1. 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

2. 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

3. Surface Anatomy of Lateral Aspect of the Head
Figure 11.26

4. 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

5. 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

6. The Neck
Figure 11.27

7. 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

8. Triangles of the Neck The sternocleidomastoid muscles divide the neck
Anterior triangle
Posterior triangle
Figure 11.28a

9. Triangles of the Neck
Figure 11.28b

10. The Trunk
The trunk consists of the
Thorax
Abdomen
Pelvis and perineum

11. 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

12. Muscles of the Thorax
Pectoralis major
Serratus anterior

13. The Anterior Thorax and Abdomen
Figure 11.29

14. 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

15. Inguinal Hernia
Figure 11.30

16. 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

17. The Pelvis and Perineum
Four bony structures define the perineum
Pubic symphysis
Two ischial tuberosities
Coccyx

18. 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

19. 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

20. Surface Anatomy of the Back
Figure 11.31a

21. Muscles of the Back
Trapezius
Latissimus dorsi
Erector spinae

22. Surface Anatomy of the Back
Figure 11.31b

23. 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

24. Shoulder and Arm
Figure 11.32a, b

25. 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

26. 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

27. The Arm
Figure 11.34

28. 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

29. The Anterior Surface of the Forearm and Fist
Figure 11.35a

30. Forearm Bones Radius – partly covered in muscle
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

31. 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

32. Other Structures of the Forearm
Anatomical snuff box bordered by
Extensor pollicis brevis
Extensor pollicis longus

33. The Hand Dorsum of hand Palmar surface 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

34. The Dorsum of the Hand
Figure 11.36

35. 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

36. The Gluteal Region
Figure 11.37

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

38. Lower Limb and Gluteal Region
Figure 11.38a

39. 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

40. Thigh
Figure 11.38b

41. The Thigh The Femoral Triangle Popliteal fossa
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

42. 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

43. Leg and Foot
Figure 11.40a, c

44. 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

45. Muscle Groups of the Leg
Figure 11.41

46. Foot Tendons on the dorsal surface of the foot
Extensor digitorum longus tendon
Extensor hallucis longus

47. Foot
Figure 11.40d