Human Anatomy, Color Atlas and Textbook: With STUDENT CONSULT Online Access, 5e

440 Pages·2008·68.79 MB·English

by  John A. Gosling

Human Anatomy
Commissioning Editor: Madelene Hyde
Development Editor: Heather McCormick, Joanne Scott
Project Manager: Bryan Potter
Design: Stewart Larking
Illustration Manager: Bruce Hogarth
Illustrator: Richard Tibbitts/Antbits
Marketing Manager: Alyson Sherby
Human AnattoFifth mEditiony
Color Atlas and Textbook
Photography by:
J.A. Gosling, A.L. Bentley
MD, MB ChB, FRCS ABIPP, AIMBI, MBKS
Professor of Anatomy Medical Photographer
Stanford University Faculty of Life Sciences
USA University of Manchester
UK
P.F. Harris
MD, MB ChB, MSc
Embalming and section cutting by:
Emeritus Professor of Anatomy
J.T. Davies
LIAS
University of Manchester
UK Formerly Senior Anatomical Technician
Faculty of Life Sciences
J.R. Humpherson
MB ChB
University of Manchester
Formerly Senior Lecturer in Anatomy UK
Faculty of Life Sciences
Contributors to previous editions:
University of Manchester
J.L. Hargreaves
BA(hons)
UK
Medical Photographer
I. Whitmore
MD, MB BS, LRCP MRCS
Professor of Anatomy
Stanford University
USA
P.L.T. Willan
MB ChB, FRCS
Formerly Professor of Anatomy
University of UAE
Al-Ain
United Arab Emirates
An imprint of Elsevier Limited
First edition 1985
Second edition 1990
Third edition 1996
Fourth edition 2002
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by him/her/them in accordance with the Copyright, Designs and Patents
Act 1988.
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ISBN: 978-0-7234-3451-1
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vvv
Preface to fi fth edition
This edition maintains the unique combination of concise yet lations has been integrated throughout the text and none of the
comprehensive text with images of dissections, each undertaken anatomical content of the fourth edition has been deleted.
to illustrate features described in the text. Typically the illustra-
tions and text are grouped together on the left and right sides of The terminology conforms to the internationally agreed Termino-
self-contained spreads, making for easy cross-reference. logia Anatomica. In addition this edition possesses a list of “alter-
native terms”, including eponyms, which have been selected
In this fi fth edition we have been driven by a desire to improve because they are used frequently. The larger font size for text
the contents and enhance their relevance as new courses evolve. introduced in the fourth edition has been retained and the font
The text has been refi ned by remedying omissions and removing for fi gure labels changed.
ambiguities. In addition, all the diagrams accompanying the dis-
sections have been checked and, where necessary, amended to J.A.G., P.F.H., J.R.H., I.W., P.L.T.W.,
improve clarity and accuracy. Several free-standing diagrams, 2008
including those illustrating dermatomes, have been redrawn. The
introductory pages for the chapters on the abdomen and back
have been expanded and improved.
Acknowledgements for all editions
The authors are indebted to Dr Waqar Bhatti, Professors R.S.
In many institutions changing educational approaches have
Harris and A.R. Moody and to the Department of Radiology at
resulted in the phasing out of traditional topographical anatomy
Manchester University for the provision of radiographs, CT and
courses that included dissection. In their place have appeared
MR scans.
integrated courses which incorporate imaging and clinical ana-
tomical relevance. We have responded to this trend by enhancing
Our families deserve a special mention, as without their untiring
the radiographic content; for example, in the observation skills
pages for the upper and lower limbs scans are accompanied by support and patience these editions would certainly not have
corresponding cadaver sections. New chest radiographs appear come to publication.
in the thorax chapter and several radiographs have been replaced
by higher quality images. New material describing clinical corre- We thank them all.
vi
Preface to fi rst edition
Despite the many anatomical atlases and textbooks currently quent chapters describe anatomy primarily through dissection, a
available, there appeared to be a need for a book which combined regional approach has been employed. Features of bones are
the advantages of each of these forms of presentation. This book described only when considering their related structures, espe-
was conceived with the intention of fi lling that need. With a cially muscles and joints; osteology is not considered in its own
unique combination of photographs of dissections, accompany- right. The internal structure of the ear and eye are beyond the
ing diagrams and concise text, this volume aims to provide the scope of this book since the study of these topics requires micros-
student with a better understanding of human anatomy. copy; the anatomy of the brain and spinal cord are also excluded
as they are usually taught in special courses.
The basis of this work is the cadaver as seen in the dissecting
room; therefore, reference to surface and radiological anatomy is The level of detail contained in this book is appropriate for current
minimal. Likewise, comments on the clinical and functional sig- courses in topographical anatomy for medical and dental under-
nifi cance of selected anatomical structures are brief. However, graduates. In addition, it will be of value to postgraduates and to
comparison is made where appropriate between the anatomy of students entering those professions allied to medicine in which
the living and that of the cadaver. anatomy is part of the curriculum.
Each dissection was specially prepared and photographed to The terminology employed is that which is most frequently
display only a few important features. However, since photo- used in clinical practice. Where appropriate, alternatives (such as
graphs of dissections are inherently diffi cult to interpret, each is those recommended in Nomina Anatomica) are appended in
accompanied by a guide in the form of a drawing. Each drawing brackets.
is coloured and labelled to highlight the salient features of the
dissection and is accompanied by axes to indicate the orientation Preparation of the dissections and the text has occupied the
of the specimen. Adjacent photographs often depict different authors for nearly fi ve years. Our objective was to create a high
stages of the same dissection to help the student construct a three- quality and visually attractive anatomical work and we hope that
dimensional image. the time and effort spent in its preparation is refl ected in the fi n-
ished product.
The fi rst chapter introduces anatomical terminology, provides
general information about the basic tissues of the body, and J.A.G., P.F.H., J.R.H., I.W., P.L.T.W.
includes overall views of selected systems. Because the six subse- Manchester, 1985
vvviiiiii
Contents
Preface to the fi fth edition v Joints of Hand 125 Pelvic Wall and Floor 232
Preface to the fi rst edition vi Exam Skills 127 Pelvic Nerves 236
Human Anatomy User Guide ix Clinical Skills 128 Pelvic Blood Vessels and
Observation Skills 130 Lymphatics 238
1 • Basic Anatomical Concepts Perineum 240
Male External Genitalia 244
Terms of Position and Movement 2 4 • Abdomen
Female External Genitalia 246
Basic Tissues and Structures 5 Introduction 136
Exam Skills 248
Anterior Abdominal Wall 140
Clinical Skills 249
2 • Thorax Inguinal Canal 146 Observation Skills 250
Scrotum 149
Introduction 26
Peritoneum 152 6 • Lower Limbs
Skeleton of Thorax 28
Stomach 158
Thoracic Wall 30 Introduction 254
Spleen 162
Pleura 36 Anterior Compartment of Thigh 259
Duodenum 164
Lungs 38 Medial Compartment of Thigh 264
Pancreas 167
Bronchi 42 Gluteal Compartment 267
Liver 170
Mediastinum 43 Posterior Compartment of Thigh 272
Jejunum and Ileum 175
Pericardium 44 Popliteal Fossa 274
Caecum, Appendix and Colon 179
Heart 45 Posterior Compartment of Leg 276
Portal Venous System 184
Mediastinal Structures 57 Sole of Foot 280
Kidneys and Suprarenal Glands 186
Exam Skills 64 Hip Joint 292
Abdominal Aorta 190
Clinical Skills 65 Knee Joint 296
Iliac Vessels 192
Observation Skills 66 Tibiofi bular Joints 301
Inferior Vena Cava 193
Ankle Joint 302
Lymphatics of Abdomen 195
Joints of Foot 306
3 • Upper Limbs Autonomic Nerves of Abdomen 197
Arches of Foot 309
Introduction 72 Posterior Abdominal Wall 200
Exam Skills 311
Deltoid 76 Diaphragm 203
Clinical Skills 312
Axilla 77 Exam Skills 207
Observation Skills 314
Anterior Compartment of Arm 82 Clinical Skills 208
Cubital Fossa 85 Observation Skills 210 7 • Head and Neck
Anterior Compartment of Forearm 86
Introduction 320
Palm and Digits 90 5 • Pelvis and Perineum
Neck 322
Muscles Attaching Upper Arm to
Introduction 214 Contents of Carotid Sheath 330
Trunk 100
Pelvic Cavity 214 Superfi cial Structures of Face and
Short Scapular Muscles 103
Rectum 218 Scalp 333
Posterior Compartment of Arm 106
Female Internal Reproductive Parotid Gland 337
Posterior Compartment of Forearm 108
Organs 219 Masseter, Temporalis and Infratemporal
Dorsum of Hand 114
Pelvic Ureters 222 Fossa 340
Clavicular and Shoulder Joints 115
Bladder 223 Digastric and Styloid Muscles 345
Elbow Joint 119
Female Urethra 225 Mylohyoid and Related Structures 347
Radioulnar Joints 121
Male Urethra 226 Pterygopalatine Fossa 351
Wrist Joint 122
Male Internal Organs of Nasal Cavities and Paranasal Air
Joint of Carpus 123 Reproduction 228 Sinuses 354
viii CONTENTS
Palate 358 8 • Back Clinical Skills 411
Pharynx 390 Observation Skills 412
Introduction 392
Larynx 363
Vertebrae and Joints 396
Exam and Clinical Skills Answers 415
Cranium and Contents 369
Muscles 404
Orbit 376
Meninges 407 Alternative Terms 419
Exam Skills 382
Spinal Cord 408
Clinical Skills 383 Index 421
Exam Skills 410
Observation Skills 384
ix
Human Anatomy User Guide
Organization In diagrams showing muscle attachments on bone, the areas are
shown using the muscle colour enclosed by different coloured
This book begins with a chapter on basic anatomical concepts.
lines. Similarly, in other diagrams coloured lines indicate the
Then there are seven chapters, each with its own introduction, on
extent of a compartment or space.
the different regions of the body. Information is usually presented
in dissection order, progressing from the surface to deeper struc-
tures. The limbs are described from proximal to distal with the
joints considered last.
Texts and Photographs
Where possible the text and photographs are arranged on self-
contained two-page spreads, so that the reader can locate relevant
illustrations without turning a page. In these cases, the references
in brackets appear as “(Fig.x.xx)”. Additional cross-references to Coracobrachialis
illustrations or text are given as “(see Fig. y.yy)” or “(see page z)”
Brachialis
which direct the reader to a different spread.
Pectoralis major
Accompanying Diagrams Deltoid
Adjacent to each photograph is a line diagram in which colour is
used to focus attention on particular structures in the dissection.
The colours conform to the following code:
Artery Ligament/Tendon
Labels and Leader Lines
The structures of particular interest in each diagram are labelled.
Bone Mesentery/Peritoneum
A single structure is named in a label either with a single leader
line or by a leader line which branches to show different parts of
the same structure. However, if two or more structures are named,
Capsule Muscle
the fi rst has the main leader line terminating on it while the sub-
sequent structures are indicated by side branches given off at
progressively shorter distances from the label. A leader line
Duct Nerve
ending in an arrow indicates a space or cavity.
Fat Organ
Lumen of
vein
Fibrocartilage Space Vein,
artery
and nerve
Vein
Gland Vein
Hyaline cartilage