Nmsk 1 Exam -Dr. Foster

Front 1

What Wolf's law states?

Back 1

Wolf’s law states that bone grows in response to stress.

Front 2

Three Functions of Bone:

Back 2

1. Structural support.
2. Mineral homeostasis.
3.Hematopoiesis.

Front 3

Define: Hematopoiesis.

Back 3

the formation of blood cells in the living body (especially in the bone marrow).

Front 4

2 ways of bone formation:

Back 4

1.Endochondral : high cartilage gives rise to the bone
2.Intramembranous : from the dermis of the skin

Front 5

End of the bone is called the _______

Back 5

Epiphysis.

Front 6

Shaft of the bone is called the ________

Back 6

Diaphysis.

Front 7

Between Epiphysis and Diaphysis is the _____

Back 7

Metaphysis.

Front 8

What bone structure do you need between the epiphysis and the diaphysis for the bone to grow in length?

Back 8

Physis

Front 9

Coverings of the bone outside is dense connective tissue called ______with _______cells in there.

Back 9

periosteum
ostoprogenitor

Front 10

define ostoprogenitor cells

Back 10

A mesenchymal cell that differentiates into an osteoblast. Also called preosteoblast

Front 11

Outside of the bone is periosteum the inside is ____

Back 11

endosteum

Front 12

Name the 3 Cells of the bone

Back 12

Osteoblast
Osteocytes
Osteoclasts

Front 13

Osteoblast have a well developed ____, many ____, and numerous ______.

Back 13

1. Osteoblast have a well developed Golgi complex, many cisternae of rER and numerous mitochondria

Front 14

Immature bone cell, make ______ which is active in _____.

Back 14

osteoid.
protein synthesis

Front 15

Osteoblast produce ______

Back 15

bone matrix.

Front 16

The un-calcified bone matrix made by these immature osteocytes is called ____

Back 16

osteoid.

Front 17

Osteoblasts – also produce ________ which appears to play a role in mineralization of bone.

Back 17

alkaline phosphatase

Front 18

Alkaline phosphatase is a useful clinical marker for _________.

Back 18

bone formation activity.

Front 19

Canaliculi link the lacunae and serve as a means for the passage of _____ and _____

Back 19

nutrients and information

Front 20

Osteocytes conform to the shape of the lacunae and send processes into _______, where they form _______ with the processes of adjacent cells.

Back 20

canaliculi
gap junctions

Front 21

Mature osteocytes have many __________, but a decrease in the number of other organelles.

Back 21

lysosomes

Front 22

Osteoclasts derived from _______ cells

Back 22

bone marrow

Front 23

Osteoclasts are large _______ cells with ________ cytoplasm that occupy Howship's lacunae etched, by enzymatic action, into the surface of bone that is being resorbed.

Back 23

multinucleated
acidophilic

Front 24

Osteoclasts secrete acids: _______ and other ______ enzymes to break down the organic matrix

Back 24

collagenase
proteolytic

Front 25

Which cell type respond to Ca decrease?

Back 25

Osteoblast

Front 26

Ca drop, ___1____released. In response to ____1____, osteoblasts secrete ____2___stimulating factor (a cytokine). The osteoblast directing the activity of ___2____ even during development and attract them to the site of stress. VERY IMPORTANT!!!

Back 26

1. PTH
2. osteoclast

Front 27

Bone grow ________.

Back 27

appositionaly

Front 28

What is appositional bone growth?

Back 28

The appositional growth of bones is a process by which bones increase in diameter.

Front 29

________ lay down new bone matrix the osteoid and when it is trapped into osteoid it becomes _____

Back 29

Osteoblast
osteocytes.

Front 30

bones are extremely _____organs

Back 30

dynamic

Front 31

They respond to changes in weight, posture and other mechanical stresses by changing their _______with changing the activities of the cells in the bone.

Back 31

internal architecture

Front 32

It is generally accepted that the coordinated actions of _______ and ______control bone remodeling

Back 32

osteoclasts
osteoblasts

Front 33

What are surface lining cells?

Back 33

osteoblasts

Front 34

Lining cells become _____ cells that are active osteoblast laying matrix in that area.

Back 34

cuboidal

Front 35

What are Micro cracks ?

Back 35

. Micro cracks are responses to stress and osteocytes in the area are respond to them, they are able to recognize the stressful situation which distrupts the environment and send the signal to the next cell in line through the canaculia and send the signal up to the central/Haversan canal which has osteon, osteoclast too.

Front 36

The osteocytes release ______ which influence the activity of osteoblast (surface cells)

Back 36

chemofactors

Front 37

____ sense stress signals, so they will communicate with each other and send signals up to the bone lining cells which are inactive ____ and becomes active and release signals to_____ to increase their activity.

Back 37

OCY
OB
OCL

Front 38

_____starts bone resorption (break down) which is coupled with new bone formation by ____. This paired process is called bone remodeling.

Back 38

OCL
OB

Front 39

what is Interstitial Lamaellae?

Back 39

Remnants of Haversian systems that were partially resorbed

Front 40

.According to Wolff’s law, bone is deposited in areas where load bearing is _____. In contrast, bone will be resorbed in areas with _____ stress.

Back 40

high
with no/low stress

Front 41

define Articular Cartilage

Back 41

A layer of hyaline cartilage on the ends of bones forming an articulation

Front 42

The cartilage and the _______ provide a low friction, lubricated surface allowing smooth painless motion

Back 42

synovium

Front 43

In the long bone you found _____around that is the hyaline cartilage and outside of that you found bone tissue.

Back 43

synovial fluid

Front 44

The synovial fluid is a low friction material with a lot of _______.

Back 44

hyaluronic acid

Front 45

List the Four Zones of Articular Cartilage:

Back 45

1.Superficial tangential zone
2. Middle (transitional zone):
3.Deep zone
4.Calcified zone

Front 46

Which zone?
smooth nearly frictionless surface. Thin collagen fibrils parallel to surface, chondrocytes elongated and parallel to the surface, proteoglycan content lowest and water content highest.

Back 46

1.Superficial tangential zone

Front 47

What zone?
highest concentration of proteoglycans and lowest water content. Collagen perpendicular to surface. Give some structural stability and resist movement.

Back 47

3.Deep zone

Front 48

contains calcified cartilage next to subchondral bone. *deep and calcified zones separated by the tidemark.

Back 48

4.Calcified zone

Front 49

What zone?
chondrocytes rounded and in irregular arrangement, collagen fibers less organized.

Back 49

2. Middle (transitional zone):

Front 50

define Synovium:

Back 50

Secretes synovial fluid which lubricates surfaces, reducing friction. Lines synovial joints are bursae and tendon sheaths.

Front 51

The synovium (synovial membrane) is composed of 2 major cell types:

Back 51

A and B

Front 52

Type A synoviocyte c'teristics:

Back 52

macrophage-like (remove particulate debris from joints); remove material accumulated in the synovial fluid.

Front 53

Type B synoviocyte c'teristics:

Back 53

fibroblast-like cells (secrete hyaluronic acid present in synovial fluid). Hyaluronic acid helps reduce friction.

Front 54

Articular surface does not have a ______Thus, synovial fluid acts to deliver and remove material from the articular cartilage.

Back 54

blood supply

Front 55

Synovial fluid does not contain ______and therefore will not promote ___formation.

Back 55

fibrinogen
clot

Front 56

Ligaments are important in protecting_____ from instability but at the same time allow normal movement with minimal resistance.

Back 56

joints

Front 57

define: ligaments

Back 57

collagenous tissue which unites two or more bones. Something like a rope and a robber band. When you pull on the ligament it gives away first. It has a little bit more elasticity to it.

Front 58

define: Tendon

Back 58

connective tissue attachment uniting muscle to muscle, cartilage or bone. It’s like a rope you pull on it and it does not move.

Front 59

Ligaments and tendons are both ______ tissue.

Back 59

dense regular connective

Front 60

Tendons are composed of _______ that are uniformly stiff and do not allow _____

Back 60

very highly organized collagen fibers
significant elongation of the fibers.

Front 61

Ligaments are not as highly organized into parallel bundles and at rest are somewhat crimped. This allows for a small amount of _______to occur before the fibers tighten

Back 61

stretching

Front 62

Ligaments and tendons are _______and contain mechanorecetors important in _______.

Back 62

highly vascularized
proprioception

Front 63

Define ethesis

Back 63

Enthesis is the point at which a tendon or ligament inserts into bone.

Front 64

A disease of the entheses is known as an_______ or _______

Back 64

"enthesopathy"
"enthesitis."

Front 65

Ligaments and tendons attach to bone in 2 ways:

Back 65

direct and indirect

Front 66

A “direct” attachment involving _______intermediate This enthesis consists of four zones. Attachment occurs along ________.

Back 66

fibrocartilage (Fibrocartilaginous entheses).

epiphysis

Front 67

An “indirect” attachment to the bone or periosteum (also called ______enthesis; associated with Sharpey's fibers). No fibrocartilage involvement. Occurs along _______

Back 67

Fibrous
Diaphysis

Front 68

The direct enthesis has 4 zones:

Back 68

1. the tendon or ligament
2.unmineralized fibrocartilage
3.mineralized fibrocartilage
4. lamellar bone.

Front 69

Direct enthesis of zone 1.the tendon or ligament ___

Back 69

displaying longitudinally oriented fibroblasts and a parallel arrangement of collagen fibers); and becomes contanious into zone 2

Front 70

Direct enthesis of zone 2.unmineralized fibrocartilage is _____

Back 70

(denser than cartilage, but not as rigid as bone); just like the intervertebral disc (good at bearing weight, resist stress)

Front 71

Direct enthesis of zone 3 mineralized fibrocartilage is the ______

Back 71

(the uncalcified fibrocartilage and calcified cartilage are separated by a “tidemark” which is a black line between bone and cartilage

Front 72

define tidemark

Back 72

which is a black line between bone and cartilage

Front 73

Fibrous entheses or indirect attachment may be subdivided into two categories :

Back 73

periosteal and bony.

Front 74

Fibrous Periosteal

Back 74

the tendon attaches to the periosteum, which thus indirectly attaches the tendon to the bone. Fibrous periosteal attachments spread the force transmitted by the tendon over a broad area.

Front 75

Bony

Back 75

the periosteum is absent and the tendon inserts directly into the bone itself.

Front 76

In the limbs, fibrous entheses are characteristic of tendons that attach to_____, whereas
fibrocartilaginous insertions are typical of _______.

Back 76

diaphyses
epiphyses

Front 77

List 4 reasons why is it important fibrous entheses and fibrocartilaginous enthesis attached to different sites:

Back 77

1. Fibrocartilage is more resistant to stress. Bone is not, it either breaks or tare a tendon.
2. The attachments look different.
3. Epiphyses at smooth areas attach, smooth interaction for fibrocartilage.
4. Indirect, is around a rougher area, fibrous entheses.
The 2 different attachemnt play different role during actions
. Fibrous /indirect can resist without tearing apart. IN the direct the angle of collagen fibers changes.

Front 78

Define: sprain

Back 78

injury of ligament causing some degree of damage to the ligament fibers or their attachments.*

Front 79

Define: sprain– first degree

Back 79

-minimal tearing of fibers with histologic evidence of swelling and hemorrhage

Front 80

Define: sprain– second degree

Back 80

-partial tear of ligament with gross evidence of swelling and hemorrhage

Front 81

Define: sprain– third degree

Back 81

– third degree-complete tear with extensive edema and hematoma

Front 82

Define: sprain-– avulsion-point

Back 82

– avulsion-point of origin or insertion pulls off of bone attachment *

Front 83

Define: strain

Back 83

Strain - injury of muscle-tendon unit

Front 84

In ligaments that can heal such as the MCL, the process is divided into 3 stages of healing:

Back 84

1. inflammation
2. proliferation
3. remodeling

Front 85

Define Inflamation in a healing process:

Back 85

involving formation of a blood clot and release of attractants for inflammatory cells (day 0-10);

Front 86

define Proliferative in a healing process:

Back 86

involving increase of cell density in the ligament remnant and new collagen (types I and III [embryonic and elastic]) (day 10-21);

Front 87

Define Remodeling, in healing process:

Back 87

• alignment of the new matrix,
• cross-linking of collagen occurs,
• type III collagen is replaced with type I, and
• decrease cell proliferation (~ day 21 -52 weeks).
• * Some ligaments, especially intra-articular ligaments such as the ACL fail to heal after rupture. Separated by the synovial cavity.

Front 88

ntra-articular ligament don’t heal good because it does not form a ______that could lead to an inflammatory response that would help in the healing process.

Back 88

blot clot

Front 89

Skeletal muscle fibers are invested by an _____ a C.T. fiber coating that fills the spaces between______

Back 89

endomysium,
muscle fibers.

Front 90

Groups of muscle fibers are termed fascicles and the C.T. capsule that separates or surrounds them is the ______

Back 90

perimysium.

Front 91

The tough fibrous C.T. sheath of elastic, collagenous and reticular fibers that surrounds an entire named muscle is the _________

Back 91

epimysium.

Front 92

Define Deep Fascia

Back 92

The deep fascia surrounding muscle is composed of densely packed collagen bundles and elastic fibers. The area of the deep fascia adjacent to a muscle contains a high concentration of hyaluronic acid.

Front 93

Define: . Extrafusal fibers

Back 93

All of the ordinary skeletal muscle fibers outside of the spindle are known as extrafusal muscle fibers
. Extrafusal fibers are innervated by (UMNs )large alpha myelinated motor fibers coming from anterior horn cells.

Front 94

Define: intrafusal muscle fibers

Back 94

, the small intrafusal muscle fibers receive motor innervation from small nerve fibers called gamma efferents.

Front 95

The muscle spindle has an extensive sensory receptor innervation that measure _________ of the extrafusal muscle fibers that surround it

Back 95

stretch (changes in length)

Front 96

The Golgi tendon organs lie within the ____1__ in contact with the muscle contractile elements and are, therefore, sensitive to changes in the tension applied by muscle contraction on the ____1___.

Back 96

tendon

Front 97

These Golgi tendon organs provide information on the state of tension to the ___.
This system is thus a major determinant of organized coordinate muscle control.

Back 97

CNS

Front 98

Type 1 muscle fiber c'teristics:

Back 98

1. metabolism: oxidative
2. contractile behaviour: slow twitch
3. size of motor neuron: small
4. resistance to fatigue: high
5. activity used for': aerobic
6. force production: low
7. mitochondrial density" high
8. capillary density:high
9. glycolytic capacity: low
10. major storage fuel: triglycerides CP

Front 99

Type 2a muscle fiber c'teristics:

Back 99

1. metabolism: oxidative and glycolytic
2. contractile behaviour:fast twitch/fatigue resistant
3. size of motor neuron: large
4. resistance to fatigue: intermediate
5. activity used for' long term anaerobic
6. force production: high
7. mitochondrial density" high
8. capillary density: intermediate
9. glycolytic capacity: low
10. major storage fuel: glycogen CP

Front 100

Type 2b muscle fiber c'teristics:

Back 100

1. metabolism: glycolytic
2. contractile behaviour: fast twitch, fatigue sensitive
3. size of motor neuron: very large
4. resistance to fatigue: low
5. activity used for': short term anaerobic
6. force production: very high
7. mitochondrial density" low
8. capillary density:low
9. glycolytic capacity: low
10. major storage fuel: glycogen