Tendons, ligaments + muscles Flashcards
What do tendons do?
*Transfer force generated by muscle to bony attachments
*Support joints
*Store energy
What do ligaments do?
*Attach / stabilise bones/joints
*Protect tendons
*Proprioception
What type of collagen are tendons?
*95% collagen type I
*1-5% type III
What type of collagen are ligaments?
*90% collagen type I
*10% type III
What type of injuries can occur to tendons/ligaments?
*Extrinsic - external trauma (laceration)
*Intrinsic - overload / degenerative
*Intrasynovial / extrasynovial
*Extensor vs Flexor tendon
How are tendon / ligament injuries diagnosed?
*History - age, type, previous injury, recent exercise, wound / laceration
*Clinical exam - stance / gait, palpation
*Diagnostic imaging - ultrasound, radiography, MRI
What should be assessed with ultrasound in tendon / ligament disorders?
*Change in cross sectional area
*Fibre echogenicity
*Margination
*Position - rupture
*Focal lesion vs generalised changes
*Acute vs chronic changes
*Blood flow to assess neovascularisation
What are the clinical signs of acute inflammatory phase of tendon / ligament injury?
*Lameness
*Pain on palpation
*Heat
*Swelling
What is the pathology of acute inflammatory phase of tendon / ligament injury?
*Haemorrhage
*Inflammation
-neutrophils
-macrophages + monocytes
-oedema
-proteolytic enzymes
What are the treatment principles of acute inflammatory phase of tendon / ligament injury?
*Limit inflammation - cold therapy / NSAIDs
*Protect limb / reduce further damage - supporting bandage / rest
What are the clinical signs of proliferative phase of tendon / ligament injury?
*Reduction / absence of lameness
*Resolution of signs of inflammation
*Tendon still palpably enlarged
*signs of re-injury if exercised too early
What is the pathology of proliferative phase of tendon / ligament injury?
*Angiogenesis
*Fibroplasia
What are the treatment principles of proliferative phase of tendon / ligament injury?
*Promote angiogenesis
*Minimise formation of excessive scar tissue
*Early exercise if lesion filled in
What are the clinical signs of tissue modelling phase of tendon / ligament injury?
*Stiffer / thicker tendon
What is the pathology of tissue modelling phase of tendon / ligament injury?
*Fibrosis
*Gradual change from collagen III to I
What are the treatment principles of tissue modelling phase of tendon / ligament injury?
*increased loading + exercise programme
*Improve fitness
*Monitor progress by repeat ultrasound exam