Cribriform fascia | |
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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]
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]
When the eponym is used, it is named for Franz Kaspar Hesselbach. [3] [4]
Varicose veins, also known as varicoses, are a medical condition in which superficial veins become enlarged and twisted. These veins typically develop in the legs, just under the skin. Varicose veins usually cause few symptoms. However, some individuals may experience fatigue or pain in the area. Complications can include bleeding or superficial thrombophlebitis. Varices in the scrotum are known as a varicocele, while those around the anus are known as hemorrhoids. Due to the various physical, social, and psychological effects of varicose veins, they can negatively affect one's quality of life.
The great saphenous vein (GSV) or long saphenous vein is a large, subcutaneous, superficial vein of the leg. It is the longest vein in the body, running along the length of the lower limb, returning blood from the foot, leg and thigh to the deep femoral vein at the femoral triangle.
Inguinal lymph nodes are lymph nodes in the groin. They are situated in the femoral triangle of the inguinal region. They are subdivided into two groups: the superficial inguinal lymph nodes and deep inguinal lymph nodes.
The popliteal vein is a vein of the lower limb. It is formed from the anterior tibial vein and the posterior tibial vein. It travels medial to the popliteal artery, and becomes the femoral vein. It drains blood from the leg. It can be assessed using medical ultrasound. It can be affected by popliteal vein entrapment.
In the human body, the femoral vein is the vein that accompanies the femoral artery in the femoral sheath. It is a deep vein that begins at the adductor hiatus as the continuation of the popliteal vein. The great saphenous vein, and the deep femoral vein drain into the femoral vein in the femoral triangle when it becomes known as the common femoral vein. It ends at the inferior margin of the inguinal ligament where it becomes the external iliac vein. Its major tributaries are the deep femoral vein, and the great saphenous vein. The femoral vein contains valves.
The small saphenous vein is a relatively large superficial vein of the posterior leg.
Superficial veins are veins that are close to the surface of the body, as opposed to deep veins, which are far from the surface.
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.
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.
The superficial iliac circumflex artery, the smallest of the cutaneous branches of the femoral artery, arises close to the superficial epigastric artery, and, piercing the fascia lata, runs lateralward, parallel with the inguinal ligament, as far as the crest of the ilium.
The saphenous nerve is the largest cutaneous branch of the femoral nerve. It is derived from the lumbar plexus (L3-L4). It is a strictly sensory nerve, and has no motor function. It commences in the proximal (upper) thigh and travels along the adductor canal. Upon exiting the adductor canal, the saphenous nerve terminates by splitting into two terminal branches: the sartorial nerve, and the infrapatellar nerve. The saphenous nerve is responsible for providing sensory innervation to the skin of the anteromedial leg.
In human male anatomy, the dorsal veins of the penis are blood vessels that drain the shaft, the skin and the glans of the human penis. They are typically located in the midline on the dorsal aspect of the penis and they comprise the superficial dorsal veinof the penis, that lies in the subcutaneous tissue of the shaft, and the deep dorsal veinof the penis, that lies beneath the deep fascia.
The popliteal lymph nodes, small in size and some six or seven in number, are embedded in the fat contained in the popliteal fossa, sometimes referred to as the 'knee pit'. One lies immediately beneath the popliteal fascia, near the terminal part of the small saphenous vein, and drains the region from which this vein derives its tributaries, such as superficial regions of the posterolateral aspect of the leg and the plantar aspect of the foot.
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.
The anterior cutaneous branches of the femoral nerve consist of the following nerves: intermediate cutaneous nerve and medial cutaneous nerve.
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.
Communicating veins are veins that communicate two different points of the same venous system. Other veins that connect the superficial venous system with the deep venous system are known as perforator veins.
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.
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.
This article incorporates text in the public domain from page 468 of the 20th edition of Gray's Anatomy (1918)