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What is anisitrophy

Anisotrophy is the phenomenon of variable tissue reflectivity with changing angle of insonation.
The ability of a substance or material to display different properties depending on the angle of insonation

1

What is a bursa

A bursa is a potential space becoming fluid filled sacs in the presence of pathology

2

What is tendonopathy

A general descriptive term used for a diseased tendon where tendons appear heterogenous and dissimilar to the contra lateral side. On U/S a focal hypoechoic area will be seen in 2 planes

3

Describe a tendon

Composed of parallel running fascicles of collagen fibres which interweave and interconnect producing an echogenic fibrillation pattern on U/S in their long plane.
Tendons are the insertion all portions of muscles.
Tendons are subject to anisitrophy so the angle of incidence must be kept at 90 degrees to the tendon

4

Describe a Ligament

Composed of dense regular connective tissue similar to tendons.
They contain more interweaving collagen fibres than tendons and so are not as fribrillar as tendons.
On U/S short homogenous, hypoechoic bands about 2-3mm thick, applied close to bony contours

5

Describe a Nerve

Nerves are comprised of fascicles of neuronal fibres surrounded by epineurium
- they are less echogenic than tendons and more echogenic than muscle on U/S
In trans they have a dotty echo texture, in long they appear more ribbon like than the fribrillar pattern of tendons

6

What is bone?

Bone is the hard substance mainly composed of calcium that forms the skeleton of the body.
Bones protect and support internal organs.
Muscles pull against bone to make the body move.
Bone marrow in centre of many bones makes and stores red blood cells.

7

What is the enthesis ?

The enthesis is where the tendon attaches to the bone

8

W hat is an osteofibrous tunnel?

A tunnel formed by bone and restrained by ligaments, retinaculum and annular pulleys

9

Describe Gout

Gout is the deposition of uric acid crystals.
Tophi are soft tissue agglomerates commonly found in the foot, elbow and hand

10

Describe muscles

Muscles contain filaments that slide past each other producing a contraction that changes both length and shape of the cell.
On U/S muscles appear hypoechoic with fibroadipose septa of the perimysum seen as hyperechoic lines separating the muscle bundles.

11

What is a bursa?

A bursa is a potential space becoming fluid filled sacs in the prescence of pathology.
They occur in areas where friction may occur and help to reduce this around tendon/ bone, tendon/ tendon interfaces.

12

What is articular cartilage?

Articular cartilage covers the articular surface of bone.
It appears as a hypoechoic homogenous smooth layer overlying the bony contours

13

Where is the sural nerve?

The sural Nerve lies adjacent to the SSV

14

What are Sharpey's fibres?

Sharpeys fibres anchor the periosteum to the cortical bone.
They aid in fracture healing

15

What is a joint?

The junction of two or more bones; an articulation

16

What is a retinaculum?

This is not a muscle but a fibrous band of fascia around tendons that holds them in place. It's function is mainly stabilisation of tendons

17

What is a pulley?

Pulleys are fibrous sheaths which bind the flexor tendons to the bone and prevent bow stringing.

18

Describe an articular capsule

Double layered membrane that surrounds and encloses the joint
Outer layer- dense fibrous connective tissue
Inner layer- synovial membrane .
Synovial fluid nourishes the articular cartilage and lubricates the joint surfaces.
Also acts as a weight bearing element as it keeps the bones of the joints separate

19

Describe skin

Varies in depth between 1.5-4mm and is composed of the dermis and epidermis.
Epidermis- stratified epithelium ( superficial)
Dermis- (deep layer) - thick layer containing large amounts of collagen and a rich network of vessels, lymphatic sand nerve endings.
The dermis also contains sebaceous and sweat glands, hair follicles and erector pili muscles.
Deep to the dermis the subcutaneous tissue lies between the skin and the fascia, it acts as a gliding plane between these structures it also stores fat and participates in temperature control.

20

Name the types of muscle contractions

Isometric- muscle contracts but no change in its length
Isotonic- muscle contracts and simultaneously shortens
Eccentric- muscles contracts and lengthens

21

What is the most common site for muscle pathology

The myotendinous junction is the most common site of partial or complete muscle injury

22

Name the complications of muscle tears

Cysts
Myositis ossificans
Calcific myoneurosis (rare)