Preface

vii

Acknowledgments

xi

List of Clinical Blue Boxes

xix

Figure Credits

xxiii

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 the 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

46

Peripheral Nervous System

47

Somatic Nervous System

57

Autonomic Nervous System

57

Medical Imaging Techniques

66

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

127

Pericardium

128

Heart

135

Superior Mediastinum and Great Vessels

160

Posterior Mediastinum

166

Anterior Mediastinum

171

Surface Anatomy of Heart and Mediastinal Viscera

171

2

Abdomen

181

Overview: Walls, Cavities, Regions, and Planes

183

Anterolateral Abdominal Wall

184

Fascia of 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 Testis

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

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

355

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

404

Features of Anal Triangle

409

Male Urogenital Triangle

418

Female Urogenital Triangle

428

Sectional Imaging of Pelvis and Perineum

434

4

Back

439

Overview of Back and Vertebral Column

440

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 Nerve Roots

496

Spinal Meninges and Cerebrospinal Fluid

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

545

Organization of Proximal Lower Limb

545

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

S95

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 Region and Foot

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

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

Venous Drainage of Upper Limb

689

Lymphatic Drainage of Upper Limb

692

Cutaneous Innervation of Upper Limb

693

Motor Innervation (Myotomes) of Upper Limb

693

Pectoral and Scapular Regions

697

Anterior Axioappendicular Muscles

697

Posterior Axioappendicular and Scapubhumeral Muscles

700

Scapubhumeral (Intrinsic Shoulder) Muscles

704

Surface Anatomy of Pectoral, Scapular, and Deltoid Regions

707

Axilla

713

Axillary Artery

715

AxillaryVein

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

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

5urface 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 of Brain

882

Venous Drainage of Brain

883

Eye, Orbit, Orbital Region, and Eyeball

889

Orbits

889

Eyelids and Lacrimal Apparatus

891

Eyeball

893

Extraocular 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

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

Mandrbular Nerve (CN V₃)

1065

Abducent Nerve (CN VI)

1068

Facial Nerve (CN VII)

1068

Vestibulocochlear Nerve (CN VIII)

1071

Glossopharyngeal Nerve (CN IX)

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