Clinical Anatomy An Illustrated Review with Questions and Explanations

315 Pages·2003·30.86 MB·English

by  Richard Snell

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tahir99-VRG & vip.persianss.ir
tahir99-VRG & vip.persianss.ir
Editor: Betty Sun
Managing Editor: Emilie Linkins
Marketing Manager: Joe Schott
Project Editor: Paula C. Williams
Designer: Doug Smock
Compositor: Maryland Composition, Inc.
Printer: Data Reproductions Corp.
Copyright © 2004 Lippincott Williams & Wilkins
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The publisher is not responsible (as a matter of product liability, negligence, or
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publication contains information relating to general principles of medical care which

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Library of Congress Cataloging-in-Publication Data
p
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Snell, Richard S.
p
Clinical anatomy : an illustrated review with questions and explanations / Richard S.
i
v
Snell.—4th ed.
p. cm.
Includes index.
ISBN 0-7817-4316-8
1. Human anatomy—Outlines, syllabi, etc. 2. Human anatomy—Examinations,
questions, etc. I. Title.
QM31.S7 2003
611’.0076—dc21 2003044694
The publishers have made every effort to trace the copyright holders for borrowed
material. If they have inadvertently overlooked any, they will be pleased to make the
necessary arrangements at the first opportunity.
To purchase additional copies of this book call our customer service department at
[phone] or fax orders to [phone]. International customers should call
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03 04 05
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Clinica l a na tomy is the stu dy of the ma croscopic
stru ctu re a nd fu nction of the body
a s it rela tes to the pra ctice of
medicine a nd other hea lth sciences.
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tahir99-VRG & vip.persianss.ir
P R E F A C E
T
his book is written for medical, dental, allied health scans, MRI studies, and sonograms. The extensive use of ta-
students, and nurses who are preparing for exami- bles simplifies the learning of muscles and their actions and
nations. It is also for students during their clinical nerve supplies and assists in the memorization of the
clerkships and for interns who require a quick review of ba- distribution of cranial and peripheral nerves. To emphasize
sic clinical anatomy. clinical relevance, short clinical notes are highlighted by the
This edition has been modified to reflect the reduced use of icons, and the notes are enclosed in a gray box. For a
amount of material required in modern curricula. No longer more extensive review, this book can be used in con-
is anatomic detail described that cannot be used in relation junction with the 7th edition of Clinical Anatomy, also pub-
to patients for the purpose of making diagnoses and insti- lished by Lippincott Williams & Wilkins.
tuting appropriate treatment. To further emphasize this I wish to express my sincere thanks to Ira Alan Grunther,
theme, the review questions at the end of each chapter are AMI, for his excellent artwork. To the staff of Lippincott
increasingly centered around patients in a clinical setting. Williams & Wilkins, I wish to express my gratitude for their
Again, I thank the many students and instructors for their patience and assistance throughout the preparation of this
written comments on how this book could be improved to new revised edition.
satisfy their needs.
The clinical anatomy has been presented in a condensed
form with numerous simple diagrams, radiographs, CT R.S.S.
vii
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tahir99-VRG & vip.persianss.ir
C O N T E N T S
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
CHAPTER 1 Thorax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
CHAPTER 2 Abdomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
CHAPTER 3 Pelvis and Perineum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
CHAPTER 4 Upper Limb . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113
CHAPTER 5 Lower Limb . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
CHAPTER 6 Head and Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
CHAPTER 7 Back . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283
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11
C H A P T E R
Th o ra x
THORACIC WALL the xiphoid process at the xiphisternal joint. On each side,
it articulates with the second to the seventh costal cartilages
(Fig. 1-1).
Bones of the Thoracic Wall
The bones of the thoracic wall consist of the sternum, the
Xiphoid Process
ribs, and the costal cartilages (Fig. 1-1).
The xiphoid process is a thin plate of cartilage that becomes
ossified at its proximal end during adult life. No ribs or costal
STERNUM
cartilages are attached to it.
The sternum is a flat bone that is divided into three parts: the
manubrium, the body, and the xiphoid process.
CLINICAL NOTES
Manubrium
S M B
TERNUM AND ARROW IOPSY
The manubrium forms the upper part of the sternum. It ar-
ticulates with the body of the sternum at the manubrioster- Because the sternum possesses red hemopoietic mar-
nal joint, and it also articulates with the clavicles and with row throughout life, the body of the sternum is a com-
the first costal cartilage and the upper part of the second mon site for marrow biopsy.
costal cartilage on each side.
The sternal angle (angle of Louis) is formed by the ar-
ticulation of the manubrium with the body of the sternum
RIBS
(Fig. 1-1). It is an important surface landmark, and it lies at
There are twelve pairs of ribs, all of which are attached pos-
the level of:
teriorly to the thoracic vertebrae. Ribs are divided into three
1. The second costal cartilage. categories:
2. The intervertebral disc between the fourth and fifth
• True ribs: The upper seven pairs are attached to the
thoracic vertebrae.
sternum by their costal cartilages.
3. The junction of the ascending aorta and the aortic arch
• False ribs: The eighth, ninth, and tenth pairs are attached
and the junction of the aortic arch and the descending
anteriorly to each other and to the seventh rib by their
thoracic aorta.
costal cartilages and small synovial joints.
4. The bifurcation of the trachea.
• Floating ribs: The eleventh and twelfth pairs have no
5. The junction of the superior mediastinum and the
anterior attachment.
inferior mediastinum (see p. 9).
Body of the Sternum Typical Rib
The body of the sternum articulates above with the The typical rib is a long, twisted flat bone with a rounded su-
manubrium at the manubriosternal joint and below with perior border and a grooved inferior border (the costal
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