Radiological Anatomy [antikvár]

SURFACE ANATOMY Surface anatomy deals with the surface contours of the human body and the surface projections of the deeper organs (bowels, blood-vessels, nerves, etc.). Knowledge of surface anatomy is indispensable for physical examination of patients, for radiography and for surgical interventions. Surface anatomy is, thus, an important chapter in clinical anatomy. The methods of examination are, in the order of succession: inspection, palpation, percussion and auscultation. INSPECTION This is the first phase of medical investigation, in the course of which the constitution, the state of nutrition, the colour and blood supply of the skin and visible mucous membranes, the shape of the protruding muscles and bones of the patient are examined (Figs la—2b). The condition and function of organ systems, structural groups and single structures, e.g. condition of the seventh cranial nerve from the mimetic muscles, etc. can also be studied in the living subject. Familiarity with normal conditions enables us to diagnose a number of pathological changes at first sight. PALPATION Palpation supplies information on the position, shape and size of particular structures, their relations to the surroundings, mobility, surface, substance, etc. In order to be able to apply this method witli success it is necessary to know the physiologically palpable structures and their properties. We must know that certain organs are palpable only in certain positions, while others can be felt at points differing with the momentary posture of the body. The functioning of certain organs can be studied by palpation in the living organism, e.g. arterial pulse, heartbeat, patellar movement, etc. Of particular value is palpation towards the end of pregnancy when the movements of the foetus can be felt and sometimes even seen. Often also the condition of joints can be observed by palpating them during movement. PERCUSSION Percussion, as a method of examination, was first described in 1761 by L. Auenbrugger, a Viennese physician. Percussion makes various parts of the body vibrate. These vibrations give rise to a sound or noise the nature of which depends on the following factors: air-content, shape and position of the organ, quality and condition of its tissues (elastic, inelastic, taut, slack, etc.). Percussion is understood to mean indirect tappings. The second or third finger of one hand is placed on the area to be examined, and then lightly tapped with the tip of the second or third finger of the other hand. Successful use of this method comes with experience. 3