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Medicine 1 > Anatomy - Rheumatoid arthritis and Osteoarthritis > Flashcards

Anatomy - Rheumatoid arthritis and Osteoarthritis Flashcards

1
Q

What is osteoarthritis and where does it usually occur?

A

Wearing down of protective cartilage at end of bones over time

  • Knees
  • Hip
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2
Q

What are the characteristics of osteoarthritis?

A
  • Sclerosis
  • Muscle weakness
  • Fibrocartilage and ligaments
  • Angiogenesis
  • Neural ingrowth
  • CNS adaptation
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3
Q

What are the properties of surgery for arthritis?

A
  • Arthroplasty - very effective
  • Problems selecting patients
  • Resource problems
  • Longevity of replaced joints
  • Timing of surgery pre-retirement
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4
Q

How are NSAIDs used in arthritis and what are the complications?

A
  • High dose
  • Some cause peptic ulcers
  • Higher chance of peptic ulcers in females
  • More than 1 NSAID causes peptic ulcers
    • risk with ulcer history
  • Worsened outcome with corticosteroid use
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5
Q

Where do NSAIDs cause adverse effects?

A
  • Hut
  • Renal
  • Skin
  • Liver
  • CNS
  • Haematological
  • Cardiovascular
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6
Q

What are the properties of rheumatoid arthritis?

A
  • Uncommon
  • Inflammatory disease
  • Destructive tissue response
  • Ummunological and non-immunological mechanisms
  • Can acheive disease modification
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7
Q

What are the epidemiological risk factors for arthritis?

A
  • Age
  • Gender
  • Post-partum
  • Stress
  • Genetic
  • Smoking
  • Low education
  • Deprivation
  • Periodontal disease
  • Microbiome
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8
Q

What are the areas affected by rheumatoid arhtiritis?

A
  • Systemic disease
  • Emphasis on joints
  • Eyes
  • Skin
  • Vasculitis
  • Lungs
  • Salivary glands
  • Pericarditis
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9
Q

What are the implications of use of prednisolone for arthritis?

A
  • Osteoporosis
  • Cataracts
  • Weight gain
  • Diabetes
  • Hypertension
  • Dependence
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10
Q

What are the mechanisms of DMARDs (disease modifying anti-rheumatic drugs)?

A
  • Synovitis
  • Release damaging factors (i.e. cytokines and proteases)
  • Reduce joint damage
  • Improve functional outcome
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11
Q

What are some exmaples of DMARDs?

A
  • Corticosteroids
  • Methotrexate
  • Cyclophosphamide
  • Ciclosporin A
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12
Q

What plays a bog role in inflammation?

A

Tumour necrosis factor

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13
Q

What happens when you block tumour necrosis factor?

A

Reduced inflammation

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14
Q

How does the foot move when contactin ground when walking?

A
  • Heel makes first contact
  • Rolls over its lateral side
  • Pressure then shifted to medial forefoot
  • Big toe next at point of ‘foot off’
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15
Q

What are the properties of the hip joint?

A
  • Ball and socket joint
  • Large degree of freedom
  • 21 separate muscles move and stabilise it
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16
Q

What are the proeprties of the knee joint?

A
  • Hinge joint
  • 14 muscles move and stabilise it
  • Movement guided by menisci and strong collateral and cruiciate ligaments
17
Q

What are the properties of the foot/ankle joint complex?

A
  • Mortise joint
  • Moved and stabilised by 33 muscles on each side
  • Strongest are plantar flexors
  • Flexor digitorum longus and flexor hallucis longus work via tendon straps
  • Arch of foot is maintained by strong ligaments and intrinsic foot muscles
18
Q

What are the properties of the human gait cylce?

A
  • Sub-divided into 6-9 different periods
  • Full cycle = defined as stance phase followed by single swing phase
19
Q

What happens during the loading phase?

A
  • Between initial heel contact and end of first period of double limb support
20
Q

What happens during the mid-stance phase?

A
  • From beginning of single limb support to time when weight is on forefoot
  • Momentum causes tibia to move forward on talus
  • Plantar flexors change from eccentric to vconcentric load
  • Hip abductors active to prevent pelvic tilt
21
Q

What happens during the temrinal stance phase?

A
  • Between when weight is on forefoot to heel contact of the other limb
  • Plantar flexors macimally concentrically active
  • Hip abductors active
22
Q

What happens during the pre-swing phase?

A
  • From heel contact of swinging contralateral limb to toe off stance limb
  • Extensors of foot are active so foot can move freely
23
Q

What happens during the mid-swing phase?

A
  • From toe off to moment when tibis of swinging limb is vertically orientated
  • Plantar flexors and hip abductors at rest
24
Q

What happens during the terminal swing phase?

A
  • From vertical tibia of swinging limb to initial contact
  • Hamstrings briefly worked eccentrically

Medicine 1 (28 decks)

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