MOORE S ’ Essential Clinical SIXTH EDITION A呵U俗it切旧Editor:Cry冒扭ITaylor Development Ed位or:Kathleen H. Scogna (freela且ce);Andrea Vosburgh (in-house) Edit01也lCoordinator: Lindsay Ries Marketing Man唔er:Jason Oberacker Production P呵ectMan唔旷JJoan Sinclair Design Coordinator: Stephen Druding Art Director: Jen皿ferClements A付如ts:Imagineering缸t.com,lead artist Natalie Intven, MSc, BMC; Dragonfly Media Group, lead artist Rob Duck响rall Manufac阳ringCoord切ator: Margie Orzech Prepress Vendor: Absolute Servi阻,Inc. Six由Edition Cop严ight© 2019 Wolters囚uwer Co阳ight© 2015,到11, 2007, 2002, 1995 Llppinco忧W曲皿s& Wilkins, a Wolters Kluw哩rbusiness. All d掉“reserved,’Thisbook is protec时bycopyri~ht.No part of出sbookmaybe吨roducedor transmi削扭 曲yform or by any means, including as photoα>pies or scanned-in or other electronic copies, or u出redby any M岛rmationstorage and retrieval sys怡mwithout written permission from也叫同1ghtowner, except for brief quotations embodied in critical articles and reviews. Ma恒血lsappearing in也sbook prepared by indi·咄咄 部artof也由officialduties as U.S. government employees are not covered by也eab阴-mentionedc咱I right To req回挝permi岱ion,抖e凶econtact Wol怡rsKlu\\嘀rerat Two Corr Philadelphia, PA 19103, via email at [email protected],町由ourwebsite at shop.lww.com (products and services). 9 8 7 6 5 4 3 2 I Printed in China Librarγof Congress Cataloging-in-Publication Data I I Names: Moore, Keith L., au也or. Agur, A. M.孔,au也or. Dall町,缸也ur F., II, au也or.I Digest of (w1。此): Moore, Keith L. Clinically oriented anatomy. ’Title: Moore's essential clinical anatomy I Anne M.R. Agur, Authur F. Dall町 II ; founding coau由or(with Anne M.R. Agur)阻dcoauthor for first to B负heditions, Keith L. Moore. Other titles: Essential clinical ana切my I I Description: Six也edition. Phtladelphia : Wolters Kluwer, [细19] Preceded by Essential clini四Ianatomy I Kei也LMoore, Anne M.R. Agur, I Ar也urF. Dall町II.Fi£也edition. [2015]. Kei也LMoo的name I appear百first扭曲eprevious editions. Parent te对:Clinicallyoriented anatomy I Kei由LMoore, Ar也田F.Daile黑灿neM.R. Agur. Eighth I edition. [2018]. Includes bibliographical references and index. I Identifiers: LCCN 2018048208 ISBN 9781496369臼9(paperb剧。 I Subje伽:I MESH: Anatomy Handbooks I I Classification: LCC QM23.2 NLM QS 39 DDC 612---dc23 LC record available at https://lccn.loc.gov/2018048208 ’This work is provided“as is," and the publisher disclaims any and all warranties, express or implied, including any warranties as to accuracy, comprehensiveness, or cuπ·ency of the content of也iswork τ'his work is no substitute for individual patient assessment based on health care professionals' examinatioI l ofeacbp咀.en ditions, medication histo亨,laboratorydata, and o也erfactors unique to the patient.τ'he publisher does not pro训demedical advice or guid阻白,and出iswork is merely a reference tool. Health凶mprofessionals, and not也epublisher, are solely responsible for由.euseof也iswork, including all medical judgmen扭扭dfor血y resul出ig也agnosisand trea恼ients. Given continuous, rapid a曲ancesin medical science and health info口nation,independent professional veri fication of medical diagnoses, indi四.tions,approp血tepharmaceutical selections and dosages, and treatment op吕onsshould be made and health四mprofessionals should consult a varie吵。fsources. When prescribing medication, health c缸eprofessionals are ad世sedto consult the product information sheet (the manufac turer's package insert) accomp叫ngeach drug to ve吟,amongo出er也ings,conditions of use, warnings and side effects and identify anr changes in dosage schedule or contraindicatio时,partiCl曲峙证由emedica tion to be administered is new, infrequently used or has a narrow therapeutic range. To由emaximum extent permitted under applicable law, no responsib血tyis assumed by the publisher for皿.yinjury and/or damage to persons or p吨er妙,“amatter of products liability, negligence law or o也erwise,or from any reference to or use by any person of也iswork. shop.lww.com To my husband, Enno, and my family, Kristina, Erik, and Amy, for their supp。时and encouragement. -AMRA T。 Muriel, my bride, best friend, c。unselor, and m。ther。f。urs。ns, and t。。urfamily一 Tristan, Lana, Elijah, Finley, Sawye巳and Dashiell; Denver; Skyle巳 Sara, and Daws。n-with l。ve and great appreciation for their support, understanding, good humo巳 and, m。st。fall, patience. -AFD In L。ving Memo叩。f Mari。n My best friend, wife, c。lleague, mothe「。f。urfive children, and grandmother of。ur nine grandchildren f。rher l。,ve, unc。nditi。nal supp。rt, and understanding. w。nderful mem。rieskeep you in 。ur hearts and minds. -KLM And with sincere appreciation f。rthe anatomical donors without whom our studies w。uld n。tbe p。ssible and for the support and patience of their families. Anne M.R. Agu民BSc(OT), MSc, PhD Arthur F. Dalley”,PhD, FAAA Keith L. M。。re,MSc, PhD, H。”.DSc, FIAC, FRSM, FAAA Preface ~ I Twenty-two years have passed since 由e fir事t edition of understand the praclical value of姐atom沪 In response Essen伽l Clinical Anatcn呵W郁published. The main aim to our reader嚣’suggestions,也eclinical boxes have been of the six也咄阳总协 pro协 a oompact yet thorou快 grouped.τ均arealso cl幽幽dby山倒lo咄gicons如 textbook of d部沁alanatomy for students and practitioners 阻击cate耻typeof cli皿d姐forma恤mcovered: in the h倒Ithcare professions and related disciplines. With. An制mical 唰ations. 命四ese each edition, we strive如make也ehook even more student blue boxes feature 缸end协Thebasic approach th制nderliesthis textbook is to ana协m部alvariations that may be encountered in也e也- section lab or in pra皑白,emphas国鸣也eclinical impor • pro悦.dea basic text of human clinical ana·协myfor use in U且ceofawa:r弩nessofsuch v也iations. current health scien四scurricula. • pre盹nt舶appropriateamount of cli皿倒llyrelevant ana 出 c:yde. fi 四e阳 blue boxes 叫问问制 to皿.calmaterial in a readable姐dinteres始ng岛rm. developmental fac协r窜出ataffect pos恼a时姐刷my姐d • place emphasis on clinical ana协•my也atis impo戏剧tfor 础伯因calphenomena导创iicallyassociated悦.th.也.ges prac恒。e. of证e-cltildhood,adolescence, adult, and advanced age. • pro悦dea cone始eclini铺llyoriented anatomical overview forclini凶Icourses画subsequentyear队 Traumai肌⑥Theeffi刷刷刷maficeven岱-such ·辑rveas a rapid review when preparing for e础mina出ns, as fractures of bones or dislocations ofj oints一佣normal par世cularly those prepared by the National Board of 础atomyand也aclinical mani如tations础ddys缸nction Medi铺IE础miners. resulting from such恤j旧ies are featured in these blue • offer eno啪 information 如由ose wi由ing 协 refresh boxes. their knowledge of clin阳1姐.atom)巳 Diagn峭的rocedures . . 灿刷刷叫features This edition has been thoroughly revised, keeping in mind icon 由emany画valuablecomments received from s阳dents,col 姐dobse凹捕。nsthat play a role in physical也伊osisare le唔ues,姐dm飞往ewer思Keyfeatures include the following: U咱就ed.in these blue以lX6S. ·咀1e art progt"础l con出iuesto under嚣。revision and re address呻 Surgical procedures• • These blue boxes 缸.ementwi由eachedition. All of the温础饺ationsareh且 抽pi岱asthe姐彻micalb四sofs urgical pro四dures,such colox, highlight凶P即恼tfac始,andshow anat·。myi且re as 也eplanning of incisions and the anatomical basis of la挝onto d画沁alme也cin怠andsurg•创y.A great effort has regional anesthesia. been made to fur也erimprove clarity of labeling姐d协 place诅.ustrationson也epages being viewed as也怠诅us Padtology. \.I)The effect ofd isease on normal础恤实 回,tionsare cited in the text. such as can出rofthe bJ1创st,姐dana协micalstru仗田esor • New overview ill田f:l'ationsoft he sensol)'姐dmotor inner p且nciplesinvolved in the con直nementor dissemination of vati侃。ftheupp即相dlower limbs fac出tateinte伊tion. disease制出n由ebody are the types of切piescovered it且 • A d.escrip姐onof也怠也uct出事and缸且.ctionof the enteric 也e崎blueboxes. nervous system姐dits uniquβ叫ein也einnervation of the digestive位“thas been added也athi酬ightsimpor • Surl总.ce姐篇阳myisintegr羽饱din协也ediscu闹。nof倒chre tant new informa·岱m about也is system、统ructure 姐d gion如demo山回te出erelationship between ana始my姐d function. ph同cal棚minati.on,也gnos忌,andcli皿calprocedures. • Newsu血ω姐atomyphoto伊掉sof cli血alprocedures • Medical油ages of r础。伊1phic,computed tomo伊:phy 姐d也e泣relevant姐atomyemph四mtheimpo戎相愧。f (CT),magne由附onancei皿aging(MRI),姐dultrasonog knowledge of clin部al姐a加m;沪 raph ie嚣tudieshave been included, often with co.rrelative • More illustrated clinical ooITelation、 known as “clini 诅us怕怡。肌Cwrent也,gnosticimaging tech皿quesdem cal blue boxes," have been included to he恰 studen铃 佣sf:l'ate相制myas it is often viewed clinically. 辆自 viii p陀face • Student resources, including case studies accompa The p盯ent of由is book, Clinically Oriented Anat例呵 nied by clinico-anatomical problems and USMLE-style (GOA), is recommended as a resource for more detailed mul目ple-choice ques世ons, are available to students on descriptions of human anatomy and its relationshi~ and im line at http;//thePoint.lww.com/MooreECA6e, providing p。此ance to medicine and surgery. Moore's Essential Clini a convenient and comprehensive means of self-testing calAnatom锣,Maddition抽its own unique诅ustrationsand and review. manuscript, h臼u叫咀lized mater ls from Clinical与Oriented • Instructors may contact their sales representative through Anatomy and Grant云AtlasofA nato呵, http://thePoint.lww.com/MooreECA6e for information We again welcome your comments and suggestions for about accessing the instructor resources, including im improvements in future editions. ages, for use 扭曲eirteaching and course materials. Anne M. R. Agur 咀ieterminology adheres怕也e Terminologia Anatomica University of Toronto (1998) approved by the lnte口iationalFederation of Associa Faculty of Medicine tions of Anatomists (IFAA). The official English equivalent 恒rms are used也roughoutthe present edition. When new Arthur F. Dalley II terms 缸e introduced however. the Latin forms as used in Vanderbilt University Europe, Asia, and other parts of the world appear in p缸e岳 School of Medicine 出eses. ’The roots and derivation of terms 缸e included to help students understand the me皿ng of由e terminology. Eponyms, although not endorsed by the IFA A, appear in pa rentheses to assist students during their clinical studies. Acknowledgments ~ I We wish抽出四kthe创lo呐ngcolleagues who w即·einvited Rebe饥到1t.L.Prat、PhD by也epublisher柏树由t回也也developmentof this sixth 民币essor。fAna如my edition. Dep ar恼entof Foundational Medical Studies Oakland University Willi甜EBeaumont School of Me也cine REVIEWERS FOR THE SIXTH EDITION Roch制阳,Michigan Hanan Dawood Yas幅,MD KeiichiAld怡,MD,PhD Assist.ant Professor and Head of Ana协.myand Professor and Ch础 Embryology D句“恤ent Dep阳恤1entof Clinical Anatomy De阳恤entofA剧协my姐dEmbryology To悖。Medicaland Dental U皿versity Beni SuefUniversity To句。,Japan Beni Suef, Beni Suef Covemorate, Egypt Quentin儿Fo郎,BSc徊。”),PhD, FRCPS (Glasg) REVIEWERS FOR THE FIFTH EDITION Associate Professor, Clini凶IAnatomy Dep缸恤1entofAna协myand Neuroscience τ'he University of Melbourne Kacie Bhushan Victoria., Austr现ia Nova Southeas怡mUniversity Fort Lauderdale, Florida Cb伽aM.I础man-Bonfi酌,PhD,~,cscs Associate Professor and DiJ:冠ctorof Curriculum and Leonard J. Clea町,PhD Inst rue勘n,Clinical Anatomy 民币essor Dep红恼1entof Interdisciplinary Health Sciences The U皿四闹。,。f'Il部asH翻地ScienceCenter Medical School Arimna School of Health Sciences Houston, Texas A.T. S创!Un如ersity Alan Crandall, MS Mesa, Arizona Idaho St.ate U皿versity G俯首royNoel, PhD Pocatello, Idaho Associate Professor and Direc协•r,Division of Ber也aEscobaJ.,.PonιMD Anatomi臼lSciences Loma Linda University Depar恒1entofAna协·my姐dCell Biology Loma Llnda. California McGill University Montreal, Quebec, C础ada 恼。·masG由ngwater,PhD Professor。fNeuroanatomy Bassam Nyaeme, MD University of E也nbw:gh Facul职BasicH辅I出Sciences Edinbu啦,UnitedKingdom British Columbia Ins挝阳怜。£Technology Bumaby,Bri出hColumbia, Canada William Hube鸟PhD Professor Mo回caOb监nge鸟,~hD St. Louis Community College at Forest Park Professor, Vice Chair and Associate Vice President for St. Lo回s,Missouri Rese创由Compliance Dep缸恤1entof Cell Biology甜dAna协my Lorraine Jades恼,PhD Chi凶goMedical School, School of Graduate and Associate Professor Postdoctoral S阳dies University of Guelph Chicago, Illinois Ont a巾,Canada IX