Surface Landmarks of the Limbs

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UL: Shoulder & Arm - Peak Performance Points

  • Acromion: Palpable tip of the shoulder; highest bony point.
  • Clavicle: S-shaped; fractures common at junction of middle and outer thirds.
  • Coracoid Process: Palpated in deltopectoral groove, inferior to lateral clavicle.
  • Greater Tubercle of Humerus: Most lateral bony point of shoulder; rotator cuff insertion.
  • Deltoid Muscle: Forms rounded contour; common site for intramuscular injections.
  • Surgical Neck of Humerus: Common fracture site; risk to axillary nerve & posterior circumflex humeral artery.
  • Spiral Groove: Obliquely crosses posterior humerus; lodges radial nerve & profunda brachii artery.
  • Brachial Artery: Medial to biceps brachii; palpated for brachial pulse, used for BP.

Surface landmarks of the shoulder and upper arm

⭐ Axillary nerve injury (surgical neck of humerus fracture / anterior shoulder dislocation) causes deltoid paralysis & regimental badge area anesthesia (skin over deltoid).

UL: Forearm & Hand - Handy Landmarks

  • Elbow/Proximal Forearm:
    • Olecranon (ulna): Point of elbow.
    • Radial head: Below lat. epicondyle; rotates (pronation/supination).
  • Wrist (Distal Forearm):
    • Styloid processes: Radial (lat., extends more distally), Ulnar (med.).
    • Lister's tubercle: Dorsal radius; pulley for Ext. Pollicis Longus.
  • Hand:
    • Anatomical Snuffbox:
      • Borders: Abductor pollicis longus & Extensor pollicis brevis (lat.), Extensor pollicis longus (med.).
      • Floor: Scaphoid, trapezium. Contains radial artery.
    • Pisiform: Anteromedial wrist; base of hypothenar.
    • Hook of Hamate: Deep, distal/radial to pisiform.
    • Metacarpal heads: Knuckles.
    • Palmar creases.

Anatomical Snuffbox: Borders and Floor

⭐ Tenderness in the anatomical snuffbox (floor: scaphoid, lunate) strongly suggests scaphoid fracture, a common wrist injury.

LL: Hip & Thigh - Foundation Formations

  • Anterior Superior Iliac Spine (ASIS): Key bony landmark; attachment for inguinal ligament & sartorius.
  • Iliac Crest: Palpable superior border of ilium; highest point is supracristal plane (L4 vertebra).
  • Pubic Tubercle: Medial attachment of inguinal ligament.
  • Greater Trochanter: Prominent bony projection on lateral proximal femur; palpate with hip rotation.
  • Ischial Tuberosity: Bears weight when sitting; hamstring attachment.
  • Femoral Triangle: Boundaries: inguinal ligament (superior), sartorius (lateral), adductor longus (medial).
    • Contents (Lateral to Medial): Femoral Nerve, Artery, Vein, Lymphatics (📌 NAVEL).

⭐ The femoral artery is palpated at the midinguinal point (midway between ASIS & pubic symphysis) for pulse & vascular access.

  • Adductor Tubercle: Medial aspect of distal femur; insertion of adductor magnus.
  • Patella: Sesamoid bone within quadriceps tendon; apex points inferiorly.

LL: Leg & Foot - Ground Control Points

  • Leg Key Points:
    • Tibial tuberosity: Insertion of patellar ligament.
    • Anterior border of tibia (shin): Subcutaneous, palpable.
    • Medial malleolus: Distal tibia, medial ankle prominence.
    • Lateral malleolus: Distal fibula, lateral ankle prominence.
    • Head of fibula: Posterolateral to lateral tibial condyle.
  • Foot Key Points:
    • Base of 5th metatarsal: Prominent, for peroneus brevis.
    • Sustentaculum tali: Medial calcaneal shelf, supports talus.
    • Foot Arches: Medial & lateral longitudinal, transverse.
    • 📌 Tarsal Bones: Tiny Cats Nip My Inner Leg Carefully (Talus, Calcaneus, Navicular, Medial, Intermediate, Lateral cuneiforms, Cuboid).

⭐ Dorsalis pedis pulse, crucial for assessing peripheral circulation, is found lateral to the extensor hallucis longus tendon on the foot dorsum. Arteries of the Leg and Foot

High‑Yield Points - ⚡ Biggest Takeaways

  • Axillary artery: Palpable in lateral axillary wall, inferior to deltopectoral groove.
  • Brachial artery: Medial to biceps tendon in cubital fossa.
  • Radial artery: Lateral to FCR tendon at wrist; common pulse site.
  • Femoral artery: Located at mid-inguinal point; key for access.
  • Popliteal artery: Deep in popliteal fossa; palpate with knee flexed.
  • Dorsalis pedis artery: Lateral to EHL tendon on foot dorsum.
  • Great saphenous vein: Anterior to medial malleolus; for IV access/cutdown.

Practice Questions: Surface Landmarks of the Limbs

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Which arteries supply the talus?

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Flashcards: Surface Landmarks of the Limbs

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An imaginary plane drawn, extending between _____ of eye and the angle of mandible, is known as Ohngren's line

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An imaginary plane drawn, extending between _____ of eye and the angle of mandible, is known as Ohngren's line

medial canthus

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