Msk Mod. 1

Front 1

synovial joint

Back 1

joint that has a space(synovial cavity) btw articulating bones.

Front 2

synovial fluid
synovial membrane

Back 2

fluid in the synovial cavity which is secreted by the synovial membrane. fluid allows joint to move freely w/ little friction, supplies nutrients to the bone cells, and remeoves waste products.

Front 3

what does articular mean?

Back 3

the face wehre bones touch

Front 4

Articular cartilage

Back 4

type of cartilage along the surface of the bone that touches anther bone. It's smooth, and slippery, and reduces friction.

Front 5

articular capsule

Back 5

surrounds the joint and ecloses it. The capsule has an outer fibrous covering, and an inner synovial lining. THe outer capsule is dense connectve tissuethat attaches to the peristeum of the articulating bones.

Front 6

Ligaments

Back 6

the fibers of some capsules that are arranges in parallel bundles that are adapted to resist strains

Front 7

articular fat pads

Back 7

accumulations of fat in each joint

Front 8

articular discs or menisci

Back 8

pads of fibrocartilage that le btw the bones and are attached to the fibrous capsule

Front 9

Bursae

Back 9

sac-like structures that are situated to reduce frictin with movement

Front 10

tendon sheaths

Back 10

also reduce friction; tube-like bursae that wrap around the tendon

Front 11

Tendon

Back 11

a cord of dense regular connective tissue that attaches a muscle to the periosteum of a bone.

Front 12

Aponeurosis

Back 12

when a connective tissue extends as a broad, flat layer

Front 13

What are the greater and lesser tuberosity?

Back 13

2 parts of the humerus:
greater=posterior
lesser=anterior

Front 14

what are the 4 tendons of the rotator cuff?

Back 14

supraspinatus
infraspinatus
teres minor
subscapularis

Front 15

AC joint

Back 15

acromionclavcular joint

Front 16

where are the acromion and choricoid located?

Back 16

acromion=posterior
choricoid=anteior

Front 17

what is the sonographic appearance of a muscle?

Back 17

mypoechoic w/ hyperechoic striations

Front 18

How does the U/S appearance of a tendon change based on the angle of the beam?

Back 18

-90 degree angle=hyperechoic and homogenous
-not 90 degrees=may have heterogenous and hypoechoic areas mimiking pathology

Front 19

anistropy

Back 19

when a tendon is not scanned at 90 degrees, it may have hypoechoic or heterogenous areas that mimick pathology

Front 20

What frequency transducer is used for scanning MSK?

Back 20

7-12 linear

Front 21

What are some techniques used for MSK scanning?

Back 21

-comparing contralateral sides
-compression to view underlying structures
-color doppler

Front 22

Tendon tear

Back 22

discontinuity of the tendon
hypoechoic area of hemorrhage/fluid

Front 23

How are rotator cuff tears classified?

Back 23

partial thickness tear
full thickness tear
acute
chronic

Front 24

differentiate btw acute and chronic tears

Back 24

acute=bicep tendon rupture, falls, and shourlder dislocations
chronic-cumulative progression of injury. May result form playing tennis, lifting hands above head, swimming, or rock climbing

Front 25

Explain partial thickness tear

Back 25

-begins at the critical zone of the anterolateral supraspinatus tendon and image as focal disruptions of tendon fibers.
-involves bursal, or articular cuff surface, or intrasubstance material.
-Acue=anechoic defect
-Chronic-hyperechoic area from mixing of blood and bursal tissue . Diffuse thinning of tendon also indicates chronic partial thickness tear.

Front 26

critical zone

Back 26

zone located 1 cm to the insertion of the supraspinatus into the greater tuberosity

Front 27

full-thickness tear

Back 27

involves full thickenss and full width of the tendon
-retraction of multiple tendons occurs
-2-4 cm separation btw torn tendon ends
-

Front 28

Name the tendons most suseptible to tears from most frequent to least.

Back 28

Supraspinatus
infraspinatus
subscapularis
teres minor

Front 29

when measuring the length of a tear, which measurement is taken?

Back 29

the largest measurement is used to classify the tear

Front 30

Describe how the length of a tear is used to classify it?

Back 30

-partial thickness
-small full thickness=1-2cm AP over greater tuberosity
-Large full thickness-2-4cm
-complete tears=>4cm

Front 31

How does the compression test help determine if a tear exists

Back 31

Normal=cannot be compressed
Injured tendon=flattens as torn edges move apart

Front 32

Why is it important to compare to the contralateral side?

Back 32

Fatty infiltration of the supraspinatus and intraspinatus fossa changes the echo appearance of this area, giving a false appearance of normalcy. When comparing the contralateral side, the scanner is able to see the difference.

Front 33

What is the double effusion sign?

Back 33

Joint effusion around the biceps tendon combined with SASD bursitis appears as double effusion. This is 95% postive of predictuving retator cuff tear.

Front 34

Tendonitis? What does it look like sonographically?

Back 34

tendon inflammation
SONOGRAPHICALLY:
-hypoechoic thickened toendon
-common in shoulrder, wrist, heel, and elbow
-acute tendonitis(tendosynovitis) involves tendon and surrounding synovial sheath
-fluid within synovial sheath appearing as a halo in trx

Front 35

tendinosis

Back 35

internal tendon degeneration due to an imbalence btw tendon breakdown, and tendon repair. Can result from overuse, injury, or decreased healing response

Front 36

What are some possible pathologies associated with the rotater cuff?

Back 36

Acute/chronic tenonitis
partial/complete tear
effusion

Front 37

What are some possible pathologies associated with the tendons in the elbow?

Back 37

-bursitits
-acute/chronic tendonitits
-effusion

Front 38

What are some possible pathologies associated with the hand/wrist?

Back 38

-acute/chronic tenosynovitis

Front 39

explain some possible pathologies associated with teh knee?

Back 39

-patellar bursitis
-acute/chronic tendinits(patellar)
-partial/complete tear
-baker's cyst
-effusion

Front 40

what are some possible pathologies of the foot/ankle?

Back 40

-calcaneal bursitis
-acute/chronic achilles teninitis
-partial/complete tear(achilles tendon)

Front 41

What are the bones of the hand and wrist from prox to distal?

Back 41

Radius, and ulna
carpals
metacarpals
phalanges

Front 42

What are the bones and tendons of the knee from prox to distal?

Back 42

femur
patella(knee cap)
patellar tendon
tibia/fibula

Front 43

What are the muscles and tendons of the calf and ankle from prox to distal?

Back 43

gastrocnemius
soleus
achilles tendon

Front 44

How does a normal muscle appear sonographically?

Back 44

homogenous with echogenic striations

Front 45

Why is the achilles tendon at an increased risk for injury?

Back 45

because there is a limited blood supply

Front 46

What is the most common sight of an achilles tendon tear, and why?

Back 46

2-6 cm from the calcaneal(distal) because there is decreased blodd flow in that area

Front 47

Where does the infraspinatus tendon lie in realation to the scapular spine?

Back 47

inferior, and latera

Front 48

What tendon is the posterior glenoid a glood landmark to locate? Where is this tendon located in relation to the labrum?

Back 48

infraspinatus tendon is anterior to the posterior labrum.

Front 49

what are the symptoms of a rotator cuff tear?

Back 49

-pain in shoulder and arm, which varies depending on how serious tear is
-weakness and tenderness in the shoulder
-difficulty moving shoulder, esp. wehn trying to lift your arm above your head
-inablity to sleep on the shoulder
-snapping or crackling sounds when moving the shoulder

Front 50

T/F most rotator cuff tears develop suddenly?

Back 50

false-most develop gradually, but they can happen suddenly too--you might feel a pop, intense pain, and weakness of the arm

Front 51

wha tis the sonographic appearance of a rotator cuff tear?

Back 51

-hypoechoic defect in the tendon

Front 52

look at pictures

Back 52

in notes(esp. quizzes), and textbook!!

Front 53

achilles tendon

Back 53

ropelike band of fibrous tissue in the back of the ankle that connects the calf muscles to the calcaneus
-sometimes called heel cord
-largest tendon in the human body
-when the calf muscles contract, achilles tendon is tightened, pulling the heel. This allows you to point your toe, and stand top toed.

Front 54

why is the achilles tendon so vital?

Back 54

-for walking, running and jumping

Front 55

where does a complete tear through the achilles tendon occur?

Back 55

2 inches above the heel bone
-called an achilles tendon rupture

Front 56

what are the causes of the achilles tendon rupture?

Back 56

-can grow weak and thin with age, and lack of use.
-when it is weak, it is prone to injury or rupture
-certain illnesses(arthritis, and diabetes) and medications(corticosteroids, and some antibiotics) can increase risk of rupture
-often occurs in middle-aged male athletes(the weekend warrior who is engaging in a pick up game of basketball)
-injury occurs during sports that require bursts of jumping, pivoting, and running

Front 57

what are the symptoms of achilles tendon rupture?

Back 57

-sudden severe pain at back of ankle or calf(being hit by rock or shot)
-loud pop or snap
-gap/depression seen in tendon about 2 inches above calcaneus
-pain, swelling, and stiffness followed by brusing and weakness
-pain may decrease quickly and smaler tendons may retain the ability to point the toes
-standing tiptoe and pushing off when walking will be impossible
-complete tear is more common than partial tear

Front 58

Tendinosis

Back 58

refers to tiny tears(microtears) in the tissue around the tendon caused by overuse
-usually, achilles tendon pain is the result of tendinosis, not tendinitits

Front 59

what may cause microtears(tendinosis) to occur in the achilles tendon?

Back 59

-overuse or repeated movements(sports, work, or other)
-lots of pushing off or stop-and-go movements, you can get microtears
-can happen w/ a change in how long, hard, or often you exercise
-microtears may not be able to heal quickly or completely

Front 60

what are the symptoms of tendinosis of the achilles tendon?

Back 60

-swelling and mild/severe pain
-gradual, or sudden pain when walking or running
-may have less strength and range of motion in the ankle

Front 61

what is the sonographic appearance of an achilles tendonosis?

Back 61

--increased thickness of tendon
-hypoechoic
-increased vascularity

Front 62

when scanning the rotator cuff, and biceps tendons, what is the optimal patient position?

Back 62

-biceps=sitting
-subscap=sitting, and rotate arm medially, and laterally
-suptraspinatus=sitting, and hand behind back, or on hip
-infraspinatus=sitting, and hand grabbing other wrist.