Palmar Aponeurosis by Amna Shaheen.ppt

Palmar aponeurosis
Aponeurosis
DPT

1. •Dakson institute of
health sciences,Islamabad
•Topic: Palmar Aponeurosis
•Presented by: Amna Shaheen
DPT Roll:01

2. Aponeurosis

3. Aponeurosis
A flat/thin sheet of connective
tissue in your body.
It help connect muscles to bone.
Important for Movement and
posture.
You have Aponeurosis all over
your body.

5. Palmar Aponeurosis

7. Palmar Aponeurosis:
The central part of the
deep fascia of the palm.
Highly specialized
thickened structure with
little mobility.
Triangular in shape in
centre of Palm.

9. Continue,,,
It covers underlying
neurovascular and tendon
structures.
It considered as degenerated
tendon of Palmaris Longus.
Fuses medially and laterally with
deep fascia.

11. Function:
•Gives firm attachment
to the skin of palm to
improve grip.
•Protect Underlying
tendons, vessels
&nerves.

12. Mainly it covers:
Superficial Palmar Arch.
Long flexor Tendon.
Terminal part of median nerve.
Superficially ulnar nerve.
Hypothenar & Thenar muscles.

14. Apex:
Lies proximally & blends with flexor
retinaculum.
Continuous with tendon of Palmaris
Longus.

15. Base:
Base is from distal border of
flexor retinaculum.
Rise out distally towards fingers.
Base is further divided into
Superficial & deep strata.

16. Superficial Strata:
Attached to
dermis.

17. Deep strata
Again divided into four slips (one for
each finger) .
Slips opposite the heads of
Metacarpals of medial four digits.

18. Clinical relevance:
Thickening and contraction
due to inflammation of ulnar
side of aponeurosis leads to
DUPUYTREN’s
CONTRACTURE.

21. Dupuytren’s contracture:
A benign, progressive disease of
Palmar fascia/ Palmar
Aponeurosis.
It results in thickening, shortening,
and fibrosis of the fascia and
Aponeurosis of palm.

23. Continue,,
Dupuytren’s disease affects
hands/fingers and result in contracture
deformities.
Commonly afected digits are fourth &
fifth digits.
Disease begins with cords & nodules.

25. Conservative approach/Physical
Therapy
Ultrasound waves.
Heat [early stage of disease.
Brace/splint to stretch digits.
A range of motion of fingers to
prevent adhesions.