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McKinley/O’Loughlin Human Anatomy, 2nd Edition CHAPTER 13 Answers to “What Did You Learn?” 1. Eyebrows protect against sunlight and potential mechanical damage, eyelids close reflexively to protect against foreign objects moving near the eye, and eyelashes prevent airborne particles from contacting the eyeball. 2. The narrow part of the nasal region between the eyes is called the bridge of the nose. 3. The anterior region of the neck contains the larynx, trachea and suprasternal notch. 4. The sternocleidomastoid muscle partitions the neck into an anterior triangle and a posterior triangle. 5. The sternal angle is the articulation between the manubrium and body of the sternum. It is easily palpated and located at the level of the costal cartilage of the second rib, so this landmark is clinical important for counting the ribs. 6. The more superior levels of the iliac crests are at the same level as the spinous process of the L4 vertebra. The clinical significance is that by palpating the iliac crests, one can determine the level of this vertebra and thus then determine the appropriate placement for a lumbar puncture needle. 7. The triangle of auscultation is formed by the boundaries of the rhomboid major, trapezius and latissimus dorsi muscles. When an individual flexes the back, this triangle becomes larger and respiratory sounds may be heard easily through a stethoscope and not muffled by the muscles. McKinley/O’Loughlin 8. Human Anatomy, 2nd Edition The pectoralis major forms the anterior axillary fold at the anterior border of the axilla. The latissimus dorsi and teres major muscles form the posterior axillary fold at the posterior border of the axilla. 9. Located on the anterior surface of the elbow region, the cubital fossa is a depression within which the median cubital vein is located. This vein is a common location for venipuncture. 10. The pulse of the brachial artery can be palpated along the medial side of the arm. 11. The femoral triangle is on the anterior side of the thigh. Within this triangle extend all the major vessels of the lower limb and the femoral nerve, and is an important arterial pressure point to control lower limb hemorrhage. 12. The great saphenous vein and the small saphenous vein are the two superficial veins observed on the surface of the leg. 13. On the dorsum of the foot, the tendons for tibialis anterior, extensor digitorum longus, and extensor hallucis longus are clearly seen, especially when the foot is dorsiflexed. Answers to “Content Review” 1. The facial region contains the auricular, nasal, orbital, oral, and the mental regions. The auricular region is composed of the inner and outer structures of the ear, the auricle, the external auditory canal, and the mastoid process. The nasal region contains the nose (including the bridge of the nose, dorsum nasi, apex, nostrils, and the ala nasi). The orbital region contains the eyeballs, eyebrows, eyelids, and superior palpebral fissures. The oral region includes the cheek, lips, McKinley/O’Loughlin Human Anatomy, 2nd Edition and the structures of the oral cavity, and the philtrum. The mental region contains the chin. 2. The vertebra prominens is the C7 vertebra. Its spinous process may be easily palpated at the midline base of the posterior neck. . 3. The two major triangles of the neck are the anterior triangle and the posterior triangle. The anterior cervical triangle can be subdivided into the carotid (contains the carotid artery), muscular (contains the sternohyoid and sternothyroid muscles), submandibular (contains the submandibular gland), and submental (contains cervical lymph nodes) triangles. The posterior cervical triangle is subdivided into the occipital (contains the external jugular vein) and supraclavicular (contains part of the subclavian artery and vein) triangles. 4. The superficial inguinal ring is superior to the medial portion of the inguinal ligament. It may be palpated superolateral to the pubic tubercle. This ring represents a weak spot in the abdominal wall and is the site of inguinal hernias. 5. The spinal tap [lumbar puncture] must be performed inferior to the end of the spinal cord to prevent damage to the spinal cord. The physician must palpate the iliac crests to identify the level of the L4 vertebra, then make the puncture between L3 and L4 when the back is flexed by the patient. 6. The medial and lateral epicondyles may be palpated along the medial and lateral portions above the elbow, respectively. The olecranon may be palpated along the posterior aspect of the elbow. Finally, the head of the radius may be palpated just distal to the lateral epicondyle of the humerus, especially when one pronates and supinates the forearm. McKinley/O’Loughlin 7. Human Anatomy, 2nd Edition The tendons of four flexor muscles on the forearm may be palpated along the anterior surface of the wrist: flexor carpi ulnaris, superficial digital flexor, palmaris longus, and flexor carpi radialis. 8. The iliac crests form the superior borders of the buttocks. The natal cleft separates the buttocks into two prominences. The inferior border of the gluteus maximus and some fat form the gluteal fold of each buttock. 9. The popliteal fossa is the depression on the posterior part of the knee joint that is often the site of vascular problems in the elderly. 10. (a) The pulse for the posterior tibial artery may be palpated posteroinferior to the medial malleolus of the tibia. (b) The greater trochanter can be palpated on the superior lateral surface of the thigh. (c) The medial and lateral malleoli are prominent projections at the distal end of the tibia and fibula (respectively) that form part of the ankle. (d) The tendinous attachments of the hamstring muscles can be palpated along the posterior aspect of the knee joint when the knee is flexed.