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MSK physiology Flashcards

(93 cards)

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1
Q

State the functions of the skeleton

A
  • Protect vital organs
  • Houses bone marrow
  • Shape/support
  • Allows locomotion/movement
  • Stores calcium
  • Transmits body weight
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2
Q

State the different classes and shapes of bone

A 
Long
Short
Flat
Irregular
Sesamoid
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3
Q

Give 3 examples of a long bones

A

Femur
Phalanges
Metacarpals

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4
Q

Give an example of a short bone

A

Carpal

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5
Q

Give 4 examples of flat bones

A

Rib
Some bones of the skull
Sternum
Ileum of pelvis

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6
Q

Give 3 examples of irregular bones

A

Vertebra
Mandible
Sacrum

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7
Q

Give an example of a sesamoid bone

A

Patella

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8
Q

What are the two macrostructures of bone?

A

Cortical (compact)

Trabecular (spongey)(cancellous)

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9
Q

What are the two microstructures of bone

A

Woven 1

Lamellae 2

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10
Q

What are the 3 parts of a long bone?

A

Epiphysis (end)
Metaphysis
Diaphysis (shaft)

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11
Q

Where are the epiphyseal plates located?

A

Between the epiphysis and metaphysis

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12
Q

What are the two devisions of the skeleton?

A

Axial

Appendicular

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13
Q

Where in the long bone is trabecular bone most likely to be found?

A

Epiphysis

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14
Q

Describe the structure of trabecular bone

A

Bone struts with hole in between, filled with bone marroq

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15
Q

Describe cortical bone

A

Dense, located at the periphery of the diaphysis in long bones

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16
Q

Describe woven bone

A

Primary bone
Poorly organised
No clear structure
Lay down quickly

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17
Q

Describe lamellae bone

A

Secondary bone
Made slowly
Highly organised
In layers

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18
Q

What is the importance of hallow areas in bone

A
  • Reduce mass
  • Mass away from neural axis
  • House bone marrow
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19
Q

What is the importance of having wide ends of bone

A

-Load spread over a larger SA

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20
Q

What is the importance of having trabecular bone within a long bone

A
  • Reduces mass

- Load spread over larger SA/structural support

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21
Q

Describe the composition of bone

A

Inorganic 60%
Organic 30%
Water 10%

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22
Q

What makes up the inorganic component of bone?

A

Calcium hydroxyapatite

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23
Q

What makes up the organic component of bone?

A

90% Collagen

10% Non-collagenous proteins e.g Glycoproteins/Protoglycans

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24
Q

What are the two types of bone formation?

A

Intramembranous ossification

Endochondral ossification

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25
Define intramembranous ossification
Formation of primary bone with no prior cartilaginous template/proformer
26
What type of bones are formed by intramembranous bone formation
Flat bones
27
Describe the process of intramembranous ossification
Osteoprogenitor cells within a primitive mesenchyme develop into osteoblasts Osteoblast secrete osteoid (mainly type 1 collagen) Osteoid becomes ossified by calcium hydroxyapatite also secreted by osteoblasts
28
What type of bones are formed by endrochondral ossification?
Long bones
29
Describe endrochondral ossification
1)Proformer cartilage - hyaline 2)Shaft of the proformer is calcified 3)Bony colar develops 4)Collar penetrated by blood vessels - bring more osteoprogenitor cells 5)Osteoprogenitor cells develop in osteoblasts Osteoblast secrete osteoid 6)1 primary ossification centre is developed 7)2 primary ossification centres later develop in the epiphyses 8)Expansion of the ossification centres - 9)Cartilage proformer reduced only to the epiphyseal plates 10) Lengthening via epiphyseal plates 11) Closure of epiphyseal plates
30
Two what hormones is the epiphyseal cartilage particularly responsive to?
``` GH Sex hormones (hence growth spurt at puberty) ```
31
Which bone cells secrete RANK ligand?
Osteoblasts
32
Which cells have high alkaline phosphate activity?
Osteoblasts
33
Describe the function of osteoclasts?
Bone resorption Dissolve the mineralised matrix Breakdown collagen
34
What do osteoblasts secrete to dissolve the mineralised matrix?
Hydrochloric acid
35
What do osteoblast secrete in order to breakdown type 1 collage of bone?
Cathepsin K
36
What are the reasons for bone remodelling?
``` Repair damage Obtain calcium Form bone shape 1 woven to 2 lamellar bone In response to loading - exercising Reorganise fibrils to improve mechanical strength Pathological ```
37
Give an example of a bone formed by a combination of intramembranous and endochondral ossification?
Scapula
38
What type of collagen is found in basement membranes?
IV
39
Where is type I collagen found?
Bone, teeth, skin, ligament, tendon
40
Where is type II collagen found?
Cartilage
41
What type of collagen is found at the liver/kidneys/spleen/uterus/arteries
III - Reticulin
42
How is reticulin different from the other types of collagen?
Forms branched fibres
43
Where is type V collagen found?
Placenta
44
Which collagen types form fibrils?
I, II, III, V, XI
45
Describe the structure of a collagen fibre
Triple polypeptide alpha helix = tropocollagen (cross linking) Overlapping tropocollagen molecules = collagen fibril (cross linking) Several collagen fibrils = collagen fibre
46
How is collagen synthesised?
Tropocollagen molecules synthesised by fibro/osteoblast and secreted Collage fibrils/fibres arranges extracellularly
47
What is the purpose of collagen in the organic bone matrix
Provide tensile strength
48
What is the purpose of protoglycans in the organic bone matrix?
To withstand pressure
49
What are the properties of protoglycans
``` Negative charge Allows binding of water Friction free surfaces Compressive stiffness Can also be used a signalling molecule ```
50
Where are protoglycans found?
All cartilaginous tissues
51
How does cartilage breakdown occur
Inflammatory response - cytokines | Chondroclasts release protienases in response to cytokines
52
What is the role of integrins in terms of bone?
Collagen and fibronectin receptors Control cell shape, movement and can alter gene expression by a kinase cascade Allow cross talk between ECM and cells
53
What provides the function of bone
Extracellular matrix
54
How does a deficiency of sex hormone lead to someone being tall?
Late closure of the epiphyseal plates
55
What type of cells are osteoblasts derived from?
Mesenchymal
56
What type of cells are osteoclasts derived from?
Haemopoetic cells
57
Where in the bone do osteoblasts lie?
Howship's lacunae
58
What are the sex hormone stimulators of?
Bone growth
59
What is growth hormone a stimulator of?
Growth of epiphyseal cartilage
60
What is calcium needed for?
Blood clotting Nerve function Muscle contraction
61
Where is calcium stored?
Skeleton - Calcium hydroxyapatite
62
In what different forms does calcium exist in the body? Which in the most imp
- Ionised* - Complex - Bound to plasma proteins (not filtered at kidneys)
63
How does pH affect the extracellular (ionised) Ca?
Increase in pH Increased negative charge on albumin Increased binding of Ca Decreased extracellular Ca
64
What hormones are involved in Ca homeostasis?
Parathyroid hormone Calcitonin Vitamin D
65
Where is parathyroid hormone released from?
Chief cells of parathyroid gland
66
Where is calcitonin released from?
Parafollicular C cells of thyroid follicles
67
Where is vitamin D (inactive D) synthesised?
Skin, in the presence of UV radiation
68
What is the active form of Vit D
1,25-hydroxyvitaminD
69
Where is Vitamin D activated
1) Liver | 2) Kidney
70
What is the overall aim of PTH?
Increase Ca serum levels
71
What are the individual actions of PTH?
1) Increase bone resorption - increase osteoclast activity 2) Increase Ca reabsorption at the kidney - DCT 3) Decrease phosphate reabsorption at the kidney - PCT 4) Activate vitamin D (at kidney 1-hydroxylase) - increase absorption of Ca and phosphate
72
What is the overall action of calcitonin? How does it do this?
Decrease serum Ca levels | Decrease bone resorption - decrease osteoclastic activity
73
What are the variables of strain put on bone?
``` Magnitude Frequency Hold/rest periods No. of cycles Site Age Drugs ```
74
What affect does increased physical activity have on bone?
Increased activity Increased strain Bone formation
75
Define a fracture
A soft tissue injury further complicated by a breach in continuity of the bone
76
In terms of bone remodelling, what is coupling?
Formation occurring at the same sites as resorption is taking place
77
Other than coupling, what is an important factor of bone remodelling?
Balance
78
Which bone cells CONTROL bone remodelling?
OsteoBlasts
79
Which cells secrete RANK-Ligand
Osteoblasts
80
Where are RANKL receptors found?
Osteoclasts
81
What is the role of RANKL?
Stimulates resorption - osteoclasts to release Cathepsin K and HCl
82
What is the role of Osteoprotegrin?
Prevents RANK-RANKL binding by binding to RANKL | Increases bone density (prevents bone resorption)
83
What other factors beside RANKL/OPG influence bone remodelling?
``` Hormones (endocrine) including 1,25 dihydroxyvitamin D PTH/PTHrP Oestrogen Leptin Paracrine/autocrine including Prostaglandins Interleukin-1 (IL-1) Interleukin-6 (IL-6) Tumour necrosis factor (TNF) ```
84
What are the stages of fracture healing?
``` Haematoma/Inflammation Soft callus(repair) Bony callus(repair) Remodelling ```
85
Why do bones break?
Normal bone - abnormal load | Abnormal bone - normal load
86
State the different types of fracture
``` Comminuted Spiral Wedge Open Transverse Oblique Avulsion Segmental Impact Torus (looks like welling) ```
87
What happens during the haematoma phase of fracture healing?
Death of osteocytes | Periosteal stripping
88
What happens during inflammation of fracture healing?
Neovascularisation | Osteoclasts clear debris
89
What happens during repair stage of fracture healing?
Cartilage proformer - soft callus Osteoblast secrete osteoid - hard callus Increased vascularity
90
What happens during the remodelling stage of fracture healing?
Woven bone to lamellar bone | Vascularity returns to normal
91
How is fracture healing (closed) unique?
No scaring
92
What are the principles of fracture management?
Reduce Immobilise Rehabilitate
93
What factors affect fracture healing?
``` Patient -Age -Sex The fracture -site -bone-cortical v cancellous -vascularity Treatment ```

Phase 1 EDF (12 decks)

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