Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill

Physiology: The Unity of Companies, 2003

Form and Function, Third
Edition

B
ATLAS

Surface Anatomy
The Importance of External Anatomy 392

Head and Neck (fig. B.1) 393

Trunk 394
• Thorax and Abdomen (fig. B.2) 394
• Back and Gluteal Region (fig. B.3) 395
• Pelvic Region (fig. B.4) 396
• Axillary Region (fig. B.5) 397

Upper Limb 398

• Lateral Aspect (fig. B.6) 398
• Antebrachium (forearm) (fig. B.7) 398
• Wrist and Hand (fig. B.8) 399

Lower Limb 400

• Thigh and Knee (fig. B.9) 400
• Leg (figs. B.10–B.12) 401
• Foot (figs. B.13–14) 404

Muscle Test (fig. B.15) 406

 Saladin: Anatomy & Atlas B Surface Anatomy
Physiology: The Unity of
Form and Function, Third
Edition
392 Part Two Support and Movement
The Importance of External
Anatomy
In the study of human anatomy, it is easy to become so pre-
occupied with internal structure that we forget the impor-
tance of what we can see and feel externally. Yet external
anatomy and appearance are major concerns in giving a
physical examination and in many aspects of patient care.
A knowledge of the body’s surface landmarks is essential
to one’s competence in physical therapy, cardiopul-
monary resuscitation, surgery, making X rays and electro-
cardiograms, giving injections, drawing blood, listening to
heart and respiratory sounds, measuring the pulse and
blood pressure, and finding pressure points to stop arterial
bleeding, among other procedures. A misguided attempt
to perform some of these procedures while disregarding or
misunderstanding external anatomy can be very harmful
and even fatal to a patient.
Having just studied skeletal and muscular anatomy
in the preceding chapters, this is an opportune time for
Atlas B
you to study the body surface. Much of what we see there
reflects the underlying structure of the superficial bones
and muscles. A broad photographic overview of surface
anatomy is given in atlas A (see fig. A.5). In the following
pages, we examine the body literally from head (fig. B.1)
to toe (fig. B.14), studying its regions in more detail. To
make the most profitable use of this atlas, refer to the
skeletal and muscular anatomy in chapters 8 to 10. Relate
drawings of the clavicles in chapter 8 to the photograph in
figure B.1, for example. Study the shape of the scapula in
chapter 8 and see how much of it you can trace on the pho-
tographs in figure B.3. See if you can relate the tendons
Text © The McGraw−Hill
Companies, 2003
visible on the hand (fig. B.8) to the muscles of the forearm
illustrated in chapter 10, and the external markings of the
pelvis (fig. B.4) to bone structure in chapter 8.
For learning surface anatomy, there is a resource
available to you that is far more valuable than any labo-
ratory model or textbook illustration—your own body.
For the best understanding of human structure, compare
the art and photographs in this book with your body or
with structures visible on a study partner. In addition to
bones and muscles, you can palpate a number of superfi-
cial arteries, veins, tendons, ligaments, and cartilages,
among other structures. By palpating regions such as the
shoulder, elbow, or ankle, you can develop a mental
image of the subsurface structures better than you can
obtain by looking at two-dimensional textbook images.
And the more you can study with other people, the more
you will appreciate the variations in human structure
and be able to apply your knowledge to your future
patients or clients, who will not look quite like any text-
book diagram or photograph you have ever seen.
Through comparisons of art, photography, and the living
body, you will get a much deeper understanding of the
body than if you were to study this atlas in isolation from
the earlier chapters.
At the end of this atlas, you can test your knowledge
of externally visible muscle anatomy. The two photo-
graphs in figure B.15 have 30 numbered muscles and a list
of 26 names, some of which are shown more than once in
the photographs and some of which are not shown at all.
Identify the muscles to your best ability without looking
back at the previous illustrations, and then check your
answers in appendix B at the back of the book.
 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

Atlas B Surface Anatomy 393

Occipital
Frontal

Orbital
Temporal
Nasal

Auricular Oral

Buccal (cheek)
Mental
Nuchal (posterior cervical)
Cervical

Atlas B
(a)

Frons (forehead)
Root of nose
Bridge of nose
Superciliary Lateral commissure
ridge
Superior palpebral
sulcus
Medial commissure
Inferior palpebral
Dorsum nasi
sulcus
Apex of nose
Auricle (pinna) Ala nasi
of ear
Mentolabial sulcus
Philtrum
Labia (lips) Mentum (chin)
Trapezius muscle Sternoclavicular
joints

Supraclavicular Clavicle
fossa Suprasternal notch
Sternum

(b)

Figure B.1 The Head and Neck. (a) Anatomical regions of the head, lateral aspect. (b) Features of the facial region and upper thorax.
 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

394 Part Two Support and Movement

Supraclavicular Sternocleidomastoid
fossa
Thyroid cartilage
Clavicle Trapezius
Suprasternal notch
Deltoid Acromion

Manubrium
Pectoralis major
Body
Sternum
Nipple
Xiphoid
process

Rectus
abdominis
Serratus anterior

Tendinous Linea semilunaris

insertion of Linea alba
rectus abdominis
Umbilicus

Anterior superior
Atlas B

spine of ilium External abdominal

oblique
Iliac crest

Inguinal ligament

(a)

Supraclavicular Trapezius m.
fossa
Sternum:
Clavicle
Suprasternal notch
Acromion
Deltoid m. Manubrium
Angle
Breast: Body (gladiolus)
Axillary tail Xiphoid process
Nipple

Areola
Corpus (body)

Linea alba

Rectus
Costal margin
abdominis m.
Umbilicus
Linea semilunaris

External abdominal
oblique m.
Anterior superior
spine of ilium

(b)

Figure B.2 The Thorax and Abdomen, Ventral Aspect. (a) Male; (b) female. All of the features labeled are common to both sexes, though
some are labeled only on the photograph that shows them best.
 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

Atlas B Surface Anatomy 395

Flexor carpi ulnaris

Brachioradialis

Biceps brachii
Triceps brachii
Deltoid
Anterior part
Middle part
Posterior part
Teres major

Infraspinatus
Medial border
of scapula
Trapezius
Vertebral furrow
Erector spinae
Latissimus dorsi

Atlas B
Iliac crest
(a)

Acromion

Medial border
Infraspinatus of scapula
Trapezius

Inferior angle
of scapula
Latissimus
Olecranon dorsi
Erector spinae

Iliac crest
Sacrum
Gluteus medius
Coccyx
Gluteus maximus
Natal cleft

Greater
trochanter
of femur
Gluteal fold
Hamstring muscles

(b)

Figure B.3 The Back and Gluteal Region. (a) Male; (b) female. All of the features labeled are common to both sexes, though some are labeled
only on the photograph that shows them best.
 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

396 Part Two Support and Movement

(a)
Atlas B

(b)

Figure B.4 The Pelvic Region. (a) The anterior superior spines of the ilium are marked by anterolateral protuberances (arrows). (b) The posterior
superior spines are marked in some people by dimples in the sacral region (arrows).
 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

Atlas B Surface Anatomy 397

Olecranon

Biceps brachii

Triceps brachii

Anterior axillary fold (pectoralis major)

Deltoid

Atlas B
Axilla (armpit)

Posterior axillary fold (latissimus dorsi)

Pectoralis major

Latissimus dorsi

Serratus anterior

Rectus abdominis

External abdominal oblique

Figure B.5 The Axillary Region.

 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

398 Part Two Support and Movement

Trapezius

Acromion

Interphalangeal Deltoid
joints
Pectoralis major

Metacarpophalangeal Biceps brachii

joints
Triceps brachii
Styloid process Long head
of ulna Lateral head
Brachioradialis
Extensor carpi
Extensor digitorum radialis longus
Lateral epicondyle
of humerus
Olecranon

Figure B.6 The Upper Limb, Lateral Aspect.

Atlas B

Biceps brachii Triceps brachii

Cubital fossa Medial epicondyle
of humerus
Cephalic vein
Olecranon
Median cubital vein
Head of radius
Brachioradialis
Brachioradialis
Flexor carpi radialis
Palmaris longus
Flexor carpi ulnaris Flexor carpi ulnaris

Extensor carpi ulnaris

Extensor digitorum

Styloid process of
Styloid process of radius ulna
Hypothenar eminence
Thenar eminence Tendons of extensor digitorum
Flexion creases
Palmar surface of hand

Pollex (thumb) Dorsum of hand

Volar surface of fingers

Flexion lines

(a) (b)

Figure B.7 The Antebrachium (forearm). (a) Ventral aspect; (b) dorsal aspect.
 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

Palmaris longus tendon

Flexor carpi radialis tendon

Flexion creases

Thenar eminence

Hypothenar eminence

Pollex (thumb)
Flexion creases
I

Metacarpophalangeal
joint

Interphalangeal
joints

Atlas B
II
IV
III
(a)
( )

Styloid process of radius

Styloid process of ulna

Extensor pollicis brevis tendon

Anatomical snuffbox
Extensor pollicis longus tendon
Extensor digiti minimi tendon
Extensor digitorum tendons

Adductor pollicis

(b)

Figure B.8 The Wrist and Hand. (a) Ventral aspect; (b) dorsal aspect.

399
 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

400 Part Two Support and Movement

Lateral Medial

Lateral Medial

Vastus lateralis
Tensor fasciae latae

Biceps femoris
(long head)
Rectus femoris
Semitendinosus

Semimembranosus

Gracilis
Gracilis
Atlas B

Vastus lateralis

Vastus medialis

Quadriceps
femoris tendon
Popliteal fossa
Iliotibial band

Patella

Patellar ligament

Tibial tuberosity

(a) (b)

Figure B.9 The Thigh and Knee. (a) Ventral aspect; (b) dorsal aspect.
 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

Atlas B Surface Anatomy 401

Vastus lateralis

Biceps femoris

Iliotibial band

Lateral epicondyle of femur

Head of fibula

Patellar ligament

Lateral head of gastrocnemius

Soleus

Atlas B
Fibularis longus

Tibialis anterior

Fibularis longus and fibularis

brevis tendons

Calcaneal tendon

Lateral malleolus

Calcaneus

Figure B.10 The Leg and Foot, Lateral Aspect.

 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

402 Part Two Support and Movement

Semimembranosus

Semimembranosus tendon

Patella

Medial epicondyle of femur

Semitendinosus tendon
Medial condyle of tibia

Medial head of gastrocnemius

Tibia
Atlas B

Soleus

Medial malleolus

Extensor hallucis longus tendon

Medial longitudinal arch

Head of metatarsal I

Abductor hallucis

Figure B.11 The Leg and Foot, Medial Aspect.

 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

Atlas B Surface Anatomy 403

Medial Lateral

Hamstring muscles

Biceps femoris tendon

Semitendinosus tendon

Popliteal fossa

Atlas B
Gastrocnemius
Medial head

Lateral head

Soleus

Fibularis longus

Tibialis anterior

Calcaneal tendon

Lateral malleolus

Extensor digitorum brevis

Calcaneus

Figure B.12 The Leg and Foot, Dorsal Aspect.

 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

404 Part Two Support and Movement

Calcaneal tendon

Lateral malleolus

Extensor digitorum brevis

Lateral longitudinal arch

Atlas B

Extensor digitorum longus

tendons
(a)

Medial malleolus

Calcaneal tendon

Medial longitudinal arch

Calcaneus

Head of metatarsal I

(b)

Figure B.13 The Foot. (a) Lateral aspect; (b) medial aspect.
 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

Soleus

Tibia

Tibialis anterior

Medial malleolus

Lateral malleolus

Site for palpating dorsal pedal artery

Extensor hallucis longus tendon

Extensor digitorum longus tendons

Digits (I–V)
Head of metatarsal I

Atlas B
II
Hallux (great toe)
III
V IV III II I I
IV
Hallux (great toe)

V
Head of metatarsal I
(a)
Transverse arch

Head of metatarsal V

Abductor digiti minimi

Abductor hallucis

Medial longitudinal arch

Lateral longitudinal arch

Lateral malleolus

Calcaneus

(b)

Figure B.14 The Right Foot. (a) Dorsal aspect, (b) plantar aspect.

405
 Saladin: Anatomy & Atlas B Surface Anatomy Text © The McGraw−Hill
Physiology: The Unity of Companies, 2003
Form and Function, Third
Edition

406 Part Two Support and Movement

1 8
9 17
2 23
10
18 24
19 25
3 11 20
4 12 26
13 27

21
14
22

5
Atlas B

6
28
7

29
15 30
16

(a) (b)

Figure B.15 Muscle Test. To test your knowledge of muscle anatomy, match the 30 labeled muscles on these photographs to the alphabetical list
of muscles below. Answer as many as possible without referring to the previous illustrations. Some of these names will be used more than once, since the
same muscle may be shown from different perspectives, and some of these names will not be used at all. The answers are in appendix B.

a. biceps brachii j. infraspinatus s. sternocleidomastoid

b. brachioradialis k. latissimus dorsi t. subscapularis
c. deltoid l. pectineus u. teres major
d. erector spinae m. pectoralis major v. tibialis anterior
e. external abdominal oblique n. rectus abdominis w. transversus abdominis
f. flexor carpi ulnaris o. rectus femoris x. trapezius
g. gastrocnemius p. serratus anterior y. triceps brachii
h. gracilis q. soleus z. vastus lateralis
i. hamstrings r. splenius capitis