Tendinous arch

Arcus tendineus

Definition

Muhammad A. Javaid

A tendinous arch is a curved band of dense fibrous tissue that represents a thickened portion of fascia or aponeurosis. It provides a strong line of attachment for muscles or forms a fibrous bridge over neurovascular structures, allowing them to pass safely beneath it.

Examples

  • Tendinous arch of the diaphragm – formed by the medial and lateral arcuate ligaments, arching over the psoas major and quadratus lumborum muscles.

  • Tendinous arch of the levator ani – a condensation of obturator fascia providing origin for the iliococcygeus part of the pelvic diaphragm.

  • Tendinous arch of the flexor retinaculum (carpal tunnel) – forms the roof of the carpal tunnel, transmitting flexor tendons and the median nerve.

Clinical relevance

Entrapment of nerves or vessels may occur where they pass under a tendinous arch, as in carpal tunnel syndrome.

References

  • Gray, H. (2016) Gray’s anatomy the anatomical basis of clinical practice. 41st edition. Edited by S. Standring. New York: Elsevier.

  • Mauroy B, Goullet E, Stefaniak X, Bonnal JL, Amara N. Tendinous arch of the pelvic fascia: application to the technique of paravaginal colposuspension. Surg Radiol Anat. 2000;22(2):73-9.