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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
Q

Subchondral bone

A

bony material under the cartilage
-the calcified zone anchors the articular cartilage to the subchondral bone

26
Q

Synovitis

A

inflammation of the synovial membrane (joint effusion)

27
Q

What are the causes and symptoms of synovitis?

A

-over use, trauma
-increased production of synovial fluid (swelling-effusion; decreased viscosity)
-heat and pain

28
Q

Bog spavin

A

synovitis of the tibial tarsal joint (swelling on the dorsal aspect)

29
Q

Septic arthritis

A

infection in a joint (VERY BAD)

30
Q

Septic arthritis causes and symptoms

A

-puncture, laceration, surgery or injections
-heat, pain, swelling
-usually starts with synovitis followed by cartilage damage (arthritis)
-needs to be treated right away

31
Q

Osteoarthritis

A

degenerative joint disease (often a progressive disease)

32
Q

Osteoarthritis starts with:

A

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
Q

After synovitis in osteoarthritis:

A

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
Q

Eventually after cartilage damage in osteoarthritis:

A

Subchondral bone damage
-severe articular cartilage damage
-damage may penetrate deep layers of cartilage
-subchondral bone may be affected
-severe inflammation, pain

35
Q

After subchondral bone damage in osteoarthritis:

A

there is reduced joint function
-joint capsule is thickened
-collateral ligaments may lose flexibility
-decreased synovial fluid
-flexibilty reduced, chronic pain

36
Q

At osteoarthritis’ worst:

A

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
Q

Bone spavin

A

boney growth
-horse will have less movement in the joint
-hock
-cartilage can wear away and bones fuse together

38
Q

Osselet

A

-in the fetlock
-over time cartilage wears down and boney growth occurs
-usually the horse has synovitis when first beginning

39
Q

Goals of osteoarthritis treatment

A

-reduce further damage and preserve joint function
-prevent permanent damage to the articular surfaces, deeper layers, ligaments, and bones

40
Q

Reducing further damage from osteoarthritis includes:

A

-rest (reduce exercise, evaluate work load/surface/hoof care/etc.)
-control inflammation

41
Q

How to control inflammation for osteoarthritis:

A

-cold therapy
-nonsteroidal anti-inflammatory drugs (NSAIDS)
-steroidal anti-inflammatory drugs (corticosteroids)
-interleukin-1 receptor antagonist protein (IRAP)

42
Q

NSAIDS

A

used systemically (oral, IV, or IM administration)

43
Q

Common NSAIDS

A

-phenylbutazone (bute) - oral or IV (not IM)
-flunixin (banamine) - oral, IV, or IM

44
Q

Bute and Banamine

A

inhibit prostaglandin production by inhibiting “cyclo-oxygenase” enzyme (COX)
-not specific inhibition may have some side effects (typically GI irretation)

45
Q

COX-II inhibitor (equioxx)

A

NSAID that acts only on COX enzyme involved in inflammatory prostaglandin synthesis
-fewer side effects, more expensive

46
Q

Steroidal anti-inflammatory drugs (corticosteroids)

A

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
Q

Common corticosteroids:

A

-cortisone
-dexamethasone
-can suppress some immune functions
-some can have negative affects on cartilage health

48
Q

Interleukin-1 receptor antagonist protein (IRAP)

A

-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
Q

Ways to restore/preserve joint function

A

-hyaluronic acid
-polysulfated glucosaminoglycans (PSGAGS)
-Pentosan Polysulfate
-Biologics (PRP and stem cells)
-polyacrylamide hydrogels

50
Q

Hyaluronic acid

A

-intra-articular or systemic
-enhance lubrication in joint (improve viscosity and reduce friction, may decrease inflammation via physical effects)

51
Q

Polysulfated Glycosaminoglycans (PSGAGS)

A

-systemic, possibly intra-articular
-can improve cartilage health
-can improve lubrication
-decrease inflammation
-Adequan (injectable IM)

52
Q

Pentosan Polysulfate

A

-systemic, IM
-may enhance chondrocytes and synoviocyte activity
-support cartilage repair
-maintain normal synovial fluid composition
-reduce inflammation
-slow progression of OA

53
Q

Biologics

A

-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
Q

Polyacrylamide Hydrogels

A

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
Q
A

ASC 410 (22 decks)

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