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LOCO 2 > Normal and abnormal synoviol joints > Flashcards

Normal and abnormal synoviol joints Flashcards

1
Q

What lines the surfaces of synovial joints

A

Articular cartilage

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2
Q

What type of cartilage is found on the articulating surfaces of synovial joints

A

Hyaline cartilage

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3
Q

What are the 2 main membranes of a joint capsule

A

Outer fibrous capsule and inner synovial membrane

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4
Q

Function of articular cartilage

A

Reduces friction and absorb impact/ shock

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5
Q

Where is hyaline cartilage found

A

Capping the end of bones in synovial joints

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6
Q

What does the deeper layer submerge with

A

Subchondral bone

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7
Q

What is the tidemark

A

Calcified layer that the subchondral bone merges with

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8
Q

Upon what structure do the properties of articular cartilage depend upon

A

Composition of the ECM

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9
Q

What cells are responsible for maintaining and regulating the composition of ECM

A

Chondrocytes

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10
Q

Name in order from superficial to deep the layers of the articular cartilage

A 
Superficial zone
Middle zone
Deep zone
Tide mark
Calcified zone
Subchondral zone
Cancellous bone
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11
Q

In which direction do chondrocytes move

A

Surface layer to deep

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12
Q

How do the chondrocytes appear in the superficial zone

A

Flattish

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13
Q

How do the chondrocytes appear in the deep zone

A

More rounded

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14
Q

What % of the total volume of cartilage are chondrocytes

A

<5%

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15
Q

In which layer are chondrocytes stacked

A

Deep/ radial layer

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16
Q

What do chondrocytes sit in

A

Lacuna

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17
Q

What staining is used to see hyaline cartilage layers

A

Safranin-O

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18
Q

What % water is the ECM of cartilage

A

80

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19
Q

What collagen is found in the ECM of cartilage

A

Mainly collagen II

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20
Q

What is the function of the collagen found in cartilage (2)

A
  • Network gives overall framework and shape

- Makes pockets filled with proteoglycan complexes

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21
Q

How do proteoglycans interact with water, and why

A

Draw water into cartilage

Regulates compressibility

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22
Q

What type of collagen is found in the deep cartilage (not II)

A

X

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23
Q

Describe the structure of collagen in the articular surface of cartilage

A

Parallel arrangement
Surface highest tensile properties
Allows for gliding

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24
Q

Describe the structure of collagen in the intermediate layer of the cartilage

A

Criss-crossed oblique allows compression

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25
Q

Describe the structure of collagen in the deep layer of the cartilage

A

Perp to surface

26
Q

Name 4 types of collagen found in cartilage

A

II, IX, X, XI

27
Q

What % of dry weight is made up by collagen

A

40-70%

28
Q

What % of dry weight is made up by proteoglycans

A

15-40%

29
Q

What is the structure of a proteoglycan

A

Core protein with glycosaminoglycan (GAG) side chain

30
Q

What are GAGs

A

Linear polysaccharides with repeating units

31
Q

2 most prevelant GAGs in synovial joint

A

Keratin sulphate

Chondroitin sulphate

32
Q

What is the core protein of the proteoglycan found in the synovial joint

A

Hyaluronan

33
Q

State the ways in which a osteoarthritic synovial joint differs from a normal health one

A
  • Fibrotic
  • Synovitis
  • Cartilage failure
  • HA depolymerised
  • Osteophytes
  • Subchondral cysts
  • Vascular engorgement
34
Q

Name 4 extrinsic/ biochemical factors for the development of osteoathritis

A

High BMI
Physical activity levels
Occupational exposures
Past joint injury

35
Q

Name 5 genetic links to osteoathritis

A
  • ASTN2
  • GDF5
  • GLN3
  • DOT1L
  • 7q22
36
Q

Name 5 systemic risk factors for the development of osteoathritis

A 
Post- menopausal HRT
Bone mineral density
Diet
Female
Increasing age
37
Q

Describe the genetics behind 7q22

A

Loss of GPCR 22= 30% increased risk of knee OA

38
Q

What is DOT1L

A

Enzyme: master protector of chondrocytes

39
Q

What is GDF5

A

Growth differentiation factor 5

40
Q

What is ASTN2 thought to be involved in

A

Pain and neuronal adhession

41
Q

Does synovitis occur primary or secondary to established bone and cartilage pathology

A

Secondary

42
Q

What is the effect of synovitis

A

Drives further inflammatory damage to adjacent bone and cartilage
Major cause of pain and lsos of function

43
Q

What does HMGB2 stand for

A

high mobility group protein 2

44
Q

Where is HMGB2 uniquely expressed

A

In the superficial zone chondrocytes

45
Q

What is the role of HMGB2

A

Supports chondrocyte survival

Regulates specific differentiation status of superficial zone cells

46
Q

What is the result of HMGB2 loss

A

Superficial zone cell death
Loss of progenitor cells
Reduced ECM component synthesis

47
Q

Name the 3 stages articular cartilage goes through macroscopically

A

Fibrillation
Erosion/ cracking
Eburnation

48
Q

What happens during eburnation

A

Complete loss of cartilage

Exposed bone becomes polished

49
Q

Microscopically, name the 3 changes that occur in osteoathritis

A

Chondrocyte necrosis
Focal clumps/ clones of chondrocytes
Change to fibrocartilage from hyaline

50
Q

Where is chondrocyte necrosis most significant

A

Superficial layers

51
Q

What happens during the change to fibrocartilage from hyaline

A

Type 1 instead of 2
Reduced thickness of articular cartilage
Thickening of calcified cartilage merging with subchondral bone

52
Q

How does movement of the water differ in people with OA as opposed to normal

A

Early stage: cartilage swells increasing the water.

Loss of proteoglycans mean less compressible so water moves in and out faster

53
Q

How does collagen network change in OA

A

Breaks down due to release of enzymes from stressed chondrocytes and synovial membrane cells

54
Q

What is chondromalacia

A

Softened cartilage

55
Q

What does CSPC stand for

A

Chondrocyte stem/ progenitor cell

56
Q

What characterises early OA

A

Loss of superficial zone and changes to ECM of the articular cartilage
Cell clusters emerge

57
Q

What characterises late OA

A

Continued loss of ECM and chondrocyte hypertrophy

58
Q

What happens due to exposure of underlying bone due to cartilage erosion

A
  • Microfractures of trabeculae
  • Increased osteoblastic activity
  • Surface undergoes focal pressure necrosis
59
Q

What is the result of focal pressure necrosis

A

Subarticular cysts

60
Q

What happens due to vascular engorgement

A

Slower blood flow and bone marrow oedema

61
Q

How does osteoathritis appear on an x-ray

A

Loss of joint space
Subchondral sclerosis
Trabecular fracture
Subchondral cysts

62
Q

Name the therapeutic targets for OA treatment in the early stages

A

1) Cartilage stem/ progenitor cells could help regenerate joint resurfacing
2) ECM production and chondroprotection

LOCO 2 (25 decks)

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