Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
16 Cards in this Set
- Front
- Back
|
What is a tendon?
|
A dense irregularly arranged connective tissue that attaches muscle to bone and has the highest tensile strength of all the connective tissue
|
|
|
Why are tendons so strong?
|
High proportion of collagen T1 that is tightly packed in parallel alignment to the direction of force applied.
|
|
|
Give some points on the structure of tendons
|
Muscle tendon junction
Tendon Bone Insertion Avascular |
|
|
What are Tendons composed of?
|
(Cells) Tenocytes/fibroblasts 20%:80% Water, Collagen T1 (60%) and T3, Ground substance, PGs and HPs
There are more PGs closer to bone insertion |
|
|
Can composition of tendons change?
|
Yes, depending on mechanical adaption and stresses placed in the tissue.
|
|
|
Tendon healing occurs in three processes.
Name them and their duration |
Inflammation 0-7 days
Repair 2-60 days Re-modelling 28-180 days |
|
|
Describe the inflammatory process
|
Inflam cells migrate from epitenious tissues, epi tendon and endotendon to clear up the necrotic tissue
Granulation tissue, haematoma and tissue debris fills the defect Scaffolding formed by matrix proteins |
|
|
Describe the Repair process
|
Tenocyte migrate to zone of insertion and commence synthesis of collagen.
TGF-Beta stimulates collagen T III production and deposition in RANDOM order Intrinsic fibroblast reabsorb collagen and secrete normal type 1 into zone of insertion. HELPS restore Parallel fibre orientation and tensile stability |
|
|
Describe the Re-modelling process
|
Stability=normal use of the tendon
Tensile strength is increased by cross-linking fibrils. Not completely restored Hypercellular defects such as PG increase and thinner collagen fibrils |
|
|
What are acute tendon problems?
|
RC tear - sudden tear when failing onto the arm while is stretched out or after sudden jerking motion when heavy lifting
|
|
|
What are chronic tendon problems?
|
RC tendinitis/impingement syndrome
Tendon fibres spray and become inflamed due to bony surface that tendons cross |
|
|
What causes chronic tendon problems?
|
evnetual wear and tear of the tendon. Over-head work, sleeping on the arm for extended periods of time
|
|
|
Describe partial and full tears
|
Partial: The tear does not severe the attachment to the bone
Full: Can vary in size but the end result is complete detachment from the bone attachment site. |
|
|
Signs and symptoms of RC tear
|
Acute sudden onset of pain
Made worse when utilizing arm above shoulder level Chronic: Gradual worsening of pain, weakness and loss of motion. Difficult to put a timeline on it Affects sleep, worse at night |
|
|
Treatment of acute tear?
|
1st Conservative
2nd Sub Acromial steroid injection +Surgical repair +Physiotherapy Young but bad tear? Surgery, physio, rehab and NSAIDs Old but bad? Rehab, NSAIDS, Physiotherapy Irreparable? Muscle transfer Physio Debridement |
|
|
Treatment of chronic tear?
|
Conservative measures
Physio SA steroid Surgical |
