Biceps tendon sheath !
The biceps tendon sheath lines the long biceps tendon in its groove on the humerus; it is an extension of the shoulder joint lining.
Official name: Intertubercular (biceps) tendon sheath
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What it is
The sleeve around the long biceps tendon in its groove.
What it does
Lets the tendon glide; it is continuous with the shoulder joint.
Key facts
- Where
- Intertubercular groove, under the transverse humeral ligament
- Function
- Synovial sleeve continuous with the shoulder joint around the long head of biceps
Relations
- Contents
- Long biceps tendon
- Superficial
- Transverse humeral ligament bridging the groove; below it, the pectoralis major tendon on the lateral lip; the anterior deltoid over all
- Medial
- Lesser tuberosity with the subscapularis tendon
- Lateral
- Greater tuberosity
- Deep
- Floor of the intertubercular groove, where the latissimus dorsi tendon inserts
How to find it
With the arm at the side and the elbow bent at 90°, the groove is felt on the front of the humeral head under the anterior deltoid; turning the arm in and out rolls the groove, and any tender spot, under the finger.
Examination
- Speed test: pain in the groove on resisted forward elevation with the elbow straight and palm up suggests biceps tendinopathy
- Yergason test: pain in the groove on resisted supination with the elbow bent; a palpable snap suggests tendon instability
On imaging
The short-axis ultrasound view shows the tendon centred in the groove; an empty groove means dislocation or rupture. Fluid around the tendon is read together with fluid in the joint.
Clinical notes
- Rupture of the long head gives a Popeye bulge low in the arm, usually in older people with rotator cuff disease, with little loss of strength
- Tenotomy or tenodesis of the long head treats painful tendinopathy and SLAP lesions
Memory aid
Lady between two majors: latissimus dorsi in the floor of the groove, pectoralis major on its lateral lip, teres major on its medial lip.
Related conditions
Test yourself
Think of the answer, then tap the question to see it.
Why does fluid in the biceps tendon sheath often reflect a shoulder effusion?
The sheath is an extension of the shoulder joint's synovium, so joint fluid tracks into it.
What do the Speed and Yergason tests assess in the biceps tendon sheath?
Speed: pain in the groove on resisted forward elevation, elbow straight, palm up (tendinopathy). Yergason: pain on resisted supination, elbow bent; a snap suggests instability.
When does the long biceps tendon dislocate out of its sheath, and in which direction?
Medially, out of the intertubercular groove, when the subscapularis tendon is torn.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- vagina tendinis intertubercularis TA2 2570
- Official Spanish (DeCS)
- Vaina tendinosa intertubercular
- English (TA2)
- Intertubercular (biceps) tendon sheath
Related
Sources: Terminologia Anatomica (TA2); Anatomy, Shoulder and Upper Limb, Biceps Muscle.
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Representative model, for educational purposes only.
