Module 11: MSK (a) Flashcards

1
Q

MSK

-Sites of Blood cell formation?

A
  1. Skull
  2. Pelvis
  3. Sternum
  4. Femur
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2
Q

Functions of the bones?

-Mineral storage

A
  1. Bones store
    - Calcium
    - Phosphate
    - Carbonate
    - Magnesium
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3
Q

Bone

-Make up?

A
  1. Connective tissue that is rigid and flexible
  2. Made of
    - Crystallized minerals (calcium) — Rigidity
    - Collagen fibers — Flexibility
  3. Tensile strength refers to the bones being Strong AND flexible
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4
Q

Absorption Vs Resorption

A
  1. Absorption — taking up of tissues or fluids originating OUTSIDE the body
  2. Resorption — Taking of of products or tissues originating INSIDE the body
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5
Q

Bone Cells

-3 Types

A
  1. Osteocytes — Start as osteoblasts — most abundant cells in the bone — MAINTAIN bone matrix — Respond to parathyroid hormone signals —Coordinate osteoblasts and osteoclasts to form and resort bone
  2. Osteoblasts — Form New bone — Synthesis of osteoid which is non-mineralized bone matrix — Synthesize osteoid
    - Become osteocytes that are imbedded in bone — synthesize collagen and proteoglicans
  3. Osteoclasts — Bone resorption — Release hydrogen chloride to breakdown bone tissue — body takes this back up and uses it to regulate serum calcium or to build new bone
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6
Q

Bone Cells

-Osteocytes

A
  1. Osteocytes — Start as osteoblasts — most abundant cells in the bone — MAINTAIN bone matrix — Respond to parathyroid hormone signals —Coordinate osteoblasts and osteoclasts to form and resort bone
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7
Q

Bone Cells

-Osteoblasts

A
  1. Osteoblasts — Form New bone — Synthesis of osteoid which is non-mineralized bone matrix — Synthesize osteoid
    - Become osteocytes that are imbedded in bone — synthesize collagen and proteoglicans
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8
Q

Bone Cells

-Osteoclasts

A
  1. Osteoclasts — Bone resorption — Release hydrogen chloride to breakdown bone tissue — body takes this back up and uses it to regulate serum calcium or to build new bone
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9
Q

Bone matrix

-Organic Vs Inorganic

A
  1. 35% Organic — Proteoglycans & Albumin (Collagen fibers are synthesized & secreted by osteoblasts)
  2. 65% inorganic — Calcium & Phosphate
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10
Q

Bone Matrix

-Proteoglycans

A
  1. Polysaccharides — Glucosamine & Chondroitin
    - Strengthen the bone by forming compression resistant networks between COLLAGEN & CALCIUM
    - Help deposit calcium in the bone
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11
Q

Bone Matrix

-Albumin

A
  1. Albumin is a type of glycoproteins (identical to serum albumin)
    - Transports essential elements such as hormones, ions, and other metabolites to and from the bone cells (matrix)
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12
Q

Bone Matrix

-Calcium & Phosphate

A
  1. Calcium and phosphate are minerals
  2. Calcium — Regulates vitamin D and thereby promotes mineralization
  3. Phosphate — Balance of organic and inorganic phosphate required for proper bone mineralization — regulates vitamin D
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13
Q

Compact Bone

-Info

A
  1. 85% of skeleton — Forms outer layer of all bones — Extremely strong & main weight bearing structure in long bones
  2. Haversian System (Osteon) is the basic structure all unit of compact bone
    - Concentric lamellar form the central Haversian canal which runs longitudinally down the length of the bone and contains nerves and blood vessels
  3. Volkmann’s canals —Run perpendicular (transverse) to the Haversian canals and interconnect them with each other
    - Connections to the periosteum allow blood and nerves to travel to and from the bone
    - Periosteum is the outer portion of the bone
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14
Q

Spongy Bone

-Info

A
  1. 15% of skeleton & forms the inner layer of bone — Found in the epiphysis and metaphysics of long bones & Vertebral bodies
    - Spongy bone is stiff and ductile — Can be deformed w/out losing toughness — Pliable and not brittle
  2. Trabeculae — transfers mechanical loads from the articular surface to cortical bone — Main load bearing structure in vertebrae
    —Spaces between trabeculae are filled w/ red bone marrow
  3. LACKS haversian system
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15
Q

Long Bones

A
  1. Diaphysis — Shaft of long bone — may contain fat (yellow marrow) or red bone marrow.
  2. Metaphysis— Epiphyseal plate is where growth occurs
  3. Epiphysis — Red bone marrow — blood formation
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16
Q

Joints

-Movement Classification (3)

A
  1. Synarthrosis —Fibrous — Immovable joints — Ex: Sutures in the skull —
  2. Amphiarthrosis — Cartilaginous — Slightly movable — Ex: Pubic symphysis & intervertebral discs —
  3. Diarthrosis — Synovial — Freely movable — Ex: Shoulders, hips, knees, wrists, ankle, etc. —
17
Q

Skeletal Muscle

-Longest muscle

A
  1. Sartorius muscle is the longest muscle in the body

- Attaches at anterior superior iliac spine and attaches to superior medial tibia

18
Q

Skeletal Muscle

-Fusiforme Muscles

A
  1. Long and strap-like — Runs in straight line between attachment points (tendons) — Ex: Biceps, triceps, quads

2.

19
Q

Skeletal Muscle

-Pennate Muscles

A
  1. Flat, broad, slightly “fan-shaped.” Ex: Deltoid, pectoralis muscles
20
Q

4 Phases of Muscle Contractions

-All Steps

A
  1. Excitation — Spread of action potential from nerve to neuromuscular junction. Acetylcholine is released
  2. Coupling —Calcium release leaves actin free to bind w/ myosin — Caused by binding of calcium to troponin
  3. Contraction — Thin filament, actin, slides over myosin (thick filament) — cross bridge causes muscle to shorten
  4. Relaxation — Cross bridge detaches and sarcomere lengthens as calcium is pumped back into sarcoplasmic reticulum
21
Q

Motor Unit

-Definition

A
  1. Functional unit of the neuromuscular system
    - Consists of the lower motor neurons and the muscle fibers it innervated
    - Motor unites contract as a whole when receiving electrical impulse
  2. Neuromuscular Junction - Where the nerve synapses with muscle cells
  3. Acetylcholine will travel between the NM junction to conduct the signal
22
Q

Skeletal Muscle Innervation

-Innervation ratio

A
  1. ## Defined as the # of muscle fibers innervated by one lower motor neuron
  2. Lower Innervation ratios allow for more precise movementsTEST — Ex: Lateral rectum muscle has ratio of 3
  3. Higher Innervation ratios are for muscles that do not require precise movements but need GREATER ENDURANCE.
    - Ex: Calf muscle has ratio of 2000
23
Q

Skeletal Muscle Innervation

-Muscle Fiber Types

A
  1. Type I — Slow Twitch — Greater endurance — Ex: marathoner or triathlete — higher Innervation ratios
  2. Type II — Fast Twitch — Part of motor units w/ lower Innervation ratios — Ex: Ocular muscles
  3. Type II has 2 subtypes
    - Type IIa — fast twitch muscle fibers — quicker, more precise, and more powerful contraction but fatigue easier than type 1
    - Type IIx — higher proportion in those with sedentary lifestyle — If they work out, even a little, these convert to IIa fibers
24
Q

Skeletal Muscle Innervation

-Strength of Contraction

A
  1. Motor Unit recruitment — When a motor neuron is activated, it creates an action potential.
    - All muscle fibers innervated by the motor neuron are stimulated and contract
    - Activation of one motor neuron results in a weak but distributed muscle contraction
    - Activation of more motor neurons will result in more muscle fibers being activated — Stronger muscle contraction
  2. Type I (slow twitch) motor units will be activated first and, if needed, the type IIa (fast-twitch) the nType IIx
25
Q

Aging and the MSK System

-Bones

A
  1. Significant bone loss
  2. Bone that is present becomes Stiff and brittle
  3. Bone remodeling takes longer
    - Bone loss is caused by bone remodeling taking longer d/t slow mineralization and increased bone resorption
  4. OSTEOPOROSIS will often result
26
Q

Aging and the MSK System

-Joints

A
  1. Cartilage becomes more rigid, fragile and stiff

2. Decreased ROM — Careful flexibility exercises are very important to stress to your older patients

27
Q

Aging and the MSK System

-Muscles

A
  1. Apoptosis of muscle cells — Oxidative stress causes mitochondrial dysfunction w/in cells & results in apoptosis of muscle cells
  2. Decreased muscle strength and bulk
28
Q

Aging and the MSK System

-Sarcopenia

A
  1. Age-related muscle loss — sedentary individuals can lose as much as 3-5% of muscle mass each decade after 30
  2. Type II cells decrease to a greater extent than slower Type I fibers
  3. Educate Older patient to exercise and include weight training to
    - Improve, maintain, or slow low of muscle strength
    - Help increase bone mineral density
    - Improve balance, coordination and mobility
    - Improve lean body mass & decrease risk for falls