clinical importance of fascia Flashcards

0
Q

fascial colloids ; what are the two states

A

sol (liquid)

gel (solid)

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1
Q

what is fascia?

A

a colloidal matrix with embedded collagen fibers
contractile elements
colloids respond to heat and cold/movement/tissue pH

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2
Q

sol state (liquid) colloid is produced by..(3)

A

heat
less acidic pH
mobilization - active (exercise)/passive(manipulation, massage)

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3
Q

gel (solid) state produced by.. (3)

A

cold
more acidic pH (inflammation/infection)
immobilization

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4
Q

what is contractile elements

A

several different sites of fascia have been demonstrated to contain myofibroblasts( fibroblasts with s.muscle-like feature)

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5
Q

contractile element in vitro evidence

A

human lumbar fascia
stretched isometrically for 15 min
then rested for 30-60 min/then stretched again
resistance to stretch was greater each successive stretch

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6
Q

contractile elements - evidence

fresh fascial samples induced to contact reversibly and repeatedly by superperfusion with…?

A

mepyramine
calcium chloride
adonosine

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7
Q

fascial innervation- what innervate all form of connective tissue?(sensory)

A

small caliber, neuropeptide containing, primary afferent (sensory) fibers

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8
Q

what motor innervate all fascia?

A

peripheral sympathetic efferent fibers (visceromotor)

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9
Q

importance of peripheral sympathetic efferent fibers

visceromotor

A

play a role in modulating the cellular components (mast cell) of the connective tissue and contribute to the maintenance of tissue integrity

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10
Q

what is myofascial continuity

A

muscle cells live embedded in a fascial matrix
it is the fascia that makes a muscle functional
they allow the muscles and bones to glide against one another
the fascias coalesce into tendons and entheses (attachment)
other fascias coalesce to form the ligament g

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11
Q

myofascial continuity - what attach to bone via sharpey’s fibers which penetrate into the dense cortical bone?

A

ligaments and tendons

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12
Q

what is sharpey’s fiber?

A

ligament and tendons attach to bone vis this fiber, which penetrate into the dense cortical bone

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13
Q

myofascial continuity - what about superficial fibers?

A

they are continuous with the periosteum

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14
Q

investing fascia carries what to muscles?

A

carries motor and sensory nerves to muscles

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15
Q

investing fascia carries nutrient arteries to what ?

A

fascia carries the nutrients arteries to muscle and bone

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16
Q

investing fascia carries what drainage and vessels?

A

venous drainage and lymphatic vessels

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17
Q

why fascia is critical to the surgeon?

A

is what you put your needle and thread through to sew things back together again

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18
Q

what is tensegrity?

A

a combination of tension and compression elements

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19
Q

examples of tensegrity?

A

geodesic domes
bicycle wheels
fascia and bones

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20
Q

examples of compression element?

A

geodesic strut structure
hub and rim in bicycle
lumbar spine

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21
Q

example of tension

A

spokes in bicycle

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22
Q

what forms the root of the mesentery?

A

parietal peritoneum
6’’ of mesentery supplies 30 feet of small intestine
attaches to post. abdominal wall across the lumbar spine

23
Q

root of the mesentery carries..

A
sympathetic/parasympathetic nerves
visceral afferent
arterial supply
venous drainage
lympathetic drainage
24
Q

root of the mesentery is volunerable to…?

A

increased lumbar lordorsis
omental obesity
scoliosis (new vs longstanding)

25
Q

what is tension element of transversus aponeurosis

A

abdominal wall, esp transversalis fascia

26
Q

compression element of transversus aponeurosis

A

lumbar spine

27
Q

transvers aponeurosis becomels…what?

A

thick lumbodorsal fascia

28
Q

transversus aponeurosis is vulnerable to ?

A

abd wall weakness (weak muscles/hernia)
mesenteric obesity
hypermobility states

29
Q

what is psoas fascia?

A

osteomyelitis of the lumbar spine can spread down the psoas fascia under the linguinal ligament and present as swelling in the groin

30
Q

tension component of fasciai lata

A

illiotibial band

investing fascia of thigh

31
Q

compression component of fascia lata

A

innominate
femur
fibula
talus and calcaneus

32
Q

what are those uniques of fascia lata?

A

has an external mechanism to control tension in the illiotibial band
tensor fascia lata muscle
gluteus maximus muscle

33
Q

fascia lata is vulnerable to?

A

leg lenth inequality -> pelvic side shift
instability of knee
ankle sprain
arch collapse

34
Q

leg length inequality -> pelvic sideshift

consequences?

A
excessive tension on iliotibial band
trochanteric bursitis
fibular nerve compression
premature osteoarthritis of the hip joint on longer leg side
excessive supination of the foot
abnormal ankle/foot mechanics
35
Q

if the knee is unstable from trauma to its supporting ligament;

A

muscle cramping and trigger point development in the gluteus maximus and tensor fascia lata muscle

36
Q

knee instability - reciprocal interrelation

A

if muscles are weakened, knee instability develops

37
Q

what causes ankle sprain?

A

draws fibular head inferiorly and posteriorly

if held in this position, increases tension in ITB

38
Q

consequence of ankle sprain?

A

result in pelvic side shift

has same impact long term as leg length inequality

39
Q

tension element of plantar fascia

A

plantar aponeurosis

40
Q

compression element of plantar fascia

A

bones of the medial and lateral longtiudinal arch

41
Q

plantar fascia is volunerable to..?

A
longtitudinal arch collapse (plantar fascilitis)
gait abnormalities (wide ranging impact on the rest of the body)
42
Q

effect of plantar fasciotomy

A

29% increase in vertical displacement of the longitudinal arch of the foot with weight bearing
192% increase in tensil strain on the long plantar ligament
215% increase in tensil strain on the short plantar ligament
279% increase in tensil strain on the spring ligament

43
Q

subscapular fascia?

A

allows motion of scapula against the rib cage

44
Q

acapulothoracic joint is same as ?

A

a fascial joint

45
Q

subscapular fascia is volunerable to?

A

abnormal tracking of scapula (due to shoulder gridle problem)
distortion of rib cage (scoliosis and kyposis)

46
Q

net result of subscapular fascia - scapulo thoracic syndrom

A

inflammation of the fascial joint
with scarring and condensation of the fascia
loss of shoulder motion
scraping or grinding sound as scapula is circumducted

47
Q

what is cranial dura

A

a reciprocal tension memebrane
similar to the spokes in a wheel
instead of a circle, it is more like sphere (radiating from the middle)

48
Q

compression element of cranial dura?

A

ethmoid
basisphenoid
petrous temporal

49
Q

tension element of cranial dura?

A

falx cerebri
tentorium cerebelli
falx cerebelli

50
Q

damage to the dura

A

leads to alteration of tension on the venous sinuses and altered cerebral blood flow
change in shape of cranium with potential for tension or compressive cranial neuropoathies

51
Q

complex regional pain syndrome (reflex sympathetic dystrophy syndrome)

A

develop fascial contracture

shortening/tightening of the fascias in the involved body regions, contractures

52
Q

contractures: palmar fascia

A

depuytren diseases

53
Q

contractures: plantar fascia

A

plantar fibromatosis

54
Q

contracture: shoulder capsule

A

frozen shoulder