PREFACEThis edition of Grant's Atlas has, like its predecessors, required intenseclinical comments have been added in this edition, providing even more rel-research,market input, and creativity.It is not enough to rely on a solidreputaevanceforstudentssearchingformedicalapplicationofanatomical conceptstion; with each new edition, we have adapted and changed many aspects ofEnhanced diagnostic imaging and surface anatomy.Because medicaltheAtiaswhilemaintainingthecommitmenttopedagogicalexcellenceandimaging has taken on increased importance in the diagnosis and treatmentanatomical realism that has enriched its long history.Medical and health sci-of injuries and illnesses,diagnostic images are used liberally throughouttheences education, and the role of anatomy instruction and application within it,chapters, and a special imaging section appears at the end of each chapter.continually evolve to reflect newteaching approaches and educational modOver 100 clinically relevant magnetic resonance images (MRls), computed to-els. The health care system itself is changing, and the skills and knowledgemography (CT) scans,ultrasound scans, and corresponding orientation draw-that future health carepractitioners must masterare changing along with it.ings are included in this edition.Labeled surface anatomy photographs withFinally,technologicadvances inpublishing,particularlyinonlineresourcesandethnicdiversitycontinueto bean importantfeature in this new editionelectronic media, have transformed the way students access content and theUpdated and improved tables.Tables help students organize complex infor-methods by which educators teach content. All of these developments havemation in an easy-to-use format ideal for review and study. In addition to muscles,shaped the vision and directed the execution of this thirteenth edition of Grant'stables featuring nerves,arteries,and other relevant structures are included.TheAtlas,asevidencedbythefollowingkeyfeatures.table format in this edition received a substantial update; a consistent color codeClassic"Grant's"images updated fortoday's students.Aunique featureisusedtoclearlydemarcatecolumns.Tablesarestrategicallyplacedonthesameof Grant's Atlas is that, rather than providing an idealized view of human anatpage as the illustrations that demonstrate the structures listed in the tables.omy,theclassic illustrationsrepresentactual dissectionsthatthestudentcanLogical organizationand layout.The organizationand layout of theAtashavedirectlycomparewithspecimensinthelab.Becausetheoriginalmodelsusedalways been determined with ease-of-use as the goal.Although thebasic organiza-forthese illustrations were real cadavers,the accuracy ofthese illustrations istion by bocy region was maintained in this edition, the order of plates within everyunparalleled,offering students the best introduction to anatomypossible.Overchapterwasscrutinizedtoensurethatitislogicalandpedagogicallyeffective.Sec-the years and in this edition, we have made many changes to the illustrationstions within each chapter further organize the region into discrete subregions; thesetomatchtheshiftingexpectationsofstudents,addingmorevibrantcolorsandsubregionsappearasheadingsonthepages.Readersneedonlyglanceattheseupdating the style. All figures were carefully analyzed to ensure that labelheadings to orient themselves to the region and subregion that the figures on theplacement remained effective and that the illustration's relevance was stillpage belong to.A chapter table of contents comprises the first page of each chapter.clear.Helpful learning and teachingtools.Thethirteenth edition of Grant's AtlasSchematic illustrations.Full-color schematic illustrations and orientationoffersa widerangeofonlineresourcesforboththestudentandtheinstruc-figuressupplementthedissectionfiguresoclarifyanatomicalconceptsshowtor on Lippincott Williams & Wilkins thePoint site: http://thePoint.lww.com/the relationships of structures, and give an overview of the body region beingGrantsAtlas13e.Students have access to an online e-book,an interactive atlasstudied.TheillustrationsconformtoDr.Grant'sadmonitiontokeepitsimple"containing all of the atlas images, an interactive question bank, and selectedextraneous labels weredeleted,and some labelswereaddedto identifykeyvideoclipsfromthebest-sellingAcland'sVideoAtlasofHumanAnatomycol-structuresandmaketheillustrationsasusefulaspossibletostudentslection.For instructors,online ancillaries includean interactive atlas with slideLegends with easy-to-find clinical applications.Admittedly,artwork isshow and image-export functions as well as an image bank.the focus of any atlas; however, the Grant's legends have long been consideredWe hope that you enjoy using this thirteenth edition of Grant's Atlas and thata unique and valuable feature of the Atlas.The observations and commentsit becomes a trusted partner in your educational experience.We believe thatthataccompanythe illustrationsdrawattentiontosalientpointsandsignificantthis new edition safeguards the Atlas's historical strengths while enhancing itsstructures that might otherwise escape notice. Their purpose is to interpret theusefulness to today's studentsillustrations without providing exhaustive description. Readability, clarity, andpracticality were emphasized in the editing of this edition. Clinical commentsAnne M.R.Agurwhichdeliverpractical"pearlsthatlinkanatomicfeatureswiththeirsignifi-ArthurF.Dalley IIlcance in health care practice,appearin bluetext within thefigurelegends.Newvi
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AOKNOWTEDGMENTSStarting with the first edition of this Atas published in 1943, many peopleWe would like to thank the hundreds of instructors and students who havehavegivengenerouslyoftheirtalentsandexpertiseandweacknowledgetheirovertheyears communicated via thepublisheranddirectlywith the editor theirparticipation with heartfelt gratitude. Most of the original carbon-dust halftonessuggestions for how this Atlas might be improved. Finally, we would like toon which this book is based were created by Dorothy Foster Chubb, a pupil ofacknowledgethereviewerswhoreviewedpreviouseditionsoftheAtlasaswelMax Brodel and oneof Canada's firstprofessionally trained medical illustrators.as the following reviewers who reviewed the twelfth edition and provided expertShe was later joined by Nancy Joy, who is Professor Emeritus in the Division ofadvice on the development of this edition in particular:Biomedical Communications,University of Toronto.Mrs.Chubb was mainly reFACULTYREVIEWERSsponsible for the artwork of the first two editions and the sixth edition; Miss Joy,forthoseinbetween.insubsequenteditions,additionallineandhalftoneillus-Belinda Beck, Griffith University, Queesnsland, Australiatrationsby ElizabethBlackstock,Elia HopperRoss,and MargueriteDrummondJulietteCooper,UniversityofManitoba,Winnipeg,Manitoba,Canadawere added. In recent editions, the artwork of Valerie Oxorn and the surfaceDonaldFletcher,East CarolinaStateUniversity,Greenville,NorthCarolinaanatomy photography of Anne Rayner of Vanderbilt University Medical Center'sGeorgina Fyfe, Curtin University,Perth,AustraliaMedical Art Group have augmented the modern look and feel of the atlas.Doug Gould, The Ohio State University,Columbus,OhioMuchcredit isalsodueto Charles E.Storton forhisroleinthepreparationRod Green, Latrobe University, Victoria, Australiaof themajority of the original dissections and preliminary photographic work.WeJanSmit,Queen'sUniversityBelfast,UnitedKingdomalso wish to acknowledge the work of Dr. James Anderson, a pupil of Dr. Grant,Mark Stringer,UniversityofOtago,NewZealandunder whose stewardship the seventh and eighth editions were publishedMarjan Vandersteen, Universiteit Hasselt, Diepenbeek,BelgiumThe following individuals also provided invaluable contributions to previousBruce Wainman,McMaster University,Hamilton,Ontario,Canadaeditions of the atlas and are gratefully acknowledged: C.A.Armstrong.P.G.Ash-Robert Whitaker, University of Cambridge, United Kingdommore, D. Baker, D.A. Barr, J.V. Basmajian, S. Bensley, D. Bilbey. J. Bottos, W. Boyd,J. Callagan, H.A. Cates, S.A. Crooks, M. Dickie, C. Duckwall, R. Duckwall, J.W.ASTUDENT REVIEWERSDuckworth, F.B. Fallis, J.B. Francis, J.S. Fraser, P. George, R.K. George, M.G. Gray,B.L. Guyatt, C.W. Hill, W.J. Horsey, B.S. Jaden, M.J. Lee, G.F. Lewis, I.B. MacDon-Merrian Brooksald, D.L. Maclntosh, R.G. MacKenzie, S. Mader, K.O. McCuaig. D. Mazierski, W.R.Tameka ByrdMitchell, K. Nancekivell, A.J.A. Noronha, S. O'Sulivan, W. Pallie, W.M. Paul, D. Rini,Daniel ChoiC. Sandone, C.H.Sawyer,A.I.Scott, J.S. Simpkins, J.S. Simpson, C.G.Smith,IM.Terry DeanThompson, J.S. Thompson,N.A.Watters, R.W.Wilson, B. Vallecoccia, and K.Yu.StephenGoldbergPeter HakimTHIRTEENTH EDITIONAndrewJensenDaniel KouWeareindebtedto ourcolieagues andformer professorsfortheirencour-Malini Kumaragementespecially Dr. Keith L. Moore for his expert advice and Drs, DanielJanelle LumO. Graney, Lawrence Ross, Ryan Splttgerber, Lily Cabellon, and DouglasLeahPhillabaumJ. Gould for their invaluable input.We extend ourgratitude to our medicalillustrator Valerie Oxorn,whoseWe hope that readers and reviewers will find many of their suggestions incor-artistic skills andanatomical insights made substantial contributions to thisporated into the twelfth edition and will continue to provide their valuable input.edition. We would also like to acknowledge Jennifer Clements, Art Director atLippincott Williams & Wilkins, who managed the art program for this edition.Anne M.R. AgurSpecial thanks go to everyone at LippincottWilliams&Wilkins-ArthurF.DalleyIIespecially Crystal Taylor, Acquisitions Editor, and Julie Montalbano, ProductManager.All of your efforts and expertise aremuchappreciated.vili
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CONTENTSDrJohn Charles Boileau GrantviLymphaticDrainage186PrefaceviSectional Anatomy and Imaging 190viliAcknowledgmentsListof TablesxiPelvisandPerineum 1973xiliTableandFigureCreditsPelvic Girdle198Thorax 12051Ligaments of Pelvic GirdleFloor andWalls of Pelvis206Pectoral Region2210SacralandCoccygeal PlexusesS212Breast4Peritoneal Reflections in PelvisBonyThoraxandJoints12Rectum and Anal Canal214Thoracic Wall 19Organs of Male Pelvis220Thoracic Contents27Vesselsof MalePelvis228Pleural Cavities30Lymphatic Drainage of Male Pelvis and Perineum232234Mediastinum31Innervationof MalePelvicOrgansLungsandPleura32Organs of Female Pelvis236Bronchi and Bronchopulmonary Segments38Vessels of Female Pelvis242Innervation and Lymphatic Drainageof Lungs44Lymphatic Drainage of Female Pelvis and Perineum248External Heart 46InnervationofFemalePelvicOrgans250CoronaryVessels56Subperitoneal RegionofPelvis254256Conduction System of Heart60SurfaceAnatomyof Perineum258Internal HeartandValves61Overviewof MaleandFemalePerineum68Male Perineum 265Superior Mediastinum and Great VesselsDiaphragm75FemalePerineum273Posterior Thorax76Imagingand Sectional Anatomyof Pelvisand Perineum280Overview of Autonomic Innervation8688Overview of Lymphatic Drainage of ThoraxBack 2894Sectional Anatomy and Imaging 90OverviewofVertebralColumn290Abdomen 97Cervical Spine2982302Craniovertebral JointsOverview 98Thoracic Spine304AnterolateralAbdominalWall100LumbarSpine306Inguinal Region 110Ligaments and Intervertebral Discs308Testis120Bones,Joints,and Ligaments of Pelvic Girdle313Peritoneum and Peritoneal Cavity122e320Anomalies of VertebraeDigestive System 132MusclesofBack322Stomach133Suboccipital Region332Pancreas, Duodenum,and Spleen136Spinal Cord and Meninges336Intestines140344VertebralVenousPlexuses150ComponentsofSpinalNerves345Liver and GallbladderBiliaryDucts160DermatomesandMyotomes348Portal Venous System 164Autonomic Nerves 350Posterior Abdominal Viscera 166ImagingofVertebralColumn354Kidneys169173Posterolateral Abdominal Wall5Lower Limb357Diaphragm178Abdominal Aorta and Inferior Vena Cava179SystemicOverviewof LowerLimb:Bones358Autonomic Innervation180Systemic Overview of Lower Limb:Nerves362370Systemic Overviewof Lower Limb:Blood Vesselsix
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CONTENTSSystemicOverviewof LowerLimb:Lymphatics374TemporomandibularJoint 678SystemicOverviewofLowerLimb:MusculofascialTongue682Compartments376Palate688Teeth691Retro-Inguinal PassageandFemoral Triangle378Anteriorand Medial Compartmentsof Thigh382NoeParanasalSinueandPterypalatinFs696LateralThigh 389Ear709Lymphatic Drainage of Head 722Bones and MuscleAttachmentsof Thigh390Gluteal Region and Posterior Compartment of Thigh392Autonomic Innervation of Head723Hip Joint402Imaging of Head724Knee Region410Neuroanatomy:OverviewandVentricularSystem728KneeJoint416Telencephalon(Cerebrum)andDiencephalon731Brainstemand Cerebellum 740Anteriorand Lateral Compartments ofLeg,DorsumofFoot430PosteriorCompartmentof Leg440Imaging of Brain746TibiofibularJoints450Soleof Foot451Neck 7518Ankle,Subtalar,and Foot Joints456ArchesofFoot474Subcutaneous Structures and Cervical Fascia752BonyAnomalies475Skeleton of Neck756Imaging and Sectional Anatomy476Regions of Neck758Lateral Region (PosteriorTriangle) of Neck7606764UpperLimb481Anterior Region (Anterior Triangle)of NeckNeurovascularStructuresof Neck768SystemicOverviewofUpperLimb:Bones482VisceralCompartmentofNeck774Systemic Overview of Upper Limb: Nerves488Root and Prevertebral Region of Neck778Systemic Overview of Upper Limb:Arteries494Submandibular Region and Floor of Mouth784SystemicOverviewof Upper Limb:Veins and Lymphatics496PosteriorCervical Region789Pharynx792SystemicOverviewof Upper Limb:MusculofascialIsthmusofFauces798Compartments500Pectoral Region 502Larynx804509Sectional Anatomy and Imaging of Neck 812Axilla, Axillary Vessels, and Brachial PlexusScapular RegionandSuperficial Back 520ArmandRotatorCuff524Cranial Nerves 817Joints of Shoulder Region538ElbowRegion546Overview of Cranial Nerves818ElbowJoint552Cranial NerveNuclei822AnteriorAspectofForearm558CranialNerve I:Olfactory824AnteriorAspectofWristandPalmof Hand562Cranial Nerve ll:Optic825PosteriorAspectofForearm:582Cranial Nerves II, IV, and Vi: Oculomotor, Trochlear,PosteriorAspectofWristandDorsumofHand586andAbducent827Lateral Aspect of Wrist and Hand 592Cranial Nerve V:Trigeminal830Medial Aspect of Wrist and Hand595Cranial Nerve VIl:Facial837Bones and Joints of Wrist and Hand596838Cranial Nerve Vil: VestibulocochlearFunction of Hand:Grips and PinchesS604840CranialNerveIX:Glossopharyngeal605ImagingandSectional AnatomyCranialNerveX:Vagus843CranialNerveXI:Spinal Accessory844Head 611Cranial Nerve Xl: Hypoglossal 845Summaryof AutonomicGangliaof Head846Cranium612Summary of Cranial NerveLesions847632Sectional Imaging of Cranial Nerves848FaceandScalpMeninges and Meningeal Spaces641Cranial Base and Cranial Nerves646REFERENCES851BloodSupplyofBrain652Orbit and Eyeball 656INDEX853Parotid Region 668Temporal Region and Infratemporal Fossa670
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LISTOFTABLESTHORAX5.20Muscles in Sole ofFootThird Layer45415.214551.1Muscles of Thoracic Wall 23Muscles in Sole of FootFourth Layer5.22Joints of Foot 4671.226Muscles of Respiration1.3Surface Markings of Parietal Pleura (Blue) and Surface Markings of Lungs6UPPERLIMBCovered with Visceral Pleura (Pink) 336.1491Cutaneous Nervesof Upper Limb6.22ABDOMENClinical Manifestations of Nerve Root Compression: Upper Limb (UL)4926.32.1Dermatomes of Upper Limb 493Principal Muscles of Anterolateral Abdominal Wall 1086.42.26507Boundaries of Inguinal Canal 112Anterior Axio-Appendicular Muscles2.36.5512Characteristics of Inguinal Hernias119Arteries of Proximal Upper Limb (Shoulder Region and Arm)2.46.6Brachial Plexus515Terms Used to Describe Parts of Peritoneum1242.56.7Superficial Back (Posterior Axio-Appendicular) and Deltoid Muscles521Parts and Relationships of Duodenum1376.82.6MovementsofScapula523155Schemaof TerminologyforSubdivisionsoftheLiver6.92.7176Scapulohumeral Muscles525Principal Muscles of Posterior Abdominal Wall2.86.10ArmMuscles528Autonomic Innervation of Abdominal Viscera (Splanchnic Nerves)1836.11558Arteries ofForearm3PELVISANDPERINEUM6.12Muscles of Anterior Aspect of Forearm5613.1Differences Between Male and Female Pelves2026.13Muscles of Hand5733.2Muscles of Pelvic Walls and Floor2076.14Arteries of Hand 5813.32116.15Nervesof SacralandCoccygeal PlexusesMuscles of Posterior Surface of Forearm5833.4Arteries of Male Pelvis62296.16Lesions of Nenves of Upper Limb6033.5Lymphatic Drainage of Male Pelvis and Perineum2337HEAD3.6Effect of Sympatheticand Parasympathetic Stimulation on7.11234Foramina and other Apertures of Cranial Fossae, and Contents620Urinary Tract, Genital System, and Rectum7.23.7Main Muscles of Facial Expression635Arteries of Female Pelvis2477.3Nerves of Face and Scalp 6373.8249Lymphatic Drainageof Structures of Female Pelvis andPerineum7.43.9Arteries of Superficial Faceand Scalp638Muscles of Perineum2607.5Veins of Face6394BACK7.6OpeningsbyWhichCranial NervesExitCranial Cavity6474.1Typical Cervical Vertebrae (C3-C7)2987.7Arterial Supply to Brain6534.23047.8Thoracic VertebraeActions of Muscles of Orbit Starting from Primary Position6624.3Lumbar Vertebrae3067.9Muscles of Orbit 6634.4331Intrinsic Back Muscles7.10665ArteriesofOrbit4.5Muscles of Atlanto-Occipital andAtianto-AxialJoints3347.11Muscles of Mastication (Acting on Temporomandibular Joint)6787.12MovementsofTemporomandibularJoint6795LOWERLIMB7.13Muscles of Tongue6835.1Motor Nerves of Lower Limb3637.14Muscles of Soft Palate6905.2CutaneousNervesof LowerLimb3657.15Primary and Secondary Dentition6955.3Nerve Lesions3665.48NECKNerve Root (Anterior Ramus) Lesions3675.58.1752Muscles of Anterior Thigh385Platysma5.6Muscles of Medial Thigh 3868.2Cervical Regions and Contents7585.78.3Muscles of Gluteal Region394Sternocleidomastoid and Trapezius7595.8Muscles of Posterior Thigh (Hamstring)3958.4767Suprahyoid and Infrahyoid Muscles5.98.5Nerves of Gluteal Region400Arteries of Neck7705.10Arteries of Gluteal Region and Posterior Thigh4018.6Prevertebral and Scalene Muscles7805.11Bursae Around Knee4238.7783LateralVertebral Muscles5.12Muscles of Anterior Compartment of Leg4318.8Muscles of Posterior Cervical Region7895.138.9Common, Superficial, and Deep Fibular (Peroneal) Nerves432Muscles of Pharynx7945.148.10Arterial Supply to Dorsum of Foot435Muscles of Larynx8085.15Muscles of Lateral Compartmentof Leg4379CRANIAL NERVES5.16Muscles of Posterior Compartment of Leg4409.1Summary of Cranial Nerves8215.17Arterial Supply of Leg and Foot4499.2Olfactory Nerve (CN I) 8245.18Muscles in Sole of Foot—First Layer4529.35.19Optic Nerve (CN II)825Muscles in Sole of Foot—Second Layer453xi
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