指屈筋腱腱鞘の走査電子顕微鏡による観察--機能解剖学的アプロ-チ
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概要
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The structure of the tendon sheath of flexor tendon of human fingers was observed macroscopically, histologically and using a scanning electron microscope. Morphological changes in the tendon sheath due to fingerr flexion and extension, as well as the tendon sheath in the static condition of fingers, were observed. The parietal layer of the tendon sheath of the flexor tendon of a finger consisted of band areas and non-band areas. According to band runnings, the bands were classified into annular and cruciate bands. Four annular bands (A<SUB>1</SUB>, A<SUB>2</SUB>, A<SUB>3</SUB>, A<SUB>4</SUB>) and three cruciate bands (C<SUB>1</SUB>, C<SUB>2</SUB>, C<SUB>3</SUB>) were observed in the tendon sheath of the index, middle, ring, and the little fingers. On the other hand, two annular bands (A<SUB>1</SUB>, A<SUB>2</SUB>) and one oblique band were observed in the tendon sheath of the thumb. Other bands which might be atypical were also observed. Protrusions were aligned on the surface of a visceral layer glide of the tendon sheath and of the band in the parietal layer. These protrusions in the visceral layer were aligned in the direction of the tendon's running, and those in the band were aligned in a direction of the band's running. These protrusions were covered with the reticular fibers in the superficial layer and were covered with small fibers transversely running on the protrusions in the deep layer. This structure was considered to be proper for tendon glide. The bands had a small fiber ligament structure ; these fibers were considered to be collagen fibrils. This structure was enough to serve the purpose of band function as a“pulley”. Also, on sites surfaces other than the bands in the parietal layer, protrusions covered with reticular fibers were observed, but the arrangement was irregular. When bending the fingers, the space between the bands is folded in the palmar side, resulting in a reduce palmar site length. The degree of folds was the most remarkable near A<SUB>2</SUB> and A<SUB>4</SUB> bands, indicating that the functions of these bands as“pulleys”is significant. The tendon sheath surface has a structure which facilitates tendon glide. At the same time, the tendon sheath is sufficiently flexible to morphological changes on the flexion of fingers. On the other hand, the structure is strong enough to prevent bow-stringing of the tendon when bending the finger.
- 学校法人 昭和大学・昭和医学会の論文