Abstract
The aim of this study was to analyse the organization of the deep fascia of the pectoral region and of the thigh. Six unembalmed cadavers (four men, two women, age range 48–93 years old) were studied by dissection and by histological (HE, van Gieson and azan-Mallory) and immunohistochemical (anti S-100) stains; morphometric studies were also performed in order to evaluate the thickness of the deep fascia in the different regions. The pectoral fascia is a thin lamina (mean thickness ± SD: 297 ± 37 μm), adherent to the pectoralis major muscle via numerous intramuscular fibrous septa that detach from its inner surface. Many muscular fibres are inserted into both sides of the septa and into the fascia. The histological study demonstrates that the pectoral fascia is formed by a single layer of undulated collagen fibres, intermixed with many elastic fibres. In the thigh, the deep fascia (fascia lata) is independent from the underlying muscle, separated by the epimysium and a layer of loose connective tissue. The fascia lata presents a mean thickness of 944 μm (±102 μm) and it is formed by bundles of collagen fibres, arranged in two to three layers. In each layer, the fibres are parallel to each other, whereas the orientation of the fibres varies from one layer to the adjacent one. The van Gieson elastic fibres stain highlights the presence of elastic fibres only in the more external layer of the fascia lata. In the thigh the epimysium is easily recognizable under the deep fascia and presents a mean thickness of 48 μm. Both the fascia lata and pectoral fascia result innerved, no specific differences in density or type of innervations is highlighted. The deep fascia of the pectoral region is morphologically and functionally different from that of the thigh: the fascia lata is a relatively autonomous structure with respect to the underlying muscular plane, while the pectoralis fascia acts as an additional insertion for the pectoralis major muscle. Different portions of the pectoralis major muscle are activated according to the glenohumeral joint movements and, consequently, selective portions of the pectoral fascia are stretched, activating specific patterns of proprioceptors. So, the pectoralis muscle has to be considered together with its fascia, and so as a myofascial unit, acting as an integrated control motor system.
Similar content being viewed by others
Notes
The Authors assumed the Anglo–Saxon classification of the fasciae of the neck. Indeed, the term “superficial fascia”, used in the French and Italian classifications, referred to the fascia covering the sternocleidomastoid and the trapezius muscles, could misunderstand with the “true” superficial fascia, that is the fibroadipose lamina enveloping the platysma muscle, and that shows completely different macro and microscopic characteristics.
References
Basmajian JW (1989) Grant’s method of anatomy, 11th edn. Williams & Wilkins, Baltimore, pp 359–371
Chiarugi G (1975) Istituzioni di Anatomia dell’Uomo, vol 1. Società editrice libraria, Milano, p 146
Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Phillips N, Best TM, Benjamin M (2006) The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. J Anat 208:309–316
Gerlach UJ, Lierse W (1990) Functional construction of the superficial and deep fascia system of the lower limb in man. Acta Anat 139:11–25
Graf RM, Bernardes A, Auersvald A, Damasio RC (2000) Subfascial endoscopica transaxillary augmentation mammaplasty. Aesthetic Plast Surg 24:216–220
Hwang K, Kim DJ (2005) Anatomy of pectoral fascia in relation to subfascial mammary augmentation. Ann Plast Surg 55:576–579
Jinde L, Jianlianq S, Xiaopinq C, Xiaoyan T, Jiaqinq L, Qun M, Bo L (2006) Anatomy and clinical significance of pectoral fascia. Plast Reconstr Surg 118:1557–1560
Kent GC (1978) Comparative anatomy of the vertebrates. Mosby Co., Saint Louis
Langevin HM (2006) Connective tissue: a body-wide signalling network? Med Hypotheses 66:1074–1077
Langevin HM, Sherman KJ (2007) Pathophysiological model for chronic low back pain integrating connective tissue and nervous system mechanisms. Med Hypotheses 68:74–80
Maas H, Meijer JM, Huijing PA (2005) Intermuscular interactions between synergists in rat originates from both intermuscular and extramuscular myofascial force transmission. Cells Tissues Organs 181:38–50
Meijer HJ, Baan GC, Huijing PA (2006) Myofascial force transmission is increasingly important at lower forces: firing frequency related length-force characteristics of rat extensor digitorum longus. Acta Physiol 186:185–195
Myers TW (2001) Anatomy trains. Churchill Livingstone, Oxford, pp 171–194
Paoletti S (2002) Les Fascias. Rôle des tissus dans la mécanique humaine. Sully, Vannes, pp 193–199
Rijkelijkhuizen JM, Meijer HJM, Baan GC, Huijing PA (2007) Myofascial force transmission also occurs beween antagonistic muscles located within opposite compartments of the rat lower hind limb. J Electromyogr Kines 17:690–697
Sato T, Hashimoto M (1984) Morphological analysis of the fascial lamination of the trunk. Bull Tokyo Med Dent Univ 31:21–32
Standring S, Ellis H, Healy J, Johnson D, Williams A (2005) Gray’s anatomy, 39th edn. Churchill Livingstone, London, pp 817–852
Staubersand J, Li Y (1996) Zum Feinbau der Fascia cruris mit besonderer intrafaszialer nerven. Manuelle Medizin, vol 34. Springer, Heidelberg, pp 196–200
Stecco C, Porzionato A, Macchi V, Tiengo C, Parenti A, Aldegheri R, Delmas V, De Caro R (2006) Histological characteristics of the deep fascia of the upper limb. Ital J Anat Embryol 111:105–110
Stecco C, Gagey O, Belloni A, Pozzuoli A, Porzionato A, Macchi V, Aldegheri R, De Caro R, Delmas V (2007) Anatomy of the deep fascia of the upper limb second part: study of innervation. Morphologie 91:38–43
Stecco C, Porzionato A, Macchi V, Parenti A, Aldegheri R, Delmas V, De Caro R (2008) The expansions of the pectoral girdle muscles onto the brachial fascia: morphological aspects and spatial disposition. Cell Tissues Organ 19 (Epub ahead of print)
Stecco L (1996) La Manipolazione Neuroconnettivale. Marrapese, Roma, pp 45–62
Stecco L (2004) Fascial manipulation for musculoskeletal pain. Piccin, Padova, pp 123–130
Stecco L, Stecco C (2007) Manipolazione fasciale. Parte pratica. Piccin, Padova, pp 3–29
Stefanelli A (1968) Anatomia comparata: morfologia dei vertebrati. Ed. dell’Ateneo, Roma
Stilwell D (1957) Regional variations in the innervation of deep fasciae and aponeuroses. Anat Rec 23:94–104
Tebbetts JB (2004) Does fascia provide additional, meaningful coverage over a breast implant? Plast Reconstr Surg 113:777–779
Testut JL, Jacob O (1905) Précis d’anatomie topographique avec applications medico-chirurgicales, vol III. Gaston Doin et Cie, Paris, p 302
Vleeming A, Stoeckart R, Snijders CJ (1995) The posterior layer of the thoracolumbar fascia. Spine 20:753–758
Yahia H, Rhalmi S, Newman N (1992) Sensory innervation of human thoracolumbar fascia, an immunohistochemical study. Acta Orthop Scand 63:195–197
Yucesoy CA, Maas H, Koopman B, Grootenboer HJ, Huijing PA (2006) Mechanisms causing effects of muscle position on proximo-distal muscle force differences in extra-muscular myofascial force transmission. Med Eng Phys 28:214–226
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Stecco, A., Macchi, V., Masiero, S. et al. Pectoral and femoral fasciae: common aspects and regional specializations. Surg Radiol Anat 31, 35–42 (2009). https://doi.org/10.1007/s00276-008-0395-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-008-0395-5