Download Introductory Surface Anatomy

Introductory Surface Anatomy
Aaron Camp | PhD
Bios1168 | Functional Musculoskeletal anatomy
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Surface Anatomy
•  Identification of anatomical structures including
bones, ligaments, tendons, muscle bodies,
nerves and the vasculature from:
i)  visual inspection
ii)  palpation of surface forms
•  anterior/ lateral and posterior aspects
Surface Anatomy
i) 
visual inspection
• 
identify anatomical structures
• 
look for:
alignment head and neck
levels of shoulder
clavicle alignment (swelling, deformity)
muscle bulk (or lack of it eg deltoid, pecs, biceps, infraspinatus)
position of scapula
bony landmarks
• 
Static/ dynamic movements
Surface Anatomy
ii) 
palpation of surface forms
- important to distinguish between structures in determining pain
source
- important in A/C, S/C joint problems
- general palpation for temperature changes, palpable oedema,
sweating
- Palpation is firm but feel more if less pressure
• 
anterior/ lateral and posterior aspects
Surface Anatomy
•  visible and palpable anatomy forms the basis of any clinical
examination and movement analysis.
•  relate visual anatomy and palpable anatomy to radiological
examination, subjective history and objective examination
•  Must know ‘normal’ anatomy before you can assess ‘abnormal’
anatomy and hence provide management strategies (exercise
prescription or manual treatment)
Anterior View
Bones
Joints
Muscles
If structure is not palpable will be
indicated.
Anterior View Bones
1. Clavicle
Sternal end
2. sternoclavicular joint
Acromial end
2a. acromial clavicular joint
3. Costoclavicular lig – not palpable
Scapula
4. Coracoid process
5. Coracoclavicular lig – not palpable
6. Acromion
.
2a
Anterior View- Bones
.
..
7. Humerus
8. Greater tubercle
.
15
11
9. Lesser tubercle
10. Bicipital groove - not palpable
12
11. Head of humerus
12. Glenohumeral joint - not palpable
13. Medial epicondyle
14. Lateral epicondyle
15. Rib no1
. .
14
13
Lumley JS ‘08
Anterior View- muscle attachments
Coracoid process
1. pectoralis minor
2. coracobrachialis
3. Short head of biceps
Greater tubercle
6. suprapinatus, (infraspinatus, teres
minor)
Lesser tubercle
7. subscapularis
Anterior View- muscle attachments
Intertubercular groove
8. pectoralis major
9. latissimus dorsi
10. teres major
12. deltoid
14. sternal head
15. clavicular head of pectoralis major
Anterior View- muscle attachments (groups of 3)
Coracoid process
5. short head biceps
6. coracobrachialis
7. pectoralis minor
11. Long head of biceps through the
groove
Intertubercular groove
12. latissimus dorsi
13. pectoralis major
+ teres major (not shown)
Anterior View- muscle bellies
pectoralis major
4. clavicular head
5. sternal head
Palpable as the anterior axillary
fold, also clearly visible on
suitable specimens
More visible with resisted
adduction, medial rotation
Anterior View- muscle bellies
biceps
4. long head
5. short head
muscle belly palpable
and more visible with supination and
res. flexion
Lateral view- Bones
1.  Sternum
2.  manubrium
3. clavicle
4. coracoid process
5. acromion
6. greater tubercle
7. lesser tubercle
8. supracondylar ridge
9. lateral epicondyle
10. olecranon
Lateral view- muscles
14. serratus anterior
.
.
15. deltoid
15
3 parts:
anterior/ middle/ posterior
16
16. deltoid tuberosity
14
Superolateral view
Deltoid and attachments
1.  clavicle
2.  Acromion
3.  spine of scapula
4. deltoid tuberosity
5. anterior fibres
6. posterior fibres
7. middle fibres
Posterior view
i) 
visual inspection
• 
look for:
- alignment head and neck
- levels of shoulder
- muscle bulk (or lack of it
eg deltoid, infraspinatus, UT)
- scapula depression/ elevation
=> UT?
- protraction => tight pec
major?
- inferior angle (tilting) => tight
pectoralis minor?
- winging of scapula => weak
serratus anterior
Posterior view- bones
1.  acromion
2.  spine of scapula
3.  medial border
4.  inferior angle
5.  base of spine
6.  superior angle
7.  glenoid fossa (GHJ)
8.  humerus
Posterior View- muscles
9. trapezius
10. deltoid
11. latissimus dorsi post axillary fold
14. rhomboid
16. infraspinatus
17. teres major
Others not palpable but need to
be aware of position
Posterior View- muscles
2. infraspinatus
4. teres major
5. long head triceps
6. lat head triceps
7. medial head triceps
9. axillary nerve
10. radial nerve
Others not palpable but need to
be aware of position
Arm
elevation
deltoid
UT
SA
LT
Lateral rotation of
scapula
deltoid
. .
IS
.
LS
MT
rhomboids
UT
Blood Vessels and Nerves
1)  subclavian artery
2) axillary artery
3) brachial artery
6) brachial plexus
8) pectoralis minor
8
Introductory Surface Anatomy
Aaron Camp | PhD
Bios1168 | Functional Musculoskeletal anatomy