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Intertubercular Tendon Sheath
Connective Tissue

Intertubercular Tendon Sheath

Vagina tendinis intertubercularis

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Anatomical Relations

The intertubercular tendon sheath wraps around the proximal portion of the tendon of the long head of the biceps brachii, within the intertubercular sulcus (or bicipital groove).

This sulcus sits between the greater and lesser tubercles of the proximal humeral shaft. The transverse humeral ligament bridges the gap between the two tubercles and acts as a retinaculum for the tendon of the long head of biceps brachii and its surrounding intertubercular tendon sheath.

The intertubercular tendon sheath is bounded on both sides by the tendon of the pectoralis major, laterally, and the teres major, medially (Standring, 2016)

It runs distally within the sulcus and is accompanied the ascending branch of the anterior circumflex humeral artery as far as the surgical neck of the humerus (Standring, 2016).

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The intertubercular tendon sheath has an outer fibrous component and an inner double layered sheath of synovial membrane that is akin to a longitudinal bursa. The synovial layer is composed of an inner, visceral layer and an outer, parietal layer. The synovium produces a thin layer of lubricating fluid between the visceral and parietal layers which surround the tendons. The intertubercular tendon sheath is continuous with the synovial membrane of the glenohumeral joint.


The intertubercular tendon sheath provides a well-lubricated, smooth surface that reduces friction during movement of the tendon.


Standring, S. (2016) Gray's Anatomy: The Anatomical Basis of Clinical Practice. Gray's Anatomy Series 41st edn.: Elsevier Limited.

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Tendon Sheath

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Tenosynovectomy refers to the excision of thickened tendon sheath and other tissue surrounding a tendon, commonly seen in infection, chemical irritation, and rheumatoid arthritis (synovectomy).

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