Clinical Anatomy: A Revision and Applied Anatomy for Clinical Students

472 Pages·2002·10.22 MB·English

by  Harold Ellis

Clinical Anatomy
A revision and applied anatomy
for clinical students
HAROLD ELLIS
◊
CBE, MA, DM, MCh, FRCS, FRCOG, FACS (Hon)
Clinical Anatomist, Guy’s, King’s and
St Thomas’ School of Biomedical Sciences;
Emeritus Professor of Surgery, Charing Cross
and Westminster Medical School, London;
Formerly Examiner in Anatomy, Primary FRCS (Eng)
TENTH◊ EDITION
Blackwell
Science
To my wife and late parents
© 1960, 1962, 1966, 1969, 1971, 1977, 1983, 1992, 1997, 2002 by
Blackwell Science Ltd
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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,
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Designs and Patents Act 1988, without the prior permission of the publisher.
First published 1960 Seventh edition 1983
Second edition 1962 Revised reprint 1986
Reprinted 1963 Eighth edition 1992
Third edition 1966 Ninth edition 1997
Fourth edition 1969 Reprinted 2000
Fifth edition 1971 Tenth edition 2002
Sixth edition 1977 Reprinted 2003, 2004
Reprinted 1978, 1980 Greek edition 1969
Library of Congress
Cataloging-in-publication Data
Ellis, Harold, 1926–
Clinical anatomy: a revision and applied anatomy for clinical students/
Harold Ellis—10th ed.
p. cm.
Includes bibliographical references and index.
ISBN 0-632-05195-7 (pbk.)
1. Human anatomy. I. Title.
QM23.2 .E43 2002
611—dc21
2001056590
ISBN 0-632-05195-7
A catalogue record for this title is a available from the British Library
Set in Hong Kong by SNP Best-set Typesetter Ltd
Printed and bound in India by Replika Press PVT Ltd
For further information on Blackwell Publishing, visit our website:
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Contents
Preface, xi
Acknowledgements, xii
Part 1: The Thorax
◊
Surface anatomy and surface markings, 3
◊ ◊Surface markings of the more important thoracic contents, 4
The thoracic cage, 7
◊ ◊The thoracic vertebrae, 8
◊ ◊The ribs, 8
◊ ◊The costal cartilages, 11
◊ ◊The sternum, 11
◊ ◊The intercostal spaces, 12
◊ ◊The diaphragm, 14
◊ ◊The pleurae, 19
The lower respiratory tract, 20
◊ ◊The trachea, 20
◊ ◊The bronchi, 24
◊ ◊The lungs, 24
The mediastinum, 29
◊ ◊The pericardium, 29
◊ ◊The heart, 31
◊ ◊The superior mediastinum, 44
◊ ◊The oesophagus, 44
◊ ◊The thoracic duct, 48
◊ ◊The thoracic sympathetic trunk, 50
On the examination of a chest radiograph, 52
◊ ◊Radiographic appearance of the heart, 53
Part 2: The Abdomen and Pelvis
◊
Surface anatomy and surface markings, 59
◊ ◊Vertebral levels, 59
◊ ◊Surface markings, 60
The fasciae and muscles of the abdominal wall, 61
◊ ◊Fasciae of the abdominal wall, 61
iv Contents
◊ ◊The muscles of the anterior abdominal wall, 62
◊ ◊The anatomy of abdominal incisions, 64
◊ ◊The inguinal canal, 67
Peritoneal cavity, 70
◊ ◊Intraperitoneal fossae, 73
◊ ◊The subphrenic spaces, 73
The gastrointestinal tract, 74
◊ ◊The stomach, 74
◊ ◊The duodenum, 80
◊ ◊Small intestine, 82
◊ ◊Large intestine, 83
◊ ◊The appendix, 84
◊ ◊The rectum, 86
◊ ◊Arterial supply of the intestine, 91
◊ ◊The portal system of veins, 93
◊ ◊Lymph drainage of the intestine, 94
◊ ◊The structure of the alimentary canal, 95
◊ ◊The development of the intestine and its congenital abnormalities, 96
The gastrointestinal adnexae: liver, gall-bladder and its ducts,
pancreas and spleen, 99
◊ ◊The liver, 99
◊ ◊The biliary system, 104
◊ ◊The gall-bladder, 106
◊ ◊The pancreas, 108
◊ ◊The spleen, 110
The urinary tract, 112
◊ ◊The kidneys, 112
◊ ◊The ureter, 116
◊ ◊The embryology and congenital abnormalities of the kidney and
ureter, 117
◊ ◊The bladder, 120
◊ ◊The urethra, 122
The male genital organs, 124
◊ ◊The prostate, 124
◊ ◊The scrotum, 127
◊ ◊Testis and epididymis, 127
◊ ◊Vas deferens (ductus deferens), 132
◊ ◊The seminal vesicles, 133
The bony and ligamentous pelvis, 133
◊ ◊The os innominatum, 133
◊ ◊The sacrum, 134
Contents v
◊ ◊The coccyx, 136
◊ ◊The functions of the pelvis, 136
◊ ◊Joints and ligamentous connections of the pelvis, 136
◊ ◊Differences between the male and female pelvis, 137
◊ ◊Obstetrical pelvic measurements, 138
◊ ◊Variations of the pelvic shape, 140
The muscles of the pelvic floor and perineum, 142
◊ ◊The anterior (urogenital) perineum, 143
◊ ◊The posterior (anal) perineum, 145
The female genital organs, 147
◊ ◊The vulva, 147
◊ ◊The vagina, 148
◊ ◊The uterus, 149
◊ ◊The Fallopian tubes, 155
◊ ◊The ovary, 156
◊ ◊The endopelvic fascia and the pelvic ligaments, 157
◊ ◊Vaginal examination, 159
◊ ◊Embryology of the Fallopian tubes, uterus and vagina, 160
The posterior abdominal wall, 161
◊ ◊Clinical features, 162
◊ ◊The suprarenal glands, 163
◊ ◊Abdominal aorta, 163
◊ ◊Inferior vena cava, 165
◊ ◊Lumbar sympathetic chain, 165
Part 3: The Upper Limb
◊
The female breast, 171
◊ ◊Structure, 171
◊ ◊Blood supply, 171
◊ ◊Lymphatic drainage, 171
◊ ◊Development, 173
◊ ◊Clinical features, 174
Surface anatomy and surface markings of the
upper limb, 175
◊ ◊Bones and joints, 175
◊ ◊Muscles and tendons, 176
◊ ◊Vessels, 178
◊ ◊Nerves, 180
The bones and joints of the upper limb, 181
◊ ◊The scapula, 181
◊ ◊The clavicle, 181
◊ ◊The humerus, 182
vi Contents
◊ ◊The radius and ulna, 184
◊ ◊The bones of the hand, 187
◊ ◊The shoulder, 189
◊ ◊The elbow joints, 194
◊ ◊The wrist joint, 197
◊ ◊The joints of the hand, 198
The arteries of the upper limb, 201
◊ ◊The axillary artery, 201
◊ ◊The brachial artery, 201
◊ ◊The radial artery, 202
◊ ◊The ulnar artery, 203
The brachial plexus, 203
◊ ◊The segmental cutaneous supply of the upper limb, 207
The course and distribution of the principal nerves of the
upper limb, 207
◊ ◊The axillary nerve, 207
◊ ◊The radial nerve, 207
◊ ◊Branches, 209
◊ ◊The musculocutaneous nerve, 209
◊ ◊The ulnar nerve, 209
◊ ◊The median nerve, 210
The anatomy of upper limb deformities, 212
The spaces of the hand, 216
◊ ◊The superficial pulp space of the fingers, 216
◊ ◊The ulnar and radial bursae and the synovial tendon sheaths of the
fingers, 217
Part 4: The Lower Limb
◊
The anatomy and surface markings of the lower limb, 223
◊ ◊Bones and joints, 223
◊ ◊Bursae of the lower limb, 224
◊ ◊Mensuration in the lower limb, 224
◊ ◊Muscles and tendons, 227
◊ ◊Vessels, 229
◊ ◊Nerves, 231
The bones and joints of the lower limb, 233
◊ ◊The os innominatum, 233
◊ ◊The femur, 233
◊ ◊The patella, 239
◊ ◊The tibia, 240
Contents vii
◊ ◊The fibula, 242
◊ ◊A note on growing ends and nutrient foramina in the long bones, 242
◊ ◊The bones of the foot, 243
◊ ◊The hip, 243
◊ ◊The knee joint, 247
◊ ◊The tibiofibular joints, 251
◊ ◊The ankle, 251
◊ ◊The joints of the foot, 252
◊ ◊The arches of the foot, 253
◊ ◊The anatomy of walking, 255
Three important zones of the lower limb—the femoral
triangle, adductor canal and popliteal fossa, 256
◊ ◊The femoral triangle, 256
◊ ◊The fascia lata, 256
◊ ◊The femoral sheath and femoral canal, 257
◊ ◊Femoral hernia, 258
◊ ◊The lymph nodes of the groin and the lymphatic drainage of the lower
limb, 259
◊ ◊The adductor canal (of Hunter) or subsartorial canal, 260
◊ ◊The popliteal fossa, 261
The arteries of the lower limb, 263
◊ ◊Femoral artery, 263
◊ ◊Popliteal artery, 265
◊ ◊Posterior tibial artery, 265
◊ ◊Anterior tibial artery, 266
The veins of the lower limb, 267
◊ ◊Clinical features, 268
The course and distribution of the principal nerves of the
lower limb, 269
◊ ◊The lumbar plexus, 269
◊ ◊The sacral plexus, 271
◊ ◊The sciatic nerve, 273
◊ ◊The tibial nerve, 275
◊ ◊The common peroneal nerve, 275
◊ ◊Segmental cutaneous supply of the lower limb, 277
Part 5: The Head and Neck
◊
The surface anatomy of the neck, 281
◊ ◊The fascial compartments of the neck, 282
The thyroid gland, 284
◊ ◊The parathyroid glands, 288
viii Contents
The palate, 290
◊ ◊The development of the face, lips and palate with special reference to their
congenital deformities, 291
The tongue and floor of the mouth, 293
◊ ◊The tongue, 293
◊ ◊The floor of the mouth, 297
The pharynx, 298
◊ ◊The nasopharynx, 298
◊ ◊The oropharynx, 300
◊ ◊The palatine tonsils, 300
◊ ◊The laryngopharynx, 302
◊ ◊The mechanism of deglutition, 303
The larynx, 306
◊ ◊Blood supply, 308
◊ ◊Lymph drainage, 309
◊ ◊Nerve supply, 309
◊ ◊Clinical features, 309
The salivary glands, 311
◊ ◊The parotid gland, 311
◊ ◊The submandibular gland, 314
◊ ◊The sublingual gland, 315
The major arteries of the head and neck, 316
◊ ◊The common carotid arteries, 316
◊ ◊The external carotid artery, 316
◊ ◊The internal carotid artery, 318
◊ ◊The subclavian arteries, 321
The veins of the head and neck, 323
◊ ◊The cerebral venous system, 323
◊ ◊The venous sinuses of the dura, 324
◊ ◊The internal jugular vein, 326
◊ ◊The subclavian vein, 328
The lymph nodes of the neck, 330
◊ ◊Clinical features, 331
The cervical sympathetic trunk, 332
◊ ◊Clinical features, 333
The branchial system and its derivatives, 333
◊ ◊Branchial cyst and fistula, 334
Contents ix
The surface anatomy and surface markings of the head, 335
The scalp, 336
The skull, 338
◊ ◊Development, 340
◊ ◊Clinical features, 341
The accessory nasal sinuses, 342
◊ ◊The frontal sinuses, 342
◊ ◊The maxillary sinus (antrum of Highmore), 343
◊ ◊The ethmoid sinuses, 345
◊ ◊The sphenoid sinuses, 345
The mandible, 346
◊ ◊The temporomandibular joint, 347
◊ ◊The teeth, 348
The vertebral column, 349
◊ ◊The cervical vertebrae, 350
◊ ◊The thoracic vertebrae, 352
◊ ◊The lumbar vertebrae, 352
◊ ◊The sacrum, 352
◊ ◊The coccyx, 352
◊ ◊The intervertebral joints, 353
Part 6: The Central Nervous System
◊
The spinal cord, 359
◊ ◊Age differences, 360
◊ ◊Structure, 360
◊ ◊Descending tracts, 361
◊ ◊Ascending tracts, 362
◊ ◊The membranes of the cord, 363
The brain, 366
◊ ◊The medulla, 366
◊ ◊The pons, 367
◊ ◊The cerebellum, 369
◊ ◊The midbrain, 371
◊ ◊The diencephalon, 373
◊ ◊The hypothalamus, 373
◊ ◊The pituitary gland (hypophysis cerebri), 374
◊ ◊The thalamus, 375
◊ ◊The cerebral hemispheres, 376
◊ ◊The cerebral cortex, 376
◊ ◊The insula, 380
◊ ◊The connections of the cerebral cortex, 380
x Contents
◊ ◊The basal ganglia, 380
◊ ◊The long ascending and descending pathways, 382
◊ ◊The membranes of the brain, 388
◊ ◊The ventricular system and the cerebrospinal fluid circulation, 389
The cranial nerves, 393
◊ ◊The olfactory nerve (I), 393
◊ ◊The optic nerve (II) and the visual pathway, 393
◊ ◊The oculomotor nerve (III), 395
◊ ◊The trochlear nerve (IV), 397
◊ ◊The trigeminal nerves (V), 398
◊ ◊The abducent nerve (VI), 403
◊ ◊The facial nerve (VII), 404
◊ ◊The auditory (vestibulocochlear) nerve (VIII), 406
◊ ◊The glossopharyngeal nerve (IX), 408
◊ ◊The vagus nerve (X), 409
◊ ◊The accessory nerve (XI), 411
◊ ◊The hypoglossal nerve (XII), 412
The special senses, 413
◊ ◊The nose, 413
◊ ◊The ear, 414
◊ ◊The eye and associated structures, 418
The autonomic nervous system, 423
◊ ◊Visceral afferents, 426
◊ ◊The sympathetic system, 427
◊ ◊The sympathetic trunk, 427
◊ ◊The parasympathetic system, 430
Glossary of eponyms, 435
Index, 441