Limbs and back week 2 Flashcards
briefly describe tendons
dense regularly arranged tissue that attach muscle to bone
highest tensile strength of all connective tissue
high proportion of collagen
closely packed parallel arranged in direction of force
Describe the composition of tendons
dense connective tissue (parallel fibres of collagen I)
sparsely vascularised
cellular (fibroblasts / tenocytes ) - 20%
Extracellular (80%) 70% water, 30% solids - collagen I, ground substance, elastin, collagen III
What is the origin and insertion of the supraspinatous muscle?
supraspinous fossa
greater tubercle
What is the function of the supraspinatous?
assists in the abduction of the nerve
What is the innervation of the supraspinatous?
supra scapular nerve
What is the origin and insertion of teres minor?
axillary border
greater tubercle
What is the function of teres minor?
external rotation
What is the innervation of theres minor?
axillary nerve
What is the origin and insertion of infraspinatous?
infraspinatous border
greater tubercle
What is the function of the infraspinatous?
external rotation
What is the innervation of infraspinatous?
supra scapular nerve
What is the origin and insertion of subscapularis?
sub scapular fossa
lesser tubercle
What is the function of subscapularis?
internal roation
What is the innervation of subscapularis?
supra-scapular nerve
What are risk factors associated with tendon injuries?
older age
attrition (wear and tear)
bone spurs
acromion shape
tendonopathy leading to tears
trauma (mostly acute)
genetic
What are the two types of tendon injury?
acute and chronic
What tests can be used to assess the supraspinatous?
ROM - forward elevation / abduction
Strength - arms out in scapular plane - don’t let me push your arms down
What tests can be used to examine infraspinatous and teres minor?
ROM - external rotation with elbow at side
Strength - arms tucked in and resisted external rotation
What tests can be used to examine subscapularis?
ROM - thumb behind back
Strength - belly press / push off behind back
What are non-operative treatment options for rotator cuff tears?
physiotherapy
injection (steroid / local anaesthetic ) for pain
analgesia
What are surgical treatment options for rotator cuff tears?
repair tendon to bone - arthroscopic / open surgery
platelet rich plasma injection?
What is involved in the physiotherapy treatment of rotator cuff tears?
early controlled mobilisation
what are the joints of the shoulder?
glen-humeral joint
accromio-clavicular joint
What are the roots of the axillary nerve?
C5 and C6
What muscles are innervated by the axillary nerve?
teres minor and deltoid
What are the roots of the musculocutaneous nerve?
C5, C6, C7
What muscles are innervated by the musculocutaneous nerve?
coracobrachialis, brachial, biceps bracchi
What are the roots of the radial nerve?
C5, C6, C7, C8, T1
What muscles are innervated by the radial nerve?
triceps brachia, extensor and supinator muscles
What are the roots of the ulnar nerve?
(C7) C8, T1
What muscles are innervated by the ulnar nerve?
antebrachial, hypothenar, deep intrinsic muscles of the hand
What are the roots for the median nerve?
C6, C7, C8, T1
What muscles are innervated by the median nerve
ante brachial, thenar muscles, some lumbricles
What are the 3 layers of blood vessels?
tunica intima, tunica media, tunica adventitia
Describe the tunica intima
a single layer of squamous epithelium
provides a smooth, friction-reducing lining for the vessel
Describe the tunica media
smooth muscle, connective tissue (elastic fibres)
vasoconstriction and vasodilation to control BP
Describe the tunica externa
made of fibrous connective tissue
protective and supporting layer
Describe anastmoses
arterioles communicating with another form anastomoses
anatomical - circle of Willis in the brain
functional - mesenteric vessels of the GI tract
Describe collateral circulation
enlargement of vascular results in collateral circulation
small arteries anastomose more frequently and can result in extensive networks allowing ongoing perfusion
name peripheral pulses
temporal
carotid
brachial
popliteal
dorsalis
posterior tibial
Give examples of some non-modifiable risk factors for atherosclerosis
increasing age
male sex
family history
Give examples of some modifiable risk factors for atherosclerosis
hyperlipidaemia
hypertension
smoking
diabetes
obesity
What is an aneurism?
localised dilation of the affected artery over 50% normal diameter
What are some causes of aneurism?
atherosclerotic
congenital
post-stenotic
traumatic
inflammatory
mycotic
What is an embolism?
the blockage of a blood vessel by solid, liquid, or gas at a site distant from its origin
Describe the triple helix structure of collagen
3 polypeptide chains
each chain is a polipropine helix
each chain folds into triple helix
each chain has a repeating glycine-X-Y residue
Describe collagen maturation
formation of collagen alpha chain in the ER
3 come together, spontaneously form triple helix
moved to golgi
pumped out into the extracellular space
proteins interact to form fibrils - aggregates
larger than the cells that secreted them
What are the most common results of sport injuries?
fractures and dislocations
major muscle - ligament - tendon injuries
head and spinal injuries
chest and abdominal injuries
