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General Anatomy
and Musculoskeletal System
THIEME
Atlas of Anatomy
Consulting Editors
Lawrence M. Ross, M.D., Ph.D.,
DepartmentofNeurobiologyandAnatomy
UniversityofTexasMedicalSchoolatHouston
Edward D. Lamperti, Ph.D.,
ImmuneDiseaseInstituteand
HarvardMedicalSchool
Authors
Michael Schuenke, M.D., Ph.D.,
InstituteofAnatomy
ChristianAlbrechtUniversityKiel
Erik Schulte, M.D.,
DepartmentofAnatomyandCellBiology
JohannesGutenbergUniversity
Udo Schumacher, M.D.,
FRCPath,CBiol,FIBiol,DSc,
InstituteofAnatomyII:ExperimentalMorphology
CenterforExperimentalMedicine
UniversityMedicalCenterHamburg-Eppendorf
In collaboration with Jürgen Rude
Illustrations by
Markus Voll
Karl Wesker
1694Illustrations
100Tables
Thieme
Stuttgart · New York
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LibraryofCongressCataloging-in-PublicationDataisavailablefromthe Important note: Medicine is an ever-changing science undergoing
publisher. continualdevelopment.Researchandclinicalexperiencearecontinu-
allyexpandingourknowledge,inparticularourknowledgeofproper
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AllgemeineAnatomieundBewegungssystem:PrometheusLernatlas accordancewiththestateofknowledgeatthetimeofproductionof
derAnatomie. thebook.
Nevertheless, this does not involve, imply, or express any guarantee
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Foreword Preface
OurenthusiasmfortheTHIEMEAtlasofAnatomybeganwheneachof AsitstartedplanningthisAtlas,thepublishersoughtouttheopinions
us, independently, saw preliminary material from this Atlas. Both of and needs of students and lecturers in both the United States and
uswereimmediatelycaptivatedbythenewapproach,theconceptual Europe. The goal was to find out what the “ideal” atlas of anatomy
organization,andbythestunningqualityanddetailoftheimagesof shouldbe—idealforstudentswantingtolearnfromtheatlas,master
theAtlas.WeweredelightedwhentheeditorsatThiemeofferedusthe theextensiveamountsofinformationwhileonabusyclassschedule,
opportunity to cooperate with them in making this outstanding re- and,intheprocess,acquiresound,up-to-dateknowledge.Theresultof
sourceavailabletoourstudentsandcolleaguesinNorthAmerica. thisworkisthisAtlas.TheTHIEMEAtlasofAnatomy,unlikemostother
atlases,isacomprehensiveeducationaltoolthatcombinesillustrations
Asconsultingeditorswewereaskedtoreview,foraccuracy,theEnglish with explanatory text and summarizing tables, introducing clinical
editionoftheTHIEMEAtlasofAnatomy.Ourworkinvolvedaconversion applications throughout, and presenting anatomical concepts in a
ofnomenclaturetotermsincommonusageandsomeorganizational step-by-stepsequencethatallowsfortheintegrationofbothsystem-
changes to reflect pedagogical approaches in anatomy programs in by-systemandtopographicalviews.
NorthAmerica.Thistaskwaseasedgreatlybytheclearorganizationof
theoriginaltext.Inallofthis,wehavetrieddiligentlytoremainfaithful SincetheTHIEMEAtlasofAnatomyisbasedonafreshapproachtothe
totheintentionsandinsightsoftheoriginalauthors. underlying subject matter itself, it was necessary to create for it an
entirelynewsetofillustrations—ataskthattookeightyears.Ourgoal
We would like to thank the team at Thieme Medical Publishers who was to provide illustrations that would compellingly demonstrate
worked with us. Heartfelt thanks go first to Cathrin E. Schulz, M.D., anatomicalrelationsandconcepts,revealingtheunderlyingsimplicity
Senior Editor, for her assistance and constant encouragement and ofthelogicandorderofhumananatomywithoutsacrificingdetailor
availability. aesthetics.
WewouldalsoliketoextendourthankstoStefanieLangner,Production With the THIEME Atlas of Anatomy, it was our intention to create an
Manager,andAnnieHollins,AssistantEditor,forcheckingandcorrecting atlas that would guide students in their initial study of anatomy,
ourworkandpreparingthisvolumewithcareandspeed. stimulate their enthusiasm for this intriguing and vitally important
subject, and provide a reliable reference for experienced students
LawrenceM.Ross, andprofessionalsalike.
EdwardD.Lamperti
“Ifyouwanttoattainthepossible,youmustattempttheimpossible”
(RabindranathTagore).
MichaelSchünke,ErikSchulte,UdoSchumacher,
MarkusVoll,andKarlWesker
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Acknowledgments
Firstwewishtothankourfamilies.Thisatlasisdedicatedtothem. WearegratefultoAntjeBühl,whowastherefromthebeginningasproj-
ectassistant,working“behindthescenes”onnumeroustaskssuchas
WealsothankProf.ReinhardGossrau,M.D.,forhiscriticalcomments repeatedproofreadingandhelpingtoarrangethefigurelabels.
andsuggestions.Wearegratefultoseveralcolleagueswhorendered
valuablehelpinproofreading:Mrs.GabrieleSchünke,JakobFay,M.D., WeoweagreatdeptofthankstoMartinSpencker,ManagingDirector
Ms.ClaudiaDücker,Ms.SiminRassouli,Ms.HeinkeTeichmann,andMs. ofEducationalPublicationsatThieme,especiallytohisabilitytomake
SylviaZilles.WearealsogratefultoDr.JuliaJürns-Kuhnkeforhelping quick and unconventional decisions when dealing with problems and
withthefigurelabels. uncertainties.Hisopennesstoalltheconcernsoftheauthorsandart-
istsestablishedconditionsforacooperativepartnership.
WeextendspecialthankstoStephanieGayandBertSender,whocom-
posedthelayouts.Theirabilitytoarrangethetextandillustrationson Without exception, our collaboration with the entire staff at Thieme
facingpagesformaximumclarityhascontributedgreatlytothequality MedicalPublisherswasconsistentlypleasantandcordial.Unfortunately
oftheAtlas. wedonothaveroomtolisteveryonewhohelpedinthepublicationof
thisatlas,andwemustlimitouracknowledgmentstoafewcolleagues
Weparticularlyacknowledgetheeffortsofthosewhohandledthisproj- whomadeaparticularlynotablecontribution:RainerZepfandMartin
ectonthepublishingside: Waletzko for support in all technical matters; Susanne Tochtermann-
WenzelandManfredLehnert,representingallthosewhowereinvolved
JürgenLüthje,M.D.,Ph.D.,executiveeditoratThiemeMedicalPublish- intheproductionofthebook;AlmutLeopoldfortheIndex;Marie-Luise
ers, has “made the impossible possible.” He not only reconciled the Kürschnerandherteamforcreatingthecoverdesign;toBirgitCarlsen
wishesoftheauthorsandartistswiththedemandsofrealitybutalso andAnneDöbler,representingallthosewhohandledmarketing,sales,
managedtokeepateamoffivepeopleworkingtogetherforyearsona andpromotion.
projectwhosegoalwasknowntousfromthebeginningbutwhosefull
dimensionswecametoappreciateonlyovertime.Heisdeservingof TheAuthors
ourmostsincereandheartfeltthanks.
Sabine Bartl, developmental editor, became atouchstone for the au-
thorsinthebestsenseoftheword.Shewasabletodeterminewhether
abeginningstudent,andthusonewhoisnot(yet)aprofessional,could
clearly appreciate the logic of the presentation. The authors are in-
debtedtoher.
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Table of Contents
General Anatomy
1 HumanPhylogenyandOntogeny 5 TheMuscles
1.1 HumanPhylogeny.................................... 2 5.1 TheSkeletalMuscles................................. 40
1.2 HumanOntogeny: 5.2 TheTendonsandMechanisms
Overview,Fertilization,andEarliest ThatAssistMuscleFunction .......................... 42
DevelopmentalStages .............................. 4
1.3 Gastrulation,Neurulation,andSomiteFormation ....... 6
6 TheVessels
1.4 DevelopmentoftheFetalMembranesandPlacenta ..... 8
1.5 DevelopmentofthePharyngeal(Branchial)Arches 6.1 OverviewoftheHumanCardiovascularSystem.......... 44
inHumans ......................................... 10 6.2 TheStructureofArteriesandVeins .................... 46
1.6 EarlyEmbryonicCirculationandtheDevelopment 6.3 TheTerminalVascularBed ............................ 48
ofMajorBloodVessels ............................... 12
1.7 BoneDevelopmentandRemodeling ................... 14
7 TheLymphaticSystemandGlands
1.8 OssificationoftheLimbs ............................. 16
1.9 DevelopmentandPositionoftheLimbs ................ 18 7.1 TheHumanLymphaticSystem ........................ 50
7.2 ExocrineandEndocrineGlands........................ 52
2 OverviewoftheHumanBody
8 GeneralNeuroanatomy
2.1 TheHumanBody
(Proportions,SurfaceAreas,andBodyWeights).......... 20 8.1 DevelopmentoftheCentralNervousSystem(CNS) ...... 54
2.2 TheStructuralDesignoftheHumanBody .............. 22 8.2 NeuralCrestDerivativesandtheDevelopment
ofthePeripheralNervousSystem(PNS) ................ 56
8.3 TopographyandStructureoftheNervousSystem........ 58
3 SurfaceAnatomyoftheBody,Landmarks
8.4 CellsoftheNervousSystem .......................... 60
andReferenceLines
8.5 StructureofaSpinalCordSegment .................... 62
3.1 TermsofLocationandDirection,CardinalPlanes 8.6 SensoryInnervation:
andAxes ........................................... 24 AnOverview ..................................... 64
3.2 BodySurfaceAnatomy ............................... 26 8.7 DermatomesandCutaneousNerveTerritories......... 66
3.3 BodySurfaceContoursandPalpableBonyProminences .. 28 8.8 MotorInnervation .................................. 68
3.4 LandmarksandReferenceLinesontheHumanBody ..... 30 8.9 DifferencesbetweentheCentral
3.5 BodyRegions(RegionalAnatomy) ..................... 32 andPeripheralNervousSystems ...................... 70
8.10 TheAutonomicNervousSystem ...................... 72
4 TheBonesandJoints
4.1 TheBonySkeletonandtheStructureofTubularBones.... 34
4.2 ContinuousandDiscontinuousJoints:
SynarthrosesandDiarthroses ......................... 36
4.3 BasicPrinciplesofJointMechanics ..................... 38
IX
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