Anatomy for Anaesthetists

Harold Ellis, CBE, MA, DM, MCh, FRCS, FRCP, FRCOG FACS (Hon)Clinical Anatomist, Guy’s, King’s and St Thomas’s School of Biomedical Sciences; and EmeritusProfessor of Surgery, Charing Cross and Westminster Medical School, London, UKAndrew Lawson, FFARCSI, FANZCA, FRCA, MScHon. Consultant in Pain Medicine, Chelsea & Westminster Hospital, London, UK

• Preface to the Ninth (jubilee) Edition xiForeword to the First Edition xiiiIntroduction to the First Edition XIIIAcknowledgements to the Ninth (Jubilee) Edition xvPart 1: The Respiratory Pathway, Lungs, Thoracic Wall and DiaphragmThe mouth 3The palate 3The nose 6The paranasal sinuses 9Blood supply 10Nerve supply 11Structure 13The functions of the nose 13The pharynx 15The nasopharynx 15The oropharynx 16Vascular, lymphatic and nerve supply 17The laryngopharynx 18The structure of the pharynx 18The muscles of the pharynx 19Deglutition 21The larynx 24The laryngeal cartilages 24The laryngeal ligaments 26The muscles of the larynx 33Blood supply 36Lymph drainage 36Nerve supply 37Structure 42The trachea 42Relations 43Vascular, lymphatic and nerve supply 46The main bronchi 46The pleura 48The lines of pleural reflection 48The intercostal spaces 51The intercostal muscles 52The neurovascular bundle 53The mediastinum 56The lungs 57The lung lobes 61The relationships at the root of the lung 62The bronchopulmonary segments 63Bronchoscopic anatomy 66The structure of the lung and bronchial tree 67The pulmonary blood supply 69Lymphatics 71Innervation 71The development of the respiratory tract 71The diaphragm 72Anatomical features 72The diaphragm as a muscle of respiration 75The diaphragm and the ‘cardiac sphincter’ 75The development of the diaphragm 76Part 2: The Heart and Great Veins of the NeckThe pericardium 81The heart 82The chambers of the heart 84The conducting system of the heart 88The blood supply of the heart 89Nerve supply 90Surface markings 90Developmental anatomy 92The development of the heart 92The development of the aortic arches and their derivatives 93The fetal circulation 95Congenital abnormalities of the heart and great vessels 96The great veins of the neck 98Part 3: The Vertebral Canal and its ContentsThe vertebrae and sacrum 109The vertebrae 109The cervical vertebrae 109The thoracic vertebrae 113The lumbar vertebrae 114The sacrum 120Vertebral anomalies 125The intervertebral ligaments 127The spinal meninges 130The dura mater 130The arachnoid mater 131The pia mater 131The compartments related to the spinal meninges 132The cerebrospinal fluid 136The spinal cord 137The structure of the cord 139Blood supply 142Part 4: The Peripheral NervesThe spinal nerves 149Meningeal relations 149Vertebral relations 149The paravertebral space 150The posterior primary rami 151The anterior primary rami 154The cervical plexus 156Formation of the plexus 156Summary of branches 157The stellate ganglion 161The brachial plexus 165Formation of the plexus 165The relations of the brachial plexus 168The branches of the brachial plexus 169Supraclavicular branches of the brachial plexus 174Infraclavicular branches of the brachial plexus 174Variations 188The segmental innervation of the upper limb 190The thoracic nerves 190Anterior primary rami 190The lumbar plexus 192Formation of the plexus 193Distribution of the lumbar plexus 195The sacral and coccygeal plexuses 201Formation of the plexuses 202Relations 202Summary of the branches of the sacral plexus 204The collateral branches 204The terminal branches 205The sciatic foramina 219The coccygeal plexus 219The segmental innervation of the lower limb 220Part 5: The Autonomic Nervous SystemIntroduction 225Autonomic afferents 227The sympathetic system 228Spinal level 228The sympathetic trunk 228The ganglia of the sympathetic trunk 231The plexuses of the sympathetic system 236Higher sympathetic centres 239The parasympathetic system 239The cranial outflow 239The sacral outflow 241Afferent parasympathetic fibres 241Part 6: The Cranial NervesIntroduction 245The basic plan of the cranial nuclei 245The olfactory nerve (I) 247The optic nerve (II) 249The oculomotor nerve (III) 251The trochlear nerve (IV) 253The trigeminal nerve (V) 254The ophthalmic nerve (V ′) 258The maxillary nerve (V ′′) 261The mandibular nerve (V ′′′) 268The abducent nerve (VI) 275The facial nerve (VII) 275The auditory (vestibulocochlear) nerve (VIII) 279The glossopharyngeal nerve (IX) 281The vagus nerve (X) 284Course and relations 285The branches and distribution of the vagus nerve 287The accessory nerve (XI) 289The hypoglossal nerve (XII) 290Part 7: Miscellaneous Zones of InterestThe thoracic inlet 295Outlines and boundaries 295The 1st rib 295Cervical ribs 297Surface markings 297The antecubital fossa 298Boundaries 298Roof 298Contents 298Structures of clinical importance 300The orbit and its contents 303The bony orbit 303The orbital foramina 305The subdivisions of the orbit 305The eyeball 306Contents of the eyeball 308The orbital muscles 309The fascial sheath of the eye 310The eyelids and conjunctiva 311The lacrimal apparatus 312The abdominal wall 314Landmarks 314Fascia 315Muscles 315Blood supply 319Nerve supply 319Part 8: The Anatomy of PainIntroduction 323Classification of pain 324Peripheral receptors and afferent fibres 324Peripheral sensitization 325Cutaneous nociceptors 325Other somatic structures 325Visceral nociception 326The spinal cord and central projections 326The dorsal horn 326Ascending systems 328Spinothalamic tract 328Spinoreticular tract 329Cerebral processing and the pain matrix 329Modulation of pain signals 330Cortical modulation 330Descending inhibitory pathways 331The gate control theory of pain 332Central sensitization of pain 332The autonomic nervous system and pain 333Index 335