Download Outline 8

Lecture 8
(Note: Your textbook devotes very little text to the subject of surface anatomy. Instead,
the book utilizes many labeled pictures. Be aware that exam questions may come from
the outline or may be in the form of unlabeled pictures)
Intro to Surface Anatomy
Surface Anatomy is concerned with identifying body structures on the surface as they
relate to _______________ structures
 Visual inspection – directly observing the structure and markings of surface
features
 Palpation- Feeling with firm pressure or perceiving by sense of touch
 Percussion – ______________________ firmly on specific body sites to detect
resonating vibrations
 Auscultation – listening to sounds emitted from organs
Applications: Maintenance of physical fitness and medical diagnosis and treatment
 Fitness
o Knowing where _______________ and muscle groups are located
 Diagnosis & Treatment
o Knowing where to
 Record a ________________
 Insert a needle or tube
 Listen to _________________ of internal organs
 Take radiographs
Most of the bones of the skeleton are palpable and provide landmarks for locating other
anatomical structures
 Exceptions: certain bones of the _____________
The effectiveness of visual inspection and palpation in studying a person’s surface
anatomy is influenced by the thickness of the hypodermis, which varies in accordance
with the amount of subcutaneous ______________ tissue present
Head
General Regions of the Head
 Cranial Regions
 _______________ Region – posterior region
 Frontal Region – anterior and superior region
 Temporal Region
o ________________ region (also covered by scalp)
o Attachment for the temporalis muscle, which can be palpated when
jaw is repeatedly clenched
o This region is often the point of entry for surgical procedures

Facial Regions
 Orbital region that surrounds (and includes) the eye
o _________________ protect from sunlight and mechanical blows
o __________________ close by reflex to protect against objects
moving towards the eye or visual stimuli
o ___________________ prevent air-born particles from contacting the
eyeball
o _____________________ secretions (tears) wash away chemicals or
foreign materials
o _______________________ is a thin mucous membrane that covers
the anterior surface of the eyeball and lines the undersurface of the
eyelid; it reduces friction during blinking
o ________________ is the white of the eye that gives the eye its shape
o __________________ is the transparent anterior portion of the eye
that refracts incoming light
o _________________ is the circular, colored, muscular portion of the
eye that regulates the amount of incoming light
o ___________________ is the opening in the center of the iris through
which light enters the eyeball
 the auricular region of the ear
o ______________________ is the fleshy pinna of the ear that projects
from the side of the head and projects sound into the external acoustic
canal
o __________________ is the rim of the auricle, shaped and supported
by eleastic cartilage
o _________________ is the inferior portion of the auricle
o _________________ is the small posteriorly directed projection
partially covering and protecting the the external acoustic canal
 the nasal region serving the respiratory system
o ________________ of the nose is the point in the skull where the nasal
and frontal bones unite
o __________________ is the firm narrow part between the eyes
o _______________ is the tip of the nose
o _________________ or external nares are the paired openings into the
nose
o The __________________________ is the lateral depression where
the ala of the nose contacts the tissues of the face
o __________________ (or ala) of the nose forms the flaired outer
margin of each nostril
 the oral region serving the digestive and respiratory systems
o _____________ are upper and lower anterior borders of the mouth
o __________________ is the anterior portion of the lower jaw
o ___________________ is the vertical depression in the medial part of
the upper lip
Trunk
Vital visceral organs in the trunk make the surface anatomy of this region especially
important
The ________________ (vertebral furrow) is visible, no matter how much adipose tissue
is present
The vertebral spines are ________________
 One may observe the furrow or palpate the spines to determine defects of the
vertebral column
The _____________________ are palpable on the back
 The base of the spine of the scapula is level with the third thoracic vertebra and
the inferior angle of the scapula is even with the seventh thoracic vertebra
 The medial and lateral borders are also ______________________
The triangle of auscultation is present on the back
 It’s the region bordered by the rhomboid major, ___________________, and
latissimus dorsi
 At this site one can more easily hear _______________________ sounds without
interference from thick muscles
The palpable structures of the thorax include:
 the ______________________
 the ______________
 the costal _________________ is the lower oblique boundary of the rib cage
o the costal ________________ is the location where the costal margins
come together as an inverted V of the position of the xiphoid process of
the sternum
The important surface anatomy features of the abdomen include:
 the _____________ alba - A tendinous, midventral raphe from the xiphoid
process to the symphysis pubis
 the ___________________ semilunaris - These paired and slightly curved vertical
lines represent the lateral border of the rectus sheaths which enclose the rectus
____________________ muscle on each side.
 the ________________________- site of attachment of the fetal umbilical cord
 the costal _______________- lower oblique boundary of the rib cage
o
right costal margin is over the liver an gallbladder
o
left costal margin is over the stomach and spleen
 the _______________ crest- Highest point is opposite the body of the fourth
lumbar vertebra, - needed in spinal anesthesia
 the ________________- can be palpated at the anterior union of the two halves of
the pelvic girdle
Pelvis and Perineum
The crest of the ilium, the symphysis pubis, and the inguinal ligament and McBurney’s
point are important pelvic landmarks
 The iliac crest and the symphysis pubis are both palpable
 The __________________ ligament extends from the anterior superior iliac spine
to the symphysis pubis
o It’s clinically important because hernias may occur along it
o Ligament can’t be seen, but there is a groove overlying the ligament that
can be seen
 ____________________ point is 1/3 of the distance from the right anterior
superior iliac spine on a line between that spine and the umbilicus.
 An appendectomy is made through an incision at this point

The _____________________ is the region that contains the external genitalia
and the anal opening
Shoulder and Upper Extremity
The surface anatomy of the shoulder and upper extremity is important because of the
frequent trauma to these regions. Vessels of the upper extremity are also used as pressure
points and for intravenous injections or blood withdrawal.

The _________________, clavicles, and humerus are palpable in the shoulder

The axilla is clinically important because of the vessels, ____________, and
lymph nodes located there

The brachial artery is an important pressure point in the brachium.

The medial cubital vein is important for the removal of ___________ or for
intravenous therapy

The ulna, radius, and their processes are palpable landmarks of the forearm
 The ______________ nerve can be palpated in the ulnar sulcus posterior to
the medial epicondyls
 The sulcus and ulnar nerve together are referred to as the “funny bone”



The knuckles, fingernails, and tendons for the extensor muscles of the forearm
can be observed on the posterior aspect of the hand
The anatomical ____________________ is created by two tendons pulled taut
o Pulsations of the radial artery can be detected here
o The two tendons include:
 The tendon of the __________________ pollicis brevis muscle
 The tendon of the extensor pollicis longus muscle
Flexion creases and the __________________ eminence are important
features on the anterior surface of the hand
o The thenar eminence is the thickened muscular portion of the hand
that forms the base of the thumb

Digits have two types of joints
 MP joints are metacarpophalangeal joints – connecting metacarpals and
phalanges
 Interphalangeal joints are found between the bones of individual digits
 DIPs are distal interphalangeal joints
 PIPs are proximal interphalangeal joints
Buttock
 The massive bones and muscles in the buttock and lower extremity serve as
weight-bearers and locomotors.
 Gluteus __________________ – forms most of the inferolateral “fleshy” part of
the buttock
 Natal cleft- vertical separation between the buttocks
 Gluteal fold – inferior _______________ of the gluteus maximus
 Iliac crest – can be palpated
 The horizontal line between the iliac crests bisects the spinous
process of the 4th lumbar vertebrae
 Injections can safely be given 5 to 7 cm inferior to the crest
without much risk to the sciatic nerve
Lower Extremity
 The thigh has three muscle groups: ________________ (quadriceps), medial
(adductors), and posterior (hamstrings)
 The femoral triangle and popliteal fossa are clinically important surface
landmarks
o Femoral __________________: Depression inferior to the location of the
inguinal ligament on the anteromedial surface in the upper part on the
thigh
 Major vessels of the lower extremity and the femoral
_______________ traverse this region
o Popliteal Fossa: Depression on the posterior aspect of the knee joint
 Important due to vascular problems that occur here in the
________________, due to reduced muscle tone and inactivity

The structures of the leg include the tibia and fibula, the muscles of the calf, and
the saphenous veins
o Great and small __________________ veins are superficial
blood vessels

The surface anatomy of the foot includes structures adapted to support the weight
of the body, maintain balance, and function during locomotion
o Lateral longitudinal arch – curvature along the
________________ side of the foot
o Medial longitudinal arch – curvature along the medial side of
the foot