Tendon and Ligament Disease and Injury

Question 1

how much of a tendon/ligament is water?

Answer 1

55%

Question 2

what are tenocytes?

Answer 2

specialized elongated fibroblasts that synthesize the extracellular matrix

Question 3

what is the endotenon?

Answer 3

reticular network of connective tissue that surrounds each fiber

Question 4

where are tendon sheaths typically located?

Answer 4

where a tendon makes an abrupt change in course: particularly over a joint

Question 5

where are bursae located?

Answer 5

where tendons or ligaments pass over bony prominences

Question 6

what is crimp?

Answer 6

undulating or wavy pattern of the collagen fibrils
in part responsible for elasticity of tendon

Question 7

what is the ultimate tensile strength?

Answer 7

load at which tendon breaks

Question 8

what are the clinical signs of a repetitive trauma?

Answer 8

pain
heat
swelling

Question 9

when does the subacute/inflammatory stage of healing begin?

Answer 9

with onset of injury

Question 10

what does immobilization help with in the subacute phase?

Answer 10

decreases pain
prevents additional injury
hastens dissipation of inflammatory mediators

Question 11

what does mobilization help with with the muscles?

Answer 11

increases length of stride
increases hind limb propulsion
increases muscle tone

Question 12

what is the main type of collagen in tendons and ligaments?

Answer 12

type I

Question 13

where are rounded cells in tendons and ligaments more common?

Answer 13

damaged areas
more metabolically active

Question 14

what is the paratenon?

Answer 14

loose areolar connective tissue

Question 15

what is the epitenon?

Answer 15

connective tissue sheath containing the tendon’s vascular, lymphatic, and nerve supply that surrounds the whole tendon

Question 16

what is the myotendinous junction?

Answer 16

interdigitation of muscle cell membranes with collagen fibers

Question 17

what is the yield region of a tendon stretching?

Answer 17

irreversible lengthening: cross link rupture and slippage of collagen fibrils
elastic deformation ends and plastic deformation begins

Question 18

what are the causes of pain with repetitive trauma to soft tissues?

Answer 18

matrix changes
vascular changes
tenocyte changes
biochemical changes
ion channel changes

Question 19

how does cold therapy help in the inflammatory phase?

Answer 19

decreases enzymatic activity
reduces formation of inflammatory mediators
slows down nerve conduction

Question 20

what does early mobilization help with with capsules and ligaments?

Answer 20

increase elasticity and tolerance for work
increase proprioception
increase control of movement

Question 21

what does remodeling of a tendon do?

Answer 21

increases type I collagen and helps align fibrils more parallel
scar stronger but less functional
affected by controlled loading

Question 22

how often does collagen turnover occur in a tendon?

Answer 22

about every 6 months

Question 23

temperatures above _________ are known to result in fibroblast death in vitro

Answer 23

42.5 degrees celsius

Question 24

what is released if anti-inflammatory therapy is not initiated in time during the subacute/inflammatory phase?

Answer 24

substantial release of proteolytic enzymes

Question 25

where does reinjury often occur with a tendon injury?

Answer 25

adjacent to original injury where tissue mechanical properties differ