— lesson 2—

INTRODUCTION TO
TOPOGRAPHIC ANATOMY

Prof.: MD, Nikita Klyshko

External body reference points allow you to draw
boundaries that separate one area from another

Projection is the outline of an organ or part of it on the

surface of a body

Syntopia - the position of the organs in relation to the

adjacent anatomical formations (organs, muscles, vessels,
nerves, etc.).

Syntopia of the organ is described in the process of layer-by-

layer study of the area, usually from the surface to the depth.
Anatomical planes
There are three planes commonly
used; sagittal, coronal and
transverse
•Sagittal plane – a vertical line which divides the
body into a left section and a right section.
•Coronal plane – a vertical line which divides the
body into a front (anterior) section and back
(posterior) section.
•Transverse plane – a horizontal line which divides
the body into an upper (superior) section and a lower
(inferior) section.
Anatomical terms of movement
 Flexion and Extension

Flexion and extension are movements that occur in the sagittal

plane. They refer to increasing and decreasing the angle between
two body parts:

• Flexion refers to a movement that decreases the angle between

two body parts.
• Extension refers to a movement that increases the angle between
two body parts.
 Abduction and Adduction

Abduction and adduction are two terms that are used to describe
movements towards or away from the midline of the body.

• Abduction is a movement away from the midline – just as abducting

someone is to take them away.
• Adduction is a movement towards the midline. Adduction of the hip
squeezes the legs together.
 Medial and Lateral Rotation

Medial and lateral rotation describe movement of the limbs around

their long axis

• Medial rotation is a rotational movement towards the midline. It is

sometimes referred to as internal rotation.
• Lateral rotation is a rotating movement away from the midline.
This is in the opposite direction to the movements described
above.
 Elevation and Depression

• Elevation refers to movement in a superior direction (e.g. shoulder

shrug).
• Depression refers to movement in an inferior direction.
 Pronation and Supination
• With your hand resting on a table in front of you, and keeping your shoulder
and elbow still, turn your hand onto its back, palm up. This is the supine
position, and so this movement is supination.
• Again, keeping the elbow and shoulder still, flip your hand onto its front,
palm down. This is the prone position, and so this movement is
named pronation.
 Dorsiflexion and Plantarflexion

Dorsiflexion and plantarflexion are terms used to describe movements at the

ankle. They refer to the two surfaces of the foot; the dorsum (superior
surface) and the plantar surface (the sole)
• Dorsiflexion refers to flexion at the ankle, so that the foot points more
superiorly. Dorsiflexion of the hand is a confusing term, and so is rarely used.
The dorsum of the hand is the posterior surface, and so movement in that
direction is extension. Therefore we can say that dorsiflexion of the wrist is
the same as extension.
• Plantarflexion refers extension at the ankle, so that the foot points inferiorly.
Similarly there is a term for the hand, which is palmarflexion.
 Inversion and Eversion

Inversion and eversion are movements which occur at the ankle

joint, referring to the rotation of the foot around its long axis.
• Inversion involves the movement of the sole towards the median
plane – so that the sole faces in a medial direction
• Eversion involves the movement of the sole away from the median
plane – so that the sole faces in a lateral direction.
 Body reference points
(external and internal) are anatomical formations that are easily determined
visually or palpably.
They allow to establish the location of the organ or structure of the human body

External reference points of the External reference points of the posterior

front surface of the chest: surface of the chest
1 - jugular fossa 1 – spine of scapula
2 - sternocleidomastoid muscle 2 – Inferior angle of scapula
3 - clavicle 3 – spinous processes of the
4 - sternum thoracic vertebrae
5 – musculus pectoralis major
Topographic lines of the chest (anterior view)

1 - linea mediana anterior

2 - linea sternalis dextra et
sinistra
3 - linea parasternalis dextra
et sinistra
4 - linea medioclavicularis
dextra et sinistra
Topographic lines of the chest (side view)

5 linea axillaris anterior

6 linea axillaris media
7 linea axillaris posterior
Topographic lines of the chest (back view)
8 linea mediana posterior
9 linea vertebralis
10 linea paravertebralis
11 linea scapularis
Regions of abdomen

1 – Epigastric region (regio epigastrica)

2 – Left hypochondric region (regio
hypochondrica sinistra)
3 - Right hypochondric region (regio
hypogastrica dextra)
4 - Umbilical area (regio umbilicalis)
5 – Left lateral abdominal region (regio
lateralis sinistra)
6 - Right lateral abdominal region
(regio lateralis dextra)
7 – Pubic region (regio pubica)
8 – Left iliac region (regio iliaca
sinistra)
9 - Right iliac region (regio iliaca
dextra)
 Borders that separate one area from another are conducted using
external referent points

Projection is the outline of an

organ or part of it on the surface
of a body
Syntopy - the position of the
organs in relation to the adjacent
anatomical formations (organs,
muscles, vessels, nerves, etc.).

Projection of internal organs on the

anterolateral wall of the abdomen
 Layered structure of the shoulder
1.Skin
2.Subcutaneous tissue
3.Superficial fascia
4.Superficial layer of the own fascia of the
shoulder
5.Shoulder muscles, neurovascular bundle
of the region
6.Deep layer of the own fascia of the
shoulder
7.Brachial bone
Layered structure of the shoulder – studding of all layers of the area
sequentially, starting from the skin ending with bone
5. musculus biceps brachii)
Skin
Layered structure of the
Subcutaneus anterior area of shoulder
tissue

Superficial fascia
neurovascular bundle
Superficial layer of
the fascia of the Musculus brachialis
shoulder

Brachial bone
The neurovascular bundle of the
anterior region of the shoulder
(brachial artery, brachial vein,
median nerve: elements of the
neurovascular bundle)
Layered structure of the hand

1 Skin
2 – Subcutaneus tissue
3 – Palmar aponeurosis
4 – Subaponeurotic fat tissue space
5 – Finger flexor tendon
6 – Subtendon fat tissue space
7 – metacarpal bones
8 – fat tissue space of back of the hand
Handling surgical instruments
Surgical knot tying