Fascia Anatomy

Question 1

Fascia

Answer 1

collagenous-based soft tissues in the body, including the cells that create and maintain that network of extra-cellular matrix (ECM)
o Includes all the other similar tissues arrayed in different ways around body (ex: tendons, ligaments, bursae, endomysium, perimysium, epimysium
o Found around organs also – coelomic bags – hold the organs in the peritoneum and mesentery in your abdominal cavity
 Mediastinum, pericardium, and pleura that hold the organs in chest cavity
o Connective tissue in body is continuous with all other connective tissue
o Membranes – dura, pia, and perineuria – that surround the brain, spinal cord, and peripheral nerves
o Ex: Cornea of eye; Enamel covering teeth; Valves of heart
o Has its own innervation and neurovascular bundles and lymphatic drainage routes
o Acts as a “skeleton” to hold organs in the body
o Remove everything except fascia and could still tell shape of person
o Remove fascia and you would be a blob

Question 2

Fascial Functions

Answer 2

o	Packaging
o	Passageways
o	Protection
o	Power
o	Proprioception & Nociception

Question 3

Packaging

Answer 3

o Organizes and separates
o Envelopes muscles, bones, joints, organs
o Provides autonomy for the individual muscles and viscera
o Give us our shape

Question 4

Passageways

Answer 4

o Permits passage of nerves, arteries, veins, and lymphatics to pass throughout body

Question 5

Protection

Answer 5

o Joins, supports, and binds together body structures
o Provides stable attachments
o Provides balance between motion and stability
o Contains homeostatic mechanisms for immune function and tissue repair

Question 6

Power

Answer 6

o Stabilizes/provides fulcra for muscles to function

o Joins/bonds/separates structures into functional units

Question 7

Proprioception

Answer 7

 Continuum of fascia throughout the body allows it to serve as a body-wide mechanosensitive signaling system and is useful n proprioception (brain’s awareness of where the body is in space)
 Important to stretch TIGHT areas; overly stretched muscles/mobile areas can have adverse affects on muscles that are tight during the same movement

Question 8

Nociception

Answer 8

 Nerves of fascia have fascia
 All layers of these fascia contain plexi of noticeptors (pain receptors)
• Fascia have abundant free and encapsulated nerve endings; described as thoracolumbar fascia
 Fascia contains several terminal ending of nociceptors, responsible for muscle pain
• Present in all types of tissues within muscle (connective tissue, adventitia of arterioles and venuoles, fat cells, etc.)

Question 9

Inelastic Fascia

Answer 9

– can promote lymphatic flow; important in assisting the immune system
o “fascial wrap” increases the pressure within the compartment when a muscle contracts thus helping blood and lymphatic fluid move against gravity back towards the heart

Question 10

Inherent Motions Palpable Through Fascia

Answer 10

o Respiration – pull on fascia is transmitted through body unit; palpable anywhere in body because of fascial continuity
 Inhalation
• Spinal curves straighten; Extremities externally rotate
 Exhalation
• Spinal curves accentuate; Extremities internally rotate

Question 11

Fascia Development

Answer 11

derived embryologically from mesoderm

Question 12

Superficial Fascia

Answer 12

– contains subcutaneous nerves, vessels, and lymphatics; skin muscles
• Holds vast majority of the 15L of interstitial fluid; slight changes in fluid flow can alter the shear force on the cell surface and its biomechanical environment
• Interstitial flow regulates nutrient transport to metabolically active cells and plays a crucial role in maintaining healthy tissue
 Attached to skin – composed of connective tissue and fat
 Dense
• Ex: scalp, back of neck, palms of hands
 Loose – variable thickness; often fat between muscle and skin that help in thermal insulation and energy storage
• Ex: areas where skin moves freely

Question 13

Deep Fascia

Answer 13

 Most extensive fascia; series of connective sheets and bands that hold the muscles and other structures in place
• Composed mainly of collagenous fibers
 Divided into outer investing layer, internal investing layer, intermediate membranes
 Loosely joined to superficial fascia by fibrous strands
 Covers/partitions muscles into groups
 Tougher and contains denser connective tissue
 Has ability to adapt to volume variation of muscles during contraction, and to resist high pressure without damage
 Ex: iliotibial band – transmits pull of tensor fascia lata and gluteus maximus to femur and tibia

Question 14

Fascial Composition

Answer 14

o Ground Substance – major part of ECM; varies in consistency from fluid to semi-fluid
 Transparent, colorless, and fills spaces between fibers and cells
o Collagen – major insoluble fibrous protein in ECM and connective tissue; 60-70% overall mass
 Most abundant protein in animal kingdom
 Has colloidal properties, enabling it to change it quality (fluid to solid), depending upon rate of force but keeps its strength and resist change in length (completely inelastic)
o Elastin – protein that allows fascia to be stretched and then return to its original positions
 Abundant in areas of expansion-relaxation
 Not made after the age of 12/13
 Once body loses elasticity, can never regain it back
• Reduced or damaged due to stress, hormones, smoking, sunlight, aging, etc.
o Consider the role in circulatory system

Question 15

Properties of Fascia

Answer 15

– defined as “viscoelastic”
o Viscosity – capability of a solid to continually yield under stress with a measurable rate of deformation
o Elasticity – ability to resume original shape after deformation
o Plasticity – ability to retain shape attained by deformation

Question 16

Compartment Syndromes

Answer 16

o	Forearm (volar compartment) and leg (anterior compartment) most commonly affected
o	Deep posterior compartment of leg is easily missed

Question 17

Fascial Summary

Answer 17

o Is ever-present throughout the body
o Needs water to function properly
o Can change its own qualities, depending on the body’s needs
o Can accommodate the expansile properties of the body
o Can resist compressive forces, providing safe passage for nerves, vessels, and lymphatic channels
o Maintains our shape and plays a large role in tensegrity
o Compartmentalizes structures of the body, yet can work distally via epimuscular pathways
o Assists in proprioception and nociception
o Aids in immune function