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Introductory Surface Anatomy Aaron Camp | PhD Bios1168 | Functional Musculoskeletal anatomy NO JOB CUTS AT SYDNEY UNI You are paying for your education- you deserve to get the best quality. NO JOB CUTS AT SYDNEY What can you do about it? › Sign the petition @ http://www.ipetitions.com/petition/senate-stop-job-cuts/ › Write to the Vice-Chancellor expressing your opposition to the cuts: [email protected] 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