Hollinshead's textbook of anatomy

938 Pages·1997·56.837 MB·English

by  Cornelius Rosse, Penelope Gaddum-Rosse

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Hollinshead's
Textbook of Anatomy

Hollinshead's
\
Textbook of Anatomy
Fifth Edition
Cornelius Rosse, M.D., D. Sc.
Professor
Penelope Gaddum-Rosse, Ph.D.
Associate Professor
Department of Biological Structure
University of Washington School of Medicine
Seattle, Washington
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5th Edition
Copyright © 1997 by Lippincott-Raven Publishers.
Copyright © 1985,1974,1967,1962 by Harper & Row, Publishers, Inc. All rights reserved. This book is protected
by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted, in any form or by any
means—electronic, mechanical, photocopy, recording, or otherwise—without the prior written permission of the
publisher, except for brief quotations embodied in critical articles and reviews. Printed in the United States of
America. For information write Lippincott-Raven Publishers, 227 East Washington Square, Philadelphia, PA
19106.
Materials appearing in this book prepared by individuals as part of their official duties as U.S. Government em¬
ployees are not covered by the above-mentioned copyright.
Library of Congress Cataloging-in-Publication Data
Rosse, Cornelius.
Hollinshead's textbook of anatomy. — 5th ed. / Cornelius Rosse,
Penelope Gaddum-Rosse.
p. cm.
Rev. ed of: Textbook of anatomy. 4th ed. / W. Henry Hollinshead,
Cornelius Rosse. cl985.
Includes bibliographical references and index.
ISBN 0-397-51256-2 (alk. paper)
1. Human anatomy. I. Gaddum-Rosse, Penelope. II. Hollinshead,
W. Henry (William Henry), 1906- Textbook of anatomy. HI. Title.
[DNLM: 1. Anatomy. QS 4 R828h 1997]
QM23.2.H57 1997
611—dc20
DNLM/DLC
for Library of Congress 96-8005
CIP
Care has been taken to confirm the accuracy of the information presented and to describe generally
accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or
for any consequences from application of the information in this book and make no warranty, express or
implied, with respect to the contents of the publication.
The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set
forth in this text are in accordance with current recommendations and practice at the time of publication.
However, in view of ongoing research, changes in government regulations, and the constant flow of
information relating to drug therapy and drug reactions, the reader is urged to check the package insert for
each drug for any change in indications and dosage and for added warnings and precautions. This is
particularly important when the recommended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA)
clearance for limited use in restricted research settings. It is the responsibility of the health care provider to
ascertain the FDA status of each drug or device planned for use in their clinical practice.
Preface
The motivation for this fifth edition of Textbook of Anatomy remains essentially unchanged
from that expressed by its original author, W. Henry Hollinshead, PhD, who first pub¬
lished the book in 1962 and revised it through two successive editions: "to present to the
student of medicine and dentistry an account of anatomical facts and concepts that he will
need to know, or know where to acquire, during his years of formal study in his chosen
profession; to provide a foundation of anatomical knowledge sufficient to build upon
when more detailed knowledge becomes necessary; and to help make the study of
anatomy more meaningful by emphasizing functional aspects and indicating some of the
many ways in which anatomical knowledge influences medical practice." Weakened by
protracted illness. Professor Hollinshead lived to voice his approval of the new aspects and
directions introduced in the fourth edition, but passed away soon after its publication. His
long and distinguished career was dedicated chiefly to graduate medical education in the
surgical specialties. His three-volume Anatomy for Surgeons is without equal in anatomical
scholarship. The Textbook of Anatomy he prepared for students of medicine and dentistry
was steeped in the same spirit. It is our intent to keep that spirit alive for future generations
of students in the health-related professions and provide a resource of anatomical infor¬
mation that retains its usefulness and value through the ever changing trends of medical
education.
The unprecedented expansion of biomedical knowledge during recent decades has ne¬
cessitated an evaluation of curricula in the health-related professions. Consequently, the
relatively stable period in medical education that prevailed during the middle third of this
century has been followed by experimentation with curricular content and the design of
new strategies and resources for learning. One of the noteworthy features of this process
has been the active involvement of students, not only as experimental material but as crit¬
ical monitors of the experimental results.
Three main conclusions may be drawn at this stage from the curricular reforms of the
recent past: 1) experimentation and evaluation must continue, and flexibility must be built
into the health-related professional curricula, anticipating not only the continued expan¬
sion of the biomedical sciences but also changes in the educational background of future
student populations and in the needs of the health professions; 2) students are capable of,
and motivated for, independent learning. Appropriate learning resources must be devel¬
oped for this purpose, and curricular structure must place the responsibility for much of
the learning on the student in order to foster an attitude for continued independent learn-
v
VI Preface
ing beyond graduation; and 3) it is not adequate to define curricular content by the sets of
facts and skills on which the everyday practice of the profession relies. Unless the use of
such facts and skills is based on a thorough and broad understanding of human biology, the
practitioner will be restricted to the routine and conventional, degrading health care de¬
livery from the professional to the trade level. Preparation for the practice of a profession de¬
mands education rather than mere training. Education is a protracted developmental pro¬
cess, resulting in a qualitative change in the learner's ability to integrate and use diverse
types of information to handle not only routine but also novel and unfamiliar situations. In
the process of education, the learner inevitably encounters many facts and concepts that
will not surface in the everyday practice of the profession; yet, without such facts and con¬
cepts, an understanding of human biology could not be obtained.
Anatomy is basic to education in the health-related professions. . .The ultimate pur¬
pose of anatomy education is to assist the student in developing an implicit and fully in¬
ternalized understanding of the 3-dimensional (3-D) dynamic structure of the living hu¬
man body so that he or she can apply the appropriate cognitive skills when clinical
problems call for anatomical reasoning. Anatomical reasoning is the cognitive process that
relates manifestations of normal and abnormal function to anatomic entities and seeks to
explain these manifestations in terms of the attributes of different anatomic structures.
Anatomical reasoning is required for intelligently engaging in such fundamental clinical
tasks as performing a physical examination, interpreting symptoms and signs of normalcy
and disease, selecting appropriate diagnostic tests, particularly those concerned with
imaging the body and interpreting the findings, and administering treatment for problems
encountered in primary care and medical emergency settings." (Rosse, Academic Medicine,
1995; 70:499.).
Contrary to the opinion of many, the study of anatomy need not consist of the memo¬
rization of long lists of names; rather, it should rely on the visualization of parts and re¬
gions of the body in three dimensions based on an understanding of how these relation¬
ships have come about and why they exist. Such an understanding may be gained through
the study of embryology. Therefore, developmental considerations have been included lib¬
erally in this text without an attempt to present a comprehensive account of embryology.
Many chapters and sections of the book begin with an introductory account of embryology
in order to present the organizational plan of an anatomic region or organ. Developmental
considerations are also used throughout the chapters to explain anatomical relationships
and to introduce relevant congenital abnormalities as well as other concepts. The organi¬
zation of chapters that deal with the gross anatomy of body regions and parts is such that
it facilitates integration of the text with dissection of the cadaver. Many of these chapters,
or their major sections, end by summarizing anatomy from the perspective of the physical
examination. In our opinion, the physical examination is, in fact, the assessment of func¬
tional anatomy. Skills for eliciting physical signs would be most profitably learned in con¬
junction with the study of anatomy, an approach that would promote anatomical reason¬
ing in clinical practice. Although examples of various clinical conditions are used
abundantly to illustrate anatomical principles, the main emphasis is on the anatomical
knowledge required for performing and interpreting physical signs in particular regions or
parts of the body.
Our motivation for promoting anatomical reasoning requires that a comprehensive ac¬
count be given of the anatomy of the human body. We have made no attempt to limit the
information to so-called essential facts. Defining what is essential, and for what purpose, is
an intractable problem. A comprehensive view of anatomy should enable both students
and practitioners of medicine and dentistry to put into appropriate context the detailed in¬
formation that is relevant to the problems they intend to solve. Each chapter and each of its
sections usually begin with an overall view that sets the scene for enhancing this basic in¬
formation in the remaining parts of the chapter or individual section. A different font is
used for presenting a third layer of information which provides insights into the material
from different viewpoints.
The aim of this three-tiered approach is to make apparent a system according to which