Human anatomy; Medicine -- Study and teaching; Palpation
Teachers of anatomy should follow the example of Sir C. Bell, who was
in the habit of introducing, from time to time, a powerful muscular
fellow to his class, ‘in order to show how much of the structure of
the body, such as the articulations and the muscles, might be learned
without actual dissection.’[A][1]
At the same time, it is only fair to say that ‘landmarks’ cannot always
be defined with precision. A considerable latitude must be allowed for
natural variations in different persons. In some, their anatomy stands
out beautifully clear; in others, it is masked by obesity. Selecting,
therefore, for study a moderately lean person, let us begin with the
head.
[A] The references throughout are to Notes at the end of the book.
_THE HEAD._
3. =Scalp: its density.=--The great toughness of the scalp, more
especially at the back of the head, is owing to its intimate connection
with the cranial aponeurosis, the scalp vessels and hair bulbs
intervening. This density often obscures the diagnosis of tumours on
the cranium. A tumour growing upon the head may be either above or
below the aponeurosis of the scalp. If below, it will have a firm
resisting feel, being bound down by the aponeurosis. Nevertheless
its firmness and resistance may depend not simply on its confinement
beneath the aponeurosis, but on its having its origin within the
skull. Look with suspicion, then, on every tumour on the head that
will not readily permit you to move it about, so as to be sure of its
connections prior to an attempt at extirpation.
The scalp moves freely over the pericranium, to which it is very
loosely connected by areolar tissue. When suppuration takes place in
this tissue free incisions through the dense scalp must be made to let
the pus out.
4. =Arteries of scalp.=--The supra-orbital artery can be felt beating
just above the supra-orbital notch, and traced for some way up the
forehead; the temporal (anterior branch) ascends tortuously about one
inch and a quarter behind the external angular process of the frontal
bone; the occipital can be felt near the middle of a line drawn from
the occipital protuberance to the mastoid process; the posterior
auricular, near the apex of the mastoid process. All these arteries can
be effectually compressed against the subjacent bone.
Public-domain text, read in full here on John Shaqi.
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