SHEAVES [ligamenta (PNA, JNA, BNA)] — connective tissue educations in the form of tyazhy or plates, representing one of types of continuous connection of bones (syndesmosis) and being a part of the strengthening device of joints. Besides, sheaves call folds, including duplikatura of serous covers (see. Bryushina , Pleura ), the connecting internals with walls of perigastriums or among themselves and being a part of the holding device of internals (e.g., lig. falciforme hepatis, lig. hepatogastricum, etc.), and also the obliterated embryonal vessels and channels (e.g., lig. teres hepatis, lig. arteriosum).
Names C. are given by their situation, a form, color; quite often names C. are made from names of bones, bodies and other educations, to-rye connect Page. In some cases depending on a form and S.'s appointment call arches (arcus), seams (raphe), etc.
Development of S. relating to to a skeleton (see), it is closely connected with development of bones (see. Bone ) and joints (see). Pages are differentiated in the embryonal period from mesenchymas (see), surrounding the forming joint ends of bones. Are formed by Nek-rye S. as a result of a phylogenetic reduction of muscles; naira., sacral bugornaya S. (lig. sacrotuberale) represents the degenerating part of a big gluteus.
At newborn S. are anatomically created, but also more rastyazhima, than at adults are less strong. With age crimpiness of collagenic bunches in S. decreases and respectively S.'s distensibility
== Morfofunktsionalnaya the characteristic == decreases
Most of S. relating to a skeleton are constructed from issued dense fibrous connecting fabric (see). They consist of wavy curved bunches of collagenic fibers (see. Collagen ) and a small amount of elastic fibers, to-rye in the direction do not match collagenic. In places of an attachment of S. to bones it is found cartilaginous tissue (see). Fibers of deep layers of S. are directly fastened to a bone, and surface fibers pass in periosteum (see).
Mechanical characteristics of S. are defined by properties being their part collagen (see)] they are characterized by high elasticity and big durability on stretching and rather low distensibility. Therefore S. are capable to maintain big loading. E.g., iliofemoral S. maintains loading to 350 kgfs, but at the loading close to limit, S. are exposed to irreversible stretching.
Nek-rye S., the sinelastozam called by A. Rauber, consist entirely of elastic connecting fabric; elastic fibers form in them in parallel the going tyazh. Such S. stretch at small loading and can be extended by 2,5 times, and after unloading revert to the original state. Thanks to it they perform in the office of the movement spring function — napr, a yellow linking of a rachis (ligg. flava).
S.'s blood supply is carried out by nearby arteries. The vessels feeding S. anastomose with vessels of the joint capsule, the next muscles. In S. arteries pass along yarns of connecting fabric. Veins accompany with S. arteries.
Limf, S.'s capillaries begin between yarns, the making S., and form plane networks, from to-rykh a lymph flows in superficial and deep limf, vessels of the respective area of a body.
Pages are richly innervated. On their surface and are in depth as free nerve terminations (see), and the encapsulated nervous little bodies, including lamellar little bodies (Fater's little bodies — Pachini). Villages have painful and proprioceptive sensitivity (see).
The most part of S. genetically, anatomically both is functionally connected with joints and shall be considered as auxiliary elements of the last. In relation to the joint capsule distinguish three types of S.: 1) extra capsular (ligg. extracapsularia), located out of the joint capsule, but often interwoven into it; 2) capsular (ligg. capsularia), the representing thickenings of the joint capsule; 3) intra capsular (ligg. intracapsularia), being in a joint cavity and covered with a synovial membrane.
Together with the joint capsule and muscles (see) S. provide strengthening of joints and contact of joint surfaces of bones: napr, sciatic and femoral S. (lig. ischio-femorale), the doubled S. (lig. bifurca tum), etc. Many S. brake and limit the movements in joints: iliofemoral S. (lig. iliofemorale), interosseous collision and calcaneal S. (lig. talocalcaneum interosseum). There are directing S., to-rye exert impact on the course of the movement in a joint, interacting at the same time with other its parts: napr, elbow collateral S. of an elbow joint (lig. collateral ulnare). At a row C. the specified functions are combined. E.g., medial deltoid S. of an ankle joint (lig. mediale) performs the strengthening, braking and directing functions.
Pages play an important role in a statics of a body and its parts. As showed elektromiografichesky researches (see. Electromyography ), stabilization of various parts of a body in certain provisions is reached at the expense of the copular device at the minimum activity of muscles. The irritation of proprioretseptor of S. at change of their tension plays an essential role in control of movements in joints.
Along with S. relating to joints there are S. tense between parts of the same bone, forming as if bridges under to-rymi there pass vessels and nerves: napr, top and bottom cross S. of a shovel (ligg. transversa scapulae sup. et inf.). Parts (partes) of sheaves and fibrous vaginas belong to copular educations; membranes (membranae) tense between bones (e.g., an interosseous membrane of a forearm — membrana interossea antebrachii) or the closing openings in bones (a locking membrane — membrana obturatoria), tendinous bands, and also the reinforced sites of fastion which are retinaculums of sinews of muscles of a forearm and shin (retinacula); the bunches (fasciculi) which are reinforced sites of sheaves or fastion and having a certain direction and fixing; strings (chordae) — the dense connective tissue tyazh which are quite often the rest of embryonal vessels and channels (the name is used preferential in JNA).
From bodies of other systems possesses the most differentiated copular device throat (see); Pages not only supplement her cartilaginous skeleton, but also participate in function of a phonation (voice S., ligg. vocalia).
The villages which are folds of serous covers (a peritoneum, a pleura) are a part of the holding device of internals, carry out vessels and nerves to bodies.
Methods of a research
the Research C., belonging to a skeleton, in most cases consists in a research of the corresponding joint or department musculoskeletal system (see methods of a research in articles Ankle joint , Knee joint , Elbow joint , Shoulder joint , Hip joint ). To special rentgenol. to methods of a research C. belongs ligamentografiya (see).
See also Joints (methods of a research) .
Distinguish malformations, damages, diseases of Page. Malformations of S. of joints meet at malformations of joints and independent value have no.
The most frequent type of pathology of S. are them damages. Most often S.'s damages occur at athletes. S.'s damages make 15 — 39,5% of all sports injuries. S.'s damages classify by extent of disturbance of their integrity on stretchings, partial gaps or anguishes (see. Distortion ) and complete separations. Distinguish S.'s rupture on its extent, S.'s separation at the place of its attachment and an avulsion fracture — S.'s separation with a bone fragment. In most cases S.'s damage results from an indirect injury owing to nefiziol. the movements in this or that joint, or at the sudden and sharp movement in the increased volume. Anguishes of separate fibers C. can be a consequence of its long microtraumas (see).
The wedge, a picture of damages of S. is characterized by the localized morbidity and a swelling in the place of damage. If S. is the auxiliary device of a joint, disorder of its function is noted: restriction of movements, patol. mobility of the jointed bones. At a dense prileganiye of S. to a synovial membrane of the joint capsule it is possible hemarthrosis (see). Diagnosis of damage of S. is based on the anamnesis taking into account a wedge, and rentgenol. data. Rentgenol. the research confirms patol. mobility of the jointed bones at S.'s rupture, allows to reveal a bone fragment in the place of an attachment of the injured sheaf at an avulsion fracture.
Treatment of damages of S. damages, conservative or operational depending on character. In the acute period the immobilization of the damaged area, S.'s sewing together at its gap is carried out. According to indications plastic recovery of S. is carried out also in the remote period after an injury.
Prevention of damages of S. consists in observance a gigabyte. standards of the contents of venues of exercises and sport and correct technique of holding these occupations.
To to diseases Pages refer dystrophic, inflammatory processes, calcification and ossifikatsrsh Page.
Dystrophic changes of S. can develop at them hron. to a microtrauma. Dystrophic changes of interspinal linking of nizhnepoyasnichny and lumbosacral department of a backbone are known under the name «Bostrup's disease» (see. Backbone, pathology ).
The tendovaginitis (S.'s inflammation) can arise at nek-ry inf. diseases (e.g., a brucellosis), at long microtraumatization of S. as a result of an overstrain of a muscle, a sinew the cut passes through educated S. the channel, after the injury which is followed by hemorrhage in S. with the subsequent organization of a hematoma. Special cases of a tendovaginitis are: the stenosing tendovaginitis of a ring linking of a brush (a ring part of fibrous vaginas) — the clicking finger (see), the stenosing tendovaginitis of a palmar ligament of wrist and cross ligament of a wrist (retinaculum of sgibatel) — the syndrome of a carpal tunnel stenosing a tendovaginitis of a dorsal ligament of wrist (a retinaculum of razgibatel) — de Querven's disease, etc. At a tendovaginitis in S. diffusion and focal inflammatory infiltrates, a hyalinosis of collagenic fibers, formation of cartilaginous structures from connective tissue elements are defined. The wedge, a picture is usually characterized by morbidity and restriction of mobility in the corresponding joint, night paresthesias in the field of a brush and fingers (at a syndrome of a carpal tunnel). The current of a ligakhmentit is more often a chronic, acute current is observed at a brucellous tendovaginitis.
Treatment of a tendovaginitis, as a rule, conservative: rest, physiotherapeutic procedures, injections of a hydrocortisone to the area of defeat. According to indications at the stenosing tendovaginites the ligamentotomiya — a section of the affected ligament is carried out.
S.'s calcification can sometimes be observed at advanced age in connection with changes of connective tissue educations. Perhaps posttraumatic calcification or ossification of a tibial collateral sheaf in the field of a knee joint (see. Pellegrini — Shtida a disease ). Ossification of a front longitudinal ligament of backbone at the level of the affected vertebras in some cases occurs at spondylitis (see) an infectious etiology.
Tumors, developing from sheaves, meet extremely seldom.
Bibliography: Anatomy of intraorganic vessels, under the editorship of M. G. Mrives, page 104, D., 1948; Grandfather's V. S. Is also big V. I. The analysis of result of treatment at damages of the copular and capsular device of extremities, Voyen. - medical zhurn., No. 3, page 31, 1974; Ivanitsky M. F. Movements of a human body, M., 1938, bibliogr.; Movshovich I. A. Plastics lavsan at injuries of ligaments and sinews of a musculoskeletal system, Surgery, No. 1, page 74, 1977; About y-with about in A. S. Reliability of biological fabrics, page 82, M., 1971; The Specialty surgery, under the editorship of A. A. Vishnevsky and V. S. Levitte, t. 3, page 138, M., 1963; Elkin M. A. and JI and A. D. The stenosing tendovaginites of a wrist and fingers, JI., 1968; In artel D. L. and. lake of Surgical repositioning of the medial collateral ligament, J. Bone Jt Surg., v. 79-A, p. 107, 1977; Biehl G. u. Peters G. Behand-lungsergebnisse bei 450 Bandscheibenopera-tionen, Z. Orthop., Bd 109, S. 836, 1971; In r an u s H. Anatomie des Menschen, Bd 1—2, B., 1929 — 1934; Hall M. C. The locomotor system, functional anatomy, Springfield, 1965.
V. S. Speransky; E. V. Bogutskaya (pathology).