Deep fascia

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Deep fascia
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Identifiers
Latin fascia profunda
Anatomical terminology

Deep fascia (or investing fascia) is a fascia, a layer of dense connective tissue that can surround individual muscles and groups of muscles to separate into fascial compartments.

Contents

This fibrous connective tissue interpenetrates and surrounds the muscles, bones, nerves, and blood vessels of the body. It provides connection and communication in the form of aponeuroses, ligaments, tendons, retinacula, joint capsules, and septa. The deep fasciae envelop all bone (periosteum and endosteum); cartilage (perichondrium), and blood vessels (tunica externa) and become specialized in muscles (epimysium, perimysium, and endomysium) and nerves (epineurium, perineurium, and endoneurium). The high density of collagen fibers gives the deep fascia its strength and integrity. The amount of elastin fiber determines how much extensibility and resilience it will have. [1] The continuity of the deep fasciae within the human body inspired the artistic expression seen in the Fascial Net Plastination Project, which is prominently displayed at the Body Worlds exhibition in Berlin. [2]

Examples

Examples include:

Fascial dynamics

Deep fascia is less extensible than superficial fascia. It is essentially avascular, [3] but is richly innervated with sensory receptors that report the presence of pain (nociceptors); change in movement (proprioceptors); change in pressure and vibration (mechanoreceptors); change in the chemical milieu (chemoreceptors); and fluctuation in temperature (thermoreceptors). [4] [5] Deep fascia is able to respond to sensory input by contracting; by relaxing; or by adding, reducing, or changing its composition through the process of fascial remodeling. [6]

Fascia may be able to contract due to the activity of myofibroblasts which may play a role in wound healing. [7]

The deep fascia can also relax. By monitoring changes in muscular tension, joint position, rate of movement, pressure, and vibration, mechanoreceptors in the deep fascia are capable of initiating relaxation. Deep fascia can relax rapidly in response to sudden muscular overload or rapid movements. Golgi tendon organs operate as a feedback mechanism by causing myofascial relaxation before muscle force becomes so great that tendons might be torn. Pacinian corpuscles sense changes in pressure and vibration to monitor the rate of acceleration of movement. They will initiate a sudden relaxatory response if movement happens too fast. [8] Deep fascia can also relax slowly as some mechanoreceptors respond to changes over longer timescales. Unlike the Golgi tendon organs, Golgi receptors report joint position independent of muscle contraction. This helps the body to know where the bones are at any given moment. Ruffini endings respond to regular stretching and to slow sustained pressure. In addition to initiating fascial relaxation, they contribute to full-body relaxation by inhibiting sympathetic activity which slows down heart rate and respiration. [4] [9]

When contraction persists, fascia will respond with the addition of new material. Fibroblasts secrete collagen and other proteins into the extracellular matrix where they bind to existing proteins, making the composition thicker and less extensible. Although this potentiates the tensile strength of the fascia, it can unfortunately restrict the very structures it aims to protect. The pathologies resulting from fascial restrictions range from a mild decrease in joint range of motion to severe fascial binding of muscles, nerves and blood vessels, as in compartment syndrome of the leg. However, if fascial contraction can be interrupted long enough, a reverse form of fascial remodeling occurs. The fascia will normalize its composition and tone and the extra material that was generated by prolonged contraction will be ingested by macrophages within the extracellular matrix. [10]

Like mechanoreceptors, chemoreceptors in deep fascia also have the ability to promote fascial relaxation. We tend to think of relaxation as a good thing, however fascia needs to maintain some degree of tension. This is especially true of ligaments. To maintain joint integrity, they need to provide adequate tension between bony surfaces. If a ligament is too lax, injury becomes more likely. Certain chemicals, including hormones, can influence the composition of the ligaments. An example of this is seen in the menstrual cycle, where hormones are secreted to create changes in the uterine and pelvic floor fascia. The hormones are not site-specific, however, and chemoreceptors in other ligaments of the body can be receptive to them as well. The ligaments of the knee may be one of the areas where this happens, as a significant association between the ovulatory phase of the menstrual cycle and an increased likelihood for an anterior cruciate ligament injury has been demonstrated. [11] [12]

Related Research Articles

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:

<span class="mw-page-title-main">Levator ani</span> Broad, thin muscle group, situated on either side of the pelvis

The levator ani is a broad, thin muscle group, situated on either side of the pelvis. It is formed from three muscle components: the pubococcygeus, the iliococcygeus, and the puborectalis.

<span class="mw-page-title-main">Sartorius muscle</span> Longest muscle in the human body

The sartorius muscle is the longest muscle in the human body. It is a long, thin, superficial muscle that runs down the length of the thigh in the anterior compartment.

<span class="mw-page-title-main">Fascial compartment</span> Section within the body containing muscles and nerves and surrounded by fascia

A fascial compartment is a section within the body that contains muscles and nerves and is surrounded by deep fascia. In the human body, the limbs can each be divided into two segments – the upper limb can be divided into the arm and the forearm and the sectional compartments of both of these – the fascial compartments of the arm and the fascial compartments of the forearm contain an anterior and a posterior compartment. Likewise, the lower limbs can be divided into two segments – the leg and the thigh – and these contain the fascial compartments of the leg and the fascial compartments of the thigh.

<span class="mw-page-title-main">Fascia</span> Layer of connective tissue in the body

A fascia is a generic term for macroscopic membranous bodily structures. Fasciae are classified as superficial, visceral or deep, and further designated according to their anatomical location.

<span class="mw-page-title-main">Anterior cruciate ligament</span> Type of cruciate ligament in the human knee

The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments in the human knee. The two ligaments are called "cruciform" ligaments, as they are arranged in a crossed formation. In the quadruped stifle joint, based on its anatomical position, it is also referred to as the cranial cruciate ligament. The term cruciate is Latin for cross. This name is fitting because the ACL crosses the posterior cruciate ligament to form an "X". It is composed of strong, fibrous material and assists in controlling excessive motion by limiting mobility of the joint. The anterior cruciate ligament is one of the four main ligaments of the knee, providing 85% of the restraining force to anterior tibial displacement at 30 and 90° of knee flexion. The ACL is the most frequently injured ligament in the knee.

<span class="mw-page-title-main">Omohyoid muscle</span> Human neck muscle

The omohyoid muscle is a muscle in the neck. It is one of the infrahyoid muscles. It consists of two bellies separated by an intermediate tendon. Its inferior belly is attached to the scapula; its superior belly is attached to the hyoid bone. Its intermediate tendon is anchored to the clavicle and first rib by a fascial sling. The omohyoid is innervated by the ansa cervicalis of the cervical plexus. It acts to depress the hyoid bone.

<span class="mw-page-title-main">Aponeurosis</span> Tissue which connects muscles to other organs

An aponeurosis is a flattened tendon by which muscle attaches to bone or fascia. Aponeuroses exhibit an ordered arrangement of collagen fibres, thus attaining high tensile strength in a particular direction while being vulnerable to tensional or shear forces in other directions. They have a shiny, whitish-silvery color, are histologically similar to tendons, and are very sparingly supplied with blood vessels and nerves. When dissected, aponeuroses are papery and peel off by sections. The primary regions with thick aponeuroses are in the ventral abdominal region, the dorsal lumbar region, the ventriculus in birds, and the palmar (palms) and plantar (soles) regions.

<span class="mw-page-title-main">Endomysium</span> Connective tissue ensheathing individual muscle fibres

The endomysium, meaning within the muscle, is a wispy layer of areolar connective tissue that ensheaths each individual muscle fiber, or muscle cell. It also contains capillaries and nerves. It overlies the muscle fiber's cell membrane: the sarcolemma. Endomysium is the deepest and smallest component of muscle connective tissue. This thin layer helps provide an appropriate chemical environment for the exchange of calcium, sodium, and potassium, which is essential for the excitation and subsequent contraction of a muscle fiber.

<span class="mw-page-title-main">Semitendinosus muscle</span> One of the hamstring muscles; posterior part of the thigh

The semitendinosus is a long superficial muscle in the back of the thigh. It is so named because it has a very long tendon of insertion. It lies posteromedially in the thigh, superficial to the semimembranosus.

<span class="mw-page-title-main">Tensor fasciae latae muscle</span> Muscle of the thigh

The tensor fasciae latae is a muscle of the thigh. Together with the gluteus maximus, it acts on and is continuous with the iliotibial band, which attaches to the tibia. The muscle assists in keeping the balance of the pelvis while standing, walking, or running.

<span class="mw-page-title-main">Thoracolumbar fascia</span> Anatomical feature

The thoracolumbar fascia is a complex, multilayer arrangement of fascial and aponeurotic layers forming a separation between the paraspinal muscles on one side, and the muscles of the posterior abdominal wall on the other. It spans the length of the back, extending between the neck superiorly and the sacrum inferiorly. It entails the fasciae and aponeuroses of the latissimus dorsi muscle, serratus posterior inferior muscle, abdominal internal oblique muscle, and transverse abdominal muscle.

<span class="mw-page-title-main">Fascia lata</span> Deep fascia of the thigh

The fascia lata is the deep fascia of the thigh. It encloses the thigh muscles and forms the outer limit of the fascial compartments of thigh, which are internally separated by the medial intermuscular septum and the lateral intermuscular septum. The fascia lata is thickened at its lateral side where it forms the iliotibial tract, a structure that runs to the tibia and serves as a site of muscle attachment.

<span class="mw-page-title-main">Transversalis fascia</span> Aponeurosis between the transverse abdominal muscle and the extraperitoneal fat

The transversalis fascia is the fascial lining of the anterolateral abdominal wall situated between the inner surface of the transverse abdominal muscle, and the preperitoneal fascia. It is directly continuous with the iliac fascia, the internal spermatic fascia, and pelvic fascia.

<span class="mw-page-title-main">Root of penis</span> Internal portion of the human penis

In human male anatomy, the radix or root of the penis is the internal and most proximal portion of the human penis that lies in the perineum. Unlike the pendulous body of the penis, which is suspended from the pubic symphysis, the root is attached to the pubic arch of the pelvis and is not visible externally. It is triradiate in form, consisting of three masses of erectile tissue; the two diverging crura, one on either side, and the median bulb of the penis or urethral bulb. Approximately one third to one half of the penis is embedded in the pelvis and can be felt through the scrotum and in the perineum.

Fascia training describes sports activities and movement exercises that attempt to improve the functional properties of the muscular connective tissues in the human body, such as tendons, ligaments, joint capsules and muscular envelopes. Also called fascia, these tissues take part in a body-wide tensional force transmission network and are responsive to training stimulation. As of 2018 the body-wide continuity of this tensional system has been expressed in an educational manner within the Fascial Net Plastination Project. The FNPP brought together experts in anatomy, dissection, and plastination, and it was the first project of its kind to plastinate a complete human fascia specimen.

<span class="mw-page-title-main">Vaginal support structures</span> Structures that maintain the position of the vagina within the pelvic cavity

The vaginal support structures are those muscles, bones, ligaments, tendons, membranes and fascia, of the pelvic floor that maintain the position of the vagina within the pelvic cavity and allow the normal functioning of the vagina and other reproductive structures in the female. Defects or injuries to these support structures in the pelvic floor leads to pelvic organ prolapse. Anatomical and congenital variations of vaginal support structures can predispose a woman to further dysfunction and prolapse later in life. The urethra is part of the anterior wall of the vagina and damage to the support structures there can lead to incontinence and urinary retention.

Fascial Manipulation is a manual therapy technique developed by Italian physiotherapist Luigi Stecco in the 1980s, aimed at evaluating and treating global fascial dysfunction by restoring normal motion/gliding to the system.

<span class="mw-page-title-main">Robert Schleip</span> German [[Fascia]] Researcher

Robert Schleip is a German psychologist, human biologist and author, best known for his research in the field of fascia. His work includes numerous scientific papers and books, which have contributed to the understanding of fascia and its role in musculoskeletal health. He serves as the Director of the Fascia Research Group at both the University of Ulm and the Technical University of Munich. Schleip is also the Founding Director of the Fascia Research Society, the Research Director of the European Rolfing Association and Vice President of the Ida P. Rolf Research Foundation.

The Fascial Net Plastination Project is an anatomical research initiative established in 2018 aimed at plastinating and studying the human fascial network. Spearheaded by Robert Schleip, in collaboration with Body Worlds, Fascia Research Group, and the Fascia Research Society, the project focuses on preserving the fascia, a complex connective tissue network that plays a crucial role in the human body's structure and function.

References

  1. ↑ Hedley, Gil (2005). The Integral Anatomy Series Vol. 2: Deep Fascia and Muscle (DVD). Integral Anatomy Productions. Retrieved 2006-07-17.
  2. ↑ "FR:EIA - Fascial Net Plastination Project". Body Worlds. Retrieved 2024-08-26.
  3. ↑ Rolf, Ida P. (1989). Rolfing . Rochester, VT: Healing Arts Press. p.  38. ISBN   0892813350.
  4. 1 2 Schleip, Robert (2003). "Fascial plasticity – a new neurobiological explanation: Part 1". Journal of Bodywork and Movement Therapies. 7 (1): 11–9. doi:10.1016/S1360-8592(02)00067-0.
  5. ↑ Gatt, Adrianna; Agarwal, Sanjay; Zito, Patrick M. (2021). "Anatomy, Fascia Layers". StatPearls. StatPearls Publishing.
  6. ↑ Myers, Thomas W. (2002). Anatomy Trains. London, UK: Churchill Livingstone. p. 15. ISBN   0443063516.
  7. ↑ Tomasek, James J.; Gabbiani, Giulio; Hinz, Boris; Chaponnier, Christine; Brown, Robert A. (2002). "Myofibroblasts and mechano-regulation of connective tissue remodelling". Nature Reviews Molecular Cell Biology. 3 (5): 349–63. doi:10.1038/nrm809. PMID   11988769.
  8. ↑ Chaitow, Leon (1988). Soft Tissue Manipulation. Rochester, VT: Healing Arts Press. pp. 26–7. ISBN   0892812761.
  9. ↑ Schleip, Robert (2003). "Fascial plasticity – a new neurobiological explanation Part 2". Journal of Bodywork and Movement Therapies. 7 (2): 104–16. doi:10.1016/S1360-8592(02)00076-1.
  10. ↑ Paoletti, Serge (2006). The Fasciae: Anatomy, Dysfunction & Treatment. Seattle, WA: Eastland Press. pp. 138, 147–9. ISBN   093961653X.
  11. ↑ Wojtys, E. M.; Huston, L. J.; Lindenfeld, T. N.; Hewett, T. E.; Greenfield, M. L. (1998). "Association between the menstrual cycle and anterior cruciate ligament injuries in female athletes". The American Journal of Sports Medicine. 26 (5): 614–9. doi:10.1177/03635465980260050301. PMID   9784805.
  12. ↑ Heitz, N. A.; Eisenman, P. A.; Beck, C. L.; Walker, J. A. (1999). "Hormonal changes throughout the menstrual cycle and increased anterior cruciate ligament laxity in females". Journal of Athletic Training. 34 (2): 144–9. PMC   1322903 . PMID   16558557.
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