CONNECTIVE TISSUE AND CONNECTIVE FASCIA

Connective tissue

Connective tissue is an integral part of ECM. It does not present solutions of continuity: every tissue and organ contains connective tissue and their functions depend in an extraordinary way on anatomo-functional interconnections. Embryologically most of the connective tissues derive from the mesoderm, some connective tissues of the skull derive directly from the neuroectoderm.
What until recently was considered a "trivial" fabric of connection and filling, is actually a system with countless fundamental functions.

Functions of the connective tissue
Maintenance of posture, connection and protection of organs, acid-base balance, hydrosaline metabolism, electrical and osmotic balance, blood circulation, nerve conduction, proprioception, motor coordination, barrier to the invasion of bacteria and inert particles, immune (leukocytes, mast cells, macrophages, plasma cells), inflammatory processes, repair and filling of damaged areas, energy reserve (lipids), water and electrolytes, about 1/3 of total plasma proteins, cell migration, intercellular and extra-intracellular communication, etc.

Connective tissue band

Among the various types of connective tissue (connective tissue proper, elastic tissue, reticular tissue, mucous tissue, endothelial tissue, adipose tissue, cartilage tissue, bone tissue, blood and lymph), the connective fascia is the "bridge" that leads us from MEC to posture.

The outermost layer / cylinder, present under the dermis, represents the superficial fascia. At the level of the head this band continues into the galea capitis (or aponeurotic galea which covers the upper part of the skull, connecting posteriorly to the external protuberance of the occipital bone, via the nuchal line, and anteriorly to the frontal bone, by means of a short and narrow extension), while it merges with the deep fascia at the level of the sole of the foot (forming the retinacles of the talus) and of the palm of the hands (carpal retinacles). The superficial fascia is composed of loose connective tissue (subcutaneous in which there may be a weave of collagen and above all elastic fibers) and adipose (therefore its thickness, as well as its location, depends on our diet). Through fibers, this fascia forms a continuum with the dermis and epidermis towards the outside and, at the same time, anchors itself to the underlying tissues and organs. and thermal (insulating layer), it is a passageway for nerves and blood vessels and allows the skin to slide over the deep fascia. Like the deep fascia it has little vascularization.

Under the superficial fascia there is the deep fascia, also called cervico-thoraco-lumbar, which represents a rather cohesive cylindrical layer around the body (trunk and limbs). It consists of irregular dense connective tissue formed by wavy collagen fibers and elastic fibers (arranged in a transverse, longitudinal and oblique pattern) and forms a membrane that covers the external muscular part. This sheath, developed around the notochord (which forms the embryonic median axis), covers the body extending from the skull, at the level of the margin of the jaw and the cranial base with which it is fused (and from which the skull is formed, which however forms part meningeal layer having the same embryological origin), from here it goes towards the upper limbs (until it merges with the superficial fascia at the level of the retinacles of the palm of the hand) and anteriorly passes under the pectoral muscles, covers the intercostal muscles and the ribs, the abdominal aponeurosis and connects to the pelvis. The deep fascia turns posteriorly connecting to the transverse processes and then to the spinous processes thus forming two compartments (right and left) containing the paravertebral muscles. bone) in which the various fascial compartments of the body converge and from which the portion of the deep fascia which runs through the lower limbs until it merges with the superficial fascia, at the level of the sole of the foot in the retinacles of the talus departs. A distinctive feature of the deep fascia is that of forming structural and functional compartments, that is, containing certain muscle groups with specific innervation. The compartment also confers specific morpho-functional characteristics to the muscle: a muscle that contracts inside a sheath develops a pressure that supports the contraction itself. The transversus abdominis muscles constitute the active part of the thoraco-lumbar fascia. single muscle, the deep fascia comes into contact, through the septa, the aponeuroses and tendons (formed by parallel and almost completely inextensible collagen fibers), with the epimysium (fibro-elastic connective tissue that covers the entire muscle). L "epimysium extends into the muscle belly, forming the perimysium (loose connective tissue that lines the muscle fiber fascicles) and" endomysium (delicate lining of the muscle fiber). nourishment This fascia is directly linked both anatomically and functionally to the neuromuscular spindles and to the or Golgi tendon gani (Stecco, 2002).
Like the superficial fascia, the deep fascia is poorly vascularized (surgical incisions are often made where the fascia overlaps or merges as the strength of these areas allows for secure anchoring and easier scar repairs) and provides passageways for nerves and vases.
As discussed in the chapter "Biomechanics of the deep fascia", the latter is of "enormous importance from a postural point of view.
The cylinder constituted by the deep fascia contains two further longitudinal cylinders placed one behind the other and forming, the anterior one, the visceral fascia and the posterior one the meningeal.

The cylinder placed anteriorly inside the deep fascia, called visceral or splanchnic fascia, is a fascial column that forms the mediastinum, extending from the mouth to the anus through various portions with similar structure and embryology: it starts from the base of the skull, extends down along the median axis (endocervical fascia, pharyngeal), forms the film covering the parietal pleura of the lungs (endothoracic fascia), crosses the diaphragm, surrounds various areas of the abdominal cavity, wrapping the peritoneal sac (endoabdominal fascia) and extends to the pelvis (endopelvic fascia). The greater portion of this fascia is found around the thoracic organs, on the median axis, where it forms a column, the mediastinal compartment of the thorax. The thoracic mediastinum then continues with the abdominal one, also acting as a large duct for fluids. At the abdominal level, the endoabdominal fascia departs from the axial column to completely cover the suspended organs and then rejoins with it (the mesentery is rich in this fascia). In some places the visceral fascia tends to specialize (e.g. it thickens around the kidneys to protect them). This band therefore has the great advantage of being able to create compartments but, being also a deposit of fat, it can create mass problems by deforming the body cavity. Eg. in the obese a "structural and therefore functional alteration of the diaphragm can occur: if the increase in endothoracic mass is such as to push the ribs outward, this causes a flattening of the diaphragm so that by contracting, instead of functioning as a vertical muscle that lowers by lifting the ribs, pulls the rib edges inwards, transforming into an expiratory muscle. In this situation it becomes impossible to carry out a physiological deep breathing and you will have to resort to short, superficial and frequent breaths with all the health consequences deriving from this. Some researchers include this fascia in the deep one.

The posterior cylinder, contained in the deep fascia and placed behind the visceral fascia, represents the meningeal fascia which encloses the "entire central nervous system. The cranial bone, practically suspended on the meningeal material, has a" neuroectodermal origin, developing from the cranial base by differentiation of the cells of the cranial neural crest; it is therefore part of the meningeal layer (and not of the cervico-thoraco-lumbar which stops, as we have seen, at the cranial base). Removing the occipital bone leads to the dura mater, the upper starting point of the meningeal fascia which extends down to approx. the II sacral vertebra via the dural sac (containing arachnoid, pia mater, spinal cord, sacral cord, spinal spinal roots, nerves of the cauda equina and cerebrospinal fluid).The meningeal fascia has a protective and nourishing function of the central nervous system.

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