Deep fascia (or investing fascia) is a
fascia
A fascia (; plural fasciae or fascias; 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. ...
, a layer of
dense connective tissue
Dense connective tissue, also called dense fibrous tissue, is a type of connective tissue with fibers as its main matrix element. The fibers are mainly composed of type I collagen. Crowded between the collagen fibers are rows of fibroblasts, fibe ...
that can surround individual
muscle
Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of muscl ...
s and groups of muscles to separate into
fascial compartment
A fascial compartment is a section within the body that contains muscles and nerves and is surrounded by deep 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 forea ...
s.
This fibrous connective tissue interpenetrates and surrounds the muscles, bones, nerves, and blood vessels of the body. It provides connection and communication in the form of
aponeuroses
An aponeurosis (; plural: ''aponeuroses'') is a type or a variant of the deep fascia, in the form of a sheet of pearly-white fibrous tissue that attaches sheet-like muscles needing a wide area of attachment. Their primary function is to join muscl ...
,
ligaments
A ligament is the fibrous connective tissue that connects bones to other bones. It is also known as ''articular ligament'', ''articular larua'', ''fibrous ligament'', or ''true ligament''. Other ligaments in the body include the:
* Peritoneal li ...
,
tendons
A tendon or sinew is a tough, high-tensile-strength band of dense fibrous connective tissue that connects muscle to bone. It is able to transmit the mechanical forces of muscle contraction to the skeletal system without sacrificing its ability ...
,
retinacula
A retinaculum (plural ''retinacula'') is a band of thickened deep fascia around tendons that holds them in place. It is not part of any muscle. Its function is mostly to stabilize a tendon. The term retinaculum is New Latin, derived from the Latin ...
,
joint capsule
In anatomy, a joint capsule or articular capsule is an envelope surrounding a synovial joint.septa
The Southeastern Pennsylvania Transportation Authority (SEPTA) is a regional public transportation authority that operates bus, rapid transit, commuter rail, light rail, and electric trolleybus services for nearly 4 million people in five coun ...
. The deep fasciae envelop all bone (
periosteum
The periosteum is a membrane that covers the outer surface of all bones, except at the articular surfaces (i.e. the parts within a joint space) of long bones. Endosteum lines the inner surface of the medullary cavity of all long bones.
Structure ...
and
endosteum
The endosteum (plural endostea) is a thin vascular membrane of connective tissue that lines the inner surface of the bony tissue that forms the medullary cavity of long bones.
This endosteal surface is usually resorbed during long periods of ma ...
);
cartilage
Cartilage is a resilient and smooth type of connective tissue. In tetrapods, it covers and protects the ends of long bones at the joints as articular cartilage, and is a structural component of many body parts including the rib cage, the neck an ...
(
perichondrium
The perichondrium (from Greek el, περί, peri, around, label=none and el, χόνδρος, chondros, cartilage, label=none) is a layer of dense irregular connective tissue that surrounds the cartilage of developing bone. It consists of two sep ...
), and blood vessels (
tunica externa
The tunica externa (New Latin "outer coat"), also known as the tunica adventitia (New Latin "additional coat"), is the outermost tunica (layer) of a blood vessel, surrounding the tunica media. It is mainly composed of collagen and, in arteries, i ...
) and become specialized in muscles (
epimysium
Epimysium (plural ''epimysia'') (Greek ''epi-'' for on, upon, or above + Greek ''mys'' for muscle) is the fibrous tissue envelope that surrounds skeletal muscle. It is a layer of dense irregular connective tissue which ensheaths the entire muscle ...
,
perimysium
Perimysium is a sheath of connective tissue that groups muscle fibers into bundles (anywhere between 10 and 100 or more) or fascicles.
Studies of muscle physiology suggest that the perimysium plays a role in transmitting lateral contractile ...
, and
endomysium
The endomysium, meaning ''within the muscle'', is a wispy layer of areolar connective tissue that ensheaths each individual Skeletal muscle#Skeletal muscle fibers, muscle fiber, or muscle cell. It also contains capillaries and nerves. It overlies ...
) and nerves (
epineurium
The epineurium is the outermost layer of dense irregular connective tissue surrounding a peripheral nerve. It usually surrounds multiple nerve fascicles as well as blood vessels which supply the nerve. Smaller branches of these blood vessels p ...
,
perineurium
The perineurium is a protective sheath that surrounds a nerve fascicle. This bundles together axons targeting the same anatomical location. The perineurium is composed from fibroblasts.
In the peripheral nervous system, the myelin sheath of each ...
, and
endoneurium
The endoneurium (also called endoneurial channel, endoneurial sheath, endoneurial tube, or Henle's sheath) is a layer of delicate connective tissue around the myelin sheath of each myelinated nerve fiber in the peripheral nervous system. Its comp ...
). The high density of
collagen
Collagen () is the main structural protein in the extracellular matrix found in the body's various connective tissues. As the main component of connective tissue, it is the most abundant protein in mammals, making up from 25% to 35% of the whole ...
fibers gives the deep fascia its strength and integrity. The amount of
elastin
Elastin is a protein that in humans is encoded by the ''ELN'' gene. Elastin is a key component of the extracellular matrix in gnathostomes (jawed vertebrates). It is highly elastic and present in connective tissue allowing many tissues in the bod ...
fiber determines how much
extensibility
Extensibility is a software engineering and systems design principle that provides for future growth. Extensibility is a measure of the ability to extend a system and the level of effort required to implement the extension. Extensions can be th ...
and resilience it will have.
Examples
Examples include:
*
Fascia lata
The fascia lata is the deep fascia of the thigh. It encloses the thigh muscles and forms the outer limit of the fascial compartments of thigh, which are internally separated by the medial intermuscular septum and the lateral intermuscular septu ...
*
Deep fascia of leg
The deep fascia of leg, or crural fascia forms a complete investment to the muscles, and is fused with the periosteum over the subcutaneous surfaces of the bones.
The deep fascia of the leg is continuous above with the fascia lata (deep fascia o ...
*
Brachial fascia
The brachial fascia (deep fascia of the arm) is continuous with that covering the deltoideus and the pectoralis major muscle, by means of which it is attached, above, to the clavicle, acromion, and spine of the scapula; it forms a thin, loose, me ...
*
Buck's fascia
Buck's fascia (deep fascia of the penis, Gallaudet's fascia or fascia of the penis) is a layer of deep fascia covering the three erectile bodies of the penis.
Structure
Buck's fascia is continuous with the external spermatic fascia in the scrotu ...
Fascial dynamics
Deep fascia is less extensible than
superficial fascia
A fascia (; plural fasciae or fascias; 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 orga ...
. It is essentially
avascular
The blood vessels are the components of the circulatory system that transport blood throughout the human body. These vessels transport blood cells, nutrients, and oxygen to the tissues of the body. They also take waste and carbon dioxide away f ...
, but is richly
innervated
A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system.
A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the e ...
with
sensory receptor
Sensory neurons, also known as afferent neurons, are neurons in the nervous system, that convert a specific type of stimulus, via their receptors, into action potentials or graded potentials. This process is called sensory transduction. The cell ...
s that report the presence of pain (
nociceptors
A nociceptor ("pain receptor" from Latin ''nocere'' 'to harm or hurt') is a sensory neuron that responds to damaging or potentially damaging stimuli by sending "possible threat" signals to the spinal cord and the brain. The brain creates the sens ...
); change in movement (
proprioceptors
Proprioception ( ), also referred to as kinaesthesia (or kinesthesia), is the sense of self-movement, force, and body position. It is sometimes described as the "sixth sense".
Proprioception is mediated by proprioceptors, mechanosensory neurons ...
); change in pressure and vibration (
mechanoreceptors
A mechanoreceptor, also called mechanoceptor, is a sensory receptor that responds to mechanical pressure or distortion. Mechanoreceptors are innervated by sensory neurons that convert mechanical pressure into electrical signals that, in animals, a ...
); change in the chemical milieu (
chemoreceptors
A chemoreceptor, also known as chemosensor, is a specialized sensory receptor which transduces a chemical substance (endogenous or induced) to generate a biological signal. This signal may be in the form of an action potential, if the chemorecept ...
); and fluctuation in temperature (
thermoreceptors
A thermoreceptor is a non-specialised sense receptor, or more accurately the receptive portion of a sensory neuron, that codes absolute and relative changes in temperature, primarily within the innocuous range. In the mammalian peripheral nervous s ...
).
Deep fascia is able to respond to sensory input by contracting; by relaxing; or by adding, reducing, or changing its composition through the process of fascial remodeling.
Fascia may be able to contract due to the activity of
myofibroblasts
A myofibroblast is a cell phenotype that was first described as being in a state between a fibroblast and a smooth muscle cell.
Structure
Myofibroblasts are contractile web-like fusiform cells that are identifiable by their expression of α-sm ...
which may play a role in wound healing.
The deep fascia can also relax. By monitoring changes in muscular tension, joint position, rate of movement, pressure, and vibration, mechanoreceptors in the deep fascia are capable of initiating relaxation. Deep fascia can relax rapidly in response to sudden muscular overload or rapid movements.
Golgi tendon organs
The Golgi tendon organ (GTO) (also called Golgi organ, tendon organ, neurotendinous organ or neurotendinous spindle) is a proprioceptor – a type of sensory receptor that senses changes in muscle tension. It lies at the interface between a muscl ...
operate as a feedback mechanism by causing myofascial relaxation before muscle force becomes so great that tendons might be torn.
Pacinian corpuscles
Pacinian corpuscle or lamellar corpuscle or Vater-Pacini corpuscle; is one of the four major types of mechanoreceptors (specialized nerve ending with adventitious tissue for mechanical sensation) found in mammalian skin. This type of mechanorecept ...
sense changes in pressure and vibration to monitor the rate of
acceleration
In mechanics, acceleration is the rate of change of the velocity of an object with respect to time. Accelerations are vector quantities (in that they have magnitude and direction). The orientation of an object's acceleration is given by the ...
of movement. They will initiate a sudden relaxatory response if movement happens too fast. Deep fascia can also relax slowly as some mechanoreceptors respond to changes over longer timescales. Unlike the Golgi tendon organs, Golgi receptors report joint position independent of muscle contraction. This helps the body to know where the bones are at any given moment.
Ruffini endings respond to regular stretching and to slow sustained pressure. In addition to initiating fascial relaxation, they contribute to full-body relaxation by inhibiting sympathetic activity which slows down heart rate and respiration.
[
When contraction persists, fascia will respond with the addition of new material. Fibroblasts secrete collagen and other proteins into the ]extracellular matrix
In biology, the extracellular matrix (ECM), also called intercellular matrix, is a three-dimensional network consisting of extracellular macromolecules and minerals, such as collagen, enzymes, glycoproteins and hydroxyapatite that provide stru ...
where they bind to existing proteins, making the composition thicker and less extensible. Although this potentiates the tensile strength
Ultimate tensile strength (UTS), often shortened to tensile strength (TS), ultimate strength, or F_\text within equations, is the maximum stress that a material can withstand while being stretched or pulled before breaking. In brittle materials t ...
of the fascia, it can unfortunately restrict the very structures it aims to protect. The pathologies resulting from fascial restrictions range from a mild decrease in joint range of motion
Range of motion (or ROM), is the linear or angular distance that a moving object may normally travel while properly attached to another. It is also called range of travel (or ROT), particularly when talking about mechanical devices and in mechanic ...
to severe fascial binding of muscles, nerves and blood vessels, as in compartment syndrome
Compartment syndrome is a condition in which increased pressure within one of the body's anatomical compartments results in insufficient blood supply to tissue within that space. There are two main types: acute and chronic. Compartments of the ...
of the leg. However, if fascial contraction can be interrupted long enough, a reverse form of fascial remodeling occurs. The fascia will normalize its composition and tone and the extra material that was generated by prolonged contraction will be ingested by macrophages within the extracellular matrix.
Like mechanoreceptors, chemoreceptors in deep fascia also have the ability to promote fascial relaxation. We tend to think of relaxation as a good thing, however fascia needs to maintain some degree of tension. This is especially true of ligaments. To maintain joint integrity, they need to provide adequate tension between bony surfaces. If a ligament is too lax, injury becomes more likely. Certain chemicals, including hormones
A hormone (from the Ancient Greek, Greek participle , "setting in motion") is a class of cell signaling, signaling molecules in multicellular organisms that are sent to distant organs by complex biological processes to regulate physiology and beh ...
, can influence the composition of the ligaments. An example of this is seen in the menstrual cycle
The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that make pregnancy possible. The ovarian cycle controls the production and release of eggs a ...
, where hormones are secreted to create changes in the uterine
The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the hollow organ, organ in the female reproductive system, reproductive system of most female mammals, including humans that accommodates the embryonic development, embryonic an ...
and pelvic floor
The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus muscle, and associated connective tissue which span the area underneath the pelvis. The pelvic diaphragm is a muscular partition formed by the lev ...
fascia. The hormones are not site-specific, however, and chemoreceptors in other ligaments of the body can be receptive to them as well. The ligaments of the knee may be one of the areas where this happens, as a significant association between the ovulatory phase of the menstrual cycle and an increased likelihood for an anterior cruciate ligament
The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments (the other being the posterior cruciate ligament) in the human knee. The two ligaments are also called "cruciform" ligaments, as they are arranged in a crossed formation ...
injury has been demonstrated.
It has been suggested that manipulation of the fascia by acupuncture
Acupuncture is a form of alternative medicine and a component of traditional Chinese medicine (TCM) in which thin needles are inserted into the body. Acupuncture is a pseudoscience; the theories and practices of TCM are not based on scientifi ...
needles is responsible for the physical sensation of qi flowing along meridians in the body, even though there is no physically verifiable anatomical
Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having it ...
or histological
Histology,
also known as microscopic anatomy or microanatomy, is the branch of biology which studies the microscopic anatomy of biological tissues. Histology is the microscopic counterpart to gross anatomy, which looks at larger structures vis ...
basis for the existence of acupuncture points
This article provides a comprehensive list of acupuncture points, locations on the body used in acupuncture, acupressure, and other treatment systems based on Traditional Chinese Medicine (TCM).
Locations and basis
More than four hundred ...
or meridians.
References
{{Muscular system
Fascia