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18 Cards in this Set
- Front
- Back
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primary diagnostic imaging test for tendon/ligament injury |
ultrasound |
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advantages of U/S |
1. cost effective ($< MRI and CT) 2. sensitive & specific 3. early detection of lesions 4. early intervention 5. monitor progress of healing
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How does an U/S work? |
it generates high frequency sound waves and records the returning echoes |
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What structures within the body would appear hyperechoic, hypoechoic, and anechoic? |
anechoic (black)= BV
hypoechoic = lesion
hyperechoic (white) = bone, gas |
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describe the penetration and resolution quality of low, mid, and high transducers |
low: excellent P, poor R
mid: good P and R
high: poor P, excellent R |
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what view does an U/S provide you when you orient your probe transverse to the desired region? How about the orientation when probe is longitudinally oriented? |
transverse: cross section of fibers
longitudinal: parallel to fibers |
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what are the basic parameters we evaluate in an ultrasound? |
1. cross sectional area (increased?) 2. echogenicity (on transverse) 3. fiber pattern (on longitudinal) |
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MRI is the common diagnostic modality for what species? what other species can it also be used on? |
humans
small animals and horses |
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advantages and disadvantages of MRI |
adv: nice anatomic detail despite density
dis: high cost, not easily available |
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T/F: an injury response to soft tissue is readily visible on U/S when immediately taken after injury |
FALSE, it takes 4-5 days or so to see a injury response) |
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what are the responses of injured tendon/ligament to acute injury? |
1. fiber disruption due to hemorrhage, edema, fibrolysis 2. inflammatory cells > further fibrolysis 3. compartment syndrome> increased pressure (compression) in confined region >necrosis |
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What repairs do you see during early healing? |
1. granulation tissue replaces fibrin clot 2. type III collagen synthesis -immature -weak to type I -fiber not well aligned w/ longitudinal axis of tendon or ligament |
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after early healing (>6 months), what remodeling responses do you see? |
1. Type I replaces Type III (but some persist) 2. fibers realign along axis |
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what are responses of tendon/ligament to chronic strain injuries |
1. decreased performance 2. mild to moderate chronic lameness 3. local soft tissue fibrosis 4. DJD if joint instability is present 5. calcifications (see mineralization, not a lot of fiber tearing unlike acute) |
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what synovial structure injuries are deemed medical emergencies? and what is their prognosis? |
tendon sheath synovial bursae joint capsule
guarded prognosis |
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what intralesional injections are used and contraindicated for tendon/ligament injuries? |
1. stem cell 2. platelet rich plasma 3. hyaluronic acid 4. GAGs
Corticosteroids contraindicated |
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why is acoustic shock wave therapy used for ligament/tendon injuries? |
it releases kinetic energy at site , altering tissues: -increases cellular permeability -stimulate cellular division -stimulate cytokine production -neovacularization @ tendon-bone junction |
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what types of rehabilitation is recommended for rendon/ligament injuries? when would each type of rehab is appropriate? |
1. complete immobilization (ONLY apply if there's a loss of limb support or severe tear/rupture) 2. passive range of motion (SA patients) 3. controlled exercise program (equine) 4. stall rest (equine) 5. free exercise (contraindicated for >6-7 mo post-injury b/c healing process takes a long time!) |
