Introduction of Regional Anatomy Jin Lianzhou 金联洲 Office: Room A219, Building 07 Labs: Room A215, Building 10 E-mail: jinlz007@qq.com Cell: 15157761503, 671503 QQ: 1027083345

Books Grant’s dissector Gray’s anatomy for students Netter’s atlas

Importance of the regional anatomy If anatomy is simply memorised and not understood, it will soon be forgotten. The practice of good medicine requires a significant knowledge of anatomy Dissecting material is both scarce and immensely valuable; therefore you must always scrupulously follow the instructions and tutor, otherwise much time and effort may be wasted.

Arrangement of the every operation At any time, only two members of a dissecting table group are able to dissect Number 1: operator Number 2: assistant Those who are not dissecting should follow both the text and dissection

Attitude of operations A good dissection should display clearly and cleanly the main features of the region. You should be as neat and accurate as you can, for a slovenly dissector will be a slovenly doctor. There must be no blind dissection, you must always have a preliminary session with the manual to find out what main structures are to be looked for, and where to expect to find them. During dissection, in addition to reading the dissecting instructions and dissecting, you should all the time be discussing and questioning with your fellow students and with your tutors matters such as the relation of the anatomy that is being dealt with to development, function, and the related practical importance.

Attitude to the cadaver You must always remember that former living persons have donated their bodies for medical studies in good faith. Therefore the cadaver must be treated with respect and dignity. Improper behaviour in the dissecting laboratory cannot be tolerated

The back

SKELETAL FRAMEWORK vertebrae Skull Scapulae pelvic bones ribs

Surface anatomy

SKIN INCISIONS

SUPERFICIAL FASCIA Occipital artery Greater occipital nerve Other posterior rami

Muscles of the Back

Muscles of the Back (intrinsic)

Triangles of the Back The triangle of auscultation The lumbar triangle is bounded by the latissimus dorsi muscle, the trapezius muscle, and the rhomboid major muscle. Within the triangle of auscultation, intercostal space 6 has no overlying muscles. This area is particularly well-suited for auscultation (listening to sounds produced by thoracic organs, particularly the lungs). The lumbar triangle is bounded by the latissimus dorsi muscle, the external oblique muscle, and the iliac crest. The floor of the lumbar triangle is the internal oblique muscle of the abdomen. On rare occasions, the lumbar triangle is the site of a lumbar hernia.

The neck Compartments Triangles Visceral Vertebral Vascular Anterior Posterior

Fascia of the neck Superficial fascia Deep fascia Platysma External jugular vein, anterior jugular vein subcutaneous nerves (branches of cervical plexus) Deep fascia Investing layer Prevertebral layer Pretracheal layer Carotid sheath

Superficial venous drainage External jugular v. Anterior jugular v.

Anterior triangle of the neck

Muscles in the anterior triangle Suprahyoid muscles Stylohyoid Digastric Mylohyoid Geniohyoid Infrahyoid muscles Sternohyoid Omohyoid Thyrohyoid Sternothyroid

Vessels Common carotid arteries Internal carotid a. External carotid a. superior thyroid a. ascending pharyngeal a. lingual a. facial a. occipital a. posterior auricular a. superficial temporal a. maxillary a. Internal jugular vein

Internal jugular vein Ophthalmic v. Superficial temporal v. Pterygoid plexus Facial v. Cavernous sinus Emissary v. Deep facial v. Maxillary v. Internal jugular vein Retromandibular v.

Nerves Facial nerve [VII] Glossopharyngeal nerve [IX] Vagus nerve [X] superior laryngeal nerve Internal external Accessory nerve [XI] Hypoglossal nerve [XII] Ansa cervicalis

Thyroid and parathyroid glands Arterial supply Superior thyroid artery Inferior thyroid artery: a branch of the thyrocervical trunk Venous drainage Superior, middle and inferior thyroid veins Parathyroid glands

Posterior triangle of the neck

Muscles

Vessels

Arteries

Nerves

Root of the neck Arteries Nerves Lymphatics Subclavian arteries Phrenic nerves Vagus nerves Sympathetic nerves Lymphatics