4. Learning Objectives
• What are the main components of human
musculoskeletal system?
• What are the main structure & functions of
joints?
• What are the main functions of human
joint’s cartilage?
• What are the main types of joint diseases?
5. The Musculoskeletal System
The Musculoskeletal system is composed of the bones,
muscles and joints
which all have an important functions in the body.
6. The Bones
A connective tissue consisting of three types of cell that
contribute to bone homeostasis.
These are bone-building osteoblasts, stationary osteocytes
(mature bone cells), and bone-destroying osteoclasts,
embedded in a mineralized matrix infused with
spaces and canals.
An equilibrium between osteoblasts and osteoclasts
maintains bone tissue.
8. The Bones- Classification of bones
• Long Bones
• Long bones are long and skinny.
• Some examples would be the
bones
• in your arms, legs, and fingers.
9. The Bones- Classification of bones
• Short Bones
Short bones in the human body are cube-like,
with length, width, and height measurements
approximately equal.
They include the carpal bones (hands, wrist)
and tarsal bones (feet, ankles).
10. The Bones- Classification of bones
• Irregular Bones
such as the spinal vertebrae and calcaneus
(heel), consist predominantly of cancellous
bone with a thin shell of cortical bone.
11. The Bones- Classification of bones
• Flat Bones
Thin, flat bones that are usually curved
Examples are sternum, ribs, scapula
12. The Bones- Functions of bones
Support and Protection
Bones give shape to body parts such as the head, legs, arm, and trunk.
Bones also support and protect soft structures in the body. For example, the
bones of the cranium protect the brain.
Body Movement
Skeletal muscles attach to bone. When these skeletal muscles contract, the
bones they are attached to move producing body movements.
Blood Cell Formation
The red bone marrow of bone produces new blood cells.
Storage of Inorganic Salts
Calcium phosphate is the most abundant inorganic salt stored in bone matrix.
It is the primary source of calcium for all body cells.
13. The Muscles
Muscles are responsible for your body's
every move. Muscles control all of the
movements in our body with one
simple action
15. The Muscles
Skeletal muscles
are attached to bones and allow us to
move our bones and joints.
They control the movements we make,
from writing with a pencil and snapping
our fingers to running and swimming.
16. The Muscles
Smooth muscle
Smooth muscles are associated with
internal organs and are autonomically
controlled .
Visceral Smooth muscle.
Multi-unit smooth muscles
blood vessels, arrector pili muscles
(body hair), iris of eye
17. The Muscles
Cardiac muscle
A special type of muscle found only in the
heart.
It shares the characteristics of both other
types of muscle found in the human body.
18. The Joints
A joint is the location at which two or more
bones make contact. They are constructed
to allow movement and provide mechanical
support, and are classified structurally
and functionally.
19. The Joints-Structure
The Structure of a Normal Joint
“synovial joints” also called
“diarthrodial joints.”
They consist of two bones and a fibrous
capsule holding the two bones together
but the joint is far more complicated than
just a hinge made of fiber and bone.
20. The Joints-Structure
Cartilage:
a hard but slippery coating on
the end of each bone.
Cartilage, which breaks down and
wears away in osteoarthritis.
Joint Capsule:
a tough membrane sac
that holds all the bones and other
joint parts together.
21. The Joints-Structure
Synovium:
a thin membrane inside the joint capsule.
Synovial fluid:
a fluid that lubricates the joint and keeps
the cartilage smooth and healthy.
22. The Joints-Structure
Ligaments, tendons, and muscles:
tissues that keep the bones stable and
allow the joint to bend and move.
Ligaments are tough, cord-like tissues
that connect one bone to another.
Tendons are tough, fibrous cords
that connect muscles to bones.
Muscles are bundles of specialized cells
that contract to produce movement
when stimulated by nerves.
23. The Joints- Cartilage
Cartilage is 65 to 80 percent water.
Three other components make up the rest of cartilage tissue:
collagen, proteoglycans, and chondrocytes.
The Key to Healthy Joints
a fibrous protein. Collagen is also the building block of
skin, tendon, bone, and other connective tissues.
• Collagen
24. The Joints- Cartilage
1. Proteoglycans
2. a combination of proteins and sugars.
Strands of proteoglycans and collagen
weave together and form a mesh-like tissue.
This allows cartilage to flex and absorb
physical shock.
The Key to Healthy Joints
25. The Joints- Cartilage
1. Chondrocytes
2. cells that are found all through the cartilage.
They mainly help cartilage stay healthy and
grow. Sometimes, however, they release
substances called enzymes that destroy
collagen and other proteins.
The Key to Healthy Joints
28. Structure of Normal Cartilage
Divided into 4 morphologically distinct zones:
Superficial: flattened chondrocytes.
High collagen-to-proteoglycan ratio and high
water content.
Collagen fibrils form thin sheet parallel to
articular surface giving the superficial zone an
extremely high tensile stiffness.
Restricts loss of interstitial fluid, encouraging
pressure of fluid.
29. Structure of Normal Cartilage
Transitional zone:
Small spherical chondrocytes.
Higher proteoglycan and lower water
content than superficial zone.
Collagen fibrils bend to form arcades.
30. Structure of Normal Cartilage
Radial Zone:
Occupies 90% of the column of articular cartilage.
Proteoglycan content highest in upper radial zone.
Collagen oriented perpendicular to bone
providing anchorage to underlying calcified matrix.
Chondrocytes are largest and most synthetically
active in this zone.
31. Structure of Normal Cartilage
Calcified zone:
Articular cartilage is attached to the
subchondral bone via a thin layer of calcified
cartilage.
During injury and OA, the mineralization
front advances causing cartilage to thin.
35. Mobiease
®
• Glucosamine Sulphate
Glucosamine is commonly used as a
treatment for osteoarthritis.
Glucosamine was first identified in 1876 by
G. Ledderhose but the stereochemistry
was not fully defined until 1939 by the
work of Walter Haworth.
D-Glucosamine is made naturally in the form
of glucosamine-6-phosphate
36. Mobiease
®
• Glucosamine Sulphate
glucosamine is commonly used for the treatment of osteoarthritis.
Since glucosamine is a precursor for glycosaminoglycans, and
glycosaminoglycans are a major component of joint cartilage,
supplemental glucosamine may help to rebuild cartilage and
treat arthritis.
Its use as a therapy for osteoarthritis appears safe and effective.
37. Mobiease
®
• Glucosamine Sulphate
• Glucosamine Sulfate (also known as Glucosamine
Sulphate) is the form that has been tested in dozens of
clinical trials.
• The main physiological function of glucosamine on joints
is to stimulate the manufacture of cartilage components
as well as promote the incorporation of sulfur into
cartilage.
• In Europe, glucosamine is approved as a medical drug
and is sold in the form of glucosamine sulphate.
38. Mobiease
®
• Glucosamine Sulphate
• In other words, glucosamine is not only responsible for
stimulating the manufacture of substances necessary for
proper joint function, it also is responsible for stimulating
joint repair.
39. Mobiease
®
• Glucosamine Sulphate
• It may play a role in the promotion and maintenance of
the structure and function of cartilage in the joints of the
body.
• Glucosamine may also have anti-inflammatory properties.
ACTIONS AND PHARMACOLOGY
40. Mobiease
®
• Glucosamine Sulphate
• Biochemically, glucosamine is involved in glycoprotein
metabolism.
• Glycoproteins, known as proteoglycans, form the ground
substance in the extra-cellular matrix of connective tissue.
• The glucosamine-containing glycosaminoglycan
hyaluronic acid is vital for the function of articular
cartilage.
MECHANISM OF ACTION
41. Mobiease
®
• Glucosamine Sulphate
• GAG (glycosaminoglycans ) chains are fundamental
components of aggrecan found in articular cartilage.
• Aggrecan confers upon articular cartilage shock-
absorbing properties.
e.g. Rebuilds damaged cartilage, by stimulating the
synthesis and inhibiting the degradation of
glycosaminoglycans and proteoglycans.
MECHANISM OF ACTION
42. Mobiease
®
• Glucosamine Sulphate
• About 90% of glucosamine administered orally as a
glucosamine salt gets absorbed from the small
intestine, and from there it is transported via the
portal circulation to the liver.
• It appears that a significant fraction of the ingested
glucosamine is catabolized by first-pass metabolism
in the liver.
• Some uptake in the articular cartilage is seen.
PHARMACOKINETICS
43. Mobiease
®
• Glucosamine Sulphate
• Glucosamine is indicated for the treatment and
prevention of osteoarthritis.
Indications
• There are no known contraindications to glucosamine
supplementation.
Contraindications
44. Mobiease
®
• Glucosamine Sulphate
• Fight inflammation, encourage new cartilage to be
built, and inhibit the production of enzymes that
destroy cartilage
• Play an important role in lubricating the joints,
• Increasing joint mobility and slowing or preventing the
deterioration of joint cartilage.
• Relief of joint pain and improvement of symptoms.
Health Benefits
45. Mobiease
®
• The most effective treatment for DJD
Every double-blinded trial which has investigated the
efficacy of glucosamine sulphate has reported
efficacy in treating osteoarthritis.
All clinical research studying glucosamine sulphate
suggests that it is not only a safe and effective
treatment to reduce the symptoms of osteoarthritis,
but may even be valuable in actually reversing the
progression of this painful disease.
Glucosamine Sulphate
46. Mobiease
®
Chondroitin:
Glucosamine, Chondroitin, or MSM?
Chondroitin sulfates are a class of glycosaminoglycans
which, like glucosamine, are important constituents of
normal cartilage.
Animal studies suggest that chondroitin functions as an
anti-inflammatory.
48. Eucalyptus oil
Active constituent
The major constituent in eucalyptus leaves is a volatile oil known as
eucalyptol (1,8-cineol).
The leaf oil should contain approximately 70–85% eucalyptol.
Further more p-cymene, alpha-pinenes, limonene, camphene.
Has Antioxidant Effects.
Eucalyptus contains substances related to menthol, and has a warming
effect on the skin and muscles.
This could result in a pain-relieving effect on sore muscles.
During muscle and joint pains, massaging eucalyptus oil on the skin
surface helps in getting relief from the pain.
The volatile eucalyptus oil is analgesic and anti inflammatory in nature.
Therefore it is often recommended to patients suffering from
rheumatism, sprained ligaments and tendons, stiff muscles, aches, fibrosis
and even nerve pain.
49. biloba Gingko
stimulate circulation
Antioxidant Properties
Cartilage has no blood vessels or lymphatics and the nutrition of the cells
diffuses through the matrix. This explains the slowness of healing process
in cartilages.
50. Gotu Kola (Centella(
Gotu Kola contains chemicals called triterpines (saponins).
Which enhance the formulation of tough, fibrous Protein
known as collagen in bones, cartilage and connective tissue.
These substances work to promote healthy blood vessels by
strengthening their walls and improving blood flow.
so Improve circulation.
Antioxidant capacity.
.
51. Clove Oil
The chemical composition and biological activity of clove essential oil, Eugenol.
Is used as a topical application to relieve pain , natural analgaesic .
Clove essential oil possesses anti inflammatory, antioxidant and anaesthetic
properties.
inhibitory effects of clove on pro-inflammatory cytokines production by
macrophages.
The action of the essential oil of clove on the production of these cytokines
macrophages was also investigated in vitro.
Treatment of mice with water extract of clove was found to inhibit macrophages
to produce both IL-1beta and IL-6.
The essential oil of clove also inhibited the production of these cytokines in
vitro.
Eugenol was found to be the major component of the clove extract and essential
oil, and is the causative agent of cytokine inhibition.
Taken together, these data suggest an anti-inflammatory action of this oil.
52. Campher & Menthol
Camphor
Is a stimulant, rubefacient & antipruritic . When in combination with
other ingredient like menthol, it becomes ideal for painful areas.
Provide symptomatic relief for mild to moderate muscular and joint
aches and pains, muscle cramps, shoulder aches and stiff neck
For the temporary relief of pain associated with rheumatism, arthritis,
neuralgia, sprains and strains of joints and muscles.
Its counterirritant action is due to vasoconstriction which leads to the
activation of reflex mechanisms resulting in improved local circulation.
Camphor is used exclusively because of its local effects. When rubbed on
the skin, it acts as a rubefacient and causes localized vasodilatation , which
gives feelings of comfort and warmth.
As an anti-pruritic gent, when applied gently on the skin, it may create a
feeling of coolness, and a mild, local anaesthetic effect, which may be
followed by numbness.
Campher extracts display free radical scavenging activities.
53. Menthol
It is a terpene compound that is well known for its cold or
heat sensations as well as its antinociceptive and
counterirritant properties
It dilates the blood vessels causing a sensation of coldness,
followed by an analgesic effect.
Menthol also acts as a penetration enhancer, increasing
the penetration of componants when applied on the skin, to
give a faster onset of action.
It is utilized to soothe the effects of muscle soreness, and
even joint pain .
If an athlete becomes injured, immediate and effective
treatment must be applied to help sustain their performance
capabilities and prevent further injuries.
54. Glycerin
Moisturizer
The primary use of glycerin for the skin is as a moisturizer for
dry, rough or scaly skin.
Irritants
It's been known in scientific circles for years that glycerol protects skin
against irritation. In a study published in the journal Dermatology in
1998, researchers pretreated skin with several irritating substances
and then applied glycerol to the area under an air-tight and water-
tight dressing. The glycerol staved off any negative effects from the
irritations, provided a significant improvement of the protective
barrier function in the skin and caused skin cells to regenerate.
Anti Bruising and AntiSwelling
55. Vit C & vit C Acetate
Anti-Oxidant effect
Vitamin C is one of the more powerful and well-known
antioxidants.
Vitamin C, as a free-radical fighter, helps ward off many illnesses
linked to oxidation, including arthritis.
stimulates collagen synthesis, and to a lesser extent the synthesis
of aggrecan.
Proteoglycan synthesis is increased in chondrocyte cultures.
An animal study showed that vitamin C has a protective effect on
knee cartilage.
The effect of chondrocyte protection could be mediated by its
antioxidant capacity.
57. Collagen synthesis & Vit C
vitamin C are required for collagen synthesis.
Hydroxyproline, an amino acid, is vital for the
stability of collagen, and vitamin C assists in the
production of hydroxyproline.
Conversely, a deficiency in vitamin C halts
production of hydroxyproline, and subsequently
the body cannot create collagen.
Antiinflammtory effect
Vitamin C functions as an anti-inflammatory,
and helps the body fight inflammatory diseases,
including arthritis.
58. Reduce muscle aches
For a study published in 2006, 18 healthy men
took either a placebo or three grams of vitamin
C in supplement form each day for two weeks.
Next, all participants performed 70 elbow
extensions, then continued taking either the
placebo or vitamin C supplements for four days.
Study results showed that vitamin C reduced
muscle soreness.
Zainuddin Z, Newton M, Sacco P, Nosaka K. "Effects of massage on delayed-onset muscle soreness, swelling,
and recovery of muscle function." J Athl Train. 2005 40(3):174-80.
60. According to British Medical Journal (BMJ)
2010;341:c4675 doi:10.1136/bmj.c4675
Compared with placebo, oral glucosamine, chondroitin, and their
combination do not reduce joint pain or have an impact on narrowing
of joint space.
62. Mobiease TGG Dual-Action
Formula
Mobiease Transdermal
Glucosamine Gel contains the
highest concentration of
glucosamine. Its proprietary
transdermal technology penetrates
the skin and delivers glucosamine
directly to the joints to rebuild
cartilage. Its unique dual-action
formula allows for quick relief from
discomfort and rebuilds cartilage in
the long run.
Comparing the efficacy of Mobiease TG Gel and oral delivery of glucosamineComparing the efficacy of Mobiease TG Gel and oral delivery of glucosamine
MobieaseMobiease
68. Table shows opinion rating of the treatment
with Mobiease TGG outcome based on site
of pain
69. Mobiease TGG Dual-Action Formula
• Chondroitin sulfates are a class of glycosaminoglycans which, like
glucosamine, are important constituents of normal cartilage.
• Human studies suggest that chondroitin functions as an anti-
inflammatory.
• Several researchers have suggested that Methylsulfonylmethane
(MSM) has anti-inflammatory effects (Morton et al. 1986; Childs, 1994; Murav'ev et al., 1991).
• MSM source of Sulfur which is needed for healthy joints.
• Hyaluronic acid is most commonly used to treat osteoarthritis of the
knee.
• According to the Australian Rheumatology Association Hyaluronic
acid help reduce the pain caused by osteoarthritis. Some patients
find relief from symptoms within a few days. Full benefits usually are
reached 3-5 weeks after the treatment.
71. Mobiease TGG Dual-Action Formula
• Fight inflammation, encourage new cartilage to be
built, and inhibit the production of enzymes that
destroy cartilage
• Play an important role in lubricating the joints,
• Increasing joint mobility and slowing or preventing
the deterioration of joint cartilage.
• Relief of joint pain and improvement of symptoms.
