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Small Animal Surgery > Muscle & Tendon Injury > Flashcards

Muscle & Tendon Injury Flashcards

1
Q

What are the 4 classification of muscle injuries?

A
  1. contusions - blunt
  2. strains - indirect
  3. lacerations - sharp
  4. musculotendinous - overstretching, strain
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2
Q

What is the difference between sprains and strains?

A

SPRAIN = injures ligaments that connect two bones

STRAIN = injures (stretching, tearing) muscle or the tendon that attaches muscle to bone —> most common at the musculotendinous junction

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3
Q

What muscles are more prone to strains?

A

those that cross over 2+ joints

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4
Q

What are the 3 stages of muscle strain?

A
  1. myositis, bruising
  2. myositis, tearing of fascial sheath
  3. tearing of fascial sheath, muscle fiber disruption, hematoma formation
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5
Q

What are the 2 mechanisms of muscle healing?

A
  1. direct regeneration of myofibrils
  2. fibrous scar tissue formation
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6
Q

What 4 things are required for regeneration of myofibrils?

A
  1. source of myofibroblasts
  2. intact extracellular matrix
  3. adequate vascularization and innervation
  4. limited wound stress
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7
Q

What is the time frame of strain healing?

A
  • immediate hematoma formation
  • 6-12 hr = cellular infiltration and phagocytosis
  • 48 hr = healing by capillary invasion, myoblast proliferation, and myofiber formation
  • 4-6 days = fibroblast formation and scar formation
  • 10 days = new collagen network
  • 14 days = tissue strength rapidly increases

(tendons and ligaments take longer due to decreased vasculature)

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8
Q

What muscles are most commonly affected by Stage I and II strains?

A

power muscles:

  • triceps
  • biceps femoris
  • quadriceps
  • tensor fascia lata
  • semitendinosus
  • semimembranosus
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9
Q

What muscles are most commonly affected by Stage III strains?

A

secondary muscles

  • long head of triceps
  • gracillis
  • gastrocnemius
  • tensor fascia lata
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10
Q

What treatment is recommended for strains? Advanced stages?

A

early cold compresses, NSAIDs, immobilization

  • eliminate gaps
  • muscle apposition
  • exercise restriction for 12 weeks
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11
Q

What is the most common causes of ruptured long head of triceps and serratus ventralis?

A

racing greyhounds - depression caudal and distal to scapula

dogs and cats - dorsal displacement of scapula

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12
Q

In what breeds is a ruptured gracillius most common? Where does this most commonly occur? What treatment is required?

A
  • racing greyhounds
  • GSDs
  • Foxhounds

musculotendinous junction or origin at the medial thigh

surgery

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13
Q

What is the most common muscle strain? What are the 3 most common signs? What treatment is needed?

A

iliopsoas and pectineus

  1. pain on muscle palpation
  2. lameness
  3. pain on extenion and internal rotation of hip

conservative - rest, NSAIDs, muscle relaxers, rehab

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14
Q

What is muscle contracture? What are 6 causes?

A

abnormal shortening of muscle, making it resistant to stretch due to fibrous CT replacement

  1. compartment syndrome
  2. infection
  3. trauma
  4. repetitive strain
  5. fracture disease
  6. prolonged immobilization
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15
Q

What muscles are most commonly affected by contracture?

A
  • infraspinatus
  • quadriceps
  • gracillis
  • semitendinosus
  • sartorius
  • supraspinatus
  • teres minor
  • iliopsoas
  • brachialis
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16
Q

What breeds are most commonly affected by infraspinatus muscle contracture? What signs are seen?

A

working and athletic dogs —> unilateral

  • forelimb lame 4-6 weeks before contracutre seen
  • advances limb
  • carpal flexation
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17
Q

What is characteristic of infraspinatus muscle contracture? How is it treated?

A
  • shoulder abducted
  • elbow adducted
  • lower limb externally rotated

tendonectomy at insertion

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18
Q

What is the most common cause of quadricepts muscle contracture? What are the 2 most common signs? Treatment?

A

common after fractures. inyoung, growing dogs with poor immobilization or post-op use —> not fixed in a way that causes compression

  1. atrophied muscles
  2. tight band of muscle fused into callus

early rehabilitation (surgical options limited)

19
Q

What breed is most commonly affected by gracillis and semitendinous muscle contracture? What are 4 signs? Treatment?

A

GSDs

  1. limb jerks
  2. hyperflexion of tarsus
  3. internal rotation of metatarsals
  4. firm muscles

conservative

20
Q

What signalment is most commonly associated with flexor carpi ulnaris muscle contracture? What sign is seen? Treatment?

A

puppies 6-24 weeks old

carpus is flexed and unable to be extended

limited activity, support bandages over 2-3 weeks

21
Q

What is myositis ossificans? What are the 2 most common causes? Treatment?

A

heterotrophic bone formation in muscle

  1. trauma
  2. dogs with VWD - microhemorrhage, chronic inflammation

surgical removal - recurrence common

22
Q

What is responsible for tendon healing? What are paratendons? Why is it so slow?

A

fibroblasts to produce new collagen

vascular buds and undifferentiated cells from surrounding tissues (gastrocnemius, triceps)

sheathed and avascular —> especially digital tendons, no gaps!

23
Q

What is most important for tendon healing? When is limited exercise started?

A

tensile strength

6 weeks —> typically reaches original strength by 1 year

24
Q

What kind of suture is used for tendon repair? What 2 patterns are used?

A

monofilament synthetic long-term absorbable or non-absorbable

  1. Krachow locking loop - flat tendons, lessens likelihood of pullout
  2. 3 loop pulley - round tendons, enhances grip and purchase
25
Q

What treatment is recommended for severed digital flexor tendons?

A
  • flexion bandage/splint for 6 weeks
  • normal weight bearing for the next 6 weeks

surgery not usually necessary

26
Q

What are the 2 most common causes of biceps tendon injury? What does it result in? In what dogs is it most common?

A

rupture, tenosynovitis (guide dog harness, incidental)

medial displacement of tendon causing medial movement on flexion —> required surgery

  • racing Greyhounds
  • Poodles
  • Border Collie
27
Q

What signalment is most commonly associated with long digital extensor tendon injury? What sign is most common? Treatment?

A

immature large breed dogs

lameness with swelling at tendon

surgical correction

28
Q

How are tendon injuries diagnosed?

A
  • swelling and pain on palpation
  • instability on manipulation
29
Q

How are stifle ligament tears diagnosed?

A
  • standard radiographs
  • stress radiographs
  • GA for opening of joint space and comparison to contralateral side
30
Q

What are the 3 classifications of ligament sprains? What treatment is recommended for each?

A

FIRST DEGREE = mild, few fibers damaged, hematoma, edema, stable —> conservative

SECOND DEGREE = moderate, more fibers torn, ligament stretched, partial instability —> conservative or surgery

THIRD DEGREE = severe, completely torn, severe swelling, extremely unstable —> surgery

31
Q

What conservative treatment is used for ligament sprains?

A
  • activity restriction for 3-6 weeks
  • cold-hot packs
  • immobilization
32
Q

What are 6 important aspects to the surgical treatment of ligament sprains?

A
  1. exploration
  2. suture plication to stretch ligament tighter
  3. suture ligament
  4. reattach to bone
  5. protect with an internal sling
  6. post-op immobilization with a splint or external fixator
33
Q

What sutures are used for collateral ligament repair? What needs to be maintained?

A

non-absorbable —> screws and tunnel

center or rotation

34
Q

What length of joint immobilization if recommended for collateral ligament repair?

A

as short as possible, usually 3-4 weeks, with a cast, splint, or transarticular external fixator

  • 6 week maximum for tendon repair
35
Q

What is thermology/gram/graphy?

A

study of heat

map of temperature distributions in structures or regions

use of thermograms to study heat distribution in structures or regions

36
Q

What is medical infrared imaging / digital infrared thermal imaging? What is it dependent on?

A

deriving diagnostic indications from highly detailed and sensitive infrared images of the body

skin temperature —> sympathetic control of cutaneous perfusion and its response to pathology anywhere in the body

37
Q

Visible light vs. infrared light:

A
38
Q

Who developed the first thermoscope? When was the first thermal image taken? What veterinary species first used it?

A

Galileo Galilei

1948 —> took 40 mins

equine medicine

39
Q

What technology is used to make thermographs?

A

liquid crystal thermography system

  • focal array detector
  • high speed image acquisition
  • improved spatial resolution
40
Q

How has thermal imaging been used in human medicine?

A
  • breast cancer
  • burn patients
  • rheumatology
  • vascular disorders
  • inflammatory disorders
  • radiculopathies
  • IVDD
  • Chiari malformation
  • polygraph testing
41
Q

How has thermography been used for breast cancer in humans?

A

picks up recruitment of blood vessels much sooner than mammograms

  • up to 6 years earlier
42
Q

How are thermograms assessed?

A
  • average temperature over the ROI (regions of interest)
  • pattern analysis - visual vs. image recognition analysis
43
Q

How is medical infrared imaging commonly used for in veterinary medicine?

A

orthopedic, neurologic, and oncologic conditions

  • add in image recognition software for greater specificity
44
Q

What future studies may medical infrared imaging be used for?

A
  • KCS
  • acupuncture
  • tens therapy
  • cryotherapy
  • aquatherapy
  • skin graft viability
  • cancer detection

Small Animal Surgery (34 decks)

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