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BRS1 - Valentine > Connective tissues and Rheumatology intro > Flashcards

Connective tissues and Rheumatology intro Flashcards

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1
Q

what are the features of connective tissues

A
  • Protectd snd insulate internal organs
  • major transport system within the body
  • site of stred energy reserves
  • binds together, support and strenghtens other body tissues
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2
Q

what are all connective tissues derived from embryologically speaking?

A

Mesenchyme from mesoderm

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3
Q

what are the 3 classes of components of connective tissue?

A

Cells and ECM

ECM is amde out of:

fibres and

Ground substances- Macromelocules and glycoprotiens

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4
Q

what are the components of fibres in connetive tissue?

A

Reticular

Elastic

Collagen

have varying amount in combination for each part of the body

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5
Q

what types of cells make up part of connective tissue

A
  • Fibroblast
  • Macrophage
  • Mast cell
  • Plasma cell
  • Lymphocyte]
  • Leukocyte
  • Adipose cell
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6
Q

does connective tissue have a nerve supply and blood supply? any exceptions?

A

yes

except CARTILAGE and tendons(avascular)

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7
Q

what is the function of ground substance and give examples

A
  • Supports cells and binds cells and fibres together
  • found between cells and fibres
  • provides a medium for exchange of substances

E.g Hyaluronic acid

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8
Q

what are the features of elastic fibres?

A
  • Smaller in diameter than collagen fibres
  • made up of protein elastin
  • Branch to form network
  • found in blood vessels
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9
Q

what are the features of reticular fibres?

A

Provide support for the walls of blood vessels

made up of collagen (smaller diameter) with a glycoprotein covering

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10
Q

what is the feature and function of fibroblasts

A

They are large flat cells with branching processes

they migrate throughout connective tissue secreting the fibres and ground substances

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11
Q

what are the types of connective tissues?

A
  1. proper= divided into loose and dense
  2. cartilage
  3. Bone tissue
  4. Blood
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12
Q

what are the types of loose connective tissue and what is each significance?

A
  • Areolar- most common form; lines organs
  • Adipose- fatcells
  • Reticular- contains reticular fibre and used to support spleen
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13
Q

what are the types of Dense connective tissue and what is each significance

A

Regular- tight; used for tendon as it contains lots of collagen

Irregular- form on skin as a mesh

Elastic- part of vertebrae

all contian more collagen than loose connecitve tissue

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14
Q

what is the blood supply and nerve supply to cartilage? any exceptions?

A

Most cartilages are AVASCULAR and has NO nerve supply EXCEPT perichondrium

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15
Q

what cells make up cartilages?

A

Chondroblasts- in growing cartilages

Chondrocyte

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16
Q

describe the matrix of cartilages

A

Chondrocytes makes matrix which contains:

  • Gel-like ground substance
  • Fibres: collagen, elastic fibres in some
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17
Q

what are the 3 types of cartilages?

A
  1. Elastic cartilage
  2. Fibrocartilage
  3. Hyaline cartilage
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18
Q

what are the distinguishing features of hyaline cartilages?

Study These Flashcards
A
  1. most abundant in body
  2. weakest of the 3 types; doesnt contain much collagen fibres.
  3. gel like ground substance
  4. found in end of long bones to cushion joints and at epiphyseal plates.
19
Q

what are the features of Fibrocartilages?

Study These Flashcards
A
  • Strongest type- contains Type 1 collagen
  • Chondrocytes are scattered among visible bundles of collagen fibres
  • No perichondrium
  • Found in IV discs (annulus fibrosis), pubic symphysis and meniscus
20
Q

what are the features of elastic cartilages?

Study These Flashcards
A
  • chondrocytes are lcoated in elastic fibres
  • provides strength and elasticity
  • found in external ear and epiglottis
21
Q

what are the components of compact bone?

Study These Flashcards
A
  • osteon - basic unit of compact bone
  • Lamellae- concentric circles of matrix
  • Lacunae- spaces that house cells
  • Osteocytes- mature bone cells
22
Q

what is contained in the trabeculae

Study These Flashcards
A

spaces filled with red bone marrow

23
Q

what are the CONFOUNDING features of Rheumatoid arthritis?

what is the othr form of arthritis that it distinguishes itself from?

Study These Flashcards
A
  • Autoimmune disorder
  • affects joints bilaterally
  • results in swollen painful joints- inflammation
  • Symtoms worse in morning following rest.

Osteoarthritis

24
Q

what are the joints changes in RA?

Study These Flashcards
A

reduced joint space

cartilage wears away

bone erosion

inflammed synovial membrane

25
In RA,what are the cells and factors responsible for its onset?
IL- 1, IL-6, IL-17, TNF-alpha chondrocyte, macrophages, osteoclasts(due to RANKL)
26
In RA, what joints are typically spared?
Thoracolumbar spine DIPs of fingers IPs of toes
27
in RA, what joints are normally affected?
Wrists, MCP, PIP joints- all BILATERALLY polysrticular- more than 3 different joints affected
28
Contrast RA to OA
RA- inflammatory, OA- degenerative RA-Autoantibodies, OA- No antibodies RA- small joints, OA- large weight bearing joints
29
what are the clinical key features of RA?
* subcutaneous or periosteal nodules at pressure points * Ulnar deviation (prominent in right hand) * swelling of MCP and PIP- confined; fells like a firm sponge. * Marginal bone erosion and joint space narrowing on x ray.
30
what is the typical course of RA in the past without treatment.
* 50% of patient show joint space narrowing or erosions in first 2 years. * By 10 years,50% of young working patients are disabled * lower life expectany; women(-10), men(-4)
31
what are the treatment principles for RA?
use MDT team
32
what investigations can be done to confirm RA?
* blood test- autoantibodies * X-ray- check for narrowing of joints and erosion and soft tissue damage * ultrasound- check for inflammtion
33
What are the stages of assesement?
* Assess current activity * Document degree of damage * Document extra-articular manifestations * Asess prior RX responses and side effects
34
what are the critical elements of therapy for RA?
* Education- build relationship * Exercise- strengthening exercises; physio * Medications- analgesic, immunosuppresive, cytotoxic. balance therapeutic index
35
What are the treatment options? For RA
36
what are the different drug options? For RA
* NSAIDS- symptomatic relief- no change in progresion * Low dose prednisolone * Intra-articular steroids- useful for flares * Disease modifying anti-rheumatoid drugs * Immunosuppressive drugs * Biological therapy that inhibit the cytokines
37
Give examples of DMARDs and give any significance?
* Minocycline- modest[ work best early * Sulfasalazine, hydroxychloroquine * Intramuscular gold- rare remmsion; close monitoring * Leflunomide- pyrimidine inhib
38
Give examples of Immunosuppresive drugs?
* Methotrexate- most effective DMARD * Azathioprine * Cyclophosphamide- effective for vasculitis * cyclosporine; can cause renal toxicity
39
what is an example of a DMARD biological therapy
Etanercept soluble TNF receptor, blocks TNF; can block IL-11 and other cytokune factors
40
why does the drugs given to patient need monitoring and how often?
adverse effects on blood liver, kidney etc patients seen 3-6 times a year; 4-8wk interval
41
what are the extraarticular manifestations of RA
affects, liver, spleen, neurological, bine marrow, musculoskeltal
42
what are the ohter 2 UCTD (Undifferentiated connective tissue disease) that isnt RA
SLE scleroderma
43
what are the featuresand symptoms of SLE
Systemic effect- multiple organs and system symptoms * Butterfly skin rash * oral ulcers * photosensitivity * Alopecia- bald patches
44
What are the symptoms of Scleroderma?
1. Reflux 2. Raynaud's phenomena 3. Digital- sclerodactyly 4. ulcerations skin is shiny and hard and loss of wrinkles: normal tissue replaced by connective tissues. Autoimmune

BRS1 - Valentine (54 decks)

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