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Anatomy An easy-to-read book written by students for students, edited by senior clinicians and anatomy academics, with contributions from leading anatomists and clinicians. Anatomical facts are correlated with clinical settings, especially medical emergencies, and important points are highlighted with clear learning points. The text is supplemented by diagrams and images, which form an essential part of this book. It covers the students’ learning objectives in undergraduate anatomy curricula and helps in preparing them for practical and written exams. It forms a solid foundation for future clinical exams based on the knowledge of anatomical facts in a clinical setting. Key Features • Presents a concise, accessible guide to regional and clinically applied anatomy, which clearly demonstrates to students the level of knowledge required for medical and healthcare-related curricula • Uses high-quality clinical and intraoperative images integrated into the text to emphasize important topics through bullet points • Features seven logically arranged sections, each devoted to a body region or system, which includes a self-test quiz, with the single best answer and spotter-style questions Anatomy Regional, Surgical, & Applied Edited by Qassim F. Baker, MBChB FRCS (Eng.) Royal College of Surgeons of England United Kingdom Philip J. Adds, BSc MSc FAS FIBMS SFHEA St. George’s University of London London, United Kingdom Cover art: Skeleton drawing by Nigel Rose First edition published 2023 by CRC Press 6000 Broken Sound Parkway NW, Suite 300, Boca Raton, FL 33487-2742 and by CRC Press 4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN CRC Press is an imprint of Taylor & Francis Group, LLC © 2023 selection and editorial matter, Qassim F. Baker and Philip J. Adds; individual chapters, the contributors This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publishers. The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently verified. The reader is strongly urged to consult the relevant national drug formulary and the drug companies’ and device or material manufacturers’ printed instructions, and their websites, before admin- istering or utilizing any of the drugs, devices or materials mentioned in this book. This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including pho- tocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, access www.copyright.com or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. For works that are not available on CCC please contact [email protected] Trademark notice: Product or corporate names may be trademarks or registered trademarks and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging‑in‑Publication Data Names: Baker, Qassim F., editor. | Adds, Philip James, editor. Title: Anatomy : regional, surgical, and applied / edited by Qassim F. Baker, Philip J. Adds. Other titles: Anatomy (Baker) Description: First edition. | Boca Raton, FL : CRC Press, 2023. | Includes bibliographical references and index. | Summary: “An easy-to-read book written by students for students, edited by senior clinicians and anatomy academics, with contributions from leading anatomists and clinicians. Anatomical facts are correlated with clinical settings, especially medical emergencies, and important points are highlighted with clear learning points”-- Provided by publisher. Identifiers: LCCN 2022027069 (print) | LCCN 2022027070 (ebook) | ISBN 9781032321165 (hardback) | ISBN 9781032321141 (paperback) | ISBN 9781003312895 (ebook) Subjects: MESH: Anatomy, Regional | Handbook Classification: LCC QM25 (print) | LCC QM25 (ebook) | NLM QS 39 | DDC 611/.9--dc23/eng/20220830 LC record available at https://lccn.loc.gov/2022027069 LC ebook record available at https://lccn.loc.gov/2022027070 ISBN: 9781032321165 (hbk) ISBN: 9781032321141 (pbk) ISBN: 9781003312895 (ebk) DOI: 10.1201/9781003312895 Typeset in Warnock Pro by KnowledgeWorks Global Ltd. DEDICATIONS To my mother, my first teacher, whom I lost during the preparation of this book, and to my wife, who has supported me all the way. ‑Qassim F. Baker To the students who have inspired me, and to my wife for supporting me. ‑Philip J. Adds v CONTENTS Foreword ...............................................................................................................................................................................................................................vii Preface .................................................................................................................................................................................................................................viii Editors ....................................................................................................................................................................................................................................ix Contributors ..........................................................................................................................................................................................................................x Artists and Technical Support .......................................................................................................................................................................................xii Acknowledgements (Clinicians Who Contributed Images) ...................................................................................................................................xiii List of Abbreviations .........................................................................................................................................................................................................xiv 1A Neuroanatomy: Anatomy of the Brain .......................................................................................................................................................1 Reviewed by Richard Dyball 1B Neuroanatomy: Anatomy of the Spinal Cord ..........................................................................................................................................15 Reviewed by Valentina Gnoni 2 Anatomy of the Head and Neck .................................................................................................................................................................33 Reviewed by Qassim F. Baker, David Sunnucks, and Georga Longhurst 3 Anatomy of the Upper Limb .......................................................................................................................................................................80 Reviewed by Philip J. Adds and Joanna Tomlinson 4 Anatomy of the Thorax ..............................................................................................................................................................................109 Reviewed by Qassim F. Baker and Mohammed Al Janabi 5 Anatomy of the Abdomen .........................................................................................................................................................................149 Reviewed by Qassim F. Baker and David Sunnucks 6 Anatomy of the Pelvis and Perineum .....................................................................................................................................................197 Reviewed by Paul Carter, Qassim F. Baker, and Philip J. Adds 7 Anatomy of the Lower Limb ....................................................................................................................................................................234 Reviewed by Philip J. Adds and Joanna Tomlinson Index ....................................................................................................................................................................................................................................271 vi FOREWORD “Anatomy … teaches us a rational Method of curing Diseases …” The text is heavily informed by medical students at the sharp with these words, John Hunter, widely regarded as the “father of end of their anatomical learning, some of whom have taken an the scientific basis of surgery”, began his anatomy lectures in the intercalated BSc in anatomy, and all of whom have been involved late eighteenth century. Those sentiments have not changed sig- in near-peer anatomy teaching, demonstrating to students of nificantly in the intervening years, although a modern surgeon’s medicine and related healthcare professions. Their experience clinical repertoire includes procedures that Hunter, who worked is therefore very close to that of the intended audience; the tips long before the introduction of anaesthesia, antisepsis, and tech- that helped them grapple with anatomical “tiger territories” will nological advances such as functional MRI and robotic surgery, be welcomed by their readers. The line drawings are by medical could not have anticipated. students, underlining the authors’ intention that this should be Learning anatomy for the first time has always been a daunt- a book “BY students FOR students”, filled with tips, revision and ing task, possibly even more so in today’s overcrowded timetables: spotter questions, clinical images, and labelled photos of cadav- without appropriate guidance, undergraduate medical and den- eric specimens. It deserves to be popular with all students learn- tal students often struggle in a minefield of details while missing ing clinically relevant anatomy. clinically relevant points. This user-friendly book, based on the undergraduate anatomy course taught at St. George’s, University of London, inhabits the middle ground between textbooks that are Susan Standring too basic and those that contain detail that is not required until the Emeritus Professor of Anatomy postgraduate level, and then only for specific groups of trainees. King’s College, London vii PREFACE It all began with a meeting of a small group of students and We were also fortunate to have had the input of clinical col- anatomy staff on 31 May 2017, in Room 1, Jenner Wing, St. leagues from the UK and around the world, who supplied many of George’s, University of London (SGUL). The idea was simple: to the images and gave helpful feedback on the text. Special thanks put together an anatomy handbook containing all the anatomy must go to Prof Stephen Carmichael and Associate Prof Stephanie that was taught to medical and other healthcare science students Woodley for taking the time to review the book and giving valu- at SGUL, together with relevant clinical details. If the idea was able feedback, and to Prof Susan Standring for kindly agreeing to simple, the challenge was anything but: to change the concept write the Foreword. of anatomy from a massive and rather intimidating obstacle to a Many years ago, while a student myself, I remember being told lively, energetic, engaging subject that constitutes a vital part of “there is no such thing as the perfect anatomy book, so you will the medical curriculum and is practically applied within the sur- have to write your own”. It has taken 40 years, but we got there in gical theatres and clinical setting. Who better to advise on this the end. aspect but the students themselves, who are at the sharp end of So, is this the perfect anatomy book? Perhaps not, but we anatomy curriculum, not only learning the subject but also help- believe that it will fill a gap in the literature, and we hope that ing as anatomy demonstrators in the DR, teaching junior students future generations of students will find it lively, interesting, and of medicine, biomedical science, physiotherapy, and paramedic not too daunting! science, among others. Our student collaborators, then, played a Note: In each section, we have provided some exam-style revi- pivotal role in writing this book and became involved in put- sion questions and some self-test quiz questions – some without ting the sections together, digging into references and further answers – to encourage readers to dig deeper and consolidate reading, to enable them to give their best input. As the book pro- their understanding. gressed, the number of student contributors grew, involving writ- ers and artists from SGUL and other universities. Truly, we could not have done it without them. Qassim F. Baker and Philip J. Adds viii EDITORS Qassim F. Baker, MBChB FRCS Philip J. Adds, BSc MSC FAS (Eng.), has been an international FIBMS SFHEA, retired in and UK examiner for the Royal 2021 as Reader in Anatomical College of Surgeons England since Sciences and Head of Anatomy 2015, and before that was an exam- at St. George’s, University of iner and tutor for the Iraqi Medical London. He has had over Specialisation Board (1996–2004). 20 years of experience teach- He was previously a Professor ing anatomy to medical and of Surgery at two universities in other students of healthcare Malaysia (2013–2016); Assistant sciences and has published Professor at the Department of widely, with over 50 peer-reviewed papers, specialising in mus- Surgery, Medical College, University culoskeletal anatomy and the detailed anatomy of the orbit. of Baghdad; and the Head of the Before starting his teaching career, he worked for the Tissue Department of Surgery at two Services arm of the National Blood Service, retrieving tissues teaching hospitals in Iraq between 1990 and 2004. Mr. Baker has including bone, skin, and tendons from donors post-mortem. dedicated his career to teaching and mentoring medical, biomedi- While at Tissue Services, he established the first national cal, and postgraduate students and edited two books in clinical Amniotic Membrane Bank for ocular surface reconstruction surgery. His second book, Clinical Surgery: A Practical Guide, for surgery. He is a Fellow of the Anatomical Society, Fellow of the candidates sitting their FRCS/MRCS exams (London: Hodder/ Institute of Biomedical Science, and Senior Fellow of the Higher Arnold, 2009), received a 4-star review from the Annals of Royal Education Academy. Although retired from full-time teach- College of Surgeons England and Yearbook of ASiT (Association ing, his interests include anatomy and anatomical education. of Surgeons in Training). He frequently talks at grand rounds, He is the UK Editor for the journal Clinical Anatomy and seminars, and conferences in the Middle East on breast cancer, the Editor-in-Chief of the Journal of Plastination. His previ- thyroid surgery, and medical education. He was awarded the ous books are Adds & Shahsavari The Musculoskeletal System “Best Lecturer” at the Educational and Qualifying Course for (London: Informa Healthcare, 2011) and Degueurce Fragonard Teaching and University Staff Training, March 2000, University Museum: The Ecorchés (New York: Blast Books, 2011) (as of Baghdad, Iraq. translator). ix