2. Fascia
• It is defined as a sheet or band of fibrous tissue
lying deep to the skin that lines, invests and
separates structures within the body.
There are three general classifications of fascia:
• Superficial fascia: blends with the reticular layer
beneath the dermis.
• Deep fascia: envelopes muscles, bones and
neurovascular structures.
• Visceral fascia: provides membranous investments
that suspend organs within their cavities.
3.
4. The fascia lata
• It is a deep fascial investment of the
whole thigh musculature.
• It encloses the thighs like a stocking but
one whose top is too large.
• Posteriorly, it forms the strong popliteal
fascia which is continuous below with the
fascia of the back of the leg.
5. The fascia lata
• Anteriorly:
– It is attached to the inguinal ligament.
• Superiorly:
– The inguinal ligament, pubic arch, body of pubis, and pubic tubercle;
– The Scarpa fascia
• (approximately a finger's breadth inferior to the inguinal ligament).
• Laterally:
– The iliac crest.
• Posteriorly:
– The sacrum, coccyx, sacrotuberous ligament, and ischial tuberosity.
• Inferiorly:
– On the front and sides of the knee, & subcutaneous bony prominences
around the knee and the deep fascia of the leg distally.
6. MODIFICATIONS OF FASCIA LATA
• ILIOTIBIAL TRACT
• SAPHENOUS OPENING
–The cribriform fascia (L. cribrum, a
sieve)
• INTERMUSCULAR SEPTA
– The lateral intermuscular septum
– The medial intermuscular septum
– The posterior intermuscular septum
7. ILIOTIBIAL TRACT
• The iliotibial tract is a longitudinal thickening of the
fascia lata, where it forms a 5 cm wide band.
• Superiorly the tract splits into two layers. The
superficial lamina is attached to the tubercle of the iliac
crest, and the deep lamina to the capsule of the hip
joint.
• (a) Two important muscles are inserted into its upper
part,
– The gluteus maximus; posteriorly
– The tensor fasciae latae, anteriorly
• Inferiorly. the tract is attached to a smooth area on the
anterior surface of the lateral condyle of the tibia.
8.
9. The iliotibial tract/band
• . The ITT/ITB has three main functions:
• Movement:The iliotibial tract stabilizes the knee both
in extension and in partial flexion: and is therefore used
constantly during walking and running.
In leaning forwards with slightly flexed knees, the tract
is the main support of the knee against gravity.
• Compartmentalisation: The deepest aspect of ITT
extends centrally to form the lateral intermuscular
septum of the thigh and attaches to the femur.
• Muscular sheath – forms a sheath for the tensor fascia
lata muscle
10. SAPHENOUS OPENING (fossa ovalis)
• This is an oval gap or hiatus in the fascia lata inferior
to the medial part of the inguinal ligament,
approximately 4 cm inferolateral to the pubic
tubercle.
• It is usually approximately 3.75 cm in length and
2.5 cm in breadth, and its long axis is vertical.
• Its medial margin is smooth but its superior, lateral,
and inferior margins form a sharp crescentic edge,
the falciform margin.
• This falciform margin is joined medially by fibrofatty
tissue, the cribriform fascia (L. cribrum, a sieve)
which covers the saphenous opening.
11. Cribriform fascia
• This fascia is pierced by:
– The great saphenous vein and its tributaries and
– Efferent lymphatics from the superficial inguinal lymph
nodes, giving it a sieve-like appearance, whence it
derives the name of cribriform fascia.
• After passing through the saphenous opening and
cribriform fascia, the great saphenous vein enters
the femoral vein. The lymphatic vessels enter the
deep inguinal lymph nodes
12. Tensor Fascia Lata (TFL)
• The tensor fascia lata is a gluteal muscle that acts as a
abductor, flexor, and internal rotator of the hip.
• When stimulated, the tensor fasciae lata tautens the iliotibial
band and braces the knee, especially when the opposite foot
is lifted.
• This property gives an elastic stocking up the thigh. When
the fascia lata is pulled taut, it forces muscle groups closer
together within their intermuscular septa towards the femur.
This action centralises muscle weight and limits outward
expansion.
• It makes muscle contraction more efficient in
compressing deep veins. This ensures adequate venous
return to the heart from the lower limbs.
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14.
15.
16.
17. INTERMUSCULAR SEPTA
• Three intermuscular septa divide the thigh into three
compartments:
• The lateral intermuscular septum is the thickest of
these septa. It extends from the iliotibial tract to the
lateral lip of the linea aspera. It separates the anterior
compartment of the thigh from the posterior
compartment.
• The medial intermuscular septum is attached to the
medial lip of the linea aspera, and separates the
anterior compartment of the thigh from the medial
compartment.
• The posterior intermuscular septum is poorly defined.
It separates the medial compartment of the thigh from
the posterior compartment.
18. INTERMUSCULAR COMPARTMENTS
• The thigh muscles are separated into three
compartments anterior, medial, and posterior.
• The walls of these compartments are formed by the
fascia lata and three fascial intermuscular septa that
arise from its deep aspect and attach to the linea
aspera of the femur.
• The lateral intermuscular septum is especially
strong; the other two septa are relatively weak.
• This septum offers a welcome internervous plane to
surgeons needing wide exposure of the femur.
