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Access to the eBook is limited to the first individual who redeems the PIN, located on the inside cover of this book, at studentconsult.inkling.com and may not be transferred to another party by resale, lending or other means. GRAY’S ANATOMY REVIEW This page intentionally left blank SANATOMY ’ REVIEW Y SECOND EDITION A R G Marios Loukas, MD, PhD Peter H. Abrahams, MBBS, FRCS(ED), FRCR, DO(Hon), FHEA Professor, Department of Anatomical Sciences Dean of Basic Sciences Professor Emeritus of Clinical Anatomy St. George’s University School of Medicine Institute of Clinical Education Grenada, West Indies Warwick Medical School University of Warwick R. Shane Tubbs, MS, PA-C, PhD Coventry, United Kingdom Professor of Anatomy Stephen W. Carmichael, PhD, DSc Children’s of Alabama Birmingham, Alabama; Professor Emeritus of Anatomy and Orthopedic Surgery Department of Anatomical Sciences Mayo Clinic St. George’s University Rochester, Minnesota Grenada, West Indies; Centre of Anatomy and Human Identification University of Dundee Dundee, United Kingdom 1600 John F. Kennedy Blvd. Ste. 1800 Philadelphia, PA 19103-2899 GRAY’S ANATOMY REVIEW, SECOND EDITION ISBN: 978-0-323-27788-4 Copyright  2016 by Elsevier, Inc. All rights reserved. First edition copyright 2010, Churchill Livingstone, an imprint of Elsevier Inc. No part of this publication 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 publisher. Details on how to seek permission and further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. International Standard Book Number: 978-0-323-27788-4 VP Global Medical Education Content: Madelene Hyde Senior Content Strategist: Jeremy Bowes Content Development Specialist: Lauren Boyle Publishing Services Manager: Patricia Tannian Senior Project Manager: John Casey Design Direction: Julia Dummitt Printed in Canada Last digit is the print number: 9 8 7 6 5 4 3 2 1 To my daughter, Nicole, my son, Chris, and my wife, Joanna, for their continuous support and love ML To Kevin, Kendall, and Logan Tubbs— the perfect family RST To “Lucy in the Sky with Diamonds,” who puts up with my early mornings and late nights— For all the descendants of “Papi and Lulu” PA To Susan Stoddard and Allen Carmichael SC v This page intentionally left blank PREFACE Rote memorization of anatomic facts has been the 4. The explanations of the answers emphasize the criti- cardinal feature of exhaustive, and exhausting, courses cal importance of understanding normal and dys- in human anatomy for many generations of students functional human anatomy. in medicine, dentistry, and other allied health science 5. Student understanding is further enhanced by criti- programs. Often, little distinction was made between cal examination of alternative, incorrect answers the wheat and the chaff, and little attention was given that students might be tempted to choose. to the practical, clinical application of the data. In 6. Finally, the review provides a succinct distillation of the face of the modern explosion of information and the plethora of facts in clinical anatomy, assisting technical advances in the medical sciences, Gray’s the student’s learning and understanding of impor- Anatomy for Students was conceived and written as a tant concepts in the practice of medicine, irrespec- clinically oriented, student-friendly textbook of human tive of the student’s career choice. anatomy. The authors, Richard L. Drake, A. Wayne The questions in this review are correlated with the Vogl, and Adam W. M. Mitchell, have provided a following textbooks: sound basis for student learning and understanding of • Gray’s Anatomy for Students, ed 3, by Richard L. both normal and altered human anatomy in the clini- Drake, A. Wayne Vogl, and Adam W. M. Mitchell cal setting. • Netter Atlas of Human Anatomy, ed 6, by Frank Gray’s Anatomy Review was designed for use by Netter students after they have read the textbook and is in • McMinn’s and Abrahams’ Clinical Atlas of Human keeping with the objectives of a course that uses this Anatomy, ed 7, by Peter H. Abrahams, Jonathan D. textbook. The questions, answers, and explanations in Spratt, Marios Loukas, and Albert N. Van Schoor this book are intended to serve multiple purposes for Each answer is referenced to pages in Gray’s (GAS), students in various programs. Netter’s (N) and McMinn’s (McM). 1. This review provides a thought-provoking source for For the embryology chapter we have correlated the study by students in preparation for examinations in clinical vignettes with Before We Are Born: Essentials various programs of gross anatomy. of Embryology and Birth Defects, ed 8, by Keith L 2. To avoid pointless memorization by the student, all Moore, TVN Persaud, and Mark G. Torchia. the questions are framed within clinical vignettes We have incorporated or adapted many drawings, that guide the student toward practical applications full-color illustrations, and radiographic images in an of the textual material. attempt to accelerate the learning process and to 3. The multiple-choice, single-best-answer format of enhance understanding of both the anatomy and the the questions is designed to facilitate student review clinical applications. The primary sources on which we in preparation for the USMLE and similar qualifying have drawn for illustrative material are from McMinn’s examinations. and Abrahams’ Clinical Atlas of Human Anatomy. vii This page intentionally left blank