Fascia

A fascia (/ˈfæʃ(i)ə/; plural fasciae /ˈfæʃii/; adjective fascial; from Latin: "band") is a band or sheet
of connective tissue, primarily collagen, beneath the skin that attaches, stabilizes, encloses, and
separates muscles and other internal organs.[1] Fascia is classified by layer, as superficial fascia,
deep fascia, and visceral or parietal fascia, or by its function and anatomical location.
 Fascia

The rectus sheath (extensive vertical darker gray at left), an example of a fascia

Details

Precursor mesenchyme

Identifiers

Latin fascia

MeSH D005205 (https://meshb.nlm.nih.gov/record/ui?ui

=D005205)

TA98 A04.0.00.031 (http://www.unifr.ch/ifaa/Public/Ent

ryPage/TA98%20Tree/Entity%20TA98%20EN/04.
0.00.031%20Entity%20TA98%20EN.htm)

TA2 2015 (https://ta2viewer.openanatomy.org/?id=201

5)

FMA 78550 (https://bioportal.bioontology.org/ontologie

s/FMA/?p=classes&conceptid=http%3A%2F%2Fp
url.org%2Fsig%2Font%2Ffma%2Ffma78550)

Anatomical terminology

Like ligaments, aponeuroses, and tendons, fascia is made up of fibrous connective tissue
containing closely packed bundles of collagen fibers oriented in a wavy pattern parallel to the
direction of pull. Fascia is consequently flexible and able to resist great unidirectional tension
forces until the wavy pattern of fibers has been straightened out by the pulling force. These
collagen fibers are produced by fibroblasts located within the fascia.[1]

Fasciae are similar to ligaments and tendons as they have collagen as their major component.
They differ in their location and function: ligaments join one bone to another bone, tendons join
muscle to bone, and fasciae surround muscles and other structures.

Structure …

There exists some controversy about what structures are considered "fascia", and how types of
fascia should be classified.[2] The two most common systems are:

The one specified in the 1983 edition of Nomina Anatomica (NA 1983)

The one specified in the 1997 edition of Terminologia Anatomica (TA 1997)

NA 1983 TA 1997 Description Example

(not
Superficial considered This is found in the subcutis in most regions of the Fascia of
fascia fascia in this body, blending with the reticular layer of the dermis.[3] Scarpa
system)

This is the dense fibrous connective tissue that

Deep Fascia of Transverse
interpenetrates and surrounds the muscles, bones,
fascia muscles fascia
nerves and blood vessels of the body.

This suspends the organs within their cavities and

Visceral Visceral fascia,
wraps them in layers of connective tissue Pericardium
fascia parietal fascia
membranes.

Superficial fascia
…
Superficial fascia is the lowermost layer of the skin in nearly all of the regions of the body, that
blends with the reticular dermis layer.[4] It is present on the face, over the upper portion of the
sternocleidomastoid, at the nape of the neck, and overlying the breastbone.[5] It consists mainly
of loose areolar, and fatty adipose connective tissue and is the layer that primarily determines
the shape of a body. In addition to its subcutaneous presence, superficial fascia surrounds
organs and glands, neurovascular bundles, and is found at many other locations where it fills
otherwise unoccupied space. It serves as a storage medium of fat and water; as a passageway
for lymph, nerve and blood vessels; and as a protective padding to cushion and insulate.[6]

Superficial fascia is present, but does not contain fat, in the eyelid, ear, scrotum, penis and
clitoris.[7]

Due to its viscoelastic properties, superficial fascia can stretch to accommodate the deposition
of adipose that accompanies both ordinary and prenatal weight gain. After pregnancy and
weight loss, the superficial fascia slowly reverts to its original level of tension.

Visceral fascia
…
Visceral fascia (also called subserous fascia) suspends the organs within their cavities and
wraps them in layers of connective tissue membranes. Each of the organs is covered in a double
layer of fascia; these layers are separated by a thin serous membrane.

The outermost wall of the organ is known as the parietal layer

The skin of the organ is known as the visceral layer. The organs have specialized names for
their visceral fasciae. In the brain, they are known as meninges; in the heart they are known as
pericardia; in the lungs, they are known as pleurae; and in the abdomen, they are known as
peritonea.[8]

Visceral fascia is less extensible than superficial fascia. Due to its suspensory role of the organs,
it needs to maintain its tone rather consistently. If it is too lax, it contributes to organ prolapse,
yet if it is hypertonic, it restricts proper organ motility.[9]

Deep fascia …
Deep fascia is a layer of dense fibrous connective tissue which surrounds individual muscles,
and also divides groups of muscles into fascial compartments. This fascia has a high density of
elastin fibre that determines its extensibility or resilience.[10] Deep fascia was originally
considered to be essentially avascular. However, more recent investigations confirmed a rich
presence of thin blood vessels.[11] Deep fascia is also richly supplied with sensory receptors.[12]
Examples of deep fascia are fascia lata, fascia cruris, brachial fascia, plantar fascia,
thoracolumbar fascia and Buck's fascia.

Function …
Fasciae were traditionally thought of as passive structures that transmit mechanical tension
generated by muscular activities or external forces throughout the body. An important function
of muscle fasciae is to reduce friction of muscular force. In doing so, fasciae provide a
supportive and movable wrapping for nerves and blood vessels as they pass through and
between muscles.[13] Fascial tissues are frequently innervated by sensory nerve endings. These
include myelinated as well as unmyelinated nerves. Based on this a proprioceptive, nociceptive
as well as interoceptive function of fascia has been postulated.[14] Fascial tissues – particularly
those with tendinous or aponeurotic properties – are also able to store and release elastic
potential energy.

Clinical significance …

Fascia becomes important clinically when it loses stiffness, becomes too stiff or has decreased
shearing ability.[15] When inflammatory fasciitis or trauma causes fibrosis and adhesions, fascial
tissue fails to differentiate the adjacent structures effectively. This can happen after surgery
where the fascia has been incised and healing includes a scar that traverses the surrounding
structures.

Anatomical compartments
…
A fascial compartment is a section within the body that contains muscles and nerves and is
surrounded by fascia. In the human body, the limbs can each be divided into two segments – the
upper limb can be divided into the arm and the forearm and the sectional compartments of both
of these – the fascial compartments of the arm and the fascial compartments of the forearm
contain an anterior and a posterior compartment. Likewise, the lower limbs can be divided into
two segments – the leg and the thigh and these contain the fascial compartments of the leg and
the fascial compartments of the thigh.

A fasciotomy may be used to relieve compartment syndrome as a result of high pressure within
a fascial compartment.

See also …

Clavipectoral fascia

Endothoracic fascia