Bursae & Tendons

Question 1

What is the function of bursae?

Answer 1

cushion & lubrication

Question 2

What are bursae?

Answer 2

CT sacs lined with synovium (allowing pouch to roll)

Question 3

Why are bursae involved in Rheumatoid arthritis?

Answer 3

lined with synovium

Question 4

Where are bursae generally located?

Answer 4

anywhere with prominent bone around soft tissue

Question 5

When do deep lying bursae develop?

Answer 5

before birth

Question 6

When do adventitial bursae develop?

Answer 6

excess friction create new bursae
(eg. Baastrup’s syndrome = interspinous bursitis)

Question 7

A person with a “water-ballooning” effect around the olecranon (aka “water on the elbow”) likely has what condition?

Answer 7

bursitis

Question 8

What is tendinitis?

Answer 8

acute tearing of fibers creates an inflammatory reaction

Question 9

What is tendinosis?

Answer 9

chronic overuse creates collagen degenerative microtears without inflammation

Question 10

Compare the healing times of tendinitis & tendinosis

Answer 10

Tendinitis: 6 wks
Tendinosis: 6 wks - 6 mo

Question 11

Tennis/golfer’s elbow is an example of ____

Answer 11

tendinOSIS

Question 12

Only tendons with ____ can have tenosynovitis

Answer 12

tendon sheathes

Question 13

Achilles tendon (can/cannot) have tenosynovitis

Answer 13

cannot (no tendon sheath)

Question 14

Tendons of finger flexors and extensors (can/cannot) have tenosynovitis

Answer 14

can (have extensive tendon sheathes)

Question 15

What are tendon sheathes?

Answer 15

tubes surrounding the tendons (that have to move a lot), lined with synovium and filled with synovial fluid

Question 16

What are the layers of a tendon sheath?

Answer 16

visceral layer
- synovial fluid
parietal layer

Question 17

Why are tendon sheathes affected by Rheumatoid arthritis?

Answer 17

lined by synovium

Question 18

What is the function of mesotendons?

Answer 18

(synovial fold) connects tendon to tendon sheath

Question 19

What is tenosynovitis?

Answer 19

inflammation of tendon sheath synovium, leading to ^fibrin, thickening synovial fluid and increasing friction

Question 20

What are the causes of non-infectious tenosynovitis?

Answer 20

• overuse (repetitive strain)
• autoimmune (rheumatoid/psoriatic arthritis)
• idiopathic

Question 21

Taking a pressure washer to the palm of the hand can cause ____ tenosynovitis

Answer 21

septic (infectious)

Question 22

What occurs in infectious/septic tenosynovitis?

Answer 22

• purulent exudate
• necrosis of tendon sheath, tendon & other structures

Question 23

What are the signs and symptoms of tenosynovitis?

Answer 23

• stiffness
• pain
• swelling, redness, warmth
• decreased ROM
• may worsen w/ activity, decreased w/ rest

Question 24

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

Answer 24

abductor pollicis longus & brevis

Question 25

What is the treatment for tendinosis and tenosynovitis?

Answer 25

• Infectious: antibiotics
• PEACE & LOVE
• splint
• NSAIDs
• corticosteroids
• surgery

Question 26

What does “PEACE & LOVE” stand for?

Answer 26

Protect
Elevate
Avoid anti-inflammatories
Compress
Educate
& after a few days
Load
Optimism
Vascularization
Exercise

Question 27

Which structure helps prevent excessive unit loads in joints:
A) synovial fluid
B) periosteum
C) synovial villi
D) posterior cruciate ligament

Answer 27

PLL

Question 28

(TRUE/FALSE)
type A cells are hyaluronate producing fibroblast-like synoviocytes

Answer 28

FALSE
(type A = macrophages)

Question 29

Which of the following is not lined by the synovium?
A) bare area
B) periosteum
C) articular cartilage
D) joint capsule

Answer 29

A, B, C