Abstract
Introduction: Mesoscopic anatomy provides morphological insight into scales from micrometer to the whole body, particularly including a scale of hundreds micrometers between macroscopy and microscopy. Anatomical definition of ‘deep fascia’ varies widely. At the macroscopic level, ‘dissectible’ or ‘visible’ has been used to define the deep fascia. The ambiguous definition around the true nature of the deep fascia remains the same as it was in the 1st edition of Gray’s Anatomy. The objective of this presentation is to comprehensively demonstrate the direct mesoscopic evidence for the nature, origin and architecture of the human deep fascia in the head, neck, torso and limbs.
Methods: Using a combination of epoxy sheet plastination and confocal microscopy methods, the mesoscopic anatomical features of the fascia-like structures were systematically examined in the cadaveric head, neck, torso and limbs.
Results: Three basic types of the fascia-like structural configuration were identified. Their localization and distribution in the human body are regional-dependent at a scale of hundreds of micrometers.
Discussion: Mesoscopic anatomy of the deep fascia highlights both challenges and opportunities that are brought forth by studies at a scale of hundreds of micrometers and strongly indicates that some classic anatomical concepts based on macroscopic observations need to revisit at a mesoscopic scale. Mesoscopic anatomy will foster a closer collaboration between the cadaver-based structural study and its translation into various practical disciplines, e.g., contemporary medical imaging, endoscopic and robotic surgeries.