Skandalakis Panagiotis N, Zoras Odyseas, Skandalakis John E, Mirilas Petros
Center for Surgical Anatomy, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Am Surg. 2006 Jan;72(1):16-8.
In Terminologia Anatomica of 1998, the fasciae of the trunk are listed as parietal, extraserosal, and visceral. Parietal fascia is defined as the fascia located outside the parietal layer of a serosa (e.g., pleura, peritoneum) lining a body wall cavity. The parietal fascia of the thorax is endothoracic fascia, and that of the abdomen is endoabdominal fascia. According to Terminologia Anatomica, endoabdominal fascia comprises: 1) transversalis fascia and 2) investing abdominal fascia: deep, intermediate and superficial. Thus, transversalis fascia is the innermost layer of endoabdominal fascia and, consequently, not synonymous with it. We assert that transversalis fascia is the inner epimysium of transversus abdominis muscle; no separate deep investing fascia exists. Embryologically, deep, intermediate and superficial layers of investing fascia are produced as muscular primordia--originating from somites invading somatopleura--penetrate somatic wall connective tissue, and thus obtain epimysium on either side, which give layers of investing fascia. In the thoracic wall, muscle layers are not separated and no distinct investing fasciae are found on them. Furthermore, in the thorax extraserosal fascia does not exist. Therefore, only endothoracic fascia is found on the inner side of the innermost intercostal muscle, which is deprived of investing fascia, to separate this muscle from pleura.
在1998年的《解剖学名词》中,躯干的筋膜分为壁层、浆膜外和脏层。壁层筋膜被定义为位于衬覆体壁腔的浆膜(如胸膜、腹膜)壁层外侧的筋膜。胸部的壁层筋膜是胸内筋膜,腹部的壁层筋膜是腹内筋膜。根据《解剖学名词》,腹内筋膜包括:1)腹横筋膜和2)包绕性腹部筋膜:深层、中层和浅层。因此,腹横筋膜是腹内筋膜的最内层,所以它与腹内筋膜并非同义词。我们认为腹横筋膜是腹横肌的内肌外膜;不存在单独的深层包绕筋膜。从胚胎学角度来看,包绕筋膜的深层、中层和浅层是随着肌肉原基(起源于侵入体壁层的体节)穿透体壁结缔组织而形成的,因此在两侧获得肌外膜,从而形成包绕筋膜的各层。在胸壁,肌层没有分离,其上也没有明显的包绕筋膜。此外,在胸部不存在浆膜外筋膜。因此,在最内层肋间肌内侧仅发现胸内筋膜,该肋间肌没有包绕筋膜,胸内筋膜将其与胸膜分隔开。