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ESA 1 - Body Logistics > Session 4.2 - Group Work > Flashcards

Session 4.2 - Group Work Flashcards

1
Q

What is surface anatomy?

A

The study of EXTERNAL FEATURES OF THE BODY, that can be visualised without dissection.

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2
Q

What are the features you should be able to locate on yourself/each other?

A

ON THE HEAD

  • Mastoid Process
  • Nasal Bones and Nasal Cartilages
  • Zygomatic Arch
  • Angle of Mandible

ON THE NECK

  • Hyoid Bone
  • Thyroid and Cricoid Cartilage
  • Sternocleidomastoid Muscle
  • C7 Vertebrae Spinous Processes

ON THE THORAX

  • Manubriosternal Joint
  • Nipples
  • Costal Margin
  • Intercostal Spaces

ON THE ABDOMEN
- Umbilicus

ON THE UPPER LIMB

  • Biceps Tendon
  • Medial Epicondyle, Ulnar Nerve and Olecranon
  • Head of Ulna
  • Radial Artery at the Wrist
  • Thenar Eminence

ON THE LOWER LIMB

  • Iliac Crest
  • Greater Trochanter
  • Tibial Tuberosity
  • Anterior (Subcutaneous) Tibia
  • Medial and Lateral Malleoli
  • Calcaneum and Achilles Tendon
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3
Q

What are the features of the head that you need to identify?

A
  • Mastoid process
  • Nasal bones and nasal cartilages
  • Zygomatic arch
  • Angle of mandible
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4
Q

Identify the mastoid process on yourself

A

Bony lump POSTERIOR to the ear lobe

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5
Q

Fig. 6 (left)
(Slide 6)

Label the image

A
  • Mastoid process

Bony lump POSTERIOR to the ear lobe

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6
Q

What is the clinical relevance of the mastoid process?

A
  • Site of bruising in basal skull fractures (aka battle’s sign)
  • Common site of bacterial infection (mastoiditis)
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7
Q

What is the site of bruising in basal skull fractures (of the mastoid process) known as?

A

Battle’s sign

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8
Q

What is battle’s sign?

A

Site of bruising in basal skull fractures (mastoid process)

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9
Q

The mastoid process is a common site of …?

A

Bacterial infection

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10
Q

What is mastoiditis?

A

Bacterial infection of the mastoid process (it is a common site of bacterial infection)

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11
Q

Fig. 6 (top right)

What does this image show?

A

Site of bruising in basal skull fractures (aka Battle’s Sign)

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12
Q

Fig. 6 (bottom right)

What does this picture show?

A

Common site of bacterial infection of the mastoid process (mastoiditis)

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13
Q

Identify the nasal bones and nasal cartilages on yourself

A

Nasal Bone - superior, firm part of external nose

Nasal Cartilage - inferior, soft part of external nose

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14
Q

Fig. 8

Label the nasal bone and nasal cartilage

A

Nasal Bone - superior, firm part of external nose

Nasal Cartilage - inferior, soft part of external nose

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15
Q

Where is the nasal bone?

A

SUPERIOR, firm part of external nose

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16
Q

What is the superior, firm part of external nose?

A

Nasal bone

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17
Q

What is the nasal cartilage?

A

INFERIOR, soft part of external nose

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18
Q

What is the inferior, soft part of external nose?

A

Nasal Cartilage

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19
Q

Fig. 8

Label the image

A
  • Frontal bone
  • Nasal bones
  • Frontal process of maxilla
  • Lateral process of septal nasal cartilages
  • Septal cartilage
  • Minor alar cartilage
  • Accessory nasal cartilage
  • Lateral crus of major alar cartilage
  • Medial crus of major alar cartilage
  • Septal nasal cartilage
  • Anterior nasal spine of maxilla
  • Alar fibrofatty tissue
  • Infraorbital foramen
  • Nasal Bone - superior, firm part of external nose
  • Nasal Cartilage - inferior, soft part of external nose
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20
Q

What is the clinical relevance of the nasal anatomy?

A

If someone is having a nosebleed (epistaxis), press on the nasal cartilage NOT the nasal bone.

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21
Q

What is epistaxis?

A

Nosebleeds

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22
Q

What is the medical term for nosebleeds?

A

Epistaxis

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23
Q

Where should you hold the nose to prevent epistaxis?

A

On the nasal cartilage, NOT the nasal bone.

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24
Q

What is the zygomatic arch?

A

‘cheek bone’

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25
What is the 'cheek bone' more formally known as?
Zygomatic arch
26
Where does the zygomatic arch lie?
Starts ANTERIOR to the tragus and extends ANTEROMEDIALLY
27
What starts anterior to the tragus and extends anteromedially?
The zygomatic arch ('cheek bone')
28
What is the clinical relevance of the zygomatic arch?
- Superficial temporal pulse can be palpated just superior to the zygomatic arch, and anterosuperior to the tragus. - This is the site of artery biopsy in a person with suspected temporal arteritis
29
Where can the superficial temporal pulse be palpated?
Just superior to the zygomatic arch, and anterosuperior to the tragus
30
What can be palpated superior to the zygomatic arch, and anterosuperior to the tragus?
The superficial temporal pulse
31
Where would you do an artery biopsy in a person with suspected temporal arteritis?
Just superior to the zygomatic arch, and anterosuperior to the tragus
32
What is temporal arteritis?
A condition in which the temporal arteries become inflamed or damaged.
33
Fig. 10 (slide 10) Label the image
- External ear - External auditory meatus - Pterion - Superior margin of orbit - Frankfort line - Inferior margin of orbit --> Zygomatic arch ('cheek bone') starts anterior to the tragus and extends anteromedially
34
Fig. 12 (left) What is this image showing?
Angle of mandible
35
What is the clinical relevance of the angle of mandible?
When performing a 'jaw thrust' in a person to maintain their airway, you find the angle of the mandible and pull the bottom jaw anteriorly
36
How do you perform a jaw thrust?
Find the angle of the mandible and pull the bottom jaw anteriorly
37
What is a jaw thrust used for?
For maintaining a person's airway
38
What do you do to maintain a person's airway?
A jaw thrust (find the angle of the mandible and pull the bottom jaw anteriorly)
39
Fig. 12 (right) What is this image showing?
A jaw thrust (find the angle of the mandible and pull the bottom jaw anteriorly) done to maintain a person's airway
40
What are the features of the neck that you need to identify?
- Hyoid bone - Thyroid and cricoid cartilage - Sternocleidomastoid muscle - C7 vertebrae spinous processes
41
Fig. 15 Label the image
- Body of the hyoid bone - Greater horn of the hyoid bone - Laryngeal prominence - Lamina of the thyroid cartilage - Cricoid cartilage - Lobe of the thyroid gland - First tracheal ring - Isthmus of the thyroid gland
42
Identify the thyroid cartilage
Inferior to hyoid bone
43
What is the thyroid cartilage?
'Adam's apple'
44
What lies inferior to the hyoid bone?
Thyroid cartilage
45
Identify the cricoid cartilage
Inferior to thyroid cartilage
46
What lies inferior to thyroid cartilage?
Cricoid cartilage
47
Fig. 17 (right) Label the image.
- Thyroid notch - Laryngeal prominence - Position of cricothyroid ligament - Arch of cricoid cartilage - Cricoid cartilage - inferior to thyroid cartilage - Thyroid cartilage ('adam's apple') - inferior to hyoid bone
48
What is the clinical relevance of the thyroid and cricoid cartilage?
The membrane between the two cartilages, the cricothyroid membrane, is the site you would perform an emergency cricothyroidotomy in the case of upper airway obstruction
49
Where is a cricothyroidotomy performed?
The cricothyroid membrane
50
What is a cricothyroidotomy?
An emergency procedure performed in the case of upper airway obstruction
51
What is the emergency procedure that is performed in the case of an upper airway obstruction called?
A cricothyroidotomy
52
Fig. 17 (top left) What is this image showing?
An emergency cricothyroidotomy being performed,at the cricothyroid membrane (membrane between the thyroid and cricoid cartilage)
53
Fig. 17 (bottom left) Label the image
- Thyroid cartilage - Cricothyroid membrane - Cricoid cartilage
54
Identify sternocleidomastoid muscle.
Extending between sternum, clavicle and mastoid process.
55
Where does sternocleidomastoid extend between?
- Sternum 'sterno' - Clavicle 'cleido' - Mastoid process 'mastoid'
56
Fig. 19 Label the image
- Mandible - Sternocleidomastoid - Clavicle - Mastoid process - Trapezius
57
Identify C7 vertebrae spinous process.
Vertebra prominens
58
What is C7 vertebrae also known as?
Vertebra prominens
59
What is vertebra prominens?
C7
60
What is the clinical relevance of the C7 vertebrae?
By identifying C7 you can count down and locate any vertebrae, which is useful when describing the location of spinal tenderness.
61
How can you identify the location of spinal tenderness in vertebrae?
Locate C7 (vertebra prominens) via its bony prominence (spinous process) and count down
62
Fig. 21 (left) Label the image.
- Jugular notch - Vertebra prominens (C7) - Midthorax C5-C7; T1-T8 visible
63
Fig. 21 (right) Label the image
C7 spinous process ('vertebra prominens')
64
What are the features on the thorax that you need to identify?
- Manubriosternal joint - Nipples - Costal margin - Intercostal spaces
65
Fig. 24 (left) Label the image
- Jugular notch - Sternoclavicular joint - Rib I - Manubrium of sternum - Body of sternum - Xiphoid process - Rib X - Clavicle - Coracoid process - STERNAL ANGLE - Costal cartilage - Costal margin Ribs II to IX (2-9) labelled
66
What is the clinical relevance of the manubriosternal joint?
The sternal angle (or 'Angle of Louis') is at the T4/5 vertebral level, which is also the level of: - Rib 2's costal cartilage - Division of superior and inferior mediastinum - End of ascending aorta and start of aortic arch - Tracheal bifurcation
67
What is the manubriosternal joint also known as?
Sternal angle | Angle of Louis
68
What is the sternal angle also known as?
Manubriosternal joint | Angle of Louis
69
What is the Angle of Louis also known as?
Manubriosternal joint | Sternal angle
70
Where is the sternal angle?
T4/5 vertebra level
71
What is the sternal angle also the level of?
- Rib 2's costal cartilage - Division of superior and inferior mediastinum - End of ascending aorta and start of aortic arch - Tracheal bifurcation
72
At what level is the costal cartilage for rib 2?
Sternal angle (T4/5)
73
At what level is the division of the superior and inferior mediastinum?
Sternal angle (T4/5)
74
At what level is the end of the ascending aorta?
Sternal angle (T4/5)
75
At what level is the start of the aortic arch?
Sternal angle (T4/5)
76
At what level does tracheal bifurcation occur?
Sternal angle (T4/5)
77
Fig. 24 (right) Label the image
- Sternal angle - Aortic arch - Superior mediastinum - Trachea - Rib II - TIV - TV - Inferior mediastinum
78
At what level do the nipples sit?
4th intercostal space just lateral to mid-clavicular line
79
When are nipples not at the 4th intercostal space?
- In women | - Men with gynaecomastia
80
What is gynaecomastia?
Gynaecomastia (sometimes referred to as "man boobs") is a common condition that causes boys' and men's breasts to swell and become larger than normal.
81
What is the medical term for the swelling and enlargement of male breasts?
Gynaecomastia
82
Fig. 26 (right) Label the image
- Jugular notch - Sternoclavicular joint - Rib I - Manubrium of sternum - Body of sternum - Xiphoid process - Rib X - Clavicle - Coracoid process - Sternal angle - Costal cartilage - Costal margin Ribs II to IX
83
What is the clinical relevance of the level of the nipples?
Indicate the level of the superior border of the liver / right hemidiaphragm
84
What structures can be found at the level of the nipples (4th intercostal space)
- Superior border of the liver | - Right hemidiaphragm
85
Fig. 26 (bottom left) Label the image
- Liver - Diaphragm - Costal margin - Gallbladder - Spleen - Stomach
86
Fig. 28 Label the image
- Jugular notch - Sternoclavicular joint - Rib I - Manubrium of sternum - Body of sternum - Xiphoid process - Rib X - Clavicle - Coracoid process - Sternal angle - Costal cartilage - COSTAL MARGIN Ribs II to IX
87
How can you find the intercostal spaces?
1) Find angle of Louis 2) Palpate 2nd rib 3) Palpate inferiorly = 2nd ICS 4) Can then count intercostal spaces from there
88
Fig. 30 (left) Label the image
Intercostal Spaces 1-5 | Draw out accurately
89
What is the clinical relevance of being able to identify the intercostal spaces?
You can: - Correctly place ECG leads - Know where to listen with your stethoscope to hear each heart valve Chest drains are inserted through the ICSs
90
Fig. 30 (right) What is this image showing?
ECG leads and chest drain insertion through the ICS This requires knowledge of identification of the intercostal spaces.
91
What are the features on the abdomen that you need to identify?
- Umbilicus
92
Fig. 33 (left) Label the image
- Abdomen | - Umbilicus
93
What is the clinical relevance of umbilicus?
- At the vertebral level of L3-4, which is also the level of the bifurcation of the aorta - Can be used to divide the abdomen into quadrants, which can be used when describing sites of abdominal pain
94
Where is the level of umbilicus?
Vertebral level L3-4
95
What occurs at vertebral level L3-4?
- Umbilicus | - Level of bifurcation of the aorta
96
Where are the quadrants of the abdomen split?
Vertical line at the midline Horizontal line at umbilicus
97
Fig. 33 (right) Label the image
- Right Upper Quadrant - Left Upper Quadrant - Right Lower Quadrant - Left Lower Quadrant
98
What are the features on the upper limb that you need to identify?
- Biceps tendon - Medial epicondyle, ulnar nerve and olecranon - Head of ulna - Radial artery at the wrist - Thenar eminence
99
Fig. 36 Label the image
Biceps tendon
100
What is the clinical relevance of the biceps tendon?
Can palpate MEDIALLY to it to locate the brachial pulse
101
Where can you find the brachial pulse?
MEDIAL to the biceps tendon
102
Fig. 38 (right) Label the image - black dashes
- Humerus - Ulnar nerve - Medial epicondyl - Flexor carpi ulnaris muscle - Ulna
103
Fig. 38 (right) Label the image - green arrows Label medial and lateral
- Medial epicondyle - Ulnar nerve - Olecranon ('tip of elbow') Medial to lateral
104
What is the olecranon commonly known as?
'Tip of elbow'
105
What is the tip of the elbow more formally known as?
The olecranon
106
Where does the ulnar nerve lie?
Lateral to the medial epicondyl Medial to the olecranon
107
Order from medial to lateral Medial epicondyl Olecranon Ulnar nerve
Medial to lateral: Medial epicondyl Ulnar nerve Olecranon
108
What is the clinical relevance of the medial epicondyle, ulnar nerve and olecranon?
Ulnar nerve runs LATERAL to the medial epicondyle and MEDIAL to the olecranon, allowing easy marking for cubital tunnel decompression surgeries Can tap on ulnar nerve at the point it runs between the olecranon and the medial epicondyl to perform tinel's test, and see if the nerve is irritated
109
Where is cubital tunnel decompression surgery performed?
The ulnar nerve, at the level of the elbow at the cubital tunnel - lateral to the medial epicondyl and medial to the olecranon
110
What is cubital tunnel decompression surgery?
Performed to relieve the pressure on the ulnar nerve The ligament that forms the "roof" of the cubital tunnel is cut and divided.
111
How can pressure on the ulnar nerve be relieved?
Cubital tunnel decompression surgery
112
What is Tinel's Test?
A test to detect irritated nerves performed by percussing over the nerve to elicit a sensation of tingling ("pins and needles")
113
Where can Tinel's Test of the ulnar nerve be performed?
At the point where it runs between the olecranon and the medial epicondyle (Tinel's Test detects irritated nerves)
114
Fig. 38 (left) Label the image
- Medial Epicondyle | - Olecranon
115
Identify the head of ulna
Bony part of the MEDIAL side of the DISTAL forearm
116
What lies on the bony part of the medial side of the distal forearm?
The head of ulna
117
Fig. 40 (top) Label the image
- Styloid process of radius - Head of ulna - Styloid process of ulna
118
Fig. 40 (bottom) Label the image
- Deltoideus - Biceps brachii - Lateral eminence - Medial eminence - Abd. poll. long. & Ext. poll. brev. - Triceps brachii - Medial epicondyle - Olecranon - Anconeus - Flex. carp. ulnaris - Ext. carp. ulnaris - Head of ulna
119
Where is the radial artery at the wrist located?
LATERAL to Flexor Carpi Radialis tendon
120
What lies lateral to the Flexor Carpi Radialis tendon?
Radial artery
121
What is the clinical relevance of the radial artery at the wrist?
It can be palpated to obtain a radial pulse
122
Where can the radial pulse be elicited?
The radial artery at the wrist, lateral to the flexor carpi radialis tendon
123
Fig. 42 (top) What is this image showing?
Palpation of the radial pulse (at the radial artery)
124
Fig. 42 (bottom left) Label the image
- Flexor carpi radialis tendon - Palmaris longus tendon - Flexor carpi ulnaris
125
Fig. 42 (bottom right) Label the image
- Thenar eminence - Radial artery - Ulnar artery - Hypothenar eminence - Pisiform - Ulnar nerve
126
Fig. 44 (left) Label the image
- Flexor carpi radialis tendon - Tubercle of the scaphoid - THENAR EMINENCE - Recurrent branch of the median nerve - Hypothenar eminence - Flexor retinaculum - Pisiform - Flexor carpi ulnaris tendon - Median nerve
127
What is the clinical relevance of the thenar eminence?
In carpal tunnel syndrome, this muscle can appear 'wasted' (ie reduced muscle bulk)
128
What can appear wasted in carpal tunnel syndrome?
The thenar eminence (reduced muscle bulk)
129
What can happen to the thenar eminence in carpal tunnel syndrome?
Appears wasted (i.e. reduced muscle bulk)
130
Fig. 44 (right) What is this image showing?
A wasted thenar eminence, as in, in carpal tunnel syndrome.
131
What are the features on the lower limb that you need to identify?
- Iliac crest - Greater trochanter - Tibial tuberosity - Anterior (subcutaneous) tibia - Medial and lateral malleoli - Calcaneum and achilles tendon
132
Fig. 47 (left) Label the image
- Iliac crest - Ilium - Acetabulum - Ischium - Pubis
133
Fig. 47 (right skeleton) Label the image
1. External occipital protuberance 2. Spinous processes of vertebrae 3. Clavicle 4. Spinous proceses of scapula 5. Inferior angle of scapula 6. Iliac crest
134
Fig. 47 (right) Label the image
1. External occipital protuberance 2. Spinous processes of vertebrae 3. Clavicle 4. Spinous proceses of scapula 5. Inferior angle of scapula 6. Iliac crest C-7 Vertebra prominens T-3 spine T-7 spine L4
135
What is the clinical relevance of the iliac crest?
- Top of Iliac Crest is at Vertebral Level l4, which is used to identify the correct level of needle insertion when performing a lumbar puncture (between L3 and L4) - Iliac crest is the site of bone marrow harvest - Iliac crest is often the site of bone grafts to other parts of the body e.g. dental procedures
136
Where is the top of the iliac crest?
Vertebral Level L4
137
Where is lumbar puncture performed?
Between L3 and L4; which is identified by finding the top of the iliac crest
138
What is the iliac crest a site of?
- Bone marrow harvest | - Bone grafts to other parts of the body e.g. dental procedures
139
The iliac crest is often a site of bone grafts to other parts of the body such as ___?
Dental procedures
140
Where is a common site of bone marrow harvest?
Iliac crest
141
Where is a common site of bone grafts to other parts of the body?
Iliac crest
142
Identify the greater trochanter
On the lateral surface of the thigh, inferior to iliac crest
143
What surface anatomy landmark can be found on the lateral surface of the thigh, inferior to the iliac crest?
The greater trochanter
144
Fig. 49 Label the image
Greater trochanter - on lateral surface of thigh, inferior to iliac crest
145
Identify the tibial tuberosity.
On the anterior surface of the proximal tibia
146
What is the clinical relevance of the tibial tuberosity?
You hit the area superior to this when performing the knee jerk reflex
147
Where do you hit in the knee jerk reflex?
The area anterior to the tibial tuberosity (found on the anterior surface of the proximal tibia)
148
Fig. 51 (left) Label the image
- Quadriceps (thigh muscle) - Patellar tendon - Tibial tuberosity - Patella (knee cap) - Femur (thigh bone) - Tibia (leg bone)
149
Fig. 51 (right) Label the image
- Patella - Head Of Fibula - Tibial Tuberosity - Tibial Tuberosity - on the ANTERIOR surface of the PROXIMAL tibia
150
What is the clinical relevance of the anterior (subcutaneous) tibia?
As the bone is so superficial: - fractures are often open - can be used for emergency access (using interosseous drill)
151
What is the relevance of the tibia bones placement?
It is very superficial
152
What is the clinical significance of tibial fractures?
As the bone is so superficial, fractures are often open
153
Why are fractures often open in tibial fractures?
Because the bone is so superficial
154
Why can the tibia be used for emergency access?
Because the bone is so superficial
155
What is the relevance of the superficial placement of the tibia bone?
- Fractures are often open | - Can be used for emergency access
156
How can the tibia bone be used for emergency access?
Using interosseous drill
157
Fig. 53 (left) What is this image depicting?
An open tibial fracture, due to the bone being superficial
158
Fig. 53 (clinical relevance, right) What is this image showing?
Emergency access of the tibia using interosseous drill (done because the bone is superficial)
159
Fig. 53 (right) Label the bone
Tibia
160
Fig. 55 (top) Label the image (black dashes)
- Tibialis anterior tendon - Medial malleolus - Calcaeneal tendon - Lateral malleolus
161
Fig. 55 (top) Label the image (green arrows)
- Medial malleolus at DISTAL end of tibia | - Lateral malleolus at DISTAL end of fibula
162
Where is the medial malleolus located?
Distal end of tibia
163
Where is the lateral malleolus located?
Distal end of fibula
164
What is found at the distal end of the tibia?
Medial malleolus
165
What is found at the distal end of the fibula?
Lateral malleolus
166
What is the clinical relevance of the medial malleolus?
The posterior tibial pulse can be palpated just POSTERIOR to the medial maleolus
167
Where can the posterior tibial pulse be palpated?
Posterior to the medial malleolus
168
Fig. 55 (bottom right) label the image
- Lateral condyle - Head of fibula - Fibula - Fibular notch - Lateral malleolus - Medial condyle - Tibial tuberosity - Tibia (shinbone) - Medial malleolus
169
Where is the calcaneum?
'Heel bone'
170
What is the 'heel bone'?
Calcaneum
171
Where is the achilles tendon?
Attaches distally to the calcaneum
172
What attaches distally to the calcaneum?
Achilles tendon
173
Fig. 57 (middle) Label the image (black dashes)
- Gastrocnemius - Soleus - Achilles tendon
174
Fig. 57 (middle) Label the image (green arrows)
Achilles tendon - attaches distally to the calcaneum Calcaneum ('heel bone')
175
Fig. 57 (right) Label the image (green arrows)
Achilles tendon - attaches distally to the calcaneum Calcaneum ('heel bone')
176
What is the clinical relevance of the calcaneum?
Pressure sores commonly occur over the calcaneum, and can cause infection to spread to the bone (osteomyelitis)
177
What is osteomyelitis?
Infection of the bone
178
What is a complication of pressure sores?
Osteomyelitis (infection of the bone)
179
What can osteomyelitis be a complication of?
Pressure sore
180
Fig. 57 (top left) What is this image showing?
Pressure sore (grade ?) on the calcaneum
181
What is the clinical relevance of the Achilles tendon?
It can rupture, especially if the patient is taking steroids
182
For what patients is the Achilles tendon more likely to rupture?
Especially if the patient is taking steroids
183
Fig. 57 (bottom left) What is this image showing?
Achilles tendon rupture

ESA 1 - Body Logistics (18 decks)

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