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Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
A T L A S BSurface Anatomy
The Importance of External Anatomy 392
Head and Neck (fig. B.1) 393
Trunk 394• Thorax and Abdomen (fig. B.2) 394• Back and Gluteal Region (fig. B.3) 395• Pelvic Region (fig. B.4) 396• Axillary Region (fig. B.5) 397
Upper Limb 398• Lateral Aspect (fig. B.6) 398• Antebrachium (forearm) (fig. B.7) 398• Wrist and Hand (fig. B.8) 399
Lower Limb 400• Thigh and Knee (fig. B.9) 400• Leg (figs. B.10–B.12) 401• Foot (figs. B.13–14) 404
Muscle Test (fig. B.15) 406
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
s B
The Importance of ExternalAnatomyIn the study of human anatomy, it is easy to become so pre-occupied with internal structure that we forget the impor-tance of what we can see and feel externally. Yet externalanatomy and appearance are major concerns in giving aphysical examination and in many aspects of patient care.A knowledge of the body’s surface landmarks is essentialto one’s competence in physical therapy, cardiopul-monary resuscitation, surgery, making X rays and electro-cardiograms, giving injections, drawing blood, listening toheart and respiratory sounds, measuring the pulse andblood pressure, and finding pressure points to stop arterialbleeding, among other procedures. A misguided attemptto perform some of these procedures while disregarding ormisunderstanding external anatomy can be very harmfuland even fatal to a patient.
Having just studied skeletal and muscular anatomyin the preceding chapters, this is an opportune time foryou to study the body surface. Much of what we see therereflects the underlying structure of the superficial bonesand muscles. A broad photographic overview of surfaceanatomy is given in atlas A (see fig. A.5). In the followingpages, we examine the body literally from head (fig. B.1)to toe (fig. B.14), studying its regions in more detail. Tomake the most profitable use of this atlas, refer to theskeletal and muscular anatomy in chapters 8 to 10. Relatedrawings of the clavicles in chapter 8 to the photograph infigure B.1, for example. Study the shape of the scapula inchapter 8 and see how much of it you can trace on the pho-tographs in figure B.3. See if you can relate the tendons
visible on the hand (fig. B.8) to the muscles of the forearmillustrated in chapter 10, and the external markings of thepelvis (fig. B.4) to bone structure in chapter 8.
For learning surface anatomy, there is a resourceavailable to you that is far more valuable than any labo-ratory model or textbook illustration—your own body.For the best understanding of human structure, comparethe art and photographs in this book with your body orwith structures visible on a study partner. In addition tobones and muscles, you can palpate a number of superfi-cial arteries, veins, tendons, ligaments, and cartilages,among other structures. By palpating regions such as theshoulder, elbow, or ankle, you can develop a mentalimage of the subsurface structures better than you canobtain by looking at two-dimensional textbook images.And the more you can study with other people, the moreyou will appreciate the variations in human structureand be able to apply your knowledge to your futurepatients or clients, who will not look quite like any text-book diagram or photograph you have ever seen.Through comparisons of art, photography, and the livingbody, you will get a much deeper understanding of thebody than if you were to study this atlas in isolation fromthe earlier chapters.
At the end of this atlas, you can test your knowledgeof externally visible muscle anatomy. The two photo-graphs in figure B.15 have 30 numbered muscles and a listof 26 names, some of which are shown more than once inthe photographs and some of which are not shown at all.Identify the muscles to your best ability without lookingback at the previous illustrations, and then check youranswers in appendix B at the back of the book.
392 Part Two Support and Movement
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
s B
Atlas B Surface Anatomy 393
(b)
SuperciliaryridgeSuperior palpebralsulcus
Inferior palpebralsulcusAuricle (pinna)of earPhiltrum
Labia (lips)
Trapezius muscle
Supraclavicularfossa
Frons (forehead)
Root of nose
Bridge of nose
Lateral commissure
Medial commissure
Dorsum nasiApex of noseAla nasi
Mentolabial sulcus
Mentum (chin)
Sternoclavicularjoints
Clavicle
Suprasternal notch
Sternum
Figure B.1 The Head and Neck. (a) Anatomical regions of the head, lateral aspect. (b) Features of the facial region and upper thorax.
Frontal
Orbital
Nasal
Oral
Mental
Cervical
Occipital
Temporal
Auricular
Buccal (cheek)
Nuchal (posterior cervical)
(a)
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
s B
394 Part Two Support and Movement
(b)
Supraclavicularfossa
Clavicle
Deltoid m.
Rectusabdominis m.
Anterior superiorspine of ilium
Trapezius m.
Suprasternal notchAcromion
Manubrium
Angle
Body (gladiolus)
Xiphoid process
Linea alba
Linea semilunaris
Costal margin
Corpus (body)
Areola
Nipple
Axillary tail
Breast:
Umbilicus
Sternum:
External abdominaloblique m.
Figure B.2 The Thorax and Abdomen, Ventral Aspect. (a) Male; (b) female. All of the features labeled are common to both sexes, thoughsome are labeled only on the photograph that shows them best.
Supraclavicularfossa
Clavicle
Deltoid
Pectoralis major
Nipple
Rectusabdominis
Tendinousinsertion ofrectus abdominis
Anterior superiorspine of ilium
Iliac crest
Inguinal ligament
(a)
Sternocleidomastoid
Thyroid cartilage
Trapezius
Suprasternal notch
Acromion
Manubrium
Body
Xiphoidprocess
Serratus anterior
Linea alba
Linea semilunaris
Umbilicus
Sternum
External abdominaloblique
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
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Atlas B Surface Anatomy 395
Infraspinatus
Trapezius
Iliac crest
Gluteus medius
Gluteus maximus
Hamstring muscles
Acromion
Medial borderof scapula
Inferior angleof scapula
Latissimusdorsi
Erector spinae
Sacrum
CoccyxNatal cleft
Greatertrochanterof femur
Gluteal fold
Olecranon
(b)
Figure B.3 The Back and Gluteal Region. (a) Male; (b) female. All of the features labeled are common to both sexes, though some are labeledonly on the photograph that shows them best.
Flexor carpi ulnaris
Brachioradialis
Biceps brachiiTriceps brachiiDeltoid
Anterior partMiddle part
Posterior part
Teres major
Infraspinatus
Medial borderof scapula
Trapezius
Vertebral furrow
Erector spinae
Latissimus dorsi
Iliac crest
(a)
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
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396 Part Two Support and Movement
Figure B.4 The Pelvic Region. (a) The anterior superior spines of the ilium are marked by anterolateral protuberances (arrows). (b) The posteriorsuperior spines are marked in some people by dimples in the sacral region (arrows).
(a)
(b)
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
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Atlas B Surface Anatomy 397
Olecranon
Biceps brachii
Triceps brachii
Anterior axillary fold (pectoralis major)
Deltoid
Axilla (armpit)
Posterior axillary fold (latissimus dorsi)
Pectoralis major
Latissimus dorsi
Serratus anterior
Rectus abdominis
External abdominal oblique
Figure B.5 The Axillary Region.
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
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398 Part Two Support and Movement
Interphalangealjoints
Metacarpophalangealjoints
Styloid processof ulna
Extensor digitorum
Trapezius
Acromion
Deltoid
Pectoralis major
Biceps brachii
Triceps brachiiLong headLateral head
BrachioradialisExtensor carpiradialis longus
Lateral epicondyleof humerusOlecranon
Figure B.6 The Upper Limb, Lateral Aspect.
(b)
Triceps brachii
Olecranon
Head of radius
Brachioradialis
Flexor carpi ulnaris
Extensor carpi ulnaris
Extensor digitorum
Tendons of extensor digitorum
Dorsum of hand
Figure B.7 The Antebrachium (forearm). (a) Ventral aspect; (b) dorsal aspect.
Cubital fossa
Cephalic vein
Median cubital vein
Brachioradialis
Styloid process of radius
Thenar eminence
Palmar surface of hand
Pollex (thumb)
Flexion lines
(a)
Biceps brachiiMedial epicondyleof humerus
Flexor carpi radialisPalmaris longusFlexor carpi ulnaris
Styloid process ofulna
Hypothenar eminence
Flexion creases
Volar surface of fingers
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
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399
(b)
Styloid process of radius
Styloid process of ulna
Extensor pollicis brevis tendonAnatomical snuffboxExtensor pollicis longus tendon
Extensor digiti minimi tendonExtensor digitorum tendons
Adductor pollicis
Figure B.8 The Wrist and Hand. (a) Ventral aspect; (b) dorsal aspect.
Hypothenar eminence
Thenar eminence
Pollex (thumb)
Palmaris longus tendon
Flexion creases
Flexion creases
Flexor carpi radialis tendon
Interphalangealjoints
Metacarpophalangealjoint
( )
I
II
IIIIV
V
(a)
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
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400 Part Two Support and Movement
Lateral Medial
Tensor fasciae latae
Rectus femoris
Gracilis
Vastus lateralis
Vastus medialis
Quadricepsfemoris tendon
Iliotibial band
Patella
Patellar ligament
Tibial tuberosity
(a)
Figure B.9 The Thigh and Knee. (a) Ventral aspect; (b) dorsal aspect.
(b)
Lateral Medial
Vastus lateralis
Biceps femoris (long head)Semitendinosus
Semimembranosus
Gracilis
Popliteal fossa
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
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Atlas B Surface Anatomy 401
Vastus lateralis
Biceps femoris
Iliotibial band
Lateral epicondyle of femur
Head of fibula
Patellar ligament
Lateral head of gastrocnemius
Soleus
Fibularis longus
Tibialis anterior
Fibularis longus and fibularisbrevis tendons
Calcaneal tendon
Lateral malleolus
Calcaneus
Figure B.10 The Leg and Foot, Lateral Aspect.
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
s B
402 Part Two Support and Movement
Semimembranosus
Semimembranosus tendon
Patella
Medial epicondyle of femur
Semitendinosus tendon
Medial condyle of tibia
Medial head of gastrocnemius
Tibia
Soleus
Medial malleolus
Extensor hallucis longus tendon
Medial longitudinal arch
Head of metatarsal I
Abductor hallucis
Figure B.11 The Leg and Foot, Medial Aspect.
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
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Atlas B Surface Anatomy 403
Medial Lateral
Hamstring muscles
Semitendinosus tendon
Biceps femoris tendon
Popliteal fossa
Gastrocnemius
Medial head
Lateral head
Soleus
Fibularis longus
Tibialis anterior
Calcaneal tendon
Lateral malleolus
Extensor digitorum brevis
Calcaneus
Figure B.12 The Leg and Foot, Dorsal Aspect.
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
s B
404 Part Two Support and Movement
Calcaneal tendon
Lateral malleolus
Extensor digitorum brevis
Lateral longitudinal arch
Extensor digitorum longustendons
(a)
Calcaneal tendon
Medial malleolus
(b)
Medial longitudinal arch
Calcaneus
Head of metatarsal I
Figure B.13 The Foot. (a) Lateral aspect; (b) medial aspect.
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
s B
Tibia
Soleus
Tibialis anterior
Medial malleolus
Head of metatarsal I
Hallux (great toe)
(a)
Lateral malleolus
Site for palpating dorsal pedal artery
Extensor digitorum longus tendons
Extensor hallucis longus tendon
IIIIIIIVV
(b)
Lateral longitudinal arch
Lateral malleolus
Transverse arch
Digits (I–V)
Medial longitudinal arch
Calcaneus
Head of metatarsal I
Head of metatarsal V
Abductor digiti minimi
Abductor hallucis
Hallux (great toe)I
II
III
IV
V
Figure B.14 The Right Foot. (a) Dorsal aspect, (b) plantar aspect.
405
Saladin: Anatomy & Physiology: The Unity of Form and Function, Third Edition
Atlas B Surface Anatomy Text © The McGraw−Hill Companies, 2003
Atla
s B
406 Part Two Support and Movement
89
10
11
12
13
14
1516
5
3
2
1
4
6
7
(a)
Figure B.15 Muscle Test. To test your knowledge of muscle anatomy, match the 30 labeled muscles on these photographs to the alphabetical listof muscles below. Answer as many as possible without referring to the previous illustrations. Some of these names will be used more than once, since thesame muscle may be shown from different perspectives, and some of these names will not be used at all. The answers are in appendix B.
(b)
27
26
25
24
28
29
30
2317
18
19
20
21
22
a. biceps brachii
b. brachioradialis
c. deltoid
d. erector spinae
e. external abdominal oblique
f. flexor carpi ulnaris
g. gastrocnemius
h. gracilis
i. hamstrings
j. infraspinatus
k. latissimus dorsi
l. pectineus
m. pectoralis major
n. rectus abdominis
o. rectus femoris
p. serratus anterior
q. soleus
r. splenius capitis
s. sternocleidomastoid
t. subscapularis
u. teres major
v. tibialis anterior
w. transversus abdominis
x. trapezius
y. triceps brachii
z. vastus lateralis