Musculoskeletal Phys

Question 1

Synovial fluid will follow Starling’s Law, which states…

Answer 1

the capillary fluid dynamics are dictated by hydraulic and oncontic forces

Question 2

What is oncontic force?

Answer 2

similar to osmotic force, but only considers PROTEINS instead of all solutes

Question 3

What is hydraulic pressure in regard to synovial fluid?

Answer 3

positive pressure in vessel v. negative pressure in interstitium leads to water LEAVING vessel

Question 4

What is oncotic pressure in regard to synovial fluid?

Answer 4

higher protein concentration outside v inside vessels, leading to water ENTERING vessel

Question 5

The net water movement in capillaries is close to 0. Why?

Answer 5

oncotic pressure typically equals hydraulic pressure, so very little change in volume between outside and inside vessels

Question 6

When enough water leaves vessels to cause a decrease in inside volume and an increase in interstitum (outside volume, what happens?

Answer 6

water movement stops
(blood pressure decreases)

Question 7

If blood pressure drops below what is considered “average”, what happens?

Answer 7

venous circulation, and water enters vessel

Question 8

Water also moves through ______ to decrease interstitial pressure

Answer 8

lymphatics

Question 9

_____ ______ is formed by filtration from the vasculature in joint spaces

Answer 9

synovial fluid

Question 10

Water and nutrients pass through synovial membrane vis ________ gradient

Answer 10

hydraulic

Question 11

Since there is little protein in synovial space and lots of proteins in plasma/interstitium, _____ pressure is created and cancels out hydraulic gradient

Answer 11

oncotic

Question 12

What is the primary joint macromolecule?

Answer 12

hyaluronic acid

Question 13

Hyaluronic acid is produced by __________

Answer 13

synoviocytes

Question 14

Hyaluronic acid helps maintain ______ pressure. How?

Answer 14

hydraulic

large molecules in small number that bind water and provide shock absorption

Question 15

Synovial membrane has ______ that provide oxygenation

Answer 15

villi (villus)

Question 16

Villi are prone to injury due to…

Answer 16

poor oxygenation at the tip

Question 17

Where else can you find villi?

Answer 17

GI tract

Question 18

Synovial nutrition and health relies on _______ to maintain healthy joint

Answer 18

movement

Question 19

Fluid movement is facilitated by changes in _______ ______

Answer 19

joint geometry

Question 20

Immobilization results in reduced ____ _______

Answer 20

joint nutrition

Question 21

Movement will create oncotic pressure because…

Answer 21

movement creates decreased concentration of proteins in synovial fluid due to compression

Question 22

Joint dysfunction, like with a sprain, occurs because…

Answer 22

hyaluronic acid becomes short and numerous, causing oncotic pressure to pull water INTO joint capsule and causes swelling

Question 23

How can we help with joint pains/dysfunction?

Answer 23

inject hyaluronic acid into joint

Question 24

The joint capsule is at it’s loosest and 0 pressure in ______ position

Answer 24

neutral

Question 25

What is the term for an increase in the amount of fluid in the synovial space?

Answer 25

synovial effusion

Question 26

Synovial effusion is caused by what 5 factors?

Answer 26

1) increased vascular hydraulic pressure 2) functional lymphatic obstruction 3) increased permeability of membrane 4) increased oncotic pressure 5) increased compliance with

Question 27

Increased hydraulic pressure typically results in _____

Answer 27

edema

Question 28

Increased permeability commonly occurs with ______

Answer 28

inflammation

Question 29

What is the leading cause of synovial effusion?

Answer 29

increased permeability

Question 30

Increase in oncotic pressure is caused by breakdown of which molecule?

Answer 30

hyaluronic acid

Question 31

Which cause of synovial effusion is a factor in chronic distension of joint capsule?

Answer 31

increased compliance

Question 32

What is the difference between a tight/painful swollen joint and a "body" joint, or a looser, nonpainful swollen joint?

Answer 32

body joints are more likely due to a previous untreated joint injury, causing capsule to accommodate and grow in size