112897_S_I_XII_Titelei:_ 06.11.2014 9:05 Uhr Seite 1 Johannes W.Rohen Chihiro Yokochi Elke Lütjen-Drecoll Anatomy: A Photographic Atlas Eighth Edition 112897_S_I_XII_Titelei:_ 06.11.2014 9:05 Uhr Seite 2 Coeditions in 20 Languages 112897_S_I_XII_Titelei:_ 06.11.2014 9:05 Uhr Seite 3 Johannes W.Rohen Chihiro Yokochi Elke Lütjen-Drecoll Anatomy: A Photographic Atlas Eighth Edition with 1209 Figures, 1096 in Color, and 113 Radiographs, CT, and MRI Scans 112897_S_I_XII_Titelei:_ 06.11.2014 9:05 Uhr Seite IV IV Prof. Dr. med. Dr. med. h.c. Johannes W. Rohen Anatomisches Institut II der Universität Erlangen-Nürnberg Universitätsstraße 19, 91054 Erlangen, Germany Chihiro Yokochi, M.D. Professor emeritus, Department of Anatomy Kanagawa Dental College, Yokosuka, Kanagawa, Japan Correspondence to: Prof. Chihiro Yokochi, c/o Igaku-Shoin Ltd., 1-28-23 Hongo, Bunkyo-ku Tokyo 113-8719, Japan Prof. Dr. med. Elke Lütjen-Drecoll Anatomisches Institut II der Universität Erlangen-Nürnberg Universitätsstraße 19, 91054 Erlangen, Germany 8th edition This work is provided “as is,” and the publisher disclaims any and all war- ranties, express or implied, including any warranties as to accuracy, compre- Copyright © 2016 Schattauer GmbH and Wolters Kluwer hensiveness, or currency of the content of this work. Copyright © 2011, 2006, 2002 Schattauer GmbH and Lippincott Williams & This work is no substitute for individual patient assessment based upon Wilkins. Copyright © 1998 F. K. Schattauer Verlagsgesellschaft mbH and healthcare professionals’ examination of each patient and consideration of, Williams & Wilkins. Copyright © 1993, 1988, 1983 F. K. Schattauer Verlags- among other things, age, weight, gender, current or prior medical conditions, gesellschaft mbH and IGAKU-SHOIN Medical Publishers, Inc. medication history, laboratory data and other factors unique to the patient. 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To the maximum extent permitted under applicable law, no responsibility is assumed by the publisher for any injury and/or damage to persons or property, as a matter of Printed in Germany products liability, negligence law or otherwise, or from any reference to or use by any person of this work. Cataloging-in-Publication Data available on request from publisher. ISBN: 978-1-4511-9318-3 LWW.com 112897_S_I_XII_Titelei:_ 06.11.2014 9:05 Uhr Seite V V Preface to the Eighth Edition The knowledge of the structure and topography of the various student can study the systematic anatomy of the involved bones, organs of the human body is a prerequisite not only for the joints, muscles, nerves, and vessels. education of medical students but also for everyone involved in The correlations between clinical images like MRI and CT diagnostic and therapy of human diseases. This knowledge can scans can best be learned if sections of scans can be directly optimally be gained by dissection of the human body, with an compared with cadaveric anatomical sections of the same region. excellent atlas by one’s side. Today there exist a number of good In this edition, a number of MRI scans have been added that anatomic atlases, but most of them contain mainly schematic have been taken in a plane of the related anatomical section. In drawings, which minimally reflect reality. In contrast, the photo- addition, functional MRI scans of the heart and the related graphs of the actual anatomic specimens have the advantage of anatomical preparations are included, hopefully increasing the conveying the reality of the object with its proportions and importance of the atlas for clinical purposes. spatial dimensions in a more accurate manner. While preparing this new edition, the authors were reminded On the other hand, schematic drawings help us to better un- of how precisely, beautifully, and admirably the human body is derstand the photos. Therefore, in this eighth edition, the number constructed. If this book helps the student or physician to appre- of drawings has greatly been increased and old drawings have ciate the overwhelming beauty of the anatomical architecture been replaced by new ones specifically adapted to their accom- of these tissues and organs, then it greatly fulfills its task. Deep panying photos. interest and admiration of these anatomical structures may The didactic purpose of this atlas is not only to help the stu- create the “love for the human being,” which unhesitatingly dent understand the topography of the human body. We also ho- becomes the inspiration to pursue the vocation of medicine. pe to provide a way to systematically learn the anatomical struc- tures and functions. Therefore, the chapters of regional anatomy Erlangen, Germany; Spring 2015 J. W. Rohen are consequently placed behind a systematic description of the C. Yokochi anatomical structures – e.g., before dissecting an extremity, the E. Lütjen-Drecoll Acknowledgments The preparations of the anatomical specimens shown in this cally adapted to the photos in this edition and revised most of atlas were time consuming and required profound knowledge. the old ones. We express our many thanks to him for his most ex- Therefore, all were prepared by anatomists or surgeons. The cellent and time consuming work. majority were prepared by the authors and coworkers either in We are greatly indebted to our coworkers from the Depart- the Department of Anatomy in Erlangen or in the Department of ment of Radiology, especially Prof. M. Uder and his colleagues Anatomy, Kanagawa, Dental College in Tokyo. We would like to (Erlangen) who took the time to perform MRI scans specifically express our great gratitude to Prof. S. Nagashima, Prof. K. Okamoto, adapted to specimens in our atlas and who added scans to the and Dr. M. Takahashi (all Japan) who worked for extended periods heart chapter that significantly improved our ability to elucidate in Germany in the Department of Anatomy in Erlangen, and to the functional aspects of this organ. Also, we extend our thanks Dr. K. Schmidt, Dr. G. Lindner-Funk (both Nuremberg), Dr. M. Rexer to Prof. W. J. Huk and Prof. W. Bautz (both Erlangen), Prof. (Fürth), R.M. Mc Donnell (Dallas, USA), and Mr. J. Bryant (Erlangen) A. Heuck (Munich), and Dr. Wieners (Berlin) for their excellent for dissecting specimens with great skill and knowledge. MRI and CT scans. We are also greatly indebted to Mr. H. Sommer (SOMSO Co., In addition, we express our many thanks to our secretary Mrs. Coburg, Germany) who kindly provided a number of excellent L. Koehler for her untiring and excellent cooperation and to bone specimens. Dr. C. Sims-O’Neil for her careful corrections of the proofs of the All the excellent macro photos of specimens newly included in new edition. this eighth edition, most notably those of the skeletal system Finally, we gratefully acknowledge the head of our publisher and of the heart, were contributed by our photographer Mr. M. (Schattauer Verlag, Stuttgart) Mr. D. Bergemann and his coworkers, Gößwein, to whom we express our great gratitude. particularly Mrs. E. Wallstein, who prepared the final layout of Most important for this new eighth edition was the work of the Atlas and worked intensely together with the authors on the our artist Mr. J. Pekarsky. He created many new drawings specifi- new structure of this edition. 112897_S_I_XII_Titelei:_ 06.11.2014 9:05 Uhr Seite VI VI Preface to the First Edition Today there exist any number of good anatomic atlases. Conse- seen in the photographs. The complicated architecture of the quently, the advent of a new work requires justification. We skull bones, for example, was not presented in a descriptive way, found three main reasons to undertake the publication of such a but rather through a series of figures revealing the mosaic of book. bones by adding one bone to another, so that ultimately the First of all, most of the previous atlases contain mainly composition of skull bones can be more easily understood. schematic or semischematic drawings, which often reflect reality Finally, the authors also considered the present situation in only in a limited way; the third dimension, i.e., the spatial effect, is medical education. On one hand there is a universal lack of lacking.In contrast, the photo of the actual anatomic specimen cadavers in many departments of anatomy, while on the other has the advantage of conveying the reality of the object with its hand there has been a considerable increase in the number of proportions and spatial dimensions in a more exact and realistic students almost everywhere. As a consequence, students do not manner than the “idealized,” colored “nice” drawings of most have access to sufficient illustrative material for their anatomic previous atlases. Furthermore, the photo of the human specimen studies. Of course, photos can never replace the immediate corresponds to the student’s observations and needs in the observation, but we think the use of a macroscopic photo dissection courses. Thus he has the advantage of immediate instead of a painted, mostly idealized picture is more appropriate orientation by photographic specimens while working with the and is an improvement in anatomic study over drawings alone. cadaver. The majority of the specimens depicted in the atlas were pre- Secondly, some of the existing atlases are classified by sys- pared by the authors either in the Dept. of Anatomy in Erlangen, temic rather than regional aspects. As a result, the student needs Germany, or in the Dept. of Anatomy, Kanagawa Dental College, several books each supplying the necessary facts for a certain Yokosuka, Japan. The specimens of the chapter on the neck and region of the body. The present atlas, however, tries to portray those of the spinal cord demonstrating the dorsal branches of macroscopic anatomy with regard to the regional and stratigraphic the spinal nerves were prepared by Dr. K. Schmidt with great skill aspects of the object itself as realistically as possible. Hence it is and enthusiasm. The specimens of the ligaments of the vertebral an immediate help during the dissection courses in the study of column were prepared by Dr. Th. Mokrusch, and a great number medical and dental anatomy. of specimens in the chapter of the upper and lower limb was very Another intention of the authors was to limit the subject to the carefully prepared by Dr. S. Nagashima, Kurume, Japan. essential and to offer it didactically in a way that is self-explana- Once again, our warmest thanks go out to all of our coworkers tory. To all regions of the body we added schematic drawings of for their unselfish, devoted and highly qualified work. the main tributaries of nerves and vessels, of the course and mechanism of the muscles, of the nomenclature of the various Erlangen, Germany; Spring 1983 J. W. Rohen regions, etc. This will enhance the understanding of the details C. Yokochi 112897_S_I_XII_Titelei:_ 06.11.2014 9:05 Uhr Seite VII VII Contents 1 General Anatomy 2 Head and Neck 1 19 2.1 Skull Position of the Inner Organs, Palpable Points, __________________________________ 20 and Regional Lines____________________________ 2 Bones of the Skull ____________________________ 21 Planes and Directions of the Body________________ 4 Disarticulated Skull I __________________________ 24 Osteology __________________________________ 6 Sphenoidal and Occipital Bones ________________ 24 Skeleton of the Human Body __________________ 6 Temporal Bone ____________________________ 26 Bone Structure ____________________________ 8 Frontal Bone ______________________________ 28 Ossification of the Bones______________________ 9 Calvaria ____________________________________ 29 Arthrology __________________________________ 10 Base of the Skull ______________________________ 30 Types of Joints ____________________________ 10 Skull of the Newborn__________________________ 35 Architecture of the Joint ______________________ 12 Median Sections through the Skull ______________ 36 Myology ____________________________________ 13 Disarticulated Skull II __________________________ 38 Shapes of Muscles __________________________ 13 Ethmoidal Bone ____________________________ 38 Structure of the Muscular System________________ 14 Ethmoidal and Palatine Bones__________________ 39 Comparative Imaging of Skeletal Palatine Bone and Maxilla ____________________ 40 and Muscular Structures in MRI and X-Ray ________ 15 Sphenoidal, Ethmoidal, and Palatine Bones________ 43 Organization of the Circulatory System __________ 16 Maxilla, Zygomatic Bone, and Bony Palate ________ 45 Organization of the Lymphatic System____________ 17 Pterygopalatine Fossa and Orbit ________________ 46 Organization of the Nervous System ______________ 18 Orbit, and Nasal and Lacrimal Bones ____________ 47 Bones of the Nasal Cavity ______________________ 48 Septum and Cartilages of the Nose ______________ 49 Maxilla and Mandible with Teeth ________________ 50 Deciduous and Permanent Teeth ________________ 51 Mandible and Dental Arch______________________ 52 2.2 Masticatory Apparatus and Muscles of the Head __________________ 53 Temporomandibular Joint ______________________ 54 Ligaments of the Temporomandibular Joint________ 55 Temporomandibular Joint and Masticatory Muscles__ 56 Facial Muscles ________________________________ 60 Supra- and Infrahyoid Muscles __________________ 62 Section through the Cavities of the Head__________ 64 Maxillary Artery ______________________________ 65 112897_S_I_XII_Titelei:_ 06.11.2014 9:05 Uhr Seite VIII VIII Contents 2 Head and Neck 2.3 Brain and Regions of the Head ______ 66 Visual Apparatus ______________________________ 134 Orbit ____________________________________ 134 Brain and Cranial Nerves ______________________ 67 Lacrimal Apparatus and Lids __________________ 135 Trochlear (N. IV), Facial (N. VII), Extra-ocular Muscles ________________________ 136 Vestibulocochlear (N. VIII), Glossopharyngeal (N. IX), Layers of the Orbit __________________________ 138 Vagus (N. X), Accessory (N. XI), Eye Accommodation ________________________ 140 and Hypoglossal (N. XII) Nerves ________________ 69 Macula and Vessels of the Eye__________________ 141 Trigeminal Nerve (N. V) ________________________ 70 Visual Pathway and Areas ____________________ 142 Facial Nerve (N. VII)__________________________ 72 Connection with the Brain Stem ________________ 73 Optic (N. II), Oculomotor (N. III), Trochlear (N. IV), 2.5 Nasal and Oral Cavities ______________ 145 Ophthalmic (N. V ), and Abducent (N. VI) Nerves ____ 74 1 Base of the Skull with Cranial Nerves ____________ 76 Nasal Cavity ________________________________ 146 Regions of the Head __________________________ 78 Paranasal Sinuses __________________________ 146 Lateral Region ______________________________ 78 Nerves and Arteries__________________________ 148 Retromandibular Region______________________ 82 Sections through the Nasal and Oral Cavities ______ 150 Para- and Retropharyngeal Regions______________ 85 Oral Cavity __________________________________ 152 Hyoid Bone and Muscles ______________________ 152 Submandibular Triangle ______________________ 154 2.4 Brain and Sensory Organs ____________ 86 Salivary Glands ____________________________ 155 Scalp and Meninges____________________________ 87 Meninges ____________________________________ 88 2.6 Neck and Organs of the Neck ________ 156 Dura Mater and Dural Venous Sinuses ____________ 88 Dura Mater ________________________________ 90 Median Sections through the Head and Neck ______ 157 Pia Mater and Arachnoid ______________________ 91 Muscles of the Neck __________________________ 158 Brain ________________________________________ 92 Larynx ______________________________________ 160 Median Sections____________________________ 92 Cartilages and Hyoid Bone ____________________ 160 Arteries and Veins __________________________ 94 Muscles __________________________________ 162 Arteries __________________________________ 95 Vocal Folds ________________________________ 163 Arteries and the Arterial Circle of Willis __________ 100 Nerves ____________________________________ 164 Cerebrum ________________________________ 101 Larynx and Oral Cavity__________________________ 165 Cerebellum ________________________________ 104 Pharynx ____________________________________ 166 Dissections ________________________________ 106 Muscles __________________________________ 168 Limbic System ______________________________ 109 Vessels of the Head and Neck __________________ 170 Hypothalamus______________________________ 110 Arteries __________________________________ 170 Subcortical Nuclei __________________________ 111 Arteries and Veins __________________________ 172 Ventricular System __________________________ 114 Veins ____________________________________ 173 Brain Stem________________________________ 116 Lymph Vessels and Nodes______________________ 174 Coronal and Cross Sections ____________________ 118 Regions of the Neck ____________________________ 176 Horizontal Sections __________________________ 120 Anterior Region ____________________________ 176 Auditory and Vestibular Apparatus ______________ 124 Lateral Region ______________________________ 180 Temporal Bone ____________________________ 127 Middle Ear ________________________________ 128 Auditory Ossicles ____________________________ 130 Internal Ear ________________________________ 131 Auditory Pathway and Areas __________________ 133