Surface Anatomy - Dr Heaton

Surface Anatomy Overview

  • Institution: Barts and The London School of Medicine and Dentistry

  • Contributors: Dr. T. Heaton, Dr. P. Vickerton

Learning Objectives

  • Review dermatomes of the upper and lower limbs

  • Describe major surface landmarks of the upper and lower limbs

Dermatomes

Cranial Nerves

  • V1: Trigeminal Nerve

  • V2, V3: Mandibular and Maxillary branches

Upper Limb Dermatomes

  • C4: Top of shoulder

  • C5: Over deltoid

  • C6: Over thumb

  • C7: Middle finger

  • C8: Little finger

  • T1: Medial forearm

  • T2: Axillary skin

Dermatomes of the Chest and Abdomen

  • T2: Axilla

  • T3 to T5: Intercostal space

  • T4: Nipple line

  • T10: Umbilicus

  • T12: Inguinal ligament

  • Major landmarks: Costal margin, anterior superior iliac spine, pubic tubercles

Shoulder Bony Landmarks

  • Clavicle

  • Acromioclavicular joint

  • Greater and Lesser tuberosity

  • Coracoid process

  • Spine of scapula

  • Medial border of scapula

  • Sternoclavicular joint

Upper Limb Musculature

Shoulder Muscles

  • Deltoid

  • Pectoralis major

  • Trapezius

  • Supraspinatus

  • Infraspinatus

  • Teres major

  • Latissimus dorsi

Vascular Structures

  • Cephalic vein

  • Axillary vessels

Arm Anatomy

Main Structures

  • Deltoid

  • Biceps brachii

  • Triceps brachii

Nerves and Vascular Structures

  • Median nerve

  • Ulnar nerve

  • Brachial artery

Elbow Anatomy

  • Radial nerve

  • Ulnar nerve

  • Medial epicondyle larger than lateral

  • Ulnar nerve crosses behind medial epicondyle

Cubital Fossa

  • Contains biceps tendon, brachial artery, median nerve

Wrist Anatomy

  • Distal position of radial and ulnar styloid processes

  • Head of ulna recognized by rounded prominence

Important Structures

  • Flexor Carpi Radialis

  • Ulnar artery and nerve

  • Palmaris Longus muscle

  • Flexor Carpi Ulnaris

Anatomical Snuffbox

  • Extensor pollicis longus

  • Extensor pollicis brevis

  • Abductor pollicis longus

Lower Limb Dermatomes

  • L1: Inguinal region

  • L2: Upper thigh

  • L3: Over knee

  • L4: Medial malleolus

  • L5: Dorsum of foot

  • S1: Sole of foot and 5th toe

  • S2: Popliteal fossa

Bony Pelvis Anatomy

Anterior View

  • Iliac crest

  • Anterior superior iliac spine (ASIS)

  • Pubic tubercle

Posterior View

  • PSIS (Posterior Superior Iliac Spine)

  • Ischial tuberosity

Clinical Landmarks

  • Spinal cord terminates at L1/2 in adults

  • Highest level of iliac crest corresponds to L4 vertebra

Gluteal Region

Nerve Pathways

  • Sciatic nerve location

Safe Injection Area

  • Upper outer quadrant of gluteus medius for intramuscular injections

Key Landmarks in the Gluteal Region

  • Gluteus Maximus, Tensor Fasciae Latae, Sartorius

Tibial and Fibular Anatomy

  • Tibial tuberosity: Attachment of patellar ligament

  • Head of fibula level with tibial tuberosity

  • Hamstring tendons palpable at the borders of popliteal fossa

Ankle Joint and Foot Anatomy

  • Medial and lateral malleoli

  • Important for understanding joint movements and foot structure

Vascular Structures of the Lower Limb

  • Posterior tibial artery

  • Dorsalis Pedis artery

Measurements for Leg Length Discrepancies

  • True leg length determined from ASIS to medial malleolus