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MD - Week 3

Muscle, Tendon & Ligament Pathology

QuestionAnswer
Define Neurogenic Changes To Muscle? Changes due to dysfunction of the nerve supply.
Define Myogenic Changes To Muscle? A primary change in the myofiber.
What Can Cause Injury To The Muscle? -Trauma -Ischaemia (lack of oxygen) -Toxins -Nutritional deficiencies (selenium, vitamin D) -Infections
Define Contusion Inflammation and haematoma formation from blunt, non-penetrating trauma.
Define Strain Physical injury occurring at the myotendinous junction (tendon).
Define Laceration Direct trauma to muscle from a sharp object.
Define Rupture Physical injury caused by active contraction whilst the muscle is passively extended.
Define Contracture State of muscle shortening not caused by contraction (physical injury).
What Is Muscle Atrophy And What Are The Three Forms Of Muscle Atrophy? -A reduction in the diameter of the muscle fibre (and hence size) -Denervation atrophy = neurogenic atrophy, damage to motor units -Disuse atrophy = occurs when muscle stops working -Malnutrition atrophy = muscle proteins metabolised for nutrients
What Is Hypertrophy? An increase in muscle fibre size, can be due to an increase in physiological work, or compensatory.
What Is Congestion? Stasis of blood within the vessels.
What Is Ischaemia? A restriction in the blood supply, can be due to external pressure on the muscle, vascular occlusion, or swelling in a non-expandable compartment.
In What Four Ways Can Myocytes Respond To Muscle Injury? -Degeneration -Necrosis -Regeneration -Repair
What Form Of Necrosis Is The Most Common In Muscle? Segmental necrosis.
What Does Muscle Regeneration Depend On? -Sarcolemmal tube being intact -Basal lamina being intact -Availability of satellite cells
What Is The Function Of Satellite Cells Within Muscle? -Precursors to muscle cells -Quiescent (in dormant state) but can re-enter cell cycle following injury -When diving, will produce a myoblast and satellite cell
Describe The Process Of Muscle Regeneration -Inflammatory stage, neutrophils and macrophages invade area of injury and phagocytose necrotic debris -Satellite cells activate and produce myoblasts -Myoblasts fuse to form myotubes, create scaffold -Fibres grow and differentiate to form sarcomeres
Describe The Process Of Muscle Regeneration By Budding (Occurs When Sarcolemma Is Not Intact) -Myotubes are formed, extend to ends of ruptured sarcolemma -Sarcoplasm buldges, contains muscle giant cells -Myotubes bridge the gap
Define Tendons Attaches muscle to bone.
Define Ligaments Attaches bone to bone, can be peri-articular or intra-articular.
What Are The Functions Of Tendons? -Transmit forces from the muscle to bone -Motor control (mechanoreceptors, golgi tendon organ) -Elastic storage -Supports the limb
What Components Make Up A Tendon? -Water and collagen -Collagen fibres in a crimped pattern, acts to buffer the tendon -Tenocytes -Proteoglycans -Cartilage oligomeric matrix proteins -Elastin -Fibronectin
What Is The Blood Supply Like To A Tendon And Where Is The Blood Supply Most Abundant? -Sparse -Most abundant on the periphery
Define Tendonitis Inflammation of the tendon.
Describe The Process Of Tendon Healing -Defect fills with blood and inflammatory products -Angiogenesis occurs, and fibroblasts enter -Granulation tissue bridges gap -Collagen type III formed -Fibrous bridge forms -Remodelling collagen III, aligning along long axis
What Are The Functions Of Ligaments? -Stabilises the joint -Helps joint glide through the normal range of movement -Prevents excessive movement of joints -Joint proprioception
Define Sprain Stretching or tearing of a ligament.
Define Desmitis Inflammation of the ligament.
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