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MSK Week 5 2017/18 > 11: Tendon problems > Flashcards

11: Tendon problems Flashcards

(57 cards)

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1
Q

30% of MSK consultations are ___ related.

A

tendon

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2
Q

Tendon problems tend to be (chronic / self-limiting).

A

self-limiting

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3
Q

What is tendinopathy?

A

General term for disease of a tendon

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4
Q

What is tendonitis?

A

Inflammation of a tendon

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5
Q

What is tendonosis?

A

Chronic disease which has damaged a tendon’s ECM

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6
Q

What is tenosynovitis?

A

Inflammation of a tendon sheath

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7
Q

What is enthesopathy?

A

Inflammation of a tendon’s ORIGIN or INSERTION

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8
Q

Many tendon problems don’t show any inflammation on histology. What type of disease refers to this?

What are two examples?

A

Tendinopathy

Tennis and golfer’s elbow

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9
Q

What structures link the origins and insertions of tendons and ligaments?

A

Entheses

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10
Q

What are some types of drug which are known to cause tendinopathy?

A

Steroids

Antibiotics

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11
Q

What components of tendons degenerate in tendinosis?

A

Collagen

ECM

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12
Q

Which enzymes are responsible for the breakdown of tendon ECM in tendonosis?

A

Matrix metalloproteinases

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13
Q

Tendonosis occurs at areas of (good / poor) blood supply.

A

poor blood supply

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14
Q

What are the conservative options for treating tendinopathy?

A

Rest

Physiotherapy

Analgesia , NSAIDs

Injections (be very careful where you do this)

Splinting

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15
Q

What is debridement?

A

Removal of diseased tissue from a wound

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16
Q

What shoulder pathologies is decompression carried out for?

A

Supraspinatus tendonitis

Subacromial compression

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17
Q

What is synovectomy, and in which upper limb disease would it be considered?

A

Removal of inflamed synovium

Wrist RA where there is a risk of tendon rupture

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18
Q

Which tendons are often considered for tendon replacement surgery?

A

Tibialis posterior

Extensor pollicis longus

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19
Q

What is the most common rotator cuff tendinopathy?

A

Supraspinatus tendonitis

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20
Q

Who tends to get rotator cuff tendinopathies?

A

Athletes (particularly throwing events)

Manual workers (e.g painters)

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21
Q

What are the symptoms of rotator cuff tendinopathy?

A

Achy pain in arm

Difficulty sleeping, reaching, raising arm

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22
Q

What are the clinical signs of rotator cuff tendinopathy?

A

Painful arc

+ve Hawkins-Kennedy test

+ve Jobe’s test

+ve Scarf test

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23
Q

How may rotator cuff tendinopathy be treated conservatively?

And surgically?

Study These Flashcards
A

Physiotherapy, analgesia, steroid injections

Subacromial decompression

24
Q

What is the insertion of the short head of biceps brachii?

Study These Flashcards
A

Coracoid process of scapula

25
What is the **insertion** of the long head of biceps brachii?
**Supraglenoid tubercle** **of scapula**
26
What is the distal attachment of the short head of biceps brachii?
**Radial tuberosity**
27
What is the distal attachment of the long head of biceps brachi?
**Bicipital aponeurosis of ulna**
28
How does biceps brachii tendinopathy present clinically?
**Anterior shoulder pain radiating to elbow**
29
What movements exacerbate the pain of biceps brachii tendinopathy?
**Shoulder flexion** **Elbow flexion** **Forearm pronation**
30
What are some distinct signs of biceps brachii rupture?
**Bruising** **Popeye sign**
31
Biceps brachii tendinopathy is managed ___ or \_\_\_.
**conservatively** or **surgically**
32
What is **lateral epicondylitis**? Where does it occur? Is it inflammatory?
**Tennis elbow** **Extensor origin of elbow** **No** (yet -itis for some reason)
33
When is pain felt for patients with **lateral epicondylitis**?
**Extension of middle finger**
34
What is **medial epicondylitis**? Where does it occur? Is it inflammatory?
**Golfer's elbow** **Flexor origin of elbow** No
35
What is **De Quervain's tenosynovitis**? Which tendons are involved?
Inflammation of tendons of thumb ## Footnote **Abductor pollicis longus** **Extensor pollicis brevis**
36
Where is the pain of **De Quervain's tenosynovitis** felt?
**Styloid process of radius**
37
What is the specific clinical test for **De Quervain's tenosynovitis**? How is it carried out?
**Finklestein's test** 1. Thumb in fist 2. Adduct hand 3. Pain!
38
What is a hand complication of rheumatoid arthritis?
**Extensor tendon rupture**
39
What are the main symptoms of extensor tendon rupture?
**Extensor weakness** **Dropped finger** (perma-flex)
40
What is the management required to prevent extensor tendon rupture secondary to RA?
**1. RA treatment!!!** **2. Synovectomy**
41
If extensor tendon rupture secondary to RA has already occurred, what surgical intervention can help restore function?
**Tendon transfer**
42
Which tendon becomes inflamed and caught on the tendon sheath in trigger finger?
**Flexor digitorum superficialis**
43
How is trigger finger treated?
**Observation** **+/- Injection** **+/- Surgical release** (division of A1 pulley)
44
What aspects of the extensor mechanism of the knee can rupture?
**Quadriceps tendon** **Patellar tendon**
45
What is the broad name for the group of diseases including Osgood-Schlatter syndrome?
**Traction apophysitis**
46
Should steroid injections be used for quadriceps, patellar or Achilles tendon ruptures?
**Nooooo**
47
What are some clinical findings of someone with a tendinopathy related to the extensor mechanism of the knee?
**Palpable gap** or **swelling** **Inability to straight leg raise** **Patella** may be displaced superiorly or inferiorly
48
How does a ruptured tendon appear on ultrasound or MRI?
**White blurry mess**
49
What is the only option for treating extensor mechanism ruptures?
**Surgical repair**
50
Osgood-Schlatter disease involves the ___ \_\_\_ at its insertion on the ___ \_\_\_.
**patellar tendon** **tibial tuberosity**
51
Who tends to get Osgood-Schlatter disease?
**Young, active boys**
52
What is left on the tibial tubercle after Osgood-Schlatter disease has resolved?
Bony lump - normal
53
What may rupture following a sudden deceleration in sports like squash or running?
**Achilles tendon**
54
What other risk factors exist for Achilles tendon rupture?
**RA** **Steroid use** **Achilles tendonitis**
55
Achilles tendonitis patients will have difficulty ___ the foot.
**plantarflexing**
56
What are the conservative and surgical options for Achilles tendon rupture?
**Conservative** - plaster splinting **Surgical** - tendon repair
57
Which tendon, responsible for maintaining the medial arch of the foot, may rupture following tenosynovitis?
**Tibialis posterior**

MSK Week 5 2017/18 (12 decks)

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