Achilles tendon 380167 225347538 2008-07-13T05:43:30Z PurrfectPeach 6502504 /* Anatomy */ leg -> calf, judging by pic that's what it should read {{Infobox Anatomy | Name = Achilles tendon | Latin = tendo calcaneus, tendo Achillis | GraySubject = 129 | GrayPage = 483 | Image = achilles-tendon.jpg | Caption = Posterior view of the foot and leg, showing the Achilles tendon (''tendo calcaneus''). The gastrocnemius muscle is cut to expose the soleus. | Image2 = Ankle.PNG | Caption2 = Lateral view of the human ankle, including the Achilles tendon | Precursor = | System = | Artery = | Vein = | Nerve = | Lymph = | MeshName = Achilles+tendon | MeshNumber = A02.880.176 | DorlandsPre = t_04 | DorlandsSuf = 12793915 | }} :''This is about vertebrate anatomy. For the metaphor of a single vulnerable spot, see [[Achilles' heel]].'' :''For specific information about injury to the Achilles tendon, see [[Achilles tendon rupture]].'' The '''Achilles tendon''' (or occasionally '''Achilles’ tendon'''), also known as the '''calcaneal tendon''' or the '''tendocalcaneous''', is a [[tendon]] of the posterior [[leg]]. It serves to attach the [[gastrocnemius]] (calf) and [[soleus]] [[muscle]]s 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 calf, 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 (Anatomy)|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 connective tissue|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. Because eponyms have no relationship to the subject matter anatomical eponyms are being replaced by descriptive terms. The current terminology for Achilles tendon is calcaneal tendon. However, recently the medical community has decided to revert to the old eponyms and this tendon is, once again, known as the Achilles. ==Role in disease== [[Achilles tendinitis]] 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 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 drug]]s (NSAIDs) are generally to be avoided as they make the more-common tendinopathy (degenerative) injuries worse{{Fact|date=February 2007}}; 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.{{Fact|date=December 2007}} In case of [[Achilles tendon rupture]] is concerned, there are three main types of treatment: the open and the percutaneous operative methods, and nonoperative approaches. ==References== <references/> {{unreferenced|date=January 2008}} ==External links== * [http://www.conquestchronicles.com/special/The_Achilles_Tendon_Injury The Achilles Tendon Injury] ==Additional images== <gallery> Image:Gray551.png|The popliteal, posterior tibial, and peroneal arteries. Image:Gray1239.png|Back of left lower extremity. Image:Gray1241.png|The mucous sheaths of the tendons around the ankle. Lateral aspect. Image:Gray1242.png|The mucous sheaths of the tendons around the ankle. Medial aspect. </gallery> {{Lower limb general}} [[Category:Human anatomy]] [[Category:Tendons]] [[Category:Pelvic limb anatomy]] [[da:Akillessene]] [[de:Achillessehne]] [[es:Tendón de Aquiles]] [[eo:Aĥila tendeno]] [[fr:Tendon d'Achille]] [[hr:Petna tetiva]] [[id:Tendon Achilles]] [[nl:Achillespees]] [[ja:アキレス腱]] [[pl:Ścięgno Achillesa]] [[pt:Tendão de Aquiles]] [[fi:Akillesjänne]] [[sv:Akillessenan]] [[tr:Aşil tendonu]]