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Integral Anatomy Artwork
Season 1 - Episode 2

Superficial Fascia

75 min - Tutorial
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Description

Gil delves into the world of fascia, taking a close look so you can develop a deeper and more intimate understanding of it.

This video was filmed and produced by Gil Hedley. It includes videos and photos of dissections of cadavers (embalmed human donors). You can visit his website for more information about his workshops.

What You'll Need: No props needed

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Oct 31, 2019
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Transcript

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Well, the time has come in the programming that follows when we delve into the world of fashion. Now, having peeked under the skin, we've already gotten a glimpse of superficial fashion layer. But in the following segments, we'll take a much closer look at it and develop our understanding of it considerably. Superficial fascia is, for many people, a surprising layer. So when you feel what you're feeling now, do you recognize it as something you felt as a therapist?

Yes. Mm-hmm. Yes. But do you also recognize it as superficial fascia? It's something you felt as a therapist, but it's nothing that you ever identified.

I never would've identified this as superficial fascia. I never would've. And you're talking to somebody who's been involved in working on people since 75. Since 75? Yeah.

So since 1975, you've been feeling this tissue, you've been working this tissue, but you've never had a sense that this was, you could identify this as something that would be in the... Superficial. You know these textures in your hands, right? Yes. And I've been wrong twice.

Okay. No, I've never would've thought this. So do you think that sometimes when you think you're working on deep fascia, you may just be working on superficial fascia? Now I know. This isn't a bad thing.

No. It's great. It's instructive. Many people, when they learn about fascia, they have a certain idea in their mind. They tend to think mentally of the deep fascia, the sort of white, strappy sheets surrounding the musculature.

And when they see superficial fascia for the first time, they say, that's not fascia, that's fat. Well, in some places, and in some books, the layer that I'm referring to as superficial fascia is commonly understood also as the adipose layer. However, it is in fact a fascia, a loose areolar fascia. A fascia is a subcategory of body tissue, what we call connective tissue. So there are, let's say, two major types of fascia.

Fascia means it's kind of a shitty, aponeurotic implication to the word. And also the ancient Romans understood fascia to mean like a wispy thing, like a cloud. Well it's definitely the loose areolar connective tissues that fall more into this category of the wispy, cloud-like layer, relative to the more strappy, strong, flat, fibrous nature of the deep fascia, or even say the wrappings of the organs, the bags around organs, which would have that thin fibrous quality as well. So the superficial fascia then, the adipose layer, is a loose areolar fascia, a loose areolar connective tissue. Areolar means areous, like a bubble wrap.

Only the difference is that instead of the bubble wrap being filled with air, like it is when we receive a package and it's filled with bubble wrap, the superficial fascia bubbles are filled with adipose. So the structuring matrix of the superficial fascia is this loose areolar connective tissue. And the breadth of it, the depth of it, is given by the relative amount of adipose that's deposited in it. So superficial fascia can be quite thin actually, or it can be very thick. Just look around and go to the supermarket and you'll see some thick superficial fascia that, on people's forms, and the glorious variety in which human beings are walking around on the planet, we can observe that even on the same body, superficial fascia can be very thin in one area, very thick in another, depending on a person's disposition and propensity to store energy in different areas of their body.

Returning then to the laboratory, we refresh our memory of the male form here with the skin intact. And in the same way that we have universal coverage of the body with skin, just deep to the skin, it's readily apparent that we also have a uniform and universal coverage of the form with superficial fascia. The deposition of fat can't necessarily be predicted in its depth by looking at its surface. But there are a few areas of the body, the scrotum, the eyelid, the labia major, where we can always be assured that there is no fatty deposition. It simply doesn't deposit there in anybody.

But beyond this fact of the universal coverage of the body with superficial fascia, we can also notice that superficial fascia has a generally yellow color. It's a yellow layer. It's a yellow layer whether the form is male or female. It's a yellow layer whether the form is alive or dead or a cadaver. The layer is yellow regardless of whether the cadaver form is from one race or another.

We're all universally yellow underneath. Now the shades of yellow change. They can be greenish yellow or canary yellow or pale yellow. There can be reddish tones depending upon blood supply, brownish tones, etc. But in general, the superficial fascia is a yellow layer.

In the cheek, we see a very dense matrix of the superficial fascia as compared to the chest area here. The breasts themselves are specialized shapes within the layer of the superficial fascia. Without superficial fascia, the female form is quite masculinized as we'll see further on. For now, we observe the form generally. When we look at this female form, we can say that her shape is her morphology.

Her shape is primarily defined by two layers, by the superficial fascia layer because later on we'll find her body is quite distinctly shaped relative to this layer and that this layer gives her her form. In comparison, it's the muscle layer that primarily defines this gentleman's form and his superficial fascia follows quite directly the contours of the underlying deep fascia and muscle man. Again, by comparison, this female form, it's really two layers. As an endomorph, her body is shaped primarily by her gut and the gut is not rounded due to a tremendous deposition of superficial fascia but just from the shape of the underlying organs whereas the gentleman's form here doesn't primarily present the gut as a shaping element. However, both this female form and the male form have about the same amount of superficial fascia lying on their belly wall.

Here we'll take a closer up look at the superficial fascia starting here with the thigh region of the female figure. We see the spidery vasculature as it networks its way across the outer surfaces of the superficial fascia in order to meet up with the skin. We also can note the loose bubbly matrix that constitutes the structuring of the superficial fascia here. On the stouter gentleman's form we see much larger vasculature running along the surface. Like myself, many people have large veins running at the periphery of their body right along underneath the skin.

Here we see the branchings of the gentleman's great saphenous vein in the lower margins of the image here crossing over at the knee. As we take a closer up look at the superficial fascia of the face area we can see even some beard stubble at this level but more relevant the matrix of the superficial fascia here is extremely dense. The facial musculature, the platysma, the superficial muscles of expression actually act upon the superficial fascia itself rather than upon some skeletal form. Here at the heel the superficial fascia is quite specialized. The fibrous matrix is extremely fibrous here creating the cushion of the heel pad.

The fat deposited into the fibrous matrix giving us a bit of a shock absorber. At the head we see the river in pathways of the vasculature coursing through the layer of the superficial fascia which similar to the area of the face is quite dense in the structuring of its matrix. We look up very close we can still see the impressions of the back of the skin on the tissue. The superficial fascia here is quite thin and we see on the left the deep fascia somewhat exposed. We mentioned earlier that at the eyelid the labia major and the scrotum will have no deposition of fatty tissue instead at the scrotum we have the dartos layer supplanting the deposition of adipose in the superficial fascia.

We can see the margins at the penis to the right and left where the superficial fascia and its fatty deposition peters out. As we come closely here to the thigh we can see the dimpled form of the superficial fascia where the matrix creates a more loose arrangement of adipose deposition. This is the kind of dimpling that is the bane of dieter's cellulite in this area would be the impressions of the patterning of the matrix of the superficial fascia made upon the skin and then stretched or distended by the deposition of adipose in that matrix. As we follow down the arm we note bruising in the superficial fascia both at the elbow and at the wrist and at the hand anyone who's ever had an IV inserted in any of these places knows how easy it is to become bruised here when a vein blows out as they say and bleeds into the underlying superficial fascia. We see then the anatomy of a bruise in this form.

This is an extremely common artifact in cadavers given that most people die in hospitals in our country with some form of medical intervention or another. Here in the man's breast area we see the dense and fibrous lay of the superficial fascia and when we compare that to the female figure we can see the much more loose arrangement of the superficial fascia in the breast tissue. As we come in closely again to the male figure we can see the scar tissue on the left evidence of the incision and then also the fine vasculature center frame. Coming here close on to the belly wall we'll remember the discoloration of the belly tissue and here we can see that unlike in the arm where the tissue is discovered as an artifact of a medical intervention here the discoloration is merely the result of the passage of time on the cadaver form and the impression of the coloration of the cecum from below. We also see in the white lines the different shapes of the fibrous structure of the superficial fascia here at the belly wall as compared to other areas of the body that we've seen so far.

We take a wider view on the gentleman's midsection. You can see how thin the superficial fascia is over the forearm region as compared to the belly wall and upper thigh and then the gentleman by comparison to the female figure we can see the man's pubis of the female and then of the male figure where the fat is deposited over the pubic bone. Here from the back we can see quite different types and distributions of structuring to the superficial fascia of the back in the shoulder area the mid-back and the gluteal region as we focus in first in on the gluteal region we note the characteristic shape of the human buttocks is defined by the superficial fascia within which in this area there's sort of a specialized fibrous strap called the gluteal fold a part of the superficial fascia layer when it's removed the configuration of the rear end is quite different when we see it in its muscular form as opposed to the form of the superficial fascia coming close into the gluteal region from the vantage of the side we can see here the more swirling and loose arrangement of the fibrous matrix of the superficial fascia as compared say to the face or heel and then here by comparison directly the heel tissue again in its dense and extremely fibrous quality as well as that of the whole foot the entire plantar surface of the foot is quite fibrous with small bubbles containing the adipose tissue as opposed to the large more swirling and loosely organized tissue of the gluteal region which we see here again as we draw back on the image now if we take a look along the leg we'll see here at the foot the very very thin layer we can see the dorsal-pedal vein and through the superficial fascia we can see the tendons deep to the deep fascia and as we come slowly we see about a millimeter or two of superficial fascia laying along the calf some of it has been removed with the skin and we see the deep fascia the white fibrous matrix underneath the superficial fascia here it's very difficult to dissect off the entire superficial fascia of a form in the way that we demonstrated possible with the skin because in some areas of the body it is so thin that it's impossible to demonstrate its whole body integrity on every form as an independent structure nonetheless we can show its arrangement in all areas of the body here at the shoulder region is an extremely dense and fibrous matrix of connective tissue it's having a browner and reddish coloration and in this particular gentleman I'd go so far as to say that he demonstrates the mild beginnings of a dowager's hump and we'll inspect that much more closely when we dissect the superficial fascia and see it in cross section again the back from a different vantage point and we can see the gentleman's musculature showing through underneath the superficial fascia his form is very much defined by his his his musculature as we see the rounding of his shoulders and last with his arms spread out and at the shoulder area there we see the very the very fibrous and and dense kind of superficial fascia in the upper portion of the back but here at the midsection of the back we have a very light fatty deposition and the loose aerial or connective tissue barely demonstrates a bubbly structure at all it's quite matted down unlike here in the buttocks region and over the sacrum where we see again this looser and more generous deposition of the fatty tissue finally again the gluteal folds and we'll look at this region as defined by the musculature later on and it'll be shocking how different the shape is as compared to that which is defined by the superficial fascia here working our way up the back across those three very different areas and types of superficial fascia matrix finally we're restored to our full view of the form the gentleman poses quite an elegant structure to study and I was incredibly appreciative and remain so of this fabulous gift now if you go to the old textbooks this this fascia is also actually called campers fascia why is called campers fascia I can't tell you there's probably some gentleman named camper who got his dissertation based on this fascia but I like to speak in general because it's a whole body layer of the superficial fashion in general other people call this the adipose layer and it is that because within the superficial fascia lies the adipose and deep to it lies a layer that's sort of shiny and strong we have a straw a layer with tremendous integrity the skin we can see a little bit of skin here we left this to mark the navel so that the viewer would have a landmark even though we're going to drop beneath it so what I'm going to do is I take my scalpel and I'm going to make an incision but I have to do it very gently because again I don't know how I don't know how deep it is I don't want to cut beneath it so I'm going to pass my scalpel here into the superficial fascia and I can feel with the scalpel something of the depth I'm going to go around the navel here again we'll leave that as a landmark of the depth of the fascia when we're done I'm going to keep on going just going to run right on down this midline here clear on down to the pubic bone and even over the pubic symphysis to the base of the penis okay now if I get my fingers in here I can actually pry back the superficial fascia and it's not going so I didn't go deep enough again I'm trying to do a nice dissection so I don't go too deep the first time so now I'm going to go a little deeper what I'm trying to do is get to the layer of the superficial fat of the deep fascia through the superficial fascia without cutting the deep fascia because I want to show it to you now I'm getting down there a little better I get my finger down there I can start to push it off okay now as we create attention here we can see that the superficial fascia is rooted onto the deep fascia with these fibrous strands collagenous fibrous strands now we know that the superficial fascia is a loose areolar connective tissue whereas the deep fascia isn't loose or areolar at all it's it's like saran wrap or UPS strapping tape or something like that but if I keep stroking this with my hemostats here it's not even given to that I'm gonna have to bring my scalpel in I need a stronger tool well before I do that though let's talk a little bit about the depth of the superficial fascia okay so here we have the surface and then we go into its depth now I'll give this I don't know half an inch so we're going to use the scalpel tip here and I'm gonna cut through some of this relationship of the deep fascia to the superficial fascia now what what is in these strands oh my goodness all kinds of stuff the blood vessels and the nerves are here they're still very small when we're looking at them at this level they are perforating vessels vessels that go like through the layers if we're working with onion layers they're going to be layers that go through the onion layers so I call those perforating vessels here's one a little vessel and it's a little blood vessel that's feeding the superficial fascia and I pass my scalpel blade through it and I drag this blade and begin to identify the tissue underneath I'm gonna take tuck this out of the way here and sure enough we have a little better better view now without all those little connections there we can start to see a shiny layer underneath the deep fascia so we're gonna we know where to look now see now that we're at the tissue depth we can accelerate the process a little bit and I can flip my blade through here you see these you can even hear them they're quite fibrous and tough and that's what I'm teasing through with my scalpel blade so that we can ultimately demonstrate deep fascia man now we're looking at superficial fashion man well look at deep fashion man and ultimately deep fascia woman this fuzz it just melts when you touch it it's a very ephemeral tissue and you can just actually use my pinky this is blunt dissection instead of the scalpel I can use my fingers because this tissue will yield to my hands okay and we begin to understand that the superficial fascia even though when we're dissecting it at first seems to be coming apart almost it has a tremendous integrity so I can pull it as hard as I can it doesn't break okay this is superficial fascia in depth this is it in cross-section you can have a large person to have a large skin well the superficial fascia is even larger usually even in this skinny depth it's going to be heavier than a skin it's tough but it's fluffy at the same time it has elasticity to it because it bends and moves with us and then when we lift it up and view the deep fascia underneath we see the relationships between the two now the relationship between the skin and the superficial fascia is very intimate we got that a cantaloupe pattern on the skin that we took note of but here it's a looser relationship there are still these tough threads connecting it oh this is a beautiful shot there's still these loose threads connecting it these ones and then there's this fuzz and I can get in between them so we're kind of all going in between a perforating here's a perforating vessel here and then we're going to get into a little innervation of the superficial fascia it's a live vibrant organ okay now if I pull up on it I'm pulling up on the deep fascia there too excellent you see how it lifts up the bag underneath I'm actually lifting up the bag of the deep fascia all over the musculature because this is the anterior rectus sheath here that's what we're looking at this is a little blood vessel and then I go this way I'm not trying to repair my little hole here that I made by accident and a slice on over it be a little extra ginger there so disrupted the integrity of the underlying layer a little bit and it's my goal to preserve the superficial fascia the deep fascia as much as possible but also in some sense to demonstrate the integrity of the superficial fascia which is actually coming up in one piece I wonder if it will be possible on some form to actually demonstrate the entire superficial fascia the way the skin was demonstrated in the first video wouldn't that be something if you could if you could take off the entire superficial fascia in one piece oh now I'm creating goals for myself because then no one would argue about it my goodness they'd say there really is an entire full body layer that has structural integrity is innervated it's full of blood vessels it has an important function it's not something we should be trying to get rid of it's something that's our God given endowment it's a layer of our body that represents part of our wholeness that needs to be understood embraced fallen in love with accepted and and that way we can move on to a new relationship with it because the relationship that we've been demonstrating in our country lately has been a little bit aggressive towards this tissue people take it out with surgery oh that is cool oh that's nice there we go now you might notice this redness here and this is a little bit of brownness here so we have a little bit of brownness and a little bit of redness the colors are changing remember we're dealing with a cadaver the cadaver tissues lie all the time they're constantly they're constantly absorbing colors from tissues underneath that are no longer alive and functioning see how now when I lift up here it's like there's a sheet almost see the sheet this is the relationship if I lay it down it's flat when I pick it up it's a sheet but the only way to get this tissue off here is to go through that sheet and these fibers here and when I scratch it back that sheet kind of melts away and disappears and I'm left with this tough external layer which now at this point often students look at it and they say my gosh that's muscle oh no I went through to the muscle layer and they get all upset and I think oh no I've gone to the muscle layer when in fact this isn't a muscle layer at all this is the deep fascia but it's also has what students are perceiving as striations because the deep fashion itself is sort of stripity it's like strapping tape but it has different fiber orientations the deeper you go into it so people think oh I want to file I just got a little hole in it there you see the fibers here there's that film on top of it and pull this film back and I want to get I want to keep on my layer here so I'm gonna back off there I don't want to make a big hole by accident so here I go there see there's a hole in the deep fascia and that's muscle tissue underneath now as soon as you touch a scalpel blade to muscle tissue it loses all integrity it just falls apart so I'm awful careful when I come around muscle tissue with a scalpel it's the wrong tool the hand is the only tool worthy of handling the muscles because muscles integrity is dependent upon the fascia that wraps them and once you've disrupted the integrity of the fascia that wraps them that protein just wants to kind of fall apart well that is just too pretty what I'd like to do is backlight this superficial fascia the light passes through the skin well it looks like light passes through superficial fascia too you see we our bodies respond to light and certain frequencies of light are able to pass through our bodies of course our skin filters some frequencies of light our superficial fascia filters some frequencies of light but light penetrates our bodies sound waves penetrate our bodies electromagnetic frequencies of all sorts penetrate our bodies this is a stark demonstration of the fact that it's possible for electromagnetic frequencies to pass through our body so if you believe that you are not susceptible to the waves from your cell phone or you are not susceptible to the waves from from your your surrounding electromagnetic environment this is a stark demonstration that in fact frequencies from the electromagnetic spectrum enter our body and I would go further and say that they influence our health in a deep and important way and that actually the light has a cleansing function relative to the blood and that when we are not exposed to healthy forms of light we are also therefore not having our blood cleansed appropriately and it disrupts the blood chemistry ultimately and results in sickness so deep fascia superficial fascia I put my hand in front of it see I put my hand in front of the superficial fashion of the light and you can see the light easily penetrates now this is a lot of light but golly so is the sun all right so how much I appreciate the the gift of the form and I intend for my form also to be a gift ultimately and those who watch this video are no elderly person you might also or someone who's about to pass or pass on let their body pass on that those people may donate their forms and encourage others to learn more about it so folks have been trying to donate their bodies to me for years and I am constantly turning them on to their local donor program which is the best way to do that I am not set up to accept bodies for donation in case you become inspired to donate your body based on what you learn on these DVDs I wish I could help you personally and use your form but in fact instead I'll encourage you to call your local donor program at your local university and make your donation there this is getting bigger and bigger we're working our way around the bend here see here's the anterior superior iliac spine the superficial fascia on it the skin gone and then we back it off and we see underneath it it's still a bony prominence and we're closer to it than we were before and they keep on combing back this tissue all the fuzz is getting prettier down here huh can you catch that and get the light on that right down along this edge here and demonstrate that intimate relationship of the superficial fascia to the deep fashion see we're interested in as much about the layers as we are in the relationships of the layers because it's often in our relationships that we get gummed up this is true in our body and it's also true in our lives the relationships are often the stumbling points and it's a place where we need sometimes the most work so sometimes we're stuck in our relationships in our bodies sometimes we're stuck in our relationships in our lives and if we take a close look at them we can look at the way that we're intimately tied one layer to another one person to another and give it the time it deserves to work out the kinks that way we'll leave this planet better than when we got here now of course when you see it at this level it's quite an illusion right because we just spent well 10 minutes going through fuzz to be able to demonstrate the intimate relationship here would appear that it wasn't attached at all but that's an illusion created by a scalpel I can rock the body with the superficial fascia so don't let anyone tell you that your fatty tissue doesn't have integrity and in fact the bigger you get the more integrity it has and some level because the matrix of it increases as well and so there's a tremendous amount of structure going on in a large person's fatty tissue it's a liquid layer at 98.6 degrees this is a liquid layer yet the connective tissue structure of it if we look at the back of the superficial fascia we can see the strands of tougher fibers running through the deposition of the adipose so all along we have here's a bubble of adipose embraced by strands of of collagenous fibers that are tougher and it's these tough fibers that give the tissue its integrity so that if this gentleman were to lose every bit of his adipose in a superficial fascia layer he would still have superficial fascia it would be matted down it would increase in its density and in fact if this gentleman were larger and lost some weight it would just create a matte of that fibrous tissue lacking the adipose so here we have the superficial fascia in the belly area also known as campers fascia and if we pull that back we don't come exactly to the deep fascia yet because there's one more intervening plane or layer of fascia known as scarpass fascia in this particular area of the body in every area of the body there are differences and we see the beautiful blood vessels backlit and the fuzz down at the base we could probably take a little farther scarpass fascia doesn't go all the way eventually also it peters out but it does go down towards the scrotum or the labia major in a female example beautiful so next time you're doing a dissection you can hunt for that additional fascia now if we're giving a massage right and you're working the belly wall here and we've removed the skin now we're on the superficial fascia of course there are organs underneath and at room temperature we have a firmer tissue but at body temperature we have more of a liquid layer and it's of course possible to touch everything in the body ultimately but always through the layers so it's so important to understand and respect the layers to get permission to go through them and to know what layers you're going through in the deep underneath and ultimately we have the muscle layer and then the bags or the viscera and the viscera themselves here excellent just for now we'll notice the superficial fascia here which is very thin and and and it coming at the at your shin it comes to bone and you don't really have more than you know a millimeter of of superficial fascia and fatty tissue overlaying it and yet still it's a tissue with definite integrity it's the passageway of the great saphenous vein the superficial cutaneous nerves it's a structure with integrity and life and it's in continuity with all the other superficial fascia of the body and all the other layers of the body through these perforating vessels okay so I'm going to come up around the shin here and we'll create an even bigger sheath now just watch my fingertips you see you see how it wiggles I'm with this is what happens if you get your fingers tacky on somebody's skin and you get a wiggling sensation you're wiggling the superficial fascia on the deep fascia can you see that wiggle action see I'm wiggling this this one layer on top of another way this is how you can start to read layers because the layer that wiggles that's not the deep fascia the layer that wiggles is the superficial fascia sliding and wiggling on top of the deep fascia and that doesn't mean it's going to break free and we don't want it to break free it belongs there so now I can peek underneath it get a little bit of a grip on it here with my hemostat and try not to go through too much it's very tricky again you never really know exactly what the depth of the tissue is until you've gone through it too far and then you know so if I start to lift up here there we go okay I'm a little shy I'm laying on now I'm being timid I've left the blood vessel down along the deep fascia I'll show it to you in a second when I get this off so this is actually coming up nicely now it's going to come off in a big sheet for us just too lucky here okay so we see this thin layer of superficial fascia overlying the deep fascia the curl fascia right here that's quite a different texture too it's as smooth as the as the belly of a fish or something like that it's wet and it's fibrous and yet it's smooth this is when you put your finger along the superficial fascia it's grainy and a little lumpy due to the loose area or quality of the superficial fascia and the deposition of the fatty tissue when you go behind it we see that the back of the superficial fascia here has quite a different texture it's smooth again it creates something of a sliding surface relative to the deep fascia and I'd or off like to talk about the muscle sliding once against the other like silk stockings also the fascia sliding once against the other like silk stockings so still I pass my scalpel here to disrupt the relationship of the two and yet it's still a very loose relationship and it took a lot less scalpel work to reveal the superficial fascia here than it did to remove the skin here which dull the scalpel blade right so my scalpel blade doesn't even get dull when I'm working with the differentiation of the superficial fascia from the deep the way it did so the relationship between the deep fascia and the superficial fascia is a lighter relationship it's not quite as quite as intense a relationship as that between the skin and superficial fascia this is the great saphenous vein coming down to form the dorsal pital vein here and here and it just doesn't have any blood in it so I didn't see the coloration so this is a vein unlike this other tissue here it's crossing over here we have the nerve underlying the vein here's the nerve right and it starts to get real particular see now we're the crossroads of the trees so if I put my way through here I see the vein and the vein is overlying the nerve at this point unless that's a vein too no that's the nerve nerve nerve nerve vein you start to get into some pretty structures now recalling our demonstration of superficial fascia man just below skin man with the reflection of the skin by the group here we repeat the demonstration but this time reflecting back the superficial fascia to reveal deep fascia man lying underneath although quite thin at the leg we're still able to demonstrate its sheet like quality when reflected and in the upper body a more substantial cloak at this point lending to the cadaver form a stunning cape here we take a closer look in at the complexity of structure in the axilla the left armpit area here with the lymph nodes in the right corner of the screen and the beautiful branchings of the vascular network and then once again folding back the cape here looking at the latissimus dorsi on the right side with the superficial fascia still related into the back area and the complexity of the axilla here reduced we drew the fascia further and further all clear around the back and all around to the other side so we were able to basically dissect off the entire superficial fascia of the torso in one large piece the color seems similar but the superficial fascia is mostly gone as you can see my hand is running down the deep fascia here at the area of the anus we haven't finished the dissection and we still have superficial fascia surrounding the sacrum and the medial part of the gluteal muscles here and then as we come down the legs we can see it's been very nicely cleaned actually and the deep fascia is shining so that shining look takes a lot of work the superficial fascia like the skin is attached to the layer beneath it it doesn't just pop off so when it comes off at first it's more of a rough look with some of the attachment points and fatty tissues still attached to the fat to the fascia beneath it and then with some careful scalpel work it's possible to create this very clean look but realize that this is an artifact of hours of meticulous dissection as opposed to a representation of the ease with which the tissues come apart it does come apart with some ease as you saw on the camera already but now you know we have a cleaner image down here at the leg we can ultimately find the same kind of shiny fascia like we have in the back we can find it starting to peak through here but it'll take quite a bit of cleaning to represent the entire lumbar dorsal fascia here in this area for now it's still covered with a thin film of the adipose layer that's still remaining and you can see it's a moist layer over on top of the deep fascia in this region we have the superficial fascia that's been sectioned actually it's quite thick here and this is the spot where we have what is commonly known as a dowager's hump and there's a mild representation of the dowager's hump in this gentleman's structure and that tissue itself is a very dense fibrous tissue where the and the fat that intervenes amongst the fibers is more a dark brownish reddish color as opposed to a light yellow or a canary yellow color and that represents a stored packet of energy which has its own psychodynamic qualities that can be discussed and explored this isn't complete then this dissection there's still more to go to completely reveal deep fascia man beneath superficial fascia man but I thought it would be important to share this middling step between the layers as a way to help the viewer understand how very stylized many anatomical pictures are and what a level of illusion they represent and so far as you can't really grasp what it took to both create the picture and exactly what are the qualities of the tissues of one relative to another the dissection progression invites us to observe the tissue in place to palpate it with our hands to differentiate the tissue to reflect it and remove it already we've seen the initiation of the reflection of the superficial fascia of the abdominal wall the lifting of the tissue as the scalpel passes through the relationships of the superficial fascia to the deep fascia but now we're able to look at the completed project where the entire superficial fascia the torso has been dissected away from the body it's now a new creation in itself and we're able to inspect it on its own as an organ with its own integrity its own structural strength and its own purpose and meaning at this point here we see where the navel was this is that center line cut we made when we initially began to reflect the superficial fascia from the area of the penis here which this was the tissue which overlays the scrotum and then the cut came all the way up to the chest area here was the intrusion from a medical procedure on the left side which caused some scarring in the superficial fascia and here is the area some of it that was over the gluteals so the pectoral area pectoral area abdominal area down by the groin and here on the back showing through I can lift it up and just when we just the way we move if only I could move in so dynamic away as we have this moving now that would be a wonderful stretch but our fascia moves with us so I'm constantly wanting to rehabilitate the reputation of this tissue the reputation of this layer the adipose layer the superficial fascia because just like the skin it's an incredibly dynamic moving tissue that's protective that's sensitive and which if we are to have an integrated experience of our bodies it would be important for us to develop a positive relationship with there are some imperfections in the dissection of course the idea never very rarely is executed in the physical at the level that we can see that here we have the area that was filling the armpit filled with lymph nodes and blood vessels here we have an area at the base of the neck where we can note a dowager's hump had been forming in the gentleman's structure a little bit from the arm and then these thicker regions by the lower back and buttocks this area here overlaying the spine the superficial fascia certainly grows thinner where it overlays the spine there's quite a variety of color we can attribute that both to the fact that the tissue has been embalmed and preserved and that the form is dead as well as to the fact that superficial fascia itself has many different colors sometimes dark yellow sometimes lighter yellow sometimes a tan color sometimes brown sometimes reddish where there's been wounding or different levels of oxygenation perhaps of the tissue so we go in any range from yellow to canary yellow to orangeish colors and some of the fat and reddish as well the tissue is very strong if I use as much strength as I have I can't really pull it apart here it's thickness here I would gauge it about a half an inch here it's quite thin more like two or three millimeters on a given form this tissue can be six inches even a foot thick on a very large person this gentleman was extremely lean and yet we can still demonstrate the integrity of his superficial fascia truly a beautiful and awesome structure sense organ a warming device a place of sensuality and comfort as well as a place of reserve energy stored life force emotional movement and other probably as yet undiscovered functions and purposes having explored the male figure in his superficial fascia in depth and taking an up close look at it we turn our attention to this female cadaver form whose even distribution of superficial fascia enabled our dedicated group to have the rare experience of reflecting and removing the entire superficial fascia of her form intact in one piece is a rare experience even for a group of integral anatomists and that represents only one of the many gifts which were offered to us by this particular form our culture places a premium on fat free and no fat and there is a certain level of problematization of the adipose layer the superficial fascia in our culture and yet as we view and appreciate this superficial fascia here we can come to a deeper understanding of the many positive attributes of this layer that cannot be dismissed and which we judge at our own risk really at our risk of health and our risk of human experience superficial fascia like all connective tissues is piezoelectric it has the capacity to generate electrical fields when stretched and pulled in gravity it's my belief that this is part of what makes this a sensing layer so that the interaction of the fields generated by the superficial fascia with the surrounding fields in the environment enable the sensitive person sensitive in virtue of their superficial fascia to listen to their surrounding environments at a very deep level perhaps this might be a physiological and anatomical root of what we reference as female intuition and our general cultural movement to judge and dismiss and diminish the adipose layer may in fact represent not only a judgment of the feminine but of a feminine power which is inherent in this layer for both men and women the same time we can recognize in this figure here how without the superficial fascia ultimately the form is masculinized and the demand the unreasonable demand for the reduction in an inordinate manner of this layer is in a sense asking women to reduce something that is inherent to their structure and something that is integral to all human form our culture also defines where on the body superficial fascia may ideally manifest and yet those ideals make no reference to the natural genetic dispositions and the psychodynamic tendencies of any given individual each person is quite unique in their patterns of distribution of superficial fascia and it is unreasonable to place upon ourselves the demand that it should be distributed just here at the hips or just here at the breasts and not elsewhere as well instead let's make an invitation to both recognize this layer and acknowledge it and accept it as inherent to our human form as inherent to it as any other layer and requiring our acceptance and integration of it so that we might step into the power of this layer the power of this layer is both something at a physiological level and a sensitivity level as we've discussed as well as the shifting power in a culture when a culture accepts this feminine layer also this layer represents to us all a form of resource while it's true that in our culture we have epidemic obesity this is hardly the fault of the layer itself what it represents instead is a distorted relationship with the layer which we can correct by engaging it accepting it and developing our understanding of it it's my hope that this exploration of superficial fascia will provide grist for the mill and provoke curiosity and investigation on the part of scientists and somonauts alike who can explore and tell us more about the properties of this layer within recent times it's been demonstrated that the entire layer is replete with actively contractile muscle fibers previously overlooked and that these muscle fibers are part of our wound healing response this I learned from Robert Schleip who is exploring with researchers in England this contractile property of fascia itself of course within the female superficial fascia the breast also resides and there we have a place of nourishment and specialization of the fibers there even on this form there was never a place on the whole body where the superficial fascia was more than an inch and a half thick at its greatest depth here at the belly wall we can see that the superficial fascia of the female figure was no thicker than that of the gentleman about a half an inch thick which is really a minimal distribution of fascia

Comments

Kate M
1 person likes this.
Wow. I find I have to take this slowly - in multiple viewings. It's heavy stuff. It's heavy to look so closely at the "stuff" we're all made of. And to look squarely at the truth of where we're all headed... 
1 person likes this.
This is incredible.  I always liked looking at Anatomy and Physiology books, and remember spending a long time looking at my sister's medical degree human dissection book.  However this is a much more integrated experience, seeing the relationships and connections between layers and parts of the body.  The body is always explored with respect and reverence.  I also love that Gil reflects on the wonder of each and every body, and encourages us to re-examine our relationship with the adipose layer.
Heather F
i was really enjoying this until the mention of the superficial fascia being a 'feminine' layer and the resulting commentary, it gave me alot of gender dysphoria and I dislike the binary in general. I wish the video had kept on being scientific and explanatory and less gender biased in body form. Not every AFAB is going to have significant adipose deposits, nor is adipose inherently feminine. 
Sara S
Amazing! I'm so grateful for this series

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