Fascia of Scarpa

Fascia of Scarpa

The subcutaneous inguinal ring. (Superficial fascia visible at top.)
Details
Latin stratum membranosum telae subcutaneae abdominis
Identifiers
Gray's p.408
Dorlands
/Elsevier		 f_03/12355525
Anatomical terminology

The membraneous deep layer of the superficial fascia (fascia of Scarpa) is a layer of the anterior abdominal wall. It is found deep to the Camper Fascia and superficial to the External Oblique muscle.

Structure

It is thinner and more membranous in character than the superficial fascia of Camper, and contains a considerable quantity of orange elastic fibers.

It is loosely connected by areolar tissue to the aponeurosis of the Obliquus externus abdominis, but in the midline it is more intimately adherent to the linea alba and to the pubic symphysis, and is prolonged on to the dorsum of the penis, forming the fundiform ligament; above, it is continuous with the superficial fascia over the rest of the trunk; below and laterally, it blends with the fascia lata of the thigh a little below the inguinal ligament; medially and below, it is continued over the penis and spermatic cord to the scrotum, where it helps to form the dartos.

From the scrotum it may be traced backward into continuity with the deep layer of the superficial fascia of the perineum (superficial perineal fascia or fascia of Colles).

In the female, it is continued into the labia majora and from there to the fascia of Colles.

History

It is named for Antonio Scarpa[1] Antonio Scarpa's description of the membranous superficial fascia is vague in his 1809 hernia monograph.[2] Life-size illustrations included by Scarpa do not identify the layer even though some show all the other anatomical layers of the abdominal wall in the inguinal region. A probable description of the fascia is in the text which discusses femoral (called crural) hernia in the male. Scarpa describes that 'below the skin' we find 'a layer of condensed substance forming the second covering of the hernia' which adheres to 'the aponeurosis of the fascia lata'. A little later he describes this layer as being membranous and he believes it has a role in containing this particular herniation. In 1810, Abraham Colles described detailed methods of dissection to expose membranous superficial fascia in the lower abdomen and the inguino-perineal region including the penis and scrotum. Colles clearly associated the subcutaneous limitation of urine extravasation from a ruptured urethra with the attachments of membranous superficial fascia to deeper structures.[3]

Clinical significance

Scarpa's belief that the fascia stops hernias from forming is not thought to be true today. Some anatomists suggest the membranous superficial fascia is the scaffold which attaches the skin to the deeper structures so that the skin does not sag with gravity but still stretches as the body flexes or changes shape with exercise.[3] The attachment of the fascia to deeper layers confines fluid which may have come from inside the body in certain diseases giving rise to clinical signs such as urethral disruption noticed by Colles and bruising in Cullen's sign or Grey Turner's sign.[3]

References

This article incorporates text in the public domain from the 20th edition of Gray's Anatomy (1918)

  1. ↑ synd/2925 at Who Named It?
  2. ↑ ref name=Scarpa / A. Scarpa. Sull' ernie: memorie anatomico-chirurgiche. Milano, d. reale Stamperia, 1809; 2nd edition, 1820.
  3. ↑ 3.0 3.1 3.2 Ullah, S. M.; Grant, R. C.; Johnson, M; McAlister, V. C. (2013). "Scarpa's fascia and clinical signs: The role of the membranous superficial fascia in the eponymous clinical signs of retroperitoneal catastrophe". Annals of The Royal College of Surgeons of England 95 (7): 519–22. doi:10.1308/003588413X13629960048514. PMID 24112501.

External links