Instant Anatomy 5th Edition Robert H. Whitaker and Neil R. Borley
How many times have you looked up the course of an artery or nerve in one of the excellent anatomy textbooks that are available today only to ind that the details are spread over several sections of the book and that an instant summary is not available? At times like this you wish there was a quick reference book with all the answers neatly catalogued in dictionary format.
We have attempted to provide such a concise text for rapid reference. Of course, we emphasise that this is not a text for learning anatomy from scratch but one that should be used in conjunction with one of the fuller texts that has stood the test of time. The book is designed for those who already have some working knowledge of anatomy and need to ind accurate facts quickly.
Both authors have been suficiently recent students of anatomy for higher degrees and for teaching undergraduate medical students that each can remember the problems that both students and they themselves encountered. The book has been compiled with this in mind.
It is designed primarily for undergraduate medical students and prospective surgeons who are studying for a higher degree in surgery. For each of these groups we believe it will be ideal. However, it should also be extremely useful for all clinicians who need to remind themselves of anatomical facts at all stages in their careers and for other professional groups such as nurses, physiotherapists and radiographers.
Inevitably in a book of this size there has been some selection of material for inclusion and no attempt has been made to provide details of minutiae that appear in the fuller text.
The authors’ original artwork was redrawn with a graphics program by Jane Fallows, medical illustrator, to whom the authors owe an immense debt of gratitude for her skill and patience.
ARTERIES
Right coronary artery. Originates from the anterior aortic sinus. It passes anteriorly between the pulmonary trunk and the right auricle to reach the atrioventricular sulcus in which it runs down the anterior surface of the right cardiac border and then onto the inferior surface of the
heart. It terminates at the junction of the atrioventricular sulcus and the posterior interventricular groove by anastomosing with the circumflex branch of the left coronary artery and giving off the posterior interventricular (posterior descending) artery. It supplies the right atrium and
part of the left atrium, the sinuatrial node in 60% of cases, the right ventricle, the posterior part of the interventricular septum and the atrioventricular node in 80% of cases.
Left coronary artery. Arises from the left posterior aortic sinus. It passes laterally, posterior to the pulmonary trunk and anterior to the left auricle to reach the atrioventricular groove where it divides into an anterior interventricular (formally left anterior descending) artery and circumflex branches.
VEINS
The cerebrum, cerebellum and bones of the skull are drained by the external, internal and meningeal veins to the sinuses. The sinuses lie between the endosteal and meningeal layers of the dura mater, either as an endothelial lined space in its free edge (inferior sagittal and straight sinuses) or
as a similarly lined space where the dura is reflected over the bone of the inner surface of the skull. They are characteristically thin walled, contain no valves and communicate freely with each other.
Superior sagittal sinus. Lies in the superior margin of the falx cerebri draining the arachnoid granulations as it does so. It commences at the foramen caecum and, posteriorly, usually drains as a continuation into the right transverse sinus. It frequently connects at its termination with the left transverse sinus.
Inferior sagittal sinus. Runs in the inferior free margin of the falx cerebri draining medial cortical veins as it does so, and terminates by fusing with the great cerebral vein of Galen and right and left basal veins to form the straight sinus.
Straight sinus. Runs in the junction of the falx cerebri and tentorium cerebelli for
a short distance before terminating in its continuation—the left transverse sinus.
Transverse (lateral) sinus. Runs in the lateral border of the tentorium cerebelli grooving the occipital and squamous temporal bones to terminate in the sigmoid sinus just as it receives the superior petrosal sinus from the cavernous sinus on each side.
LYMPHATICS
From: Cisterna chyli To: Left subclavian V
Thoracic duct Receives:
• Left jugular trunk
• Left subclavian trunk
• Cisterna chyli
• Most thoracic lymphatics (except right upper thorax)
Drains:
• All body tissue below the diaphragm
• Left arm
• Left head and neck
• Left thorax
• Lower right thorax
It originates from the upper cisterna chyli on the right anterolateral side of the body of T12, lying lateral to the abdominal aorta. It passes posterior to the right crus of the diaphragm and ascends on the right posterior intercostal arteries with the aorta on its left and the azygos vein on its right. It slopes to the left in the mid-thorax crossing the vertebral column posterior to the oesophagus at the level of T5. It continues superiorly to the left of the vertebral column, posterolateral to the oesophagus, posteromedial to the upper mediastinal
pleura and posterior to the initial part of the left subclavian artery. It then passes anterior to the inferior cervical (stellate) ganglion before arching anteriorly over the left vertebral and left subclavian arteries and the dome of the pleura to lie along the medial edge of scalenus anterior before reaching the posterosuperior aspect of the left subclavian vein as the latter joins the left internal jugular vein.
CRANIAL NERVES
OLFACTORY NERVE (I)
From: Olfactory epithelium
To: Olfactory cortex
Contains: Special sense (smell)
The olfactory epithelium lines the superior surface of the superior concha, upper medial nasal septum and inferior surface of the cribriform plate of the ethmoid bone. The fibres of the olfactory cells run in the submucosa to pass through the cribriform
plate of the ethmoid bone where they synapse in the olfactory bulb which lies on its superior surface. The bulb leads posteriorly to the olfactory tract which lies in the anterior cranial fossa on the inferior surface of the frontal lobe and conveys fibres to the anterior olfactory nucleus
(in the posterior aspect of the olfactory bulb), to the prepiriform cortex, anterior perforating substance and septal areas.
OPTIC NERVE (II)
From: Retina
To: Lateral geniculate body
Contains: Special sense (sight)
The ganglion cells of the retina pass fibres out of the globe of the eye via the optic disc to enter the optic N which passes through the orbit within the dural sheath and within the cone of muscles. The nerve passes through the optic canal in the body of the sphenoid bone into the middle cranial fossa where it lies medial to the anterior clinoid process. The ophthalmic artery lies inferior to it in the canal and
runs forwards to pierce the dura around the nerve inferomedially about 1cm behind the eyeball. The nerve continues posteriorly at first lateral to, then superior to, the sella turcica where it forms the optic chiasma. Fibres from both eyes are distributed to each optic tract with medial retinal fibres
(temporal visual fields) crossing to the opposite side. Each tract passes from the posterolateral angle of the chiasma, lying lateral to the pituitary infundibulum, to run lateral to the cerebral peduncle and medial to the uncus of the temporal lobe to reach the lateral geniculate body.
PERIPHERAL NERVES
CERVICAL PLEXUS (C1,2,3,4,5)
From: C1,2,3,4,5 Ns
To: Ns as shown
It arises mostly from the anterior primary rami deep between scalenus medius and scalenus anterior at the level of C1–C4 vertebrae and is covered by prevertebral fascia lying deep to sternocleidomastoid. The cutaneous branches pierce the prevertebral fascia and run into the posterior triangle of the neck where they pierce the investing layer of the deep cervical fascia to terminate in subcutaneous Ns.
Ansa cervicalis (C1–C3). Superior root
(anterior primary rami C1)—passes directly to the hypoglossal N (XII) between rectus capitis anterior and lateralis. It leaves
the hypoglossal N lateral to the occipital artery and runs anterior to the internal and common carotid arteries where it joins the inferior root. Inferior root (anterior primary rami C2,3)—passes laterally around the internal jugular vein having pierced the prevertebral fascia at the level of C2/3. It runs forwards and anteriorly as a long loop to meet with the superior root anterior to the common carotid artery.
Suboccipital N (posterior primary ramus of C1). Emerges through the dura to run beneath the vertebral artery closely applied to the posterior arch of the atlas (C1).
It pierces the posterior atlanto-occipital
membrane between obliquus capitis superior and rectus capitis posterior major to terminate in muscular branches in the suboccipital triangle.
Greater occipital N (posterior primary rami of C2, and a small contribution from C3). Emerges from the posterior spinal dura
at the intervertebral foramen and passes posteriorly over the transverse process
of the axis (C2) below obliquus capitis inferior. It then winds around this muscle to ascend deep to semispinalis piercing it and trapezius near to their insertions into the superior nuchal line. It terminates as cutaneous branches running in the scalp with the occipital artery.
Spinal accessory N (XIs) (lateral roots
C1–C5) is formed from the unique lateral roots of C1–C5 and ascends within the subarachnoid space lateral to the cord
and posterior to the denticulate ligament, to pass through the foramen magnum posterior to the vertebral artery to meet with the cranial root.
Phrenic N (see pp. 124–125).
Great auricular N (C2,3). Supplies skin over parotid gland and angle of jaw (this is the only area of the face that is not supplied by a cranial nerve), lower lateral auricle below external auditory meatus and whole of posterior (medial) auricle.
