Clinical Anatomy (eBook)

Applied Anatomy for Students and Junior Doctors

Harold Ellis, Vishy Mahadevan (Autoren)

eBook Download: EPUB

2018 | 14. Auflage
John Wiley & Sons (Verlag)
9781119325512 (ISBN)

Infos

Now in its fourteenth edition, Clinical Anatomy is the definitive text offering medical students, postgraduate trainees and junior doctors the anatomical information they need to succeed in a clinical setting.

Professor Harold Ellis and Professor Vishy Mahadevan provide an accessible, comprehensive, and detailed exploration of anatomy, specifically designed for students and trainees at all levels. Revised and updated, the fourteenth edition contains more information about the nervous system as well as medical images, diagrams and photographs that are overlaid with anatomical illustrations, revealing detailed surface anatomy. This edition: 

• Puts greater emphasis on clinical relevance and contains more content for non-surgical trainees
• Offers a variety of illustrative clinical scenario case studies
• Contains many more medical images and diagrams such as CT and MRI
• Presents expanded information on the nervous system
• Includes a companion website that contains digital flashcards of all the illustrations and photographs presented in the book

Written for medical students, junior doctors, and those studying for The Royal College of Surgeons examinations, the new edition of Clinical Anatomy continues to be an essential resource for understanding the basics of clinical anatomy.

THE AUTHORS

HAROLD ELLIS, Clinical Anatomist, King's College London and Emeritus Professor of Surgery

VISHY MAHADEVAN, Professor of Surgical Anatomy, Royal College of Surgeons of England

Inhalt

Preface to the Fourteenth Edition, xiii

Preface to the First Edition, xv

Acknowledgements to the Fourteenth Edition, xvii

Acknowledgements to the First Edition, xix

About the Companion Website, xx

Part 1: The Thorax

Introduction, 3

Surface anatomy and surface markings, 3

The thoracic cage, 7

The lower respiratory tract, 20

The mediastinum, 30

On the examination of a chest radiograph, 54

Part 2: The Abdomen and Pelvis

Surface anatomy and surface markings, 59

The fasciae and muscles of the abdominal wall, 62

Peritoneal cavity, 70

The gastrointestinal tract, 75

The gastrointestinal adnexae: liver, gall bladder and its ducts,pancreas and spleen, 97

The urinary tract, 110

The male genital organs, 121

The bony and ligamentous pelvis, 129

The muscles of the pelvic floor and perineum, 138

The female genital organs, 142

The posterior abdominal wall, 155

Computed axial tomography, 161

Part 3: The Upper Limb

Surface anatomy and surface markings of the upper limb, 165

The bones and joints of the upper limb, 170

Three important zones of the upper limb: the axilla,the cubital fossa and the carpal tunnel, 189

The arteries of the upper limb, 192

The brachial plexus, 193

The course and distribution of the principal nerves of the upper limb, 197

Compartments of the upper limb, 201

The female breast, 202

The anatomy of upper limb deformities, 206

The spaces of the hand, 210

Part 4: The Lower Limb

Surface anatomy and surface markings of the lower limb, 217

The bones and joints of the lower limb, 227

Three important zones of the lower limb: the femoral triangle,adductor canal and popliteal fossa, 251

The arteries of the lower limb, 258

The veins of the lower limb, 261

The course and distribution of the principal nerves of the lower limb, 264

Compartments of the lower limb, 271

Part 5: The Head and Neck

Surface anatomy of the neck, 277

The thyroid gland, 282

The parathyroid glands, 286

The palate, 288

The tongue and floor of the mouth, 291

The pharynx, 296

The larynx, 303

The salivary glands, 309

The major arteries of the head and neck, 313

The veins of the head and neck, 321

The lymph nodes of the neck, 327

The cervical sympathetic trunk, 329

The branchial system and its derivatives, 330

Surface anatomy and surface markings of the head, 331

The scalp, 333

The skull, 334

The paranasal sinuses (accessory nasal sinuses), 340

The mandible, 344

The vertebral column, 347

Part 6: The Nervous System

Introduction, 357

The brain, 357

The spinal cord, 381

The cranial nerves, 388

The special senses, 406

The autonomic nervous system, 417

Glossary of eponyms, 427

Index, 433

Rezensionen

"Clinical Anatomy makes the perfect compendium to read and recap, as well as to return to revisit one's own learning ... a must-have anatomy book for students of all clinical healthcare professions." - Journal of Perioperative Practice

Textauszug

Part 1
The Thorax

Introduction

The clinical anatomy of the thorax, together with the anatomy of radiological and other imaging techniques of the thorax are in daily use in clinical practice. The routine clinical examination of the patient’s chest is little more than an exercise in relating the deep structures of the thorax to the chest wall. Moreover, several commonly undertaken procedures – chest aspiration, insertion of a chest drain or of a subclavian line, placement of a cardiac pacemaker, for example – have their basis, and their safe performance, in sound anatomical knowledge.

Surface anatomy and surface markings

Much of the working life of an experienced clinician is spent in relating the patient’s surface anatomy to underlying deep structures (Fig. 1; see also Figs 11, 22).

Fig. 1 Lateral view of the thorax – its surface markings and vertebral levels. (Note that the angle of Louis (T4/5) demarcates the lower boundary of the superior mediastinum, the upper margin of the heart and the beginning and end of the aortic arch.)

The following bony prominences can usually be palpated in the living subject (corresponding vertebral levels are given in brackets):

• superior angle of the scapula (T2);
• upper border of the manubrium sterni, the suprasternal notch (T2/3);
• spine of the scapula (T3);
• sternal angle (of Louis) – the transverse ridge at the manubriosternal junction (T4/5);
• inferior angle of the scapula (T8); it also overlies the 7th rib;
• xiphisternal joint (T9);
• lowest part of the costal margin – 10th rib (the subcostal line passes through L3).

Note from Fig. 1 that the manubrium sterni corresponds to the 3rd and 4th thoracic vertebrae and overlies the aortic arch, and that the body of the sternum corresponds to the 5th–8th vertebrae and neatly overlies the heart.

Since the 1st and 12th ribs are difficult to feel, the ribs should be enumerated from the 2nd costal cartilage, which articulates with the sternum at the angle of Louis.

The spinous processes of all the thoracic vertebrae can be palpated in the midline posteriorly, but it should be remembered that the first spinous process that can be felt is that of C7 (the vertebra prominens).

The position of the nipple varies considerably in the female, but in the male it usually overlies the 4th intercostal space approximately 10 cm (4 in) from the midline. The apex beat, which marks the lowest and outermost point at which the cardiac impulse can be palpated, is normally in the 5th intercostal space 9 cm (3.5 in) from the midline and within the midclavicular line. (This corresponds to just below and medial to the nipple in the male, but it is always preferable to use bony rather than soft‐tissue points of reference.)

The trachea is palpable in the suprasternal notch midway between the heads of the two clavicles.

The trachea (Figs 1, 2)

Fig. 2 The surface markings of the lungs and pleura – anterior view.

The trachea commences in the neck at the level of the lower border of the cricoid cartilage (C6) and runs vertically downwards to end below the level of the sternal angle of Louis (T4/5), just to the right of the midline, by dividing to form the right and left main bronchi. In the erect position and in full inspiration the level of bifurcation is at T6.

The pleura (Figs 2, 3)

Fig. 3 The surface markings of the lungs and pleura – posterior view.

The cervical pleura can be marked out on the surface by a curved line drawn from the sternoclavicular joint to the junction of the medial and middle thirds of the clavicle; the apex of the pleura is approximately 2.5 cm (1 in) above the clavicle. This fact is easily explained by the oblique slope of the first rib. It is important because the pleura can be wounded (with consequent pneumothorax) by a stab wound – and this includes the surgeon’s knife and the anaesthetist’s needle – above the clavicle, or, in an attempted subclavian vein catheterization, below the clavicle. The lines of pleural reflexion pass from behind the sternoclavicular joint on each side to meet in the midline at the 2nd costal cartilage (the angle of Louis). The right pleural edge then passes vertically downwards to the 6th costal cartilage and then crosses:

• the 8th rib in the midclavicular line;
• the 10th rib in the midaxillary line;
• the 12th rib at the lateral border of the erector spinae.

On the left side the pleural edge arches laterally at the 4th costal cartilage and descends lateral to the border of the sternum, owing, of course, to its lateral displacement by the heart; apart from this, its relationships are those of the right side.

The pleura actually descends just below the 12th rib margin at its medial extremity – or even below the edge of the 11th rib if the 12th is unusually short; obviously, in this situation, the pleura may be opened accidentally in making a loin incision to expose the kidney, perform an adrenalectomy or drain a subphrenic abscess.

The lungs (Figs 2, 3)

The surface projection of the lung is somewhat less extensive than that of the parietal pleura as outlined previously, and in addition it varies quite considerably with the phase of respiration. The apex of the lung closely follows the line of the cervical pleura and the surface marking of the anterior border of the right lung corresponds to that of the right mediastinal pleura. On the left side, however, the anterior border has a distinct notch (the cardiac notch) that passes behind the 5th and 6th costal cartilages. The lower border of the lung has an excursion of as much as 5–8 cm (2–3 in) in the extremes of respiration, but in the neutral position (midway between inspiration and expiration) it lies along a line which crosses the 6th rib in the midclavicular line, the 8th rib in the midaxillary line and reaches the 10th rib adjacent to the vertebral column posteriorly.

The oblique fissure, which divides the lung into upper and lower lobes, is indicated on the surface by a line drawn obliquely downwards and outwards from 2.5 cm (1 in) lateral to the spine of the 3rd thoracic vertebra along the 5th intercostal space to the 6th costal cartilage approximately 4 cm (1.5 in) from the midline. This can be represented approximately by abducting the shoulder to its full extent; the line of the oblique fissure then corresponds to the position of the medial border of the scapula.

The surface markings of the transverse fissure (separating the middle and upper lobes of the right lung) is a line drawn horizontally along the 4th costal cartilage and meeting the oblique fissure where the latter crosses the 5th rib.

The heart (Fig. 4)

Fig. 4 The surface markings of the heart (see text).

The outline of the heart can be represented on the surface by an irregular quadrangle bounded by the following four points (Fig. 4):

1. the 2nd left costal cartilage 1.25 cm (0.5 in) from the edge of the sternum;
2. the 3rd right costal cartilage 1.25 cm (0.5 in) from the sternal edge;
3. the 6th right costal cartilage 1.25 cm (0.5 in) from the sternum;
4. the 5th left intercostal space 9 cm (3.5 in) from the midline (corresponding to the apex beat).

The left border of the heart (indicated by the curved line joining points 1 and 4) is formed almost entirely by the left ventricle (the auricular appendage of the left atrium peeping around this border superiorly); the lower border (the horizontal line joining points 3 and 4) corresponds to the right ventricle and the apical part of the left ventricle; the right border (marked by the line joining points 2 and 3) is formed by the right atrium (see Fig. 24a).

A good guide to the size and position of your own heart is given by placing your clenched right fist palmar surface inwards immediately inferior to the manubriosternal junction. Note that the heart is approximately the size of the subject’s fist, lies behind the body of the sternum (therefore anterior to thoracic vertebrae 5–8) and bulges over to the left side.

The surface markings of the vessels of the thoracic wall are of importance if these structures are to be avoided when performing aspiration of the chest. The internal thoracic (internal mammary) vessels run vertically downwards behind the costal cartilages 1.25 cm (0.5 in) from the lateral border of the sternum. The intercostal vessels lie immediately below their corresponding ribs (the vein above the artery) so that it is safe to pass a needle immediately above a rib, but hazardous to pass it immediately below (see Fig. 8).

The thoracic cage

The thoracic cage is formed by the vertebral column behind, the ribs and intercostal spaces on either side and the...

Produkt-Details

• Erscheint lt. Verlag: 29.8.2018
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete
• Schlagworte: Allg. Chirurgie • Allgemeine u. Innere Medizin • anatomical illustrations for understanding clinical anatomy • Anatomie • anatomy • clinical scenarios case studies • CT photographs for understanding clinical anatomy • diagrams for understanding clinical anatomy • General & Internal Medicine • general surgery • Guide to Applied Anatomy for Students and Junior Doctors • information on the nervous system • <p>Guide to Clinical Anatomy • medical images for understanding clinical anatomy • Medical Science • Medizin • Resource to Applied Anatomy for Students and Junior Doctors • Resource to Clinical Anatomy • Surface anatomy and surface markings of the upper limb</p> • Text on Clinical Anatomy • Text to Applied Anatomy for Students and Junior Doctors • the clinical anatomy of the abdomen • the clinical anatomy of the pelvis • The clinical anatomy of the thorax • Understanding Applied Anatomy for Students and Junior Doctors • Understanding Clinical Anatomy
• ISBN-13: 9781119325512 / 9781119325512