SURFACEANATOMY

UPPER LIMB
RRACHIAL ARTERY.
old the arm at right
angles to the trunk
Mark a polnt al the junction
the lower border of of anterior with palm directed upwards
teres anterior 1/3 & &posterior
Dosterior 2/3
2/3 of
of the
the lateral
lalerai wall of axilla, at
Mark another major.
point at the level of wa
Join these two points neck of radiusmedial to the tendon
of biceps.
Aullary art Clavicle

Bchial art

RADIAL ARTERY
Mark a point at the level of neck of radius
medial to the tendon of
Second pont on the pulsation of radial biceps.
artery at the wrist in the interval between the
of flexor carpi radialis tendon
medially and the lower part of anterior border of radius laterally.
Third point on its pulsation in the anatomical snuff box.

sOPERFICIAL PALMAR ARCH:

Mark a point on the lateral side of the pisiform bone.
Mark the hook of hamate.
Put a point on the centre of the palm at the level of distal border of the extended
thumb. Connect the three points by a line with convexity facing distally.

Level of
extended thumb
Sup. arch

Deeparch
Hookhamate-
Thenar eminence
Pisrom

DEEP PALMAR ARCH:

A horizontal line, approximately 4 cm long, distal to the hook of hamate, about one
the level of superficial palmar arch.
finger's breadth proximal to
1GMC RI
77
 2 cm above
ve the mid point
AXILLARY NERVE deltoid
muscle,
the
oft deltoid.
lt is marked as a horizo line o n the insertion

and the
process
romion
between the tip of the

BLEXOR RETINACULUM:
bonya d eTiuhercle Scaphoid to the
T u b e r c l e ofScap
It can be outlined by defining its which joins the with
Proximal border: A irved line, to the hook or
'Trapezium
concavity upwards. the crest of
which joins
border: A curved line
DIstal downwards.
hamate with concavity
Crost ropezlum

Hook hamale
Tub. Scaphokd

Pisiiorm
Lower end radius

Head ofuna

EXTENSOR RETINACULUM:
across the back of the wrist, directed
A band of 2 cm width, extending obliquely
downwards and medially. of the radius above styloid process,
Lateral attachment: One
inch of anterior border
& Pisiform bones.
Medial attachment: Triquetral

LOWERLIMB
crest. Lateral end of the
at the anterior end of iliac
. Anterior superior iliac spine: Palpable
end of inguinal ligament.
fold of groin. Attachment of lateral
of fold of groin. Attachment
2. Pubic tubercle: A small bony projection felt at the medial end
of medial end of inguinal ligament.

3. Iliac crest: Palpable bony ridge from anterior superior iliac spine to the posterior superior
iliac spine.

4. Mid inguinal point (or) Femoral point

Midpoint between the anterior superior iliac spine and pubic symphysis.

. Midpoint of Inguinal ligament:

Midpoint between the anterior superior iliac spine and pubic tubercle

6. Greater trochanter: Lies a hand's breadth below the tubercle of iliac crest

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 t u b e r c l e :
i
It t on deep pressure on the medal sude ot thigh ahove the
with thigh semitlexad. abducted and laterally otated
with thi
metial
dductor fëmur
the
le of

A s a c spne
Fod groin
Md point ing ig
Mid ing point
Pblc tub
Symph pubes

Tendon Add. magnus

Adductor tub

Nelaton's line:
and the most prominent part of ischial tuberosity
Line joining anterior superior iliac spine
which crosses the apex
of greater trochanter and the centre of acetabulum.

Bryant's triangle: backwards with the subject in

Draw a horizontal line from the anterior superior iliac spine
recumbent posture.
above line to the top of greater trochanter.
Draw a perpendicular line to the of
the anterior superior iliac spine and the top greater
Complete the triangle by joining
rochanter. backward.
trochanter is displaced upward or
In dislocation of hip joint, greater

NELATOws
LING

ER
TOCNTUA

IsCHIAL
TUNROSITY

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 ARTERIES

KFEMORAL ARTERY: iliac spine & pubic symphysis,

between anterior superior and laterally rotated.
.Midpoint semiflexed, abducted
2. Adductor Tubercl nnecting
with thigh
the above two points represents the femoral artery in the thigh

Upper 2/3 of the line o

A. p OC p i n Fod groin

.Mdpoinking
Md ing po*

Pubic A

symph pubis

T e n d o n Ad. magnus

Aduclor tuo

DORSALIS PEDIS ARTERY:

malleoli.
1. A point midway between the two
intermetatarsal space.
2. A in the proximal end of first
point
VEINS
A.GREAT SEPHENOUS VEIN:
Marked by joining the following points.
1. On the dorsum of foot at the medial end of the dorsal venous arch.
2. In front of the medial malleolus.
3. On the medial border of tibia at the junction of upper 2/3 and lower 1/3 of leg.
4. At the adductor tubercle.
5. Just below the centre of saphenous opening.

2. SMALL SAPHENOUS VEIN:

Join the following points.
1. On the dorsum of foot at the lateral border ofthe dorsal venous arch.
2. Behind the lateral malleolus.
3. Just lateral to tendocalcaneus above the lateral malleolus.
4. Centre of popliteal fossa.

NERVES
ySCIATIC NERVE:
1. Apoint 2.5cm lateral to midpoint between posterior superior iliac spine and ischial
tuberosity.
2. A point medial to
midpoint between the greater trochanter and ischial
3. A point on
the
upper angle ofpopliteal tuberosity,
where it divides into tibial & common fossa Gjunction of upper 2/3 & lower 1/3
peroneal nerves).
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 Post sup hac
apire

Ischal tub
Gt trochanter

Popiteal lossa

2 OMMON PERONEAL NERVE

Upper angle of popliteal fossa.
. Point on the lateral side
peroneal nerves.
of the neck of fibula, where it divides in to supericia ep
At this point, it is vulnerable to injury from a
oula.
tightly applied plaster cast or a fracture ofneck of

RETINACULA
SUPERIOR EXTENSOR RETINACULUM:
/ band 3 cm broad directed medially and upwards
1, Anterior border of distal, subcutaneous
part of fibula
2. Anterior border of distal end of tibia.

INFERIOR EXTENSOR RETINACULUM:

/y" Shaped Band
1. Stem: At the lateral end, attached to the upper surface of calcaneum.
border
2. Proximal Band: 1 cm wide and extends from the medial end of stem to the
anterior
of medial malleolus.
3. Distal Band: 1 cm wide & passes downwards and medially merging with plantar

aponeuroSis. Sup.ext retinaculum

M e d . malleokus

Ind ext retinaculum

Dorsais pedis an.

JFLEXOR RETINACULUM:
the medial malleolus to the medial border of plantar
A band 2.5 cm wide extending from backwards.
downwards and
uriace of calcaneum. Directed
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 ABDOMEN AND PELVIS

ABDOMINAL PLANES

line): Extends and pubicmidpoint afo icle

from the
mammary
A. Mid clavicular line (lateral or iliac spine symphysis
superior
to a point midway between the anterior
the suprasternal notch
Addison): It lies midway between an d
B. Transpyloric plane (of to a hand's breadth below the
It corresponds
upper border of pubic symphysis. lower border of body of LI and tip of 9h costal
the
xiphisternal joint. It intersects
cartilage. are:
in the transpyloric plane
Important structures lying
i. Pylorus of Stomach
ii. Fundus of gall bladder
ii. Hila of both kidneys
mesenteric artery from
aorta
iv. Origin of superior vein
of portal
v. Neck of the pancreas and origin
vi. Anterior end of spleen
vii. Inferior margin of liver

below the 10th rib at the level of L3.

Sub costal plane: It passes
Structures lying at this plane:
from the aorta
i. Origin of lInferior mesenteric artery
. IlI part of duodenum

D. Trans tubercularPlane:
the upper border of body of L5.
It joins the tubercles of iliac crests. Passes through
Indicates the level of formation of inferior vena cava.

Ipguinal canal:
*"

(a) Mark the deep inguinal ring % above the midinguinal point.
tubercle.
(b) Mark the superficial inguinal ring just above and lateral to the pubic
Join the above points by two parallel lines of 3.75cm long.

IAC
rUNAL RN
AKGUINAL
wcANALEAN
TERNA

Fois
ONALIS

Umbilicus:
It is a birth scar situated in the linea alba opposite to the intervertebral disc between L3
and L4 vertebra.

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S C E R A :

Stomach:

ifice:
Cardiac orifi Mark
short
a
point 2.5 cm to the left of median plane on the 7th costal cartilage
Draw two parallel lines 2
above point,
cm apart inclining downwards and to the c
Pyloric orifice:
Mark a
point 1.2 cm to the right of midline on
wo shor parallel lines 2 cm inclining upwards and
the transpylorie p
to the right from the above po

Nirsih n

Position of appendix:
McBurney's point: Connect anterior superior iliac spine and umbilicus by a line on the right
side. The junction between the medial 2/3 rd and lateral 1/3r ofthat line represents the base

of appendix.

3. Liver:
Upper border:
Join the following points.
1. A point on the Rt. 5th rib just below the nipple.
2. Xiphisternal joint.
3. A point a little below and medial to the left nipple
Right border:
Join the following points.
costal cartilage.
I. A point I cm below the tip of right 10th
2. Draw a convex line from below the right nipple to the above point.

Lower border:
I. Draw the median and Transpyloric planes
2. Mark the tip of 9th costal cartilage
Join the lower end of right border
to the lett end of the upper border by a line crossing the

median plane at the Transpyloric plane.

Xiphisternal

Tr. Pyloic

F n s ga
pane

Subcastal pkave
4. Fundus of gall bladder:
the junction of linea semilunaris
and tip gth costal
of Ri.9th co
LIeS at

transpyloric plane.
artilage in the

5. Kidney
Posterior Surface Marking:
Map out the Morris Parallelogram:
levels of T|l and L 3 spines
I. Drawtwo horizontal lines at the
2. Draw two vertical lines 2.5 cm and 9.5 cm irom the median plane
3. Mark the hilum of kidney at the level of L I spine.
Kidneys are drawn within the parallelogram with their long axis oblique so
so thats
that the
the lower are farther from
poles the median plane upper
poles are nearer and

Morris
Parallelogram
RL kidneyY

Ureter

Post sup. Hac

spine.

THORAX
1. Suprasternal notch (or) Jugular notch:
It is above the upper border of manubrium between the sternal ends of clavicles. Trachea
can be felt in the notch.

Sternal angle (Angle of Louis):

Felt as a transverse ridge, 5 cm below the suprasternal notch.
Anatomical events at the sternal angle are:
. It marks the manubriosternal joint.
2. Lies at the level of intervertebral disc between T4 & TS vertebra.
3. Second costal cartilage articulates with sternum here.
4. Marks the plane dividing superior mediastinum& inferior mediastinum.
5. Trachea bifurcates into two
principle bronchi.
6. Ascending aorta ends.
7. Arch of aorta begins and ends.
8. Descending aorta begins.
9. Pulmonary trunk divides.
10. Pleurae of both sides come into
11. Azygos vein arches over the rootapposition.
of right lung to join superior vena cavä.

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L U N G

erior margin of right lung:

Mark the
following points.
1.At the right sternoclavicular
2. At the sternal angle
just
joint.
3. At the xiphisternal
to the
right of midline.
hints 1&2
joint just to the right of midline.
Joinpoints by a curved line and then
arry the line vertically to point 3.
carry

Md axilary bne

Mdclavicular hne-
Cardiac notch

Obique fissure

Lower border
lung

Anterior margin of left lung:

Mark the following points.
1. At the left sternoclavicular joint.
2. At the sternal angle just to the left of midline.
Join the above points by a curved line then carry the line vertically downwards
upto the level of 4h costal cartilage.
3. From this level the line passes laterally for 3.5 cm from the sternal margin and then
curves downwards and medially to 6h costal cartilage 4 cm from the midline (cardiac
notch).

Aosterior margin:
Mark two points:
1. A point 2 cm lateral to 10th thoracic spine.
2. A point 2 cm lateral to 7th cervical spine.
Join the above 2 points by a vertical line.

Vetsb border tcapulaa

Lug soo

Occa fasue

Lowe boraer kung

S»ero-spinais

colo-dpmg

pl.

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Inferior margin :
.Mark a point at the xiphisternal joint just to the right of midline for the
point left 6th costal cartilage 4 cm from the midline for the lef luna
right
t lung and a and
on
the
2. On the 6h rib in the midclavicular line.
3. On the 8th rib in the midaxillary line.
4. On the 10h rib at the lateral border of erector spinea muscle.
Join the above points bya curved line. Then carry this line horizontallyto
cm lateral to 10th thoracic spine.
horizontally to a
point 2
PLEURA

Anferior margin (or) costodiaphragmatic line of pleural reflection:

Mark these points.
1. Xiphisternal joint
2. On the 8th rib in the mid-clavicular line.
3. On the 10th rib in the mid-axillary line.
4. On the 12th rib at the mid-scapular line lateral to 12h thoracic spine.

Mdaxlany in- Moclavicular hne

Lower border of lung

cosb diaphragm pl e.

HEART

Apex:
It lies in the left sth intercostal space % inch medial to midclavicular line.

Buperior border:
Marked by a line connecting the following
1. A point on the lower border
points.
of 2nd left costal cartilage % inch from the sternal margin.
2. A point on the upper border of 3rd
right costal cartilage % inch from the sternal margin.
Right border:
Mark the following points:
1. A point on the upper
2. A point in the
border of 3d right costal cartilage inch from the sternal margn.
4h
right intercostal space 1% inches from the midline.
3. A point on the 6th right costal
cartilage % inch from the sternal margin.
Join the above points by a curved line with convexity to right.

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 ferior border:
eMarked by a line connecting the
A point on the 6th following points:
right costal cartilage
point at the xiphisternal joint. % inch from the sternal margin.
A point in the
left 5ih intercostal space inch medial to midclavicular line
Leftborder
Marked by a line connecting the
, A point on the lower border following points:
2. of 2md left costal
A point in the left 5h intercostal space inchcartilage inch from
medial to%midclavicular
unc line.

L t second cart

Rt. third cart

Left nipple
Rt. founh interspace
Apex beat

A Rt.
sixth cart
Xiphistemal junction

HEAD& NECK

Pterion (or)Sylvian point and temporal

A small circular area where frontal, parietal, greater wing of sphenoid
3.5 cm behind the fronto zygomatic suture.
bones meet. It lies 4 cm above the zygomatic arch &
It marks the anterior branch of middle meningeal artery.
BREGMA

oDTTAR
SUPERIO
TEMORAL PAIRIE
ER TE
LAmBDA
sUPRAMEATAL
CREST
PTERION
EDUPDRMz
NASION

REYSASE LUN iNION

zvGomATICO

VEaMAT
FRONTALL sUPRA-MEATAL
SUTUNE TRIANGLE

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Suprameatal triangle
Bounded above by supramastoid crest,in front by posterosuperior
acoustic meatus, behind by posterior vertical tangent to posterior margin ofmargin of
externolnal
meatus. xternal acoustic
This triangle is the lateral wall of mastoid antrum, which lies at a depth of1
this triangle. 2s

Reid's base line:

Horizontal line connecting the lower border of infraorbital margin to the
external acoustic meatus. centre af

Frankfurt's plane:
Plane passing through the lower border of infradorbital
external acoustic meatus. margin to the upper border of

GLANDS
Thyroid gland:
Sthmus:E
Draw a horizontal line of 1.5 cm
which marks the upper border. length I cm below the lower border
of cricoid cartilage
Draw another horizontal line of 1.5 cm
the lower border. length 1.25cm from the above line which
marks

Lateral lobes:
Mark a point at the lateral end of lower border of
2. Mark a point 1cm below the lateral end
isthmus
of lower border of isthmus
3. Another point 2.5em lateral to the
point above.
4. Mark a point on the anterior border of
sternomastoid at the level of laryngeal
This marks the extent of upper
pole. prominence.
Mark a point at the lateral end of
upper border of isthmus.

Hyoid
Arch Cricoid
Laryng. prom.
First trach. ring
Sterno-mastd -Isthmus

Lat.lobe
Supra-sternal notch
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 Parotid duc

Mark lower border of

midway concha of the ear
Mark point
a

Middddle 1/3 of the line between ala

joining theseof2thepointsnose and
r
red margin of
upper lip
falatine tonsil: repres
oresents parotid uct.

Represented
of the
angle of
by anoval area over
front
mandible. the
ne lower
part of
part o the masseter muscle
just above & in

Rightcommom carotid
ARTERIES
lies in the artery:
neck and arises
t ies
1. from
2
At the right
At the level of
branchiocephalic
sternoclavicular joint.
trunk behind the right sternoclavicular
stermoclavicular joint.
upper border of thyroid
cartilage on the right side.
common carotid artery:
Thoracic part: From a
ofleftsternoclavicular joint. point just to the left of manubrium sterni ascends up to the ieve
Cervical part: similar to Rt. Side.

nt. Carotid

Exn carotid
Comm. Carotid

subclavian

External carotid artery:

From the upperborder of thyroid cartilage (disc between C 3 &C4), it passes upwards
midway between the mastoid tip and mandibular angle.
Here enters the substanceof parotid gland.
Divides into superficial temporal and maxillary artery, behind the neck of mandible.
. At the level of upper border ofthyroid cartilage,
2. Between of mastoid process and angle of mandible
tip
mandible.
3. Behind the neck of

Eacial artervY ot masserer. Put a point 1.2 cm lateral to anple af

Mark a point at the anteroinferior angle
Join all these points.
t. point at the medial angle of eye.
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 VEINS

External iugular vein:

I.Mark a point below the angle of mandible.
2. Mark a point at the upper border of clavicle immediately lateral to posterior t
terior border of
sternomastoid. Join these points.

InternalJugular vein:
Mark a pointatthe lobule of ear. Mark medial end of clavicle, join these two points
by parallel lines.

Int. jugular
Ext Jugular

Subclavian

VERTEBRAL LEVELS OF IMPORTANT STRUCTURES

Cl: LEVEL OF NASO PHARYNX
C2: LEVEL OF OROPHARYNX & SOFT PALATE
WITH MOUTH OPEN
C3: LEVEL OF BODY OF HYOID BONE &
GREATER CORNUA
C3-C4 JUNCTION: UPPER BORDER OF
THYROID CARTILAGE &
BIFURCATION OF COMMON CAROTID
ARTERY
C4-C5:LEVEL OF THYROID CARTILAGE
C6: LEVEL OF CRICOID
CARTILAGE.

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