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The fascia lata is the
deep fascia Deep fascia (or investing fascia) is a fascia, a layer of dense connective tissue that can surround individual muscles and groups of muscles to separate into fascial compartments. This fibrous connective tissue interpenetrates and surrounds the mu ...
of the
thigh In human anatomy, the thigh is the area between the hip (pelvis) and the knee. Anatomically, it is part of the lower limb. The single bone in the thigh is called the femur. This bone is very thick and strong (due to the high proportion of bone ...
. It encloses the thigh muscles and forms the outer limit of the
fascial compartments of thigh The fascial compartments of thigh are the three fascial compartments that divide and contain the thigh muscles. The fascia lata is the strong and deep fascia of the thigh that surrounds the thigh muscles and forms the outer limits of the compartm ...
, which are internally separated by the medial intermuscular septum and the lateral intermuscular septum. The fascia lata is thickened at its
lateral Lateral is a geometric term of location which may refer to: Healthcare *Lateral (anatomy), an anatomical direction *Lateral cricoarytenoid muscle *Lateral release (surgery), a surgical procedure on the side of a kneecap Phonetics *Lateral cons ...
side where it forms the
iliotibial tract The iliotibial tract or iliotibial band (ITB; also known as Maissiat's band or the IT band) is a longitudinal fibrous reinforcement of the fascia lata. The action of the muscles associated with the ITB (tensor fasciae latae and some fibers of gl ...
, a structure that runs to the
tibia The tibia (; ), also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates (the other being the fibula, behind and to the outside of the tibia); it connects ...
and serves as a site of muscle attachment.


Structure

The fascia lata is an investment for the whole of the thigh, but varies in thickness in different parts. It is thicker in the upper and lateral part of the thigh, where it receives a fibrous expansion from the
gluteus maximus The gluteus maximus is the main extensor muscle of the hip. It is the largest and outermost of the three gluteal muscles and makes up a large part of the shape and appearance of each side of the hips. It is the single largest muscle in the human ...
, and where the
tensor fasciae latae The tensor fasciae latae (or tensor fasciæ latæ or, formerly, tensor vaginae femoris) is a muscle of the thigh. Together with the gluteus maximus, it acts on the iliotibial band and is continuous with the iliotibial tract, which attaches to th ...
is inserted between its layers; it is very thin behind and at the upper and medial part, where it covers the adductor muscles, and again becomes stronger around the knee, receiving fibrous expansions from the tendon of the
biceps femoris The biceps femoris () is a muscle of the thigh located to the posterior, or back. As its name implies, it has two parts, one of which (the long head) forms part of the hamstrings muscle group. Structure It has two heads of origin: *the ''long h ...
laterally, from the sartorius medially, and from the
quadriceps femoris The quadriceps femoris muscle (, also called the quadriceps extensor, quadriceps or quads) is a large muscle group that includes the four prevailing muscles on the front of the thigh. It is the sole extensor muscle of the knee, forming a large ...
in front.


Function

The fascia lata surrounds the tensor fasciae latae muscle. It is a fibrous sheath that encircles the thigh subcutaneously. This encircling of the muscle allows the muscles to be bound together tightly.


Above and behind

The fascia lata is attached, above and behind (i.e. proximal and posterior), to the back of the
sacrum The sacrum (plural: ''sacra'' or ''sacrums''), in human anatomy, is a large, triangular bone at the base of the spine that forms by the fusing of the sacral vertebrae (S1S5) between ages 18 and 30. The sacrum situates at the upper, back part ...
and
coccyx The coccyx ( : coccyges or coccyxes), commonly referred to as the tailbone, is the final segment of the vertebral column in all apes, and analogous structures in certain other mammals such as horses. In tailless primates (e.g. humans and other ...
; laterally, to the
iliac crest The crest of the ilium (or iliac crest) is the superior border of the wing of ilium and the superiolateral margin of the greater pelvis. Structure The iliac crest stretches posteriorly from the anterior superior iliac spine (ASIS) to the posteri ...
; in front, to the
inguinal ligament The inguinal ligament (), also known as Poupart's ligament or groin ligament, is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may de ...
, and to the superior ramus of the pubis; and medially, to the inferior ramus of the pubis, to the inferior ramus and tuberosity of the
ischium The ischium () form ...
, and to the lower border of the
sacrotuberous ligament The sacrotuberous ligament (great or posterior sacrosciatic ligament) is situated at the lower and back part of the pelvis. It is flat, and triangular in form; narrower in the middle than at the ends. Structure It runs from the sacrum (the lower ...
. From its attachment to the iliac crest it passes down over the
gluteus medius The gluteus medius, one of the three gluteal muscles, is a broad, thick, radiating muscle. It is situated on the outer surface of the pelvis. Its posterior third is covered by the gluteus maximus, its anterior two-thirds by the gluteal aponeur ...
to the upper border of the
gluteus maximus The gluteus maximus is the main extensor muscle of the hip. It is the largest and outermost of the three gluteal muscles and makes up a large part of the shape and appearance of each side of the hips. It is the single largest muscle in the human ...
, where it splits into two layers, one passing superficial to and the other beneath this muscle; at the lower border of the muscle the two layers reunite.


Laterally

Laterally, the fascia lata receives the greater part of the tendon of insertion of the gluteus maximus, and becomes proportionately thickened. The portion of the fascia lata attached to the front part of the iliac crest, and corresponding to the origin of the tensor fasciae latae, extends down the lateral side of the thigh as two layers, one superficial to and the other beneath this muscle; at the lower end of the muscle these two layers unite and form a strong band, having first received the insertion of the muscle. This band is continued downward under the name of the
iliotibial band The iliotibial tract or iliotibial band (ITB; also known as Maissiat's band or the IT band) is a longitudinal fibrous reinforcement of the fascia lata. The action of the muscles associated with the ITB (tensor fasciae latae and some fibers of glu ...
and is attached to the lateral condyle of the
tibia The tibia (; ), also known as the shinbone or shankbone, is the larger, stronger, and anterior (frontal) of the two bones in the leg below the knee in vertebrates (the other being the fibula, behind and to the outside of the tibia); it connects ...
. The part of the iliotibial band which lies beneath the
tensor fasciae latae The tensor fasciae latae (or tensor fasciæ latæ or, formerly, tensor vaginae femoris) is a muscle of the thigh. Together with the gluteus maximus, it acts on the iliotibial band and is continuous with the iliotibial tract, which attaches to th ...
is prolonged upward to join the lateral part of the capsule of the
hip joint In vertebrate anatomy, hip (or "coxa"Latin ''coxa'' was used by Celsus in the sense "hip", but by Pliny the Elder in the sense "hip bone" (Diab, p 77) in medical terminology) refers to either an anatomical region or a joint. The hip region is ...
.


Below

Below, the fascia lata is attached to all the prominent points around the
knee joint In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia (tibiofemoral joint), and one between the femur and patella (patellofemoral joint). It is the largest joint in the hu ...
, viz., the
condyle A condyle (;Entry "condyle"
in
head of the fibula The fibula or calf bone is a leg bone on the lateral side of the tibia, to which it is connected above and below. It is the smaller of the two bones and, in proportion to its length, the most slender of all the long bones. Its upper extremity ...
. On either side of the
kneecap The patella, also known as the kneecap, is a flat, rounded triangular bone which articulates with the femur (thigh bone) and covers and protects the anterior articular surface of the knee joint. The patella is found in many tetrapods, such as m ...
it is strengthened by transverse fibers from the lower parts of the vasti muscles (three of the four
quadriceps The quadriceps femoris muscle (, also called the quadriceps extensor, quadriceps or quads) is a large muscle group that includes the four prevailing muscles on the front of the thigh. It is the sole extensor muscle of the knee, forming a large ...
) which are attached to and support this bone. Of these the lateral are the stronger, and are continuous with the iliotibial band. The deep surface of the fascia lata gives off two strong intermuscular septa, which are attached to the whole length of the
linea aspera The linea aspera ( la, rough line) is a ridge of roughened surface on the posterior surface of the shaft of the femur. It is the site of attachments of muscles and the intermuscular septum. Its margins diverge above and below. The linea aspera ...
and its prolongations above and below; the lateral intermuscular septum, the stronger of the two, extends from the insertion of the
gluteus maximus The gluteus maximus is the main extensor muscle of the hip. It is the largest and outermost of the three gluteal muscles and makes up a large part of the shape and appearance of each side of the hips. It is the single largest muscle in the human ...
to the lateral condyle, separates the
vastus lateralis The vastus lateralis (), also called the vastus externus, is the largest and most powerful part of the quadriceps femoris, a muscle in the thigh. Together with other muscles of the quadriceps group, it serves to extend the knee joint, moving the ...
in front from the short head of the
biceps femoris The biceps femoris () is a muscle of the thigh located to the posterior, or back. As its name implies, it has two parts, one of which (the long head) forms part of the hamstrings muscle group. Structure It has two heads of origin: *the ''long h ...
behind, and gives partial origin to these muscles; the medial intermuscular septum is the thinner one and separates the
vastus medialis The vastus medialis (vastus internus or teardrop muscle) is an extensor muscle located medially in the thigh that extends the knee. The vastus medialis is part of the quadriceps muscle group. Structure The vastus medialis is a muscle present ...
from the adductor muscles. Besides these there are numerous smaller septa, separating the individual muscles, and enclosing each in a distinct sheath.


Deep fascia of leg

The deep fascia of the lower leg is a continuation of the fascia lata.


Clinical significance


Transplantation

Since the 1920s fasciae latae from deceased donors have been used in reconstructive surgery. In 1999 preserved mashed fasciae latae became FDA-approved as a tissue product designed to replace areas of lost fascia or collagen. The fascia lata normally performs the function of encircling and tightening the muscles in the thigh. Because of this function, it has been used as grafts for patients with facial paralysis. The fascia lata offers supports to the muscles that make up the face and this support increases the recovery of the facial muscles. The surgeons use the fascia lata as a sort of facial sling to support up the paralyzed face and loops the fascia lata around the center of the lower lip, the corner of the mouth and the center of the upper lip. A small portion of fascia lata harvested through a sub centimeter skin incision on the lower lateral side of the thigh is used for reconstructing the ear drum in tympanoplasty surgery. A larger portion is used in nasal endoscopic skull base surgery.


History


Etymology

It is named from its great extent. "Latus" give the superlative "Latissimus" meaning broadest or widest.


Additional images

File:Gray542.png, The superficial branches of the internal pudendal artery. File:Gray545.png, Femoral sheath laid open to show its three compartments.


References

{{Authority control Lower limb anatomy Fascia