Landmarks and Spaces

Question 1

Triangle of auscultation

Answer 1

Borders: Latissimus dorsi, medial border of scapula, trapezius

Contents: 6th and 7th ribs and 6th intercostal space

Opened most when scapula is drawn anteriorly by crossing arms and trunk is flexed

Question 2

Carpal tunnel

Answer 2

Borders: Pisiform, hook of hamate, trapezium, scaphoid, flexor retinaculum

Contents: Median nerve, flexor digitorum superficialis, flexor digitorum profundus, flexor pollicis longus

Ulnar nerve and ulnar artery are superficial and medial; flexor carpi radialis is lateral

Question 3

Quadrangular space

Answer 3

Borders: Humerus surgical neck, teres minor, long head of triceps brachii (lateral border), teres major

Contents: Posterior circumflex humeral artery, axillary nerve

Question 4

Humeral intertubercular groove

Answer 4

Borders: Greater tubercle, lesser tubercle

Contents: Tendon of long head of biceps brachii

Axillary nerve wraps laterally from posterior surface to further innervate deltoid and overlying skin

Question 5

Triangular space

Answer 5

Borders: Teres minor, long head of triceps brachii (medial border), teres major

Contents: Circumflex scapular artery

Question 6

Triangular interval, a.k.a. Triceps hiatus

Answer 6

Borders: Humerus, long head of triceps brachii (lateral border)

Contents: Profunda brachii artery, radial nerve

Question 7

Suprascapular foramen

Answer 7

Borders: Superior transverse ligament of scapula, scapular notch

Contents: Suprascapular nerve

Suprascapular artery is superior to ligament (Army over the bridge, Navy under the bridge)

Question 8

Radial groove

Answer 8

Location: Posterior humerus, about 1/2 way distal

Contents: Radial nerve, crossing inferolaterally

Question 9

Anatomical snuff box

Answer 9

Borders: Extensor retinaculum, extensor pollicis brevis, extensor pollicis longus

Contents: Radial artery

Question 10

Intervertebral foramen

Answer 10

Borders (e.g. T4-T5): Inferior vertebral notch of T4, superior vertebral notch of T5

Contents: T4 spinal nerve

Question 11

Ulnar groove

Answer 11

Location: Posterior medial epicondyle of humerus

Contents: Ulnar nerve

Question 12

Vertebral foramen

Answer 12

Borders: Pedicles, laminae, body

Contents: Spinal cord

Question 13

Transverse foramen of cervical vertebra

Answer 13

Borders: Transverse process, pedicle

Contents: Vertebral artery

Question 14

Costal groove

Answer 14

Location: Inferior border of all ribs except 1st, 11th, and 12th

Contents: Intercostal vessels, intercostal nerve

Question 15

Suboccipital triangle

Answer 15

Borders: Rectus capitis posterior major, obliquus capitis inferior, obliquus capitis superior

Contents: Suboccipital nerve, vertebral artery

Question 16

Deltopectoral groove

Answer 16

Borders: Deltoid, pectoralis major

Contents: Cephalic vein

Question 17

Cubital fossa

Answer 17

Borders: Brachioradialis, pronator teres, antebrachial fascia/bicipital aponeurosis, brachialis and supinator

Contents: Brachial veins, median nerve (medial), brachial artery (intermediate), biceps brachii tendon (lateral)

Question 18

Cubital tunnel

Answer 18

Borders: Medial epicondyle of humerus, olecranon, tendinous arch of flexor carpi ulnaris

Contents: Ulnar nerve

Question 19

Ulnar tunnel, a.k.a. Guyon’s canal

Answer 19

Borders: Palmar carpal ligament, flexor retinaculum, pisiform, hook of hamate

Contents: Ulnar nerve, ulnar artery

Superficial to carpal tunnel

Question 20

Hepatic triad

Answer 20

Sheath: Hepatoduodenal ligament

Contents: Hepatic artery proper, bile duct, hepatic portal vein

Anterior to omental foramen of Winslow

Question 21

Aortic hiatus

Answer 21

Location: Posteromedial aspect of diaphragm at T12

Contents: Abdominal aorta, thoracic duct, azygous vein, hemi-azygous vein

Question 22

Deep inguinal ring

Answer 22

Borders: Transversalis fascia

Contents: Gonadal artery and vein, spermatic cord/round ligament of uterus

Space for indirect inguinal hernia; lateral to inferior epigastric vessels

Question 23

Hesselbach’s triangle

Answer 23

Borders: Inferior epigastric vessels, inguinal ligament, rectus abdominis

Contents: Medial inguinal fossa

Space for direct inguinal hernia; superficial inguinal ring is anterior to this at inferior corner

Question 24

Pectinate line

Answer 24

Junction of: Visceral part of anal canal (superior) and somatic part of anal canal (inferior)

Question 25

Retroinguinal space of Bogros

Answer 25

Borders: Transversalis fascia, peritoneum, iliac fascia Contents: Medial aspect- Femoral artery and vein Lateral aspect- Iliopsoas

Question 26

Cystohepatic triangle of Calot

Answer 26

Borders: Common hepatic duct, cystic duct, inferior border of liver Contents: Cystic artery; also Lund's node, the sentinel lymph node of the gallbladder

Question 27

Unnamed perineal space of Sistani

Answer 27

Borders: Inferior (arcuate) public ligament, perineal membrane Contents: Dorsal nerve and vessels of penis/clitoris

Question 28

Obturator canal

Answer 28

Borders: Obturator internus, body of pubis at obturator foramen Contents: Obturator artery and vein, obturator nerve

Question 29

Greater sciatic foramen

Answer 29

Borders: Greater sciatic notch, sacrotuberous ligament, sacrospinous ligament Contents: Piriformis Suprapiriform- Superior gluteal artery and vein, superior gluteal nerve Infrapiriform- Inferior gluteal artery and vein, internal pudendal artery and vein, 6 nerves (inferior gluteal, pudendal, sciatic, posterior femoral cutaneous, nerve to obturator internus, nerve to quadratus femoris)

Question 30

Lesser sciatic foramen

Answer 30

Borders: Lesser sciatic notch, sacrotuberous ligament, sacrospinous ligament Contents: Internal pudendal artery and vein, pudendal nerve, nerve to obturator internus, tendon of obturator internus

Question 31

Pudendal canal / Alcock's canal

Answer 31

Borders: Obturator fascia (along oburator internus in ischioanal fossa) Contents: Internal pudendal artery, internal pudendal vein, pudendal nerve

Question 32

Esophageal hiatus

Answer 32

Location: Medial aspect of diaphragm at T10 Contents: Esophagus, posterior vagal trunk

Question 33

Adductor canal

Answer 33

Location: Deep to sartorius Contents: Femoral artery, femoral vein, saphenous nerve, nerve to vastus medialis

Question 34

Adductor hiatus

Answer 34

Borders: Femur superior to medial condyle, tendinous insertion of adductor magnus Contents: Femoral artery, femoral vein

Question 35

Femoral triangle

Answer 35

Borders: Inguinal ligament, sartorius, adductor longus, iliopsoas and pectineus (floor), fascia lata (roof) Contents: Femoral nerve, femoral artery, femoral vein, lymphatics (NAVL from lateral to medial)

Question 36

Saphenous opening

Answer 36

Borders: Fascia lata with falciform lateral border, fascia cribrosa (covering) Contents: Great saphenous vein

Question 37

Femoral canal

Answer 37

Location: Medial compartment of femoral sheath at femoral ring Contents: Fat, some lymphatics Site of femoral hernia

Question 38

Pes anserinus

Answer 38

Location: Medial to tibial tuberosity Contents: Tendinous insertions of gracilis, sartorius, and semitendinosus