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MSK > Physiology 3 > Flashcards

Physiology 3 Flashcards

1
Q

how are synovial joints supported?

A

extra-articular structures

  • ligaments
  • tendons
  • bursors
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2
Q

give 2 functions of joints

A

structural support

purposeful movement

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3
Q

give roles of joints in movement

A

distribute stress (often through muscles over joint)
confer stability via shape, ligaments and synovial fluid
joint lubrication
- cartilage interstitial fluid
- synovium derived hyaluronic acid
- synovium derived lubricin

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4
Q

how does a joint confer stability?

A

shape of articular component
ligaments
synovial fluid (acts as adhesive seal that permits sliding motion)

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5
Q

what are the functions of synovial fluid?

A
  • lubricates joint
  • facilitates movement by reducing friction
  • minimises wear and tear via lubrication
  • aids nutrition of articular cartilage
  • supplies chondrocytes (cartilage cells) with O2 and nutrients and removes CO2 and waste products
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6
Q

how much synovial fluid is in the knee?

A

<3.5 ml

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7
Q

is synovial fluid static?

A

no

continuously replenished by synovial membrane

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8
Q

is synovial fluid thin or viscous?

A

viscous

due to presence of hyaluronic acid (mucin) produced by synovial cells

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9
Q

is synovial fluid always the same?

A

no
viscosity and elasticity varies with joint movement
rapid movement = decreased viscosity and increased elasticity

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10
Q

where are constituents of synovial fluid derived from?

A

dialysis of blood plasma

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11
Q

how many cells are contained within synovial fluid?

A

only a few

mainly mononuclear leucocytes

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12
Q

what changes occur in synovial fluid in osteoarthritis?

A

the ability of synovial fluid to change viscosity and elasticity is defective

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13
Q

what does synovial fluid look like?

A

clear and colourless

high viscosity

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14
Q

what is the cell count of synovial fluid?

A

<200/mm3 WBC
- polymorphs make up <25/mm3
WBC count will increase in inflammatory and septic arthritis

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15
Q

when can synovial fluid be red?

A

traumatic synovial tap

haemorrhagic arthritis

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16
Q

how does clarity/colour of synovial fluid change in septic arthritis?

A

becomes opaque due to high number of WBCs
variable colour
less viscous

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17
Q

what does articular cartilage do?

A

mainly prevents wear and tear of joints by providing low friction, lubricated gliding surface
distributes pressure to bone

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18
Q

what determines the mechanical properties of articular cartilage?

A

determined by composition of ECM and interaction between solid and fluid phase of cartilage

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19
Q

what are the zones of articular cartilage?

A

superficial
middle (biggest)
deep
calcified

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20
Q

how do zones of articular cartilage differ?

A

organization of collagen fibres and relative content of cartilage components

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21
Q

what type of cartilage is articular cartilage?

A

hyaline

22
Q

what properties of articular cartilage have?

A

elastic

sponge-like

23
Q

what are the components of articular cartilage?

A

special ECM made of water, collagen (mostly type 2) and proteoglycans

24
Q

what is the function of water in cartilage?

A

maintains resiliency of tissue and contributes to nutrition and lubrication
70% of cartilage net weight (unevenly distributed)

25
Q

what is the function of collagen in cartilage?

A

provides tensile strength and stiffness and maintains architecture
20% of cartilage net weight (mainly type 2)

26
Q

what is the function of proteoglycans in cartilage?

A

compressive properties associated with weight bearing

10% of cartilage weight

27
Q

what are proteoglycans composed of and where are they found?

A

glycosaminoglycan

highest concentration in middle and deep zone of cartilage

28
Q

what happens to cartilage components with age?

A

they all decrease with age

29
Q

what makes up most of the total cartilage volume in the body?

A

ECM (98%)

30
Q

what maintains the ECM?

A

chondrocytes

they synthesise, organise and degrade

31
Q

how do articular cartilage cells receive nutrients and O2?

A

articular cartilage is avascular so they get nutrients from synovial fluid

32
Q

how do the rates of ECM degradation and synthesis match up?

A

degradation never exceeds synthesis

33
Q

how do chondrocytes break down ECM components?

A

metalloproteinse proteolytic enzymes

  • collagenase
  • stromelysin
34
Q

how does ageing affect articular cartilage?

A

changes in relative amounts of the 3 components of cartilage changes the mechanical properties of the cartilage

35
Q

how might ECM cause joint disease?

A

if rate of ECM degredation exceeds synthesis rate

36
Q

what are the catabolic factors of cartilage matrix turnover and what do they do?

A

TNF alpha, IL-1

stimulate proteolytic enzymes and inhibit proteoglycan synthesis

37
Q

what are the anabolic factors of cartilage matrix turnover and what do they do?

A

TGF beta and IGF 1

stimulate proteoglycan synthesis and counteract effects of IL1

38
Q

what are the markers of cartilage degredation?

A

serum and synovial keratin sulphate
- increase = cartilage breakdown
type 2 collagen in synovial fluid
- increase = cartilage breakdown

39
Q

give 4 examples of problems that can arise in a joint?

A

osteoarthritis - cartilage and synovial composition deteriorate
rheumatoid arthritis - synovial cell proliferation and inflammation cause rheumatoid arthritis

40
Q

what causes rheumatoid arthritis?

A

synovial cell proliferation and inflammation cause rheumatoid arthritis

41
Q

what causes gouty arthritis?

A

deposition of salt crystals (e.g uric acid)

42
Q

what causes tendonitis?

A

injury and inflammation to periarticular structures causing soft tissue rheumatism - injury to the tendon

43
Q

3 changes in subchondral bone in osteoarthritis?

A

cyst formation
osteophyte formation
sclerosis

44
Q

what are the 3 types of joint?

A

synovial
fibrous
cartilaginous

45
Q

describe fibrous joints

A 
syanthrosis
unites bone (e.g skull sutures)
doesn't allow any movement
46
Q

describe cartilaginous joints

A

AKA amphiarthrosis
bones united by cartilage
allows limited movement
e.g - IV discs, pubic symphysis

47
Q

what are synovial joints?

A

diarthrosis
bones separated by a cavity containing synovial fluid and united by a fibrous capsule as well as extra-articular structures

48
Q

what lines the inner aspect of fibrous capsule of synovial joints?

A

synovial membrane

- vascular connective tissue with capillary networks and lymphatics

49
Q

what is the function of the synovial membrane?

A

contains synovial cells which produce synovial fluid

50
Q

what covers the articular surfaces?

A

hyaline cartilage

51
Q

what are the 2 types of synovial joint?

A

simple (one pair of articular surfaces)

compound (more than one pair of articular surfaces - eg. elbow)

MSK (66 decks)

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