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Musculoskeletal 1 > Pathophys - Cartilage and Bone > Flashcards

Pathophys - Cartilage and Bone Flashcards

1
Q

mesenchymal stem cell derivatives

A
  • muscle cells
  • adipocytes
  • osteoblasts
  • fibroblasts
  • chondroblasts
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2
Q

what is unique about the derivation of osteoclasts?

A

they come from the monocyte cell line

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3
Q

fibroblasts secrete what?

A

components of connective tissue

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4
Q

define connective tissue

A
  • tissue that connect, supports, binds, or separates other tissues or organs
  • typically have relatively few cells embedded in an amorphous matrix
  • often has collagen or other fibers like cartilagenous, fatty and elastic tissues
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5
Q

what is the most abundant protein in the body?

A

collagen

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6
Q

proteoglycans are precursor molecules for what?

A

collagen

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7
Q

function of proteoglycans

A

bind collagen fibrils, elastic fibers and reticular fibers together

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8
Q

where do elastic fibers predominate?

A

in blood vessels and ligaments

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9
Q

reticular fibers predominate where?

A

in lymphatic tissue and basement membranes

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10
Q

vitamin C is a cofactor for what process?

A

hydroxylation of proline and lysine

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11
Q

the deficiency of vitamin C causes what?

A
  • scurvy

- poor wound healing

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12
Q

ehlers-danlos syndrome

A
  • defective procollagen peptidase results in uncleaved procollagen or in lysyls hydroxylase
  • so can’t hydroxylate lysine needed for staggered array of tropocollagen
  • hyperelasticity, joint dislocations, vascular wall rupture
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13
Q

osteogenesis imperfecta

A
  • point mutation in collagen gene resulting in reduction in type 1 collagen
  • type 1 collagen is needed for normal ossification
  • brittle bones and blue sclera
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14
Q

what are the two most important things to remember about osteogenesis imperfecta?

A
  • type 1 collagen deficient

* blue sclera

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15
Q

goodpasture’s syndrome

A
  • auto-antibodies to type IV collagen

- results in renal and or lung basement membrane thickening

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16
Q

marfans syndrome

A
  • defect in fibrillin 1 gene, chromosome 15
  • fibrillin surrounds elastic fiber core
  • results in dilation of aorta, mitral prolapse, periosteal changes (elongation)
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17
Q

presentation of pt w/ marfan’s

A
  • tall stature
  • high arched palate
  • myopia
  • mitral valve prolapse
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18
Q

a mitral valve prolapse causes what heart sound?

A

systolic click

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19
Q

general overview of collagen production (in terms of cells)

A
  • chondroblasts form chondrocytes
  • chondrocytes make tropocollagen
  • tropocollagen molecules overlap into collagen fibrils
  • fibril bind together to form fibers
  • fibers bind together to form tendons
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20
Q

structure of tropocollagen

A

3 alpha strand proteins arranged in alpha helix

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21
Q

functions of ECM

A
  • cell adhesion
  • cell-cell communication
  • differentiation
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22
Q

ECM formation

A
  • chondroblast form chondrocytes
  • chondrocytes secrete ECM
  • young collagen from ECM matures
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23
Q

ECM is primarily made of what two things?

A
  • aggregan

- type II collagen

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24
Q

What is the significance of ECM being negatively charged?

A

it holds water

25
Q

cartilage at the end of long bones is what?

A

articular cartilage

26
Q

what is the the thickest cartilage of the human body and why

A
  • the articular cartilage of the patella

- d/t the huge stress on the patella-femoral joint during resisted knee extension

27
Q

characteristics of cartilage

A
  • limited repair
  • nutrition supplied by diffusion
  • very slow turnover in ECM
28
Q

what are the three types of cartilage

A
  • hyaline
  • elastic
  • fibrocartilage
29
Q

pathophys of osteoarthritis

A
  • there are biomechanical and chemical processes involving the cartilage, synovium, bone and soft tissues surrounding the joint
  • they can be sparked by a single traumatic event, repeated microtrauma or genetic, metabolic, or systemic factors affecting the integrity of cartilage
30
Q

what is secreted by chondrocytes during osteoarthiritis progression?

A

-metalloproteinases (MMPs)

31
Q

MMPs

A
  • inclue collagenase, stromelysin and gelatinase

- degrade cartilage

32
Q

what could make cartilage more susceptible to MMPs?

A

inappropriately low levels of tissue inhibitors of MMPs

33
Q

what is a unique property of chondrocytes?

A
  • chondrocytes secrete the things needed to build cartilage

- but also secrete the MMPs that break it down

34
Q

during cartilage remodeling, what are the levels of matrix and protease/inhibitor ratio during a net increase?

A
  • increased fibroblasts laying down matrix (matrix synthesis)
  • decreased protease: inhibitor ratio (MMP)
35
Q

during cartilage remodeling, what are the levels of matrix and protease/inhibitor ratio during a net decrease?

A
  • decreased matrix synthesis

- increased protease: inhibitor ratio

36
Q

what are the main findings in an XR of a joint w/ osteoarthirits?

A
  • narrowing of joint space

- subchondral sclerosis

37
Q

cell derivatives for bone formation

A
  • mesenchymal stem cell –> osteoblasts

- bone marrow –> monocyte –> osteoclast

38
Q

what type of bone growth grows on a cartilaginous template?

A

endochondrial

39
Q

what are the two parts of endochondrial bone growth?

A
  • osteoclast chase

- chondrocyte run

40
Q

osteoclast chase

A
  • osteoclasts (from monocytes) enlarge the bone marrow cavity
  • creates an invading front of ossification
41
Q

chondrocyte run

A
  • calcification of the cartilage matrix surrounding hypertrophic chondrocytes
  • proliferating chondrocytes away from the ossification front increase the length of the cartilage
42
Q

Haversian system

A
  • fundamental functional unit of much compact bone

- composed of an artery in the middle of an osteon which is filled with osteocytes

43
Q

what signaling system is used by osteoblasts?

A

RANKL

44
Q

RANKL signaling system

A
  • macrophages are signaled on to make osteoclasts

- can be used to heal and remodel

45
Q

intramembranous bone growth

A

-bone grows directly by connective tissue basement membrane developing into bone

46
Q

intramembranous bone growth is important for what two things?

A
  • fracture healing

- development of the skill

47
Q

mechanism of intramembranous bone growth

A
  • mesenchymal stem cells –> osteoblasts and osteocytes
  • secrete type I collagen (osteoid)
  • lay down mineralization
48
Q

content of bone

A
  • 50-70% mineral
  • 20-40% organic matrix
  • 5-10% water
  • <3% lipids
49
Q

minerals contained in bone

A

Ca, Pi, PPi, Mg, K, hydroxyapatitie, and others

50
Q

increase in extracellular PPi has what effect on hydroxyappetite?

A

decrease

51
Q

decrease in extracellualr PPi has what effect on hydroxyappetite?

A

increase (i.e increased mineralization)

52
Q

hydroxyapatite function

A

storage unite for Ca and phosphorus

53
Q

what hormones regulate the mineralization of bone?

A
  • PTH

- Vit. D

54
Q

describe bone remodeling (aka bone metabolism)

A
  • lifelong process
  • mature bone tissue is removed from skeleton (bone resporption)
  • new bone tissue is formed (ossification)
  • control fracture repair and micro damage
55
Q

what is the main hormone in bone remodeling?

A

PTH

56
Q

PTH is secreted by the?

A

parathyroid gland

57
Q

PTH regulates what?

A

serum Ca

58
Q

PTH is primarily secreted in response to what?

A

lowered serum Ca

59
Q

function of PTH

A
  • decrease in serum Ca leads to:
  • PTH acting on osteoblasts
  • this indirectly activates osteoclasts to tear down bone and release Ca

Musculoskeletal 1 (14 decks)

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