BD Chaurasia's

567 Pages·2006·11.89 MB·English

FOURTH EDITION ME4RG BdoTecfc
ACC No J.
BD Chaurasia's
Regional and Applied
Dissection and Clinical
VOLUME 3
Head, Neck and
Brain
Late Dr BD Chaurasia
1937-1985
FOURTH EDITION
*"» ""•" "~"
BD ChaurasiaV"
Regional and Applied
Dissection and Clinical
VOLUME 3
Head, Neck and
Brain
CBS
CBS PUBLISHERS & DISTRIBUTORS
NEW DELHI • BANGALORE
Medical knowledge is constantly changing. As new information becomes available,
changes in treatment, procedures, equipment and the use of drugs become necessary.
The author and the publisher have, as far as it is possible, taken care to ensure that the
information given in this text is accurate and up to date. However, readers are strongly
advised to confirm that the information, especially with regard to drug usage, complies
with the latest legislation and standards of practice.
BD Chaurasia's
HUMAN ANATOMY
Regional and Applied
Dissection and Clinical
Volume 3 4/e
Copyright © Publishers and Author
ISBN .-81-239-1157-2
Fourth Edition: 2004
Reprinted: 2005, 2006
First Edition: 1979
Reprinted: 1980, 1981, 1982, 1983, 1984, 1985, 1986, 1987, 1988
Second Edition: 1989
Reprinted: 1990, 1991, 1992, 1993, 1994
Third Edition: 1995
Reprinted: 1996, 1997, 1998, 1999, 2000, 2001, 2002, 2003, 2004, 2005
Editor:
The fourth edition has been revised by Dr Krishna Garg, Ex-Professor and Head,
Department of Anatomy, Lady Hardinge Medical College, New Delhi.
All rights reserved. No part of this book may be reproduced or transmitted in
any form or by any means, electronic or mechanical, including photocopying,
recording, or any information storage and retrieval system without permission, in
writing, from the author and the publishers,
Production Director: Vinod K. Jain
Published by:
Satish Kumar Jain for CBS Publishers & Distributors,
4596/1-A, 11 Darya Ganj, New Delhi - 110 002 (India) E-
mail:
dedicated to
my teacher
Y ^l/ima
FOURTH EDITION
BD Chaurasia's
Regional and Applied
Dissection and Clinical
VOLUME 1
Upper Limb and Thorax
VOLUME 2
Lower Limb, Abdomen
Pelvis
VOLUME 3
Neck Brain
flBOUT TH6 €DITOR
Dr. Krishna Garg joined Department of flnatomu, lady Hardinge Medical College, Neuj Delhi, in 1964 and learnt
and taught anatomy tiil 1996 except for a brief stint at Maulana flzad Medical College. She has been decorated
as Felloui of Indian Medical Rssociatioft-fkademy of Medical Specialists, Member of flcademy of Medical Sciences
and fellow of International Medical Science flcademy. She recieved flppreciation fluiard in 1999 from Delhi Medical
flssGdation and Excellence fluiard in Rnatomy on Doctors Day in 2004. Krishna Garg is the co-author of Textbook
of Histology and Neuroanatemu, Having revised BD Chaurasia's Hand Booh of General flneitomy in 1996,she has
nouj revised and brought out the 4th edition of the three volumes of BD Chaurasia's Human flnatomu.
This human anatomy is not systemic but regional Lots of tables for the muscles are provided
Oh yes, it is theoretical os uuell as practical €ven methods for testing are incorporated
Besides the gross features, it is chiefly dinical Numerous coloured illustrations are added
Inducted in anatomy, it is also histologicoj So that right half of brain gets stimulated
flnatomy is not only of adult but also embryological Hope these volumes turn highly useful
It is concise, comprehensive and dinieal The editor's patience and perseverance prove fruitful
Surface marking is provided in the
beginning To light the instinct of surgeon-in-
the-fnaking
Preface to the Fourth Edition
In July 1996, I had gone to the office of CBS the real author and artist in BD Chaurasia. A
Publishers and Distributors to hand over the number of diagrams on ossification, surface
manuscript of the third edition of our Textbook of marking, muscle testing, in addition to radiographs,
Histology, when Mr SK Jain, Managing Director of have been added.
CBS, requested me to shoulder the responsibility The beauty of most of the four-colour figures lies
of editing the three volumes of their extremely in easy reproducibility in numerous tests and
popular book BD Chaurasia's Human Anatomy, the examinations which the reader can master after a
third edition of which was earlier edited by few practice sessions only. This makes them user-
respected Prof. Inderbir Singh. This was a 'God friendly volumes. Figures are appreciated by the
given gift' which I accepted with great gratitude. underutilised right half of the cerebral cortex,
This had also been the wishful thinking of my son, leaving the dominant left half for other jobs in
now a nephrologist in the US. about 98% of right-handed individuals. At the
The three volumes of the fourth edition of this beginning of each chapter, a few introductory
book are extremely student-friendly. All out efforts sentences have been added to highlight the
have been made to bring them closer to their importance of the topic covered. A brief account of
hearts through serious and subtle efforts. Various the related histology and development is put forth
ways were thought of, which I discussed with my so that the given topic is covered in all respects.
colleagues and students, and have been incorporated The entire clinical anatomy has been put with the
in these volumes. respective topic, highlighting its importance. The
One significant method suggested was to add volumes thus are concise, comprehensive and
'practical skills' so that these volumes encompass clinically-oriented .
theoretical, practical and clinical aspects of various Various components of upper and lower limbs
parts of human body in a functional manner. The have been described in a tabular form to revise and
paragraphs describing human dissection, printed appreciate their "diversity in similarity". At the
with blue background, provide necessary end of each section, an appendix has been added
instructions for dissection. These entail identifying wherein the segregated course of the nerves has
structures deeper to skin which need to be cut and been aggregated, providing an overview of their
separated to visualise the anatomic details of entire course. These appendices also contain some
various structures. clinicoanatomical problems and multiple choice
Dissection means patiently clearing off the fat questions to test the knowledge and skills acquired.
and fasciae around nerves, blood vessels, muscles, Prayers, patience and perseverance for almost 8
viscera, etc. so that their course, branches and years have brought out this new edition aimed at
relations are appreciated. This provides the providing a holistic view of the amazing structures
photogenic memory for the 'doctor-in-making'. First which constitute the human anatomy.
year of MBBS course is the only time in life when There are bound to be some errors in these
one can dissect at ease, although it is too early a volumes. Suggestions and comments for correction
period to appreciate its value. Good surgeons always and improvement shall be most welcome: These
refresh their anatomical knowledge before they go may please be sent to me through e-mail at
to the operation theatre.
Excerpts
from
Preface to the First
Edition
r l^he necessity of having a simple, systematized The book has been intentionally split in three
_L and complete book on anatomy has long been parts for convenience of handling. This also makes
felt. The urgency for such a book has become all a provision for those who cannot afford to have the
the more acute due to the shorter time now whole book at a time.
available for teaching anatomy, and also to the It is quite possible that there are errors of omis-
falling standards of English language in the sion and commission in this mostly single handed
majority of our students in India. The national attempt. I would be grateful to the readers for their
symposium on "Anatomy in Medical Education" suggestions to improve the book from all angles.
held at Delhi in 1978 was a call to change the I am very grateful to my teachers and the authors
existing system of teaching the unnecessary of numerous publications, whose knowledge has
minute details to the undergraduate students. been freely utilised in the preparation of this book.
I am equally grateful to my professor and colleagues
This attempt has been made with an object to for their encouragement and valuable help. My
meet the requirements of a common medical special thanks are due to my students who made
student. The text has been arranged in small me feel their difficulties, which was a great
classified parts to make it easier for the students incentive for writing this book. I have derived
to remember and recall it at will. It is adequately maximum inspiration from Prof. Inderbir Singh
illustrated with simple line diagrams which can (Rohtak), and learned the decency of work from Shri
be reproduced without any difficulty, and which also SC Gupta (Jiwaji University, Gwalior).
help in understanding and memorizing the I am deeply indebted to Shri KM Singhal
anatomical facts that appear to defy memory of a (National Book House, Gwalior) and Mr SKJain
common student. The monotony of describing the (CBS Publishers and Distributors, Delhi), who have
individual muscles separately, one after the other, taken unusual pains to get the book printed in its
has been minimised by writing them out in tabular present form. For giving it the desired get-up, Mr
form, which makes the subject interesting for a VK Jain and Raj Kamal Electric Press are gratefully
lasting memory. The relevant radiological and acknowledged. The cover page was designed by
surface anatomy have been treated in separate MrVasant Paranjpe, the artist and photographer
chapters. A sincere attempt has been made to deal, of our college; my sincere thanks are due to him. I
wherever required, the clinical applications of the acknowledge with affection the domestic
subject. The entire approach is such as to attract assistance of Munne Miyan and the untiring
and inspire the students for a deeper dive in the company of my Rani, particularly during the odd
subject of anatomy. hours of this work.
Gwalior
February, 1981 BD CHAURASIA
Acknowledgements
I am grateful to Almighty for giving me the constructive guidance and Dr MS Bhatia, Head,
opportunity to edit these three volumes, and Department of Psychiatry, UCMS, Delhi, who
further for sustaining the interest which many a suggested the addition of related histology.
times did oscillate. It is my pleasure to acknowledge Prof. Mahdi
When I met Mr YN Arjuna, Publishing Director in Hasan, Ex-Prof. & Head, Department of Anatomy,
CBS, in May 2003, light was seen at the end of the and Principal, JN Medical College, Aligarh; Prof.
tunnel and it was felt that the work on the volumes Veena Sood and Dr Poonam Singh of DMC, Ludhiana;
could begin with definite schedule. He took great Prof. S Lakshmanan, Rajah Muthiah Medical
interest in going through the manuscript, College, Tamil Nadu; Prof. Usha Dhall and Dr Sudha
correcting, modifying and improving wherever Chhabra, Pt. BD Sharma PGIMS, Rohtak; Prof.
necessary. He inducted me to write an introductory Ashok Sahai, KG Medical College, Lucknow; Prof.
paragraph, brief outlines of embryology and histology Balbir Singh, Govt. Medical College, Chandigarh;
to make it a concise and complete textbook. Prof. Asha Singh, Ex-Prof. & Head, MAMC, New
Having retired from Lady Hardinge Medical Delhi; Prof. Vasundhara Kulshrestha, SN Medical
College within a fortnight of getting this assignment College, Agra; and Dr Brijendra Singh, Head,
and having joined Santosh Medical College, Department of Anatomy, ITS Centre for Dental
Ghaziabad, my colleagues there really helped me. Science and Research, Muradnagar, UP, for
I am obliged to Prof. Varsha Katira, Prof.Vishram inspiring me to edit these volumes.
Singh, Dr Poonam Kharb, Dr Tripta Bhagat (MS I am obliged to my mother-in-law and my mother
Surgery), Dr Nisha Kaul and Ms Jaya. They even did whose blessings have gone a long way in the
dissection with the steps written for the new edition completion of this arduous task. My sincere thanks
and modified the text wherever necessary. are due to my husband Dr DP Garg, our children
From 2000-03, while working at Subharti Medical Manoj and Rekha, Meenakshi and Sanjay, Manish
College, Meerut, the editing of the text continued. and Shilpa, and the grandchildren, who challenged
DrSatyam Khare, Associate Professor, suggested me at times but supported me all the while. The
me to write the full course of nerves, ganglia, cooperation extended by Rekha is much appreciated.
multiple choice questions, etc. with a view to
I am deeply indebted to Mr SK Jain Managing
revise the important topics quickly. So, appendices
Director of CBS, Mr VK Jain, Production Director,
have come up at the end of each section. I am
grateful to Prof. AKAsthana, Dr AKGarg and Mr BM Singh and their team for their keen interest
Dr Archana Sharma for helping me when required. and all out efforts in getting the volumes published.
The good wishes of Prof. Mohini Kaul and Prof. I am thankful to Mr Ashok Kumar who has
Indira Bahl who retired from Maulana Azad Medical skillfully painted black and white volumes into
College; Director-Prof. Rewa Choudhry, Prof. Smita coloured volumes to enhance clarity. Ms Deepti
Kakar, Prof. Anita Tuli, Prof. Shashi Raheja of Lady Jain, Ms Anupam Jain and Ms Parul Jain have
Hardinge Medical College; Director-Prof. Vijay carried out the corrections very diligently. Lastly,
Kapoor, Director-Prof. JM Kaul, Director-Prof. Shipra the job of pagination came on the shoulders of
Paul, Prof. RK Suri and Prof. Neelam Vasudeva of Mr Karzan Lai Prashar who has left no stone
Maulana Azad Medical College; Prof. Gayatri Rath of unturned in doing his job perfectly.
Vardhman Mahavir Medical College; Prof. Ram Last, but not the least, the spelling mistakes
Prakash, Prof. Veena Bharihoke, Prof. Kamlesh have been corrected by my students, especially
Khatri, Prof. Jogesh Khanna, Prof. Mahindra Nagar, Ms Ruchika Girdhar and Ms Hina Garg of 1st year
Prof. Santosh Sanghari of University College of Bachelor of Physiotherapy course at Banarsidas
Medical Sciences; Prof. Kiran Kucheria, Prof. Rani Chandiwala Institute of Physiotherapy, New Delhi,
Kumar, Prof. Shashi Wadhwa, Prof. Usha Sabherwal, and Mr Ashutosh Gupta of 1 st Year BDS at ITS Centre
and Prof. Raj Mehra of All India Institute of Medical for Dental Science and Research, Muradnagar.
Sciences and all my colleagues who have helped May Almighty inspire all those who study these
me sail through the dilemma. volumes to learn and appreciate CLINICAL
I am obliged to Prof. DR Singh, Ex-Head, ANATOMY and DISSECTION and be happy and
Department of Anatomy, KGMC, Lucknow, for his successful in their lives.
Delhi April
2004 KRISHNA GARG