The document summarizes the anatomy and characteristics of fascia. It describes the superficial fascia as a layer of loose connective tissue that connects the skin to underlying structures, with variable thickness, fat content, and presence of flat sheets of muscle in some regions. The quantity of subcutaneous fat differs between sexes and climates. The superficial fascia is most distinct on the lower abdominal wall, differentiating into two layers. It is also well differentiated in the limbs, perineum, and thin in other areas. Deep fascia forms a membrane wrapping the limbs and body wall with varying thickness and absence in some areas. It is firmly anchored to underlying bone and surrounds neurovascular structures in the neck.

1. Yapa Wijeratne
Faculty of Medicine
University of Peradeniya

2.  Fascia: masses of connective tissue large
enough to be visible to the unaided eye.

3.  The skin is connected to the underlying bones or deep
fascia by a layer of loose areolar connective tissue.
 This layer, usually referred to as superficial fascia, is of
variable
1. Thickness
2. Fat content
3. Flat sheets of muscles- in some regions.
 The quantity and distribution of subcutaneous fat differs
o in the sexes-more in females.
o with climate (rather than race)-more in colder
geographical regions.

4.  Flat sheets of muscles are also present in
some regions. These include
 Skeletal muscles
 Platysma
 Palmaris brevis
 Smooth muscles
 Subareolar muscle of the nipple
 Dartos
 Corrugator cutis ani

5.  The superficial fascia is most distinct on the
lower abdominal wall where it differentiates into
two layers.

8.  Well differentiated in
1. limbs
2. perineum
 Thin
1. Dorsal aspects of the hands and feet,
2. the sides of the neck and face,
3. around the anus
4. over the penis and scrotum
 Almost absent
 external ears.

9.  Strong connective tissue bands traverse the
superficial fascia binding the skin to the
underlying aponeurosis of the scalp, palm and
sole.
 Typical superficial fascia is lacking in the palms
and soles, where numerous strong connective
tissue collagenous bands tether the dermis of
the skin to underlying structures.
 Also atypical is the skin of the scalp, where
dense dermal connective tissue and the
epicranial aponeurosis are bound together as a
layer that ‘rides’ on loose connective tissue
overlying the periosteum of the skull.

10.  The limbs and body wall are wrapped in a membrane
of fibrous tissue, the deep fascia.
 It varies widely in thickness.
 Very well developed:
 iliotibial tract of the fascia lata
 So thin/Scarcely demonstrable (usually considered to
be absent):
 Over the rectus sheath
 External oblique aponeurosis of the abdominal wall
 Entirely absent:
 Face,
 Ischioanal fossa

11.  Where deep fascia passes directly over bone it is
always anchored firmly to the periosteum.
 In the neck, as well as the investing layer of deep
fascia, there are other deeper fascial layers enclosing
neurovascular structures, glands and muscles.
 Intermuscular septa are laminae of deep fascia which
extend between muscle groups and frequently become
continuous with the periosteum of bones.
 Transverse thickenings of deep fascia over
tendons, attached at their margins to bones, form
retinaculae at the wrists and ankles and fibrous
sheaths on the fingers and toes.

12.  Deep fascia is very sensitive.
 Its nerve supply, and that of subcutaneous
periosteum, is that of the overlying skin.
 The nerves to muscles supply the
intermuscular septa and deep periosteum.