MSK Flashcards
Skeletal muscle contains long organized units called
Muscle fibers
Muscles have fibers that either run parallel to bone, fane shape, or ____ pattern
Pennate
Feather-like muscle pattern runs OBLIQUE to long axis of muscle
Pennate
All fascicles are on the same side of the tendon
Unipennate
There are fascicles on both sides of the central tendon
Bipennate
The central tendon branches within a pennate muscle
Multipennate
Convergence of fibers to a central tendon
Circumpennate
Attachment of muscle occurs at proximal and distal portions of bundle; it is a collection of tough collagenous fibers called a ____
Tendon
Connects muscle to bone:
Tendon
Attachments of tendons/muscle are either ____ or _____
Cordlike or flat sheet(anoneuroses)
_____ attachment occurs in flat muscles like the recurs abdominis
Aponeuroses
Insertion of tendon to bone:
Enthesis
Tubular sac surroundings tendon that has 2 layers:
Synovial sheath
_____ is one example of tendon with synovial sheath
Biceps tendon
____ doesn’t have a synovial sheath(it has a fat layer instead), making it harder to image
Achilles
Connect bone to bone
Ligaments
Saclike structure surrounding joints and tendons containing viscous fluid:
Bursa
Purpose of bursa:
Reduce friction
Interwoven and interconnected collagen fibers found in tendon run in a ______ path
Parallel
Avascular structure, 1 cm long, longitudinally appears as triangular hypoechoic area in distal tendon:
Enthesis
Parallel lines, alternating hypoechoic & hyperechoic lines: ____ pattern
Fibrillar pattern
Must scan _____ to tendon
Perpendicular
Artifact that makes tendon look hypoechoic or anechoic
Anisotrophy
Only sonographical difference between ligaments and tendons is; ligament is slightly _____ echogenic than tendon
Less
_____ imaging; Only method used into image injuries
Longitudinal imaging
Cruciate ligament (knee joint) appears _______. Unlike the other ligaments in large joints of the body
Hypoechoic
Proximal portion of muscle:
Origin
Distal end of muscle:
Insertion
Muscle fibers appear sonographically as ____
Hypoechoic
Muscle appears homogeneous with multiple, fine ____ echoes
Parallel
Normal nerve appears sonographically: ______ when compared to muscle, but _____ compared to tendon
Hyperechoic
Hypoechoic
Major bursa of body is bursa found in the ____
Shoulder
Categorizing the bursa is based on relation to joint space:
Communicating or noncommunicating
Communicating bursa that sonographers see is _______ located in the medial _____ fossa
Bakers cyst
Medial popliteal fossa
Example of superficial noncommunicating bursa is the :
Prepatellar bursa
Technique to correct anisotropy:
Heel-toe
Angle and direction of the reflected beam depend on the ____
Angle of incidence
Function of sound bouncing between 2 closely placed reflectors within imaging structure:
Comet tail artifact
bending of transmitted sound beam to an oblique path…results in hypoechoic band posterior to structure—Refractile shadowing is seen as ___ artifact
Edge artifact
Speed of sound within soft tissue ___
1540 m/sec
Time of flight artifact AKA:
Speed of sound
Artifact occurs when retuning sound wave passes between two tissue with different speeds
Time of flight/ Speed of Sound
If speed of sound is less than average in tissue, artifact appears ____
Farther away from transducer
If speed of sound is faster, artifact is _____ to transducer
Closer
Correction technique for reverberation
Use a stand-off pad or find a different acoustic window
Correction technique for refractile artifact
Compound imaging or tissue harmonics
Correction technique for time of flight/speed of sound artifact
Change angle of incidence/find different acoustic window
Position used to image supraspinatus tendon(shoulder)
Crass or Bouffard position
Indications for wrist sonography: tingling with nerve percussion: ____ sign
Tinel sign
Indications for wrist sonography: pain with wrist flexion when sustained for a minute or longer—_____ sign
Phalens sign
Carpal tunnel syndrome affects the _____ nerve
Median
Carpal tunnel syndrome is:
entrapment/compression of the median nerve
Largest tendon in body
Achilles tendon
Plantar flexion with squeezing of the calf. If no movement exam is positive for tendon rupture
Thompson test
What makes healing difficult for Achilles injuries
The lack of blood supply
Most common dislocation is
Deep to subscapularis anterior to glenohumeral joint capsule
Rotator cuff tears are classified as either
Partial-thickness or full-thickness tears
Rotator cuff tear causes: acute:
Biceps tendon rupture
Falls
Shoulder dislocation
Rotator cuff tear: chronic:
Overuse; constantly lifting arms over head—stocking shelves, tennis, swimming, rock climbing
Tear of the rotator cuff that involves the full thickness and width of the tendons
Full thickness tear
Tendinitis more often only occurs in the
Shoulder
Pain of the thumb side of wrist
De Quervains
Creaking sound
Crepitus
Most common pathological condition of muscles of the limbs
Tear
Muscle tear: retracted hyperechoic muscle surrounded by hematoma: _____ sign
Clapper-in-bell sign