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Medicine Phase One > Phase One: Week Six > Flashcards

Phase One: Week Six Flashcards

1
Q

What is the definition of osteoarthritis?

A

Progressive disorder of the joints caused by gradual loss of cartilage and resulting in the development of bony spurs and cysts at the margins of the joints.

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2
Q

What are some symptoms of Osteoarthritis?

A
  • Pain, especially when doing load-bearing activities, such as walking
  • Short-lived stiffness in the morning, which improves in 30 minutes or less when you start to move
  • Difficulty moving affected joints or doing certain activities
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3
Q

How is osteoarthritis clinically diagnosed?

A 
PAIN
DECREASED WALKING DISTANCE
SLEEP DISTURBANCE
LIMP  -Trendelenburg sign
STIFFNESS
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4
Q

What are the non-operative treatments for osteoarthritis?

A
  • Medications
  • Physiotherapy
  • Walking aids
  • Joint injections
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5
Q

When treating osteoarthritis, what it the function of Corticosteroid injections?

A

•Reduce inflammation response around joints Tend to have more rapid effect than NSAIDs

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6
Q

When treating osteoarthritis, what it the function of viscous supplements?

A

This replaces the modified synovial fluid and allows the fluid to be more elastic and have increased velocity.

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7
Q

What is the surgical treatment of osteoarthritis?

A
  • Arthroscopy
  • Cartilage transplantation
  • Joint replacement
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8
Q

Give four examples of cartilage transplants

A

Osteo-Articular Transplant (OAT) procedures
Autologous Chondrocyte Implantation (ACI)
Cadaver allografts
Osteotomy

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9
Q

What is the function of endomysium?

A

This covers muscle fibres

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10
Q

What is the function of perimysium?

A

This covers muscle fascicles

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11
Q

What covers the whole muslce?

A

The Epimysium

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12
Q

What is the function of the Epimysium?

A

Covers the whole muslce

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13
Q

What covers the muscle fibres?

A

Endomysium

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14
Q

What covers the muscle fascicles?

A

Perimysium

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15
Q

Describe the process of muslce contraction

A
  1. Action potential travels to the neuromuscular junction
  2. Calcium channels open and calcium flows into the presynaptic cleft
  3. Calcium causes vesicles containing acetylcholine to fuse with membrane and release Ach into the synaptic cleft
  4. Ach stimulates the opening of sodium channels on the post-synaptic membrane
  5. Sodium influx cause an action potential to form in the muslce
  6. The action potential is triggered along the sarcolemma, T tubule and transverse terminal cisternae which triggers calcium release
  7. Calcium binds to the troponin allowing the myosin-binding sites to be uncovered as tropomyosin is pulled away

Cross Bridge formation

  1. ATP binds to the myosin head, causing the dissociation of the actin-myosin complex
  2. ATP is hydrolysed, causing myosin heads to return to their resting configuration
  3. A cross-bridge is formed as myosin binds to a new position on actin
  4. There is a power stroke, causing the filaments to slide past each other as phosphate is released
  5. ADP is released
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16
Q

What is the function of acetylcholinesterase?

A

Acetylcholinesterase, also known as AChE or acetylhydrolase, is the primary cholinesterase in the body. It is an enzyme that catalyses the breakdown of acetylcholine.

17
Q

What are the two regulatory proteins?

A

Troponin and Tropomyosin.

18
Q

What is the function of titin?

A

Holds thick filaments in place

19
Q

What is the function of alpha-actin?

A

This forms Z-lines

20
Q

What is the function of Myomesin?

A

This forms the M-line

21
Q

What is the function of Nebulin?

A

This is a thin filament anchoring protein

22
Q

What is the function of dystrophin?

A

Structural link between muscle cytoskeleton and extracellular matrix to maintain muscle integrity

23
Q

Name the five structural protien of muslce

A 
Myomesin
Dystrophin
Nebulin
Titin
Alpha-actin
24
Q

What is the difference between Titin and Nebulin?

A

Titin holds thick filaments in place whereas Nebulin holds thin filaments in place

25
Q

What structural protein makes up the M-line?

A

Myomesin

26
Q

What structural protein makes up the Z-line?

A

Alpha-actin

27
Q

What structural protein is a structural link between muscle cytoskeleton and extracellular matrix to maintain muscle integrity

A

Dystrophin

28
Q

What is the difference between the musculotendinous junction and the osteotendinous junction ?

A

he point at which the tendon forms attachment to the muscle is also known as the musculotendinous junction (MTJ) and the point at which it attaches to the bone is known as the osteotendinous junction (OTJ).

29
Q

Describe the process of inflammation

A

There is vasoconstriction as the first response, but this is very transient and over-ruled by vasodilation.
There is vasodilation very early and this is mediated by NO, bradykinin and histamine, released from damaged or infected cells. There is the opening of new capillary beds that allows in more blood flow, this contributes to the redness and heat.
In normal blood flow, there is an axial (central flow). There is a plasma peripheral layer. During inflammation, because of the increased vasodilation causing increase vascualr permeability from histamine, bradykinin, NO, leukotriene B4 and PAF, the central stream becomes wider and the plasma layer around the centre becomes narrower due to the loss of plasma. This allows the chemical produced from cells to move to the edges of the vessels in a process called migration.
Rolling IL-1 and TNF are released from macrophages, mast cells and endothelial cell when they encounter damaged of infected cells. They act on endothelium layer causing more expression of E-selectin. P-selectin is normally store in granules (Weibel-Palade bodies) and only histamine and thrombin can activate is and causes it to go onto endothelial cells. The selectins on the endothelial cells bind to sialyl-lewis-x modified proteins. This is a glycoprotein.
Adhesion is mediated by integrins (expressed on leukocytes) binds to ICAMs on the endothelial cells. The chemokines produced (Il-8, C5a, IL-1, TNF-alpha, Leukotriene B4) bind to proteoglycan on the endothelial cells and activate rolling leukocytes. This results in firm adhesion.
PECAM-1 will help the leukocyte to migrate (diaphesis). The leukocytes secrete collagenase to degrade the basement membrane. The basement membrane will be repaired after its damage.
Chemotaxis is the locomotion orientated along a chemical gradient. Chemoattractant are either exogenous (bacteria products) or endogenous (IL-8 and leukotriene B4). Chemotaxis is help by actin polymerization on the leukocytes which results in the formation of the filopodium tail.
There is then phagocytosis when the cell reaches the area.

30
Q

What three things happen to blood vessels during inflammation?

A
  • increased vasodilation
  • increased vascualr permeability
  • increased leukocyte migration

Medicine Phase One (44 decks)

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