Showing posts with label Skin and Fascia. Show all posts
Showing posts with label Skin and Fascia. Show all posts

Sunday, May 6, 2018

Deep Fascia

Deep Fascia


Deep fascia is the dense fibrous connective tissue that interpenetrates and surrounds the muscles, bones, nerves and blood vessels of the body. It is in the form of a fibrous sheet which invests the body beneath the superficial fascia. It is devoid of fat, and is usually inelastic and tough.

Distribution of deep fascia


  • Deep fascia is best defined in the limbs where it forms tough and tight sleeves and in the neck where it forms a collar.
  • It is ill-defined on the trunk and face

Important Features of Deep Fascia


1. Extensions (prolongations) of the deep fascia form:

  • The intermuscular septa which divide the limb into compartments.
  • The fibroareolar sheaths for the muscles, vessels and nerves.
2. Thickenings of the deep fascia form:

  • Retinacula (retention bands) around certain joints like wrist and ankle.
  • The palmar and plantar aponeuroses for protection of nerves and blood vessels.
3. Deep fascia never crosses a subcutaneous hone. Instead it blends with its periosteum and is bound down to the bone.

Modifications of Deep Fascia


1. Forms the intermuscular septa separating functionally different group of muscles into separate compartments.

2. Covers each muscle as epimysium which sends in the septa to enclose each muscle fasciculus known as perimysium. From the perimysium septa pass to enclose each Muscle fiber. These fine septa are the endomysium. Through all these connective tissue septa, e.g. epimysium, perimysium and endomysium, arterioles, capillaries, venules, lymphatics and nerves traverse to reach each muscle fibred.

3. Deep fascia covers each nerve as epineurium, each nerve fascicle as perineurium and individual nerve fibered as endoneurium. These connective tissue coverings support the nerve fibers and carry capillaries and lymphatics.

4. Forms sheaths around large arteries, e.g. carotid sheath, axillary sheath. The deep fascia is dense around the artery and rather loose around the vein to give an allowance for the vein to distend.

5. Modified to form the capsule, synovial membrane and bursae in relation to the joints.

6. Forms tendon sheaths wherever tendons cross over a joint. This mechanism prevents wear and tear of the tendon. In the region of palm and sole it is modified to form aponeuroses, e.g. palmar and plantar aponeuroses which afford protection to the underlying-structures. It also forms septa between various muscles. These septa are specially well developed in the calf muscles of lower limb. The contraction of calf muscles in the tight sleeve of deep fascia helps in pushing the venous blood and lymph towards the ‘heart. Thus the deep fascia helps in venous and lymphatic return from the lower limb.

7. In the forearm and leg, the deep fascia is modified to form the interosseous membrane, which keeps:

  • The two bones at optimum distance.
  • Increases surface area for attachment of muscles.
  • Transmits weight from one bone to other.

Functions of Deep Fascia


  1. Deep fascia keeps the underlying structures in position an preserves the characteristic surface contour of the limbs and neck.
  2. It provides extra surface for muscular attachment
  3. It helps in venous and lymphatic return.
  4. It assists muscles in their action by the degree of tension and pressure it exerts upon their surfaces.
  5. The retinacula act as pulleys and serve to prevent the loss of power. In such situations the friction is minimized by the synovial sheaths of tendons.


Superficial Fascia

Superficial Fascia


Superficial fascia is a general coating of the body beneath the skin, made up of loose areolar tissue with varying amounts of fat. It is the layer that primarily determines the shape of the body. In addition to its subcutaneous presence, the supreficial fascia surrounds organs , glands and neurovascular bundles. It is also found at many other locations where it fills otherwise unoccupied space.

Distribution of Fat in Superficial Fascia


  • Fat is abundant in the gluteal region (buttocks), lumbar region (flanks), front of the thighs, anterior abdominal wall below the umbilicus, mammary gland, postdeltoid region, and the cervicothoracic region.
  • In females, fat is more abundant and is more evenly distributed than in males.
  • Fat is absent from the eyelids, external ear, penis, and scrotum.
  • The subcutaneous layer of fat is called the panniculus adiposus.
  • In females fat is in the superficial fascia of the lower abdomen, upper thigh, whereas in males it is inside the abdominal cavity.
  • In general, in women fat forms a thicker and more even layer than in men.
  • Fat (adipose tissue) fills the hollow spaces like axilla and orbits.
  • Fat present around the kidneys in abdomen supports the organs.

Types of fats


There are two types of fat; i.e. yellow and brown fat. Most of the body fat is yellow, only in hibernating animals it is brown. The cells of brown fat are smaller with several small droplets, and multiple mitochondria.

Fat cells are specialized cells and the size of fat cells increases during accumulation of fat, rather than the number of cells. Any attempt to reduce excessive fat (obesity) must be slow and steady and not drastic, as the latter may cause harm to the body.

Important Features of Superficial Fascia


  • Superficial fascia is most distinct in the lower part of the anterior abdominal wall, perineum, and the limbs.
  • It is very thin on the dorsal aspect of the hands and feet, sides of the neck, face, and around the anus.
  • It is very dense in the scalp, palms, and soles.
  • Superficial fascia shows stratification (into two layers) in the lower part of anterior abdominal wall, perineum, and uppermost parts of thighs.
  • It contains:
    (a) Subcutaneous muscles in the face, neck and scrotum
    (b) Mammary gland
    (c) Deeply situated sweat glands
    (d) Localized groups of lymph nodes
    (e) Cutaneous nerves and vessels.

Functions of Superficial Fascia


  • Superficial fascia facilitates movements of the skin.
  • It serves as a soft medium for the passage of nerves and vessels to the skin.
  • It conserves body heat because by nature, fat is a bad conductor of heat.

Sweat Glands

Sweat Glands


Sweat glands, also known as sudoriferous glands, are small tubular structures of skin that produce sweat. They are distributed all over the skin, except lips, glans penis and nail bed. These glands are of two types: Eccrine and Apocrine.

Eccrine Sweat Glands


Eccrine glands are much more abundant and distributed in almost every part of the skin. Each one of these is a single tube, the deep part of which is coiled into a ball. The coiled part is called body of the gland. It lies in the deeper part of corium or in the subcutaneous tissue. The straight part is called duct. It traverses the dermis and epidermis and opens on the surface of the skin.

The glands are large in the axilla and groin. They are most abundant in the regions of palms and soles and least abundant in the neck and back.
The eccrine glands are merocrine in nature, which means that they produce their thin watery secretion without any disintegration of the epithelial cells. They are supplied and controlled by cholinergic sympathetic nerves.The glands help in regulation of body temperature by evaporation of sweat and also help in excreting the body salts.

Apocrine Sweat Glands


The apocrine are confined to axilla, eyelids (where they are known as Moll’s glands), nipple, and areola of the breast, perianal region and the external genitalia. They are larger than the eccrine glands and produce a thicker secretion having a characteristic smell. They develop in close association with hair and their ducts typically open into the distal ends of hair follicles.

The Ceruminous glands of the external auditory meatus are modified apocrine sweat glands. The apocrine glands also are merocirne in nature, but are regulated by a dual autonomic control. Some research workers are not inclined towards calling these glands as sweat glands. The main reason behind this is that they don’t respond sufficiently to temperature changes.

Average secretion of sweat


On average, about one liter of sweat is secreted each day. The total water loss on daily basis for a healthy adult individual is about 1500 ml. This shows that greater part of the water lost from our body is in the form of sweat. In hot climates, the proportion rises to even  a higher value and the secretion of sweat may amount to 3-7 liters per day. As long as the sweat glands are intact, the skin can regenerate, however, if the sweat glands are lost, skin grafting becomes necessary.


Sebaceous Glands

Sebaceous Glands


Sebaceous glands are microscopic glands in the skin that secrete an oily secretion known as sebum. They are widely distributed all over the dermis of skin, except for the palms and soles. They are especially abundant in the scalp and face. They are also very numerous around the apertures of ear, nose, mouth and anus.

Structure of Sebaceous Glands


Sebaceous glands are small and sacculated in appearance. They are made up of a cluster of about 2-6 piriform alveoli. Their ducts open into the hair follicles, with the exception of lips, glans penis, inner surface of prepuce, labia minora, nipple and areola of the breast, and tarsal glands of the eyelid, where the ducts open on the surface of the skin.

Nature of Sebaceous Glands


Sebaceous glands are holocrine in nature, which means that they produce their secretion by complete degeneration of the central cells of the alveolus. The degenerated central cells are then replaced by proliferating peripheral cells.

Role of Sebum


The secretion of sebaceous glands is under hormonal control, especially the androgens. The sebum, which is the secretion of the sebaceous glands, lubricates the skin and protects it from moisture, desiccation and harmful sun rays. Sebum also lubricates hair and prevent them from becoming brittle. In addition, the sebum also has some bacterial action. Sebum makes the skin water proof, thus reducing the loss of water from skin surface.


Anatomy of Hair

Anatomy of Hair


Hair are keratinous filaments derived from invaginations of the germinative layer of epidermis into the dermis. These are peculiar to mammals (like feathers to the birds), and help in conservation of their body heat. However, in man the heat loss is prevented b the cutaneous sensation of touch

Distribution of Hair


Hair are distributed all over the body, except on the palms, soles, dorsal surface of distal phalanges, umbilicus, glans penis, inner surface of prepuce, the labia minora, and inner surface of labia majora. The length, thickness and color of the hair vary in different part of the body and in different individuals.

Structure of Hair


  • Each hair has an implanted part called the root, and a projecting part called the shaft.
  • The root is surrounded by a hair follicle (a sheath of epidermis and dermis), and is expanded at its proximal end to form the hair bulb.
  • Each hair bulb is invaginated at its end by the hair papilla (vascular connective tissue) which forms the neurovascular haunt of the hair and its sheath.
  • Hair grows at the hair bulb, by proliferation of its cells capping the papilla.
  • The hair follicles, enclosing hair roots lie obliquely to the surface of the skin, which is responsible for characteristic hair strearns in different parts of the body.

Arrectores Pilorum Muscles


The arrectores pilorum muscles (smooth muscles supplied by sympathetic nerves) connect the undersurface of the follicles to the superficial part of the dermis. Contraction of these muscles leads to erection of hair, squeezes out the sebum and produces “goose skin”.


Fetal Hair


The fetal skin is covered by fine hair called lanugo (primary hair). These are mostly sited by birth and are replaces during infancy by another set of fine hair called his secondary hair). These are retained in most parts of the body, but are replaced by the thick and dark terminal hair of the scalp and eyebrows, and other hairy areas of the adult skin.

Growth rate and life span


The hair grow at the rate of about 1.5-2mm per week. Their growth is controlled by hormones. The life span of the hair varies from 4 months (eyelashes, axillary hair) to 4 years (scalp hair)