What Is Surface Anatomy?

Hello.

I'm Professor Claire Smith,

and I'm head of Anatomy at Brighton and Sussex Medical School.

And today we're going to talk about surface anatomy.

We might be thinking, What is surface anatomy?

Claire Surface anatomy and anatomy actually means in Greek

to cut apart to cut the body apart.

So anatomy involves different components.

It involves Osti ology, the study of our bones.

It involves histology, the study of actually, when we look down a microscope,

that really fine detail what our body looks like.

It involves gross anatomy, and that's not just like gross.

That's horrible. Gross anatomy is actually about what we see with our with our eyes.

So the study of muscles, bones, nerves, etcetera.

It also involves the study of imaging,

how we see the body through ultrasound through X ray through MRI

and how we study embryology.

So how why we're not the same when we're very tiny

to when we're an adult and how we change during ageing.

Why might we need to know about surface anatomy?

Surface anatomy forms the basis of clinical examination for doctors,

dentists and a range of health care professionals.

I'm sure you've all been to a health care professional you've

all had maybe your lungs listened to or a bone examined,

or an area that was sore palpate ID or per cussed, um, and fell to assessed.

So service anatomy is really important for us to

be able to make diagnosis is for understanding treatment,

Um, and for a range of other things, too,

when we think about anatomy, we have to think about the anatomical position,

and this enables us to always come back to how the body is viewed,

and you now can undertake the anatomical position.

So I'd like you to stand there with your head facing straight,

your eyes facing straight.

Put your arms down by your side with your palms facing forward,

stand with your feet together and your toes pointing forward.

And this is the anatomical position

from which all other types of movement and terms are described.

So, for example, if I want to think about something that's above or below,

I might use the term superior

and inferior.

If I want to describe something that's towards the front of the body,

I would use the term anterior or the back of the body posterior.

There's a few more terms as well, but hopefully that gives you some starting points.

When we think about surface anatomy,

we think about actually what can be seen from the outside

the moment perhaps a patient walks in through the door.

So it's about looking at the surface projections that are given by the body.

And this might be about where bones are within our skin.

It might be looking at the colour of our skin, Um,

any any injuries or anything any any medical conditions.

Service anatomy allows us to gently feel and

palpate the skin to understand what is normal.

What is maybe anatomical variation, but also what might be pathological

and surface anatomy has been used for centuries as part of diagnosis and treatment,

and continues to be a really important part of health care training today.

Surface anatomy, links to emitting

and when X rays were invented in 18 95

this first enabled us to see inside the body

and later on in the 19 twenties,

so kind of only in the past 100 years have we had ultrasound

and ultrasound enables us to link surface anatomy.

So what we might see and feel on top of our body,

and we can really quickly put a probe on and see actually structures within the body.

And in a way that is quick is harmless

and the patient doesn't feel any pain.

Ultrasound is as portable as our phones, so it's really quick and easy

and may one day overtake actually the stethoscope

as a means of examination and treatment,

we've been talking a little bit about touching and feeling, and in medical terms,

these are called pal patient.

So PAL patient is where using your dominant hand

on your index finger and your middle finger,

you gently press structures and you're pressing to

feel for structures such as bone and muscle.

It also involves percussion when you're looking to

understand what a sound a structure makes,

Um, and to do this is slightly more complex, but you're going to be using,

um over to make some sound.

And you might go over an area which is really dull,

sounding like the liver or bone or an area which is really hollow,

like the stomach or the lungs, for example,

it's important to think that we are all individuals, and we are not textbooks,

textbooks and other medical resources are amazing,

and they give us the most common form of what the human body is.

But I can guarantee that structures within your body are different to

structures within your brothers or sisters or family or friends bodies.

We are all unique, and this is where the study of anatomy is still evolving.

This is also really why health care needs to learn on lots of different patients, um,

and needs to examine people to understand, actually how that might be, um,

not only across different individuals, different genders and different ages,

of people as well.

When considering anatomy and surface anatomy,

we need to think about what skin colour might be.

As a variant,

we need to think about body size as well as well as gender and assigned sex at birth.

There is also natural variation,

and I'm going to give you an example of natural variation.

If

we're looking at this muscle here and it's called Palmyra's longest,

and to see if you have it,

you take your thumb and your little finger and you

squeeze them together and against a little bit of resistance,

so either get someone to pull that way or resist it

and you can see that just here and here I have two tendons.

If I had this muscle,

I would have attendant That elevated came up right in the midline here, but I don't

This muscle, Palmyra's longest, goes up into your palm

and was a really essential muscle for helping us squeeze our

palm to hold onto things as part of our revolution.

And in some of us many, many years ago, that muscle just disappeared.

And this evolution is happening all the time in our bodies.

There's muscles within our body within our hands and our feet.

Um, that will be slowly evolving as as as our bodies evolved,

the world around us evolves far quicker than our bodies can keep up.

Our natural evolution takes hundreds of millions of years.

Um, and this is an example of that.

So we're going to have a look and to see if we can see this muscle. Palmyra's longest

and my good colleague Catherine here has this muscle on one side,

but not on the other, which is also part of normal variation.

So on Katherine's left side,

I'm going to ask her to bring her little finger and her thumb together

and we're going to hence, her wrist,

and immediately we can see really clearly this tendon in the middle.

And this is the Palmyra's longest tendon.

We can also see tendons just on the right and left side

that are also helping Catherine

flex her wrist.

If I asked Catherine to do this on the other side,

thank you. We can see that there is no equivalent tendon.

We can see some of the other tendons that are helping Catherine flex her wrist.

So on this side,

the Palmyra's longest tendon is scrunching up her

palm and helping her flex on this side.

It doesn't matter that she hasn't got it.

It's just the same effect, Um,

but being brought about by other muscles when thinking about surface anatomy,

we need to think about the largest organ of the body, and that is our skin.

Our skin is amazing, and it's there to give us physical protection.

To help regulate our body temperature and to produce vitamin D.

Our skin is divided into three layers. The very outer layer is called the epidermis,

and the epidemics has layers of keratin sat on top of it,

and this keratin can be really thin if we were to take the example of our eyelids,

or it can be really thick if we take the example from the soul of our foot.

The next layer down is the dermis,

and the dermis contains sweat glands and hair, follow cores

and some really special muscles called the erector papilloma muscle.

And this muscle makes a hair follow. Cool move so that your hair can stand on end.

And this is important in regulating our temperature.

So you might notice when you walk into a cold environment your hairs on your arm,

for example, stand on end,

and this traps the heat nearer our body.

We then move down to the innermost layer,

and this is called the hypothalamus

and the hypo dermis contains varying amounts of

fat or adipose tissue as it's medically known,

and the amount of adipose tissue or fat varies depending on the body region.

So back to our eyelid example.

There's not a lot of adipose tissue in your eyelid,

but in areas such as your abdomen or your thighs, for example,

there might be more amounts of fat