HUMAN ANATOMY: A Prosection Guide

3rd Edition

Frank J. Daly Cover image

www.kendallhunt.com Send all inquiries to: 4050 Westmark Drive Dubuque, IA 52004-1840

Copyright © 2010 by Frank J. Daly.

ISBN 978-0-7575-

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the copyright owner.

Printed in the United States of America 10 9 8 7 6 5 4 3 2 1 iii

GROSS ANATOMY LABORATORY PROCEDURES

1. Appropriate laboratory attire is required: Scrubs (full-length, scrub pants), close-toed shoes (no Crocs), safety glasses, and Nitrile gloves.

Scrubs are available in the campus bookstore (no specific color required). NO shorts or skirts permitted, even if made from scrub material. Safety glasses for splash protection are available in the lab. Gloves will be provided; please try to limit use to ~ 1 pair/session. Long hair must be tied back, away from the face. Long necklaces should be removed. Contact Lenses are NOT advised, as they are permeable to volatile compounds and may result in injury. Students should bring their lab manual to lab sessions.

2. No food or beverages are allowed in the laboratory - EVER.

Smoking and/or chewing gum is prohibited in the laboratory.

3. No cadaveric materials (or models) are EVER to be removed from the Gross Anatomy lab.

This is a State and a Federal law. You WILL be prosecuted to the fullest extent of the law.

Models, prepared specimens, etc., are available during scheduled class and open lab times. Any student who damages a model will be held financially responsible. Model keys are found in the 3-ring notebooks and at http://faculty.une.edu/cas/fdaly.

4. No gloves should be worn outside of the lab or while a student is handling models or real bone.

This also pertains to x-ray lightboxes, LCD screens, and blackboards. The reason that you wear gloves is to protect yourself. Handling “clean” material with dirty gloves negates the safety of using gloves.

5. Keep the floor free from material that might fall from the dissection tables.

The embalming fluid is VERY slippery. To avoid falling hazards, please clean slippery spots immediately. (Don’t wait to be asked!) Spray Simple Green on the greasy spot AND wipe until dry; just spraying is NOT enough. iv

6. Please keep all material (skin, organs, limbs, etc.) at the table with the rightful “owner.”

This is to ensure that when the cadavers have finished their role at the University, they will be returned in full to the surviving family members.

7. Keep the cadaveric tissue moistened with the wetting solution provided (Infutrace).

Infutrase minimizes the vaporization of the phenolic compounds in the embalming solution. Help maintain the dissections by making sure that the body bags are closed.

8. There are no “clean sinks” in the lab.

The sinks in the lab are used to wash tools and trays, as well as hands. Wash your hands prior to leaving the lab AND again after changing in the locker room.

9. Pregnant or nursing women are STRONGLY discouraged from participating in the laboratory.

There is evidence that indicates women exposed to phenolic solvents during pregnancy have increased incidence of children born with congenital birth defects. Those interested in laboratory alternatives will be accommodated.

10. Report all injuries sustained in laboratory to an instructor/teaching assistant.

You will be required to fill out an injury report form. Forms are located in the wall hangers near sinks in lab. v

TREATMENT OF CADAVERA

1. Confidentiality of the identity of all bodies must be assured, including anonymous donation, for student usage.

2. Matriculating students are authorized to utilize human bodies for anatomical courses of medicine, dentistry, or allied health sciences at institutions authorized by State statutes. This use is subject to the rules and regulations prescribed by the Anatomical Board, and the Board may allow such people access to the location where bodies are utilized for anatomical study without further specific approval. Faculty members, residents, medical students, and appropriate non-faculty medical, dental, or nursing practitioners not enrolled in a course at an institution for study may also utilize the cadavera, if given permission by the responsible person designated by that institution. The study must be carried out in the approved areas given this purpose within that institution, as described below.

3. A body or bodies must be utilized in specific locations approved by the Anatomical Board. Such locations are to be construed as restricted areas and must be designed to ensure the proper security of the body, prevent unauthorized access or usage, contain facilities required for the proper manner of scientific usage, and remain in a securely locked condition when not in immediate use. Places for body storage, such as departmental morgues, are to be construed as restricted areas. Access is to be limited to the faculty and appropriate staff of that responsible person designated by that institution for admission to this restricted area. Only applications giving legitimate reasons for access will be approved.

4. Photographs of a body or any of its parts are not to be made for any reason without the express CONSENT of the Anatomical Board or the responsible person designated by the institution. The Board retains the right to edit, with respect to propriety, all photographs utilizing gross anatomical human material intended for publication, and the Board must be notified of intention to publish such material.

5. The Anatomical Board emphasizes the importance of maintaining the continuing good will of the public. Students who will utilize bodies for anatomical study are to be thoroughly instructed on the proper manner of professional conduct. No action is to be made, public or private, that in any way will demean the human body. Conversational improprieties and any other manner of unprofessional or unethical conduct are strictly prohibited. The need for genuine and sincere respect for the dignity of the deceased human body and the obligation to treat the body in a responsible and professional manner are to be regarded as essential. While authorized students or others approved by the Board or by the responsible person of an institution have access to locations for body usage, SUCH INDIVIDUALS DO NOT HAVE THE AUTHORITY IN TURN TO GRANT ADMISSION OR VISITATION PRIVILEGES FOR GUESTS NOT APPROVED BY THE RESPONSIBLE PERSON DESIGNATED BY THE INSTITUTION. Only persons having legitimate purpose shall be granted admission or the privilege of usage. All guests granted admission to location for anatomical study must comply with the professional standards outlined herein.

*** Students with hypersensitivities to formaldehyde: be aware that respiratory masks are available at Student Health. *** Respirators issued by the University MUST have a written physician’s approval for use. Disposable respirators may also be found at www.homedepot.com or www.lowes.com. vi

REFERENCES

Ayers DM (1972) Bioscientific Terminology: Words from Latin and Greek Stems, University of Arizona Press

Borror DJ (1971) Dictionary of Word Roots and Combining Forms, Mayfield Publishing, Palo Alto

Donath T (1969) Anatomical Dictionary with Nomenclatures and Explanatory Notes, Pergamon Press, Oxford, UK

Drake RL, Vogl W, Mitchell AWM (2005) Gray’s Anatomy for Students (1st ed.) Elsevier

Field EJ, Harrison RJ (1968) Anatomical Terms: Their Origin and Derivations (3rd ed.), Heffer, Cambridge, UK

Grine FE (2005) Regional Human Anatomy (2nd ed.) McGraw Hill, New York.

Mayhew TM (2001) Anatomical Terms and What They Mean, Nottingham University Press, UK

Meta LA, Natrajan M, Kothari ML (1996) Understanding anatomical terms, Clin Anatomy 9:330-6

Moore KL, Agur AM (2002) Essential Clinical Anatomy (2nd ed.) Lippincott Williams & Wilkins, Baltimore

Moore KL, Dalley AF (1999) Clinically Oriented Anatomy (4th ed.) Lippincott Williams & Wilkins, Baltimore

Netter FH (2003) Atlas of Human Anatomy (3rd ed.) Icon Learning Systems

Peterson D (1999) Gross Anatomy Lab Manual, University of New England, unpublished

Pugh (2000) Stedman's Medical Dictionary (27th ed.), Lippencott, Williams & Wilkins, Baltimore

Skinner HA (1961) The Origin of Medical Terms (2nd ed.) Williams & Wilkins, Baltimore

Wilheim (2007) Quick guide to the language of science and medicine, Mosby / Elsevier

Williams PL (1999) Gray’s Anatomy (38th ed.) Churchill Livingstone, UK http://www.archives.nd.edu/cgi-bin/words.exe http://www.biology,ualberta.ca/courses.hp/zool250/Roots WORD BANK AND DEFINITIONS arbor tree, tree structure with branches, gallows arch(ae/i)- ancient a- / an- without, from, after areola little space or area, courtyard, garden plot ab- / abduc- / abduct / abducens away from, lead, take or carry away, detach arthro- joint acetabulum small (vinegar) cup, ~2 oz asper- rough acro- summit, top, promontory ast(e)r- star acromion highest point (acro-) of shoulder (omos) Atlas Greek Titan forced to hold the world on his ad- / adduct to, towards, near shoulders adenoid resembles a gland atr- / atrium vestibule, entrance hall, reception hall af- / afferent moving towards center, inflowing aus- / aur- ear, gold al / ala / ali wing auscultate to listen to something alb- / albugo- / albicans opaque white, whitish tinge, pale, pearl axi- / axon axis, axle, pole alveolus basin, serving bowl, hollow sac, cavity azyg- unpaired, single amphi- both sides, double basi- at the bottom ampulla flask, jug, or bottle for holding liquids bi- two, double amygdala almond-shaped, almond-like biceps two heads ana- up, back, again bifid cleft in two parts anacephaly no brain (head) blast- germ layer anastomosis to supply or to connect with a mouth brachi- / brachium anconeus clamp, bracket, armrest bregma "front part of head" angi- vessel / choke, throttle, strangle brevi- / brevis short angul- angle, apex, corner, nook bronch- air passage, windpipe annu - / anus/ annular 1 year, annual, ring, circlet bucca- / buccal mouth cavity, cheek ansa handle, loop, end of a rope buccinator trumpeter ante- before, in front of, first (in time, place or orde bulbo / bulbus plant bulb or garlic-like anterograde away from cell body bursa pouch or purse anti- prevent, against, opposite, resisting calc- / calcaneus stone / heel / calcium / limestone antrum cave, cavity, hollow without bony walls calyx / calyces chalice, cup of a flower appendix that which hangs on, supplement, appendage -campus level field, open space for games, sea aqueduct conduit, canal, water (aqua) leading (ductus) canaliculus little canal pipe cap- / capit / cipit / capitate head, that which has a head capill- / capillary fine hair

arach- / arachnoid spider, resembles a spiderweb, cobweb vii card- / cord- heart carina keel of boat condyl- / condyle knuckle viii carotid produces stupor, refers to sleep contra- / contralateral opposite, against carpus wrist coracoid / coranoid resembles a crow's beak cauda / caudal tail cornu horn cauda equina horse's tail coronal / coronary refers to a crown, left / right direction cav- / cava hollow corp- / corpus body cecum blind cortico- pertains to the cortex celiac beer, belly cost- / costal rib, refers to rib ceph- / cephal head, brain cox- / coccyx hip / cuckoo cerebellum little cerebrum crani- skull cerebro- / cerebrum brain cremaster suspender, hanger cerv- / cervical cribri- / cribiform sieve, form of a sieve chiasm crossing cric- / cricoid ring, resembles a ring chondr- / condro- cartilage crist- crest chord cord, rope crista galli crest of a rooster chorda tympani cord of the tympanum cru- / crus / crural leg, shank choroid membrane, dance cruci- cross-like chyle bile cubit / cubital elbow cili- eyelash cune - / cuneiform wedge, form of a wedge circum- around cusp point cistern reservoir cycl- circular clav- / cleid- / clavus key cyst- bladder clinoid resembles a 4 post bed dartos flayed clivus slope decuss- / decussate cross banding, link unlike structures co- / con- / collat- with, together, borne together deferens carrying (fero) away (de) cochl- / cochlos snail deltoid resembles the letter delta, a triangle (Δ) coel- hole dendr- / dendrite tree, branched coll- / colli neck / of the neck dens / dent- / odont- tooth colliculus hillock, mound, small hill derm- skin colon large intestine di- two com- / con- with dia- across, through commis- / commissure sent out, link like structures diaphragm a wall across or dividing something concha shell digastric two bellies digit / digitorum finger / of the fingers gastr- / gaster / gastric stomach, pouch, refers to stomach distal furthest from center of body or origin gemin- twin dors- / dorsal back, refers to the back genu- knee, joint duct- / duction lead, leading glans acorn duodenum twelve fingerbreadths glen- / glenoid socket, resembles a socket, pupil, or honey- dur- / dura hard or tough comb ecto- / extra- outside, outside of glia- glue ef- / effer- / efferent carry away / refers to leaving the center of an glo- / gloss- / glott- tongue object gluteal refers to ejacul- throw out gonad seed emissary sending out gracil- slender endo- inside, within gubernaculum governor endothelium beneath the cell layer gyrus / gyri circle, rounded elevation enter- intestine hallu- / hallux / halluci- great toe epi- upon, on top of hamat- / hamulus hook, little hook epididymis upon the testicle, upon the twin haustrum machine for drawing up water from a well epithelium upon the cell layer helix coil equi- horse, equal hemi- half ethmoid resembles a sieve hepat- / hepatic liver, refers to liver ex- / exo- out of, away from, outside hiatus aperture, opening, or yawning falc- / falx sickle-shaped structure hilium small bit or trifle fasc- / fascic / fascia bundle, ribbon or strip hippo- horse fibula clasp or pin hippocampus horse track, seahorse fimbria fringe hister- uterus flav - / flavum yellow, golden horizontal resembles where earth meets sky, side to side flexion bending direction flocculus lock of wool hormo- that which excites foramen / foramina opening hydro water fornix vault or arch hydrocephalus water on brain (head) fossa shallow depression, ditch, trench, hyo- / hyoid u-shaped, resembles the letter U fovea shallow round depression, pit, hole hyper- above, over fund- / fundus to pour / foundation, bottom, open area hypo- beneath, under, below gangl- / ganglion knot, swelling ileum twisted ix incus anvil lumbrical earthworm x infra- under, beneath luna- / lunate / lunar moon, moon-like, moon shaped infundibulum funnel lute- yellow inguinal refers to the lymph clear water, spring water innominate not named (hip bone) macula spot inter- between magni- large intra- within maj- / major greater ipsi- same side malleus hammer, mallet iris rainbow mamm- / mast- / mastoid breast, resembles a breast -issimus most, to the extreme mandib- lower jaw jejunum empty, barren, hungry, fasting, unproductive manu hand jugular refers to throat masseter chewer kerat- cornea matri- / mater mother kinesis movement maxi- / maxim large, greatest kyphosis bent, hunchback maxill- jaw labi- lips meatus passage, channel, canal labyrinth maze medi- medium lacer- / lacerum torn medull- marrow, center most part, quintessence lacrim- / lacrimal tears, refers to tears melan / melanin black, dark lact- milk mening- / meninx membrane lacuna- / lacunar space, hollow or lake meniscus crescent lamboid resembles a lambda (λ) mentum chin lamina / lamella- leaf, layer mes- / meso- middle lati- wide, broad, spacious meta- after, beyond latissimus most lateral, lateral to the extreme min - / minor smaller lens bean, lentil minim- smallest levator lifter mitral refers to a bishop's hat (mitre) lig- tie, bind motor mover lin- line multi- many ling- / lingua / lingula tongue / little tongue myo- muscle lith- / lithoid stone, resembles a stone, rock nari- / narls- nostril, nose longissimus longest, long to the extreme neo- new lordosis backward bending nephr- / nephros kidney nerve bundled fascicles outside central nervous system parotid beside the ear neur- nerve pars part nigr- black parvi- / parvo- little node knot pectus / pectoris chest nuch- / nuchal back of neck ped- / pes / pod- / peduncle foot / little foot nucle- / nucleus little nut pellucid- shining through obturat- / obturator closed, that which is closed or occluded peri- around, surrounding occip- back of head periostium around (peri) the bone (osteon) occulta hidden pes anserinus goose foot ocul- / opti- / ophthalmo- eye petr- / petrous rock, hard -oid like, resembles , in the shape of phalanx / phalanges close formation of solidiers olecranon skull (cranion) of the ulna (olene) -phragm partition, fence olfact smell phren- / phrenic diaphragm, mind oligo- few, scanty -physis growth oment- / omentum fatty covering , fatty entrails, bowels, pia tender omo- shoulder pinea- / pineal pine cone from shoulder (omo-) to hyoid bone pinna / pinnat- feather opponens opposing pisum / pisi- / pisiform pea, form of a pea or- / os- / osti- mouth platy- / platysma flat orbi- circle pleura side of body orchid- testis plex- / plexus interwoven, braid, plait -orum belonging to, property of plica fold, double up os coxae bone of the hip pneumo- / pneumon- air, lung oseoph- / esoph- gullet pollex thumb oss- / osteo- bone pons bridge ot- / otic ear popliteal refers to the hollow of the knee palate / patella plate, small plate post- behind, after, subordinate to pallid pale pre- / pro- before, in front of, forward, first, promoting pampiniform form of a tendril profund- / profunda deep pancreas all flesh pronate to bend forward papilla little nipple proprioceptive to take one's own, sensory info from muscles, para- adjacent, beside, near / two like parts, pair tendons parietal refers to a wall prostrate lie flat xi proximal nearest to center of body or origin scler- hard xii psoas loin sella turcica Turkish saddle pter- / pterion / pterygoid wing, resembles a wing semi- half ptosis falling septum partition pubi- sexually mature serrat- / serratus jagged edged, saw toothed, notched pudendal shamed sesamoid resembles a herb seed pulmo- lung sigm- / sigmoid resembles the letter S or sigma (Σ) pyrus- / pyri- / piriform form of a pear sin- / sinus cavity, recess, hollow, bay quadri- / quarter / tetr- four sipho- tube or trumpet quadriceps four heads soma / -some body radius wheel spoke sphen- / sphenoid wedge, resembles a wedge ramus branch sphinct- closing, band raph seam splenius bandage re- back again squam- / squamous fish scale, flat rect- / rectus / rectum straight stapes stirrup ren- / renal kidney, refers to kidney stell- / stellate star ret- / rete / retina net, network, little net stern- / sternum breastbone, chest retro- behind, after, backward styl- / styloid column, pen, peg, resembles olumn, pen or retrograde back towards cell body peg rhin- / rhino- nose, snout sub- below, under, beneath rhombus / rhomboid diamond shaped, resembles a diamond sulc- / sulcus furrow or ditch risorius from risor, to laugh or smile super- / supra- beyond, above, over, excessive rostr- / rostral beak, prow supin- / supinate to lie back, bend backwards rota- turn, rotate, revolve, turn around syn- / synapse joined together, with rubr- / rubro red synovial joined with (syn-) an egg (ovum) saccul- little bag, purse, sachet tactile relating to touch sacr- / sacrum holey, holy, sacred, consecrated taenia / tenia ribbon, band sagittal resembles an arrow, anteroposterior talus / tarsus ankle salpinx / salpingo- tube or trumpet tect- / tectum covered, roof, roof-like covering, ceiling saphenous visible tegmentum skin, body armor, covering, clothing sartorius tailor tele- fra, end scala / scalene ladder, staircase, uneven, unequal length tenacul- holding scap- / scaph- / scaphoid hollow, bowl, ship, resembles a boat or skiff tentor- spreading like a tent teres round, smooth ventr- / ventral belly, anterior thalam- inner chamber, bedchamber, marriage cham- verm- / vermiform worm, form of a worm ber vesi- / vessic- bladder, blister -thele / -thelium cell layer vincula chains thenar palm of hand, base of thumb visc- / viscera organs of body cavity thyreo- / thryroid resembles a shield vita life tibia flute vitr- / vitreous glass, glassy trab- / trabecula beam, supporting beam vomer ploughshare trachy / trachea rough xiphi / xyphoid sword, resembles a sword tract drawing out, enlongated path of central nerv- zyg- / zygos / zygote yoke, something that is yoked or joined ous system trago- / tragus goat trans- across, through trapez- / / trapezoid four sided table trema- hole tri- / ter- / terti- three, triple triceps / triquetrum three heads / three corners trigeminal three twins trochanter runner trochlea pulley, block and tackle tuber swelling outgrowth tunica covering tympan- / tympanum drum ulna / ole- elbow umbilic- / omphalos navel, belly button unc- / uncus hook uv- / uvela / uvula grapes, little grape vagina sheath vagus wandering valgus knock knee, converging at knee varus bowlegged vas- vessel velum veil xiii

xv

TABLE OF CONTENTS

GROSS ANATOMY LABORATORY PROCEDURES...... iii TREATMENT OF CADAVERA ...... v WORD BANK AND DEFINITIONS ...... vii INTRODUCTION ...... 1 Anatomical Terms...... 1 NERVOUS/VASCULAR/SKELETAL SYSTEMS...... 5 Nervous System ...... 5 Vascular System ...... 6 Skeletal System ...... 6 DELTOID/PECTORAL ...... 13 Superficial Back ...... 13 Acromioclavicular Joint ...... 14 Pectoral Region...... 15 Sternoclavicular Joint ...... 16 Breast and Lymphatic Tissue ...... 16 Deltoid Region...... 17 Glenohumeral Joint ...... 18 AXILLA AND BRACHIAL REGION ...... 21 ...... 21 Brachial Region ...... 22 Vasculature1 ...... 23 ANTEBRACHIUM, HAND, AND JOINTS...... 27 Elbow Joint ...... 27 Radioulnar Joints ...... 28 Wrist Joint ...... 28 Anterior Antebrachium...... 29 Posterior Antebrachium ...... 31 Muscles of the Hand ...... 33 UPPER EXTREMITY REVIEW ...... 35 Shoulder ...... 35 Brachium ...... 35 Antebrachium...... 36 Hand ...... 36 BACK ...... 39 Deep Back ...... 41 Sub-Occipital Triangle ...... 42 Vertebral Column...... 43 Spinal Cord ...... 44 GLUTEAL ...... 47 Gluteal ...... 47 Lumbrosacral Plexus 1 – Posterior ...... 48 Hip Joint ...... 49 Sacroiliac Joint ...... 49 THIGH ...... 53 Medial Thigh ...... 53 Posterior Thigh...... 54 Anterior Thigh ...... 54 xvi

KNEE & LEG & FOOT ...... 59 ...... 59 Knee Joint ...... 59 Ankle Joint ...... 60 Leg ...... 61 Foot ...... 63 LOWER EXTREMITY REVIEW...... 65 Back ...... 65 Gluteal ...... 65 Thigh ...... 65 Leg ...... 66 Foot ...... 66 BRAIN/SKULL ...... 69 Cerebral Cortex ...... 69 Diencephalon ...... 70 Brainstem ...... 70 Cerebellum...... 70 Limbic Structures ...... 71 Cerebral Blood Supply ...... 72 Meninges ...... 72 Cerebrospinal Fluid ...... 73 SKULL 1 – EXTERNAL SKULL (Closed Skulls)...... 74 NECK ...... 79 Superficial Neck ...... 79 Root of the Neck ...... 80 Neck Triangles ...... 81 Deep (Pre-Verebral) Neck...... 83 Sub-Occipital Triangle ...... 84 EAR, NOSE, THROAT ...... 87 Ear ...... 87 Larynx and Trachea ...... 88 Pharynx and the Esophagus ...... 89 SKULL 2 – ANTERIOR/MIDDLE/POSTERIOR CRANIAL FOSSA (Open Skulls)...... 90 Cranial Nerves ...... 92 FACE/MASTICATION/EYE ...... 97 Facial Nerves ...... 97 Nerves ...... 97 Scalp...... 98 Mastication ...... 99 Temporomandibular Joint ...... 99 Cranial Nerves ...... 100 Eye ...... 101 SKULL 3 – ANTERIOR/MIDDLE/POSTERIOR CRANIAL FOSSA ...... 103 ...... 107 Thoracic Wall...... 107 Breast and Lymphatic Tissue ...... 108 Lungs & Pleurae...... 109 Diaphragm ...... 109 Mediastinum ...... 110 Heart ...... 111 xvii

ABDOMEN I ...... 115 Anterior Abdominal Wall ...... 115 Posterior Abdominal Wall...... 116 Abdominal Blood ...... 117 Hepatic Portal System ...... 117 Nerves of the Abdominal Cavity...... 118 Urinary System...... 119 Suprarenal Glands ...... 119 Peritoneal Cavity...... 119 II ...... 123 Gastrointestinal Tract 1 ...... 123 Esophagus ...... 123 Stomach ...... 123 Small Intestine: Duodenum ...... 123 Gastrointestinal Tract 2 ...... 124 Small Intestine: Duodenum, Jejunum, Ileum...... 124 Cecum/Vermiform Appendix ...... 125 Large Intestine: Ascending, Transverse, Descending, Sigmoid Colon ...... 125 Accessory Digestive Organs ...... 125 Liver...... 125 Gallbladder ...... 126 Pancreas ...... 126 Spleen ...... 126 ...... 129 Pelvic Cavity ...... 129 Pelvic Diaphragm...... 129 Perineal Muscles...... 130 Female ...... 130 Female Pelvis ...... 131 Male Pelvis...... 132 Male Perineum...... 132