It works with the extensor digitorum communis to the small finger. The muscle belly is in the forearm. The tendon travels through a tough band or retinaculum at the wrist and then into the hand. It works with other tendons that attach to the dorsum or back of the finger to straighten the three small finger joints. The EIP tendon straightens the index finger.
It works with the extensor digitorum communis to the index finger. It has its own muscle belly in the forearm and then, as it becomes a tendon, it travels through a tough band, or retinaculum, in the wrist.
It travels down the hand and attaches to the back of the index finger to straighten the three index finger joints. The APL tendon runs on the radial side of the wrist the side the thumb is on.
Its muscle belly is in the forearm and then travels inside a tough band, or retinaculum, across the wrist. It attaches to the metacarpal bone of the thumb and helps pull the thumb away from the rest of the hand.
This tendon along with the extensor policies brevis tendon can get inflamed and painful. The FPL tendon bends the thumb. It is unique to humans. It starts as a muscle in the forearm and then travels as a tendon in the wrist through the carpal tunnel. It is then covered by a tunnel, or sheath, and inserts into the most distal farthest from your body bone in the thumb.
The EPL straightens the most distal farthest from your body joint of the thumb. Its muscle belly is in the forearm and the tendon travels along the wrist and enters the third compartment of the band that holds the tendons in position at the wrist.
It then travels around a prominent part of the radius bone that acts like a pulley. The tendon then attaches to the most distal bone in the thumb. The EPB tendon is in the forearm and then runs along the radial side of the wrist.
This tendon also travels in the first compartment of the band that holds the tendons in position at the wrist. The FCR tendon is one of two tendons that bend the wrist. Therefore, they have a white color when compared to the muscles with a much higher blood vessel density.
However, there are a few factors such as the anatomical location, structure, previously damaged condition, and physical activity level of tendons that contribute to blood supply besides the small amount of vascular structure.
There are studies that show that blood flow increases in tendons in the case of increasing physical activity in the literature. There are more vascular tendons due to their anatomical position or shape and function. The flushing of tendons is primarily derived from the synovium at the point of attachment to the bone or paratenon. However, some tendons feed on the tendon like the Achilles tendon and the paratenon structure, and some tendons are fed by a true synovial sheath they are surrounded.
Bone and tendon adhesion is a layer of cartilage where blood flow cannot pass directly from the bone-tendon compound. Instead, they make anastomosis with the veins on the periosteum and make indirect connections [ 16 ]. In contrast, tendons have a very rich neural network and are often innervated from the muscles in which they are associated or from the local cuticle nerves.
However, experimental studies on humans and animals have shown that tendons have different characteristics of nerve endings and mechanoreceptors. They play an important role especially for proprioception position perception and nociception pain perception in joints.
In fact, studies have shown that there is internal growth in the nervous and vascular systems during the healing of tendon, which causes chronic pain. Internal growth of the vein is an indicator of the tendon trying to heal, but because of this growth, nerves may feel pain in areas without pain before. This means that the nerves play an important role not only in the proprioception but also in the nociception. Nerve endings are located below the muscle-tendon junction and typically in the bone-tendon junction in the form of Golgi organs, Pacini bodies, and Ruffini endings.
Of these, the Golgi organs are only mechanically stimulated by pressure and compression, so that they receive information from the power produced by the muscle. Pacinian bodies are rapidly adaptive mechanoreceptors due to nerve endings with a highly sensitive capsular end to deformation, thus dynamically responding to deformation, but are insensitive to constant or stable changes. Ruffin termination results from multiple, thin capsule-tipped, and single axons and has slowly adapting mechanoreceptors and thus continues to receive information until a constant warning level is stimulated during deformation [ 17 ].
The tendons are surrounded by loose, porous connective tissue, which is called paratenon. A complex structure, paratenon, protects the tendon and allows shifting tendon cover format. Tendon sheaths consist of two continuous layers: parietal on the outside and visceral on the inside. The visceral layer is surrounded by synovial cells and produces synovial fluid.
In some tendons, the tendon sheath extends along the tendon, while in others it is found only in the binding parts of the bone. The parietal synovial layer is found only under the paratenon in the body regions where tendons are exposed to high friction.
This is called the epitenon and surrounds the fascicles. In regions where friction is less, tendon is surrounded by paratenon only. At the tendon-bone junction, the collagen fibers of endotenon continue into the bone and become a peritendon. The regions of the tendon bonding to the bone consist of a dense connective tissue, which is able to adhere to the hard bone from the dense connective tissue and is resistant to movement and damage.
Although they occupy a small area in size, the areas of adhesion to the bone have a complex structure that is much different from that of the tendon itself. According to the size of the load they carry, they show a different proportion of collagen bundles [ 18 ]. The tendons cling to the bone is a complex event; collagen fibers mix into fibrocartilage, mineralize, and then merge with the bone.
Sticking to the bone is done in two ways. In the first type, the adhesion of many collagen fibers is direct to the bone, while the second type indirectly adheres to the periosteum. In other words, the tendon is attached to the bone in the form of fibrous or indirect adhesion to the metaphysics and diaphysis of long bones or fibrocartilaginous or direct adhesion to the epiphyses of the bone.
In fibrous adhesions, while the collagen fibers of the tendon are permanently adhered to the periosteum during bone development, fibrocartilaginous adhesions have a gradual transition from tendon to bone. This gradual transition in fibrocartilaginous adhesions includes the tendon, decalcified fibrocartilage, calcified fibrocartilage, and four zones of bone, so that the uniform distribution of the load at the adhesion site and the joint movement and the coordination of the collagen fibers are ensured.
However, changes in the fibrocartilaginous structure due to compressive loading vary depending on the adhesion sites of the tendons. This ensures better protection against compressive forces. The bones of the tendons are composed of four regions within the bone; at the end of the tendon region 1 , collagen fibers enter the fibrocartilage fibrous cartilage—region 2.
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