Pathophysiology of Bone and Osteoarthritis Flashcards
what is the skeleton made up of from conception?
cartilage and fibrous membrane
what is the process of bone growth called?
ossification
what is the skeletal cartilage surrounded by?
dense perichondrium (dense irregular connective tissue that surrounds the cartilage of developing bone)
what are the three types of cartilage found in the human body?
1, hyaline (joints)
- elastic (external ear)
- fibrocartilage (invertebrate discs)
two ways cartilage grows?
- appositional
2. interstitial
explain how appositional growth occurs?
Mitotic division of preexisting chondrocytes in perichondrium secrete new matrix next to existing cartilage tissue (growth from the outside)
explain how interstitial growth occurs?
Chondrocytes within cartilage divide and secrete new matrix, expanding the cartilage (growth from within)
what are the functions of bones?
- structural - support, protect, movement
- mineral storage - calcium and phosphate
- lipid storage
- blood cell formation - hematopoiesis in marrow cavities
what are the classifications of bones?
- long bone e.g. humerus
- short bone e.g. carpal, tarsal
- flat bone e.g. ribs, skull
- irregular bone e.g. hip, vertebrate
what are the 2 major types of bones?
- compact bone
2. cancellous bone (spongy)
what is the role of compact bone?
for movement (mechanical) and protection -made up of dense bone tissue on outside enclosed by periosteum (a thick fibrous membrane)
what is the role of cancellous bone?
-regulates metabolic
Ca2+ and its storage. And stem cells are stored there too
what is the head of the long bone called?
epiphysis
what is the length of the long bone/bone shaft called?
diaphysis
what is the periosteum?
Thick fibrous membrane and attachment for muscles and tendons Blood vessels, nerves, and lymphatic vessels
what is the endosteum?
Thin membrane of connective tissue lining inner surface of (all) bony tissue
what is the medullary cavity filled with?
yellow bone marrow called adipose
where is red marrow contained in the bone?
in the epiphyses
what is the metaphysis?
-Narrow area containing epiphyseal (growth) plate.
what replaces the metaphysis and epiphyseal plate in fully formed adult bone?
osseous tissue for metaphysis and epiphyseal line
what is the structural unit of the compact bone called?
osteon
what is the concentric rings of calcified matrix in the compact bone called?
lamella
what is the centre of each osteon called?
central canal where the blood vessels, lymphatic vessels and nerves run through to the periosteum and endosteum
what are the three types of lamellae?
- concentric
- circumferential
- interstitial
what is the matrix structure of the spongy bone called?
trabeculae
where does the spongy bone get its blood supply from?
- blood vessels of periosteum
2. blood that circulates in the marrow cavities
what is the structure of the trabeculae?
- contains irregularly arranged lamellae and osteocytes interconnected by cannaliculi
- trabeculae form along lines of stress to provide strength
what is the space between trabeculae filled with?
bone marrow which is highly vascular
what does the red bone marrow do?
- Supplies nutrients to osteocytes in trabeculae
* Forms red and white blood cells
what does the yellow bone marrow do?
stores fat
what bones are formed from intramembraneous ossification?
bones of skull and the clavicles (flat bones)
what do osteoclasts and osteoblasts do?
Bone resorbing (osteoclasts) and bone forming cells (osteocytes and -blasts)
what are resorption bays?
grooves formed by osteoclasts when breaking matrix
how does bone resorption work?
- osteoclast secrete lysosomal enzymes that digest organic matrix
- also secrete acids that convert calcium salts into soluble forms
what happens to the matrix once digested by the lysosomal enzymes?
transcytosed across the osteoclast cell where it is secreted into the interstitial fluid and then into the blood
what is osteoarthritis?
degenerative disease of synovial joints, characterised by breakdown of articular cartilage and proliferative changes of surrounding bones
where is the most common site of osteoarthritis?
the knee joint
is osteoarthritis inflammatory or not?
mainly a non-inflammtory diseases of the synovial joints
what are risk factors of osteoarthritis?
- obesity
- occupation
- joint injury
- joint alignment
- bone shape
- age
- genetics
- nutrition
non-pharmacological treatment of osteoarthritis?
- provide appropriate info and education
- increased activity and exercise
- weight loss if needs be
what is first line treatment to osteoarthritis?
- paracetamol
2. topical NSAID
what to substitute paracetamol with or add to it if ineffective or insufficient?
Oral NSAID or Cox 2 inhibitor with a P