Bursae & Tendons Flashcards
What is the function of bursae?
cushion & lubrication
What are bursae?
CT sacs lined with synovium (allowing pouch to roll)
Why are bursae involved in Rheumatoid arthritis?
lined with synovium
Where are bursae generally located?
anywhere with prominent bone around soft tissue
When do deep lying bursae develop?
before birth
When do adventitial bursae develop?
excess friction create new bursae
(eg. Baastrup’s syndrome = interspinous bursitis)
A person with a “water-ballooning” effect around the olecranon (aka “water on the elbow”) likely has what condition?
bursitis
What is tendinitis?
acute tearing of fibers creates an inflammatory reaction
What is tendinosis?
chronic overuse creates collagen degenerative microtears without inflammation
Compare the healing times of tendinitis & tendinosis
Tendinitis: 6 wks
Tendinosis: 6 wks - 6 mo
Tennis/golfer’s elbow is an example of ____
tendinOSIS
Only tendons with ____ can have tenosynovitis
tendon sheathes
Achilles tendon (can/cannot) have tenosynovitis
cannot (no tendon sheath)
Tendons of finger flexors and extensors (can/cannot) have tenosynovitis
can (have extensive tendon sheathes)
What are tendon sheathes?
tubes surrounding the tendons (that have to move a lot), lined with synovium and filled with synovial fluid
What are the layers of a tendon sheath?
visceral layer
- synovial fluid
parietal layer
Why are tendon sheathes affected by Rheumatoid arthritis?
lined by synovium
What is the function of mesotendons?
(synovial fold) connects tendon to tendon sheath
What is tenosynovitis?
inflammation of tendon sheath synovium, leading to ^fibrin, thickening synovial fluid and increasing friction
What are the causes of non-infectious tenosynovitis?
- overuse (repetitive strain)
- autoimmune (rheumatoid/psoriatic arthritis)
- idiopathic
Taking a pressure washer to the palm of the hand can cause ____ tenosynovitis
septic (infectious)
What occurs in infectious/septic tenosynovitis?
- purulent exudate
- necrosis of tendon sheath, tendon & other structures
What are the signs and symptoms of tenosynovitis?
- stiffness
- pain
- swelling, redness, warmth
- decreased ROM
- may worsen w/ activity, decreased w/ rest
Which of the following tendons are inflamed in De Quervains tendosynovitis?
A) flexor digitorum superficialis
B) abductor pollicis longus & brevis
C) flexor digiti minimi
D) adductor pollicis
abductor pollicis longus & brevis
What is the treatment for tendinosis and tenosynovitis?
- Infectious: antibiotics
- PEACE & LOVE
- splint
- NSAIDs
- corticosteroids
- surgery
What does “PEACE & LOVE” stand for?
Protect
Elevate
Avoid anti-inflammatories
Compress
Educate
& after a few days
Load
Optimism
Vascularization
Exercise
Which structure helps prevent excessive unit loads in joints:
A) synovial fluid
B) periosteum
C) synovial villi
D) posterior cruciate ligament
PLL
(TRUE/FALSE)
type A cells are hyaluronate producing fibroblast-like synoviocytes
FALSE
(type A = macrophages)
Which of the following is not lined by the synovium?
A) bare area
B) periosteum
C) articular cartilage
D) joint capsule
A, B, C
