Tendon injuries

Question 1

What is a musculotendinous junction

Answer 1

An area where the mechanical features of the muscle change into the mechanical features of the tendon

Question 2

What cells make up tendons

Answer 2

Longitudinal arrangement of cells (tenocytes) and fibres (collagen)

Question 3

What are collagen bundles covered by

Answer 3

endotenon

Question 4

What are fascicles covered by

Answer 4

paratenon

Question 5

What are tendons covered by

Answer 5

epitenon

Question 6

Describe the blood supply of tendons

Answer 6

Enter through the vincula and a fine network of blood vessels in paratenon

Question 7

What connects tendons to tendon sheaths

Answer 7

vincula - allow the tendon to move and still supply blood supply

Question 8

What is the synovial lining in tendon sheaths

Answer 8

There is a synovial lining within all sheaths with fluid which allows for gliding lubrication and nutrition of the tendons

Question 9

What are pulleys

Answer 9

Thickenings which hold tendons down to the bone

Question 10

What are the properties of tendons

Answer 10

Flexible and very strong in tension
They need to move to survive as their water content and glycosaminoglycan concentration and strength decreases

Question 11

What is the tendon most at risk of degeneration

Answer 11

achilles tendon

Question 12

What happens in degeneration of the achilles tendon

Answer 12

Intrasubstance mucoid degeneration

Question 13

How does degeneration of the achilles present

Answer 13

swollen, painful, tender but it could be asymptomatic

Question 14

What do the tendons of extensor pollicis brevis and abductor pollicis longus pass through

Answer 14

Tendon sheath at the radial aspect of the wrist

Question 15

How does inflammation of tendons present

Answer 15

swollen, marked tenderness , hot and red

Question 16

What tests positive in a finklestein’s test

Answer 16

Inflammation of a tendon

Question 17

What is an example of a condition which has inflammation of a tendon

Answer 17

de Quervain’s stenosing tenovaginitis

Question 18

What is enthesiopathy

Answer 18

Inflammation at the insertion to bone usually muscles or tendons - usually caused by repetitive injury

Question 19

What is an example of enthesiopathy of muscles and tendons

Answer 19

Lateral humour epicondylitis - tennis elbow

Question 20

What is an example of enthesiopathy of ligaments

Answer 20

Plantar fasciitis - inflammation of the plantar fascia of the foot

Question 21

What is an example of a traction apophysitis

Answer 21

Osgood Schlatter’s disease

Question 22

What happens in Osgood Schlatter’s disease

Answer 22

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

Question 23

Who is Osgood Schlatter’s disease most commonly found in

Answer 23

Adolescent active boys - not seen in adults once their growth plates have fused

Question 24

What is the treatment for osgood schlatters disease

Answer 24

rest

Question 25

What is Avulsion

Answer 25

Pulling off of tendons off bone fragments

Question 26

What is the most common example of avulsion

Answer 26

Mallet finger - extensor tendon that inserts into dorsum of base of distal phalanx of finger

Question 27

What happens in mallet finger

Answer 27

The load exceeds the failure strength while the muscle is contracting - forced flexion in an extended finger is a common cause

Question 28

What is the treatment of avulsion

Answer 28

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

Question 29

What is a intrasubstance rupture

Answer 29

Load exceeds failure strength which causes tendon rupture

Question 30

What is the most common tendon location for intrasubstance rupture

Answer 30

Achilles tendon Intrasubstance rupture - tear

Question 31

What sports does intrasubstance rupture of achilles (tear) occur in

Answer 31

sports with sprint starts such as sprinting, tennis and squash

Question 32

What is the test used to test for achilles tendon rupture

Answer 32

Positive simmond's (squeeze) test

Question 33

What is the positive simmond's squeeze test

Answer 33

If someone squeezes the calf muscle, the foot will plantar flex - if the achilles is damaged this will not occur

Question 34

What is the treatment for a ruptured tendon

Answer 34

Conservative - mobilise or use a splint/cast Operative - if high risk of rerupture

Question 35

When is operative treatment done

Answer 35

High risk of rerupture or if the individual does high activity

Question 36

What is the most common cause of laceration of tendons

Answer 36

accidental cutting of self

Question 37

What is the most common treatment for lacerations

Answer 37

Immediate repair of the tendons