ANATOMY

Ulysses R. Rallon, BSN- RN, Llb., MD, DPBS, FPSGS, FPCS

General Surgeon
 DEFINITION
Is the study of the structure of the human
body
Is a descriptive science
 DEFINITION
Three Approaches :
Regional Anatomy
Considers the organization of the human body as major
parts or segments
Systemic Anatomy
Study of the bodys organ systems that work together
to carry our complex functions
Clinical Anatomy
Emphasizes aspects of bodily structure and function
important in the practice of medicine, dentistry and
allied health sciences.
 The study of anatomy requires a clinical
vocabulary that defines position,
movements, relationships, and planes of
reference and describes the systems of the
human body.
 ANATOMIC POSITION
Expressed in relation to one consistent
position
Ensures that description are not ambiguous
Refers to the body position as if the person
were standing upright
Head, gaze and toes directed anteriorly
Arms adjacent to the sides with the palms facing
anteriorly
Lower limbs close together with the feet parallel
 ANATOMIC PLANES
Based on four imaginary planes that intersect
the body in the anatomical position
Median
Sagittal
Frontal
Transverse
 ANATOMIC PLANES
Based on four imaginary planes that intersect
the body in the anatomical position
Median
The vertical plane passing longitudinally through the
body
Divides the body into right and left halves
 ANATOMIC PLANES
Based on four imaginary planes that intersect
the body in the anatomical position
Sagittal
Vertical planes passing though the body parallel to the
median plane
 ANATOMIC PLANES
Based on four imaginary planes that intersect
the body in the anatomical position
Frontal
Vertical planes passing through the body at right angles
to the median plane
Divide the body into anterior (front) and posterior
(back) parts.
 ANATOMIC PLANES
Based on four imaginary planes that intersect
the body in the anatomical position
Transverse
Horizontal planes passing through the body at right
angles to the median and frontal planes
Divides the body into superior( upper) and
inferior(lower) parts.
Referred to as transaxial or axial planes
ANATOMIC POSITION
 RELATIONSHIP AND COMPARISON
Adjectives arranged in pairs of opposites
Describes relationship of parts of the body
Compare the position of two structures
relative to each other
 RELATIONSHIP AND COMPARISON
Superior
Refers to a structure that is nearer the vertex (the
topmost point of the cranium)

Inferior
Refers to structure that is situated nearer the sole
of the foot.
 RELATIONSHIP AND COMPARISON
Posterior
Denotes the surface of the body or nearer to the
back

Anterior
Denotes the front surface of thebody
Rostral
Used instead of anterior when describing parts of the
brain
Denotes nearer the anterior part of the head
 RELATIONSHIP AND COMPARISON
Medial
Indicate a structure nearer to the median plane

Lateral
Indicates that the structure is farther away from
the median plane
RELATIONSHIP AND COMPARISON
Dorsum
Refers to the superior aspect of any part that
protrudes anteriorly from the body
e.g. Dorsum of the foot
Refers to both superior and posterior surfaces in
humans
 RELATIONSHIP AND COMPARISON
Superficial, intermediate and deep
Describes the position of structures relative to the surface of the
body
Relationship of one structure to another underlying or overlying
structure

External
Means outside of or farther from the center of an organ or
cavity

Internal
Means inside or close to the center, independent of direction
 RELATIONSHIP AND COMPARISON
Proximal
Used when contrasting positions nearer to or from
the attachment of a limb or the central aspect of a
linear structure

Distal
Used when contrasting positions farther from the
attachment of a limb or the central aspect of
linear structure
RELATIONSHIP AND COMPARISON
 LATERALITY
Bilateral
Paired structures having right or left members
Unilateral
Refers to those occurring on one side only
Ipsilateral
Something occurring on the same side of the body as
another structure
Contralateral
Occurring on the opposite side of the body relative to
another structure
 MOVEMENT
Most are defined in relationship to the
anatomical position
Occurring within and around axes aligned with
specific anatomical planes
May also be considered in pairs of opposing
movement
MOVEMENT
MOVEMENT
 Integumentary System
The skin
readily accessible
one of the best indicators of general health
careful observation is important in physical
examinations
considered in the differential diagnosis of almost
every disease.
 Integumentary System
The skin:
provides:
Protection of the body from environmental effects:
Abrasions
fluid loss
harmful substances
ultraviolet radiation
invading microorganisms.
 Integumentary System
The skin:
provides:
Containment for the body's structures:
tissues and organs
vital substances especially extracellular fluids
preventing dehydration
may be severe when extensive skin injuries
(e.g., burns) are experienced.
 Integumentary System
The skin:
provides:
Heat regulation:
through the evaporation of sweat
the dilation or constriction of superficial blood vessels.
Sensation
(e.g., pain) by way of superficial nerves and their sensory
endings.
Synthesis and storage of vitamin D.
 Integumentary System
The skin:
the body's largest organ
consists of:
the epidermis
a superficial cellular layer
the dermis,
a deep connective tissue layer
 Integumentary System
The epidermis:
a keratinized epithelium
it has a tough, horny superficial layer
provides a protective outer surface overlying its
regenerative and pigmented deep or basal layer
has no blood vessels or lymphatics
nourished by the underlying vascularized dermis
 Integumentary System
The dermis:
supplied by arteries that enter its deep surface to
form a cutaneous plexus of anastomosing arteries.
supplied with afferent nerve endings that are
sensitive to touch, irritation (pain), and
temperature
Most nerve terminals are in the dermis, but a few
penetrate into the epidermis.
 Integumentary System
The dermis:
a dense layer of interlacing collagen and elastic
fibers.
provide skin tone
account for the strength and toughness of skin.
 Integumentary System
The dermis:
Karl Langer
an Austrian anatomist
studied the skin of unembalmed cadavers
Observed that:
the bundles of collagen fibers in the dermis run in all
directions to produce a tough felt-like tissue
in any specific location most fibers run in the same direction.
noted that stab wounds in a cadaver's skin produced by an ice
pick are slit-like rather than rounded because the pick splits
the dermis in the predominate direction of the collagen fibers
and allows the wound to gape.
 Integumentary System
The dermis:
The predominant pattern of collagen fibers determines the
characteristic tension and wrinkle lines in the skin.
The tension lines (also called cleavage lines or Langer lines)
tend to spiral longitudinally in the limbs
run transversely in the neck and trunk
Tension lines at the elbows, knees, ankles, and wrists are parallel
to the transverse creases that appear when the limbs are flexed
The elastic fibers of the dermis deteriorate with age and
are not replaced
in older people the skin wrinkles and sags as it loses its elasticity.
 Integumentary System
The skin:
contains many specialized structures
The deep layer of the dermis contains:
hair follicles
with associated smooth arrector muscles
Contraction of the arrector muscles of hairs erects the
hairs, causing goose bumps.
are generally slanted to one side
several sebaceous glands
lie on the side
contraction of the arrector muscles causes the hairs to
stand up straighter, compressing the sebaceous glands
and helping them secrete their oily product onto the skin
surface.
 Integumentary System
The skin:
contains many specialized structures
The deep layer of the dermis contains:
sweat glands
The evaporation of the watery secretion (sweat)
provides a thermoregulatory mechanism for heat loss
(cooling)
the small arteries (arterioles)
Involved in the loss or retention of body heat
dilate to fill superficial capillary beds to radiate heat (skin
appears red)
constrict to minimize surface heat loss (skin, especially
of lips and fingertips, appears blue)
 Integumentary System
The skin:
contains many specialized structures
Other integumentary structures or derivatives
include:
the hair
the nails (fingernails, toenails)
the mammary glands
the enamel of teeth.
 Integumentary System
The skin:
the subcutaneous tissue (superficial fascia)
Located between the overlying skin (dermis) and underlying
deep fascia
composed mostly of loose connective tissue and stored fat
contains :
sweat glands
superficial blood vessels
lymphatic vessels
cutaneous nerves
The neurovascular structures course in this layer, distributing
only their terminal branches to the skin
 Integumentary System
The skin:
the subcutaneous tissue (superficial fascia)
provides for most of the body's fat storage
its thickness varies greatly, depending on:
nutritional state
in different sites in the same individual
Example:
the relative abundance of subcutaneous tissue
evident by the thickness of the fold of skin at the
waist or thighs
the anteromedial part of the leg (the shin, the
anterior border of the tibia) or the back of the
hand, the latter two being nearly devoid of it.
 Integumentary System
The skin:
the subcutaneous tissue (superficial fascia)
provides for most of the body's fat storage
its thickness varies greatly, depending on:
between the sexes:
In mature females, it tends to
accumulate in the breasts and thighs
In males, in the lower abdominal wall.
 Integumentary System
The skin:
the subcutaneous tissue (superficial fascia)
participates in thermoregulation, functioning as
insulation, retaining heat in the body's core.
provides padding that protects the skin from
compression by bony prominences, such as in the
buttocks.
 Integumentary System
The skin:
Skin ligaments (L. retinacula cutis)
numerous small fibrous bands
extend through the subcutaneous tissue
attach the deep surface of the dermis to the underlying
deep fascia
 Integumentary System
The skin:
Skin ligaments (L. retinacula cutis)
The length and density of these ligaments determines
the mobility of the skin over deep structures
Where skin ligaments are longer and sparse, the skin is more
mobile, such as on the back of the hand
Where ligaments are short and abundant, the skin is firmly
attached to the underlying deep fascia, such as in the palms
and soles
Skin ligaments are long but particularly well developed in the
breasts, where they form weight-bearing suspensory
ligaments
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
Fascias :
constitute the wrapping, packing, and insulating
materials of the deep structures of the body.
Underlying the subcutaneous tissue (also called
superficial fascia) almost everywhere is the deep fascia
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
Fascias :
The deep fascia:
is a dense, organized connective tissue layer
devoid of fat
covers most of the body parallel to (deep to) the
skin and subcutaneous tissue
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
Fascias :
The deep fascia:
Extensions from its internal surface invest deeper
structures, such as individual muscles and
neurovascular bundles, as investing fascia
Its thickness varies widely.
In the face and ischioanal fossa, distinct layers of
deep fascia are absent.
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
Fascias :
The deep fascia:
In the limbs
groups of muscles with similar functions sharing the
same nerve supply are located in compartments,
separated by thick sheets of deep fascia, called
intermuscular septa
extend centrally from the surrounding fascial
sleeve to attach to the bones.
contain or direct the spread of an infection or a
tumor.
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
Fascias :
The deep fascia:
In a few places, gives attachment (origin) to the underlying
muscles
In most places, the muscles are free to contract and glide
deep to it.
itself never passes freely over bone
Where it contacts bone, it blends firmly with the periosteum
(bone covering).
 Integumentary System
Fascias, Fascial Compartments, Bursae, and Potential
Spaces
Fascias :
The deep fascia:
The relatively unyielding
limits the outward expansion of the bellies of contracting skeletal
muscles.
Blood is pushed out as the veins of the muscles and compartments are
compressed.
Valves within the veins allow the blood to flow only in one direction
(toward the heart), preventing the backflow that might occur as the
muscles relax.
Thus deep fascia, contracting muscles, and venous valves work
together as a musculovenous pump to return blood to the heart,
especially in the lower limbs where blood must move against the
pull of gravity
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
Fascias :
The deep fascia:
Near certain joints (e.g., wrist and ankle), becomes markedly
thickened, forming a retinaculum (plural = retinacula)
hold tendons in place where they cross the joint during
flexion and extension
preventing them from taking a shortcut, or bow stringing,
across the angle created
 Integumentary System
Fascias, Fascial Compartments, Bursae, and Potential
Spaces
Subserous fascia
with varying amounts of fatty tissue
lies between the internal surfaces of the musculoskeletal
walls and the serous membranes lining the body cavities.
These are the:
Endothoracic
Endoabdominal
Endopelvic fascias
the latter two may be referred to collectively as
extraperitoneal fascia.
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
Bursae
closed sacs or envelopes of serous membrane
a delicate connective tissue membrane capable of
secreting fluid to lubricate a smooth internal surface
are collapsed or essentially empty, except for a thin
layer of lubricating fluid secreted by the membrane.
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
Bursae
Usually occurring in locations subject to friction
enable one structure to move more freely over another.
Subcutaneous bursae
occur in the subcutaneous tissue between skin and
bony prominences, such as at the elbow or knee
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
Bursae
subfascial bursae
lie beneath deep fascia
subtendinous bursae
facilitate the movement of tendons over bone.
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
Bursae
Synovial tendon sheaths
are a specialized type of elongated bursae
wrap around tendons
usually enclosing them as they traverse osseofibrous tunnels
that anchor the tendons in place
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
Bursae :
occasionally communicate with the synovial cavities of
joints.
formed only of delicate, transparent serous membrane
and are collapsed
are not easily noticed or dissected in the laboratory.
It is possible to display bursae by injecting and
distending them with colored fluid
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
bursae and synovial tendon sheaths:
empty, or potential, sacs or spaces
lined with or formed of a serous or synovial membrane
encountered in the study of anatomy.
these spaces are collapsed so that they have no depth
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
bursae and synovial tendon sheaths:
their walls are apposed with only a thin film of lubricating
fluid between them.
When the wall is interrupted at any point or when a fluid is
secreted or formed within them in excess, they become
realized spaces; however, this condition is abnormal or
pathological.
Such collapsed bursal sacs surround many important organs
(e.g., the heart, lungs, and abdominal viscera) and structures
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
bursae and synovial tendon sheaths
the heart is surrounded by but is not inside the
pericardial sac.
Each lung is surrounded by but is not inside a pleural
sac
The abdominal viscera are surrounded by but are not
inside the peritoneal sac.
 Integumentary System
Fascias, Fascial Compartments, Bursae, and
Potential Spaces
bursae and synovial tendon sheaths
the inner layer of the serous sac (the one adjacent to the
fist, viscus, or viscera) is called the visceral layer; the outer
layer or the one in contact with the body wall is called the
parietal layer.
Such a surrounding double layer of membranes, moistened
on their apposed surfaces
confers freedom of movement on the surrounded structure
when it is contained within a confined space, such as the
heart within the thorax and a tendon traversing an
osseofibrous tunnel.
 Integumentary System
Fascias, Fascial Compartments, Bursae, and Potential
Spaces
Fascial Planes
Potential spaces between adjacent fascias or fascia-lined
structures or within loose areolar fascias, such as the subserous
fascias.
Used to separate structures to create actual spaces that allow
movement and access to deeply placed structures.
extrapleural or extraperitoneal fascial planes
Allow operation outside the membranes lining the body cavities,
minimizing the potential for contamination, the spread of infection, and
consequent formation of adhesions within the cavities.
Unfortunately, these planes are often fused and difficult to
establish or appreciate in the embalmed cadaver.