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25 Cards in this Set
- Front
- Back
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what is a tendon |
Dense,regularly arranged tissue that attaches muscle to bone |
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what tissue has the highest tensile strength of all connective tissue |
tendons....duuh |
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what substance is there a high proportion of in tendons |
collagen |
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how is the collagen in tendons arranged |
Closely packed parallel arrangement in direction of force |
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what are the 3 components of tendon structure |
tendon bone insertion muscle-tendon junction |
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what term can be used to describe the vascularisation of tendons |
it is sparsely vascularised |
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break down the components of a tendon by % and list the individual substances in each component |
-70% H20 -30% solids - collagen type I and III - ground substance - elastin
cellular (20%) - fibroblasts/tenocytes extracellular (80%) |
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what are the 2 types of tendon healing |
intrinsic and extrinsic |
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what are the 3 phrases of healing and how long do they each take |
Inflammation - (day 0-7) Repair - (day 3-60) Remodelling - (day 28-180) |
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what cytokines and other mediators are involved in tendon healing |
– PDGF (Chemotaxis) |
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what controls chemotaxis (delivery of cells to healing site) in tendon repair |
PDGF |
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what controls what type of collagen is made in the tendon during repair |
TGFß (transforming growth factor btw...) |
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what are the stages that occur in the tendon repair inflammatory phase |
Inflammatory cells migrate from: Defect is rapidly filled with granulation tissue, haematoma and tissue debris Matrix proteins laid down as scaffolding for collagen synthesis |
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why are matrix proteins laid down in the tendon repair inflammatory phase |
they are laid down as scaffolding for collagen synthesis |
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in the tendon repair inflammatory phase where do the inflammatory cells actually migrate from |
– Epitendinous tissues (sheath, periosteum, soft tissues) – Epitendon and endotendon |
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during the tendon repair stage, what cells are recruited, what do they do and on what day do they arrive? |
-fibroblasts and tenocytes migrate to the zone of injury -they begin to synthesise collagen type III -they do this by day 5 |
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what type of collagen is initially laid down in tendon repair and in what pattern is it laid? |
-collagen type III is laid down -it is laid in a haphazard pattern |
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during the tendon repair stage, what type of fibroblasts take over in the 4th week and what do they do |
INTRINSIC fibroblasts take over the healing process by both synthesising and reabsorbing collagen
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during the tendon repair stage, the tendon is increasingly orientated along the line of force, what other big change takes place in terms of collagen fibres? |
change from type III to type I collagen |
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in tendon repair stage, how does vascular ingrowth occur? |
via collagen/fibroconnectin scaffolding |
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what happens during the remodelling stage of tendon repair |
this phase is acquired through normal every day use of the tendon cross linking between fibrils further increasing tendon tensile strength |
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complete regeneration of the tendon is never achieved, why is this |
– Defect remains hyper cellular (excess no of cells) |
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in patient rehab, what can controlled mobilisation prevent in patients |
Early controlled mobilisation can: |
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what effect will excessive loading have on scar tissue |
it will disrupt the repair tissue |
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what conditions would require optimal healing for tendons |
– Surgical apposition and mechanical stabilisation – Minimal soft tissue damage |
