Wed Wk 3 MSK Flashcards
in haversian system, central canal is circled by concentric __ of bony matrix
lacunae are filled w O__ and extracellular bone fluid
canaliculi raidate to create a network w adjacent ___, w cytoplasmic processes of osteocytes in the canaliculi
canaliculi send nutrients/waste w/in neighboring lamellae via __ jxn
osteocytes maintain __ of mineralized matrix, control calcium homeostasis
directly dictated by __ and PTH/calcitonin indirectly
also sense mechanical _ to modulate activity of OB in bone remodeling
lamellae
osteocytes
lamellae
gap
structure
Ca
stress
P__ presents in MA w symmetric proximal muscle weakness
muscle enzymes are __
Antibodies include ANA and anti Jo 1 aka anti-__-__synthase
biopsy shows E__ mononuclear infiltrate w patchy muscle fiber necrosis
both poly/dermatomyositis can occur as paraneoplastic cx w A___
pt w pain over LE has lateral \_\_ seen in \_\_ player w backhard insertion of ECRB and extensor digitorum used in wrist \_\_ trauma leads to angio\_\_ tendinosis w no inflam infiltrate if it occurred on ME, dx is \_\_\_
antibodies to desmoglein are seen in P__ vulgaris
polymyositis elevated histidyl-tRNA endomysial adenoca
pemphigus
epicondylitis tennis externsor carpi radialis brevis extension fibroblastic medial epicondylitis
overuse of the APL/APB seen in de __ tenosynovitis
pt w sx of GCA needs __/__ testing to rule out dx
if positive, get __ artery biopsy
pt w myeloproliferative disorder and recurrent monoarthritis has __
inc __ or dec clearance
MSU forms __ in cooler lower extremity joints
uptake by __ leads to free rad/cytokine release and inflamm
synovial culture w many leuks but no crystals/orgs has __ arthritis
de Quervian
ESR/CRP
temporal
gout
uric acid
crystals
PMN
rheumatoid
__ dislocation of shoulder is most common
occurs w __ rotation and abducted arm (ie throwing)
deltoid is __ w protrusion of the acromion
anterior axillary __ due to displacement
injures the __ nerve
AC joint sublux seen w D__ blow on shoulder
shoulder is swollen w __ displacemetn of clavicle
pt w triad of osteolytic lesions, endocrine abnorms, cafe au lait macules has __
mosaic somatic mutation in __ gene that activates G protein a subunit
leads to gain of fxn mutation, stimulating __ to produce large CALM, unilateral, and irregular
girls may have P__ puberty
inc release of Fibroblasts, IL __ and OC leads to fibrous __
may be assc w T/A/C
anterior external flattened fullness axial
downward
upward
Mccune Albright GNAS melanocytes precocious 6, dysplasia thyrotoxicosis, acromegaly, cushing
resting membrane potential is highly permeable to __ efflux
also a small number of __ channels for influx, thus MP is always less than K value
MP is a __ of equilibrium potentials, w Cl plying little role
Type 1 muscle fibers perform low level sustained __ like posture
high myoglobin and __ allow for aerobic metabolism
think S and P muscles
Type 2 fibers are for rapid powerful __
generate __ via anaerobic glycolysis
K
Na
combination
contractions
mitochondria
soleus/paraspinal
force
ATP
pt w erythema, swelling, pain out of proportion to exam, fever and hypoTN has __ fascitis
think strep __ and Staph __ or Clostridium __
__ is coag/catalase neg, PYR positive w wide zone hemolysis
S pyo enters deep layers, due to prodxn of H__ and enzymes
__ protein is virulence factor that prevents activation of alternative complement
can secrete Hemolysins __/_ to cause hemolysis
Superantigens cause __ shock
Tx w surgical __ and broad spectrum __
C perfringens is __ forming, anaerobic gram neg __
produces __ zone of B hemolysis
Strep agalactiae is coag/cata neg gram + cocci w __ zone B hemolysis
enhanced when near __ as a CAMP test
necrotizing
pyo, aureus, perfringens
strep pyo
hyalurondase
O/S
septic
debridement, antibiotics
spore, rod
double
narrow
Staph aureus
use __ to tx Gout in pt w hx of peptic ulcer
works by inhibiting microtubule __
interrupts __ dependent fxns like chemotaxis/phagocytosis/degranulation
dec prodxn of leuk __
SE include N, ab pain and D__
disuse atrophy results in cell __ and reduced size
pathologic form is due to lack of __ or dec hormonal/neuro __, mechanical compression, poor __
atrophy seen as dec __/__ w dec protein syntehsis and lost myofibrils
can lead to A__
colchicine polymerization cytoskeleton B4 diarrhea
death
use, stimulation, intake
mito/RER
apoptosis
fibrillin 1 is found in blood __ and p__ and suspensory ligaments of lens
acts as scaffold for __
osteoporosis presents w __ bone mass and deterioration of tissues
primarily involves __ bone, important maintaining vertebral column
w progression, involes __ bone in long bones
labs should be __
insoluble calcium requires __ environment for proper absorption
acid suppressing meds like __ inhibs dec absorption of dietary calcium
other meds that can result in osteoporosis are anticonvulsants that induce p450 like P/P/C that inc VD catabolism
aromatase inhib/medroxyprogesterone dec __
GnRH agonsts dec T/E
glucocorticoids dec bone _
vessels, periosteum
elastin
dec
cancellous
compact
normal
acidic
PP
phenytoin, phenobarbitol, carbamezepine
estrogen
testosterone, estrogen
formation
meds for osteoporosis
Ca/__ as needed
Bisphosphonates attach to h__ binding sites on bone surface
inhibit __ mediated bone resoprtion
D__ binds RANKL and prevents interaction w RANK
reduces differentitation/survival of __
Recombinant PTH T__ stimulates maturation of OB
inc GI __ absorption and renal tubular reabsorption
E__ is TNF a inhib alongside MTX for RA
fusion of TNFA receptor and Fc portion of __
acts as __ receptor
C/I are antibodies that target TNFa
I__ is used for CML
small molecule __ receptor inhibitor
VD hydroxyappetite OC denosumab OC teriparatide Ca
etanercept
IgG1
decoy
cetuximab, infliximab
imatinib
TK
in older pt w DM, HTN, alcoholism and warfarin therapy, look for spontaneous __ hematoma
femoral nerve descends through fibers of __ muscle
problems w __ muscles, w weakening of iliopsoas
problems climbing __ and have knee buckling
lose __ reflex and sensory over thigh
may have acute severe pain in G/lower ab, back
pt w SLE has anti __ antibodies that specific
Smith protein complxes w __ in cytoplasm to form snRPs
RNA poly 1 forms 18s, 5.8s and __ rRNA
RNA poly 2 forms micro, _ and _ RNA
RNA poly 3 forms __ and 5srRNA
retroperitoneal psoas major quads stairs patellar groin
Smith snRNA 28s snRNA, mRNA tRNA
Golgi tendon organs are __ receptors at jxn of muscle/tendon
innervated by group __ sensory axons
GTO connected in series to skeletal muscle __
when muscle contracts, inc tension is transmitted via tendon to __
the 1b sensory axons contact inhib interneurons in __ to synpase on a motor neurons in muscle
acts as __ feedback to regulate muscle tension
w too much contraction, GTO causes muscle __
A delta fibers are myelinated fibers that sense temp/__
assc w __ pain and make up affarent portion of reflex arc
muscle spindles are connected in __ w extrafusal fibers
innervated by group 1a and __ sensory axons
sensitive to change in muscle __
mediate __ reflex in DTR
when stretched, reflex activation causes __ to resist stretch
sensory 1b fibers GTO spinal cord negative relaxation
nociception
sharp
parallel 2 length myotactic contraction
P__ corpuscles are rapid adapting mechanoreceptors found in subq of skin, mesentery, peritoneum, and joints
Rufini end organs are __ adapting mechanoreceptors in same areas
both mediate __/proprioception and vibration
innervated by myelinted __ fibers
supraspinatus/infraspinatus innervated by __ nerve
teres minor innervated by __ nerve
Supraspinatus for A__
infraspinatus/teres minor for __ rotation
subscapularis for __ rotation
__ tubules are invaginations in the sarcolemma
found in __ muscles and contain L type ca channels
allow depolarization to rapidly __ through muscle fiber
ensures Ca release is __ w synchronized contraction of myofibrils
pacinian
slow
touch
A beta
suprascapular
axillary
abduction
external
internal
Transverse
striated
propagate
continuous
pain on weight bearing, dec range of motion may indicate O__
due to impaired __ supply to bone
could be T/E occlusion like SCD or Fat emboli
G__ use
Vascular inflam like V__
alcohol abuse and traumatic __
biopsy shows __ shaped zone of necrosis
articular cartilage is __ but damaged
dead bony __ w empty lacunae
necrosis of surrounding __
pt has crhonc, progressive __ w no swelling/erythema
GCA has granulomatous inflammation w __ thickening, elastic lamina fragmentation and __ formation
osteonecrosis blood thrombotic, embolic GC vasculitis fracture wedge viable trabeculae adipocytes
media, giant cell
pt w acute monoarticular arthritis, effusion, dec range of motion w synovial fluid lueks > 100, 000 has S__
tx w __ to prevent joint destrxn, osteomyetis, sepsis
mcc of death in acute rheuatic fever is P__
this can lead to mitral __ w cardiac dilation and __
cx due to __ response, thus sepsis is unlikely
path of SLE is due to binding of __ to self antigens w deposition of immune complexes
septic arthritis
ab
pancarditis
regurg, failure
autoimmune
autoantibodies
Fas receptors involed in __ pathway of apoptosis
upon binding __, receptors form a trimer and bind FADD
this stimulates initator caspases number __/__ and activate executioner caspases __/__
leads to __ w cleaved DNA, fragment nucleus, organelle digestion and membrane blebbing
T cells express __ w clonal expansion, and eventually undergo apoptosis if stimulated by self antigen
mutations in this process lead to accumulation of __ T cells in AI dz
extrinsic FASL 8, 10 3, 6 apoptosis
FASL
autoreactive
