Human anatomy; Medicine -- Study and teaching; Palpation
LANDMARKS MEDICAL AND SURGICAL.
1. In clinical teaching, we often have occasion to point out, on
the surface of the living body, what may be called ‘medical and
surgical landmarks.’ By ‘landmarks’ we mean surface-marks, such as
lines, eminences, depressions, which are guides to, or indications
of, deeper-seated parts. This practice is not only most useful but
absolutely necessary; because many, even advanced students of anatomy,
are not so ready as they ought to be in their recognition of parts
when covered by skin. Students who may be familiar enough with bones,
muscles, blood-vessels, or viscera in the dissected subject, are often
sadly at fault when they come to put this knowledge into practice in
the living.
For instance, ask a student to put his finger on the exact place where
he would feel for the head of the radius, the coracoid process of
the scapula, the tubercle of the scaphoid bone in the foot; ask him
to compress effectually one of the main arteries; to chalk the line
of its course; to map on the chest the position of the heart and the
several valves at its base; to trace along the walls of the chest the
outline of the lungs and pleura; to point out the bony prominences
about the joints, and their relative position in the different motions
of the joints; test him about the muscles and tendons which can be
seen or felt as they stand out in relief or remain in repose; let him
introduce his finger into the several orifices of the body, and say
what parts are accessible to the touch:--questions such as these, even
a good anatomist, unaccustomed to deal with the living subject, might
possibly find himself at a loss to answer.
2. =Object in view.=--Our main object, therefore, is to induce in
students the habit of looking at the living body with anatomical eyes,
and with eyes too at their fingers’ ends. The value of this habit
cannot be too highly estimated. Is it not of the utmost importance
to an operating surgeon that he should have in his mind’s eye the
various structures of the body as they lie grouped, connected, and
working together? Should he not try at least to see them with the same
clearness and accuracy as if they were perfectly transparent?
Moreover, the habit of examining the living body with ‘anatomical eyes’
and ‘surgical fingers’ teaches the eye and the hand to act together,
and trains that delicate sense of touch which every surgeon should
possess.
This habit is within easy reach of any one who has carefully dissected
for himself, and learned what to feel for. Plates will not give him
this knowledge. Let a student examine his own body with a skeleton
before him. Better still that two should work thus together, each
serving as a model to the other.
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