Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2 PATHOPHARM > EXAM 1 (BONES) > Flashcards

EXAM 1 (BONES) Flashcards

1
Q

hematopoietic stem cells form both ____ and ____ cells.

A

form both blood and immune cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In adults, blood cells originate exclusively in the marrow cavities of the…

A

skull vertebrae, ribs, sternum, shoulders, and pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Bones have a crucial role in mineral homeostasis, particularly ____, ____, _____, and _____.

A

calcium, phosphate, carbonate, and magnesium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 3 Constituents of bone tissue

A

Cells (Osteoblasts, osteocytes, and osteoclasts)

Fibers: Fibers in bone lend support, strength, and the ability to stretch.

Ground substance: the background material within which all other connective tissue elements are embedded. It’s a gel like substance containing large carbohydrates and proteins. In skeletal tissue, the ground substance becomes mineralized by deposition of calcium salts, which develops into bone.

Crystallized minerals: particularly calcium, provide bone rigidity and compressive strength.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

the 3 types of cells found within bone tissue are

A

Osteoblasts, osteocytes, and osteoclasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

describe the function of Ground substance in skeletal tissue

A

the background material within which all other connective tissue elements are embedded. It’s a gel like substance containing large carbohydrates and proteins.

In skeletal tissue, the ground substance becomes mineralized by deposition of calcium salts, which develops into bone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the function of calcium in our bones

A

provide bone rigidity and compressive strength.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how do bone cells form bones

A

Starts with the production of BONE MATRIX which consists of ground substance, collagen, and other proteins

The next step in bone formation is CALCIFICATION. Minerals are deposited and then crystallize: Minerals bind tightly to collagen fibers, providing the ability to stretch, and it provides compressional strength, which allows it to withstand the pressure and weight bearing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

DEFINE Osteoblasts

A

Primary bone-producing cells

Respond to parathyroid hormone by producing osteocalcin (vitamin k dependent proteins) that promotes mineralization

Synthesize osteoid (nonmineralized bone matrix) and mineralize newly formed bone matrix

Express RANKL (controls breakdown of old bone cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define Osteocytes

A

Transformed osteoblasts that are surrounded in osteoid (unmineralized portion of bone) as it hardens from deposited minerals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe Osteoclasts

A

The major resorptive cells of the bone (breaks down old or damaged bone)

Assist the endocrine and renal systems in maintaining serum calcium and phosphorus levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 2 phases of bone mineralization

A

Formation of the initial mineral deposit (initiation)

Proliferation or accretion of additional mineral crystals on the initial mineral deposits (growth)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

____ Makes up bulk of bone matrix

A

Collagen fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

define Proteoglycans

A

Strengthen bone

Play role in bone calcium deposition and calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

the function of Bone albumin

A

maintains osmotic pressure of bone fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the 4 parts of the bone matrix

A

collagen fibers

proteoglycans (calcification)

glycoproteins (traffic directors)

bone minerals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what type of bone contains the haversian system

A

compact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how does your body maintain bone integrity

A

bone precursor cells (create osteoblast/clasts) line vascular channels and are on the free surfaces of bone and sense when there is injury to the bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the 3 phases of remodeling

A

Activation of the remodeling cycle
Resorption
Formation of new bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the 5 phases of bone repair

A

hematoma (clot) formation (hours)

procallus formation: fibrogartaligenic soft callus (days)

Callus formation: bony/cart forms a connective bridge across bone fracture during repair (weeks)

replacement: the multicellular units of top of bone turn into hardened lamellar or trabecular bone

remodeling: the osteoclasts/blasts remodel to the shape of bone before injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

define pathological fracture

A

a bone breaks that normally wouldn’t d/t osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the most common sites for osteoporosis related fractures

A

spine, femoral neck, and the wrist.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what two chemicals decrease bone reabsorption?

A

OPG and estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

glucocorticoids can cause ____

A

osteoporosis b/c it allows for the survival of osteoclasts AND suppresses osteoblasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

peak bone mass is reached at age ___

A

30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is the major determining factor of bone mass

A

heredity (responsible for up to 70%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

describe someone likely to experience osteoporosis

A

white/fair skin, thin, small stature, female, old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are early/late manifestations of osteoporosis? +

A

Early: pain

Late: bone deformities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

define kyphosis

A

hunched back and loss of height d/t vertical collapse from osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what are one of the only labs that would indicate osteoporosis?

A

Alkaline phosphatase (ALP) New bone growth/healing fracture = elevated ALP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the best way to diagnose osteoporosis

A

DXA (dual xray absorptiometry). Also use the TBS (trabecular bone score) measures how well/poorly structured the bone is

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How do you read a DXA score

A

Zero is normal. Goes up to 2.5, down to -2.5. The lower the negative number the worse the bone density. Unit is in “standard deviations”. Normal (zero) is what a healthy 30 year old bones look like

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

when would you use a Z-score instead of a DXA score?

A

when the pt is under the age of 30 and needs to be compared to what norm is for their own age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What bone disease results from vitamin d deficiency

A

OSTEOMALACIA (delayed or inadequate mineralization of osteoid). When forming bones, calcification doesn’t occur so bones are soft. Pts experience pain, bone malformation, fractures, and vertical collapse. Have to treat cause of vit d deficiency to fix. (cancer, HIV, kidney/liver disease, impaired GI absorption)

35
Q

What is the second most common bone disease after osteoporosis

A

Pageants disease (osteitis deformans) is the accelerated remodeling of spongy bone and deposition of disorganized bone. Makes bones LARGE AND SOFT. Pts tend to be asymptomatic. Treated with bisphosphonates.

36
Q

When a bone breaks, where does the hematoma form that will eventually turn into granular tissue

A

medullary canal

37
Q

What is procallus

A

a fibrocartilaginous callus that forms over both ends of a completely broken bone within a few days after injury

38
Q

if the pt does not participate in weight bearing activities after a procallus is formed between the broken bones, _____ can occur.

A

resorption

39
Q

What are the two methods of fracture healing

A

Direct/primary healing: screws and pins. no callus forms. healed by osteoclast/blast through intramembranous bone formation

Indirect/secondary healing: cast application

40
Q

If a pt’s fracture heals unaligned with eachother (displaced) then the doctor has to surgically ____ the site since it will likely break again if healed incorrectly.

A

reduce

41
Q

T/F: Immobilization without weight bearing helps heal a broken bone

A

False. without weight bearing movement to facilitate the remodeling process, the callused area will degrade. You do, however, need to keep it immobilized to preventing slow healing

42
Q

where does bruising usually occur after injury resulting in a fracture

A

distal to the fracture site

43
Q

T/F: Immediately after a fracture, the area will be numb

A

True, often nerve damage causes a feeling of numbness at the site of fracture for several minutes followed by extreme pain. If numbness continues, its indicative of an emergent complication.

44
Q

How can you tell the difference between an angular fracture and every other fracture?

A

Angular fractures happen in bones that are shaped weird (slightly curved/bent) and significant swelling that isn’t painful. The pain the pt will feel is generalized bone pain/ache.

45
Q

How do you treat a nondisplaced fracture?

A

immobilization with a splint/cast

46
Q

How do you treat a displaced fracture?

A

reduce the bones (traction or surgery/internal fixation) and hold them in place, immobilize

47
Q

What is the difference between skin and skeletal traction

A

Skin is used preop to tire muscles and decrease spasming

Skeletal you drill a pin through the skin into the bone distal to the fracture site and use traction via the pins.

48
Q

an immovable joint (Ex: skull)

A

synarthrosis

49
Q

a joint that is slightly movable (Ex; between the vertebrae)

A

amphiarthrosis

50
Q

A freely movable joint (ex: hip/shoulder)

A

diarthrosis

51
Q

bone-bone joint

A

fibrous joint. Ex: fibrous sutures between the fontanels of children become bone by adulthood

52
Q

bones connected by a ligament/membrane

A

syndesmosis joint: Ex: radius and ulna, tibia and fibia

53
Q

Bone fits into a socket perfectly and is connected by a ligament

A

gomphosis joint: Ex: teeth

54
Q

What are the 2 types of cartilaginous joints

A

symphysis (bones united by a pad/disc of FIBROCARTILIDGE. absorbs shocks and stabilizes Ex: discs between vertebrae)

synchondrosis (bones united by HYALINE CARTILEDGE. Between yours ribs/sternum provide ease of movement when breathing)

55
Q

What type of joint is the most common

A

synovial. Can move circular and angular

56
Q

What are the 3 types of synovial joint?

A

uni, bi, and multiaxial according to the shape of the bone’s end

57
Q

Define the joint/articular capsule

A

fibrous connective tissue around the end of the bones meeting in the joint. It has nerves, blood vessels, and lymphatic vessels. Nerves let you know the rate and direction of motion as well as compression, tension, vibration, and pain.

58
Q

Describe the synovial membrane of a joint

A

Its a smooth, delicate lining around the inside of the joint capsule and has 2 layers. The first layer (vascular intima) is the physical connective tissue and fat and the second (thin cellular intima) secrets WBC and lubricant.

59
Q

What is synovial fluid made of

A

Basically super filtrated plasma with hydralonic acid and WBCs floating around

60
Q

What is the most common age-related disease of the synovial joints

A

osteoarthritis

61
Q

define osteoarthritis

A

the damage/loss of articular cartilage, local inflammation, new bone formation around the joint, and bone changes underneath the articular Cartlidge where the bones meet. Also mild thickening of the synovial membrane thus the enlargement of the joint capsule

62
Q

which arthritis is from age/wear and tear

A

osteo

63
Q

Whats the difference between a genetic and epigenetic influence on risk of disease

A

genetics can’t be changed, epigenetics can be changed. Epigenetics come from the environment and force certain sleeper genes to be expressed, but these genes can turn back off.

64
Q

what causes irritation synovitis

A

joint mice (small pieces of osteophytes that break off the bone into the synovial cavity)

65
Q

describe the step by step process of osteoarthritis

A
  1. articular cartilage flakes off, longitude fissures appear
  2. subchondral bone unprotect b/c cartilage is thin
  3. subchondral bone becomes sclerotic (hard/dense)
  4. cysts develop on the subchondral bone
  5. Pressure builds up in the cysts until they explode into the synovial cavity
  6. Osteophytes grow all over random bits of cartilage and make weird looking bone structures around the joint
  7. The injured joint capsule adheres to the bones and limits movement
66
Q

describe the physiological process of the breakdown of articular cartilage

A

Proteoglycans (proteins that provide support/structure of the joint) become injured and can’t regulate the passing of synovial fluid in/out of cartilage. Too much fluid enters the cartilage which causes weight bearing movement to damage the cartilage.

Also interlukin-1 and tumor necrosis factor

Also cell signaling proteins cause collagen breakdown that destroys fibrils that give the joint it’s ability to absorb impact

67
Q

what are the clinical manifestations of osteoarthritis

A

worsened w/ activity and improves w/ rest. Morning stiffness that lasts no more than 30min. Joints may be tender w/ limited range of motion. NO SYSTEMIC MANIFESTATIONS

68
Q

herberden (distal) and bouchard (proximal) nodes are clinical manifestations of what disease

A

osteoarthritis

69
Q

The valgus (knees in) and varus (knees out) deformity are signs of what disease

A

osteoarthritis

70
Q

T/F: You can use various lab tests/biomarkers to dx osteoarthritis

A

false, except for erythrocyte sedimentation rate (ESR) may be increased, synovial fluid aspiration, and x-rays

71
Q

What would you do to treat osteoarthritis

A

Exercise, topical/oral NSAIDs, steroid injections, hyaluronic acid injections, glucosamine and chondroitin supplements

72
Q

what is the 1st line treatment for osteoarthritis

A

1st GEN NSAIDs (Ibuprofen). Inhibits COX-1 (ALL TISSUE/THINS BLOOD), AND COX-2 (INJURED TISSUE/STROKE MI)

Dont take lithium or SSRIs

73
Q

Whats the topical NSAID to know

A

Volatren/Diclofenac

74
Q

what are the 2nd gen nsaids to know

A

celecoxib/celebrex

Doesn’t touch COX -1 (for people w/ platelet/kidney/GI issues) and selectively inhibtis COX-2

75
Q

describe the pathophys of RA

A

your body is repeatedly exposed to an antigen that your body attacks until your body creates an abnormal IGG and IGM that attacks host cells instead of the antigen

76
Q

What are the two most common rheumatoid factors

A

IGG and IGM

77
Q

Describe the chain of evets that lead to RA Sx

A
  1. antigen triggers imune response in genetric prone indv
  2. T cells become activated. They make RANKL (increase osteoclast) and cytokines to attack infected cells. They start to activate B cells
  3. B cells get confused and attack our own tissue, causing injury to the joints PLUS cytokines degrading even more because they think its all infected
78
Q

what areas of the body does RA tend to affect the most?

A

Ulnar drift (wrist/hands curled, bent weirdly fingers). can also affect the heart, skin, lungs, and cause anemia. Also subcutneous nodules of the hands

MCP/PIP joints

79
Q

What are the clninical manifestations of RA

A

joints are soft, warm, stiff (greater than 30min when they wake up/pain is worst in the morning or long pds of inactivity) and swollen

INACTIVITY CAN IMPROVE PAIN

Can happen at any age although usually older women

80
Q

What is Pannus

A

Where vascular fibrous tissue grows between two bones where the joint usually is, usually resulting in the fusion of bones together (bony ankolosis). This can completely immobilize the joint.

81
Q

What tests can you use to Dx RA

A

Elevated ESR, Presence of Rh factor (abnormal IGG/IGM), increased titers for antinuclear antibodies

82
Q

what does an RA pt’s synovial fluid look like

A

cloudy, contains fibrin flex, enzyme MMP-3, increase WBC

83
Q

describe Ankylosing Spondylitis

A

Inflammatory joint disease of the spine or sacroiliac joints causing stiffening and fusion of the joints

84
Q

describe Gout

A

Inflammatory response to excessive quantities of uric acid
Blood (hyperuricemia)
Other body fluids, including synovial fluid

Elevated levels lead to formation of monosodium urate crystals in joints
Cause acute, painful inflammation
Joint damage: gouty arthritis

2 PATHOPHARM (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions