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Clinical Anatomy: Applied Anatomy for Students and Junior Doctors, 12th Edition




Clinical Anatomy: Applied Anatomy for Students and Junior Doctors, 12th Edition

Harold Ellis, Vishy Mahadevan

ISBN: 978-1-118-35581-7 May 2012 Wiley-Blackwell 352 Pages


Written by one of the great teachers of Anatomy, this 50th anniversary edition of Clinical Anatomy continues to provide thousands of medical students, postgraduate trainees and junior doctors across the world with essential anatomical information within a clinical setting. It is particularly appropriate for those preparing for the Membership of the Royal College of Surgeon's Exam.

For this new edition, Professor Harold Ellis is joined, for the first time, by a co-author. Professor Vishy Mahadevan is Barber's Company Reader in Anatomy at the Royal College of Surgeons, a renowned teacher of surgical trainees and is also an examiner for the MRCS Exam. Together they provide a detailed, easy-to-follow structured text suitable for anatomy students and trainees of all levels.

Fully revised and updated, this new edition features new and re-drawn illustrations, new images of normal anatomy (radiographs, CTs and NMRs) to aid understanding, a revised neuroanatomy section to provide greater clarity and an expansion of the lower limb section.

In order to provide revision support, Clinical Anatomy has its own website featuring digital flashcards of all the images found in the textbook available to download for free at

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: