Deep Fascia of Thigh- Fascia Lata

Describe the attachments of Deep Fascia of Thigh (Fascia Lata).

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Deep fascia of thigh ( Fascia Lata) is a tough fibrous sheath that envelops the whole of the thigh.  Its attachments are as follows:

• Superiorly- it is attached to the following structures which form the boundary between the pelvis and lower limb. 
  • Anteriorly – to the inguinal ligament
  • Laterally – to the iliac crest
  • Posteriorly – to  the ischial tuberosity, sacrotuberous ligament, sacrum and coccyx.
  • Medially – to the pubis and ischiopubic ramus. 
• Inferiorly-  Its attachments are as follows:
  • Anteriorly and on Sides–  it is attached to subcutaneous bony prominences and the capsule of the knee joint.
  • Posteriorly – it forms the popliteal fascia.

Enumerate the modifications of deep fascia of thigh.

Following are the modifications of deep fascia of thigh or fascia lata

• Iliotibial tract
• Intermuscular septa
• Saphenous opening

Iliotibial tract

• It is thickened fascia lata along the lateral surface of thigh.
• Is about 5 cm wide .
• It receives insertion of two muscles i.e. tensor fasciae latae and superficial 3/4th of gluteus maximus.
• It splits above to enclose tensor fasciae latae. The superficial layer is attached to the iliac crest and the deep layer is attached to capsule of hip joint.
• Inferiorly it is attached to flattened triangular area on anterior surface of lateral condyle of tibia.
• It stabilizes the knee in extended as well as semiflexed position.

Intermuscular septa

• Fascia lata sends three intermuscular septa (lateral, posterior and medial), which are attached to the linea aspera of femur and divide the muscles of thigh into three compartments.
  • Extensor /anterior compartment– between lateral and medial septa.
  • Adductor/medial compartment – between medial and posterior septa.
  • Flexor/ posterior compartment– beteen posterior and lateral septa.

Saphenous opening

• It is an oval opening in the fascia lata, located in the upper medial part of front of thigh.
• Its center is approximately 3-4cm inferior and late to pubic tubercle.
• Is 3-4 cm in length.
• It is bounded by a sharp margin (falciform margin) along its superior, lateral and inferior borders, but its medial border is ill-defined.
• It is covered by areolar membrane called cribriform fascia.

Enumerate the structures that  pierce cribriform facia.

Following are the structures piercing cribriform fascia or passing through saphenous opening are:

• Great saphenous vein.
• Superficial epigastric artery*
• Superficial external pudendal artery*
• Superficial circumflex iliac artery*
• Few lymph vessels connecting superficial and deep inguinal lymph nodes.

*The corresponding veins do not pierce cribriform fascia, because they drain into great saphenous vein (GSP), before the GSP pierces cribriform fascia.