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Title: Topographic Anatomy
Description: Gives you descriptions of every region of the body, great for more understanding of anatomy! These notes are brilliant for medical students in 1st and 2nd year, but also to revise your knowledge in later on years!
Description: Gives you descriptions of every region of the body, great for more understanding of anatomy! These notes are brilliant for medical students in 1st and 2nd year, but also to revise your knowledge in later on years!
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Fronto-Parieto-Occipital Region
Boundaries
➢ Anteriorly - supra-orbital margin
➢ Laterally - superior temporal line
➢ Posteriorly - superior nuchal line
Surface Anatomy
➢ Skin - thick and hairy with sebaceous glands
➢ Subcutaneous tissue - richly vascularized
➢ Epicranial aponeurosis - occipitofrontal muscle and aponeurosis
➢ Loose connective tissue
➢ Pericranium
➢ Skull - frontal squama, parietal bone and occipital squama
Neurovasculature
➢ Frontal - supratrochlear and supraorbital arteries, veins and nerves
➢ Temporal - superficial temporal artery and vein, auriculotemporal nerve
➢ Occipital - occipital artery and vein, major occipital nerve
➢ Retroauricular - Posterior auricular artery and vein, minor occipital nerve
Lymphatic Vasculature
➢ Parotid lymph nodes
➢ Occipital lymph nodes
➢ Retroauricular lymph nodes
Base of the Skull
➢
Inferior portion of neurocranium and viscerocranium except from mandible
It features
➢ Alveolar arch of maxillae (free border of alveolar process surrounding and
supporting maxillary teeth)
➢ Palatine process of maxillae
➢ Palatine bone
➢ Sphenoid bone
➢ Vomer bone
➢ Temporal bone
➢ Occipital bone
Hard palate is formed by:
➢ Anteriorly - palatal process of maxillae
➢ Posteriorly - horizontal plates of palatine bones
➢ The free posterior border of hard palate projects posteriorly in median plane as the
posterior nasal spine
➢ Posterior to central incisor teeth is the incisive foramen, a depression in the
midline of bony palate into which incisive canals open
➢ The right and left nasopalatine nerves pass from nose through a variable number of
incisive canals and foramina
➢ Posterolaterally are greater and lesser palatine foramina
➢ Superior to posterior edge of palate are 2 large openings: choanae (posterior nasal
apertures), which are separate by each other by the vomer, an unpaired bone that forms
a part of the bony nasal septum
Sphenoid
➢ Wedged between frontal, temporal and occipital bones
➢ Consists of a body and 3 pairs of processes: greater wings, lesser wings and
pterygoid processes
➢ Greater and lesser wings of sphenoid spread laterally from lateral aspects of body
of the bone
➢ The greater wings have orbital, temporal and infratemporal surfaces apparent in
facial, lateral and inferior views of exterior of cranium
➢ The pterygoid processes, consisting of lateral and medial pterygoid plates, extend
inferiorly on each side of sphenoid from junction of body and greater wings
➢ Groove for cartilaginous part of pharyngotympanic tube lies medial to spine of
sphenoid, inferior to junction of greater wing of sphenoid and petrous part of
temporal bone
➢ Depression in squamous part of temporal bone, called mandibular fossae,
accommodate the mandibular condyles when mouth is closed
Cranial base if formed posteriorly by occipital bone, which articulates with sphenoid
anteriorly
Occipital
➢ 4 parts of occipital bone are arranged around foramen magnum
➢ Major structures pass through this foramen are: spinal cord (where it becomes
continuous with medulla oblongata of the brain); the meninges of the brain and spinal
cord: the vertebral arteries: anterior and posterior spinal arteries; and the spinal
accessory nerve
➢ On lateral parts of occipital bone are 2 large protuberances, the occipital condyles, by
which the cranium articulates with vertebral column
Jugular foramen
➢ Large opening between occipital bone and petrous part of temporal bone
➢ Internal jugular vein and several cranial nerves emerge from the cranium
➢ The entrance to carotid canal for internal carotid artery is just anterior to jugular
foramen
Stylomastoid foramen
➢ Lies posterior to base of styloid process
➢ Transmits facial nerve and stylomastoid artery
Temporal and Mastoid Regions
Temporal Region
Boundaries
➢ Inferiorly - zygomatic arch
➢ Superiorly - superior temporal line
Surface Anatomy
➢ Skin - thin and hairy
➢ Subcutaneous tissue
➢ Superficial temporal artery, vein, zygomaticotemporal nerve and auriculotemporal
nerve
under flexor retinaculum and continues into palm
...
Its terminal branch - posterior interosseous nerve descends together with posterior interosseous artery
Anterior and Posterior Regions of Wrist
Flexor and Extensor Retinaculum
➢ The antebrachial fascia thickens posteriorly over the distal ends of the radius and
ulna to form a transverse band, the extensor retinaculum, which retains the extensor
tendons in position
➢ The antebrachial fascia also forms an anterior thickening, which is a continuous with
extensor retinaculum - palmar carpal ligament
➢ Distal and at a deeper level to the latter, antebrachial fascia is also continued as the
flexor retinaculum - this fibrous band extends between anterior prominences of the
outer carpal bones and converts anterior concavity of the carpus into a carpal
tunnel, through which flexor tendons and median nerve pass
Carpal Tunnel
➢ Median nerve enters the hand through carpal tunnel, deep to flexor retinaculum,
along with the nine tendons of FDS, FDP, FPL
➢ Carpal tunnel is the passageway deep to the flexor retinaculum between tubercles of
the scaphoid and trapezoid bones on the lateral side and the pisiform and hook of
hamate on the medial side
➢ Distal to carpal tunnel, the median nerve supplies 2 and a half thenar muscles and
the 1st and 2nd lumbricals
Palmar Fascia
➢ Continues beyond the extensor and flexor retinacula as the palmar fascia
➢ Central part of palmar fascia, the palmar aponeurosis, is thick, tendinous and
triangular and overlies central compartment of the palm
➢ Its apex is located proximally, is continuous with the tendon of the palmaris longus
➢ Aponeurosis forms 4 distinct thickenings that radiate to the bases of the fingers and
becomes continuous with the fibrous tendon sheaths of the digits
➢ Bands are traversed distally by superficial transverse metacarpal ligament, which
forms base of palmar aponeurosis
➢ Strong skin ligaments extend from palmar aponeurosis to the skin - these ligaments
hold palmar skin close to aponeurosis, allowing little sliding movement of the skin
Palmar Region
➢
➢
➢
Fasciae of the hand are direct continuations of the antebrachial fascia
2 fasciae, superficial and deep are distinguished on the palmar surface of the hand
Superficial fascia is a thin sheet covering the muscles of the thenar and hypthenar
P
palmar digital nerves that subdivide in the middle of the palm into proper palmar
digital nerves for 2nd - 4th finger
3rd common palmar digital nerve has an anastomoses with 4th common palmar
digital nerve that derives from superficial branch of ulnar nerve
Hypothenar Eminence
➢ Ulnar artery divides immediately after passing ulnar canal
➢ Deep branch of ulnar artery disappears between flexor digiti minimi and abductor
digiti minimi
➢ Superficial branch of ulnar artery gives rise to ulnar palmar proper artery for 5th
finger and then turns medially into superficial palmar arch
➢ Ulnar nerve parallels medially the ulnar artery and divides into deep branch of ulnar
nerve and superficial branch of ulnar nerve
➢ Superficial branch of ulnar nerve gives off ulnar palmar proper nerve for 5th finger and
common palmar nerve for 4th- 5th finger
Deep Layer
➢ Deep palmar arch lies at level of the base of the metacarpals, 2cm proximal to superficial
palmar arch - formed by anastomoses of deep palmar branch of radial artery with deep
palmar branch of ulnar artery
➢ From deep palmar arch arise palmar metacarpal arteries
➢ Princeps pollicis artery lies at border between thenar and mesothenar - it supplies with its
branches the thumb and lateral side of 2nd finger
➢ Deep branch of ulnar nerve accompanies the deep palmar arch and gives off branches
Dorsum Of The Hand
Boundaries
➢ Superiorly - line between radial and ulnar styloid processes
➢ Inferiorly - carpo -metacarpal joints
Surface Anatomy
➢ Skin
➢ Subcutaneous tissue with dorsal digital veins draining into the dorsal metacarpal
veins which unite to form the dorsal venous network, superficial branch of the radial
nerve passing over the snuffbox and extensor retinaculum and dorsal branch of
ulnar nerve
➢ Dorsal fascia and extensor retinaculum
➢ Extensor digitorum, digiti minimi and indicis, extensor pollicis longus and brevis
➢ Dorsal metacarpal arteries which are branches of the dorsal carpal arch
➢ Dorsal digital artery of thumb which is a branch of the radial artery
➢ Muscles and bones
Anatomical Snuffbox
➢ Medial - tendon of extensor pollicis longus
➢ Lateral - tendon of the extensor pollicis brevis and abductor pollicis longus
➢ Proximally - styloid process of radius
➢ Floor - scaphoid and trapezium
Contents
➢ Radial artery
➢ Superficial branch of radial nerve
➢ Cephalic vein
Digits of Hand
14 phalanges, 3 in each finger and 2 in the thumb
➢ Each has a head, shaft and proximal base
➢ Palmar surface is flat but slightly concave anteriorly in long axis
➢ Bases of proximal phalanges carry concave, oval facets adapted to metacarpal
heads - their own heads are smoothly groove like pulley and encroach more on to the
palmar surfaces
➢ The bases of the middle phalanges carry 2 concave facets separated by a smooth
ridge, conforming to heads of proximal phalanges
➢ Bases of distal phalanges are adapted to pulley-like heads of middle phalanges
➢ Heads of distal phalanges are non-articular and carry a rough, crescentic palmary
tuberosity, to which pulps of fingertips are attached
Ligaments and Muscles
➢ Articular ligaments and muscles are attached to phalanges
➢ Tendon of flexor digitorum profundus is attached to palmar aspect of base of
phalanx and tendon of extensor digitorum to its dorsal surface
➢ Tendon of flexor digitorum superficialis and its fibrous sheath are attached to sides
of the middle phalanx and a part of extensor digitorum is attached to base dorsally
➢ Fibrous flexor sheath is attached to sides of a proximal phalanx, part of
corresponding dorsal interosseous is attached to its base laterally and anterior
dorsal interosseous is attached medially
Phalanges of little finger and thumb differ:
➢ Abductor and flexor digiti minimi are attached to medial side of base of the
proximal phalanx of little finger
➢ Tendon of extensor pollicis brevis and oblique head of adductor pollicis (dorsally)
and oblique and transverse heads of adductor pollicis, are sometimes conjoined with
first palmar interosseous (medi
Title: Topographic Anatomy
Description: Gives you descriptions of every region of the body, great for more understanding of anatomy! These notes are brilliant for medical students in 1st and 2nd year, but also to revise your knowledge in later on years!
Description: Gives you descriptions of every region of the body, great for more understanding of anatomy! These notes are brilliant for medical students in 1st and 2nd year, but also to revise your knowledge in later on years!