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Gray's Anatomy for Students E-Book

Gray's Anatomy for Students E-Book

Richard Drake | A. Wayne Vogl | Adam W. M. Mitchell

(2014)

Abstract

Anatomy texts just don’t get any better than Gray's Anatomy for Students! Now in its 3rd edition, this completely revised medical textbook continues its focus on just the core information you need for your anatomy courses, presenting everything in an easy-to-read, visually appealing format that facilitates study.

  • Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability.
  • Obtain reliable, accessible coverage of everything you will learn in your contemporary anatomy classes with expert knowledge from a team of authors who share a wealth of diverse teaching and clinical experience.
  • Easily locate and remember specific structures. More than 1,000 innovative, original illustrations by renowned illustrators Richard Tibbitts and Paul Richardson capture anatomical features with unrivalled clarity.
  • Understand the practical applications of anatomical concepts through unique coverage of surface anatomy, correlative diagnostic images, and clinical case studies.
  • Expedite the review of basic concepts from each chapter with Conceptual Overviews.
  • Stay current and engaged in your anatomy courses with many new "In the Clinic" boxes, which offer access to in-depth clinical discussions related to specific diseases or procedures.
  • Source your review material quickly and easily thanks to a list of additional relevant study aids at the beginning of each chapter.
  • Improve your comprehension of cranial nerves with help from a brand-new visual map summarizing cranial nerve distribution and function.
  • Further enhance your learning by pairing this textbook with its companion review products, Gray's Anatomy for Students Flashcards, 3rd Edition (ISBN: 978-1-4557-1078-2) and Gray’s Atlas of Anatomy 2nd Edition (ISBN 978-1-4557-4802-0)!

Table of Contents

Section Title Page Action Price
Front cover cover
Inside front cover ifc1
Grays_In_Book_Ads i
Gray's Anatomy for Students iii
Copyright page vi
Acknowledgments vii
Dedications vii
Preface ix
About the Book xi
The idea xi
The book xi
Organization xi
Content xi
What the book does not contain xii
Terminology xii
Anatomical use of adverbs xiii
Index of Clinical Content xv
Table of Contents xix
1 The Body 1
ADDITIONAL LEARNING RESOURCES for Chapter 1, The Body, on STUDENT CONSULT (www.studentconsult.com) 1
What is anatomy? 2
How can gross anatomy be studied? 2
Important anatomical terms 2
The anatomical position 2
Anatomical planes 2
Terms to describe location 4
Anterior (ventral) and posterior (dorsal), medial and lateral, superior and inferior 4
Proximal and distal, cranial and caudal, and rostral 4
Superficial and deep 4
Imaging 5
Diagnostic imaging techniques 5
Plain radiography 5
Contrast agents 6
Subtraction angiography 6
Ultrasound 7
Doppler ultrasound 7
Computed tomography 7
Magnetic resonance imaging 8
Nuclear medicine imaging 8
Positron emission tomography 9
Image interpretation 10
Plain radiography 10
Chest radiograph 10
Abdominal radiograph 10
Gastrointestinal contrast examinations 10
Urological contrast studies 10
Computed tomography 10
Magnetic resonance imaging 11
Nuclear medicine imaging 11
Safety in imaging 11
Body systems 12
Skeletal system 12
Cartilage 12
Bone 13
Joints 18
Synovial joints 18
Descriptions of synovial joints based on shape and movement 19
Specific types of synovial joints (Fig. 1.21) 20
Solid joints 20
Skin and fascias 24
Skin 24
Fascia 24
Muscular system 25
Cardiovascular system 27
Lymphatic system 29
Lymphatic vessels 29
Lymph nodes 30
Lymphatic trunks and ducts 30
Nervous system 31
Central nervous system 31
Brain 31
Spinal cord 32
Meninges 32
Functional subdivisions of the CNS 32
Somatic part of the nervous system 33
Dermatomes 34
Myotomes 35
Visceral part of the nervous system 38
Sympathetic system 40
1. Peripheral sympathetic innervation at the level of origin of the preganglionic fiber 41
2. Peripheral sympathetic innervation above or below the level of origin of the preganglionic fiber 42
3. Sympathetic innervation of thoracic and cervical viscera 43
4. Sympathetic innervation of the abdomen and pelvic regions and the adrenals 44
Parasympathetic system 45
Sacral preganglionic parasympathetic fibers 46
Cranial nerve preganglionic parasympathetic fibers 46
Visceral sensory innervation (visceral afferents) 46
Visceral sensory fibers accompany sympathetic fibers 46
Visceral sensory fibers accompany parasympathetic fibers 46
The enteric system 47
Nerve plexuses 48
Somatic plexuses 48
Visceral plexuses 48
Other systems 48
Clinical cases 50
2 Back 51
ADDITIONAL LEARNING RESOURCES for Chapter 2, Back, on STUDENT CONSULT (www.studentconsult.com): 51
Conceptual overview 53
General description 53
Functions 54
Support 54
Movement 54
Protection of the nervous system 55
Component parts 56
Bones 56
Typical vertebra 57
Muscles 57
Vertebral canal 59
Spinal nerves 60
Relationship to other regions 61
Head 61
Thorax, abdomen, and pelvis 62
Limbs 62
Key features 62
Long vertebral column and short spinal cord 62
Intervertebral foramina and spinal nerves 63
Innervation of the back 63
Regional anatomy 64
Skeletal framework 64
Vertebrae 64
Typical vertebra 68
Cervical vertebrae 69
Atlas and axis 71
Thoracic vertebrae 72
Lumbar vertebrae 72
Sacrum 72
Coccyx 72
Intervertebral foramina 72
Posterior spaces between vertebral arches 73
Joints 77
Joints between vertebrae in the back 77
Symphyses between vertebral bodies (intervertebral discs) 78
Joints between vertebral arches (zygapophysial joints) 78
“Uncovertebral” joints 78
Ligaments 80
Anterior and posterior longitudinal ligaments 80
Ligamenta flava 80
Supraspinous ligament and ligamentum nuchae 81
Interspinous ligaments 82
Back musculature 84
Superficial group of back muscles 84
Trapezius 87
Latissimus dorsi 89
Levator scapulae 89
Rhomboid minor and rhomboid major 89
Intermediate group of back muscles 90
Deep group of back muscles 92
Thoracolumbar fascia 92
Spinotransversales muscles 92
Erector spinae muscles 93
Transversospinales muscles 95
Segmental muscles 97
Suboccipital muscles 97
Spinal cord 99
Vasculature 100
Arteries 100
Veins 102
Meninges 103
Spinal dura mater 103
Arachnoid mater 103
Subarachnoid space 103
Pia mater 104
Arrangement of structures in the vertebral canal 104
Spinal nerves 106
Nomenclature of spinal nerves 109
Surface anatomy 111
Back surface anatomy 111
Absence of lateral curvatures 111
Primary and secondary curvatures in the sagittal plane 112
Useful nonvertebral skeletal landmarks 112
How to identify specific vertebral spinous processes 114
Visualizing the inferior ends of the spinal cord and subarachnoid space 115
Identifying major muscles 116
Clinical cases 118
3 Thorax 121
ADDITIONAL LEARNING RESOURCES for Chapter 3, Thorax, on STUDENT CONSULT (www.studentconsult.com): 121
Conceptual overview 123
General description 123
Functions 124
Breathing 124
Protection of vital organs 124
Conduit 124
Component parts 124
Thoracic wall 124
Superior thoracic aperture 126
Inferior thoracic aperture 126
Diaphragm 127
Mediastinum 128
Pleural cavities 128
Relationship to other regions 130
Neck 130
Upper limb 130
Abdomen 130
Breast 131
Key features 132
Vertebral level TIV/V 132
Venous shunts from left to right 132
Segmental neurovascular supply of thoracic wall 134
Sympathetic system 136
Flexible wall and inferior thoracic aperture 136
Innervation of the diaphragm 138
Regional anatomy 139
Pectoral region 139
Breast 139
Arterial supply 139
Venous drainage 139
Innervation 139
Lymphatic drainage 139
Breast in men 141
Muscles of the pectoral region 142
Pectoralis major 142
Subclavius and pectoralis minor muscles 143
Thoracic wall 143
Skeletal framework 143
Thoracic vertebrae 143
Typical thoracic vertebra 143
Articulation with ribs 144
Ribs 144
Distinct features of upper and lower ribs 146
Rib I 146
Rib II 146
Rib X 146
Ribs XI and XII 146
Sternum 147
Manubrium of the sternum 147
Body of the sternum 147
Xiphoid process 148
Joints 148
Costovertebral joints 148
Joint with head of rib 148
Costotransverse joints 149
Sternocostal joints 149
Interchondral joints 150
Manubriosternal and xiphisternal joints 150
Intercostal spaces 150
Muscles 152
Intercostal muscles 152
External intercostal muscles 154
Internal intercostal muscles 154
Innermost intercostal muscles 154
Subcostales 154
Transversus thoracis muscles 154
Arterial supply 155
Posterior intercostal arteries 155
Anterior intercostal arteries 156
Venous drainage 156
Lymphatic drainage 158
Innervation 158
Intercostal nerves 158
Diaphragm 161
Arterial supply 162
Venous drainage 162
Innervation 162
Movements of the thoracic wall and diaphragm during breathing 162
Pleural cavities 162
Pleura 163
Parietal pleura 164
Peripheral reflections 165
Visceral pleura 166
Pleural recesses 166
Costomediastinal recesses 166
Costodiaphragmatic recesses 166
Lungs 167
Root and hilum 167
Right lung 169
Left lung 169
Bronchial tree 172
Bronchopulmonary segments 173
Pulmonary arteries 174
Right pulmonary artery 174
Left pulmonary artery 174
Pulmonary veins 174
Bronchial arteries and veins 174
Innervation 176
Lymphatic drainage 176
Mediastinum 180
Middle mediastinum 180
Pericardium 181
Fibrous pericardium 181
Serous pericardium 182
Vessels and nerves 183
Heart 184
Cardiac orientation 184
Base (posterior surface) and apex 184
Surfaces of the heart 187
Margins and borders 187
External sulci 188
Cardiac chambers 190
Right atrium 191
Right ventricle 192
Tricuspid valve 192
Pulmonary valve 193
Left atrium 193
Left ventricle 194
Mitral valve 194
Aortic valve 196
Cardiac skeleton 197
Coronary vasculature 198
Coronary arteries 198
Right coronary artery. 198
Left coronary artery. 198
Variations in the distribution patterns of coronary arteries. 198
Cardiac veins 204
Great cardiac vein. 204
Middle cardiac vein. 204
Small cardiac vein. 204
Posterior cardiac vein. 204
Other cardiac veins. 204
Coronary lymphatics 204
Cardiac conduction system 206
Sinu-atrial node 206
Atrioventricular node 206
Atrioventricular bundle 206
Cardiac innervation 206
Parasympathetic innervation 209
Sympathetic innervation 209
Visceral afferents 209
Pulmonary trunk 209
Ascending aorta 210
Other vasculature 210
Superior mediastinum 210
Thymus 210
Right and left brachiocephalic veins 213
Left superior intercostal vein 214
Superior vena cava 215
Arch of aorta and its branches 215
The first branch 216
The second branch 216
The third branch 216
Ligamentum arteriosum 216
Trachea and esophagus 218
Nerves of the superior mediastinum 218
Vagus nerves 218
Right vagus nerve 219
Left vagus nerve 220
Phrenic nerves 221
Right phrenic nerve 221
Left phrenic nerve 221
Thoracic duct in the superior mediastinum 222
Posterior mediastinum 222
Esophagus 222
Relationships to important structures in the posterior mediastinum 222
Arterial supply and venous and lymphatic drainage 222
Innervation 223
Esophageal plexus 224
Thoracic aorta 225
Azygos system of veins 226
Azygos vein 227
Hemiazygos vein 227
Accessory hemiazygos vein 227
Thoracic duct in the posterior mediastinum 227
Sympathetic trunks 229
Branches from the ganglia 229
Anterior mediastinum 230
Surface anatomy 231
Thorax surface anatomy 231
How to count ribs 231
Surface anatomy of the breast in women 232
Visualizing structures at the TIV/V vertebral level 232
Visualizing structures in the superior mediastinum 234
Visualizing the margins of the heart 235
Where to listen for heart sounds 236
Visualizing the pleural cavities and lungs, pleural recesses, and lung lobes and fissures 236
Where to listen for lung sounds 238
Clinical cases 241
4 Abdomen 253
ADDITIONAL LEARNING RESOURCES for Chapter 4, Abdomen, on STUDENT CONSULT (www.studentconsult.com): 253
Conceptual overview 255
General description 255
Functions 256
Houses and protects major viscera 256
Breathing 258
Changes in intraabdominal pressure 258
Component parts 259
Wall 259
Abdominal cavity 260
Inferior thoracic aperture 262
Diaphragm 262
Pelvic inlet 263
Relationship to other regions 263
Thorax 263
Pelvis 263
Lower limb 264
Key features 265
Arrangement of abdominal viscera in the adult 265
Development of the foregut 265
Development of the midgut 265
Development of the hindgut 268
Skin and muscles of the anterior and lateral abdominal wall and thoracic intercostal nerves 268
The groin is a weak area in the anterior abdominal wall 269
Vertebral level LI 271
The gastrointestinal system and its derivatives are supplied by three major arteries 271
Venous shunts from left to right 273
All venous drainage from the gastrointestinal system passes through the liver 274
Portacaval anastomoses 275
Blockage of the hepatic portal vein or of vascular channels in the liver 275
Abdominal viscera are supplied by a large prevertebral plexus 276
Regional anatomy 277
Surface topography 277
Four-quadrant pattern 277
Nine-region pattern 278
Abdominal wall 280
Superficial fascia 280
Superficial layer 280
Deeper layer 280
Anterolateral muscles 282
Flat muscles 282
External oblique 282
Associated ligaments 283
Internal oblique 284
Transversus abdominis 284
Transversalis fascia 285
Vertical muscles 286
Rectus abdominis 286
Pyramidalis 287
Rectus sheath 287
Extraperitoneal fascia 288
Peritoneum 288
Innervation 289
Arterial supply and venous drainage 291
Lymphatic drainage 292
Groin 292
Inguinal canal 294
Deep inguinal ring 294
Superficial inguinal ring 295
Anterior wall 296
Posterior wall 296
Roof 296
Floor 296
Contents 296
Spermatic cord 297
Round ligament of the uterus 297
Inguinal hernias 299
Indirect inguinal hernias 299
Direct inguinal hernias 300
Abdominal viscera 303
Peritoneum 303
Innervation of the peritoneum 303
Peritoneal cavity 304
Omenta, mesenteries, and ligaments 307
Omenta 307
Greater omentum 307
Lesser omentum 307
Mesenteries 309
Mesentery 309
Transverse mesocolon 309
Sigmoid mesocolon 309
Ligaments 309
Organs 310
Abdominal esophagus 310
Stomach 310
Small intestine 312
Duodenum 312
Jejunum 313
Ileum 314
Large intestine 319
Cecum and appendix 320
Colon 322
Rectum and anal canal 324
Liver 328
Diaphragmatic surface 328
Visceral surface 330
Associated ligaments 330
Lobes 331
Gallbladder 331
Pancreas 333
Duct system for bile 337
Spleen 338
Arterial supply 343
Anterior branches of the abdominal aorta 343
Celiac trunk 344
Left gastric artery 344
Splenic artery 346
Common hepatic artery 347
Superior mesenteric artery 348
Inferior pancreaticoduodenal artery 348
Jejunal and ileal arteries 349
Middle colic artery 350
Right colic artery 350
Ileocolic artery 350
Inferior mesenteric artery 350
Left colic artery 350
Sigmoid arteries 350
Superior rectal artery 350
Venous drainage 354
Portal vein 354
Splenic vein 355
Superior mesenteric vein 355
Inferior mesenteric vein 356
Lymphatics 358
Innervation 358
Sympathetic trunks 359
Splanchnic nerves 359
Thoracic splanchnic nerves 359
Lumbar and sacral splanchnic nerves 361
Pelvic splanchnic nerves 361
Abdominal prevertebral plexus and ganglia 361
Parasympathetic innervation 361
Vagus nerves 363
Pelvic splanchnic nerves 363
Enteric system 364
Sympathetic innervation of the stomach 364
Posterior abdominal region 366
Posterior abdominal wall 367
Bones 367
Lumbar vertebrae and the sacrum 367
Pelvic bones 367
Ribs 367
Muscles 368
Psoas major and minor 368
Quadratus lumborum 369
Iliacus 369
Diaphragm 369
Structures passing through or around the diaphragm 370
Domes 371
Blood supply 371
Innervation 371
Viscera 373
Kidneys 373
Relationships to other structures 374
Renal fat and fascia 376
Kidney structure 377
Renal vasculature and lymphatics 378
Ureters 379
Ureteric vasculature and lymphatics 380
Ureteric innervation 380
Suprarenal glands 386
Suprarenal vasculature 387
Vasculature 387
Abdominal aorta 387
Visceral branches 388
Posterior branches 388
Inferior phrenic arteries 388
Lumbar arteries 388
Median sacral artery 389
Inferior vena cava 390
Lymphatic system 392
Pre-aortic and lateral aortic or lumbar nodes (para-aortic nodes) 392
Nervous system in the posterior abdominal region 394
Sympathetic trunks and splanchnic nerves 394
Abdominal prevertebral plexus and ganglia 395
Lumbar plexus 398
Iliohypogastric and ilio-inguinal nerves (L1) 398
Iliohypogastric nerve 400
Ilio-inguinal nerve 400
Genitofemoral nerve (L1 and L2) 401
Lateral cutaneous nerve of thigh (L2 and L3) 401
Obturator nerve (L2 to L4) 401
Femoral nerve (L2 to L4) 401
Surface anatomy 402
Abdomen surface anatomy 402
Defining the surface projection of the abdomen 402
How to find the superficial inguinal ring 403
How to determine lumbar vertebral levels 404
Visualizing structures at the LI vertebral level 405
Visualizing the position of major blood vessels 406
Using abdominal quadrants to locate major viscera 407
Defining surface regions to which pain from the gut is referred 408
Where to find the kidneys 409
Where to find the spleen 409
Clinical cases 410
5 Pelvis and Perineum 421
ADDITIONAL LEARNING RESOURCES for Chapter 5, Pelvis and Perineum, on STUDENT CONSULT (www.studentconsult.com): 421
Conceptual overview 423
General description 423
Functions 423
Contains and supports the bladder, rectum, anal canal, and reproductive tracts 423
Anchors the roots of the external genitalia 425
Component parts 426
Pelvic inlet 426
Pelvic walls 426
Pelvic outlet 428
Pelvic floor 429
Pelvic cavity 429
Perineum 430
Relationship to other regions 432
Abdomen 432
Lower limb 433
Key features 434
The pelvic cavity projects posteriorly 434
Important structures cross the ureters in the pelvic cavity 435
The prostate in men and the uterus in women are anterior to the rectum 436
The perineum is innervated by sacral spinal cord segments 436
Nerves are related to bone 437
Parasympathetic innervation from spinal cord levels S2 to S4 controls erection 438
Muscles and fascia of the pelvic floor and perineum intersect at the perineal body 439
The course of the urethra is different in men and women 440
Regional anatomy 441
Pelvis 441
Bones 441
Pelvic bone 441
Components of the pelvic bone 443
Ilium 443
Pubis 444
Ischium 444
Sacrum 444
Coccyx 445
Joints 446
Lumbosacral joints 446
Sacro-iliac joints 446
Pubic symphysis joint 448
Orientation 448
Differences between men and women 448
True pelvis 449
Pelvic inlet 449
Pelvic wall 450
Ligaments of the pelvic wall 450
Muscles of the pelvic wall 450
Obturator internus 450
Piriformis 451
Apertures in the pelvic wall 452
Obturator canal 452
Greater sciatic foramen 452
Lesser sciatic foramen 452
Pelvic outlet 453
Pelvic floor 454
The pelvic diaphragm 454
Levator ani 454
Coccygeus 456
The perineal membrane and deep perineal pouch 457
Perineal body 459
Viscera 460
Gastrointestinal system 460
Rectum 460
Anal canal 460
Urinary system 462
Ureters 462
Bladder 463
Neck of bladder 464
Urethra 466
In women 466
In men 467
Preprostatic part. 467
Prostatic part. 468
Membranous part. 468
Spongy urethra. 468
Reproductive system 470
In men 470
Testes 470
Epididymis 470
Ductus deferens 470
Seminal vesicle 473
Prostate 473
Bulbo-urethral glands 473
In women 475
Ovaries 476
Uterus 477
Uterine tubes 478
Cervix 479
Vagina 480
Fascia 481
In women 481
In men 481
Peritoneum 481
In women 483
Broad ligament 483
In men 485
Nerves 486
Somatic plexuses 486
Sacral and coccygeal plexuses 486
Sacral plexus 487
Sciatic nerve. 488
Pudendal nerve. 491
Other branches of the sacral plexus. 491
Coccygeal plexus 492
Visceral plexuses 492
Paravertebral sympathetic chain 492
Pelvic extensions of the prevertebral plexus 494
Sympathetic fibers 494
Parasympathetic fibers 494
Visceral afferent fibers 494
Blood vessels 495
Arteries 495
Internal iliac artery 496
Posterior trunk 496
Anterior trunk 496
Ovarian arteries 498
Median sacral artery 498
Veins 499
Lymphatics 501
Perineum 502
Borders and ceiling 502
Perineal membrane and deep perineal pouch 502
Ischio-anal fossae and their anterior recesses 504
Anal triangle 504
Urogenital triangle 506
Structures in the superficial perineal pouch 506
Erectile tissues 506
Clitoris 507
Penis 508
Erection 508
Greater vestibular glands 508
Muscles 508
Ischiocavernosus 508
Bulbospongiosus 508
Superficial transverse perineal muscles 510
Superficial features of the external genitalia 510
In women 510
In men 511
Superficial fascia of the urogenital triangle 512
Somatic nerves 513
Pudendal nerve 513
Other somatic nerves 515
Visceral nerves 515
Blood vessels 516
Arteries 516
Internal pudendal artery 516
Inferior rectal arteries 516
Perineal artery 516
Terminal part of the internal pudendal artery 516
External pudendal arteries 516
Testicular and cremasteric arteries 516
Veins 516
Lymphatics 519
Surface anatomy 520
Surface anatomy of the pelvis and perineum 520
Orientation of the pelvis and perineum in the anatomical position 520
How to define the margins of the perineum 520
Identification of structures in the anal triangle 522
Identification of structures in the urogenital triangle of women 523
Identification of structures in the urogenital triangle of men 524
Clinical cases 527
6 Lower Limb 533
ADDITIONAL LEARNING RESOURCES for Chapter 6, Lower Limb, on STUDENT CONSULT (www.studentconsult.com): 533
Conceptual overview 535
General introduction 535
Function 537
Support the body weight 537
Locomotion 537
Component parts 539
Bones and joints 539
Muscles 543
Relationship to other regions 545
Abdomen 545
Pelvis 545
Perineum 545
Key points 545
Innervation is by lumbar and sacral spinal nerves 545
Nerves related to bone 550
Superficial veins 550
Regional anatomy 551
Bony pelvis 551
Ilium 551
Ischial tuberosity 552
Ischiopubic ramus and pubic bone 553
Acetabulum 553
Proximal femur 554
Greater and lesser trochanters 554
Intertrochanteric line 554
Intertrochanteric crest 556
Shaft of the femur 556
Hip joint 558
Ligaments 560
Gateways to the lower limb 562
Obturator canal 562
Greater sciatic foramen 562
Lesser sciatic foramen 563
Gap between the inguinal ligament and pelvic bone 563
Nerves 563
Femoral nerve 563
Obturator nerve 565
Sciatic nerve 565
Gluteal nerves 565
Ilio-inguinal and genitofemoral nerves 566
Lateral cutaneous nerve of thigh 566
Nerve to quadratus femoris and nerve to obturator internus 566
Posterior cutaneous nerve of thigh 566
Perforating cutaneous nerve 566
Arteries 566
Femoral artery 566
Superior and inferior gluteal arteries and the obturator artery 566
Veins 568
Lymphatics 570
Superficial inguinal nodes 570
Deep inguinal nodes 570
Popliteal nodes 571
Deep fascia and the saphenous opening 571
Fascia lata 571
Iliotibial tract 571
Saphenous opening 572
Femoral triangle 572
Femoral sheath 573
Gluteal region 574
Muscles 574
Deep group 576
Piriformis 576
Obturator internus 576
Gemellus superior and inferior 577
Quadratus femoris 577
Superficial group 577
Gluteus minimus and medius 577
Gluteus maximus 578
Tensor fasciae latae 578
Nerves 579
Superior gluteal nerve 579
Sciatic nerve 579
Nerve to quadratus femoris 580
Nerve to obturator internus 580
Posterior cutaneous nerve of the thigh 580
Pudendal nerve 580
Inferior gluteal nerve 580
Perforating cutaneous nerve 580
Arteries 582
Inferior gluteal artery 582
Superior gluteal artery 582
Veins 583
Lymphatics 583
Thigh 583
Bones 584
Shaft and distal end of femur 584
Patella 586
Proximal end of tibia 587
Tibial condyles and intercondylar areas 587
Tibial tuberosity 588
Shaft of tibia 588
Proximal end of fibula 588
Muscles 589
Anterior compartment 590
Iliopsoas—psoas major and iliacus 591
Quadriceps femoris—vastus medialis, intermedius, and lateralis and rectus femoris 592
Vastus muscles 593
Rectus femoris 593
Patellar ligament 593
Sartorius 593
Medial compartment 594
Gracilis 594
Pectineus 596
Adductor longus 596
Adductor brevis 596
Adductor magnus 597
Obturator externus 597
Posterior compartment 598
Biceps femoris 598
Semitendinosus 598
Semimembranosus 599
Arteries 600
Femoral artery 600
Deep artery of thigh 600
Lateral circumflex femoral artery 601
Medial circumflex femoral artery 602
Perforating arteries 602
Obturator artery 602
Veins 603
Great saphenous vein 603
Nerves 603
Femoral nerve 604
Obturator nerve 604
Sciatic nerve 605
Tibial nerve 605
Common fibular nerve 606
Knee joint 606
Articular surfaces 606
Menisci 607
Synovial membrane 609
Fibrous membrane 610
Ligaments 610
Patellar ligament 611
Collateral ligaments 611
Cruciate ligaments 612
Locking mechanism 612
Vascular supply and innervation 613
Tibiofibular joint 616
Popliteal fossa 616
Contents 617
Tibial and common fibular nerves 617
Popliteal artery and vein 617
Roof of popliteal fossa 617
Leg 618
Bones 618
Shaft and distal end of tibia 618
Shaft and distal end of fibula 619
Joints 620
Interosseous membrane of leg 620
Posterior compartment of leg 621
Muscles 621
Superficial group 621
Gastrocnemius 621
Plantaris 621
Soleus 621
Deep group 623
Popliteus 623
Flexor hallucis longus 624
Flexor digitorum longus 624
Tibialis posterior 624
Arteries 626
Popliteal artery 626
Anterior tibial artery 626
Posterior tibial artery 626
Veins 627
Nerves 627
Tibial nerve 627
Sural nerve 628
Medial calcaneal nerve 628
Lateral compartment of leg 628
Muscles 628
Fibularis longus 628
Fibularis brevis 629
Arteries 629
Veins 629
Nerves 630
Superficial fibular nerve 630
Anterior compartment of leg 630
Muscles 630
Tibialis anterior 630
Extensor hallucis longus 631
Extensor digitorum longus 631
Fibularis tertius 631
Arteries 632
Anterior tibial artery 632
Veins 632
Nerves 632
Deep fibular nerve 632
Foot 633
Bones 634
Tarsal bones 634
Proximal group 634
Talus 635
Calcaneus 636
Intermediate tarsal bone 637
Distal group 637
Metatarsals 637
Phalanges 638
Joints 638
Ankle joint 638
Medial ligament (deltoid ligament) 639
Lateral ligament 640
Intertarsal joints 640
Subtalar joint 642
Talocalcaneonavicular joint 642
Ligaments 642
Calcaneocuboid joint 644
Ligaments 644
Tarsometatarsal joints 644
Metatarsophalangeal joints 645
Deep transverse metatarsal ligaments 645
Interphalangeal joints 646
Tarsal tunnel, retinacula, and arrangement of major structures at the ankle 646
Flexor retinaculum 646
Extensor retinacula 647
Fibular retinacula 647
Arches of the foot 648
Longitudinal arch 648
Transverse arch 648
Ligament and muscle support 648
Plantar aponeurosis 649
Fibrous sheaths of toes 649
Extensor hoods 650
Intrinsic muscles 650
On the dorsal aspect 651
Extensor digitorum brevis and extensor hallucis brevis 651
In the sole 651
First layer 652
Abductor hallucis 652
Flexor digitorum brevis 652
Abductor digiti minimi 653
Second layer 653
Quadratus plantae 653
Lumbricals 654
Third layer 654
Flexor hallucis brevis 655
Adductor hallucis 655
Flexor digiti minimi brevis 655
Fourth layer 656
Dorsal interossei 656
Plantar interossei 656
Arteries 657
Posterior tibial artery and plantar arch 657
Lateral plantar artery 657
Medial plantar artery 657
Dorsalis pedis artery 658
Veins 659
Nerves 659
Tibial nerve 660
Medial plantar nerve 660
Lateral plantar nerve 660
Deep fibular nerve 661
Superficial fibular nerve 662
Sural nerve 662
Saphenous nerve 662
Surface anatomy 663
Lower limb surface anatomy 663
Avoiding the sciatic nerve 663
Finding the femoral artery in the femoral triangle 664
Identifying structures around the knee 664
Visualizing the contents of the popliteal fossa 666
Finding the tarsal tunnel—the gateway to the foot 667
Identifying tendons around the ankle and in the foot 668
Finding the dorsalis pedis artery 669
Approximating the position of the plantar arterial arch 669
Major superficial veins 670
Pulse points 671
Clinical cases 672
7 Upper Limb 683
ADDITIONAL LEARNING RESOURCES for Chapter 7, Upper Limb, on STUDENT CONSULT (www.studentconsult.com): 683
Conceptual overview 685
General description 685
Functions 686
Positioning the hand 686
The hand as a mechanical tool 689
The hand as a sensory tool 689
Component parts 690
Bones and joints 690
Muscles 692
Relationship to other regions 693
Neck 693
Back and thoracic wall 694
Key points 695
Innervation by cervical and upper thoracic nerves 695
Nerves related to bone 699
Superficial veins 700
Orientation of the thumb 701
Regional anatomy 702
Shoulder 702
Bones 702
Clavicle 702
Scapula 702
Proximal humerus 704
Greater and lesser tubercles 704
Surgical neck 705
Joints 705
Sternoclavicular joint 705
Acromioclavicular joint 706
Glenohumeral joint 707
Muscles 713
Trapezius 714
Deltoid 714
Levator scapulae 714
Rhomboid minor and major 715
Posterior scapular region 716
Muscles 717
Supraspinatus and infraspinatus 717
Teres minor and teres major 717
Long head of triceps brachii 717
Gateways to the posterior scapular region 717
Suprascapular foramen 717
Quadrangular space (from posterior) 718
Triangular space 719
Triangular interval 719
Nerves 719
Suprascapular nerve 719
Axillary nerve 719
Arteries and veins 719
Suprascapular artery 720
Posterior circumflex humeral artery 721
Circumflex scapular artery 721
Veins 721
Axilla 721
Axillary inlet 723
Anterior wall 723
Pectoralis major 724
Subclavius 724
Pectoralis minor 725
Clavipectoral fascia 725
Medial wall 726
Serratus anterior 726
Intercostobrachial nerve 727
Lateral wall 727
Posterior wall 728
Subscapularis 730
Teres major and latissimus dorsi 730
Long head of the triceps brachii 730
Gateways in the posterior wall 730
Quadrangular space 730
Triangular space 730
Triangular interval 731
Floor 731
Contents of the axilla 731
Biceps brachii 732
Coracobrachialis 732
Axillary artery 733
Superior thoracic artery 734
Thoraco-acromial artery 734
Lateral thoracic artery 735
Subscapular artery 735
Anterior circumflex humeral artery 735
Posterior circumflex humeral artery 735
Axillary vein 736
Brachial plexus 738
Roots 739
Trunks 739
Divisions 739
Cords 739
Branches (Table 7.7) 740
Branches of the roots 740
Branches of the trunks 741
Branches of the lateral cord 742
Branches of the medial cord 742
Median nerve. 742
Branches of the posterior cord 746
Lymphatics 748
Axillary process of the mammary gland 749
Arm 750
Bones 751
Shaft and distal end of the humerus 751
The condyle 752
The two epicondyles 752
The three fossae 752
Proximal end of the radius 752
Proximal end of the ulna 752
Muscles 754
Coracobrachialis 754
Biceps brachii 754
Brachialis 755
Posterior compartment 755
Arteries and veins 756
Brachial artery 756
Profunda brachii artery 756
Veins 759
Nerves 760
Musculocutaneous nerve 760
Median nerve 761
Ulnar nerve 761
Radial nerve 761
Elbow joint 764
Cubital fossa 768
Forearm 771
Bones 773
Shaft and distal end of radius 773
Shaft and distal end of ulna 773
Joints 774
Distal radio-ulnar joint 774
Interosseous membrane 775
Pronation and supination 775
Muscles involved in pronation and supination 776
Biceps brachii. 776
Supinator. 776
Pronator teres and pronator quadratus. 776
Anconeus. 776
Anterior compartment of the forearm 776
Muscles 776
Superficial layer 777
Flexor carpi ulnaris 777
Palmaris longus 777
Flexor carpi radialis 777
Pronator teres 777
Intermediate layer 779
Flexor digitorum superficialis 779
Deep layer 781
Flexor digitorum profundus 781
Flexor pollicis longus 781
Pronator quadratus 781
Arteries and veins 782
Radial artery 782
Ulnar artery 783
Veins 783
Nerves 784
Median nerve 784
Ulnar nerve 784
Radial nerve 785
Posterior compartment of the forearm 785
Muscles 785
Superficial layer 785
Brachioradialis 785
Extensor carpi radialis longus 787
Extensor carpi radialis brevis 787
Extensor digitorum 787
Extensor digiti minimi 788
Extensor carpi ulnaris 788
Anconeus 788
Deep layer 788
Supinator 788
Abductor pollicis longus 790
Extensor pollicis brevis 790
Extensor pollicis longus 790
Extensor indicis 790
Arteries and veins 791
Posterior interosseous artery 791
Anterior interosseous artery 792
Radial artery 792
Veins 792
Nerves 792
Radial nerve 792
Hand 792
Bones 793
Carpal bones 793
Proximal row 793
Distal row 793
Articular surfaces 793
Carpal arch 793
Metacarpals 793
Phalanges 795
Joints 795
Wrist joint 795
Carpal joints 795
Carpometacarpal joints 796
Metacarpophalangeal joints 796
Deep transverse metacarpal ligaments 796
Interphalangeal joints of hand 796
Carpal tunnel and structures at the wrist 798
Palmar aponeurosis 800
Palmaris brevis 800
Anatomical snuffbox 800
Fibrous digital sheaths 801
Extensor hoods 802
Muscles 804
Dorsal interossei 808
Palmar interossei 809
Adductor pollicis 809
Thenar muscles 809
Opponens pollicis 809
Abductor pollicis brevis 809
Flexor pollicis brevis 809
Hypothenar muscles 810
Opponens digiti minimi 810
Abductor digiti minimi 810
Flexor digiti minimi brevis 810
Lumbrical muscles 810
Arteries and veins 810
Ulnar artery and superficial palmar arch 812
Radial artery and deep palmar arch 812
Veins 814
Nerves 814
Ulnar nerve 814
Median nerve 817
Superficial branch of the radial nerve 818
Surface anatomy 819
Upper limb surface anatomy 819
Bony landmarks and muscles of the posterior scapular region 819
Visualizing the axilla and locating contents and related structures 820
Locating the brachial artery in the arm 821
The triceps brachii tendon and position of the radial nerve 822
Cubital fossa (anterior view) 822
Identifying tendons and locating major vessels and nerves in the distal forearm 824
Normal appearance of the hand 825
Position of the flexor retinaculum and the recurrent branch of the median nerve 826
Motor function of the median and ulnar nerves in the hand 826
Visualizing the positions of the superficial and deep palmar arches 827
Pulse points 827
Clinical cases 829
8 Head and Neck 835
ADDITIONAL LEARNING RESOURCES for Chapter 8, Head and Neck, on STUDENT CONSULT (www.studentconsult.com): 835
Conceptual overview 837
General description 837
Head 837
Major compartments 837
Other anatomically defined regions 838
Neck 839
Compartments 840
Larynx and pharynx 840
Functions 841
Protection 841
Contains upper parts of respiratory and digestive tracts 841
Communication 841
Positioning the head 841
Connects the upper and lower respiratory and digestive tracts 841
Component parts 842
Skull 842
Cervical vertebrae 844
Hyoid bone 845
Soft palate 846
Muscles 846
In the head 846
In the neck 846
Relationship to other regions 847
Thorax 847
Upper limbs 847
Key features 848
Vertebral levels CIII/IV and CV/VI 848
Airway in the neck 849
Cranial nerves 850
Cervical nerves 851
Functional separation of the digestive and respiratory passages 851
Triangles of the neck 854
Regional anatomy 855
Skull 855
Anterior view 855
Frontal bone 856
Zygomatic and nasal bones 856
Maxillae 856
Mandible 856
Lateral view 857
Lateral portion of the calvaria 858
Temporal bone 858
Visible part of the facial skeleton 858
Mandible 859
Posterior view 859
Occipital bone 859
Temporal bones 860
Superior view 860
Inferior view 860
Anterior part 861
Middle part 861
Anterior half 861
Vomer 861
Sphenoid 861
Body 861
Pterygoid processes 861
Greater wing 862
Posterior half 863
Index 1137
A 1137
B 1139
C 1140
D 1142
E 1142
F 1143
G 1145
H 1145
I 1146
J 1147
K 1148
L 1148
M 1149
N 1151
O 1151
P 1152
Q 1155
R 1155
S 1155
T 1158
U 1159
V 1160
W 1161
X 1161
Y 1161
Z 1161
Inside back cover ibc1