Atlas of Anatomy (eBook)

Anne M Gilroy, Brian R MacPherson, Jamie Wikenheiser, Michael Schuenke, Erik Schulte, Udo Schumacher (Autoren)

eBook Download: EPUB

2020 | 4. Auflage
778 Seiten
Georg Thieme Verlag KG
978-1-63853-695-6 (ISBN)

Infos

<p><strong><em>Quintessential Atlas of Anatomy expands on widely acclaimed prior editions!</em></strong></p> <p><cite>Atlas of Anatomy, Fourth Edition</cite> builds on its longstanding reputation of being the highest quality anatomy atlas published to date. With more than 2,000 exquisitely detailed illustrations, including over 120 new to this edition, the Atlas helps students and seasoned clinicians master the details of human anatomy.</p> <p><strong>Key Features:</strong></p> <ul> <li>NEW! Expanded Radiology sections include over 40 new radiographs, CTs, and MRIs</li> <li>NEW! A more dissectional approach to the head and neck region places neck anatomy before that of the head – the way most students dissect</li> <li>NEW! Additional images and tables detail the challenging anatomy of the peritoneal cavity, inguinal region, and infratemporal and pterygopalatine fossae</li> <li>NEW! Almost 30 new clinical boxes focus on function, pathology, diagnostic techniques, anatomic variation, and more</li> <li>NEW! More comprehensive coverage clarifies the complexities of the ANS, including revised wiring schematics</li> <li>Also included in this new edition:</li> <ul> <li>Muscle Fact spreads provide origin, insertion, innervation, and action</li> <li>An innovative, user-friendly format: every topic covered in two side-by-side pages</li> <li>Online images with 'labels-on and labels-off' capability are ideal for review and self-testing</li> </ul> </ul> <p><strong>What users say about the Atlas of Anatomy:</strong></p> <p><em>'I can't say enough how much I like the organization of this text. I think Thieme has 'hit the nail on the head' with structuring everything by region (Lower Limb) and sub-region (Ankle & Foot). It's very easy to find what you're looking for…'</em></p> <p><em>'The figures in the</em> Atlas of Anatomy <em>are exemplary and surpass other competing texts. The images are clear, precise, and aesthetically colored. The unique views presented in this work are also very helpful for studying a three-dimensional subject such as human anatomy.'</em></p> <p>This book includes complimentary access to a digital copy on <a href='https://medone.thieme.com'>https://medone.thieme.com.</a></p>

Textauszug

2 Bones, Ligaments & Joints

Vertebral Column: Overview

The vertebral column (spine) is divided into four regions: the cervical, thoracic, lumbar, and sacral spines. Both the cervical and lumbar spines demonstrate lordosis (inward curvature); the thoracic and sacral spines demonstrate kyphosis (outward curvature).

Fig. 2.1 Vertebral column
Left lateral view.

Clinical box 2.1

Spinal development

The characteristic curvatures of the adult spine appear over the course of postnatal development, being only partially present in a newborn. The newborn has a “kyphotic” spinal curvature (A); lumbar lordosis develops later and becomes stable at puberty (C).

Fig. 2.2 Normal anatomical position of the spine
Left lateral view.

Clinical box 2.2

Abnormal Vertebral Column Curvatures

Vertebral Column: Elements

Fig. 2.3 Bones of the vertebral column
The transverse processes of the lumbar vertebrae are originally rib rudiments and so are named costal processes.

Fig. 2.4 Structural elements of a vertebra
Left posterosuperior view. With the exception of the atlas (C1) and axis (C2), all vertebrae consist of the same structural elements.

Fig. 2.5 Typical vertebrae
Superior view.

Cervical Vertebrae

The seven vertebrae of the cervical spine differ most conspicuously from the common vertebral morphology. They are specialized to bear the weight of the head and allow the neck to move in all directions. C1 and C2 are known as the atlas and axis, respectively. C7 is called the vertebra prominens for its long, palpable spinous process.

Fig. 2.6 Cervical spine
Left lateral view.

Fig. 2.7 Atlas (C1)

Fig. 2.8 Axis (C2)

Fig. 2.9 Typical cervical vertebra (C4)

Clinical box 2.3

Injuries in the cervical spine

The cervical spine is prone to hyperextension injuries, such as “whiplash,” which can occur when the head extends back much farther than it normally would. The most common injuries of the cervical spine are fractures of the dens of the axis, traumatic spondylolisthesis (anterior slippage of a vertebral body), and atlas fractures. Patient prognosis is largely dependent on the spinal level of the injuries (see p. 42).

This patient hit the dashboard of his car while not wearing a seat belt. The resulting hyperextension caused the traumatic spondylolisthesis of C2 (axis) with fracture of the vertebral arch of C2, as well as tearing of the ligaments between C2 and C3. This injury is often referred to as “hangman’s fracture.”

Thoracic & Lumbar Vertebrae

Fig. 2.10 Thoracic spine
Left lateral view.

Fig. 2.11 Typical thoracic vertebra (T6)

Fig. 2.12 Lumbar spine
Left lateral view.

Clinical box 2.4

Osteoporosis

The spine is the structure most affected by degenerative diseases of the skeleton, such as arthrosis and osteoporosis. In osteoporosis, more bone material gets reabsorbed than built up, resulting in a loss of bone mass. Symptoms include compression fractures and resulting back pain.

Fig. 2.13 Typical lumbar vertebra (L4)

Sacrum & Coccyx

The sacrum is formed from five postnatally fused sacral vertebrae. The base of the sacrum articulates with the 5th lumbar vertebra, and the apex articulates with the coccyx, a series of three or four rudimentary vertebrae. See Fig. 19.1, p. 230.

Fig. 2.14 Sacrum and coccyx

Fig. 2.15 Sacrum
Superior view.

Intervertebral Disks

Fig. 2.16 Intervertebral disk in the vertebral column
Midsagittal section of T11–T12, left lateral view. The intervertebral disks occupy the spaces between vertebrae (intervertebral joints, see p. 16).

Fig. 2.17 Structure of intervertebral disk
Anterosuperior view with the anterior half of the disk and the right half of the end plate removed. The intervertebral disk consists of an external fibrous ring (anulus fibrosus) and a gelatinous core (nucleus pulposus).

Fig. 2.18 Relation of intervertebral disk to vertebral canal
Fourth lumbar vertebra, superior view.

Fig. 2.19 Outer zone of the annulus fibrosus
Anterior view of L3–L4 with intervertebral disk.

Clinical box 2.5

Disk herniation in the lumbar spine

As the stress resistance of the anulus fibrosus declines with age, the tissue of the nucleus pulposus may protrude through weak spots under loading. If the fibrous ring of the anulus ruptures completely, the herniated material may compress the contents of the intervertebral foramen (nerve roots and blood vessels—see posterolateral herniation below). These patients often suffer from severe local back pain. Pain is also felt in the associated dermatome (see p. 42). When the motor part of the spinal nerve is affected, the muscles served by that spinal nerve will show weakening. It is an important diagnostic step to test the muscles innervated by a nerve from a certain spinal segment, as well as the sensitivity in the specific dermatome. Example: The first sacral nerve root innervates the gastrocnemius and soleus muscles; thus, standing or walking on toes can be affected (see p. 446).

Posterior herniation (A, B) In the MRI, a conspicuously herniated disk at the level of L3–L4 protrudes posteriorly (transligamentous herniation). The dural sac is deeply indented at that level. *CSF (cerebrospinal fluid).

Posterolateral herniation (C, D) A posterolateral herniation may compress the spinal nerve as it passes through the intervertebral foramen. If more medially positioned, the herniation may spare the nerve at that level but impact nerves at inferior levels.

Microdiscectomy surgery (E, F) is performed in order to remove a portion of a herniated disc that is irritating the nerve root. Through a small incision, the erector spinae muscles are reflected laterally to expose the ligamentum flavum, which is then removed in order to access the nerve roots in the spinal canal. A small portion of the facet joint may be removed to both facilitate access and relieve pressure on the nerve roots. Only the herniated portion of the disk is removed with the remaining tissue left intact.

Joints of the Vertebral Column: Overview

Table 2.2

Joints of the vertebral column

Craniovertebral joints

①

Atlanto-occipital joints

Occiput–C1

②

Atlantoaxial joints

C1–C2

Joints of the vertebral bodies

③

Uncovertebral joints

C3–C7

④

Intervertebral joints

C2–S1

Joints of the vertebral arch

⑤

Zygapophyseal joints

C2–S1

Fig. 2.20 Zygapophyseal (intervertebral facet) joints
The orientation of the zygapophyseal joints differs between the spinal regions, influencing the degree and direction of movement.

Fig. 2.21 Uncovertebral joints
Anterior view. Uncovertebral joints form during childhood between the uncinate processes of C3–C7 and the vertebral bodies immediately superior. The joints may result from fissures in the cartilage of the disks that assume an articular character. If the fissures become complete tears, the risk of...

Produkt-Details

• Erscheint lt. Verlag: 9.7.2020
• Zusatzinfo: Beilage: Online resource
• Verlagsort: Stuttgart
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Chirurgie
• Themenwelt: Studium ► 1. Studienabschnitt (Vorklinik) ► Anatomie / Neuroanatomie
• Schlagworte: Abdomen • anatomy • Atlas • Back • Head and Neck • Lower Limb • Neuroanatomy • pelvis and perineum • Thorax • Upper Limb
• ISBN-10: 1-63853-695-3 / 1638536953
• ISBN-13: 978-1-63853-695-6 / 9781638536956