The Concept of Junctional Anatomy Flashcards
What is junctional anatomy
- The study of anatomy where any distinct regions of the body meet
Give 4 examples of junction in the body
- Where the head meets the neck
- Where the neck emerges from the thorax
- Where the upper limbs take root in the thorax
- Where the lower limbs take root from the pelvic girdle
What are the major junctional areas of the body
- Atlanto-occipital joint
- Root of the neck
- The axilla and the shoulder joint
- The hip joint
Give an alternative definition for junctional anatomy (joining and converging) and give some examples of when this would apply
- The study of the body’s anatomy where a minimum of two anatomical entities come together or diverge from each other.
- Web spaces of the hand, anatomical areas where bones change their morphology, splitting of blood vessels.
Give another alternative definition of junctional anatomy (changes in layout) and give some examples of when this would apply
- The study of the body’s anatomy where the anatomical layout of tissues changes with the desired functions of that part of the body.
- The ankle joint
Slide 12
Slide 14
What are Langer’s line and what causes the pattern they form
- Linear clefts in the skin
- Pattern is caused by underlying collagen fibres
What is the controversy around Langer’s lines
- Surgical incision have been recommended along or parallel to Langer’s lines to avoid permanent scarring. However they do not correspond to the best surgical orientation for incisions.
What are striae distensae
- Stretchmarks
- Occur from tissue under the skin tearing from overstretching or rapid growth
- Rum perpendicular to tension lines of the skin
Why do plastic surgeons consider
Striae distensae a better guide to skin
incisions than Langer’s Lines
- Striae distensae lines can be used to determine the direction skin tension lines. Aligning surgical incisions here results in minimal tension across the closure of the incision, optimal scar formation and minimal wound contraction.
Slide 18
Slide 22
What is the significance of a junction in trauma medicine
- You cannot apply a tourniquet
- Blood vessels transverse these areas
- Profound bleeding is a major risk
What is a Type 1 junctional trauma
- Wound enters the junctional zone however surgical control can be gained without entering an adjacent body cavity.
What is a type 2 junctional trauma
-Wound enters a junctional zone which requires surgical access to enter a body cavity to gain control of the haemorrhage.
What are some causes of junctional trauma causes and give examples of them
- Penetration (knife, bullet, shrapnel)
- Blunt (fall, tackle, car accident)
What is the relationship between the energy of the object causing the trauma and the damage it will cause in the junctional zone
- The higher the energy of the object, the more damage caused.
What are the 2 injuries a bullet can cause to the body
- Injury due to the path of the bullet
- Injury due to energy wave released by the buller
What are the key anatomical points to remember when trauma is in the shoulder joint/axilla (blood vessels)
- Sides of the body and aortic arch.
- Origin of axillary artery
- Location of axillary artery
- Zones of axillary artery
- Branches of axillary artery
What is the difference between the right side of the aortic arch and the left side of it
- Right side gives rise to brachiocephalic (which then gives rise to right subclavian and right common carotid)
- Left side of the aortic arch gives raise to left subclavian and left common carotid directly
Where does the axillary artery originate and what is its location
- Subclavian artery
- Starts at 1st rib and ends inferior to the border of the teres major muscle
How many ‘zones’ does the axillary artery have and what are their positions
- 3 zones
- Zone 1 (above pec minor, gives off 1 branch)
- Zone 2 (behind pec minor, gives off 2 branches)
- Zone 3 (distal to pec minor muscle, gives off 3 branches)
What is the mnemonic used to remember the branches of the axillary artery in each zone
- Stay (Superior thoracic)
- Till (thoracoacromial trunk)
- Late (Lateral thoracic)
- S (subscapular)
- P (Posterior circumflex)
- A (Anterior circumflex)
What are the key anatomical points to remember when trauma is in the shoulder joint/axilla (brachial plexus)
- Brachial plexus is found on top of the third zone of the axillary artery.
- Can be identified by the M shape of the plexus
What are the key anatomical points to remember when trauma is in the shoulder joint/axilla (Common Carotid Artery)
- Main blood supply to the brain
- Wrapped in carotid sheath (fascia for protection)
- One carotid may be compromised as long as other is fully functioning
