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Physio > Physio Lecture Block 2 > Flashcards

Physio Lecture Block 2 Flashcards

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1
Q

What does the skeletal System contain

A

Bones
Cartilage
ligaments
connective Tissues

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2
Q

skeletal system functions

A

Support
protection
leverage (movement)
mineral homeostasis (storage and release)
triglyceride storage (yellow marrow)
Hemopoiesis (red and white blood cells formation) found in red marrow

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3
Q

Axial Skeleton

A

Skull
Hyoid
Auditory
Vertebral column
Thorax
only 80 bones total and appears more central

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4
Q

Appendicular

A

Pectoral Girdle (shoulder)- clavicle and scapula
Upper Limbs
Pelvic Girdle (hips etc.)
Lower Limbs (extremities)
126 total bones

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5
Q

Types of Bone/Bone classification

A

Long- humerus
Short - wrist bone
Flat - sternum
Irregular - vertebra
Sesamoid - patella
Sutural- fetal skeleton
pneumatized - ethmoid ??

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6
Q

layers of connective tissue that are important growth and remodeling

A

endosteum and periosteum

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7
Q

Periosteum

A

-connective tissue membrane covering the EXTERNAL SURFACE of a bone
-continuous with tendons and connective Tissues of joints
-attached to bone matrix via perforating fibers

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8
Q

Two layers of the periosteum

A

outer fibrous and inner osteogenic

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9
Q

Endosteum

A

Lines the INNER surface of bone: **marrow cavity, trabeculae of spongy bone, and canals of compact bone
**Contains Osteogenic cells (this is where it gets importance for bone growth and remodeling)

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10
Q

Short Bone Anatomy

A

Compact bone, the spongy bone, and then red blood marrow in between spongy bone

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11
Q

Anatomy of a flat bone

A

Periosteum, then compact, then spongy, endosteum lines inner space (kinda between spongy it looks like)

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12
Q

Are sutural bones part of the 206 bones of the body?

A

No they are in addition if present at al

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13
Q

Articulations (AKA JOINTS OR ARTHROSES) definition

A

a point of contact between
-Bones (elbow)
-Bones and Cartilage (epiphyseal plates)
-Bones and Teeth

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14
Q

Arthrology definition

A

Study of Teeth

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15
Q

Kinesiology definition

A

Study of the body in motion

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16
Q

How are joints classified (2 ways)?
What are the 3 types of each?

A

Based on anatomical structure!
Fibrous
Cartilaginous
Synovial

Based on Function!
Synarthrosis
Amphiarthrosis
Diarthrosis

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17
Q

Synarthrosis, Amphiarthrosis, and Diarthrosis explained

A

Syn= immovable
Amphi= Slightly movable
Di= Freely movable

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18
Q

Fibrous Joint

A

Dense Irregular CT between bones

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19
Q

What type of tissue is Cartilaginous

A

Hyaline Cartilage between Bones

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20
Q

Synovial

A

synovial fluid between bones

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21
Q

Synarthroses examples

A

Immovable
*sutures
*Gomphosis (fibrous and looks like root of tooth/alveoli area)
*Synchondrosis (cartilaginous joint idk where tho)

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22
Q

amphiarthrosis

A

slightly movable- examples: intervertebral discs
*Syndesmosis (fibrous)- between tibia and fibia
*Interosseous Membrane (fibrous) also between fibia and tibia?
*Symphysis (such as pubic) (is cartilaginous joint)

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23
Q

diarthroses (Name and describe all 6!)

A

Freely movable- examples
*Gliding Joint (back and forth side to side between navicular and cueniforms of tarsus.
*Hinge Joint (elbows, knees- monoaxial and only swing in one direction) specifically trochlea of humerus and trochlear notch of ulna
*Pivot Joint (head of radius and radial notch of ulna)
*Condyloid Joint- joint between radius and the scaphoid and lunate carpus
*Saddle Joint- between trapezium of carpus and metacarpal of the thumb
* Ball and Socket- (between head of femur and acetabulum of hip)

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24
Q

All diarthroses are what type of joints?

A

Synovial!

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25
Q

functions of synovial fluid

A

*lubrication of the joint
*provision of nutrients to articular cartilage
*shock absorption

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26
Q

accessory structures of synovial joints

A

*bursae (little pillows)
*menisci (articular discs)
*intra and extracapsular ligaments
*tendons (bone to muscle)

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27
Q

Two types of arthritis

A

osteoarthritis (degenerative)
-bone ends rub together and it is due to wear and tear over time

Rheumatoid Arthritis (inflammatory) basically auto immune and more typically older patients. Involves a swollen and inflamed synovial membrane because the body thinks it is a pathogen

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28
Q

Shoulder Joint is . . .

A

also called glenohumeral joint
diarthrosis- freely moveable
a ball and socket joint
tri-axial joint (more injury)

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29
Q

What is the shoulder joint stabilized by?

A

4 ligaments and the tendons of 4 muscles
Rotator cuff muscles:
-supraspinatus
-infraspinatus
-subscapularis
-Tres Minor

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30
Q

Knee Joint is . . .

A

also called tibiofemoral
diarthrosis, hinge joint, mono axial, and medial and lateral menisci cushion the joint

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31
Q

Ligaments that stabilize the knee joint

A

7!!
2 intracapsular
5 extracapsular

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32
Q

test for ACL vs PCL

A

ACL= anterior drawer test
PCL = posterior drawer test

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33
Q

where is yellow bone marrow found?

A

Diaphysis

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34
Q

Bone Cells

A

Osteogenic Cells
Osteoblasts
Osteocytes
Osteoclasts

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35
Q

Osteogenic Cells
what are they formed from?
What do they become?

A

AKA Osteoprogenitor Cells or “Bone Stem Cells”
formed from mesenchyme
differentiate into osteoblasts

Cycle example (need to be able to explain)
osteogenic Cells -> mitosis -> daughter osteogenic cells -> differentiation -> osteoblasts (some change and some do not)

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36
Q

Osteoblasts

A

cells that build bones (BONE FORMATION)
These are IMMATURE bone cells and the golgi folds on surface giveaway its role in secretion
*synthesize organic components (collagen fibers) of matrix
*Initiate calcification- take Ca from blood and put in matrix by exocytosis

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37
Q

Osteocytes

A

Mature Bone cells
Involved in MAINTENANCE of bone tissue
Senses microdamage and mechanical forces on bone- sends signals for repair (VIA DENDRITES)

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38
Q

Osteoclasts
what do they release and for what function?
Where are they derived from?

A

break down bone- RESORPTION
*Release proteolytic enzymes and acids to degrade collagen and release minerals to blood
*Derived from Myeloid Stem Cells NOT osteogenic cells

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39
Q

Osteoclasts parts and functions

A

Sealing Zone- Growth, depositing, and fixing
Ruffled Border- Secretory with “resorption lacuna” which are amino acids floating around
Functional Secretory Domain-releases out into blood

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40
Q

goal/s of bone remodeling

A

Achieve Strength for loading and lightness for mobility
Reach Peak Strength (during growth) and Maintain this by removing damaged bone in adulthood

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41
Q

How does bone modeling achieve Strength and lightness

A

-Strategically deposit bone where it is needed for strength
-Remove bone from where it is not needed to avoid bulk

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42
Q

Fatigue Damage and How the bone responds to it with each bone cell type

A
  1. detect location and magnitude of damage (osteoclast)
  2. remove damage (osteoclast)
  3. Replace it with new bone (osteoblast)
  4. Restore bone material composition, microarchitecture, and macroarchitecture
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43
Q

Extracellular Matrix of Bones

A

Ground Substance (GAG, water, minerals, noncollagenous proteins)
and Organic components- COLLAGEN FIBERS

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44
Q

Ground Substance

A

GAGS- glycosaminoglycans
Glycoproteins (polysaccharides and protein)
they are negatively charged so they trap water

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45
Q

Collagen Fibers

A

*fibrous protein arranged in a helical form (Type 1 collagen)
*Very resistant to pulling forces
*Provides flexibility and framework for deposition of calcium crystals

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46
Q

Hierarchial Organization of Collagen in Bone

A

osteoblast-tropocollagen-microfibril-fibril-fiiber-lamella-osteon- compact cortical bone-bone

47
Q

Inorganic Components of ECM

A
  1. Water- 25% and is attracted to ground substance
  2. Hydroxyapatite Ca10(PO4)6OH2
    Forms mineral plates that fill spaces within collagen fibers
48
Q

What two things provide strength to the ECM??

A

Collagen and Minderals
collagen provides flexibility and minerals provide firmness

49
Q

experiments to test the strength of collagen and then minerals

A

collagen- proteolytic enzymes applied and bone becomes brittle and crumbly
Minerals- soak in vinegar and it becomes flexible

50
Q

Rickets

A

Children
Calcium deficiency due to lack of vitamin D
Flexible,bowed legs

51
Q

Scurvy

A

problem with collagen synthesis due to vitamin C deficiency
brittle, easily broken bones

52
Q

Spongy Bone organization

A

Irregular lattice of thin plates called trabeculae
osteocytes in lacunae

53
Q

Spongy Bone Location

A

*Epiphyses of Long Bones
*Surrounds Marrow Cavities
*Flat, short, Irregular bones

54
Q

Spongy Bone Functions

A

*Withstand forces from many directions- trabeculae arranged along lines of stress
*Lightens the skeleton- less strong than compact bone
*Contains red marrow for hemopoiesis

55
Q

Compact Bone Organization

A

Solid network of bone organized in concentric ring structures called osteons

56
Q

Compact Bone Location

A

-External layer of all bones
-Diaphysis of long bones

57
Q

Compact Bone Function

A

Gives long Bones ability to withstand forces along longitudinal axis

58
Q

Why is every bone not compact bone?

A

too heavy and too difficult to remodel

59
Q

what is the functional unit of a compact bone?

A

osteon

60
Q

What is the epiphyseal of the long bone made of in infants?

A

Cartilage

61
Q

epiphyseal plates stay as what until the end of adulthood?

A

Cartilage

62
Q

bones of a baby before birth are composed of:

A

1) loose connective tissue (messenchyme)
2) Hyaline Cartilage

63
Q

Ossification

A

*Replacement of connective tissue by bone
*Begins during the second month of development
*Continues for many years after birth

64
Q

two types of ossification

A

Intramembranous and Endochondral

65
Q

intramembranous ossification

A

Within membrane
messenchyme becomes bone

66
Q

Endochondral Ossification

A

Inside Cartilage
Messenchyme–>cartilage –> bone

67
Q

Bones formed by intramembranous ossification

A

Cranial, Facial, Sternum, Clavicles

68
Q

Heterotrophic Bone Formation
- Also considered intramembranous ossification

A

abnormal stresses can cause bone formation where it is not supposed to be
sesamoid bones

69
Q

Sesamoid Vs. Bone spur

A
70
Q

Intramembranous ossification Steps

A

1) Development of ossification center: Messenchymal cells become osteogenic cells, then blasts, then those secrete bone matrix
2) Calcification
osteoblasts deposit calcium in the matrix and then blasts diff. into cytes
3) Formation of Trabeculae- ECM develops into trabec that fuse to form spongy bone
4)Development of Periosteum- remodel of spongy bone to compact bone

71
Q

what is an essential part of ossification?

A

Calcification

72
Q

Endochondral Ossfication

A

Most bones formed this way
Growth in LENGTH at epiphyseal plate is triggered by this

73
Q

Endochondral Ossification Steps

A

1, development of a cartilage model
2. growth of cartilage model
3. blasts create a primary ossification center
4. osteoclasts create a marrow cavity
5. around birth, secondary ossification centers form in the epiphyses
6. spongy bone replaces cartilage at epiphyses (except for plates)

74
Q

Types of Endo ossification

A

Primary-
*marrow cavity formed
*replaces all cartilage with bone
*located in diaphysis and cocurs before birth
Secondary-
*no marrow cavity
*some cartilage left for growth plates and artic. cart.
*located in epiphyses
*occurs at time of birth

75
Q

What are the two processes that occur at the growth of an epiphyseal plate

A
  1. interstitial growth of cartilage
  2. Endochondral ossification
76
Q

What occurs/is meant by interstitial growth of cartilage

A

cartilage grows from within at the epiphyseal side of the epiphyseal plate

77
Q

4 steps of interstitial growth

A
  1. Mesenchymal cells differentiate into chondroblasts
  2. chondroblasts build matrix and differentiate into chondrocytes
  3. chondrocytes divide and spread apart
  4. cartilage tissue grows from within
78
Q

Endochondral Ossification is when

A

cartilage is replaced by bone on the diaphyseal side of the epiphyseal plate

79
Q

Diaphysis grows in LENGTH but the thickness of what does not change

A

the thickness of the epiphyseal plate

80
Q

Epiphyseal Plate growth (summary/should be able to roughly explain the steps)

A

*Diaphyseal osteoclasts breakdown calcified cartilage
*Osteoblasts lay down spongy bone
*Chondrocytes Continue to form cartilage matrix in prolif. region
*Length growth stops when clasts and blasts are working faster than chondrocytes in the proliferation zone- epiphyseal plate becomes the epiphys line

81
Q

at what age for male and female do plates close?

A

18 females
21 males

82
Q

why do epiphyseal plates close and what forms after?

A

epiphyseal cartilage stops dividing and are replaced by bone
the epiphyseal line forms

83
Q

——- cannot occur after the epiphyseal plate closes

A

interstitial growth

84
Q

Appositional growth is what? And what does it generated?

A

growth in width
It generates new osteons

85
Q

What does appositional growth increase?

A

bone diameter
cortical width
medullary cavity size

86
Q

Appositional growth steps

A

*periosteal osteogenic cells become osteoblasts
*these blasts build bone on outer surface of the bone
*endosteal osteoclasts increase the diameter of medullary by breaking down from the middle

87
Q

4 steps leading to osteons being added on the periosteal side

A

1) ridges in Periosteum create groove for blood vessel
2) periosteal ridges fuse, making an endosteum lined tunnel
3) blasts in endosteum build concentric lamellae inward towards center of tunnel Foraming a new osteon
4) bone grows outward and osteon formation repeats

88
Q

2 fracture classifications

A

Traumatic
Pathologic

89
Q

Traumatic Fracture

A

normal bone experiencing abnormal force

90
Q

pathologic fracture

A

abnormal bone experiencing normal forces

91
Q

Gross classification of fractures

A

*Incomplete: partially broken “greenstick”
*Complete: all the way through, loss of continuity
*Displaced Vs. Non-displaced: separation between the broken pieces or not
*Open (Compound) Vs Closed (simple): open is where there is a complete displaced fracture in which one or more broken pieces break the surface

92
Q

Comminuted Fracture

A

Think Finger example
hypertension from finger bent backwards too far, tendon tears and pulls off the bone
avulsion injury from Jersey finger

93
Q

What is an epiphyseal fracture and why is this naming different from avulsion, spiral, etc.

A

it is different because it is named via location and not based off of the nature of the break
This fracture can be incomplete or complete and it is on the plate between diaphysis and epiphysis

94
Q

3 steps of bone- repair
need to be able to explain each (double check on slide 39 of 2.6

A

1) formation of fracture hematoma (6-8 hours)
2a) fibrocartilage callus formation (3 weeks)
2b) bony callus formation(Endochondral ossification) (3-4 months)
3) Bone remodeling (6-9 months)

95
Q

Bone Fracture Treatment

A

Immobilization
Reduction (open)- surgical use of rods, screws, etc.
reduction (closed)- manipulation of bone without surgery

96
Q

3 Factors that Influence Bone

A

Diet
Hormones
Excercise

97
Q

Minerals and Vitamis and what they do for your bones

A

Ca and K+ found in blood
Vitamin A Stimson osteoblast activity
Vitamin C needed for collagen synthesis
Vitamin D stimulates Ca absorption in GI tract (rickets)
Vitamins K and B12 needed for synthesis of bone proteins

98
Q

What is the normal range of blood calcium?

A

8.5-11 mg/dL

99
Q

Why is calcium important and what are some ways we control its entry and exit from the blood?

A

Membrane excitability
blood clotting
secondary messenger

Control entry and exit:
-Bone storage
-Kidney excretion
-Intestinal Absorption

100
Q

What 3 hormones are involved in Ca homeostasis

A

Calcitonin
calcitrol (vitamin D)
Parathyroid hormone

101
Q

What is Calcitonin’s
Stimulus
Source:
Target Tissue:
Action:
and End Result:

A

Stimulus: High blood Ca
Source: thyroid gland
Target Tissue: bone, kidney, intestine
Action:
inhibits clast activity
increases Ca excretion in kidneys
Inhibits absorption of Ca at intestine
End Result: decreased blood Ca levels (- Feedback Loop)

102
Q

Parathyroid Hormone
Stimulus
Source:
Target Tissue:
Action:
and End Result:

A

Stimulus: low blood Ca
Source: parathyroid gland
Target Tissue: bone, kidney, intestine
Action:
-Stim clast activity
-decrease excretion of Ca at kidney
-Stimulates intestinal absorption of calcium and promotes Calcitrol action
End Result: Increase blood calcium levels

103
Q

Calcitrol is what form of vitamin D

A

Active Form

104
Q

When is vitamin D converted to the active Form only if what is present

A

PTH

105
Q

Calcitrol
Stimulus
Source:
Target Tissue:
Action:
and End Result:

A

Stimulus: PTH, low blood Ca
Source: kidney
Target Tissue: bone, kidney, intestine
Action:
End Result:

106
Q

How much calcium do you need per day

A

1000 ng Ca per day

107
Q

What hormones act on osteoclasts?

A

calcitonin and parathyroid hormone

108
Q

What hormones act on osteoblasts

A

GH and Estrogen/Test.

109
Q

Growth Hormone (somatotropin) stimulates what?

A

cell growth and protein synthesis (collagen)
secretion of IGF’s that stim osteoblast activity

110
Q

Pituitary Dwarfism

A

Children with low levels of GH- slow epiphyseal growth

111
Q

Pituitary Gigantism

A

hypersecretion of GH in childhood
-accelerated epiphyseal growth

112
Q

Acromegaly

A

Hypersecretion of GH AFTER puberty
leads to appositional growth in skull hands and feet and cartilage because epiphyseal plates of long bones are already closed

113
Q
A

Physio (4 decks)

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