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LOCO 2 > Normal and abnormal synoviol joints > Flashcards

Normal and abnormal synoviol joints Flashcards

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1
Q

What lines the surfaces of synovial joints

A

Articular cartilage

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2
Q

What type of cartilage is found on the articulating surfaces of synovial joints

A

Hyaline cartilage

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3
Q

What are the 2 main membranes of a joint capsule

A

Outer fibrous capsule and inner synovial membrane

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4
Q

Function of articular cartilage

A

Reduces friction and absorb impact/ shock

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5
Q

Where is hyaline cartilage found

A

Capping the end of bones in synovial joints

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6
Q

What does the deeper layer submerge with

A

Subchondral bone

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7
Q

What is the tidemark

A

Calcified layer that the subchondral bone merges with

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8
Q

Upon what structure do the properties of articular cartilage depend upon

A

Composition of the ECM

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9
Q

What cells are responsible for maintaining and regulating the composition of ECM

A

Chondrocytes

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10
Q

Name in order from superficial to deep the layers of the articular cartilage

A 
Superficial zone
Middle zone
Deep zone
Tide mark
Calcified zone
Subchondral zone
Cancellous bone
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11
Q

In which direction do chondrocytes move

A

Surface layer to deep

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12
Q

How do the chondrocytes appear in the superficial zone

A

Flattish

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13
Q

How do the chondrocytes appear in the deep zone

A

More rounded

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14
Q

What % of the total volume of cartilage are chondrocytes

A

<5%

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15
Q

In which layer are chondrocytes stacked

A

Deep/ radial layer

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16
Q

What do chondrocytes sit in

A

Lacuna

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17
Q

What staining is used to see hyaline cartilage layers

A

Safranin-O

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18
Q

What % water is the ECM of cartilage

A

80

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19
Q

What collagen is found in the ECM of cartilage

A

Mainly collagen II

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20
Q

What is the function of the collagen found in cartilage (2)

A
  • Network gives overall framework and shape

- Makes pockets filled with proteoglycan complexes

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21
Q

How do proteoglycans interact with water, and why

A

Draw water into cartilage

Regulates compressibility

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22
Q

What type of collagen is found in the deep cartilage (not II)

A

X

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23
Q

Describe the structure of collagen in the articular surface of cartilage

A

Parallel arrangement
Surface highest tensile properties
Allows for gliding

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24
Q

Describe the structure of collagen in the intermediate layer of the cartilage

A

Criss-crossed oblique allows compression

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25
Describe the structure of collagen in the deep layer of the cartilage
Perp to surface
26
Name 4 types of collagen found in cartilage
II, IX, X, XI
27
What % of dry weight is made up by collagen
40-70%
28
What % of dry weight is made up by proteoglycans
15-40%
29
What is the structure of a proteoglycan
Core protein with glycosaminoglycan (GAG) side chain
30
What are GAGs
Linear polysaccharides with repeating units
31
2 most prevelant GAGs in synovial joint
Keratin sulphate | Chondroitin sulphate
32
What is the core protein of the proteoglycan found in the synovial joint
Hyaluronan
33
State the ways in which a osteoarthritic synovial joint differs from a normal health one
- Fibrotic - Synovitis - Cartilage failure - HA depolymerised - Osteophytes - Subchondral cysts - Vascular engorgement
34
Name 4 extrinsic/ biochemical factors for the development of osteoathritis
High BMI Physical activity levels Occupational exposures Past joint injury
35
Name 5 genetic links to osteoathritis
- ASTN2 - GDF5 - GLN3 - DOT1L - 7q22
36
Name 5 systemic risk factors for the development of osteoathritis
``` Post- menopausal HRT Bone mineral density Diet Female Increasing age ```
37
Describe the genetics behind 7q22
Loss of GPCR 22= 30% increased risk of knee OA
38
What is DOT1L
Enzyme: master protector of chondrocytes
39
What is GDF5
Growth differentiation factor 5
40
What is ASTN2 thought to be involved in
Pain and neuronal adhession
41
Does synovitis occur primary or secondary to established bone and cartilage pathology
Secondary
42
What is the effect of synovitis
Drives further inflammatory damage to adjacent bone and cartilage Major cause of pain and lsos of function
43
What does HMGB2 stand for
high mobility group protein 2
44
Where is HMGB2 uniquely expressed
In the superficial zone chondrocytes
45
What is the role of HMGB2
Supports chondrocyte survival | Regulates specific differentiation status of superficial zone cells
46
What is the result of HMGB2 loss
Superficial zone cell death Loss of progenitor cells Reduced ECM component synthesis
47
Name the 3 stages articular cartilage goes through macroscopically
Fibrillation Erosion/ cracking Eburnation
48
What happens during eburnation
Complete loss of cartilage | Exposed bone becomes polished
49
Microscopically, name the 3 changes that occur in osteoathritis
Chondrocyte necrosis Focal clumps/ clones of chondrocytes Change to fibrocartilage from hyaline
50
Where is chondrocyte necrosis most significant
Superficial layers
51
What happens during the change to fibrocartilage from hyaline
Type 1 instead of 2 Reduced thickness of articular cartilage Thickening of calcified cartilage merging with subchondral bone
52
How does movement of the water differ in people with OA as opposed to normal
Early stage: cartilage swells increasing the water. | Loss of proteoglycans mean less compressible so water moves in and out faster
53
How does collagen network change in OA
Breaks down due to release of enzymes from stressed chondrocytes and synovial membrane cells
54
What is chondromalacia
Softened cartilage
55
What does CSPC stand for
Chondrocyte stem/ progenitor cell
56
What characterises early OA
Loss of superficial zone and changes to ECM of the articular cartilage Cell clusters emerge
57
What characterises late OA
Continued loss of ECM and chondrocyte hypertrophy
58
What happens due to exposure of underlying bone due to cartilage erosion
- Microfractures of trabeculae - Increased osteoblastic activity - Surface undergoes focal pressure necrosis
59
What is the result of focal pressure necrosis
Subarticular cysts
60
What happens due to vascular engorgement
Slower blood flow and bone marrow oedema
61
How does osteoathritis appear on an x-ray
Loss of joint space Subchondral sclerosis Trabecular fracture Subchondral cysts
62
Name the therapeutic targets for OA treatment in the early stages
1) Cartilage stem/ progenitor cells could help regenerate joint resurfacing 2) ECM production and chondroprotection

LOCO 2 (25 decks)

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