Anatomy, Fascia

Summary:

When learning about fascia as a practitioner, it is loosely defined by saying that it is connective tissue and surrounds everything. A researcher needs a much clearer definition and understanding. This short online book clearly defines and explains the anatomy of fascia. It discusses the multiple scientific definitions of fascia and the constituents within each of the different parts of fascia. It even sheds some light on the interaction of fascia and emotions.

Anatomy, Fascia

Bruno Bordoni; Matthew Varacallo.

Bordoni, B., & Varacallo, M. (2019). Anatomy, Fascia. StatPearls. StatPearls Publishing. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/29630284Anatomy, Fascia

Introduction

Researchers do not agree on one, comprehensive "fascia" definition. Despite the scientific uncertainty, there is agreement with medical text that the fascia covers every structure of the body, creating a structural continuity that gives form and function to every tissue and organ.  The fascial tissue has a ubiquitous distribution in the body system; it is able to wrap, interpenetrate, support, and form the bloodstream, bone tissue, meningeal tissue, organs, and skeletal muscles. The fascia creates different interdependent layers with several depths, from the skin to the periosteum, forming a three-dimensional mechano-metabolic structure [1]. 

The Fascia and Its Affect on Individual Health [2][3]

Three large groups of scholars have attempted to define the fascia. The Federative Committee on Anatomical Terminology (FCAT), founded in 1989 from the General Assembly of the International Federation of Associations of Anatomists (IFAA), introduced the term "fascia superficialis" and "fascia profunda." The superficial fascia is a “whole loose layer of subcutaneous tissue lying superficial to the denser layer of fascia profunda.” The deep fascia, according to this definition, lies below the superficial fascia, highlighting two fasciae. In 2011, the Federative International Programme on Anatomical Terminologies (FIPAT), in agreement with FCAT, defined the fascia as “a sheath, a sheet, or any other dissectible aggregations of connective tissue that forms beneath the skin to attach, enclose, and separate muscles and other internal organs.” The FIPAT builds on the text of international anatomical terminology. The second definition specifies the term connective tissue, which functions to divide, separate, and support different structures. The connective tissue or fascia begins under the skin, excluding the epidermis from the fascia set.

The third group of scholars is the Fascia Nomenclature Committee (2014), born from the Fascia Research Society founded in 2007. The board gave the following description of fascia: “The fascial system consists of the three-dimensional continuum of soft, collagen containing, loose and dense fibrous connective tissues that permeate the body. It incorporates elements such as adipose tissue, adventitia and neurovascular sheaths, aponeuroses, deep and superficial fasciae, epineurium, joint capsules, ligaments, membranes, meninges, myofascial expansions, periosteum, retinacula, septa, tendons, visceral fasciae, and all the intramuscular and intermuscular connective tissues including endo-/peri-/epimysium.  The fascial system interpenetrates and surrounds all organs, muscles, bones and nerve fibers, endowing the body with a functional structure, and providing an environment that enables all body systems to operate in an integrated manner.” This is the broadest definition of the fascia. The concept of a continuum of the collagen and connective structure, the cellular diversity that makes up the fascia, is emphasized. It is this continuum itself that assures the health of the body.

These scientific definitions allow healthcare practitioners to make some deductions about the fascia. The fascia includes everything that presumes the presence of collagen/connective tissue or from which it is derived. All the tissue considered as "specialized connective tissue" of mesodermal derivation are inserted into the fascial system. These include blood, bone, cartilage, adipose tissue, hematopoietic tissue, and lymphatic tissue. The fascial system has no discontinuity in its path, with layers of different characteristics and properties overlapping.