MSK The fascia lata

Question 1

How does the width of the fascia lata change at different sites?

Answer 1

It is thickest at superolateral aspects of thigh originating from fascia from glut max and med
It is also thick around the knee where it is reinforced by tendons.
It is thinnest at the medial thigh where it covers the adductor muscles

Question 2

Describe the 3 intermuscular septa of the fascia lata

Answer 2

The 3 intermuscular septa attach to the femur and divides the thigh muscles in anterior, posterior and medial

The lateral septum is the strongest because it is reinforced by the iliotibial tract

Question 3

What is the location and function of the saphenous opening?

Answer 3

It is just inferior of the inguinal ligament
Serves as an entry for lymphatic vessels (drain into superficial inguinal lymph nodes) and the great saphenous vein (drains into femoral vein)

Question 4

What are femoral hernias and how do they present clinically?

Answer 4

Develop when gastric viscera protrudes through the femoral canal
The protrusion becomes noticeable when it exits through the saphenous opening, protrudes a swelling inferior to the inguinal ligament

Question 5

What is the iliotibial tract and what are its functions?

Answer 5

A thickening of the fascia lata (strengthened posteriorly by glut max fibres) which extends from iliac tubercle to lateral condyle of tibia.

3 main functions:

• movement, acts as an extensor, abductor and lateral rotator
• compartmentalisation, extends centrally to form lateral intermuscular septum of thigh
• sheath for the tensor fascia lata muscle

Question 6

What is the tensor fascia lata and what are its functions?

Answer 6

A gluteal muscle that acts as a flexor, abductor and internal rotator of hip. It tenses the fascia lata

Originates from iliac crest and inserts into the iliotibial tract - tautens the tract to brace the knee when the oppo foot is lifted
Increases muscle efficiency by compressing deep veins to ensure adequate venous return

Question 7

What are the attachments of the fascia lata?

Answer 7

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

Question 8

What structures does the fascia lata make?

Answer 8

Laterally it forms the iliotibial tract

Inferiorly it ends at the knee joint and becomes the deep fascia of the leg - Crural fascia.

Centrally it forms the 3 intermuscular septa

Question 9

What are some uses of a fascia lata graft?

Answer 9

Iliotibial tract provides high density of CT fibres while leaving majority of fibres intact

• heart valve replacements
• eyelid reparations
• dura mater repair
• urinary incontinence treatment