Dense connective tissue
Connective tissue is a term used to describe a variety of types of tissues. It comprises a diverse group of cells that can be found in different parts of the body. It is an important structural element that supports and separates spaces between our organs and tissues in the human body. The cells that make this connective tissue are loosely packed into an extracellular matrix, which is a structural network surrounding and supporting cells within the connective tissue.
Dense connective tissue is a type of connective tissue that can be further split into dense regular connective tissue and dense irregular connective tissue. Dense regular connective tissue comprises structures such as ligaments, tendons and aponeuroses, whilst dense irregular tissue is more widely distributed throughout the body.
This article will describe the cell types making up connective tissue as well as the histology and function of dense regular and dense irregular connective tissue .
|Collagen arrangement||The collagen fibers are arranged in a regular parallel fashion to allow strength and stretch.|
|Composition||Almost completely filled with bundles of collagen and few fibroblasts.|
|Location||Found in ligaments, tendons and aponeuroses.|
|Fiber arrangement||There can be a multilayered arrangement of fibers to form sheets of tissue e.g aponeurotic fascia.|
|Function||Provides strong connections and resistance to force in the musculoskeletal system.|
|Collagen arrangement||The collagen fibers are irregularly arranged in a compact interwoven web.|
|Composition||Has small amount of ground substance (a gel-like substance that fills spaces between fibers and cells) and has few cells - mostly fibroblasts.|
|Location||Found in hollow organs forming the submucosa and in the skin as the reticular layer.|
|Fiber arrangement||Multilayered arrangement of fibers is not found in this tissue.|
|Function||Main function: supports and protects organs by resisting tearing.|
- Cell Types
- Dense irregular connective tissue
- Dense regular connective tissue
- Clinical notes
There are two types of dense connective tissue made up of different types of cells. These cells include collagen and fibroblasts.
The most abundant and important fibers of connective tissue are composed of collagen.
Collagen is a protein that is made by specialized cells called fibroblasts. There are different types of collagen that can be found throughout the body, but notably in connective tissue is collagen type I. Structurally, this type of collagen is composed of three stranded collagen molecules that are packed together to form so called collagen fibrils whose alignment yields characteristic ultrastructural striations.
These collagen fibers then fill the extracellular matrix giving the white appearance of dense connective tissue e.g sclera of the eye.
Ground substance is also found in the extracellular matrix. This is a highly hydrated complex mixture of macromolecules filling the space between fibers in the connective tissue.
Ground substance acts both as a lubricant and a barrier to penetration by foreign objects.
Fibroblasts are responsible for the synthesis of collagen and extracellular matrix. They appear as flattened, fusiform or spindle shaped cells. They have large euchromatic nuclei with prominent nucleoli. The cytoplasm of young and active cells are basophilic due to the presence of high concentration of rough endoplasmic reticulum, mitochondria and many sets of Golgi apparatus.
The old and inactive fibroblasts, also known as fibrocytes, have reduced cytoplasm with few cell organelles and flattened heterochromatic nuclei. Fibrocytes are fewer in number but have been shown to increase in quantity secondary to pathology such as tissue damage. This causes them to become activated and to therefore perform the function of both fibroblasts and macrophages.
In general, fibroblasts become very active during wound repair and healing process, when they proliferate and form fibrous matrices. A specialized form of fibroblasts known as myofibroblasts also appear during wound contraction. The myofibroblasts are characterized by the presence of actin filaments and dense bodies. Overall, these cells exhibit the properties of fibroblasts as well as that of smooth muscle cells.
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Dense irregular connective tissue
Dense irregular connective tissue is a 3-dimensional structure that can withstand significant force from different directions.
The strength of dense connective tissue comes from the high proportion of randomly organized type I collagen fibers in the tissue that are oriented randomly in a compact interwoven 3-dimensional web.
Collagen fibers have good tensile strength meaning that they are resistant to breaking under tension. This therefore makes collagen important in the supportive functions of this tissue.
They are also surrounded by small amounts of ground substance. Ground substance is amorphous and gel-like in texture and contains molecules such as proteoglycans and adhesive glycoproteins.
Among the collagen fibers there is also a network of elastic fibers to limit the distensibility of the tissue.
Dense irregular connective tissue is found in high concentrations in body parts where support is needed to prevent the effects of forces that pull in multiple directions.
For example, it can be found within hollow organs, arranged to form a distinct layer known as the submucosa. In this layer, the fiber bundles lie in varying planes which allow the excessive distention of these organs.
Similarly, the skin also has a thick layer of dense connective tissue. This layer is called the reticular layer of the dermis and is essential in resisting any stretching forces that may be applied to the skin.
Dense regular connective tissue
Dense regular connective tissue is mainly made up of type I collagen fibers. The collagen fibers are densely packed together and arranged in parallel to each other. This arrangement allows the fibers to have a good resistance to forces pulling along a single axis, but also gives some ability to stretch. A small amount of ground substance is present around dense regular connective tissue fibers and cells.
It is found in areas of the body where large amounts of tensile strength are required, like in ligaments, tendons and aponeuroses.
Tendons and ligaments attach to bones, and the role of dense regular connective tissue is to dissipate forces to bones.
Tendons are generally resistant to extension, but they are flexible. A tendon comprises fascicles of collagen fibers, which run parallel along their axis. In a cross section, a tendon will usually appear round or oval in shape. Where a tendon attaches to a bone, there is a transition from pure dense fibrous connective tissue, unmineralized fibrocartilage, mineralized fibrocartilage and bone.
Meanwhile, aponeuroses are flat sheets of collagen fibers that normally comprise numerous layers. Aponeuroses are important in attaching bone to muscle. In some muscles, the bone attachment is only partially aponeurotic, and partially tendinous, but in some cases, the bone attachment is entirely aponeurotic.
Ligaments form from thick bundles of connective tissue, mainly forming from collagen. Despite their density, ligaments can still be fairly elastic. Ligaments need to be strong as they connect bones together, and hold joints in place.
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Tendonitis is inflammation of the tendons and their attachments to muscle. This usually occurs due to overuse or strain. It can be associated with diseases such as diabetes, rheumatoid arthritis or infection. The inflammation and pain caused by tendonitis causes limited range of motion.
Common locations include:
- DeQuervain’s tenosynovitis: this is the most common and is swelling in the tendon sheath of the tendons of the thumb.
- Lateral epicondylitis: known as tennis elbow. The patient experiences pain on the backside of the elbow and the forearm.
- Medial epicondylitis: known as golfer’s elbow. This causes pain from the elbow to the wrist.
- Rotator cuff tendonitis: this is known as biceps tendonitis. It causes inflammation on the rotator cuff of the shoulder.
Diagnosis of tendonitis is via joint aspiration where the healthcare provider uses a needle to a small amount of fluid from the joint. This fluid is then tested for signs of infection or gout.
Treatment of tendonitis includes the use of anti-inflammatory agents like cortisone injections or splinting the area to reduce movement.
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