent further synovitis, disadvantage → no long term improvement)

31
Q

Is a partial or full thickness defect in articular cartilage going to induce an improved healing response?

A

(Full thickness, will trigger extrinsic repair which entails mesenchymal tissue inflow from subchondral bone, partial thickness defects only trigger an intrinsic repair)

32
Q

What arthroscopic surgical technique can be utilized to aid extrinsic repair efforts?

A

(Making microfractures in the subchondral bone → better quality of fibrocartilage healing, increased type II collagen)

33
Q

If you can make sure that your surgical approach to arthrodesis is very stable, it can decrease the time the horse needs to be in a cast, why is that a good thing?

A

(Less chance of secondary issues due to casting such as wounds/pressure sores and a shorter hospital stay)

Equine BCM Lecture (16 decks)

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