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ASC 410 > Joints > Flashcards

Joints Flashcards

1
Q

Joint

A

the junction of bones

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2
Q

Ligaments stabilize the joint by…

A

connecting the bones

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3
Q

Extra-articular ligaments

A

found outside of the joint capsule

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4
Q

Example of extra-articular ligaments

A

the collateral ligaments

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5
Q

Intra-articular ligaments

A

found within the joint capsule

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6
Q

Example of intra-articular ligaments

A

cruciate ligaments

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7
Q

Joint capsule

A

surrounds the joint

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8
Q

What is the joint capsule comprised of?

A

2 layers
-the outer layer - fibrous portion
-the inner layer - synovial membrane

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9
Q

Outer layer of the joint capsule

A

provides strength to capsule and may be connected to the collateral cartilages

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10
Q

Inner layer of the joint capsule

A

-responsible for amount and composition of the synovial fluid
-has some capacity to remove debris from the synovial fluid (phagocytosis)
-contains nerves

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11
Q

Where does pain in a joint usually stem from and why?

A

issues with the synovial membranes because it contains nerves

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12
Q

Physical characteristics of synovial fluid

A

-clear/slightly yellow
-viscous
-slippery
-thick

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13
Q

What are the two important compounds in synovial fluid?

A

-hyaluronan
-lubricin

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14
Q

What is the function of synovial fluid?

A

-reduces friction within the joint
-provides nutrients to articular cartilages (especially important because blood supply to cartilage is minimal and decreases with maturity)

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15
Q

What is the viscosity of synovial fluid determined by?

A

the amount of hyaluronan
-the more hyaluronan, the more viscous/thick

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16
Q

Articular cartilage

A

covers the ends of the opposing bones in a joint

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17
Q

Hyaline cartilage

A

-smooth
-whitish
-shiny
-slippery
-low friction
-minimal vascularization

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18
Q

Major components of articular cartilage

A

-mostly water (allows some resilience to compression)
-collagen
-proteoglycans (hyaluronan and aggrecan)
-chondrocytes (maintain, renew cartilage slowly; there are not many of them)

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19
Q

How well do articular cartilages heal?

A

not good if at all

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20
Q

The 4 zones of articular cartilage:

A

-superficial (tangential zone)
-Transitional (middle zone)
-radial (deep zone)
-subchondral bone

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21
Q

Superficial (tangential) zone

A

top layer, right below the synovial fluid
-sideways fibers
-hard
-should endure the force of back and forth movement

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22
Q

Transitional (middle) zone

A

has water, collagen, chondrocytes, and proteoglycans
-decompress and absorb concussion

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23
Q

Radial (deep) zone

A

bottom layer (seaweed looking)
-has uncalcified and calcified cartilage
-right on top of the subchondral bone and anchors to the bone

24
Q

Tidemark

A

the edge between the uncalcified and calcified cartilage

25
Subchondral bone
bony material under the cartilage -the calcified zone anchors the articular cartilage to the subchondral bone
26
Synovitis
inflammation of the synovial membrane (joint effusion)
27
What are the causes and symptoms of synovitis?
-over use, trauma -increased production of synovial fluid (swelling-effusion; decreased viscosity) -heat and pain
28
Bog spavin
synovitis of the tibial tarsal joint (swelling on the dorsal aspect)
29
Septic arthritis
infection in a joint (VERY BAD)
30
Septic arthritis causes and symptoms
-puncture, laceration, surgery or injections -heat, pain, swelling -usually starts with synovitis followed by cartilage damage (arthritis) -needs to be treated right away
31
Osteoarthritis
degenerative joint disease (often a progressive disease)
32
Osteoarthritis starts with:
synovitis -brings inflammatory cells, compounds to the area (prostaglandins, cytokines, enzymes) -increase in blood flow, heat -increase synovial fluid (lower in viscosity than normal)
33
After synovitis in osteoarthritis:
Cartilage damage -if synovitis gets worse or continues -enzymes, inflammatory cells, etc -degrade collagen -the superficial layer of the articular cartilage is damaged -loss of normal smooth shiny structure (pitted, grooved, yellow, soft; function is affected)
34
Eventually after cartilage damage in osteoarthritis:
Subchondral bone damage -severe articular cartilage damage -damage may penetrate deep layers of cartilage -subchondral bone may be affected -severe inflammation, pain
35
After subchondral bone damage in osteoarthritis:
there is reduced joint function -joint capsule is thickened -collateral ligaments may lose flexibility -decreased synovial fluid -flexibilty reduced, chronic pain
36
At osteoarthritis' worst:
there is loss of joint function -articular surface (subchondral bone) can adhere to opposing articular surfaces -"ankylosing" arthritis -- joint fuses -no joint flexibility -may be less painful though
37
Bone spavin
boney growth -horse will have less movement in the joint -hock -cartilage can wear away and bones fuse together
38
Osselet
-in the fetlock -over time cartilage wears down and boney growth occurs -usually the horse has synovitis when first beginning
39
Goals of osteoarthritis treatment
-reduce further damage and preserve joint function -prevent permanent damage to the articular surfaces, deeper layers, ligaments, and bones
40
Reducing further damage from osteoarthritis includes:
-rest (reduce exercise, evaluate work load/surface/hoof care/etc.) -control inflammation
41
How to control inflammation for osteoarthritis:
-cold therapy -nonsteroidal anti-inflammatory drugs (NSAIDS) -steroidal anti-inflammatory drugs (corticosteroids) -interleukin-1 receptor antagonist protein (IRAP)
42
NSAIDS
used systemically (oral, IV, or IM administration)
43
Common NSAIDS
-phenylbutazone (bute) - oral or IV (not IM) -flunixin (banamine) - oral, IV, or IM
44
Bute and Banamine
inhibit prostaglandin production by inhibiting "cyclo-oxygenase" enzyme (COX) -not specific inhibition may have some side effects (typically GI irretation)
45
COX-II inhibitor (equioxx)
NSAID that acts only on COX enzyme involved in inflammatory prostaglandin synthesis -fewer side effects, more expensive
46
Steroidal anti-inflammatory drugs (corticosteroids)
may be used systemically (goes everywhere) -commonly used intra-articularly for OA -reduce inflammation by inhibiting a different phase of the inflammatory cascade than NSAIDS
47
Common corticosteroids:
-cortisone -dexamethasone -can suppress some immune functions -some can have negative affects on cartilage health
48
Interleukin-1 receptor antagonist protein (IRAP)
-reduces inflammation by inhibiting interleukin 1 (IL-1) (a pro inflammatory cytokine) -a biologic produced from autologous blood (horse's own blood processed to make IRAP) -administered intra-articularly
49
Ways to restore/preserve joint function
-hyaluronic acid -polysulfated glucosaminoglycans (PSGAGS) -Pentosan Polysulfate -Biologics (PRP and stem cells) -polyacrylamide hydrogels
50
Hyaluronic acid
-intra-articular or systemic -enhance lubrication in joint (improve viscosity and reduce friction, may decrease inflammation via physical effects)
51
Polysulfated Glycosaminoglycans (PSGAGS)
-systemic, possibly intra-articular -can improve cartilage health -can improve lubrication -decrease inflammation -Adequan (injectable IM)
52
Pentosan Polysulfate
-systemic, IM -may enhance chondrocytes and synoviocyte activity -support cartilage repair -maintain normal synovial fluid composition -reduce inflammation -slow progression of OA
53
Biologics
-Platelet rich plasma (PRP) -- autologous blood, intra-articular, reduce inflammation, may stimulate repair? -stem cells -- autologous cells, intra-articular, reduce inflammation, may stimulate repair?
54
Polyacrylamide Hydrogels
substances previously used in cosmetology -intra-articular injection -integrates into some joint tissues -may restore some joint flexibility -increase lubrication/reduce friction -reduce inflammation
55

ASC 410 (22 decks)

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