Fascia lata

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Fascia lata
Gray431.png
The fossa ovalis. (Fascia lata labeled at bottom left.)
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Iliotibial tract.
Details
Identifiers
Latin fascia lata
MeSH D005206
TA98 A04.7.03.002
TA2 2689
FMA 13902
Anatomical terminology

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. [1]

Contents

Structure

The fascia lata is an investment for the whole of the thigh, but varies in thickness in different parts. It is thicker in the upper and lateral part of the thigh, where it receives a fibrous expansion from the gluteus maximus, and where the tensor fasciae latae is inserted between its layers; it is very thin behind and at the upper and medial part, where it covers the adductor muscles, and again becomes stronger around the knee, receiving fibrous expansions from the tendon of the biceps femoris laterally, from the sartorius medially, and from the quadriceps femoris in front.

Function

The fascia lata surrounds the tensor fasciae latae muscle. It is a fibrous sheath that encircles the thigh subcutaneously. This encircling of the muscle allows the muscles to be bound together tightly.[ citation needed ]

Above and behind

The fascia lata is attached, above and behind (i.e. proximal and posterior), to the back of the sacrum and coccyx; laterally, to the iliac crest; in front, to the inguinal ligament, and to the superior ramus of the pubis; and medially, to the inferior ramus of the pubis, to the inferior ramus and tuberosity of the ischium, and to the lower border of the sacrotuberous ligament.

From its attachment to the iliac crest it passes down over the gluteus medius to the upper border of the gluteus maximus, where it splits into two layers, one passing superficial to and the other beneath this muscle; at the lower border of the muscle the two layers reunite.

Laterally

Laterally, the fascia lata receives the greater part of the tendon of insertion of the gluteus maximus, and becomes proportionately thickened.

The portion of the fascia lata attached to the front part of the iliac crest, and corresponding to the origin of the tensor fasciae latae, extends down the lateral side of the thigh as two layers, one superficial to and the other beneath this muscle; at the lower end of the muscle these two layers unite and form a strong band, having first received the insertion of the muscle.

This band is continued downward under the name of the iliotibial band and is attached to the lateral condyle of the tibia.

The part of the iliotibial band which lies beneath the tensor fasciae latae is prolonged upward to join the lateral part of the capsule of the hip joint.

Below

Below, the fascia lata is attached to all the prominent points around the knee joint, viz., the condyles of the femur and tibia, and the head of the fibula.

On either side of the kneecap it is strengthened by transverse fibers from the lower parts of the vasti muscles (three of the four quadriceps) which are attached to and support this bone.

Of these the lateral are the stronger, and are continuous with the iliotibial band.

The deep surface of the fascia lata gives off two strong intermuscular septa, which are attached to the whole length of the linea aspera and its prolongations above and below; the lateral intermuscular septum, the stronger of the two, extends from the insertion of the gluteus maximus to the lateral condyle, separates the vastus lateralis in front from the short head of the biceps femoris behind, and gives partial origin to these muscles; the medial intermuscular septum is the thinner one and separates the vastus medialis from the adductor muscles.

Besides these there are numerous smaller septa, separating the individual muscles, and enclosing each in a distinct sheath.

Deep fascia of leg

The deep fascia of the lower leg is a continuation of the fascia lata. [2]

Clinical significance

Transplantation

Since the 1920s fasciae latae from deceased donors have been used in reconstructive surgery. In 1999 preserved mashed fasciae latae became FDA-approved as a tissue product designed to replace areas of lost fascia or collagen. [3] The fascia lata normally performs the function of encircling and tightening the muscles in the thigh. Because of this function, it has been used as grafts for patients with facial paralysis. The fascia lata offers supports to the muscles that make up the face and this support increases the recovery of the facial muscles. The surgeons use the fascia lata as a sort of facial sling to support up the paralyzed face and loops the fascia lata around the center of the lower lip, the corner of the mouth and the center of the upper lip. [4] A small portion of fascia lata harvested through a sub centimeter skin incision on the lower lateral side of the thigh is used for reconstructing the ear drum in tympanoplasty surgery. A larger portion is used in nasal endoscopic skull base surgery.

History

Etymology

It is named from its great extent. "Latus" give the superlative "Latissimus" meaning broadest or widest. [5]

Additional images

Related Research Articles

<span class="mw-page-title-main">Human leg</span> Lower extremity or limb of the human body (foot, lower leg, thigh and hip)

The human leg is the entire lower limb of the human body, including the foot, thigh or sometimes even the hip or buttock region. The major bones of the leg are the femur, tibia, and adjacent fibula. The thigh is between the hip and knee, while the calf (rear) and shin (front) are between the knee and foot.

<span class="mw-page-title-main">Gluteus maximus</span> Largest and most superficial of the three gluteal muscles

The gluteus maximus is the main extensor muscle of the hip in humans. It is the largest and outermost of the three gluteal muscles and makes up a large part of the shape and appearance of each side of the hips. It is the single largest muscle in the human body. Its thick fleshy mass, in a quadrilateral shape, forms the prominence of the buttocks. The other gluteal muscles are the medius and minimus, and sometimes informally these are collectively referred to as the glutes.

<span class="mw-page-title-main">Hip</span> Anatomical region between the torso and the legs, holding the buttocks and genital region

In vertebrate anatomy, hip refers to either an anatomical region or a joint.

The biceps femoris is a muscle of the thigh located to the posterior, or back. As its name implies, it consists of two heads; the long head is considered part of the hamstring muscle group, while the short head is sometimes excluded from this characterization, as it only causes knee flexion and is activated by a separate nerve.

<span class="mw-page-title-main">Adductor magnus muscle</span> Muscle in the thigh

The adductor magnus is a large triangular muscle, situated on the medial side of the thigh.

<span class="mw-page-title-main">Gracilis muscle</span> Most superficial muscle on the medial side of the thigh

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 semimembranosus muscle is the most medial of the three hamstring muscles in the thigh. It is so named because it has a flat tendon of origin. It lies posteromedially in the thigh, deep to the semitendinosus muscle. It extends the hip joint and flexes the knee joint.

<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 the iliotibial band and is continuous with the iliotibial tract, which attaches to the tibia. The muscle assists in keeping the balance of the pelvis while standing, walking, or running.

The linea aspera is a ridge of roughened surface on the posterior surface of the shaft of the femur. It is the site of attachments of muscles and the intermuscular septum.

<span class="mw-page-title-main">Muscles of the hip</span> Causes movement in the hip

In human anatomy, the muscles of the hip joint are those muscles that cause movement in the hip. Most modern anatomists define 17 of these muscles, although some additional muscles may sometimes be considered. These are often divided into four groups according to their orientation around the hip joint: the gluteal group; the lateral rotator group; the adductor group; and the iliopsoas group.

<span class="mw-page-title-main">Sacrotuberous ligament</span>

The sacrotuberous ligament is situated at the lower and back part of the pelvis. It is flat, and triangular in form; narrower in the middle than at the ends.

<span class="mw-page-title-main">Iliotibial tract</span> Longitudinal fibrous reinforcement of the fascia lata

The iliotibial tract or iliotibial band is a longitudinal fibrous reinforcement of the fascia lata. The action of the muscles associated with the ITB flex, extend, abduct, and laterally and medially rotate the hip. The ITB contributes to lateral knee stabilization. During knee extension the ITB moves anterior to the lateral condyle of the femur, while ~30 degrees knee flexion, the ITB moves posterior to the lateral condyle. However, it has been suggested that this is only an illusion due to the changing tension in the anterior and posterior fibers during movement. It originates at the anterolateral iliac tubercle portion of the external lip of the iliac crest and inserts at the lateral condyle of the tibia at Gerdy's tubercle. The figure shows only the proximal part of the iliotibial tract.

<span class="mw-page-title-main">Superior gluteal artery</span>

The superior gluteal artery is the terminal branch of the posterior division of the internal iliac artery. It exits the pelvis through the greater sciatic foramen before splitting into a superficial branch and a deep branch.

<span class="mw-page-title-main">Wing of ilium</span> Flat portion of the hip bone

The wing(ala)of ilium is the large expanded portion of the ilium, the bone which bounds the greater pelvis laterally. It presents for examination two surfaces—an external and an internal—a crest, and two borders—an anterior and a posterior.

<span class="mw-page-title-main">Posterior compartment of thigh</span> One of the fascial compartments that contains the knee flexors and hip extensors

The posterior compartment of the thigh is one of the fascial compartments that contains the knee flexors and hip extensors known as the hamstring muscles, as well as vascular and nervous elements, particularly the sciatic nerve.

<span class="mw-page-title-main">Deep fascia of leg</span> Forms a complete investment to the muscles

The deep fascia of leg, or crural fascia forms a complete investment to the muscles, and is fused with the periosteum over the subcutaneous surfaces of the bones.

<span class="mw-page-title-main">Outline of human anatomy</span> Overview of and topical guide to human anatomy

The following outline is provided as an overview of and topical guide to human anatomy:

<span class="mw-page-title-main">Hip bone</span> Bone of the pelvis

The hip bone is a large flat bone, constricted in the center and expanded above and below. In some vertebrates it is composed of three parts: the ilium, ischium, and the pubis.

<span class="mw-page-title-main">Vastus muscles</span> Human thigh muscles

The vastus muscles are three of the four muscles that make up the quadriceps femoris muscle of the thigh. The three muscles are the vastus intermedius, the vastus lateralis, and the vastus medialis located in the middle, on the outside, and inside of the thigh, respectively. The fourth muscle is the rectus femoris muscle a large fleshy muscle which covers the front and sides of the femur.

References

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

  1. Moore, KL; Dalley, AF; Agur, AM (2013). Clinically Oriented Anatomy (7th ed.). Lippincott Williams & Wilkins. p. 532. ISBN   978-1-4511-8447-1.
  2. Anatomy.med Archived September 9, 2006, at the Wayback Machine
  3. Burres S (October 1999). "Preserved particulate fascia lata for injection: a new alternative". Dermatol Surg. 25 (10): 790–4. doi:10.1046/j.1524-4725.1999.99118.x. PMID   10594581. Archived from the original on 2013-01-05.
  4. Gillies, H. D. (1934). "Experiences with fascia lata grafts in the operative treatment of facial paralysis". Proc R Soc Med. 27 (10): 1372–1382. PMC   2205492 . PMID   19989927.
  5. Diab, M (1999). Lexicon of Orthopaedic Etymology. Amsterdam: Harwood Academic Publishers. ISBN   978-9057025976.