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BRS Y1 > Week 6- Intro to Bone & Soft Tissue > Flashcards

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
Q

What does the inorganic component of the bone matrix contain?

A

Calcium hydroxyapatite

Osteocalcium phosphate

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26
Q

What are the 2 types of way bone grows?

A

Woven or lamellar

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27
Q

What is woven bone?

A

Immature bone that is produced first, it is relatively weak and eventually mineralised and replaced by mature bone

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28
Q

What is lamellar bone?

A

Mature, minerlaised woven bone, relatively strong

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29
Q

What are the 2 types of mature bone?

A

Cortical and cancellous

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30
Q

Describe cortical bone

A

Compact and dense, suitable for weight bearing

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31
Q

Describe cancellous bone

A

Spongy bone w a honeycomb structure, not suitable for weight bearing

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32
Q

What are the 4 structures at the end of long bones (in order from topmost)

A

Epihysis
Physis
Metaphysis
Diaphysis

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33
Q

Describe the process of intra membranous ossification

A

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

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34
Q

What is intramembranous ossification?

A

Formation of flat bones of skull, clavicle and mandible, bone development from fibrous membranes

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35
Q

Describe the process of endochondral ossification

A 
Bone collar formation
Cavitation
Periosteal bud invasion
Diaphysis elongation
Epiphyseal ossification
36
Q

What is endochondral ossification?

A

Development of long bone from a hyaline cartilage model

37
Q

What has a shorter time frame out of endochondral and intramembrous ossification?

A

Endochondral ossification

38
Q

What is the primary ossification center in endochondral ossification?

A

Diaphysis

39
Q

What is the secondary ossification center in endochondral ossification

A

Epiphysis

40
Q

What is interstitial growth? What key structure is involved with it

A

Long bone lengthening, involves the epiphyseal plate (the zone of elongation)

41
Q

What is the epiphyseal plate?

A

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
Q

Define appositional growth

A

Deposition of bone under the periosteum to increase its thickness

43
Q

Describe the appositional growth process

A

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
Q

What hormone effects bone during calcium homeostasis when plasma calcium levels are low?

A

PTH

45
Q

How do bones help raise plasma calcium when its low?

A

Binding of PTH to receptors increases calcium mobilisation, helping raise plasma calcium

46
Q

How do bones help reduce plasma calcium when calcium is too high?

A

Calcitonin is produced by the parathyroid cells, it binds to receptors in bone. This causes reduced osteoclast activity, helping reduce plasma calcium

47
Q

What hormone effects bone during calcium homeostasis when plasma calcium levels are high?

A

Calcitonin

48
Q

What is the role of tendon?

A

To attach skeletal muscle to bone

49
Q

Describe the structure of tendon

A

Parallel arrays of collagen fibres closely packed together and arranged in bundles

50
Q

Describe the functions of tendons

A

Transmit muscle forces to bone
Store elastic energy/recoil
Resist compressive stresses

51
Q

Describe the structure of collagen

A

3 alpha chains wrapped around each other to form a triple helix

52
Q

How many types of collagen are there and where are they found?

A

I- ligaments, tendons, skin, dermis
II- cartilage, vitreous body, nucleus pulposus
III- skin, vessel wall, reticular fibre of most tissues

53
Q

What are the 2 main functions of ligament?

A

To join bone to bone to stabilise joints

To enable proprioception

54
Q

How do ligaments work?

A

They have functional subunits that tighten and loosen depending on joint position

55
Q

Describe the innervation/vascularisation of ligaments

A

They are not densely innervated or vascularised, they have a few nerves and blood vessels in the outer layer

56
Q

What is the outer layer of a ligament called?

A

Epiligament

57
Q

What type of receptor do ligaments contain?

A

Proprioreceptors

58
Q

How do ligaments transmit pain signals?

A

Via type C fibers

59
Q

What cells produce collagen?

A

Fibroblasts

60
Q

What does ligament consist of?

A

90% type 1 collagen (strong)
9% type 3 collagen (immature- more prevalent in healing tissue)
1% fibroblast cells (cells that make ligament)

61
Q

What are the 3 main roles of cartiledge?

A

To act as a shock absorber to reduce friction
Cover and protect long bones and joints
Structural component of ribs and IV discs

62
Q

What is cartilage made of?

A

Chondrocytes- produce large amounts of collagenous ECM

63
Q

What are the 3 types of ECM chondrocytes produce?

A

Hyaline
Elastic
Fibrocartilage

64
Q

What is osteoarthritis?

A

The wearing down of cartilage

65
Q

Describe the vascularity of cartilage

A

It is avascular

66
Q

What mineral is released with osteoclast activity?

A

Calcium

67
Q

What are the 3 types of joints?

A

Fibrous
Cartilaginous
Synovial

68
Q

What are the 3 types of fibrous joints?

A

Sutures
Syndesmosis
Interosseous membrane

69
Q

What are the 2 types of cartilaginous joints?

A

Synchondroses

Symphyses

70
Q

What are the 6 types of synovial joints?

A 
Plane
Hinge
Condyloid
Pivot
Saddle
Ball and socket
71
Q

What is the most common and mobile type of joint?

A

Synovial

72
Q

What are the 2 components of a joint capsule in a synovial joint and what are their functions?

A

Articular capsule: outer part, keeps bones together structurally
Synovial membrane: contains synovial fluid

73
Q

What is the function of synovial fluid?

A

To reduce friction during movement of the joint

74
Q

What does poor joint stability lead to a risk of?

A

Dislocation

75
Q

What does inappropriate stress to ligaments lead to?

A

Injury

76
Q

What are the factors affecting joint stability?

A

Joint shape, ligaments, tendons, cartilage

77
Q

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?

A

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
Q

What are important things to ask in a pediatric history?

A

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
Q

What are some common differentials for a limping child?

A

Rickets, stress fracture, transient synovitis of the hip

80
Q

What are some life threatening differentials for a limping child?

A

Primary bone tumor, osteomyelitis, septic arthritis, haematological malignancy,

81
Q

What is a joint aspiration?

A

When a sample of synovial fluid is taken from the joint by a needle to be tested

82
Q

What are diagnostic criteria for septic arthritis of the hip?

A 
Kocher
Heart rate
Temperature
White cell count
Can they out weight on the hip
83
Q

What is the treatment for transient synovitis of the hip?

A

Prescribe non steroidal anti inflammatories

84
Q

How may T2DM affect wounds?

A

People with T2DM often have poor wound healing, bone healing and soft tissue healing

85
Q

How does bacteria in septic arthritis affect joint fluid?

A

Joint fluid will be turbid ie cloudy and pus like as well as straw coloured instead of clear

86
Q

How are inflammatory markers affected in gout?

A

ESR- raised
CRP- raised
WBC- stays the same

BRS Y1 (52 decks)

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