Anatomy for Dental Students

380 Pages·2013·8.5 MB·English

by  Martin Atkinson

Anatomy for dental students
This page intentionally left blank
Anatomy for dental
students
FOURTH EDITION
Martin E. Atkinson
B.Sc., Ph.D.
Professor of Dental Anatomy Education,
University of Sheffi eld

1
3
Great Clarendon Street, Oxford OX2 6DP,
United Kingdom
Oxford University Press is a department of the University of Oxford.
It furthers the University’s objective of excellence in research, scholarship,
and education by publishing worldwide. Oxford is a registered trade mark of
Oxford University Press in the UK and in certain other countries
© Oxford University Press, 2013
The moral rights of the author have been asserted
First Edition published 1983
Second Edition published 1989
Third Edition published 1997
Fourth Edition published 2013
Impression: 1
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, without the
prior permission in writing of Oxford University Press, or as expressly permitted
by law, by licence or under terms agreed with the appropriate reprographics
rights organization. Enquiries concerning reproduction outside the scope of the
above should be sent to the Rights Department, Oxford University Press, at the
address above
You must not circulate this work in any other form
and you must impose the same condition on any acquirer
British Library Cataloguing in Publication Data
Data available
ISBN 978-0-19-923446-2
Printed in China by
C&C Off set Printing Co.Ltd
Oxford University Press makes no representation, express or implied, that the
drug dosages in this book are correct. Readers must therefore always check
the product information and clinical procedures with the most up-to-date
published product information and data sheets provided by the manufacturers
and the most recent codes of conduct and safety regulations. The authors and
the publishers do not accept responsibility or legal liability for any errors in the
text or for the misuse or misapplication of material in this work. Except where
otherwise stated, drug dosages and recommendations are for the non-pregnant
adult who is not breastfeeding.
Preface to fourth edition of
Anatomy for Dental Students
I was delighted to be asked to edit the fourth edition of A natomy for Dental Students by Oxford University
Press. It brought things full circle for me. Jim Moore, one of the original authors alongside David Johnson, was
one of my excellent anatomy teachers at Birmingham University and was instrumental in guiding me into a
career in anatomy. It is fi tting that I can repay that debt by editing “Johnson and Moore”.
Reading the preface to the fi rst edition published almost thirty years ago shows that many aspects of den-
tal education are still much the same. Development of dental course delivery and assessment continues
in many dental schools and the introduction of integrated curricula blur or demolish traditional subject
boundaries. Why then is there still a need for a “single subject” book in this brave new world? David
Johnson and Jim Moore hit the bull’s eye with their fi rst aim in the original preface—that all health care
professionals need a sound working knowledge of the structure and function of the human body and its
application to their particular clinical area. This is paramount whether students study anatomy as a named
subject or whether it is integrated into wider units of the curriculum. Three editions of A natomy for Dental
Students have provided a concise and precise account of the development, structure and function of the
human body relevant to dental students and practitioners and it is my hope that the fourth edition will
continue in that role.
Anatomy and publishing technology have advanced considerably since the last edition in 1997. The fourth
edition has an entirely diff erent style and presentation which will make it easier to use. One new feature of
the fourth edition is the use of text boxes; ‘clinical’ boxes emphasise the application of anatomical informa-
tion to clinical practice and ‘sidelines’ boxes contain additional interesting material not necessarily required
in all dental courses. Colour illustrations are used much more extensively; all the fi gures have been expertly
redrawn by David Gardner but the majority are based on the original drawings of Anne Johnson. David
redrew Figures 3.2, 5.1, 5.3, 5.4, 14.1, 15.19, 17.1, 17.2, 18.5, 20.5, 24.6, 26.2, 26.1, 27.8, 28.6, 28.11, 28.14 and
32.17 from illustrations published in B asic Medical Science for Speech and Language Therapy Students by
Martin Atkinson and Stephen McHanwell; I am grateful to Wiley-Blackwell for permission to use them.
The entire book has been edited and reordered to bring it into line with the requirements of students
studying dental courses today. Section 1 on the basic structure and function of systems pertinent to dental
practice has been expanded to benefi t students who enter dental school without a biological background
and also those who have studied one of the myriad modular higher level biology courses where vital mate-
rial on human biology often falls through the gaps. Section 1 should create a level playing fi eld for everyone
irrespective of their previous biological experience. An appreciation of the nervous system, especially the
cranial nerves, is fundamental to understanding the head and neck; the section on the nervous system
therefore now precedes the section on head and neck anatomy. The head and neck section has been
substantially reordered to describe the anatomy from the superfi cial to deep aspects of the head and then
down the neck, the sequence of dissection usually followed by those who still have the opportunity to carry
it out. An innovative approach to the study of the skull is used in chapter 22. The skull is assembled bone by
bone so that the relationships and contributions of each bone to diff erent subdivisions of the skull can be
appreciated. The requisite detail of specifi c bones is then described with reference to soft tissue anatomy
in chapters 23 onwards, each covering a particular region of the head and neck or their development. All
the chapters on the nervous system and embryology and development have been rewritten to incorporate
recent advances in these subjects; the developmental chapters have been integrated with the pertinent
anatomy.
vi
  Preface to fourth edition of Anatomy for Dental Students
I wish to thank my colleagues Keith Figures and Adrian Jowett for their helpful discussions on various clini-
cal aspects of anatomy and current guidelines to clinicians issued in the UK; I am also grateful to Keith for
reading various clinically related sections and giving me extremely useful comments. Nevertheless any errors
in the book are entirely my responsibility. Martin Payne kindly provided some of the radiographs used in
chapter 31. Thanks also to Martin and Jane Wattam for introducing me to the wonders of cone beam compu-
terized tomography. I am indebted to Geraldine Jeff ers, my editor at Oxford University Press—the most ex-
acting but also the most encouraging and supportive editor I have ever worked with—great craic Geraldine.
I must also thank Hannah Lloyd and Abigail Stanley who played a signifi cant part in bringing this edition to
fruition. Diana—thanks as ever for your support, encouragement, and input throughout this venture. Can life
return to normal now?
M.E.A.
Sheffi eld
June 2012
Table of contents
Abbreviations and symbols i x
Online Resource Centre x
How to use this book x i
S ection 1 Introduction and developmental anatomy
1 The study of anatomy 3
2 The locomotor system 7
3 The central nervous system 17
4 The circulatory system 32
5 The respiratory system 38
6 The gastrointestinal system 42
7 Skin and fascia 46
8 Embryonic development—the fi rst few weeks 49
S ection 2 The thorax
9 The surface anatomy of the thorax 65
10 T he thoracic wall and diaphragm 69
11 T he lower respiratory tract and its role in ventilation 78
12 T he heart, pericardium, and mediastinum 86
13 D evelopment of the heart, respiratory, and circulatory systems 98
S ection 3 The central nervous system
14 I ntroduction to the central nervous system 109
15 T he structure of the central nervous system 113
16 M ajor sensory and motor systems 138
17 T he autonomic nervous system 153
18 T he cranial nerves 159
19 D evelopment of the central nervous system 181
S ection 4 Head and neck
20 I ntroduction and surface anatomy 189
21 E mbryology of the head and neck 199
22 T he skull 207
23 T he face and superfi cial neck 222
viii
  Table of contents
24 T he temporomandibular joints, muscles of mastication, and the infratemporal
and pterygopalatine fossae 241
25 T he oral cavity and related structures 257
26 M astication 277
27 T he nasal cavity and paranasal sinuses 284
28 T he pharynx, soft palate, and larynx 292
29 S wallowing and speech 308
30 T he orbit 312
31 R adiological anatomy of the oral cavity 320
32 T he development of the face, palate, and nose 326
33 D evelopment and growth of the skull and age changes 332

Glossary 349
Index 353
Abbreviations and symbols

β beta Hz Hertz
° degree ICP intracranial pressure
% percent ID inferior dental (block)
Ach acetylcholine IMO intramembranous ossifi cation
AE anterior extension K+ potassium ion
ANS autonomic nervous system LRT lower respiratory tract
AV atrioventricular m metre
BA basicranial μ m micrometer
BMP bone morphogenic protein MRI magnetic resonance imaging
Ca++ calcium ion mV millivolt
CHL conducting hearing loss Na+ sodium ion
Cl– chloride ion NA noradrenalin
cm centimetre nm nanometer
CN cranial nerve PM premotor (cortex)
CNS central nervous system PNS peripheral nervous system
CPR cardiopulmonary resuscitation ® registered trademark
CSF cerebrospinal fl uid RA retinoic acid
CT computed-assisted tomography SA sinoatrial
CVA cerebrovascular accident SEA spheno-ethmoidal angle
DPT dental panoramic tomograph SHH sonic hedgehog
ECM extracellular matrix SMA supplemental motor area
ECO endochondral ossifi cation SNHL sensorineural hearing loss
e.g. exempli gratia (for example) TCMS transcutaneous magnetic stimulation
FGF fi broblastic growth factor TMJ temporomandibular joint
fMRI functional magnetic resonance imaging TSNC trigeminal sensory nuclear complex
g gram UK United Kingdom
GAG glycosaminoglycan URT upper respiratory tract
GIT gastrointestinal tract VPL ventroposterolateral
h hour VPM ventroposteromedial