Fascial Nomenclature: An Update

Abstract

Throughout the development of anatomy as a scientific study, authors have been challenged to give a singular comprehensive definition of what should be considered as a fascial tissue. Instead, the multiplicity of synthesis and analysis is the true richness of scientific research: individual points of view and background look at the fascia from their own perspective, sometimes influenced by their own cultural assumptions. No person or organization in science ever have the absolute truth, because scientific truth is always evolving, driven by new observations and analysis of data. Only by observing the fascia from multiple perspectives (doctor, surgeon, osteopath, physiotherapist, bioengineer and more) can we define more fully what fascial tissue is. It becomes the synergistic result of several scientific disciplines (anatomy, cardiology, angiology, orthopaedics, osteopathy, cytology, and more). The fascia is not the exclusive domain of a few people or individual private associations, but of all researchers who journey through the study of knowledge and arrive at an understanding, improving the clinical aspects for the good of the patient, without profit. This article reviews the embryological evolution of muscle and connective tissue to affirm how the fascial system should be ideally conceptualized: an absolute anatomic functional continuum.

Eosinophilic Fasciitis of Wrists with a Positive Prayer Sign

“…EF is characterized by inflammation, swelling, and thickening of the skin and fascia. The fascia is a sheet or band of fibrous connective tissue under the skin that separates different layers of tissues under the skin [3]. Its etiology remains unknown, but 30-60% of cases may have a recent history of strenuous exercise or trauma [4].…”

A Review of the Theoretical Fascial Models: Biotensegrity, Fascintegrity, and Myofascial Chains

“…The Federative International Program on Anatomical Terminologies (FIPAT) (2011) defines the fascia: "a sheath, a sheet, or any other dissectible aggregations of connective tissue that forms beneath the skin to attach, enclose, and separates muscles and other internal organs" [2]. Another authoritative organization, the Fascia Nomenclature Committee (2014), defines the fascia: "The fascial system includes adipose tissue, adventitia, neurovascular sheaths, aponeuroses, deep and superficial fasciae, dermis, epineurium, joint capsules, ligaments, membranes, meninges, myofascial expansions, periosteum, retinacula, septa, tendons (including endotendon/peritendon/epitendon/paratendon), visceral fasciae, and all the intramuscular and intermuscular connective tissues, including endomysium, perimysium, epimysium" [3]. Since connective tissue falls within the meaning of fascia, the Foundation of Osteopathic Research and Clinical Endorsement (FORCE), founded in 2013, has added blood and lymph or specialized connective tissue to the fascial nomenclature [4,5].…”

The Shape and Function of Solid Fascias Depend on the Presence of Liquid Fascias

“…The philosophy of biotensegrity can be applied to the whole body, as well as to every single body area, up to the cell, as in a previous article, where I have shown in detail the different connections [3]. The model marries the definition of what is the fascial continuum, according to Fascia Nomenclature Committee: "The fascial system includes adipose tissue, adventitia, neurovascular sheaths, aponeuroses, deep and superficial fasciae, dermis, epineurium, joint capsules, ligaments, membranes, meninges, myofascial expansions, periosteum, retinacula, septa, tendons (including endotendon/peritendon/epitendon/paratendon), visceral fasciae, and all the intramuscular and intermuscular connective tissues, including endomysium/perimysium/epimysium" [4]. What is not taken into consideration when trying to understand how to correctly apply this model (mechanical model), is the function of body fluids [5].…”

“…These afferent/efferent impulses come from the fascia and the tissues that are not considered as part of the fascia in a biunivocal mode. In this definition, these tissues include: epidermis, dermis, fat, blood, lymph, blood and lymphatic vessels, tissue covering the nervous filaments (endoneurium, perineurium, epineurium), voluntary striated muscle fibers, and the tissue covering and permeating it (epimysium, perimysium, endomysium), ligaments, tendons, aponeurosis, cartilage, bones, meninges, and tongue" [4]. The biotensegrity model does not match the presence of body fluids, as it does not take them into consideration.…”

“…The biotensegrity model does not match the presence of body fluids, as it does not take them into consideration. Another model called fascintegrity and created by the Foundation of Osteopathic Research and Clinical Endorsement (FORCE) group involves blood and lymph (specialized connective tissue) [4]. The human body is made up of fluids, from its entirety to the individual cell; without the presence of fluids, the human body or the single-cell could not adapt, could not survive and would not have the shape we know [3].…”