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Flashcards in Fascia Lata Deck (68):
1

What is fascia defined as?

A sheet or band of fibrous tissue lying deep to the skin that lines, invests and separates structures within the body

2

What are the general classifications of fascia?

Superficial 
Deep fascia
Visceral

3

What does superficial fascia do?

Blends with the reticular layer beneath the dermis

4

What does deep fascia do?

Envelopes muscles, bones and neurovascular structures

5

What does visceral fascia do?

Provides membranous investments that suspend organs within their cavities

6

What is the fascia lata?

A deep fascial investment of the whole thigh musculature

7

What is fascia lata analogus to?

A strong, extensible and elasticated stocking

8

Where does the fascia lata begin most proximally?

Around the iliac crest and inguinal ligament

9

Where does the fascia lata end most distally?

The bony prominences of the tibia

10

What happens to the fascia lata at the bony prominences of the tibia?

It continues to become the deep fascia of the leg (crural fascia)

11

How much does the width of the fascia lata vary at different regions of the thigh?

Considerably

12

Where is the fascia lata thickest?

Along the superolateral aspect of the thigh, originating from the fascial condensations from the gluteus maximus and medius 
Around the knee

13

What happens to the fascia lata around the knee?

It receives reinforcing fibres from tendons

14

Where is the fascia lata thinnest?

Where it covers the adductor muscles of the medial thigh

15

What does the deepest aspect of the fascia lata give rise to?

Three intermuscular septa that attach centrally to the femur

16

What do the three intermuscular septa of the fascia lata do?

Divides the thigh musculature into three compartments, anterior, medial, and lateral

17

Which intermuscular septa is strongest?

The lateral

18

Why is the lateral intermuscular septa strongest?

Due to reinforcement from the iliotibial tract

19

What is present in the fascia lata?

The saphenous opening

20

What is the saphenous opening?

An ovoid hiatus

21

Where is the saphenous opening found?

Just inferior to the inguinal ligament

22

What does the saphenous opening serve as?

An entry point for efferent lymphatic vessels, and the great saphenous vein

23

What do the efferent lymphatic vessels drain into?

The superficial inguinal lymph nodes

24

What does the great saphenous vein drain into?

The femoral vein

25

What covers the saphenous opening?

A covering of membranous tissue called the cribriform fascia

26

How does the saphenous opening develop?

Inferomedially from a sharp margin of the gap (the falciform margin)

27

When do femoral hernias develop?

When an out-pouching of gastric viscera protrudes through the femoral canal

28

When does the protrusion of gastric viscera become noticeable?

When it exits superficially through the saphenous opening within the fascia lata, producing a swelling inferior to the inguinal ligament

29

What is necessary when a femoral hernia presents?

To investigate promptly

30

Why is it important to investigate femoral hernias promptly?

Due to the high risk of incarceration 
To rule out other pathology, such as lymphadenopathy

31

What is the iliotibial tract?

A longitudinal thickening of the fascia lata

32

How is the iliotibial tract strengthened posteriorly?

By fibres from the gluteus maximus

33

Where is the iliotibial tract located?

Laterally in the thigh, extending from the iliac tubercle to the lateral tibial condyle

34

What are the main functions of the iliotibial tract?

Movement 
Compartmentalisation 
Muscular sheath

35

How is the iliotibial tract involved with movement?

Acts as an extensor, abductor, and lateral rotator of the hip 
Additional role in providing lateral stabilisation to the knee joint

36

How is the ITT involved in compartmentalisation?

The deepest aspect of the ITT extends centrally to form the lateral intermuscular septum of the thigh, and attaches to the femur

37

What does the ITT form a sheath for?

The tensor fascia lata muscle

38

What is the tensor fascia lata?

A gluteal muscle

39

What does the tensor fascia lata act as?

A flexor, abductor and internal rotator of the hip 
Additional role in tensing the fascia lata

40

Where does the tensor fascia lata orginate?

From the iliac crest

41

Where does the tensor fascia lata descend?

Down the superolateral thigh

42

Where does the tensor fascia lata insert?

Into the anterior aspect of the iliotibial tract, at the junction of the middle and upper thirds of the thigh

43

What happens when the tensor fascia lata is stimulated?

It tautens the iliotibial band, and braces the knee, especially when the opposite foot is lifted
Makes muscle contraction more efficient in compressing deep veins

44

What happens when the fascia lata is pulled taut?

It forces the muscle groups closer together within their intermuscular septa towards the femur. This action centralises muscle weight and limits outward expansion, which in turn reduces the overall force required for movement at the hip joint

45

What does the compression of deep veins ensure?

Adequate venous return to the hear from the lower limbs

46

What proximal attachments does the fascia lata form?

Multiple superior attachments around the pelvis and hip region- posterior, lateral, anterior and medial

47

What is the proximal posterior attachment of the fascia lata?

Sacrum and coccyx

48

What is the proximal lateral attachment of the fascia lata?

Iliac crest

49

What is the proximal anterior attachment of the fascia lata?

Inguinal ligament 
Superior pubic rami

50

What is the medial anterior attachment of the fascia lata?

Inferior ischiopubic rami
Ischial tuberosity 
Sacrotuberous ligament

51

Proximally, what is the fascia lata continuous with?

Regions of deep and superficial fascia at its superior aspect

52

What does the deep iliac fascia do?

Descends from the thoracic region at the diaphragm, covers the entire ilacus and psoas regions, and blends with the fascia lata superiorly

53

What blends with fascia lata just below the inguinal ligament?

Superficial fascia from the inferior abdominal wall (Scarpa fascia) and perineal region

54

What does the lateral thickening of fascia lata form?

The iliotibial tract

55

What does the lateral thickening of fascia lata receive?

Tendon insertions superiorly from the gluteus maximus and tensor fascia lata

56

What happens to the widened band of fibres from the lateral thickening of the fascia lata?

They descend the lateral thigh and attaches to the lateral tibial condyle on the anterolateral (Gerdy) tubercle

57

Where does the fascia lata end inferiorly?

The knee joint

58

What does the fascia lata become at the knee joint?

The deep fascia of the leg (the Crural fascia)

59

Where are fascia lata attachments made at the knee?

At the bony prominences around the knee, including the femoral and tibial condyles, patella, head of fibula and the tibial tuberosity

60

What does the deep aspect of the fascial lata produce?

Three intermuscular septa

61

Where do the three intermuscular septa attach centrally?

To the femur

62

What does the lateral intermuscular septa join?

The lateral lip of the linea aspera

63

What do the medial and anterior intermuscular septa attach to?

The medial lip of the linea aspera

64

How to the attachments of the intermuscular septa to the linea aspera lips continue?

Along the length of the femur to include the supracondylar lines

65

What can dermatofasciotomy and debridement leave?

Large wound sites that require post-operative grafts to facilitate tissue regeneration and healing

66

Why is a fascia lata graft a popular choice/

As the iliotibial tract provides a particularly high concentration of connective tissue fibres, and can be surgically harvested whilst leaving the majority of fibres in tact

67

What have advancements have been made in the use of fascia lata in reconstructive surgery?

Heart valve replacements 
Eyelid reparations 
Dura mater repair 
Urinary incontinence treatment (fascia lata sling)

68

What is the main advantage of using fascia lata as opposed to an artificial product?

It is well vascularised upon transplantation, whereas the later requires microvascular anastomosis