Cribriform fascia

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Cribriform fascia
Gray580.png
The great saphenous vein and its tributaries at the saphenous opening
Details
Identifiers
Latin fascia cribrosa
TA98 A04.7.03.020
TA2 2706
FMA 58735
Anatomical terminology

The cribriform fascia, fascia cribrosa, also Hesselbach's fascia, is the portion of fascia covering the saphenous opening in the thigh. It is perforated by the great saphenous vein and by numerous blood and lymphatic vessels. (A structure in anatomy that is pierced by several small holes is referred to as cribriform from Latin cribrum meaning sieve). [1]

Contents

Clinical significance

The cribriform fascia has been proposed for use in preventing new vascularization when surgery is performed at the join between the great saphenous vein and the femoral vein. [2]

Eponym

When the eponym is used, it is named for Franz Kaspar Hesselbach. [3] [4]

Related Research Articles

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The gracilis muscle is the most superficial muscle on the medial side of the thigh. It is thin and flattened, broad above, narrow and tapering below.

<span class="mw-page-title-main">Superficial epigastric artery</span> Large blood vessel

The superficial epigastric artery arises from the front of the femoral artery about 1 cm below the inguinal ligament, and, passing through the femoral sheath and the fascia cribrosa, turns upward in front of the inguinal ligament, and ascends between the two layers of the superficial fascia of the abdominal wall nearly as far as the umbilicus.

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<span class="mw-page-title-main">Saphenous opening</span>

In anatomy, the saphenous opening is an oval opening in the upper mid part of the fascia lata of the thigh. It lies 3–4 cm below and lateral to the pubic tubercle and is about 3 cm long and 1.5 cm wide.

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A neurovascular bundle is a structure that binds nerves and veins with connective tissue so that they travel in tandem through the body.

Franz Kaspar Hesselbach was a German surgeon and anatomist who was a native of Hammelburg.

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<span class="mw-page-title-main">Ultrasonography of chronic venous insufficiency of the legs</span> Non-invasive medical procedure

Ultrasonography of suspected or previously confirmed chronic venous insufficiency of leg veins is a risk-free, non-invasive procedure. It gives information about the anatomy, physiology and pathology of mainly superficial veins. As with heart ultrasound (echocardiography) studies, venous ultrasonography requires an understanding of hemodynamics in order to give useful examination reports. In chronic venous insufficiency, sonographic examination is of most benefit; in confirming varicose disease, making an assessment of the hemodynamics, and charting the progression of the disease and its response to treatment. It has become the reference standard for examining the condition and hemodynamics of the lower limb veins. Particular veins of the deep venous system (DVS), and the superficial venous system (SVS) are looked at. The great saphenous vein (GSV), and the small saphenous vein (SSV) are superficial veins which drain into respectively, the common femoral vein and the popliteal vein. These veins are deep veins. Perforator veins drain superficial veins into the deep veins. Three anatomic compartments are described, (N1) containing the deep veins, (N2) containing the perforator veins, and (N3) containing the superficial veins, known as the saphenous compartment. This compartmentalisation makes it easier for the examiner to systematize and map. The GSV can be located in the saphenous compartment where together with the Giacomini vein and the accessory saphenous vein (ASV) an image resembling an eye, known as the 'eye sign' can be seen. The ASV which is often responsible for varicose veins, can be located at the 'alignment sign', where it is seen to align with the femoral vessels.

<span class="mw-page-title-main">Giacomini vein</span>

The Giacomini vein or cranial extension of the small saphenous vein is a communicating vein between the great saphenous vein (GSV) and the small saphenous vein (SSV). It is named after the Italian anatomist Carlo Giacomini (1840–1898). The Giacomini vein courses the posterior thigh as either a trunk projection, or tributary of the SSV. In one study it was found in over two-thirds of limbs. Another study in India found the vein to be present in 92% of those examined. It is located under the superficial fascia and its insufficiency seemed of little importance in the majority of patients with varicose disease, but the use of ultrasonography has highlighted a new significance of this vein. It can be part of a draining variant of the SSV which continues on to reach the GSV at the proximal third of the thigh instead of draining into the popliteal vein. The direction of its flow is usually anterograde but it can be retrograde when this vein acts as a bypass from an insufficient GSV to SSV to call on this last one to collaborate in draining. Many discussions exist about this vein, some of them confusing to a non-expert reader. Insufficiency in the Giacomini vein can present in isolation but is mostly seen together with a GSV insufficiency. It has been shown to be effectively treated either with endovenous laser ablation or by ultrasound guided sclerotherapy.

References

PD-icon.svgThis article incorporates text in the public domain from page 468 of the 20th edition of Gray's Anatomy (1918)

  1. O.D.E. 2nd edition 2005
  2. De Maeseneer, MG; Philipsen, TE; Vandenbroeck, CP; Lauwers, PR; Hendriks, JM; De Hert, SG; Van Schil, PE (2007). "Closure of the cribriform fascia: an efficient anatomical barrier against postoperative neovascularisation at the saphenofemoral junction? A prospective study". European Journal of Vascular and Endovascular Surgery. 34 (3): 361–6. doi: 10.1016/j.ejvs.2007.03.020 . PMID   17513142.
  3. synd/3213 at Who Named It?
  4. F. K. Hesselbach. Anatomisch-chirurgische Abhandlung über den Urspurng der Leistenbrüche. Würzburg, Baumgärtner, 1806.