Musculoskeletal And Rheumatology Flashcards
(38 cards)
Name the connective tissue surrounding muscle, muscle fascicles and muscle fibre
Epimysium surrounds muscle
Perimysium surrounds muscle fascicle
Endomysium surrounds muscle fibre
What is a sarcomere
The repeating unit on a myofibril from one Z disc to another Z disc
Describe the functional classification of joints
Synarthroses - generally allow no movement
Amphiarthroses - allow v limited movement
Diarthroses - allow free movement
What are the components of a snyovial joint and describe each of them
Synovium
- 1 to 3 cells thick
- contains type A synoviocytes (phagoctic and macrophage-like) and type B synoviocytes (fibroblast-like and produce hyaluronic acid)
- contains Type I collagen
Synovial fluid
- Hyaluronic acid-rich viscous fluid
Articular Cartilage
- contains Type II collagen
- contains Proteoglycan (aggrecan)
What us cartilage composed of
Chondrocytes
ECM: water, collagen, proteoglycans (maily aggrecan)
Whta is aggrecan and what is it characterised by
Proteoglycan with many chondroitan suplhate and keratin sulphate chains
Characterised by its ability to interact with Hyaluronan (HA) to form large proteoglycans
2 main pathological chnages of osteoarthritis
Cartilage degeneration Bony remodelling (leads to formation of osteophytes/bony spurs. Osetopenia and bone erosion is therefore for RA not OA, also this is why swelling for OA is bony as oppose to effusion and red/hot for RA)
Which joints are typically affected in OA?
Joints of hand: DIP, PIP, CMC
spine
Weight-bearing joints of the lower limbs: knees, hips, first MTP
Sings and symptoms of osteoarthritis
Joint enlargement -Bouchards nodes (PIP) and Heberdens (DIP) Joint stiffness after immobility Joint crepitus Joint instability Joint pain Limitations of range of motion
Main method of diagnosing OA
X ray
5 c,inical manifestations of inflammation
Calor (heat) Dulor (pain) Tumor (swelling) Loss of function Rubor (redness)
Physiological cellular and molecular chnages that occur during inflammation
Increased blood flow
Migration of leucocytes to the tissue
Activation and differentiation of leucocytes
Cytokine production
Causes of inflammatory joint disease
1) infection
- TB (chronic)
- septic arthritis (acute)
2) crystal arthritis
- gout
- pseudogout
3) immune mediated/autoimmune
- psoriatic arthritis
- rheumatoid arthritis
- SLE
- reactive arthritis
Risk factors for septic arthritis
Immune suppressed
Pre existing joint damage
Intarvenous drug user
How many joints are usually affected in septic arthritis and what is the main exception
1 joint - monoarthritis
Exception = gonococcal septic arthritis causes polyarthritis
When to consider septic arthritis for a patient
Fever
Red hot and painful swelling of joint
Which bacteria are commonly reposnsible for septic arthritis
Staphylococcus aureus
Streptococcus
Gonococcus
How can you treat septic arthritis
Lavage (wash out)
IV antibiotics
Causes of hyperuracaemia
- foods rich in purine foods
- kidney failure (reduced excretion of uric acid)
- genetic tendancy
Risk factors for pseudo gout
Age (elderly)
Background OA
Intercurrent infection
Strong radiographic indicator of gout
Juxta articular rat bite erosions
Juxta articular means near a joint
Clinical features of gout
Acute monoarthritis (commonly Podagra: gout of foot eso big toe - first MTP joint) Joints in feet, ankles, knees, wrists, elbows and fingers affected Crystal deposits (tophi) - yellowish appearance
3 key features of RA
1) chronic arthritis
- symmetrical
- morning stiffness
- joint erosion
- polyarthritis
2) extra articular disease
- vasculitis
- episcleritis
- subcutaneous nodules
3) prescence of rheumatoid factor in blood
Pattern of joint involvment in RA
Symmetrical Polyarthritis MTP PIP CMC wrists Knees
