clinical importance of fascia

Question 0

fascial colloids ; what are the two states

Answer 0

sol (liquid)

gel (solid)

Question 1

what is fascia?

Answer 1

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

Question 2

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

Answer 2

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

Question 3

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

Answer 3

cold
more acidic pH (inflammation/infection)
immobilization

Question 4

what is contractile elements

Answer 4

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

Question 5

contractile element in vitro evidence

Answer 5

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

Question 6

contractile elements - evidence

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

Answer 6

mepyramine
calcium chloride
adonosine

Question 7

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

Answer 7

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

Question 8

what motor innervate all fascia?

Answer 8

peripheral sympathetic efferent fibers (visceromotor)

Question 9

importance of peripheral sympathetic efferent fibers

visceromotor

Answer 9

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

Question 10

what is myofascial continuity

Answer 10

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

Question 11

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

Answer 11

ligaments and tendons

Question 12

what is sharpey’s fiber?

Answer 12

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

Question 13

myofascial continuity - what about superficial fibers?

Answer 13

they are continuous with the periosteum

Question 14

investing fascia carries what to muscles?

Answer 14

carries motor and sensory nerves to muscles

Question 15

investing fascia carries nutrient arteries to what ?

Answer 15

fascia carries the nutrients arteries to muscle and bone

Question 16

investing fascia carries what drainage and vessels?

Answer 16

venous drainage and lymphatic vessels

Question 17

why fascia is critical to the surgeon?

Answer 17

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

Question 18

what is tensegrity?

Answer 18

a combination of tension and compression elements

Question 19

examples of tensegrity?

Answer 19

geodesic domes
bicycle wheels
fascia and bones

Question 20

examples of compression element?

Answer 20

geodesic strut structure
hub and rim in bicycle
lumbar spine

Question 21

example of tension

Answer 21

spokes in bicycle

Question 22

what forms the root of the mesentery?

Answer 22

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

Question 23

root of the mesentery carries..

Answer 23

sympathetic/parasympathetic nerves
visceral afferent
arterial supply
venous drainage
lympathetic drainage

Question 24

root of the mesentery is volunerable to…?

Answer 24

increased lumbar lordorsis
omental obesity
scoliosis (new vs longstanding)

Question 25

what is tension element of transversus aponeurosis

Answer 25

abdominal wall, esp transversalis fascia

Question 26

compression element of transversus aponeurosis

Answer 26

lumbar spine

Question 27

transvers aponeurosis becomels…what?

Answer 27

thick lumbodorsal fascia

Question 28

transversus aponeurosis is vulnerable to ?

Answer 28

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

Question 29

what is psoas fascia?

Answer 29

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

Question 30

tension component of fasciai lata

Answer 30

illiotibial band

investing fascia of thigh

Question 31

compression component of fascia lata

Answer 31

innominate
femur
fibula
talus and calcaneus

Question 32

what are those uniques of fascia lata?

Answer 32

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

Question 33

fascia lata is vulnerable to?

Answer 33

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

Question 34

leg length inequality -> pelvic sideshift

consequences?

Answer 34

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

Question 35

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

Answer 35

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

Question 36

knee instability - reciprocal interrelation

Answer 36

if muscles are weakened, knee instability develops

Question 37

what causes ankle sprain?

Answer 37

draws fibular head inferiorly and posteriorly

if held in this position, increases tension in ITB

Question 38

consequence of ankle sprain?

Answer 38

result in pelvic side shift

has same impact long term as leg length inequality

Question 39

tension element of plantar fascia

Answer 39

plantar aponeurosis

Question 40

compression element of plantar fascia

Answer 40

bones of the medial and lateral longtiudinal arch

Question 41

plantar fascia is volunerable to..?

Answer 41

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

Question 42

effect of plantar fasciotomy

Answer 42

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

Question 43

subscapular fascia?

Answer 43

allows motion of scapula against the rib cage

Question 44

acapulothoracic joint is same as ?

Answer 44

a fascial joint

Question 45

subscapular fascia is volunerable to?

Answer 45

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

Question 46

net result of subscapular fascia - scapulo thoracic syndrom

Answer 46

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

Question 47

what is cranial dura

Answer 47

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

Question 48

compression element of cranial dura?

Answer 48

ethmoid
basisphenoid
petrous temporal

Question 49

tension element of cranial dura?

Answer 49

falx cerebri
tentorium cerebelli
falx cerebelli

Question 50

damage to the dura

Answer 50

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

Question 51

complex regional pain syndrome (reflex sympathetic dystrophy syndrome)

Answer 51

develop fascial contracture

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

Question 52

contractures: palmar fascia

Answer 52

depuytren diseases

Question 53

contractures: plantar fascia

Answer 53

plantar fibromatosis

Question 54

contracture: shoulder capsule

Answer 54

frozen shoulder