surface anatomy palpation – feeling internal structures through the skin “living anatomy” –...
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Surface Anatomy
• Palpation – feeling internal structures through the skin
• “Living anatomy” – provides information about– Palpation of arterial pulses– Skeleton, muscles, and blood vessels– Sounds of the heart and lungs– Where to give injections
The Head
• Cranium – selected structures felt through the skin– Superciliary arches – External occipital protuberance – Mastoid process – Temporalis muscle – at temple region– Frontalis muscle
• Feel wrinkling of the forehead when eyebrows are raised
The Head
• Face – selected structures felt through the skin– Lacrimal fossa – Root and bridge of the nose– Auricle of the ear– Zygomatic arch– Masseter muscle– Mandible – Temporomandibular joint
The Neck
• Skeletal landmarks– Spinous processes of cervical vertebrae
• C7 is particularly prominent (vertebra prominens)
– Hyoid bone – in the anterior, superior neck– Laryngeal prominence – the “Adam’s Apple”– Cricoid cartilage – inferior to the laryngeal
prominence– Jugular notch – depression in the superior
part of the sternum
Muscles of the Neck
• Sternocleidomastoid – most prominent neck muscle– Sternal head– Clavicular head
• Deep to the sternocleidomastoid – Common carotid artery – Internal jugular vein
• Trapezius – posterior aspect of the neck
Triangles of the Neck
• The sternocleidomastoid muscles divide the neck– Anterior triangle– Posterior triangle
Figure 11.28a
The Thorax
• Sternum – portions felt through the skin– Manubrium, xiphoid process, and sternal
angle
• Midaxillary line – line from the center of the axilla onto the lateral thoracic wall
• Midclavicular line – vertical line from midpoint of the clavicle to the groin
The Abdomen
• Structures felt through the skin– Iliac crest– Anterior superior iliac spine– Inguinal ligament
• Runs medially from anterior superior iliac spine to the pubic tubercle
– Pubic crest
Muscles and other Abdominal Surface Features
• Linea alba– The “white line” extending from xiphoid
process to the pubic symphysis
• Rectus abdominis– Linea semilunaris – lateral margin of rectus
abdominis
The Pelvis and Perineum
• Four bony structures define the perineum – Pubic symphysis– Two ischial tuberosities– Coccyx
The Back
• Posterior median furrow – vertical groove along the midline
• Spinous processes of vertebrae
• Spine of the scapula– Medial end is opposite T3
• Medial border of the scapula
The Back
• Inferior angle of the scapula
• Iliac crests– Supracristal line – intersects L4
• Sacrum – superior to cleft in the buttocks
• Coccyx – posterior to the anus
Upper Limb and Shoulder
• The Axilla– Base of the axilla – where armpit hair grows– Deep to the axilla – axillary lymph nodes and
blood vessels– Anterior axillary fold – pectoralis major– Posterior axillary fold –latissimus dorsi and
teres major
Figure 11.33
The Shoulder
• Acromion – lateral end of the spine of the scapula
• Acromioclavicular joint
• Deltoid muscle– Covers the greater
tubercle of the humerus
The Arm
• The region between the shoulder and elbow
• Humerus– Palpated through skin along its entire length
• Biceps brachii
• Medial bicipital groove– The medial boundary of the biceps brachii
• Triceps brachii
The Elbow
• Lateral and medial epicondyles of the humerus – Ulnar nerve – “funny bone” runs across
medial epicondyle
• Olecranon process of the ulna
• Cubital fossa – (antecubital fossa)– Forms anterior surface of forearm
Forearm
• Bones– Ulna – palpate entire length
• Styloid process and head – distal end
• Radius – partly covered in muscle– Head of the radius – proximal end– Styloid process – distal end
Muscles of the Forearm
• Flexor muscles – anterior forearm– Flexor carpi radialis– Palmaris longus
• This muscle is absent in about 30% of people
• Extensor muscles – posterior forearm
Other Structures of the Forearm
• Anatomical snuff box bordered by– Extensor pollicis brevis– Extensor pollicis longus
The Hand
• Dorsum of hand– Dorsal venous network– Tendons of extensor digitorum
• Palmar surface– Thenar eminence (not labeled on figure
11.35b)– Hypothenar eminence (see figure 11.17a–c )– Pisiform bone
Gluteal Region
• Iliac crests
• Posterior superior iliac spine
• Sacroiliac joint
• Prominences of the buttocks– “Cheeks” of the buttocks– Formed from subcutaneous fat and the gluteal
muscles
Lower Limb and Gluteal Region
• Natal cleft (gluteal cleft) – Vertical midline groove between “cheeks”
• Gluteal fold– Horizontal fold below each “cheek”
• Ischial tuberosities
• Greater trochanter of the femur– Located at the lateral hip
Thigh
• Medial and lateral condyles of the femur
• Patella
• Three groups of muscles– Quadriceps femoris – anterior thigh
• Vastus lateralis – injection site
– Adductors – medial thigh– Hamstrings – posterior thigh
The Thigh
• The Femoral Triangle – Superior border – inguinal ligament– Inferior borders
• Sartorius• Adductor longus
• Popliteal fossa– Diamond-shaped hollow on posterior knee
• Defined by borders of “hamstring” tendons and gastrocnemius
Leg and Foot
• Palpate patella to find the patellar ligament
• Structures of the proximal leg– Tibial tuberosity – Lateral and medial condyles of the tibia– Head of the fibula
• Structures of the distal leg– Medial malleolus– Lateral malleolus
Muscle Groups of the Leg
• Posterior calf muscles– Gastrocnemius and soleus
• Calcaneal tendon – inferior end of the soleus and gastrocnemius
• Anterior compartment muscles– Tibialis anterior– Extensor digitorum– Fibularis
Foot
• Tendons on the dorsal surface of the foot– Extensor digitorum longus tendon– Extensor hallucis longus