Kaplan High-Yield Muskuloskeletal and Connective Tissue

168 Pages·05.276 MB·English

by  Stephen Bagley

Lecture Objectives
Musculoskeletal and Connective
Tissue
Stephen Bagley, M.D.
Resident Physician,
University of Pennsylvania
MMSS0011-- 1
Musculoskeletal System: Dermatology
Musculoskeletal System: Dermatology
Anatomy, physiology, and disease of:
–  Skin
–  Muscles and ligaments
–  Peripheral nerves
–  Bones
–  Connective tissue

MMSS0011-- 2
Lecture 1 - Dermatology
Musculoskeletal and Connective
Tissue

Lecture 1 - Dermatology

MMSS0011-- 3
Anatomy of the Epidermis
Skin layers from surface to base
Epidermal layers:
Basement membrane
C. – Stratum corneum
L. – Stratum lucidum
G. – Stratum granulosum
S. - Stratum spinosum
Stratum basalis
B. – Stratum basalis

Mnemonic: Californians
Like Girls in String Bikinis
Kaplan Pathology 2010: Figure 11-1
FA 2012: 404.1 • FA 2011: 370.1 • FA 2010: 366 MS01- 4
• ME 3e 451
Stratum corneum
Skin layers from surface to base
Epidermal layers:
Basement membrane
C. – Stratum corneum
•  Top layer
•  Continuously
sloughed off
Stratum basalis
•  Composed of keratin
filled anucleate cells
•  Calluses: stratum
corneum hypertrophy

Kaplan Pathology 2010: Figure 11-1
FA 2012: 404.1 • FA 2011: 370.1 • FA 2010: 366 MS01- 5
• ME 3e 451
Stratum lucidum
Skin layers from surface to base
Epidermal layers:
Basement membrane
L. – Stratum lucidum
Stratum basalis
Kaplan Pathology 2010: Figure 11-1
FA 2012: 404.1 • FA 2011: 370.1 • FA 2010: 366 MS01- 6
• ME 3e 451
Stratum granulosum
Skin layers from surface to base
Epidermal layers:
Basement membrane
G. – Stratum granulosum
Stratum basalis
Kaplan Pathology 2010: Figure 11-1
FA 2012: 404.1 • FA 2011: 370.1 • FA 2010: 366 MS01- 7
• ME 3e 451
Stratum spinosum
Skin layers from surface to base
Epidermal layers:
Basement membrane
S. - Stratum spinosum
Stratum basalis
Kaplan Pathology 2010: Figure 11-1
FA 2012: 404.1 • FA 2011: 370.1 • FA 2010: 366 MS01- 8
• ME 3e 451
Stratum basalis
Skin layers from surface to base
Epidermal layers:
Basement membrane
B. – Stratum basalis
•  Home to stem cells
Stratum basalis
Kaplan Pathology 2010: Figure 11-1
FA 2012: 404.1 • FA 2011: 370.1 • FA 2010: 366 MS01- 9
• ME 3e 451
Basement membrane
Skin layers from surface to base
Basement membrane:
•  Separates the epidermis from the dermis
en:wp, commons.wikimedia.org. Used with permission.
FA 2012: 404.1 • FA 2011: 370.1 • FA 2010: 366 MS01- 10
• ME 3e 451
Review of epidermal anatomy
Skin layers from surface to base
Epidermal layers:
Basement membrane
C. – Stratum corneum
L. – Stratum lucidum
G. – Stratum granlosum
S. - Stratum spinosum
Stratum basalis
B. – Stratum basalis

Kaplan Pathology 2010: Figure 11-1
FA 2012: 404.1 • FA 2011: 370.1 • FA 2010: 366 MS01- 11
• ME 3e 451
Epithelial cell junctions
Epithelial Cell Junctions
Kaplan Anatomy: Figure I-1-10
FA 2012: 404.3 • FA 2011: 370.2 • FA 2010: 366 MS01- 12
• ME 3e 82
Zona occludens
Zona Occludens
Kaplan Anatomy: Figure I-1-10
Zona occludens (tight junctions):
•  Prevents diffusion across paracellular space
•  Composed of:
•  Claudins: Adhesive proteins
•  Occludins: Block diffusion in between cells
FA 2012: 404.3 • FA 2011: 370.2 • FA 2010: 366 MS01- 13
• ME 3e 82
Zona adherens
Zona Adherens
Kaplan Anatomy: Figure I-1-10
Zona adherens (intermediate junctions):
Composed of:
•  Cadherins: pericellular adhesive molecules responsible for cell to cell connection
•  Cadherins connect the intracellular actin filaments of adjacent cells
•  CADherins are Ca2+ dependent ADhesion molecule
FA 2012: 404.3 • FA 2011: 370.2 • FA 2010: 366 MS01- 14
• ME 3e 82
Zona occludens versus zona adherens
Zona Occludens Vs. Zona Adherens
Kaplan Anatomy: Figure I-1-10
Name Zona occludens Zona adherens
Contain Claudins and occludins Cadherins
FA 2012: 404.3 • FA 2011: 370.2 • FA 2010: 366 MS01- 15
• ME 3e 82
Macula adherens (desmosome)
Macula Adherens (Desmosome)
Kaplan Anatomy: Figure I-1-10
Macula adherens (desmosome): The most important junction
•  Composed of cadherins
•  Cadherins connect the intracellular intermediate filaments of adjacent cells
•  Desmoplakin attaches to the intermediate filaments
FA 2012: 404.3 • FA 2011: 370.2 • FA 2010: 366 MS01- 16
• ME 3e 82
Macula adherens (desmosome)
Macula Adherens (Desmosome)
Kaplan Anatomy: Figure I-1-10
Macula adherens (desmosome): Clinical correlate
•  Pemphigus vulgaris:
•  Auto-antibodies developed against the desmosome
•  Clinical manifestation: Epithelial sloughing
FA 2012: 404.3 • FA 2011: 370.2 • FA 2010: 366 MS01- 17
• ME 3e 82
Gap junctions
Gap Junction
Kaplan Anatomy: Figure I-1-10
Gap junctions:
•  Open channels which allow electric and metabolic communication between two
cells
•  Composed of connexons
•  Connexons have a central channel which allows flow between two cells
FA 2012: 404.3 • FA 2011: 370.2 • FA 2010: 366 MS01- 18
• ME 3e 82
Basement membrane - 1
Basement Membrane
Kaplan Anatomy: Figure I-1-10
Basement membrane:
•  A sheet-like structure underlying virtually all epithelia, which consists of basal lamina and
reticular lamina
•  A barrier between the epithelial cell layer and the connective tissue (e.g. dermis)
FA 2012: 404.3 • FA 2011: 370.2 • FA 2010: 366 MS01- 19
• ME 3e 82
Basement membrane - 2
Basement Membrane
en:wp, commons.wikimedia.org. Used with permission.
Basement membrane:
•  A sheet-like structure underlying virtually all epithelia, which consists of basal lamina and
reticular lamina
•  A barrier between the epithelial cell layer and the connective tissue (e.g. dermis)
FA 2012: 404.3 • FA 2011: 370.2 • FA 2010: 366 MS01- 20
• ME 3e 82