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 Congress Cataloging-in-Publication Data

Ellis, Harold, 1926– author.
Anatomy for anaesthetists / Harold Ellis, Andrew Lawson. -- Ninth edition.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-118-37598-3 (cloth : alk. paper) -- ISBN 978-1-118-37594-5 --
ISBN 978-1-118-37595-2 (emobi) -- ISBN 978-1-118-37596-9 (epdf) --
ISBN 978-1-118-37597-6 (epub)
I. Lawson, Andrew (Medical ethicist), author. II. Title.
[DNLM: 1. Anatomy. 2. Anesthesia. QS 4]
QM23.2
611′.0024617--dc23
2013024798

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: Science Photo Library image: © POGEE/SCIENCE PHOTO LIBRARY
Color-enhanced x-ray showing endotracheal intubation
Cover design by Meaden Creative

Preface to the Ninth (Jubilee) Edition

I little thought, when I wrote the Introduction to the first edition of Anatomy for Anaesthetists for its publication in 1963, that one day I would be composing the introduction to its ninth (Jubilee) edition in 2013! The place of anatomy in anaesthetic practice is often considered merely as a prerequisite for the safe practice of local anaesthetic blocks. However, it is also important in understanding the anatomy of the airways, the functions of the lung and circulation, monitoring of neuromuscular blocks, long-term pain control and many other aspects of practical anaesthesia. This book is not intended to be a textbook of regional anaesthetic techniques; there are many excellent texts that cover this important field. However, it is a textbook written for anaesthetists, keeping in mind the special requirements of their daily practice. The anaesthetist requires a particularly specialized knowledge of anatomy. Some regions of the body, for example the respiratory passages, the major veins and the peripheral nerves, the anaesthetist must know with an intimacy of detail that rivals or even exceeds that of the surgeon; other areas can be all but ignored.

The first edition was written in collaboration with that talented medical artist, the late Margaret McLarty. I was then joined by my anaesthetic colleague at Westminster Medical School, Professor Stanley Feldman, as co-author. Dr William Harrop-Griffiths contributed much help on peripheral nerve blocks to the eighth edition. I am now delighted to have Dr Andrew Lawson as my collaborator. He has already added the important chapter on the anatomy of pain to the last two editions. He is not only an anaesthetist but also an expert in pain management and brings his expertise in this field in describing important clinical applications of anatomy to this aspect of anaesthetic practice.

In this ninth edition, we have carefully revised and expanded the text and have added new illustrations, including modern imaging techniques that are of particular interest to the anaesthetist. We hope this book will continue to serve anaesthetists as it has done over the past 50 years.

Harold Ellis
July 2013

Foreword to the First Edition

The anaesthetist faced with higher examinations is confronted with the problem of how far he should delve into the many related specialities; and owing to constant change of emphasis, the answers will never be final. Professor Ellis, as a surgeon who has interested himself in our speciality for a number of years, here sets out boldly the anatomy he believes the present-day young anaesthetist should be familiar with when confronting the examiners. The choice of material, and its presentation, are full of commonsense, so that the book is attractive to the established anaesthetist in his daily work, and for occasional reading.

I have had the privilege of working with both authors for a number of years, and I can think of no pair better fitted to highlight the essentials of anatomy for the anaesthetist. Professor Ellis is an outstanding teacher, and in the field of medical artists Miss McLarty is distinguished by her flair for stressing points of anatomical importance to the clinician. I persuaded them to collaborate on a series of articles which recently appeared in Anaesthesia. Though these have been added to considerably they form the basis of this book.

Professor Sir Robert Macintosh

Introduction to the First Edition

The anaesthetist requires a peculiarly specialized knowledge of anatomy. Some regions of the body – the nerve pathways and respiratory passages for example – he must know with an intimate detail which rivals that of the surgeon; other areas he may all but ignore. As far as we know this book is the first to be designed with his particular needs in mind. It should prove of value to examination candidates and we hope also to the practical anaesthetist in his day to day work.

Harold Ellis, London
Margaret McLarty, Oxford
1963