Gray's Anatomy for Students,3/e(IE)





Stay current and engaged in your anatomy courses with many new "In the Clinic" boxes, which offer access to in-depth clinical discussions related to specific diseases or procedures.


Source your review material quickly and easily thanks to a list of additional relevant study aids at the beginning of each chapter.


Improve your comprehension of cranial nerves with help from a brand-new visual map summarizing cranial nerve distribution and function.


Access the entire contents online at Student Consult, where you can also take advantage of an online anatomy and embryology self-study course, medical clinical cases, physical therapy clinical cases, self-assessment questions, and more.


[Key Features]







Obtain reliable, accessible coverage of everything you will learn in your contemporary anatomy classes with expert knowledge from a team of authors who share a wealth of diverse teaching and clinical experience.


Easily locate and remember specific structures. More than 1,000 innovative, original illustrations by renowned illustrators Richard Tibbitts and Paul Richardson capture anatomical features with unrivalled clarity.


Understand the practical applications of anatomical concepts through unique coverage of surface anatomy, correlative diagnostic images, and clinical case studies.


Expedite the review of basic concepts from each chapter with Conceptual Overviews.

What is anatomy? 4




How can gross anatomy be studied? 4




Important anatomical terms 4




Imaging 7




Diagnostic imaging techniques 7




Nuclear medicine imaging 10




Image interpretation 11




Plain radiography 12




Computed tomography 12




Magnetic resonance imaging 13




Nuclear medicine imaging 13




Safety in imaging 13




Body systems 14




Skeletal system 14




Cartilage 14




Bone 15




Joints 20




Skin and fascias 26




Skin 26




Fascia 26




Muscular system 27




Cardiovascular system 29




Lymphatic system 31




Lymphatic vessels 31




Lymph nodes 32




Lymphatic trunks and ducts 32




Nervous system 34




Central nervous system 34




Functional subdivisions of the CNS 34




Somatic part of the nervous system 35




Visceral part of the nervous system 41




Other systems 52




Clinical cases 53








2 Back




Conceptual overview 56




General description 56




Functions 57




Support 57




Movement 57




Protection of the nervous system 58




Component parts 58




Bones 58




Muscles 60




Vertebral canal 62




Spinal nerves 63




Relationship to other regions 64




Head 64




Thorax, abdomen, and pelvis 65




Limbs 65




Key features 65




Long vertebral column and short spinal cord 65




Intervertebral foramina and spinal nerves 66




Innervation of the back 66




Regional anatomy 67




Skeletal framework 67




Vertebrae 67




Intervertebral foramina 75




Posterior spaces between vertebral arches 75




Joints 79




Joints between vertebrae in the back 79




Ligaments 82




Anterior and posterior longitudinal ligaments 82




Ligamenta flava 82




Supraspinous ligament and ligamentum




nuchae 83




Interspinous ligaments 84




Back musculature 86




Superficial group of back muscles 86




Intermediate group of back muscles 92




Deep group of back muscles 93




Suboccipital muscles 99




Spinal cord 101




Vasculature 102




Meninges 104




Arrangement of structures in the vertebral




canal 106




Spinal nerves 107




Surface anatomy 112




Back surface anatomy 112




Absence of lateral curvatures 112




Primary and secondary curvatures in the sagittal




plane 112




Useful nonvertebral skeletal landmarks 112




How to identify specific vertebral spinous




processes 114




Visualizing the inferior ends of the spinal cord and




subarachnoid space 115




Identifying major muscles 116




Clinical cases 118








3 Thorax




Conceptual overview 124




General description 124




Functions 125




Breathing 125




Protection of vital organs 125




Conduit 125




Component parts 125




Thoracic wall 125




Superior thoracic aperture 126




Inferior thoracic aperture 126




Diaphragm 127




Mediastinum 128




Pleural cavities 128




Relationship to other regions 129




Neck 129




Upper limb 130




Abdomen 130




Breast 130




Key features 130




Vertebral level TIV/V 130




Venous shunts from left to right 132




Segmental neurovascular supply of thoracic




wall 132




Sympathetic system 134




Flexible wall and inferior thoracic aperture 134




Innervation of the diaphragm 134




Regional anatomy 137




Pectoral region 137




Breast 137




Muscles of the pectoral region 139




Thoracic wall 141




Skeletal framework 141




Intercostal spaces 147




Diaphragm 156




Venous drainage 158




Innervation 158




Movements of the thoracic wall and diaphragm




during breathing 158




Pleural cavities 159




Pleura 159




Lungs 163




Mediastinum 176




Middle mediastinum 177




Superior mediastinum 204




Posterior mediastinum 215




Anterior mediastinum 223




Surface anatomy 224




Thorax surface anatomy 224




How to count ribs 224




Surface anatomy of the breast in women 225




Visualizing structures at the TIV/V vertebral




level 226




Visualizing structures in the superior




mediastinum 227




Visualizing the margins of the heart 227




Where to listen for heart sounds 228




Visualizing the pleural cavities and lungs, pleural




recesses, and lung lobes and fissures 228




Where to listen for lung sounds 229




Clinical cases 233








44 Abdomen




Conceptual overview 246




General description 246




Functions 247




Houses and protects major viscera 247




Breathing 249




Changes in intra-abdominal pressure 249




Component parts 250




Wall 250




Abdominal cavity 251




Inferior thoracic aperture 253




Diaphragm 253




Pelvic inlet 254




Relationship to other regions 254




Thorax 254




Pelvis 254




Lower limb 255




Key features 256




Arrangement of abdominal viscera in the




adult 256




Skin and muscles of the anterior and lateral




abdominal wall and thoracic intercostal




nerves 259




The groin is a weak area in the anterior abdominal




wall 260




Verterbral Level L1 262




The gastrointestinal system and its derivatives are




supplied by three major arteries 262




Venous shunts from left to right 264




All venous drainage from the gastrointestinal




system passes through the liver 265




Abdominal viscera are supplied by a large




prevertebral plexus 266




Regional anatomy 268




Surface topography 268




Four-quadrant pattern 268




Nine-region pattern 269




Abdominal wall 270




Superficial fascia 270




Anterolateral muscles 272




Extraperitoneal fascia 278




Peritoneum 279




Innervation 279




Arterial supply and venous drainage 280




Lymphatic drainage 282




Groin 282




Inguinal canal 284




Inguinal hernias 288




Abdominal viscera 292




Peritoneum 292




Peritoneal cavity 293




Organs 297




Arterial supply 327




Venous drainage 337




Lymphatics 341




Innervation 341




Posterior abdominal region 348




Posterior abdominal wall 349




Viscera 355




Vasculature 366




Lymphatic system 372




Nervous system in the posterior abdominal




region 374




Sympathetic trunks and splanchnic nerves 374




Surface anatomy 382




Abdomen surface anatomy 382




Defining the surface projection of the




abdomen 383




How to find the superficial inguinal ring 384




How to determine lumbar vertebral levels 385




Visualizing structures at the L1 vertebral




level 386




Visualizing the position of major blood




vessels 387




Using abdominal quadrants to locate major




viscera 388




Defining surface regions to which pain from the gut




is referred 389




Where to find the kidneys 390




Where to find the spleen 390




Clinical cases 391








5 Pelvis and perineum




Conceptual overview 406




General description 406




Functions 406




Contain and support bladder, rectum, anal canal,




and reproductive tracts 406




Anchors the roots of the external genitalia 408




Component parts 408




Pelvic inlet 408




Pelvic walls 409




Pelvic outlet 409




Pelvic floor 411




Pelvic cavity 411




Perineum 412




Relationship to other regions 414




Abdomen 414




Lower limb 414




Key features 415




The pelvic cavity projects posteriorly 415




Important structures cross the ureters in the pelvic




cavity 415




The prostate is anterior to rectum 417




The perineum is innervated by sacral spinal cord




segments 417




Nerves are related to bone 418




Parasympathetic innervation from spinal cord levels




S2 to S4 controls erection 418




Muscles and fascia of the pelvic floor and perineum




intersect at the perineal body 419




Gender determines the course of the urethra 419




Regional anatomy 421




Pelvis 421




Bones 421




Joints 426




Orientation 428




Gender differences 428




True pelvis 429




Vicera 438




Fascia 458




Peritoneum 460




Nerves 462




Blood vessels 471




Lymphatics 477




Perineum 478




Borders and ceiling 478




Ischio-anal fossae and their anterior recesses 480




Anal triangle 480




Urogenital triangle 483




Somatic nerves 490




Visceral nerves 492




Blood vessels 492




Veins 494




Lymphatics 496




Surface anatomy 497




Surface anatomy of the pelvis and perineum 497




Orientation of the pelvis and perineum in the




anatomical position 497




How to define the margins of the perineum 497




Identification of structures in the anal triangle 499




Identification of structures in the urogenital triangle




of women 500




Identification of structures in the urogenital triangle




of men 501




Clinical cases 504








6 Lower limb




Conceptual overview 512




General introduction 512




Function 513




Support the body weight 513




Locomotion 515




Component parts 517




Bones and joints 517




Muscles 518




Relationship to other regions 520




Abdomen 520




Pelvis 521




Perineum 521




Key points 521




Innervation is by lumbar and sacral spinal




nerves 521




Nerves related to bone 525




Superficial veins 525




Regional anatomy 526




Bony pelvis 526




Proximal femur 529




Hip joint 532




Gateways to the lower limb 535




Nerves 537




Arteries 540




Veins 542




Lymphatics 542




Deep fascia and the saphenous opening 544




Femoral triangle 545




Gluteal region 547




Muscles 548




Nerves 551




Arteries 554




Veins 554




Lymphatics 554




Thigh 555




Bones 555




Muscles 561




Arteries 569




Veins 573




Nerves 573




Knee joint 575




Tibiofibular joint 584




Popliteal fossa 584




Leg 585




Bones 586




Joints 588




Posterior compartment of leg 588




Lateral compartment of leg 595




Anterior compartment of leg 596




Foot 600




Bones 600




Joints 605




Tarsal tunnel, retinacula, and arrangement of major




structures at the ankle 612




Arches of the foot 614




Plantar aponeurosis 615




Fibrous sheaths of toes 615




Extensor hoods 616




Intrinsic muscles 616




Arteries 622




Veins 624




Nerves 624




Surface anatomy 628




Lower limb surface anatomy 628




Avoiding the sciatic nerve 628




Finding the femoral artery in the femoral




triangle 630




Identifying structures around the knee 630




Visualizing the contents of the popliteal fossa 632




Finding the tarsal tunnel-the gateway to the




foot 633




Identifying tendons around the ankle and in the




foot 634




Finding the dorsalis pedis artery 635




Approximating the position of the plantar arterial




arch 635




Major superficial veins 636




Pulse points 637




Clinical cases 638








77 Upper limb




Conceptual overview 650




General description 650




Functions 651




Positioning the hand 651




The hand as a mechanical tool 651




The hand as a sensory tool 654




Component parts 654




Bones and joints 654




Muscles 655




Relationship to other regions 657




Neck 657




Back and thoracic wall 658




Key points 659




Innervation by cervical and upper thoracic




nerves 659




Nerves related to bone 663




Superficial veins 663




Orientation of the thumb 664




Regional anatomy 665




Shoulder 665




Bones 665




Joints 668




Muscles 675




Posterior scapular region 678




Muscles 678




Gateways to the posterior scapular region 680




Nerves 682




Arteries and veins 682




Axilla 684




Axillary inlet 685




Anterior wall 686




Medial wall 688




Lateral wall 690




Posterior wall 691




Gateways in the posterior wall 692




Floor 693




Contents of the axilla 693




Arm 710




Bones 712




Muscles 715




Arteries and veins 717




Nerves 720




Elbow joint 724




Cubital fossa 729




Forearm 731




Bones 732




Joints 734




Anterior compartment of the forearm 736




Muscles 736




Arteries and veins 742




Nerves 743




Posterior compartment of the forearm 745




Muscles 745




Arteries and veins 750




Nerves 751




Hand 751




Bones 752




Joints 754




Carpal tunnel and structures at the wrist 756




Palmar aponeurosis 758




Palmaris brevis 759




Anatomical snuffbox 759




Fibrous digital sheaths 759




Extensor hoods 760




Muscles 762




Arteries and veins 767




Nerves 770




Surface anatomy 775




Upper limb surface anatomy 775




Bony landmarks and muscles of the posterior




scapular region 775




Visualizing the axilla and locating contents and




related structures 777




Locating the brachial artery in the arm 779




The triceps brachii tendon and position of the radial




nerve 779




Cubital fossa (anterior view) 779




Identifying tendons and locating major vessels and




nerves in the distal forearm 781




Normal appearance of the hand 782




Position of the flexor retinaculum and the recurrent




branch of the median nerve 783




Motor function of the median and ulnar nerves in




the hand 783




Visualizing the positions of the superficial and deep




palmar arches 784




Pulse points 784




Clinical cases 786












8 Head and neck




Conceptual overview 796




General description 796




Head 796




Neck 798




Functions 799




Protection 799




Contains upper parts of respiratory and digestive




tracts 799




Communication 800




Positioning the head 800




Connects the upper and lower respiratory and




digestive tracts 800




Component parts 800




Skull 800




Cervical vertebrae 802




Hyoid bone 803




Soft palate 804




Muscles 804




Relationship to other regions 805




Thorax 805




Upper limbs 805




Key features 806




Vertebral levels CIII/IV and CV/VI 806




Airway in the neck 806




Cranial nerves 807




Cervical nerves 808




Functional separation of the digestive and




respiratory passages 808




Triangles of the neck 811




Regional anatomy 812




Skull 812




Anterior view 812




Lateral view 814




Posterior view 816




Superior view 818




Inferior view 819




Cranial cavity 822




Roof 822




Floor 823




Meninges 830




Cranial dura mater 830




Arachnoid mater 833




Pia mater 833




Arrangement of meninges and spaces 834




Brain and its blood supply 835




Brain 835




Blood supply 837




Venous drainage 842




Cranial nerves 848




Olfactory nerve [I] 849




Optic nerve [II] 850




Oculomotor nerve [III] 850




Trochlear nerve [IV] 850




Trigeminal nerve [V] 851




Ophthalmic nerve [V1] 852




Maxillary nerve [V2] 852




Mandibular nerve [V3] 852




Abducent nerve [VI] 852




Facial nerve [VII] 852




Vestibulocochlear nerve [VIII] 853




Glossopharyngeal nerve [IX] 853




Vagus nerve [X] 853




Accessory nerve [XI] 854




Hypoglossal nerve [XII] 854




Face 856




Muscles 857




Parotid gland 863




Innervation 865




Vessels 869




Scalp 873




Layers 873




Innervation 874




Vessels 876




Lymphatic drainage 877




Orbit 878




Bony orbit 878




Eyelids 879




Lacrimal apparatus 882




Sensory innervation 882




Fissures and foramina 885




Fascial specializations 886




Muscles 887




Vessels 892




Innervation 893




Eyeball 898




Ear 902




External ear 903




Middle ear 906




Internal ear 913




Temporal and infratemporal fossae 920




Bony framework 920




Temporomandibular joints 922




Masseter muscle 925




Temporal fossa 926




Infratemporal fossa 929




Pterygopalatine fossa 940




Skeletal framework 940




Gateways 941




Contents 942




Neck 947




Fascia 948




Superficial venous drainage 950




Anterior triangle of the neck 954




Posterior triangle of the neck 968




Root of the neck 976




Pharynx 985




Skeletal framework 986




Pharyngeal wall 987




Fascia 990




Gaps in the pharyngeal wall and structures passing




through them 990




Nasopharynx 991




Oropharynx 993




Laryngopharynx 993




Tonsils 993




Vessels 994




Nerves 996




Larynx 997




Laryngeal cartilages 998




Extrinsic ligaments 1000




Intrinsic ligaments 1001




Laryngeal joints 1002




Cavity of the larynx 1003




Intrinsic muscles 1005




Function of the larynx 1008




Vessels 1010




Nerves 1012




Nasal cavities 1013




Lateral wall 1014




Regions 1015




Innervation and blood supply 1016




Skeletal framework 1016




External nose 1018




Paranasal sinuses 1018




Walls, floor, and roof 1020




Nares 1024




Choanae 1024




Gateways 1024




Vessels 1026




Innervation 1028




Oral cavity 1030




Multiple nerves innervate the oral cavity 1031




Skeletal framework 1031




Walls: the cheeks 1034




Floor 1035




Tongue 1037




Salivary glands 1044




Roof-palate 1047




Oral fissure and lips 1055




Oropharyngeal isthmus 1055




Teeth and gingivae 1056




Surface anatomy 1061




Head and neck surface anatomy 1061




Anatomical position of the head and major




landmarks 1062




Visualizing structures at the CIII/CIV and CVI




vertebral levels 1063




How to outline the anterior and posterior triangles




of the neck 1063




How to locate the cricothyroid ligament 1064




How to find the thyroid gland 1065




Estimating the position of the middle meningeal




artery 1066




Major features of the face 1067




The eye and lacrimal apparatus 1068




External ear 1069




Pulse points 1070




Clinical cases 1071