Anatomy books

Sunday, March 6, 2016

Surface anatomy /living anatomy : important structures with easy points for drawing

Living Anatomy
1.      Frontal sinus
1st point- On the nasion
2nd point- 2.5 cm above the 1st point.
3rd point- At the junction of the medial 1/3 and the lateral 2/3 of the supra- orbital margin.
Join the points.
Related information:
Drainage areas: middle meatus of nasal cavity
Lining epithelium: pseodustratified ciliated columnar epithelium 
Functions of sinus: resonance of voice, lightening the wt of bone 
What is the name of sinus containing bones: pneumatic bone
2.      Parotid duct 
1st point: just in front and below the tragus
2nd point : between the ala of nose and the sharp margin of the upper lip
Join the 1st and 2nd point. The middle third of this line is parotid duct
Related questions:What type of gland it is? Ans: exocrine gland (because it has a duct)
According to the nature of secretion: it is pure serous in nature
Parts of this gland: Parenchyma (glandular portion )and stroma (connective tissue)
Histology: Serous acini are present. (Serous acini are darkly stain and cells of acini contain round nuclei)
Duct is present
Development of glands: Parenchyma: endodermal in origin. Stroma: mesodermal in origin
Opening of parotid duct: at the vestibule of mouth opposite the crown of 2nd molar teeth
3.      Isthmus of thyroid gland
1st point:  1.25 cm below the cricoid cartilage
2nd point: 1.25cm below the 1st point

Draw two 1.25 cm long horizontal lines along the 1st and 2nd point.
 1.      Sternal angle : it is an important bony landmark
It helps counting the number of ribs because the 2nd costal cartilages articulate at this level
It separates the superior mediastinum to inferior mediastinum
It is correspond with lower border of T4 vertebra
2.      Rt border of heart
1st point: On   the upper border   of the right 3rd costal cartilage about 2.5 cm from the median   plane.
2nd point: on   the right 6th costal cartilage about 2.5 cm from the median plane
Join these two points by a convex line towards the right.
SN: (The maximum convexity of which lies at a distance of 3.25am from the median plane in the 4th intercostal space.)
Related questions:
How it is formed?  Ans: it is formed by right atrium
3.      left border of heart
1) 1st    Point – On the lower border of the left 2nd costal cartilage about 2.5 cm from the median plane.
2) 2nd   point- At the apex beat left 5th intercostal space just medial to mid-clavicular line Join   these two points by line with convexity directed upwards and to the left.
Related questions:
How it is formed? Ans: it is formed by left ventricle of the heart
4. Lower border of the Heart
1st point: on   the right 6th costal cartilage about 2.5 cm from the median plane
2nd   point-At the apex beat left 5th intercostal space just medial to mid-clavicular line

Apex of the   Heart
It is situated in the left 5th intercostal space just medial to midclavicular   line.
Related questions:  How it is formed?
Ans: It is formed by only left ventricle of the heart.
Apex of the Lung
1st pointrt/lt  sternoclavicular   joint
 2nd point –at the junction of medial 1/3 and lateral 2/3 of clavicle
Join these two points & the summit of the curve being situated in the neck about 2.5cm above the medial   third of clavicle.    
by which structure  apex of the lung is covered?
Ans:    The apex of the lung is covered by cervical pleura (part of parietal pleura) and supra-pleural membrane
What is suprapleural membrane?
Ans: it is formed by endothoracic fascia
Attachment : internal border of 1st rib and transverse process of C7                                                                                                                                                                                                                                                                    
Arch of the Aorta
1) 1st point –On the right end of the   sternal angle.
2) 2nd point –On the   centre of the manubrium   sterni
3)3rd point- sternal end of left 2nd costal cartilage 
Join the points by a curved line which represents the outer border of the arch of aorta; then the inner   border is drawn   below  &  paralled to it about 2.5 cm apart  .
Importance points :  It is the continuation of ascending aorta and It is continued as descending thoracic aorta
Related questions : What are the branches of arch of aorta?
  1. brachiocephalic artery/ trunk : right common carotid and right subclavian artery
  2. left common carotid artery
  3. left subclavian artery
What is the type of these arteries?  Ans : elastic artery.
Why they known as elastic artery? They contain large numbers of elastic lamina within the tunica media. 




7.      Trans- pyloric plane
It is indicated by a transverse line drawn midway between the jugular notch and the top of the symphysis pubis (or roughly in between the xiphisternal junction and the umbilicus.)
 The following important structures are situated opposite this plan:-
1)      Pyloric part of the stomach.
2)      Fundus of the gall-bladder.
3)      Hilum of the kidneys.
4)      Tip of the 9th costal cartilage.
5)      Origin of the superior mesenteric artery.
6)      Lower border of the body of the 1st lumbar vertebra or upper border of its spine.
7)      Lower end of the spinal cord and beginning of the filum terminale.
Trans-tubercular plane: It is indicated by a transverse line of  the trunk at the level of the tubercle of the iliac crest. It cuts the upper border of the body and spine of the 5th lumbar vertebra.

   Fundus of gall bladder : it is marked at anterior abdominal wall at tip of the 9th costal cartilage (depression in anterior abdominal wall / where transpyloric plane crosses the right costal margin)
9.      Liver
Upper border is marked by joining the following points.
1st point:  in left 5th intercostal space just medial to midclavicular line .
2nd point:  at xiphisternal joint.
3rd point: at upper border of right 5th costal cartilage in right mid-clavicular line 
Lower border:
 4th point  at tip of the right 9th  costal cartilage .
5th point : 1st point of upper border (left 5th intercostal space just medial to midclavicular line )
Right lateral border: join 3rd point to 4th point
Situation of liver:
1.      Right hypochondrium
2.      Epigastric region
3.      Left hypochondrium
4.      Right lumbar region
10.  McBurney’s point : at 1st draw a line from the right anterior superior iliac spine to umbilicus
Then draw a point  at the junction of lateral 1/3 & medial 2/3 of line, and this is the McBurney’s point.
1 Arteria dorsalis pedis
Arteria dorsalis pedis :
1st point: in front of the ankle joint midway between medial and lateral malleolus
2nd point: at the proximal end of the 1st intermetatarsal space
Join the points by a straight line
Related information: It is the continuation of anterior tibial artery 
 1.      Brachial artery
1)      1st point- at the junction of anterior 1/3 and posterior 2/3 of the lateral wall of the axilla
2)      2nd point- 2.5 below and medial to the tendon of the biceps brachii.
Join the points by a straight line.
Related information:  brachial artery is the continuation of axillary artery.
Branches of brachial artery:
  1. Profunda Brachii.
  2. Superior Ulnar Collateral.
  3. Inferior Ulnar Collateral
  4. Nutrient
  5. Muscular
  6. Terminal branches: Radial and ulnar artery
2.      Radial artery
1st point- 2.5 below and medial to the tendon of the biceps brachii .
2nd point- In front of the wrist between the tendon of the flexor carpi radialis medially and the lower part of the anterior border of the radius laterally.(Here, practically feel the pulsation of the artery and put the point over it).
   Join the points by a line with slight outwards convexity at the upper part.
Related informations: Branches radial artery : In the Forearm:
  1.   Radial Recurrent artery,
  2.   Muscular artery 
  3.   Superficial Volar artery
 At the Wrist: Dorsal Carpal artery
    In the hand:
  1. Princeps Pollicis.
  2. Volaris Indicis Radialis.
3.      Median cubital vein
1st point : 2.25 cm above from the medial epicondyle
2nd point : 2.25 cm below from the lateral epicondyle
Join these points by an oblique line
Why median cubital vein choose for intravenous injection?
Ans : it is superficial and fixed on underlying fascia.
Related informations:
Name of the superficial vein of upper limb: cephalic vein, basilic vein, median cubital vein
Name of the deep vein of upper limb: axillary, brachial, ulna and radial vein



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