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 б
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 Netvous System (ANS) 57
MEDICAL IMAGING TECHNIQUES 66
Conventional Radiography 66
Computed Tomography 67
Ultrasonography 67
Magnetic Resonance Imaging 68
Nuclear Medicine Imaging 70
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
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
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
Musdes of Posterior Abdominal Wall 311
Nerves of Posterior Abdominal Wall 312
Vessels of Posterior Abdominal Wall 313
SECTIONAL MEDICAL IMAGING OF ABDOMEN 321
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 Ugaments 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
Baek 439
OVKVIEW OF BACK AND VERTEBRAL COLUMN 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
Lower Limb 508
OVERVIEW OF LOWER UMB 510
DEVELOPMENT OF LOWER UMB 510
BONES OF LOWER UMB 512
Arrangement of Lower Umb 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 UMB 532
Subcutaneous Tissue and Fascia 532
Venous Drainage of Lower Umb 532
Lymphatic Drainage of Lower Umb 535
Cutaneous Innervation of Lower Umb 536
Motor Innervation of Lower Umb 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 Umb 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
Musdes 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
Postenor 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 UMB 626
Hip Joint 626
Knee Joint 634
Tibiofibular Joints 64S
Ankle Joint 647
Foot Joints 650
Surface Anatomy of Joints of Knee, Ankle, and Foot 656
Upper Limb 670
OVERVIEW OF UPPER UMB 672
COMPARISON OF UPPER AND LOWER UMBS 673
BONES OF UPPER UMB 673
Clavicle 673
Scapula 675
Humerus 676
Bones of Forearm 677
Bones of Hand 679
Surface Anatomy of Upper Umb Bones 680
FASCIA, EFFERENT VESSELS. CUTANEOUS INNERVATION, AND MYOTOMES OF UPPER UMB 688
Fascia of Upper Umb 688
Lymphatic Drainage of Upper Umb 691
Cutaneous Innervation of Upper Umb 693
Motor Innervation (Myotomes) of Upper Umb 693
PECTORAL AND SCAPULAR REGIONS 697
Anterior Axio-appendicular Muscles 697
Posterior Axio-appendicular and Scapulohumeral Muscles 700
Scapulohumeral (Intrinsic Shoulder) Musdes 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
Fasda and Compartments of Palm 771
Musdes 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 UMB 793
Stemodavicular 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
Head 820
OVERVIEW OF HEAD 822
CRANIUM 822
Fada! Aspect of Cranium 822
Lateral Aspect of Cranium 827
Ocdpital 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
Musdes of Face and Scalp 844
Nerves of Face and Scalp 849
Superfidal 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
Neck 981
OVERVIEW 982
BONES OF NECK 982
Cervical Vertebrae 982
Mid Bone 984
FA6CIAOF NECK 985
HSBfl Subcutaneous Timuc 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
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 V,) 1065
Maxillary Nerve (CN V2) 1065
Mandibular Nerve (CN V,) 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