Musculoskeletal System

Question 1

The generation of different types of bone, cartilage and fat cells are created by ________ ___ cells (MSC) which are formed within the ______ ______

Answer 1

1. mesenchymal stem, 2. bone marrow

Question 2

_______ ______ is a homogeneous gelatinous medium that is composed of minerals such as ______ that give bones their rigidity and is made up of proteoglycans and hyaluronic acid.

Answer 2

1. ground substance, 2. calcium

Question 3

Bone development is regulated by two processes: _______ ossification occurs when chondrocytes are formed and develop ______ which leads to develop of osteoblasts, long bones and most bones are made this way. _______ ossification is responsible for skull and flat bone development.

Answer 3

1. endochondral, 2. cartilage, 3. intramembranous

Question 4

____ _____ _____ (BMP) plays a major role in bone formation and are members of the transforming growth factor beta superfamily

Answer 4

bone morphogenic protein

Question 5

___ genes are a large family of protein signaling factors required for development of many body systems including forming bone, developing bone mass and healing fractures.

Answer 5

Wnt

Question 6

_____, ______ and _____ are the three types of bone cells with ______ and ______ regulating ligand (RANKL) which controls ________ regulation, leading to a continuous renewal of the skeletal system.

Answer 6

1. osteoblasts, 2. osteocytes, 3. osteoclasts, 4. osteoblasts, 5. osteocytes, 6. osteoclasts

Question 7

A primary function of osteocytes are to function as ________ which respond to changes in weight or stressors on the bone.

Answer 7

mechanoreceptors

Question 8

osteoblasts initiate formation of new bones by synthesizing _____, which are composed of collagen and small amounts of glycosaminoglycans

Answer 8

osteoids

Question 9

______ (OPG) is a glycoprotein that regulates bone formation by inhibiting _______ and will compete with RANKL to bind to RANK sites and therefore regulates the rate of bone loss

Answer 9

1. osteoprotegerin, 2. osteoclasts

Question 10

The bone matrix is comprised of extracellular elements including _____ (35%) and _______ (65%)

Answer 10

1. osteoid, 2. minerals

Question 11

______ are complexes of polysaccharides that handle transport and distribution of ions, particularly _______, through the bone matrix and play a role in deposition and _______ of minerals

Answer 11

1. proteoglycans, 2. calcium, 3. calcification

Question 12

After collagen synthesis and fiber formation, the last step in bone formation is ________ which has two distinct phases: 1. formation of ______ crystals and 2. ______ of ______ into the extracellular matrix and deposit between collagen fibrils.

Answer 12

1. mineralization, 2. hydroxyapatite, 3. proliferaiton, 4. hydroxyapatite

Question 13

All bones are covered with a connective tissue called the ______ which is anchored to the bone by _____ fibers (collagenous)

Answer 13

1. periosteum, 2. Sharpey

Question 14

The human skeleton is composed of two types of skeletons, the _____ skeleton consist of 80 bones and makes up the skull, vertebral column and the thorax, while the _____ skeleton consists of 126 bones (a total of 206) and makes up the upper and lower extremities as well as the pectoral and pelvic girdle.

Answer 14

1. axonal, 2. appendicular

Question 15

Within the ______ cavity of the bone, there contains ____ marrow which is made of fat and ____ marrow which is assisted by the former and produces blood cells.

Answer 15

1. medullary, 2. yellow, 3. red

Question 16

When there are gross injuries such as fractures, bones are able to heal like tissue injuries, except instead of scar tissue, ______ ____ is formed.

Answer 16

new bone

Question 17

The stages of bone repair include: _______ formation, which occur if vessels were damaged within bone structures. ________ formation occurs next where fibroblasts and osteoblasts produce ______ (granulation tissue). Then ______ formation occurs where woven bone or callus is made and allows for phosphate to bind with calcium and induce hardening of the bone. Lastly, _______ and ______ happen where bone cells become replaced with bone structures which leads to eventual replication of the injured bone.

Answer 17

1. hematoma, 2. procallus, 3. procallus, 4. callus, 5. replacement, 6. remodeling

Question 18

A site where two bones meet is generally known as a _____ these are categorized by movement, which includes _______ (synarthrosis), ______ _____ (amphiarthrosis) and _______ _____ (diarthrosis). They are also categorized on structure and include the following: ______, _____ and _____

Answer 18

1. joints, 2. immoveable, 3. slightly moveable, 4. freely moveable. 5. fibrous, 6. cartilaginous, 7. synovial

Question 19

Fibrous joints are generally ________ but can allow for some mobility depending on the subtype of this joint which includes ______, found in flat bones of child skulls, ______ allows for some streching of paired bones such as the radial and ulnar bones, and lastly ______ is a form of fibrous joints that is a conical projection that fits into a socket such as the mandible or maxilla.

Answer 19

1. synarthroses, 2. sutures, 3. syndesmosis, 4. gomphosis

Question 20

Cartilaginous joints are divided into two types of sub joints. A _____ allows for two bones to be connected by fibrocartillage which includes examples like the _____ ____. A ______ is a joint that uses _____ cartilage rather than fibrocartilage and is found in areas such as joints between the sternum and ribs.

Answer 20

1. symphysis, 2. symphysis pubis, 3. syncondrosis, 4. hyaline

Question 21

Synovial joints are the most movable of joints and are composed of several parts including the ______ capsule, ______ cavity, _______ fluid which lubricates joints for movement and ______ cartilage.

Answer 21

1. joint, 2. joint, 3. synovial, 4. articular

Question 22

An important component to muscle cell formation involves _____ _____ an enzyme that adds phosphate groups to substrate proteins allowing for the cell proccesses to occur.

Answer 22

protein kinase

Question 23

The _____ is a connective tissue framework that surrounds skeletal muscles and are divided into three layers: the ______ is the surface layer and tapers on ends to form _____. the ______ is the layer that subdivided muscle fibers into fascicles and the inner layer or the ______ surrounds the fasicles and all play a role in buffering muscle from strains.

Answer 23

1. fascia, 2. epimysium, 3. tendons, 4. perimysium, 5. endomysium

Question 24

Muscles contain sensory receptors including ______, that respond to muscle stretching and ____ ____ organs which are actually dendrites that branch to nearby tendons. These structures also secrete _____ (NRG) which can increase the amount of acetylcholine receptors in the event of increased streching, tension or velocity of muscle activity.

Answer 24

1. Spindles, 2. golgi tendon, 3. neuregulin

Question 25

_____ are the most abundant msucle components and are the functional units of contraction, these components are made of _____ which consist of repeating protein filaments.

Answer 25

1. myofibrils, 2. sarcomeres

Question 26

DDH or ______ ____ of the ____ is a congenital malformation that if left subluxated (partial contact) or dislocated (no contact) can lead to osteoporosis.

Answer 26

develomental dysplasia of the hip

Question 27

_____ _____ (OI) is a collegen related bone dysplasia that can result in early fractures and skeletal deformities. Depending on the severity it can even result in stillborns. Note that this collegen deficiency also affects others areas such as vasculature and various tissues.

Answer 27

Osteogenesis Imperfecta

Question 28

____ is defined as a failure of bones to mineralize and becoming soft, which is often due to a deficiency of _______ _

Answer 28

1. Rickets, 2. Vitamin D

Question 29

When evaluating for presence of Juvenile idiopathic arthritis (JIA) one common test detected is the ______ ____ (ANA)

Answer 29

antinuclear antibody

Question 30

DMD or _____ _____ ____ is an x-linked chromosome disorder found in boys that causes increased connective tissue and fat due to muscle degeneration that typically starts in the pelvis and moves upwards to the shoulders. The DMD gene in particular is the largest gene in the human genome and encodes ______ a large membraine stabilizing protein.

Answer 30

1. Duchenne Muscular dystrophy, 2. dystrophin

Question 31

If contact between two joint surfaces is only partially lost due to injury, this is called a _____

Answer 31

subluxation

Question 32

_____ are fibrous connective tissue that connects skeletal muscle to bone, while a ______ connects bones to respective joints

Answer 32

1. tendons, 2. ligaments

Question 33

A tear or rupture of a tendon is a _____, while ligament tears are ____. when either a tendon or ligament are completely separated from their attachment site this is known as a _____

Answer 33

1. strain, 2. sprain, 3. avulsion

Question 34

When identifying osteosarcomas from regular bone development, important test results to look for include elevated _____ ______, _____ and ______ as well as identifying that bone tissue produced by osteosarcomas never mature to _____ ____.

Answer 34

1. acid phosphatase, 2. calcium, 3. phosphate, 4. compact bone

Question 35

Rheumatoid Arthritis can form ______ that may persist outside of the synovial joint area. These are capable of invading other areas including skin, cardiac valves, lung parenchyma and spleen causing a variety of symptoms including _____ and central tissue _______. Treatment consists of medication that targets _______ that normally cause _______

Answer 35

1. nodules, 2. fever, 3. necrosis, 4. cytokines, 5. inflammation

Question 36

______ ______ (AS) is a chronic inflammatory joint disease charactereized by stiffness and fusion (ankylosis) of the spine and sacroiliac joints

Question 37

_____ is an inflammatory response that occurs due to excessive uric acid in the blood and specifically synovial fluid. Overtime this can accumulate into crystals that deposit in connective tissue which prompts the immune response or _____ _____. Dairy products, caffeine and vitamin C are known to counteract these effects.

Answer 37

1. gout. 2. gouty arthritis

Question 38

______ ____ or glycogen myophosphorylase deficiency, is an autosomal recessive disease that is characterized by a lack of _____ which allows the breakdown of glycogen in the muscle. A unique feature of this disease is second wind or a feeling of energy after an initial wave of fatigue if the person rests for a while, as well as being unable to produce _____ ____

Answer 38

1. McArdle Disease, 2. phosphorylase, 3. lactic acid

Question 39

Muscle metabolism can be affected by ______ metabolism disorders, this mainly involves a lack of ______ _______ (CPT) which can lead to mild muscular symptoms as well as renal failure due to rhabdomyolysis.

Answer 39

1. lipid, 2. carnitine palmitoltransferase

Question 40

______ ______ _____ (IIM) are groups of autoimmune diseases that attack skeletal muscles. the immune response typically is either _ cell mediated (Polymyositis) or ______ (Dermatomyositis) with the latter having more symptoms that can be seen cutaneously such as a reddish/purple rash or red scaly lesions over various joints.

Answer 40

1. Idipathic Inflammatory Myopathies, 2. T, 3. Humoral

Question 41

The process of completely degrading a drug so that the opposite effect due to chemicals may occur is known as _____ (think NMBA drugs being degraded for AcH activation)

Answer 41

recurarization

Question 42

The main complication caused by rhabdomyolysis is due to _______ (which is released from muscle destruction) blocking renal tubules

Answer 42

myoglobin

Question 43

When muscle contraction occurs in smooth muscle, an additional protein known as _____ is required for muscle cell shortening due to a lack of ______. There is also an additional enyzme known as ____ _____ which does not occur in skeletal muscles that allows for calcium to pump out of cells.

Answer 43

1. calmodulin, 2. sarcomere 3. myosin phosphatase

Question 44

_____ is secreted by osteocytes to activate osteoclast activity.

Answer 44

sclerostin