MSK System Flashcards
List the 7 functions of the bone
Adapt to movement
Repairs itself
Structural support
Attachment sites for muscles
Reservoir for calcium & phosphorus
Defence against acidosis
Trap for dangerous minerals
Briefly explain bone architecture- what it looks like
Cortical and compact with strong dense regular structure
What forms a haversian system
Deposited bone replaced by lamellar bone
What is bone made if
Collagen and minerals
What specific cell are osteoblasts
Mesenchym stem cells
Functions of osteoblast
Builders-
Hormone receptors
Secrete factors to activate osteoclast
Bone marrow secrete proteins
When a osteoblast is trapped by new bone…
Forms osteocyte
Main function of osteoCLast
Breakdown bone= CLearance
Where are osteoclasts formed
Fusion of precursor cells forming a multinucleate synctium
Finish the sentence…
Bone resorption is mediated by…
And needed for…
Mediated by osteoclasts
Needed by radial growth/ bone remodelling
Define osteogenosis
Calcium phosphate crystal precipitate & attach to a collagenous lattice support
Bone arises to….
Replacement of pre existing tissue
Cartiliage is a …
Endochondral ossification
Embryonic mesenchyme
Intramembraneous ossification
Osteogenesis is needed for
Matrix formation & mineralisation
Where does ossification start
Primary zone in middle of long bones & extends as waves of ossification
Explain the process of endrochondral ossification
TELL A STORYY!
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
How does bone growth in length
By proliferation of chondrocytes at epiphyseal plate
How does bone grow in diameter
Deposit new bone under periostal collar = simultaneous resorption
What is bone marrow responsible for
Haematopoeisis
In the bone, what allows passage of mature blood cells into circulation
Narrow seive like elements
2 classification of stem cells
Haemo
Mesenchymal
What is calcium needed for
Muscle comtraction
Nt release
Resting membrane potential signal transduction
Blood coagulation
Bone
What is phosphorus needed for
Signal transduction at po4
Atp
Creatinine
Bone
What are calcium and phosphorus controlled by
Pth
Vitamin d
Where does phosphate regulation take place
Kidney
Increased PTh results in
Decreased po4 in blood
Effect of vitamin d
Inhibits PTH production
+ vit d = - PTH = + po4 in blood
Exception is renal tubular disease
Effect of hypocalcaemia on skeleton
Calcium leaves skeleton = affect strength
Plasma calcium regulation controlled by
Vitamin d
Pth
Compare how pt & vitamin d control blood calcium levels
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
In plasma calcium regulation, vitamin d ….
Inhibits PTH transcription
MOA of PTH
Bind & activate Pth receptors but doesnt not express them
Difference between bone resorption & formation
Resorption- prolonged pth activation
Formation - intermittent pth activation
List actions of vit d
More ca absorbed in si
Stimulate protein transcription
Open ca channels
Stimulate osteoclast make as PTH BUT stop pth synthesis
What is osteomalacia & rickets
Osteo-
Defective mineralisation of bone matrix when remodelling
Rickets- defective mineralisation of epiphyseal cartilage in growing skeleton
Primary PTH is caused by
HYPERcalcaemia
Symptoms of hyperparathyroidism
Stone kidney
Bones - tumour
Moans - deprrssion
Groans - gi irregula
Causes and symptoms of secondary hyperparathyroidism
increased PTH in response to hypocalcaemia
Chronic renal failure due to filtration of phospaht
Decreased activation of vit d
Decreased ca absorption
Figures of bone densities according to NICE
Normal less than 1
Osteopenia 1-2.5
Osteoporosis- more than 2.5
Risk factors for osteoporosis
AGEING
age
Gender
Ethnicity
Famikial
Smoking
Bone arcitechture under microscope
30 yr old - thick interconnected plates of bone
71 - fragile rods
Moa of nsaids
Stop cycloxygenase that produce AA metabolites
Effect of prostaglandin
Sensitive nerve endings= cause pain
What are eicasanoids
Inflamm mediators,grouped prostaglandins/ thrmoboanxe-leukotrines
Pgi2
Prostacyclin
Vasodilate
Hyperalgesic
Stop platelet aggregation
Pge2
Vasodilator/ hyperalgesic
All vasodilators synergise with
Histamine 7 bradykinin WHICh
Reducing pain but sensitise afferent C fibres
Dont increase vascular permeability but potentiate effects of histamine & bradykinin
Cox 2 pathway is
Inducible induce prostaglandin pathway = pain
Cox 1 pathway
Consituitive - induce prostaglandin
Protect gut mucosa
Haemostasis
Vasodilator
Promote ulcer healing
side effects of NSaids
Gi disturbances
Stop platelet aggregation
Stop mediated renal function
Stop uterine motility= longer gestational
Hypersensitivity reactions
Group of med for paracetamol
Analgesic & antipyretic with no anti inflammation properties
Inhibits cns prostaglandin make
Se for para
Kidney damage with prolonged use
Over dose hepatotoxicity = glutathione induction
Types of analogues for morphine
Synthetic or morphine with same moa
Difference between opium/ opioids/ opiate
Opium from papaver somniferum, morphine& alkaloids
Opioids - substance wuth synthetic/ natural liker effect
Opiate syntheticmorphine
Whats a narcotic
Morphine / codein analgesic action in cns
Endogenous opiods
All gpcr negatively linked to adenylate cyclase = cellular inhibition