Pathophysiology of Bone and Osteoarthritis Flashcards

1
Q

what is the skeleton made up of from conception?

A

cartilage and fibrous membrane

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2
Q

what is the process of bone growth called?

A

ossification

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3
Q

what is the skeletal cartilage surrounded by?

A

dense perichondrium (dense irregular connective tissue that surrounds the cartilage of developing bone)

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4
Q

what are the three types of cartilage found in the human body?

A

1, hyaline (joints)

  1. elastic (external ear)
  2. fibrocartilage (invertebrate discs)
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5
Q

two ways cartilage grows?

A
  1. appositional

2. interstitial

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6
Q

explain how appositional growth occurs?

A

Mitotic division of preexisting chondrocytes in perichondrium secrete new matrix next to existing cartilage tissue (growth from the outside)

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7
Q

explain how interstitial growth occurs?

A

Chondrocytes within cartilage divide and secrete new matrix, expanding the cartilage (growth from within)

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8
Q

what are the functions of bones?

A
  1. structural - support, protect, movement
  2. mineral storage - calcium and phosphate
  3. lipid storage
  4. blood cell formation - hematopoiesis in marrow cavities
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9
Q

what are the classifications of bones?

A
  1. long bone e.g. humerus
  2. short bone e.g. carpal, tarsal
  3. flat bone e.g. ribs, skull
  4. irregular bone e.g. hip, vertebrate
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10
Q

what are the 2 major types of bones?

A
  1. compact bone

2. cancellous bone (spongy)

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11
Q

what is the role of compact bone?

A
for movement (mechanical) and protection
-made up of dense bone tissue on outside enclosed by periosteum (a thick fibrous membrane)
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12
Q

what is the role of cancellous bone?

A

-regulates metabolic

Ca2+ and its storage. And stem cells are stored there too

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13
Q

what is the head of the long bone called?

A

epiphysis

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14
Q

what is the length of the long bone/bone shaft called?

A

diaphysis

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15
Q

what is the periosteum?

A

Thick fibrous membrane and attachment for muscles and tendons Blood vessels, nerves, and lymphatic vessels

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16
Q

what is the endosteum?

A

Thin membrane of connective tissue lining inner surface of (all) bony tissue

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17
Q

what is the medullary cavity filled with?

A

yellow bone marrow called adipose

18
Q

where is red marrow contained in the bone?

A

in the epiphyses

19
Q

what is the metaphysis?

A

-Narrow area containing epiphyseal (growth) plate.

20
Q

what replaces the metaphysis and epiphyseal plate in fully formed adult bone?

A

osseous tissue for metaphysis and epiphyseal line

21
Q

what is the structural unit of the compact bone called?

A

osteon

22
Q

what is the concentric rings of calcified matrix in the compact bone called?

A

lamella

23
Q

what is the centre of each osteon called?

A

central canal where the blood vessels, lymphatic vessels and nerves run through to the periosteum and endosteum

24
Q

what are the three types of lamellae?

A
  1. concentric
  2. circumferential
  3. interstitial
25
Q

what is the matrix structure of the spongy bone called?

A

trabeculae

26
Q

where does the spongy bone get its blood supply from?

A
  1. blood vessels of periosteum

2. blood that circulates in the marrow cavities

27
Q

what is the structure of the trabeculae?

A
  • contains irregularly arranged lamellae and osteocytes interconnected by cannaliculi
  • trabeculae form along lines of stress to provide strength
28
Q

what is the space between trabeculae filled with?

A

bone marrow which is highly vascular

29
Q

what does the red bone marrow do?

A
  • Supplies nutrients to osteocytes in trabeculae

* Forms red and white blood cells

30
Q

what does the yellow bone marrow do?

A

stores fat

31
Q

what bones are formed from intramembraneous ossification?

A

bones of skull and the clavicles (flat bones)

32
Q

what do osteoclasts and osteoblasts do?

A

Bone resorbing (osteoclasts) and bone forming cells (osteocytes and -blasts)

33
Q

what are resorption bays?

A

grooves formed by osteoclasts when breaking matrix

34
Q

how does bone resorption work?

A
  • osteoclast secrete lysosomal enzymes that digest organic matrix
  • also secrete acids that convert calcium salts into soluble forms
35
Q

what happens to the matrix once digested by the lysosomal enzymes?

A

transcytosed across the osteoclast cell where it is secreted into the interstitial fluid and then into the blood

36
Q

what is osteoarthritis?

A

degenerative disease of synovial joints, characterised by breakdown of articular cartilage and proliferative changes of surrounding bones

37
Q

where is the most common site of osteoarthritis?

A

the knee joint

38
Q

is osteoarthritis inflammatory or not?

A

mainly a non-inflammtory diseases of the synovial joints

39
Q

what are risk factors of osteoarthritis?

A
  1. obesity
  2. occupation
  3. joint injury
  4. joint alignment
  5. bone shape
  6. age
  7. genetics
  8. nutrition
40
Q

non-pharmacological treatment of osteoarthritis?

A
  1. provide appropriate info and education
  2. increased activity and exercise
  3. weight loss if needs be
41
Q

what is first line treatment to osteoarthritis?

A
  1. paracetamol

2. topical NSAID

42
Q

what to substitute paracetamol with or add to it if ineffective or insufficient?

A

Oral NSAID or Cox 2 inhibitor with a P