Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK Unit 2 > MSK Week 7 - Ligaments > Flashcards

MSK Week 7 - Ligaments Flashcards

1
Q

Anatomy of ligament

A
  • Epiligament layer
  • Hypocellular: fibroblasts
  • Hypovascular
  • Mechanoreceptors
  • Thickened bands in joint capsule of discrete cords
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are ligaments made up of?

A

Tightly packed bundles of collagen fibers, that are running in parallel, longitudinal to the ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the epiligament layer?

A

Mainly fibroblasts, vascular supply and mechanoreceptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Intraarticular ligaments

A

Within the joint capsules (ACL/PCL of the knee)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Extra articular ligaments

A

Outside the joint capsule (LCL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How are ligaments similar to tendon?

A
  • Collagen fibers in longitudinal bundles with small cross links
  • 70% water
  • 70 - 80% dry weight is type I collagen
  • About 5% elastin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ligament properties

A
  • Resist tensile forces
  • Limit joint excursion
  • Restrain abnormal motions
  • On slack exhibit crimp
  • Viscoelastic properties
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the structural properties of ligaments?

A
  • Connect bones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the motion property of ligaments?

A

Guide joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do ligaments play a proprioceptive role even though they’re “inert”?

A
  • Mechanoreceptors
  • Estrogen receptor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mechanoreceptors

A
  • Reflex arc - synergy with muscle
  • Active and passive stability
  • Functional joint stability - mechanical and sensory characteristics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sprain (injury to ligaments) mechanism of injury

A
  • High force tension - trauma
  • Excess of tensile strain
  • > about 4% collagen disrupted and sub-failure of ligament
  • > about 8% strain —> total failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are contact high force tension?

A

External force

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are non-contact high force tension?

A

Deceleration or rapid direction change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Risk factors of sprains

A
  • Attenuation of forces - recurrent microtrauma
  • Genetic predisposition
  • Inhibition/alteration of reflex arc in associated muscles
  • Hormones
  • Age
  • Disuse —> decrease tensile strength
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ligament phases of healing

A
  • Hemorrhagic
  • Inflammatory
  • Proliferation
  • Remodeling
17
Q

Hemorrhagic phase of healing

A

Hematoma in the gap, inflammatory recruitment

18
Q

Inflammatory phase of healing for ligament

A

Clearance of necrotic tissue, neovascularization, granulation tissue, recruitment of cells

19
Q

Proliferation of ligament phases of healing

A
  • By 1st week, fibroblasts arrive last, begin collagen and other protein production
  • By 2nd week, original clot more organized, capillary buds, collagen content high but disorganized
  • Highest concentration of collagen present
20
Q

Remodeling ligament phases of healing

A
  • Gradual decrease cells, matrix becomes dense and organized
  • Normalize water content and type I:III ratio
  • Up to 3 years, never 100%
  • 5th week - some tensile strength
  • 6 months - 50% strength
  • 1 yr - 80% strength
21
Q

Intraarticular ligament healing

A
  • Encased in synovium
  • Less likely to heal without surgery
  • Does not follow typical triphasic healing and timeframes
  • Blood dissipates into synovium
  • Hematoma prevented
  • Limited arrival of growth factors and cytokines needed to mediate inflammation and healing
22
Q

Extraarticular ligament healing

A
  • Epiligament layer: highly vascular, highly cellular, sensory and proprioceptive nerves
  • Greater likelihood of healing without surgery
  • Follows typical triphasic healing and timeframes
23
Q

Clinical signs of ligament injury

A
  • History of trauma
  • Point tenderness
  • Joint effusion in more severe cases
  • Joint ecchymosis in more severe cases
  • Positive stress tests - joint gapping
  • Imaging - MRI (especially for grading)
  • Graded - 1, 2, 3
24
Q

What are the decisions of management of ligament injury based on?

A
  • Function of the injured ligament
  • Degree of injury
  • Timeframe
25
Q

Protective phase management of ligament injury

A
  • Control of swelling and pain - PRICEMEN
  • Relative rest vs. complete immobilization
  • Submaximal isometrics
  • Pain free ROM (PROM, AAROM, AROM)
26
Q

Controlled motion phase management of ligament injury

A
  • Restore ROM
  • Address kinetic chain
  • Progression of strengthening
  • Stabilization and proprioception (static, supported)
27
Q

Remodeling management of ligament injury

A
  • More advanced stabilization and proprioception (dynamic, complex, unsupported)
  • Restoration of agility, power, speed for return to sport/occupation
28
Q

Medical interventions for ligament injury

A
  • Surgical repair: rehab is protocol driven
  • Biological approaches
29
Q

Growth factors biological approaches

A

Favorably alter healing environment

30
Q

Gene therapy biological approach

A

Introduction of genetically modified cells to enhance healing

MSK Unit 2 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions