Surface Anatomy lower limb.pdf
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Surface Anatomy
A branch of gross anatomy that examinesshapes and markings on the surface of thebody as they relate to deeper structures.
Essential in locating and identifying anatomicstructures prior to studying internal grossanatomy.
Health-care personnel use surface anatomyto help diagnose medical conditions and totreat patients.
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Surface Anatomy four techniques when examining surface anatomy
visual inspection
directly observe the structure and markings of surfacefeatures
palpation
feeling with firm pressure or perceiving by the sense oftouch)
precisely locate and identify anatomic features under theskin
percussion
tap sharply on specific body sites to detect resonatingvibrations
auscultation
listen to sounds emitted from organs
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Surface anatomy of lower limb
Gluteal region and thigh anterior superior and inferior iliac
spines tubercle of iliac crest ischial tuberosity greater trochanter pubic tubercle pubic crest superior border of pubic symphysis
Knee patella ligament tuberosity of tibia medial and lateral condyles and
epicondyles tendon of biceps femoris tendons of semitendinosus and
semimembranosus head of fibula
Leg anterior border of tibia neck of fibula
Ankle and foot medial and lateral malleolus calcaneal tuberosity tuberosity of navicular bone tuberosity of fifth metatarsal bone
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Gluteal Region
The inferior border of the gluteus maximus muscleforms the gluteal fold.
The gluteal (natal) cleft extends vertically to separatethe buttocks into two prominences.
In the inferior portion of each buttock, an ischialtuberosity can be palpated; these tuberositiessupport body weight while seated.
The gluteus maximus muscle forms most of theinferolateral fleshy part of the buttock.
The gluteus medius muscle may be palpated only inthe superolateral portion of each buttock.
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Gluteal Region: Landmarks
Iliac crests
Posterior superior iliac spine
Sacroiliac joint
Prominences of the buttocks
Cheeks of the buttocks
Formed from subcutaneous fat and thegluteal muscles
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The Gluteal Region
Figure 11.37
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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
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Lower Limb and Gluteal Region
Figure 11.38a
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The Thigh
Many muscular and bony features are readilyidentified in the thigh, which extends between thehip and the knee on each lower limb.
An extremely important element of thigh surfaceanatomy is a region called the femoral triangle.
The femoral artery, vein, and nerve travel throughthis region, making it an important arterial pressurepoint for controlling lower limb hemorrhage.
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Thigh : Landmarks
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
13-11Figure 11.38b
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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
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Femoral triangle
A triangular depressed area situated in theupper part of the medial aspect of the thigh justbelow the inguinal ligament
Boundaries
Superiorly (base) : the inguinal ligament
Laterally: medial border of sartorius
Medially: medial border of adductor longus
Apex: continuous with adductor canal
Anterior wall: fascia lata
Posterior wall: consists of iliopsoas, pectineusand adductor longus from lateral to medial side
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Femoral triangle
Contents Femoral n.
Femoral sheath
Femoral a. and its branches
Femoral vein and its tributaries.
Femoral canal
Deep inguinal lymph nodes
Fatty tissue
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Thigh and Knee
On the distal part of the anterior thigh, are the threeparts of the quadriceps femoris as they approach theknee.
Still on the anterior side of the thigh, three obviousskeletal features can be observed and palpated: (1) The greater trochanter is palpated on the superior lateral
surface of the thigh;
(2) the patella is located easily within the patellar tendon;and
(3) the lateral and medial condyles of both the femur andtibia are identified and palpated at each knee.
13-16Figure 11.40a, c
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Foot and Toes
The phalanges, metatarsophalangeal joints, PIP andDIP joints, and toenails are obvious surfacelandmarks readily observed when viewing either thelateral side or the dorsum of the foot.
The medial surface of the foot clearly illustrates thehigh, arched medial longitudinal arch.
At the distal end of the medial longitudinal arch, thehead of metatarsal I appears as a prominent bump.
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Bony Palpation
Medial Aspect
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Medial Calcaneous
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Talar Head
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Navicular Tubercle
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First Cuneiform
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First Metatarsal
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First Metatarsalphalangeal Joint
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First Phalanx
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Soft Tissue Palpation
Medial and Plantar Aspect
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Tibialis Posterior tendon
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Tibialis Posterior tendon (blue)Flexor Digitorum Longus tendon (red)Flexor Hallucis Longus tendon (green)
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Tom, Dick, Harry
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Calcaneonavicular ligament(Spring ligament)
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Medial Longitudinal arch
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Transverse Arch