SPPC: Musculoskeletal Ultrasound

Réussis tes devoirs et examens dès maintenant avec Quizwiz!

A basic shoulder exam consists of _____ images.

11

What should the AP measurement of the Achilles tendon be?

5-6 mm

Where is the carpal tunnel located?

Between the carpal bones and the flexor retinaculum on the palmar side of the wrist

What MSK structures are typically included in a shoulder ultrasound?

Biceps tendon Subscapularis Supraspinatus Intraspinatus Teres minor

What is the sac-like structure that surrounds the joints and tendons, containing a viscous fluid?

Bursa

Where do you scan for the Achilles tendon?

From the gastroc/soleal muscles all the way down to the calcaneus

The Achilles tendon connects the ________________ and ________________ muscles to the ______________.

Gastrocnemius and soleal muscles to the calcaneus (2/3 from gastroc, 1/3 from soleal)

What is the tunnel on the ulnar side of the wrist that often compresses the ulnar nerve?

Guyons canal

How is the patient positioned for a carpal tunnel exam?

Hand palm side up; sometimes helpful to roll up a towel to place under the wrist to place joint in a neutral position

What must we do to try and correct for anisotrophy?

Heel/toe probe to create a 90 degree angle as best we can

What type of transducer is used to scan MSK?

High frequency linear

In transverse, how do the nerve fibers appear sonographically?

Hypoechoic with a hyperechoic perineurium surrounding each fiber; the collagenous epineurium (outer layer of nerve) appears as a hyperechoic layer.

How do we want the patient positioned for an MSK ultrasound?

In a comfortable position where the joint is positioned properly for dynamic examination

When is comet tail artifact often seen in MSK?

In post-op patients who have metal pins or hardware that is placed close together

What would the abnormal appearance of the nerves be in a patient with carpal tunnel/carpal tunnel syndrome?

Large, flattened nerves

___________________ are short bands of tough fibers that connect bones to other bones.

Ligaments

Which MSK structures have the most pronounced problem with anisotrophy?

Tendons

Are tendons vascular or avascular?

Relatively avascular

If a tendon does not have a synovial sheath, what surrounds them?

The paratenon and the epitendineum

The ___________ plays an important role in imaging tendons with sonography.

Sheath

What are some common MSK exams?

Shoulder for rotator cuff Wrist for carpal tunnel Achilles tendon for tear Tendinitis (multiple sites) Biceps tendon

Where do synovial sheaths usually occur?

Shoulder, hand, wrist and ankle

Tendons are a tough bundle of _____________ tissue.

Fibrous

What are the three shapes that muscles can have?

1. Fibers that run parallel to the bone 2. Fan shape 3. Pennate pattern

What is the epitendineum?

A layer of dense connective tissue that surrounds the paratenon of the tendon without a sheath

What is the paratenon?

A layer of fat and loose connective tissue that surrounds a tendon absent of the sheath

What does anisotrophy create?

A loss of definition

What is the synovial sheath?

A tubular sac-like structure that has two layers separated by fluid

What is the largest tendon in the body?

Achilles

What does the bursa do?

Aids in reduction of friction between two musculoskeletal structures

What is Phalen's sign?

An increase in wrist compression due to hyperflexion of the wrist. Place hands top sides together, fingers toward floor and compress for 60 seconds. A positive test produces numbness, tingling, or other change of sensation in the hands.

The angle and direction of the reflected beam depend on the __________________________________.

Angle of incidence

What artifact occurs when the sound beam misses the transducer on the return because of the curve of the structure?

Anisotrophy

Tendons are either cordlike, or flat sheets called __________________.

Aponeuroses

Attachment of muscles occurs where?

At the proximal and distal portions of the bundle

What is another term to describe refractile shadowing?

Edge artifact

True or False: Tendons have to have a synovial sheath.

False; Tendons can be present with or without a synovial sheath

Nerve fibers are arranged into bundles called _______________.

Fasciculi

What does the carpal tunnel contain?

Median nerve Flexor policis ongis 8 flexor digitorum tendons

Tendons connect _____________ to ________________.

Muscle to bone

Time of flight artifact happens commonly in MSK when imaging patients with a __________________ interface.

Muscle/fat

Elements of the nerve include what?

Nerve fibers surrounded by sheets of myelin

Does the Achilles tendon have a synovial sheath?

No; it is surrounded by paratenon and epitendineum

What is Tinel's sign?

Pins and needles type tingling felt distal to a percussion site

What is Thompson's test and what is it assessing?

Plantar flexion with squeezing of the calf; tests integrity of Achilles tendon

Does the Achilles tendon have a good or poor blood supply?

Poor; heals slowly

How should a patient be positioned for an Achilles tendon exam?

Prone with foot hanging over edge of bed; if they can't lie prone, put them on their side

What artifact occurs when returning sound waves have traveled between two tissues with markedly different speeds?

Time of flight artifact

What is the purpose of the sheets of myelin surrounding nerve fibers?

To insulate and protect

True or False: For many exams, you will be moving the joint to confirm structures or injuries

True

The lack of ________________ in tendons lends itself to slow healing.

Vascularity


Ensembles d'études connexes

Texas Real Estate Commission Duties and Powers

View Set

chapter 30 Alexander the Great and his Empire for Alan

View Set

Abeka 7th Grade: Of People Reading Quiz M

View Set