What do muscles consist of?
long organized units called muscle fibers
What do voluntary controls allow us to do with muscles
What follow the muscle fibers in muscles?
What is the pennate pattern?
appears like a feather
What is bipennate?
What is unipennate?
half a feather
What is multipennate?
What is circumpennate?
What do muscles attach to?
What are tendons made of?
a collection of tough muscle fibers
What is the purpose of a tendon?
attach muscles to bones
what are the two types of tendons?
flat sheets - aponeuroses
What is a flat sheet tendon called?
What is the vascularity of tendons?
What does it mean that tendons are avascular?
What is a ligament?
bind bone to bone
What does a ligament consist of?
short bands of fibrous tissue
What gives the joints strength and support?
Where are ligaments important?
shoulders, knees and ankles
What is Bursa?
saclike structure surrounding joints and tendons
What do bursa contain?
What is the purpose of bursa?
reduce friction between bones
What is bursitis?
Inflammation of the bursa
What causes bursitis?
over use or over activity causes a fluid build up
What are the symptoms of bursitis?
Which joints are affected by bursitis?
joints with the greatest motion
How many bursa are in the knee joint?
6 posterior (popliteal)
What are the purpose of nerves that run through the muscle?
connect the muscle to the CNS
How are the nerve fibers arranged in a muscle?
bundles called fasciculi
What are the fasciculi surrounded by?
dense insulating sheaths of myelin (schwann cells)
Are msucle nerves seen with ultrasound?
What is the tissue called that attached tendons to bones?
Tendons are seen in two forms with ultrasound, what are they?
with and without synovial sheath
How does ultrasound see tendons?
with high res the complete range of motion can be seen
What are some examples of tendons are covered with a synovial sheath?
What are some examples of tendons are NOT covered with a synovial sheath?
WHat is in place of the sheath on the gastrocnemius or achilles tendon?
What is the mother of all imaging?
What helps in making a diagnosis when there is a musculoskeletal problem?
inflammation of the sheath and tendon
What is the sonographic appearance of ligaments?
thin and superficial
large joint ligaments appear as hyper echoic straplike structures
How do the cruciate ligaments of the knee appear with ultrasound?
ligaments are difficult to view with ultrasound. What can be done to help?
use of a stand-off pad
What tranducer should be ised on ligaments?
10 MHz or higher
What is the sonographic appearance of muscles?
Main portions of the muscle fibers are hypoechoic - radiate toward central tendon
connective tissue fascia surrounds fibers and is echogenic
What surrounds the muscle fiber
connective tissue fascia
What is the sonographic appearance of a connective tissue fascia?
What is the sonographic appearance of muscle in athletes?
hypoechoic due to hypertrophy
What is the sonographic appearance of sustained contraction of muscles?
same as an athletes
What are the artifacts seen when examining muscles?
time of flight artifact
What is anisotropy?
when returning sound beam misses the transducer caused by a curved reflector
What does anisotropy affect?
What are the indications for a shoulder sono?
pain with joint rotation
weakness with arm elevation
decreased range of motion
evaluation of soft tissue masses
What musculoskeletal ultrasound areas are viewed well with ultrasound?
What is a distraction tear?
occur as a result of stretching beyond maximum limit
What are the two types of muscle tears?
distraction tear (indirect)
compression tear (direct)
WHat is a compression tear
occurs due to a crushing blow (blunt trauma)
What are some examples of people that would get a distraction tear?
What are the two types of compression tears?
What is the sonographic appearance of a complete tear?
clapper in bell sign
How does the clapper in bell sign appear?
What is the sonographic appearance of a partial tear?
partial disturbance at the end
Difficult to differentiate
What is tendonitis?
inflammation of a tendon
What is the diagnosis of an achilles tendon injury dependent on?
What is the thompson test?
person on hands and knees
dr. squeezes calf
foot should move
* no movement means archilles is injured
What is the A.P. measurement of thearchcilles tendon?
5 - 6 mm
What does the rotator cuff consist of?
Where is the infraspinatus?
Where is the subscapularis?
Where is the supraspinatus?
Where is the teres minor?
Tendons usually tear at the ________?
Who has the highest risk of injury to the achilles tendon?
athletes that wear high heals
Where is the origin of the achilles tendon?
Where is the insertion of the achilles tendon?
What is the function of the achilles tendon?
stand on tippy toe
What happens to old people and the achilles tendon?
increased risk of injury
longer to repair
What is achilles tendinitis?
painful inflammatory condition
WHat is the sonographic appearance of achilles tendinitis?
halo around tendon
What is DeQuervains tendonitis?
painful condition affecting the tendons on the thumb side of your wrist
What is crepitus?
What is carpel tunnel?
repetitive stress disorder
tendon enlarges and squeezes median nerve
How many nerve fibers are in the medium nerve?
explain the anatomy of the wrist?
transverse carpel ligament
median nerve running perpendicular
9 flexor tendons
8 carpel bones
What are the symptoms of carpel tunnel?
minor - tingling