It is usually caused by prolonged sitting on a hard surface.
It is usually caused by prolonged sitting on a hard surface.
Calcific bursitis refers to calcium deposits within the bursae. This most occurs in the shoulder area; the most common bursa for calcific bursitis to occur is the subacromial bursa. A bursa is a small, fluid-filled sac that reduces friction, facilitates movements between its adjacent tissues. Inflammation of the bursae is called bursitis. Pain during rest Tenderness on palpation Stiffness Swelling Calcific bursitis may be related to: Calcific tendinitis. Sometimes calcium deposits of the involved tendons penetrate into the bursae. Chronic bursitis. Lack of bursitis treatment or repetitive bursitis may lead to calcific bursitis. X-ray MRI scan Ice Rest Non steroidal anti-inflammatory drugs Injections of steroid Physical therapy Surgical treatment Bursitis Calcific tendinitis Darlene Hertling and Randolph M. Kessler. Management of Common Musculoskeletal Disorders. Third Edition. ISBN 0-397-55150-9 Calcific bursitis at MedicineNet
The ischial tuberosity known informally as the sit bones, or as a pair the sitting bones is a large swelling posteriorly on the superior ramus of the ischium. It marks the lateral boundary of the pelvic outlet; when sitting, the weight is placed upon the ischial tuberosity. The gluteus maximus provides cover in the upright posture, but leaves it free in the seated position; the distance between a cyclist's ischial tuberosities is one of the factors in the choice of a bicycle saddle. The tuberosity is divided into two portions: a lower, somewhat triangular part, an upper, quadrilateral portion; the lower portion is subdivided by a prominent longitudinal ridge, passing from base to apex, into two parts: The outer gives attachment to the adductor magnus The inner to the sacrotuberous ligament The upper portion is subdivided into two areas by an oblique ridge, which runs downward and outward: From the upper and outer area the semimembranosus arises From the lower and inner, the long head of the biceps femoris and the semitendinosus Ischial bursitis Sitting disability This article incorporates text in the public domain from page 235 of the 20th edition of Gray's Anatomy Goossens R, Teeuw R, Snijders C.
"Sensitivity for pressure difference on the ischial tuberosity". Ergonomics. 48: 895–902. Doi:10.1080/00140130500123647. PMID 16076744. Platzer, Werner. Color Atlas of Human Anatomy, Vol. 1: Locomotor System. Thieme. ISBN 3-13-533305-1. Anatomy photo:41:st-0204 at the SUNY Downstate Medical Center - "The Female Perineum: Bones" Anatomy photo:17:os-0114 at the SUNY Downstate Medical Center - "Major Joints of the Lower Extremity: Hip bone" pelvis at The Anatomy Lesson by Wesley Norman
The gluteus maximus is the main extensor muscle of the hip. It is the largest and most superficial of the three gluteal muscles and makes up a large portion of the shape and appearance of each side of the hips, its thick fleshy mass, in a quadrilateral shape, forms the prominence of the buttocks. Its large size is one of the most characteristic features of the muscular system in humans, connected as it is with the power of maintaining the trunk in the erect posture. Other primates can not sustain standing erectly; the muscle is remarkably coarse in function and structure, being made up of muscle fascicles lying parallel with one another, collected together into larger bundles separated by fibrous septa. It arises from the posterior gluteal line of the inner upper ilium, a pelvic bone, the portion of the bone including the crest of the ilium above and behind it; the fibers are lateralward. Three bursae are found in relation with the deep surface of this muscle: One of these, of large size, separates it from the greater trochanter.
When the gluteus maximus takes its fixed point from the pelvis, it extends the acetabulofemoral joint and brings the bent thigh into a line with the body. Taking its fixed point from below, it acts upon the pelvis, supporting it and the trunk upon the head of the femur, its most powerful action is to cause the body to regain the erect position after stooping, by drawing the pelvis backward, being assisted in this action by the biceps femoris, semitendinosus and adductor magnus. The gluteus maximus is a tensor of the fascia lata, by its connection with the iliotibial band steadies the femur on the articular surfaces of the tibia during standing, when the extensor muscles are relaxed; the lower part of the muscle acts as an adductor and external rotator of the limb. The upper fibers act as abductors of the hip joints; the gluteus maximus is involved from running to weight-lifting. A number of exercises focus on the gluteus maximus as well as other muscles of the upper leg. Hip thrusts Glute bridge Quadruped hip extensions Kettlebell swings Squats and variations like split squats, pistol squats and wide-stance lunges Deadlift Reverse hyperextension Four-way hip extensions Glute-ham raise Functional assessment can be useful in assessing injuries to the gluteus maximus and surrounding muscles.
These tests include: 30 Second Chair to Stand testThis test measures a participant's ability to stand up from a seated position as many times as possible in a thirty-second period of time. Testing the number of times a person can stand up in a thirty-second period helps assess strength, flexibility and endurance, which can help determine how far along a person is in rehabilitation, or how much work is still to be done. Passive piriformis stretch; the piriformis test measures flexibility of the gluteus maximus. This requires a trained professional and is based on the angle of external and internal rotation in relation to normal range of motion without injury or impingement. In other primates, gluteus maximus consists of ischiofemoralis, a small muscle that corresponds to the human gluteus maximus and originates from the ilium and the sacroiliac ligament, gluteus maximus proprius, a large muscle that extends from the ischial tuberosity to a more distant insertion on the femur. In adapting to bipedal gait, reorganization of the attachment of the muscle as well as the moment arm was required.
Table of muscles of the human body Coccyx This article incorporates text in the public domain from page 474 of the 20th edition of Gray's Anatomy Anatomy photo:13:st-0403 at the SUNY Downstate Medical Center Cross section image: pelvis/pelvis-female-17—Plastination Laboratory at the Medical University of Vienna Cross section image: pelvis/pelvis-e12-15—Plastination Laboratory at the Medical University of Vienna Cross section image: pembody/body18b—Plastination Laboratory at the Medical University of Vienna Muscles/GluteusMaximus at exrx.net
The synovial membrane is a specialized connective tissue that lines the inner surface of capsules of synovial joints and tendon sheath. It makes direct contact with the fibrous membrane on the outside surface and with the synovial fluid lubricant on the inside surface. In contact with the synovial fluid at the tissue surface are many rounded macrophage-like synovial cells and type B cells. Type A cells maintain the synovial fluid by removing wear-and-tear debris; as for type B cells, they produce hyaluronan, as well as other extracellular components in the synovial fluid. The synovial membrane is variable but has two layers The outer layer, or subintima, can be of any type of connective tissue – fibrous, adipose or areolar; the inner layer, or intima, consists of a sheet of cells thinner than a piece of paper. Where the underlying subintima is loose, the intima sits on a pliable membrane, giving rise to the term synovial membrane; this membrane, together with the cells of the intima, provides something like an inner tube, sealing the synovial fluid from the surrounding tissue.
Just beneath the intima, most synovium has a dense net of fenestrated small blood vessels that provide nutrients not only for synovium but for the avascular cartilage. In any one position, much of the cartilage is close enough to get nutrition directly from the synovium; some areas of cartilage have to obtain nutrients indirectly and may do so either from diffusion through cartilage or by'stirring' of synovial fluid. The surface of synovium may be flat or may be covered with finger-like projections or villi, which, it is presumed, help to allow the soft tissue to change shape as the joint surfaces move one on another; the synovial fluid can be thought of as a specialised fluid form of synovial extracellular matrix rather than a secretion in the usual sense. The fluid is transudative in nature which facilitates continuous exchange of oxygen, carbon dioxide and metabolites between blood and synovial fluid; this is important since it is the major source of metabolic support for articular cartilage.
Under normal conditions synovial fluid contain <100/mL of leucocytes in which majority are monocytes. The intimal cells are of two types, fibroblasts synovial cells or type B cells and macrophage-like synovial cells. Surface cells have no basement membrane or junctional complexes denoting an epithelium despite superficial resemblance; the fibroblastic synovial cells manufacture. The water of synovial fluid is not secreted as such but is trapped in the joint space by the hyaluronan; the macrophage-like synovial cells are responsible for the removal of undesirable substances from the synovial fluid. It accounts for 25% of cells lining the synovium. Although a biological joint can resemble a man-made joint in being a hinge or a ball and socket, the engineering problems that nature must solve are different because the joint works within an completely solid structure, with no wheels or nuts and bolts. In general, the bearing surfaces of manmade joints interlock, as in a hinge; this is rare for biological joints.
More the surfaces are held together by cord-like ligaments. All the space between muscles, ligaments and cartilage is filled with pliable solid tissue; the fluid-filled gap is at most only a twentieth of a millimetre thick. This means; these may include: Providing a plane of separation, or disconnection, between solid tissues so that movement can occur with minimum bending of solid components. If this separation is lost, as in a'frozen shoulder', the joint cannot move. Providing a packing that can change shape in whatever way is needed to allow the bearing surfaces to move on each other. Controlling the volume of fluid in the cavity so that it is just enough to allow the solid components to move over each other freely; this volume is so small that the joint is under slight suction. Synovium can become irritated and thickened in conditions such as osteoarthritis, Ross River virus or rheumatoid arthritis. In general, inflamed synovium is accompanied by extra macrophage recruitment, fibroblast proliferation and an influx of inflammatory cells including lymphocytes and plasma cells.
When this happens, the synovium can interfere with the normal functioning of the joint. Excessive thickened synovium, filled with cells and fibrotic collagenous tissue, can physically restrict joint movement; the synovial fibroblasts may make smaller hyaluronan so it is a less effective lubricant of the cartilage surfaces. Under stimulation from invading inflammatory cells, the synovial cells may produce enzymes that can digest the cartilage extracellular matrix. Fragments of extracellular matrix can further irritate the synovium; the word synovium is related to the word synovia in its sense meaning "synovial fluid". The latter was coined by Paracelsus. More information is given at pronunciation. Synovial sheath
A ligament is the fibrous connective tissue that connects bones to other bones. It is known as articular ligament, articular larua, fibrous ligament, or true ligament. Other ligaments in the body include the: Peritoneal ligament: a fold of peritoneum or other membranes. Fetal remnant ligament: the remnants of a fetal tubular structure. Periodontal ligament: a group of fibers that attach the cementum of teeth to the surrounding alveolar bone. Ligaments are similar to tendons and fasciae; the differences in them are in the connections that they make: ligaments connect one bone to another bone, tendons connect muscle to bone, fasciae connect muscles to other muscles. These are all found in the skeletal system of the human body. Ligaments cannot be regenerated naturally; the study of ligaments is known as desmology. "Ligament" most refers to a band of dense regular connective tissue bundles made of collagenous fibers, with bundles protected by dense irregular connective tissue sheaths. Ligaments connect bones to other bones to form joints.
Some ligaments prevent certain movements altogether. Capsular ligaments are part of the articular capsule, they act as mechanical reinforcements. Extra-capsular ligaments join together in harmony with the other ligaments and provide joint stability. Intra-capsular ligaments, which are much less common provide stability but permit a far larger range of motion. Cruciate ligaments are paired ligaments in the form of a cross. Ligaments are viscoelastic, they strain when under tension and return to their original shape when the tension is removed. However, they cannot retain their original shape when extended past a certain point or for a prolonged period of time; this is one reason why dislocated joints must be set as as possible: if the ligaments lengthen too much the joint will be weakened, becoming prone to future dislocations. Athletes, gymnasts and martial artists perform stretching exercises to lengthen their ligaments, making their joints more supple; the term hypermobility refers to people with more-elastic ligaments, allowing their joints to stretch and contort further.
The consequence of a broken ligament can be instability of the joint. Not all broken ligaments need surgery, but, if surgery is needed to stabilise the joint, the broken ligament can be repaired. Scar tissue may prevent this. If it is not possible to fix the broken ligament, other procedures such as the Brunelli procedure can correct the instability. Instability of a joint can over time lead to wear of the cartilage and to osteoarthritis. One of the most torn ligaments in the body is the anterior cruciate ligament; the ACL is one of the ligaments crucial to knee stability and persons who tear their ACL seek to undergo reconstructive surgery, which can be done through a variety of techniques and materials. One of these techniques is the replacement of the ligament with an artificial material. An artificial ligament is a reinforcing material, used to replace a torn ligament, such as the ACL. Artificial ligaments are a synthetic material composed of a polymer, such as polyacrylonitrile fiber, polypropylene, PET, or polyNaSS poly.
Certain folds of peritoneum are referred to as ligaments. Examples include: The hepatoduodenal ligament, that surrounds the hepatic portal vein and other vessels as they travel from the duodenum to the liver; the broad ligament of the uterus a fold of peritoneum. Certain tubular structures from the fetal period are referred to as ligaments after they close up and turn into cord-like structures: Broström procedure
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