- Anulus Inguinalis
- Abduct HL and find pectineus
- Point to abdomen = supf. inguinal ring
- between the two tendons/laminae of the external oblique
- male: can pull on testicles, the inguinal ring will tense
- Bladder
- grab belly on either side of the bladder, as far as you can go
- pull down, bladder will jump out of your hand
- feels like a muscular thing
- Canalis femoralis
- for femoral artery, vein and nerve (lacuna vasorum)
- medial thigh
- borders: m. pectineus, m. Sartorius caudalis, m. adductor
- simply point to the groove
- Carpus, puncture, tendons
-Tendons: Dorsal->palmar, lat -> med:
ECU-EDL-EDC-ECR-APL-FCR-SDF-DDF-FCU
- lateral and medial collat.ligg. are palpable (from styloid proc; lat. Is from ulna, med. Is from radius)
-only acc. carpal bone is palpable
- Injection: flex carpus and feel the intercarpal grooves
*90 degrees
*radiocarpal: 3. inj. points: bw EDL and EDC, either side of ECR
*prox.intercarpal: 2 inj.points: either side of ECR
-Cephalic vein with. lat+med. radial nerve on either side
- Elbow (nerves, vessels)
- both collateral ligaments are palpable (they are very different from each other)
Injection:
1.In front of or behind collat. lig. (goes from lat.epicondyle to the lat. tuberosity on radius)
2.. 45 degree angle into olecranon fossa (prox->dist), above olecranon
- Epidural anaesthesia
- palpate sacral tubers (behind tub.coxae)
- almost in bw them is a clear depression; space bw L7 and S1 (can count from last rib to be sure you are in the right place)
- needle at right angle to skin: has to go through lig. flavum and duramater, into subarachnoid space
- Fibula
- fibular head easily palpable, sharp edge beneath is the body
- Forearm ligaments
-Shoulder joint: no ligaments (replaced by tendon of infraspinatus lat. and tendon of subscapular med.)
-Transverse lig: holds tendon of biceps in place
-Lateral and medial collat. ligg of elbow joint
-Annular ligament (around radius)
-Lig. Olecrani: enforcement of joint capsule in olecranon fossa
-Tendon of ECR
Tendon of EDC
(at carpus, all tendons are fixed in the retinaculum)
Remember; in the forearm, the cephalic vein, supf antebrachial a. and N. radialis r. supf run in a common sheath on cranial aspect; take care not to hit artery or nerves when puncturing the vein
- Hindlimb nerveblocks: fibularis, tibialis
- N. tibialis-block: find tibial nerve in soft tissue bw common calcanean tendon and digital flexors, inject from medial aspect. Aspirate to make sure you are not in the caudal branch of saphenous a.
- N. peroneus/fibularis communis-block: run thumb nail over head of fibula. Place finger on the head and inject one finger distance prox. to it
- Kidneys
- only L kidney can be palpated, as R kidney is too far cranial and covered by rib cage
- you can feel something smooth, caudal to the last rib on the left side, close to the vertebral column
- Large intestines
- on the left hand side, dorsal abdomen; feel descending colon (especially if the dog is constipated, as we are feeling for fecal balls)
- Laryngeal cartilages and the hyoid skeleton
- palpate the larynx in the ventral neck
- you can feel the thyroid cartilage and sometimes you are able to distinguish the thyroid cartilage and the cricoid cartilage (which is further caudally)
- cranial to the thyroid cartilage, you can feel the thyrohyoid bone - basihyoid bone
- Lymph nodes
Palpable ones
- Mandibular ln: rostral to mandibular salivary gland, on either side of the vein
- Superficial cervical ln: (pre-scapular): right in front of the scapula, a little ventral
- Popliteal ln: grab skin behind stifle (from cau direction)
- Inguinal ln: find the triangle bw. the inguinal canal and linea alba. Push thumb down/up until you find it
- Glands/lymph nodes of the head and neck region
Glands:
- mandibular salivary gland (+ monostomatic sublingual which is attached to it’s rostral end, within the same capsule): grab and pull downwards
- parotid salivary gland (below ear – heart shaped)
- Navel
- = scar of umbilicus
- start at the xiphoid process and move cau along the linea alba
- eventually (approximately at the level of the last rib), you will find something that feels like a scar (not so easy to actually see it)
- Nerve blocks: mentalis, infraorbitalis, alveolaris Mandibularis, lingualis
- N. mentalis: from inside the mouth, there is a mucosa behind the lower canine teeth - insert needle in a rostral diection
- N. infraorbitalis: palpate the foramen and insert needle in a caudal diection with the needle very flat towards the skin
- outside for.: block only feautures outside, inside; everything
- N.alveolaris mandibularis: inject on vent. aspect of head, from angle of mandible (1,5 cm), 90 degrees
- block will naturally numb mental nerve as well
- N. lingualis: inject medially to mandible, in a rost. diection, supf.
- Nerve blocks: N.radialis, N.ulnaris, N.medianus
N.radialis-block: Grab the triceps muscle to see lat. head, and put needle bw. lat. head and brachialis, 45 degrees and proximally
- N. ulnaris-block: in the groove bw. ECU and FCU, on lat. side prox. to acc.carpal bone
- N. medianus-block: prox. to acc.carpal bone, but more medial, bw. FCR and SDF. Put needle bw. them in 45 degrees in a prox. direction
- Palpable features of the cervical vertebrae
- Atlas: wing of atlas, articulation with the occipital bone
- Axis: processus spinosus
- the rest of them: transverse processes
- Pelvis, trochanter
- tuber sacrale
- tuber ischiadicum
- tuber coxae not so prominent in dog because the wings of the ilium are more or less perpendicular in position
- greater trochanter of femur
- Retropharyngeal lymph nodes, thyroid, m.sternocephalicus, m.sternothyroideus, m.sternohyoideus
- Medial retropharyngeal ln: may be palpated beneath the wing of the atlas (put fingers “under” sternomastoid m.)
- Thyroid gland: on cranial trachea
- M.sternocephalicus:
- m.sternomastoideus (mastoid process of temporal bone)
- m.sternooccipitalis (occipital bone)
- M.sternothyroideus + M.sternohyoideus = more midline, on trachea
- Salivary glands and lymph nodes of the head and neck region
- Mandibular + monostomatic sublingual salivary glands: palpated together: right under mandible
- Parotid salivary gland: under ear
- Mandibular lnn: in front of mandibular gland
- Superficial cervical lymph node: in front of scapula, a little ventral
- Stifle
Make a cross bw. femoral condyle and tibial tuberosity, and fibular head and patella (o+i of patellar lig. and lat.collat.lig.), insert needle a bit prox. to the cross
