Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/65

Click to flip

65 Cards in this Set

  • Front
  • Back
osteoarthritis
degenerative joint disease
oa
common chronic condition of cartilage degeneration

2ndary changes can occur in the bone -> pain, dec fxning and disability
ra
systemic dz that involves inflam in the membrane lining of the joints and often affects internal organs
ra fluctuating course of dz
- progressive joint destruction
- deformity
- disability
synovial joint
consist of 2 bone ends covered by articular cartilage
role of articular cartilage
- enabling frictionless movmt of the joint
- distributing the load across the joint (shock absorber) to prevent damage
- promoting stability during use
cartilage
- avascular and aneural
- metabolically active and undergoes continual internal remodeling
- composed primarily of water but is also made fr chondrocytes and extracellular matrix
chondrocytes
-control the sysnthesis and degradation of the matrix
-produce proteoglycans and collagen in the extracellular matrix to maintain the integrity of the matrix in healthy cartilage
joint capsule
fibrous outer layer that encapsulates the joint
synovium
lined the joint capsule

- membrane that produces a viscous fluid that lubricates the joint
synovial fluid
hyaluronic acid
glucosamine
component of hyaluronic acid
hyaluronic acid
maintain fxnal and structural characteristics of the extracellular matrix
bursae
small sacs that are lined with synovial membrane and filled with fluid to provide cushioning and lubrication for the movement of the joint
oa pathophysiology
-strength of tendons, ligaments and muscles declines with advancing age and may contribute to the devpmnt of dz
-# of chondrocytes declines due to apoptosis, dec proliferation or both
-synthesis of normal proteoglycans is reduced
apoptosis
cell death
chondrocytes
lose the ability to promote healing and cartilage remodeling resulting matric degradation
proteoglycans
depleted
matrix metalloproteinases (MMPs)
proinflammatory cytokines
promote cartilage degradation
interleukin (IL-1)
-resp for induction of chondrocytes and synovial cells to synthesize MMPs
-inhibits the synthesis of type II collagen and proteoglycans preventing collagen fr repairing itself
IL-1
enhances nitric oxide prodxn and induces chondrocyte apoptosis
oa pain occurs as a result of
-osteophytes, spurs of cartilage and bone at the joint
-synovitis
-bursitis
-tendonitis
risk factors of oa
advanced age
female gender
muscle weakness
obesity
joint trauma
heredity
congenital or developmental anatomical defects
repetitive stress
oa clinical presentation
-deep localized ache in a joint
-pain and stiffness
-mild inflam
-crepitus
crepitus
popping or cracking noise
heard in the joint upon moving
oa dx physical exam
joint tenderness
diminished range of motion
crepitus
abnormalities in joint shape
oa radiography
narrowing of joint space due to loss of cartilage and the presence of osteophytes
nonpharmacological trmt of oa
wgt loss
aerobic exercise programs
physical therapy
assitive devices
joint protection
thermal therapy
oa pharmacological trmt
apap
nsaids
cox 2 inhibitors
tramadol
porpoxyphene
capsaicin
intrarticular inj
adjunctive trmts
selected nsaids for oa
nonacetylated salicylates
nsaids
cox 2 inhibitors
nonacetylated salicylates
salsalate
magnisum salicylate
nsaids
asa
diclofenac
etodolac
ibuprofen
naproxen
nabumeton
sulindac
tolmetin
cox 2 inhibitors
celecoxib
rofecoxib
valdecoxib
nsaid moa
nonselective inhibitors of cyclooxygenase 1 and 2 as well as thromboxane synthetase
nsaid adv eff
-gi tox caused by direct mucosal injury and inhibition of prostaglandins
-renal tox result fr inhibition of prostaglandin-hyperkalemia,hyponatremia,inc serum cr,na and h20 retention
people at risk for renal toxicity
elderly
preexisting renal dz
htn
dm
chf
cirrhosis
volume depletion
volume depletion
hemorrhage
sepsis
diuretics
diarrhea
nsaid hematological eff
due to dec platelet aggregation
nsaid hepatitic tox
elevated liver enz
hepatotoxicity
cox2 inh
selective nsaids specific for cox 2 enz and exhibit analgesic and anti-inflam prop
tramadol moa
centrally acting analgesic that inhibits the reuptake of norepi and serotonin and mildly binds to the u-rec
tramadol adv eff
nausea
constipation
rash
dizziness
somnolence
orthostatic hypotension
cbz
dec the eff of tramadol
opiate analgesic used for oa
codeine
oxycodone
capsaicin
derived from chili peppers
chronic use of capsaicin
depletes stores of substance P
intra-articular injections
corticosteroids
hyaluronic acid deriv
hyaluronic acids use
improve elasticity and viscosity of synovial fluid
hyaluronic acid deriv
sodium hyaluronate(hyalgan)
hylan polymers(synvisc)
caution with hyaluronic acid
allergies to pavian proteins, feather and egg prdts
adjunctive trmt of oa
glucosamine
chondroitin
S-adenosyl-methionine (SAMe)
glucosamine
acts as a substrate for and promotes the synthesis of the glycosaminoglycans
se of glucosamine
GI discomfort
fatigue
skin rash
hyperglycemia
chondroitin
helps protect against the breakdoen of collagen and proteoglycans

usually found in combo with glucosamine
se of chondroitin
prolong bleeding time
nausea
SAMe
maintain cartilage
oa surgical intervention
arthroscopy
joint replacement
cause of ra
autoimmune dz

body loses its ability to distinguish between synovial and foreign tissue
factors in ra
environmental influences
genetic markers
tumor necrosis factor alpha
interleukin 1
IL-6
growth factors
inflammed synovium
environmental influences
bacterial infxn
viral infxn
tramadol moa
centrally acting analgesic that inhibits the reuptake of norepi and serotonin and mildly binds to the u-rec
tramadol adv eff
nausea
constipation
rash
dizziness
somnolence
orthostatic hypotension
cbz
dec the eff of tramadol
opiate analgesic used for oa
codeine
oxycodone
capsaicin
derived from chili peppers