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Gray’s Anatomy

The Anatomical Basis of Clinical Practice

Fortieth Edition

Susan Standring, PhD, DSc, FKC
Emeritus Professor of Anatomy, King’s College London, London, UK

Neil R Borley, FRCS, FRCS(Ed), MS
Consultant Colorectal Surgeon, Department of Gastrointestinal Surgery, Cheltenham General Hospital, Gloucestershire Hospitals NHS Trust, Cheltenham, UK

Patricia Collins, PhD
Associate Professor of Anatomy, Anglo-European College of Chiropractic, Bournemouth, UK

Alan R Crossman, PhD, DSc
Professor of Anatomy, Faculty of Life Sciences, The University of Manchester, Manchester, UK

Michael A Gatzoulis, MD, PhD, FESC, FACC
Professor of Cardiology, Congenital Heart Disease
Consultant Cardiologist, Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, and the National Heart and Lung Institute, Imperial College, London, UK

Jeremiah C Healy, MA, MB BChir, MRCP, FRCR
Consultant Radiologist, Chelsea and Westminster Hospital; Honorary Senior Lecturer Imperial College, London, UK

David Johnson, MA, BM BCh, DM, FRCS(Eng)
Consultant in Plastic, Reconstructive and Craniofacial Surgery, Department of Plastic and Reconstructive Surgery, Radcliffe Infirmary, Oxford, UK

Vishy Mahadevan, PhD, FRCS(Ed), FRCS(Eng)
Professor of Surgical Anatomy and Barbers’ Company Reader in Anatomy, Raven Department of Education, The Royal College of Surgeons of England, London, UK

Richard LM Newell, BSc, MB BS, FRCS
Honorary Consultant Orthopaedic Surgeon, Royal Devon and Exeter Healthcare NHS Trust, Exeter, UK

Caroline B Wigley, BSc, PhD
Senior Honorary, University Teaching Fellow, College of Medicine and Dentistry Peninsula, Exeter, UK


is an imprint of Elsevier.

© 2008, Elsevier Limited. All rights reserved.

Fortieth edition published 2008

First edition JW Parker & Son 1858

The right of Susan Standring, Neil R Borley, Patricia Collins, Alan R Crossman, Michael A Gatzoulis, Jeremiah C Healy, David Johnson, Vishy Mahadevan, Richard LM Newell and Caroline Wigley to be identified as authors of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988.

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Rights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail: healthpermissions@elsevier.com. You may also complete your request on-line via the Elsevier website at http:permissions.

Expert Consult ISBN: 978-0-443-06684-9

International Edition ISBN: 978-0-8089-2371-8

British Library Cataloguing in Publication Data

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

Library of Congress Cataloging in Publication Data

A catalog record for this book is available from the Library of Congress


No responsibility is assumed by the Publishers, Editors or Contributors for any loss or injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. It is the responsibility of the treating practitioner, relying upon independent expertise and knowledge of the patient, to determine the best treatment and method of application for the patient.

Every effort has been made to contact holders of copyright to obtain permission to reproduce copyright material. However, if any have been inadvertently overlooked, the Publisher will be pleased to make the necessary arrangements at the first opportunity.

The Publisher

Printed in Spain

Last digit is the print number: 9 8 7 6 5 4 3 2 1

Commissioning Editors: Madelene Hyde and Inta Ozols

Development Editors: Martin Mellor, Gavin Smith and Alison Whitehouse

Head of Development (Global Medicine): Louise Cook

Editorial Assistants: Julie Goolsby and Liam Jackson

Project Managers: Glenys Norquay and Bryan Potter

Illustration Managers: Merlyn Harvey, Bruce Hogarth and Gillian Richards

Illustrators (39th and 40th editions): Antbits (Paul Banville, Michael Courtney, Jonathan Dimes, Paul Richardson, Richard Tibbitts), Robert Britton, Joe Chovan, Peter Cox, Ethan Danielson, Brian Evans, Sandie Hill, Bruce Hogarth, Gillian Lee, Debbie Maizels, Annabel Milne, Philip Wilson, Martin Woodward

Page Design: Jayne Jones

Cover Design: Stewart Larking

Copyeditors: Carolyn Holleyman, with Alyson Colley

Proofreader: Ian Ross

Indexer: Susan Boobis

Marketing Managers: Jeremy Bowes (UK) and Lisa Damico (US)

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