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.
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.

Contents

 1Structure
o 1.1Superficial fascia
o 1.2Visceral fascia
o 1.3Deep fascia
 2Function
 3Clinical significance
o 3.1Anatomical compartments
 4See also
 5References
 6External links

Structure[edit]
There exists some controversy about what structures are considered "fascia", and how 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 considered This is found in the subcutis in most regions

Superficial Fascia of
fascia in this of the body, blending with the reticular layer of
fascia Scarpa
system) the dermis. [3]

This is the dense fibrous connective

Fascia of tissue that interpenetrates and surrounds the Transverse
Deep fascia
muscles muscles, bones, nerves and blood vessels of fascia
the body.
 This suspends the organs within their cavities
Visceral Visceral fascia,
and wraps them in layers of connective Pericardium
fascia parietal fascia
tissue membranes.

Superficial fascia[edit]
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.[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.[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[edit]
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[edit]
Main article: 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[edit]
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[edit]
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[edit]
Main article: Fascial compartment
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[edit]
This article uses anatomical terminology. For an overview, see Anatomical terminology.

 Clavipectoral fascia
 Endothoracic fascia
 Extracellular matrix
 Interstitial cell
 Pectoral fascia
 Thoracolumbar fascia

References[edit]
1. ^ Jump up to:a b Marieb, Elaine Nicpon; Hoehn, Katja (2007). Human anatomy & physiology.
Pearson Education. p. 133. ISBN 978-0-321-37294-9.
2. ^ Committee on Anatomical Termi, Federative. Terminologia Anatomica: International Anatomical
Terminology. Thieme Stuttgart. p. 33. ISBN 3-13-114361-4.
3. ^ Skandalakis, John E.; Skandalakis, P.N.; Skandalakis, L.J.; Skandalakis, J. (2002). Surgical
Anatomy and Technique, 2nd Ed. Atlanta, GA: Springer. pp. 1–2. ISBN 0-387-98752-5.
4. ^ Skandalakis, John E.; Skandalakis, P.N.; Skandalakis, L.J.; Skandalakis, J. (2002). Surgical
Anatomy and Technique, 2nd Ed. Atlanta, GA: Springer. pp. 1–2. ISBN 0-387-98752-5.
5. ^ Paoletti, Serge (2006). The Fasciae: Anatomy, Dysfunction & Treatment. Seattle, WA: Eastland
Press. pp. 23–24. ISBN 0-939616-53-X.
6. ^ Hedley, Gil (2005). The Integral Anatomy Series Vol. 1: Skin and Superficial fascia.
7. ^ Norman Eizenberg, General Anatomy:Principles and Applications(2008), p 70.
8. ^ Hedley, Gil (2005). The Integral Anatomy Series Vol. 3: Cranial and Visceral Fasciae (DVD).
Integral Anatomy Productions. Retrieved 2006-07-17.
9. ^ Paoletti, Serge (2006). The Fasciae: Anatomy, Dysfunction & Treatment. Seattle, WA: Eastland
Press. pp. 146–147. ISBN 0-939616-53-X.
10. ^ Hedley, Gil (2005). The Integral Anatomy Series Vol. 2: Deep Fascia and Muscle (DVD).
Integral Anatomy Productions. Retrieved 2006-07-17.
11. ^ Stecco, Carla (2015). Functional Atlas of the Human Fascial System. Edinburgh, UK: Churchill
Livingstone Elsevier. p. 59. ISBN 978-0-7020-4430-4.
12. ^ Schleip, Robert (2003). "Fascial plasticity – a new neurobiological explanation: Part 1". Journal
of Bodywork and Movement Therapies. 7 (1): 11–9. doi:10.1016/S1360-8592(02)00067-0.
13. ^ Faller, A.; Schuenke, M. (2004). The Human Body. Thieme Medical Publishers. p. 127.
14. ^ Schleip R "Fascia as an organ of communication". In: Schleip R, et al. "Fascia - the tensional
network of the human body", Elsevier Ltd, Edinburgh 2012, pages 77-112.
15. ^ "Clinical relevance of fascial tissue and dysfunctions". Curr Pain Headache Rep. 18 (8): 439.
2014. doi:10.1007/s11916-014-0439-y. PMID 24962403.