Lecture 4: Ligament, Muscle, Tendon Injuries

Question 1

Tendons are made up of longitudinal ___ bundles that is they are not ___ and have no active ___

Answer 1

collagen fiber

not elastic

no active cogntraction

Question 2

T/F

Tendons have their greatest strength when relaxed; allowing them to absorb the forces of impact.

Answer 2

FALSE

no elasticity,

they have greatest tensile strength when they are in tension

Question 3

Define a sprain:

Answer 3

stretching or tearing of a ligament

Question 4

Initial healing of a sprain takes ___, while it may take ___ for the affected area to reach max stability

Answer 4

6-10 weeks intial healing

3-6 months to reach max stabiity

Question 5

T/F

While tendon healing is slow, they typically regain their original tensile strength after 6 months

Answer 5

FALSE

max stability is reached in 6 months, rarely ever regain original strength

Question 6

What is second degree sprain?

Answer 6

partial disruption of ligament

Question 7

What is the difference in treatment in a second degree sprain that is grossly unstable verses a sprain that has no gross instability?

Answer 7

UNSTABLE
Early surgical repair to restore instability
Support with split or padded bandage

STABLE
splint 2-3 weeks as conservative management
2 weeks soft padded wrap
slow return to activity over 12 weeks

Question 8

What is a third degree sprain?

Answer 8

complete rupture, laceration, or avulsion of ligament from bone

Fx is completely lost

Vigorous Tx needed to restore Fx

Spontaneous healing by fibroplasia often leads to unstable joint

requires arthrodesis

Question 9

T/F

Scar tissue healing has greater tensile strength than ligaments tissues, leading to decreased function of the affected tendon

Answer 9

FALSE

It is nowhere near as strong as ligamentous tissues

Question 10

During repair of 3rd degree sprains, what acts as the lattice for fibroplasia?

Answer 10

fascia or a tendon graft

Question 11

Where is the anchor placed for the prosthetic ligament during Sx repair of a 3rd degree sprain?

Answer 11

anchor as close to the origin and insertion as possible

Question 12

What sutures are used for Direct Suturing of torn ligaments (primary repair)

Answer 12

far-near-near-far

bunnel mayer technique

3 loop pulley

locking loop

ALL ARE TENSION RELIEVING

Question 13

Where are the knots located for each method of tension relieving sutures used in direct suturing?

Answer 13

3 loop pulley/FNNF knot is located at ends of ligament on the outside

Locking Loop and BM technique knots are buried within the ligament and can act as foreign material

Question 14

Define muscle contusion

Answer 14

bruise of muscle with varying degrees of hemorrhage and fiber disruption

Question 15

Define a strain:

Answer 15

a longitudinal stretching or tearing of the muscle fibers or groups of fibers

Question 16

There are _ degrees of sprains. List and describe them

Answer 16

1st- mild, minimal lameness/pain/swelling

2nd- moderate, obvious lameness, soft tissue swelling, joint pain

3rd- severe, obvious lameness, significant soft tissue swelling, rapidly progressive pain

Question 17

Majority of acute/mild to moderate sprains can be cured with:

Answer 17

Not being a little bitch

conservative management rest, ice, warm packs, NSAIDS

Question 18

What are the clinical signs of a 3rd degree strain

Answer 18

Complete rupture of the Muscle-Tendon unit

unable to flex,extend joint actively or even stand

Question 19

What is required to Tx a 3rd degree strain?

Answer 19

Sx is required, same tech as ligaments, want to prevent excessive scar tissue repair- impedes Fx

external support required during healing

Question 20

What are the general principles of 3rd degree strain Tx?

Answer 20

aim for appositional repair of muscle/tendon

minimal gap and tension = less scarring

increased scar tissue , increases rick of contracture

controlled loading on tendon aids healing

alignment of collagen fibers

Question 21

What tendons are commonly strained?

Answer 21

felxor carpi ulnaris

common calcanean

Question 22

Common muscle strains?

Answer 22

semitendinosus

sartorius

Question 23

What is bicipital tenosynovitis

Answer 23

Make Swamy proud

inflammation of the tendon sheath in shoulder region

Question 24

What are the radiographic signs consistent w/ common calcaneon tendon sprain

Answer 24

soft tissue swelling

mineralization in tendons

periosteal reaction on tuber calcansous

Question 25

What are the clinical signs associated with gastrocnemius tendon tear?

Answer 25

dropped hock, curling of toes (bear claw stance)

Question 26

How do you Tx a gastrocnemius tendon tear?

Answer 26

enforced rest, NSAIDs, Sx repair or support of splint/external fixator

splint cast for 6-12 weeks

Question 27

What is contracture?

Answer 27

a condition of shortening and hardening of muscles, tendons, or other tissue, often leading to deformity and rigidity of joints

Question 28

T/F

Contracture is a common problem in rapid growing juvenile dogs, usually is self limiting and resolves as the dog ages

Answer 28

FALSE

irreversible in young dogs, commonly effects quadriceps due to trauma, affects femur Fx

physical therapy is very important in rehab after repair

Question 29

T/F

Shoulder injuries are common, easy to diagnose via radiographic imaging

Answer 29

FALSE

they are common, hard to Dx becasue rads are not specific, and injury typically in soft tissue not bone, MRI/US would be better

Question 30

T/F

Biceps Tenosynovitis and contracture of the supraspinatus are most common shoulder injuries

Answer 30

FALSE

Biceps tenosynovitis and

INFRAspinatus