labrum, intervertebral disc, and meniscus Flashcards
What is the labrum and which joints is it located in
It is a marginal fibrocartilage that is largely anueral w/no lymphocytes but has a vascular supply and is located in the GH and hip joints
What are the purposes of the labrum
Separate joint surfaces assist in jt lubrication shock absorption transmit loads protect joint edges
List the types of GH Labrum Tears/injuries
- Radial tear
- longitudinal tear
- bucket handle tear
- degenerative tear
- labral fraying
- dislocation/bankart lesion
- SLAP lesion
Where are acetabular tears and their MOI?
- 80% in anterior quadrant
- MOI mainly repetitive activity w/twisting and pivoting BUT can be femoral dysplasia or other abnormalities
What are general symptoms of labral tears
- catching/locking sensation
- painful clicking
- restricted ROM
T or F: We know how the labrum heals
False - there is some evidence suggesting that ibuprofen limits it and being closer to blood supply is better
What are some common pathologies of the intervertebral discs
- herniation
- degenerative disc disease
- discitis
what is the purpose of an intervertebral disc?
To act as a cushion b/t two bones to absorb shock
What should you see w/a normal lumbar disc
- even thickness
- no development of bone anteriorly
- easily see facet joints
- even disc space
What is the histology of an intervertebral disc?
- Fibrous annulus fibrosis (extrnal layer of overlapping fibrocartilage and collagen in cross-fiber pattern)
- Nucleus Pulposus (jelly filled rich in hyaluronic acid and type II collagen fibrils)
Sequence of disc dysfunction
- normal
- degenerative disc
- bulging disc (slight w/o nucleus pulposus)
- herniated disc
- thinning disc
- disc degen w/osteophyte formation
Where is the blood supply in a disc
through the middle of the vertebral bodies only meaning not a lot of blood in annulus fibrosis or nucleus pulposus itself just little arterioles towards it
What is a degenerative disc
1st phase w/fissures developing over time (CRT - concentric, radial, or transverse) w/joint space narrowing and osteophyte development anteriorly
What is a disc bulge
Circumferential diffuse extension of annulus 3 mm (50-100% of disc tissue) or more beyond the adjacent vertebral end plates w/o nucleus pulposus or rupture of annulus fibers
What is an annular fissure
A focal disruption of the fibers of the annulus = herniation
What is a herniation?
Localized displacement of disc material beyond the limits of the intervertebral disc space
What are the types of herniation?
Focal (<25%)
Broad (25-50%)
Generalized [extruded or sequestered] (>50%)
What is a disc protrusion?
A focal, asymmetric condition in which a segment of the disc extends beyond the margin of the adjacent vertebrae into the spinal canal
What is a disc extrusion?
The nucleus extends beyond the annulus and posterior longitudinal ligament into the epidural space & may migrate up or down the canal
What is disc sequestration?
A free fragment of disk detaches from remaining portion and floats around
What is a Schmorl Node
A focal herniation of the nucleus pulposus through the vertebral endplates occurring near center or posterior part of the disc (vertically not horizontal)
What are the S/S of disc herniation
Signs: LOF, weak mm w/o flacidity
Symptoms: SENSORY FIRST
pain radiating down, dermatome, and intensified or relaxed by different movements
What occurs w/the nucleus pulposus once herniated (for healing)
It does not return to the middle of the disc but is absorbed over time
What is a barrier to inflammation in disc healing post herniation
the annulus: if intact, inflammation cannot come inward
