Week 6- Intro to Bone & Soft Tissue Flashcards

1
Q

What 3 components make up to musculoskeletal system?

A

Bone, muscle and connective tissue

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2
Q

What are the 3 types of connective tissue and what are their roles?

A

Tendon (connects muscle to bone)
Ligaments (connects bone to bone)
Cartilage (structural support, protects tissue, attachment sites)

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3
Q

How many bones are in the human skeleton for adults and children?

A

206 (270 in children)

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4
Q

What are the 2 types of skeleton?

A

Axial and appendicular

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5
Q

What does the appendicular skeleton contain?

A

Shoulder girdle, arm, hand, pelvic girdle, leg, foot

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6
Q

What does the axial skeleton contain?

A

Ossicles, skull, hyoid bone, thoracic cage, vertebral column

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7
Q

What are functions of the skeletal system?

A

Movement, support, protecting vital organs, calcium storage, haematopoeisis

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8
Q

What are the 6 bone shapes?

A

Flat, short, sesamoid, long, irregular, sutured

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9
Q

What are bone stem cells called?

A

Osteogenic cells

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10
Q

What are mature bone cells called?

A

Osteocytes

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11
Q

What do osteogenic cells produce? What is the function of these cells

A

Osteoblasts, they form bones

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12
Q

What is the function of osteoclasts?

A

Bone breaking- they dissolve and resorb bone vis phagocytosis

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13
Q

What are osteoclasts derived from?

A

Bone marrow

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14
Q

Where are osteocytes found?

A

Embedded in matrix

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15
Q

Where are osteoclasts found?

A

Bone surfaces and sites of old, injured or unneeded bone

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16
Q

Where are osteoblasts found?

A

Growing portions of bone, including periosteum and endosteum

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17
Q

Where are osteogenic cells found?

A

Deep layers of periosteum

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18
Q

What are the repeated structural units that bone is made up of?

A

Osteons

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19
Q

What 2 structures do osteons contain?

A

Concentric lamellae around a central haversian canal

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20
Q

What dies a haversian canal contain?

A

Blood vessels, nerves and lymphatics

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21
Q

What are lacunae?

A

Small spaces containing osteocytes

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22
Q

What are volkmans canals

A

Transverse perforating canals (smaller canals coming from the central canal)

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23
Q

What percentage of the bone matrix is organic and inorganic?

A

Organic: 40%
Inorganic: 60%

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24
Q

What does the organic component of the bone matrix contain?

A

90% type 1 collagen

10% ground substance (made of proteoglycans, glycoproteins, cytokine and growth factors)

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25
What does the inorganic component of the bone matrix contain?
Calcium hydroxyapatite | Osteocalcium phosphate
26
What are the 2 types of way bone grows?
Woven or lamellar
27
What is woven bone?
Immature bone that is produced first, it is relatively weak and eventually mineralised and replaced by mature bone
28
What is lamellar bone?
Mature, minerlaised woven bone, relatively strong
29
What are the 2 types of mature bone?
Cortical and cancellous
30
Describe cortical bone
Compact and dense, suitable for weight bearing
31
Describe cancellous bone
Spongy bone w a honeycomb structure, not suitable for weight bearing
32
What are the 4 structures at the end of long bones (in order from topmost)
Epihysis Physis Metaphysis Diaphysis
33
Describe the process of intra membranous ossification
Condensation of mesenchymal cells that differentiate into osteoblasts Ossification centre forms Secreted osteoid traps osteoblasts which become osteocytes Trabecular matrix and periosteum form Compact bone develops superficial to cancellous bone Crowded blood vessels condense into red bone marrow
34
What is intramembranous ossification?
Formation of flat bones of skull, clavicle and mandible, bone development from fibrous membranes
35
Describe the process of endochondral ossification
``` Bone collar formation Cavitation Periosteal bud invasion Diaphysis elongation Epiphyseal ossification ```
36
What is endochondral ossification?
Development of long bone from a hyaline cartilage model
37
What has a shorter time frame out of endochondral and intramembrous ossification?
Endochondral ossification
38
What is the primary ossification center in endochondral ossification?
Diaphysis
39
What is the secondary ossification center in endochondral ossification
Epiphysis
40
What is interstitial growth? What key structure is involved with it
Long bone lengthening, involves the epiphyseal plate (the zone of elongation)
41
What is the epiphyseal plate?
The zone of elongation in long bone, it contains an epiphyseal side with hyaline cartilage thats active and dividing to form a matrix as well as a diaphyseal side where cartilage calcifies and dies and is replaced by bone
42
Define appositional growth
Deposition of bone under the periosteum to increase its thickness
43
Describe the appositional growth process
Ridges in periosteum create a groove for a blood vessel Periosteal ridges fuse forming an endosteum lined tunnel Osteoblasts in the endosteum build new concentric lamellae inward toward the center of the tunnel, forming a new osteon Bone grows outwards as osteoblasts build new circumferential lamellae
44
What hormone effects bone during calcium homeostasis when plasma calcium levels are low?
PTH
45
How do bones help raise plasma calcium when its low?
Binding of PTH to receptors increases calcium mobilisation, helping raise plasma calcium
46
How do bones help reduce plasma calcium when calcium is too high?
Calcitonin is produced by the parathyroid cells, it binds to receptors in bone. This causes reduced osteoclast activity, helping reduce plasma calcium
47
What hormone effects bone during calcium homeostasis when plasma calcium levels are high?
Calcitonin
48
What is the role of tendon?
To attach skeletal muscle to bone
49
Describe the structure of tendon
Parallel arrays of collagen fibres closely packed together and arranged in bundles
50
Describe the functions of tendons
Transmit muscle forces to bone Store elastic energy/recoil Resist compressive stresses
51
Describe the structure of collagen
3 alpha chains wrapped around each other to form a triple helix
52
How many types of collagen are there and where are they found?
I- ligaments, tendons, skin, dermis II- cartilage, vitreous body, nucleus pulposus III- skin, vessel wall, reticular fibre of most tissues
53
What are the 2 main functions of ligament?
To join bone to bone to stabilise joints | To enable proprioception
54
How do ligaments work?
They have functional subunits that tighten and loosen depending on joint position
55
Describe the innervation/vascularisation of ligaments
They are not densely innervated or vascularised, they have a few nerves and blood vessels in the outer layer
56
What is the outer layer of a ligament called?
Epiligament
57
What type of receptor do ligaments contain?
Proprioreceptors
58
How do ligaments transmit pain signals?
Via type C fibers
59
What cells produce collagen?
Fibroblasts
60
What does ligament consist of?
90% type 1 collagen (strong) 9% type 3 collagen (immature- more prevalent in healing tissue) 1% fibroblast cells (cells that make ligament)
61
What are the 3 main roles of cartiledge?
To act as a shock absorber to reduce friction Cover and protect long bones and joints Structural component of ribs and IV discs
62
What is cartilage made of?
Chondrocytes- produce large amounts of collagenous ECM
63
What are the 3 types of ECM chondrocytes produce?
Hyaline Elastic Fibrocartilage
64
What is osteoarthritis?
The wearing down of cartilage
65
Describe the vascularity of cartilage
It is avascular
66
What mineral is released with osteoclast activity?
Calcium
67
What are the 3 types of joints?
Fibrous Cartilaginous Synovial
68
What are the 3 types of fibrous joints?
Sutures Syndesmosis Interosseous membrane
69
What are the 2 types of cartilaginous joints?
Synchondroses | Symphyses
70
What are the 6 types of synovial joints?
``` Plane Hinge Condyloid Pivot Saddle Ball and socket ```
71
What is the most common and mobile type of joint?
Synovial
72
What are the 2 components of a joint capsule in a synovial joint and what are their functions?
Articular capsule: outer part, keeps bones together structurally Synovial membrane: contains synovial fluid
73
What is the function of synovial fluid?
To reduce friction during movement of the joint
74
What does poor joint stability lead to a risk of?
Dislocation
75
What does inappropriate stress to ligaments lead to?
Injury
76
What are the factors affecting joint stability?
Joint shape, ligaments, tendons, cartilage
77
What are some differential diagnosis for an old person who has recently had a fall and is experiencing pain where they fell? How would you investigate each one?
Fracture- do a radiograph Torn muscle- look at soft tissue around the area of pain Lumbar disc- ask if they’ve had nerve pain (shooting up the leg etc) Hernia- when an organ protudes from the membrane thats supposed to contain it Osteoarthirits- only possible if the pain has been chronic
78
What are important things to ask in a pediatric history?
Genetic history History of the birth and pregnancy Developmental milestones (were they normal) Feeding and sleeping patterns Behavior recently (any changes?) Urinary and bowel movements (normal or changed?)
79
What are some common differentials for a limping child?
Rickets, stress fracture, transient synovitis of the hip
80
What are some life threatening differentials for a limping child?
Primary bone tumor, osteomyelitis, septic arthritis, haematological malignancy,
81
What is a joint aspiration?
When a sample of synovial fluid is taken from the joint by a needle to be tested
82
What are diagnostic criteria for septic arthritis of the hip?
``` Kocher Heart rate Temperature White cell count Can they out weight on the hip ```
83
What is the treatment for transient synovitis of the hip?
Prescribe non steroidal anti inflammatories
84
How may T2DM affect wounds?
People with T2DM often have poor wound healing, bone healing and soft tissue healing
85
How does bacteria in septic arthritis affect joint fluid?
Joint fluid will be turbid ie cloudy and pus like as well as straw coloured instead of clear
86
How are inflammatory markers affected in gout?
ESR- raised CRP- raised WBC- stays the same