Surface Anatomy (PowerPoint)

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					          Surface Anatomy
• Palpation – feeling internal structures
  through the skin
• “Living anatomy” – provides information
  – 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
Surface Anatomy of Lateral
    Aspect of the Head

                        Figure 11.26
                The Head
• Face – selected structures felt through the
  – 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
  – Jugular notch – depression in the superior
    part of the sternum
The Neck

           Figure 11.27
        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
Triangles of the Neck

                        Figure 11.28b
               The Trunk
• The trunk consists of the
  – Thorax
  – Abdomen
  – Pelvis and perineum
               The Thorax
• Sternum – portions felt through the skin
  – Manubrium, xiphoid process, and sternal
• 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
       Muscles of the Thorax
• Pectoralis major
• Serratus anterior
The Anterior Thorax and

                          Figure 11.29
               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
Inguinal Hernia

                  Figure 11.30
 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
    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
Surface Anatomy of the Back

                        Figure 11.31a
        Muscles of the Back
• Trapezius
• Latissimus dorsi
• Erector spinae
Surface Anatomy of the Back

                        Figure 11.31b
    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
Shoulder and Arm

                   Figure 11.32a, b
             The Shoulder
• Acromion – lateral
  end of the spine of
  the scapula
• Acromioclavicular
• Deltoid muscle
  – Covers the greater
    tubercle of the
                            Figure 11.33
                  The Arm
• The region between the shoulder and
• Humerus
  – Palpated through skin along its entire length
• Biceps brachii
• Medial bicipital groove
  – The medial boundary of the biceps brachii
• Triceps brachii
The Arm

          Figure 11.34
                The Elbow
• Lateral and medial epicondyles of the
  – Ulnar nerve – “funny bone” runs across
    medial epicondyle
• Olecranon process of the ulna
• Cubital fossa – (antecubital fossa)
  – Forms anterior surface of forearm
The Anterior Surface of the
    Forearm and Fist

                         Figure 11.35a
• 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
  – Hypothenar eminence (see figure 11.17a–c )
  – Pisiform bone
The Dorsum of the Hand

                     Figure 11.36
              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
The Gluteal Region

                     Figure 11.37
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
Lower Limb and Gluteal Region

                         Figure 11.38a
• 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

        Figure 11.38b
                  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
              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
Leg and Foot

               Figure 11.40a, c
    Muscle Groups of the Leg
• Posterior calf muscles
  – Gastrocnemius and soleus
     • Calcaneal tendon – inferior end of the soleus and
• Anterior compartment muscles
  – Tibialis anterior
  – Extensor digitorum
  – Fibularis
Muscle Groups of the Leg

                       Figure 11.41
• Tendons on the dorsal surface of the foot
  – Extensor digitorum longus tendon
  – Extensor hallucis longus

       Figure 11.40d