Fascia | |
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![]() The rectus sheath (extensive vertical darker gray at left), an example of a fascia | |
Details | |
Precursor | Mesenchyme |
Identifiers | |
Latin | fascia |
MeSH | D005205 |
TA98 | A04.0.00.031 |
TA2 | 2015 |
FMA | 78550 |
Anatomical terminology |
A fascia ( /ˈfæʃ(i)ə/ ; pl.: fasciae /ˈfæʃii/ or fascias; [1] adjective fascial; from Latin band) is a generic term for macroscopic membranous bodily structures. [2] : 42 Fasciae are classified as superficial, visceral or deep, and further designated according to their anatomical location. [3]
The knowledge of fascial structures is essential in surgery, as they create borders for infectious processes (for example Psoas abscess) and haematoma. An increase in pressure may result in a compartment syndrome, where a prompt fasciotomy may be necessary. For this reason, profound descriptions of fascial structures are available in anatomical literature from the 19th century.
Fasciae were traditionally thought of as passive structures that transmit mechanical tension generated by muscular activities or external forces throughout the body. An important function of muscle fasciae is to reduce friction of muscular force. In doing so, fasciae provide a supportive and movable wrapping for nerves and blood vessels as they pass through and between muscles. [4]
In the tradition of medical dissections it has been common practice to carefully clean muscles and other organs from their surrounding fasciae in order to study their detailed topography and function. However, this practice tends to ignore that many muscle fibers insert into their fascial envelopes and that the function of many organs is significantly altered when their related fasciae are removed. [5] This insight contributed to several modern biomechanical concepts of the human body, in which fascial tissues take over important stabilizing and connecting functions, by distributing tensional forces across several joints in a network-like manner similar to the architectural concept of tensegrity. [6] Starting in 2018 this concept of the fascial tissue serving as a body-wide tensional support system has been successfully expressed as an educational model with the Fascial Net Plastination Project.
Fascial tissues – particularly those with tendinous or aponeurotic properties – are also able to store and release elastic potential energy.
A fascial compartment is a section within the body that contains muscles and nerves and is surrounded by 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. 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.
Fascia itself becomes clinically important when it loses stiffness, becomes too stiff, or has decreased shearing ability. [7] When inflammatory fasciitis or trauma causes fibrosis and adhesions, fascial tissue fails to differentiate the adjacent structures effectively. This can happen after surgery, where the fascia has been incised and healing includes a scar that traverses the surrounding structures.
The Fascial Net Plastination Project (FNPP) is an anatomical research initiative spearheaded by fascia researcher Robert Schleip. The project aims to enhance the study of fascia through the technique of plastination. Led by an international team of fascia experts and anatomists, the FNPP resulted in the creation of a full-body fascia plastinate known as FR:EIA (Fascia Revealed: Educating Interconnected Anatomy). [8] This plastinate provides a detailed view of the human fascial network, allowing for a better understanding of its structure and function as an interconnected tissue throughout the body.
FR:EIA was unveiled at the 2021 Fascia Research Congress and is currently exhibited at the Body Worlds exhibition in Berlin. This project represents a significant contribution to the visualization of fascia and has the potential to influence future research in fields such as medicine, physical therapy, and movement science. [8] [9]
There exists some controversy about what structures are considered "fascia" and how they should be classified. [10] [11]
The current version of the International Federation of Associations of Anatomists divides into: [10]
Two former, rather commonly used systems are:
NA 1983 | TA 1997 | Description | Example |
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Superficial fascia | (not considered fascia in this system) | This is found in the subcutis in most regions of the body, blending with the reticular layer of the dermis. [12] | Fascia of Scarpa |
Deep fascia | Fascia of muscles | This is the dense fibrous connective tissue that interpenetrates and surrounds the muscles, bones, nerves and blood vessels of the body. | Transverse fascia |
Visceral fascia | Visceral fascia, parietal fascia | This suspends the organs within their cavities and wraps them in layers of connective tissue membranes. | Pericardium |
Superficial fascia is the lowermost layer of the skin in nearly all of the regions of the body, that blends with the reticular dermis layer. [13] It is present on the face, over the upper portion of the sternocleidomastoid, at the nape of the neck and overlying the breastbone. [14] It consists mainly of loose areolar and fatty adipose connective tissue and is the layer that primarily determines the shape of a body.[ medical citation needed ] In addition to its subcutaneous presence, superficial fascia surrounds organs, glands and neurovascular bundles, and fills otherwise empty space at many other locations. It serves as a storage medium of fat and water; as a passageway for lymph, nerve and blood vessels; and as a protective padding to cushion and insulate. [15]
Superficial fascia is present, but does not contain fat, in the eyelid, ear, scrotum, penis and clitoris. [16]
Due to its viscoelastic properties, superficial fascia can stretch to accommodate the deposition of adipose that accompanies both ordinary and prenatal weight gain. After pregnancy and weight loss, the superficial fascia slowly reverts to its original level of tension.
Visceral fascia (also called subserous fascia) suspends the organs within their cavities and wraps them in layers of connective tissue membranes. Each of the organs is covered in a double layer of fascia; these layers are separated by a thin serous membrane.
Visceral fascia is less extensible than superficial fascia. Due to its suspensory role for the organs, it needs to maintain its tone rather consistently. If it is too lax, it contributes to organ prolapse, yet if it is hypertonic, it restricts proper organ motility. [18]
Deep fascia is a layer of dense fibrous connective tissue which surrounds individual muscles and divides groups of muscles into fascial compartments. This fascia has a high density of elastin fibre that determines its extensibility or resilience. [19] Deep fascia was originally considered to be essentially avascular but later investigations have confirmed a rich presence of thin blood vessels. [20] Deep fascia is also richly supplied with sensory receptors. [21] Examples of deep fascia are fascia lata, fascia cruris, brachial fascia, plantar fascia, thoracolumbar fascia and Buck's fascia.
In anatomy, the thigh is the area between the hip (pelvis) and the knee. Anatomically, it is part of the lower limb.
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.
Plastination is a technique or process used in anatomy to preserve bodies or body parts, first developed by Gunther von Hagens in 1977. The water and fat are replaced by certain plastics, yielding specimens that can be touched, do not smell or decay, and even retain most properties of the original sample.
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.
Deep fascia is a fascia, a layer of dense connective tissue that can surround individual muscles and groups of muscles to separate into fascial compartments.
In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls.
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.
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.
The masseteric fascia and parotideomasseteric fascia are fascias of the head varyingly described depending upon the source consulted. They may or may not be described as one and the same structure.
The fascia of Camper is a thick superficial layer of the anterior abdominal wall.
The lumbar fascia is the lumbar portion of the thoracolumbar fascia. It consists of three fascial layers - posterior, middle, and anterior - that enclose two muscular compartments. The anterior and middle layers occur only in the lumbar region, whereas the posterior layer extends superiorly to the inferior part of the neck, and the inferiorly to the dorsal surface of the sacrum. The quadratus lumborum is contained in the anterior muscular compartment, and the erector spinae in the posterior compartment. Psoas major lies anterior to the anterior layer. Various superficial muscles of the posterior thorax and abdomen arise from the posterior layer - namely the latissimus dorsi, and serratus posterior inferior.
The following outline is provided as an overview of and topical guide to human anatomy:
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.
Fascial spaces are potential spaces that exist between the fasciae and underlying organs and other tissues. In health, these spaces do not exist; they are only created by pathology, e.g. the spread of pus or cellulitis in an infection. The fascial spaces can also be opened during the dissection of a cadaver. The fascial spaces are different from the fasciae themselves, which are bands of connective tissue that surround structures, e.g. muscles. The opening of fascial spaces may be facilitated by pathogenic bacterial release of enzymes which cause tissue lysis. The spaces filled with loose areolar connective tissue may also be termed clefts. Other contents such as salivary glands, blood vessels, nerves and lymph nodes are dependent upon the location of the space. Those containing neurovascular tissue may also be termed compartments.
Anatomical Terminology is a specialized system of terms used by anatomists, zoologists, and health professionals, such as doctors, surgeons, and pharmacists, to describe the structures and functions of the body.
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.
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.
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. The collaboration was initiated by Robert Schleip as a joint effort between 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.
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