Pathophysiology--NU545--Unit 6--
Musculoskeletal
Bone matrix - ANS Collagen fibers, proteoglycans, BMPs, BMP-2, BMP-6, and BMP-9.
Glycoproteins - ANS Sialoprotein, osteocalcin, laminin, osteonectin, albumin,
alpha-glycoprotein, minerals (elements) calcium and phosphate
Compact bone (cortical bone) - ANS Makes up approx. 85% of the skeleton; present in every
bone; highly organized, solid, and extremely strong--basic structural unit is Haversian system.
Spongy bone (cancellous bone) - ANS Makes up approx. 15% of the skeleton; present in every
bone;
-less complex and lacks haversian systems
-the lamellae are not arranged in concentric layers but in plates or bar termed trabeculae that
branch and unite with one another to form an irregular meshwork
-spaces b/w the trabeculae are filled with red bone marrow.
Periosteum - ANS All bones are covered with a double-layered connective tissue.
Sharpey Fibers - ANS Collagenous fibers that penetrate the bone and help hold or attach
tendons and ligaments to the periosteum.
Diaphysis - ANS Narrow tubular mid portion of a long bone.
Metaphysis - ANS Broader neck of a long bone.
Epiphysis - ANS The broad end of a long bone.
Endosteum - ANS Lines the outer surfaces of both types of marrow cavity.
Flat bones - ANS (Ribs or scapulae) 2 plates of compact bone which are roughly parallel to
each other; b/w the compact bone plate is a layer of spongy bone.
Short bones - ANS (Cuboidal bones) (wrist or ankle) often cuboidal in shape; consist of spongy
bone covered by a thin layer of compact bone.
Irregular bones - ANS (Vertebrae, mandibles, other facial bones) have various shapes that
include thin and thick segments; thin part of an irregular bone consists of 2 plates of compact
, bone with spongy bone b/w the plates; thick part consists of spongy bone surrounded by later of
compact bone.
Physeal closure - ANS When the skeleton is mature, the epiphyseal plate is replaced by bone.
It unites the metaphysis and epiphysis. It occurs earlier in girls than boys.
Duchenne muscular dystrophy - ANS a type of disorder that causes degeneration of skeletal
muscle fibers. The most common of the muscular dystrophies; Described by Duchenne as a
pseudohypertrophic muscular paralysis associated with large amounts of fat and connective
tissue. Classic Duchenne MD occurs in boys only and has a history of x-linked inheritance in
half of the cases.
Osteogenesis imperfecta (OI) - ANS (Brittle bone disease) a genetic disorder of connective
tissues that affects primarily bone, usually autosomal dominant but can be autosomal recessive.
Major errors lie in the synthesis of collagen. The gene responsible for the encoding of collagen
easily mutates.
Osteoarthritis - ANS A common age-related disorder of synovial joints; classified as
non-inflammatory joint disease, characterized by local areas of loss and damage of articular
cartilage, new bone formation of joint margins (osteophytosis), subchondral bone changes,
variable degrees of mild synovitis and thickening of the joint capsule
Rheumatoid Arthritis - ANS A systemic inflammatory autoimmune disease associated with
swelling and pain in multiple joints. First joint tissue to be affected is the synovial membrane,
which lines the joint cavity.
Rhabdomyolysis manifestations - ANS Visible, dark reddish brown pigmentation of the
urine-(renal threshold for myoglobin is low [0.5mg/gl of urine] so that only 200 g of muscle need
to be damaged to cause visible changes in the urine)-elevated CK (100 times greater than
normal) and other serum enzymes--loss of potassium, phosphate, nucleotides, creatinine, and
creatine
-hypocalcemia is early on then hypercalcemia.
Rhabdomyolysis - ANS Can be a life threatening complication of severe muscle trauma with
muscle cell loss
-myoglobinuria is named for the principal manifestation of the condition—excess of myoglobin
(an intracellular muscle protein) in the urine; muscle cell damage release the myoglobin
Gout - ANS A syndrome caused by an inflammatory response to uric acid production or
excretion resulting in high levels of uric acid in the blood (hyperuricemia) and in other body
fluids, including synovial fluid.
Tophi - ANS Small white nodules of crystal deposits in subcutaneous tissues.
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