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Achilles tendon

2007 Schools Wikipedia Selection. Related subjects: Health and medicine

   Achilles tendon
   Posterior view of the foot and leg, showing the Achilles tendon (tendo
   calcaneus). The gastrocnemius muscle is cut to expose the soleus.
   Lateral view of the human ankle, including the Achilles tendon
   Latin tendo calcaneus, tendo Achillis
   Gray's subject #129 483
   MeSH Achilles+tendon
   Dorlands/Elsevier t_04/12793915

   The Achilles tendon (or occasionally Achilles’ tendon) or the calcaneal
   tendon is a tendon of the posterior leg. It serves to attach the
   gastrocnemius (calf) and soleus muscles to the calcaneus (heel) bone.

Anatomy

   The Achilles tendon is the tendonous extension of three muscles in the
   lower leg: gastrocnemius, soleus, and plantaris. In humans, the tendon
   passes behind the ankle. It is the thickest and strongest tendon in the
   body. It is about 15 cm long, and begins near the middle of the leg,
   but receives fleshy fibers on its anterior surface, almost to its lower
   end. Gradually becoming contracted below, it is inserted into the
   middle part of the posterior surface of the calcaneus, a bursa being
   interposed between the tendon and the upper part of this surface. The
   tendon spreads out somewhat at its lower end, so that its narrowest
   part is about 4 cm. above its insertion. It is covered by the fascia
   and the integument, and stands out prominently behind the bone; the gap
   is filled up with areolar and adipose tissue. Along its lateral side,
   but superficial to it, is the small saphenous vein. The achilles'
   muscle reflex tests the integrity of the S1 spinal root.

Nomenclature

   The oldest-known written record of the tendon being named for Achilles
   is in 1693 by the Flemish/Dutch anatomist Philip Verheyen. In his
   widely used text Corporis Humani Anatomia, Chapter XV, page 328, he
   described the tendon's location and said that it was commonly called
   "the cord of Achilles" ("quae vulgo dicitur chorda Achillis").

   The name Achilles' heel comes from Greek mythology. His mother, the
   goddess Thetis, received a prophecy of her son's death. In order to
   protect him, she dipped him into the River Styx, which protected his
   entire body from harm. However, in order to dip him into the river, she
   needed to grab onto his heel. During the Trojan War Achilles was struck
   on his unprotected heel by a poisoned arrow, which killed him.

Role in disease

   Achilles tendonitis is inflammation of the tendon, generally due to
   overuse of the affected limb or as part of a strain injury. More common
   is Achilles tendinosis, a degenerative condition with inflammation of
   the tendon, often accompanied by pain and swelling of the surrounding
   tissue and paratendon. Maffulli et al. suggested that the clinical
   label of tendinopathy should be given to the combination of tendon
   pain, swelling and impaired performance. Achilles tendon rupture is a
   partial or complete break in the tendon; it requires immobilisation or
   surgery. Xanthoma can develop in the Achilles tendon in patients with
   familial hypercholesterolemia.

Treatment of Achilles tendon damage

   Initial treatment of damage to the tendon is generally nonoperative.
   Orthotics can produce early relief to the tendon by the correction of
   malalignments, non-steroidal anti-inflammatory drugs (NSAIDs) are
   generally to be avoided as they make the more-common tendinopathy
   (degenerative) injuries worse; though they may very occasionally be
   indicated for the rarer tendinitis (inflammatory) injuries.
   Physiotherapy by eccentric calf stretching under resistance is commonly
   recommended, usually in conjunction with podiatric insoles or heel
   cushioning. According to reports by Hakan Alfredson, M.D., and
   associates of clinical trials in Sweden, the pain in Achilles
   tendinopathy arises from the nerves associated with neovascularization
   and can be effectively treated with 1-4 small injections of a
   sclerosant. In a cross-over trial, 19 of 20 of his patients were
   successfully treated with this sclerotherapy.

   Where tendon rupture is concerned, there are three main types of
   treatment: the open and the percutaneous operative methods, and
   nonoperative approaches.

Achilles tendon damage in popular culture

   Severance of the Achilles tendon is considered by many a particularly
   unpleasant injury. This has led authors to use it for shock value.
   Achilles tendons are severed in the movies Pet Sematary (1989),
   Sympathy for Mr. Vengeance (2002), Kill Bill (2003), House of Wax
   (2005), Hostel (2006), and Saw 3 (2006) . In the Gor novels, severing
   Achilles tendons is a punishment for slaves who try to flee.

   Ironically, during the filming of Troy (2004), Brad Pitt injured his
   achilles tendon and was unable to perform during this period.

Additional images

   The popliteal, posterior tibial, and peroneal arteries.

   Back of left lower extremity.

   The mucous sheaths of the tendons around the ankle. Lateral aspect.

   The mucous sheaths of the tendons around the ankle. Medial aspect.

   General anatomy of lower limbs
   Buttocks and Thigh

   Inguinal ligament • Obturator membrane • Femoral ring • Femoral canal •
   Femoral sheath • Femoral triangle • Adductor canal • Adductor hiatus •
   Fascia lata • Saphenous opening • Iliotibial tract • Fascial
   compartments of thigh ( Anterior, Medial, Posterior)
   Cnemis (anatomic leg)

   Popliteal fossa • Calf • Shin • Pes anserinus • Fascial compartments of
   leg ( Anterior, Lateral, Posterior)
   Foot

   Heel • Plantar fascia • Toe ( Hallux, Fifth toe) • Sole • Achilles
   tendon • Tarsal tunnel • Retinacula ( Peroneal, Inferior extensor,
   Superior extensor)
   Retrieved from " http://en.wikipedia.org/wiki/Achilles_tendon"
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   with only minor checks and changes (see www.wikipedia.org for details
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