Upper limb

Intertubercular tendon sheath of biceps (Long head of biceps sheath)

Vagina tendinis intertubercularis

Origin

Direct synovial extension of the glenohumeral joint cavity

Insertion

Ensheathes the long head of the biceps brachii tendon within the bicipital groove beneath the transverse humeral ligament

Function

Enables frictionless excursion of the biceps tendon as it traverses the intertubercular sulcus of the humerus

Innervation

Sensory branches from axillary and suprascapular nerves

Movement & chain

Glides through the bicipital groove during arm elevation and rotation

Palpation

Palpable over the anterior proximal humerus in the intertubercular groove with the arm in 10° internal rotation

Clinical

Biceps tenosynovitis, effusion within sheath (cardinal ultrasound sign of glenohumeral pathology), biceps tendon subluxation/dislocation from groove, and SLAP lesions

Segmental innervation

C5–C6 spinal segments

In clinical practice

Speed's and Yergason's clinical diagnostic tests; ultrasound-guided sheath injection, biceps tenotomy or tenodesis for refractory tendinopathy

Region in the model

Upper limb