MSK

Question 0

the characteristic long fibers are under voluntary control allowing us to do what

Answer 0

contract a muscle and move a joint

Question 1

skeletal muscle contains long organized units called what

Answer 1

muscle fibers

Question 2

MSK consists of what kind of muscles

Answer 2

cardiac

skeletal

smooth

Question 3

what 3 things follow the fibrous partitions between the bundles of muscle

Answer 3

blood vessels

lymphatics

nerves

Question 4

Muscle patterns have fibers that run _____ to the bone, have a _____ shape, or occur in a ______ pattern

Answer 4

parallel

fan

pinnate (uni-, bi-, multi-, circum-)

Question 5

what does pinnate mean

Answer 5

feather like

Question 6

attachment of the muscle occurs at the prox and distal portions of the bundle…this attachement is called a what

Answer 6

tendon

Question 7

what is a tendon

Answer 7

a collection of tough collagenous fibers

Question 8

what is a synovial sheath

Answer 8

a tubular sac surrounding a tendon that has 2 layers

fluid separates the 2 layers of the sheath and occurs in the shoulder, hand, wrist, and ankle

sheath helps significantly with US

Question 9

support and strength of a joint results in part from the ______

Answer 9

ligaments

Question 10

what is a ligament

Answer 10

short bands of tough fibers connect bones to other bones

important for knees, ankles, and shoulders

Question 11

what is a bursa

Answer 11

saclike structure surrounding joints and tendons containing a viscous fluid

Question 12

what are nerves

Answer 12

the conduits for impulses to and from the muscles and central nervous system

Question 13

what parts of the body does MSK deal with

Answer 13

shoulder
elbow
wrist
hip
thigh
ankle

Question 14

what is the gold standard for MSK

Answer 14

MRI

Question 15

what are the 4 types of tendons

Answer 15

biceps
subscapularis
infraspinatus
supraspinatus

Question 16

define location of the biceps

Answer 16

located on the anterior surface of the humerus

Question 17

define location of the subscapularis

Answer 17

located anterior medially on the rotator cuff

Question 18

define location of the infraspinatus

Answer 18

located posteriorly to the shoulder

Question 19

define location of the supraspinatus

Answer 19

abducts the arm at the shoulder

Question 20

acute disease may image a sheath that is ______ than the contained tendon

Answer 20

thicker

Question 21

what are 2 ALWAYS things to do when scanning tendons

Answer 21

image contralateral side for comparison

image 2 planes

Question 22

describe the Achilles’ tendon

Answer 22

tendon of the posterior calf attaching the gastrocnemius and soleus muscle

thickest and strongest tendon

normally 5-7 mm in thickness and 12-15 cm in diameter

Question 23

_______ imaging of the LIGAMENTS is the only method used to image injury

Answer 23

longitudinal

Question 24

why is transverse imaging of ligaments not helpful

Answer 24

because ligament is blending with the surrounding fat

Question 25

______ ligament helps maintain the proper location of the long biceps tendon within the bicipital groove

Answer 25

coracohumeral

Question 26

______ and ______ flexor tendons have a surrounding synovial sheath that allows smooth motion of the pulley system of the hand

Answer 26

superficial and deep

Question 27

what do normal dynamics of the muscle image easily in real time

Answer 27

because contraction of the muscle increases the muscle thickness and hypoechogenicity

Question 28

name a muscle that has echogenic obliquely oriented connective tissue between the muscle bundles

Answer 28

bipennate gastrocnemius muscle

Question 29

what does a small central tendon do

Answer 29

serves as the anchor

Question 30

normal nerves have a _________ appearance when compared with muscle but are _________ to tendons

Answer 30

hyperechoic hypoechoic

Question 31

the longitudinal plane of nerves reveals a ________ pattern with parallel inner linear echoes similar to the tendon

Answer 31

fibrillar

Question 32

in transverse imaging the nerve fibers appear _______ with a _______ perineurium surrounding each fiber

Answer 32

hypoechoic hyperechoic

Question 33

name the upper limb nerves

Answer 33

suprascapular median radial ulnar

Question 34

name the lower limb nerves

Answer 34

sciatic - largest nerve in body | popiteal

Question 35

what is a bursa

Answer 35

small sac between two moving surfaces, usually tendon and bone, in the bursa

Question 36

what are the 2 types of bursa found in the body

Answer 36

communicating noncommunicating

Question 37

what is one bursa communicating bursa seen often which is located in the medial popliteal fossa

Answer 37

baker's cyst - pain in knee o prox calf, swelling

Question 38

any bursa measuring greater than ____ mm is enlarged and needs to be compared with the normal contralateral side2

Answer 38

2

Question 39

sonographic evaluation of MSK

Answer 39

higher frequency transducer unless patient has larger joints positioning of the joint of interest is an IMPORTANT part of the exam place patient is comfortable position that allows for good ergonomics tissue harmonics aid in identifying fluid collection color and power doppler dynamics movements

Question 40

what 2 tendons lack a synovial sheath

Answer 40

achilles and patellar

Question 41

what are indications for shoulder sonography

Answer 41

``` shoulder pain or swelling pain with joint rotation weakness with arm elevation trauma decreased range of motion evaluation of soft tissue masses ```

Question 42

describe rotator cuff

Answer 42

shoulder anatomy is quite complex, with numerous bursa, muscles, and tendons surrounding the joint comparison with the contralateral normal shoulder always is helpful in determining the absence or presence of pathology

Question 43

what exam is used to for the shoulder during ultrasound

Answer 43

13 point shoulder US exam

Question 44

describe shoulder biceps tendon subluxation / dislocation

Answer 44

the dislocation of the biceps tendon from the bicipital groove

Question 45

when small amount of effusion is seen posterior to the tendon it might indicate what

Answer 45

mild tenosynovitis

Question 46

describe rotator cuff tears

Answer 46

biceps tendon rupture, falls, and shoulder dislocations are a few causes of an acute rotator cuff tear

Question 47

describe carpal tunnel

Answer 47

easiest to see in transverse locating the ulnar artery at the wrist crease helps orientation primary entrapment or compression neuropathy of the median nerve

Question 48

indications for wrist sonography

Answer 48

``` masses loss or decrease of digital mobility pain and swelling trauma foreign body location numbness of the middle and index finger weakness or clumsiness of the hand tingling with nerve percussion - Tinel's sign pain w/ wrist flexion when sustained for a min or longer - Phalen's sign ```

Question 49

describe normal achilles' tendon

Answer 49

largest tendon of the body may develop tendinitis AP diameter = 5-6 mm tendon thickens due to inflammation or trauma

Question 50

indications for achilles' tendon sonography

Answer 50

``` abn Thompson test trauma displacement of Kager's fat pad knot or bulge over prox tendon audible pop or snap followed by a sharp pain inability to stand on toes swelling heel pain for more than 4 weeks descreased strength or mobility postoperative monitoring ```

Question 51

describe Thompson test

Answer 51

plantar flexion will not occur with squeezing of calf while patient is kneeling on chair

Question 52

what shape does the achilles' tendon demonstrate in transverse

Answer 52

oval

Question 53

describe tendinitis

Answer 53

MOST COMMON tendon abnormalities is inflammation elasticity loss disease such as rheumatoid arthritis overuse or acute trauma

Question 54

describe anisotropy artifacts

Answer 54

sound beam misses the transducer on the return because of the curve of the structure