Concise Anatomy for Anaesthesia

148 Pages·2001·1.8 MB·English

by  Andreas G. Erdmann

Concise Anatomy
for Anaesthesia
Concise Anatomy
for Anaesthesia
Andreas G Erdmann
Fellow in Pain Management
London
Specialist Registrar in Anaesthesia
East Anglian Deanery
London San Francisco
Greenwich Medical Media
4th Floor, 137 Euston Road,
London
NW1 2AA
870 Market Street, Ste 720
San Francisco
CA 94109, USA
ISBN 1841100692
First Published 2001
Apart from any fair dealing for the purposes of research or private study,
or criticism or review, as permitted under the UK Copyright Designs
and Patents Act 1988, this publication may not be reproduced, stored,
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reproduction only in accordance with the terms of the licences issued
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Enquiries concerning reproduction outside the terms stated here should
be sent to the publishers at the London address printed above.
The rights of Andreas Erdmann to be identified as author of this work
have been asserted by him in accordance with the Copyright Designs
and Patents Act 1988.
The publisher makes no representation, express or implied, with regard
to the accuracy of the information contained in this book and cannot
accept any legal responsibility or liability for any errors or omissions that
may be made.
A catalogue record for this book is available from the British Library.
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Typeset by Phoenix Photosetting, Chatham, Kent
Printed by The Alden Group, Oxford
Contents
Foreword vii Lumbar 54
Preface ix Sacrococcygeal 56
18. The major peripheral nerves 60
Upper limb 60
Lower limb 62
Respiratory System
Abdominal wall 66
1. The mouth 2
Intercostal nerves 66
2. The nose 4
19. The autonomic nervous system 70
3. The pharynx 6
Sympathetic 70
4. The larynx 8
Parasympathetic 72
5. The trachea 14
20. The cranial nerves 76
6. The bronchi and bronchial
tree 16
7. The pleura and mediastinum 18
Appendices
8. The lungs 20
1. Dermatomes of arm 88
9. The diaphragm 22
2. Dermatomes of leg 89
Sample questions 24
3. Dermatomes of trunk 90
Sample questions 91
Cardiovascular System
10. The heart 26 Vertebral Column
11. The great vessels 30 21. The vertebrae 94
Aorta 30 22. The vertebral ligaments 100
Great arteries of the neck 30 Sample questions 101
Arteries of the limbs 32
Major veins 34
Areas of Special Interest
12. Fetal circulation 38
23. The base of the skull 104
Sample questions 40
24. The thoracic inlet 108
25. The intercostal space 112
26. The abdominal wall 114
Nervous System
27. The inguinal region 116
13. The brain 42 28. The antecubital fossa 118
14. The spinal cord 44 29. The large veins of the neck 120
15. The spinal meninges and 30. The axilla 122
spaces 47 31. The eye and orbit 124
16. The spinal nerves 50 Sample questions 128
17. The nervous plexuses 52
Cervical 52
Brachial 52 Index 137
v
Foreword
When I first started my anaesthesia job, it modern anaesthetic practice. It will be
did not take me long to realise that I was invaluable as a revision text for the
going to have to relearn a lot of anatomy FRCA, but will also help anaesthetists to
that had been implanted in my short- retain anatomy knowledge throughout
term memory during the second MB. I their careers. It will be useful for
was, incorrectly, under the impression consultants teaching trainees and also for
that anatomy was the sole preserve of the other theatre personnel to understand the
surgeon. procedures carried out by anaesthetists.
From the moment that a career in I am sure that generations of anaesthetists
anaesthesia is started, anatomy plays a will be grateful to Dr Erdmann for
part. Dr Andreas Erdmann decided to providing such a simple and
write this book following his experiences comprehensive review of an essential
during the final FRCA examination. The subject.
idea is a simple one, combining simple
line diagrams and succinct text to cover Richard Griffiths MD FRCA
all of the areas of anatomy essential to Peterborough, June 2001
vii
Preface
The origin of this concise book of constraints of this book to provide in-
anatomy results from many comments depth detail and this should be obtained
from FRCA examination candidates. by reference to some of the larger
Anatomy has always played an important textbooks. Sample questions are included
role in the examination syllabus, as well at the end of each section, and include
as being of great practical importance in questions similar to those asked in
the everyday practice of anaesthesia. It is previous examinations.
also a subject that appears to demand a
disproportionately large amount of time It is hoped that this book may also be of
during examination preparation. help to those teaching anatomy to
However, neglect of the anatomical FRCA candidates, as well as to all
subject-matter is perilous and leads to the practising anaesthetists wishing to ‘brush
loss of valuable ‘easy’ marks. up’ on some forgotten anatomical detail.
Nurses, operating theatre practitioners
The idea behind this book is to present a and other healthcare professionals will
concise and easily digestible outline of also find this book of use when gaining a
anatomy that has been extensively based practical understanding of applied
on the current FRCA examination anatomy.
syllabus. I have attempted to present the
core anatomical knowledge required for Finally, all errors and omissions are my
the Primary and Final FRCA responsibility, and any comments and
examinations in a simple and advice for improvement will be gratefully
straightforward manner. There are accepted.
numerous diagrams to illustrate the
subject matter, as well as additional space Andreas Erdmann
for the addition of personal notes. It is, June 2001
however, impossible within the
ix
Respiratory
System
1 The mouth
DESCRIPTION ● Soft palate – a suspended ‘curtain’
from the hard palate with a midline
The mouth extends from the lips
uvula; a fibrous palatine aponeurosis
(anterior) to the isthmus of the fauces
forms the skeleton of the soft palate
(posterior). There are two sections:
Vestibule – slit-like cavity between
the cheeks/lips and gingivae/teeth
Oral cavity – from the teeth to the VASCULAR SUPPLY
oropharyngeal isthmus
1. Vestibule – facial artery (via superior
and inferior labial branches)
RELATIONS 2. Teeth – maxillary artery (via superior
and inferior alveolar branches)
Roof – hard and soft palate
3. Tongue – lingual artery (venous via
Floor – tongue and reflection of the gum
lingual vein into internal jugular)
mucous membrane
4. Palate – mixed supply from facial,
Posterior – isthmus separates the oral
maxillary and ascending pharyngeal
cavity from the oropharynx
arteries
POINTS OF INTEREST
● Papilla – a papilla for the opening of
NERVE SUPPLY
the parotid duct is present on the
cheek opposite the upper second ● Vestibule:
molar tooth ● Sensory from the branches of the
● Midline frenulum – under the tongue, trigeminal nerve (V2 and V3)
has two papillae for the submandibular ● Motor from the facial nerve (VII)
duct openings and the sublingual fold ● Tongue:
(of mucous membrane) for numerous ● Taste – anterior two-thirds via the
tiny sublingual duct openings facial nerve (VII via chorda
● Isthmus – contains three structures: tympani), posterior one-third via
the palatoglossal folds (anterior), the the glossopharyngeal nerve (IX)
palatine tonsils (middle) and the ● Motor from the hypoglossal nerve
palatopharyngeal folds (posterior). It is (XII)
bounded by the soft palate above ● Palate:
● Hard palate – created by the maxilla ● Sensory and motor from the
(palatine process) anteriorly and trigeminal nerve (V2)
palatine bone posteriorly ● Taste from the facial nerve
2
The mouth
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Fig 1.1
The mouth
3