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Instant Anatomy E-Book

Robert H. Whitaker

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Beschreibung

Instant Anatomy presents anatomy and anatomical relationships in a simple, unique, schematic manner to aid the speedy understanding and retrieval of anatomical facts. It shows structures such as nerves and blood vessels in their entirety, unlike the partial, regional presentations given in most textbooks.

Covering the major aspects of anatomy, each section presents the relevant structures in double page spreads, with clear, full-colour diagrams on the left and concise text for each structure on the right. This new fifth edition includes more surface anatomy such as new myotome maps, bones of the hands and feet, principles of movement at shoulder and hip and images to clarify the understanding of the inguinal region and the lesser sac of the stomach.

Ideal for use alongside a core anatomy textbook, Instant Anatomy is the perfect quick reference guide for medical students, surgeons, radiologists and those in many other specialties. The companion website at www.instantanatomy.net with its podcasts and wide ranging multiple choice questions provide invaluable exam preparation.

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Seitenzahl: 219

Veröffentlichungsjahr: 2016

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CONTENTS

Cover

The Authors

Title Page

Copyright

Preface to Fifth Edition

Preface to First Edition

Notes on the Text

Chapter 1: Arteries

Coronary Arteries

Ascending & Arch of Aorta

Internal Carotid Artery, Vertebrobasilar System & Circle of Willis

Ophthalmic Artery

External Carotid Artery

Maxillary Artery

Middle Meningeal Artery

Subclavian Artery

Axillary Artery

Brachial Artery

Radial Artery

Ulnar Artery

Thoracic (Descending) Aorta

Abdominal Aorta

External Iliac Artery

Coeliac Trunk

Superior Mesenteric Artery

Inferior Mesenteric Artery

Internal Iliac Artery

Femoral Artery

Popliteal Artery

Anterior Tibial Artery

Posterior Tibial Artery

Fibular (Peroneal) Artery

Chapter 2: Veins

Intracranial Sinuses & Veins

Internal Jugular Vein

External Jugular Vein

Superior Vena Cava

Azygos Veins

Inferior Vena Cava

Portal Vein

Chapter 3: Lymphatics

Thoracic & Right Lymphatic Ducts

Lymph Nodes—Head & Neck

Lymph Nodes—Thorax

Lymph Nodes—Abdomen

Lymph Nodes—Upper Limb

Lymph Nodes—Lower Limb

Chapter 4: Autonomic Nervous System

Sympathetic

Parasympathetic

Summary of Taste

Abdominal Autonomics

Chapter 5: Cranial Nerves

Olfactory Nerve (I)

Optic Nerve (II)

Oculomotor Nerve (III)

Trochlear Nerve (IV)

Trigeminal Nerve—Ophthalmic Division (Va)

Trigeminal Nerve—Maxillary Division (Vb)

Trigeminal Nerve—Mandibular Division (Vc)

Abducent Nerve (VI)

Facial Nerve (VII)

Vestibulocochlear Nerve (VIII)

Glossopharyngeal Nerve (IX)

Vagus Nerve (X)

Accessory Nerve (XI)

Hypoglossal Nerve (XII)

Chapter 6: Peripheral Nerves

Cervical Plexus (C1,2,3,4,5)

Brachial Plexus (c6,6,7,8,T1)

Radial Nerve (c6,6,7,8,T1)

Musculocutaneous Nerve (c6,6,7)

Median Nerve (C6,7,8,T1)

Ulnar Nerve (C8,T1)

Phrenic Nerve (C3,4,5)

Intercostal Nerve (Typical)

Lumbar Plexus (T12,L1,2,3,4,5)

Femoral Nerve (L2,3,4)

Obturator Nerve (L2,3,4)

Sacral Plexus (L4,5,S1,2,3,4,5)

Sciatic Nerve (L4,5,S1,2,3)

Tibial Nerve (L4,5,S1,2,3)

Common Fibular [Peroneal] Nerve (L4,5,S1,2)

Superficial Fibular [Peroneal] Nerve (L5,S1,2)

Deep Fibular [Peroneal] Nerve (L4,5,S1,2)

Lateral Plantar Nerve (S1,2,3)

Medial Plantar Nerve (L4,5,S1,2,3)

Chapter 7: Dermatomes and Cutaneous Nerve Distribution

Chapter 8: Muscles

Abductor Digiti Minimi (foot)

Abductor Digiti Minimi (hand)

Abductor Hallucis

Abductor Pollicis Brevis

Abductor Pollicis Longus

Adductor Brevis

Adductor Hallucis

Adductor Longus

Adductor Magnus

Adductor Pollicis

Anconeus

Articularis Cubiti (Subanconeus)

Articularis Genu

Aryepiglotticus

Auricularis

Biceps Brachii

Biceps Femoris

Brachialis

Brachioradialis

Buccinator

Bulbospongiosus

Constrictor of Pharynx—Inferior

Constrictor of Pharynx—Middle

Constrictor of Pharynx—Superior

Coracobrachialis

Corrugator Supercilii

Cremaster

Cricothyroid

Dartos

Deep Transverse Perinei

Deltoid

Depressor Anguli Oris

Depressor Labii Inferioris

Diaphragm

Digastric

Erector Spinae—Iliocostocervicalis

Erector Spinae—Longissimus

Erector Spinae—Spinalis

Extensor Carpi Radialis Brevis

Extensor Carpi Radialis Longus

Extensor Carpi Ulnaris

Extensor Digiti Minimi (hand)

Extensor Digitorum (hand)

Extensor Digitorum Brevis (foot)

Extensor Digitorum Longus (foot)

Extensor Hallucis Longus

Extensor Indicis

Extensor Pollicis Brevis

Extensor Pollicis Longus

External Oblique Abdominis

Fibularis (Peroneus) Brevis

Fibularis (Peroneus) Longus

Fibularis (Peroneus) Tertius

Flexor Carpi Radialis

Flexor Carpi Ulnaris

Flexor Digiti Minimi Brevis (foot)

Flexor Digiti Minimi Brevis (hand)

Flexor Digitorum Accessorius (Quadratus Plantae) (foot)

Flexor Digitorum Brevis (foot)

Flexor Digitorum Longus (foot)

Flexor Digitorum Profundus (hand)

Flexor Digitorum Superficialis (hand)

Flexor Hallucis Brevis

Flexor Hallucis Longus

Flexor Pollicis Brevis

Flexor Pollicis Longus

Gastrocnemius

Gemellus Inferior

Gemellus Superior

Genioglossus

Geniohyoid

Gluteus Maximus

Gluteus Medius

Gluteus Minimus

Gracilis

Hyoglossus (& Chondroglossus)

Iliacus

Inferior Oblique (see also obliquus capitis inferior)

Inferior Rectus

Infraspinatus

Intercostals External

Intercostals Innermost

Intercostals Internal

Internal Oblique Abdominis

Interossei—Dorsal of Foot (4)

Interossei—Dorsal of Hand (4)

Interossei—Palmar of Hand (3)

Interossei—Plantar of Foot (3)

Interspinales

Intertransversarii

Intrinsic Muscle of Tongue

Ischiocavernosus

Lateral Cricoarytenoid

Lateral Pterygoid

Lateral Rectus

Latissimus Dorsi

Levator Anguli Oris

Levator Ani—Coccygeus

Levator Ani—Iliococcygeus

Levator Ani—Pubococcygeus

Levator Ani—Puborectalis

Levator Ani—Pubovaginalis (Levator Prostatae)

Levator Labii Superioris

Levator Labii Superioris Alaeque Nasi

Levator Palpebrae Superioris

Levator Scapulae

Levator Veli Palatini

Levatores Costarum

Longus Capitis

Longus Colli

Lumbricals Of Foot (4)

Lumbricals of Hand (4)

Masseter

Medial Pterygoid

Medial Rectus

Mentalis

Musculus Uvulae

Mylohyoid

Nasalis (Compressor & Dilator)

Oblique Arytenoid

Obliquus Capitis Inferior

Obliquus Capitis Superior

Obturator Externus

Obturator Internus

Occipitofrontalis

Omohyoid

Opponens Digiti Minimi (hand)

Opponens Pollicis

Orbicularis Oculi

Orbicularis Oris

Palatoglossus

Palatopharyngeus

Palmaris Brevis

Palmaris Longus

Pectineus

Pectoralis Major

Pectoralis Minor

Piriformis

Plantaris

Platysma

Popliteus

Posterior Cricoarytenoid

Procerus

Pronator Quadratus

Pronator Teres

Psoas Major

Psoas Minor

Pyramidalis

Quadratus Femoris

Quadratus Lumborum

Rectus Abdominis

Rectus Capitis Anterior

Rectus Capitis Lateralis

Rectus Capitis Posterior Major

Rectus Capitis Posterior Minor

Rectus Femoris (Quadriceps Femoris I)

Rhomboid Major

Rhomboid Minor

Risorius

Salpingopharyngeus

Sartorius

Scalenus Anterior

Scalenus Medius

Scalenus Minimus

Scalenus Posterior

Semimembranosus

Semitendinosus

Serratus Anterior

Serratus Posterior Inferior

Serratus Posterior Superior

Soleus

Sphincter Ani (external)

Sphincter Urethrae

Splenius Capitis

Splenius Cervicis

Stapedius

Sternocleidomastoid

Sternohyoid

Sternothyroid

Styloglossus

Stylohyoid

Stylopharyngeus

Subclavius

Subcostalis

Subscapularis

Superficial Transverse Perinei

Superior Oblique (See Also Obliquus Capitis Superior)

Superior Rectus

Supinator

Supraspinatus

Temporalis

Temporoparietalis

Tensor Fasciae Latae

Tensor Tympani

Tensor Veli Palatini

Teres Major

Teres Minor

Thyro-Arytenoid & Vocalis

Thyro-Epiglotticus

Thyrohyoid

Tibialis Anterior

Tibialis Posterior

Transverse Arytenoid

Transversospinalis—Multifidus

Transversospinalis—Rotatores

Transversospinalis—Semispinalis

Transversus Abdominis

Transversus Thoracis (Sternocostalis)

Trapezius

Triceps

Vastus Intermedius (Quadriceps Femoris 2)

Vastus Lateralis (Quadriceps Femoris 3)

Vastus Medialis (Quadriceps Femoris 4)

Zygomaticus Major

Zygomaticus Minor

Chapter 9: Joints

Unclassified

Named joints

Acromioclavicular

Atlanto-Axial—;Lateral

Atlanto-Axial—;Median

Atlanto-Occipital

Carpometacarpal—;Thumb

Costochondral

Costotransverse—RIBS 1—10

Costotransverse—RIBS 11, 12

Costovertebral

Interchondral

Intermetatarsal

Intertarsal—Cuboideonavicular

Intertarsal—Cuneocuboid

Intertarsal—Cuneonavicular

Intertarsal—Intercuneiform

Intervertebral

Manubriosternal

Metacarpophalangeal

Metatarsophalangeal

Pisotriquetral

Radio-Ulnar—Inferior

Radio-Ulnar—Interosseous Membrane & Oblique Cord

Radio-Ulnar—Superior

Sacrococcygeal

Sacro-Iliac

Skull Sutures

Spheno-Occipital

Symphysis Pubis

Talocalcaneonavicular

Tarsometatarsal

Temporomandibular

Tibiofibular—Inferior

Tibiofibular—Interosseous Membrane

Tibiofibular—Superior

Xiphisternal

Chapter 10: Ossification Times

Chapter 11: Foramina—Skull and Spine

Aqueduct of the Vestibule

Carotid Canal

Condylar Canal

Cribriform Foramina

External Acoustic Meatus

Facial Canal

Foramen Lacerum

Foramen Ovale

Foramen Rotundum

Foramen Spinosum

Foramen Transversarium

Greater Palatine Foramen

Greater Petrosal Hiatus

Hypoglossal Canal

Incisive Canal

Incisive Foramen

Inferior Orbital Fissure

Infra-Orbital Canal

Infra-Orbital Foramen

Internal Acoustic Meatus

Intervertebral Foramen

Jugular Foramen

Lesser Palatine Foramina

Lesser Petrosal Hiatus

Mandibular Canal (Inferior Alveolar Canal)

Mastoid Foramen

Mental Foramen

Nasolacrimal Canal

Optic Canal

Palatovaginal Canal

Petrosquamous Fissure

Petrotympanic Fissure

Pterygoid Canal

Pterygomaxillary Fissure

Sphenoidal Foramen

Sphenopalatine Foramen

Squamotympanic Fissure

Stylomastoid Foramen

Superior Orbital Fissure

Supra-Orbital Foramen

Vomerovaginal Canal

Zygomaticofacial Foramen

Zygomatico-Orbital Foramen

Zygomaticotemporal Foramen

Chapter 12: Position of Structures According to Vertebral Levels Position of Structures According to Vertebral Levels

Chapter 13: Pharyngeal Derivatives

Chapter 14: Surface Anatomy and Key Areas

End User License Agreement

Guide

Cover

Table of Contents

Begin Reading

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The Authors

Robert H. Whitaker, MD, MChir, FRCS, FMAA, graduated from the University of Cambridge and trained at University College Hospital, London. He spent a year at Johns Hopkins Hospital, Baltimore, in the Urological Research Laboratories before returning to continue his training first at the St Peters Hospital group in London and then as a Senior Lecturer in Urology at the London Hospital Medical School. He was appointed as a Consultant Urologist at Addenbrooke's Hospital in Cambridge in 1973 and spent 20 years practising mostly paediatric urology before retiring from clinical practice to join the Department of Anatomy in Cambridge to help with the teaching of students and trainee surgeons. He is a Fellow and Examiner of the Medical Artists' Association of Great Britain. In 2013 he was awarded the Farquharson Teaching Award by the Royal College of Surgeons of Edinburgh.

Neil R. Borley MB, BS, FRCS, MS, trained at Guy's Hospital, London. He undertook a surgical rotation at Addenbrooke's Hospital, Cambridge, before becoming a Demonstrator in the Department of Anatomy in Cambridge under Professor Harold Ellis. He passed the Primary FRCS examination in 1993 for which he received the Hallet Prize and then continued his surgical training at Papworth Hospital and Kent & Canterbury Hospital. Thereafter he moved to Oxford as Surgical Registrar and then Clinical Lecturer in Surgery and Clinical Tutor in the Nuffield Department of Surgery. He is now a Consultant Colorectal Surgeon in Cheltenham.

Instant Anatomy

Robert H. Whitaker

MA, MD, MChir, FRCS, FMAASelwyn CollegeUniversity of Cambridge

Neil R. Borley

MB, BS, FRCS, FRCS (ed)Cheltenham General Hospital, Cheltenham

Fifth Edition

This edition first published 2016 © 2016 by Robert H. Whitaker and Neil R. Borley

Previous editions: 1994, 2000, 2005, 2010

Registered office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UKThe Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK111 River Street, Hoboken, NJ 07030-5774, USA

For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell

The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.

Library of CongressCataloging-in-Publication Data

Names: Whitaker, R. H. (Robert H.), author. | Borley, Neil R., author.

Title: Instant anatomy / Robert H. Whitaker, Neil R. Borley.

Description: 5th edition. | Chichester, West Sussex ; Hoboken, NJ : John

Wiley & Sons, Ltd., 2016. | Includes bibliographical references and index.

Identifiers: LCCN 2015048493 (print) | LCCN 2015049253 (ebook) | ISBN

9781119159384 (pbk.) | ISBN 9781119159391 (pdf) | ISBN 9781119159407 (epub)

Subjects: | MESH: Anatomy | Outlines

Classification: LCC QM31 (print) | LCC QM31 (ebook) | NLM QS 18.2 | DDC

611–dc23

LC record available at http://lccn.loc.gov/2015048493

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover image: [Production Editor to insert]

Preface to Fifth Edition

We have added some more material to this 5th edition but believe that we have kept to our original plan of a quick reference book that is user friendly. Most of the new material is presented as easy ways to remember tricky little areas of anatomy that our students have found so useful over the years. A good example is the new section entitled “rules and exceptions” which we hope you will find useful and possibly even fun.

As always we continue to believe that anatomy is the language of medicine and that at qualification as a doctor, physiotherapist, nurse or radiographer, to name just a few professions, there is a basic amount of anatomical knowledge that is essential. It is at last beginning to dawn on many specialities in medicine that many mistakes that lead to surgical or other errors are due to inadequate anatomical knowledge.

Most of the expansion in this 5th edition has been in the last section of “Surface Anatomy and Key Areas” that includes clinically applicable material such as the examination of the heart and chest. We continue to resist the occasional request for an index but please do give us feedback on your assessment of this new edition which, despite a little expansion, remains true to our initial intention to produce an instant reference book for the white coat pocket and briefcase.

Since the previous editions our Instant Anatomy Website (www.instantanatomy.net) has continued to flourish and subscriptions (www.instantanatomy.co.uk) have been taken out by a number of universities and many individuals. If you like sitting back and watching and listening to podcasts then this is the site for you.

ROBERT WHITAKER

NEIL BORLEY

Cambridge and Cheltenham, 2016

Preface to First Edition

How many times have you looked up the course of an artery or nerve in one of the excellent anatomy textbooks that are available today only to find that the details are spread over several sections of the book and that an instant summary is not available? At times like this you wish there was a quick reference book with all the answers neatly catalogued in dictionary format.

We have attempted to provide such a concise text for rapid reference. Of course, we emphasise that this is not a text for learning anatomy from scratch but one that should be used in conjunction with one of the fuller texts that has stood the test of time. The book is designed for those who already have some working knowledge of anatomy and need to find accurate facts quickly.

Both authors have been sufficiently recent students of anatomy for higher degrees and for teaching undergraduate medical students that each can remember the problems that both students and they themselves encountered. The book has been compiled with this in mind.

It is designed primarily for undergraduate medical students and prospective surgeons who are studying for a higher degree in surgery. For each of these groups we believe it will be ideal. However, it should also be extremely useful for all clinicians who need to remind themselves of anatomical facts at all stages in their careers and for other professional groups such as nurses, physiotherapists and radiographers.

Inevitably in a book of this size there has been some selection of material for inclusion and no attempt has been made to provide details of minutiae that appear in the fuller text.

The authors' original artwork was redrawn with a graphics program by Jane Fallows, medical illustrator, to whom the authors owe an immense debt of gratitude for her skill and patience.

ROBERT WHITAKER

NEIL BORLEY

Cambridge, 1994

Notes on the Text

The illustrations show the right side of the body as viewed from in front, unless otherwise indicated. The two exceptions are the cervical and brachial plexuses where it makes little difference as to which side they are viewed and they are more conveniently drawn and remembered as they are shown here. Where there might be confusion, a small compass has been added to indicate the left and right sides of the body.

Eponymous names appear sparingly and only when they are in common usage. The following abbreviations have been used as appropriate throughout the text.

List of abbreviations

ant

anterior(ly)

art(s)

artery(ies)

br(s)

branch(s)

CMC

carpometacarpal

div(s)

division(s)

ext

external

inf

inferior(ly)

int

internal

IP

interphalangeal

jnt(s)

joint(s)

lat

lateral(ly)

lig(s)

ligament(s)

med

medial(ly)

MC(s)

metacarpal(s)

MCP

metacarpophalangeal

MTP

metatarsophalangeal

MT(s)

metatarsal(s)

N(s) or

nerve(s)

post

posterior(ly)

prox

proximal

sup

superior(ly)

TMT

tarsometatarsal

V(s)

vein(s)

Note: Abbreviations are not used for muscle names or in titles. The following words are always written in full: greater, lesser, middle, superficial and combinations such as posterolateral.

1:Arteries

Coronary arteries

Ascending & arch of aorta

Internal carotid artery, vertebrobasilar system & circle of Willis

Ophthalmic artery

External carotid artery

Maxillary artery

Middle meningeal artery

Subclavian artery

Axillary artery

Brachial artery

Radial artery

Ulnar artery

Thoracic (descending) aorta

Abdominal aorta

External iliac artery

Coeliac trunk

Superior mesenteric artery

Inferior mesenteric artery

Internal iliac artery

Femoral artery

Popliteal artery

Anterior tibial artery

Posterior tibial artery

Fibular (peroneal) artery

Arterial anastomoses around scapula

Arterial anastomoses around hip

Coronary arteries

Coronary Arteries

From: Ascending aorta

To: Myocardium

Right coronary artery. Originates from the anterior aortic sinus. It passes anteriorly between the pulmonary trunk and the right auricle to reach the atrioventricular sulcus in which it runs down the anterior surface of the right cardiac border and then onto the inferior surface of the heart. It terminates at the junction of the atrioventricular sulcus and the posterior interventricular groove by anastomosing with the circumflex branch of the left coronary artery and giving off the posterior interventricular (posterior descending) artery. It supplies the right atrium and part of the left atrium, the sinuatrial node in 60% of cases, the right ventricle, the posterior part of the interventricular septum and the atrioventricular node in 80% of cases.

Left coronary artery. Arises from the left posterior aortic sinus. It passes laterally, posterior to the pulmonary trunk and anterior to the left auricle to reach the atrioventricular groove where it divides into an anterior interventricular (formally left anterior descending) artery and circumflex branches. The circumflex artery runs in the atrioventricular sulcus around the left border of the heart to anastomose with the right coronary artery. The anterior interventricular artery descends on the anterior surface of the heart in the anterior interventricular groove and around the apex of the heart into the posterior interventricular groove where it anastomoses with the posterior interventricular branch of the right coronary artery. The left coronary artery supplies the left atrium, left ventricle, anterior interventricular septum, sinuatrial node in 40% of cases and the atrioventricular node in 20%.

Dominance. In approximately 10% of hearts the posterior interventricular artery arises from the circumflex artery (left coronary) and then most of the left ventricle and interventricular septum are supplied by the left coronary artery. The heart is said to have left cardiac dominance.

Ascending & arch of aorta

Ascending & Arch of Aorta

From: Left ventricle

To: Descending aorta

Ascending aorta. Arises at the vestibule of the left ventricle at the level of the third left costal cartilage and passes upwards and slightly to the right to a point behind the sternum at the level of the manubriosternal joint (second costal cartilage) where it becomes the arch of the aorta. It is enclosed in fibrous and serous pericardium. Anterior to it are the right auricle, the infundibulum of the right ventricle and pulmonary trunk. Posterior, lie the left atrium, the right pulmonary artery and right main bronchus. To the left lie the pulmonary trunk and the left auricle. To the right are the superior vena cava and the right atrium.

Arch of aorta. The arch begins posterior to the manubriosternal joint at the level of the second costal cartilage and passes posterior and to the left, over the left main bronchus to end at the left side of the body of T4 vertebra. Its highest level is the mid-point of the manubrium sterni and at this level its three main branches emerge. Anterior and to the left of the arch are (from anterior to posterior) the left phrenic nerve, vagal and sympathetic contributions to the cardiac plexus, and the left vagus. Also, the left superior intercostal vein runs forwards on the arch anterior to the vagus and posterior to the phrenic nerve. Lateral to all these structures are the pleura and left lung. Posterior and to the right of the arch are the trachea, deep cardiac plexus, left recurrent laryngeal nerve, oesophagus, thoracic duct and the body of T4. Inferior to the arch are the pulmonary bifurcation, the left main bronchus, the ligamentum arteriosum and the left recurrent laryngeal nerve. From its superior surface emerge the brachiocephalic artery, the left common carotid and left subclavian arteries. Within the adventitia of the ascending and arch of the aorta lie baro- and chemoreceptors.

Brachiocephalic artery.