Fascia

A fascia (/ˈfæʃ(i)ə/; plural fasciae /ˈfæʃii/ or fascias;[1] adjective fascial; from Latin: "band") is a band or sheet of connective tissue, primarily collagen, beneath the skin that attaches to, stabilizes, encloses, and separates muscles and other internal organs.[2] Fascia is classified by layer, as superficial fascia, deep fascia, and visceral or parietal fascia, or by its function and anatomical location.

fascia

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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.[2]

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.

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.[5] It is present on the face, over the upper portion of the sternocleidomastoid, at the nape of the neck, and overlying the breastbone.[6] It consists mainly of loose areolar, and fatty adipose connective tissue and is the layer that primarily determines the shape of a body.[medical citation needed] 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.[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 (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.

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.[10]

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.[11] Deep fascia was originally considered to be essentially avascular but later investigations have confirmed a rich presence of thin blood vessels.[12] Deep fascia is also richly supplied with sensory receptors.[13] Examples of deep fascia are fascia lata, fascia cruris, brachial fascia, plantar fascia, thoracolumbar fascia and Buck's fascia.

Fascia becomes important clinically when it loses stiffness, becomes too stiff, or has decreased shearing ability.[16] 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.

Typically consisting of a wooden board, unplasticized PVC (uPVC), or non-corrosive sheet metal, many of the non-domestic fascias made of stone form an ornately carved or pieced together cornice, in which case the term fascia is rarely used.

The word fascia derives from Latin fascia meaning "band, bandage, ribbon, swathe". The term is also used, although less commonly, for other such band-like surfaces like a wide, flat trim strip around a doorway, different and separate from the wall surface.

In classical architecture, the fascia is the plain, wide band (or bands) that make up the architrave section of the entablature, directly above the columns. The guttae or drip edge was mounted on the fascia in the Doric order, below the triglyph. The term fascia can also refer to the flat strip below the cymatium.

Fascia is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. The tissue does more than provide internal structure; fascia has nerves that make it almost as sensitive as skin. When stressed, it tightens up.

For some people, adhesions can worsen over time, causing the fascia to compress and contort the muscles it surrounds. This can result in hard, tender knots in the muscles, called trigger points. Myofascial pain syndrome is a condition in which those trigger points cause pain to occur:

Treatment focuses on relieving pain and getting tight fascia and muscle fibers to relax. Medical options include pain relievers, physical therapy and injections of medication directly into trigger points.

Fascia is a stringy, white substance made mostly of collagen. Collagen is a type of protein that provides strength and flexibility. Fascia is soft, loose and made up of multiple layers. A liquid called hyaluronan is between each layer. The hyaluronan helps your fascia stretch as you move. Inflammation and trauma can dry up the hyaluronan and damage your fascia. When your fascia tightens, it can restrict the movement of your muscles and tissues, causing pain and other health conditions.

Superficial fascia is the outermost layer located directly under your skin. Layers of membranes, loosely packed interwoven collagen and elastic fibers make up this layer. Superficial fascia is thicker in your chest and back (torso) and gets thinner in your arms and legs. It also sometimes contains muscle fibers, which help create certain structures in your body.

Deep fascia surrounds your musculoskeletal system. It covers your muscles, bones, tendons, cartilage, nerves and blood vessels. This layer is thicker than superficial fascia. There are two subtypes of this layer:

Plantar fasciitis causes inflammation and pain in your plantar fascia, which is a thick band of tissue that stretches from your heel to your toes. It supports the arch of your foot by absorbing pressure and bearing your weight. Plantar fasciitis is one of the most common causes of heel pain.

Frozen shoulder, also called adhesive capsulitis, is a painful condition in which your shoulder movement becomes limited. It occurs when the fascia surrounding your shoulder joint becomes thick, stiff and inflamed. Lack of use causes your shoulder to thicken and become tight, making the shoulder even more difficult to move.

When your fascia lacks stiffness, internal structures can move too freely causing hernias to occur. Types of hernias caused by defects or disruptions in your fascia include inguinal hernias, femoral hernias and umbilical hernias.

A fascia is a layer of fibrous tissue. A fascia is a structure of connective tissue that surrounds muscles, groups of muscles, blood vessels, and nerves, binding some structures together, while permitting others to slide smoothly over each other. Various kinds of fascia may be distinguished. [1]

Like ligaments, aponeuroses, and tendons, fasciae are dense regular connective tissues, containing closely packed bundles of collagen fibres oriented in a wavy pattern parallel to the direction of pull. Fasciae are consequently flexible structures able to resist great unidirectional tension forces until the wavy pattern of fibres has been straightened out by the pulling force. These collagen fibres are produced by the fibroblasts located within the fascia. [1]

Fasciae are similar to ligaments and tendons as they are all made of collagen except that ligaments join one bone to another bone, tendons join muscle to bone and fasciae surround muscles or other structures. [1]

Fascia like other soft tissues has variable degree of elasticity that allow it to withstand deformation when forces and pressure are applied as it can recover and return to its starting shape and size. It response to load , compression and force, as at the beginning of loading, fascia has an elastic response in which a degree of slack is taken up .Over time, if loading persists in a slow and sustained manner, creep develops, which is a slow, delayed yet continuous deformation. After that , an actual volume change occurs as water is forced from the tissue .When loading ceases fascia return to its original shape .The restoration of shape occurs through elastic recoil via hysteresis, (which is the process of energy use and loss in which tissues are loaded and unloaded). The time needed for tissue to return to normal via elastic recoil depends on the uptake of water by the tissue and whether its elastic potential has been exceeded. When loaded for any length of time, tissues lengthen and distort until they reach a point of balance. If loading is sustained, over time, chronic deformation will result. [4]

Fascial treatment is a manual therapy method focusing on releasing specific localized areas of fascia, which have been assessed and diagnosed as being involved in the pain and movement/functional limitations. Through the appropriate manipulation of this precise part of the fascia, movement can be restored allowing optimal force transmission within the body so that you can move and function better.

There are many different definitions of fascia. Here the three most common nomenclatures are compared, including that of the Federative International Committee on Anatomical Terminology (1998), the definition included in the latest British edition of Gray's Anatomy (2008) and the newer and more comprehensive terminology suggested at the last international Fascia Research Congress (2012). This review covers which tissues are included and excluded in each of these nomenclatures. The advantages and disadvantages of each terminology system are suggested and related to different fields of application, ranging from histology, tissue repair, to muscular force transmission and proprioception. Interdisciplinary communication involving professionals of different fields is also discussed.