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Imaging Fascia Renee 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 & Dense Superficial & Deep Multiple- & 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 specimen Mount on slides Put drops of solutions on slide for specific period of time. Rinse & mount. Put in a slide box. Blood smear, Biology 101 "Old-School" Histology Put 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: Endo Peri Epi Specialized Fascial Structures: Intermuscular Septa Specialized Fascial Structures: Neurovascular Tract Specialized Fascial Structures: Periosteum How did histology help us differentiate: Regular vs. Irregular Fiber Arrangements Layers 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 labeling Co-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??
