MSK Flashcards
(173 cards)
1
Q
tendons are
A
bundles of collagen fibres
2
Q
bundles of collagen fibres
A
tendons
3
Q
tendons attach
A
muscle to bone
4
Q
tendons facilitate
A
flexion + extension
5
Q
sono appearance of tendons LAX
A
fibrillar pattern, hyperechoic strands interspersed with hypo connective tissue. tightly bound linear band of hyperechoic strands.
6
Q
sono appearance of tendons SAX
A
hyperechoic, finely punctate foci, round oval or flattened
7
Q
tendon echogenicity is highly dependent on
A
angle of insonation
8
Q
false appearance of tendon pathology is due to
A
anisotropy
9
Q
two types of fibrous sheaths
A
synovial, paratenon/peritenon
10
Q
synovial fibrous sheaths
A
wrap around tendon to decrease friction
11
Q
synovial fibrous sheaths secrete
A
synovial fluid
12
Q
loose connective tissue
A
paratenon/peritenon fibrous sheath
13
Q
achilles and patellar tendons are
A
paratenon/peritenon fibrous sheath
14
Q
don’t have synovial fluid
A
paratenon/peritenon fibrous sheath
15
Q
sono appearance of fibrous sheath
A
thin hypo area surrounding tendon
16
Q
synovial lined pouches
A
bursa
17
Q
bursa produces
A
synovial fluid
18
Q
bursa are located at
A
high friction points
19
Q
high friction points
A
where muscles + tendons are required to slip through/under/around opposing structure
20
Q
high friction points in body
A
rotator cuff - humeral head, clavicle, (sub-deltoid bursa)
21
Q
sono appearance of bursa
A
hypo, flattened, difficult to id on ultrasound
22
Q
sensory and motor function
A
nerves
23
Q
sono appearance of nerves LAX
A
railroad, fasicular appearance, hypo fibres, divided by hyper perineuron (connective tissue)
24
Q
sono appearance of nerves SAX
A
honeycomb pattern, circular nerve fibre surrounded by hyper connective tissue
25
attach bone to bone
ligaments
26
provide stability and strength
ligaments
27
composed of collagen
ligaments
28
ligaments are ___ than tendons
smaller
29
U/S assessment of bone
superficial surface only
30
bone surface irregularity
arthritis
31
functions like shock absorber
cartilage
32
location of hyaline cartilage
terminal ends of bones in any joint
33
sono appearance of cartilage
hypo, well-defined, smooth, non-compressible
34
skeletal striated muscle
muscle
35
contract and relax (extend)
muscle
36
sono appearance of muscle
hypoechoic tissue, hyperechoic fibres
37
most common joint evaluated by US
shoulder
38
bones of shoulder (4)
humerus, scapula, coracoid process, acromion process
39
bony protrusions from scapula
coracoid process, acromion process
40
tendons of shoulder
biceps, subscapularis, supraspinatus, infraspinatus, teres minor
41
strong flexor/extender of arm + elbow
biceps tendon
42
biceps tendon sits in
bicipital groove, between lesser and greater tuberosity
43
biceps tendon lies anterior to
humerus
44
scanning position for biceps tendon
arm neutral, elbow bent at 90 degrees
45
subluxation
tendon slips out of groove -LAT or MED to groove
46
beak-shaped tendon in shoulder
subscapularis
47
subscapularis arises from
underside of scapula
48
subscapularis attaches to
lesser tuberosity
49
scanning position for subscapularis
arm in external rotation
50
probe position for subscapularis
TRV
51
for subscapularis TRV on pt =
long axis on tendon
52
2 images of subscapularis
coracoid (origin), insertion
53
internal + external rotation of arm to assess
subscapularis dynamic performance, r/o impingement
54
assists in abduction of humerus
supraspinatus
55
stabilizes humeral head in glenohumeral joint
supraspinatus
56
supraspinatus sits superior to
humeral head
57
supraspinatus attaches to
greater tuberosity
58
most commonly torn tendon of rotator cuff
supraspinatus - 95%
59
scanning technique for supraspinatus
arm behind back (hyperextended, internally rotated)
60
external rotator of humeral head
infraspinatus
61
abductor of humerus
infraspinatus
62
infraspinatus sits
lateral and posterior to shoulder
63
infraspinatus extends from
scapula to greater tuberosity
64
greater tuberosity sits ___ to lesser tuberosity
lateral
65
scanning technique for infraspinatus
arm across chest "pledge" position
66
adductor of humerus
teres minor
67
greater tuberosity
lateral
68
lesser tuberosity
medial
69
95% of rotator cuff tears
supraspinatus
70
provides stability to glenohumeral joint
teres minor
71
teres minor inserts onto
greater tuberosity (lateral)
72
teres minor scanning position
"pledge" position - arm across chest
73
TRV on body = ___ on teres minor
long axis
74
knee tendons
quadriceps tendon, patellar tendon
75
base of patella is
SUPERIOR
76
Apex of patella is
INFERIOR
77
tendons from all 4 quadricep muscle join together to form the
quadriceps tendon
78
quad tendon is ___ when leg is extended
concave
79
scan quad tendon with leg
flexed
80
quad tendon inserts
base of patella (SUP)
81
quad tendon appears ___ in SAX
oval
82
patellar tendon is actually a
ligament
83
patellar tendon attaches
apex (INF) of patella to tibial tuberosity
84
patellar tendon length
5-6 cm
85
patellar tendon width
2-2.5 cm
86
patellar tendon AP
0.4 - 0.5 cm
87
patellar tendon in SAX appears
convex anteriorly, flattened posteriorly
88
most commonly imaged tendon of ankle
achilles tendon
89
achilles tendon formed by
fusion of aponeuroses of soleus and gastrocnemius muscles
90
achilles tendon inserts on
posterior surface of calcaneus (heel)
91
calcaneus
large bone forming heel
92
to assess the achilles tendon pt is
prone, foot flexed
93
achilles tendon is measured
2-3 cm above insertion
94
normal achilles tendon measurements
12- 15 mm wide
| 5 - 7 mm AP
95
Kager's triangle
fatty, anterior to distal half, variable echogenicity. represents Kager's fat pad.
96
soleus muscle is ANT to
origin
97
most hand/wrist pathology due to
overuse, compression, trauma
98
most common entrapment syndrome
Carpel tunnel syndrome
99
Carpel tunnel syndrome involves
median nerve compression
100
carpel bones
scaphoid, trapezium, trapezoid, lunate, triquetum, pisiform, capitate, hamate
101
thumb side of hand
lateral
102
scaphoid bone is ___
proximal
103
carpel tunnel
space between carpel bones and ligament (flexor retinaculum)
104
flexor retinaculum
arch between two bones sticking up - hamate (pinky), trapezium (thumb)
105
what runs in the carpel tunnel
tendons, median nerve, muscles, vessels
106
median nerve passes through
carpel tunnel
107
median nerve courses
anterior to flexor tendons of 2nd finger
108
hand/wrist scanning position
wrist/hand flat on surface, wrist in supination
109
ulnar artery is what landmark
medial landmark
110
U/S appearance of median nerve
hypo, less echogenic than tendons, honeycomb appearance
111
tears occur when
tendon becomes weak
112
contributing factors to tear
age, calcs - chronic tendonitis, previous injury i.e. partial tear, corticosteroid tx, systemic diseases - arthritis, lupus, diabetes
113
2 categories of tendon tears
complete tears, incomplete
114
complete tears are usually diagnosed
clinically
115
appearance of complete tears
complete disruption of tendon
| gap/defect can be of variable length
116
incomplete tear symptoms
tendonitis
117
appearance of incomplete tear
focal hypoechoic defects in tendon or at attachment
118
U/S appearance of tear anwhere in body
hypo defect, focal thinning, architectural distortion (loss of linear appearance), fluid-filled defects, echogenic deposits (chronic), possible non-visualization of tendon - fully retracted
119
Rotator cuff tears appearance
complete tear with retraction: deltoid muscle sits directly on top of humeral head
120
"cartilage-interface" sign
Rotator cuff complete tear. thin, hyperechoid line at interface between the normally hypo cartilage and abnormally hypo tendon
121
appearance of partial Rotator cuff tear
rim rent sign - focal abnormal echogenicity. focal abn - thin hyper defect in tendon, linear or comma-shaped
122
rotator cuff tears associated findings
joint effusion, irregularity of bone surface, Geyser sign: fluid collection superior of AC joint
123
Geyser sign
fluid collection superior of AC joint. Fluid shoots up into joint space
124
AC joint
acromion- clavicular
125
clinical signs of tear
dull chronic shoulder pain, difficulty sleeping on affected side, inability to lift arm above shoulder
126
tendonitis
inflammation
127
tendonitis is related to
sports, work
128
tendonitis can be
focal, or diffuse
129
tendonitis is
edema of tissue (swelling)
130
chronic tendonitis may have
calcifications
131
most common appearance of tendonitis
thickening of tendon (compare to unaffected side)
132
appearance of tendonitis
thickening, decreased echogenicity, ill-defined margins, hyperemia, +/- calcs (chronic)
133
peritendinitis
inflammation of peritenon
134
inflammation of peritenon
peritendinitis
135
peritendinitis occurs typically in
Achilles tendon
136
peritendinitis
hypoechoic thickening, of connective tissue around the tendon
137
inflammation of tendon sheath
tenosynovitis
138
tenosynovitis usually occurs in
hand, wrist, ankle
139
appearance of tenosynovitis
fluid in sheath id'd
140
Bursitis is due to
trauma, repeated microtrauma
141
appearance of Bursitis
sonolucent collection with ill-defined margins, hypervascular, thickened bursal walls
142
bursa is usually
flattened
143
Bursitis can occur in
sub-deltoid, olecranal, radiohumeral, patellar, calcaneal bursas
144
benign soft tissue tumour
ganglion cyst
145
ganglion cysts can develop in
any joint or tendon sheath
146
ganglion cysts occur most commonly in
hand, wrist
147
U/S appearance of ganglion cysts
cystic mass attached to tendon sheath, oval fluid-filled collection +/- posterior enhancement, may contain debris
148
chronic ganglion cysts will appear
hypoechoic solid tumour (but still actually cystic)
149
popliteal cyst aka
Baker's cyst
150
Baker's cyst
synovial cyst of knee
151
Baker's cyst is
dilated gastrocnemiosemimembranous burse
152
Baker's cyst communicates with
knee joint, at posterior medial aspect of capsule
153
Baker's cysts occur commonly with
rheumatoid arthritis
154
symptoms of a Baker's cyst
can mimic DVT or thrombophlebitis
155
Baker's cyst can
rupture and dissect into calf
156
U/S appearance of Baker's cyst
anechoic, or possible internal echoes (debris, stranding)
157
encroachement of median nerve
Carpel Tunnel syndrome
158
Carpel Tunnel syndrome
encroachement of median nerve
159
Carpel Tunnel syndrome
decrease in size of tunnel or increase in median nerve size
160
Carpel Tunnel syndrome symptoms
pain, tingling, "pins + needles"
161
sono appearance of Carpel Tunnel syndrome
flattening , enlargement, decreased mobility of nerve
162
Carpel Tunnel syndrome measurements
mean CSA at pisiform bone >/= 10 mm ABN
TRV diameter/AP diameter = 4:1 at hamate bone ABN
palmar displacement of flexor retinaculum at level of hamate 3.1 mm = ABN
163
flexor retinaculum
transverse carpal ligament, arches over carpal bones, forming the carpel tunnel
164
benign tumour of tendon sheath
giant cell tumour
165
circumscribed form of synovitis
giant cell tumour
166
giant cell tumour appearance
hypo mass with lobulated contour
167
benign cartilagenous tumour
osteochondroma
168
osteochondroma can develop into
popliteal cyst
169
osteochondroma appearance
hyperechoic area with posterior shadowing
170
benign tumour of adipose tissue
lipoma
171
lipoma characteristics
compressible, mobile, painless, hyper- but can be iso or hypo, depends on surrouding tissues
172
foreign bodies can affect surrounding tissues
edema, abcess, tissue granulation
173
sono appearance of metal
hyperechoic, comet tail, +/- hypo halo
