THE AUTHORS Robert H. Whitaker MD, MChir, FRCS graduated from the University of Cambridge and trained at University College Hospital, London. He spent a year at Johns Hopkins Hospital, Baltimore, in the Urological Research Laboratories before returning to continue his training first at the St Peters Hospital group in London then as a Senior Lecturer in Urology at the London Hospital Medical School. He was appointed as a Consultant Urologist at Addenbrooke's Hospital in Cambridge in 1973 and spent 20 years practising mostly paediatric urology before retiring from clinical practice to join the Department of Anatomy in Cambridge to help with the teaching of students and trainee surgeons. Neil R. Borley MB, BS, FRCS trained at Guy's Hospital, London and after performing house jobs in medicine and surgery there he embarked upon a career in surgery. He undertook a surgical rotation at Addenbrooke's Hospital, Cambridge, before becoming a Demonstrator in the Department of Anatomy in Cambridge under Professor Harold Ellis. He passed the Primary FRCS examination in 1993 for which he received the Hallet Prize and then continued his surgical training at Papworth Hospital and Kent and Canterbury Hospital. After moving to Oxford as Surgical Registrar, he is now Clinical Lecturer in Surgery and Clinical Tutor in the Nuffield Department of Surgery, Oxford. We would welcome and value any reader feedback. Let us know how you think this approach could be improved by emailing us at the following email address: [email protected]. This page intentionally left blank INSTANT ANATOMY This page intentionally left blank Robert H. Whitaker MD, MChir, FRCS Department of Anatomy University of Cambridge Neil R. BorZey MB, BS, FRCS, FRCS (ed) Nuffield Department of Surgery University of Oxford SECOND EDITION Blackwell Science O 2000 by Blackwell Science Ltd a Blackwell Publishing company Editorial offices: Blackwell Science Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK Tel: +44 (0) 1865 776868 Blackwell Publishing Inc., 350 Main Street, Malden, MA 02148-5020, USA Tel: +l 781 388 8250 Blackwell ScienceAsia Pty Ltd, 550 Swanston Street, Carlton, Victoria 3053, Australia Tel: +61 (0)3 8359 1011 The right of the Author to be identified as the Author of this Work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. 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, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the copyright owner. First published 1994 Second edition 2000 Reprinted 2001, 2004, 2005 Library of Congress Cataloging-in-Publication Data Whitaker, R. H. (Robert H.) Instant anatomy1Robert H. Whitaker, Neil R. Bor1ey.-2nd ed. p. cm. ISBN 0-632-05403-4 1. Human anatomy Outlines, syllabi, etc. I. Borley, Neil R. 11. Title. QM31.W55 2000 61 1-dc21 99-39812 CIP ISBN 0-632-05403-4 A catalogue record for this title is available from the British Library Set by Graphicraft Limited, Hong Kong Printed and bound in India using acid-free paper by Replika Press Pvt. Ltd For further information on Blackwell Publishing, visit our website: www.blackwellpublishing.com CONTENTSCONTENTS PrefacePreface tototo second second edition,edition,edition, ix ixix PrefacePreface tototo first firstfirst edition,edition,edition, X Xx NotesNotesNotes on on thethethe text,text,text, xixi xi .....,.-..., .. .__CY___.. ...I...._~...................................................... ..F.._.*-...".....___... (...... mrn 11:1:: Arteries, Arteries,Arteries, 1 11 ....................................................................................................................................................................... 2:2: Veins, Veins,v 47 47 ................................................................................ ............................................................................ 33: : LympLymphatics,Lymphatics, ha tics, 5 59 9 .............................................................................................................................................................................................................................................................................................................................................. 4:4: Autonomic AutonomicAutonomic nervous nervousnervous system, system, 7272.:72 ............................................................................................................................... ....................... 5:J:L Cranial 11nnwnei nerves, ,111,ai 87 .................................................................................................................................................................................................................... " ~ ..................<.....a......................... .,./ .................... mrn... 6:6:6:Peripheral Peripheral nerves,nerves,nerves, 1111 1 1 ....................................................................................................................................................................... 7:7:DermatomesDermatomesDermatomes and andand cutaneouscutaneous nerve nervenerve distribution, distribution,distribution, 143 143143 rn 88: : Muscles,Muscles, Muscles, 15 1511 ............................ _ .......................................... D 9:9:9 Joints, Joints,Joints, 177 177177 U 10: Ossifktion times, 185 m 1l: Foramina-skull and spine, 191 12: Spaces other than skull andspine, 197 13: Position of structures according to vertebral levels, 201 m 14: Pharyngeal derivatives, 203 viii We have been pleasantly surprised at the conventional corona1 view that appears success of this book and most grateful to all in all the textbooks and improved our the students and colleagues who have made understanding of this important area. We constructive criticisms. There were a number may be criticised for giving excessive space of errors of fact, expression and omission in for what might appear to some as less the original text and we very much hope that important aspects of anatomy but we have most of these have been corrected. done this because we are so aware of the We have resisted the temptation of those difficulty that some students have with who suggested that we illustrate each muscle learning these topics or even finding the as such information can be found in other information concisely in larger texts. larger texts and we fear for the loss of the We remain committed to teaching compactness that seems so popular with anatomy to a high standard even if limited in students. We have, however, expanded the the degree of complexity that has now been section on the autonomic system, partic- imposed on us by modern views on core ularly in respect to the head and neck and courses for students and dictated by those abdomen as these remain areas of wonder- who make the rules for surgical trainees. ment in the minds of many students, and We hope that this second edition will we suspect others as well (!) but they are, prove useful and be an inspiration for some of course, important clinically in respect to young surgeons. basic neurological and abdominal exam- ROBERT WHITAKER inations. We have included our favourite NEIL BORLEY lateral view of the cavernous sinus as we Cambridge and Oxford, 2000 believe that it adds considerably to the How many times have you looked up the encountered. The book has been compiled course of an artery or nerve in one of the with this in mind. excellent anatomy textbooks that are It is designed primarily for undergraduate available today only to find that the details medical students and prospective surgeons are spread over several sections of the book who are studying for a higher degree in and that an instant summary is not surgery. For each of these groups we believe available? At times like this you wish there it will be ideal. However, it should also be was a quick reference book with all the extremely useful for all clinicians who need answers neatly catalogued in dictionary to remind themselves of anatomical facts format. at all stages in their careers and for other We have attempted to provide such a professional groups such as nurses, concise text for rapid reference. Of course, physiotherapists and radiographers. we emphasise that this is not a text for Inevitably in a book of this size there has learning anatomy from scratch but one that been some selection of material for inclusion should be used in conjunction with one of and no attempt has been made to provide the fuller texts that has stood the test of details of minutiae that appear in the fuller time. The book is designed for those who texts. already have some working knowledge of The authors' original artwork was anatomy and need to find accurate facts redrawn with a graphics program by Jane quickly. Fallows, medical illustrator, to whom the Both authors have been sufficiently recent authors owe an immense debt of gratitude students of anatomy for higher degrees and for her skill and patience. for teaching undergraduate medical stu- ROBERT WHITAKER dents that each can remember the problems NEIL BORLEY that both students and they themselves Cambridge, 1994 The illustrations show the right side of inferior(1y) the body as viewed from in front, unless internal otherwise indicated. The two exceptions are interphalangeal the cervical and brachial plexuses where it joint(s) makes little