10 - Tendon injuries

Question 1

what cells are involved in longitudinal arrangement of tendons?

Answer 1

tenocytes and type 1 collagen triple helix fibres

Question 2

what are collagen bundles covered by?

Answer 2

endotenon

Question 3

what are fascicles covered by?

Answer 3

paratenon

Question 4

what are tendons covered by?

Answer 4

epitenon

Question 5

where are the blood vessels present in the tendon?

Answer 5

paratenon?

Question 6

how are tendons connected to the sheath?

Answer 6

vincula

Question 7

what is the function of tendons?

Answer 7

flexibility and very strong in tension

Question 8

consequence of immobility of tendons?

Answer 8

reduced water content and glycosaminoglycan concentration and strength

Question 9

name 4 possible injuries to tendon?

Answer 9

degeneration, inflammation, enthesiopathy, traction apophysitis

Question 10

well known result of degeneration?

Answer 10

achilles tendon - result of intrasubstance mucoid degeneration

Question 11

3 signs associated with achilles tendon?

Answer 11

swollen, painful tender

Question 12

define enthesiopathy?

Answer 12

inflammation at insertion to the bone/ tendon (usually at muscle origin rather then tendon insertion)

Question 13

common presentation of tendon enthesiopathy?

Answer 13

tennis elbow - lateral humeral epicondylitis

Question 14

common presentation of ligament enthesiopathy

Answer 14

plantar fasciitis

Question 15

what is Osgood Schlatter’s disease an example of?

Answer 15

traction apophysitis

Question 16

who is most likely to be affected by Osgood Schlatter’s disease?

Answer 16

adolescent active boys with inflammation and recurrent load

Question 17

what is the cause for avulsion +/- bone fragment?

Answer 17

failure at insertion and load exceeding failure strength while contracting muscle

Question 18

describe mallet finger?

Answer 18

insertion of extensor tendon into dorsum of base of distal phalanx of finger

Question 19

conservative treatment of avulsion?

Answer 19

retraction tendon

Question 20

2 possible operative treatments for avulsion?

Answer 20

reattachment tendon, fixation bone fragment

Question 21

example of intrasubstance tear?

Answer 21

tearing achilles tendon

Question 22

3 mechanisms for rupture in intrasubstance tear?

Answer 22

1 - pushing off with weight bearing forefoot whilst extending knee joint (e.g. sprint starts),
2 - unexpected dorsiflexion of ankle (e.g. slipping into hole),
3 - violent dorsiflexion of plantar flexed foot (e.g. fall from a height)

Question 23

test for achilles tendon rupture?

Answer 23

+ve Simmond’s (squeeze) test

Question 24

what would you feel in a ruptured achilles tendon?

Answer 24

palpable tender gap

Question 25

conservative treatments of ruptured tendons?

Answer 25

mobilise, splint/ cast

Question 26

when should you operate on a ruptured tendon?

Answer 26

when there is a high risk of rerupture, high activity and when ends cannot be opposed

Question 27

M:F - laceration of tendons?

Answer 27

M > F

Question 28

who is most affected by lacerated tendons?

Answer 28

young adults

Question 29

where is most commonly affected by laceration of tendons?

Answer 29

finger flexors - FDS and FDP