Adult MSK injury Flashcards
What drugs are associated with tendinopathies?
Fluoroquinolones, corticosteroids, statins, estrogen, NSAIDs
What are intrinsic risk factors for sports injuries?
Systemic illness (DM2, HTN), previous injury, genetics, obesity, weakness, biomechanical abnormalities
What is the role of tendons?
Tendons transmit force from muscle to bone and act as a buffer by absorbing external forces to limit muscle damage
What makes up the majority of the dry mass of tendons?
Type I collagen and elastin
What is the weakest point of the musculotendinous unit?
The myotendinous junction
What is the myotendinous junction?
A site in the musculotendinous unit where tendinous collagen fibrils are inserted into deep recesses formed by myocyte processes, allowing the tension generated by intracellular contractile proteins of muscle fibers to be transmitted to the collagen fibrils.
What is found on histology in tendonpathy?
Disordered, haphazard, healing with an absence of inflammatory cells, a poor healing response, noninflammatory intratendinous collagen degeneration, fiber disorientation and thinning, hypercellularity, scattered vascular ingrowth, and increased interfibrillar glycosaminoglycans
What are the three stages of tendon healing?
Inflammation, remodeling, and maturation
What ages are rotator cuff tendinopathies most common at?
Middle age (less common in childhood)
Where does achilles tendinopathy usually occur?
Midportion of tendon and at insertion on the calcaneous
What are the three grades of muscle strain?
Grade I: microscopic tear
Grade II: macroscopic partial tear
Grade III: complete tear
What types of muscles are more likely to be strained?
Muscles that cross two joints
What is the most common type of sprain?
Inversion ankle sprains
What ligaments can be involved in inversion ankle sprains?
Anterior talofibular ligament (most common), calcaneofibular ligament, or posterior talofibular ligament
What are the three stages of tissue healing?
Stage I - inflammatory phase (0-10 days after injury)
Stage II - proliferative phase (2-21 days after injury)
Stage III - remodeling phase (12 days-1 year after injury)
What are the components of stage I of tissue healing?
RBC/WBC infiltrate, initiation of angiogenesis, removal of necrotic material
What are the components of stage II of tissue healing?
Infiltration of specialized cells, production of type III collagen
What are the components of stage III of tissue healing?
Consolidation phase, maturation phase
Patients with achilles tendinopathy have tendon pain that is worst with:
a) sitting
b) running
c) walking
d) lying down
b) running
Which of the following muscles is most likely to suffer a muscle strain?
a) gastrocnemius
b) vastus medialis
c) short head of biceps femoris
d) tricepsbrachii
a) gastrocnemius
Rehabilitation after an ankle sprain is important because
a) most people do not exercise so at least they should have strengthening exercise for the ankle
b) exercise will maximize healing of the sprained ligament
c) it will decrease chance of experiencing another sprain at the same ankle
d) tendons are usually injured with an ankle sprain and need to be strengthened before returning to fitness and sport activities
c) it will decrease chance of experiencing another sprain at the same ankle
What does this histology show?
Tendinopathy (of the achilles)
What is the treatment for an ankle sprain?
RICE, immobilization/taping/bracing, rehab
