Topographic Surface Anatomy
STUDY AIMS
At the end of your study, you should be able to:
- Identify the key landmarks in the midline of the neck and their significance
- State the structures that are situated at the level of C6
- Outline the boundaries of the triangles of the neck
- Describe the landmarks for palpation of the main arteries, which can be palpated in the face and neck
- Identify prominent features of the face
Topographic Surface Anatomy
FACTS & HINTS
High-Yield Facts
Clinical Points
Tracheostomy
- Transverse incision through skin of neck and anterior wall of trachea
- Method for achieving a definitive airway
- Transverse incision made through skin, at midpoint between suprasternal notch and thyroid cartilage
- Platysma and pretracheal fascia divided
- Strap muscles retracted
- Thyroid isthmus divided or retracted
- Opening made between first and second tracheal rings or through second through fourth tracheal rings
- Tracheostomy tube inserted
Clinical Points
Needle Cricothyrotomy
- Done in extreme emergency
- Performed if proximal airway is obstructed, to temporarily oxygenate the patient
- Large-bore needle inserted into the cricothyroid membrane and connected to an oxygen supply
Central venous line
- Large veins such as the subclavian have relatively constant relationships to easily identifiable anatomic landmarks
- Placement of large-bore venous catheter in an emergent situation to deliver high flow of fluid or blood products
- Used for administration of chemotherapeutic agents, hyperalimentation fluids, and so on
- Used for assessing right heart (venous) pressures
- Vein located in an area bounded by the sternal and clavicular attachments of sternocleidomastoid and the clavicle-just deep to middle third of clavicle
- Subclavian vein is inferior and anterior to subclavian artery and separated from it by anterior scalene muscle
