Tendon Insertion And their Clinical syndrome Flashcards
Some conditions
Biceps tendonitis
Distal Biceps tendonitis
Tennis elbow
Biceps tendonitis
Golfers elbow
Supraspinatus tendonitis
Jumpers knees
How does the skeleton stay up
Ligament, tendons, muscles
Anatomy of a tendon or ligament
• Attach muscle to bone
• Composed of fascicles
• Separated by endotenon
• Surrounded by epitenon
Microstructure Of tendon
• Fibroblasts arranged in parallel rows (fibrils)
• Secrete Type 1 collagen (85% dry weight)
• Dense, regularly arranged tissues
Biomechanics
Strong in tension only
Can sustain 5-10% tensile strain before failure
Viscoelastic structure combines two different properties.
The term “viscous” implies that they deform slowly when exposed to an external force.
The term “elastic” implies that once a deforming force has been removed the material will return to its original configuration.
Tendons vs ligament
• Tendons connect muscles to bones
◦ Each end of a muscle there is a tendon which connects the muscle to the bones
◦ Tendons only stretch a bit
◦ Transmit forces from the muscle to the bones
◦ E.g. biceps contraction the force is transmitted to the humerus and the forearm
and results in elbow flexion
• Ligaments made of same material as tendons connect
bones to each other
◦ Help stabilise joints
◦ They have a limited stretching ability and thus limit how much a joint moves,
and protects against injury
◦ Eg elbow joint ligaments prevent instability and ensure pain free movement
• Tendons connect muscles to bones
◦ Each end of a muscle there is a tendon which connects the muscle to the bones
◦ Tendons only stretch a bit
◦ Transmit forces from the muscle to the bones
◦ E.g. biceps contraction the force is
transmitted to the humerus and the forearm and results in elbow flexion
• Ligaments made of same
material as tendons connect
bones to each other
◦ Help stabilise joints
◦ They have a limited stretching ability and thus
limit how much a joint moves, and protects
against injury
◦ Eg elbow joint ligaments prevent instability
and ensure pain free movement
What is the place where a tendon or ligament Meets the bone called?
Enthesis/ entheses
Tendon rupture vs Bone avulsion
• Depends on speed of injury
• Fast - tendon ruptures
• Slow – bone avulses
Trauma
Trauma
Often insidious
Lifting heavy weights
Overuse
Falls
Leads to inflammation of rotator cuff tendons
Inflammation of subacromial bursa
Swelling of subacromial bursa
Pain on movement of the arm especially away from side called impingement
Vascular reaction to tendinitis
Attempts at repair
Neoangiogenesis, the development of new blood vessels from a pre-existing vasculature
Causes congestion and pain
Degeneration
• Tendon degenerates
• ‘Mesenchymal
syndrome’
• Minute tears
• Fibrocartilaginous metaplasia
• Calcification
• ‘Critical zones’
Critical zone
• Area of poor blood supply
• Under surface of tendon as it inserts
• Tears occur here
Supraspinatus tendon rupture
• Inserts onto greater tuberosity
• Allows abduction of the shoulder
• Often occurs in aged tendons
• Weak shoulder abduction
• Unable to keep arm in space
• Drop arm sign
