Gray's Basic Anatomy 3rd Edition

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 THIRD EDITION

BASIC
GRAY’S
ANATOMY
Richard L. Drake, PhD, FAAA
Professor Emeritus of Surgery
Cleveland Clinic Lerner College of Medicine
Case Western Reserve University
Cleveland, Ohio

A. Wayne Vogl, PhD, FAAA

Professor of Anatomy and Cell Biology
Department of Cellular and Physiological Sciences
Faculty of Medicine
University of British Columbia
Vancouver, British Columbia

Adam W.M. Mitchell, MBBS, FRCS, FRCR

Consultant Radiologist
Director of Radiology
Fortius Clinic
London, United Kingdom

Illustrations by
Richard Tibbitts and Paul Richardson

Photographs by
Ansell Horn
Elsevier
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899

GRAY’S BASIC ANATOMY, THIRD EDITION ISBN: 978-0-323-83442-1

Copyright © 2023 by Elsevier, Inc. All rights reserved.

First Edition copyrighted 2012 by Churchill Livingstone, an imprint of Elsevier, Inc.

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
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Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
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the material herein.

Previous editions copyrighted 2018 and 2012.

Publisher: Jeremy Bowes

Director, Content Development: Rebecca Gruliow
Publishing Service Manager: Shereen Jameel
Senior Project Manager: Beula Christopher
Design Direction: Amy Buxton

Printed in India

9 8 7 6 5 4 3 2 1
 To my parents who guide me,
To my wife who supports me,
To my students who challenge me
RLD

To my family, my colleagues, my mentors, and my students

AWV

To all my family, Cathy, Max and Elsa, and my colleagues

AWMM
Acknowledgments
Any book, no matter the size, is a major undertaking, and we contributing images for the head and neck chapter; and Dr.
want to thank all of the individuals who have helped move Bruce Crawford and Logan Lee for help with images for the
this project to completion. These include William Schmitt and surface anatomy of the upper limb. We also want to thank
Rebecca Gruliow, who both helped in initially evaluating the Dr. Bradley Little and Dr. Arlo Adams for contributing non-­
need for this type of concise textbook and in moving the first binary and transgender elements to the text and Clinical
edition forward to completion. Jeremy Bowes and Rebecca Apps to make the book more inclusive.
Gruliow guided the third edition through to completion. We Finally, we are very appreciative of the numerous indi-
also appreciate the contributions of our illustrators, Richard viduals, anatomists, and educators who provided feedback
Tibbitts and Paul Richardson, who did all of the artwork. on the first and second editions and whose suggestions were
We’d also like to thank Professor Richard A. Buckingham included in this third edition.
of the Abraham Lincoln School of Medicine, University of Richard L. Drake
Illinois, for Fig. 8.100B; Dr. Murray Morrison, Dr. Joanne A. Wayne Vogl
Matsubara, Dr. Brian Westerberg, Laura Hall, and Jing Cui for Adam W.M. Mitchell

vii
Preface
Gray’s Basic Anatomy was developed in response to students chapters: The Body, Back, Thorax, Abdomen, Pelvis and
and colleagues from around the world who requested a more Perineum, Lower Limb, Upper Limb, and Head and Neck.
concise description of anatomy than that presented in Gray’s The artwork presents the same familiar illustrations from
Anatomy for Students. To accomplish this goal, we reworked Gray’s Anatomy for Students, but they have been resized to fit
the material to focus mainly on regional anatomy and inte- within a smaller format while retaining a close physical loca-
grated the clinical material, imaging, and surface anatomy tion to the text with which each figure is associated. Finally,
information directly into the text as: while some verbiage has been sacrificed in keeping with the
• Clinical apps, which give students context for why a goal of presenting a concise textbook of anatomy (e.g., mus-
strong anatomical background helps facilitate the solving cle descriptions have for the most part been incorporated
of clinical problems; into tables with no loss of content), additional clinical and
• Imaging apps, which offer students a great introduction to imaging material has been added to enhance learning in
the different techniques and modalities available for imag- context.
ing relevant anatomy; and This third edition includes numerous edits resulting from
• Surface anatomy boxes, which help students visualize the reader feedback, some new and revised figures, and revisions
relationship between anatomical structures and surface based on current research in the field of the anatomical sciences.
landmarks necessary for any kind of patient examination. We hope you will continue to find this new edition a use-
ful and valuable resource whether you are an educator or a
In addition, at the beginning of each chapter students student.
are directed to additional learning resources available on Richard L. Drake
Student Consult (Elsevier’s online educational website). A. Wayne Vogl
Summarizing, Gray’s Basic Anatomy uses a regional Adam W.M. Mitchell
approach, similar to Gray’s Anatomy for Students, with eight

ix
Index of Clinical Apps, Imaging Apps,
and Surface Anatomy Boxes

1
Osteoporosis 44
The Body Back pain 45
Herniation of intervertebral discs 45
CLINICAL APPS Joint diseases 46
Ligamenta flava 47
Bone marrow transplants 10 Vertebral fractures 47
Bone fractures 11 Pars interarticularis fractures 48
Avascular necrosis 11 Surgical procedures on the back 48
Osteoporosis 11 Nerve injuries affecting superficial back
Epiphyseal fractures 11 muscles 49
Joint replacement 13 Lumbar cerebrospinal fluid tap 59
Degenerative joint disease 14 Anesthesia within the vertebral
Arthroscopy 15 canal 60
The importance of fascias 15 Herpes zoster 60
Muscle paralysis 16
Muscle atrophy 16 IMAGING APPS
Muscle injuries and strains 16
Atherosclerosis 17 Typical cervical vertebrae 36
Varicose veins 17 Typical thoracic vertebrae 37
Anastomoses and collateral circulation 17 Typical lumbar vertebrae 37
Lymph nodes 19 Articulation between atlas and axis 40
Dermatomes and myotomes 23
Referred pain 33
SURFACE ANATOMY
IMAGING APPS How to identify specific vertebral spinous processes 41
Primary and secondary curvatures in the sagittal plane 43
Determination of skeletal age 10 Visualizing the inferior ends of the spinal cord and
subarachnoid space 58

2 Back
3 Thorax
CLINICAL APPS
CLINICAL APPS
Spina bifida 43
Vertebroplasty 43 Axillary process of breast 65
Scoliosis 44 Breast cancer 66
Kyphosis 44 Thoracic outlet syndrome 67
Lordosis 44 Cervical ribs 72
Variation in vertebral numbers 44 Rib fractures 72
The vertebrae and cancer 44 Collection of sternal bone marrow 73

xi
 Index of Clinical Apps, Imaging Apps, and Surface Anatomy Boxes

The manubriosternal joint as reference 75 Visualizing structures in the superior mediastinum 128
Surgical access to the chest 82 Visualizing structures at the TIV vertebral level 132
Thoracostomy (chest) tube insertion 82 Visualizing the mediastinum in the axial plane 141
Intercostal nerve block 83
The arrangement of pleural cavities is clinically significant 85 SURFACE ANATOMY
Innervation of parietal and visceral pleura 86
Pleural recesses 87 The breast in women 67
Pleural effusion 88 How to count ribs 76
Pneumothorax 88 Visualizing structures at the TIV/V vertebral level 76
Inhaled objects 94 Visualizing the pleural cavities and lungs, pleural recesses, and
Lung cancer 101 lung lobes and fissures 91
Pneumonia 101 Where to listen for lung sounds 93
Pericardial innervation 104 Visualizing the margins of the heart 110
Pericarditis 104 Where to listen for heart sounds 116
Pericardial effusion 105 Visualizing structures in the superior mediastinum 134
Constrictive pericarditis 105
Valve disease 116
Common congenital heart defects 117
Cardiac auscultation 117
Clinical terminology for coronary arteries 120
4 Abdomen
Cardiac conduction system 121
CLINICAL APPS
Heart attack 124
Classic symptoms of heart attack 124 Preperitoneal vs. retroperitoneal 153
Referred pain 125 Surgical incisions 160
Are heart attack symptoms the same in men and women? 125 Cremasteric reflex 161
Ectopic parathyroid glands in the thymus 127 Masses around the groin 161
Left brachiocephalic vein 129 Inguinal hernias 162
Venous access for central and dialysis lines 130 Indirect inguinal hernias 162
Using the superior vena cava to access the inferior vena Direct inguinal hernias 162
cava 130 Femoral hernias 162
Coarctation of the aorta 131 Umbilical hernias 163
Traumatic injury to the aorta 131 Incisional hernias 163
Aortic dissection 132 Sportsmen’s groin/sportsmen’s hernia 163
Aortic arch and its anomalies 132 Other hernias 163
Abnormal origin of great vessels 133 Potential problem of hernias 163
The vagus nerves, recurrent laryngeal nerves, and The peritoneum 164
hoarseness 134 Innervation of peritoneum 164
Esophagus constrictions 136 Ventriculoperitoneal shunts 164
Esophageal cancer 137 Hemodialysis and peritoneal dialysis 164
Esophageal rupture 137 Peritoneal spread of disease 164
Perforated bowel 165
IMAGING APPS The greater omentum 166
Epithelial transition between the abdominal esophagus and
Visualizing the pulmonary trunk by computed tomography 96 stomach 171
Visualizing the lungs 98 Surgery for obesity 172
Plain chest radiograph 100 Duodenal ulceration 172
Visualizing the heart 108 Examination of the bowel lumen 172
Visualizing the chambers of the heart 110 Meckel’s diverticulum 172
Visualizing the left atrium and pulmonary veins 113 Carcinoma of the stomach 172

xii
 Index of Clinical Apps, Imaging Apps, and Surface Anatomy Boxes

5
Appendicitis 175
Congenital disorders of the gastrointestinal Pelvis and Perineum
tract 178
Bowel obstruction 178 CLINICAL APPS
Diverticular disease 178
Ostomies 182 Bone marrow biopsy 226
Segmental anatomy of the liver 182 Common problems with the sacro-­iliac joints 228
Anular pancreas 184 Pelvic fracture 230
Pancreatic cancer 185 Pelvic measurements in obstetrics 232
Gallstones 186 Defecation 234
Jaundice 186 Episiotomy 236
Spleen disorders 187 Digital rectal examination 237
Vascular supply to the gastrointestinal Carcinoma of the colon and rectum 237
system 193 Bladder cancer 239
Portosystemic anastomosis 195 Bladder stones 240
Hepatic cirrhosis 195 Suprapubic catheterization 240
Psoas muscle abscess 205 Bladder infection 241
Diaphragmatic hernias 205 Urethral catheterization 241
Hiatal hernia 206 Undescended testes 242
Urinary tract stones 210 Hydrocele of the testis 243
Urinary tract cancer 210 Testicular tumors 243
Kidney transplant 210 Vasectomy 243
Abdominal aortic stent graft 213 Prostate problems 244
Inferior vena cava filter 215 Ovarian cancer 245
Retroperitoneal lymph node surgery 217 Hysterectomy 246
Tubal ligation 246
IMAGING APPS Carcinoma of the cervix and uterus 247
The recto-­uterine pouch 250
Visualizing the stomach 169 Pudendal block 254
Visualizing the jejunum and ileum 171 Prostatectomy and impotence 258
Visualizing the large intestine 173 Hemorrhoids 262
Endoscopic examination of the abdominal gastrointestinal Abscesses in the ischio-­anal fossae 265
tract 179 Urethral rupture 271
Visualizing the liver 181
Visualizing the pancreas 184 IMAGING APPS
Visualizing the diaphragm 205
Investigation of the urinary tract 211 Visualizing the male pelvic cavity and perineum in the axial
plane 276
Visualizing the female pelvic cavity and perineum in the
SURFACE ANATOMY
sagittal plane 279
Using abdominal quadrants to locate major viscera 147 Visualizing the female pelvic cavity and perineum in the
Defining surface regions to which pain from the gut is coronal plane 281
referred 147 Visualizing the female pelvic cavity and perineum in the axial
How to find the superficial inguinal ring 161 plane 282
Visualizing the position of major blood vessels 215

xiii
 Index of Clinical Apps, Imaging Apps, and Surface Anatomy Boxes

SURFACE ANATOMY SURFACE ANATOMY

Defining the margins of the perineum 264 Finding the femoral artery in the femoral triangle 303
Superficial features of the external genitalia in women 267 Visualizing the contents of the popliteal fossa 331
Superficial features of the external genitalia in men 269 Finding the tarsal tunnel—the gateway to the foot 352
Finding the dorsalis pedis artery 359
Pulse points 365

6 Lower Limb
CLINICAL APPS 7 Upper Limb
Pelvic fractures 290 CLINICAL APPS
Femoral neck fractures 292
Intertrochanteric fractures 293 Fracture of the proximal humerus 372
Femoral shaft fractures 293 Fractures of the clavicle and dislocations of the
Varicose veins 298 acromioclavicular and sternoclavicular joints 376
Deep vein thrombosis 298 Dislocations of the glenohumeral joint 377
Harvesting veins for grafts 299 Rotator cuff disorders 377
Vascular access in the lower limb 303 Quadrangular space syndrome 380
Trendelenburg’s sign 305 “Winging” of the scapula 384
Intramuscular injection in the gluteal region: avoiding the Trauma to the arteries in and around the axilla 389
sciatic nerve 307 Central venous access via the subclavian/axillary vein 389
Shin splints 313 Damage to long thoracic nerve 393
Quadriceps injury 315 Injuries to the brachial plexus 397
Hamstring injuries 317 Lymphatic drainage and breast cancer 398
Compartment syndrome 317 Rupture of biceps tendon 401
Peripheral vascular disease 320 Median nerve injury in the arm 402
Soft tissue injuries to the knee 328 Radial nerve injury in the arm 403
Clinical tests for tears in the cruciate ligaments 328 Supracondylar fracture of the humerus 407
Arthroscopy 328 Pulled elbow 407
Foot drop 340 Fracture of the head of radius 407
Fracture of the talus 342 “Tennis” and “golfer’s” elbow (epicondylitis) 407
Calcaneal (Achilles) tendon rupture 343 Ulnar nerve injury at the elbow 408
Ankle injuries 348 Construction of a dialysis fistula 409
Bunions 350 Blood pressure measurement 409
Morton’s neuroma 361 Fractures of the radius and ulna 412
Dermatomes and myotomes in the lower limb 362 Fracture of the scaphoid and avascular necrosis of the
Testing sensory innervation carried by major peripheral nerves proximal scaphoid 426
in the lower limb 363 Knuckle cracking 426
Tendon taps in the lower limb 364 De Quervain syndrome 427
Gait and gait defects 364 Carpal tunnel syndrome 428
Tenosynovitis 429
IMAGING APPS Trigger finger 429
Allen’s test 435
Visualizing the hip joint 296 Ulnar nerve injury 436
Visualizing the knee joint 328 Radial nerve injury 439
Visualizing the bones of the foot 344 Dermatomes and myotomes in the upper limb 439
Visualizing the ankle joint 347 Tendon taps in the upper limb 439
Testing sensory innervation carried by major peripheral nerves
in the upper limb 440
xiv
 Index of Clinical Apps, Imaging Apps, and Surface Anatomy Boxes

IMAGING APPS Overview of cranial nerves 481

Parotid gland—tumors and stones 490
Visualizing the sternoclavicular joint 373 Trigeminal neuralgia 491
Visualizing the acromioclavicular joint 374 Facial nerve [VII] palsy (Bell’s palsy) 496
Visualizing the glenohumeral joint 375 Scalp laceration 500
Visualizing the rotator cuff muscles 376 Orbital fracture 502
Developmental changes in the elbow joint 406 Full and partial ptosis 505
Visualizing the elbow joint 407 Horner’s syndrome 505
Visualizing the forearm 411 The H–test 514
Visualizing the hand and wrist joint 424 Ophthalmoscopy 519
Glaucoma 520
Cataracts 520
SURFACE ANATOMY
Swimmer’s ear 524
Locating the brachial artery in the right arm 404 Surfer’s ear 524
Identifying tendons and locating major vessels and nerves in Examination of the ear 525
the distal forearm 421 Mastoiditis 528
Position of the flexor retinaculum and the recurrent branch of Temporomandibular joint disorders 539
the median nerve 427 Lingual nerve injury 546
Motor function of the median and ulnar nerves in the Anesthesia of the inferior alveolar nerve 546
hand 438 Middle meningeal artery and extradural hematoma 550
Pulse points 441 Spread of infection from the pterygoid plexus into the cranial
cavity 550
Dry eye 555
Spread of neck infections 560
8 Head and Neck Central venous access 561
Tracheobronchial injury 569
Thyroidectomy 571
CLINICAL APPS
Goiter 572
Hyperparathyroidism 572
Medical imaging of the head 461
Ectopic parathyroid glands 572
Fractures of the skull vault 461
Recurrent laryngeal nerve palsy 580
Cerebrospinal fluid leak 466
Clinical lymphatic drainage of the head and neck 584
Hydrocephalus 466
Laryngoscopy 593
Meningitis 466
Cricothyrotomy 597
Endarterectomy 468
Exogenous testosterone and vocal cord mass 601
Stroke 468
Tracheostomy 603
Intracerebral aneurysms 468
Deviated nasal septum 606
Emissary veins 472
Surgical approach to the pituitary gland 609
Head injury 472
Epistaxis 614
Concussion 472
Oral cancer 617
Types of intracranial hemorrhage 473
Test for cranial nerve XII 624
Scalp and meninges 474
Test for cranial nerve X 631
Cranial nerve lesions 481

xv
 Index of Clinical Apps, Imaging Apps, and Surface Anatomy Boxes

IMAGING APPS SURFACE ANATOMY

Visualizing the skull—anterior view 447 Anatomical position of the head and major landmarks 450
Visualizing the skull—lateral view 449 Estimating the position of the middle meningeal artery 461
Visualizing the internal carotid and vertebral arteries 468 Major features of the face 497
Visualizing the muscles of the eyeball 512 The eye and lacrimal apparatus 506
Visualizing the nasal cavities and paranasal sinuses 608 How to outline the anterior and posterior triangles of the
neck 558
How to find the thyroid gland 572
How to locate the cricothyroid ligament 597
Pulse points 639

xvi
Contents

1
Joints 42
The Body Joints between vertebrae in the back 42
Ligaments 46
What is anatomy? 2 Anterior and posterior longitudinal ligaments 46
How can gross anatomy be studied? 2 Ligamenta flava 46
Important anatomical terms 2 Supraspinous ligament and ligamentum nuchae 46
Imaging 3 Interspinous ligaments 47
Diagnostic imaging techniques 3 Back musculature 48
Image interpretation 7 Superficial group of back muscles 48
Plain radiography 7 Intermediate group of back muscles 50
Computed tomography 8 Deep group of back muscles 51
Magnetic resonance imaging 8 Thoracolumbar fascia 53
Nuclear medicine imaging 8 Spinal cord 55
Safety in imaging 8 Vasculature 56
Body systems 9 Meninges 57
Skeletal system 9 Arrangement of structures in the vertebral canal 58
Cartilage 9 Spinal nerves 58
Bone 9
Joints 11

3
Skin and fascias 15
Skin 15 Thorax
Fascia 15
Muscular system 15 Regional anatomy 64
Cardiovascular system 16 Pectoral region 64
Lymphatic system 18 Breast 64
Lymphatic vessels 18 Muscles of the pectoral region 66
Lymph nodes 18 Thoracic wall 66
Lymphatic trunks and ducts 19 Superior thoracic aperture 67
Nervous system 20 Inferior thoracic aperture 67
Central nervous system 20 Skeletal framework 68
Functional subdivisions of the CNS 21 Intercostal spaces 75
Other systems 33 Diaphragm 81
Venous drainage 83
Innervation 83

2
Movements of the thoracic wall and diaphragm during
Back breathing 84
Pleural cavities 84
Regional anatomy 36 Pleura 84
Skeletal framework 36 Lungs 88
Vertebrae 36 Mediastinum 97
Intervertebral foramina 40 Anterior mediastinum 102
Posterior spaces between vertebral Middle mediastinum 102
arches 41 Superior mediastinum 126
Curvatures of vertebral column 41 Posterior mediastinum 135

xvii
 Contents

4
Perineum 262
Abdomen Borders and ceiling 263
Ischio-­anal fossae and their anterior recesses 264
Regional anatomy 146 Anal triangle 265
Surface topography 146 Urogenital triangle 265
Four-­quadrant pattern 146 Somatic nerves 271
Nine-­region pattern 146 Visceral nerves 271
Abdominal wall 147 Blood vessels 272
Superficial fascia 148 Veins 274
Anterolateral muscles 149 Lymphatics 274
Extraperitoneal fascia 152
Peritoneum 153
Innervation 153
Arterial supply and venous drainage 155
Lymphatic drainage 155
6 Lower Limb
Groin 156 Regional anatomy 286
Inguinal canal 157 The hip 287
Abdominal viscera 163 Bony pelvis 287
Peritoneum 163 Proximal femur 290
Peritoneal cavity 164 Hip joint 292
Organs 167 Gateways to the lower limb 295
Arterial supply to the gastrointestinal tract 187 Nerves 297
Venous drainage 193 Arteries 297
Lymphatics 196 Veins 298
Innervation 196 Lymphatics 299
Posterior abdominal region 201 Deep fascia and the saphenous opening 300
Posterior abdominal wall 201 Femoral triangle 301
Viscera 206 Gluteal region 303
Vasculature 212 Muscles 303
Lymphatic system 216 Nerves 305
Nervous system in the posterior abdominal region 217 Arteries 308
Sympathetic trunks and splanchnic nerves 217 Veins 308
Lymphatics 308
Thigh 309

5 Pelvis and Perineum

Bones 309
Muscles 313
Arteries 317
Regional anatomy 224 Veins 321
Pelvis 224 Nerves 321
Bones 224 Knee joint 323
Joints 227 Tibiofibular joint 329
Orientation 229 Popliteal fossa 329
Differences between men and women 229 Leg 331
True pelvis 230 Bones 331
Viscera 236 Joints 333
Fascia 247 Posterior compartment of leg 333
Peritoneum 248 Lateral compartment of leg 337
Nerves 251 Anterior compartment of leg 338
Blood vessels 258 Foot 340
Lymphatics 262 Bones 340
Joints 344
xviii
 Contents

Tarsal tunnel, retinacula, and arrangement of major Hand 422

structures at the ankle 351 Bones 423
Arches of the foot 352 Joints 425
Plantar aponeurosis 353 Carpal tunnel and structures at the wrist 426
Fibrous sheaths of toes 353 Palmar aponeurosis 427
Extensor hoods 354 Anatomical snuffbox 428
Intrinsic muscles 355 Fibrous digital sheaths 429
Arteries 357 Extensor hoods 429
Veins 359 Muscles 430
Nerves 359 Arteries and veins 432
Nerves 435

7 Upper Limb
8 Head and Neck
Regional anatomy 368
Shoulder 370 Regional anatomy 445
Bones 370 Head 446
Joints 372 Neck 446
Muscles 377 Skull 446
Posterior scapular region 379 Anterior view 446
Gateways to the posterior scapular region 379 Lateral view 448
Nerves 380 Posterior view 451
Arteries and veins 381 Superior view 451
Axilla 381 Inferior view 452
Axillary inlet 382 Cranial cavity 454
Anterior wall 382 Roof 455
Medial wall 383 Floor 455
Lateral wall 384 Meninges 462
Posterior wall 384 Cranial dura mater 462
Gateways in the posterior wall 386 Arachnoid mater 465
Floor 386 Pia mater 465
Contents of the axilla 386 Meningeal spaces 465
Arm 398 Brain and its blood supply 466
Bones 398 Brain 466
Muscles 401 Blood supply 467
Nerves 401 Venous drainage 469
Arteries and veins 403 Cranial nerves 475
Elbow joint 405 Olfactory nerve [I] 475
Cubital fossa 408 Optic nerve [II] 475
Forearm 410 Oculomotor nerve [III] 477
Bones 410 Trochlear nerve [IV] 478
Joints 412 Trigeminal nerve [V] 478
Anterior compartment of the forearm 414 Ophthalmic nerve [V1] 478
Muscles 414 Maxillary nerve [V2] 479
Arteries and veins 414 Mandibular nerve [V3] 479
Nerves 417 Abducent nerve [VI] 479
Posterior compartment of the forearm 418 Facial nerve [VII] 479
Muscles 418 Vestibulocochlear nerve [VIII] 479
Arteries and veins 418 Glossopharyngeal nerve [IX] 480
Nerves 421 Vagus nerve [X] 480
xix
 Contents

Accessory nerve [XI] 480 Laryngopharynx 590

Hypoglossal nerve [XII] 484 Tonsils 590
Face 484 Vessels 590
Muscles 484 Nerves 591
Parotid gland 487 Larynx 592
Innervation 489 Laryngeal cartilages 593
Vessels 492 Extrinsic ligaments 595
Scalp 496 Intrinsic ligaments 596
Layers 496 Laryngeal joints 597
Innervation 498 Cavity of the larynx 598
Vessels 499 Intrinsic muscles 600
Lymphatic drainage 500 Function of the larynx 601
Orbit 501 Vessels 602
Bony orbit 501 Nerves 603
Eyelids 502 Nasal cavities 604
Lacrimal apparatus 505 Lateral wall 605
Sensory innervation 506 Regions 605
Fissures and foramina 507 Skeletal framework 606
Fascial specializations 509 External nose 606
Muscles 510 Paranasal sinuses 607
Vessels 513 Walls, floor, and roof 609
Innervation 515 Nares 611
Eyeball 519 Choanae 611
Ear 522 Gateways 611
External ear 522 Vessels 613
Middle ear 526 Innervation 614
Internal ear 530 Oral cavity 616
Temporal and infratemporal fossae 535 Skeletal framework 617
Bony framework 536 Walls: the cheeks 620
Temporomandibular joints 538 Floor 621
Masseter muscle 540 Salivary glands 627
Temporal fossa 540 Roof—palate 629
Infratemporal fossa 541 Oral fissure and lips 633
Pterygopalatine fossa 550 Oropharyngeal isthmus 634
Skeletal framework 551 Teeth and gingivae 634
Gateways 551
Contents 552

9
Neck 557
Fascia 558 Neuroanatomy (e-only)
Superficial venous drainage 560
Anterior triangle of the neck 561 Jennifer M. McBride, PhD
Posterior triangle of the neck 572 Cleveland Clinic, Cleveland Clinic Lerner College of Medicine
Root of the neck 577
To access this BONUS chapter PLUS the complete enhanced
Pharynx 584
eBook - see the inside front cover for instructions + your
Skeletal framework 585
unique PIN code.
Pharyngeal wall 586
Fascia 587
Gaps in the pharyngeal wall and structures passing through
them 587
Nasopharynx 588 Index 641
Oropharynx 590
xx