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Surface Anatomy
• Palpation – feeling internal structures
through the skin
• “Living anatomy” – provides information
about
– Palpation of arterial pulses
– Skeleton, muscles, and blood vessels
– Sounds of the heart and lungs
– Where to give injections
The Head
• Cranium – selected structures felt through
the skin
– Superciliary arches
– External occipital protuberance
– Mastoid process
– Temporalis muscle – at temple region
– Frontalis muscle
• Feel wrinkling of the forehead when eyebrows are
raised
Surface Anatomy of Lateral
Aspect of the Head
Figure 11.26
The Head
• Face – selected structures felt through the
skin
– Lacrimal fossa
– Root and bridge of the nose
– Auricle of the ear
– Zygomatic arch
– Masseter muscle
– Mandible
– Temporomandibular joint
The Neck
• Skeletal landmarks
– Spinous processes of cervical vertebrae
• C7 is particularly prominent (vertebra prominens)
– Hyoid bone – in the anterior, superior neck
– Laryngeal prominence – the “Adam’s Apple”
– Cricoid cartilage – inferior to the laryngeal
prominence
– Jugular notch – depression in the superior
part of the sternum
The Neck
Figure 11.27
Muscles of the Neck
• Sternocleidomastoid – most prominent
neck muscle
– Sternal head
– Clavicular head
• Deep to the sternocleidomastoid
– Common carotid artery
– Internal jugular vein
• Trapezius – posterior aspect of the neck
Triangles of the Neck
• The sternocleidomastoid muscles divide
the neck
– Anterior triangle
– Posterior triangle
Figure 11.28a
Triangles of the Neck
Figure 11.28b
The Trunk
• The trunk consists of the
– Thorax
– Abdomen
– Pelvis and perineum
The Thorax
• Sternum – portions felt through the skin
– Manubrium, xiphoid process, and sternal
angle
• Midaxillary line – line from the center of
the axilla onto the lateral thoracic wall
• Midclavicular line – vertical line from
midpoint of the clavicle to the groin
Muscles of the Thorax
• Pectoralis major
• Serratus anterior
The Anterior Thorax and
Abdomen
Figure 11.29
The Abdomen
• Structures felt through the skin
– Iliac crest
– Anterior superior iliac spine
– Inguinal ligament
• Runs medially from anterior superior iliac spine to
the pubic tubercle
– Pubic crest
Inguinal Hernia
Figure 11.30
Muscles and other Abdominal
Surface Features
• Linea alba
– The “white line” extending from xiphoid
process to the pubic symphysis
• Rectus abdominis
– Linea semilunaris – lateral margin of rectus
abdominis
The Pelvis and Perineum
• Four bony structures define the perineum
– Pubic symphysis
– Two ischial tuberosities
– Coccyx
The Back
• Posterior median furrow – vertical
groove along the midline
• Spinous processes of vertebrae
• Spine of the scapula
– Medial end is opposite T3
• Medial border of the scapula
The Back
• Inferior angle of the scapula
• Iliac crests
– Supracristal line – intersects L4
• Sacrum – superior to cleft in the buttocks
• Coccyx – posterior to the anus
Surface Anatomy of the Back
Figure 11.31a
Muscles of the Back
• Trapezius
• Latissimus dorsi
• Erector spinae
Surface Anatomy of the Back
Figure 11.31b
Upper Limb and Shoulder
• The Axilla
– Base of the axilla – where armpit hair grows
– Deep to the axilla – axillary lymph nodes and
blood vessels
– Anterior axillary fold – pectoralis major
– Posterior axillary fold –latissimus dorsi and
teres major
Shoulder and Arm
Figure 11.32a, b
The Shoulder
• Acromion – lateral
end of the spine of
the scapula
• Acromioclavicular
joint
• Deltoid muscle
– Covers the greater
tubercle of the
humerus
Figure 11.33
The Arm
• The region between the shoulder and
elbow
• Humerus
– Palpated through skin along its entire length
• Biceps brachii
• Medial bicipital groove
– The medial boundary of the biceps brachii
• Triceps brachii
The Arm
Figure 11.34
The Elbow
• Lateral and medial epicondyles of the
humerus
– Ulnar nerve – “funny bone” runs across
medial epicondyle
• Olecranon process of the ulna
• Cubital fossa – (antecubital fossa)
– Forms anterior surface of forearm
The Anterior Surface of the
Forearm and Fist
Figure 11.35a
Forearm
• Bones
– Ulna – palpate entire length
• Styloid process and head – distal end
• Radius – partly covered in muscle
– Head of the radius – proximal end
– Styloid process – distal end
Muscles of the Forearm
• Flexor muscles – anterior forearm
– Flexor carpi radialis
– Palmaris longus
• This muscle is absent in about 30% of people
• Extensor muscles – posterior forearm
Other Structures of the Forearm
• Anatomical snuff box bordered by
– Extensor pollicis brevis
– Extensor pollicis longus
The Hand
• Dorsum of hand
– Dorsal venous network
– Tendons of extensor digitorum
• Palmar surface
– Thenar eminence (not labeled on figure
11.35b)
– Hypothenar eminence (see figure 11.17a–c )
– Pisiform bone
The Dorsum of the Hand
Figure 11.36
Gluteal Region
•
•
•
•
Iliac crests
Posterior superior iliac spine
Sacroiliac joint
Prominences of the buttocks
– “Cheeks” of the buttocks
– Formed from subcutaneous fat and the gluteal
muscles
The Gluteal Region
Figure 11.37
Lower Limb and Gluteal Region
• Natal cleft (gluteal cleft)
– Vertical midline groove between “cheeks”
• Gluteal fold
– Horizontal fold below each “cheek”
• Ischial tuberosities
• Greater trochanter of the femur
– Located at the lateral hip
Lower Limb and Gluteal Region
Figure 11.38a
Thigh
• Medial and lateral condyles of the femur
• Patella
• Three groups of muscles
– Quadriceps femoris – anterior thigh
• Vastus lateralis – injection site
– Adductors – medial thigh
– Hamstrings – posterior thigh
Thigh
Figure 11.38b
The Thigh
• The Femoral Triangle
– Superior border – inguinal ligament
– Inferior borders
• Sartorius
• Adductor longus
• Popliteal fossa
– Diamond-shaped hollow on posterior knee
• Defined by borders of “hamstring” tendons and
gastrocnemius
Leg and Foot
• Palpate patella to find the patellar ligament
• Structures of the proximal leg
– Tibial tuberosity
– Lateral and medial condyles of the tibia
– Head of the fibula
• Structures of the distal leg
– Medial malleolus
– Lateral malleolus
Leg and Foot
Figure 11.40a, c
Muscle Groups of the Leg
• Posterior calf muscles
– Gastrocnemius and soleus
• Calcaneal tendon – inferior end of the soleus and
gastrocnemius
• Anterior compartment muscles
– Tibialis anterior
– Extensor digitorum
– Fibularis
Muscle Groups of the Leg
Figure 11.41
Foot
• Tendons on the dorsal surface of the foot
– Extensor digitorum longus tendon
– Extensor hallucis longus
Foot
Figure 11.40d