Musculoskeletal Growth Injury and Repair – Ligament, Tendon and Bone Flashcards
What are ligaments?
Dense bands of collagenous tissue which span a joint and provide stability
What are ligaments made of?
Type 1 collagen fibres
Fibroblasts
Sensory fibres
Surface vessels
Ligaments are said to have crimping. What does this allow for?
Stretch
->idk think of crimping a pasty allowing it to stretch while cooking in the oven
What is the difference in the composition of tendons and ligaments?
Ligaments have a lower percentage of collagen but higher percentage of water and proteoglycans
Why may ligament ruptures occur?
Force exceeds the strength of the ligament
What is one of the most common sites of a ligament injury?
Ankle joint
Describe the healing process of ligaments.
Initial haematoma
Proliferative phase to produce scar tissue
Remodelling so matrix becomes more ligament like
When would a ligament injury require conservative treatment?
Partial injury
No instability
Poor surgery candidate
When would a ligament injury require operative treatment?
Instability
Expectation of highly functioning ligaments e.g. sportsmen
Compulsory- multiple
->if ligament cannot be repaired, may be replaced, often with tendon taken from the hamstrings.
Which structure is often attached to muscle and comes an a composite unit?
Tendon
Tendons may have a sesamoid bone within the tendon itself. Give an example.
Patella
What do all tendons have?
Some form of tendon sheath
What is the structure of tendon like?
Longitudinal arrangement of tenocytes and type 1 collagen fibres
How does blood supply get into tendons?
Via vincula
How are tendons connected to the tendon sheath?
Via vincula
What holds the tendon to the bone in the fingers?
Strong annular pulleys
What is the function of tendons?
Very strong under tension and flexible- they pull on bones in order to bend joints
What happens if tendons are immobilised for a long period of time?
The water and GAG content falls and reduces strength
Tendons can have problems with degeneration.
Which tendon is known for having problems with degeneration?
Achilles tendon
Sometimes degeneration of the Achilles tendon can be a precursor to what?
Rupture
Which areas of tendon are more likely to degenerate?
Areas with a lower blood supply
Give an example of a common type of tendon inflammation.
De Quervain’s tenosynovitis/tenovaginitis
Which test is used to diagnose de Quervain’s syndrome?
Finklestein’s test
What is enthesiopathy?
Inflammation at the insertion to bone muscle/tendon
->usually at muscle origin rather than tendon insertion
What causes enthesiopathy?
Repetitive movements
->e.g. tennis elbow or lateral humeral spicondylitis
Tennis elbow is a type of enthesiopathy. What type of enthesiopathy is it known as?
Lateral humeral epicondylitis
There can be enthsiopathy at insertion of ligaments. Give an example.
Plantar fasciitis
Osgood Schlatter’s disease is an example of a traction apophysitis injury. What happens here?
The patellar tendon inserts into the anterior tibial tuberosity.
If it pulls on the apophysis rather than the bone, it causes pain and swelling of the apophysis
In which group of people is traction apophysitis like Osgood Schlatter’s disease more common?
Adolescent active boys
What is the management of Osgood Schlatter disease?
If want the pain to stop completely, need to stop the activity causing pain
If want to continue the activity and can put up with the pain, this can be done