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Surface anatomy of the female seen anteriorly and posteriorly.
Hey everyone! This is Nicole from Kenhub, and in this tutorial, we'll be looking at the surface anatomy of the female body.
In this tutorial as I mentioned, we'll be looking at the surface anatomy of the female body and while aspects of the surface anatomy are the same or pretty similar between the sexes, there are a few differences some of which we'll be highlighting in this tutorial. Surface anatomy is important to know especially when you're conducting a clinical examination as surface anatomy will not only provide you with major anatomical landmarks but also will help you with diagnosis itself especially when you're engaged in activities such as auscultation, inspection, palpation, percussion and function testing.
As in addition to being bodily organs, landmarks can be formed by the shape of the underlying tissue and therefore can be considered a bony landmark which indicates a bony structure lying beneath it or a soft tissue landmark which indicates that muscle or some other kind of soft tissue is lying beneath it. And as we go along, we'll point out if the structure is a bony or soft tissue landmark or if it is indeed an external organ of the body.
Surface anatomy in the female like the surface anatomy in the male body can also be divided into an anterior aspect and a posterior aspect which each can be divided into an upper and lower half. And, of course, we'll begin with the upper half of each aspect before moving onto the lower half. But first let's begin with the anterior aspect.
So, on our anterior surface, the first structure I want to look at is the soft tissue landmark of the trapezius muscle whose outline can be seen here highlighted in green. The trapezius muscle seen here on the right from the posterior aspect is a flat triangular muscle of the shoulder girdle whose function is to stabilize and secure the shoulder blade at the thorax among other tasks. And although these muscle is found on the back of the body extending from the occipital bone and the nuchal ligament to the spinous processes of the twelfth thoracic vertebra, the spine of the scapula – the part of its outline where it inserts into the clavicle and the acromion – can be seen on the anterior aspect of the body as you can see on the image on the right. Another soft tissue landmark that is quite easily discernible is the bulge of the deltoid muscle. This fleshy bulge overlies the deltoid muscle which can be seen in green on the right.
From a soft tissue landmark, let's move on to the bony landmark of the clavicle. The clavicle, which you can see clearly on the image on the right, is an elongated S-shaped bone that rests horizontally on the sternum across the upper part of the rib cage and the acromial end of the scapula. On most humans, it's relatively easy to see and palpate depending on the amount of body fat an individual possesses. The clavicle is also known colloquially as the "collar bone".
Between the proximal ends of the clavicle at the base of the neck is a visible depression called the suprasternal notch. This depression also known as the jugular notch outlines the superior concave border of the manubrium and you can see the superior border of the manubrium just here. This tip is not only quite easy to visualize but also easily palpable. Unlike the suprasternal notch, the sternal line is a mostly invisible but easily palpated line that runs vertically between the breasts. This imaginary line passes through the midline of the sternum and overlies the body of the sternum.
One of the more prominent features that differs from male surface anatomy is the breasts. Although males do possess breasts or mammary glands, they are more prominent in female anatomy due to the fact that they play a role as accessory reproductive organs while in males they are essentially rudimentary. As such, the breasts in females are usually larger and more easily distinguishable and you can see an image of the lobules of the mammary gland on the right just here.
On the breasts themselves is a circular pigmented area of skin known as the areola. The term areola comes from the Latin meaning "small area". At the center of the areolae are projections known as nipples. At the tip of the cylindrical prominences is a fissure where the lactiferous glands terminate or open into which of course are mainly involved in the production of milk for a newborn to suckle. And we can see the lactiferous glands in the nipple on the image on the right.
At the junction between the upper arm and the forearm anteriorly is the cubital fossa. This triangularly-shaped area or depression contains four important structures – the median nerve, the radial nerve, the brachial artery and the tendons of the biceps brachii muscle. In addition, the cubital fossa is also a common site for venipuncture and, during blood pressure measurements, the diaphragm of the stethoscope is placed on this area to palpate the pulse of the brachial artery.
A prominent surface landmark is the umbilicus more commonly referred to as the navel or the belly button. This surface landmark which – when is located within the umbilical depression is colloquially called an "innie" and when it protrudes from this depression, it's colloquially called an "outie" – does not depict any underlying soft tissue or bone but rather represents a scar at the attachment site of the fetal umbilical cord.
Next we can see on either side of the pelvis two bony projections that can easily be palpated. These surface projections represent the underlying protrusions of the anterior superior iliac spine of the pelvic bones. The image of our lateral view of the left pelvis on the right corresponds with this bony landmark in the image of our female. Moving further down, another surface landmark unique to the female body is the mons pubis. This is a rather massive fatty tissue situated over the pubic symphysis which we can see here on the right. The mons pubis segments inferiorly to create the labia majora and, in post-pubescent females, is generally covered in hair.
On the anterior aspect of the lower limb at what we essentially refer to as the knee, we can see this circular triangular protrusion that can easily be palpated. This marks the position of the underlying patella or kneecap which is the largest sesamoid bone in the body. This bone sits in front of the knee joint protecting it from damage.
At the lower end of the lower leg on the medial aspect of what we commonly refer to as the ankle, a bony protrusion known as the medial malleolus can be found. The medial malleolus is essentially a bony protrusion found at the inferior end of the tibia which we can see on our right. Now on the lateral aspect of the ankle, the bony protrusion seen here is the lateral malleolus. As we saw before, the medial malleolus is formed by the inferior protrusion of the tibia whereas the lateral malleolus is formed by the protrusion of the fibula at its inferior end.
Let's move on to the posterior aspect of the female body now and look at the inferior angle of the scapula which depending on the amount of body fat an individual possesses can also be easily visualized and palpated. On a lean person, these surface projections of the inferior angle of the underlying scapula can quite easily be seen especially when the shoulders are pulled back.
Moving inferiorly a bit further, this space or groove seen here between the buttocks is known as the intergluteal cleft, and on the right here is an image of the gluteus maximus whose external protrusions create this cleft. The intergluteal cleft runs from the sacrum to the perineum and is often colloquially referred to as the "butt crack". Inferior to the buttocks is this crease seen here known as the gluteal sulcus. It is worth noting that the gluteal sulcus is not actually formed by the inferior border of the gluteus maximus muscle although the crease does line up with the border. It is instead formed by a fold of skin.
On the posterior aspect of the knee joint, we see this diamond-shaped depression known as the popliteal fossa. Its boundaries are formed by the muscles of the thigh and the leg and it has several important blood vessels and nerves that pass through it including the popliteal artery, the popliteal vein and the sciatic nerves which at the popliteal fossa superior border divides into the tibial nerve and the common popliteal nerve.
Finally, the heel is also a pretty prominent surface landmark formed by the posterior protrusion of the calcaneus which is more commonly known as the heel bone. The Achilles tendon attaches to this bone which plays an important role in weightbearing and stability.
So now that we've reached the end of this tutorial, let's briefly go over what we've looked at today. So on the anterior aspect of the female body we saw the trapezius, deltoid, the clavicle, the suprasternal notch, the sternal line, breasts, areola, cubital fossa, umbilicus, the anterior superior iliac spine, the mons pubis, the patella, the medial malleolus, and the lateral malleolus while on the posterior aspect we saw the inferior angle of the scapula, the intergluteal cleft, the gluteal fold, the popliteal fossa, and the calcaneus.
And that's the end of our tutorial. Thanks again for watching.
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Now, good luck everyone, and I will see you next time.