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241 A&P > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

i. Contains no blood vessels or nerves

ii. Surrounded by the perichondrium (dense irregular CT) that resists outward expansion

A

Skeletal Cartilage

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2
Q

a. Provides support, flexibility, and resilience
b. Most abundant skeletal cartilage
c. Present in these cartilages
i. Articular – covers the ends of long bones
1. Form a joint
ii. Costal – connects the ribs to the sternum
iii. Respiratory – makes up larynx; reinforces air passages
iv. Nasal - supports the nose

A

Skeletal Cartilage

Hyaline

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3
Q

a. Similar to hyaline cartilage
i. BUT contains more elastic fibers
ii. Found in
1. External ear
2. Epiglottis

A

Skeletal Cartilage

Elastic

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4
Q

a. Highly compressed
b. Great tensile strength
c. Contains collagen fibers – Really thick, can see them
d. Found in
i. Menisci of the knee
ii. Pubic symphysis
iii. Glenoid (shoulder)
iv. Acetabular labrum (hip)
v. Intervertebral discs
e. Located in places that take a LOT of compression

A

Skeletal Cartilage

Fibrocartilage

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5
Q

Appositional Growth
Insterstitial Growth
Calcification/Ossification

A

Types of growth in cartilage

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6
Q

i. Cells in the perichondrium secrete matrix against the external face of existing cartilage
ii. Grows to the side and outward

A

Appositional Growth

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7
Q

i. Lacunae bound chondrocytes inside the cartilage divide and secrete new matrix,
ii. expanding the cartilage from within.

A

Interstitial Growth

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8
Q

i. During normal bone growth
1. Increases length and width of the bone
ii. During old age
1. Decreases flexibility at the joints

A

Calcification/Ossification

growth of cartilage

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9
Q

Axial Skeleton

Appendicular Skeleton

A

Major regions of skeleton

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10
Q

i. Bones of skull
ii. Vertebral column
iii. Rib cage

A

Axial region of skeleton

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11
Q

i. Bones of upper limbs
ii. Lower limbs
iii. Shoulder
iv. Hip

A

Appendicular region of skeleton

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12
Q

a. Support – form the framework that supports the body and cradles soft organs
b. Protection – provide a protective case for the brain, spinal cord, and vital organs
c. Movement – provide levers for muscles
d. Mineral storage – reservoir for minerals, especially calcium and phosphorus
e. Blood cell formation – hematopoiesis occurs within the red marrow cavities of bones

A

5 important functions of bones

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13
Q

Long
Short
Flat
Irregular

A

Classifications of bones based on shape

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14
Q

Bone shape - longer than they are wide

Ex: Humerus

A

Long bones

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15
Q

Bone shape - Cube shaped bones of the wrist and ankle

A

Short bone shape

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16
Q

Bone shape - thin, flattened, and a bit curved

i. Eg. Sternum
ii. Most skull bones

A

Flat bone

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17
Q

Bone shape - bones with complicated shapes

i. Ex: vertebrae
ii. Pelvis bone

A

Irregular bone shape

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18
Q

bone-forming cells

A

osteoblasts

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19
Q

mature bone cells

A

osteocytes

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20
Q

large cells that resorb or break down bone matrix
As bone resorbed, minerals released into blood
Similar to macrophage

A

osteoclasts

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21
Q

mitotic cartilage cells

A

chondroblasts

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22
Q

more mature cartilage cells

A

chondrocytes

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23
Q

i. Sites of Muscle and Ligament Attachment

bone marking

A

Projections

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24
Q

i. Lets things go through?
ii. Or hold up against?
iii. Conduit/canal for blood vessels and nerves
(bone marking type)

A

Depressions/Openings

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25
Q

One bone type is the dense outer layer; a.k.a. cortical bone

The other is honeycomb of trabeculae filled with bone marrow aka: woven bone, trabecular bone, cancellous bone

A

Compact Bone

Spongy Bone

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26
Q

Contains:
Diaphysis
Epiphyses

A

Long Bone

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27
Q
  1. Tubular shaft that forms the axis of long bones
  2. Composed of compact bone (cortical bone) that surrounds the medullary cavity
    a. Yellow bone marrow (fatty) contained in medullary cavity
A

Long Bone

Diaphysis

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28
Q
  1. Expanded ends of the long bones
  2. Exterior is compact bone
  3. Interior is spongy bone
  4. Joint surfaces are covered with articular (hyaline) cartilage& perichondrium
  5. Epiphyseal Plate
  6. Epiphyseal Line
A

Long Bone

Epiphyses

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29
Q

Part of the Long Bone

a. Active hylaine Cartilage
b. Separates diaphysis from epiphyses until end of puberty
c. Ossifies –> growth ceases –> epiphyseal line

A

Epiphyseal Plate

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30
Q

Part of Long Boone

a. Detected on x-ray
b. Separates the diaphysis from the epiphyses after growth in length stops
c. The epiphyseal plate has been ossified. (after long bone growth stops)

A

Epiphyseal Line

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31
Q
  • Bone Membrane
  • Double layered protective membrane
    1. Outer fibrous layer – Dense Irregular Connective Tissue
    2. Inner Osteogenic (new) layer composed of osteoblasts and osteoclasts
    3. Richly supplied with nerve fibers
    a. This is the source of pain during bone fractures and bone bruises
    4. Supplied with blood and lymphatic vessels, which enter the bone via nutrient foramina
    a. A hole
    5. Secured to the underlying bone by Sharpey’s fibers
A

Periosteum

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32
Q
  1. VERY delicate membrane covering internal medullary surfaces of bones
  2. Also osteogenic
A

Endosteum

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33
Q

Bones that form within tendons

Example includes the patella

A

Sesamoid bones

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34
Q

Bone Marking

rounded projection

A

Tuberosity

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35
Q

Bone Marking

narrow, prominent ridge of bone

A

Crest

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36
Q

Bone Marking

large, blunt irregular surface

A

Trochanter

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37
Q

Bone Marking

narrow ridge of bone

A

LineS

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38
Q

Bone Marking

small rounded projection

A

Tubercle

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39
Q

Bone Marking

Raised area above a condyle

A

Epicondyle

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40
Q

Bone Marking

Sharp, slender projection

A

Spine

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41
Q

Bone Marking

Any bony prominence

A

Process

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42
Q

Bone Marking

bony expansion carried on a narrow neck

A

Head

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43
Q

Bone Marking

Smooth, nearly flat articular surface

A

Facet

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44
Q

Bone Marking

Rounded articular projection

A

Condyle

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45
Q

Bone Marking

Arm like bar of bone

A

Ramus

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46
Q

Bone Marking

Canal like passageway

A

Meatus

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47
Q

Bone Marking

Cavity within a bone

A

Sinus

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48
Q

Bone Marking

Shallow, basin like depression

A

Fossa

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49
Q

Bone Marking

Furrow

A

Groove

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50
Q

Bone Marking

Indentation at the edge of a structure

A

Notch

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51
Q

Bone Marking

Narrow, slit like opening

A

Fissure

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52
Q

Bone Marking

Round or oval opening through bone

A

Foramen

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53
Q

i. Thin plates of periosteum-covered compact bone on the outside with endosteum-covered spongy bone (known as diploe) on the inside
ii. Have no diaphysis or epiphyses
iii. Contain red (hematopoietic) bone marrow between the trabeculae

A

Short/Flat/Irregular Bone Structure

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54
Q

i. Infants
1. Found in medullary cavity and every bone’s spongy bone
Childhood - red marrow slowly replaced by yellow marrow
ii. Adults
1. Only found in the diploe of flat bones
2. Head of the femur
3. Head of the humerus

A

Location of Hematopoietic Tissue (Red Marrow)

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55
Q

The structural unit of COMPACT bone

A

Osteon

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56
Q

Made of
LAmellae
Haversian canal
Volkmann’s canals

A

Osteon - structural unit of compact bone

Microscopic Structure of Compact Bone

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57
Q

a. Weight bearing, column-like matrix tubes
i. Composed mainly of collagen
ii. Osteon lamellae + interstitial lamellae + circumferentiale lamellae

A

Microscopic Structure of Compact Bone

Lamellae - Osteon

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58
Q

a. Central canal

b. Central channel containing blood vessels and nerves

A

Microscopic Structure of Compact Bone
Haversian canal
Osteon

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59
Q

Microscopic Structure of Compact Bone
a. Channels lying at right angles to the central canal
b. Connecting blood and nerve supply of the periosteium to that of the Haversian canal
Perpendicular to the Haversian canal

A

Microscopic Structure of Compact Bone

Volkmann’s canals

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60
Q

Microscopic Structure of Compact Bone

  1. Small cavities in bone that contain osteocytes
  2. Osteocytes – mature bone cells
A

Lacunae

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61
Q

Microscopic Structure of Compact Bone
1. Hair-like canals that connect lacunae to each other and the central canal
allow osteocytes to share nutrients and communicate

A

Cannaliculi

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62
Q

composed of proteoglycans, glycoproteins, and collagen

A

Un-minzeralized bone matrix composition

Osteoid

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63
Q 
Osteoblasts
Osteocytes
Osteoclasts
Osteoid
The *LIVING* part of the bone
A

Organic Composition of Bone

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64
Q

i. Hydroxyapatites
1. Mineral salts
2. 65% of bone by mass
3. Primarily calcium phosphates
4. Responsible for
a. Bone hardness
b. Resistance to compression

A

Inorganic Composition of BOne

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65
Q
  1. The process of bone tissue formation, which leads to:
    a. Formation of bony skeletons in embryos
    b. Bone growth until early adulthood
    c. Bone thickness
    d. Bone remodeling
    e. Bone repairing
A

Osteogenesis and Ossification

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66
Q

Bone Growth

a. “Within the membrane”
b. Formation of most of the flat bones of skull, the mandible, and part of clavicles
c. Recall the fibrous connective tissue membranes are formed by the mesenchyme cells

A

Intramembranous Ossification

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67
Q

a. Ossification center appears in the fibrous connective tissue membrane
i. This fibrous membrane is actually Dense Irregular CT
b. Bone matrix (osteoid) is secreted within the fibrous membrane
c. Bone (diploe) and periosteum form
d. Bone collar of compact bone forms and red marrow appears
e. In babies, this continues for awhile. The babies have soft spots of dense irregular connective tissue. Will continue to make bone

A

Stages of Intramembranous Ossification

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68
Q
  1. Bones form by replacing hyaline cartilage
  2. Formation of all long bones and most other bones of the body EXCEPT FLAT
  3. Uses hyaline cartilage templates or “models” for bone construction
  4. Requires the breakdown of hyaline cartilage prior to ossification
A

Endochondral Ossification

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69
Q

a. Primary ossification center develops in center of hyaline template
the epiphyseal cartilage on side closest to epiphysis is relatively INACTIVE.
b. Formation of periosteal (osteoid) bone collar
c. Calcification and Cavitation of the diaphysis hyaline cartilage
d. Invasoin of internal cavities by the periosteal bud, and spongy bone formation
e. Diaphysis elongates and medullary cavity forms
i. Plus the appearance of secondary ossification centers in the epiphyses
f. Ossification of the epiphyses, with hyaline cartilage remaining only in the epiphyseal plates

A

Endochondral Ossification

Steps

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70
Q

i. Cartilage continually grows and is replaced by bone
ii. Cartilage on the side of the epiphyseal plate closest to the epiphysis is relatively inactive
iii. Cartilage abutting the diaphysis (shaft) of the bone organizes into a pattern that allows fast, efficient growth
iv. Cells of the epiphyseal plate closest to the diaphysis form 3 functionally different zones
1. Growth
2. Transformation
3. Osteogenic

A

Growth in LENGTH of Long Bones

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71
Q

i. Appositional Growth – Bone is added by osteoblasts at the periosteal surface and resorbed by osteoclasts at the endosteal surface
ii. Allows for thicker, stronger bones without becoming too heavy.
1. How we remodel from fetal bone shape to adult bone shape.

A

Growth in WIDTH of Long Bones

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72
Q

i. Epiphyseal plate activity is stimulated by Growth Hormone

A

Hormones/Nutrients in Reg of Bone Growth/Maintenance

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73
Q

i. Testosterones and Estrogens
1. Initially promote adolescent growth spurts
2. Cause masculinization and feminization of specific parts of the skeleton
3. Later induce epiphyseal plate closure, ending longitudinal bone growth

A

Puberty Bone Growth and Maintenance

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74
Q

Gigantism

A

Bone Growth and Maintenance

Too much Growth Hormone

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75
Q

Pituitary Dwarfism

A

Bone Growth and Maintenance

Too Little Growth Hormone

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76
Q

a. When adjacent osteoblasts and osteoclasts deposit and resborb bone at periosteal and endosteal surfaces, respectively
1. Osteoblasts
a. Deposit bone at periosteal and endosteal surfaces
2. Osteoclasts
a. Resorb bone at periosteal and endosteal surfaces

A

Bone remodeling

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77
Q

i. Occurs where bone is injured or added or where added strength is needed
ii. Sites of new matrix deposition (By osteoblasts) are revealed by the

A

Bone Deposition

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78
Q

un-mineralized band of bone matrix

abrupt transition zone between the osteoid seam and the older mineralized bone

A

Osteoid seam

Calcification front

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79
Q

One week to calcify

A

osteoid

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80
Q
  1. Diet rich in
    a. Protein
    b. Vitamins
    i. A
    ii. C
    iii. D
    iv. K2
    c. Calcium
    d. Phosphorus
    e. Magnesium
    f. Manganese
  2. Poor nutrition = weak bones and poor fracture healing
  3. Alkaline phosphatase is essential for the mineralization of bone
  4. Also mechanical stimulation (gravity loading)
A

Dietary Requirements for Calcification

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81
Q

i. Accomplished by osteoclasts
1. Essentially mobile phagocytes
ii. Resorption bays - grooves formed by osteoclasts as they break down bone matrix
iii. Resorption involves osteoclasts secretion of
1. Lysosomal enzymes that hydrolyze the organic matrix
2. Acids that convert calcium salts into soluble forms
iv. Dissolved matrix is transcytosed (“across the cell”) acorss the osteoclasts’s cell where it is secreted into the interstitial fluid and then into the blood
v. Osteoclasts then undergo apoptosis
1. Cell death

A

How does bone resorption work?

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82
Q

a. Body will add/remove as needed
i. Transmission of nerve impulses
ii. Muscle contraction
iii. Blood coagulation (clotting)
iv. Secretion by glands and nerve cells (neurotransmitters)
v. Cell division (mitosis/meiosis)
b. Homeostatic Mechanisms
i. Rising Blood calcium levels trigger the thyroid to release calcitonin
1. Stimulates calcium salt deposit in bone
ii. Falling Blood Ca levels triggers the parathyroid gland to release PTH
1. Signals osteoclasts to degrade bone matrix and relase Ca into the blood

A

Hormonal Mechanism/Control Loop to maintain Calcium homeostasis in the body

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83
Q

a. “a bone grows or remodels in response to the forces or demands placed upon it”
b. Few observations supporting this include
i. Long bone compact bone is thickest midway along the shaft
1. Where bending stress is greatest
ii. Curved bones are thickest where they are most likely to buckle
iii. Handedness (R or L) results in bones being larger in the dominant upper extremity
iv. Bony projections are largest where heavy, active muscles attach
c. Clinically used to maximize the healing of fractures.

A

Wolff’s law

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84
Q
  1. Bones retain their normal position
  2. Bone ends are out of normal alignment
  3. Bone is broken all the way through
  4. Bone is not broken all of the way through
A

i. Non-displaced Fracture
ii. Displaced Fracture
iii. Complete Fracture
iv. Incomplete Fracture

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85
Q
  1. The tracture I parallel to the long axis of the bone

2. Found often in prison escapees

A

Linear fracture

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86
Q
  1. Think perpendicular

2. The fracture is perpendicular to the long axis of the bone

A

Transverse

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87
Q

i. Comminuted
ii. Compression
iii. Spiral
Epiphysea
iv. Depressed
v. Greenstick

A

Common Types of Fractures

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88
Q

i. Comminuted
1. Bone fragments into three or more pieces
2. Common in the elderly

A

i. Comminuted
1. Bone fragments into three or more pieces
2. Common in the elderly

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89
Q

ii. Compression
1. Bone is crushed
2. Common in porous bones (of spine)

A

ii. Compression
1. Bone is crushed
2. Common in porous bones (of spine)

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90
Q

iii. Spiral
1. Ragged break when bone is excessively twisted
2. Common sports injury
a. Soccer players who already have a knee brace

A

iii. Spiral
1. Ragged break when bone is excessively twisted
2. Common sports injury
a. Soccer players who already have a knee brace

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91
Q

iv. Epiphyseal
1. Epiphysis separates from diaphysis along epiphyseal line
2. Occurs where cartilage cells are dying

A

iv. Epiphyseal
1. Epiphysis separates from diaphysis along epiphyseal line
2. Occurs where cartilage cells are dying

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92
Q

v. Depressed
1. Broken bone portion pressured inward
2. Typical skull fracture

A

v. Depressed
1. Broken bone portion pressured inward
2. Typical skull fracture

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93
Q

vi. Greenstick
1. Incomplete fracture where one side of the bone breaks and the other side bends
2. Common in children
a. Bones are more flexible

A

vi. Greenstick
1. Incomplete fracture where one side of the bone breaks and the other side bends
2. Common in children
a. Bones are more flexible

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94
Q
  1. Hematoma (blood pool formation)
  2. Fibrocartilaginous callus forms
  3. Bony Callus forms
  4. Bone remodeling
A

Healing a Bone Fracture

The steps

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95
Q

a. Torn blood vessels hemorrhage
b. Mass of clotted blood (the hematoma) forms at the fracture site
c. Site becomes swollen, painful, and inflamed
i. Due to highly innervated and highly vascularized periosteum

A

Healing a Bone Fracture
The steps
Hematoma

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96
Q

a. Granulation tissue (soft callus) forms a few days after the fracture
b. Capillaries grow into the tissue and phagocytic cells begin cleaning debris
c. Osteoblasts and fibroblasts migrate to the fracture and begin reconstructing the bone
d. Fibroblasts secrete collagen fibers that connect broken one ends
e. Osteoblasts begin forming spongy bone
f. Osteoblasts furthest from capillaries secrete an externally bulging cartilaginous matrix that later calcifies.
g. Entire mass of repair tissues = fibrocartilaginous callus, which splints the fractured bone
i. It holds the bone but is not healed

A

Healing a Bone Fracture
The steps
Fibrocartilaginous callus forms

97
Q

a. New bone traveculae appear in the fibrocartilaginous callus
b. Fibrocartilaginous callus converts into a bony (hard) callus to spongy bone
c. Bone callus appears on x-ray 10-14 days after injury, and continues until firm union is formed 2-3 months later
i. Up to 4 months if elderly

A

Healing a Bone Fracture
The steps
Bony Callus Forms

98
Q

a. Excess material on the bone shaft exterior and in the medullary canal is remoed
b. Compact bone is laid down to reconstruct shaft walls
c. Responds to mechanical stress
i. May take up to 18 months to restore pre-fracture shape

A

Healing a Bone Fracture
The steps
Bone remodeling

99
Q

Disorders of Bone Remodeling

i. Adult bones are inadequately mineralized causing softened, weakened bones (osteoid)
ii. Main symptom is pain when weight is put on the affected bone (periosteal pain)
iii. Caused by insufficient absorption of calcium and/or vitamin D deficiency

A

Osteomalacia

100
Q

Disorders of Bone Remodeling

i. Children’s bones are inadequately mineralized, causing softened, weakened bones
ii. Signs
1. Bowed legs and deformities of the pelvis, skull, and rib cage
iii. Caused by
1. Insufficient absorption of calcum and/or by vitamin D deficiency
iv. Isolated cases in the U.S.
1. Essentially eliminated due to fortified juice, cereal and milk products
2. Breastfeeding mothers who are deficient in Vit. D. and Calcium (don’t absorb w/o Vit D) will have unsufficient Calcium and Vitamin D in the milk, so infants will develop this.

A

Rickets

101
Q

Disorders of Bone Remodeling

i. Bone matrix contains inadequate collagen (low tensile strength) and bones fracture easily
ii. Genetic and often present at birth
iii. Results in multiple (often fatal) fractures as infant comes through the birth canal.

A

Osteogenesis Imperfecta

102
Q

Disorders of Bone Remodeling

i. Group of diseases where bone reabsorption outpaces bone deposition
ii. Bones become so fragile that sneezing, stepping off a curb, or pulling on a heavy door can cause fractures
iii. Spongy bone of the spine is the most vulnerable
iv. Occurs most often in menopausal women (estrogen restrains osteoclasts)

A

Osteoporosis

103
Q

Disorders of Bone Remodeling

v. Prevention and Treatment
1. Calcium, Vitamin D and Vitamin K supplements
2. Increased Weight Bearing Exercise
3. Hormone (estrogen) replacement therapy (HRT) slows bone loss but does not reverse it
a. Serious side effects
i. Increase of heart attack,
ii. Stroke,
iii. And breast cancer
4. Natural bio-identical progesterone cream prompts new bone growth
5. Statins (drugs for lowering cholesterol) also found to increase bone mineral density but have serious side effects including liver and muscle damage.
e. Paget’s Disease

A

Osteoporosis Treatment

104
Q

Disorders of Bone Remodeling

i. Characterized by excessive and inconsistent bone formation and breakdown
ii. Pagetic bone has an excessively high ratio of spongy to compact bone
iii. Pagetic bone has patches of reduced mineralization, which causes spotty weakening of bone
iv. Late in the disease, osteoclast activity decreases, but osteoblast activity continues tow work,
1. Leaves regions of excessive bone thickening and filling of the medullary cavity
2. Usually localized in the spine, pelvis femur, and skull
a. Unknown cause  suspect a viral trigger
v. Some successful control via a Calcitonin inhaler (increases Calcium mineralization)

A

Paget’s Disease

105
Q
  1. Mesoderm gives rise to embryonic mesenchymal cells, which produce dense irregular connective tissue membranes and the hyaline cartilage that form the embryonic skeleton
  2. The embryonic skeleton ossifies in a predictable timetable that allows fetal age to be easily determined from sonograms
  3. By birth, most long bones are well ossified
    a. Except for the epiphyses
A

Fetal Developmental Aspects of Bone Formation

106
Q
  1. By age 25, nearly all bones are completely ossified
  2. In old age, bone resorption outpaces deposition
  3. A single gene that codes for vitamin D docking determines both the tendency to accumulate bone mass early in life, and the risk for osteoporosis later in life
    a. The more you hold on to, the more you have to lose.
A

By age 25

107
Q

a. Transmit weight of trunk to the lower limbs
b. Surrounds and protects the spinal cord
c. Flexible, curved structure containing 26 irregular bones (vertebrae)

A

Vertebral Column

108
Q 
7 Cervical bones
12 Thoracic bones
5 Lumbar
Sacrum
Coccyx
A

Vertebral Column

109
Q

Increases resilience, flexibility, and force load capability of the _

A

Vertebral Column

110
Q

a. Outward curvature of the spine (arch points posteriorly

i. Thoracic Kyphosis

A

Kyphosis (it’s the middle one and points posteriorly)

111
Q

a. Inward curvature of the spine
i. Cervical lordosis
ii. Lumbar lordosis

A

Lordosis

112
Q

i. Anterior and posterior longitudinal ligaments
1. From neck to sacrum, anterior and posterior to the body of the vertebra
ii. Ligamentum flavum
1. Connects adjacent vertebrae (lamina to lamina)
iii. Short ligaments
1. Connect each vertebra to those above and below
a. Ex:
i. Supraspinous ligament
ii. Interspinous ligament

A

Ligaments of Vertebral Column

113
Q

i. Fibrocartilage pad composed of two parts

A

Intervertebral Discs

114
Q
  1. Nucleus pulposus
    a. Inner gelatinous nucleus that gives the disc its elasticity and compressibility
  2. Annulus fibrosus
    a. “Annular rings”
    b. Outer collar composed of alternating diagonal layers of collagen and fibrocartilage
A

Intervertebral Discs

Componenets

115
Q

a. Inner gelatinous nucleus that gives the disc its elasticity and compressibility

A

Intervertebral Disc

Nucleus Pulposus

116
Q

a. “Annular rings”

b. Outer collar composed of alternating diagonal layers of collagen and fibrocartilage

A

Intervertebral Disc

Annulus fibrosus

117
Q

a. In conjunction with the spinal curvatures, serves to increase the force load capability of the spine

A

Purposse of Intervertebral Disc

118
Q

a. Important to mtaintain these neutral curvatures

b. Increase the resilience, flexibility, and force load capability of the spine

A
  1. Indicate a common function of the spinal curvatures and the intervertebral discs.
119
Q
  1. Abnormal lateral curve

a. Usually in the T spine

A

Scoliosis

120
Q
  1. Hunchback

a. Only pathological IF excessive

A

Hyperkyphosis

121
Q
  1. Swayback

a. Only pathological IF excessive

A

Hyperlordosis

122
Q

i. Ilia have a decreased forward tilt
ii. Adapted for support of male’s heavier build and stronger muscles
iii. Cavity of true pelvis is narrow and deep

A

Male Pelvis

123
Q

i. Adapted for childbearing
ii. True pelvis (inferior to pelvic brim) begins at the pelvic inlet and defines the upper portion of the birth canal
iii. Cavity of the true pelvis is broad, shallow, and has greater capcity

A

Female Pelvis

124
Q

Lighter, thinner, smoother

Heavier, thicker, more prominent markings

A

F/M Bone Thickness

125
Q

80-90 degrees 50-60 degrees

A

Pubic arch/angle

126
Q

Small; farther apart Large; closer together

A

Acetabula

127
Q

Wider, shorter; sacral curvature is accentuated

Narrow, longer; sacral promontory more ventral

A

Sacrum

128
Q

More movable; straighter

Less movable; curves ventrally

A

Coccyx

129
Q

Wide and shallow Narrow and deep

A

Greater Sciatic Notch

130
Q

Wider; oval from side to side Narrow, basically heart shaped

A

Pelvic inlet (brim)

131
Q

Wider; ischial tuberosities shorter, farther apart and everted

Narrower; ischial tuberosities longer, sharper, and point more medially

A

Pelvic Outlet

132
Q

a. Arches are maintained by interlocking foot bones, ligaments, and tendons
b. Arches allow the foot to bear weight

A

Importance of foot arches

133
Q
  • Locate
    i. Lateral longitudinal
    ii. Medial longitudinal
    iii. Transverse
A

foot arches yay!

134
Q

Joint classification based on amount of movement allowed by the joint

A

Functional

135
Q

Immovable

A

Synarthroses

136
Q

Slightly movable joints

A

Amphiarthroses

137
Q

Freely movable

A

Diarthroses

138
Q

Weakest parts of the skeleton

A

Joints

139
Q

Any site where two or more bones meet

A

Articulation

140
Q

Give the skeleton mobility

Hold the skeleton together

A

Function of joints

141
Q 
classification is based on the material binding the bones together and whether or not a joint cavity is present.
Include
Fibrous
Cartilaginous
Synovial
A

Structural Classification of Joints

142
Q
  1. The bones are JOINED by fibrous tissue (denser Connective Tissues Propers, periosteum)
  2. There is NO joint cavity.
    Suture
    Syndesmosis
    Gomphosis
A

Fibrous Joint

143
Q
  1. Occurs between the bones of the skull
  2. Comprised of interlocking junctions filled with thick and short dense irregular CT
  3. Binds bones tightly together, but allows for growth during youth
  4. Immovable due to tightness of CT fibers (synarthrosis)
  5. ~ Age 40
    a. Many skull bones are fused and joints now called synostoses (“without movement of bone)
A

Fibrous Joint

Suture

144
Q
  1. Bones are connected together by a fibrous tissue ligament (dense regular CT)
  2. Movement is slight to moderate (amphiarthrosis), dependent upon the fiber length
    a. Ex:
    i. Connection between the tibia and fibula
    ii. Connection between the radius and ulna
A

Fibrous Joint

Syndesmosis

145
Q
  1. The peg-in socket fibrous joint between a tooth and its alveolar socket (synarthrosis)
  2. The dense regular CT fibrous connection is referred to as the periodontal ligament
    Function: Synarthroses
A

Fibrous Joint

Gomphosis

146
Q
  1. Articulating bones are united by cartilage
  2. There is no joint cavity

Synchondroses
Symphysis

A

Cartilaginous Joints

147
Q

a. A bar/plate of hyaline cartilage unites the bone
b. All are synarthrotic joints
i. Ex:
1. Epiphyseal plates of children and adolescents
2. Joint between the costal cartilage of the first rib and the manubrium of the sternum

A

Cartilaginous Joints

Synchondroses

148
Q

a. Hyaline cartilage covers the articulating surface of the bone and is fused to an intervening pad of fibrocartilage
b. Slightly moveable (amphiarthrotic) joints designed for strength and flexibility
i. Ex:
1. Intervertebral joints
2. Pubic symphysis of the pelvis

A

Cartilaginous Joints

Symphysis

149
Q
  1. Joints in which the articulating bones are separated by a fluid-containing joint cavity
  2. All are freely moveable (diarthroses)
  3. Ex:
    a. All limb joints
    b. Most other joints of the body
A

Synovial Joints

150
Q 
Articular cartilage: = hyaline
Joint (synovial) cavity = small potential space
1.	Articular capsule = 
2.	Synovial Fluid 
3.	Reinforcing ligaments
4.	Nerve and Blood Vessels
A

Components of ANY synovial Joint

151
Q

a. Outer fibrous capsule of dense irregular CT
b. Inner synovial membrane of loose connective CT
i. Mostly Areolar
ii. Plus Serous Membrane
1. Whose epithelial cells = simple squamous!

A

Articular (joint) Capsule

Synovial Fluid

152
Q

a. Viscous and slippery filtrate of plasma (from blood capillaries) + hyaluronic acid
i. Lubricates and nourishes the articular cartilage
b. Contains phagocytes which clean up microbes and cellular damage debris

A

Synovial Fluid

General Synovial Joint Components

153
Q

Capsular ligaments
Extracapsular LIgaments
Intracapsular ligaments
All are dense regular CT

A

Reinforcing ligaments

Synovial Joints

154
Q

i. “intrinsic” ligaments
1. Areas of dense regular CT within the dense irregular CT portion of the capsule
2. Buried within capsule; not in the fluid

A

Capsular Ligaments

155
Q

i. Distinct dense regular CT band

ii. Outside the capsule

A

Extracapsular Ligaments

Synovial Joints

156
Q

i. Distinct dense regular CT band
ii. Inside the capsule
deep the capsule; within the synovial space; covered by synovial membrane

A

Intracapsular Ligametns

Synovial Joints

157
Q

a. Rich supply to the capsule and synovial membrane
b. Capillaries are the source of synovial fluid plasma
c. Nerves detect pain and provide feedback on stretch and joint position

A

Nerve and Blood Vessels associated with ANY Synovial Joint

158
Q
  1. Fat pads
  2. Fibrocartilage discs
  3. Friction-Reduction Structures: Bursae and Tendon Sheaths
A

Associated with some synovial joints, but not all

159
Q

a. For additional cushioning in some joints
i. EX:
1. Suprapatellar
2. infrapatellar

A

Fat pads

160
Q

i. For shock absorption and improved joint stability
b. Ex:
i. Meniscus of knee
ii. Glenoid labrum of the shoulder

A

Fibrocartilage discs

161
Q

i. Flattened, fibrous sac lined with synovial membranes and containing synovial fluid
ii. Common where ligaments, muscles, skin, tendons or bone rub together

Friction reducers

A

Bursa

162
Q

i. Elongated bursa that wraps completely around a tendon

Friction reducer

A

Tendon Sheath

163
Q

a. Lubricates and nourishes the articular cartilage.

A

Function of hyaluronic acid in the synovial fluid

164
Q
  1. Bursae found where these things rub together; Tendon sheaths are wrapped around a tendon
A

FACT

165
Q

i. Plane
ii. Hinge
iii. Pivot
iv. Condyloid
v. Saddle
vi. Ball and Socket

A

6 Types of Synovial Joints

166
Q
  1. Articular surfaces are essentially flat
  2. Allow only slipping or gliding movements
  3. Only example of nonaxial joints in the body
    a. Examples
    i. Between proximal and distal row of carpals
    ii. Facets(?) of vertebrae
A

Plane Joint

167
Q
  1. Cylindrical projections of one bone fits into a trough-shaped surface on another
  2. Uniaxial joints which permits flexion and extension only
    a. Examples
    i. Elbow joint
    ii. Interphalangeal joints
  3. Fingers and toes
A

Hinge

168
Q
  1. Rounded end of one bone protrudes into a ring of bone or ligament ring of another
  2. Uniaxial joints which permit rotation only
    a. Examples
    i. Joint between the atlas and axis (AA) joint (?)
    ii. Proximal Radioulnar joint
A

Pivot

169
Q
  1. = Condylar = Ellipsoid Joints
  2. Oval articular surface of one bone fits into a complementary oval depression in another
    a. Both articular surfaces are oval
  3. Biaxial joints which permit all angular motions
    a. Flexion-Extension
    b. Abduction – Adduction
    c. Examples
    i. Radiocarpal (wrist) joints
    ii. Metacarpophalangeal (knuckles) joints
A

Condyloid

170
Q
  1. Each articular surface has both a concave and a convex surface
  2. Biaxial joints similar to condyloid joints but with greater movement allowed
    a. ONLY example
    i. Carpometacarpal joint of the pollex
A

Saddle

171
Q
  1. A spherical/hemispherical head of one bone articulates with a cup-like socket
  2. Multiaxial joints – most freely moving synovial joints; move in all planes
    a. ONLY example
    i. Glenhumeral joint (shouler) and
    ii. acetabulofemoral joint (hip)
A

Ball and Socket

172
Q

i. Shape of Articular surfaces
1. Determines what movements are even possible
ex: hip vs. elbow
ii. Ligaments
iii. Muscle Tone

A

how Joint STABILITY is determined

173
Q
  1. Def: unites bones are prevents excessive/undesirable motion via stretch receptors
A

Ligaments

174
Q
  1. Stretch receptors send signals to CNS
    a. Response: skeletal muscles surrounding the joint contract to provide increased stability by tightening the tendons
  2. No elastic tissue
    a. So when stretched, ligaments remain stretched and stretch signals are now delayed
    i. So easier to overstress the joint
    ii. Joint becomes hypermobile
  3. Will tear when > approximately 5% of resting length
A

Ligaments

175
Q
  1. Works at a baseline level of muscle co-contraction around a joint
  2. Muscle tendons are crossing the joint, therefore act as stabilizing factors
  3. Muscle contraction, and thus tendon stabilization, increases with ligament stretch receptor output
  4. This is critical factor for stability of
    a. Shoulder joint
    b. Knee joint
    c. Arches of the foot
A

Muscle Tone

176
Q

i. Muscle attachment arrangement across a joint

ii. Planes of motion permitted by joint shape

A

How Joint MOBILITY is determined

177
Q

“Origin” O

“Insertion” I

A

i. Muscle attachment arrangement across a joint

178
Q

where there is attachment to the stationary bone

A
  1. Origin “O”
179
Q

where the muscle attachment to the movable bone

A

Insertion “I”

180
Q

Nonaxial
Uniaxial
Biaxial
Multiaxial

A

The planes of motion permitted by joint shape

181
Q

– slipping or gliding movements only (no axis of motion)

A

Nonaxial

182
Q
  1. – movement in one plane (one axis of motion)
A

Uniaxial

183
Q

– movement in two planes ( two axis of motion)

A

Biaxial

184
Q

– movement n or around all three planes (three axis of motion)

a. Some muscle groups have divisons at different O&I attachment sites, allowing for movement in all 3 planes
i. Ex: hamstrings

A

Multiaxial

185
Q

Range of Motion

i. One flat bone surface glides or slips over another similar surface
1. Ex:
a. Intercarpal & Intertarsal joints
b. Between the facets of the vertebrae

A

Gliding Movements

186
Q

Range of Motion

bending movement that decreases the angle of the joint

A

Flexion

187
Q

Range of Motion

– reverse of flexion; joint angle is increased

A

Extension

188
Q

Range of Motion

movement beyond the normal range of motion

A

Hyperextension

189
Q

Range of Motion

movement away from the midline

A

Abduction

190
Q

Range of Motion

movement towards the midline

A

Adduction

191
Q

Range of Motion

  1. The turning of a bone around its own long axis
  2. Occurs as right rotation and left rotation between Atlas and Axis (AA Joint- between the first and second cervical vertebrae)
  3. Occurs as internal rotation & External rotation
    a. Hip
    b. Shoulder joints
A

Rotation

192
Q 
Range of Motion
movement describes a cone in space
1.	Occurs in all 3 planes so appears like a circle
2.	Occurs at ball and socket joints only
a.	Shoulder
b.	Hips
A

Circumduction

193
Q
  1. Forearm palm up and palm down motions, respectively (radius and ulna are parallel)
    Palm down - radius rotates over ula
  2. Occurs at the proximal radioulnar joint
A

Supination and Pronation

194
Q
  1. Up and down movement of the ankle joint
A

iii. Dorsiflexion and Plantarflexion

195
Q
  1. SUbtalar Joint (between talus and calcaneus) medial and lateral movement
A

Inversion and Eversion

196
Q
  1. Scapula or mandible anterior/posterior movement
    a. Ex: protraction = shoulders rounded anteriorly; mandible jaw juts anteriorly
    b. Retraction = boobs out for shoulder; underbite in mandible
A

v. Protraction and Retraction

197
Q
  1. Scapula or mandible superior/inferior movement

a. Ex: elevation = close jaw, shrug shoulders

A

vi. Elevation and Depression

198
Q
  1. Touching of the thumb to the tip of any other digit on the same hand
A

Opposition

199
Q

i. Ball and socket joint in which mobility is sacrificed to obtain greater stability
ii. Head of the femur articulates with the deep acetabulum of the os coxa
iii. Overall, good range of motion, but limited (as compared to shoulder range of motion) by the deep socket, strong capsule and thick strong ligaments

A

Hip

200
Q
  1. Strong stability is maintained by
    a. Acetabular labrum (horseshoe-shaped fibrocartilage)
    i. Deepens the socket
    b. Strong and thick joint capsule
    i. Weakest posteriorly
    ii. Site of dislocations
    c. Multiple thick, heavy ligaments
    d. Tendons of 12+ muscles
A

Hip

201
Q
  1. Other ligamentum teres
    a. Attaches from head of femur to lower acetabulum
    b. Contains an artery which provides blood supply to the head of the femur
    c. No stabilizing function
A

Hip

202
Q

i. Hinge joint that allows flexion and extension only
ii. Strong capsule
iii. Radius and ulna articulate with the humerus
iv. Radius also articulates with the humerus
1. Annular ligament around radial head – creates the pivot joint (pronation-supination)
v. Stabilizing Ligaments
1. Ulnar collateral ligament
2. Radial collateral ligament

A

Elbow

203
Q

c. Temporomandibular Joint (TMJ highlights)
i. Modified hinge joint
ii. Mandibular condyle articulates with the mandibular fossa of the temporal bone
iii. Two types of movement
1. Hinge shape permits depression and elevation of mandible (open-close jaw)
2. Condylar sape permts lateral excursion (side-to-side motion) = grinding teeth
3. Fibrocartilage disc can displace, causing “popping/clicking” or jaw stuck open/closed

A

TMJ

204
Q

i. Ball and socket joint in which stability is sacrified to obtain greater mobility
ii. Head of humerus articulartes with the shallow glenoid fossa of the scapula

A

Shoulder

205
Q

(horseshoe shaped fibrocartilage) serves to deepen the socket

A

Shoulder

Glenoid labrum

206
Q

Thin & loose joint capsule

a. Four key ligaments
b. Tendon of the long head of biceps
c. Rotator cuff

A

Glenoid Labrum

Shoulder

207
Q

(weakest anteriorly and inferiorly; site of dislocations)

A

a. Thin & loose joint capsule

208
Q

b. Four key ligaments
i. One coracohumeral
ii. Three glenohumeral

A

of the Glenoid Labrum

209
Q

i. Which travels through the intertubercular groove and secures the humerus to the glenoid cavity

A

c. Tendon of the long head of biceps
Glenoid Labrum
Shoulder

210
Q

i. Made of tendons of 4 muscles
ii. Encircles the shoulder joint and blends with the articular capsule
1. Muscle tendons
a. Supraspinatus
b. Infraspinatus
c. Teres minor
d. Subscapularis

A

Rotator Cuff
Glenoid Labrum
Shoulder

211
Q

i. Largest and most complex joint of the body
ii. Modified hinge joint (bicondylar)
iii. Three joints in one surrounded by single joint cavity

A

Knee

212
Q
  1. Allows flexion
  2. Extension
  3. Some rotation at the end of extension
    a. “screw-home” mechanism
A

Knee

Modified hinge joint

213
Q
  1. Joint capsule only covers the posterior and medial/lateral aspects of the joint cavity
  2. Merges anteriorly with the patellar tendon and patellar retinaculum
    a. Patellofemoral joint
    b. Medial and lateral joints
A

Three joints in one surrounded by single joint cavity

Also, the knee

214
Q

a. Quadriceps femoris muscle tendon
b. Patellar retinaculum
i. Dense regular CT connecting the femur and tibia
c. Patellar tendon
i. Patellar ligament, per text, but actually sesamoid bone
d. Medial and collateral ligaments

A

Stabilizing Structures

Knee Ligaments and Tendons - Anterior

215
Q

a. Adductor magnus muscle tendon
i. One of the Adductor muscles
b. Semimembranousus muscle tendon
i. One of the Hamstring muscles
c. Gastrocnemius muscle tendon
i. Of the calf muscle
d. Popliteus muscle
i. Small muscle in the popliteal region
e. Multiple additional ligaments

A

Knee Ligaments and Tendons - Posterior View

216
Q

a. Anterior cruciate ligament
i. Stretch signals the muscle to decelerate internal rotation of the femur
1. Ex: lowering in a one-leg squat
b. Posterior cruciate ligament
i. Stretch signals the muscle to decelerate posterior translation of the tiba on the femur
1. Ex: walking down a steep hill

A

The Knee

3. Intracapsular Supporting Structures

217
Q

i. Stretch signals the muscle to decelerate internal rotation of the femur
1. Ex: lowering in a one-leg squat

A

Anterior Cruciate Ligament (ACL)

218
Q

i. Stretch signals the muscle to decelerate posterior translation of the tiba on the femur
1. Ex: walking down a steep hill

A

Posterior Cruciate ligament

219
Q

semilunar cartilages that serve to deepen tibial articular surfaces (better fit)

A

Knee

Medial/Lateral Meniscus

220
Q

Common Sports Injury

  1. The ligaments reinforcing a joint are stretched or torn
    a. Once stretched, remain stretched
  2. Partially torn ligaments slowly repair themselves and fill with poorly organized scar tissue
  3. Completely torn ligaments require prompt surgical repair for re-attachment to bone
A

Sprain

221
Q

whereas

1. A muscle with torn fibers (mild, moderate, severe)

A

Strain

222
Q
  1. There is often a snap and a pop of overstressed cartilage
  2. Common high-impact injury
    a. Especially the meniscus
  3. The meniscus, glenoid and acetabular labra and posterior patellar hyaline cartilage are frequently damaged
  4. Typically repaired with arthroscopic surgery
A

Cartilage Injuries

223
Q
  1. Occur when bones are forced completely out of alignment
    a. No contact of joint surfaces
  2. Tend to occur at weakest point of a joint capsule
  3. Usually accompanied by sprains, strains, inflammation, and pain-induced joint immobilization
  4. Usually caused by serious falls that are common sports injuries
A

Dislocations

224
Q
  1. Partial dislocation of a joint

2. Bone surfaces are still congruous but not in the correct position

A

Subluxation

225
Q

Inflammatory Joint Conditions

  1. An inflammation of the bursa, usually caused by a blow or overuse
    a. Creates friction
  2. Symptoms
    a. Pain swelling
  3. Treatment
    a. Anti-inflammatory drugs
    b. Anti-inflammatory modalities
    i. Rest
    ii. Ice
    iii. Ultrasound
    c. Excessive fluid may be aspirated to prevent further frictiion
A

Bursitis

226
Q

Inflammatory Joint Conditions

  1. Inflammation of tendon sheaths (like a Panini) typically caused by over use (friction)
  2. Symptoms treatment
    a. Similar to Bursitis
A

Tendonitis

227
Q
  1. A group of more than 100 different joint-damaging inflammatory or degenerative diseases
  2. Most widespread crippling diseases in the U.S.
  3. Symptoms
    a. Pain
    b. Stiffness
    c. And swelling of a joint
  4. Acute forms
    a. Caused by bacteria and are treated with IV antibiotics

Chronic Forms
Osteo
Rheumatoid
Gouty

A

Arthritis

228
Q

a. Most common chronic arthritis
b. Often called “wear and tear” arthritis
c. Affects women more than men
d. Most individuals will develop some degree of OA
i. Unless you are a total couch potato
e. More prevalent in the aged, and is related to the normal aging process

A

Osteoarthritis

229
Q

i. OA reflects the years of abrasion and compression causing increased production of metalloproteinase enzymes that break down articular cartilage faster than it can be replaced
ii. Without protection of hyaline cartilage, the exposed bone ends thicken, enlarge from bone spurs=osteophytes and restrict movement due to a change of joint shape
iii. Joints most affected are those that receive the most use on a daily basis
1. Cervical and lumbar spines
2. Fingers
3. Knuckles
4. Pollex
5. Knees
6. And hips

A

Osteoarthritis disease course

230
Q
  1. Slow and irreversible
  2. Treatments are symptomatic
    a. Mild anti-inflammatory meds (NSAIDS) along with moderate activity to facilitate synovial fluid protection
  3. Swimming ideal due to buoyancy effect of water and decreased gravity effect on joints
  4. Magnetic therapy
    a. Some evidence of pain relief
  5. Glucosamine and chondroitin sulfate supplements – no reproducible evidence
  6. Surgical: shaving of bone spurs and total or partial joint replacements
A

Osteoarthritis Treatment

231
Q

a. Chronic, Inflammatory autoimmune disease (viral vs. leaky gut trigger), with an insidiuous onset
b. Usually arises between the ages of 30 to 50, but can occur at any age
c. Signs and symptoms
i. Joint tenderness
ii. Bone fusion
iii. Osteoporosis
iv. Muscle atrophy due to disuse of bones, anemia, and cardiovascular problems often co-present
v. The course of RA is marked with exacerbations and remissions

A

Rheumatoid Arthritis

232
Q

i. RA begins with synovitis (inflammation of synovial membrane) of the affected joint
ii. Inflammatory chemicals are insappropriately released (irritate nerves and cause pain)
iii. Inflammatory blood cells migrate to joint, causing swelling
1. Increased permeability
iv. Inflamed synovial membrane thickens into a pannus
1. Feels like hardening glue
v. Pannus erodes cartilage
vi. Scar tissue forms and the articulating bone ends connect
vii. The end ossification result
viii. Known as ankylosis produces bent, deformed joints

A

Rheumatoid Arthritis Disease Course

233
Q
  1. Conservative therapy
    a. Aspirin
    b. Gluten-free diet
    c. Physical/occupational therapy
  2. Progressive treatment
    a. Strong anti inflammatory drugs or immunosuppressants
    i. Many classes of immunosuprresive drugs lead to liver failure
  3. Newer drug (Enbrel) neutralizes the harmful properties of inflammatory chemicals
    a. Less toxic to the liver
  4. Surgical
    a. Multiple total joint replacements (often of the fingers, too)
A

Rheumatoid Arthritis Treatment

234
Q

a. Deposition of uric acid crystal in joints and soft tissue, followed by a localized inflammatory response
i. Pain, redness, swelling
b. Typically, affects the joint at the base of the hallux
c. Affects men more than women (naturally higher uric acid levels)
d. If untreated , the bone ends fuse (ankylose) and immobilize the joint
e. Treatment
i. Colchicine
ii. NSAIDS
iii. Glucocorticoids

A

Gouty Arthritis

235
Q

a. By embryonic week 8, synovial joints resemble adult joints and are further modified after birth by the mechanical effects of loading

A

Embryonic Development of Joints

236
Q

b. Fibrous and cartilaginous joints are not as well-developed
i. Ex:
1. Infant skull has more bones than the adult skull
2. Connected by four fontanelles
a. Unossified remnants of fibrous membranes between fetal skull bones
ii. Most sutures ossify by age 40 and epiphyseal plates ossify at the end of puberty

A

Development of embryonic development

237
Q

i. Ligaments and tendons shorten and weaken
ii. Intervertebral discs lose water content with a resultant decrease in compressive load tolerance and become more likely to herniate
iii. Most people in their 70s have some degree of OA

A

Few problems occur until late middle age when advancing year take the toll on joints

238
Q

d. Prudent exercise that coaxes joints through their full range of motion (especially swimming once signs and symptoms of arthritis are apparent) is key to postponing joint problems

A

Straight up fact

241 A&P (19 decks)

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