Surface Anatomy - All Flashcards
Locate the apex beat
- where would it move to if the beat is moved
- what is the significance of this
5ICS MCL
Beat moved LATERALLY => cardiomegaly
Locate the pubic symphysis
Midline cartilaginous joint connecting the SUPERIOR RAMI of the left and right PUBIC bones
Locate the angle of the jaw
Posterior border at the junction of the ramus of the mandible
Locate McBurney’s point
-clinical significance
2/3ds of the way between the UMBILICUS and ASIS
-closer to ASIS
Base of appendix here
-tender => acute appendicitis
Locate the mastoid process
-clinical significance in trauma
Behind the earlobe
Battle sign
-bruising of the mastoid from basal skull trauma
Locate the jugular notch
-contents of the JN
Between the clavicles and above the sternum
Common carotid artery
Trachea
Internal jugular vein
Locate the carotid pulse
-how would you palpate it
Between trachea and sternocleidomastoid
Tell patient to turn head to one side and place finger anterior to SCM
Anatomical snuffbox
- borders
- contents
- describe the clinical significance of the anatomical snuffbox
Borders
- EPL, EPB, APL
- base - scaphoid
Contents
- radial artery
- branch of radial nerve
- cephalic vein
Scaphoid fracture => localised pain in anatomical snuffbox
If untreated, AVN
Locate the posterior tibial pulse
Behind the medial malleolus
Location of
- the heart valves
- auscultation spots
Aortic - L 3ICS => R 2ICS
Pulmonary - L 3CC => L 2ICS
Tricuspid - R 4ICS => L 4ICS
Mitral - L 4CC => L 5ICS MCL
Location of the thyroid cartilage
C4 - Adam’s apple
Location of the cricothyroid membrane
-clinical significance
Below thyroid cartilage
Site of cricothyrotomy
Location of the
- mid inguinal point
- mid point of the inguinal ligament
What is the clinical significance
Mid inguinal point - between ASIS and pubic symphysis
-femoral pulse here
Mid point of the inguinal ligament - between ASIS and pubic tubercle
-deep inguinal ring and femoral nerve here
Location of the transpyloric plane
What is the vertebral level
Halfway between the jugular notch and pubic symphysis
L1 - cuts through pylorus
Location of the subcostal plane
What is the vertebral level
Line between lower parts of costal margin
L3
Where is the Angle of Louis
-what structures are found at the Angle of Louis
2nd rib
RATPLANT Rib 2 Aortic arch Tracheal bifurcation Pulmonary bifurcation Left recurrent laryngeal Azygos system => IVC Nerves - cardiac plexus Thoracic duct => L subclavian
Where would you insert a chest drain
5ICS MAL
Where would you do a liver biopsy
-how would you angle the needle
9ICS MAL via costodiaphragmatic recess
-insert needle downwards to avoid lungs
Aspirating a tension pneumothorax
5ICS MAL
Where would you do a lumbar puncture
- why is this important
- when would you do a lumbar puncture
Between
L3-4
L4-5
L5-S1
Avoid piercing SC, ends at L1-2
Diagnosis of CNS infection -GBS, MS -CNS vasculitis -CT negative SAH Therapeutics -relieve benign raised ICP
Function of the
-biceps brachii
How to test
Elbow flexion, supination
Keep elbow at 90deg with forearm in supination
Hold elbow and forearm and tell them to pull against resistance
Function of the
-soleus
How to test
Plantarflexion
Tell patient to push the sole of their foot against resistance
Function of the
-masseter
How to test
Elevation, protrusion and ipsilateral mv
Tell patient to open and close mouth
Function of the
-sternocleidomastoid unilaterally
How to test
Contralateral rotation
Ipsilateral lateral flexion
Tell patient to rotate head
Function of the
-sternocleidomastoid bilaterally
How to test
Cervical flexion
Tell patient to put neck towards sternum
Function of the
-iliopsoas
How to test
Hip flexion
Tell patient to lay flat and raise whole leg against resistance
Function of the
-brachioradialis
How to test
Elbow flexion when forearm is partially pronated
Tell patient to keep forearm partially pronated
Ask them to flex elbow against resistance
Function of the
-rectus femoris
How to test
Hip flexion
Leg extension
Tell patient to sit on couch with legs over edge
Tell patient to lift leg whilst leg with knee flexed
Function of the
-deltoid
How to test
Shoulder abduction, flexion, extension
Ask patient to hold arms laterally
Ask them to resist you pushing up and down, forwards and back
Function of the
-temporalis
How to test
Closes jaw
Ask patient to clench jaw to palpate muscle
Function of the
-supraspinatus
How to test
Abduction of the arm at the shoulder
Empty can test
-ask patient to put arm out infront, horizontally abduct slightly and have arms internally rotated => thurmbs down like they’re emptying a can
Ask patient to lift arm against resistance
What organs can you palpate in a healthy person
Lower pole of right kidney
Cecum
Sigmoid colon
What are the
-boundaries
-contents
of the carpal tunnel
How to test for carpal tunnel
Boundaries
- deep carpal arch - scaphoid, trapezium, hamate, pisiform
- flexor retinaculum
Contents
- median nerve
- FPL
- 4 tendons of FDP
- 4 tendons of FDS
Tinel - tap median nerve to elicit pain
Phalen - inverse prayer hands for 60s to elicit pain
Contents of the
-axilla
Clinical significance of the axilla
Axillary vein, artery, lymph nodes
Biceps brachii
Brachial plexus
Key region for LN biopsy
75% of lymph drains into axilla breast LN so must be removed in breast cancer
Risk of damage to long thoracic nerve => winging of the scapula
