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[libribook.com] Traumatic Scar Tissue Management 1st Edition
Figure 2.3Fascial membranes and rentinacula cutis fibers. Cross-section from the skin to musculature, showingfascial membranes and retinacula cutis fibers (RCF). (Adapted from Stecco et al. 2013.)Retinacula cutis fibers (RCF)Fibrous strands that invest and are continuous throughout the skin, superficialand deep fasciae layers. RCF play a role in tissue connectivity and mobility.
Clinical ConsiderationWhen thickened, as a result of injury or trauma, these vertical septa canrestrict and impact function. Any undue ‘tugging’ of bound tissue (e.g.during ‘normal’ movement) can lead to hypersensitization and consequentpain (Stecco 2004, 2009, Muscolino 2012).Deep/axial fascia (DF)Deeper scars (e.g. following surgery or due to penetrating puncture wounds) willimpact the deep fascia layer and, potentially, the underlying muscular fascia (epi,peri and endomysium).Generally speaking, DF presents throughout the body as a multilayerorganization, typically 2–3 dense collagen bundle layers interspersed with looseCT layers that contain collagen, adipocytes and are rich in HA. The dense layersserve to augment force transmission and the loose layers augment slide/glide.In each dense layer the collagen bundles are arranged in parallel with adjacent(above or below) layers arranged at a 78° angle to one another. Thisconfiguration (interspersed with sliding layers) allows for multidirectionalmovement and the ability of fascia to counter/resist tension multidirectionally(see Fig. 2.4).DF displays some distinct regional differences:
- Page 213 and 214: ViscoelasticityThe ability of a med
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- Page 221 and 222: Diamond M (2012) Scars and adhesion
- Page 223 and 224: General HistologyExtracellular Matr
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- Page 238 and 239: Skin HistologyThe skin comprises:
- Page 241 and 242: Figure 2.2The delicate, well-hydrat
- Page 243 and 244: DermisThe dermis is made up of laye
- Page 245 and 246: Fascia Structure and FunctionsIn th
- Page 247 and 248: fundamental characteristic is its c
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- Page 251 and 252: HistologyFascia comprises:• ECM (
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- Page 261 and 262: Fascia Layers and FunctionsFascia t
- Page 263: Clinical ConsiderationSuperficial a
- Page 268 and 269: LinkingLinking fascia is sub-divide
- Page 270 and 271: FascicularFascicular fascia augment
- Page 272 and 273: Clinical ConsiderationMuscle spindl
- Page 274 and 275: SeparatingSeparating fascia provide
- Page 276 and 277: Clinical ConsiderationFascia suppor
- Page 278 and 279: Andrade C-K (2013) Outcome-based ma
- Page 280 and 281: Ingber D (2008) Tensegrity and mech
- Page 282 and 283: tendons: organisation in vivo and r
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- Page 288 and 289: Hematic SystemThe heart, blood vess
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- Page 292 and 293: Clinical ConsiderationNerves, blood
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- Page 298 and 299: Lymphoid OrgansThe lymphoid organs
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- Page 304 and 305: SuperficialThe superficial layer is
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Clinical Consideration
When thickened, as a result of injury or trauma, these vertical septa can
restrict and impact function. Any undue ‘tugging’ of bound tissue (e.g.
during ‘normal’ movement) can lead to hypersensitization and consequent
pain (Stecco 2004, 2009, Muscolino 2012).
Deep/axial fascia (DF)
Deeper scars (e.g. following surgery or due to penetrating puncture wounds) will
impact the deep fascia layer and, potentially, the underlying muscular fascia (epi,
peri and endomysium).
Generally speaking, DF presents throughout the body as a multilayer
organization, typically 2–3 dense collagen bundle layers interspersed with loose
CT layers that contain collagen, adipocytes and are rich in HA. The dense layers
serve to augment force transmission and the loose layers augment slide/glide.
In each dense layer the collagen bundles are arranged in parallel with adjacent
(above or below) layers arranged at a 78° angle to one another. This
configuration (interspersed with sliding layers) allows for multidirectional
movement and the ability of fascia to counter/resist tension multidirectionally
(see Fig. 2.4).
DF displays some distinct regional differences:
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