Fascia is a fibrous connective tissue system that serves as a restraining envelope for muscles. It helps the body move and functions in a variety of ways. It provides pathways for lymphatics and blood vessels. The system is of great importance to surgeons, physiotherapists, massage therapists, and orthotists. The article discusses the general structure of the fascia, its cellular composition, and how it interacts with the musculoskeletal system.
The anatomy of the deep fascia consists of three distinct areas. These regions are: the neck fascia, the pretracheal fascia, and the carotid fascia. The neck fascia attaches to the hyoid bone, the clavicle, the spine, and the external occipital protuberance. The pretracheal fascia spans between the hyoid bone and the acromion of the scapula.
The deep fascia serves as a restraining envelope. The thick and resistant fascia exerts pressure on thin-walled veins and lymphatics. It also provides pathways for blood and lymphatics to reach the heart. The fascia then continues its network to form a capsule. It is also an important attachment site for muscles and other specialized organs.
The deep fascia also acts as a retinaculum over muscles and tendons. The muscle-rich iliotibial band, for example, is a major component of the restraining envelope. It acts as a retinaculum over the Achilles tendon in the lower part of the leg.
It is also an important attachment site for the quadriceps aponeurosis. This aponeurosis is involved in stabilizing the short head of the biceps brachii tendon. It also protects underlying vascular structures and the iliac artery. In the hand, the palmar aponeurosis provides a deep connection between the skin and the skeleton.
In recent years, research on the fascia has undergone a resurgence. The first international fascia research congress was held in Boston, USA. Various studies have described rich innervation of the fascia at a number of sites. However, it is unclear whether the nerve fibres actually lie in areolar connective tissue or in adipose tissues. Some researchers have argued that the innervation of the deep fascia should be considered in relation to its association with the muscles.
Several reports have suggested that the bicipital aponeurosis is also richly innervated. However, it is less heavily innervated than the fascia itself. Other regions of the deep fascia have also been described as being richly innervated. The thoracolumbar fascia and various retinacula have also been mentioned.
It is often a good idea to consider the fascial system in relation to chronic injuries. The system can be a major cause of pain and dysfunction. It can also be a source of infection. It is an area of interest to many practitioners, including orthotists and chiropractors. In addition, it can affect sporting performance.
The skeletal anatomy of the fascia involves a complex three-dimensional structure. It is comprised of elastic fibres and collagen. The elastin fibres determine the resiliency and extensibility of the tissue. The collagen fibres are also important, as they provide a framework for all the other connective tissues.
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