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Clinical Anatomy - Applied Anatomy for Students and Junior Doctors PDF

501 Pages·2013·29.66 MB·english
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Clinical Anatomy To my wife, Wendy, and my late parents H. E. To my wife, Neila, and my late parents V. M. Clinical Anatomy Applied Anatomy for Students and Junior Doctors HAROLD ELLIS CBE, MA, DM, MCh, FRCS, FRCP, 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) VISHY MAHADEVAN MBBS, PhD, FRCSEd, FDSRCSEng (Hon), FRCS Barbers’ Company Professor of Anatomy & Professor of Surgical Anatomy The Royal College of Surgeons of England Lincoln’s Inn Fields London; Member of the Court of Examiners, RCS England THIRTEENTH EDITION This edition first published 2013 © 1960, 1962, 1966, 1969, 1971, 1977, 1977, 1983, 1992, 1992, 2002, 2006, by Harold Ellis; 2010 by Harold Ellis and Vishy Mahadevan; 2013 by John Wiley & Sons, Ltd Registered office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK 111 River Street, Hoboken, NJ 07030-5774, USA For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell The right of the author to be identified as the author of this work has been asserted in accordance with the UK 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. Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought. The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom. Library of Congress Cataloging-in-Publication Data Ellis, Harold, 1926– author. Clinical anatomy : applied anatomy for students and junior doctors / Harold Ellis, Vishy Mahadevan. – Thirteenth edition. p. ; cm. Includes bibliographical references and index. ISBN 978-1-118-37377-4 (pbk. : alk. paper) – ISBN 978-1-118-37376-7 (ePDF) – ISBN 978-1-118-37375-0 (ePub) – ISBN 978-1-118-37374-3 (Mobi) – ISBN 978-1-118- 37373-6 – ISBN 978-1-118-37372-9 I. Mahadevan, Vishy, author. II. Title. [DNLM: 1. Anatomy. QS 4] QM23.2 612–dc23 2013012750 A catalogue record for this book is available from the British Library. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Cover image: The Wellcome Museum of Anatomy and Pathology, Royal College of Surgeons of England, London Cover design by Sarah Dickinson Set in 9/12 pt Palatino by Toppan Best-set Premedia Limited 01 2013 Contents Preface to the Thirteenth Edition, xiii Preface to the First Edition, xv Acknowledgements to the Thirteenth Edition, xvii Acknowledgements to the First Edition, xix About the Companion Website, xxi Part 1: The Thorax Introduction, 3 Surface anatomy and surface markings, 3 The trachea, 4 The pleura, 4 The lungs, 6 The heart, 6 The thoracic cage, 7 The thoracic vertebrae, 7 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, 25 The lungs, 25 The mediastinum, 30 The pericardium, 30 The heart, 31 The superior mediastinum, 46 The thymus, 46 The oesophagus, 47 The thoracic duct, 50 The thoracic sympathetic trunk, 52 On the examination of a chest radiograph, 55 Radiographic appearance of the heart, 56 vi Contents Part 2: The Abdomen and Pelvis Surface anatomy and surface markings, 61 Vertebral levels, 61 Surface markings of individual viscera, 63 The fasciae and muscles of the abdominal wall, 64 Fasciae of the abdominal wall, 64 The muscles of the anterior abdominal wall, 65 The anatomy of abdominal incisions, 67 The inguinal canal, 70 Peritoneal cavity, 72 Intraperitoneal fossae, 76 The subphrenic spaces, 76 The gastrointestinal tract, 77 The stomach, 77 The duodenum, 82 Small intestine, 85 Large intestine, 86 The appendix, 87 The rectum, 89 Arterial supply of the intestine, 94 The portal system of veins, 95 Lymph drainage of the intestine, 96 The structure of the alimentary canal, 97 The development of the intestine and its congenital abnormalities, 98 The gastrointestinal adnexae: liver, gall bladder and its ducts, pancreas and spleen, 101 The liver, 101 The biliary system, 106 The gall bladder, 107 The pancreas, 110 The spleen, 112 The urinary tract, 114 The kidneys, 114 The ureter, 118 The embryology and congenital abnormalities of the kidney and ureter, 119 The bladder, 121 The urethra, 124 Contents vii The male genital organs, 125 The prostate, 125 The scrotum, 128 Testis and epididymis, 129 Vas deferens (ductus deferens), 133 The seminal vesicles, 134 The bony and ligamentous pelvis, 134 The os innominatum, 134 The sacrum, 135 The coccyx, 136 The functions of the pelvis, 136 Joints and ligamentous connections of the pelvis, 137 Differences between the male and female pelvis, 137 Obstetrical pelvic measurements, 138 Variations of the pelvic shape, 139 Sacral (caudal) anaesthesia, 142 The muscles of the pelvic floor and perineum, 143 The anterior (urogenital) perineum, 144 The posterior (anal) perineum, 146 The female genital organs, 147 The vulva, 147 The vagina, 148 The uterus, 150 The Fallopian tubes, 154 The ovary, 156 The endopelvic fascia and the pelvic ligaments, 157 Vaginal examination, 158 Embryology of the Fallopian tubes, uterus and vagina, 159 The posterior abdominal wall, 161 The suprarenal glands, 162 Abdominal aorta, 163 Inferior vena cava, 164 Lumbar sympathetic chain, 166 Computed axial tomography, 167 Part 3: The Upper Limb Surface anatomy and surface markings of the upper limb, 171 Bones and joints, 171 Muscles and tendons, 172 viii Contents Vessels, 172 Nerves, 176 The bones and joints of the upper limb, 177 The scapula, 177 The clavicle, 177 The humerus, 179 The radius and ulna, 180 The bones of the hand, 183 The shoulder joint, 185 The elbow joint, 190 The wrist joint, 193 The joints of the hand, 194 Three important zones of the upper limb: the axilla, the cubital fossa and the carpal tunnel, 197 The axilla, 197 The cubital fossa, 197 The carpal tunnel, 199 The arteries of the upper limb, 199 The axillary artery, 199 The brachial artery, 200 The radial artery, 200 The ulnar artery, 201 The brachial plexus, 201 The segmental cutaneous supply of the upper limb, 203 The course and distribution of the principal nerves of the upper limb, 205 The axillary nerve, 205 The radial nerve, 205 The musculocutaneous nerve, 206 The ulnar nerve, 207 The median nerve, 208 Compartments of the upper limb, 209 Compartments in the segments of the upper limb, 209 Compartment syndrome, 210 The female breast, 210 Structure, 210 Blood supply, 211 Lymphatic drainage, 211 Development, 213

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