Clinical Anatomy

Professor Harold Ellis , Clinical Anatomist, Guy's, King's and St Thomas' School of Biomedical Sciences, London; Emeritus Professor of Surgery, Charing Cross and Westminster Medical School, London; Formerly Examiner in Anatomy, Primary FRCS (Eng). Professor Vishy Mahadevan , Barbers' Company Reader in Anatomy, Raven Department of Education, Royal College of Surgeons of England.

Preface to the Twelfth (Jubilee) Edition, xiii Preface to the First Edition, xiv Acknowledgements to the Twelfth (Jubilee) Edition, xv Acknowledgements to the First Edition, xvi Part 1: The Thorax Introduction, 3 Surface anatomy and surface markings, 3 The trachea, 4 The pleura, 4 The lungs, 6 The heart, 6 The thoracic cage, 7 The thoracic vertebrae, 8 The ribs, 8 The costal cartilages, 10 The sternum, 11 The intercostal spaces, 12 The diaphragm, 15 The pleurae, 21 The lower respiratory tract, 21 The trachea, 21 The bronchi, 26 The lungs, 26 The mediastinum, 31 The pericardium, 31 The heart, 32 The superior mediastinum, 47 The thymus, 47 The oesophagus, 47 The thoracic duct, 50 The thoracic sympathetic trunk, 52 On the examination of a chest radiograph, 55 Radiographic appearance of the heart, 56 Part 2: The Abdomen and Pelvis Surface anatomy and surface markings, 61 Vertebral levels, 61 Surface markings of individual viscera, 63 The fasciae and muscles of the abdominal wall, 64 Fasciae of the abdominal wall, 64 The muscles of the anterior abdominal wall, 65 The anatomy of abdominal incisions, 67 The inguinal canal, 70 Peritoneal cavity, 72 Intraperitoneal fossae, 75 The subphrenic spaces, 76 The gastrointestinal tract, 77 The stomach, 77 The duodenum, 82 Small intestine, 84 Large intestine, 85 The appendix, 86 The rectum, 88 Arterial supply of the intestine, 93 The portal system of veins, 94 Lymph drainage of the intestine, 95 The structure of the alimentary canal, 95 The development of the intestine and its congenital abnormalities, 97 The gastrointestinal adnexae: liver, gall-bladder and its ducts, pancreas and spleen, 100 The liver, 100 The biliary system, 105 The gall-bladder, 106 The pancreas, 108 The spleen, 111 The urinary tract, 112 The kidneys, 112 The ureter, 116 The embryology and congenital abnormalities of the kidney and ureter, 118 The bladder, 119 The urethra, 122 The male genital organs, 123 The prostate, 123 The scrotum, 126 Testis and epididymis, 126 Vas deferens (ductus deferens), 131 The seminal vesicles, 132 The bony and ligamentous pelvis, 132 The os innominatum, 132 The sacrum, 133 The coccyx, 134 The functions of the pelvis, 134 Joints and ligamentous connections of the pelvis, 134 Differences between the male and female pelvis, 135 Obstetrical pelvic measurements, 137 Variations of the pelvic shape, 138 The muscles of the pelvic fl oor and perineum, 140 The anterior (urogenital) perineum, 141 The posterior (anal) perineum, 143 The female genital organs, 145 The vulva, 145 The vagina, 145 The uterus, 147 The Fallopian tubes, 152 The ovary, 153 The endopelvic fascia and the pelvic ligaments, 154 Vaginal examination, 156 Embryology of the Fallopian tubes, uterus and vagina, 157 The posterior abdominal wall, 158 The suprarenal glands, 160 Abdominal aorta, 160 Inferior vena cava, 163 Lumbar sympathetic chain, 163 Computed axial tomography, 165 Part 3: The Upper Limb Surface anatomy and surface markings of the upper limb, 169 Bones and joints, 169 Muscles and tendons, 170 Vessels, 172 Nerves, 174 The bones and joints of the upper limb, 175 The scapula, 175 The clavicle, 175 The humerus, 177 viii Contents The radius and ulna, 178 The bones of the hand, 180 The shoulder, 183 The elbow joints, 186 The wrist joint, 190 The joints of the hand, 191 Three important zones of the upper limb: the axilla, the cubital fossa and the carpal tunnel, 193 The axilla, 193 The cubital fossa, 194 The carpal tunnel, 195 The arteries of the upper limb, 196 The axillary artery, 196 The brachial artery, 196 The radial artery, 197 The ulnar artery, 197 The brachial plexus, 198 The segmental cutaneous supply of the upper limb, 200 The course and distribution of the principal nerves of the upper limb, 200 The axillary nerve, 200 The radial nerve, 201 Branches, 203 The musculocutaneous nerve, 203 The ulnar nerve, 203 The median nerve, 205 Compartments of the upper limb, 205 Compartments in the segments of the upper limb, 206 Compartment syndrome, 206 The female breast, 207 Structure, 207 Blood supply, 207 Lymphatic drainage, 207 Development, 210 The anatomy of upper limb deformities, 211 The spaces of the hand, 214 The superfi cial pulp space of the fi ngers, 214 The ulnar and radial bursae and the synovial tendon sheaths of the fi ngers, 215 Part 4: The Lower Limb The surface anatomy and surface markings of the lower limb, 221 Bones and joints, 221 Bursae of the lower limb, 222 Mensuration in the lower limb, 222 Muscles and tendons, 225 Vessels, 227 Nerves, 228 The bones and joints of the lower limb, 231 The os innominatum, 231 The femur, 231 The patella, 236 The tibia, 236 The fi bula, 239 A note on growing ends and nutrient foramina in the long bones, 239 The bones of the foot, 240 The hip, 240 The knee joint, 245 The tibiofi bular joints, 248 The ankle, 248 The joints of the foot, 251 The arches of the foot, 251 The anatomy of walking, 253 Three important zones of the lower limb: the femoral triangle, adductor canal and popliteal fossa, 254 The femoral triangle, 254 The fascia lata, 255 The femoral sheath and femoral canal, 255 Femoral hernia, 256 The lymph nodes of the groin and the lymphatic drainage of the lower limb, 257 The adductor canal (of Hunter) or subsartorial canal, 258 The popliteal fossa, 259 The arteries of the lower limb, 261 Femoral artery, 261 Popliteal artery, 262 Posterior tibial artery, 263 Anterior tibial artery, 264 The veins of the lower limb, 264 The course and distribution of the principal nerves of the lower limb, 266 x Contents The lumbar plexus, 267 The sacral plexus, 268 The sciatic nerve, 271 The tibial nerve, 272 The common peroneal (fi bular) nerve, 273 Segmental cutaneous supply of the lower limb, 274 Compartments of the lower limb, 274 Compartments in the segments of the lower limb, 274 Compartment syndrome, 276 Part 5: The Head and Neck The surface anatomy of the neck, 279 The fascial compartments of the neck, 281 Tissue planes and fascial layers in the anterior part of neck, 281 The thyroid gland, 284 The parathyroid glands, 288 The palate, 290 The development of the face, lips and palate with special reference to their congenital deformities, 291 The tongue and fl oor of the mouth, 293 The tongue, 293 The fl oor of the mouth, 296 The pharynx, 298 The nasopharynx, 298 The oropharynx, 300 The palatine tonsils, 300 The laryngopharynx, 301 The mechanism of deglutition, 303 The larynx, 305 Blood supply, 308 Lymph drainage, 309 Nerve supply, 309 The salivary glands, 310 The parotid gland, 310 The submandibular gland, 313 The sublingual gland, 315 The major arteries of the head and neck, 315 The common carotid arteries, 315 The external carotid artery, 316 The internal carotid artery, 317 The subclavian arteries, 320 The veins of the head and neck, 322 The cerebral venous system, 322 The venous sinuses of the dura, 323 The internal jugular vein, 325 The subclavian vein, 326 The lymph nodes of the neck, 328 The cervical sympathetic trunk, 330 The branchial system and its derivatives, 332 Branchial cyst and fistula, 332 The surface anatomy and surface markings of the head, 334 The scalp, 335 The skull, 336 Floor of the cranial cavity, 339 Development, 340 The paranasal sinuses (accessory nasal sinuses), 342 The frontal sinuses, 342 The maxillary sinus (antrum of Highmore), 343 The ethmoid sinuses, 345 The sphenoidal sinuses, 345 The mandible, 346 The temporomandibular joint, 347 The teeth, 348 The vertebral column, 349 The cervical vertebrae, 349 The thoracic vertebrae, 351 The lumbar vertebrae, 352 The sacrum, 352 The coccyx, 352 The intervertebral joints, 353 Part 6: The Nervous System The brain, 359 The brainstem, 359 The medulla oblongata, 360 The pons, 360 The midbrain, 362 The cerebellum, 362 The diencephalon, 364 The hypothalamus, 364 The pituitary gland (hypophysis cerebri), 366 The thalamus, 367 The cerebral hemispheres, 368 The cerebral cortex, 368 The insula, 371 The connections of the cerebral cortex, 372 The basal ganglia, 372 The long ascending and descending pathways, 373 The membranes of the brain (the meninges), 379 The ventricular system and the cerebrospinal fl uid circulation, 380 The spinal cord, 384 Age differences, 384 Structure, 385 Descending tracts, 385 Ascending tracts, 386 The membranes of the cord (the meninges), 388 The cranial nerves, 391 The olfactory nerve (I), 391 The optic nerve (II) and the visual pathway, 392 The oculomotor nerve (III), 393 The trochlear nerve (IV), 396 The trigeminal nerves (V), 396 The abducent nerve (VI), 401 The facial nerve (VII), 403 The auditory (vestibulocochlear) nerve (VIII), 405 The glossopharyngeal nerve (IX), 406 The vagus nerve (X), 406 The accessory nerve (XI), 408 The hypoglossal nerve (XII), 409 The special senses, 410 The nose, 410 The ear, 412 The eye and associated structures, 415 The autonomic nervous system, 421 The sympathetic system, 424 The sympathetic trunk, 424 The parasympathetic system, 428 Glossary of eponyms, 432 Index, 439 A companion website for this book is available at: www.ellisclinicalanatomy.co.uk