Afascia(/ˈfæʃ(i)ə/;pl.:fasciae/ˈfæʃii/orfascias;[1]adjectivefascial;fromLatinband) is a generic term formacroscopicmembranousbodily structures.[2]: 42 Fasciae are classified assuperficial,visceralordeep,and further designated according to their anatomical location.[3]
| Fascia | |
|---|---|
 Therectus 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 | |
The knowledge of fascial structures is essential insurgery,as they create borders for infectious processes (for examplePsoas abscess) and haematoma. An increase in pressure may result in acompartment syndrome,where a promptfasciotomymay be necessary. For this reason, profound descriptions of fascial structures are available in anatomical literature from the 19th century.
Function
editFasciae 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 theFascial Net Plastination Project.
Fascial tissues – particularly those with tendinous or aponeurotic properties – are also able to store and release elastic potential energy.
Anatomical compartments
editAfascial compartmentis a section within the body that containsmusclesandnervesand is surrounded by fascia. In thehuman body,thelimbscan each be divided into two segments: Theupper limbcan be divided into thearmand theforearmand the sectional compartments of both of these – thefascial compartments of the armand thefascial compartments of the forearmcontain an anterior and a posterior compartment. The lower limbs can be divided into two segments – thelegand thethigh– and these contain thefascial compartments of the legand thefascial compartments of the thigh.
-
Photo of cross-sectional slice from a plastinated human thigh. -
Schematic drawing of a transverse section of the thigh illustrating its fascial anatomy.
Clinical significance
editFascia itself becomes clinically important when it loses stiffness, becomes too stiff, or has decreased shearing ability.[7]When inflammatoryfasciitisor trauma causesfibrosisand adhesions, fascial tissue fails to differentiate the adjacent structures effectively. This can happen after surgery, where the fascia has been incised and healing includes ascarthat traverses the surrounding structures.
Fascial Net Plastination Project
editTheFascial Net Plastination Project(FNPP) is an anatomical research initiative spearheaded by fascia researcherRobert Schleip.The project aims to enhance the study of fascia through the technique ofplastination.Led by an international team of fascia experts and anatomists, the FNPP resulted in the creation of a full-body fascia plastinate known asFR: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 2021Fascia Research Congressand is currently exhibited at theBody Worldsexhibition 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]
Terminology
editThere 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]
- Fascia craniocervicalis
- Fascia trunci
- Fascia parietalis
- Fascia extraserosalis
- Fascia visceralis
- Fasciae membrorum
- Fasciae musculorum
- Fascia investiens
- Fascia propria musculi
Previous terminology
editTwo former, rather commonly used systems are:
- The one specified in the 1983 edition ofNomina Anatomica(NA 1983)
- The one specified in the 1997 edition ofTerminologia Anatomica(TA 1997)
| NA 1983 | TA 1997 | Description | Example |
|---|---|---|---|
| Superficial fascia | (not considered fascia in this system) | This is found in thesubcutisin most regions of the body, blending with the reticular layer of thedermis.[12] | Fascia of Scarpa |
| Deep fascia | Fascia of muscles | This is thedense fibrous connective tissuethat 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 tissuemembranes. | Pericardium |
Superficial
editSuperficial fascia is the lowermost layer of theskinin nearly all of the regions of thebody,that blends with thereticular dermislayer.[13]It is present on theface,over the upper portion of thesternocleidomastoid,at thenapeof theneckand overlying thebreastbone.[14]It consists mainly of looseareolarand fattyadiposeconnective tissueand is the layer that primarily determines the shape of a body.[medical citation needed]In addition to itssubcutaneouspresence, superficial fascia surroundsorgans,glandsandneurovascular bundles,and fills otherwise empty space at many other locations. It serves as a storage medium offatandwater;as a passageway forlymph,nerveandblood vessels;and as a protective padding to cushion and insulate.[15]
Superficial fascia is present, but does not contain fat, in theeyelid,ear,scrotum,penisandclitoris.[16]
Due to itsviscoelasticproperties, superficial fascia can stretch to accommodate the deposition of adipose that accompanies both ordinary andprenatalweight gain. Afterpregnancyand weight loss, the superficial fascia slowly reverts to its original level of tension.
Visceral
editVisceral fascia (also calledsubserous fascia) suspends the organs within their cavities and wraps them in layers of connective tissuemembranes.Each of the organs is covered in a double layer of fascia; these layers are separated by a thinserous membrane.
- The outermost wall of the organ is known as theparietallayer
- The skin of the organ is known as theviscerallayer. The organs have specialized names for their visceral fasciae. In the brain, they are known asmeninges;in the heart they are known aspericardia;in the lungs, they are known aspleurae;and in the abdomen, they are known asperitonea.[17]
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 organprolapse,yet if it ishypertonic,it restricts proper organmotility.[18]
Deep
editDeep fascia is a layer ofdense fibrous connective tissuewhich surrounds individualmusclesand divides groups of muscles intofascial compartments. This fascia has a high density ofelastinfibre that determines itsextensibilityor 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 withsensory receptors.[21]Examples of deep fascia arefascia lata,fascia cruris,brachial fascia,plantar fascia,thoracolumbar fasciaandBuck's fascia.
See also
editReferences
edit- ^"Definition of FASCIA".merriam-webster.Retrieved12 August2022.
- ^Standring, Susan (2020).Gray's Anatomy: The Anatomical Basis of Clinical Practice(42nd ed.). New York.ISBN978-0-7020-7707-4.OCLC1201341621.
{{cite book}}:CS1 maint: location missing publisher (link) - ^Gatt, Adrianna; Agarwal, Sanjay; Zito, Patrick M. (2023),"Anatomy, Fascia Layers",StatPearls,Treasure Island (FL): StatPearls Publishing,PMID30252294,retrieved2023-05-16
- ^Faller, A.; Schuenke, M. (2004).The Human Body.Thieme Medical Publishers.p. 127.
- ^Stecco, Carla (2015).Functional Atlas of the Human Fascial System.Churchill Livingstone.ISBN978-0702044304.
- ^Schleip, Robert (2022).Fascia: The Tensional Network of the Human Body: The science and clinical applications in manual and movement therapy.Elsevier.ISBN978-0702071836.
- ^Klingler, W.; Velders, M.; Hoppe, K.; Pedro, M.; Schleip, R. (2014). "Clinical relevance of fascial tissue and dysfunctions".Curr Pain Headache Rep.18(8): 439.doi:10.1007/s11916-014-0439-y.PMID24962403.S2CID4217127.
- ^ab"FR:EIA - Fascial Net Plastination Project".Body Worlds.Retrieved2024-08-26.
- ^"About Jihan Adem & Gary Carter - Fascia Focused Anatomy Labs".fasciaanatomylabs.Retrieved2024-08-26.
- ^ab"Terminologica anatomia humana. A04.0.00.031: fascia".ifaa.unifr.ch.International Federation of Associations of Anatomists. 2013-01-29.Retrieved2024-03-23.
- ^Committee on Anatomical Termi, Federative (1998).Terminologia Anatomica: International Anatomical Terminology.Thieme Stuttgart. p. 33.ISBN3-13-114361-4.It is acknowledged that the various definitions of fascia offered by recognised authorities do not enjoy universal agreement and all have varying deficiencies. These definitions currently fall short of an agreed, descriptive, fully embracing definition that would suit all interested medical agencies/researchers and allied disciplines (16).
- ^Skandalakis, John E.; Skandalakis, P.N.; Skandalakis, L.J.; Skandalakis, J. (2002).Surgical Anatomy and Technique, 2nd Ed.Atlanta, GA: Springer. pp.1–2.ISBN0-387-98752-5.
- ^Skandalakis, John E.; Skandalakis, P.N.; Skandalakis, L.J.; Skandalakis, J. (2002).Surgical Anatomy and Technique, 2nd Ed.Atlanta, GA: Springer. pp.1–2.ISBN0-387-98752-5.
- ^Paoletti, Serge (2006).The Fasciae: Anatomy, Dysfunction & Treatment.Seattle, WA: Eastland Press. pp.23–24.ISBN0-939616-53-X.
- ^Hedley, Gil (2005).The Integral Anatomy Series Vol. 1: Skin and Superficial fascia.
- ^Norman Eizenberg,General Anatomy:Principles and Applications(2008), p 70.
- ^Hedley, Gil (2005).The Integral Anatomy Series Vol. 3: Cranial and Visceral Fasciae(DVD). Integral Anatomy Productions.Retrieved2006-07-17.
- ^Paoletti, Serge (2006).The Fasciae: Anatomy, Dysfunction & Treatment.Seattle, WA: Eastland Press. pp.146–147.ISBN0-939616-53-X.
- ^Hedley, Gil (2005).The Integral Anatomy Series Vol. 2: Deep Fascia and Muscle(DVD). Integral Anatomy Productions.Retrieved2006-07-17.
- ^Stecco, Carla (2015).Functional Atlas of the Human Fascial System.Edinburgh, UK: Churchill Livingstone Elsevier. p. 59.ISBN978-0-7020-4430-4.
- ^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.
External links
edit
- Fascia Research
- lesson1layersofbodyat The Anatomy Lesson by Wesley Norman (Georgetown University)