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pj1311 semester 2 > MSK System > Flashcards

MSK System Flashcards

1
Q

List the 7 functions of the bone

A

Adapt to movement
Repairs itself
Structural support
Attachment sites for muscles
Reservoir for calcium & phosphorus
Defence against acidosis
Trap for dangerous minerals

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2
Q

Briefly explain bone architecture- what it looks like

A

Cortical and compact with strong dense regular structure

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3
Q

What forms a haversian system

A

Deposited bone replaced by lamellar bone

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4
Q

What is bone made if

A

Collagen and minerals

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5
Q

What specific cell are osteoblasts

A

Mesenchym stem cells

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6
Q

Functions of osteoblast

A

Builders-
Hormone receptors
Secrete factors to activate osteoclast
Bone marrow secrete proteins

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7
Q

When a osteoblast is trapped by new bone…

A

Forms osteocyte

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8
Q

Main function of osteoCLast

A

Breakdown bone= CLearance

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9
Q

Where are osteoclasts formed

A

Fusion of precursor cells forming a multinucleate synctium

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10
Q

Finish the sentence…
Bone resorption is mediated by…
And needed for…

A

Mediated by osteoclasts
Needed by radial growth/ bone remodelling

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11
Q

Define osteogenosis

A

Calcium phosphate crystal precipitate & attach to a collagenous lattice support

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12
Q

Bone arises to….

A

Replacement of pre existing tissue

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13
Q

Cartiliage is a …

A

Endochondral ossification

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14
Q

Embryonic mesenchyme

A

Intramembraneous ossification

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15
Q

Osteogenesis is needed for

A

Matrix formation & mineralisation

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16
Q

Where does ossification start

A

Primary zone in middle of long bones & extends as waves of ossification

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17
Q

Explain the process of endrochondral ossification
TELL A STORYY!

A

Cartilage model laid by chomdrocyte
Cartilage calcified forming scaffold for osteoblast
Osteoblast make mateix by secreting osteoid
Osteoblast secrete alkaline phosphate to calcify matrix
Wave of osteoclast removes calcified cartilage & make lacunae bone

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18
Q

How does bone growth in length

A

By proliferation of chondrocytes at epiphyseal plate

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19
Q

How does bone grow in diameter

A

Deposit new bone under periostal collar = simultaneous resorption

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20
Q

What is bone marrow responsible for

A

Haematopoeisis

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21
Q

In the bone, what allows passage of mature blood cells into circulation

A

Narrow seive like elements

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22
Q

2 classification of stem cells

A

Haemo
Mesenchymal

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23
Q

What is calcium needed for

A

Muscle comtraction
Nt release
Resting membrane potential signal transduction
Blood coagulation
Bone

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24
Q

What is phosphorus needed for

A

Signal transduction at po4
Atp
Creatinine
Bone

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25
Q

What are calcium and phosphorus controlled by

A

Pth
Vitamin d

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26
Q

Where does phosphate regulation take place

A

Kidney

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27
Q

Increased PTh results in

A

Decreased po4 in blood

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28
Q

Effect of vitamin d

A

Inhibits PTH production
+ vit d = - PTH = + po4 in blood

Exception is renal tubular disease

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29
Q

Effect of hypocalcaemia on skeleton

A

Calcium leaves skeleton = affect strength

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30
Q

Plasma calcium regulation controlled by

A

Vitamin d
Pth

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31
Q

Compare how pt & vitamin d control blood calcium levels

A

Pth - 3 mechanisms fast- increase bone resorption & distal tubing reabsorption & renal vit d synthesis

Vit d - dihydroxyvitamin d - 2 mechanisms = + bone resorption & + intestinal ca absorption

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32
Q

In plasma calcium regulation, vitamin d ….

A

Inhibits PTH transcription

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33
Q

MOA of PTH

A

Bind & activate Pth receptors but doesnt not express them

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34
Q

Difference between bone resorption & formation

A

Resorption- prolonged pth activation
Formation - intermittent pth activation

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35
Q

List actions of vit d

A

More ca absorbed in si
Stimulate protein transcription
Open ca channels
Stimulate osteoclast make as PTH BUT stop pth synthesis

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36
Q

What is osteomalacia & rickets

A

Osteo-
Defective mineralisation of bone matrix when remodelling

Rickets- defective mineralisation of epiphyseal cartilage in growing skeleton

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37
Q

Primary PTH is caused by

A

HYPERcalcaemia

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38
Q

Symptoms of hyperparathyroidism

A

Stone kidney
Bones - tumour
Moans - deprrssion
Groans - gi irregula

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39
Q

Causes and symptoms of secondary hyperparathyroidism

A

increased PTH in response to hypocalcaemia

Chronic renal failure due to filtration of phospaht
Decreased activation of vit d
Decreased ca absorption

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40
Q

Figures of bone densities according to NICE

A

Normal less than 1
Osteopenia 1-2.5
Osteoporosis- more than 2.5

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41
Q

Risk factors for osteoporosis

A

AGEING
age
Gender
Ethnicity
Famikial
Smoking

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42
Q

Bone arcitechture under microscope

A

30 yr old - thick interconnected plates of bone
71 - fragile rods

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43
Q

Moa of nsaids

A

Stop cycloxygenase that produce AA metabolites

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44
Q

Effect of prostaglandin

A

Sensitive nerve endings= cause pain

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45
Q

What are eicasanoids

A

Inflamm mediators,grouped prostaglandins/ thrmoboanxe-leukotrines

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46
Q

Pgi2

A

Prostacyclin
Vasodilate
Hyperalgesic
Stop platelet aggregation

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47
Q

Pge2

A

Vasodilator/ hyperalgesic

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48
Q

All vasodilators synergise with

A

Histamine 7 bradykinin WHICh
Reducing pain but sensitise afferent C fibres
Dont increase vascular permeability but potentiate effects of histamine & bradykinin

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49
Q

Cox 2 pathway is

A

Inducible induce prostaglandin pathway = pain

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50
Q

Cox 1 pathway

A

Consituitive - induce prostaglandin
Protect gut mucosa
Haemostasis
Vasodilator
Promote ulcer healing

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51
Q

side effects of NSaids

A

Gi disturbances
Stop platelet aggregation
Stop mediated renal function
Stop uterine motility= longer gestational
Hypersensitivity reactions

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52
Q

Group of med for paracetamol

A

Analgesic & antipyretic with no anti inflammation properties
Inhibits cns prostaglandin make

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53
Q

Se for para

A

Kidney damage with prolonged use
Over dose hepatotoxicity = glutathione induction

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54
Q

Types of analogues for morphine

A

Synthetic or morphine with same moa

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55
Q

Difference between opium/ opioids/ opiate

A

Opium from papaver somniferum, morphine& alkaloids
Opioids - substance wuth synthetic/ natural liker effect
Opiate syntheticmorphine

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56
Q

Whats a narcotic

A

Morphine / codein analgesic action in cns

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57
Q

Endogenous opiods

A

All gpcr negatively linked to adenylate cyclase = cellular inhibition

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58
Q

Where can opiods act

A

More than one receptor can be agonist for one and antagonist for second and partial for third

59
Q

Opioid analgesic effects

A

Effective in acute/ chronic pain
Tumour growth
Tissue inflammation
Reduce affective component pain

60
Q

Opioid effect on brain stem

A

Terminate descending fibres in dorsal horn
Inhibit primary afferent firing
Stimulate intrinsic internuerons

61
Q

Opioids can cause…

A

Resp depression in therapeutic doses however no CV depression

62
Q

Moa for codeine and treatment

A

Low affinity for opioids receptors
Mild to moderate pain relied
Cough supression
Control of diarhea
Can be combined with paracetamol and aspirin

63
Q

Se of codiene

A

Nausea vomiting
Sedation disziness
Constipation

64
Q

Differnece between codeine and dihydrocodein

A

Di- low efficacy & same potency 2 codeine / metabolised to active compound

65
Q

Why do 10% of population have no therapeutic effect to codeine

A

Lack metabolising enzyme converting to morphine

66
Q

3 theories for pain

A

Periphery to spinal cord = primary fibres- dorsal horn neurones

Spinal gate theory of pain- not at afferent synapse

Ascending patways & brain

67
Q

Definition of pain

A

Unpleasant sensory & emotional experience associated with actual pr potential tissue damage

68
Q

Pain is a combination of

A

Sensory (discriminative)
&
Affective
(Emotional) components

69
Q

Definition of nociception

A

Sensory of pain alone
Activity starts in nociceptor

70
Q

Pain can be a mixture of

A

Nociceptice & non noci

71
Q

Define nociceptive pain

A

Stimulation of specific pain receptors @ dista end of sensory neurones heat/stretch

72
Q

Define non noci pain

A

Peripheral & cns , generated by nerve cell dysfunction

73
Q

Pain classed a disease with

A

Being 20% of population
In females more
Some wanting to die

74
Q

Differenct between acute and chronic pain

A

Acute- predictable/ tissue damage/ circuitry known/ unimodal treatment/ responds predictably

Chronic- opposite & difficult to treat persist longer than 12 weeks or beyond tissue healing time

75
Q

Define somatic pain with characteristic

A

Tissue muscle joint pain
Nocireceptors / inflammation
Sharp localised pain
Useful meds para weak opioids

76
Q

Visceral pain

A

Internal organs of main body cavities
Thorax abdomen
Nocireceptors
Deep vague ache
Weak strong opioid

77
Q

2 types of nociceptors

A

Mechanical- strong sharp pain- d fibres
Polymodal- dull burning - c fibres

78
Q

Sharp pain has a
Dull pain has a

A

Low threshold fast transmission
High threshold & slow transmission

79
Q

AB fibres in spinal gate theory are

A

Mechanoreceptors

80
Q

Ad receptors at gate theory are

A

Mechano
Noci

81
Q

C receptors in gate theorh are

A

Noci
Thermo
Mechanical

82
Q

In the ascending pathway and brain theory, describe pathway

A

To lambic system- spinothalamuc oathway
Percieved @ subcortical
Localises @ cortical level

83
Q

What closes the spinal gate

A

Release of 5 ht nkradrenaline enkephalin

84
Q

Pain can chnage plasticity leading to

A

Increased sensitivity to pain

85
Q

Increased sensitivity to pain

A

Hyperalgesia

86
Q

Allodynia

A

Responding with pain when there is no pain

87
Q

Persistent pain is a

A

Physiological process allowing healing

88
Q

The MSK is

A

Connection of bones & muscle fibres via connective tissue and tendons

89
Q

Functions of msk

A

Locomotion
Maintenance if posture
Respiration
Communication
Constriction of organ vessels
Heart beat
Production of body heat

90
Q

Properties of muscles

A

Contract - shorten /pulling force
Excitability- respond to stimuli
Extensibility- stretched back to original
Elasticity- recoil to original length

91
Q

Classification of gross anatomy

A

Skeletal
Smooth
Cardiac

92
Q

Skeletal

A

Locomotion
Pressure
Resp movements
Voluntary in action
Controlled by somatic motor neurones

93
Q

Smooth

A

Walls of hollow organs
Bv/ iris
Mix food in gi
Dilate contrict pupils
Not striated & mononucleated

94
Q

Cardiax

A

Heart
Source if movement of blood
Autorhymic striated & mononulceated

95
Q

Movement of muscke

A

Skeletal
Origin
Insertion
Indirect
Direct

96
Q

Skeletal movements

A

Movement by tension between ends

97
Q

Origin movement

A

Proximal attachment muscle attaches to least moveable area

98
Q

Insertion

A

Distal movement muscle attaches to muscle moves most

99
Q

Indirect attachment

A

Epimysium extends beyond muscle as tendon to periosteum of bone

100
Q

Direct attachment

A

Epimysium adheres/ fuses to periosteum

101
Q

Skeletal muscle organisation

A

Muscle
Fasicle
Muscle fibre
Myofibril
Myofilament

102
Q

A muscle cell eith a cell membrane is a

A

Sarcolemma

103
Q

Epimysium tissue

A

Dense regular surrounding entire muscle

104
Q

Perimysium

A

Collagen & elasctic fibres called fasicle

105
Q

Endomysium

A

Loose connective tissue surrounding individual muscle fibres

106
Q

Aponeurosis

A

Collagen fibres of all 3 layers = flattened tendon like structures

107
Q

Muscle fibres vary depending on

A

Atp pathway
Myoglobin content
Sustained ot short work
Atp decomposition
Slow/ fast twitch

108
Q

Slow twitch - fatigue resistant musckes are:

A

Slow oxidative/ slow actin atpase enzyme
Slow mysoin & contractility
High myoglobin
Strong prolonged contraction

109
Q

Examples of slow twitch

A

Postural= spinal extensor
Antigravity = calf muscle

110
Q

Fast twitch fatigue muscles are

A

Everything fast eg fast oxidative/ atpase / contractility
Plenty glycogen
High intensity contractions
Extensive sarcoplasmic reticulum = rapid release & storage of ca ions

111
Q

3 types of joints and differences

A

Fibrous
Cartilage
Synovial

Different degrees of mobility

112
Q

Fibrous joint

A

Cannot move
connective tissue eg fontanelles

113
Q

Cartilaginous joint

A

Entirely cartilage little movement
2 types synchondroses & symphyses
Fibrocartilagepubic, verterbrae

114
Q

Synovial joint

A

Joint with space between adjoining bones
Synovial cavity filled with fluid
Synovial fluid = greater movements

115
Q

Weakest joint

A

Synovial

116
Q

Why is a synovial joint covered with hyaline cartilage

A

Prevent excessive pressure to allow joint to move easily

117
Q

Describe meniscus

A

Cartilage on bothe ends never come into contact
Separated by thin film joint fluid & 2 shock absorbers

118
Q

List the synovial joints

A

Gliding
Ball & socket
Hinge joint
Saddle joint
Pivit
Condyloid

119
Q

Description of gliding joint

A

Bones meet flat bones move along in any direction, very flexible
Carpals
Metacarpals

120
Q

Description of ball & socket

A

Highest freedom of motion
Shoulder & hip
For support

121
Q

Description of hinge joint

A

Elbow
Flexion & tension
Joint capsule= strength & lubrication resistance to mecahnical stress

122
Q

Description of saddle joint

A

Saddle & horse
Stability & flexibilty
Thumb

123
Q

Pivot joint

A

Cervical vertebrae

124
Q

Condyloid joint

A

Egg shaped ball & socket

125
Q

Cartilage is

A

Strong avascular chondroitin collagen
Can be hyalin
Elastic & fibrocartilage

126
Q

Tendon is A

A

Fibrous connective tissue attach kuscle to structure eg eyeball

127
Q

Ligament is a

A

Finrous elastic attachment from bone to bone made of fibrocyted

128
Q

2 types if ligaments

A

White rich collagenous sturdy & elastix
Yellow elastic rush

129
Q

What does intracellular fluid between myofibrils contain

A

Large quantities of K/ mg2 / phosphate/ protein enzymes / mitochondria/ ATP

130
Q

Myofibrils are

A

Repeated sarcomere light & dark bands depending on how light passes

131
Q

Myosin & actin attach to which bands

A

Actin- light I band
Myosin - dark A band

132
Q

I & A bands are polarises by

A

I band isotropic to polarised light
A band anisotropic to polarised light

133
Q

What is a sarcomere

A

Actin and myosin, repeating unit of 2Z desks end of acting attached to zdisk and myosin M band

134
Q

What is the function of the Sarco plasmic reticulum?

A

Regulates calcium storage, release uptake and is important to muscle contraction

135
Q

Describe the process of muscle contraction

A

Miles in cross bridges attached to the actin, filament working/the mile Stillhead pivots, and then is it pours on the actin filament, sliding it towards the m line
As the new ATP attaches to the myosin head, the Crossbridge detaches is ATP is split into ADP and pie cooking of the myosin head occurs

136
Q

What is a motor unit?

A

Single motor neurone

137
Q

How is the skeletal muscle excited?

A

By large myelinated, nerve fibres originating from motoneurons in anterior hands of spinal cord

138
Q

In the neuromuscular junction, how does synaptic signalling occur?

A

Action potential is initiated in both directions towards the muscle fibre ends releasing a CH

139
Q

What is a transverse tubule and how does action potential take place?

A

Skeletal muscle fibres action potential spreads along the surface membrane, and the maximum muscle contraction requires deep penetration of muscle fibre. The transverse tubules allow transmission of action potential throughout the muscle.

140
Q

The role of ACH receptors

A

Na influx and depolarisation

141
Q

The role of na in AP

A

Greater depolarisation

142
Q

The role of calcium in action potential

A

Calcium influx

143
Q

The role of calcium, 2+ an action potential

A

 Changes tropomyosin, enabling active sites

144
Q

What is a myasthenia gravis?

A

Autoimmune disease, which targets and destroys AC hate receptors

pj1311 semester 2 (6 decks)

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