Tendon injuries Flashcards
What is a musculotendinous junction
An area where the mechanical features of the muscle change into the mechanical features of the tendon
What cells make up tendons
Longitudinal arrangement of cells (tenocytes) and fibres (collagen)
What are collagen bundles covered by
endotenon
What are fascicles covered by
paratenon
What are tendons covered by
epitenon
Describe the blood supply of tendons
Enter through the vincula and a fine network of blood vessels in paratenon
What connects tendons to tendon sheaths
vincula - allow the tendon to move and still supply blood supply
What is the synovial lining in tendon sheaths
There is a synovial lining within all sheaths with fluid which allows for gliding lubrication and nutrition of the tendons
What are pulleys
Thickenings which hold tendons down to the bone
What are the properties of tendons
Flexible and very strong in tension
They need to move to survive as their water content and glycosaminoglycan concentration and strength decreases
What is the tendon most at risk of degeneration
achilles tendon
What happens in degeneration of the achilles tendon
Intrasubstance mucoid degeneration
How does degeneration of the achilles present
swollen, painful, tender but it could be asymptomatic
What do the tendons of extensor pollicis brevis and abductor pollicis longus pass through
Tendon sheath at the radial aspect of the wrist
How does inflammation of tendons present
swollen, marked tenderness , hot and red
What tests positive in a finklestein’s test
Inflammation of a tendon
What is an example of a condition which has inflammation of a tendon
de Quervain’s stenosing tenovaginitis
What is enthesiopathy
Inflammation at the insertion to bone usually muscles or tendons - usually caused by repetitive injury
What is an example of enthesiopathy of muscles and tendons
Lateral humour epicondylitis - tennis elbow
What is an example of enthesiopathy of ligaments
Plantar fasciitis - inflammation of the plantar fascia of the foot
What is an example of a traction apophysitis
Osgood Schlatter’s disease
What happens in Osgood Schlatter’s disease
Insertion of patellar tendon into anterior tibial tuberosity - pain at the tibial tubercle where the patellar tendon inserts onto the tibia - causes swelling at the apophysis
Who is Osgood Schlatter’s disease most commonly found in
Adolescent active boys - not seen in adults once their growth plates have fused
What is the treatment for osgood schlatters disease
rest
What is Avulsion
Pulling off of tendons off bone fragments
What is the most common example of avulsion
Mallet finger - extensor tendon that inserts into dorsum of base of distal phalanx of finger
What happens in mallet finger
The load exceeds the failure strength while the muscle is contracting - forced flexion in an extended finger is a common cause
What is the treatment of avulsion
Depends on the type of avulsion and where
Conservative: mainly used on fingers because retraction of tendon makes this ineffective - Stack splints which hold finger in extension which lets tendon stick back down onto the phalynx
Operative:
- reattach tendon through bone
- Fix the bone fragment that came off
What is a intrasubstance rupture
Load exceeds failure strength which causes tendon rupture
What is the most common tendon location for intrasubstance rupture
Achilles tendon
Intrasubstance rupture - tear
What sports does intrasubstance rupture of achilles (tear) occur in
sports with sprint starts such as sprinting, tennis and squash
What is the test used to test for achilles tendon rupture
Positive simmond’s (squeeze) test
What is the positive simmond’s squeeze test
If someone squeezes the calf muscle, the foot will plantar flex - if the achilles is damaged this will not occur
What is the treatment for a ruptured tendon
Conservative - mobilise or use a splint/cast
Operative - if high risk of rerupture
When is operative treatment done
High risk of rerupture or if the individual does high activity
What is the most common cause of laceration of tendons
accidental cutting of self
What is the most common treatment for lacerations
Immediate repair of the tendons
