Preface / vii
Acknowledgments / xi
List of Clinical Blue Boxes / xix
Figure Credits / xxv
Introduction to Clinically Oriented
Anatomy/ 1
APPROACHES TO STUDYING ANATOMY / 2
Regional Anatomy / 2
Systemic Anatomy / 3
Clinical Anatomy / 4
ANATOMICOMEDICAL TERMINOLOGY / 4
Anatomical Position / 5
Anatomical Planes / 5
Terms of Relationship and Comparison / 6
Terms of Laterality / 7
Terms of Movement / 7
ANATOMICAL VARIATIONS / 12
INTEGUMENTARY SYSTEM / 12
FASCIAS, FASCIAL COMPARTMENTS, BURSAE,
AND POTENTIAL SPACES / 16
SKELETAL SYSTEM / 19
Cartilage and Bones / 19
Bone Markings and Formations / 20
Joints / 25
MUSCLE TISSUE AND MUSCULAR SYSTEM / 29
Types of Muscle (Muscle Tissue) / 29
Skeletal muscles / 29
Cardiac Striated Muscle / 36
Smooth Muscle / 36
CARDIOVASCULAR SYSTEM / 37
Vascular Circuits / 37
Blood Vessels / 37
LYMPHOID SYSTEM / 43
NERVOUS SYSTEM / 46
Central Nervous System / 47
Peripheral Nervous System / 47
Somatic Nervous System / 57
Autonomic Nervous System (ANS) / 57
MEDICAL IMAGING TECHNIQUES / 66
Conventional Radiography / 66
Computed Tomography / 67
Ultrasonography / 67
Magnetic Resonance Imaging / 68
Nuclear Medicine Imaging / 70
1 Thorax / 71
OVERVIEW OF THORAX / 72
THORACIC WALL / 72
Skeleton of Thoracic Wall / 74
Thoracic Apertures / 78
Joints of Thoracic Wall / 79
Movements of Thoracic Wall / 81
Muscles of Thoracic Wall / 86
Fascia of Thoracic Wall / 91
Nerves of Thoracic Wall / 91
Vasculature of Thoracic Wall / 93
Breasts / 98
Surface Anatomy of Thoracic Wall / 99
VISCERA OF THORACIC CAVITY / 106
Pleurae, Lungs, and Tracheobronchial Tree / 108
Overview of Mediastinum / 128
Pericardium / 128
Heart / 135
Superior Mediastinum and Great Vessels / 160
Posterior Mediastinum / 166
Anterior Mediastinum / 171
Surface Anatomy of Heart and Mediastinal Viscera / 171
Auscultatory Areas / 173
2 Abdomen / 181
OVERVIEW: WALLS, CAVITIES, REGIONS,
AND PLANES / 183
ANTEROLATERAL ABDOMINAL WALL / 184
Fascia of the Anterolateral Abdominal Wall / 186
Muscles of Anterolateral Abdominal Wall / 187
Neurovasculature of Anterolateral Abdominal Wall / 193
Internal Surface of Anterolateral Abdominal Wall / 201
Inguinal Region / 202
Spermatic Cord, Scrotum, and Testes / 206
Surface Anatomy of Anterolateral
Abdominal Wall / 210
PERITONEUM AND PERITONEAL CAVITY / 217
Embryology of Peritoneal Cavity / 218
Peritoneal Formations / 219
Subdivisions of Peritoneal Cavity / 221
ABDOMINAL VISCERA / 226
Overview of Abdominal Viscera and Digestive Tract / 226
Esophagus / 229
Stomach / 230
Contents
Structure and Function of Vertebrae / 440
Regional Characteristics of Vertebrae / 443
Ossification of Vertebrae / 453
Variations in Vertebrae / 455
VERTEBRAL COLUMN / 464
Joints of Vertebral Column / 464
Movements of Vertebral Column / 470
Curvatures of Vertebral Column / 470
Vasculature of Vertebral Column / 472
Nerves of Vertebral Column / 473
MUSCLES OF BACK / 482
Extrinsic Back Muscles / 482
Intrinsic Back Muscles / 482
Surface Anatomy of Back Muscles / 492
Suboccipital and Deep Neck Muscles / 492
CONTENTS OF VERTEBRAL CANAL / 496
Spinal Cord / 496
Spinal Nerves and Nerve Roots / 496
Spinal Meninges and Cerebrospinal Fluid (CSF) / 498
Vasculature of Spinal Cord and Spinal Nerve Roots / 501
5 Lower Limb / 508
OVERVIEW OF LOWER LIMB / 510
DEVELOPMENT OF LOWER LIMB / 510
BONES OF LOWER LIMB / 512
Arrangement of Lower Limb Bones / 512
Hip Bone / 514
Femur / 516
Tibia and Fibula / 520
Bones of Foot / 522
Surface Anatomy of Bones of Foot / 524
FASCIA, VEINS, LYMPHATICS, EFFERENT VESSELS,
AND CUTANEOUS NERVES OF LOWER LIMB / 532
Subcutaneous Tissue and Fascia / 532
Venous Drainage of Lower Limb / 532
Lymphatic Drainage of Lower Limb / 535
Cutaneous Innervation of Lower Limb / 536
Motor Innervation of Lower Limb / 538
POSTURE AND GAIT / 542
Standing at Ease / 542
Walking: The Gait Cycle / 542
ANTERIOR AND MEDIAL REGIONS OF THIGH / 545
Organization of Proximal Lower Limb / 532
Anterior Thigh Muscles / 545
Medial Thigh Muscles / 548
Neurovascular Structures and Relationships in
Anteromedial Thigh / 551
Surface Anatomy of Anterior and Medial Regions of
Thigh / 557
GLUTEAL AND POSTERIOR THIGH REGIONS / 562
Gluteal Region: Buttocks and Hip Region / 562
Muscles of Gluteal Region / 563
Small Intestine / 239
Large Intestine / 246
Spleen / 263
Pancreas / 265
Liver / 268
Biliary Ducts and Gallbladder / 277
Kidneys, Ureters, and Suprarenal Glands / 290
Summary of Innervation of Abdominal Viscera / 301
DIAPHRAGM / 306
Vessels and Nerves of Diaphragm / 307
Diaphragmatic Apertures / 308
Actions of Diaphragm / 309
POSTERIOR ABDOMINAL WALL / 309
Fascia of Posterior Abdominal Wall / 310
Muscles of Posterior Abdominal Wall / 311
Nerves of Posterior Abdominal Wall / 312
Vessels of Posterior Abdominal Wall / 313
SECTIONAL MEDICAL IMAGING OF ABDOMEN / 321
3 Pelvis and Perineum / 326
INTRODUCTION TO PELVIS AND PERINEUM / 327
PELVIC GIRDLE / 327
Bones and Features of Pelvic Girdle / 328
Orientation of Pelvic Girdle / 330
Joints and Ligaments of Pelvic Girdle / 330
PELVIC CAVITY / 338
Walls and Floor of Pelvic Cavity / 338
Peritoneum and Peritoneal Cavity of Pelvis / 343
Pelvic Fascia / 345
NEUROVASCULAR STRUCTURES OF PELVIS / 349
Pelvic Arteries / 350
Pelvic Veins / 355
Lymph Nodes of Pelvis / 356
Pelvic Nerves / 357
PELVIC VISCERA / 362
Urinary Organs / 362
Rectum / 368
Male Internal Genital Organs / 376
Female Internal Genital Organs / 382
Lymphatic Drainage of Pelvic Viscera / 400
PERINEUM / 402
Fasciae and Pouches of Urogenital Triangle
Features of Anal Triangle / 410
Male Urogenital Triangle / 418
Female Urogenital Triangle / 428
SECTIONAL IMAGING OF PELVIS AND PERINEUM / 434
Magnetic Resonance Imaging / 434
4 Back / 439
OVERVIEW OF BACK AND VERTEBRAL COLUMN
VERTEBRAE / 440
Structure and Function of Vertebrae / 440
Regional Characteristics of Vertebrae / 443
Ossification of Vertebrae / 453
Variations in Vertebrae / 455
VERTEBRAL COLUMN / 464
Joints of Vertebral Column / 464
Movements of Vertebral Column / 470
Curvatures of Vertebral Column / 470
Vasculature of Vertebral Column / 472
Nerves of Vertebral Column / 473
MUSCLES OF BACK / 482
Extrinsic Back Muscles / 482
Intrinsic Back Muscles / 482
Surface Anatomy of Back Muscles / 492
Suboccipital and Deep Neck Muscles / 492
CONTENTS OF VERTEBRAL CANAL / 496
Spinal Cord / 496
Spinal Nerves and Nerve Roots / 496
Spinal Meninges and Cerebrospinal Fluid (CSF) / 498
Vasculature of Spinal Cord and Spinal Nerve Roots / 501
5 Lower Limb / 508
OVERVIEW OF LOWER LIMB / 510
DEVELOPMENT OF LOWER LIMB / 510
BONES OF LOWER LIMB / 512
Arrangement of Lower Limb Bones / 512
Hip Bone / 514
Femur / 516
Tibia and Fibula / 520
Bones of Foot / 522
Surface Anatomy of Bones of Foot / 524
FASCIA, VEINS, LYMPHATICS, EFFERENT VESSELS,
AND CUTANEOUS NERVES OF LOWER LIMB / 532
Subcutaneous Tissue and Fascia / 532
Venous Drainage of Lower Limb / 532
Lymphatic Drainage of Lower Limb / 535
Cutaneous Innervation of Lower Limb / 536
Motor Innervation of Lower Limb / 538
POSTURE AND GAIT / 542
Standing at Ease / 542
Walking: The Gait Cycle / 542
ANTERIOR AND MEDIAL REGIONS OF THIGH / 545
Organization of Proximal Lower Limb / 532
Anterior Thigh Muscles / 545
Medial Thigh Muscles / 548
Neurovascular Structures and Relationships in
Anteromedial Thigh / 551
Surface Anatomy of Anterior and Medial Regions of
Thigh / 557
GLUTEAL AND POSTERIOR THIGH REGIONS / 562
Gluteal Region: Buttocks and Hip Region / 562
Muscles of Gluteal Region / 563
Posterior Thigh Region / 569
Neurovascular Structures of Gluteal and
Posterior Thigh Regions / 572
Surface Anatomy of Gluteal
and Posterior Thigh Regions / 578
POPLITEAL FOSSA AND LEG / 584
Popliteal Region / 584
Anterior Compartment of Leg / 587
Lateral Compartment of Leg / 595
Posterior Compartment of Leg / 596
Surface Anatomy of Leg / 603
FOOT / 609
Skin and Fascia of Foot / 610
Muscles of Foot / 610
Neurovascular Structures and Relationships in Foot / 614
Surface Anatomy of Ankle and Foot Regions / 622
JOINTS OF LOWER LIMB / 626
Hip Joint / 626
Knee Joint / 634
Tibiofibular Joints / 645
Ankle Joint / 647
Foot Joints / 650
Surface Anatomy of Joints of Knee, Ankle, and Foot / 656
6 Upper Limb / 670
OVERVIEW OF UPPER LIMB / 672
COMPARISON OF UPPER AND LOWER LIMBS / 673
BONES OF UPPER LIMB / 673
Clavicle / 673
Scapula / 675
Humerus / 676
Bones of Forearm / 677
Bones of Hand / 679
Surface Anatomy of Upper Limb Bones / 680
FASCIA, EFFERENT VESSELS, CUTANEOUS INNERVATION,
AND MYOTOMES OF UPPER LIMB / 688
Fascia of Upper Limb / 688
Lymphatic Drainage of Upper Limb / 691
Cutaneous Innervation of Upper Limb / 693
Motor Innervation (Myotomes) of Upper Limb / 693
PECTORAL AND SCAPULAR REGIONS / 697
Anterior Axio-appendicular Muscles / 697
Posterior Axio-appendicular
and Scapulohumeral Muscles / 700
Scapulohumeral (Intrinsic Shoulder) Muscles / 704
Surface Anatomy of Pectoral, Scapular, and Deltoid
Regions / 707
AXILLA / 713
Axillary Artery / 715
Axillary Vein / 718
Axillary Lymph Nodes / 719
Brachial Plexus / 721
ARM / 731
Muscles of Arm / 731
Brachial Artery / 736
Veins of Arm / 737
Nerves of Arm / 737
Cubital Fossa / 739
Surface Anatomy of Arm and Cubital Fossa / 739
FOREARM / 744
Compartments of Forearm / 744
Muscles of Forearm / 746
Arteries of Forearm / 757
Veins of Forearm / 760
Nerves of Forearm / 761
Surface Anatomy of Forearm / 764
HAND / 771
Fascia and Compartments of Palm / 771
Muscles of Hand / 773
Long Flexor Tendons and Tendon Sheaths
in Hand / 779
Arteries of Hand / 779
Veins of Hand / 782
Nerves of Hand / 782
Surface Anatomy of Hand / 786
JOINTS OF UPPER LIMB / 793
Sternoclavicular Joint / 794
Acromioclavicular Joint / 796
Glenohumeral Joint / 796
Elbow Joint / 800
Proximal Radio-Ulnar Joint / 804
Distal Radio-Ulnar Joint / 806
Wrist Joint / 809
Intercarpal Joints / 809
Carpometacarpal and Intermetacarpal Joints / 811
Metacarpophalangeal and Interphalangeal Joints / 812
7 Head / 820
OVERVIEW OF HEAD / 822
CRANIUM / 822
Facial Aspect of Cranium / 822
Lateral Aspect of Cranium / 827
Occipital Aspect of Cranium / 828
Superior Aspect of Cranium / 829
External Surface of Cranial Base / 829
Internal Surface of Cranial Base / 830
Walls of Cranial Cavity / 835
Regions of Head / 836
FACE AND SCALP / 842
Face / 842
Scalp / 843
Muscles of Face and Scalp / 844
Nerves of Face and Scalp / 849
Superficial Vasculature of Face and Scalp / 855
Surface Anatomy of Face / 859
CRANIAL MENINGES / 865
Dura Mater / 865
Arachnoid Mater and Pia Mater / 872
Meningeal Spaces / 872
BRAIN / 878
Parts of Brain / 878
Ventricular System of Brain / 878
Arterial Blood Supply to Brain / 882
Venous Drainage of Brain / 883
EYE, ORBIT, ORBITAL REGION, AND EYEBALL / 889
Orbits / 889
Eyelids and Lacrimal Apparatus / 891
Eyeball / 893
Extra-ocular Muscles of Orbit / 898
Nerves of Orbit / 903
Vasculature of Orbit / 905
Surface Anatomy of Eye and Lacrimal Apparatus / 907
PAROTID AND TEMPORAL REGIONS,
INFRATEMPORAL FOSSA, AND
TEMPOROMANDIBULAR JOINT / 914
Parotid Region / 914
Temporal Region / 916
Infratemporal Fossa / 916
ORAL REGION / 928
Oral Cavity / 928
Lips, Cheeks, and Gingivae / 928
Teeth / 930
Palate / 934
Tongue / 938
Salivary Glands / 943
PTERYGOPALATINE FOSSA / 951
Pterygopalatine Part of Maxillary Artery / 951
Maxillary Nerve / 951
NOSE / 955
External Nose / 955
Nasal Cavities / 956
Vasculature and Innervation of Nose / 959
Paranasal Sinuses / 960
EAR / 966
External Ear / 966
Middle Ear / 967
Internal Ear / 973
8 Neck / 981
OVERVIEW / 982
BONES OF NECK / 982
Cervical Vertebrae / 982
Hyoid Bone / 984
FASCIA OF NECK / 985
Cervical Subcutaneous Tissue and
Platysma / 985
Deep Cervical Fascia / 987
SUPERFICIAL STRUCTURES OF NECK: CERVICAL
REGIONS / 989
Sternocleidomastoid Region / 989
Posterior Cervical Region / 992
Lateral Cervical Region / 992
Anterior Cervical Region / 999
Surface Anatomy of Cervical Regions and Triangles of
Neck / 1005
DEEP STRUCTURES OF NECK / 1012
Prevertebral Muscles / 1012
Root of Neck / 1012
VISCERA OF NECK / 1018
Endocrine Layer of Cervical Viscera / 1018
Respiratory Layer of Cervical Viscera / 1021
Alimentary Layer of Cervical Viscera / 1032
Surface Anatomy of Endocrine and Respiratory Layers
of Cervical Viscera / 1039
LYMPHATICS OF NECK / 1051
9 Summary of Cranial
Nerves / 1053
OVERVIEW / 1054
OLFACTORY NERVE (CN I) / 1054
OPTIC NERVE (CN II) / 1061
OCULOMOTOR NERVE (CN III) / 1062
TROCHLEAR NERVE (CN IV) / 1064
TRIGEMINAL NERVE (CN V) / 1065
Ophthalmic Nerve (CN V1) / 1065
Maxillary Nerve (CN V2) / 1065
Mandibular Nerve (CN V3) / 1065
ABDUCENT NERVE (CN VI) / 1068
FACIAL NERVE (CN VII) / 1068
Somatic (Branchial) Motor / 1068
Visceral (Parasympathetic) Motor / 1068
Somatic (General) Sensory / 1068
Special Sensory (Taste) / 1068
VESTIBULOCOCHLEAR NERVE (CN VIII) / 1071
GLOSSOPHARYNGEAL NERVE (CN IX) / 1072
Somatic (Branchial) Motor / 1072
Visceral (Parasympathetic) Motor / 1072
Somatic (General) Sensory / 1072
Special Sensory (Taste) / 1072
VAGUS NERVE (CN X) / 1073
SPINAL ACCESSORY NERVE (CN XI) / 1075
HYPOGLOSSAL NERVE (CN XII) / 1075
Appendix A: References and Suggested Readings / 1083
Index / 1087
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