The plantar fascia is the thick connective tissue which supports the arch on the bottom of the foot. It runs from the tuberosity of the calcaneus forward to the heads of the metatarsal bones; the plantar fascia is a broad structure that spans between the medial calcaneal tubercle and the proximal phalanges of the toes. Recent studies suggest that the plantar fascia is an aponeurosis rather than true fascia; the Dorland’s Medical Dictionary defines an aponeurosis as: a white, flattened or ribbon-like tendinous expansion, serving to connect a muscle with the parts that it moves, a term applied to certain fasciae. Further, it defines the plantar aponeurosis as bands of fibrous connective tissue radiating toward the bases of the toes from the medial process of the tuber calcanei; the plantar fascia is made up of predominantly longitudinally oriented collagen fibers. There are three distinct structural components: the medial component, the central component, the lateral component; the central component is most prominent.
In younger people the plantar fascia is intimately related to the Achilles tendon, with a continuous fascial connection between the two from the distal aspect of the Achilles to the origin of the plantar fascia at the calcaneal tubercle. However, the continuity of this connection decreases with age to a point that in the elderly there are few, if any, connecting fibers. There are distinct attachments of the plantar fascia and the Achilles tendon to the calcaneus so the two do not directly contact each other. There is an indirect relationship whereby if the toes are dorsiflexed, the plantar fascia tightens via the windlass mechanism. If a tensile force is generated in the Achilles tendon it will increase tensile strain in the plantar fascia. Clinically, this relationship has been used as a basis for treatment for plantar fasciitis, with stretches and night stretch splinting being applied to the gastrocnemius/soleus muscle unit; the plantar fascia contributes to support of arch of the foot by acting as a tie-rod, where it undergoes tension when the foot bears weight.
One biomechanical model estimated. In an experiment using cadavers, it was found that failure of the plantar fascia averaged at loads of 1189 ± 244 newtons. Failure most occurred at the proximal attachment to the calcaneus, consistent with the usual location of symptoms. Complete rupture or surgical release of the plantar fascia leads to a decrease in arch stiffness and a significant collapse of the longitudinal arch of the foot. By modeling it was predicted such conditions would result in a 17% increase in vertical displacement and a 15% increase in horizontal elongation of the foot when it was loaded at 683 newtons. Surgical release significantly increases both stress in the plantar ligaments and plantar pressures under the metatarsal heads. Although most of the figures mentioned above are from either cadaver studies or investigations using models, they highlight the large load the plantar fascia is subjected to while contributing to the structural integrity of the foot; the plantar fascia has an important role in dynamic function during gait.
It was found the plantar fascia continuously elongated during the contact phase of gait. It went through rapid elongation before and after mid-stance, reaching a maximum of 9% to 12% elongation between mid-stance and toe-off. During this phase the plantar fascia behaves like a spring. In addition, the plantar fascia has a critical role in normal mechanical function of the foot, contributing to the "windlass mechanism"; when the toes are dorsiflexed in the propulsive phase of gait, the plantar fascia becomes tense, resulting in elevation of the longitudinal arch and shortening of the foot. One can liken this mechanism to a cable being wound around the drum of a windlass. Plantar fasciitis is an painful degenerative process of the plantar fascia. Calcaneal spur is a small calcified bone extension located on the inferior aspect of the calcaneus or on the back of the heel at the insertion of the Achilles tendon; the condition is a response to plantar fasciitis over a period of time. It may be related to ankylosing spondylitis in children.
Plantar fibromatosis is a uncommon non-malignant thickening of the plantar fascia. Psoriatic arthritis is a type of inflammatory arthritis. Plantar fascial rupture/tear is a uncommon painful tearing of the plantar fascia; the tear can be partial. Plantar_fascia at the Duke University Health System's Orthopedics program soleoffoot at The Anatomy Lesson by Wesley Norman Heel Pain Symptoms. Plantar Fasciitis diagnosis and treatment | Patient.
Pectoral muscles are the muscles that connect the front of the human chest with the bones of the upper arm and shoulder. Pectoralis major is a fan-shaped muscle, which makes up the bulk of the chest muscle, it lies under the breast. It serves to flex and rotate the humerus, the long bone of the upper arm. Pectoralis minor is a triangular muscle located beneath the pectoralis major, it attaches to the ribs, serves to stabilize the scapula, the large bone of the shoulder. The pectoral fascia is a thin layer of tissue over the pectoralis major, extending toward the latissimus dorsi muscle on the back. Along with the pectoralis major and pectoralis minor, the subclavius muscle forms the axilla or armpit; the subclavius moves the shoulder forward. Serratus anterior is another muscle on the front of the chest, it moves the scapula forward as when throwing a punch. Between the ribs are various groups of intercostal muscles, which help with breathing. Gray, Henry. Anatomy of the Human Body. Philadelphia and New York: Lea and Feibiger.
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Aponeurosis of the abdominal external oblique muscle
The aponeurosis of the abdominal external oblique muscle is a thin but strong membranous structure, the fibers of which are directed downward and medially. It is joined with that of the opposite muscle along the middle line, covers the whole of the front of the abdomen. In the middle line, it interlaces with the aponeurosis of the opposite muscle, forming the linea alba, which extends from the xiphoid process to the pubic symphysis; that portion of the aponeurosis which extends between the anterior superior iliac spine and the pubic tubercle is a thick band, folded inward, continuous below with the fascia lata. The portion, reflected from the inguinal ligament at the pubic tubercle is attached to the pectineal line and is called the lacunar ligament. From the point of attachment of the latter to the pectineal line, a few fibers pass upward and medialward, behind the medial crus of the superficial inguinal ring, to the linea alba. In the aponeurosis of the external oblique above the pubic crest, is a triangular opening, the superficial inguinal ring, formed by a separation of the fibers of the aponeurosis in this situation.
This article incorporates text in the public domain from page 410 of the 20th edition of Gray's Anatomy "Anatomy diagram: 25466.086-1". Roche Lexicon - illustrated navigator. Elsevier. Archived from the original on 2014-01-01. Cross section image: pelvis/pelvis-e12-2—Plastination Laboratory at the Medical University of Vienna Anatomy photo:35:07-0102 at the SUNY Downstate Medical Center - "Anterior Abdominal Wall: The External Abdominal Oblique Muscle" Anatomy image:7028 at the SUNY Downstate Medical Center
Connective tissue is one of the four basic types of animal tissue, along with epithelial tissue, muscle tissue, nervous tissue. It develops from the mesoderm. Connective tissue is found in between other tissues everywhere in the body, including the nervous system. In the central nervous system, the three outer membranes that envelop the brain and spinal cord are composed of connective tissue, they protect the body. All connective tissue consists of three main components: ground substance and cells. Not all authorities include blood or lymph as connective tissue because they lack the fiber component. All are immersed in the body water; the cells of connective tissue include fibroblasts, macrophages, mast cells and leucocytes. The term "connective tissue" was introduced in 1830 by Johannes Peter Müller; the tissue was recognized as a distinct class in the 18th century. Connective tissue can be broadly subdivided into connective tissue proper, special connective tissue. Connective tissue proper consists of loose connective tissue and dense connective tissue Loose and dense connective tissue are distinguished by the ratio of ground substance to fibrous tissue.
Loose connective tissue has much more ground substance and a relative lack of fibrous tissue, while the reverse is true of dense connective tissue. Dense regular connective tissue, found in structures such as tendons and ligaments, is characterized by collagen fibers arranged in an orderly parallel fashion, giving it tensile strength in one direction. Dense irregular connective tissue provides strength in multiple directions by its dense bundles of fibers arranged in all directions. Special connective tissue consists of reticular connective tissue, adipose tissue, cartilage and blood. Other kinds of connective tissues include fibrous and lymphoid connective tissues. Fibroareolar tissue is a mix of fibrous and areolar tissue. New vascularised connective tissue that forms in the process of wound healing is termed granulation tissue. Fibroblasts are the cells responsible for the production of some CT. Type I collagen is present in many forms of connective tissue, makes up about 25% of the total protein content of the mammalian body.
Characteristics of CT: Cells are spread through an extracellular fluid. Ground substance - A clear and viscous fluid containing glycosaminoglycans and proteoglycans to fix the body water and the collagen fibers in the intercellular spaces. Ground substance slows the spread of pathogens. Fibers. Not all types of CT are fibrous. Examples of non-fibrous CT include adipose blood. Adipose tissue gives "mechanical cushioning" to the body, among other functions. Although there is no dense collagen network in adipose tissue, groups of adipose cells are kept together by collagen fibers and collagen sheets in order to keep fat tissue under compression in place; the matrix of blood is plasma. Both the ground substance and proteins create the matrix for CT. Connective tissues are derived from the mesenchyme. Types of fibers: Connective tissue has a wide variety of functions that depend on the types of cells and the different classes of fibers involved. Loose and dense irregular connective tissue, formed by fibroblasts and collagen fibers, have an important role in providing a medium for oxygen and nutrients to diffuse from capillaries to cells, carbon dioxide and waste substances to diffuse from cells back into circulation.
They allow organs to resist stretching and tearing forces. Dense regular connective tissue, which forms organized structures, is a major functional component of tendons and aponeuroses, is found in specialized organs such as the cornea. Elastic fibers, made from elastin and fibrillin provide resistance to stretch forces, they are found in the walls of large blood vessels and in certain ligaments in the ligamenta flava. In hematopoietic and lymphatic tissues, reticular fibers made by reticular cells provide the stroma—or structural support—for the parenchyma—or functional part—of the organ. Mesenchyme is a type of connective tissue found in developing organs of embryos, capable of differentiation into all types of mature connective tissue. Another type of undifferentiated connective tissue is mucous connective tissue, found inside the umbilical cord. Various types of specialized tissues and cells are classified under the spectrum of connective tissue, are as diverse as brown and white adipose tissue, blood and bone.
Cells of the immune system, such as macrophages, mast cells, plasma cells and eosinophils are found scattered in loose connective tissue, providing the ground for starting inflammatory and immune responses upon the detection of antigens. There are many types of connective tissue disorders, such as: Connective tissue neoplasms including sarcomas such as hemangiopericytoma and malignant peripheral nerve sheath tumor in nervous tissue. Congenital diseases include Ehlers-Danlos Syndrome. Myxomatous degeneration – a pathological weakening of connective tissue. Mixed connective tissue disease – a disease of the autoimmune system undifferentiated connective tissue disease. Systemic lupus erythematosus – a major autoimmune disease of connective tissue Scurvy, caused by a deficiency of vitamin C, necessary for the synthesis of collagen. For microscopic viewing, most of the connective tissue staining-techniques, colour tissue fibers in contrasting shades. Collagen may be differentially stained by any of the following: Van Gieson's stain Masson's trichrome stain Mallory's t
The palmar aponeurosis invests the muscles of the palm, consists of central and medial portions. The central portion occupies the middle of the palm, is triangular in shape, of great strength and thickness, its apex is continuous with the lower margin of the transverse carpal ligament, receives the expanded tendon of the palmaris longus. Its base divides below into one for each finger; each slip gives off superficial fibers to the skin of the palm and finger, those to the palm joining the skin at the furrow corresponding to the metacarpophalangeal articulations, those to the fingers passing into the skin at the transverse fold at the bases of the fingers. The deeper part of each slip subdivides into two processes, which are inserted into the fibrous sheaths of the flexor tendons. From the sides of these processes offsets are attached to the transverse metacarpal ligament. By this arrangement short channels are formed on the front of the heads of the metacarpal bones; the intervals between the four slips transmit the digital vessels and nerves, the tendons of the lumbricales.
At the points of division into the slips mentioned, numerous strong, transverse fasciculi bind the separate processes together. The central part of the palmar aponeurosis is intimately bound to the integument by dense fibroareolar tissue forming the superficial palmar fascia, gives origin by its medial margin to the palmaris brevis, it covers the superficial volar arch, the tendons of the flexor muscles, the branches of the median and ulnar nerves. The lateral and medial portions of the palmar aponeurosis are thin, fibrous layers, which cover, on the radial side, the muscles of the ball of the thumb, and, on the ulnar side, the muscles of the little finger; this article incorporates text in the public domain from page 460 of the 20th edition of Gray's Anatomy lesson5mus&tendonsofhand at The Anatomy Lesson by Wesley Norman lesson5flexretinac&palmapon at The Anatomy Lesson by Wesley Norman
Abdominal external oblique muscle
The external oblique muscle is the largest and the outermost of the three flat muscles of the lateral anterior abdomen. The external oblique is situated on the anterior parts of the abdomen, it is broad and irregularly quadrilateral, its muscular portion occupying the side, its aponeurosis the anterior wall of the abdomen. In most humans, the oblique is not visible, due to subcutaneous fat deposits and the small size of the muscle, it arises from eight fleshy digitations, each from the external surfaces and inferior borders of the fifth to twelfth ribs. These digitations are arranged in an oblique line which runs inferiorly and anteriorly, with the upper digitations being attached close to the cartilages of the corresponding ribs, the lowest to the apex of the cartilage of the last rib, the intermediate ones to the ribs at some distance from their cartilages; the five superior serrations increase in size from above downward, are received between corresponding processes of the serratus anterior muscle.
From these attachments the fleshy fibers proceed in various directions. Its posterior fibers from the ribs to the iliac crest form a free posterior border; those from the lowest ribs pass nearly vertically downward, are inserted into the anterior half of the outer lip of the iliac crest. This aponeurosis formed from fibres from either side of the external oblique decussates at the linea alba; the aponeurosis of the external oblique muscle forms the inguinal ligament. The muscle contributes to the inguinal canal. Just deep to the external oblique is the internal oblique muscle; these muscles are in the deepest layer of the abdominal wall. The external oblique muscle is supplied by ventral branches of the lower six thoracoabdominal nerves and the subcostal nerve on each side; the cranial portion of the muscle is supplied by the lower intercostal arteries, whereas the caudal portion is supplied by a branches of either the deep circumflex iliac artery or the iliolumbar artery. The external oblique functions to pull the chest downwards and compress the abdominal cavity, which increases the intra-abdominal pressure as in a valsalva maneuver.
It performs ipsilateral side-bending and contralateral rotation. So the right external oblique would side rotate to the left; the internal oblique muscle functions except it rotates ipsilaterally. The oblique strain is a common baseball injury in pitchers. In both batters and pitchers it can affect the contralateral side external oblique, or the trailing internal oblique. Crunch Side plank Sit-up This article incorporates text in the public domain from page 409 of the 20th edition of Gray's Anatomy Anatomy image:7061 at the SUNY Downstate Medical Center Cross section image: pembody/body8a—Plastination Laboratory at the Medical University of Vienna
The gizzard referred to as the ventriculus, gastric mill, gigerium, is an organ found in the digestive tract of some animals, including archosaurs, some gastropods, some fish, some crustaceans. This specialized stomach constructed of thick muscular walls is used for grinding up food aided by particles of stone or grit. In certain insects and molluscs, the gizzard features chitinous teeth; the word gizzard comes from the Middle English giser, which derives from a similar word in Old French gésier, which itself evolved from the Latin gigeria, meaning giblets. Birds store it in their crop if necessary; the food passes into their glandular stomach called the proventriculus, sometimes referred to as the true stomach. This is the secretory part of the stomach; the food passes into the gizzard. The gizzard can grind the food with swallowed stones and pass it back to the true stomach, vice versa. In layman's terms, the gizzard'chews' the food for the bird as it does not have teeth to chew food the way humans and other mammals do.
Bird gizzards are lined with a tough layer made of the carbohydrate-protein complex koilin, to protect the muscles in the gizzard. By comparison, while in birds the stomach occurs in the digestive tract prior to the gizzard, in grasshoppers the gizzard occurs prior to the stomach, while in earthworms there is only a gizzard, no stomach; some animals that lack teeth will grit to aid in fragmenting hard foods. All birds have gizzards; those that do employ the following method of chewing: "A bird swallows small bits of gravel that act as'teeth' in the gizzard, breaking down hard food such as seeds and thus helping digestion.". These stones are called gizzard stones or gastroliths and become round and smooth from the polishing action in the animal's stomach; when too smooth to do their required work, they may be regurgitated. The mullet found in estuarine waters worldwide, the gizzard or mud shad, found in freshwater lakes and streams from New York to Mexico, have gizzards; the gillaroo, a richly colored species of trout found in Lough Melvin, a lake in the north of Ireland, has a gizzard, used to aid the digestion of water snails, the main component of its diet.
Alligators and crocodiles have gizzards. Earthworms have gizzards. All birds have gizzards; the gizzards of emus, chickens and ducks are most notable in cuisine. Some crustaceans have a gizzard although this is referred to as a gastric mill. Dinosaurs that are believed to have had gizzards based on the discovery of gizzard stones recovered near fossils include: Psittacosaurus Massospondylus Sellosaurus Omeisaurus Apatosaurus Barosaurus Dicraeosaurus SeismosaurusThe belief that Claosaurus had a gizzard has been discredited on the grounds that the fossil remains this claim was based on were another species and the stones from a stream. At least some pterosaurs had gizzards; the most notable cases are Rhamphorhynchus. Poultry gizzards are a popular food throughout the world. Grilled chicken gizzards are sold throughout Southeast Asia. In Indonesia and liver are considered part of a complete fried poultry dish. In Mexico they are eaten with chicken soup, they are served grilled and prepared scrambled with eggs, onions and salsa.
Stewed gizzards are eaten as a snack in Portugal. In Hungary it is made with paprika. In Ghana, it is eaten fried or grilled. Grilled, skewered gizzards, with spices and optional green peppers and onions, are popular. In Nigeria gizzard is either fried and served with stew and fried plantain. Pickled turkey gizzards are a traditional food in some parts of the Midwestern United States. In Chicago, gizzard is deep fried and served with french fries and sauce; the Chamber of Commerce in Potterville, Michigan has held a Gizzard Fest each June since 2000. In the Southern United States, the gizzard is served fried, sometimes eaten with hot sauce or honey mustard, or added to crawfish boil along with crawfish sauce, it is used in traditional New Orleans gumbo. Gizzard and mashed potato is a popular food in many European countries. In France the Dordogne region, duck gizzards are eaten in the traditional Périgordian salad, along with walnuts and lettuce. In Iran some kebab restaurants mix chicken gizzards in their koobideh kebabs to increase the meat content.
In Italy gizzards are used mixed with other offal. In Japan, gizzard is called zuri or sunagimo. In Kyushu, gizzard is fried into karaage. In Korea, chicken gizzard, called dak-ttongjip, is eaten as anju or yasik; the word Sangdana is used to refer to chicken gizzards in Northern India and Pakistan. The word is derived from Persian. Another name for it is Pathri, it may be served cooked in a curry while barbecued skewered gizzards are popular. In Nepal, gizzard is called pangra, it is eaten most with drinks. In Yiddish, gizzards are referred to as pipik'lach meaning navels; the gizzards of kosher species of birds have a green or yellowish membrane lining the inside, which must be peeled off before cooking, as it lends a ve