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Block 4 > Week 1 > Flashcards

Week 1 Flashcards

1
Q

What are the properties of the calcified cartilage layer of articular cartilage?

A
  • rests on underlying cortex of bone
  • stains slightly darker
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2
Q

What are the layers of spinal meninges?

A
  • Dura mater (spinal dural sheath)
  • Arachnoid
  • Pia mater
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2
Q

What is the role of estrogen in bone strength?

A
  • prevents accelerated bone loss
  • act to reduce bone resorbing actions of PTH
  • increases blood levels of calcitrol but doesnt stimulate its production
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3
Q

Describe Psoriasis

A
  • accerlerated keratinocyte mitosis in stratum basale and spinosum
  • turnover happens in 1 week instead of 4
    • leads to thickening of epidermis
  • red, itchy, plaques of thickened skin
  • autoimmune
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4
Q

Describe the function and physiology of myosin V

A
  • has a very long lever arm in order to take larger steps
  • one arm has to be attached at least 50% of the time
    • relate to monkey bar climbing
  • myosin V transports vesicles in cells
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5
Q

What is an isogenic group?

A
  • Represent mitotic division of chondroblasts (stem cells)
  • responsible for intersititial growth
  • sit within holes of hyaline cartilage in groups of single, doubles, or quadruples
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5
Q

How do glucocorticoids affect bones?

A
  • inhibit vitamin D intestinal Ca2+ transport
  • able to reverse hypercalcemia
  • can cause steroid induced osteoporosis
    • decrease osteoblasts and cytes
    • increase osteoclasts
    • muscle weakness
  • increased risk of fracture
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6
Q

Describe the properties of Langerhans’ cells

A
  • originate in bone marrow
  • antigen-presenting cells
  • capable of phagocytosis
  • mainly found in stratum spinosum
    • oral, esophageal, rectal, and vaginal epithelium
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7
Q

What is the yield point/stress?

A
  • The point where a material goes from the elastic region to the plastic region on the stress/strain curve
  • structural changes occur to the specimen
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7
Q

What are the keratinized cells characteristics?

A
  • loss of organelles
  • thickened plasma membrane
  • bundles of tonofilaments
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8
Q

What is appositional growth and who can do it?

A
  • Hyaline and elastic cartilage
  • chondrogenic cells from inner layer of perichondrium become chondroblasts to add new layers onto those previously formed
  • newly forming cartilage has lots of appositional growth
    • older cartilage has few chondrogenic cells so appositional growth less common but occurs
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9
Q

What role does the cerebrum in pain processing?

A
  • Sensory cortex
  • Limbic system
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10
Q

Name these ligaments

A
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10
Q

What is the function of eccrine sweat glands?

A
  • responds to heat and nervous stress
  • purpose
    • cooling/thermoregulatory
    • excretion (urea/ammonia)
    • emotional sweating
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11
Q

Function of hyaline cartilage

A
  • resistant to compression
  • provides cushioning
  • smooth and low friction surface for joings
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11
Q

What is the function of bone?

A
  • Protects internal organs
  • support and movement
  • hemopoiesis (red marrow)
  • energy storage (yellow marrow -fat)
  • mineral reservior (Ca2+ and phosphate)
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12
Q

What is contained within a tendon structure?

A
  • water
  • Type I and III collagen
  • tenocytes
  • proteoglycans
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13
Q

Why are there enlargements at the cervical and lumbosacral levels?

A
  • enlargement because it gives rise to the innervation of the limbs
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14
Q

What is hysteresis?

A
  • Energy lossed due to internal friction during cyclic differences between loading and unloading
  • Tendon with repetitive loading, hysteresis will become mnimal
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15
Q

What is the biophyschosocial model?

A
  • Health and illness is the result of the interaction of mechanisms
    • cellular
    • tissue
    • organismic
    • interpersonal
    • environmental
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15
Q

What are the Erector Spinae muscles>

A
  • Spinalis - spine to spine
  • Longissimus - sacrospinous to ribs and transcerse processes
  • Iliocostalis - from sacral area

powerful extenders, innervated by dorsal rami

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15
Q

What is a motor unit?

A
  • its all the muscle cells that a motor neuron innervates
  • the more motor units recruited, the more force generated known as **recruitment **
    • ​interneuron in the spinal cord helps recruit more units
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16
Q

What muscles make up the suboccipital triangle?

A
  • Rectus Capitis major
    • C2 spine to occipital bone
    • litt bit of rotation and good extender
  • Superior oblique
    • C1 trans to occipital bone
    • extension
  • Inferior oblique
    • C2 spine to C1 trans
    • rotation
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17
Q

Describe stress/strain curve of a tendon

A
  • Toe region
    • uncrimping of collagen fibers
  • Linear Region
    • slope is eleastic modulus of tendon
  • Failure region
    • permanent stretching
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18
Q

How does the spinous processes differ between the different vertebrae levels?

A
  • Cervical - horizontal
  • Thoracic - points inferiorly
  • Lumbar - large squarish spinous process
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18
Q

What are the properties of the papilary layer of the dermis?

A
  • dermal papillae interdigitate with epidermal ridges
  • superficial layer
  • contains meisners corpuscles (fine touch receptors)
  • type III collagen fibers and elastic fibers
  • Type VII ifbers to anchor epidermis to dermis
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18
Q

What does peritrichial nerve ending sense and where is it located?

A
  • located
    • wrapped around the base and shaft of hair follicle
  • stimulated by hair movement
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19
Q

What is the IASP definition of pain?

A
  • an unpleasant sensory and
  • emotional experience associated with
  • actual or potential tissue damage or
  • described in terms of such damage
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20
Q

What is Wolff’s law?

A
  • Bone remodels in response to stress placed on it
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20
Q

What is the fundamental contractile unit of muscle?

A
  • muscle sacromere
    • contracts when myosin and actin slide past each other
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21
Q

Function and disease of Myosin V

A
  • Involved in melanosome transport and certain neurological functions
  • Disease
    • Griscelli’s Syndrome - point mutation leads to hypopigmentations and neurological defects
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22
Q

What are the properties of the tangential layer of articular cartilage?

A
  • chondrocytes (maintain cartilage), small and flat, lay parallel to the surface
  • lamina splendens (most superficial) has no cells
  • very fine collagen fibersrun parallel to surface
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22
Q

What are the properties of the arrector pili muscle?

A
  • SM
  • elecates hair and causes goose bumps depressions of skin where the muscle attaches to dermis
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23
Q

What is osteomalacia?

A
  • decreased mineralization of new bone matrix
  • commonly caused by Vit D deficiency, chronic renal failure
  • Clinical features
    • Children: failure to grow, rickets
    • Adults: bone pain, proximal myopathy or fractures with minor trauma
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23
Q

What are the properties of spinosum?

A
  • several layers thick
  • tonofibrils
    • bundles of cytokeratin + desmosome = spiny processes
  • prickle cells with intracellular bridges
  • kertinocytes in deeper layers and they divide
  • melanocytes and langerhans cells
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24
Q

How do you diagnosis osteoporosis?

A
  • Dual energy X-ray absorptiometry (DEXA or DXA) test for
    • woman age 65 older
    • patients aged 60 and increased risk for osteoporosis
  • T score
    • -1: normal bone density
    • -1 and -2.5: sign of osteopenia
    • -2.5: bone density indicates osteoporosis
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24
Q

What are the functions of integument (skin)?

A
  • Protection
  • sensory receptor
  • role in secretion (urea/NH4+)
  • Vit D metabolism
  • regulation of blood pressure and body temp
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25
Q

What are the splenius muscles?

A
  • Splenius capitis - spinous processes to skull
  • Splenius cervicis - spinous processes to transverse processes of cervical vertebrae
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25
Q

What is viscoelastic?

A
  • properties sensitive to how fast and how long strain rate is applied
  • bone ductile with slow loading, brittle with rapid loading
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25
Q

What does Ruffini end organ sense and where is it located?

A
  • sensitive to pressure and responds to pacinian corpuscle stretching
  • location
    • skin and joint capsule
    • pacinian corpuscle found in hypodermis and deep fascia tissues
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26
Q

What are the structural features of hair follicles?

A
  • hair follicles formed by epidermis and dermis together
    • no hair follicles are formed after birth
  • comprised of hair shaft and a hair bulb
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28
Q

What is allodynia?

A
  • pain resulting from normally painless stimuli
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28
Q

What is the Haversian system or osteon?

A
  • around each capillary canal lamella of bone surrounds it in a circular fashion
    • lamella can be inner, outer circumferential, interstitial
  • lacuane contain osteocytes that are interconnected by canaliculi
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29
Q

Clinical features and pathogenesis of muscle myopathy?

A
  • mutations to MyHC II a
  • Clinical features
    • muscle weakness
    • trophy near shoulders, hand and thigh muscles
  • Pathogenesis
    • mutations to SH1 helix in myosin
    • alters actin-myosin ATPase activity
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30
Q

What are the properties of the stratum basale?

A
  • rest on basal lamina
  • keratinocytes
    • divide continuously
    • desmosome (each other), hemidesmosomes (basement membrane)
  • cytokeratin increases going towards surface
  • melanocytes, Merkel’s cells
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32
Q

According to the biopsychosocial perspective what is pain influenced by?

A
  • Biological/physical
    • tissue damage, tension, sleep, overuse
    • inappropriate medications
    • physical deconditioning
  • Psychological/emotional
    • mood (depression, anxiety, anger)
    • personal ideas about pain
    • avoidance
  • Social factors
    • impact of others, cultural issues, past learning history
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33
Q

What role does thalamus play in pain processing?

A
  • all sensory (not olfactory) systems send signals to the thalamus they are directed to the specific cortical representation areas
  • lateral and medial pain systems
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33
Q

Clinical features and pathogenes to Distal arthrogryposis, Freeman-Sheldon syndrome, Sheldon Hall syndrome

A
  • mutations to embryoni MyHC 3
  • Clinical features
    • joint conractions with predominant distal involvement
  • Pathogenesis
    • mutations in troponin I, troponin T, tropomyosin, perinatal myosin and embryonic myosin
    • thought to disrupt development
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33
Q

Describe apocrine sweat glands

A
  • large specialized sweat glands
    • axilla, areola of nipple, and perianal glands of Moll in eyelids and ceruminous (wax) glands of ear
  • scent glands
    • release by merocrine process
  • dont function until puberty
    • response to hormonal influences
    • respond to emotional and sensory stimuli but no heat
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34
Q

Describe the metaphyseal-epiphyseal system

A
  • supplies the metphyseal part of the long bones (tips)
  • anastomose with nutrient arterial system
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35
Q

Describe graph

A
  • isometric
    • muscle length remains static as tension increases
  • concentric
    • muscle contracture with decreasing muscle length
  • eccentric
    • muscle contracts with stimultaneous lengthening
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36
Q

What are the effects of Fibroblast growth factor 23 (FGF23)?

A
  • inhibits calcitrol production and phosphate reabsorption in kidney
  • made by
    • osteoblasts and osteocytes in bone
    • stimulated by calcitrol production
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38
Q

What level does the spinal cord end?

A
  • L2
  • transition into the cauda equina
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38
Q

What are the properties of osteoclasts?

A
  • large, motile, multinucleated and have acidophilic cytoplasm
  • bone marrow precursor
  • stimulated by calcitonin, osteoclast stimulating factor from osteoblasts
  • occupy Howship’s lacunae (shallow depressions)
    • attach to bone to create a microenvironment and acidify this area
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40
Q

What are the extrinisic back muscles?

A
  • Levator scapulae
  • Trapezius
  • Rhomboids - minor,major
  • Latissimus Dorsi
  • Serratus posterior S/I
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40
Q

What are the two different bone formation processes?

A
  • Inramembranous
    • direct mineralization of matrix secreated
    • most flat bones are formed this way
  • Endochondral
    • deposition of bone matrix on a preexisting cartilage matrix
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41
Q

What do muscles attach to on the lateral surface of each superior marticular facet?

A
  • Mammillary processes
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42
Q

What are the cells located within bone?

A
  • osteoprogenitor cells - mesenchymal
  • osteoblasts - osteoprogenitor
  • osteocytes - osteoprogenitor and osteoblasts
  • Bone lining cells
  • osteoclasts - bone marrow precursor
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43
Q

What are the effects of raloxifene?

A
  • increases bone density and appears to decrease number of fractures
  • decreases total cholesterol
  • decreases incidence of cancer
  • side effects
    • increased thromboembolic events
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44
Q

What is the nerve supply to the bones?

A
  • vasomotor innervates blood to the interior of bone
  • periosteal nerves are sensory nerves
    • some are pain
    • periosteum is sensitive to tearing or tension
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45
Q

What is the lymphatic drainage of bones?

A
  • abundant in periosteum
  • Absent in the medulla of the bone
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46
Q

What are the 5 layers of the epidermis?

A
  • Stratum basale (closest to the basement membrane)
  • stratum spinosum
  • stratum granulosum
  • stratum lucidum
  • stratum corneum
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47
Q

What is endosteum?

A
  • lines the central cavity within a bone
  • CT composed of monolayer of osteoprogenitor, osteoblasts, and endosteal cells
  • during injury will differentiate into osteoblasts to repair damage
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49
Q

Does cartilage have a b lood flow?

A
  • no, cartilage does not have a blood supply
  • everything has to flow through ECM
    • acts as a selective filtration system
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50
Q

What are the effects of PTH?

A
  • Decreased Ca2+ excretion by kidneys, increased excretion of phosphate
  • conversion Vit D to calcitriol causes
    • increased Ca2+ absorption in intestine
    • mobilizes Ca2+ from bone
  • stimulates osteoblasts which stimulate osteoclasts to release Ca2+ into the blood
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50
Q

What is melanins?

A
  • contribute to skin, eye and hair color
    • differences in between light/dark is rates of melanin synthesis, accumulation and degradation
  • freckles
    • patches of epidermal melanin
  • made by melanocytes
  • in keratinocytes they surround nuclei
    • protect DNA from sun rays and absorbs free radicals
    • eventually keratinocytes will degrade melanin
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51
Q

Describe the triple Jeopordy of bone aging

A
  • Reduction in vertical trabecula
  • reduction in thickness of trabeculae
  • increased length of traveculae
53
Q

What are the three components of the cruciate liagment?

A
  • Superior longituidinal band
  • Transverse ligament of Atlas
  • Inferior longitudinal band

covered posteriorly by tectorial membrane from posterior longitudinal ligament

54
Q

Describe Creep

A
  • Continued deformation of tissue
    • result of constant stress for an extended period of time
  • for tendons creep will result in elongation
55
Q

What does the plastic region imply?

A
  • Region is from yield point to ultimate tensile stress (failure point)
  • structural changes are irreversible in the specimen
55
Q

What are the features of the epidermis?

A
  • keratinized stratified squamous epithelium
  • made from ectoderm
  • regenerated every 30 days
    • keratinocytes divide at night
  • overlies projections of dermis (dermal papillae) to form epidermal ridges
  • has 5 layers
57
Q

How are bones classified?

A
  • According to their shape
    • long, short, flat, irregular
58
Q

Describe the annulus fibrosis

A
  • part of IV disc
  • peripheral ring of fibrocartilage
    • runs oblique
59
Q

What are the structural properties of musle myosin II?

A
  • myosin is a dimer
    • each heavey chain has a motor domain and a tail
  • myosin are actin based motors
    • able to detect direction of actin molecule
60
Q

What is hyperhidrosis?

A
  • excessive sweating
  • sweating of hands most distressing
  • treatment
    • antiperspirants
    • lontophoresis
    • drugsn (lots of side effects)
    • surgery for axillary glands
61
Q

What is the perichondrium?

A
  • a layer of dense irregular connective tissue that surrounds the cartilage of developing bone. - made by fibroblasts
  • Contains two layers
    • outer fibrous layer - fibroblasts to make collagenous fibers
    • inner chondrogenic layer - undifferentiated to make chondroblasts or chondrocytes
62
Q

What are two important questions you should ask patients when assessing their pain and its disruption of their life?

A
  • How much does pain interfere with your activity levels?
  • How much does you avoid activities because of pain?
63
Q

What is contained within the hypodermis (subcutaneous fascia)?

A
  • not part of skin
  • thickness will vary
  • loose CT and adipose tissue
    • panniculus adiposus = really thick
  • contains large blood vessels (subcutaneous plexus)
64
Q

Describe the bisphasic nature of articular cartilage

A
  • Two phases: fluid and solid
  • Type II collagen with proteoglycans to strength and attract water
  • when load is applied fluid exudate is created
64
Q

What forces affect muscles ability to generate force and contraction?

A
  • myosin isoforms: SM myosin is much slower
  • frequency of stimulation
  • number of motor unit stimulated
  • degree of stretch
  • whether muscle is allowed to shorten
64
Q

Describe length-tension relationship

A
  • altering the starting length of the muscle affects the strength of the muscle contraction
  • either completely streched out or complete overlap will generate much less force
65
Q

What are the properties of stratum lucidum?

A
  • seen only in thick skin
  • acidophilic
  • contains immature keratin called eleidin
66
Q

What are the two components of the intervertebral discs?

A
  • Annulus fibrosis
  • Nucleus pulposis
68
Q

Posterior longitudinal ligament

A
  • Narrow and somewhat weaker muscle on posterior side of vertebrae
  • limits flexion
70
Q

What is the movement around the anteroposterior axis?

A
  • Lateral Bending
72
Q

What is the blood supply to the long bones?

A
  • Nutrient Arterial System
  • Metaphyseal-epiphyseal system
  • Periosteal systemones

Bones recieve 5-20% of cardiac output

73
Q

What are the components of the ECM of bone?

A
  • organic components 35%
    • Type 1 collagen
    • Proteoglycans
    • Multi-adhesive glycoprotein
  • Inorgnaic components 65%
    • hydroxyapatite crystals (Ca2+ and phosphorus)
73
Q

Where is and what does Meissner corpuscle sensory receptors receive?

A
  • present in the dermal papilla of
    • fingers, hand, food, front of forearm, lips and tongue
  • tactile receptor - fine touch
73
Q

What are the 3 types of skin cancer and which one is the worst?

A
  • basal cell carcinoma
    • most common from stratum basale, high cure rate with early Dx
  • squamous cell carcinoma
    • 20% of cancers from stratum spinosum, high cure rate with early Dx
  • melanoma
    • 5% of cancers but causes 75% of skin cancer deaths
    • grows rapidly and metastasizes quickly
74
Q

What is anisotrophy?

A
  • mechanical propeties different in all directions of loading
  • orthotropy
    • mechanical properties symmetric within two planes
    • ie long bone: Axial and transverse loading
76
Q

What is the blood supply to the spinal cord?

A
  • Aorta
    • posterior radicular artery > posterior spinal artery
    • anterior medullary artery > anterior spinal artery (only present at specific levels)
77
Q

How is smooth vs skeletal muscle regulated?

A
  • Thin filament (skeletal and cardiac)
  • Thick filament (SM)
    • myosin light chain kinase creates an active myosin
    • myosin light chain phosphatase inactivates myosin
78
Q

What are the sources for ATP in muscle?

A
  • ATP
  • Creatine phosphate
  • glycogen (anaerobic/aerobic)
  • lipolysis
79
Q

Describe cancellous, spongy, or traveculated bone

A
  • mature spongy bone is arranged as trabeculae
  • found in all bone types, cavity of diphysis and epiphysis
  • possess lamellae, but no osteons
  • covered by an endosteum
80
Q

Describe the properties of Merkels Cells

A
  • found in stratum basale
    • most numerous in thick skin
  • derived from neural crest
  • have desmosomes and tonofilaments
  • **sensory mechanoreceptors **
81
Q

What occurs to tendon strength in regards to age and immbilization?

A
  • tendon strength increases to maturity then remains constant
    • physiological strain on tendons 2-5% but can handle up to 25%
  • Weeks after immobilization period, losses 40% of strength and even after a year, near normal but not perfect
83
Q

What factors interfere with movement of the spine?

A
  • thickness of intervertebral discs
  • orientation of articular facets
  • attachment of ribs
  • size, elasticity and orientation of muscles of back and abdominal wall
85
Q

What is the stress strain differences between cortical and travecular bone?

A
  • Trabecular
    • lower ultimate stress
    • ductile
    • can absorb significant energy with minimal mass
  • Cortical Bone
    • high ultimate stress - strongest in compression, weakest at transverse
    • brittle
86
Q

What are the transcersospinae muscles?

A
  • semispinalis 6-8 to skull
  • multifidus 3-5
  • long rotators 2
  • short rotators 1
87
Q

What is the movement around the transverse axis?

A
  • Flexion
  • Extension
88
Q

What is the function of cartilage?

A
  • provies shape and flexibility
  • shock absorber
  • facilitates smooth movement of joints
90
Q

How do ventral and dorsal rami exit the sacrum?

A
  • Ventral - anterior sacral foramina
  • Dorsal - posterior sacral foramina
91
Q

What is an important note about the internal vertebral venous plexus?

A
  • communicates with both venous sinues of brain and venous plexus of the plevis
  • possivle for prostate cancer to metastasize in CNS
92
Q

What does the substantia gelatinosa contain?

A
  • located in the dorsal horn of spinal cord
  • contains excitatory neuropetide input from primary afferent neurons
94
Q

How is trabeculated or spongy bone formed?

A
  • mesenchymal cells > osteoblasts
    • bone matrix creates a randomly orientated network of spicules and traveculae
  • calcification occurs
    • osteoblasts get stuck in matrices and become osteocytes
95
Q

What are the intrinsic back muscle layers?

A

From superficial to deep

  • Splenius muscles
  • Erector spinae muscles
  • Transversospinae muscles
97
Q

What is a feature between nerve root length and vertebral column?

A
  • as you move closer to the cauda equina each successive nerve root gets longer and longer to reach its intervertebral foramen
  • dural sac ends around S2
98
Q

Describe the sebaceous glands

A
  • embedded in dermis all over the body expects palms and soles.
    • most abundant on face
    • secretions empty at neck of hair follicle
  • holocrine glands make sebum that in puberty would lead to acne
99
Q

What is Paget’s disease?

A
  • excessive bone resorption and formation
  • clinical features
    • bone pain
    • skeletal deformity
    • neurological complications or fractures
101
Q

Anterior longitudinal ligament

A
  • Anterior portion of the vertebral column, thick ligament
  • limits extension
  • prevents herinated discs
101
Q

Describe periosteal system

A
  • low pressure system
  • supplies outer 1/3 cortex
102
Q

What is the conus medullaris?

A
  • inferior, tapered end of spinal cord
103
Q

What are the properties of elastic cartilage?

A
  • has perichondrium
  • does not undergo calcification
  • chondroblasts, chondrocytes in much higher number than hyaline
  • has type II collagen but masked by lots of elastic fibers
  • very limited repair
104
Q

What is the movement around the vertical axis?

A
  • Rotation
105
Q

Describe the nutrient arterial system to long bones

A
  • High pressure from systemic
  • enter through nutrient foramina
    • divide into ascedning and descending medullary branches
  • supplies
    • medullary cavity
    • inner 2/3 of cortex via Haversian system
107
Q

What is periosteum?

A
  • covers the external surface of bone
  • consists of an outer layer of dense fibrous CT and inner cellular layer that has osteoporgenitor cells and periosteal cells
  • during injury will differentiate into osteoblasts to repair damage
108
Q

What is hyperalgesia?

A
  • heightened sense of pain to noxious stimuli
109
Q

What are the properties of stratum granulosum?

A
  • lamellar bodies (granules)
    • release GAGs and phospholipids into intracellular space
  • membrane-less keratohyalin granules
    • contain histidine and cystine rich proteins that will bind to tonofilaments
  • bundles of tonofilaments
    • attachment of proteins to tonofilaments is the first step in keratinization
  • this layer is critical to water proofing the deeper layers
110
Q

What are the properties of stratum corneum?

A
  • Most superficial layer
  • dead, platelike, enucleated kertinocytes
    • contain mature keratin
  • keratin birefringent scleroprotein
    • made of at least 6 polypeptides + tonofilaments
111
Q

How does time effect the second contraction of muscle?

A
  • the shorter the time between each contraction signal it will cause the second peak to be higher
    • additional influx of Ca2+ promotes a second contraction which is added to the first = temporal summation
  • if signal is frequency limitlessly you get complete tetanus until muscle fatigue
112
Q

Describe eccrine sweat glands

A
  • simple coiled tubular gland, located nearly everywhere
  • secretory unit
    • dark cells - secrete glycoproteins
    • clear cells - secrete water and electrolytes
    • myoepithelial cells
  • ducts lined with stratified cubodial epithelium
    • modifies sweat absorbing electrolyes
    • excretes ions, urea, lactic acid
113
Q

What is the gate control theory?

A
  • sensory inputs to spinal cord start to interact at very first steps of transmission
  • theory suggests non-painful input (rubbing or massaging) closes the gates to painful input, preventing if from traveling to CNS
114
Q

Function of myosin IIa

A
  • involved in cell division
115
Q

What are the properties of the dermis?

A
  • contains collagen and elastic fibers
  • derived from mesoderm
  • contains two layers
    • papillary layer (superficial)
    • recticular layer
116
Q

What are selective estrogen receptor modulators (SERMs)?

A
  • drugs that have tissue specific effects
  • function as competitive inhibitors in tissues with alpha estrogen receptors
    • agonists with beta estrogen receptor
  • two examples
    • tamoxifen
    • raloxifene
118
Q

What are the stages of myosin attachment?

A
  • attached
    • locked tightly to actin
  • released
    • ATP binds to back of head to cause the myosin to have lower affinity for the actin and release
  • cocked
    • ATP is hydrolyzed as the head moves forward but ADP and Pi stay attached
  • force-generating
    • weak binding occurs between the myosin and actin
    • ADP and Pi dettach and its at its original position
  • attached
119
Q

What are secondary curvatures?

A
  • Cervical
  • Lumbar
121
Q

What are the primary curvatures?

A
  • Thoracic
  • Sacral
122
Q

What are the layers of articular cartilage?

A
  • Tangential layer (closest to joint space)
  • Transitional zone
  • Radial Zone
  • Calcified cartilage layer
123
Q

How do local anesthetics and lidoderm patches work?

A
  • in nociceptor signaling to the CNS it blocks the transformation of the pain signal
    • prevents action potential generation
125
Q

What are the properties of fibrocartilage?

A
  • resists deformation under stress
  • no perichondrium
  • Type 1 collagen is dominent with some type II
  • parallel columns of chondrocytes, fibroblasts
  • located in IV discs, pubic symphysis
126
Q

What is stress relaxation?

A
  • Over time the force necessary to maintain deformation of a structural decreases
127
Q

What is isotrophy?

A
  • Uniformity in all orientations
  • ie sphere
129
Q

Function and disease myosin VI and VII

A
  • involved in maintaining orgnization of actin-filled stereocilia
  • Disease
    • mutations associated with hearing loss
    • certain myosin VII mutations associated wiht Usher syndrome
130
Q

What is structures are contained within the axial skeleton?

A
  • Skull
  • Vertebral column 33 vertebrae
    • 7 cervical
    • 12 thoracic
    • 5 lumbar
    • 5 sacral
    • 4 coccygeal
  • Ribs
  • Sternum
131
Q

Clinical features and pathogenesis of laing myopathy

A
  • mutations to B-cardiac myosin (MyHC7)
  • clinical features
    • weakness of ankle dorsiflexion
    • hanging big toe
  • Pathogenesisi
    • mutations in LMM region of myosin
    • disrupt myosin filament formation or interactions with myosin binding proteins like titin
132
Q

How is structural strength defined?

A
  • Brittle
    • Glass
  • Ductile
    • able to absorb more energy before it breaks
133
Q

Describe the function and physiology of myosin II

A
  • low duty motor
    • arm has to be attached about 10% of the time
  • short arms
  • drives muscle contraction
  • functional unit is ~20 heads
    • many myosin II molecules are required to propel actin filament to create thick filament
134
Q

What are the effects of bisphosphonates?

A
  • reduces turnover of bone
    • prevents the number and activity osteoclasts
  • takes 48 hours to block bone resorption
  • should not be taken with milk products
  • side effects
    • GI
    • gastric ulcers
    • take with water and dont lay down for 30 mins
135
Q

Hormone replacement therapy

A
  • estrogen at menopause inhibits effect of oestoclasts on bone resorption
  • increased cardiovascular events with women with a history of heart disease
  • increased risk of breast cancer and harder to find tumors
137
Q

What is spondylolithesis?

A
  • forward displacement of a vertebrae
  • most commonly occurs after a fracture or break but doesnt have to
138
Q

What is the periaqueductal Grey (PAG)?

A
  • target of the spinomesencephalic neurons
  • very important in regulation of nociception
    • relays descending pain modulation
139
Q

What is intersititial growth and who uses it?

A
  • occurs in all cartilages
  • growth starting in different centers within a structure that is already formed
  • important for growth of long bones at epiphyseal plate
141
Q

What does lamina V contain?

A
  • receives input from Adelta and C-fiber nociceptors
    • key neurons responsible for central sensitization
142
Q

What are the structural properties of myosin?

A
  • many different types of myosin not all involved in muscle
    • Have similar motor domains
  • Have different tail lengths
    • differences correspond to differences in cargo and regulation
    • tail acts as a lever, bigger tail bigger steps
143
Q

What are the structural features of hyaline cartilage?

A
  • ECM has Type II collagen firbrals and aggrecan to make it absorb water
  • components of hyaline matrix are not evenly distributed
  • Growth and repair is very limited so scar tissue forms
144
Q

Why is the TRPV1 receptor important?

A
  • nociceptor that its stimulate by capsaicin
146
Q

Where is hyaline cartilage located?

A
  • fetal skeletal tissue
  • epiphyseal plates
  • articular surface of synovial joints
  • costal cartilages of rib cage
  • rings of trachea
147
Q

Describe the properties of the reticualr layer of the dermis

A
  • thicker
  • follicles, sweat and sabaceous glands
  • dense irregular CT
  • elastic fibers and bundles of collagen (type I)
  • contains many sensory fibers
148
Q

What is Anterior spinal artery syndrome?

A
  • blockage of anterior segmental medullary arteries
  • T8-L2 region most clinically important because aortic aneurysm
  • damages motor neurons and can cause level loss
150
Q

Describe compact bone

A
  • structural unit: called osteons (Haversian system)
  • Voklmann’s canal: horizontal channels containing blood vessels from bone marrow
  • different kinds of lamellae
  • endosteum
  • periosteum
152
Q

What are the structural features of nociceptor?

A
  • usually unmyelinated axons (C-fiber and Adelta-fiber)
    • small cell body diameters
  • encode stimulus intensity into noxious range
153
Q

What is failure strength?

A
  • Structures because of progressive structural damange from cyclic loading will approach a fatigue limit
    • results in a stress fracture
154
Q

Properties of melanocytes

A
  • from neural crest cells
  • located in stratum basale
    • highly mobile because they have no desmosomes
  • inject melanin into keratinocytes
155
Q

Function of tropomyosin

A
  • Wraps around actin filament blocking myosin from binding sites
  • Ca2+ binding to troponin C results in tropomyosin moving away from myosin binding sites
    • cooperative binding of Ca2+, creating a steep binding curve
156
Q

What are the properties of the radial zone of chondrocytes?

A
  • Fairly large condrochytes
    • form raidial columns, perpendicular to surface
    • collagen fibers follow the columns
157
Q

What are the three phases of a muscle twitch?

A
  • Latent period
    • Ca2+ activation
    • difference between signal and muscle reaction
  • Contraction
    • actin-myosin cycle
    • cycling of cross linking
  • Relaxation
    • pumping Ca2+ out of muscle
158
Q

Describe the nucleus pulosis

A
  • Part of the IV discs
  • Gelatinous core
  • able to deform
    • most common area for stress L5/S1 and L4/L5
159
Q

What is spondylolysis?

A
  • stress fracture of pars interarticularis of the vertebrae
    • can be the result of repeated stress to hte spine
  • Shows up as Scotty Dog with a collar in an X-ray
160
Q

What is osteoporosis?

A
  • thinning of bone
  • common in post-menopausal women
  • increased morbidity and mortality
  • accelerated by
    • premature or surgical loss of ovarian function
    • drugs (corticosteriods)
    • lifestyle (alcohol or smoking)
161
Q

What are the effects of Tamoxifen?

A
  • blocks estrogen receptor in breast cancer cells
    • may prevent breast cancer
  • used in conjuction with surgery or chemotherapy
  • side effects
    • hot flashes
    • nausea/vomiting
162
Q

What does free nerve endings sense and where are they located?

A
  • respond to pain and temperature
    • lack myelin or Schwann cells
  • found in
    • epidermis
    • corneal epithelium
163
Q

What are the effects of Denosumab?

A
  • Human monoclonal antibody against RANKL
    • treats osteoporosis
  • inhibits the maturation of pre-osteoclasts into osteoclasts
  • side effects
    • increased urinary and respiratory tract infections
    • joing pain
    • eczema
164
Q

What is the properties of the transitional zone of articular cartilage?

A
  • Chrondocytes slightly larger
    • occur single and in isogenous groups
  • Collagen fibers run oblique
165
Q

What are the features articular cartilage?

A
  • subset of hyaline cartilage
  • sits on the ends of bones to lubrricate, prevent wear and be slighlt compressible
  • does not have a perichondrium, poorly vascularized
166
Q

Properties of Herniated discs

A
  • occurs when there is excessive pressure on the disc
    • impinges the root below the herniating level
  • occurs posterolateral direction
  • Most common at L4/L5 and L5/S1

Block 4 (3 decks)

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