Fascia Lata

Question 1

Anatomical structure

Answer 1

Deep fascial investment of the whole thigh musculature
Begins proximally around the iliac crest and inguinal ligament
Ends distally to the bony prominences of the tibia (continues to become deep fascia of the leg)
Ovoid hiatus (saphenous opening) - entry point for efferent lymphatic vessels and the great saphenous vein draining into the femoral vein

Question 2

Femoral hernias

Answer 2

Develop when an out-pouching of gastric viscera protrudes through the femoral canal
Becomes noticeable when it exits superficially through the saphenous opening within the fascia lata
Swelling inferior to inguinal ligament
Investigate promptly due to high risk of incarceration with femoral hernias and to rule out lymphadenopathy

Question 3

Iliotibial tract

Answer 3

Longitudinal thickening of fascia lata, strengthened posteriorly by fibres of the glut. max.
Laterally in the thigh, extending from iliac tubercle to lateral tibial condyle
- Movement - extensor, abductor and lateral rotator of the hip, provides lateral stabilisation of the knee
- Compartmentalisation - extends centrally to form lateral intermuscular septum of the thigh, attaches to femur
- Muscular sheath - forms sheath for tensor fascia lata muscle

Question 4

Tensor fascia lata

Answer 4

Gluteal muscle, acts as a flexor, abductor and internal rotator of the hip
Origin - iliac crest
Insertion - anterior aspect of iliotibial tract

Question 5

Attachments - Proximal

Answer 5

Posterior - sacrum and coccyx
Lateral - iliac crest
Anterior - inguinal ligament, superior pubic rami
Medial - inferior ischiopubic rami, ischial tuberosity, sacrotuberous ligament

Question 6

Attachments - Lateral

Answer 6

Lateral thickening form iliotibial tract
Receives tendon insertions superiorly from glut. max. and tensor fascia lata
Attachment - lateral tibial condyle on anterolateral tubercle

Question 7

Attachments - Inferior

Answer 7

Bony prominences around knee including femoral and tibial condyles, patella, head of fibula and tibial tuberosity

Question 8

Attachments - Central

Answer 8

Lateral septum - joins to lateral lip of linea aspera

Medial and anterior septum - attach to medial lip of linea aspera

Question 9

Transplantation

Answer 9

Dermatofasciotomy and debridement can leave large wound sites which require grafting
Fascia lata graft is a popular choice and the iliotibial tract provides a high concentration of connective tissue fibres and can be harvested leaving the majority of fibres intact
It is well vascularised upon transplantation