FINAL EXAM: NR511 (LATEST UPDATE ) DIFFERENTIAL
DIAGNOSIS & PRIMARY CARE PRACTICUM EXAM QUESTIONS AND
100%CORRECT DETAILED ANSWERS|| GRADED A+
What are the two components of the synovium? -ANSWER: Intima and Stroma
Characteristics of Intima (three) -ANSWER: Presence of synoviocytes
Produce synovial fluid
Phagocytose joint debris
Characteristics of Stroma (three) -ANSWER: Loose or dense irregular connective tissue
Blends with fibrous joint capsule
Cell populations include macrophages, lymphocytes, mast cells
Capsule - Composition -ANSWER: Dense, irregular connective tissue
Reinforced by areas of dense connective tissue
Capsule - Function -ANSWER: Joint stability, structure, and vessel/nerve supply
T/F - the capsule does not contain mechanoreceptors -ANSWER: False - the joint capsule
contains many mechanoreceptors, which are involved in joint proprioception
,What is a Pacinian Corpuscle? -ANSWER: Layers of connective tissue around a nerve, which
are responsive to stretch, tension, and pressure
Well-represented in the joint capsule
What are the components of articular cartilage? -ANSWER: Glycosaminoglycan
Mainly type II collagen
Presence of chondrocytes
T/F - because cartilage healing involves different types of collagen, the newly restored cartilage
does not integrate as well into the damaged structure -ANSWER: True - cartilage is mostly type
II collagen, but the healing process uses mostly type I and type III collagen, which leads to
poorer integration
What happens to collagen that is close to a bony insertion point? -ANSWER: Exposed to an
enzyme that triggers calcification of cartilage
Results in tide mark - transition between uncalcified and calcified cartilage
Found in areas of high mechanical demand, to minimize an abrupt rise in tissue stress
At the ____________________, collagen fibres from the _______________ of calcified
cartilage insert directly into the cortical bone. -ANSWER: osteochondral junction, radial zone
T/F - osteoporosis is protective against osteoarthritis development -ANSWER: True!
,More squishy bone is able to absorb more load, with less chance of damaging the articular
cartilage
What is osteochondrosis? -ANSWER: Cartilage becomes inflamed due to overuse or
biomechanical factors.
Growth Plate -ANSWER: Plate of proliferating cartilage, the physis, that unites bones
Can have osteochondrosis or fractures here.
T/F - Cartilage has a good healing capacity -ANSWER: False - extremely limited healing
capacity, due to a lack of vessels
Cartilage defects larger than _________ are thought to rarely, if ever, heal. -ANSWER: 2 mm.
T/F - in cartilage injuries, it is expected that a minimal inflammatory response would occur -
ANSWER: True - due to minimal blood flow, inflammatory response does not happen as
effectively
Acute Chondral Injuries (definition) -ANSWER: An acute mechanical disruption of articular
cartilage
Four types of traumatic lesions have been classified
Types of Traumatic Chondral Lesions (four) -ANSWER: Type 1 - linear
Type 2 - stellate
Type 3 - flap
Type 4 - crater
, Type I Chondral Lesion (Characteristics) -ANSWER: Linear
- usually results form a major shearing force
- typically associated with a rotational injury
Does NOT reach bony layer
Type II Chondral Lesion (Characteristics) -ANSWER: Stellate, "star like"
- usually results from excessive compressive or rotational force
- point of impact with cracks radiating out from it
Can occur in conjunction with bruising of the underlying bone
Type III Chondral Lesion (Characteristics) -ANSWER: Flap
- most likely rotational trauma, although cause is not often remembered
- sensations of catching or locking
Type IV Chondral Lesion (Characteristics) -ANSWER: Crater
- tear occurs at tidemark, resulting in bare patch of exposed underlying bone
- can have loose pieces of cartilage floating in the joint space
- inflammation
- sensations of catching or locking
Why are many chondral injuries asymptomatic? -ANSWER: There is no nerve supply to
cartilage; can only feel symptoms if damage extends to the bone or synovium
Why is chondral damage progressive? -ANSWER: - lack of healing leads to permanent defects
DIAGNOSIS & PRIMARY CARE PRACTICUM EXAM QUESTIONS AND
100%CORRECT DETAILED ANSWERS|| GRADED A+
What are the two components of the synovium? -ANSWER: Intima and Stroma
Characteristics of Intima (three) -ANSWER: Presence of synoviocytes
Produce synovial fluid
Phagocytose joint debris
Characteristics of Stroma (three) -ANSWER: Loose or dense irregular connective tissue
Blends with fibrous joint capsule
Cell populations include macrophages, lymphocytes, mast cells
Capsule - Composition -ANSWER: Dense, irregular connective tissue
Reinforced by areas of dense connective tissue
Capsule - Function -ANSWER: Joint stability, structure, and vessel/nerve supply
T/F - the capsule does not contain mechanoreceptors -ANSWER: False - the joint capsule
contains many mechanoreceptors, which are involved in joint proprioception
,What is a Pacinian Corpuscle? -ANSWER: Layers of connective tissue around a nerve, which
are responsive to stretch, tension, and pressure
Well-represented in the joint capsule
What are the components of articular cartilage? -ANSWER: Glycosaminoglycan
Mainly type II collagen
Presence of chondrocytes
T/F - because cartilage healing involves different types of collagen, the newly restored cartilage
does not integrate as well into the damaged structure -ANSWER: True - cartilage is mostly type
II collagen, but the healing process uses mostly type I and type III collagen, which leads to
poorer integration
What happens to collagen that is close to a bony insertion point? -ANSWER: Exposed to an
enzyme that triggers calcification of cartilage
Results in tide mark - transition between uncalcified and calcified cartilage
Found in areas of high mechanical demand, to minimize an abrupt rise in tissue stress
At the ____________________, collagen fibres from the _______________ of calcified
cartilage insert directly into the cortical bone. -ANSWER: osteochondral junction, radial zone
T/F - osteoporosis is protective against osteoarthritis development -ANSWER: True!
,More squishy bone is able to absorb more load, with less chance of damaging the articular
cartilage
What is osteochondrosis? -ANSWER: Cartilage becomes inflamed due to overuse or
biomechanical factors.
Growth Plate -ANSWER: Plate of proliferating cartilage, the physis, that unites bones
Can have osteochondrosis or fractures here.
T/F - Cartilage has a good healing capacity -ANSWER: False - extremely limited healing
capacity, due to a lack of vessels
Cartilage defects larger than _________ are thought to rarely, if ever, heal. -ANSWER: 2 mm.
T/F - in cartilage injuries, it is expected that a minimal inflammatory response would occur -
ANSWER: True - due to minimal blood flow, inflammatory response does not happen as
effectively
Acute Chondral Injuries (definition) -ANSWER: An acute mechanical disruption of articular
cartilage
Four types of traumatic lesions have been classified
Types of Traumatic Chondral Lesions (four) -ANSWER: Type 1 - linear
Type 2 - stellate
Type 3 - flap
Type 4 - crater
, Type I Chondral Lesion (Characteristics) -ANSWER: Linear
- usually results form a major shearing force
- typically associated with a rotational injury
Does NOT reach bony layer
Type II Chondral Lesion (Characteristics) -ANSWER: Stellate, "star like"
- usually results from excessive compressive or rotational force
- point of impact with cracks radiating out from it
Can occur in conjunction with bruising of the underlying bone
Type III Chondral Lesion (Characteristics) -ANSWER: Flap
- most likely rotational trauma, although cause is not often remembered
- sensations of catching or locking
Type IV Chondral Lesion (Characteristics) -ANSWER: Crater
- tear occurs at tidemark, resulting in bare patch of exposed underlying bone
- can have loose pieces of cartilage floating in the joint space
- inflammation
- sensations of catching or locking
Why are many chondral injuries asymptomatic? -ANSWER: There is no nerve supply to
cartilage; can only feel symptoms if damage extends to the bone or synovium
Why is chondral damage progressive? -ANSWER: - lack of healing leads to permanent defects
