Imaging FasciaRenee Stenbjorn, MPA, LMT

My goal:

Utilize images to inform the student of the complex structural system of fascia.

Your goal?

Historical Definition

Fascia: general description, a band of tissue.

General meaning: undifferentiated tissue surrounding a more specialized tissue.

LANGEVIN, MD, H., HUIJING, PHD, P.. Communicating About Fascia: History, Pitfalls, and Recommendations.International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice, North America, 2, oct. 2009. Available at: <http://www.ijtmb.org/index.php/ijtmb/article/view/63>. Date accessed: 14 Jan. 2013.

Current understanding

Forms of connective tissue:Loose & DenseSuperficial & DeepMultiple- & Single-layered

LANGEVIN, MD, H., HUIJING, PHD, P.. Communicating About Fascia: History, Pitfalls, and Recommendations.International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice, North America, 2, oct. 2009. Available at: <http://www.ijtmb.org/index.php/ijtmb/article/view/63>. Date accessed: 14 Jan. 2013.

Gross Anatomy

Photography of anatomical structures: What is it?What do we learn?

"Old-School" Histology

Gradations of pink, some purples, blues:

Procedures: Create a specimenMount on slidesPut drops of solutions on slide for specific period of time. Rinse & mount.

Put in a slide box.

Blood smear, Biology 101

"Old-School" HistologyPut in a slide box.

What do we learn from histology?

Highlights & differentiates:Cells, fibers & tissues

Gives insight into cellular structures.

Histology of Connective Tissue types: Dense Irregular

Abundant Collagen fibers, few cells.What type of tissues?

Histology of Connective Tissue types: Dense Regular

Abundant Collagen fibers, arranged in same direction, f few cells.What type of tissues?

Histology of Connective Tissue types: Areolar

Sparsely arranged fibers, not ordered in a predominant direction. Oftern refferd to as "Loose" but Dr. Langevin suggests this label is too mechanical in description

Connective Tissue types: Bone

Connective Tissue types: Blood

Specialized Fascial Structures:

Superficial Fascia: aka: hypoderm, hypodermis, stratum subcutaneous, etc.

Continuous with the dermis, directly underneath the skin

Specialized Fascial Structures:

Deep Fascia

Specialized Fascial Structures:

Muscular Fascial layers:

EndoPeriEpi

Specialized Fascial Structures:

Intermuscular Septa

Specialized Fascial Structures:

Neurovascular Tract

Specialized Fascial Structures:

Periosteum

How did histology help us differentiate:

Regular vs. Irregular Fiber ArrangementsLayers of fascia Structural differences

Really old school...what Golgi saw

VERY toxic...

Imaging Cells & Fibers

Immunohistochemistry: We can localize molecular structures rather than just cellular structures.

Can measure DNA & RNA activity

What is different?

Process of IHC Fluorescent labelingCo-localization of molecules

A Study of Collagen in the Nervous System

What is a collagen?

How do we know where the collagen is...?

Dissecting a human brain...

Dr. Liechnetz, MCV

Compared to a mouse brain...

Understanding Blots

What do those dark spots mean?

Putting the theory to the test

Can we find Collagen XVIII (18) in the brain?

Using immunohistochemistry to locate structures.

Example: Cerebellum staining

Collagen 18 found in Purkinje cells in the cerebellum!

Let's take a look: layers of fascia

How images help us understand layers of tissue

Confocal imaging

A method of converting IHC images into 3-D images that further our understanding of tissues.

3-D images

Z Stack

What have we learned from these images?

The Neuromuscular Junction

Understanding the relationship between nerve & muscle

The Extracellular Matrix

What's in it?Why do we care?Key to hydration.

Fascial Innervation

Sensory Mechanism

Tensigrity architecture allows cells to sense mechanical changes.

These changes result in control of cell function & tissue development

Donald Ingber

Connective tissue: a body-wide signaling network?

Looking even deeper with Electron Microscopy

Seeing the textures

Understanding the structures

The myofascia...

Imaging with Ultrasound

From treatment to imaging: Principles in imaging with US.

What can we see with US: what do these images tell us?

Ultrasound for differentiating layers

Imaging trigger points!!

Video Imaging

It's a living tissue.

What does all of this tell us about treatment??