What is an aponeurosis?
The medical term of aponeurosis comes from Latin. Literally translated, the term means as much as tendon plate. This refers to the flat or flat connective tissue structures that serve the sinewy approach of one or more muscles and appear as an extension of muscle tendons.
Known examples of aponeuroses in addition to the palate aponeurosis are the palmar aponeurosis, the plantar aponeurosis, the rectus sheath, the tongue aponeurosis and the patella retinaculum. The plantar fascia strains the arch of the foot and maintains it. It protects the muscles, nerves, blood vessels and tendons on the sole of the foot. The Palmaraponeurose on the hand come to similar functions. The structure of the aponeuroses differs with the localization. Of other types of connective tissue, aponeurosis differs mainly by their function and their anatomical layered shape. All aponeuroses are always directly related to at least one muscle and its tendon.
Anatomy & Construction
The palate aponeurosis is heavily fibrous layer of connective tissue that serves as the base for the soft palate. Palate muscles to the palate movement radiate into the connective tissue.
The palmar aponeurosis consists of complex three-dimensionally arranged longitudinal, transversal and vertical fibers and is connected by fibrous connective tissue with the surface fascia of the hand. It lies in the central palm of the hand on the short hollow hand muscles and laterally fuses with the fascia of the hypothenar and Thenarmuskulatur. The plantar aponeurosis is rooted on the heel bone and diverge in a V-shape into the toe joint capsule and toe flexor tendon of the toe core joint.
The rectus sheath consists of the aponeuroses of the three abdominal muscles Musculus obliquus internus abdominis, Musculus transversus abdominis and Musculus obliquus externus abdominis. It surrounds the rectus abdominis muscle. The Tongue Aponeuros is a tough connective tissue layer between the tongue mucosa and the tongue muscles. The aponeurosis Retinaculum patellae is supporting the kneecap and belongs to the outer joint capsule layer of the knee joint.
Function & Tasks
The main task of all aponeuroses is the formation of the muscle tendon attachment. The palate aponeurosis is often referred to in this context as a functional tendinitis of the muscles tensor veli palatini. However, recent findings suggest that this aponeurosis is more likely to be an extension of adjacent peritoneal bone. The palmar aponeurosis is irreplaceable for the grasping movement of the hand. She tenses the skin on the palmar side of the hand.
Because of its fiber tracts, it establishes close contact between the object being grasped and the hand while protecting the blood vessels and nerves beneath the connective tissue layer. Plantar neoplasia stabilizes the longitudinal arch of the foot skeleton. It has an ideal functional lever arm for arch support. By dense fiber bundles, the aponeurosis is fused into the plantar skin and fixes the skin through this tight anchorage. This creates the basis for a secure footing. The fat pads between their fiber webs serve as pressure pads. The rectus sheath shortens the muscle fibers of the abdominal wall. If the abdominal wall contracted too tightly, the abdominal space would be narrowed and the organs would not have enough space.
The rectus sheath also joins the tendon plates of the abdominal muscles into a single unit. The tongue aponeurosis serves the stable approach of the tongue muscles and the patella retinaculum forms a retaining band for the kneecap. Consequently, all aponeuroses have a stabilizing and retaining function. In most cases, the connective tissue layers also take over protective functions. Despite these tasks, the structures are rather passive structural elements.
Any aponeurosis of the body can be affected by inflammation. This pathological phenomenon is also referred to as fasciitis and most commonly affects plantar necrosis on the foot. When the plantar tendon plate is inflamed, the doctor speaks of plantar fasciitis.
Most of the time, this phenomenon is preceded by overuse of the associated musculature. Such overloads occur especially in sports, jumping or running. Dancing, football and basketball are considered risk factors. In addition to overloads, the inflammations can also be caused by previous injuries to the foot. Plantar fasciitis manifests as severe heel pain, which usually increases with exercise. The beginning is insidious. Over time, symptoms increase over weeks or even months. The pain can cause inability to walk on the climax of the disease. Normally, the pain starts sharply at the beginning of a strain, but recurs within a certain amount of stress.
Foot aponeurosis also affects Ledderhose's disease, which causes thickening of the connective tissue and corresponds to fibromatosis. At the hand aponeurosis the same phenomenon is called Dupuytren's disease. In both phenomena, nodes in the aponeuroses slowly grow in size. Painful nodules can restrict the ability to move. Although both diseases are considered to be benign diseases, therefore, surgical removal may be indicated.
The primary cause of the growths is unknown. Myofibroblasts cause connective tissue proliferation. What factors stimulate them is the subject of current research. According to speculation, injuries, genetic components, primary diseases such as diabetes mellitus and nicotine or alcohol consumption may play a role in disease etiology. All patients with benign connective tissue overgrowth at a specific body site are at an increased risk of undergoing further connective tissue proliferation.