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Anatomy for Anaesthetists 8th ed. - H. Ellis, S. Feldman, W. Harrop-Griffiths (Blackwell, 2004) WW PDF

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.. Anatomy for Anaesthetists AFAA01 11/11/03 13:38 Page i This page intentionally left blank .. .. ANATOMY FOR ANAESTHETISTS HAROLD ELLIS CBE, MA, DM, FRCS, FACS(Hon) Clinical Anatomist, Guy’s King’s and St Thomas’s School of Biomedical Sciences, London Emeritus Professor of Surgery, University of London STANLEY FELDMAN BSc, MB, FRCA Emeritus Professor of Anaesthetics, Charing Cross and Westminster Medical School WILLIAM HARROP-GRIFFITHS MA, MB, BS, FRCA Consultant Anaesthetist, St Mary’s Hospital, Paddington, London with a chapter on the Anatomy of Pain contributed by ANDREW LAWSON FFARCSI, FANZCA, FRCA, MSc Consultant in Anaesthesia and Pain Management, Royal Berkshire Hospital, Reading Eighth edition AFAA01 11/11/03 13:38 Page iii .. .. © 1963, 1969, 1977, 1983, 1988, 1993, 1997, 2004 by Blackwell Science Ltd a Blackwell Publishing company Blackwell Science, Inc., 350 Main Street, Malden, Massachusetts 02148-5020, USA Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK Blackwell Science Asia Pty Ltd, 550 Swanston Street, Carlton, Victoria 3053, Australia The right of the Author to be identified as the Author of this Work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. First published 1963 Second edition 1969 Third edition 1977 Reprinted 1979 Fourth edition 1983 Fifth edition 1988 Reprinted 1990 Sixth edition 1993 Reprinted 1995 Seventh edition 1997 Reprinted 1998 Italian first edition 1972 Japanese fourth edition 1989 German fifth edition 1992 Library of Congress Cataloging-in-Publication Data Ellis, Harold, 1926– Anatomy for anaesthetists / Harold Ellis, Stanley Feldman, William Harrop-Griffiths; with a chapter on the Anatomy of pain contributed by Andrew Lawson.—8th ed. p. ; cm. Includes bibliographical references and index. ISBN 1-4051-0663-8 1. Human anatomy. 2. Anesthesiology. [DNLM: 1. Anatomy. 2. Anesthesia. QS 4 E47a 2003] I. Feldman, Stanley A. II. Harrop-Griffiths, William. III. Title. QM23.2.E42 2003 611′.0024617—dc22 2003020753 ISBN 1405 1066 38 A catalogue record for this title is available from the British Library Set in 10/13.5pt Sabon by Graphicraft Limited, Hong Kong Printed and bound in Denmark, by Narayana Press, Odder Commissioning Editor: Stuart Tayler Editorial Assistant: Katrina Chandler Production Editor: Rebecca Huxley Production Controller: Kate Charman For further information on Blackwell Publishing, visit our website: http://www.blackwellpublishing.com AFAA01 11/17/03 10:26 Page iv .. .. Contents Part 1: The Respiratory Pathway 1 The Mouth 3 The Nose 7 The Pharynx 16 The Larynx 26 The Trachea 42 The Main Bronchi 48 The Pleura 50 The Lungs 53 Part 2: The Heart 71 The Pericardium 73 The Heart 75 Developmental Anatomy 86 Part 3: The Vertebral Canal and its Contents 95 The Vertebrae and Sacrum 97 The Spinal Meninges 119 The Spinal Cord 125 Part 4: The Peripheral Nerves 137 The Spinal Nerves 139 The Cervical Plexus 146 The Brachial Plexus 153 The Thoracic Nerves 180 The Lumbar Plexus 183 The Sacral and Coccygeal Plexuses 192 Part 5: The Autonomic Nervous System 213 Introduction 215 The Sympathetic System 218 The Parasympathetic System 228 Part 6: The Cranial Nerves 233 Introduction 235 The Olfactory Nerve (I) 238 The Optic Nerve (II) 239 v AFAA01 11/11/03 13:38 Page v .. vi Contents The Oculomotor Nerve (III) 242 The Trochlear Nerve (IV) 244 The Trigeminal Nerve (V) 245 The Abducent Nerve (VI) 266 The Facial Nerve (VII) 267 The Auditory (Vestibulocochlear) Nerve (VIII) 272 The Glossopharyngeal Nerve (IX) 273 The Vagus Nerve (X) 276 The Accessory Nerve (XI) 282 The Hypoglossal Nerve (XII) 283 Part 7: The Anatomy of Pain 285 Introduction 287 Classification of Pain 288 Peripheral Receptors and Afferent fibres 288 The Spinal Cord and Central Projections 290 Modulation of Pain 294 The Gate Control Theory of Pain 295 The Sympathetic Nervous System and Pain 296 Part 8: Zones of Anaesthetic Interest 297 The Thoracic inlet 299 The Diaphragm 305 The Intercostal Spaces 311 The Abdominal Wall 318 The Antecubital Fossa 324 The Great Veins of the Neck 330 The Orbit and its Contents 336 Index 349 .. AFAA01 11/11/03 13:38 Page vi .. Acknowledgements The first two editions of this textbook were prepared in collaboration with that skilled medical artist Miss Margaret McLarty. The illustrations for the sixth edition were almost all drawn or redrafted by Rachel Chesterton; we thank her for the excellent way in which they have been executed. Further illustrations for the seventh and this edition were prepared by Jane Fallows with great skill. vii .. AFAA01 11/11/03 13:38 Page vii .. Introduction The anaesthetist requires a particularly specialized knowledge of anatomy. Some regions of the body, for example the respiratory passages, the major veins and the peripheral nerves, the anaesthetist must know with an intimacy of detail that rivals or even exceeds that of the surgeon; other areas can be all but ignored. Although formal anatomy teaching is no longer part of the syllabus of the FRCA in the UK, its importance for the safe practice of anaesthesia is recognized by the examiners, who always include questions on anatomy related to anaesthesia in this examination. The role of anatomy in anaesthetic teaching is often con- sidered merely as a prerequisite for the safe practice of local anaesthetic blocks. However, it is also important in understanding the anatomy of the airway, the function of the lungs, the circulation, venous access, monitoring neuromuscular block and many other aspects of practical anaesthesia. For this reason, this book is not intended to be a textbook for regional anaesthetic techniques; there are many excellent books in this field. It is an anatomy book written for anaesthetists, keeping in mind the special requirements of their daily practice. In this eighth edition, we have revised much of the text, we have taken the opportunity to expand and update the sections of special interest to anaesthetists and we have included new and improved illustrations. William Harrop-Griffiths of St Mary’s Hospital, London, joins us as our new co-author. He brings with him special expertise in modern anaesthetic technology and has greatly assisted us in updating the text and illustrations. Dr Andrew Lawson has fully updated his important section on the Anatomy of Pain and has given valuable advice on procedures relevant to the practice of pain medicine. viii AFAA01 11/11/03 13:38 Page viii .. Part 1 The Respiratory Pathway AFAC01 11/11/03 13:39 Page 1

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