General Anatomy and Musculoskeletal System

634 Pages·2015·174.48 MB·English

by  Michael Schuenke

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Volum e 1
General Anat om y and Musculoskelet al Syst em
THIEME At las of Anat o m y
2nd Edit ion
Latin Nomenclature
Authors
Michael Schuenke, MD, PhD
Institute of Anatomy
Christian Albrecht University, Kiel
Erik Schulte, MD
Department of Anatomy and Cell Biology
Johannes Gutenberg University, Mainz
Udo Schumacher, MD
FRCPath, CBiol, FIBiol, DSc
Institute of Anatomy II: Experimental Morphology
University Medical Center, Hamburg-Eppendorf
Consulting Editor
Lawrence M. Ross, MD, PhD
Department of Neurobiology and Anatomy
The University of Texas Medical School at Houston
Consulting Editor, Latin Nomenclature
Hugo Zeberg, MD
Department of Neuroscience
Karolinska Institute, Stockholm
Illustrations by
Markus Voll
Karl Wesker
Thieme
New York • Stuttgart • Delhi • Rio de Janeiro
000_Frontmatter_Lat_Print.indd 3 17.04.15 09:42
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Library of Congress Cataloging-in-Publication Data
Schünke, Michael, author.
[Allgemeine Anatomie und Bewegungssystem. English]
Thieme atlas of anatomy. General anatomy and musculoskeletal sys- Important note: Medicine is an ever-changing science undergoing con-
tem / Michael Schuenke, Erik Schulte, Udo Schumacher ; illustrations by tinual development. Research and clinical experience are continually
Markus Voll, Karl Wesker ; consulting editor, Lawrence M. Ross ; con- expanding our knowledge, in particular our knowledge of proper treat-
sulting editor, Latin nomenclature, Hugo Zeberg. -- 2nd edition, Latin ment and drug therapy. Insofar as this book mentions any dosage or
nomenclature. application, readers may rest assured that the authors, editors, and
p. ; cm. publishers have made every e ort to ensure that such references are
General anatomy and musculoskeletal system in accordance with the state of knowledge at the time of production
Atlas of anatomy of the book.
Translation of the third edition of Allgemeine Anatomie und Bewe- Nevertheless, this does not involve, imply, or express any guarantee
gungssystem with Latin anatomical terms. or responsibility on the part of the publishers in respect to any dosage
Includes bibliographical references and index. instructions and forms of applications stated in the book. Every user is
Summary: “THIEME Atlas of Anatomy: General Anatomy and Muscu- requested to examine carefully the manufacturer’s lea ets accompa-
loskeletal System, Second Edition, Latin Nomenclature is an ideal educa- nying each drug and to check, if necessary in consultation with a phy-
tional tool for anyone studying musculoskeletal anatomy. Each region is sician or specialist, whether the dosage schedules mentioned therein
presented in a manner that builds understanding: starting with bones, or the contraindications stated by the manufacturers di er from the
joints, and muscles, then vasculature and nerves, and concluding with statements made in the present book. Such examination is particularly
topographic illustrations. This atlas begins with a concise overview of important with drugs that are either rarely used or have been newly
general anatomy and moves on to the detailed anatomy of the trunk wall, released on the market. Every dosage schedule or every form of appli-
upper limb, and lower limb. Key Features: Labels and anatomic termi- cation used is entirely at the user’s own risk and responsibility. The
nology are in Latin nomenclature. Expanded coverage of tissue structure authors and publishers request every user to report to the publish-
and development, functional testing, diagnostic imaging, and diseases of ers any discrepancies or inaccuracies noticed. If errors in this work are
the musculoskeletal system. Exquisite full-color illustrations with clear, found after publication, errata will be posted at www.thieme.com on
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a topic. Hundreds of clinical applications integrated into the anatomic Some of the product names, patents, and registered designs referred
descriptions, emphasizing the vital link between anatomic structure and to in this book are in fact registered trademarks or proprietary names
function. Access to WinkingSkull.com PLUS, with over 500 images from even though speci c reference to this fact is not always made in the
the book for labels-on and labels-o review and timed self-tests. The text. Therefore, the appearance of a name without designation as pro-
THIEME Atlas of Anatomy series also features Neck and Internal Organs, prietary is not to be construed as a representation by the publisher that
and Head and Neuroanatomy. Each atlas is available in softcover”--Pro- it is in the public domain.
vided by publisher.
ISBN 978-1-60406-923-5 (v. 1 : alk. paper) -- ISBN 978-1-62623-
083-5 (ebook : v. 1)
I. Schulte, Erik, author. II. Schumacher, Udo, author. III. Title. IV. Title:
General anatomy and musculoskeletal system. V. Title: Atlas of anatomy.
[DNLM: 1. Musculoskeletal System--anatomy & histology--Atlases. 2.
Anatomy--Atlases. WE 17]
QM25
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Co nte nts
Foreword by Lawrence M. Ross, Brian R. MacPherson, and Anne M. Gilroy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XI
Preface to the Second Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XIII
Preface to the First Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .XV
A Note on the Use of Latin Terminology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .XVII
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XIX
Ge ne ral Anatomy
1 Human Phylogeny and Ontogeny 4.7 Basic Principles of Joint Mechanics: Stability
and Transmission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
1.1 Human Phylogeny . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
4.8 Fractures: Classi cation, Healing,
1.2 Human Ontogeny: Overview, Fertilization,
and Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
and Earliest Developmental Stages . . . . . . . . . . . . . . . . . . . . 4
1.3 Human Ontogeny: Gastrulation, Neurulation,
5 The Muscles
and Somite Formation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.4 Human Ontogeny: Development of the Fetal Membranes
5.1 Skeletal Muscles: Overview . . . . . . . . . . . . . . . . . . . . . . . . . . 54
and Placenta . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
5.2 Skeletal Muscles: Muscle Fiber Types and Pennate
1.5 Development of the Pharyngeal (Branchial) Arches
and Nonpennate Skeletal Muscles . . . . . . . . . . . . . . . . . . . . 56
in Humans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
5.3 Skeletal Muscles: Structure and Function . . . . . . . . . . . . . . 58
1.6 Early Embryonic Circulation and the Development
5.4 The Tendons and Mechanisms That Assist Muscle
of Major Blood Vessels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60
1.7 Primordial Skeleton, Prenatal Skeletal Development,
and Ossi cation Centers . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
6 The Vessels
1.8 Bone Development and Remodeling . . . . . . . . . . . . . . . . . . 16
1.9 Ossi cation of the Limbs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 6.1 Overview of the Human Cardiovascular
1.10 Basic Skeletal Structure and Development System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
and Position of the Limbs . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 6.2 The Structure of Arteries and Veins . . . . . . . . . . . . . . . . . . 64
6.3 The Terminal Vascular Bed . . . . . . . . . . . . . . . . . . . . . . . . . 66
2 Overview of the Human Body
7 The Lymphatic System and Glands
2.1 The Human Body: Proportions, Surface Areas,
and Body Weights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 7.1 The Human Lymphatic System . . . . . . . . . . . . . . . . . . . . . . 68
2.2 The Structural Design of the Human Body . . . . . . . . . . . . . . 24 7.2 Exocrine and Endocrine Glands . . . . . . . . . . . . . . . . . . . . . . 70
3 Surface Anatomy of the Body, Landmarks, 8 General Neuroanatomy
and Reference Lines
8.1 Development of the Central Nervous
3.1 Terms of Location and Direction, Cardinal Planes System (CNS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
and Axes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 8.2 Neural Crest Derivatives and the Development
3.2 Location and Designation of Imaging Planes . . . . . . . . . . . . 28 of the Peripheral Nervous System (PNS) . . . . . . . . . . . . . . 74
3.3 Body Surface Anatomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 8.3 Topography and Structure of the Nervous
3.4 Body Surface Contours and Palpable Bony Prominences . . 32 System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
3.5 Landmarks and Reference Lines on the Human Body . . . . . 34 8.4 Cells of the Nervous System . . . . . . . . . . . . . . . . . . . . . . . . 78
3.6 Body Regions (Regional Anatomy) . . . . . . . . . . . . . . . . . . . . 36 8.5 Structure of a Spinal Cord Segment . . . . . . . . . . . . . . . . . . 80
8.6 Sensory Innervation: An Overview . . . . . . . . . . . . . . . . . . . 82
8.7 Sensory Innervation: Principles of Dermatome
4 The Bones and Joints
and Plexus Formation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
4.1 The Bony Skeleton and the Structure of Tubular Bones . . . 38
8.8 Sensory Innervation: Dermatomes and Cutaneous
4.2 Continuous and Discontinuous Joints: Overview and False
Nerve Territories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Joints (Synarthroses) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
8.9 Motor Innervation: Organization of the Spinal Cord
4.3 True Joints: Components and Intra- and Extra-articular
and Re exes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Structures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
8.10 Motor Innervation: Upper (First) and Lower (Second)
4.4 True Joints: Structure of Joint Capsule
Motor Neurons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90
and Hyaline Cartilage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
8.11 Di erences between the Central and Peripheral
4.5 Degenerative Joint Diseases as Exempli ed by Hip Joint
Nervous Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92
Arthrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
8.12 The Autonomic Nervous System . . . . . . . . . . . . . . . . . . . . 94
4.6 Basic Principles of Joint Mechanics: Movements . . . . . . . . . 48
8.13 Lesions of Peripheral Nerves . . . . . . . . . . . . . . . . . . . . . . . . 96
V
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Table of Contents
Trunk Wall
9 Bones, Ligaments, and Joints 11 Musculature: Topographical Anatomy
9.1 The Skeleton of the Trunk . . . . . . . . . . . . . . . . . . . . . . . . . 100 11.1 The Back Muscles and Fascia Thoracolumbalis. . . . . . . . . . 166
9.2 The Bony Spinal Column . . . . . . . . . . . . . . . . . . . . . . . . . . 102 11.2 The Intrinsic Back Muscles: Lateral and Medial Tracts
9.3 Development of the Spinal Column . . . . . . . . . . . . . . . . . 104 of the M. erector spinae . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
9.4 The Structure of a Vertebra . . . . . . . . . . . . . . . . . . . . . . . 106 11.3 The Intrinsic Back Muscles: Short Nuchal Muscles . . . . . . . 170
9.5 The Cervical Spine (Vertebrae cervicales) . . . . . . . . . . . . 108 11.4 The Thoracic Wall Muscles and Fascia endothoracica . . . . 172
9.6 The Thoracic Spine (Vertebrae thoracicae) . . . . . . . . . . . 110 11.5 The Thoracoabdominal Junction: The Diaphragma . . . . . . 174
9.7 The Lumbar Spine (Vertebrae lumbales) . . . . . . . . . . . . . 112 11.6 The Anterolateral and Anterior Abdominal Wall
9.8 Os sacrum and os coccygis . . . . . . . . . . . . . . . . . . . . . . . . 114 Muscles* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
9.9 The Intervertebral Disk (Disus intervertebralis): 11.7 Structure of the Abdominal Wall and Rectus Sheath
Structure and Function . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 (Vagina musculi recti abdominis) . . . . . . . . . . . . . . . . . . . . 178
9.10 The Ligaments of the Spinal Column 11.8 The Pelvic Floor Muscles: Overview of the Regio
(Columna vertebralis): Overview and perinealis and Super cial Fasciae . . . . . . . . . . . . . . . . . . . . 180
Thoracolumbar Region . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 11.9 Structure of the Pelvic Floor and Pelvic Spaces:
9.11 Overview of the Ligaments of the Cervical Spine . . . . . . 120 Female versus Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182
9.12 The Ligaments of the Upper Cervical Spine 11.10 The Muscles of the Female Pelvic Floor and Wall . . . . . . . . 184
(Atlantooccipital and Atlantoaxial Joints) . . . . . . . . . . . . . 122 11.11 Pelvic Floor Muscles: M. levator ani . . . . . . . . . . . . . . . . . . 186
9.13 The Intervertebral Facet Joints, Motion Segments, 11.12 Pelvic Floor Muscles: Their Relation to Organs
and Range of Motion in Di erent Spinal and Vessels in Males and Females . . . . . . . . . . . . . . . . . . . . 188
Regions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
9.14 The Uncovertebral Joints of the Cervical Spine . . . . . . . . 126
9.15 Cross-sectional Anatomy of the Lumbar Spine . . . . . . . . 128 12 Neurovascular Systems: Forms and Relations
9.16 Degenerative Changes in the Lumbar Spine . . . . . . . . . . 130
12.1 The Arteries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190
9.17 The Thoracic Skeleton . . . . . . . . . . . . . . . . . . . . . . . . . . . . 132
12.2 The Veins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
9.18 The Sternum and Ribs (Costae) . . . . . . . . . . . . . . . . . . . . 134
12.3 The Lymphatic Vessels and Lymph Nodes . . . . . . . . . . . . 194
9.19 The Costovertebral Joints and Thoracic Movements . . . . 136
12.4 The Nerves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
9.20 The Bony Pelvis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
9.21 The Pelvic Ligaments and Pelvic Measurements . . . . . . . 140
9.22 The Sacroiliac Joint (Art. Sacroiliaca) . . . . . . . . . . . . . . . . 142
13 Neurovascular Systems: Topographical Anatomy
13.1 Anterior Trunk Wall: Surface Anatomy
10 Musculature: Functional Groups
and Super cial Nerves and Vessels . . . . . . . . . . . . . . . . . . . 198
10.1 The Muscles of the Trunk Wall: 13.2 Posterior Trunk Wall: Surface Anatomy
Their Origin and Function . . . . . . . . . . . . . . . . . . . . . . . . . . 144 and Super cial Nerves and Vessels . . . . . . . . . . . . . . . . . . . 200
10.2 The Intrinsic Back Muscles (M. ercetor spinae): 13.3 Posterior Trunk Wall, Posterior View . . . . . . . . . . . . . . . . . 202
Lateral Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 13.4 Posterior Trunk Wall, Anterior View . . . . . . . . . . . . . . . . . . 204
10.3 The Intrinsic Back Muscles (M. ercetor spinae): 13.5 Anterior Trunk Wall: Overview and Location
Medial Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 148 of Clinically Important Nerves and Vessels . . . . . . . . . . . . 206
10.4 The Intrinsic Back Muscles (Short Nuchal and 13.6 Anterior Trunk Wall: Nerves, Blood Vessels,
Craniovertebral Joint Muscles) and the Prevertebral and Lymphatics in the Breast . . . . . . . . . . . . . . . . . . . . . . . . 208
Muscles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150 13.7 Anterior Trunk Wall:
10.5 The Muscles of the Abdominal Wall: The Inguinal Canal (Canalis inguinalis) . . . . . . . . . . . . . . . . 210
Anterolateral Muscles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152 13.8 Anterior Abdominal Wall:
10.6 The Muscles of the Abdominal Wall: Anatomy and Weak Spots . . . . . . . . . . . . . . . . . . . . . . . . . . 212
Anterior and Posterior Muscles . . . . . . . . . . . . . . . . . . . . . . 154 13.9 Inguinal and Femoral Hernias . . . . . . . . . . . . . . . . . . . . . . . 214
10.7 The Functions of the Abdominal Wall Muscles . . . . . . . . . . 156 13.10 Topographic Anatomy of Inguinal Hernias . . . . . . . . . . . . . 216
10.8 The Muscles of the Thoracic Cage (Mm. intercostales, 13.11 Diagnosis and Treatment of Hernias . . . . . . . . . . . . . . . . . . 218
subcostales, scaleni, and M. transversus thoracis) . . . . . . 158 13.12 Rare External Hernias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220
10.9 The Muscles of the Thoracic Cage: The Diaphragma . . . . . 160 13.13 Development of the External Genitalia . . . . . . . . . . . . . . . 222
10.10 The Muscles of the Pelvic Floor and Perineum: 13.14 Male External Genitalia: Descensus testis
Diaphragma pelvis and Deep and Super cial Perineal and Funiculus spermaticus. . . . . . . . . . . . . . . . . . . . . . . . . . 224
Muscles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162 13.15 Male External Genitalia: The Testis and Epididymis . . . . . . 226
10.11 Secondarily Incorporated Trunk Muscles: Spinocostal, 13.16 Male External Genitalia: The Fasciae
Spinohumeral, and Thoracohumeral . . . . . . . . . . . . . . . . . 164 and Erectile Tissues of the Penis . . . . . . . . . . . . . . . . . . . . . 228
VI
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Table of Contents
13.17 Male External Genitalia: Nerves and Vessels 15.5 The Posterior Muscles of the Shoulder Joint:
of the Penis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230 M. deltoideus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 304
13.18 Female External Genitalia: Overview and Episiotomy . . . . 232 15.6 The Posterior Muscles of the Shoulder Joint:
13.19 Female External Genitalia: Neurovascular Structures, Mm. latissimus dorsi and teres major . . . . . . . . . . . . . . . . . 306
15.7 The Anterior Muscles of the Shoulder Joint:
Erectile Tissues, Erectile Muscles, and Vestibule . . . . . . . . 234
Mm. pectoralis major and coracobrachialis . . . . . . . . . . . . 308
15.8 The Anterior Muscles of the Arm:
Mm. biceps brachii and brachialis . . . . . . . . . . . . . . . . . . . . 310
Uppe r Limb
15.9 The Posterior Muscles of the Arm:
Mm. triceps brachii and anconeus . . . . . . . . . . . . . . . . . . . 312
15.10 The Muscles of the Anterior Forearm:
14 Bones, Ligaments, and Joints
The Super cial and Deep Flexors . . . . . . . . . . . . . . . . . . . . 314
15.11 The Muscles of the Forearm: The Radialis Muscles . . . . . . 316
14.1 The Upper Limb as a Whole . . . . . . . . . . . . . . . . . . . . . . . . . 238
15.12 The Muscles of the Posterior Forearm:
14.2 Integration of the Shoulder Girdle into the Skeleton
The Super cial and Deep Extensors . . . . . . . . . . . . . . . . . . 318
of the Trunk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
15.13 The Intrinsic Muscles of the Hand:
14.3 The Bones of the Shoulder Girdle . . . . . . . . . . . . . . . . . . . . 242
The Thenar and Hypothenar Muscles . . . . . . . . . . . . . . . . . 320
14.4 The Bones of the Upper Limb: The Humerus . . . . . . . . . . . 244
15.14 The Intrinsic Muscles of the Hand: Mm. lumbricales
14.5 The Bones of the Upper Limb: Torsion of the Humerus . . . 246
and interossei (Metacarpal Muscles) . . . . . . . . . . . . . . . . . . 322
14.6 The Bones of the Upper Limb: The Radius and Ulna . . . . . 248
15.15 Overview of Muscle Functions:
14.7 The Bones of the Upper Limb: The Articular Surfaces
Shoulder Joint (Art. humeri) . . . . . . . . . . . . . . . . . . . . . . . . 324
of the Radius and Ulna . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
15.16 Overview of Muscle Functions: Elbow Joint . . . . . . . . . . . . 326
14.8 The Bones of the Upper Limb: The Hand . . . . . . . . . . . . . . 252
15.17 Overview of Muscle Functions: Wrist . . . . . . . . . . . . . . . . . 328
14.9 The Bones of the Upper Limb: The Carpal Bones . . . . . . . . 254
14.10 Architecture of the Radiocarpal Junction and the
16 Musculature: Topographical Anatomy
Metacarpus; Distal Radius and Scaphoid Fractures . . . . . . 256
14.11 The Joints of the Shoulder: Overview and Clavicular
16.1 The Posterior Muscles of the Shoulder Girdle
Joints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258
and Shoulder Joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 330
14.12 The Joints of the Shoulder: Ligaments of the Clavicular
16.2 The Posterior Muscles of the Shoulder Joint and Arm . . . . 332
and Scapulothoracic Joints . . . . . . . . . . . . . . . . . . . . . . . . . 260
16.3 The Anterior Muscles of the Shoulder Girdle
14.13 The Joints of the Shoulder: Articular Surfaces, Articular
and Shoulder Joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 334
Capsule, and Articular Cavity of the Articulatio humeri . . 262
16.4 The Muscles of the Shoulder Joint and Anterior Arm . . . . 336
14.14 The Joints of the Shoulder: Ligaments, Reinforcing
16.5 The Muscles of the Anterior Forearm . . . . . . . . . . . . . . . . . 338
Capsule, and Rotator Interval of the Articulatio humeri . . 264
16.6 The Muscles of the Posterior Forearm . . . . . . . . . . . . . . . . 340
14.15 The Joints of the Shoulder: The Subacromial Space . . . . . 266
16.7 Cross-sectional Anatomy of the Arm and Forearm . . . . . . 342
14.16 The Bursa subacromialis and Bursa subdeltoidea . . . . . . . 268
16.8 The Tendon Sheaths of the Hand . . . . . . . . . . . . . . . . . . . . 344
14.17 Shoulder Arthroscopy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 270
16.9 The Dorsal Digital Expansion . . . . . . . . . . . . . . . . . . . . . . . . 346
14.18 X-Ray and Cross-sectional Anatomy of the Shoulder . . . . 272
16.10 The Intrinsic Muscles of the Hand: Super cial Layer . . . . . 348
14.19 Movements of the Shoulder Girdle and Shoulder Joint . . . 274
16.11 The Intrinsic Muscles of the Hand: Middle Layer . . . . . . . . 350
14.20 The Elbow Joint (Articulatio cubiti) as a Whole . . . . . . . . . 276
16.12 The Intrinsic Muscles of the Hand: Deep Layer . . . . . . . . . 352
14.21 The Elbow Joint (Articulatio cubiti):
Capsule and Ligaments . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278
17 Neurovascular Systems: Forms and Relations
14.22 The Forearm: Proximal and Distal Radioulnar Joints . . . . . 280
17.1 The Arteries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 354
14.23 Movements of the Elbow and Radioulnar Joints
17.2 The Veins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 356
(Articulationes radioulnares) . . . . . . . . . . . . . . . . . . . . . . . . 282
17.3 The Lymphatic Vessels and Lymph Nodes . . . . . . . . . . . . . 358
14.24 Overview of the Ligaments of the Hand . . . . . . . . . . . . . . . 284
17.4 The Plexus brachialis: Structure . . . . . . . . . . . . . . . . . . . . . 360
14.25 Intrinsic Ligaments of the Hand, Compartments
17.5 Supraclavicular Part of the Plexus brachialis
of the Joint, and Ulnocarpal Complex . . . . . . . . . . . . . . . . . 286
(Pars supraclavicularis) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 362
14.26 The Carpal Tunnel (Canalis carpi) . . . . . . . . . . . . . . . . . . . . 288
17.6 Pars infraclavicularis of the Plexus brachialis:
14.27 The Ligaments of the Fingers . . . . . . . . . . . . . . . . . . . . . . . 290
Overview and Short Branches . . . . . . . . . . . . . . . . . . . . . . . 364
14.28 The Carpometacarpal Joint of the Thumb
17.7 Pars infraclavicularis of the Plexus brachialis:
(Articulatio carpometacarpalis pollicis) . . . . . . . . . . . . . . . 292
N. musculocutaneus and N. axillaris . . . . . . . . . . . . . . . . . . 366
14.29 Movements of the Hand and Finger Joints . . . . . . . . . . . . . 294
17.8 Pars infraclavicularis of the Plexus brachialis: N. radialis . . 368
15 Musculature: Functional Groups 17.9 Pars infraclavicularis of the Plexus brachialis: N. ulnaris . . 370
17.10 Pars infraclavicularis of the Plexus brachialis:
15.1 Functional Muscle Groups . . . . . . . . . . . . . . . . . . . . . . . . . . 296
N. medianus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 372
15.2 The Muscles of the Shoulder Girdle: Mm. trapezius,
sternocleidomastoideus, and omohyoideus . . . . . . . . . . . 298
18 Neurovascular Systems: Topographical Anatomy
15.3 The Muscles of the Shoulder Girdle: Mm. serratus
anterior, subclavius, pectoralis minor, levator scapulae, 18.1 Surface Anatomy and Super cial Nerves and Vessels:
and rhomboidei major and minor . . . . . . . . . . . . . . . . . . . . 300 Anterior View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 374
15.4 The Posterior Muscles of the Shoulder Joint: 18.2 Surface Anatomy and Super cial Nerves and Vessels:
The Rotator Cu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302 Posterior View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 376
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Table of Contents
18.3 The Shoulder Region: Anterior View . . . . . . . . . . . . . . . . . 378 19.19 The Knee Joint: The Cruciate and Collateral Ligaments
18.4 The Axilla (Regio axillaris): Anterior Wall . . . . . . . . . . . . . 380 (Ligg. cruciata et collateralia) . . . . . . . . . . . . . . . . . . . . . . . 444
18.5 The Axilla (Regio axillaris): Posterior Wall . . . . . . . . . . . . 382 19.20 The Knee Joint: The Menisci . . . . . . . . . . . . . . . . . . . . . . . . 446
18.6 Conduction Anesthesia of the Plexus brachialis:
19.21 The Movements of the Knee Joint . . . . . . . . . . . . . . . . . . . . 448
Principle, Pathways, and Administering the Block . . . . . . 384
19.22 The Knee Joint (Art. genus): Capsule and Joint Cavity . . . . 450
18.7 The Anterior Brachial Region
19.23 Cross-sectional Anatomy of the Knee. . . . . . . . . . . . . . . . . 452
(Regio brachialis anterior) . . . . . . . . . . . . . . . . . . . . . . . . . 386
19.24 The Joints of the Foot: Overview of the Articulating
18.8 The Shoulder Region: Posterior and Superior Views . . . . 388
Bones and Joints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 454
18.9 The Posterior Brachial Region
19.25 The Joints of the Foot: Articular Surfaces . . . . . . . . . . . . . . 456
(Regio brachialis posterior) . . . . . . . . . . . . . . . . . . . . . . . . 390
19.26 The Joints of the Foot:
18.10 The Elbow (Regio cubitalis) . . . . . . . . . . . . . . . . . . . . . . . . 392
The Talocrural and Subtalar Joints . . . . . . . . . . . . . . . . . . . . 458
18.11 The Anterior Forearm Region
19.27 The Ligaments of the Foot . . . . . . . . . . . . . . . . . . . . . . . . . . 460
(Regio antebrachialis anterior) . . . . . . . . . . . . . . . . . . . . . 394
19.28 The Movements of the Foot . . . . . . . . . . . . . . . . . . . . . . . . 462
18.12 The Posterior Forearm Region (Regio antebrachialis
19.29 Overview of the Plantar Vault and the Transverse Arch
posterior) and the Dorsum of the Hand (Dorsum
(Arcus pedis transversus) . . . . . . . . . . . . . . . . . . . . . . . . . . . 464
manus) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 396
19.30 The Longitudinal Arch (Arcus pedis longitudinalis)
18.13 The Palm of the Hand (Palma manus):
of the Foot. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 466
Epifascial Nerves and Vessels . . . . . . . . . . . . . . . . . . . . . . 398
19.31 The Sesamoid Bones (Ossa sesamoidea)
18.14 The Palm of the Hand (Palma manus): Vascular Supply . 400
and Deformities of the Toes . . . . . . . . . . . . . . . . . . . . . . . . 468
18.15 The Carpal Tunnel (Canalis carpi) . . . . . . . . . . . . . . . . . . . 402
19.32 X-Ray and Cross-sectional Anatomy of the Foot . . . . . . . . 470
18.16 The Ulnar Tunnel and Anterior Carpal Region
19.33 Human Gait . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 472
(Regio carpalis anterior) . . . . . . . . . . . . . . . . . . . . . . . . . . 404
20 Musculature: Functional Groups
20.1 The Muscles of the Lower Limb: Classi cation . . . . . . . . . . 474
Low e r Limb
20.2 The Hip and Gluteal Muscles: The Inner Hip Muscles . . . . 476
20.3 The Hip and Gluteal Muscles: The Outer Hip Muscles . . . . 478
20.4 The Hip and Gluteal Muscles: The Adductor Group . . . . . . 480
19 Bones, Ligaments, and Joints
20.5 The Anterior Thigh Muscles: The Extensor Group . . . . . . . 482
19.1 The Lower Limb: General Aspects . . . . . . . . . . . . . . . . . . . . 408
20.6 The Posterior Thigh Muscles: The Flexor Group . . . . . . . . . 484
19.2 The Anatomic and Mechanical Axes of the Lower Limb . . 410
20.7 The Leg Muscles: The Anterior and Lateral
19.3 The Bones of the Pelvic Girdle . . . . . . . . . . . . . . . . . . . . . . . 412
Compartments (Extensor and Fibularis* Group) . . . . . . . . 486
19.4 The Femur (Os femoris): Importance of the Femoral
20.8 The Leg Muscles: The Posterior Compartment
Neck Angle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 414
(Super cial Flexor Group) . . . . . . . . . . . . . . . . . . . . . . . . . . 488
19.5 The Femoral Head and Deformities of the
20.9 The Leg Muscles: The Posterior Compartment
Femoral Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 416
(Deep Flexor Group) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 490
19.6 The Patella . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 418
20.10 The Short Muscles of the Foot: Dorsum, and Medial
19.7 The Tibia and Fibula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 420
and Lateral Compartments of the Plantar Surface . . . . . . 492
19.8 The Bones of the Foot from the Dorsal
20.11 The Short Muscles of the Foot: Central Compartment
and Plantar Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 422
of the Plantar Surface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 494
19.9 The Bones of the Foot from the Lateral and Medial
20.12 Overview of Muscle Functions: Hip Joint . . . . . . . . . . . . . . 496
Views; Accessory Tarsal Bones . . . . . . . . . . . . . . . . . . . . . . 424
20.13 Overview of Muscle Functions: Knee Joint . . . . . . . . . . . . . 498
19.10 The Hip Joint (Articulatio coxae): Articulating Bones . . . . 426
20.14 Overview of Muscle Functions: Ankle Joints . . . . . . . . . . . . 500
19.11 The Ligaments of the Hip Joint: Stabilization
of the Femoral Head (Caput femoris) . . . . . . . . . . . . . . . . . 428
21 Musculature: Topographical Anatomy
19.12 The Ligaments of the Hip Joint: Nutrition
of the Femoral Head (Caput femoris) . . . . . . . . . . . . . . . . . 430 21.1 The Muscles of the Medial and Anterior Thigh, Hip,
19.13 Cross-sectional and X-Ray Anatomy of the Hip Joint. and Gluteal Region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 502
Typical Medical Condition of the Elderly: 21.2 The Muscles of the Anterior Thigh, Hip,
Femoral Neck Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . 432 and Gluteal Region: Origins and Insertions . . . . . . . . . . . . 504
19.14 Cross-sectional Anatomy of the Hip Joint (Art. coxae): 21.3 The Muscles of the Lateral and Posterior Thigh, Hip,
Sonographic Representation of Hip Joint E usion . . . . . . . 434 and Gluteal Region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 506
19.15 The Movements and Biomechanics of the Hip Joint . . . . . 436 21.4 The Muscles of the Posterior Thigh, Hip,
19.16 The Development of the Hip Joint . . . . . . . . . . . . . . . . . . . 438 and Gluteal Region: Origins and Insertions . . . . . . . . . . . . 508
19.17 The Knee Joint (Articulatio genus): Articulating Bones . . . 440 21.5 The Muscles of the Lateral and Anterior Leg:
19.18 The Ligaments of the Knee Joint: An Overview . . . . . . . . . 442 Origins and Insertions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 510
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