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ABDOMEN > MSK > Flashcards

MSK Flashcards

1
Q

tendons are

A

bundles of collagen fibres

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2
Q

bundles of collagen fibres

A

tendons

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3
Q

tendons attach

A

muscle to bone

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4
Q

tendons facilitate

A

flexion + extension

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5
Q

sono appearance of tendons LAX

A

fibrillar pattern, hyperechoic strands interspersed with hypo connective tissue. tightly bound linear band of hyperechoic strands.

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6
Q

sono appearance of tendons SAX

A

hyperechoic, finely punctate foci, round oval or flattened

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7
Q

tendon echogenicity is highly dependent on

A

angle of insonation

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8
Q

false appearance of tendon pathology is due to

A

anisotropy

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9
Q

two types of fibrous sheaths

A

synovial, paratenon/peritenon

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10
Q

synovial fibrous sheaths

A

wrap around tendon to decrease friction

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11
Q

synovial fibrous sheaths secrete

A

synovial fluid

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12
Q

loose connective tissue

A

paratenon/peritenon fibrous sheath

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13
Q

achilles and patellar tendons are

A

paratenon/peritenon fibrous sheath

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14
Q

don’t have synovial fluid

A

paratenon/peritenon fibrous sheath

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15
Q

sono appearance of fibrous sheath

A

thin hypo area surrounding tendon

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16
Q

synovial lined pouches

A

bursa

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17
Q

bursa produces

A

synovial fluid

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18
Q

bursa are located at

A

high friction points

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19
Q

high friction points

A

where muscles + tendons are required to slip through/under/around opposing structure

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20
Q

high friction points in body

A

rotator cuff - humeral head, clavicle, (sub-deltoid bursa)

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21
Q

sono appearance of bursa

A

hypo, flattened, difficult to id on ultrasound

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22
Q

sensory and motor function

A

nerves

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23
Q

sono appearance of nerves LAX

A

railroad, fasicular appearance, hypo fibres, divided by hyper perineuron (connective tissue)

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24
Q

sono appearance of nerves SAX

A

honeycomb pattern, circular nerve fibre surrounded by hyper connective tissue

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25
Q

attach bone to bone

A

ligaments

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26
Q

provide stability and strength

A

ligaments

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27
Q

composed of collagen

A

ligaments

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28
Q

ligaments are ___ than tendons

A

smaller

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29
Q

U/S assessment of bone

A

superficial surface only

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30
Q

bone surface irregularity

A

arthritis

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31
Q

functions like shock absorber

A

cartilage

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32
Q

location of hyaline cartilage

A

terminal ends of bones in any joint

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33
Q

sono appearance of cartilage

A

hypo, well-defined, smooth, non-compressible

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34
Q

skeletal striated muscle

A

muscle

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35
Q

contract and relax (extend)

A

muscle

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36
Q

sono appearance of muscle

A

hypoechoic tissue, hyperechoic fibres

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37
Q

most common joint evaluated by US

A

shoulder

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38
Q

bones of shoulder (4)

A

humerus, scapula, coracoid process, acromion process

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39
Q

bony protrusions from scapula

A

coracoid process, acromion process

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40
Q

tendons of shoulder

A

biceps, subscapularis, supraspinatus, infraspinatus, teres minor

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41
Q

strong flexor/extender of arm + elbow

A

biceps tendon

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42
Q

biceps tendon sits in

A

bicipital groove, between lesser and greater tuberosity

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43
Q

biceps tendon lies anterior to

A

humerus

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44
Q

scanning position for biceps tendon

A

arm neutral, elbow bent at 90 degrees

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45
Q

subluxation

A

tendon slips out of groove -LAT or MED to groove

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46
Q

beak-shaped tendon in shoulder

A

subscapularis

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47
Q

subscapularis arises from

A

underside of scapula

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48
Q

subscapularis attaches to

A

lesser tuberosity

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49
Q

scanning position for subscapularis

A

arm in external rotation

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50
Q

probe position for subscapularis

A

TRV

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51
Q

for subscapularis TRV on pt =

A

long axis on tendon

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52
Q

2 images of subscapularis

A

coracoid (origin), insertion

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53
Q

internal + external rotation of arm to assess

A

subscapularis dynamic performance, r/o impingement

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54
Q

assists in abduction of humerus

A

supraspinatus

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55
Q

stabilizes humeral head in glenohumeral joint

A

supraspinatus

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56
Q

supraspinatus sits superior to

A

humeral head

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57
Q

supraspinatus attaches to

A

greater tuberosity

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58
Q

most commonly torn tendon of rotator cuff

A

supraspinatus - 95%

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59
Q

scanning technique for supraspinatus

A

arm behind back (hyperextended, internally rotated)

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60
Q

external rotator of humeral head

A

infraspinatus

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61
Q

abductor of humerus

A

infraspinatus

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62
Q

infraspinatus sits

A

lateral and posterior to shoulder

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63
Q

infraspinatus extends from

A

scapula to greater tuberosity

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64
Q

greater tuberosity sits ___ to lesser tuberosity

A

lateral

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65
Q

scanning technique for infraspinatus

A

arm across chest “pledge” position

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66
Q

adductor of humerus

A

teres minor

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67
Q

greater tuberosity

A

lateral

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68
Q

lesser tuberosity

A

medial

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69
Q

95% of rotator cuff tears

A

supraspinatus

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70
Q

provides stability to glenohumeral joint

A

teres minor

71
Q

teres minor inserts onto

A

greater tuberosity (lateral)

72
Q

teres minor scanning position

A

“pledge” position - arm across chest

73
Q

TRV on body = ___ on teres minor

A

long axis

74
Q

knee tendons

A

quadriceps tendon, patellar tendon

75
Q

base of patella is

A

SUPERIOR

76
Q

Apex of patella is

A

INFERIOR

77
Q

tendons from all 4 quadricep muscle join together to form the

A

quadriceps tendon

78
Q

quad tendon is ___ when leg is extended

A

concave

79
Q

scan quad tendon with leg

A

flexed

80
Q

quad tendon inserts

A

base of patella (SUP)

81
Q

quad tendon appears ___ in SAX

A

oval

82
Q

patellar tendon is actually a

A

ligament

83
Q

patellar tendon attaches

A

apex (INF) of patella to tibial tuberosity

84
Q

patellar tendon length

A

5-6 cm

85
Q

patellar tendon width

A

2-2.5 cm

86
Q

patellar tendon AP

A

0.4 - 0.5 cm

87
Q

patellar tendon in SAX appears

A

convex anteriorly, flattened posteriorly

88
Q

most commonly imaged tendon of ankle

A

achilles tendon

89
Q

achilles tendon formed by

A

fusion of aponeuroses of soleus and gastrocnemius muscles

90
Q

achilles tendon inserts on

A

posterior surface of calcaneus (heel)

91
Q

calcaneus

A

large bone forming heel

92
Q

to assess the achilles tendon pt is

A

prone, foot flexed

93
Q

achilles tendon is measured

A

2-3 cm above insertion

94
Q

normal achilles tendon measurements

A

12- 15 mm wide

5 - 7 mm AP

95
Q

Kager’s triangle

A

fatty, anterior to distal half, variable echogenicity. represents Kager’s fat pad.

96
Q

soleus muscle is ANT to

A

origin

97
Q

most hand/wrist pathology due to

A

overuse, compression, trauma

98
Q

most common entrapment syndrome

A

Carpel tunnel syndrome

99
Q

Carpel tunnel syndrome involves

A

median nerve compression

100
Q

carpel bones

A

scaphoid, trapezium, trapezoid, lunate, triquetum, pisiform, capitate, hamate

101
Q

thumb side of hand

A

lateral

102
Q

scaphoid bone is ___

A

proximal

103
Q

carpel tunnel

A

space between carpel bones and ligament (flexor retinaculum)

104
Q

flexor retinaculum

A

arch between two bones sticking up - hamate (pinky), trapezium (thumb)

105
Q

what runs in the carpel tunnel

A

tendons, median nerve, muscles, vessels

106
Q

median nerve passes through

A

carpel tunnel

107
Q

median nerve courses

A

anterior to flexor tendons of 2nd finger

108
Q

hand/wrist scanning position

A

wrist/hand flat on surface, wrist in supination

109
Q

ulnar artery is what landmark

A

medial landmark

110
Q

U/S appearance of median nerve

A

hypo, less echogenic than tendons, honeycomb appearance

111
Q

tears occur when

A

tendon becomes weak

112
Q

contributing factors to tear

A

age, calcs - chronic tendonitis, previous injury i.e. partial tear, corticosteroid tx, systemic diseases - arthritis, lupus, diabetes

113
Q

2 categories of tendon tears

A

complete tears, incomplete

114
Q

complete tears are usually diagnosed

A

clinically

115
Q

appearance of complete tears

A

complete disruption of tendon

gap/defect can be of variable length

116
Q

incomplete tear symptoms

A

tendonitis

117
Q

appearance of incomplete tear

A

focal hypoechoic defects in tendon or at attachment

118
Q

U/S appearance of tear anwhere in body

A

hypo defect, focal thinning, architectural distortion (loss of linear appearance), fluid-filled defects, echogenic deposits (chronic), possible non-visualization of tendon - fully retracted

119
Q

Rotator cuff tears appearance

A

complete tear with retraction: deltoid muscle sits directly on top of humeral head

120
Q

“cartilage-interface” sign

A

Rotator cuff complete tear. thin, hyperechoid line at interface between the normally hypo cartilage and abnormally hypo tendon

121
Q

appearance of partial Rotator cuff tear

A

rim rent sign - focal abnormal echogenicity. focal abn - thin hyper defect in tendon, linear or comma-shaped

122
Q

rotator cuff tears associated findings

A

joint effusion, irregularity of bone surface, Geyser sign: fluid collection superior of AC joint

123
Q

Geyser sign

A

fluid collection superior of AC joint. Fluid shoots up into joint space

124
Q

AC joint

A

acromion- clavicular

125
Q

clinical signs of tear

A

dull chronic shoulder pain, difficulty sleeping on affected side, inability to lift arm above shoulder

126
Q

tendonitis

A

inflammation

127
Q

tendonitis is related to

A

sports, work

128
Q

tendonitis can be

A

focal, or diffuse

129
Q

tendonitis is

A

edema of tissue (swelling)

130
Q

chronic tendonitis may have

A

calcifications

131
Q

most common appearance of tendonitis

A

thickening of tendon (compare to unaffected side)

132
Q

appearance of tendonitis

A

thickening, decreased echogenicity, ill-defined margins, hyperemia, +/- calcs (chronic)

133
Q

peritendinitis

A

inflammation of peritenon

134
Q

inflammation of peritenon

A

peritendinitis

135
Q

peritendinitis occurs typically in

A

Achilles tendon

136
Q

peritendinitis

A

hypoechoic thickening, of connective tissue around the tendon

137
Q

inflammation of tendon sheath

A

tenosynovitis

138
Q

tenosynovitis usually occurs in

A

hand, wrist, ankle

139
Q

appearance of tenosynovitis

A

fluid in sheath id’d

140
Q

Bursitis is due to

A

trauma, repeated microtrauma

141
Q

appearance of Bursitis

A

sonolucent collection with ill-defined margins, hypervascular, thickened bursal walls

142
Q

bursa is usually

A

flattened

143
Q

Bursitis can occur in

A

sub-deltoid, olecranal, radiohumeral, patellar, calcaneal bursas

144
Q

benign soft tissue tumour

A

ganglion cyst

145
Q

ganglion cysts can develop in

A

any joint or tendon sheath

146
Q

ganglion cysts occur most commonly in

A

hand, wrist

147
Q

U/S appearance of ganglion cysts

A

cystic mass attached to tendon sheath, oval fluid-filled collection +/- posterior enhancement, may contain debris

148
Q

chronic ganglion cysts will appear

A

hypoechoic solid tumour (but still actually cystic)

149
Q

popliteal cyst aka

A

Baker’s cyst

150
Q

Baker’s cyst

A

synovial cyst of knee

151
Q

Baker’s cyst is

A

dilated gastrocnemiosemimembranous burse

152
Q

Baker’s cyst communicates with

A

knee joint, at posterior medial aspect of capsule

153
Q

Baker’s cysts occur commonly with

A

rheumatoid arthritis

154
Q

symptoms of a Baker’s cyst

A

can mimic DVT or thrombophlebitis

155
Q

Baker’s cyst can

A

rupture and dissect into calf

156
Q

U/S appearance of Baker’s cyst

A

anechoic, or possible internal echoes (debris, stranding)

157
Q

encroachement of median nerve

A

Carpel Tunnel syndrome

158
Q

Carpel Tunnel syndrome

A

encroachement of median nerve

159
Q

Carpel Tunnel syndrome

A

decrease in size of tunnel or increase in median nerve size

160
Q

Carpel Tunnel syndrome symptoms

A

pain, tingling, “pins + needles”

161
Q

sono appearance of Carpel Tunnel syndrome

A

flattening , enlargement, decreased mobility of nerve

162
Q

Carpel Tunnel syndrome measurements

A

mean CSA at pisiform bone >/= 10 mm ABN
TRV diameter/AP diameter = 4:1 at hamate bone ABN
palmar displacement of flexor retinaculum at level of hamate 3.1 mm = ABN

163
Q

flexor retinaculum

A

transverse carpal ligament, arches over carpal bones, forming the carpel tunnel

164
Q

benign tumour of tendon sheath

A

giant cell tumour

165
Q

circumscribed form of synovitis

A

giant cell tumour

166
Q

giant cell tumour appearance

A

hypo mass with lobulated contour

167
Q

benign cartilagenous tumour

A

osteochondroma

168
Q

osteochondroma can develop into

A

popliteal cyst

169
Q

osteochondroma appearance

A

hyperechoic area with posterior shadowing

170
Q

benign tumour of adipose tissue

A

lipoma

171
Q

lipoma characteristics

A

compressible, mobile, painless, hyper- but can be iso or hypo, depends on surrouding tissues

172
Q

foreign bodies can affect surrounding tissues

A

edema, abcess, tissue granulation

173
Q

sono appearance of metal

A

hyperechoic, comet tail, +/- hypo halo

ABDOMEN (4 decks)

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