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Soft tissue is all the tissue in the body that is not hardened by the processes of
ossification Ossification (also called osteogenesis or bone mineralization) in bone remodeling is the process of laying down new bone material by cells named osteoblasts. It is synonymous with bone tissue formation. There are two processes resulting in t ...
or
calcification Calcification is the accumulation of calcium salts in a body tissue. It normally occurs in the formation of bone, but calcium can be deposited abnormally in soft tissue,Miller, J. D. Cardiovascular calcification: Orbicular origins. ''Nature Mat ...
such as
bone A bone is a Stiffness, rigid Organ (biology), organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red blood cell, red and white blood cells, store minerals, provid ...
s and
teeth A tooth ( : teeth) is a hard, calcified structure found in the jaws (or mouths) of many vertebrates and used to break down food. Some animals, particularly carnivores and omnivores, also use teeth to help with capturing or wounding prey, tear ...
. Soft tissue connects, surrounds or supports internal organs and bones, and includes
muscle Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of muscl ...
,
tendon A tendon or sinew is a tough, high-tensile-strength band of dense fibrous connective tissue that connects muscle to bone. It is able to transmit the mechanical forces of muscle contraction to the skeletal system without sacrificing its ability ...
s,
ligament A ligament is the fibrous connective tissue that connects bones to other bones. It is also known as ''articular ligament'', ''articular larua'', ''fibrous ligament'', or ''true ligament''. Other ligaments in the body include the: * Peritoneal li ...
s,
fat In nutrition science, nutrition, biology, and chemistry, fat usually means any ester of fatty acids, or a mixture of such chemical compound, compounds, most commonly those that occur in living beings or in food. The term often refers spec ...
,
fibrous tissue Fiber or fibre (from la, fibra, links=no) is a natural or artificial substance that is significantly longer than it is wide. Fibers are often used in the manufacture of other materials. The strongest engineering materials often incorporate ...
,
lymph Lymph (from Latin, , meaning "water") is the fluid that flows through the lymphatic system, a system composed of lymph vessels (channels) and intervening lymph nodes whose function, like the venous system, is to return fluid from the tissues to ...
and
blood vessel The blood vessels are the components of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide away ...
s,
fascia A fascia (; plural fasciae or fascias; adjective fascial; from Latin: "band") is a band or sheet of connective tissue, primarily collagen, beneath the skin that attaches to, stabilizes, encloses, and separates muscles and other internal organs. ...
e, and
synovial membrane The synovial membrane (also known as the synovial stratum, synovium or stratum synoviale) is a specialized connective tissue that lines the inner surface of capsules of synovial joints and tendon sheath. It makes direct contact with the fibrous ...
s.Definition
at
National Cancer Institute The National Cancer Institute (NCI) coordinates the United States National Cancer Program and is part of the National Institutes of Health (NIH), which is one of eleven agencies that are part of the U.S. Department of Health and Human Services. ...
  It is sometimes defined by what it is not – such as "nonepithelial, extraskeletal
mesenchyme Mesenchyme () is a type of loosely organized animal embryonic connective tissue of undifferentiated cells that give rise to most tissues, such as skin, blood or bone. The interactions between mesenchyme and epithelium help to form nearly every o ...
exclusive of the
reticuloendothelial In immunology, the mononuclear phagocyte system or mononuclear phagocytic system (MPS) also known as the reticuloendothelial system or macrophage system is a part of the immune system that consists of the phagocytic cells located in reticular co ...
system and
glia Glia, also called glial cells (gliocytes) or neuroglia, are non-neuronal cells in the central nervous system (brain and spinal cord) and the peripheral nervous system that do not produce electrical impulses. They maintain homeostasis, form mye ...
".


Composition

The characteristic substances inside the
extracellular matrix In biology, the extracellular matrix (ECM), also called intercellular matrix, is a three-dimensional network consisting of extracellular macromolecules and minerals, such as collagen, enzymes, glycoproteins and hydroxyapatite that provide stru ...
of soft tissue are the
collagen Collagen () is the main structural protein in the extracellular matrix found in the body's various connective tissues. As the main component of connective tissue, it is the most abundant protein in mammals, making up from 25% to 35% of the whole ...
,
elastin Elastin is a protein that in humans is encoded by the ''ELN'' gene. Elastin is a key component of the extracellular matrix in gnathostomes (jawed vertebrates). It is highly elastic and present in connective tissue allowing many tissues in the bod ...
and
ground substance Ground substance is an amorphous gel-like substance in the extracellular space that contains all components of the extracellular matrix (ECM) except for fibrous materials such as collagen and elastin. Ground substance is active in the development, m ...
. Normally the soft tissue is very hydrated because of the ground substance. The
fibroblasts A fibroblast is a type of biological cell that synthesizes the extracellular matrix and collagen, produces the structural framework ( stroma) for animal tissues, and plays a critical role in wound healing. Fibroblasts are the most common cells o ...
are the most common cell responsible for the production of soft tissues' fibers and ground substance. Variations of fibroblasts, like
chondroblasts Chondroblasts, or perichondrial cells, is the name given to mesenchymal progenitor cells in situ which, from endochondral ossification, will form chondrocytes in the growing cartilage matrix. Another name for them is subchondral cortico-spongious ...
, may also produce these substances.


Mechanical characteristics

At small strains, elastin confers
stiffness Stiffness is the extent to which an object resists deformation in response to an applied force. The complementary concept is flexibility or pliability: the more flexible an object is, the less stiff it is. Calculations The stiffness, k, of a b ...
to the tissue and stores most of the
strain energy In physics, the elastic potential energy gained by a wire during elongation with a tensile (stretching) force is called strain energy. For Linear elasticity, linearly elastic materials, strain energy is: : U = \frac 1 2 V \sigma \epsilon = \frac ...
. The collagen fibers are comparatively inextensible and are usually loose (wavy, crimped). With increasing tissue deformation the collagen is gradually stretched in the direction of deformation. When taut, these fibers produce a strong growth in tissue stiffness. The
composite Composite or compositing may refer to: Materials * Composite material, a material that is made from several different substances ** Metal matrix composite, composed of metal and other parts ** Cermet, a composite of ceramic and metallic materials ...
behavior is analogous to a
nylon stocking Stockings (also known as hose, especially in a historical context) are close-fitting, variously elastic garments covering the leg from the foot up to the knee or possibly part or all of the thigh. Stockings vary in color, design, and transparen ...
, whose rubber band does the role of elastin as the
nylon Nylon is a generic designation for a family of synthetic polymers composed of polyamides ( repeating units linked by amide links).The polyamides may be aliphatic or semi-aromatic. Nylon is a silk-like thermoplastic, generally made from petro ...
does the role of collagen. In soft tissues, the collagen limits the deformation and protects the tissues from injury. Human soft tissue is highly deformable, and its mechanical properties vary significantly from one person to another. Impact testing results showed that the stiffness and the damping resistance of a test subject’s tissue are correlated with the mass, velocity, and size of the striking object. Such properties may be useful for forensics investigation when contusions were induced. When a solid object impacts a human soft tissue, the energy of the impact will be absorbed by the tissues to reduce the effect of the impact or the pain level; subjects with more soft tissue thickness tended to absorb the impacts with less aversion. Soft tissues have the potential to undergo large deformations and still return to the initial configuration when unloaded, i.e. they are
hyperelastic material A hyperelastic or Green elastic materialR.W. Ogden, 1984, ''Non-Linear Elastic Deformations'', , Dover. is a type of constitutive model for ideally elastic material for which the stress–strain relationship derives from a strain energy density ...
s, and their stress-strain curve is
nonlinear In mathematics and science, a nonlinear system is a system in which the change of the output is not proportional to the change of the input. Nonlinear problems are of interest to engineers, biologists, physicists, mathematicians, and many other ...
. The soft tissues are also
viscoelastic In materials science and continuum mechanics, viscoelasticity is the property of materials that exhibit both viscous and elastic characteristics when undergoing deformation. Viscous materials, like water, resist shear flow and strain linearly wi ...
,
incompressible In fluid mechanics or more generally continuum mechanics, incompressible flow ( isochoric flow) refers to a flow in which the material density is constant within a fluid parcel—an infinitesimal volume that moves with the flow velocity. An eq ...
and usually
anisotropic Anisotropy () is the property of a material which allows it to change or assume different properties in different directions, as opposed to isotropy. It can be defined as a difference, when measured along different axes, in a material's physic ...
. Some viscoelastic properties observable in soft tissues are: relaxation, creep and
hysteresis Hysteresis is the dependence of the state of a system on its history. For example, a magnet may have more than one possible magnetic moment in a given magnetic field, depending on how the field changed in the past. Plots of a single component of ...
. In order to describe the mechanical response of soft tissues, several methods have been used. These methods include: hyperelastic macroscopic models based on strain energy, mathematical fits where nonlinear constitutive equations are used, and structurally based models where the response of a linear elastic material is modified by its geometric characteristics.


Pseudoelasticity

Even though soft tissues have viscoelastic properties, i.e. stress as function of strain rate, it can be approximated by a hyperelastic model after precondition to a load pattern. After some cycles of loading and unloading the material, the mechanical response becomes independent of strain rate. :\mathbf=\mathbf(\mathbf,\dot) \quad\rightarrow\quad \mathbf=\mathbf(\mathbf) Despite the independence of strain rate, preconditioned soft tissues still present hysteresis, so the mechanical response can be modeled as hyperelastic with different material constants at loading and unloading. By this method the elasticity theory is used to model an inelastic material. Fung has called this model as pseudoelastic to point out that the material is not truly elastic.


Residual stress

In physiological state soft tissues usually present
residual stress In materials science and solid mechanics, residual stresses are Stress (physics), stresses that remain in a solid material after the original cause of the stresses has been removed. Residual stress may be desirable or undesirable. For example, l ...
that may be released when the tissue is excised.
Physiologists Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemical ...
and
histologists Histology, also known as microscopic anatomy or microanatomy, is the branch of biology which studies the microscopic anatomy of biological tissue (biology), tissues. Histology is the microscopic counterpart to gross anatomy, which looks at larg ...
must be aware of this fact to avoid mistakes when analyzing excised tissues. This retraction usually causes a
visual artifact Visual artifacts (also artefacts) are artifact (error), anomalies apparent during visual representation as in digital graphics and other forms of imagery, especially photography and microscopy. In digital graphics * Image quality#Image quality f ...
.


Fung-elastic material

Fung developed a
constitutive equation In physics and engineering, a constitutive equation or constitutive relation is a relation between two physical quantities (especially kinetic quantities as related to kinematic quantities) that is specific to a material or substance, and approx ...
for preconditioned soft tissues which is :W = \frac\left + c\left( e^Q -1 \right) \right/math> with :q=a_E_E_ \qquad Q=b_E_E_ quadratic forms of Green-Lagrange strains E_ and a_, b_ and c material constants. W is the strain energy function per volume unit, which is the mechanical strain energy for a given temperature.


Isotropic simplification

The Fung-model, simplified with isotropic hypothesis (same mechanical properties in all directions). This written in respect of the principal stretches (\lambda_i): :W = \frac\left (\lambda_1^2 + \lambda_2^2 + \lambda_3^2 - 3) + b\left( e^ -1 \right) \right/math> , where a, b and c are constants.


Simplification for small and big stretches

For small strains, the exponential term is very small, thus negligible. :W = \fraca_E_E_ On the other hand, the linear term is negligible when the analysis rely only on big strains. :W = \fracc\left( e^ -1 \right)


Gent-elastic material

:W = - \frac \ln \left(1 - \left( \frac \right) \right) where \mu > 0 is the shear modulus for infinitesimal strains and J_m > 0 is a stiffening parameter, associated with limiting chain extensibility. This constitutive model cannot be stretched in uni-axial tension beyond a maximal stretch J_m, which is the positive root of :\lambda_m^2 + 2\lambda_m - J_m - 3 = 1


Remodeling and growth

Soft tissues have the potential to grow and remodel reacting to chemical and mechanical long term changes. The rate the fibroblasts produce
tropocollagen Collagen () is the main structural protein in the extracellular matrix found in the body's various connective tissues. As the main component of connective tissue, it is the most abundant protein in mammals, making up from 25% to 35% of the whole ...
is proportional to these stimuli. Diseases, injuries and changes in the level of mechanical load may induce remodeling. An example of this phenomenon is the thickening of farmer's hands. The remodeling of connective tissues is well known in bones by the
Wolff's law Wolff's law, developed by the German anatomist and surgeon Julius Wolff (surgeon), Julius Wolff (1836–1902) in the 19th century, states that bone in a healthy animal will adapt to the loads under which it is placed. If loading on a particular ...
(
bone remodeling Bone remodeling (or bone metabolism) is a lifelong process where mature bone tissue is removed from the skeleton (a process called ''bone resorption'') and new bone tissue is formed (a process called ''ossification'' or ''new bone formation''). T ...
). Mechanobiology is the science that study the relation between stress and growth at cellular level. Growth and remodeling have a major role in the cause of some common soft tissue diseases, like arterial
stenosis A stenosis (from Ancient Greek στενός, "narrow") is an abnormal narrowing in a blood vessel or other tubular organ or structure such as foramina and canals. It is also sometimes called a stricture (as in urethral stricture). ''Stricture'' ...
and aneurisms and any soft tissue
fibrosis Fibrosis, also known as fibrotic scarring, is a pathological wound healing in which connective tissue replaces normal parenchymal tissue to the extent that it goes unchecked, leading to considerable tissue remodelling and the formation of perma ...
. Other instance of tissue remodeling is the thickening of the
cardiac muscle Cardiac muscle (also called heart muscle, myocardium, cardiomyocytes and cardiac myocytes) is one of three types of vertebrate muscle tissues, with the other two being skeletal muscle and smooth muscle. It is an involuntary, striated muscle th ...
in response to the growth of
blood pressure Blood pressure (BP) is the pressure of circulating blood against the walls of blood vessels. Most of this pressure results from the heart pumping blood through the circulatory system. When used without qualification, the term "blood pressure" r ...
detected by the
arterial An artery (plural arteries) () is a blood vessel in humans and most animals that takes blood away from the heart to one or more parts of the body (tissues, lungs, brain etc.). Most arteries carry oxygenated blood; the two exceptions are the pul ...
wall.


Imaging techniques

There are certain issues that have to be kept in mind when choosing an imaging technique for visualizing soft tissue
extracellular matrix In biology, the extracellular matrix (ECM), also called intercellular matrix, is a three-dimensional network consisting of extracellular macromolecules and minerals, such as collagen, enzymes, glycoproteins and hydroxyapatite that provide stru ...
(ECM) components. The accuracy of the image analysis relies on the properties and the quality of the raw data and, therefore, the choice of the imaging technique must be based upon issues such as: # Having an optimal resolution for the components of interest; # Achieving high contrast of those components; # Keeping the artifact count low; # Having the option of volume data acquisition; # Keeping the data volume low; # Establishing an easy and reproducible setup for tissue analysis. The collagen fibers are approximately 1-2 μm thick. Thus, the resolution of the imaging technique needs to be approximately 0.5 μm. Some techniques allow the direct acquisition of volume data while other need the slicing of the specimen. In both cases, the volume that is extracted must be able to follow the fiber bundles across the volume. High contrast makes segmentation easier, especially when color information is available. In addition, the need for fixation must also be addressed. It has been shown that soft tissue fixation in
formalin Formaldehyde ( , ) (systematic name methanal) is a naturally occurring organic compound with the formula and structure . The pure compound is a pungent, colourless gas that polymerises spontaneously into paraformaldehyde (refer to section Fo ...
causes shrinkage, altering the structure of the original tissue. Some typical values of contraction for different fixation are: formalin (5% - 10%),
alcohol Alcohol most commonly refers to: * Alcohol (chemistry), an organic compound in which a hydroxyl group is bound to a carbon atom * Alcohol (drug), an intoxicant found in alcoholic drinks Alcohol may also refer to: Chemicals * Ethanol, one of sev ...
(10%), bouin (<5%). Imaging methods used in ECM visualization and their properties.


Disorders

Soft tissue disorders are medical conditions affecting soft tissue. Often soft tissue injuries are some of the most chronically painful and difficult to treat because it is very difficult to see what is going on under the skin with the soft connective tissues, fascia, joints, muscles and tendons. Musculoskeletal specialists, manual therapists and neuromuscular physiologists and neurologists specialize in treating injuries and ailments in the soft tissue areas of the body. These specialized clinicians often develop innovative ways to manipulate the soft tissue to speed natural healing and relieve the mysterious pain that often accompanies soft tissue injuries. This area of expertise has become known as
soft tissue therapy Manual therapy, or manipulative therapy, is a physical treatment primarily used by physical therapists, physiotherapists, occupational therapists to treat musculoskeletal pain and disability; it mostly includes kneading and manipulation of mus ...
and is rapidly expanding as the technology continues to improve the ability of these specialists to identify problem areas more quickly. A promising new method of treating wounds and soft tissue injuries is via platelet growth factor (PGF). There is a close overlap between the term "soft tissue disorder" and
rheumatism Rheumatism or rheumatic disorders are conditions causing chronic, often intermittent pain affecting the joints or connective tissue. Rheumatism does not designate any specific disorder, but covers at least 200 different conditions, including art ...
. Sometimes the term "soft tissue rheumatic disorders" is used to describe these conditions.


See also

*
Biomaterial A biomaterial is a substance that has been engineered to interact with biological systems for a medical purpose, either a therapeutic (treat, augment, repair, or replace a tissue function of the body) or a diagnostic one. As a science, biomateria ...
*
Biomechanics Biomechanics is the study of the structure, function and motion of the mechanical aspects of biological systems, at any level from whole organisms to organs, cells and cell organelles, using the methods of mechanics. Biomechanics is a branch of ...
* Davis's law *
Rheology Rheology (; ) is the study of the flow of matter, primarily in a fluid ( liquid or gas) state, but also as "soft solids" or solids under conditions in which they respond with plastic flow rather than deforming elastically in response to an appl ...
*
Soft tissue sarcoma A soft-tissue sarcoma (STS) is a malignant tumour, a type of cancer, that develops in soft tissue. A soft tissue sarcoma is often a painless mass that grows slowly over months or years. They may be superficial or deep-seated. Any such unexplained ...


References


External links

* {{DEFAULTSORT:Soft Tissue Biomechanics Tissues (biology) Continuum mechanics