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Case 1 > Principles of Tendon and Ligament Biology > Flashcards

Principles of Tendon and Ligament Biology Flashcards

1
Q

What are tendons and liagements

A

Dense, fibrous connective tissue

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2
Q

What is the role of Type 1 collagen

A

It provides high tensile strength

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3
Q

What does the fact that tendons and liagements are viscoelastic mean

A

They respond a different way depending on the force/ speed of movement

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4
Q

What does the crimping in tendon tissue mean

A

You are able to apply a lot of stress to a tendon without it rupturing

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5
Q

In tendons and ligaments what provides a failsafe mechanism

A

Fasciles

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6
Q

What does the fact that tendons and ligaments are not passive structures mean

A

They respond to mechanical loading and exercise

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7
Q

What are living cells in tendons called

A

Fibrblasts

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8
Q

What do fibroblasts do

A

Look after and produce ECM

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9
Q

How do fibroblasts communcate

A

Via gap junctions

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10
Q

How to fibroblasts detect and respond to mechanical loading

A

By increasing the amount of collagen

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11
Q

Why do athletes have larger tendons

A

Because of their constant, long-term commitment

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12
Q

What happens to tendons in cases of immobalisation

A

They become thinner and weaker. In long term recovery form casting it is essential in the beginning to improve motility before exerting force in order to regain controlled passive movement.

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13
Q

Why are tendons an essential component of the musculoskeletal system

A

They transfer force from muscle to bone to generate movement

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14
Q

Where do tendons attach

A

They extend from myotendinous junction (MTJ) to enthesis (osteotendinous junction)

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15
Q

What do tendons do

A

Enable the muscle bulk to be distant from the site of action, reduce bulk and occupy narrow spaces

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16
Q

What kind of movement do tendons enable

A

Proportionate movement

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17
Q

What does tendons reinforcing/ replacing joint capsules do

A

Help to stabilise joints in the shoulder and proximal interphalangeal joints

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18
Q

What does the fact that tendons have an elastic nature mean

A

They can harness energy in locomotion and add this energy to subsequent action meaning that movement is economical

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19
Q

Where do ligaments attach

A

Bone to bone (one enthesis to another)

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20
Q

What do ligaments do

A

Guide and limit joint movements by limiting allowable movements and prohibiting unwanted movements

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21
Q

What can ligaments be

A

Separate, accessory or capsule thickenings. Sometimes ligaments become part of the joint capsule

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22
Q

Where have proproception-mechanoreceptors been identified

A

In the shoulder, knee and ankle joints (and overlying cutaneous layer)

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23
Q

What hold tendons in place

A

Retinaculae

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24
Q

What do retinacular in digits do and what happens if they rupure

A

Ensure the tendon runs close to the bone, if they ruprue bowstringing occurs.

25
Q

What makes up myotendinous junctions and what do they do

A

Made up by ligaments. They transfer force from the muscle to the tendon.

26
Q

What is the key feature of the end of a muscle before it attaches it connective tissue

A

It is high invaginated

27
Q

What does invagination do

A

Increase the surface area for attachment

28
Q

Why are myotendious junctions highly adapted to transfre force

A

The muscle is high invaginated before it attaches to the connective tissue

29
Q

What are muscles that cross 2 joints called

A

Biarticular

30
Q

What are muscles tears the occurs at the MTJ typical of

A

Eccentric contraction

31
Q

What shape are flexor tendons and why

A

Round/oval which is characteristic of tendons in the palm of the hand to enable tendons to glide smoothly resulting in less friction

32
Q

What shape are extensor tendons and why

A

Flattened to prevent sublaxation (means tendons go over the top of the knuckle when you make a fist and don’t fall out of place

33
Q

What is present between tendons

A

Connective tissue

34
Q

What are the clinical characteristic of chronic tendinopathy

A

> 3 months, pain, impaired activity and stiffness, increased tendon thickness, may lead to partial/ total rupture, tendinitis-inflammation

35
Q

Histological observations during surgical interventions in chronic tendinopathy

A

No inflammatory cells, instead get disordered collagen and fatty deposits resulting in degeneration. During the initial stages inflammation may be present

36
Q

In scans what does a healthy tendon look like

A

Bright white

37
Q

In scans what does a pathological tendon look like

A

Brown and thickened or yellow due to calcification

38
Q

What is used to test for a torn Achilles tendon and what means the Achilles is ruptured

A

The Thompson test. No movement= Achilles ruptured

39
Q

Describe tendon rupture

A

Spontaneous rupture is most commonly observed during sporting activities, especially during eccentric contraction. Before a rupture a patient is asymptomatic. During a rupture there is pain, sudden popping, bruising and a little bleeding.

40
Q

Under histological examination what do most tendons sow

A

Degeneration within several cm above and below the rupture

41
Q

What are entheses

A

Attachments of tendons or ligaments to bone

42
Q

What are entheses prone to

A

Pathology

43
Q

What are examples of enthesopathies

A

Tennis elbow, heel spurs, Os-good Schlatters disease, spondylarthropathies

44
Q

What is Os-good Schlatters disease

A

Inflammation at the attachment site of the tibia

45
Q

What is ankylosing spondylitis

A

Ossification of enthesis resulting in decreased movement (back, rib expansion, neck) and effects the vertebral column as well as other regions resulting in pain and limited movement

46
Q

What is the primary target organ of ankylosing spondylitis

A

Enthesis

47
Q

Who does ankylosing spondylitis effect

A

Males when they are around 25 years old

48
Q

What are the two types of entheses

A

Fibrous and fibrocartilaginous

49
Q

What are fibrocartilaginous entheses

A

Where the tendon attaches to the end of a long bone or short bone of the hands or feet

50
Q

Which type of entheses are much more prone to pathologies

A

Fibricartilaginous

51
Q

What is the function of fibrocartilaginous entheses

A

They enable gradual bending meaning that the fiber isn’t focused at the tissue interface resulting in decreased fraying and dissapation of stress away from the tissue interface

52
Q

What is the smooth front of a fibrocartilaginous enthesis made of and what is its function

A

It is a calcium front and the smooth front strengthens and prevents movement.

53
Q

What does the fact that the fibrocartilaginous enthesis is high invaginated mean

A

`The surface area is increased and therefore a stronger attachment site is formed

54
Q

What does the strength of the fibrocartilaginous enthesis mean

A

You are more likely for the bone attachment to break off from the rest of the bone than the fibrocartilaginous enthesis to rupture

55
Q

Why does degeneration of the fibrocartilaginous enthesis occur in golfers/ tennis elbow

A

It is due to repeated loading

56
Q

What are tendons called when they change the direction of the muscle they pull

A

‘wrap around regions’ or ‘gliding regions’

57
Q

What do the wrap around pulleys of tendons do

A

Generate movement

58
Q

What is an important functional adaptation that takes place in ‘wrap around regions’

A

The area adjacent to the bone becomes compressed and therefore cartilaginous type tissue which resists compression (tendon undergoes metaplasia- changing tissue type)

59
Q

Why are tendons in the foot a common injury site in runners

A

Due to degeneration of tendons

Case 1 (10 decks)

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