1、Regional anatomyDepartment of Anatomy ，Medical CollegeQingdao UniversityXia YujunE-mail: The Regional Anatomy deals with the form, position, and relationship of the structures of several systems located in a particular region of the body.The Basic Structures of the Human BodyThe skinThe superficial

2、fascia It is a fibrous, fatty covering that underlies the skin subcutaneous tissue or subcutaneous fat The superficial blood vessels, lymphatic vessel and cutaneous nerve are situated in this layer. 3)The deep fascia It is thin but dense and strong collagenous membrane. Proper fascia4) The muscle, b

3、lood vessels, lymphatic vessels and nodes, nervesSuitable dissectiing instrumentsKnifeforcepsScissors and vascular clamp Section 1 Dissection of the Superficial Part of the Back1 Boundaries of the back the external occipital protuberance the mastoid protuberance the acromion process of the scapulaPo

4、sterior axillar line the iliac crestPlace the cadaver in the prone position.Surface anatomyPalpate the following bony landmarks: 1 the external occipital protuberance 2 the vertebra prominens (spinous process of C7) 3 spinous process of first thoracic vertebra 4 the crest of the spine of the scapula

5、 5 the acromion process of the scapula 6 the superior and inferior angles of the scapula 7 the iliac crestDissection procedures1 Skin incisionMake the following incisions: Median vertical incision Transverse incision the external occipital protuberance the mastoid protuberance the acromion process o

6、f the scapula Curve incision the iliac crestCarefully reflect the skin flaps laterally2 Superficial fasciaCutaneous Nerves: find the cutaneous nerves near the paravertebral line as they pierce the deep fascia. They are the branches of the dorsal rami of the spinal nerves.Note: the greater occipital

7、nerve 1. Locate the greater occipital nerve, which is the posterior ramus of the second cervical nerve. It emerges from the trapezius about 2.5cm below and lateral to the external occipital protuberance.2. Clean and study one cutaneous branch of a posterior ramus of a thoracic spinal nerve. 3. To as

8、sist you in finding such a nerve, carefully look for a blood vessel that follows each of these nerves. Do not waste time tracing out the cutaneous branches of all the posterior rami3 Deep fascia(Now reflect the superficial fascia of the back in line with the skin incisions, being carefully not to da

9、mage the underlying tissues.)Include the nuchal fascia and thoracolumbar fascia (they will be discussed later)4 Deep structuresClean the superficial and deep fasciae from the surface of trapeaius, latissimus dorsi and the posterior border of the obliquus externus abdominis.Muscles of the superficial

10、 layer of backTrapezius muscle. Confirm that this muscle has an extensive origin from the medial one-third of the superior nuchal line of the occipitl bone, the occipital protuberance, the ligamentum nuchae, the spinous processes of the seventh cervical vertebra and the spinous processes and suprasp

11、inous ligaments of thoracic vertebrae one to twelve.Trace the superior muscle fibers to their insertion on the lateral third of the clavicle, the middle fibers to their insertion on the acromion and the spine of the scapula, and the inferior fibers to their insertion on the base of the spine of the

12、scapula.Cut free the origin of the trapezius from the skull, the ligamentum nuchae, and the spinous processes of the vertebrae. Carefully reflect the trapezius laterally, taking care not to damage the underlying levator scapulae and rhomboid muscles.Identify and preserve the spinal part of the acces

13、sory nerve and the posterior rami of the third and fourth cervical nerves, which supply the trapezius muscle.Latissimus dorsi muscle. Confirm that this muscle arises from the posterior part of the iliac crest, the lumbar fascia, the spinous processes of the lower six thoracic vertebrae, and from the

14、 lower three or four ribs; sometimes a few fibers arise from the inferior angle of the scapula. Identify and clean the levator scapulae and rhomboid minor and rhomboid major muscles. Leave the levator scapulae intact and trace its fibers to their insertion on the medial border of the scapula. Cut fr

15、ee the origins of the rhomboid minor and major muscles from the vertebrae and carefully reflect them laterally to their insertions on the medial border of the scapula. Be careful to preserve the underlying serratus posterior superior muscle, which is sometimes stuck to the rhomboid muscles. Identify

16、 and clean the dorsal scapular nerve and the deep branches of the superficial cervical vessels that lie deep to the rhomboid muscles, close to their insertion. Identify the serratus anterior muscle at its insertion along the anterior surface of the medial border of the scapula. Define the posterior

17、border of the deltoid muscle and confirm the origin of this muscle from the spine and acromion process of the scapula. With a scalpel, cut free the origin of the deltoid muscle from the spin and acromion process but leave its attachment to the clavicle intact. Note that the deltoid fibers pass downw

18、ard to their insertion on the deltoid tuberosity of the humerus. To assist you with the later study, now remove the skin and superficial fascia from the back of the shoulder and the back of the arm, down as far as the olecranon process of the ulna. Identify and clean the supraspinatus, infraspinatus,teres minor and teres major, and the long head of the triceps muscl