Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Tendon
1. TENDON
BY Dr Vyshnav Srinivasan
JUNIOR RESIDENT
DEPT OF ORTHOPAEDICS
RLJH TAMAKA KOLAR
2. LESSON PLAN
• Name of the lecturer: Dr Vyshnav Srinivasan
• Date: 15.09.2020
• Time: 8mins
• Subject: Orthopaedics
• Topic: TENDON
3. Specific learning objectives
• At the end of the class, every one should be
able to know
• Structure of tendon
• Tendon substance
• Peritendonous structures
• Muscle tendon junction
• Tendon insertion into bone
4. INTRODUCTION
• It is a specialized musculoskeletal dense fibrous tissue.
• It have major role in providing the stability and mobility
of musculoskeletal system.
• They get inserted into bone and their ability is to resist
large tensile load with minimal deformation.
• Tendon transmit muscle force to bone that produce joint
movements.
• Disease or injuries to it can destabilize joints or leads to
loss of muscle function.
5. STRUCTURE
• It consist highly oriented dense fibrous tissue.
• High degree matrix organization and density of
matrix distinguish these tissue from irregular dense
fibrous tissue and loose fibrous tissue.
longitudinal section
transverse section
6. • Tendon consist of three parts,
* Substance of tendon itself
* The muscle tendon junction (MYOTENDINOUS JUNCTION)
* Bone insertion (ENTHESIS)
7. • Connective tissue surrounding tendon allow low friction
gliding and access for blood vessels to the tendon
substance.
• Mesotendon attaches the tendon to the surrounding
connective tissue and consists of loose elastic connective
that can stretch and recoil with the tendon and provide
blood supply to tendon substance.
8. TENDON SUBSTANCE
Multiple fascicles or bundles, consisting of
fibroblast and dense linear array of collagen fibrils
forms tendon substance.
*Collagen molecule is about 300nm long, 1-2nm
wide, and diameter of fibrils range from 50-500nm.
*Fibrils then assemble to form fascicles, which are
about 10mm in length with diameter of 50-300µm.
*Tendon fibre with a diameter of 100-500µm.
9. • Endotendon - a less dense connective tissue
containing fibroblast, blood vessels, nerve, and
lymphatics.
• Endotendon tissue continues to form epitenon, a
thin layer of connective tissue that covers surface of
tendon.
• Fibrous tissue of the epitenon continues as thin
fibrous covering of attached muscle called the
epimysium.
10.
11. MUSCLE TENDON JUNCTION
• Muscle-tendon junctions must efficiently transmit
the force of muscle contraction to the tendon.
• The attachment occurs through continuation of the
collagen fibrils of the fibrous tissue layer of muscle
into the collagen fibrils of the tendon.
12.
13. • Inter digitaion of muscle cells and tendon has the
appearance of interlocking fingers when examined by
electron microscopy.
• It provides a strong bond between muscle and
tendon.
14. PERITENDONOUS STRUCTURES
• Normal tendon gliding, efficient transmission of
muscle forces to move joints and tendon nutrition,
depends on the peritendonous connective tissue
structures called PERITENON.
• It consists of an interlacing meshwork of thin
collagen fibrils and elastic fibers filled with abundant
soft, almost fluid ground substance.
• Where tendon change course between their muscle
attachment and their bone insertion, the
surrounding connective tissue may form a bursa or a
discrete tendon sheath.
15. • Tendon sheaths and bursa resembles synovial joint
and consist of cavities lined with synovial-like cells,
they contain synovial-like fluid, and facilitate low
friction gliding between two surfaces.
16. • COMPOSITION
* Fibroblast forms the predominant cell.
* Fibroblast surrounds themselves with a dense
fibrous tissue matrix and throughout life continue to
maintain the matrix.
* Younger tissue have higher cell density and
cells with a larger cytoplasmic volume.
* With increasing age, the cell density usually
decreases and cells appear to become less active.
17. MATRIX
• Tissue fluid contributes
60% of the wet weight
of most dense fibrous
tissue.
• Macromolecules
contribute 40%.
Components
60-85% collagen
*60-80% collagen 1
*0-10% collagen 3
*2% collagen 4
*Small amounts of collagen 5,6 and
others.
15-40% non-collagenous
extracellular matrix.
*3%cartilage oligomeric matrix
protein,
18. *1-2% elastin
*1-5% proteoglycans
* 0.2% inorganic components such
as copper, manganese and calcium.
Major GAG components of tendon are dermatan
sulfate and chondroitin sulfate, which associate
with collagen and are involved in the fibril assembly
process during tendon development.
19.
20. INSERTION INTO BONE
• DIRECT INSERTION:
Most of the collagen fibrils at the insertion pass
directly from substance of the tendon into bone cortex,
usually entering at a right angle to bone surface.
Deeper collagen fibers that enter the bone pass
through four zones of increasing stiffness.
The substance of dense fibrous tissue structure,
fibrocartilage, mineralised fibrocartilage and bone
22. • INDIRECT INSERTION
It covers more bone surface area and large
proportion of collagen fibrils join periosteum.
It has superficial and deep collagen fibrils, but
most of their collagen fibrils form the superficial layer
that joins the fibrous layers of periosteum.
23. • BLOOD SUPPLY
Vascular system follows the longitudinal pattern of
the collagenous matrix, also have multiple anastamoses
between parallel vessels. Some blood vessels in tendon
enter the bone.
24. • Nerve supply
It has specialised nerve endings that lie on the
surface or within the substance of the tissue.
It function as pain receptors, vasomotor efferents,
and mechanoreceptors sensitive to stretching or
distortion.
