Session 4.2 - Group Work Flashcards
What is surface anatomy?
The study of EXTERNAL FEATURES OF THE BODY, that can be visualised without dissection.
What are the features you should be able to locate on yourself/each other?
ON THE HEAD
- Mastoid Process
- Nasal Bones and Nasal Cartilages
- Zygomatic Arch
- Angle of Mandible
ON THE NECK
- Hyoid Bone
- Thyroid and Cricoid Cartilage
- Sternocleidomastoid Muscle
- C7 Vertebrae Spinous Processes
ON THE THORAX
- Manubriosternal Joint
- Nipples
- Costal Margin
- Intercostal Spaces
ON THE ABDOMEN
- Umbilicus
ON THE UPPER LIMB
- Biceps Tendon
- Medial Epicondyle, Ulnar Nerve and Olecranon
- Head of Ulna
- Radial Artery at the Wrist
- Thenar Eminence
ON THE LOWER LIMB
- Iliac Crest
- Greater Trochanter
- Tibial Tuberosity
- Anterior (Subcutaneous) Tibia
- Medial and Lateral Malleoli
- Calcaneum and Achilles Tendon
What are the features of the head that you need to identify?
- Mastoid process
- Nasal bones and nasal cartilages
- Zygomatic arch
- Angle of mandible
Identify the mastoid process on yourself
Bony lump POSTERIOR to the ear lobe
Fig. 6 (left)
(Slide 6)
Label the image
- Mastoid process
Bony lump POSTERIOR to the ear lobe
What is the clinical relevance of the mastoid process?
- Site of bruising in basal skull fractures (aka battle’s sign)
- Common site of bacterial infection (mastoiditis)
What is the site of bruising in basal skull fractures (of the mastoid process) known as?
Battle’s sign
What is battle’s sign?
Site of bruising in basal skull fractures (mastoid process)
The mastoid process is a common site of …?
Bacterial infection
What is mastoiditis?
Bacterial infection of the mastoid process (it is a common site of bacterial infection)
Fig. 6 (top right)
What does this image show?
Site of bruising in basal skull fractures (aka Battle’s Sign)
Fig. 6 (bottom right)
What does this picture show?
Common site of bacterial infection of the mastoid process (mastoiditis)
Identify the nasal bones and nasal cartilages on yourself
Nasal Bone - superior, firm part of external nose
Nasal Cartilage - inferior, soft part of external nose
Fig. 8
Label the nasal bone and nasal cartilage
Nasal Bone - superior, firm part of external nose
Nasal Cartilage - inferior, soft part of external nose
Where is the nasal bone?
SUPERIOR, firm part of external nose
What is the superior, firm part of external nose?
Nasal bone
What is the nasal cartilage?
INFERIOR, soft part of external nose
What is the inferior, soft part of external nose?
Nasal Cartilage
Fig. 8
Label the image
- Frontal bone
- Nasal bones
- Frontal process of maxilla
- Lateral process of septal nasal cartilages
- Septal cartilage
- Minor alar cartilage
- Accessory nasal cartilage
- Lateral crus of major alar cartilage
- Medial crus of major alar cartilage
- Septal nasal cartilage
- Anterior nasal spine of maxilla
- Alar fibrofatty tissue
- Infraorbital foramen
- Nasal Bone - superior, firm part of external nose
- Nasal Cartilage - inferior, soft part of external nose
What is the clinical relevance of the nasal anatomy?
If someone is having a nosebleed (epistaxis), press on the nasal cartilage NOT the nasal bone.
What is epistaxis?
Nosebleeds
What is the medical term for nosebleeds?
Epistaxis
Where should you hold the nose to prevent epistaxis?
On the nasal cartilage, NOT the nasal bone.
What is the zygomatic arch?
‘cheek bone’
What is the ‘cheek bone’ more formally known as?
Zygomatic arch
Where does the zygomatic arch lie?
Starts ANTERIOR to the tragus and extends ANTEROMEDIALLY
What starts anterior to the tragus and extends anteromedially?
The zygomatic arch (‘cheek bone’)
What is the clinical relevance of the zygomatic arch?
- Superficial temporal pulse can be palpated just superior to the zygomatic arch, and anterosuperior to the tragus.
- This is the site of artery biopsy in a person with suspected temporal arteritis
Where can the superficial temporal pulse be palpated?
Just superior to the zygomatic arch, and anterosuperior to the tragus
What can be palpated superior to the zygomatic arch, and anterosuperior to the tragus?
The superficial temporal pulse
Where would you do an artery biopsy in a person with suspected temporal arteritis?
Just superior to the zygomatic arch, and anterosuperior to the tragus
What is temporal arteritis?
A condition in which the temporal arteries become inflamed or damaged.
Fig. 10 (slide 10)
Label the image
- External ear
- External auditory meatus
- Pterion
- Superior margin of orbit
- Frankfort line
- Inferior margin of orbit
–> Zygomatic arch (‘cheek bone’) starts anterior to the tragus and extends anteromedially
Fig. 12 (left)
What is this image showing?
Angle of mandible
What is the clinical relevance of the angle of mandible?
When performing a ‘jaw thrust’ in a person to maintain their airway, you find the angle of the mandible and pull the bottom jaw anteriorly
How do you perform a jaw thrust?
Find the angle of the mandible and pull the bottom jaw anteriorly
What is a jaw thrust used for?
For maintaining a person’s airway
What do you do to maintain a person’s airway?
A jaw thrust (find the angle of the mandible and pull the bottom jaw anteriorly)
Fig. 12 (right)
What is this image showing?
A jaw thrust (find the angle of the mandible and pull the bottom jaw anteriorly) done to maintain a person’s airway
What are the features of the neck that you need to identify?
- Hyoid bone
- Thyroid and cricoid cartilage
- Sternocleidomastoid muscle
- C7 vertebrae spinous processes
Fig. 15
Label the image
- Body of the hyoid bone
- Greater horn of the hyoid bone
- Laryngeal prominence
- Lamina of the thyroid cartilage
- Cricoid cartilage
- Lobe of the thyroid gland
- First tracheal ring
- Isthmus of the thyroid gland
Identify the thyroid cartilage
Inferior to hyoid bone
What is the thyroid cartilage?
‘Adam’s apple’
What lies inferior to the hyoid bone?
Thyroid cartilage
Identify the cricoid cartilage
Inferior to thyroid cartilage
What lies inferior to thyroid cartilage?
Cricoid cartilage
Fig. 17 (right)
Label the image.
- Thyroid notch
- Laryngeal prominence
- Position of cricothyroid ligament
- Arch of cricoid cartilage
- Cricoid cartilage - inferior to thyroid cartilage
- Thyroid cartilage (‘adam’s apple’) - inferior to hyoid bone
What is the clinical relevance of the thyroid and cricoid cartilage?
The membrane between the two cartilages, the cricothyroid membrane, is the site you would perform an emergency cricothyroidotomy in the case of upper airway obstruction
Where is a cricothyroidotomy performed?
The cricothyroid membrane
What is a cricothyroidotomy?
An emergency procedure performed in the case of upper airway obstruction
What is the emergency procedure that is performed in the case of an upper airway obstruction called?
A cricothyroidotomy
Fig. 17 (top left)
What is this image showing?
An emergency cricothyroidotomy being performed,at the cricothyroid membrane (membrane between the thyroid and cricoid cartilage)
Fig. 17 (bottom left)
Label the image
- Thyroid cartilage
- Cricothyroid membrane
- Cricoid cartilage
Identify sternocleidomastoid muscle.
Extending between sternum, clavicle and mastoid process.
Where does sternocleidomastoid extend between?
- Sternum ‘sterno’
- Clavicle ‘cleido’
- Mastoid process ‘mastoid’
Fig. 19
Label the image
- Mandible
- Sternocleidomastoid
- Clavicle
- Mastoid process
- Trapezius
Identify C7 vertebrae spinous process.
Vertebra prominens
What is C7 vertebrae also known as?
Vertebra prominens
What is vertebra prominens?
C7
What is the clinical relevance of the C7 vertebrae?
By identifying C7 you can count down and locate any vertebrae, which is useful when describing the location of spinal tenderness.
How can you identify the location of spinal tenderness in vertebrae?
Locate C7 (vertebra prominens) via its bony prominence (spinous process) and count down
Fig. 21 (left)
Label the image.
- Jugular notch
- Vertebra prominens (C7)
- Midthorax
C5-C7; T1-T8 visible
Fig. 21 (right)
Label the image
C7 spinous process (‘vertebra prominens’)
What are the features on the thorax that you need to identify?
- Manubriosternal joint
- Nipples
- Costal margin
- Intercostal spaces
Fig. 24 (left)
Label the image
- Jugular notch
- Sternoclavicular joint
- Rib I
- Manubrium of sternum
- Body of sternum
- Xiphoid process
- Rib X
- Clavicle
- Coracoid process
- STERNAL ANGLE
- Costal cartilage
- Costal margin
Ribs II to IX (2-9) labelled
What is the clinical relevance of the manubriosternal joint?
The sternal angle (or ‘Angle of Louis’) is at the T4/5 vertebral level, which is also the level of:
- Rib 2’s costal cartilage
- Division of superior and inferior mediastinum
- End of ascending aorta and start of aortic arch
- Tracheal bifurcation
What is the manubriosternal joint also known as?
Sternal angle
Angle of Louis
What is the sternal angle also known as?
Manubriosternal joint
Angle of Louis
What is the Angle of Louis also known as?
Manubriosternal joint
Sternal angle
Where is the sternal angle?
T4/5 vertebra level
What is the sternal angle also the level of?
- Rib 2’s costal cartilage
- Division of superior and inferior mediastinum
- End of ascending aorta and start of aortic arch
- Tracheal bifurcation
At what level is the costal cartilage for rib 2?
Sternal angle (T4/5)
At what level is the division of the superior and inferior mediastinum?
Sternal angle (T4/5)