Internal Organs

484 Pages·2016·3.83 MB·English

by  Michael Schuenke

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Volum e 2
Int ernal Organs
THIEME At las of Anat o m y
2nd Edit ion

Authors
Michael Schuenke, MD, PhD
Institute of Anatomy
Christian Albrecht University, Kiel
Erik Schulte, MD
Department of Anatomy and Cell Biology
Johannes Gutenberg University, Mainz
Udo Schumacher, MD
FRCPath, CBiol, FIBiol, DSc
Institute of Anatomy II: Experimental Morphology
University Medical Center, Hamburg-Eppendorf
Consulting Editor
Wayne A. Cass, PhD
Professor and Director of Graduate Studies
Department of Anatomy and Neurobiology
University of Kentucky
Illustrations by
Markus Voll
Karl Wesker
Thieme
New York • Stuttgart • Delhi • Rio de Janeiro
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Co nte nts
Foreword by Lawrence M. Ross, Brian R. MacPherson, and Anne M. Gilroy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XI
Preface to the Second Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XIII
Preface to the First Edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .XV
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .XVII
Consulting Editor Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XIX
Structure and Deve lopme nt of
Org an Syste ms
1 Body Cavities 5 Urinary System
1.1 De nitions, Overview, and Evolution of Body Cavities . . . . . . 2 5.1 Overview of the Urinary System . . . . . . . . . . . . . . . . . . . . . . 40
1.2 Organogenesis and the Development of Body Cavities . . . . 4 5.2 Development of the Kidneys, Renal Pelvis, and Ureters . . . 42
1.3 Compartmentalization of the Intraembryonic Coelom . . . . . 6 5.3 Development of Nephrons, and the Urinary Bladder
1.4 Organization and Architecture of Body Cavities . . . . . . . . . . . 8 and Ureters; Developmental Anomalies . . . . . . . . . . . . . . . .44
2 Cardiovascular System 6 Genital System
2.1 Overview and Basic Wall Structure . . . . . . . . . . . . . . . . . . . . 10 6.1 Overview of the Genital System. . . . . . . . . . . . . . . . . . . . . . .46
2.2 Terminal Vessels and Overview of the Major Blood Vessels 12 6.2 Development of the Gonads . . . . . . . . . . . . . . . . . . . . . . . . . 48
2.3 Cardiogenic Area, Development of the Heart Tube . . . . . . . 14 6.3 Development of the Genital Ducts . . . . . . . . . . . . . . . . . . . . 50
2.4 Development of the Inner Chambers of the Heart 6.4 Comparison of Gender Di erences and Relationship
and Fate of the Sinus Venosus . . . . . . . . . . . . . . . . . . . . . . . . 16 to the Urinary System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
2.5 Cardiac Septation (Formation of the Atrial, Interventricular, 6.5 Comparison of Embryonic and Mature Structures . . . . . . . .54
and Aorticopulmonary Septa) . . . . . . . . . . . . . . . . . . . . . . . . 18
2.6 Pre- and Postnatal Circulation and Common Congenital
7 Lymphatic System
Heart Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
7.1 Overview of the Lymphatic System . . . . . . . . . . . . . . . . . . . . 56
7.2 Lymphatic Drainage Pathways . . . . . . . . . . . . . . . . . . . . . . . 58
3 Respiratory System
3.1 Overview of the Respiratory System . . . . . . . . . . . . . . . . . . . 22
8 Endocrine System
3.2 Development of the Larynx, Trachea, and Lungs . . . . . . . . . 24
3.3 Lung Development and Maturation . . . . . . . . . . . . . . . . . . . . 26 8.1 Overview of the Endocrine System . . . . . . . . . . . . . . . . . . . . 60
8.2 Metabolism and Feedback Loop Regulation in
the Endocrine System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
4 Digestive System
4.1 Overview of the Digestive System . . . . . . . . . . . . . . . . . . . . . 28
9 Autonomic Nervous System
4.2 Development and Di erentiation of the
Gastrointestinal Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 9.1 The Sympathetic and Parasympathetic Nervous Systems . .64
4.3 Mesenteries and Primordia of the Digestive Organs in 9.2 A erent Pathways of the Autonomic Nervous System
the Caudal Foregut Region; Stomach Rotation . . . . . . . . . . . 32 and the Enteric Nervous System . . . . . . . . . . . . . . . . . . . . . .66
4.4 Stomach Rotation and Organ Location in the Caudal
Foregut Region; Formation of the Omental Bursa . . . . . . . .34
4.5 Rotation of the Intestinal Loop and Development of
Midgut and Hindgut Derivatives . . . . . . . . . . . . . . . . . . . . . . 36
4.6 Summary of the Development of the Midgut and
Hindgut; Developmental Anomalies . . . . . . . . . . . . . . . . . . . 38
V
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Table of Contents
Thorax
10 Overview and Diaphragm 13.4 Trachea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
13.5 Lungs:
10.1 Divisions of the Thoracic Cavity and Mediastinum . . . . . . . . 70
Shape and Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
10.2 Diaphragm:
13.6 Segmentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
Location and Projection onto the Trunk . . . . . . . . . . . . . . 72
13.7 Functional Structure of the Bronchial Tree . . . . . . . . . . . . . 140
10.3 Structure and Main Openings . . . . . . . . . . . . . . . . . . . . . . 74
13.8 Pulmonary Arteries and Veins . . . . . . . . . . . . . . . . . . . . . . . 142
10.4 Innervation, Blood and Lymphatic Vessels . . . . . . . . . . . . 76
13.9 Bronchial Arteries and Veins . . . . . . . . . . . . . . . . . . . . . . . .144
13.10 Functional Structure of the Vascular Tree . . . . . . . . . . . . . 146
11 Overview of Neurovascular Structures 13.11 Innervation and Lymphatic Drainage of the Trachea,
Bronchial Tree, and Lungs . . . . . . . . . . . . . . . . . . . . . . . . . . .148
11.1 Arteries: Thoracic Aorta . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
13.12 Respiratory Mechanics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
11.2 Veins: Vena Cava and Azygos System . . . . . . . . . . . . . . . . . . 80
13.13 Radiological Anatomy of the Lungs and Vascular System . 152
11.3 Lymphatic Vessels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82
13.14 Computed Tomography of the Lungs . . . . . . . . . . . . . . . . . 154
11.4 Thoracic Lymph Nodes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
11.5 Thoracic Innervation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
14 Esophagus and Thymus and their
Neurovasculature
12 Organs of the Cardiovascular System
and their Neurovasculature 14.1 Esophagus:
Location and Divisions . . . . . . . . . . . . . . . . . . . . . . . . . . . 156
12.1 Location of the Heart in the Thorax . . . . . . . . . . . . . . . . . . . . 88
14.2 Inlet and Outlet, Opening and Closure . . . . . . . . . . . . . . 158
12.2 Pericardium: Location, Structure, and Innervation . . . . . . .90
14.3 Wall Structure and Weaknesses . . . . . . . . . . . . . . . . . . . . 160
12.3 Heart: Shape and Structure . . . . . . . . . . . . . . . . . . . . . . . . . . 92
14.4 Arteries and Veins of the Esophagus . . . . . . . . . . . . . . . . . . 162
12.4 Structure of the Heart Musculature (Myocardium) . . . . . . .94
14.5 Lymphatic Drainage of the Esophagus . . . . . . . . . . . . . . . .164
12.5 Cardiac Chambers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
14.6 Innervation of the Esophagus . . . . . . . . . . . . . . . . . . . . . . .166
12.6 Overview of the Cardiac Valves (Valve Plane and
14.7 Thymus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168
Cardiac Skeleton) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
12.7 Cardiac Valves and Auscultation Sites . . . . . . . . . . . . . . . .100
15 Topographical Anatomy
12.8 Radiographic Appearance of the Heart . . . . . . . . . . . . . . . . 102
12.9 Sonographic Appearance of the Heart:
15.1 Surface Anatomy, Topographical Regions,
Echocardiography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
and Palpable Bony Landmarks . . . . . . . . . . . . . . . . . . . . . . . 170
12.10 Magnetic Resonance Imaging (MRI) of the Heart . . . . . . . .106
15.2 Anatomical Landmarks of the Thoracic Skeleton
12.11 Impulse Formation and Conduction System of
(Projection of Organs) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172
the Heart; Electrocardiogram . . . . . . . . . . . . . . . . . . . . . . . 108
15.3 Structure of the Anterior Thoracic Wall and its
12.12 Mechanical Action of the Heart . . . . . . . . . . . . . . . . . . . . . 110
Neurovascular Structures . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
12.13 Coronary Arteries and Cardiac Veins:
15.4 Thoracic Organs in situ:
Classi cation and Topography . . . . . . . . . . . . . . . . . . . . . . . 112
Anterior, Lateral, and Inferior Views . . . . . . . . . . . . . . . . 176
12.14 Coronary Arteries: Coronary Circulation . . . . . . . . . . . . . . . 114
15.5 Posterior Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
12.15 Coronary Heart Disease (CHD) and Heart Attack . . . . . . . 116
15.6 Heart: Pericardial Cavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
12.16 Conventional Coronary Angiography
15.7 Overview of the Mediastinum . . . . . . . . . . . . . . . . . . . . . . . 182
(Heart Catheter Examination) . . . . . . . . . . . . . . . . . . . . . . . 118
15.8 Posterior Mediastinum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
12.17 Multislice Spiral Computed Tomography (MSCT)
15.9 Superior Mediastinum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
Coronary Angiography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120
15.10 Aortic Arch and Superior Thoracic Aperture . . . . . . . . . . . 188
12.18 Balloon Dilatation, Aortocoronary Venous and
15.11 Clinical Aspects:
Arterial IMA Bypass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122
Coarctation of the Aorta . . . . . . . . . . . . . . . . . . . . . . . . . 190
12.19 Lymphatic Drainage of the Heart . . . . . . . . . . . . . . . . . . . . 124
15.12 Aortic Aneurysm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192
12.20 Innervation of the Heart . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
13 Organs of the Respiratory System and their
Neurovasculature
13.1 Lungs: Location in the Thorax . . . . . . . . . . . . . . . . . . . . . . . 128
13.2 Pleural Cavities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
13.3 Boundaries of the Lungs and Parietal Pleura . . . . . . . . . . . 132
VI
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Table of Contents
Abdome n and Pe lvis
16 Structure of the Abdominal and Pelvic Cavities: 18.21 Branches of the Superior Mesenteric Artery:
Overview Arteries Supplying the Pancreas, Small Intestine,
and Large Intestine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .260
16.1 Architecture, Wall Structure, and Functional Aspects . . . . 196
18.22 Branches of the Inferior Mesenteric Artery:
16.2 Divisions of the Abdominal and Pelvic Cavities . . . . . . . . . . 198
Arteries Supplying the Large Intestine . . . . . . . . . . . . . .262
16.3 Classi cation of Internal Organs Based on their
18.23 Supply to the Rectum . . . . . . . . . . . . . . . . . . . . . . . . . . . .264
Relationship to the Abdominal and Pelvic Cavities . . . . . .200
18.24 Portal Vein: Venous Drainage of the Stomach,
Duodenum, Pancreas, and Spleen . . . . . . . . . . . . . . . . . . . .266
17 Overview of Neurovascular Structures 18.25 Superior and Inferior Mesenteric Veins:
Venous Drainage of the Small and Large Intestine . . . . . . .268
17.1 Branches of the Abdominal Aorta:
18.26 Branches of the Inferior Mesenteric Vein:
Overview and Paired Branches . . . . . . . . . . . . . . . . . . . . .202
Venous Drainage of the Rectum . . . . . . . . . . . . . . . . . . . . . 270
17.2 Unpaired and Indirect Paired Branches . . . . . . . . . . . . . .204
18.27 Lymphatic Drainage of the Stomach, Spleen,
17.3 Inferior Vena Caval System . . . . . . . . . . . . . . . . . . . . . . . . .206
Pancreas, Duodenum, and Liver . . . . . . . . . . . . . . . . . . . . .272
17.4 Portal Venous System (Hepatic Portal Vein) . . . . . . . . . . .208
18.28 Lymphatic Drainage of the Small and Large Intestine . . . . 274
17.5 Venous Anastomoses in the Abdomen and Pelvis . . . . . . . 210
18.29 Autonomic Innervation of the Liver, Gallbladder,
17.6 Lymphatic Trunks and Lymph Nodes . . . . . . . . . . . . . . . . . 212
Stomach, Duodenum, Pancreas, and Spleen . . . . . . . . . . . 276
17.7 Overview of the Lymphatic Drainage of
18.30 Autonomic Innervation of the Intestine:
Abdominal and Pelvic Organs . . . . . . . . . . . . . . . . . . . . . . . 214
Distribution of the Superior Mesenteric Plexus. . . . . . . . 278
17.8 Autonomic Ganglia and Plexuses . . . . . . . . . . . . . . . . . . . . . 216
18.31 Distribution of the Inferior Plexus and Inferior
17.9 Organization of the Sympathetic and
Hypogastric Plexus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .280
Parasympathetic Nervous Systems . . . . . . . . . . . . . . . . . . . 218
19 Organs of the Urinary System and their
18 Organs of the Digestive System and their
Neurovasculature
Neurovasculature
19.1 Overview of the Urinary Organs; The Kidneys in situ . . . . .282
18.1 Stomach:
19.2 Kidneys:
Location, Shape, Divisions, and Interior View . . . . . . . . .220
Location, Shape, and Structure . . . . . . . . . . . . . . . . . . . .284
18.2 Wall Structure and Histology . . . . . . . . . . . . . . . . . . . . . .222
19.3 Architecture and Microstructure . . . . . . . . . . . . . . . . . . .286
18.3 Small Intestine:
19.4 Renal Pelvis and Urinary Transport . . . . . . . . . . . . . . . . . . .288
Duodenum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .224
19.5 Suprarenal Glands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .290
18.4 Jejunum and Ileum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .226
19.6 Ureters in situ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292
18.5 Large Intestine:
19.7 Urinary Bladder in situ . . . . . . . . . . . . . . . . . . . . . . . . . . . . .294
Colon Segments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228
19.8 Urinary Bladder, Bladder Neck, and Urethra:
18.6 Wall Structure, Cecum, and Vermiform Appendix . . . . .230
Wall Structure and Function. . . . . . . . . . . . . . . . . . . . . . . . .296
18.7 Location, Shape, and Interior View of Rectum . . . . . . . .232
19.9 Functional Anatomy of Urinary Continence . . . . . . . . . . . .298
18.8 Continence Organ:
19.10 Urethra . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .300
Structure and Components . . . . . . . . . . . . . . . . . . . . . . .234
19.11 Arteries and Veins of the Kidneys and Suprarenal Glands:
18.9 Function . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .236
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .302
18.10 Disorders of the Anal Canal: Hemorrhoidal Disease,
19.12 Variants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .304
Anal Abscesses, and Anal Fistulas . . . . . . . . . . . . . . . . . . . .238
19.13 Lymphatic Drainage of the Kidneys, Suprarenal Glands,
18.11 Rectal Carcinoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240
Ureter, and Urinary Bladder . . . . . . . . . . . . . . . . . . . . . . . . .306
18.12 Liver:
19.14 Autonomic Innervation of the Urinary Organs and
Position and Relationship to Adjacent Organs . . . . . . . . 242
Suprarenal Glands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .308
18.13 Peritoneal Relationships and Shape . . . . . . . . . . . . . . . .244
18.14 Segmentation and Histology . . . . . . . . . . . . . . . . . . . . . .246
20 Organs of the Genital System and their
18.15 Gallbladder and Bile Ducts:
Neurovasculature
Location and Relationships to Adjacent Organs . . . . . . . . .248
18.16 Extrahepatic Bile Ducts and Pancreatic Ducts. . . . . . . . . . .250
20.1 Overview of the Genital Tract . . . . . . . . . . . . . . . . . . . . . . . 310
18.17 Pancreas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252
20.2 Female Internal Genitalia:
18.18 Spleen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .254
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312
18.19 Branches of the Celiac Trunk:
20.3 Topographical Anatomy and Peritoneal Relationships;
Arteries Supplying the Stomach, Liver,
Shape and Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . 314
and Gallbladder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .256
20.4 Wall Structure and Function of the Uterus . . . . . . . . . . . 316
18.20 Arteries Supplying the Pancreas, Duodenum,
20.5 Positions of the Uterus and Vagina . . . . . . . . . . . . . . . . . 318
and Spleen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .258
20.6 Epithelial Regions of the Uterus . . . . . . . . . . . . . . . . . . . .320
20.7 Cytologic Smear, Conization; Cervical Carcinoma . . . . .322
VII
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Table of Contents
Ne urovascular Supply to the
Organs: A Sche matic Approach
20.8 Female Internal Genitalia: 22.1 Thymus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .400
Ovary and Follicular Maturation . . . . . . . . . . . . . . . . . . . . 324 22.2 Esophagus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .401
20.9 Pregnancy and Childbirth . . . . . . . . . . . . . . . . . . . . . . . . . . . 326 22.3 Heart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .402
20.10 Male Genitalia: Accessory Sex Glands . . . . . . . . . . . . . . . . . 328 22.4 Pericardium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .403
20.11 Prostate Tumors: Prostatic Carcinoma, Prostatic 22.5 Lung and Trachea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .404
Hyperplasia; Cancer Screening . . . . . . . . . . . . . . . . . . . . . .330 22.6 Diaphragm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .405
20.12 Male Genitalia: 22.7 Liver, Gallbladder, and Spleen . . . . . . . . . . . . . . . . . . . . . . .406
Scrotum, Testis, and Epididymis . . . . . . . . . . . . . . . . . . .332 22.8 Stomach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .407
20.13 Seminiferous Structures and Ejaculate . . . . . . . . . . . . . .334 22.9 Duodenum and Pancreas . . . . . . . . . . . . . . . . . . . . . . . . . . .408
20.14 Branches of the Internal Iliac Artery: Overview of Arteries 22.10 Jejunum and Ileum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .409
Supplying the Pelvic Organs and Pelvic Wall . . . . . . . . . . . .336 22.11 Cecum, Vermiform Appendix, Ascending
20.15 Vascularization of the Male Pelvic Organs . . . . . . . . . . . . .338 and Transverse Colon . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 410
20.16 Vascularization of the Female Pelvic Organs . . . . . . . . . . . .340 22.12 Descending Colon and Sigmoid Colon . . . . . . . . . . . . . . . . 411
20.17 Vascularization of the Female Internal Genitalia and 22.13 Rectum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 412
Urinary Bladder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .342 22.14 Kidney, Ureter, and Suprarenal Gland . . . . . . . . . . . . . . . . . 413
20.18 Lymphatic Drainage of the Male and Female Genitalia . . .344 22.15 Urinary Bladder, Prostate, and Seminal Vesicle . . . . . . . . . . 414
20.19 Autonomic Innervation of the Male Genitalia . . . . . . . . . .346 22.16 Testis, Epididymis, and Ductus Deferens . . . . . . . . . . . . . . . 415
20.20 Autonomic Innervation of the Female Genitalia . . . . . . . .348 22.17 Uterus, Uterine Tube, and Vagina . . . . . . . . . . . . . . . . . . . . 416
22.18 Uterine Tube and Ovary . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417
21 Topographical Anatomy
21.1 Surface Anatomy, Topographic Regions, and Palpable
Bony Landmarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .350
21.2 Location of the Abdominal and Pelvic Organs and their
Projection onto the Trunk Wall . . . . . . . . . . . . . . . . . . . . . . 352
21.3 Topography of the Opened Peritoneal Cavity (Supracolic
and Infracolic Part) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .354
21.4 Drainage Spaces and Recesses within the Peritoneal
Cavity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .356
21.5 Overview of the Mesenteries . . . . . . . . . . . . . . . . . . . . . . . . 358
21.6 Topography of the Omental Bursa . . . . . . . . . . . . . . . . . . . .360
21.7 Topography of the Upper Abdominal Organs:
Liver, Gallbladder, Duodenum, and Pancreas . . . . . . . . .362
21.8 Stomach and Spleen . . . . . . . . . . . . . . . . . . . . . . . . . . . . .364
21.9 Cross-Sectional Anatomy of the Upper Abdominal
Organs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .366
21.10 Topography of the Small and Large Intestine . . . . . . . . . . .368
21.11 Radiography of the Small and Large Intestine . . . . . . . . . . 370
21.12 Topography of the Rectum . . . . . . . . . . . . . . . . . . . . . . . . .372
21.13 Retroperitoneum:
Overview and Divisions . . . . . . . . . . . . . . . . . . . . . . . . . . 374
21.14 Peritoneal Relationships . . . . . . . . . . . . . . . . . . . . . . . . . . 376
21.15 Organs of the Retroperitoneum . . . . . . . . . . . . . . . . . . . . 378
21.16 Location of the Kidneys . . . . . . . . . . . . . . . . . . . . . . . . . .380
21.17 Peritoneal Relationships in the Anterior Abdominal Wall . .382
21.18 Peritoneal Relationships in the Lesser Pelvis . . . . . . . . . . . .384
21.19 Topography of Pelvic Connective Tissue,
Levels of the Pelvic Cavity, and the Pelvic Floor . . . . . . . . .386
21.20 Suspensory Apparatus of the Uterus . . . . . . . . . . . . . . . . . .388
21.21 Female Pelvis in situ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .390
21.22 Male Pelvis in situ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 392
21.23 Cross-Sectional Anatomy of the Female Pelvis . . . . . . . . . .394
21.24 Cross-Sectional Anatomy of the Male Pelvis . . . . . . . . . . .396
VIII
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