Unit 2.5 The Musculoskeletal System Flashcards
1
Q
What is the musculoskeletal system designed to do?
A
The musculoskeletal system is designed to support and protect use move us around, store essential minerals and produce red blood cells
2
Q
What produces the blood cells?
A
Blood cells are produced by the marrow located in the bones - roughy two - three million RBS are produced each second by the bone marrow to replace those worn out and destroyed by the liver.
3
Q
What does the skeletal system include?
A
Bones, joints, cartilage and ligaments
4
Q
What do joints provide?
A
Joints provide the body with flexibility and allow movement to occur.
5
Q
What is the dominant tissue in the body?
A
Muscle is the dominant tissue in the body, making up about 50% of human body mass
6
Q
What are the different types of muscles?
A
Skeletal muscle, smooth muscle and cardiac muscle each which have different functions.
7
Q
How many bones does a normal human skeletal system have?
A
206 bones, mainly for support and protection
8
Q
What does the skeleton provide?
A
An achor point for the muscles and a storage centre for minerals such as calcium and phosphorus and for triglycerides in yellow bone marrow. It is also the production site for red blood cells. The skeleton provides a rigid bone framework to protect vital organs and as an anchor point for the muscles.
9
Q
What has the tensile strength of bone in compression similar to?
A
Similar to cast iron, yet it is about one quarter of the weight.
10
Q
What are the breaking stresses that bone can resist?
A
The breaking stresses that bone can resist in compression are up to about 12.5 tonnes per square inch.
11
Q
Bone is not an inert tissue - what is it made up of?
A
Bone is made up of an extra-cellular matriculates containing different types of cells. The matrix is made up of 25% water, 25% collagen and 50% crystallised mineral salts, especially calcium phosphate which gives the bone its hardness whilst collagen gives its strength.
12
Q
What are bones constantly doing in response to stresses in the body?
A
Being built up or broken down.
13
Q
What do organic parts like collagen fibres provide?
A
Flexibility and strength.
14
Q
How often is the entire skeleton regenerated?
A
Ever 13 years on average and makes up about 18% of the body mass.
15
Q
What happens if someone lacks calcium in their diet or lac the vitamin D to absorb calcium from the digestive system?
A
Their bones will be too soft and flexible and they will suffer from rickets.
16
Q
How many types of cell are involved in the maintenance of the healthy skeleton, what are these?
A
4 types of cells:
Osteogenic cells, osteoblasts, osteocytes and osteoclasts.
17
Q
What are osteogenic cells?
A
These are unspecialised stem cells and are the only bone cells to undergo cell division.
18
Q
What are osteoblasts?
A
These are bone building cells that synthesis and secret collagen fibres and other organic components that build the extracellular matrix of bone tissue - in this way solid bone material i continuously being build up and remodelled.
19
Q
What are Osteocytes?
A
These are mature bone cells - they are osteoblasts that have become trapped within the matrix. They are the most plentiful cells and are an important part of the structure of the bone.
20
Q
What are osteoclasts?
A
These are large, relatively rare cells which are responsible for the removal of bone from areas where it is no longer needed. they are part of the process by which the skeleton is continually being remodelled to be as strong and effective as possible.
21
Q
What are the main bones from top to bottom?
A
Skull, mandible (head and jaw) Clavicle (shoulder) Scapula (back shoulder) Sternum Humerus (upper arm) Rib Vertebra Ulna (smaller bottom arm) Radius (bigger bottom arm) Pelvis Carpus, metacarpal (hand) Phalanges (fingers) Femur (top leg) Patella (knee cap) Fibula (back leg bone) Tibia (front leg bone) Tarsus, Metatarsal (foot) Phalanges (toes)
22
Q
Bone is a highly vascular tissue, with a rich supply of blood vessels, nerves and lymphatic vessels that all penetrate compact bone through what?
A
Through perforating canals.
23
Q
What do the blood vessels supply the bone cells with?
A
The oxygen and nutrients they needs for the constant remodelling of the bone that takes place all the time.
24
Q
What type of bone has few spaces and is the strongest form of bone?
A
Compact bone tissue
25
What is spongy bone composed of?
Small needle like pieces of bone and microscopic spaces that help to make bone lighter - despite the name the bone is not soft the term only describes its appearance. .
26
What do bones tend to be classified by?
According to their shape.
27
What bones are long bones?
All the bones of the limbs except the wrist and ankle are long bones, from the humerus and femur to the phalanges.
They are longer than they are wise.
28
What do long bones have at each end?
They have growth plates at each end down as epiphyses.
29
What is the structure of long bones?
They have a hard outer later of compact bone, covering inner spongy bone - the matrix of the spongy bone is filled with bone marrow and this is where many of the blood cells are made.
30
What are short bone? What do they provide?
Short bones are approximately as wide as they are long - examples being the bones of the wrist and ankle such as the carpals and tarsals. They provide stability with flexibility but not large scale movement.
31
What is the structure of short bones?
They are made up of spongy bone with a covering of compact bone and they contain a relatively large amount of bone marrow.
32
What are flat bones?
These bones form strong, flattened plates that are important both for protecting vital organs and for the attachment of muscles - these include the shoulder blade (scapula), the bones of the skull, ribs, the sternum and some of the pelvic bone. In adults the flat bones are where many of the blood cells are made.
33
What is the structure of flat bones?
They have hard, compact bone on the outside with spongy bone and red bone marrow on the inside.
34
What are irregular bones?
These bones have very non-uniform shapes - they include the vertebrae, the lower jaw and the sacrum
35
What are the sesamoid bones?
These are small, irregular floating bones found embedded in tendons over joints but not connected directly to the joint the best known i the patella (knee cap)
36
How are muscle cells unique?
They can shorten (contract)
37
Where are muscle cells often found? what do they do?
Muscle cells are often found in large blocks called muscles, working together to move the bones of the body.
38
How many type of muscles are there?
3 main types - Skeletal muscles, Smooth muscles and cardiac muscles.
39
What manner do skeletal muscle tissue work?
Skeletal muscle tissue works mainly in a voluntary manner - its activity cane controlled consciously by the brain and nervous system so it is sometimes known as voluntary muscle.
40
How does skeletal muscle look under the light microscope?
Looks striped or striated under the light microscope so can also be referred to as striated muscle.
41
What do normal adult skeletal cells not do?
Normal adult skeletal cells do not undergo cell division
42
What do the contractions of the skeletal muscle do?
The contractions of the skeletal muscle squeeze the blood through the veins towards the heart and also move the lymph through the lymphatic vessels.
43
What do most skeletal muscles have to be capable of?
Rapid movement.
44
The contraction of the skeletal muscle and the return of the muscle fibres to their relaxed state ready to contract again use a lot of what?
Energy.
45
What do muscle cell contain a lot of and what to the contraction of the skeletal muscles generate a lot of?
Muscle cells contain many mitochondria to supply this energy and the contraction of the skeletal muscles generates a lot of heat.
46
What is smooth muscle composed of?
Elongated, spindle-shaped cells.
47
What is smooth muscle not under control of?
Not under voluntary control.
48
Where is smooth muscle found?
It is found in the walls of hollow internal structure such as blood vessels and most of the visceral organs, such as the stomach, urinary bladder and respiratory passages - it is also found in the skin attached to hair follicles.
49
What function does smooth muscle have?
Smooth muscle propels substances through pathways in the body - for example, the movement of food through the digestive tract and the emptying of bowels and the bladder are a result of smooth muscle function.
50
What does the smooth muscle contraction tend to be? What does it use efficiently?
Smooth muscle contraction tends to be slow and sustained and compared with skeletal muscle, smooth muscle uses adenosine triphosphate very efficiently - it can maintain a high force of contraction with very little ATP breakdown so relatively little heat is generated by smooth muscle contraction.
51
What does cardiac muscle consist of?
A branching network of cells that are lined electrically and mechanically to function as a unit.
52
What is cardiac muscle less than compared to skeletal muscle but more resistant to?
Cardiac muscle is much less powerful than skeletal muscle but it is much more resistant to fatigue.
53
What is different about cardiac cells compared to skeletal cells?
Cardiac muscle cells are much shorter than those of skeletal michele.
54
What aren't there many of in cardiac muscle cells?
Relatively few stem cells are found in cardiac muscle so it cannot heal itself if it is damaged.
55
Where does cardiac muscle extend into?
Cardiac muscle extends into the walls of the large veins where they enter the heart.
56
How does cardiac muscle contract?
It contracts with an intrinsic (built in) rhythm but also responds to the autonomic nervous system and to hormones, which can speed up or slow down the rate of contraction.
57
What are some of the main striated muscle blocks of the body (top to bottom)
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Front:
Deltoids (shoulders)
Pectoralis Major (chest)
Biceps (top arm)
Anterior forearms
Obliques
Rectus abdominis
ilopsoas (V line)
Quadriceps
Adductors
Dorsi flextors (shin)
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Back:
Deltoids
Trapezius (middle top back)
Latissimus Dorsi (rest of back)
Triceps
Posterior forearms
Gluteals
Hamstrings
Calves.
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58
What is the whole muscle contained within? What does this do?
The whole muscle is containing within a tough outer layer called the epimysium - this stop the muscle from bulging and getting damaged when the muscle fibres contact.
59
What is each muscle fibre composed of?
Each muscle fibre is composed of main individual structures called myofibrils, the basic unit of the muscle cells.
60
What are myofibrils formed from?
2 proteins, actin and myosin.
61
In a muscle contraction, what slide along what?
In a muscle contraction, the actin filaments slide along the myosin filaments - it is the overlapping of these proteins in a smooth, sliding fashion that allows the muscle to shorten and contract.
62
What can muscle cells transfer energy from respiration into?
Muscle cells transfer energy from respiration into mechanical work as the myofibrils contraction.
63
Muscle tissue has 4 special properties, what are these?
- Electrical excitability - the membrane of the muscle cells conducts an action potential that initiates the flow of ions which cause the muscle to contract.
- Contractility - When a muscle contracts, it generates tension and pulls on its anchor points.
- Extensibility is the ability of muscle to stretch without being damaged, smooth muscle is most often stretched significantly for example when the stomach fills with food.
- Elasticity is the ability of muscle tissue to return to its original length and shape.
64
Where are muscles often found?
Muscles are often found joining 2 bones, where one bone essentially remains stationary while the other moves in some way.
65
What is the point called where the muscle attaches to the stationary bone?
Its point of origin.
66
What is the point called where the muscle attaches to the moving bone?
Its point of insertion.
67
What are the properties of a muscle affected by?
How often it is sued as well as how long and how strongly it is used.
68
When can a muscle atrophy?
A muscle can atrophy (waste away) with nerve supply intact if it is not used for a long period fo time - fr example if a broken leg is immobilised in a plaster cast.
69
What can increased amounts of work through exercise cause the muscle fibres to do?
Increase in size (hypertrophy)
70
Since the number of muscle fibres within a muscle remain the same, hypertrophy can only occur if the muscle fibres themselves do what?
If the muscle fibres themselves increase their metabolic capacity and size.
71
What does regular long lasting aerobic exercise such as swimming or running lead to?
An increase in the number of capillaries around muscle fibres resulting in greater endurance during such exercise in the future.
72
As well as enabling movement, what else do muscles do within the body?
Muscles move substances within the body, for example smooth muscle contractions move substances through the gut and the contraction of the cardiac muscle pumps blood through the arteries
73
By what process does muscle generate heat?
Muscle generates heat by a process called thermogenesis.
74
When ATPP is used to power skeletal muscle contraction, how much of the energy is transferred to the surroundings, warming them up?
75%.
75
After muscles contract and pull on a bone, they them relax, what does this not do?
This does not make them lengthen again or return the bone to its original position, to move the bone back to its original position another muscle must contract and pull the bone in the opposing direction, which stretched the original muscle back into its full length.
76
What is meant but he antagonistic relationship of muscles?
Whatever the action of one muscle, there is a second muscle to oppose it and return the bone to its original position, the muscles found in these pairs are antagonistic muscles - in this way one muscle shortens (for example the biceps_ and it antagonistic muscle (the triceps) lengthens as it is stretched out and vice versa.
77
what causes the arm to bend and straighten?
The biceps and triceps act as an antagonistic pair to bend and straighten the arm.
Biceps contact and pull arm up, triceps relaxed (pulled long and thin).
Triceps contract and pull arm down, biceps relaxed (pulled long and thin).
78
Muscles need a lot of glucose and oxygen when they contract for aerobic respiration to provide ATP used in the chemical reactions of what?
Actin and myosin.
79
What do muscles produce lots of during respiration?
Carbon dioxide which need to be removed.
80
What do muscle tissue have a rich capillary network between?
Between the artery and the veins so every muscle fibre is in contact with one of more capillaries.
81
What is the function of the capillaries?
Capillaries delivery ocyegna dn nutrients and remove the waste products of muscle metabolism.
82
What is the normal process by which muscles obtain the energy they need?
Aerobic respiration.
83
Where is much of the energy released transferred to?
The blood, warming it. which is important in maintaining the core temperature of the whole body.
84
What a muscles also well suppled with?
Motor nerves which stimulate them to contract
85
What is each nerve which penetrates a skeletal muscle accompanied by?
An artery and one or two veins.
86
The harder your muscles work, what do they need more of?
The more oxygen and glucose they need for aerobic respiration.
87
Under what circumstanced do the cells of muscles carry out anaerobic respiration?
If your rate of exercise exceeds the rate at which the heart and lungs can provide oxygen, then the body uses an alternative biochemical pathways to supply the energy it needs, aerobic respiration, then glucose is broken down without oxygen.
88
What does anaerobic respiration produce?
This produces lactic acid as a waste product.
89
What happens if lattice acid builds up in the muscles?
It lowers the pH and causes metabolic acidosis. As the lactic acid accumulates within the muscles it can cause sufficient paint to make a person stop the activity. the More lactic a id a person can tolerate in their system, the longer they can continue a particular activity.
90
What doe anaerobic exercise, for example weight lifting result in an increase in?
Increase in the strength of the muscle, however although the muscle may be powerful it has little capacity for endurance and therefore fatigues rapidly.
91
What is the ache that results from working muscles that are not sure to exercise caused by?
A mild inflammation of the muscle.
92
During extensive exercise, people may experience muscle cramps, what are these often caused by?
These are often caused by dehydration which can generate abnormally high rtes of action potentials to be fired, the exact cause is union but it may be a result go electrolyte imbalances in the extracellular fluid surrounding the muscle and nerve fibres.
93
What does the maximum force generated by a muscle reduce by between the ages of 30 and 80?
30-40%
94
What also decreases with age?
The ability of muscle to adapt to exercise also decreases with age, the same intensity and duration of exercise in an older person produces less change in the muscle than it would in a younger person.
95
The skeletal system is not made up simply of bones and muscle, there are other tissues which play an important part in holding the bone together, preventing bone from wearing away as they move over each other and attaching the muscles to the bones, what are these?
Tendons, ligaments and cartilage.
96
What are tendons? What do they do?
Tendons transmit muscle power to bones, they are extremely strong, flexible bands of fibrous tissue which attach muscle to bone, they do not stretch. They are white glistening, fibrous cords varying in length and thickness with no elasticity.
97
What is the strength of the tendon critical for?
The strength of the tendons is critical in transferring all the force of muscle contraction into moving the bone.
98
What is the size of the tendon proportional to?
The size of the tendon is proportional to the muscle they are attached to.
99
What are tendons contained in?
Tendons are contained in a self lubricating tendon sheath.
100
What are tendons sparingly supplied with? What is the result of this?
Blood vessels, and the smaller tendons, especially have none. it is partly as a result of this poor blood supply that damaged tendons tae a very long time to heal and may never repair themselves properly.
101
What are ligaments, what do they do?
Ligaments hold bones together at the joints, they are predominantly white, shiny, flexible and slightly elastic bands of sheets of tough fibrous tissue that bind bone to bone.
102
By holding the bones into place in the joints, what do ligaments provide?
Ligaments provide stability during both rest and movement, they helps restrict excessive movement such as hyperextension of hyeprflexion of the joints. They also prevent movement in certain directions, making sure the joint and therefore the bones move as is needed by the body.
103
What do ligaments also support in the body?
Many internal organs, including the uterus, the bladder, the liver and the diaphragm, they also help shape and support the breasts.
104
which ligaments are sometimes damaged during sporting activities and rather like tendon injuries, damaged ligaments can be slow to do what?
Ligaments in the ankle joint and knee are sometimes damaged and damaged ligaments can be very slow to heal.
105
What is cartilage?
Cartilage is a hard but flexible tissue, it is elastic and it is a very good shock absorber.
106
What it cartilage made up of?
Cartilage is made up of cells called chondrocytes, in a matrix made mainly of collagen fibrils.
107
There are different types of cartilage, which are most commonly found in the skeleton
Hyaline cartilage and white fibrous cartilage
108
Where is cartilage found?
Cartilage is found between the bone (like the carilage discs between the vertebrae) where it acts as a shot absorber and over the ends of bones which move together (articulate) in joints, where is acts to reduce friction and fusion the bone, for example in synovial joints such as the hip or knew.
109
What is a joint?
A joint is the point where two or more bones meet.
110
What can joints be classified as?
Joints can be classified in a number of different ways, and the different ways of classifying them often overlap - these can be fibrous, cartilaginous or synovial.
111
What are fibrous joints?
Fibrous joints connect bones without allowing any movements e.g bones of your skull and pelvis are held together by fibrous joints.
112
What are cartilaginous joints?
Cartilaginous joints are joints mine which the bones are attached by cartilage - these joints allow a small amount of movement such as in the spine of ribs.
113
What are synovial joints?
Synovial joint allow one surface to slide freely over another, the sliding surfaces are covered with a thin later of cartilage, most of the joints that allow you to move around are synovial joints, for example those in the hip, knee, shoulder an elbow.
114
What is the space between synovial joints filled with? What does this help with?
In synovial joints the spaces between the bones are filed with synovial fluid, made by the synovial membrane, this helps to lubricate the joint and protects the joint surfaces from rubbing together.
115
What are the ends of the bone covered with?
Smooth cartilage so the surfaces slide easily over each other, lubricated by the synovial fluid and preventing damage to the ends of the bones.
116
What does a synovial joint allow?
Free movement but protects the bones from wear and tear.
117
What do some complicate synovial joints also have?
Some complicated joints such as the knee also have special extra sacs of synovial fluid called bursae to give more protection to the joint,
118
What happens if the bursae becomes inflamed and swollen?
It causes painful condition such as housemaids new (prepatellar bursitis) this not only hurts but reduces the mobility of the knew joint.
119
Musculoskeletal conditions are among the most common sources of pain and discomfort and may be caused by many things, such as?
such as, poor posture, sports injury or simple wear and tear, as well as autoimmune reactions in the body - rest and painkillers followed by gentle exercise can other help.
120
What is Rheumatoid arthritis (RA)?
RA is a chronic autoimmune disease, mainly characterised by inflammation of the synovial or synovial membrane lining the joints.
121
What can RA lead to?
It can lead to long term joint damage, resulting in chronic pain, loss of function and disability.
122
RA progresses in three stages, what are these?
The first stage is the swelling of the synovial lining causing pain, warmth, stiffness, redness and swelling around the joint.
The second is the rapid division and growth of cells in the joint, which causes the synovial to thicken.
In the third stage, the inflamed cells release enzymes that may digest bone and cartilage - not only does this usually cause the joint to lose its shape and alignment it often results in a lot of pain and loss of movement.
123
Because RA is a chronic disease what does this mean?
RA continues indefinitely and may not go away. Frequent flare in disease activity can occur.
124
RA is a systemic disease, what does this mean?
It can affect other organs in the body.
125
What is critical to help the patient continue living a productive lifestyle?
Early diagnosis and treatment. Studies have shown that early aggressive treatment of RA can limit joint damage which in turn limits loss of movement, decreased ability to working potential surgery.
126
Around how many people in the U are affected by RA, what sex is it more common in? what is the most common age range for onset?
Around 400,000 people affected in the UK and it is 3 times more common in women than in men. The most common age range when it appears is between 40 and 50 years of age.
127
What is the cause of RA?
The causes are still not fully understood but factors that increase your risk of developing the disease include inherited factors which at the moment you cannot change and lifestyle choices such as smoking, earring a lot of red meat and drinking a lot of coffee.
128
What is osteoarthritis?
Primary osteoarthritis is mostly related to ageing to injury and is known as a degenerative condition.
129
With ageing, what happens to the cartilage?
The chemical composition of the cartilage changes.
130
What does repetitive use of the joints over the years cause?
Repetitive use of the joints over the years irritates and inflames the cartilage causing wear and tear to the smooth surfaces, joint pain and swelling. eventually the cartilage begins to degrease by falling or forming tiny crevices.In advanced causes there is a total loss of the cartilage cushion between the bones of the joints.
131
What does loss of the cartilage cushion cause?
Friction between the bones, leading to pain, wearing way of the bone tissue, pain and limitation of joint mobility. As the cartilage degenerates, other tissues in the joints may become very active as if to compensate, the bones at the edge of the joints may grow out forming bony spurs which also affect and often reduce the mobility of the joint.
132
What can happen to the synovial fluid when the cartilage cushion is lost?
The synovial can thicken and make more fluid than usual so the joint swells.
133
What can help stabilise the joint?
The joint capsule and ligaments thicken and together which can help stabilise the joint.
134
What are some risk factors for osteoarthritis?
These include some things you cannot change such as your age, sex (more common and severe in women, joint abnormalities you are born with, joint injuries and other joint diseases such as RA and a family genetic tendency to be affected by the disease, other risk factors you can influence to lower you risk include obesity, a strong risk factor in osteoarthritis particularly in the knee - and many people develop osteoarthritis as a result of sports injuries which can be avoided.
135
What is osteoporosis?
Oesteoporosis is a decrease in the normal density of bone, leading to fragile bones - causing abnormally porous bone that is more compressible like sponge than dense like a brick - weakening the bone leading to an increase in the risk of breaks.
136
What does osteoporosis appear to involve a greater amount of?
We know that bone is constantly being sculpted and remodelled by the actions of osteoblasts and osteoclasts, in osteoporosis it appears to involve a greater amount of osteoclast activity and therefore a greater amount go bone resorption.
137
What can cause osteoporosis bones to fracture?
Only a minor fall or injury that normally would not cause any problems, the fracture can be either in the form of cracking (as in a hip fracture_ or collapsing (a in a compressor fracture of the vertebrae of the spine)
138
Where are common areas of osteoporosis related bone fractures?
The spine, hips and wrists although osteoporosis related fractures can also occur in almost any skeletal area.
139
When is osteoporosis much more common?
In women after the menopause.
140
What is gout? Who is it more common in?
Gout is a metabolic disorder, often inherited, and more common in men than in women.
141
What does gout result from?
Gout results from crystals of uric acid being deposited in tissues of the body and it causes recurring attacks of joint inflammation (arthritis)
142
What can chronic gout lead to?
Chronic gout can lead to deposits of hard lumps of uric acid called top, in and around he joints and decreased kidney function.
143
Gout is often related to an inherited abnormality in what?
Gout is often related to an inherited abnormality in the body ability to process uric acid.
144
What does Gout cause?
Gout causes not only attack of painful arthritis but also kidney stones and blockage of the kidney filtering tubules with uric acid crystals leading to kidney failure. Some patients may develop elevated blood uric acid levels (hyperuricaemia) without having arthritis or kidney problems.
145
What does the term gout commonly refer to?
The term gout commonly refers to the painful arthritis attacks.
146
Gouty arthritic is usually an extremely painful attack with a rapid onset of joint inflammation, what is the joint inflammation precipitated by?
The joint inflammation is precipitated by deposits of uric acid crystals in the joint fluid, synovial fluid, and joint lining, synovium.
147
When does intense joint inflammation occur?
As WBCs engulf the uric acid crystals and release chemicals of inflammation, causing pain, heat and redness of the joint tissues.
148
What is important in the treatment of musculoskeletal diseases and in restoring the best possible movement and maximum pain relief to patients?
Physiotherapy, exercise, weight reduction, massage and physiological support.
149
What are non-steroidal anti-inflammatory drugs (NSAIDs) used to treat?
A wide range of musculoskeletal problems including the relief of the pain and stiffness resulting from RA of OA. They can be affective at relieving symptoms but they do not treat the underlying causes.
150
When it comes to NSAIDs what is there considerable variation in?
Differences in anti-inflammatory activity between different NSAIDs are small but there is considerable variation in individual patient tolerance and response, many patients will respond to any NSAID but patients who do not respond to one may well respond to another.
151
How do NSAIDs act?
They act by interfering with the body inflammatory process - they block the enzymes call cycle-oxygenases (COX-1 and COX-2_ which are part of the inflammatory response of the body. Inhibited the enzymes reduces swelling, fever and associated pain. They can vary in their selectivity meaning they affect different enzymes differently.
152
What side effects can NSAIDs cause?
NSAIDs can cause side effects in some people including an increase risk of gastrointestinal bleeding, but they are widely used by mullion of people daily
153
NASIDs that selectively inhibit which enzyme are thought to have fewer side effects on the gastro intestinal system?
COX-2 (coxibs)
154
What short term treatment can help to rapidly improve the system software RA?
Short term treatment with systemic corticosteroids, but long term treatment is not generally recommended as they can have severe side effects.
155
For the relief of inflammation and pain for example in tennis elbow, how can corticosteroids be administered?
Injected locally.
156
There is no cure for RA, NSAIDs treat symptoms but do not halt the process of the disease, what medicines can suppress the disease process, at least temporality?
Disease-modifying anti-rheumatic drugs (DMARDs) which do not produce an immediate therapeutic effect but require 2- 6 months of treatment for full response.
157
What do DMARDs do?
They bloc the effects of the chemicals released when the immune system attacks the joints are are often very effective at slowing down the progression oft he disease but can have some severe side effects, they are taken long term.
158
What do Biological medicines for treating RA affect?
Biological medicines affect parts of the immune system which are involved in the inflammation of the joints seen in rheumatoid and other types of arthritis.
159
What do Biologics interfere with?
Biologics interfere with the chemicals which trigger the inflammatory response in joints affected by RA - they can be extremely effective in relieving symptoms in some individuals and are often given in combination with DMARDs for maximum effect.
160
What does the treatment of OA include?
The treatment of OA includes rehabilitation techniques to minimise disability: losing weight to reduce joint damage, exercising to jeep joints mobile, topical and systemic NSAIDs, corticosteroid injections in to the affected joint (intra-articular corticosteroid injections) and low dose opioids to help control the pain - none of these affects the progression of the disease.
161
How might gout be controlled?
Gout may be controlled by medicines that reduce the formation of uric acid from purines (rate-lowering therapy) acute attacks of gout are normally treated with high doses of NSAIDs
162
What can be used to treat menopausal osteoporosis?
Medicines that affect bone metabolism can be sued to prevent or treat post menopausal osteoporosis.
163
What do Bisphosphonates world on?
Work on the bone making cells, stimulating them to be more active.
164
What is treatment with monoclonal antibodies that decrease bone resorption recommended for?
The prevention of fractures due to osteoporosis for some post menopausal women.
