Dissection Guide for Gray’s Human Anatomy

584 Pages·2006·53 MB·English

by  David A. Morton

SDissection Guide for
Human
’
Y
Anatomy
A
R
S E C O N D E D I T I O N
G
David A. Morton, PhD Kerry D. Peterson, LFP Kurt H. Albertine, PhD
Department of Neurobiology and Anatomy Director, Body Donor Program Professor of Pediatrics, Medicine,
University of Utah School of Medicine Department of Neurobiology and Anatomy and Neurobiology and Anatomy (Adjunct)
Salt Lake City, Utah University of Utah School of Medicine Course Director, Human Gross Anatomy
Salt Lake City, Utah Assistant Dean of Faculty Administration
Editor-in-Chief, The Anatomical Record
Departments of Pediatrics, Medicine,
and Neurobiology and Anatomy
University of Utah School of Medicine
Salt Lake City, Utah
1600 John F. Kennedy Blvd.
Ste. 1800
Philadelphia, PA 19103-2899
GRAY’S DISSECTION GUIDE FOR HUMAN ANATOMY ISBN-13: 978-0-443-06951-2
SECOND EDITION ISBN-10: 0-443-06951-4
Copyright © 2007, 2004 by Churchill Livingstone, an imprint ofElsevier Inc.
All rights reserved.No part ofthis publication may be reproduced or transmitted in any form or by any means, electronic
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Notice
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge,
changes in practice, treatment, and drug therapy may become necessary or appropriate. Readers are advised to check the
most current information provided (i) on procedures featured or (ii) by the manufacturer ofeach product to be administered,
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responsibility ofthe practitioners, relying on their own experience and knowledge ofthe patients, to make diagnoses,
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To the fullest extent ofthe law, neither the Publisher nor the Authors assume any liability for any injury and/or damage
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The Publisher
Library ofCongress Cataloging-in-Publication Data
Morton, David A.
Gray’s dissection guide for human anatomy / David A. Morton, Kerry D. Peterson, Kurt H. Albertine — 2nd ed.
p. cm
Rev. ed. of: Dissection guide for human anatomy / David A. Morton. 2004.
ISBN 0-443-06951-4
1. Human dissection Laboratory manuals. I. Title: Gray’s dissection guide for human anatomy. II. Peterson Kerry D.
III. Albertine Kurt H. Gray’s dissection guide for human anatomy. IV. Title.
QM34.M59 2007
611—dc22 2006040749
Acquisitions Editor:Inta Ozols
Developmental Editor:Katie DeFrancesco
Project Manager:Mary Stermel
Marketing Manager:John Gore
Printed in Hong Kong
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Acknowledgments
I express my appreciation to Tom Parks, Kerry Peterson, and Kurt Zitzlsperger — who wrote in the Gray’s Anatomy textbook he gave me
Albertine, for the opportunity to participate in the creation of this many years ago, “Don’t forget the many hours in the gross lab. That is
dissection guide. I am grateful to my parents (Gordon and Gabriella where you learned your anatomy and that’s where you should return to
Morton), who taught me to appreciate the miracle of the human body. refresh your knowledge” — stimulated me to direct this composition. My
I also thank my brothers (Gord, Joe, and Mike), my sister (Daniela), my hope is that our road map to human dissection facilitates learning in
in-laws, the Templeman family, Brian, and Bo, for their constant today’s climate of compressed medical curricula.
encouragement. I could not have completed this project without the On a personal note, I too extend sincere thanks to Dr. Parks
support of my wonderful wife, Celine, and our children (Jared, Ireland, (Chairman of Neurobiology and Anatomy), for his undaunted support;
Gabriel, and Max), who are an inspiration in my life. This project has to the body donors and their families (who are the real teachers of
been one of the highlights of my career. human anatomy and generosity); and to Kerry Peterson, for his expert
DAVIDA. MORTON, PHD direction of our body donor program, for his superlative teaching, and
for his sense of humor. Thanks also go to the Dean’s Office, particularly
to Dr. Betsy Allen, Dr. Larry Reimer, and former dean Dr. Sam Shomaker,
I express my sincere thanks to the body donors and their families, who
who provided institutional support and encouragement for our gross
have taught me more about life than about anatomy. I am grateful to
anatomy course. I am honored to have helped direct David Morton
colleagues and students who have fostered my love for anatomy and its
through this project, and I am proud to call him my colleague. I also
teaching. Foremost, I thank my wife (T.G.), for her unending support of
appreciate the invaluable input provided by three classes of medical and
my pursuits.
dental students (graduating classes of 2004 to 2006). Their constructive
KERRYD. PETERSON, LFP criticism and ideas improved the guide from their perspective, which is to
dissect efficiently and to learn what is expected. Last, I thank my wife
To health profession students who use this guide: Gross anatomy is (L.L.) for sticking by me despite the paucity of hours that I spend with her
learned through the dissecting of the human body. This conviction, and our two children. To you, I dedicate my small part in this book.
coupled with sage advice from my gross anatomy professor, Dr. Sigfried KURTH. ALBERTINE, PHD
Copyright ©2007, 2004 by Churchill Livingstone, Acknowledgments v
an imprint of Elsevier Inc.All rights reserved.
Preface to the Second Edition
With the second edition of Gray’s Dissection Guide for Human Anatomy approach for the limb dissections is regional, to maintain consistency
came a number of important changes, the principal stimulus for which throughout the guide. These organizational changes are intended to add
was the publication of the first edition of Gray’s Anatomy for Students flexibility to the dissection guide for use in human gross anatomy
(GAFS) in 2005, a year after the publication of the first edition of our courses that follow an order of dissection that differs from the order
dissection guide. The publication of GAFS provided the opportunity to followed at the University of Utah, the organizational template used for
coordinate the second edition of our dissection guide with that textbook. the first edition.
We did so through use of the same nomenclature (Termina Anatomica), A third area of modification in the second edition is the addition of
through balance of content, and through shared illustrations. Indeed, an osteology lab at the beginning of each unit.
some of the illustrations from GAFS adorn the pages of our second A fourth area of modification in the second edition is the revision
edition, adding new graphic content and improving the delivery of infor- and correction of content. This important task was facilitated by the
mation. In addition, not only have we cross-referenced our dissection invaluable advice of a dozen expert anatomists. These experts also
guide to content in GAFS; we have also cross-referenced it to the fourth encouraged us to preserve the black-and-white illustrations, using color
edition of Netter’s Atlas of Human Anatomy(NAHA) and to the Atlas of highlights to improve visual appeal.
Clinical Gross Anatomy(ACGA). Thus, for every dissection step, students The changes to the second edition prompted our editor to suggest
are pointed to additional expert knowledge provided by GAFS, NAHA, the new title, Gray’s Dissection Guide for Human Anatomy, a name that we
and ACGA. For ease and convenience, the cross-references are positioned feel honored to use. Accompanying this revision is a brilliant new cover.
at the upper right of each page. This rich cross-referencing style adds to Crafting the second edition of Gray’s Dissection Guide for Human
the original intent of our dissection guide: to focus on instructions that Anatomy has been an exciting endeavor whose successful completion
guide efficient dissection. can be attributed in no small part to contributions by numerous
Another important modification in the second edition is expansion anatomists and by the staff at Elsevier. To all of you, we offer a heartfelt
of the original four units into six. This was accomplished by dividing Unit thank-you!
1 (Back and Thorax) into two units (Unit 1: Back; Unit 2: Thorax) and by DAVIDA. MORTON, PHD
dividing Unit 4 (Limbs) into two units (Unit 5: Upper Limb; Unit 6: Lower KERRYD. PETERSON, LFP
Limb). In the first edition of our dissection guide, the limb dissections KURTH. ALBERTINE, PHD
provided a systemic anatomy approach. In this second edition, the
Copyright ©2007, 2004 by Churchill Livingstone, Preface to the Second Edition vii
an imprint of Elsevier Inc.All rights reserved.
Preface to the First Edition
The key idea behind the writing of Gray’s Dissection Guide for Human contain the text and illustrations that direct the dissection. Each unit
Anatomy was to produce a guide for efficient dissection of the entire ends with a comprehensive listing that identifies all the structures that
human body in the reduced time that is allocated today to basic science were dissected and that are therefore to be learned. Terminologia Anatomica
courses in medical schools. The object was not to produce a textbook or (copyright ©1998; with permission from the Federative Committee on
atlas of human gross anatomy. Our goals, therefore, were (1) to make the Anatomical Terminology) was used for anatomic nomenclature.
guide practical and easy to follow for medical, dental, and graduate Because course hours for the study of gross anatomy are fewer today
students so that they could finish each dissection during the assigned than they were in the past, rather than make the tables all-inclusive, we
laboratory period and (2) to provide students with clear expectations of chose to select carefully—based on our practical experience—which
the anatomic structures to be dissected and learned. anatomic structures in each region to include. We recognize that our
Accomplishing both goals required selecting a format that served guide is a distillation of the total body of gross anatomic information,
each one. We settled on a horizontal format that allowed us to position and we hope that students who desire further information will invite
the text and corresponding illustration(s) on the same page. Thus, each their course instructors to elaborate and will engage in independent
page is divided in half by a vertical bar, with text positioned on the left research through such authoritative textbooks of human anatomy as
and the corresponding illustration(s) on the right. The book is spiral the 39th edition of Gray’s Anatomy(Elsevier).
bound to display two pages simultaneously and to make the book rest It is important to note that some of the dissection approaches
stably on the book racks that are attached to dissection tables. In addi- require cuts that destroy continuity of structures. Such cuts are made to
tion, boldface type is used for the names of anatomic structures the first improve access to and/or visibility of anatomic structures. To minimize
time a structure is identified in the text. This design alerts students that the impact of these cuts, we recommend that one or more cadavers per
the named structure is to be dissected and identified. dissection room be spared so that structural continuity is preserved.
The illustrations are simple black-and-white line drawings with Students should confer with their instructors to determine whether
occasional use of color. This illustration style focuses the reader’s atten- instructions to cut a structure are to be modified or skipped.
tion on a specific dissection task. Labels, which are kept to a minimum,
are used to identify the anatomic structures to be dissected. Blue dashed Key:
lines highlight where cuts are to be made with a scalpel or saw. m. — muscle
Gray’s Dissection Guide for Human Anatomy is organized into six mm. — muscles
regional units. n. — nerve
Unit 1: Back nn. — nerves
Unit 2: Thorax a. — artery
Unit 3: Abdomen, Pelvis, and Perineum aa. — arteries
Unit 4: Head and Neck v. — vein
Unit 5: Upper Limb vv. — veins
Unit 6: Lower Limb r. — right
For each laboratory dissection, the guide begins with an overview l. — left
that identifies the structures to be dissected. The pages that follow CN — cranial nerve
Copyright ©2007, 2004 by Churchill Livingstone, Preface to the First Edition ix
an imprint of Elsevier Inc.All rights reserved.
1
Unit
Back
The purpose of this unit is to learn the anatomic structure of the
back through dissection.
Lab 1 Osteology of the Back 3
Lab 2 Superficial Back 10
Lab 3 Deep Back, Vertebral Column,
and Suboccipital Region 23
Lab 4 Spinal Cord 37
Unit 1 Back Overview 44
Copyright ©2007, 2004 by Churchill Livingstone, 1
an imprint of Elsevier Inc.All rights reserved.
1
Lab
Osteology of the Back
Prior to dissection, you should familiarize yourself with the following osteologic structures:
OSTEOLOGY Vertebral Structures Ribs
■ Spinous process ■ Head
Occipital Bone
■ Transverse process ■ Neck
■ External occipital protuberance
■ Transverse foramen (cervical vertebrae only) ■ Tubercle
■ Superior nuchal line
■ Lamina ■ Angle
■ Inferior nuchal line
■ Pedicles ■ Costal groove
Temporal Bone ■ Vertebral body
Clavicle
■ Mastoid process ■ Vertebral arch
Scapula
■ Superior articular process
■ Spine
Vertebral Column (33 Vertebrae)
■ Inferior articular process
■ Acromion
■ Cervical vertebrae (7)
■ Vertebral foramen
● Atlas (C1) ■ Lateral and medial margins
■ Intervertebral foramina (notches)
● Axis (C2) ■ Superior and inferior angles
■ Intervertebral disc
■ Thoracic vertebrae (12)
■ Lumbar vertebrae (5) Ilium
■ Sacrum (5 fused vertebrae) ■ Iliac crest
■ Coccyx (4 fused vertebrae) ■ Posterior superior iliac spine
Copyright ©2007, 2004 by Churchill Livingstone, Unit 1 ● Lab 1 Osteology of the Back 3
an imprint of Elsevier Inc.All rights reserved.
Lab 1Dissection Overview
The purpose of this laboratory session is to learn the osteology of the back through dissection. You will do
so through the following suggested sequence:
Anterior
Cervical vertebra
Thoracic vertebra
Lumbar vertebra
Posterior
1. Learn the osteology of the vertebral 2. Identify the main anatomic features 3. Examine the cervical, thoracic, 4. Examine how underlying osteologic
column. of the vertebrae. lumbar, sacral, and coccygeal structures create visual and palpable
vertebrae. surface landmarks.
4 Unit 1 ● Lab 1 Osteology of the Back Copyright ©2007, 2004 by Churchill Livingstone,
an imprint of Elsevier Inc.All rights reserved.