Dr copyright Index of Surface Anatomy · Index of Surface Anatomy Abdomen see also Aorta, Trunk dermatomes ... aka = also known as ... = joints = articulations L = left
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Table of contents Introduction 1Acknowledgement 1Dedication 1How to use this Book 2Table of Contents 3Abbreviations 7Common Terms used in Surface Anatomy 9Anatomical Planes and Relations 18Movements – general
Upper limb & shoulder 20Head, Neck & Back 22Lower limb and Hip 24Foot and Hand 25
HandGrips 26Measurements 28
Proportions and forms of human measurement 30Human face proportions 32Human body proportions 34Vitruvian Man 36(Symbol of proportionality & derivative of measurements)
Index of Surface Anatomy Abdomen see also Aorta, Trunk
Adam’s apple = Thyroid cartilage see Thyroid Adrenals see Back, Trunk Anatomical snuff box see Thumb Ankle see also Foot 50Anus see Perineum Aorta 52Appendix see Abdomen GIT Arm see also Axilla, Forearm, Shoulder 54Axilla see also Breast
Gall Bladder see Abdomen GIT, DiaphragmGenitalia –
female 120male see Penis Testis
Gluteum / Gluteal regionbones 122muscles / Sciatic N 124
Hand see also gripsbones 126dorsum extensors 128palm
features 130flexors 132flexor retinaculum 134thenar/ hypothenar eminences 136
Head see Face, Neck, Temporomandibular joint Heart see also Chest, Oesophagus 138Hip see also Gluteum 140 Hyoid see Neck, Thyroid Inguinal nodes superficial 142Kidneys see also Back 144Knee see also lower leg, popliteal fossa, Thigh 146Large Intestine see Abdomen GIT 148Leg / Lower leg
muscles and bones 150 Liver see Abdomen non-GIT, Diaphragm Lungs see also Abdomen, Chest 156Lymph nodes see Axilla, Breast, Inguinal, Mouth, NeckMouth
salivary glands 158tonsil & uvula 160
Nail 162Neck
BVs & access points 164LNs and veins 166submandibular regions 168triangles 170
Nipples see Breast Nose 174Oesophagus 184Ovaries see Pelvis, Uterus Pancreas see Abdomen non-GIT, Kidneys Pelvis see Genitalia, Perineum, Uterus also specific organs listed
Penis 186Perineum see also Genitalia 188Phrenic N see Oesophagus Pleura see Chest, Lungs Popliteal fossa 192Rectum see Abdomen GIT, Pelvis, Perineum, Sigmoid colonSalivary Glands see Head, Mouth, Neck Sciatic N see also Gluteum 194 Scrotum see Femoral Triangle, Penis, TestisShoulder
bones 196BVs & Ns 198muscles 200
Sigmoid Colon see Abdomen GIT, Large IntestineSinuses 206Small Intestine see Abdomen GIT Spleen see also Abdomen, Back, Diaphragm 208Stomach see also Abdomen 210Teeth see Face, Mouth, TMJ
A to Z of the Head & Neck for complete map Temporomandibular Joint 214Testis/Testes see also Femoral Triangle, Penis, Scrotum Perineum 216Thigh see also Femoral Triangle, Hip & Knee 218
muscle Throat see Mouth Thumb 220Thymus see also Oesophagus 222Thyroid see also Neck 222Tongue see also Mouth 224Tonsil see Mouth, Tongue Trachea see also Neck 228Trunk see Abdomen, Back Umbilicus see Abdomen Ureter see Kidneys Uterus see also Pelvis 230Uvula see Mouth, TongueVagina see Pelvis, Perineum Vagus N see Oesophagus Womb see uterusWrist see also Hand & grips 232
MCL = mid clavicular lineMCP = metacarpophalangealmed. = medial MI = myocardial infarction MIP = midinguinal point MT = metatarsal N = nerve NAD = normal (size, shape) NAD = no abnormality detected NR = nerve rootNS = nervous system/nerve supply NT = nervous tissuenv = neurovascular bundle P = pressure PAD = peripheral artery disease PaNS = parasympathetic nervous system Ph = phalangesPIIS = posterior inferior iliac spine pl. = pluralPM = pia mater PN = peripheral nerve post. = posteriorproc. = processprox. = proximalPS = pubic symphysis PSIS = posterior superior iliac spine R = right RA = right atriumRH = right hypochondrium RIF = Right Iliac Fossa S = sacral S1 = first heart sound S2 = second heart sound SA = sinoatrial SCM = sternocleidomastoid musclesing. = singular SC = spinal cord SN = spinal nerve SP = spinal process SR = sarcoplasmic reticulum subcut. = subcutaneous supf = superficial
SVC = superior vena cava SyNS = sympathetic nervous system T = thoracic TMJ = temporomandibular jointUL = upper limb, arm V = vertebra V = ventricle VC = vertebral column WM = white matter w/n = within w/o = without wrt = with respect to & = and ∩ = intersection with
Abdominal Wall RegionsAnterior view of the abdomen showing regions. There are several ways to describe the regions of the Abdomen.
This commonly used schema divides the abdomen into 9 regions,based upon anatomical landmarks - numbered
Regions are coloured areas labelled with letters
1 Xiphisternum 2 midclavicular line (MCL) - vertical line ½ way along the Clavicle 3 transpyloric plane - midway b/n Xiphisternum and umbilicus = L1 passes through pyloric sphincter and 1st part of the duodenum4 subcostal plane - passes through L35 transtubercular plane - passes through L56 Inguinal ligament 7 midinguinal point (MIP) - intersection b/n MCL and inguinal lig 8 anterior superior iliac spine = ASIS 9 iliac tubercle 10 7th rib - b= bone c = cartilage 11 MCL ∩ 9th rib12 CC - lower border of the ribs from the Xiphisternum around13 umbilicus - varies with age & weight approx. T10 dermatome
E = epigastrium - area b/n 3 & 12 H = hypochondrium - area b/n MCL 3 & 4 L = left & R = right I = iliac region - area b/n MCL & 6 L= left & R = rightL = lumbar region - area b/n MCL & 4 & 5 L = left & R = rightP = pelvic area AKA suprapubic region - area below 5 above 6 U = umbilical region - area b/n MCLs 4 & 5
Cubital FossaBones, Muscles and Vessels Anterior views - deep to superficial Clinically important area for accessing venous and arterial blood,testing reflexes and muscle strength in the upper limb - defn - thearea b/n the Biceps & its aponeurosis & the muscles of thecommon flexor origin & Brachioradialis (anterior fossa of the ant ofthe elbow)
Diaphragm = a musculotendinous dome, dividing the thorax &abdomen, centrally flattened the L(4th ICS T10-11) > R (6th ribT12) – both in the MCL (through the nipple).
Up to 1 rib higher in the supine position and in the broad-chested.
Resting respiration - ± 1cm – but may vary up to 10cm.
Attached - ant. – to the Xiphisternum, costal margin lat. - ribs 6-12post. L1-3
contraction - flattens the dome shape –pulls the IVC open ↑ abdominal P ↑ core strength lowers & moves the Liver to the L lowers & flattens the Spleen to the R
Both the Live r& Spleen are intimately related to the Diaphragmand the IVC and move as described.
1 Liver L = left R = right p = ptosed (ie lowered in inspiration) Liver edge palpable just below the CC on inspiration -
2 Gallbladder (9th CC) – divides the liver into the R & L functional ½
3 Spleen spans ribs 6-9 NAD – but in certain disease states partic parasitic infections - (malaria) may fill down to the LIF p = ptosed (ie lowered in inspiration)
4 Diaphragm e =expiration position i = inspiration position n = neutral position
The foot has 4 muscle layers overlaid with a strong protective fascia.
the central aponeurosis (4) is similar to the palmar aponeurosiswith extensions (2) to accommodate the extended MTs. A bridgingfortified transverse ligament (1) joints all the heads of the MTs toreflect the weight bearing function of the foot
Hand – Dorsum Extensor tendons & synovial sheathsThe hand is highly mobile, hence it must have strong mobile tendinousattachments. To improve mobility these expand to individual synovialsheaths commencing from the base of the fingers.
1 Abductor pollicus longus
2 Extensor pollicus brevis
3 Extensor carpi radialis longus
4 Extensor carpi radialis brevis
5 Extensor pollicus longus
6 Extensor indicis
7 Extensor digitorum (communicans)
8 Extensor digit minimi
9 Extensor carpi ulnaris – in supination / shown more laterally as in pronation
Knee – Flexed Lateral MedialThe knee is the most unstable joint in the body. It relies extensivelyon its ligaments and muscles for structural integrity as the bonysurfaces are not compatible and provide little or no support.
1 Rectus femoris t = tendon
2 Vastus lateralis 2L / V medialis 2m
3 Biceps femoris t = tendon (note bipennate muscle)
4 Iliotibial tract
5 Patella
6 femoral condyle L = lateral m = medial
7 lateral collateral lig
8 meniscus l = lateral, m = medial
9 common tendon insertion = the patella tendon (bursa behind)