Atlas References Netter: 8, 9, 31, 32, 35, 38–41, 141–142 McMinn: 28–37 Gray's Atlas: 536, 539–551 Before You Begin Palpate the following landmarks on your neck or the cadaver: Mental protuberance Hyoid bone Laryngeal prominence (“Adam's apple”) Cricoid cartilage Jugular notch Thyroid gland Anatomic Triangles Anatomy Note The neck may be divided into smaller topographic areas, the triangles of the neck. Specifically, the “carotid triangle” and…

Trochanteric Bursitis Injection Gray's Anatomy for Students: 296-299 Netter: 481, 482, 494 Clinical Application Introduce local anesthetic using an intrabursal injection to relieve pain of inflamed trochanteric bursa. Anatomic Landmarks ( Figs. VII.1 and VII.2 ) Skin Subcutaneous tissue Iliotibial fascia Tensor fasciae latae Trochanteric bursa Greater trochanter Prepatellar Bursitis Aspiration/Injection Gray's Anatomy for Students: 325–326 Netter: 498–502 Clinical Application Introduce local anesthesia into prepatellar bursa…

Atlas References Netter: 516–528 McMinn: 344–354 Gray's Atlas: 350–363 Before You Begin Identify and palpate the calcaneus , the lateral longitudinal arch , and the five metatarsal heads ( Fig. 19.1 ). Skin and Subcutaneous Tissue o Make a longitudinal incision starting from the lateral side of the calcaneus and following the lateral side of the lateral longitudinal arch, terminating at the 1st metatarsal head (…

Atlas References Netter: 495–514 McMinn: 328–343 Gray's Atlas: 318–329, 339–347 Before You Begin Identify the great and small (lesser) saphenous veins and the saphenous and sural nerves, from the previous dissection of the thigh and leg in Chapter 17 . Posterior Leg o Insert scissors or a probe between the semitendinosus and biceps femoris muscles into the popliteal fossa, and remove the superficial adipose tissue (…

Atlas References Netter: 480–485, 490–491 McMinn: 320–327 Gray's Atlas: 299, 300, 306–317 Before You Begin Palpate the following bony landmarks on the cadaver or on yourself: Anterior superior iliac spine Pubic tubercle Pubic symphysis Greater trochanter of femur Medial and lateral femoral condyles Patella Tibial tuberosity Head and neck of fibula Medial and lateral malleoli of tibia and fibula, respectively Dissection Steps o Make a horizontal…

Atlas References Netter: 492–494 McMinn: 316–319 Gray's Atlas: 301–303, 307, 314, 315 Before You Begin Typically, you will not need to make additional skin incisions if you continue the dissection on the same cadaver on which you performed the dissection of the back in Chapter 2 ( Fig. 16.1 ). If not, place the cadaver in the prone position, and incise the skin and subcutaneous tissues…

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Atlas References Netter: 358–365, 377, 378, 387, 389, 393, 395, 486–489 McMinn: 276–279 Gray's Atlas: 255–263, 266, 267, 270 Before You Begin Dissection of the male and female pelvis is discussed separately in this chapter. Dissection Tip To best dissect the perineum, first perform the gluteal region dissection, including the ischioanal fossae and thighs. This makes it much easier to expose and dissect the structures of…

Atlas References Netter: 333–357, 366, 369, 380–385, 388, 390–392 McMinn: 261–275 Gray's Atlas: 212–254, 264–265 Several techniques are used for dissection of the pelvis. This chapter describes the traditional midline hemipelvectomy. Midline Hemipelvectomy (Male) o Identify the rectosigmoid junction and expose the rectum ( Fig. 14.1 ). Posterior to the pubic symphysis, palpate the urinary bladder. o With a probe or scissors, dissect out and reflect…

Peritoneal Aspiration/Lavage Gray's Anatomy for Students: 135, 136 Netter: 252, 254 Clinical Application Procedure introduces a trocar to withdraw fluid or to introduce saline into the peritoneal cavity for irrigation. Anatomic Landmarks ( Figs. V.1 and V.2 ) Infraumbilical region Skin Subcutaneous tissue Linea alba/rectus abdominis muscle Transversalis fascia Extraperitoneal fat Parietal peritoneum Umbilicus Anterior superior iliac spine (ASIS) You’re Reading a Preview Become a Clinical…

Atlas References Netter: 265–269, 300, 311–323 McMinn: 253–261 Gray's Atlas: 183–196, 198–199 Exposing the Kidneys o Cut the white lines of Toldt (paracolic gutters) along the edges of the ascending and the descending colon, and reflect the large and small intestines to the left of the abdominal cavity ( Fig. 13.1 ). o With your fingers, retract the duodenum and pancreas to the left, without disrupting…

Atlas References Netter: 273–299, 301–305 McMinn: 234–252 Gray's Atlas: 157–182 In most cadavers, the liver occupies a significant portion of the peritoneal cavity. The gallbladder may be difficult to see at this point, but look for its fundus. Dissection Tip The gallbladder, if not surgically removed, will become visible as the dissection proceeds. Dissection Steps o With a scalpel, make a horizontal incision at the lower…

Atlas References Netter: 270–273, 276, 280, 284 McMinn: 226–233, 244, 249 Gray's Atlas: 152–156, 159, 164, 166–168, 172 Three Different Techniques for Opening the Peritoneal Cavity Dissection Tip All cuts with the scalpel should be made carefully to avoid cutting too deeply into the peritoneal cavity and underlying viscera. Technique 1 o After removal of the skin over the anterior abdominal wall, palpate the most inferior…

Atlas References Netter: 249–264, 389, 390 McMinn: 217–225, 253 Gray's Atlas: 134–146, 148–150 Before You Begin In general, the abdomen can be divided into right and left superior (upper) quadrants and right and left inferior (lower) quadrants. This division in based on drawing vertical and horizontal lines through the umbilicus ( Fig. 10.1 ). More specifically, the anterior abdominal wall can be divided into regions: the…

Subacromial Bursitis Injection Gray's Anatomy for Students: 64, 392 Netter: 192, 193 Clinical Application Provides relief for frequently inflamed bursa lying beneath the acromion near the supraspinatus tendon. Anatomic Landmarks ( Fig. IV.1 ) Anterior acromion Lateral acromion Posterior acromion Scapular spine Humeral head Acromioclavicular Joint Inspection Gray's Anatomy for Students: 35, 388, 398 Netter: 192, 193 Clinical Application Relieve pain from acromioclavicular joint irritation. Anatomic…

Atlas References Netter: 442–469 McMinn: 154–169 Gray's Atlas: 426–429, 440–456 Before You Begin Palpation Flex and extend your digits, noting the movements of the tendons beneath the skin. On the dorsal side of your hand, identify the tendons of the extensor digitorum muscle. At the flexor aspect of the palm, note the distal skin crease (crease between wrist and forearm), marking the proximal edge of the…

Atlas References Netter: 430–440, 463–469 McMinn: 148–153 Gray's Atlas: 424, 430–439, 457–459 Before You Begin Palpate the following bony landmarks on the cadaver or on yourself: Lateral and medial epicondyles of the humerus Styloid process of the radius Head, styloid process, olecranon, and shaft of the ulna Carpal bones Getting Started o Continue the incision from the lateral side of the shoulder with a vertical incision…

Atlas References Netter: 405, 414, 419–424 McMinn: 138–145 Gray's Atlas: 384–419 Before You Begin Axillary Borders The pectoral region should have been dissected before the study of the axilla is begun. Refer to Chapter 4 for the regional anatomy of the pectoral region and breast. Review the following borders of the axilla: Anterior wall: Pectoralis major and minor muscles and clavipectoral fascia Posterior wall: Latissimus dorsi,…

Thoracentesis Gray's Anatomy for Students: 62, 78 Netter: 197 Clinical Application Introduce a needle or trocar into the intrathoracic cavity, creating a conduit to allow air (pneumothorax) to escape or to help remove fluid. Anatomic Landmarks Needle: 2nd intercostal space at midclavicular line Skin Subcutaneous External intercostal fascia/muscle Internal intercostal fascia/muscle Parietal pleura Tube: 5th intercostal space at midaxillary line Skin Subcutaneous tissue Inferior angle of…

Atlas References Netter: 216–230 McMinn: 185–191 Gray's Atlas: 92–107 Before You Begin Inspection Inspect the heart externally and identify the following: Right atrium Right auricle Superior vena cava (SVC) Inferior vena cava (IVC) Subpulmonary infundibulum or conus Pulmonary artery Ascending aorta Left atrium Pulmonary veins Left auricle ( Figs. 6.1 to 6.4 ) Identify the sulcus terminalis, a shallow groove on the surface of the right…