Enthesis | |
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Identifiers | |
TH | H3.03.00.0.00034 |
Anatomical terminology |
The enthesis (plural entheses) is the connective tissue which attaches tendons or ligaments to a bone. [1]
There are two types of entheses: fibrous entheses and fibrocartilaginous entheses. [2] [3]
In a fibrous enthesis, the collagenous tendon or ligament directly attaches to the bone.
In a fibrocartilaginous enthesis, the interface presents a gradient that crosses four transition zones: [4]
A disease of the entheses is known as an enthesopathy or enthesitis . [5]
Enthetic degeneration is characteristic of spondyloarthropathy and other pathologies.
The enthesis is the primary site of disease in ankylosing spondylitis.
Entheses are widely recorded in the field of bioarchaeology where the presence of anomalies at these sites, called entheseal changes, has been used to infer repetitive loading to study the division of labour in past populations. [6] Several different recording methods have been proposed to record the variety of changes seen at these sites. [7] [8] [9] [10] [11] [12] [13] [14] [15] However, research has shown that, whichever recording method is used, entheseal changes occur more frequently in older individuals. [16] [8] [17] [18] [19] Research demonstrates that diseases, such as ankylosing spondylitis and calcific tendinitis, [20] also have to be taken into consideration. Experimental studies have demonstrated how loading history (physical activity) can increase the relative size of muscle attachment sites. [21] [22] [23] [24]
"Enthesis" is rooted in the Ancient Greek word, "ἔνθεσις" or "énthesis," meaning “putting in," or "insertion." This refers to the role of the enthesis as the site of attachment of bones with tendons or ligaments. Relatedly, in muscle terminology, the insertion is the site of attachment at the end with predominant movement or action (opposite of the origin). Thus the words (enthesis and insertion [of muscle]) are proximal in the semantic field, but insertion in reference to muscle can refer to any relevant aspect of the site (i.e., the attachment per se, the bone, the tendon, or the entire area), whereas enthesis refers to the attachment per se and to ligamentous attachments as well as tendinous ones.
The coracoid process is a small hook-like structure on the lateral edge of the superior anterior portion of the scapula. Pointing laterally forward, it, together with the acromion, serves to stabilize the shoulder joint. It is palpable in the deltopectoral groove between the deltoid and pectoralis major muscles.
The human shoulder is made up of three bones: the clavicle (collarbone), the scapula, and the humerus as well as associated muscles, ligaments and tendons.
The patella, also known as the kneecap, is a flat, rounded triangular bone which articulates with the femur and covers and protects the anterior articular surface of the knee joint. The patella is found in many tetrapods, such as mice, cats, birds and dogs, but not in whales, or most reptiles.
The Achilles tendon or heel cord, also known as the calcaneal tendon, is a tendon at the back of the lower leg, and is the thickest in the human body. It serves to attach the plantaris, gastrocnemius (calf) and soleus muscles to the calcaneus (heel) bone. These muscles, acting via the tendon, cause plantar flexion of the foot at the ankle joint, and flexion at the knee.
Tennis elbow, also known as lateral epicondylitis or enthesopathy of the extensor carpi radialis origin, is an enthesopathy of the origin of the extensor carpi radialis brevis on the lateral epicondyle. The outer part of the elbow becomes painful and tender. The pain may also extend into the back of the forearm. Onset of symptoms is generally gradual, although they can seem sudden and be misinterpreted as an injury. Golfer's elbow is a similar condition that affects the inside of the elbow.
Bioarchaeology in Europe describes the study of biological remains from archaeological sites. In the United States it is the scientific study of human remains from archaeological sites.
The biceps femoris is a muscle of the thigh located to the posterior, or back. As its name implies, it consists of two heads; the long head is considered part of the hamstring muscle group, while the short head is sometimes excluded from this characterization, as it only causes knee flexion and is activated by a separate nerve.
An enthesopathy refers to a disorder involving the attachment of a tendon or ligament to a bone. This site of attachment is known as the enthesis . If the condition is known to be inflammatory, it can more precisely be called an enthesitis.
The flexor retinaculum is a fibrous band on the palmar side of the hand near the wrist. It arches over the carpal bones of the hands, covering them and forming the carpal tunnel.
Golfer's elbow, or medial epicondylitis, is tendinosis of the medial common flexor tendon on the inside of the elbow. It is similar to tennis elbow, which affects the outside of the elbow at the lateral epicondyle. The tendinopathy results from overload or repetitive use of the arm, causing an injury similar to ulnar collateral ligament injury of the elbow in "pitcher's elbow".
X-linked hypophosphatemia (XLH) is an X-linked dominant form of rickets that differs from most cases of dietary deficiency rickets in that vitamin D supplementation does not cure it. It can cause bone deformity including short stature and genu varum (bow-leggedness). It is associated with a mutation in the PHEX gene sequence (Xp.22) and subsequent inactivity of the PHEX protein. PHEX mutations lead to an elevated circulating (systemic) level of the hormone FGF23 which results in renal phosphate wasting, and local elevations of the mineralization/calcification-inhibiting protein osteopontin in the extracellular matrix of bones and teeth. An inactivating mutation in the PHEX gene results in an increase in systemic circulating FGF23, and a decrease in the enzymatic activity of the PHEX enzyme which normally removes (degrades) mineralization-inhibiting osteopontin protein; in XLH, the decreased PHEX enzyme activity leads to an accumulation of inhibitory osteopontin locally in bones and teeth to block mineralization which, along with renal phosphate wasting, both cause osteomalacia and odontomalacia.
Enthesitis is inflammation of the entheses, the sites where tendons, ligaments and joint capsules attach to bones.
The endurance running hypothesis is a series of conjectures which presume humans evolved anatomical and physiological adaptations to run long distances and, more strongly, that "running is the only known behavior that would account for the different body plans in Homo as opposed to apes or australopithecines".
Wezmeh Cave is an archaeological site near Islamabad Gharb, western Iran, around 470 km (290 mi) southwest of the capital Tehran. The site was discovered in 1999 and excavated in 2001 by a team of Iranian archaeologists under the leadership of Dr. Kamyar Abdi. Wezmeh cave was re-excavated by a team under direction of Fereidoun Biglari in 2019.
Medieval Bioarchaeology is the study of human remains recovered from medieval archaeological sites. Bioarchaeology aims to understand populations through the analysis of human skeletal remains and this application of bioarchaeology specifically aims to understand medieval populations. There is an interest in the Medieval Period when it comes to bioarchaeology, because of how differently people lived back then as opposed to now, in regards to not only their everyday life, but during times of war and famine as well. The biology and behavior of those that lived in the Medieval Period can be analyzed by understanding their health and lifestyle choices.
Linear enamel hypoplasia (LEH) is a failure of the tooth enamel to develop correctly during growth, leaving bands of reduced enamel on a tooth surface. It is the most common type of enamel hypoplasia reported in clinical and archaeological samples, with other types including plane-form enamel hypoplasia and pitting enamel hypoplasia.
Mortuary archaeology is the study of human remains in their archaeological context. This is a known sub-field of bioarchaeology, which is a field that focuses on gathering important information based on the skeleton of an individual. Bioarchaeology stems from the practice of human osteology which is the anatomical study of skeletal remains. Mortuary archaeology, as well as the overarching field it resides in, aims to generate an understanding of disease, migration, health, nutrition, gender, status, and kinship among past populations. Ultimately, these topics help to produce a picture of the daily lives of past individuals. Mortuary archaeologists draw upon the humanities, as well as social and hard sciences to have a full understanding of the individual.
In the skeleton of humans and other animals, a tubercle, tuberosity or apophysis is a protrusion or eminence that serves as an attachment for skeletal muscles. The muscles attach by tendons, where the enthesis is the connective tissue between the tendon and bone. A tuberosity is generally a larger tubercle.
Mary Lewis is Professor of Bioarchaeology at the University of Reading. After completing a PhD in bioarchaeology at the University of Bradford in 1999, Lewis went on to lecture at Bournemouth University (2000–2004) before moving to the University of Reading in 2004. She conducted the first osteological study of a body which has been hanged, drawn, and quartered. Lewis has held editorial roles with the International Journal of Osteoarchaeology, International Journal of Paleopathology, and the American Journal of Biological Anthropology.
Near Eastern bioarchaeology covers the study of human skeletal remains from archaeological sites in Cyprus, Egypt, Levantine coast, Jordan, Turkey, Iran, Saudi Arabia, Qatar, Kuwait, Bahrain, United Arab Emirates, Oman, and Yemen.