The document describes several anatomical spaces and structures. It begins by describing the axilla region, including its borders and contents such as nerves, vessels and lymph nodes. It then discusses the cubital fossa and its clinical relevance for measuring blood pressure and performing venepuncture. Finally, it examines the carpal tunnel and its importance in carpal tunnel syndrome, as well as the anatomical snuffbox and its relationship to scaphoid fractures.
1. The brachial plexus is formed by the ventral rami of cervical and upper thoracic spinal nerves, which combine to form trunks, divisions, cords, and branches that innervate the upper limb.
2. Injuries to different parts of the brachial plexus result in paralysis of specific muscles and sensory loss in dermatomal patterns, leading to deformities such as winging of the scapula or wrist drop.
3. Treatment of brachial plexus injuries involves nerve transfers, grafts, or muscle transfers to restore function, while diagnosis relies on clinical exam plus imaging studies like MRI or CT myelography.
hey this is Vedika Agrawal and this presentation is TO EXPLAIN AND HELP YOU UNDERSTAND ANATOMY OF FOREARM.
The topic is usually mixed with hand making it difficult to understand and so i seperated it to make it easy for you.
The document discusses the anatomy of the anterior compartment of the leg and dorsum of the foot. It describes the contents of the anterior compartment including the tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius muscles. It also details the blood supply by the anterior tibial artery and nerve supply by the deep peroneal nerve. On the dorsum of the foot, it outlines the extensor hallucis brevis and extensor digitorum brevis muscles as well as the continuation of the anterior tibial artery as the dorsalis pedis artery.
After completion of this session, students should be able to discuss, identify, and describe:
The anatomical factors predisposing to nerve injuries.
The anatomy of deformity, weakness and sensory loss following the nerve injury.
The applied anatomy of clinical examination for specific nerves.
Surgical anatomy of treating nerve injuries.
The knee joint is the largest and most complex joint in the body. It consists of three joints: the medial and lateral condylar joints between the femur and tibia, and the patellofemoral joint between the femur and patella. Key structures include the cruciate ligaments which provide stability, menisci which absorb shock and distribute force, and synovial membrane which lines the joint space. The document provides detailed descriptions of the articular surfaces, ligaments, bursae, and other anatomical structures that make up the knee joint.
The lateral compartment of the leg, also known as the fibular or peroneal compartment, contains two muscles - the peroneus longus and brevis. These muscles evert the foot and plantarflex the ankle joint. The peroneus longus originates on the head of the fibula and upper lateral fibular shaft and inserts on the medial cuneiform and base of the first metatarsal. The peroneus brevis originates on the lower lateral fibular shaft and inserts on the base of the fifth metatarsal. Both muscles are supplied by the superficial peroneal nerve.
The hand has fine motor control due to its complex anatomy. It contains bones like the carpals, metacarpals and phalanges. Muscles originate from the forearm and act on the hand. The median, ulnar and radial nerves innervate muscles and provide sensation. These nerves are vulnerable to compression at specific points in the arm, elbow, forearm and wrist. The document provides an overview of the hand's embryology, bones, joints, muscles, vessels and nerves.
1. The brachial plexus is formed by the ventral rami of cervical and upper thoracic spinal nerves, which combine to form trunks, divisions, cords, and branches that innervate the upper limb.
2. Injuries to different parts of the brachial plexus result in paralysis of specific muscles and sensory loss in dermatomal patterns, leading to deformities such as winging of the scapula or wrist drop.
3. Treatment of brachial plexus injuries involves nerve transfers, grafts, or muscle transfers to restore function, while diagnosis relies on clinical exam plus imaging studies like MRI or CT myelography.
hey this is Vedika Agrawal and this presentation is TO EXPLAIN AND HELP YOU UNDERSTAND ANATOMY OF FOREARM.
The topic is usually mixed with hand making it difficult to understand and so i seperated it to make it easy for you.
The document discusses the anatomy of the anterior compartment of the leg and dorsum of the foot. It describes the contents of the anterior compartment including the tibialis anterior, extensor hallucis longus, extensor digitorum longus, and peroneus tertius muscles. It also details the blood supply by the anterior tibial artery and nerve supply by the deep peroneal nerve. On the dorsum of the foot, it outlines the extensor hallucis brevis and extensor digitorum brevis muscles as well as the continuation of the anterior tibial artery as the dorsalis pedis artery.
After completion of this session, students should be able to discuss, identify, and describe:
The anatomical factors predisposing to nerve injuries.
The anatomy of deformity, weakness and sensory loss following the nerve injury.
The applied anatomy of clinical examination for specific nerves.
Surgical anatomy of treating nerve injuries.
The knee joint is the largest and most complex joint in the body. It consists of three joints: the medial and lateral condylar joints between the femur and tibia, and the patellofemoral joint between the femur and patella. Key structures include the cruciate ligaments which provide stability, menisci which absorb shock and distribute force, and synovial membrane which lines the joint space. The document provides detailed descriptions of the articular surfaces, ligaments, bursae, and other anatomical structures that make up the knee joint.
The lateral compartment of the leg, also known as the fibular or peroneal compartment, contains two muscles - the peroneus longus and brevis. These muscles evert the foot and plantarflex the ankle joint. The peroneus longus originates on the head of the fibula and upper lateral fibular shaft and inserts on the medial cuneiform and base of the first metatarsal. The peroneus brevis originates on the lower lateral fibular shaft and inserts on the base of the fifth metatarsal. Both muscles are supplied by the superficial peroneal nerve.
The hand has fine motor control due to its complex anatomy. It contains bones like the carpals, metacarpals and phalanges. Muscles originate from the forearm and act on the hand. The median, ulnar and radial nerves innervate muscles and provide sensation. These nerves are vulnerable to compression at specific points in the arm, elbow, forearm and wrist. The document provides an overview of the hand's embryology, bones, joints, muscles, vessels and nerves.
The document discusses the anatomy and functions of the human foot. It describes how the foot is made up of bones, muscles, ligaments and arches that work together to support body weight and enable walking, running and balance. The medial and lateral longitudinal arches and transverse arch are described. Their roles in weight distribution, acting as levers and protecting structures are summarized. Common foot deformities such as flat feet, high arches, club foot and bunions are also outlined.
The radial nerve is at risk of injury at three locations in the upper limb: in the axilla, in the spiral groove of the humerus, and at the elbow. Injury in the axilla can result from pressure from a crutch and causes motor loss of triceps, wrist and finger extension, and supination as well as sensory loss in the arm and back of the forearm. Injury in the spiral groove most commonly causes motor loss of wrist and finger extension with possible sensory loss only in the hand. Radial tunnel syndrome can cause compression of the radial nerve at the elbow, resulting in loss of wrist and finger extension but no wrist drop.
The document describes the various muscles of the back, including their origins, insertions, innervation, and actions. It discusses the superficial, intermediate, and deep back muscles, categorizing them as extrinsic or intrinsic muscles. Key muscles described include the trapezius, latissimus dorsi, erector spinae group, rotatores, multifidus, semispinalis, and the suboccipital muscles.
The axilla is the space between the upper arm and chest wall. It is bounded by the clavicle, first rib, and scapula. The axilla contains the axillary artery and vein, brachial plexus nerves, lymph nodes, and loose connective tissue. The brachial plexus is formed by the union of cervical and upper thoracic spinal nerves and provides motor and sensory innervation to the upper limb. Injuries to different parts of the brachial plexus can result in specific neuropathies like Erb's palsy or Klumpke's palsy, characterized by weakness or paralysis of certain muscles.
Bone limb lower..osteology of lower limbAnbroseKisuvi
The document describes the bones of the lower limb, including the pelvis, femur, tibia, fibula, and bones of the foot. Key points include:
- The pelvis is composed of the ilium, ischium, and pubis which form the acetabulum and pelvic girdle.
- The femur has a head, neck, greater and lesser trochanters proximally and condyles distally.
- The tibia has medial and lateral condyles proximally and the medial and lateral malleoli distally.
- Bones of the foot include the tarsal bones (talus, calcaneus, navicular) and metatars
The lower limb can be divided into four main regions: the gluteal region, thigh, leg, and foot. The thigh specifically contains the femur bone and is divided into three fascial compartments by intermuscular septa. The major veins of the lower limb include the superficial great and small saphenous veins and deep femoral and popliteal veins. Lymph from the lower limb drains to either superficial or deep inguinal lymph nodes located in the femoral region.
The document provides details on the anatomy of the wrist and carpal bones. It can be summarized as:
1. The wrist joint is made up of the distal ends of the radius and ulna articulating with the proximal and distal rows of carpal bones, which then articulate with the metacarpal bones.
2. The carpal bones are arranged in two rows - the proximal row includes the scaphoid, lunate, triquetrum, and pisiform bones. The distal row includes the trapezium, trapezoid, capitate, and hamate bones.
3. The carpal bones are stabilized by intrinsic and extrinsic ligaments including the scapholunate and
brachial plexus, branches of brachial plexus, main nerves of brachial plexus and their innervations, disorders of brachial plexus injury, Erb's palsy, Klumpke's palsy, compression of brachial plexus
This document provides an overview of the surface anatomy of the upper limb. It begins by outlining the objectives of being able to palpate bony prominences, muscles, tendons, arteries, and veins. Surface anatomy is then defined as examining external body shapes and markings as they relate to deeper structures. The document then describes in detail the surface landmarks that can be palpated in the clavicle, shoulder, arm, elbow, forearm, wrist, hand, axilla, and arterial patterns.
The document summarizes the anatomy of the intercostal muscles and related structures in the thoracic wall. It describes three layers of intercostal muscles - external, internal, and transversus thoracicus. It also details the intercostal nerves, arteries and veins, and their branches. The azygos vein is summarized as connecting the inferior vena cava to the superior vena cava, passing through the thorax on the right side behind structures like the esophagus and lung roots.
This document provides an overview of the anatomy of the hand, including:
- Surface anatomy and bony landmarks of the hand and wrist
- Compartments and spaces of the hand, including the palmar aponeurosis and flexor retinaculum
- Intrinsic muscles of the hand grouped into thenar, hypothenar, lumbrical and interossei muscles
- Arterial arches including the superficial and deep palmar arches
- Nerve innervation including the median, ulnar and radial nerves
- Clinical concerns involving the hand like carpal tunnel syndrome and De Quervain's tenosynovitis are also discussed.
This document summarizes a lecture on lower limb anatomy presented by Dr. Yasir Jameel. It discusses the anatomy of the knee, including osteology, ligaments, and radiographic views. It also covers the anatomy of the leg, including muscle compartments, specific muscles, nerves like the tibial and common peroneal nerves, and arteries like the tibial posterior artery. The presentation provides detailed diagrams to illustrate the topographic, osteological, and structural anatomy of the knee and leg regions.
1) The thoracic cage is bounded superiorly by the thoracic inlet and inferiorly by the thoracic outlet and diaphragm. It contains typical intercostal spaces bounded by ribs and atypical spaces.
2) The typical intercostal spaces contain the external, internal, and innermost intercostal muscles as well as the subcostalis and sternocostalis muscles. The intercostal nerves and vessels also course through these spaces.
3) The muscles of respiration that act during inspiration include the diaphragm, external intercostals, and accessory muscles like SCM. During forced expiration, the rectus abdominis, internal intercostals, and serratus posterior inferior
The document provides an overview of the anatomy of the leg, including its bones, muscles, blood supply, innervation, and fascial compartments. It describes the tibia and fibula bones and notes the leg is divided into anterior, lateral, and posterior muscle compartments by fascia. The major muscles of each compartment and their actions are defined. The blood supply from branches of the popliteal artery and innervation from tibial and common fibular nerves are also summarized.
The posterior compartment of the thigh contains the hamstring muscles (biceps femoris, semitendinosus, semimembranosus, and part of the adductor magnus), which are supplied by branches from the sciatic nerve. It also contains cutaneous nerves that innervate the skin (medial, posterior, and lateral cutaneous nerves) and veins that drain into the great and small saphenous veins. The blood supply comes from branches of the profunda femoris artery and drains into the profunda femoris vein.
The document describes the anatomy of the popliteal fossa and back of the thigh. It contains the following key points:
1. The popliteal fossa is a diamond-shaped depression on the back of the knee that contains the popliteal artery, vein and tibial nerve.
2. The hamstring muscles originate on the ischial tuberosity and insert on the tibia or fibula. They flex the knee and extend the hip.
3. The sciatic nerve arises in the pelvis and divides into the tibial and common peroneal nerves in the popliteal fossa, supplying muscles of the thigh and leg.
The neck muscles are divided into 4 layers. The first layer includes the trapezius and latissimus dorsi muscles. The second layer includes the splenius, levator scapulae, rhomboideus major and minor, and serratus posterior superior and inferior muscles. The third layer is the erector spinae muscle. The fourth layer includes the multifidus, rotatores, interspinales, intertransversii and sub occipital muscles. The back muscles are divided into 3 groups: superficial muscles around the shoulder, intermediate muscles for respiration, and deep muscles of the vertebral column.
The axilla is the area under the arm where the upper limb meets the thorax. It contains muscles, blood vessels, nerves, and lymph nodes. The axilla provides passage from the neck, chest, and arm. Structures like the brachial plexus, axillary artery and vein pass through the apex. The axilla is bounded by the pectoralis major muscle anteriorly and the latissimus dorsi muscle posteriorly. Clinically, the axilla is important for diagnosing conditions like thoracic outlet syndrome and performing lymph node biopsies for breast cancer screening and staging.
The arm extends from the shoulder to the elbow. It contains two main compartments - anterior and posterior. The anterior compartment contains the coracobrachialis, biceps brachii, and brachialis muscles which flex the forearm. The posterior compartment contains the triceps brachii muscle which extends the forearm. The elbow joint is a complex joint formed between the humerus, ulna, and radius bones. It allows flexion-extension between the forearm and arm and pronation-supination of the forearm. Blood supply is provided by branches of the brachial artery and its profunda branch with rich anastomoses around the elbow.
The document discusses the anatomy and functions of the human foot. It describes how the foot is made up of bones, muscles, ligaments and arches that work together to support body weight and enable walking, running and balance. The medial and lateral longitudinal arches and transverse arch are described. Their roles in weight distribution, acting as levers and protecting structures are summarized. Common foot deformities such as flat feet, high arches, club foot and bunions are also outlined.
The radial nerve is at risk of injury at three locations in the upper limb: in the axilla, in the spiral groove of the humerus, and at the elbow. Injury in the axilla can result from pressure from a crutch and causes motor loss of triceps, wrist and finger extension, and supination as well as sensory loss in the arm and back of the forearm. Injury in the spiral groove most commonly causes motor loss of wrist and finger extension with possible sensory loss only in the hand. Radial tunnel syndrome can cause compression of the radial nerve at the elbow, resulting in loss of wrist and finger extension but no wrist drop.
The document describes the various muscles of the back, including their origins, insertions, innervation, and actions. It discusses the superficial, intermediate, and deep back muscles, categorizing them as extrinsic or intrinsic muscles. Key muscles described include the trapezius, latissimus dorsi, erector spinae group, rotatores, multifidus, semispinalis, and the suboccipital muscles.
The axilla is the space between the upper arm and chest wall. It is bounded by the clavicle, first rib, and scapula. The axilla contains the axillary artery and vein, brachial plexus nerves, lymph nodes, and loose connective tissue. The brachial plexus is formed by the union of cervical and upper thoracic spinal nerves and provides motor and sensory innervation to the upper limb. Injuries to different parts of the brachial plexus can result in specific neuropathies like Erb's palsy or Klumpke's palsy, characterized by weakness or paralysis of certain muscles.
Bone limb lower..osteology of lower limbAnbroseKisuvi
The document describes the bones of the lower limb, including the pelvis, femur, tibia, fibula, and bones of the foot. Key points include:
- The pelvis is composed of the ilium, ischium, and pubis which form the acetabulum and pelvic girdle.
- The femur has a head, neck, greater and lesser trochanters proximally and condyles distally.
- The tibia has medial and lateral condyles proximally and the medial and lateral malleoli distally.
- Bones of the foot include the tarsal bones (talus, calcaneus, navicular) and metatars
The lower limb can be divided into four main regions: the gluteal region, thigh, leg, and foot. The thigh specifically contains the femur bone and is divided into three fascial compartments by intermuscular septa. The major veins of the lower limb include the superficial great and small saphenous veins and deep femoral and popliteal veins. Lymph from the lower limb drains to either superficial or deep inguinal lymph nodes located in the femoral region.
The document provides details on the anatomy of the wrist and carpal bones. It can be summarized as:
1. The wrist joint is made up of the distal ends of the radius and ulna articulating with the proximal and distal rows of carpal bones, which then articulate with the metacarpal bones.
2. The carpal bones are arranged in two rows - the proximal row includes the scaphoid, lunate, triquetrum, and pisiform bones. The distal row includes the trapezium, trapezoid, capitate, and hamate bones.
3. The carpal bones are stabilized by intrinsic and extrinsic ligaments including the scapholunate and
brachial plexus, branches of brachial plexus, main nerves of brachial plexus and their innervations, disorders of brachial plexus injury, Erb's palsy, Klumpke's palsy, compression of brachial plexus
This document provides an overview of the surface anatomy of the upper limb. It begins by outlining the objectives of being able to palpate bony prominences, muscles, tendons, arteries, and veins. Surface anatomy is then defined as examining external body shapes and markings as they relate to deeper structures. The document then describes in detail the surface landmarks that can be palpated in the clavicle, shoulder, arm, elbow, forearm, wrist, hand, axilla, and arterial patterns.
The document summarizes the anatomy of the intercostal muscles and related structures in the thoracic wall. It describes three layers of intercostal muscles - external, internal, and transversus thoracicus. It also details the intercostal nerves, arteries and veins, and their branches. The azygos vein is summarized as connecting the inferior vena cava to the superior vena cava, passing through the thorax on the right side behind structures like the esophagus and lung roots.
This document provides an overview of the anatomy of the hand, including:
- Surface anatomy and bony landmarks of the hand and wrist
- Compartments and spaces of the hand, including the palmar aponeurosis and flexor retinaculum
- Intrinsic muscles of the hand grouped into thenar, hypothenar, lumbrical and interossei muscles
- Arterial arches including the superficial and deep palmar arches
- Nerve innervation including the median, ulnar and radial nerves
- Clinical concerns involving the hand like carpal tunnel syndrome and De Quervain's tenosynovitis are also discussed.
This document summarizes a lecture on lower limb anatomy presented by Dr. Yasir Jameel. It discusses the anatomy of the knee, including osteology, ligaments, and radiographic views. It also covers the anatomy of the leg, including muscle compartments, specific muscles, nerves like the tibial and common peroneal nerves, and arteries like the tibial posterior artery. The presentation provides detailed diagrams to illustrate the topographic, osteological, and structural anatomy of the knee and leg regions.
1) The thoracic cage is bounded superiorly by the thoracic inlet and inferiorly by the thoracic outlet and diaphragm. It contains typical intercostal spaces bounded by ribs and atypical spaces.
2) The typical intercostal spaces contain the external, internal, and innermost intercostal muscles as well as the subcostalis and sternocostalis muscles. The intercostal nerves and vessels also course through these spaces.
3) The muscles of respiration that act during inspiration include the diaphragm, external intercostals, and accessory muscles like SCM. During forced expiration, the rectus abdominis, internal intercostals, and serratus posterior inferior
The document provides an overview of the anatomy of the leg, including its bones, muscles, blood supply, innervation, and fascial compartments. It describes the tibia and fibula bones and notes the leg is divided into anterior, lateral, and posterior muscle compartments by fascia. The major muscles of each compartment and their actions are defined. The blood supply from branches of the popliteal artery and innervation from tibial and common fibular nerves are also summarized.
The posterior compartment of the thigh contains the hamstring muscles (biceps femoris, semitendinosus, semimembranosus, and part of the adductor magnus), which are supplied by branches from the sciatic nerve. It also contains cutaneous nerves that innervate the skin (medial, posterior, and lateral cutaneous nerves) and veins that drain into the great and small saphenous veins. The blood supply comes from branches of the profunda femoris artery and drains into the profunda femoris vein.
The document describes the anatomy of the popliteal fossa and back of the thigh. It contains the following key points:
1. The popliteal fossa is a diamond-shaped depression on the back of the knee that contains the popliteal artery, vein and tibial nerve.
2. The hamstring muscles originate on the ischial tuberosity and insert on the tibia or fibula. They flex the knee and extend the hip.
3. The sciatic nerve arises in the pelvis and divides into the tibial and common peroneal nerves in the popliteal fossa, supplying muscles of the thigh and leg.
The neck muscles are divided into 4 layers. The first layer includes the trapezius and latissimus dorsi muscles. The second layer includes the splenius, levator scapulae, rhomboideus major and minor, and serratus posterior superior and inferior muscles. The third layer is the erector spinae muscle. The fourth layer includes the multifidus, rotatores, interspinales, intertransversii and sub occipital muscles. The back muscles are divided into 3 groups: superficial muscles around the shoulder, intermediate muscles for respiration, and deep muscles of the vertebral column.
The axilla is the area under the arm where the upper limb meets the thorax. It contains muscles, blood vessels, nerves, and lymph nodes. The axilla provides passage from the neck, chest, and arm. Structures like the brachial plexus, axillary artery and vein pass through the apex. The axilla is bounded by the pectoralis major muscle anteriorly and the latissimus dorsi muscle posteriorly. Clinically, the axilla is important for diagnosing conditions like thoracic outlet syndrome and performing lymph node biopsies for breast cancer screening and staging.
The arm extends from the shoulder to the elbow. It contains two main compartments - anterior and posterior. The anterior compartment contains the coracobrachialis, biceps brachii, and brachialis muscles which flex the forearm. The posterior compartment contains the triceps brachii muscle which extends the forearm. The elbow joint is a complex joint formed between the humerus, ulna, and radius bones. It allows flexion-extension between the forearm and arm and pronation-supination of the forearm. Blood supply is provided by branches of the brachial artery and its profunda branch with rich anastomoses around the elbow.
This document provides an overview of the anatomy of the axilla. It discusses the boundaries and contents of the axilla, including the axillary artery and its branches, axillary vein, brachial plexus cords, lymph nodes, and other structures. Specifically, it describes the courses and relations of the three parts of the axillary artery, lists the branches arising from each part, and details the tributaries, drainage patterns, and groups of the axillary lymph nodes. In addition, it notes some relevant clinical correlations regarding the axilla.
The femoral triangle is an anatomical area in the upper thigh bounded by the inguinal ligament, sartorius muscle, and adductor longus muscle. It contains major neurovascular structures including the femoral artery, vein, and nerve. Other structures passing through it include the femoral branch of the genitofemoral nerve and deep inguinal lymph nodes. Due to its superficial location and contents, the femoral triangle is clinically important for accessing the femoral artery during procedures and is also a site where femoral hernias can develop.
The femoral triangle is an anatomical area in the upper thigh bounded by the inguinal ligament, sartorius muscle, and adductor longus muscle. It contains major neurovascular structures including the femoral artery, vein, and nerve. Other structures passing through are the femoral canal containing lymph nodes and the genitofemoral nerve. Due to its superficial location and contents, the femoral triangle is clinically important for accessing the femoral artery during procedures and can develop femoral hernias.
The document summarizes the anatomy of the arteries of the forearm and hand. In the forearm, the ulnar and radial arteries are the two main arteries. The ulnar artery originates near the elbow and passes down the medial side of the forearm, while the radial artery originates from the brachial artery near the elbow and passes down the lateral side. In the hand, the ulnar and radial arteries form arches that supply blood to the digits. The superficial palmar arch is formed mainly by the ulnar artery and helps supply the palm.
This document contains slide titles and numbers for a presentation on anatomy related to the arm, cubital fossa, and elbow joint. It covers topics like osteology of the elbow complex, muscles of the arm, the brachial artery, median and ulnar nerves, and common injuries like fractures and nerve lesions. The document provides an outline of the content to be reviewed in the presentation.
Anatomy upper limb scapulohumeral 24112010Lawrence James
The document provides an overview of the anatomy of the upper limb, with a focus on the scapula region. It describes the muscles that attach the scapula to the humerus, as well as the muscles on the dorsum of the scapula and the triceps brachii muscle. It then discusses the rotator cuff muscles, their origins, insertions, blood supply, and innervation. The document also describes the acromioclavicular joint and its ligaments. Finally, it reviews the topographic anatomy, arteries, and nerves of the scapular region.
The document provides detailed information about the anatomy of the axillary fossa. It describes the walls, base, apex, contents and borders of the axillary fossa. It discusses the axillary artery and its branches, axillary vein, brachial plexus, lymph nodes and clinical implications. Key structures in the axilla include the axillary artery, axillary vein, brachial plexus cords and branches, lymph nodes organized into anterior, posterior, lateral, central and apical groups, and the long thoracic nerve. Knowledge of axillary anatomy is important for clinicians and surgeons.
The axilla contains the brachial plexus, axillary vessels, and lymph nodes. It has boundaries formed by muscles and acts as a passage from the neck to the upper limb. The axillary artery passes through the axilla in three parts, giving off branches. The axillary vein lies medial to the artery, draining the upper limb. Lymph nodes in the axilla drain the arm and breast. The scapular anastomosis connects arterial branches to ensure circulation if main vessels are blocked.
The document describes the anatomy of the inguinal canal and structures related to inguinal hernia. It discusses the boundaries of the inguinal canal, fascial coverings of the spermatic cord, contents of the spermatic cord, the cremaster muscle, important structures of the inguinal canal including nerves, blood vessels, and the myopectineal orifice. It also summarizes treatment options for inguinal hernia such as open and laparoscopic surgical repairs.
The axilla is a pyramid-shaped space between the upper arm and chest wall. It has an apex that continues into the neck, and a base formed by the anterior and posterior axillary folds. The walls include the pectoralis major muscle anteriorly, subscapularis and latissimus dorsi muscles posteriorly, ribs and serratus anterior muscle medially, and coracobrachialis and biceps muscles laterally. Structures passing through the axilla include the axillary vessels, brachial plexus cords, and lymph nodes. The axillary artery gives off branches including the thoracoacromial artery in the axilla. The axillary vein drains the upper limb and
The document describes the triangles of the neck, including the anterior, posterior, and subtriangles. The anterior triangle is bounded by the median line anteriorly, sternocleidomastoid muscle posteriorly, and inferior mandible superiorly. It contains structures like the carotid sheath and is further divided into subtriangles. The posterior triangle is bounded by trapezius muscle posteriorly and sternocleidomastoid muscle anteriorly, and contains nerves like the spinal accessory nerve and branches of the brachial plexus. Both triangles and their contents are important for surgical approaches in the neck.
The anatomical snuffbox is a triangular depression on the lateral side of the wrist. It contains important structures like the radial artery and radial nerve branch. The snuffbox has three borders - the ulnar border formed by the extensor pollicis longus tendon, the radial border formed by the extensor pollicis brevis and abductor pollicis longus tendons, and the proximal border formed by the styloid process of the radius. The floor is formed by the scaphoid and trapezoid carpal bones, while the skin forms the roof. Fractures of the scaphoid bone in the snuffbox from falls on an outstretched hand can disrupt blood flow and
The document provides detailed information about the anatomy of the axilla region. It discusses the boundaries, contents, neurovasculature and lymph nodes of the axilla. The key points are:
The axilla is bounded superiorly by the clavicle, first rib and scapula. It contains the axillary vessels (artery and vein), brachial plexus nerves, lymph nodes and loose connective tissue. The axillary artery divides into three parts based on its relationship to the pectoralis minor muscle and gives off six branches. The axillary vein receives tributaries that parallel the arterial branches. The axillary nerve originates from the brachial plexus and innervates the deltoid
1. The gastrocnemius muscle consists of medial and lateral heads that are supplied by the medial and lateral sural arteries respectively.
2. The medial gastrocnemius flap is most commonly used due to its large size and reliable vascular pedicle. It can be raised as a muscle or musculocutaneous flap to cover defects of the upper leg and knee.
3. The lateral gastrocnemius flap is smaller but can be used for smaller defects of the upper lateral leg and knee. Both flaps have consistent anatomy and can be reliably elevated based on the dominant sural artery pedicles.
The brachial artery is the continuation of the axillary artery in the arm. It begins at the lower border of the teres major muscle and ends in the cubital fossa by dividing into the radial and ulnar arteries. It passes down the anterior compartment of the arm and gives off branches including the profunda brachii artery. The brachial artery has important clinical significance as the brachial pulse is used to measure blood pressure and compressing it can help control hemorrhaging in the arm.
This document describes the scapula, brachium (humerus), and associated muscles. It includes:
1. Descriptions of bone markings on the scapula like the coracoid process and acromion process, as well as the glenoid cavity.
2. Descriptions of bone markings on the humerus including the greater and lesser tubercles, trochlea, and epicondyles.
3. Details about muscle attachments to these bones like the supraspinatus originating on the supraglenoid tubercle.
4. Information about the blood supply including arteries like the suprascapular artery, and veins following the arterial drainage patterns.
Seminar presentation on arterial supply of human head & neck - carotid artery, maxillary artery, ophthalmic artery
post-graduate level
MDS- oral & maxillofacial surgery
This document discusses different types of mastitis, a common inflammation of the breast tissue that can occur when breastfeeding. It outlines signs and symptoms of mastitis such as breast tenderness and pain. Common causes include issues with breastfeeding attachment, blocked milk ducts, or stopping breastfeeding suddenly. Treatment involves continuing to breastfeed or express milk, applying heat or cold compresses, and potentially antibiotics. Prevention focuses on proper breastfeeding techniques and emptying the breasts regularly to avoid blockages. The document also briefly discusses other breast conditions such as cysts, fibroadenomas, and breast abscesses.
The document discusses liver function tests (LFTs), which are blood tests that provide information about the state of a patient's liver. It describes various LFTs that measure different aspects of liver function, including injury, biosynthesis, and biliary obstruction. Common LFTs examined are total bilirubin, ALT, AST, alkaline phosphatase, and GGT. Elevations in certain LFTs can indicate liver diseases like hepatitis, cirrhosis, or cancer. The tests are important for detecting early liver issues, assessing severity, and monitoring treatment effectiveness.
This document discusses various types of valvular heart disease, including rheumatic and non-rheumatic causes. It focuses on the anatomy, pathology, pathophysiology, clinical features, investigations, and management of mitral stenosis, mitral regurgitation, aortic stenosis, aortic regurgitation, tricuspid stenosis, tricuspid regurgitation, and pulmonic valve disease. Key points covered include the predominant involvement of the left side valves in rheumatic heart disease, common murmurs associated with different valve lesions, and treatments involving surgery, balloon dilation, or medication management.
The abdominal aorta begins at the T12 vertebrae as a continuation of the thoracic aorta. It descends behind the peritoneum on the anterior surface of the lumbar vertebrae and ends by bifurcating into the common iliac arteries at L4. It has 9 branches that supply the abdominal viscera and walls. The three major anterior branches are the celiac artery, superior mesenteric artery, and inferior mesenteric artery, which supply the foregut, midgut, and hindgut respectively.
A fracture is a broken bone, which can occur in different ways such as crosswise or lengthwise breaks. There are various types of fractures including stable, open compound, transverse, oblique, and comminuted. For a fracture to heal properly, the broken bones must be immobilized in the correct position. The body forms a blood clot and callus around the fracture to protect it. New bone cells then grow on each side of the fracture line until it closes, which can take up to a year. Normal fracture healing requires viable bone fragments, mechanical rest, and absence of infection.
This document summarizes a study on adherence to and outcomes of antenatal care clinics among women in Akala Sub County Hospital. The broad objectives are to determine if the benefits of antenatal care clinics outweigh the risks. Specific objectives are to assess staff perceptions of clinic attendance, identify factors hindering attendance, understand risks of non-attendance, and determine service delivery. Research questions focus on the impacts of delayed or non-attendance, and the quality of service delivery. The introduction provides background on the importance of antenatal care clinics in reducing mortality rates and improving pregnancy outcomes.
Serotonin is a neurotransmitter synthesized from tryptophan and found in gastrointestinal cells, neurons, and platelets. It is involved in migraine, psychosis, sleep, and gastrointestinal disorders. Serotonin is secreted from enterochromaffin cells and stored in platelets, which release it to regulate homeostasis and blood clotting. It acts through multiple receptor subtypes and has roles in cardiovascular, respiratory, gastrointestinal, and central nervous system functions, as well as in maintaining circadian rhythms and homeostasis. Imbalances in serotonin have been implicated in affective disorders, schizophrenia, and other conditions.
A furuncle is a skin infection of a single hair follicle, usually caused by Staphylococcus aureus. It presents as a red, painful nodule with a central punctum that can become fluctuant with pus. Risk factors include diabetes, HIV/AIDS, steroid use, and other immunosuppressive conditions. Treatment involves incision and drainage to remove pus, followed by antibiotics such as flucloxacillin or erythromycin. Without treatment, furuncles may burst and drain spontaneously, healing slowly with scarring.
This document provides an overview of sociology and anthropology concepts for a healthcare module. It defines sociology as the scientific study of human social life, social change, and the social causes and consequences of human behavior. Anthropology is defined as the study of human societies and cultures, both past and present. Key figures in the development of sociology are discussed, including Auguste Comte, Karl Marx, Max Weber, and Emile Durkheim. Core concepts covered include socialization, social norms, roles, values, and social stratification. The importance and various applications of sociology within the healthcare sector are also outlined.
This document provides an introduction to the Integrated Management of Childhood Illness (IMCNI) strategy. The objectives of IMCNI case management are to improve quality of care for children under five and reduce childhood mortality. IMCNI takes an integrated approach by addressing the overlapping signs and symptoms of multiple diseases threatening child health, including pneumonia, diarrhea, measles, malaria, malnutrition and HIV/AIDS. The strategy combines treatment and prevention of major childhood illnesses with aspects of nutrition, immunization and important community practices to improve child growth, development and survival.
2. Assess & Classify age 2 months upto 5 yrs.pptxMishiSoza
The main modes of transmission of diarrhoea include:
- Water contamination: Drinking water contaminated with human or animal feces which contain disease-causing organisms. This occurs when water sources are located near latrines or open defecation areas.
- Food contamination: Eating food contaminated during preparation or storage with human or animal feces which contain disease-causing organisms. This can occur if food handlers do not wash hands properly after defecating.
- Person-to-person: Spread of disease-causing organisms from the stool of an infected person through hands to the mouth of another person. This occurs due to lack of proper handwashing, especially after defecating and before handling food or eating
The document discusses pneumothorax and its management. It defines pneumothorax as the presence of air in the pleural cavity, causing partial or full lung collapse. It describes the classification, causes, clinical presentation and investigations of pneumothorax. Needle decompression or chest drain insertion are the initial management steps, while VATS or open thoracostomy may be needed for persistent or traumatic cases. Complications can include respiratory failure, cardiac arrest or hemopneumothorax.
1. Airway obstruction occurs when air cannot freely flow in or out of the lungs due to a partial or complete blockage. It is a common cause of emergency department visits and is often caused by inflammation, infection, trauma, or foreign bodies like food.
2. Airway obstruction can occur in the upper or lower airways and can be partial or complete, acute or chronic. Common causes include inhaled objects, tumors, injuries, infections, and certain medical conditions.
3. Symptoms include choking, difficulty breathing, coughing, wheezing, and cyanosis. Diagnosis involves imaging tests like chest x-rays and bronchoscopy. Management depends on the severity and cause but may include removing ob
Beyond mountains there are mountains (Haitian Proverb)
The document discusses guidelines for diagnosing and treating hypertension from the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). It outlines classifications for normal blood pressure and stages of hypertension based on systolic and diastolic readings. It also provides recommendations on lifestyle modifications, drug therapies, treatment goals, and monitoring for hypertensive patients.
Sociology and anthropology are behavioral sciences concerned with the study of human social life and culture. Sociology involves the scientific study of social patterns, institutions, and changes within societies, while anthropology primarily focuses on the classification and analysis of humans and their societies from cultural, historical, and physical perspectives. The document provides background on influential thinkers in sociology like Auguste Comte, Karl Marx, Max Weber, and Emile Durkheim. It also defines key concepts in sociology and anthropology and discusses how knowledge of these disciplines can be applied in healthcare settings.
The document provides guidance on taking a pediatric history, including focusing the history on the chief complaint, birth and medical history, developmental milestones, vaccinations, family history, and social factors. It also outlines the approach to performing a physical examination of children, with tips on techniques for different age groups and examining individual body systems in a sensitive manner. The goal is to obtain relevant information to identify health issues while maintaining the comfort, safety and dignity of pediatric patients.
Cardiac failure, also known as heart failure, results from any structural or functional disorder that impairs the heart's ability to fill with or eject blood. The causes include pump failure, pressure overload, volume overload, and multifactorial causes. The main types are left ventricular failure, right ventricular failure, and chronic heart failure. Signs and symptoms include dyspnea, orthopnea, edema, and fatigue. Diagnosis involves physical exam, chest x-ray, electrocardiogram, and echocardiogram.
Antihistamines are drugs that reduce or eliminate the effects of histamine, which is released during allergic reactions. There are several classes of antihistamines including first generation, second generation, and third generation. First generation antihistamines are effective but cause more side effects like sedation due to their ability to cross the blood brain barrier. Newer generations have been developed with greater selectivity for peripheral histamine receptors, resulting in fewer side effects. Research continues on developing more selective antihistamines and exploring the anti-inflammatory properties and potential for new treatments.
This document provides an overview of the peripheral nervous system, with a focus on receptors, sensation, pain, vision, and hearing. It discusses:
1) The divisions of the peripheral nervous system into afferent (sensory) and efferent (motor) divisions. The afferent division includes somatic sensation, proprioception, and the special senses.
2) Receptor physiology, including the types of receptors, transduction of stimuli into electrical signals, adaptation, and generation of receptor or action potentials.
3) Characteristics of pain, including nociceptors and pain neurotransmitters.
4) Anatomy and physiology of the eye, including accommodation, the retina, photore
Enzymes are biological catalysts that speed up biochemical reactions without being consumed. They achieve high catalytic efficiency by lowering the activation energy of reactions. Enzymes are usually highly specific and function by binding substrates and facilitating the formation of enzyme-substrate complexes. Many enzymes require non-protein cofactors like metal ions, coenzymes, or prosthetic groups to function. Reaction rates carried out by enzymes can be affected by factors like substrate concentration, temperature, pH, and inhibitors. Enzymes play essential roles in cellular metabolism and are regulated through various mechanisms to control metabolic pathways.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
2. The Axilla Region
• The axilla is the name
given to an area that lies
underneath the
glenohumeral joint, at
the junction of the upper
limb and the thorax.
• It is a passageway by
which neurovascular and
muscular structures can
enter and leave the
upper limb.
3. Borders
• The overall 3D shape of the axilla looks slightly like a pyramid.
The borders consist of four sides and a base with an opening at
the apex.
– Apex – Also known as the axillary inlet, this is formed by lateral
border of the first rib, superior border of scapula, and the posterior
border of the clavicle.
– Lateral wall – Formed by intertubercular groove of the humerus.
– Medial wall – Consists of the serratus anterior and the thoracic wall
(ribs and intercostal muscles).
– Anterior wall – Contains the pectoralis major and the underlying
pectoralis minor and the subclavius muscles.
– Posterior wall – Formed by the subscapularis, teres major and
latissimus dorsi.
• The size and shape of the axilla region varies with arm
abduction. It decreases in size most markedly when the arm is
fully abducted – at this point, the contents of the axilla are at
most risk of injury.
5. Contents
• The main, and clinically important contents of the axilla region
include muscles, nerves, vasculature and lymphatics:
• Axillary artery – It is the main artery supplying the upper limb. It is
commonly referred as having three parts, one medial to the
pectoralis minor, one posterior to pectoralis minor, and one lateral to
pectoralis minor. The medial and posterior parts travel in the axilla.
• Axillary vein – The main vein draining the upper limb, its two largest
tributaries are the cephalic and basilic veins.
• Brachial plexus – A collection of spinal nerves that form the
peripheral nerves of the upper limb.
• Biceps brachii and coracobrachialis – These muscle tendons move
through the axilla, where they attach to the coracoid process of the
scapula.
• Axillary Lymph nodes – The axillary lymph nodes filter lymph that
has drained from the upper limb and pectoral region. In women,
axillary lymph node enlargement is a non-specific indicator of breast
cancer.
7. Passageways Exiting the Axilla
• There are three main routes by which structures leave the
axilla.
– The main route of exit is immediately inferiorly and laterally,
into the upper limb. The majority of contents of the axilla region
leave by this method.
– Another pathway is via the quadrangular space. This is a gap in
the posterior wall of the axilla, allowing access to the posterior
arm and shoulder area. Structures passing through include the
axillary nerve and posterior circumflex humeral artery (a branch
of the axillary artery.
– The last passageway is the clavipectoral triangle, which is an
opening in the anterior wall of the axilla. It is bounded by the
pectoralis major, deltoid, and clavicle. The cephalic vein enters
the axilla via this triangle, while the medial and lateral pectoral
nerves leave.
9. Clinical Relevance
Thoracic Outlet Syndrome
• The apex of the axilla region is an opening between the
clavicle, first rib and the scapula.
• In this apex, the vessels and nerves may become
compressed between the bones – this is called thoracic
outlet syndrome.
• Common causes of TOS are trauma (e.g fractured
clavicle) and repetitive actions (seen commonly in
occupations that require lifting of the arms)
• It often presents with pain in the affected limb, (where
the pain is depends on what nerves are affected),
tingling, muscle weakness and discolouration.
10. Lymph Node Biopsy
• Approximately 75% of lymph from the breast
drains into the axilla lymph nodes, so can be
biopsied if breast cancer is suspected.
• If breast cancer is confirmed, the axillary nodes
may need to be removed to prevent the cancer
spreading.
• This is known as axillary clearance.
• During this procedure, the long thoracic nerve
may become damaged, resulting in winged
scapula
12. The cubital fossa
• is an area of transition between the anatomical arm
and the forearm.
• It is located as a depression on the anterior surface of
the elbow joint.
• Borders
– The cubital fossa is triangular in shape, and thus has three
borders:
– Lateral border – The medial border of the brachioradialis
muscle.
– Medial border– The lateral border of the pronator teres
muscle.
– Superior border – An imaginary line between the
epicondyles of the humerus.
13. The cubital fossa..
• The floor of the cubital fossa is formed
proximally by the brachialis, and distally by the
supinator muscle.
• The roof consists of skin and fascia, and is
reinforced by the bicipital aponeurosis.
• Within the roof runs the median cubital vein,
which can be accessed for venepuncture
14. Contents of the cubital fossae
• The contents of the cubital fossa include vessels, nerves
and the biceps tendon (lateral to medial):
1. Radial nerve – This is not always strictly considered part of
the cubital fossa, but is in the vicinity, passing underneath the
brachioradialis muscle. As is does so, the radial nerve divides
into its deep and superficial branches.
2. Biceps tendon – It runs through the cubital fossa, attaching to
the radial tuberosity, just distal to the neck of the radius.
3. Brachial artery – The brachial artery supplies oxygenated
blood the forearm. It bifurcates into the radial and ulnar
arteries at the apex of the cubital fossa.
4. Median nerve – Leaves the cubital between the two heads of
the pronator teres. It supplies the majority of the flexor
muscles in the forearm.
• Mnemonic for contents of the cubital fossa – Really Need
Beer To Be At My Nicest.
15. Contents of the cubital fossa
Mnemonic for contents of the cubital fossa - Really Need Beer To Be At My Nicest.
16. Clinical Relevance
1. Brachial Pulse and Blood Pressure
– The brachial pulse can be felt by palpating immediately medial to the biceps
tendon in the cubital fossa. When measuring blood pressure, this is also the
location in which the stethoscope must be placed, to hear the korotkoff
sounds.
2. Venepuncture
– The median cubital vein is located superficially within the roof of the cubital
fossa. It connects the basilic and cephalic veins, and can be accessed easily
– this makes it a common site for venepuncture.
3. Supracondylar Fractures
– A supracondylar fracture usually occurs by falling on a flexed elbow. It is a
transverse fracture, spanning between the two epicondyles.
– The displaced fracture fragments may impinge and damage the contents of
the cubital fossa.
– Direct damage, or post-fracture swelling can cause interference to the blood
supply of the forearm from the brachial artery. The resulting ischaemia can
cause Volkmann’s ischaemic contracture – uncontrolled flexion of the
hand, as flexors muscles become fibrotic and short.
– There also can be damage to the median or radial nerves.
17. The Carpal Tunnel
• The carpal tunnel is a narrow passageway found
on the anterior portion of the wrist.
• It serves as the entrance to the palm for several
tendons and the median nerve.
Borders
• The carpal tunnel is formed by two layers: a deep
carpal arch and a superficial flexor retinaculum.
• The deep carpal arch forms a concave surface,
which is converted into a tunnel by the overlying
flexor retinaculum.
18. Carpal Arch
• Concave on the palmar side, forming the base
and sides of the carpal tunnel.
• Formed laterally by the scaphoid and
trapezium tubercles
• Formed medially by the hook of the hamate
and the pisiform
19. Flexor Retinaculum
• Thick connective tissue which forms the roof
of the carpal tunnel.
• Turns the carpal arch into the carpal tunnel by
bridging the space between the medial and
lateral parts of the arch.
• Originates on the lateral side and inserts on
the medial side of the carpal arch.
21. Contents
• The carpal tunnel contains a total of 9
tendons, surrounded by synovial sheaths, and
the median nerve.
• The palmar cutaneous branch of the median
nerve is given off prior to the carpal tunnel,
travelling superficially to the flexor
retinaculum.
22. Tendons
• The tendon of flexor pollicis longus
• Four tendons of flexor digitorum profundus
• Four tendons of flexor digitorum superficialis
• The 8 tendons of the flexor digitorum profundus and
flexor digitorum superficialis are surrounded by a single
synovial sheath. The tendon of flexor pollicis longus is
surrounded by its own synovial sheath. These sheaths
allow free movement of the tendons.
• Sometimes you may hear that the carpal tunnel contains
another tendon, the flexor carpi radialis tendon, but this
is located within the flexor retinaculum and not within
the carpal tunnel itself!
24. Median Nerve
• Once it passes through the carpal tunnel, the
median nerve divides into 2 branches: the
recurrent branch and palmar digital nerves.
• The palmar digital nerves give sensory
innervation to the palmar skin and dorsal nail
beds of the lateral three and a half digits.
• They also provide motor innervation to the
lateral two lumbricals.
• The recurrent branch supplies the thenar muscle
group.
25. Clinical Relevance: Carpal Tunnel
Syndrome
• Compression of the median nerve within the carpal tunnel can
cause carpal tunnel syndrome (CTS). It is the most common
mononeuropathy and can be caused by thickened ligaments and
tendon sheaths. Its aetiology is, however, most often idiopathic. If
left untreated, CTS can cause weakness and atrophy of the thenar
muscles.
• Clinical features include numbness, tingling and pain in the
distribution of the median nerve. The pain will usually radiate to
the forearm. Symptoms are often associated with waking the
patient from their sleep and being worse in the mornings.
• Tests for CTS can be performed during physical examination:
• Tapping the nerve in the carpal tunnel to elicit pain in median nerve
distribution (Tinel’s Sign)
• Holding the wrist in flexion for 60 seconds to elicit numbness/pain
in median nerve distribution (Phalen’s manoeuvre)
• Treatment involves the use of a splint, holding the wrist in
dorsiflexion overnight to relieve symptoms. If this is
unsuccessful, corticosteroid injections into the carpal tunnel can be
used. In severe case, surgical decompression of the carpal tunnel
may be required.
28. The Anatomical Snuffbox
• The anatomical snuffbox (also known as the
radial fossa), is a triangular depression found on
the lateral aspect of the dorsum of the hand.
• It is located at the level of the carpal bones, and
best seen when the thumb is abducted.
• In the past, this depression was used to hold
snuff (ground tobacco) before inhaling via the
nose – hence it was given the name ‘snuffbox’.
29. Borders of the Anatomical Snuffbox
• As the snuffbox is triangularly shaped, it has
three borders, a floor, and a roof:
• Ulnar (medial) border: Tendon of the extensor
pollicis longus.
• Radial (lateral) border: Tendons of the abductor
pollicis longus and extensor pollicis brevis.
• Proximal border: Styloid process of the radius.
• Floor: Carpal bones; scaphoid and trapezium.
• Roof: Skin.
31. Contents of anatomical Snuffbox
• The main contents of the anatomical snuffbox are the
radial artery, a branch of the radial nerve, and
the cephalic vein.
• The radial artery crosses the floor of the anatomical
snuffbox in an oblique manner. It runs deep to the
extensor tendons. The radial pulse can be palpated in
some individuals by placing two fingers on the proximal
portion of the anatomical snuffbox.
• Subcutaneously, terminal branches of the superficial
branch of the radial nerve run across the roof of the
anatomical snuffbox, providing innervation to the skin of
the lateral 3 1/2 digits on the dorsum of the hand, and
the associated palm area.
• Also subcutaneously, the cephalic vein crosses the
anatomical snuffbox, having just arisen from the dorsal
venous network of the hand.
33. Clinical Relevance: Fractures of the
Scaphoid
• In the anatomical snuffbox, the scaphoid and the
radius articulate to form part of the wrist joint. In the
event of a blow to the wrist (e.g falling on an
outstretched hand), the scaphoid takes most of the
force. If localised pain is reported in the anatomical
snuffbox, a fracture of the scaphoid is the most likely
cause.
• The scaphoid has a unique blood supply, which runs
distal to proximal. A fracture of the scaphoid can
disrupt the blood supply to the proximal portion – this
is an emergency. Failure to revascularise the scaphoid
can lead to avascular necrosis, and future arthritis for
the patient.
35. The Inguinal Canal
• The inguinal canal is a short passage that extends
inferiorly and medially, through the inferior part of
the abdominal wall. It is superior and parallel to
the inguinal ligament.
• It acts as a pathway by which structures can pass
from the abdominal wall to the external genitalia.
• The inguinal canal also has clinical importance. It is
a potential weakness in the abdominal wall, and
therefore a common site of herniation.
37. Development of the Inguinal Canal in
men
• During development, the testes establish in the posterior
abdominal wall, and descend into the scrotum.
• A fibrous cord of tissue called the gubernaculum attaches the
inferior portion of the gonad to the future scrotum, and
guides them during their descent.
• The inguinal canal is the pathway by which the testes are able
to leave the abdominal cavity and enter the scrotum.
• In the embryological stage, the canal is flanked by an out-
pocketing of the peritoneum, and the abdominal
musculature.
• This out-pocketing (processus vaginalis) normally
degenerates, but a failure to do so can result in an indirect
inguinal hernia.
39. Development of inguinal canal in
women
• In women, there is also a gubernaculum, this
attaches the ovaries to the uterus and future
labia majora.
• Because the ovaries are attached to the uterus
by the gubernaculum, they are prevented from
descending as far as the testes, instead moving
into the pelvic cavity.
• The gubernaculum then becomes the ovarian
ligament, and round ligament of uterus.
40. ‘Mid-Inguinal Point’ and ‘Midpoint of
the Inguinal Ligament’
• The mid-inguinal point is halfway between the
pubic symphysis and the anterior superior iliac
spine. The femoral artery crosses into the lower
limb at this anatomical landmark.
• The midpoint of the inguinal ligament is exactly
as the name suggests. The inguinal ligament runs
from the pubic tubercle to the anterior superior
iliac spine, so the midpoint is halfway between
these structures. The opening to the inguinal
canal is located just above this point.
42. Boundaries
• The inguinal canal is made up of:
– Anterior and posterior walls
– Superficial and deep rings (openings)
– Roof and floor (or superior and inferior walls)
• The anterior wall is formed by the aponeurosis of the
external oblique, and reinforced by the internal oblique
muscle laterally.
• The posterior wall is formed by the transversalis fascia.
• The roof is formed by the transversalis fascia, internal
oblique and transversus abdominis.
• The floor is formed by the inguinal ligament (a ‘rolled up’
portion of the external oblique aponeurosis) and thickened
medially by the lacunar ligament.
44. NB.
• During periods of increased intra-abdominal
pressure, the abdominal viscera are pushed
into the inguinal canal.
• To prevent herniation, the muscles of the
anterior and posterior wall contract, and
‘clamp down’ on the canal.
45. INGUINAL RINGS
• The two openings to the inguinal canal are known as rings.
1. The deep (internal) ring:
– is found above the midpoint of the inguinal ligament which is
lateral to the epigastric vessels.
– The ring is created by the transversalis fascia, which
invaginates to form a covering of the contents of the inguinal
canal.
2. The superficial (external) ring:
– marks the end of the inguinal canal, and lies just superior to
the pubic tubercle.
– It is a triangle shaped opening, formed by the evagination of
the external oblique, which forms another covering of the
inguinal canal contents.
– This opening contains intercrural fibres, which run
perpendicular to the aponeurosis of the external oblique and
prevent the ring from widening.
47. Contents
• In men, the spermatic cord passes through the
inguinal canal, to supply and drain the testes.
• In women, the round ligament of uterus
traverses through the canal.
• The walls of the inguinal canal are usually
collapsed around their contents, preventing
other structures from potentially entering the
canal and becoming stuck.
48. Clinical Relevance: Direct and Indirect
Inguinal Hernias
• A hernia is defined as the protrusion of an organ
or fascia through the wall of a cavity that
normally contains it.
• Hernias involving the inguinal canal can be
divided into two main categories:
– Indirect – where the peritoneal sac enters the inguinal
canal through the deep inguinal ring.
– Direct – where the peritoneal sac enters the inguinal
canal though the posterior wall of the inguinal canal.
• Both types of inguinal hernia can present as
lumps in the scrotum or labia majora.
49. Indirect Inguinal Hernias
• This classification of hernia is the more common. It
has a congenital origin – due to the failure of the
processus vaginalis to regress.
• The peritoneal sac enters the inguinal canal via the
deep inguinal ring. The degree to which the sac
herniates depends on the amount of processus
vaginalis still present.
• As the sac moves through the inguinal canal, it
acquires the same three coverings as the contents of
the canal.
50. Direct Inguinal Hernias
• In contrast to the indirect hernia, this is
acquired in origin, due to weakening in the
abdominal musculature.
• The peritoneal sac originates from an
area medial to the epigastric vessels and
bulges into the inguinal canal via the posterior
wall.
52. The Femoral Triangle
• The femoral triangle is
a hollow area in the
anterior thigh.
• Many large
neurovascular
structures pass through
this area, and can be
accessed relatively
easily.
53. Borders
• Superior border – Formed by the inguinal ligament,
a ligament that runs from the anterior superior iliac
spine to the pubis tubercle.
• Lateral border – Formed by the medial border of
the sartorius muscle.
• Medial border – Formed by the medial border of
the adductor longus muscle. The rest of this muscle
forms part of the floor of the triangle.
– Note: Some sources consider the lateral border of the
adductor longus to be the medial border of the femoral
triangle. However, the majority state that it is the medial
border of the adductor longus
54. borders
• It also has a floor and a roof:
– Anteriorly, the roof of the femoral triangle is formed
by the fascia lata.
– Posteriorly, the base of the femoral triangle is
formed by the pectineus, iliopsoas and adductor
longus muscles.
• The inguinal ligament acts as a flexor
retinaculum, supporting the contents of the
femoral triangle during flexion at the hip.
56. Contents
• The femoral triangle contains some of the major
neurovascular structures of the lower limb. Its contents
(lateral to medial) are:
– Femoral nerve – Innervates the anterior compartment of the
thigh, and provides sensory branches for the leg and foot.
– Femoral artery – Responsible for the majority of the arterial
supply to the lower limb.
– Femoral vein – The great saphenous vein drains into the
femoral vein within the triangle.
– Femoral canal – A structure which contains deep lymph nodes
and vessels.
• The femoral artery, vein and canal are contained within a
fascial compartment – known as the femoral sheath
57. .
A good way of remembering the contents is using the acronym NAVEL:
N: Nerve.
A: Artery.
V: Vein.
E: Empty space (this is important as it allows the veins and lymph vessels
to distend, so they can cope with different levels of flow).
L: Lymph canal
58. Clinical Relevance of the Femoral
Triangle
• Femoral Pulse
– Just inferior to where the femoral artery crosses the inguinal
ligament, it can be palpated to measure the femoral pulse. The
femoral artery crosses exactly midway between the pubis
symphysis and anterior superior iliac spine. The presence of a
femoral pulse means that blood is reaching the lower extremity.
• Access to the Femoral Artery
– The femoral artery is located superficially within the femoral
triangle, and is thus easy to access. This makes it suitable for a
range of clinical procedures.
– One such procedure is coronary angiography. Here, the femoral
artery is catheterised with a long, thin tube. This tube is navigated
up the external iliac artery, common iliac artery, aorta, and into
the coronary vessels. A radio-opaque dye is then injected into the
coronary vessels, and any wall thickening or blockages can be
visualised via x-ray.
59. Clinical Relevance of the Femoral
Triangle
• Femoral Hernia
– A hernia is defined as “a condition in which part of
an organ is displaced and protrudes through the
wall of the cavity containing it“.
– In the case of femoral hernia, part of the bowel
pushes into the femoral canal, underneath the
inguinal ligament.
– This manifests clinically as a lump or bulge in the
area of the femoral triangle. It usually requires
surgical intervention to treat.
60. The Femoral Canal
• The femoral canal is an
anatomical
compartment, located
in the anterior thigh. It
is the smallest and most
medial part of the
femoral sheath.
• It is approximately
1.3cm long.
61. Borders
• The femoral canal is located in the anterior thigh, within the
femoral triangle.
• It can be thought of as a rectangular shaped compartment.
• It has four borders and an opening:
– Medial border – Lacunar ligament.
– Lateral border – Femoral vein.
– Anterior border – Inguinal ligament.
– Posterior border – Pectineal ligament, superior ramus of the pubic
bone, and the pectineus muscle
• The opening to the femoral canal is located at its superior
border, known as the femoral ring.
• The femoral ring is closed by a connective tissue layer –
the femoral septum.
• This septum is pierced by the lymphatic vessels exiting the
canal.
62. Contents
• The femoral canal contains:
– Lymphatic vessels – draining the deep inguinal
lymph nodes.
– Deep lymph node – the lacunar node.
– Empty space.
– Loose connective tissue.
• The empty space allows distension of the
adjacent femoral vein, so it can cope with
increased venous return, or increased intra-
abdominal pressure
63. Clinical Relevance: Femoral Hernia
• The femoral canal is of particular clinical importance, as it a
common site of bowel herniation.
• A hernia is defined as ‘where an internal part of the body
pushes through a weakness in the muscle or surrounding
tissue wall‘. In a femoral hernia, part of the small intestine
protrudes through the femoral ring.
• It presents as a lump situated inferolaterally to the pubic
tubercle. This type of herniation is more common in women,
due to their wider bony pelvis.
• The borders of the femoral canal are tough, and not
particularly extendible. This can compress the hernia,
interfering with its blood supply. A hernia with a compromised
blood supply is known as a strangulated hernia.
64. The Adductor Canal
• The adductor canal (Hunter’s canal, subsartorial
canal) is a narrow conical tunnel located in the
thigh.
• It is 15cm long, extending from the apex of the
femoral triangle to the adductor hiatus of the
adductor magnus.
• The canal serves as a passageway from
structures moving between the anterior thigh
and posterior leg.
65. Borders
• The adductor canal is bordered by muscular
structures:
– Anterior: Sartorius.
– Lateral: Vastus medialis.
– Posterior: Adductor longus and adductor magnus.
– The apex of the adductor canal is marked by the
adductor hiatus – a gap between the adductor
and hamstring attachments of the adductor
magnus.
67. Contents
• The adductor canal serves as a passageway from
structures moving between the anterior thigh
and posterior leg.
• It contains the femoral artery, femoral vein, nerve
to the vastus medialis and the saphenous nerve
(the largest cutaneous branch of the femoral
nerve).
• As the femoral artery and vein exit the canal, they
become the popliteal artery and vein
respectively.
68. Clinical Relevance – Adductor Canal
Block
• In the adductor canal block, local anaesthetic is
administered in the adductor canal to block the
saphenous nerve in isolation, or together with
the nerve to the vastus medialis.
• The block can be used to provide sensory
anaesthesia for procedures involving the distal
thigh and femur, knee and lower leg on the
medial side.
• The sartorius and femoral artery are used as
anatomical landmarks to locate the saphenous
nerve.
69. Clinical Relevance – Adductor Canal
Compression Syndrome
• Adductor canal compression syndrome describes
entrapment of the neurovascular bundle within
the adductor canal.
• A rare condition, it is usually caused by
hypertrophy of adjacent muscles such as vastus
medialis.
• It is most common in young males, who may
present with claudication symptoms due to
femoral artery occlusion (more common) or
neurological symptoms due to entrapment of the
saphenous nerve.
70. The Popliteal Fossa
• The popliteal fossa is a
diamond shaped area
found on the posterior
side of the knee.
• It is the main path in
which structures move
from the thigh to the
leg.
71. Borders
• The popliteal fossa is diamond shaped, with four borders.
• These borders are formed by the muscles in the posterior
compartment of the leg and thigh:
– Superomedial border: Semimembranosus.
– Superolateral border: Biceps femoris.
– Inferomedial border: Medial head of the gastrocnemius.
– Inferolateral border: Lateral head of the gastrocnemius and
plantaris.
• The popliteal fossa also has a floor and a roof.
• The floor of the popliteal fossa is formed by the posterior
surface of the knee joint capsule, and by the posterior
surface of the femur.
• The roof is made of up two layers; popliteal fascia and
skin. The popliteal fascia is continuous with the fascia lata
of the leg.
72. Contents
• The popliteal fossa is
the main conduit for
neurovascular
structures entering and
leaving the leg.
• Its contents are (medial
to lateral):
– Popliteal artery
– Popliteal vein
– Tibial nerve
– Common fibular nerve
73. Contents…
• The tibial and common fibular nerves are the most
superficial of the contents of the popliteal fossa.
• They are both branches of the sciatic nerve.
• The common fibular nerve follows the biceps femoris
tendon, running along the lateral margin of the popliteal
fossa.
• The small saphenous vein pierces the popliteal fascia of
the popliteal fossa to enter the diamond, and empty into
the popliteal vein.
• In the popliteal fossa, the deepest structure is the popliteal
artery.
• It is a continuation of the femoral artery, and travels into
the leg to supply it with blood.
74. Clinical Relevance: Swelling in the
Popliteal Fossa
• he appearance of a mass in the popliteal fossa
has many differential diagnoses.
• The two major causes are baker’s cyst and
aneurysm of the popliteal artery.
75. Baker’s Cyst
• A baker’s cyst (or popliteal cyst) refers to the
inflammation and swelling of the
semimembranosus bursa – a fluid filled sac
found in the knee joint.
• The usually arise in conjunction with arthritis
of the knee (rheumatoid or osteoarthritis).
• Whilst it usually self-resolves, the cyst can
rupture and produce symptoms similar to
deep vein thrombosis.
77. Popliteal Aneurysm
• An aneurysm is a dilation of an artery, which is greater
than 50% of the normal diameter.
• The popliteal fascia (the roof of the popliteal fossa) is
tough and non-extensible, and so an aneurysm of the
popliteal artery has consequences for the other
contents of the popliteal fossa.
• The tibial nerve is particularly susceptible to
compression from the popliteal artery. The major
features of tibial nerve compression are:
– Weakened or absent plantar flexion
– Paraesthesia of the foot and posterolateral leg