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UM - MSK > Ligaments > Flashcards

Ligaments Flashcards

1
Q

What are the Histological Composition of Ligaments

A
  • 2/3 water: contributes to viscoelastic behaviour

- 1/3 solid: collagen (mainly 6 types), proteoglycans, and elasin

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2
Q

List possible complications to healing

A

failure to:

  • reconnect appropriate locations on bone
  • produce enough scar tissue
  • produce correct type of tissue
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3
Q

List the ligament injury categories

A

Fractures
Inflammation
Systemic
Sprains

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4
Q

What are the functions of ligaments

A
  • Connect two bones together
  • Stabilize joints
  • Shared junction of restraint
  • Proprioceptor for the joint
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5
Q

T or F: Ligaments have both specific innervation and blood supply

A

True

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6
Q

Which region of a ligament is more avascular?

A

The middle region - influences healing

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7
Q

How does the material (solid) behaviour of a ligament respond to stress?

A

Crimp –> building stress –> fibers fail –> F increases –> complete disruption

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8
Q

What is the viscoelastic behaviour of a ligament in response to stress?

A
  • Higher loads: Elastic property highest - able to recovery shape
  • Lower loads: Viscous highest - acting as liquid that has to be squeezed to move
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9
Q

T or F: Hormones do not influence ligaments

A

False - hormones influence ligament function, and it may be gender specific (menstrual cycle, pregnancy, likelihood of benign joint hypermobility syndrome)

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10
Q

What are the three steps of ligament healing and length of time in each

A
  1. Inflammation - w/in 72 hours
  2. Proliferation- 48-72 hours after injury up to 6 weeks
  3. Maturation - 6 weeks or 12+ months to complete
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11
Q

avulsion fractures

A

Tensile loading of the tissue that causes the insertion stie to pull away from bone, taking a part of bone with it

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12
Q

enthesitis

A

Inflammation of insertion of ligament -> traction injury

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13
Q

ligament sprain

A

Disruptions of ligament fibers beyond elastic limits

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14
Q

What is apophysitis

A

Enthesitis in a younger child

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15
Q

What is Ehlers-Danlos Syndrome

A

A systemic ligament condition of multiple joint hypermobility

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16
Q

Effects of immobilization on ligamentous structure

A

Ligaments are strain-rate sensitive and will experience rapid deterioration without a load applied with greater than 6-9 weeks resulting in 50% reduction of strength

17
Q

Effects of exercise on ligamentous structure

A

Increase strength and stiffness no more than 10-20%

18
Q

Possible medical management of ligamentous structure

A

Surgery may be possible if: high risk for instability in future, associated lesions, age, type of sprain

19
Q

Why is it important to evaluate a ligament strain immediately after injury?

A

Edema will begin to occur later and it will be hard to accurately assess and diagnose the problem

20
Q

What tests can be done to determine the existence of a ligament sprain?

A

MRI, stress radiographs and arthrograms

21
Q

When is a ligament unstable only in the position of injury

A

When it is only a partial tear of the ligament

22
Q

What are the signs and symptoms of a grade I/mild sprain

A
  • ROM limited in one direction only
  • Pain increases w/AROM & PROM
  • limited bruising
  • localized tenderness over area of injury
23
Q

What are the signs and symptoms of a grade II/moderate sprain

A
  • stress test gives some laxity but not complete
  • dec. ROM, painful, swelling restricts mvmt
  • edema
  • ecchymosis
  • instability with WB
  • more diffusely tender
  • may be other second degree sprains in nearby ligaments
24
Q

What are the signs and symptoms of a grade III/Severe sprain

A
  • significant laxity and abnormal inc. ROM
  • severe swelling
  • ecchymosis or hemarthrosis
  • structural, functional instability
  • less painful than grade II
  • May have second degree sprains in other ligaments
25
Q

What are the effects of aging on ligaments (general)

A
  • less viscous, slower cell metabolic function

- peak just following skeletal maturity

26
Q

Ligaments in middle age

A
  • insertions weaken
  • less structural strength
  • dec. viscosity
  • dec structural length
27
Q

Ligaments and older age

A
  • clinically significant weakness
  • lose water
  • lose mass
  • stiffness

UM - MSK (9 decks)

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