Licence: Public Domain Mark
Credit: The anatomy of the human body / By J. Cruveilhier. Source: Wellcome Collection.
Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.
321/944 (page 297)
![PARTICULAR APONEUROSES. Superficial Fascia.—Aponeuroses of the Cranium—of the Face—of the Neck—of the Thorax —of the Abdomen—of the Pelvis—of the Thigh, Leg, and Foot—of the Shoulder, Arm, Forearm, and Hand. The Superficial Aponeurosis, or Superficial Fascia. From every point of the deep surface of the skin fibrous cellular lamellae arise, which intersect each other in various directions, so as to form meshes or areolae, containing adipose tissue in ordinary circumstances, and a serous fluid in cedema.* The cutaneous muscle {panniculus carnosus) of the lower animals is developed in these lamina? ; and among them are situated the sub-cutaneous vessels and nerves, and the lymphatic glands. The name of fascia superficialis has been of late applied to this assemblage of laniellge. It was pointed out in a particular manner by Glisson, who described it under the name of the general investment of the muscles, proceeding from the spine, and covering the whole body; Camper, Cowper, Scarpa, Hesselbach, Lawrence, J. Cloquet, &c., have described it upon the abdomen, in its relation with herniae ; Godman has spoken of its existence over the entire surface of the body : M. Paillard, in his inaugural dissertation, traced it with still greater exactness ; MM. Velpeau and Blandin, in their Traites d'Ana- tomie Chirurgicale, consider it as existing in almost all regions of the body. But if the word aponeurosis be employed in its ordinary acceptation, it will be found that a fascia superficialis, consisting of a fibrous texture capable of anatomical demon- stration, exists only in two kinds of situations, viz., in those where the skin is extreme- ly movable, and in those where there is a layer of sub-cutaneous vessels and nerves : in both these cases the fibrous prolongations from the skin are expanded into a thin lamina, constituting a superficial covering for these vessels and nerves, and separated from the fibrous investment of the muscles by a layer of cellular and adipose tissue, of variable thickness. In all other parts, the fibro-cellular prolongations of the skin become contin- uous either with the investing aponeuroses, or with the proper fibro-cellular sheaths of the muscles, or are lost in the sub-cutaneous cellular tissue. So true is this, that this thin areolar layer, which can with diflSculty be separated from the skin in emaciated persons, disappears altogether in those whose cellular tissue is distended by fat or se- rous effusion. Having made these remarks, I shall describe the superficial fascia in those regions only where it can be easily demonstrated, viz., in the lower part of the abdomen, and in the extremities. The Superficial Fascia of the Abdomen. This aponeurosis, from its constituting the first sub-cutaneous covering of herniae, has particularly engaged the attention of authors who have specially treated of the patho- logical anatomy of those diseases. It becomes evident in the neighbourhood of the umbilical region, but is much more dis- tinct at the fold of the groin, where it divides into two layers, one of which is attached to the femoral arch, and the other is prolonged upon the lower extremity. It is bound- ed on the inside by the median line, and on the outside by another line, extending per- pendicularly upward from the anterior superior spinous process of the ilium. It is pro- longed over the inguinal ring, and over the spermatic cord in the male subject. parallel disposition of the component filaments, and the slight amount of elasticity in particular on the ab- sence of sinuosity in the compound fasciculi. According- to the manner in which these fasciculi or fibres (as they are termed) are arranged and combined, we have either the membranous or the fascicular form of fibrous tissues. In the membranous form there are some which closely resemble the fibro-cellular membranes already allu- ded to, and consist of the shining fibres crossing each other in all directions (without anastomosis), and inter- mixed with more or less condensed cellular tissue ; for example, the thinner investing aponeurosis, the capsu- lar ligaments, the pericardium, tunica albuginea, periosteum, and dura mater. In others, again, the fibres are more parallel, though stiU intersected, and combined with cellular tissue, as in the fascia lata of tlie thigh, and in other strong investing aponeuroses. In the aponeuroses of insertion of the broad muscles, and in the expanded terminations of tendons, there is scarcely any cellular tissue, while the parallel arrangement is yet more perfect; and, finally, the latter attains its utmost perfection in the round ligaments, and in tendons, which constitute the fascicular form of fibrous tissue, and the type of the tissue itself. These textures contain but few nerves and vessels. The distribution of a branch of the fourth cranial nerve to the dura mater, alluded to in the text, has been confirmed by other anatomists. Bloodvessels abound in the periosteum, but they merely divide in that membrane, so as to enter the bone at a great number of points. The sheaths of tendons (classed among the fibrous tissues by M. Cruveilhier) display a tendency to become fibro-cartilaginous, especially at and near their attachments to the bones. They have hitherto been described (ex. gr., p. 250, 257) as if lined by vaginal synovial membranes (note, p. 177). According to Dr. Ilenle, how- ever, their interior is not covered by an epithelium. The bursce, or so-called bursal synovial membranes, formed between the tendons of muscles (p. 265), between tendons and bones (p. 265, 266, 267), and between the skin and projecting parts of bones, as over the patella, the olecranon, &c., according to the same authority, are also destitute of epithelium. It would appear, therefore, that although these cavities resemble in function the true synovial membranes, they differ anatomically from them, and consist merely of shut sacs formed in the (general cellular texture of the body. Such bursas, however, as communicate with the synovial capsules of joints (p. 216, 244), are probably lined by an epithelium.] * [Adipose tissue is never deposited m the sub-cutaneous tissue of the eyelids, nor in the male organ of gen- eration. These parts, however, may become much distended from serous infiltration.] Pp](https://iiif.wellcomecollection.org/image/b21196801_0321.jp2/full/800%2C/0/default.jpg)
