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Anatomyinnutshel00laug PDF
Anatomyinnutshel00laug PDF
IN A
NUTSHELL
LAUGHLIN
(Second Edition.)
Poor Humanty.
tuthor,
fifty
guineas.
II.
I.
'Twas
a skull
full.
But
If
If
with no lawless
emplox >'d;
gleamed,
fire it
[V.
111.
Within
this
The ready,
\\
eye.
swift
)r
To hew
(
now
avail to
>r
These hands
all
a richer
who
meed
wait on
seek Affliction's
humble shed;
And
Anonymi
shall claim
Weal or fame.
To
he gem,
them.
Hut
(
Than
'an little
m -
ANATOMY
IN A
NUTSHELL
M.
S.,
D. 0.
IX
OXE VOLUME.
KIRKSVILI.I
M.S.. D. 0.
QS
*f
3'
\lii\.
pb
<
IS1
ION
TO
fll>
WORK
AFFECTIONATELY DEDICATED
BY
THEIR FELLOW WORKER,
THE AUTHOR.
(Qui
ram
prafirit, deficit.
List of Illustrations.
Page
Plate
III.
IV.
I.
II.
V.
VI.
VII.
VIII.
IX.
X.
XI.
XII.
XIII.
XIV.
XV.
Mew
Posterior
is
21
Insertion of Biceps
Cord
of the Spinal Cord
29
Brachial Plexus
81
Hand
Position of Vessels Above and Below Diaphragm
33
30
Circulation
39
41
41
43
and Shoulder-Joint
Muscles of Face and Triangles of Xeck
External >blique Muscle of Abdomen and Numerous
44
47
*
>ther
Structures
XVI.
XVII.
XVIII.
XIX.
XX.
XXI.
XXII.
XXIII.
XXIV.
XXV.
XXVI.
XXVII.
XXVIII.
XXIX.
XXX.
X XXI.
Internal
4!)
Transversalis Muscle of
51
53
57
59
63
6
1
70
71
XXXIV.
7:;
74
SO
83
86
89
...
90
93
XXXV. The
XXXVI.
XXXVII.
XX XVIII.
XXXIX.
XL.
XI. I.
XLII.
XLIII.
17
lis
View
XXXII.
XXXIII.
25
'.il
07
00
03
in
i\
IS
...
1
1
1
07
us
1
[.1ST
OF ILLUSTRATIONS.
Page
Plate
XLIV.
X l.\
XLVI.
X
I.
VI
XLVIII.
XLIX.
I.
LI.
Id
I.
III.
LIV.
LV.
LVI.
LVII.
I.
139
142
Anterior
145
Fibula
148
151
155
Showing the
159
tar Arteries
163
I.umliricale.-..
>i
and Nerves
161
165
167
169
I.X.
171
XL
173
179
1.
1.
I.X IV.
LXV.
LXVI.
LXV]
I.
LXVIII.
I.X IX.
LX X.
LXX
I.
LXXII.
I.XXIII.
LXXIV.
LXXV.
LXXVI.
LXXVII.
LXX VIII.
LX NIX.
L.N N.N.
I.
133
136
IX.
LXII.
I.X
127
130
I.YI
I.
XXX
I.
I.NNXII.
175
177
'otninon. Superficial
(
XCV.
I.
XCVII.
195
197
199
207
209
211
Knee. loin
Showing !ondyles and Ligaments of Knee-Join1 Anterior View
X('\
191
193
203
205
Ligamentum
XC.
XCI.
XCII.
XCIII.
N< TV.
187
189
201
LXXXIV.
LXXXV.
LXXXVI.
LXXXVII.
I..N.N.NI.N
183
185
LXXXIII.
LXXXVIII.
181
Patella
Posterior Ligamenl of
(
213
215
217
219
221
226
228
229
231
View of Sternum
Bones of the Thorax
233
235
237
239
241
Posterior
The Atlas
Posterior View of Axis
Anterior View of Axis
222
223
224
LIST OF
ILLUSTRATIONS.
XI
Page
Plate
XCVIII.
XCIX.
C.
CI.
CII.
CIII.
CIV.
<
VI.
Posterior
CXIY.
'XV.
CXVL
CXVH.
Will.
CXIX.
CXX.
(XXL
CXXII.
CXXIII.
XXIV.
'XXV.
(
CXXVL
CXXVII.
(
XX VIII.
('XXIX.
CX XX.
WXXI.
<
CXXXII.
CXXXIII.
(XXXIV.
CXXXV.
CXXXVI.
CXXXVII.
CXXXVIII.
(
XXX IX.
('XI..
(
Mew of Cervical
Anterior
CIX.
CX.
CXI.
CXLT.
CXIII.
(A'.
CVII.
CVTLT.
XLI.
CXLII.
CXLIII.
CXLIV.
CXLV.
CXLVI
CXLVII.
CXLVIII.
CXLIX.
('!..
CLE
CLII.
View
243
245
247
249
251
253
255
257
Vertebrae
of Cervical Vertebrae
259
261
263
265
267
269
27:1
27.">
-'71
277
Mew of
Lungs
Posterior View of Lungs
Showing the Capacity of the Lungs
Showing Pleura- and Roof of the Lungs
Air Cells of the Lungs
A Transverse Section of the Pleurae Through Root of Lungs
Arch of Aorta and Heart
Showing Circulation of the Blood Through Heart
Semilunar Valve (Aortic)
The Thoracic Duct and Azygos Veins
Thyroid Gland of Fetus
Thyroid Cartilage (Anterior View)
Eyoid Bone/Thyroid and Cricoid Cartilages (Anterior View)
Thyroid 'artilage (Posterior View)
Arytenoid Cartilage and Epiglottis
True and False Vocal Cords
Showing the Entire Alimentary Canal and Portal Circulation
Anterior and Posterior Pi Hal's of Fauces and 'artilages of Nose
Anterior
279
281
283
285
287
289
290
291
292
293
294
295
296
297
298
299
300
301
302
303
304
305
308
310
312
314
Pharynx
A Sagittal Section of Head and Neck showing Pharynx
The Dorsum of the Tongue
31
Circumvallate Papilla-
321
of the
Relationsof Liver
316
-'.:
325
321
328
329
330
"
:;|
LIST OF
Xll
ILLUSTRATION'S.
Page
Plate
CLIII.
ci l\
CLV.
CLVI.
CIA
II.
CLVIII.
CLIX.
CLX.
CI. XI.
CLXII.
CI. XIII.
CI. XIV.
CI. XV.
CI. XVI.
CI. XVII.
CI. XVIII.
CLX IX.
CI.XX.
CLXXI.
CLXXII.
CLXXIII.
CI.WIN
CLXXV.
CLXXVI.
333
334
335
of
Caecum
336
337
33S
Valve
A Transverse Section of the Large Intestine
34o
341
339
[leo-Caecal
342
>ririee
343
344
345
346
347
348
340
350
351
352
353
354
355
356
357
358
359
360
CI. XXXI.
Sagittal Section of
361
CLXXXII.
Sagittal Section of
CLXXVII.
CLXXVIII.
CI. XXIX.
CI.
XXX.
(I. XXXIII.
CI.
XXX IV.
XXXV
CI.
CLXXXVI.
CLXXXVII.
CI.XX.W
CI.
III.
XXXIX.
CXC.
CXCI.
CXCII.
CXCIII.
CXCIV.
cxcv.
CXCVI.
CXCVII.
CXCVIII.
CXCIX.
cr.
Sinuses
OCIII.
CCIV.
cc\.
CCVI.
CCVII.
Location of Centers
in
Brain
<
at Different Levels
CCI.
ecu.
at
Showing Venae
I
distribution of
Iptical
Nasal
<
Vorticosae
(phthalmic Artery
<
iland
Region
that Muscles of Eve-Ball move Eve
Irbital
362
363
364
365
366
367
368
369
370
371
372
373
374
375
377
379
380
381
382
383
384
386
388
390
391
392
OF ILLUSTRATION--,
LIST
xill
Plate
Page
CCVIII.
CCIX.
ccx.
('('XI.
('('XII.
('('XIII.
CCXIV.
ccxv.
CCXVI.
CCXVII.
CCXVIII.
CCX IX.
ccxx.
CCXXI.
CCXX
1.
CCXXIII.
(XXIV.
(XXV.
CCXXVI.
(
CCXX VI I.
((
XXVIII.
CCXXIX.
CCX XX.
CCXXXI.
CCXXXII.
CCXXXIII.
CCXXXIV.
(
(XXXV.
CCXXXVI.
('( XXXVII.
C(
XXXVIII.
CCXXXIX.
CCX
I..
CCXLI.
CCXLII.
CCXLIII.
CCX
I.
IV.
CCXLV.
CCXLVI.
CCXLVII.
CCXLVIII.
CCXLIX.
CCL.
CCLI.
CCLII.
CCLIII.
CCLIV.
CCLV.
CCLVI.
CCLVII,
CCLVIII.
CCLIX.
CCLX.
CCLXI.
CCLXII.
393
304
Crystalline Lens
395
396
397
398
399
400
401
The Sixth
>tic
to
>t
her Structures.
Ganglion
|(i:;
405
407
109
411
413
415
117
419
421
424
426
128
430
432
434
430
438
440
442
444
446
448
450
452
15
455
450
457
1">
159
400
461
162
163
10
107
170
17:;
176
182
Lateral
170
is.".
188
491
10
LIST OF ILLUSTRATIOXS.
XIV
Page
Plate
CCLXIII.
(CI. XIV.
CCLXV.
CCLXVI.
CCLXVII.
(CI. XVIII.
(CI. XIX.
(CI. XX.
CCLXXI.
CCLXXII.
(CI. XXIII.
CCLXXIV.
(CI. XXV.
CCLXXVI.
(CI. XXVII.
CCLXXVII1.
(CI. XXIX.
(CI. XXX.
(CI. XXXI.
(CI. XXXII.
(CI. XXXIII.
('('I.
XXXIV.
CCLXXXV.
CCLXXXVI.
(CI.
XXX VII.
(CI. XXXVIII.
CCLXXXIX.
ccxc.
497
500
503
506
509
512
515
518
521
524
527
530
533
Testicle
The
53(i
539
542
545
548
Testicle
)rgans of Generation
Posterior
View
of the
551
554
557
560
563
566
569
572
575
576
Preface.
Preface to Second Edition.
little book of one hundred and fifty
which was the outgrowth of his studying
and teaching anatomy in the American School of Osteopathy. It filled its
place as it was intended only as an aid to the student in preparing his work.
There seemed to be no work upon anatomy taken up in a teachable and sys-
pages called
Anatomy
in a
Nut
Shell,
manner and the student complained that it took more time to find his
hand than to learn it when found.
In presenting the subject of anatomy to the student, we first teach a few
rules and fundamental principles to give him a working knowledge of the subject, and then we take up the work complete as it comes in the human body.
For instance in teaching the anatomy of the arm we take the clavicle, giving
its ossification, articulations, attachment of muscles and blood supply.
Then
the origin and insertion with action, blood supply and nerve supply of these
tematic
it is with every bone of the upper extremity and the entire body.
gained by saying that the greater tuberosity of the humerus has
three muscles attached to it, namely the Supraspinatus, Infraspinatus and Teres
So
muscles.
What
is
we learn the functions of these muscles? By this method of teachanatomy we find it to be one of the most interesting of all subjects both to
teacher and pupil.
The original book of one hundred and fifty pages has been revised ami
minor, unless
ing
any book
of six
"He who
that
every morning plans the transactions of the day, and follows out
"The
What was
muscles,
is
of
Blair.
omitted
in
the
is
first
to
attempt
feel
but
little
at
proud of
\v
time."
complete in itself.
anatomical knowledge.
his
Locke.
ami insertion of
Ami any one who
PREFACE.
Xvi
American School
of
in
Osteopathy, in make the drawings, and he is especCash Laughlin for writingthe entire manu-
scripl
the
lasl
editor of the A. S.
().
Dr. A. E. Daugherty,
mention
making the index.
for
Student, deserves special
in
proof-reading.
This book
anatomy, hut
of the muscles
In
is
is
to
is
Still,
ANATOMY
IN
A NUTSHELL.
LESSON
Anatomy
is
of the body.
I.
It
anatomy
1.
Osteology (os-te-ol-o-je)
2.
3.
is
the
of the bones.
joints.
4.
5.
6.
8.
9.
Genesiology (jen-e-ze-ol-o-je)
7.
Aponeurosis (ap-on-u-ro-sis)
is
is
the
anatomy
it
becomes a
tendon.
(a)
It is
when broad,
any
thin, flat
(b)
It
is
(c)
It
is
and
more or
less of a
muscle.
The name was given to these structures when they were supposed to be
any hard, whitish tissue being then considered nervous.
In present tisage aponeurosis is nearly synonymous with fascia, but it is oftener
expansions of nerves
applied to the fascia like tendons of muscles; as the aponeurosis of the external
oblique of the abdomen.
Fascia
of the
body
is
is
(Plate
XV.)
invested, just beneath the skin, with a thin, light fascia, as dis-
from the thicker, tougher and more densely fibrous deep fascia
which invests and forms sheaths for muscles and dips down among the mustinguished
17
PLATE
I.
'
V^_j
^-^^fc
^^t^"^/
:
OF THE SKULL.
MANUBRIUM
GLADIOLUS
ENSIFORM APPENDIX
OLECRANON
J"
fr
ANATOMY
All processes of
IN A NUTSHELL.
19
An apophysis is
An
a process that has grown from the bone and has no separate ossific center.
tilage.
is
this
an apophysis.
Rule 2. When there is but one epiphysis then the nutrient artery runs
towards the end of the bone which has no epiphysis; e. g., the clavicle and metacarpals and metatarsals.
Rule
3.
When
(Plate VII.)
more
Rule 4. The epiphysis which ossifies first is the larger, and the cartilage
between it and the diaphysis grows longer and faster than the cartilage at the
other extremity of the bone.
An epiphysis may become separated from the diaphysis and such an injury may be mistaken for a fracture or dislocation. A knowledge of this principle is of great importance in medical jurisprudence; e. g.. the epiphysis at the
distal end of the femur ossifies at the ninth month of fetal life.
The covering of bone is called periosteum. It covers all the bone except
the articular cartilage and uives attachment to tendons.
Periosteum besides
giving attachment to the tendons of muscles;
Gives nutrition to the bone.
1.
2.
Forms
all
.'!.
Tends
to hold the
4.
From
5.
It
it
capsular ligaments.
end
of
broken bones.
in
thickness.
in
length
periosteum and
interstitial
in
cartil-
deposits.
shaft
act as lexers
called
and have
medullary canal
in
They
by
osseous deposits
in cartilage.
In each upper extremity there is a clavicle,
humerus, ulna, radius, five metacarpal and fourteen phalanges, making 23 long
bones in each upper extremity, then in both extremities there are 2x23 or 16
In each lower extremity there is a femur, tibia, fibula, five metlong bono.
atarsals
then
in
in
in
make
IN A NUTSHELL.
ANATOMY
_>()
it
cartilage
In
viz..
middle cuneiform, and internal cuneiform, making 7 short bones in each tarsus;
then in the two tarsi there are 2x7 or 14 short bones; the 14 short bones in
the lower extremity and the 16 short ones in the upper extremity make the
bones.
30 short
LESSON
II.
flat bones, all of which are found in the trunk, and head exand these are in the extremities. They are the two patellae and two
The flat bones in the trunk protect the viscera. They are developscapulae.
ed by osseous deposits in membranes and consist of two dense layers separated
by cellular or cancellated osseous tissue, the diploe. There are the two parieIn the face there are two nasal, two
tal, frontal and occipital in the cranium.
In the thorax 24 ribs and the sternum; then there
lachrymal and the vomer.
ate the tun innominata, two patellae, two scapulae, making 40 Hat bones in the
There are 40
cept four
body.
There are
They
io
They
Irregular bones.
are found
in
two
the trunk
and head.
ethmoid.
and the hones of the face except the two nasal, two lachrymal and
the Vomer.
Then the hvoid holie.
There are s hones in the cranium. The 4 flat ones are the frontal, two
parietal and occipital: the 4 irregular ones are two temporal, sphenoid and
are the 24
vertebrae,
the sacrum,
coccyx,
temporal,
sphenoid
ethmoid.
hones in the face; the 5 tlat ones are the two nasal, two lachryThere are
mal ami vomer. The 9 irregular ones are the two superior maxillary, two
malar, two palate, two inferior turbinated and the inferior maxillary.
I
cranium and the face together there are 8 plus 14. making 22
s. if the 22 of the head are included.
In
the trunk without the head there are 53 hones, which are 24 vertebrae, 24 ribs,
sternum, sacrum, coccyx and
wo innominata. In the extremities there are
12
is, 64 in the upper and 60 in thelower.
In the pelvis there are 4 bones,
two innominata. sacrum and coccyx. \oi counting the vertebra' in the cranium
Then
hone.-.
in
the
In the
there
an-
coccyx.
:::;
vertebra?; 7 cervical,
of
12
iil>-.
7 of
and
4 in
false. 2 of
the
which
Besides the 200 hones mentioned there are sesamoid bone- which are dein tendons such as the patellae, but these on account of their size ami
veloped
flat
sutures of the skull; and the malleus, incus and stapes found
in
in
the
PLATE
The Muscul
21
\i;
.Max.
II.
WAToUY
There are 32 teeth:
IN
in
NUTSHELL.
one pair
is
<>!'
The eminences
1.
Apophyses
2.
of bones are:
femur.
ti.
7.
:;.
\.
0.
Epiphyses
1.
_'.
:;.
Coracoid, like
-1.
Coronoid, like
crown
llaninlar,
ii.
Malleolar, mallet-like
7.
Mastoid, nipple-like
8.
Odontoid, tooth-lik<
9.
Pterygoid, wing-like
10.
mm,
Spinous,
12.
Squamous,
]'.'>.
14
1.
:;.
I.
5.
face
tooth
the jaw.
in
hip-joint.
Trochlear, pulley-like
in
mm -articular
Aqueducts
Canal-
:'..
(ell-
'>.
on temporal.
1.
temporal.
Alveolar, socket-like-
2.
5.
on
">
There arc 10
1.
on sphenoid.
on temporal.
scaly
Cotyloid, cup-lik(
I'acet
axis.
on sphenoid.
Vaginal, ensheathing
There arc
'_'.
on
on sphenoid.
beak
Styloid, pen-like
on temporal hone.
thorn-like
11.
on the ulna.
on sphenoid.
hook-like
5.
Aqueduct
Vidian canal
Mastoid
the orbit.
cavities.
sphenoid hone.
7.
Fossae; also at
Grooves
On
cells in
base of skull.
inner
surface of
Parietal
artery.
!.
10.
of
Notches
Sinusi
Highmore.
Ethmoid notch on
frontal
hone.
is
called
Antrum
ANATOMY
A NUTSHELL.
IX
23
27.
2.
28.
3.
Scaphoidboat
29.
Frontal forehead
4.
Semilunar
Cuneiform
30.
Occipital
31.
Parietal
1.
Cuboid cube
Cranium helmel
19.
clasp.
Obturator closed
Glenoid shallow
20.
Cotyloid cup-like
46.
21.
Tarus ankle
47.
22.
48.
23.
Os calcisheel
Astragalus die
49.
Scapula
24.
Navicular or scaphoid
50.
Humerus
26.
Cuneiform
25.
Thyroidshield.
12.
half moon
wedge-like
Pisiform pea-like
Trapezium table
Trapezoid table shape
Os Magnum large bone
Unciform hook
Metacarpus beyond the wrist
Phalanges fingers and toes
13.
Pelvis basin
14.
Femur
15.
Patella
41.
16.
Tibia flute
42.
17.
Fibula
.").
6.
7.
5.
9.
10.
11.
18.
32.
33.
o4.
35.
36.
37.
3S.
39.
thigh
small pan
40.
43.
44.
45.
boat
wedge-like
We have said
spade
arm
elbow
breast plate
51.
Ulna
52.
Sternum
LESSON
Muscles.
III.
ber of muscles cannot be given exactly, for there are some which at times are
absent and again double. There are, ordinarily, thirteen muscles from the knee
to the ankle, but there
may
Plantaris
The
may
may
be fourteen, as the
be absent or double.
[nfracostals vary in
the
human body.
from place
1.
muscle
cess of
to place.
Plate
II.)
They take
may
be absent or double.
So
it
is
im-
names
in
various ways.
From
is
number.
the attachment,
the temporal
bone.
as Sterno-cleido
ANATnMV
24
Triceps,
NUTSHELL.
From
2.
IN A
the
From
it
is
round
stationary
teres
have
.Muscle*,
is
tv\<>
I.
or
PLATE
III.
is
and
is
pan
of the attach-
one time
must
ovial
and
at
Muscle-
(Plate ill.)
is
membrane,
for the
articular cartilage,
purpose of motion.
The bones
are larger
A.NATOMY IN A NUTSHELL.
25
the joint and are covered with articular cartilage. This cartilage has no blood
These bones are
vessels, is a hylaine variety, and is nourished by the lymph.
held together by ligaments (to bind) which are flexible but not extensible.
Hilton's
Law A
in the
body:
A. Immovable or Synarthrosis.
B. Partly movable or Amphiarthrosis.
('.
PLATE
IV.
R00T-M0TUR
ANT OR VENTRAL
ANT. PRIMARY
BRANCH
SPINAL
NtHvb
- GALL
- BURDACK
- MARGINAL
INT DIVISION
EXT. DIVISION
DIRECT
9 - DIRECT
CEREBELLAR
-ASCENDING LATERAL
9 -
TRACT
2.
we have the
(GOWERSt
10
COMMA
Cord.
following:
vera.
a.
Dentata
b.
Serrata as interfrontal.
c.
Limbosa
interparietal.
;is
as fronto-parietal.
Sutura notha.
a.
b.
3.
(A) Synarthrosis
PYRAMIDAL
Squamosa
Harmonia
as squamo-parietal.
as intermaxillary.
4.
Gomphosis,
5.
or elastic cartilage,
as the teeth.
e.
g. ;
epiphyseal
line.-.
WATiiMV
IN
NUTSHELL.
Amphiarthrosis.
I'..
I.
the innominata
Syndesmosis,
_'.
c.
All
Dlarthrosis.
the diarthrosis or
movable
2.
:;.
Trochoides or Pivet-joint,
\.
in
movements except
5.
6.
all
axial
rotation.
the carpo-metacarpal
in
thumb.
Ligaments take their names from the bones they join, as sterno-clavicuWhen it goes across
lar ligamenl which joins the sternum and the clavicle.
and
when
it goes around a
a notch or groove it is called a transverse ligament
composed
mostly of white
are
Ligaments
joint it is culled a capsular ligament.
of the lower
nucha'
ligamentum
fibrous tissue; the ligaments subflava,and the
of the
joint
If
tissue.
it
is
called cutaneous;"'
if it
goes
compound nerves
sensory.
Principle
l.
(Plate
IV.)
to
as
II.
Principle
division
!
in
III.
all
cervical.
They
are
from one
the
firsl
cervical, fourth
and
and external
and coc-
fifth sacral,
nerve-.
Principle V.
cept
firsl
The
cases except
Principle IV.
which
first
in all
be-
is
lies
in
(Plate V)
it
the intervertebral foramen, outside the sac of the dura mater, ex-
one which
is not
always present, and when present is situated
This one. and the second, are placed on the arches of
the vertebra over which the nerves pass.
The ganglia of the last four sacral
the
first
nerves are situated outside the dura mater bu1 in the spinal canal; the coccygeal ganglion when presenl is within the dura muter.
The nervi nervorum are
nerve filament^ going to the nerves and the nerve sheaths.
ANATOMY
IN A
LESSON
NUTSHELL.
27
[V.
and second spinal nerves pass outward at right anglesdownward and outward, and as the cord ends at the
second lumbar, the lower roots have a long course before they leave the canal,
and are situated around the filnni terminale of the spinal cord forming the
cauda equina.
A motor nerve is any nerve whose function is to excite muscular conn-action, anil thus effect movement in an animal body.
Most nerves are mixed in
character or sensorimotor, effecting both motion and sensation.
A sensory nerve is a nerve conveying sensory impulses, or more strictly,
one composed exclusively of sensory fibers; nearly equivalent to afferent nerve.
Vasomotor nerves are those which supply the muscular coats of the blood-
The
roots of the
first
vessels.
A nerve center is a group of ganglion-cells closely connected with one another and acting together in the performance of some function, as the cerebral
centers,
Of the cranial nerves, some are compound, some are motor and others are
They take their names, olfactory, optic, etc., from
their function, but the names, first, second, etc., from the order of piercing the
dura mater from before backward.
nerves of special sense.
Olfactory.
Distribution.
Fitncton.
Mktiiod of Ex it
ANAIOMV
28
TABLE OF CRAN1
Name.
NERVES Continued
M-
boid
Method of
Function.
KIBUTION.
Superficial
Frontalis,
Facial.
7th.
>l-l
NUTSHELL.
IX A
mastoid Foramen.
Digastric.
Auditorx
8th.
Membranous
labyrinth
oi
ear.
Exit.
Equilibrium.
Ulosso-
9th.
Pharyngeal
Pneumo,,.,s.iri,. or
oi \'-i
_asun
a-
loth
mis
-"
and
ii
tli.
,i.i
'
sometimes
jugular Foramen.
Ord'y
(taste).
Sense, Motor.
Special sense
to
li\
er
Spinal
Accessory. Motor
lJth.
Hypoglossal
Motor.
Muscles of tongue.
.1
ugular Foramen.
men.
LESSON
ART
I.
V.
K II.-.
which
As
is
not
rule the
very
far
wrong.
arteries carry
Malpighi
pure or
veins carry
impure or non-oxygenized blood, but there are exceptions to this rule forthe
pulmonary artery carries impure blood and the pulmonary veins carry pure
blood.
Perhaps the puresl Mood in the body is in the right renal vein.
When the blood enters the kidney it is as pure as when it left the left ventricle
of the heart and in the kidney it throws off more impurities than it takes
from the kidney. The left renal vein receives the spermatic vein in the male
in
the female,
SO
it
contains
blood
less
pure
than
the
PLATE V
SUPERIOR
GLOSSOPHARYNGEAL
IDDLE
CEREBELLAR PEDUNCLt
CEREBELLAR PEDUNCLE
PNEUMOGASTRIC
SPINAL ACCESSOR
CERVICAL
CKvV
_j~V
~_~"
1st
<
V-
in
NFERIOR
CEREBELLAR
PCQUNCLE
'
VENTRAL ROOTS
TERMINAL CONE
TERMINAll
FILUH
w.
<
'<
\N V.TOM1
30
These veins
vein.
renal
righl
1\
A NUTSHELL.
of the righl
the inferior
vena
have valves.
The heart is a voluntary muscle (straited) in structure bill is presided over
by the sympathetic nerve which makes it involuntary in action. The average
Its covering is called pericardium, its
weighl of the heart is about 11 ounces.
cava
:iinl
Capillaries
work
adipose tissue
found
not
arc
of capillaries
and
in
The net
epidermis.
mucous membrane muscle and
The capillary
the brain and cord.
cartilage- epithelium
is
in
tendons
aponeurose
meshes an' wider and the vessels fewer in the fascia
their simplest form the capillaries consisl only of endoIn
and ligaments.
thelial lining of the arteries and veins with which they are connected, being
both elastic ami contractile, their lumen varies under pressure.
microscopic and in order to get a drop of blood
ies
many musl
They
be ruptured.
are
Arter-
net-work around
illaries
in
the heart.
almosl
A.s
all
EINS.
the tissues
the arteries, their total capacity greatly exceed- that of the arterial system.
Not only the smaller branches, but even the larger trunks communicate with
no valvt
s.
The systemic veins aid in the general circulation and convey venous blood
to the righl auricle.
They are divided (systemically) into three sets; superficial, deep, and sinuses.
The superficial or cutaneous veins lie just under the
skin between the layers of the superficial fascia; they pierce the deep fascia to
empty
in
the
lower extremities excepl the femoral artery, one lying on each side of them in
regions they do nol accompanythe arteries.
The sinuses are venous
channels which are found only in the skull ami are formed by a separation of
;
certain
The
and veins have threecoats; fir-t the tunica intima, second the
and
third the tunica externa (adventitia).
tunica media
This third coat is the
"tily one not ruptured in ligation of an arterv.
The tunica media has muscular
arteries
PLATE
s.
VI.
ANATOMY
32
fillers
and supplied with vasomotor nerve- (vaso-constrictor and vasoThese nerves run in the same -heath and are part of the sympathet-
in
it
dilator).
The vaso-constrictor
nervous system.
ic
all
A NUTSHELL.
IN
the joint
joining
its
action.
and below
one another. This
The
called anatsomosis.
is
arteries as a
culation
i-
mean-
Its
purpose
and
for the
is
when
the
join
blood to run
main one
Arteries
called collateral.
joint
in
these small
This
cir-
a certain relation to
one
is
closed.
another.
Rule. (Plate
Above
VIII.)
same
Below the diaphragm the artercompanion veins, excepting the
companion
arteries.
are on the
renal
tricle;
it
through the tricuspid valve into the right venthrough the semilunar valves into the pulmonary
it
it
gives n{]
it
continued from the lungs through the pulmonary veins (three to five) to the
left auricle of the heart, then a systole sends it through the bicuspid valve into
i<
the
left
the body,
and
All
to pas-
it
to all parts of
Veins have valves which keep the blood from running back in its course.
veins do not have valves; some of those which do not have valves are the
veins of the dura mater, or sinuses, the pulmonary veins, veins of the portal
system and those of the spinal cord. The others will be mentioned when
described.
Arteries a- a rule do not
the
ies
valves.
The
fascia,
The deep
accompany
veins
but
join
is
superficial
vein to
make
an artery
The
like
to
the deep
veins.
;1
at
its
of the tributaries
is
base
at
the surface of
AXATOMY
IN A NUTSHELL.
LESSON
33
VI.
is
PLATE
PHALANGES. TWO
CENTERS FOR EACH BONE. ONE FOR SHAFT. ONE FOR
METACARPAL EXTREMITY.
VII.
FIFTH YEAR
CONSOLIDATE
EIGHTEENTH
APPEAR
IN
IN
THE
YEAR.
THE THIRD
CONSOLIDATE
IN
THE
TWENTIETH YEAR
METACARPUS
TWO
BC
ONE FOR
APPEARS
IN
CONSOLIDATES
CARPUS.
ONE CENTER FOR EACH BONE
ALL CARTILAGINOUS
AT
IN
THE
TWENTIETH YEAR.
BIRTH
which
is
aboul
arises
from the
left
half an inch
lefl
pulmonary artery
de-
subclavian artery.
at
first
from the
common
pul-
monary.
The hypogastric
to
iliac,
and
the placenta
IN A NUTSHELL.
ANATOMY
34
The umbilical win passes from the placenta to the under surface of the
liver going through the umbilicus and the free margin of the suspensory ligaA large
At the transverse fissure this vein divides into two branches.
ment.
right
lobe
of
and
enters
the
the
liver.
vein
portal
is
joined by the
<ne which
the ductus venosus
A smaller one
joins
Before
vena cava.
it
the
hepatic vein at
left
its
junction
to the left,
A small quantity
1.
ways;
via
ductus
vena cava.
ferior
2.
Smne
:!.
Most of
enters the liver directly and then passes through the hepatic veins.
it
and
all
this blood
The venous blood from the upper extremities and head deand here it
scending aorta.
scends
the superior vena cava into the right auricle of the heart
in
From
mixes with a small pari of the blood from the inferior vena cava.
passes through the auriculo-ventricular opening to the right
systole sends the blood from the right ventricle into the
here
pulmonary
it
ventricle.
artery, a
small pari of the blood passing into the lungs and the remainder goes through
the ductus arteriosus to the descending aorta, where
the
left
the
lil
and the
The
in
rest
and
liver,
it
The placenta
lungs.
it
ventricle after
respiratory organ.
in
The other
viscera
The
because the
the fetus
practically
venous.
At
is
birth
its
margin.
pulmonary circulation
closes about the tenth
arteries
plexus
i-
nerves situated
a
in
net-work.
the axilla.
(Plate VI.)
It
is
its
is
a net
work
of
branches supply
A.NATOMY IN A NUTSHELL.
the
arm
other half
made
On
or brachium.
We
learn the
anatomy
making
body and the
five plexuses,
few exceptions
similar, with a
is
35
in the viscera.
Cervical Plexus.
in order
first
is
called
fifth, sixth,
dorsal nerve.
much work
to be
canal.
There are eight cervical nerves although only seven cervical vertebra?, as
is above the atlas and the eighth cervinerve below the seventh cervical vertebra, or vertebra prominens.
The
vical vertebra.
first
six
of these
the cord between the spinous processes of the sixth cervical and the fourth
dorsal vertebra; the lower six dorsal or thoracic nerves leave the cord
The
five
between
Lumbar
nerves leave the cord between the spinous processes of the eleventh and twelfth
The
dorsal.
five sacral
(horse
tail.)
LESSON
Clavicle
(Key.) This
is
VII.
it
has no medullary canal as (he
and with the scapula acts ;is a cush-
It
articulate with
is
quite elastic,
is
held
in
In sonic
animals
does not
it
This
extremity.
manubrium
It
is
situated
of the
at
of the scapula.
It
has
PLATE
VII.
4
COMMON
CAROTID
INNOMINATE
A.
ARTERY
SUB- CLAVIAN VEIN AND
'
ANTERIOR
JUGOLCR-
4NTERN6L
JUGULAR,
EXTERNAL JUGULAR.
INTERCOSTAL VEIN
INTERCOSTAL AJITEHT
VENA-AZYGOS MAJOR
VENA-AZTGOS MINOR.
ANATOMY
IN A NUTSHELL.
when broken
It
It is
37
will press
is
at
the
Outer one-third.
of the Deltoid
muscle
in front
attachment
and the Trapezius behind, with a small interval
between them. The under surface has first a conoid tubercle near the posterborder and internal boundary of this part of the bone. The conoid ligament passes from this tubercle to the coracoid process of the scapula, which is
ior
immediately under
it.
line,
sometimes a
furrow, passes from the conoid process forward and outward and gives attach-
the Trapezius.
Inner two-thirds.
The
three surfaces.
outer one-third to the inner extremity of the bone, separating the anterior and
inferior surfaces.
terior
of the pos-
border of the outer one- third to the inner extremity of the bone, separat-
um the anterior and posterior surfaces of the clavicle. The posterior border
extends from the conoid tubercle to the rhomboid impression, separating the
and inferior surfaces. The anterior surface gives attachment to the
major and the Sterno-cleido-mastoid muscles. The posterior surface gives attachment to the Sterno-hyoid and occasionally the Sterno-thyroid.
It has a nutrient foramen which is directed outward according
to
Rule 2,
Lesson ].
Sometimes there are two foramina, one of which may be mi the
inferior surface.
The inferior or subclavian surface has near its inner part the
rhomboid impression which gives attachment to the costo-clavicular or rhoThe subclavian groove
boid ligament; this impression is about as inch long.
occupies about the middle' one-third of the under surface of the clavicle and
posterior
Pectoralis
The
it
sternal extremity
looks
inward,
is
triangu-
downward and
little
forward.
articular facet
It
is
than the
left.
Those
of the
its
The
is
directed
circumference
is
clavicle
is
righl
to
ANATOMY
38
IN
NUTSHELL.
Ossification. Its ossification is from two centers, one for the diaphysis,
the sixth week, or may be as early as the thirtieth day. which is the first in the
body, and the other a1 the sternal extremity, about the eighteenth or twentieth year,
begins as
It
complete ossification taking place about the twenty-fifth year.
membranous bone, but the ossification later extends into the under
lying cartilage.
(Plate XII.)
Articulation.
of the
rib
first
It
The
of the scapula.
and has
all
the
movements except
sterno-olavicu-
which belongs
rotation.
to
The blood
which
is
The
sular ligament.
at
interarticular fibro-cartilage
is
firsl
costal cartilage at
its
end
of the clavicle
manubrium below;
it
divides the synovial membrane, having one on each side.
The costo-clavicular or rhomboid ligament passes upward, backward and
outward from the sternal end of the cartilage of the first rib to the rhomboid
The inter-clavicular ligament is a flat cross-band
impression of the clavicle.
attached to the upper margin of the manubrium, connecting the upper parts
thus
The acromlo-clavicular
The
blood supply
is
(1)
articulation
is
anarthrodial joint.
(Plate XIII.)
and (3) posterior circumflex. The nerve supply is (1) circumfrom the posterior cord of the Brachial plexus, (2) suprascapular, from
thoracic
flex
make
present;
it
may
fill
the
The
interarticular fibro-cartilage
articulation,
then
there
are
is
two
not always
synovial
membrane-; more often it only occupies the upper part of the joint, then there
i> only one synovial membrane.
The trapezoid ligament is the anterior and
externa] part of the coraco-clavicular ligament and is attached above to the
oblique line of the under surface of ihe clavicle and below to the posterior half
upper surface of the coracoid process. The conoid ligament is the pos-
of the
terior
and
is
attached above
PLATE
39
IX.
ANATOMY
40
IX
NUTSHELL.
base to the conoid tubercle of the clavicle and a line running internally
for half an inch: below by its apex to the rough impression at the base of the
by
its
coracoid process.
Blood Supply.- The nutrient artery of the clavicle is from the supraThe acromial end receives a branch from the acromial thoracic
scapular.
artery and twigs from the arteries
in
LESSON
it.
VIII.
Muscles.
'The
of
muscles
Sterno-thyroid.
Sterno-cleido-mastoid;
Description.
(Plate
(XIV.)
and
Origin.
of the
at
posterior.
(Plate XI.)
Insertion.
Mastoid process of temporial bone and the outer two-thirds
or one half of the superior curved line of the occipital bone.
Action.
To depress and
Nerve Supply.
Spinal
Blood Supply.
accessory
and
(eleventh cranial)
(third'.')
nerves.)
occipital
artery, the middle sterno-mastoid artery from the superior thyroid artery, the
inferior sterno-mastoid artery from the suprascapular artery, also branches
from the posterior auricular artery.
Sterno-hyoid.
and upper
Description.
pari of
the trachea,
is
thin
with
its
fellow
in
but they are separated below from each other by a considerable interval.
Origin,
Posterior surface of the manubrium of the sternum.
end of the clavicle and posterior sterno-clavicular ligament.
i
nal
(2)
ster-
ANATOMY
IX A XUTSUhLL.
Insertion.
Action.
Nerve
cervical plexus
LI
XIX.)
communication
of
between
the
cranial nerve.
PLATE
TUBEROSITY FOR CONOID
(Plate
41
X.
POSTERIOR
GMT
STERNO-THYROiD.
STERNO HYOID.
SUBCLAVIU5
WITH THE
SCAPULA.
pectoral1s major.
capsular lkvm-t
anterior.
Left Clavicle.
Ixferioh Surface.
Blood Supply.
Sterno-thyroid.
(1)
rib,
arteries.
manubrium
of the
_'
Insertion.
Oblique
line of ala of
thyroid cartilage.
Depressor of larynx.
Nerve Supply. Branches from
Action.
cervical plexus
PLATE XL
-ANTERIOR.
PECTORALIS
MAJOF
acromial end
trapezius
posterior.Left Clavicle.
Superior Surface.
Description. (Plate
in
cle
and
its fibers
are inserted
in
the
same order
a- that in
which they
arise.
The
ANATOMY
42
JX
NUTSHELL.
humerus than
the
The
thai
and from
an expansion
is
given
off
that
covers the bicipital groove and blends with the capsule of the shoulder- joint.
An expansion is given off, which lines the bicipital groove, from the inseriton
acromio-thoracic artery.
ORIGIN.
Its
(1)
axilla.
of the
sternum
down
as far
as
(2)
the
Insertion.
(Plate XXIII.)
Draws the arm forward and downward,
Action.
in
forced inspiration.
\'i.i;\ e
Si ri ia
filaments from
--.
spinal nerves entering into the format ion of the brachial plexus.
all
is
between the Pectoralis minor and Subclavius muscles and protects the axillary
It divides above to enclose the Subclavius muscle and its
els and nerves.
two layers are attached to the clavicle, one in front of and the other behind
the muscle.
The
latter
the
the
r i
vessels.
Internally,
firsl
<
r\
of the
is
Subclavius muscle.
it
and with
Externally
it
internal to
is
cephalic veins.
Blood
Supply.
Internal
mammary,
intercostals,
superior
thoracic,
LESSON
(Plate XV).
Subclavius.
le
placed
from the
in
firsl
VIII.
is
interior surface
i-
a small triangular
firsl
rib.
It
is
mus-
separated
in
which the
ANATOMY
IN A
NUTSHELL.
43
muscle is enclosed. The insertion of this muscle is larger than the origin.
Origin. By strong tendon from the first rib and its cartilage at their
Insertion.
(Plate
third.
Action.
in a
its
middle
XL)
Depresses
downward and
for-
ward.
Nerve Supply.
Blood Supply.
fifth
arteries.
PLATE
ANTERIOR
THE INTERARTICULAR
THE
is
i-
XII.
STERNO-CLAUCULAR LIGAMENT
FIBRO-CARTILAGE
JOINT
CARTILAGE
Sterno-Claviculak Articulation.
surrounds the shoulder-joint
large
and
of
extent, covering
its
surface
is
thick.
It
it-
major by a
humeral branch of
its
border
i-
separated at
greater part of
a large
It-
its
sacculated syn-
its
texture.
Lower
the
upper part from the Peccellular interspace which lodges the cephalic vein and the
This muscle i- remarkably
the acromial thoracic artery.
It- anterior
toralLs
(3)
in
ovial bursa.
coarse in
on
it
(2)
of
and upper
acromion
proc<
border of -pine of scapula as far back as the trianThe part arising from the acromion process
the inner end.
lip of posterior
gular surface at
ANATOMY
44
IX A
NUTSHELL.
arranged
in this
PLATE
XIII
TRANSVERSE LIGAMENT
sion
in
The oblique filters arising from the tendinumber, pass upward from the intersec-
tion of the
Action.
Xi.i;\
i.
Si ppli
Blood Supply.
Jircumfiex.
rPosterior circumflex
arteries.
ANATOMY
Trapeszius.
IX a NUTSHELL.
Description. (Plate
XVIII.)
45
This
is
a broad, Hat.
trian-
gular muscle, placed immediately beneath the skin and fascia, and covering
the upper and back part of the neck and shoulders.
It
is
fleshy in the
it
is
ance and the inner one-third or one-half of the superior curved line of the occipital bone. (2)from the ligamentum nuchas. (3)from spinous processes of the seventh
and
cervical
11
all
(4)
of
Insertion (PlateXI-XX) Thesuperior fibers pass downward and outward and are inserted into the outer one- third of the posterior border of the clavicle
varing greatly in the extent of its attachment, sometimes advancing as far as
the middle of the clavicle, and may even become blended with the posterior
edge of the Sterno-mastoid oroverlapingit. The middle fibers pass horizontally
outward and are inserted into the inner margin of the acromion process and
superior
lip of
The
smooth
surface.
Action".
When
this
outward.
it
lifts
The upper
scapula
part
draws
it
LESSON
Scapula
is
IX.
the
posterior
thorax, between the second lib above and the seventh or eighth ribs
articulating with the clavicle by
made up
its
acromion process
laterally.
'This
below,
bone
is
first,
the
is
concave, deepest
this is to give
more room.
WATOMY
{li
Subscapulars muscle;
for the
this surface
On
JX A NUTSHELL.
is
der upward and outward, for the attachment of the fascia of the Subscapulars.
The vertebral asped of this surface gives attachment to the Serratus magnus,
which attachment is triangular above and below with a long narrow attachment between. The posterior surface, or dorsum, as a whole is convex. It is
separated into two parts by a second triangle, which is called the spine of the
The
part
notch, which
i-
about
at
ternal two-thirds.
is
crossed
border
continued as the coracoid process which may be called a third triangle or
rather pyramid; it gives attachment to three muscles, the short head of the Biby the transverse ligament of the scapula.
of this
i-
ceps, Coraco-brachialis,
The
it, the
minor
the
and
major.
The
axillary
and
Rhomboideus
Levator anguli scapulae,
border is the thickest of the three and would be the longest of the borders if
der
were continued
it
is
to
i.-
called,
the base;
it
It
he Teres major and minor and the long head of the Triceps.
axillary border continued to meet the superior border we have a triangle whose
base is the vertebral border, whose altitude is the superior border and whose
hypotenuse is the axillary border continued, and in this case would be the
There is a groove on the axillary border at the junction of the upper
longest.
one-third with the lower two-thirds, for the dorsalis scapulae artery, and an
The
oblique line separating the attachments of the Teres minor and major.
spine represented a- a triangle will have its base, the anterior border, attached
io the dorsum of the scapula from a point about one-fourth the distance from
the vertebral border to the glenoid fossa to within half an inch of the glenoid
between the spine and the glenoid fossa is the great scapular
fossa is the deficiency between the superior and axillary borders,
with which the head of the humerus articulates.
The altitude is the external
notch.
The glenoid
some author.- the base; the posterior border or crest reprehypontenuse of the triangle. The crest, posterior border, or hypotenuse is continued outward a- he acromion process of the scapula and is somewhat triangular.
Its upper lip gives attachment
for the Trapezius and the
lower lip to the Deltoid muscle.
This process articulates with the clavicle and
gives attachment for theligaments of that articulation, beside- to the coracoacromial ligament, between the spine of the scapula and the vertebral border
border, called by
the
is
it
the eighth
week
One
for the
body
of the scapula
one
ossification, occasionally
makes
its
appearance about
border and also
PLATE XIV
|
OCCIPITO FRONTALIS.
35- STERNO
ORBICULARIS PALPEBRARUM.
32-STERNO HYOID
33-OMO HYOIO.
37-
3 - CORRUGATOR SUPERCIlll.
4- PYRAVUOALIS.
COMPRESSOR NAR1S.
COMPRESSOR NARIUM
7 -
34-THYRO HYOID.
SCALENUS MEDIUS.
SCALENUS POSTICUS
LEVATOR ANGULI SCAPUL/t.
MINOR.
41-TRAPEZIUS.
-DILATOR
42-APONEUROSIS
NARIS POST
9 -
10-
THYROID
43 -EXT. LATERAL
DEPRESSOR
ALA NAS
LI
4S-ZYG0MA.
LEVATOR
46 INF.MAXILARV.
LABIISUP.
47 CLAVICLE.
ALfcQUE
NASI.
48 PECTORALIS
MAJOR.
49 DELTOID.
II
LEVATOR
LABII-SUP.PROP.
12-LEVATOP ANGUL
I3-2YGOMAT1CUS MINOR.
I4-2YG0MATICUS MAJOR.
15
-ORBICULARIS ORIS.
1617
RISORIUS.
-BUCCINATOR.
18-MASSETER.
19-
LEVATOR LABII
20-
DEPRESSOR
INF.
LABII INF.
2I-0EPRESSOR ANCULI
22-
ORIS.
PLATYSMA-MYOIDES.
23-ATTRAHENS AUREM.
24-
ATTOLENS AUREM.
25-RETRAHENS AUREM
26- DIGASTRIC.
27-
STYLO HYOIO.
2S-MYL0-HY0ID.
29-HYO-GLOSSUS.
30- MID.
W*
CONSTRICTOR
Muscles ok Face
\i>
17
'I'.m
vngli
!'
ANATOMY
is
NUTSHELL.
IX A
The corpear the l">tli year and join the body of the scapula the 20th year.
acoid process has two centers, the one a1 the base of the process appearsatthe
linh year and the other during the 1st year; they both join the body of the scapula the 25th year.
Articulation.
It
which
is
This
given in Lesson Vll.) and with the humerus, making the shoulder-joint.
joint is a diarthro dial joint and belongs to the sub-class enarthrodial (ball-andPlate XIII.)
socket.)
The
anterior circumflex,
('_)
is
(3)
posterior
subscapular.
last
Nerve supply.
Suprascapular and
(1)
circumflex, both
(2)
are branches
plexus.
formthe Brachial
and by
The ligaments
loose and permits
apex to the
its
free
movements
tip of the
acromion process.
are (1)
of the joint.
It
is
is
ference of the glenoid cavity and to the anatomical neck of the humerus.
may have
very
It
three openings
in
it.
A bursa
of the Biceps
of
is
are
ligament, (b)
inferior
is
called
the
or accessory ligament,
is
a sac
On
ligament.
'j
men
fossa
tin'
i- a
deeper
down
continuation of
;i
it
join.-
membrane
to the ureal
(3)
synovia!
attached to
is
it
above and
called Flood's
is
ligaments, thickened
of these
is
and
three gleno-humeral
(a)
of the joint
or pouch.
its
base.
ami
It
is
is
It
is
narrow
fibro-cartilaginous
the capsule and oxer the long head of the Biceps in the groove.
rim.
opening
at
A
in
PLATE XV
MEDIAN
NERVE.
RACHIAL ARTERY
Mk
BSSIL.C
.;
BRACHIAUS AMICUS.
SUPINATOR LONGUS
ANATOMY
50
IN A
LESSON
NUTSHELL
X.
Supraspinatus
Rhomboideus minor;
TWO
A(
in
the supraspinous
fossa-;
Infraspinatus
Ethomboideus major.
L'O
in the infraspinous
fossa;
Trapezius;.
fossa.
Deltoid.
bori>eh
of the Triceps;
Teres minor:
Coraco-brachialis
Teres major.
Pectoralis minor.
of the venter;
in
all
the
an-
(Plate XVI.)
Pectoralis minor.
Description. (Plate
at
XVI.)
This
a thin.
is
flat,
tri-
Its upper border is separated from the clavicle by a triangular interbroad internally, narrow externally, which is occupied by the costo-corIn this space is the first part of the axillary vessels ami
acoid membrane.
major.
val,
nerves.
Running
is
artery.
Origin. Upper margin ami outer surface of the third, fourth and
ribs
fifth
Insertion.
The
(Plate XXI.)
To depress
Action.-
and aids
in
forced inspira-
tion.
Nerve
Si
pply.
derived
humerus.
It
is
of large size
(Plate
XVIII.)The
Triceps
is
situated at the
named
(1)
name.
PLATE XVI
OF
BICEPS ANO
COMCO
BRtCMIA
CUTANEOUS NERV.
ANATOMY
52
IN A NUTSHELL.
and
(3)
of the back
two aponeurotic lamina', one of which is subcutaneous and covers the posterior surface of the muscle for the lower half of
After
it- extenl
the other is more deeply seated in the substance of the muscle.
receiving the attachment of the muscular fibers they join together above the
The common
tendon of the
Triceps
consists of
it
small bursa
is
tendon.
Origin.- The middle or long head arises from a rough triangular depresbelow the glenoid cavity, being blended at its upper
part
(Plate
XXI.)
arises
termuscular septum.
The
(Plate
XXII.)
humerus,
below the groove for the musculo-spiral nerve, extending from the insertionof
the Teres major to within an inch of the trochlear surface; also from the internal
borderof the humerus andfrom the back of the whole length ofthe internal and
lower part of the external intermuscular septum.
Insertion.-
Upper end
XXII.)
band of fibers being
(Plate
(Plate
XXIV.)
(Plate XYIII.)
This is a broad, flat
Latissimus dorsi. Description.
muscle which rovers the lumbar and lower half of the dorsal regions and is
gradually contracted into a narrow fasciculus which passes upward across the
interior angle of the scapula,
belongs to the
first
fibers
from
it.
It
itself.
It
terminates
in a
and
is
inches
This
is
is
the representa-
muscle of apes.
and bv
fleshy digitations
ribs,
which
PLATE XVI]
5TH CElWlCAL N
6TH
7TH
CERVICAL
N.
CERVICAL N
ACROM'AL THORACIC.
CORO.
ANT. CIRCUMFLEX.
-POST. CIRCUMFLEX.
SUPERIOR PROFUNDA.
DCPSALIS
DIGITAL BRANCHES.
\\i>
ANATOMY
54
NUTSHELL.
IN A
The
upper fibers pass longitudinally outward, the middle fibers obliquely upward,
and ihc lower fibers vertically upward, converging at the inferior angle of the
scapula.
Plate
XX.)
Into the
Insertion.-
bottom
of the bicipital
its
(Plate XXIII.)
Pectoralis major.
of the
A' riON.-
and draws
or long subscapular.
Subscapular artery.
Description. (Plates XV-XVI1I.) This is a thin irregularly quadrilateral muscle situated between the ribs and scapula at the upper
and lateral part of the chest. It is partly covered in front by the Pectoral
The axillary vessels and nerves lie
muscles, behind by the Subscapulars.
Serratus magnus.
upon
its
its
muscles.
By nine
Origin.-
border of the eight upper ribs (the second rib giving origin to two
and upper
and
slips,)
form
a thin
is
directed
slips
spread out to
backward and
is
in-
serted into nearly the whole length of the ventral aspect of the vertebral border
The lower slips converge as they pass backward from the ribs
and form a fan-shaped structure, the apex of which is inserted, partly by muscular and partly by tendinous fibers, into the triangular impression on the ven-
of the scapula.
tral
aspect
\<
of
tion.
Xi:i;\
i.
and seventh
pushing muscle.
SUPPLY.
(Plate
XXI.)
Posterior thoracic
which
is
Blood Supply,
[ntercostals, long
LESSON
XI.
jusl
fifth, sixth,
cervical nerves.
lies
Origin.
By tendinous -lips from the transverse process of the atlas, and
from the posterior tubercle- of the transverse processes of the second, third,
and fourth cervical vertebras. These slips become fleshy and unite so as to
form a flat muscle which passes downward and backward to its insertion.
Into the posterior border of the scapula between the superior
Insertion.
ANATOMY
IN A NUTSHELL.
55
angle and the triangular smooth surface at the root of the spine.
(Plate
XX.)
Action.
branch from
Vertebral, ascending
minor. (Plate XVIII.)
Blood Supply.
posterior scapular.
Rhomboideus
cervical,
Origin.
Insertion.
Smooth
To
Action.
first
superficial
and
cervical,
Ligamentum
nucha and
1
dorsal vertebrae.
(Plate
XX.)
Fifth cervical.
Posterior scapular.
major. (Plate XVIII.)
Nerve Supply.
Blood Supply.
Rhomboideus
Description.
This
muscle
is
situated immediately below the minor, the adjacent margins of the two being
occasionally united.
Spinous
Origin.
processes of
upper dorsal
vertebrae
brane.
When
a short distance, as
itself.
it
occasionally does,
(Plate
XX.)
To
Action.
Posterior scapular.
Supraspinatus. Description. (Plates
Blood Supply.
XXYIII-XY111.)
The
supra-
(Plate XX.)
Upper facet of greater tuberosity of humerus.
Raises arm and supports tuberosity of humerus.
Insertion.
A< tion.
(Plate XXIII.)
Blood Supply.
is
triangular muscle which occupies the chief part of the infraspinous fossa.
The
converge to a tendon which glides over the external border of the spine
of the scapula and passes over the posterior part of he capsular ligamenl of the
fibers
shoulder-joint.
This tendon
is
of infraspinous fossa;
tendinous
Origin.
(1) Internal two-thirds
(2)
from ridges on its surface; (3) strong fascia covering it externally ami
fibers
separating
it
Insertion. Middle
(Plate \ \
humerus.
(Plate
XXII.)
ANAloMY
56
head
A.ction.- -Rotates
Nerve Slpply.
humerus outward.
Blood Supply.
The
subscapular
brane attached
attachment by
Suprascapular artery.
Description.
Subscapulars.
in--
of
NUTSHELL.
IX A
its
inner surface to
fascia
is
some
mem-
thin
The Subscapularis
a large triangular muscle which
terminates
in a tendon which is
muscle
The
scapular fossa.
muscle.
is
fills
up the sub-
in close
contact
with the anterior part of the capsular Ligament of the shoulder-joint and glides
over
which separates
large bursa,
it
It-
by an aperature
of the joint
in the
and
its
lower border
is
Nerve Supply.
Insertion.- bower
low.
(Plate
facet
Xi:i;\i.Si
pply.Fifth
LESSON
Teres major.
somewhat
mus
in
XII.
a thick,
in a
Its
This tendon, at its insertion, lies behind that of the Latissifrom which it is separated by a synovial bursa, the two tendons,
length.
dorsi,
vessels
is
inches
XX.)
XXII.)
A.CTION.
but
(Plate
for a short
lie
upon
distance.
its
The
axillary
anterior surface.
Its
PLATE XVIII
;Tsf
SERRATUS
NTERNAL
MAGNUS
OBLIQUE
ANATOMY
5S
lower border tonus,
boundary
terior
NUTSHELL.
of the axilla.
From
Origin.
in
IN A
and from the fibrous septa interposed between it and the Teres
minor and Infraspinatus. (Plate XX.)
[nner bicipital ridge of humerus.
(Plate XXIII.)
Insertion,
Assists Lattissimus dorsi in drawing humerus downward and
A.CTION.
of the scapula,
backward.
This is the smallest of the three musand is situated at the upper and inner part of
Its fibers pass downward, backward, and a little outward, and terthe arm.
minate in a Hat tendon. This muscle is perforated l>y the musculo-cutaneous
nerve and its inner border forms a guide to the position of the brachial artery
The brachial vessels and
in tying this vessel in the upper part of its course.
median nerve lie upon its anterior surface at its insertion. (Plate XVI.)
Apex of coracoid process in common with short head of Biceps.
Origin.
Description.
Coraco-brachialis.
cle- in the
(Plate
hum<
ant.
XX
ral
region,
1.)
INSERTION.Ridge on inner
humerus about
side of shaft of
its
middle,
(Plate XXIII.)
between the origins of the Triceps and Brachialis anticus.
Action. Draws the humerus forward and inward and assits in elevating
the same.
fusiform muscle, occupying the whole of the anterior surface of the arm,
its
muscular
may
name.
belly,
Each head
and the two
it
and
has re-
is succeeded by an elongated
although closely applied to each other,
tendinous but
is
bellies,
become.- twisted
it
>pposite the
aponeurosis,
the
downward and
is
bend
bicipital
that
itself so
U]
of the
fascia
elbow
it
its
gives
off.
(semilunar fascia,)
in
The long head arises from the upper marcontinuous with the glenoid ligament. The
tendon arches over the head of the humerus, being enclosed in a special sheath
of synovial membrane, passes through an opening in the capsular ligament and
gin of the glenoid cavity
and
is
ANATOMY
descends
tion
in the bicipital
groove,
in
IX A NUTSHELL.
which
it
is
59
common
(Plate XXV.)
Action.
notch of the scapula to the hyoid bone, thus dividing the anterior and posterior
(Plate XIV.)
triangles of the neck into two triangles each.
Origin. From the superior border of the scapula, internal to the supra-
scapular notch.
(Plate
XX.)
PLATE XIX.
MIDDLE
CONSTRICTOR
LESSER
OF
PHARYNX.
CORNU.
GREATER CORNU
\
f/
1/1
'If
HYO-GLOSSUS.
STYLO- HYOID.
THYRO-HYOID.
GENIO-HYOID
MYLO-HYOID
STERNO-HYOID.
Into the lower borderof the bgdy of hyoid bone. (Plate XIX.)
Blood Supply. Lingual and superior thyroid from the external carotid,
Insertion.
and the
inferior thyroid
axis.
the
betweenthe
cervical plexus
and
supraspinous fossa, infraBpinous fossa and the spine all get the suprascapular artery from the thyroid
axis. The infraspinous fossa, in addition, receives the dorsails scapula? which is
he
a branch of the subscapular, from the third portion of the axillary.
fossa,
is supplied
ANATOMY
60
IN A NUTSHELL.
LESSON
XIII.
(Plates
anatomical neck;
it
the Biceps.
facets, the
atus muscle, the middle one tor the Infraspinatus muscle, and the lowerone for
The lesser tuberosity is in the form of a cone and has atthe Teres minor.
tached to
the
the Subscapulars.
it
menl
ment
the bone;
of tin'
is
its
bicipital
outer ridge
is
also anterior
of the Pectoralis
diaphysis
The
and is for the attachand is for the attachToo- major; the groove has the Latissimus dorsi attached. The
somewhat triangular on cross section and has three surfaces and
way down
posterior
is
three borders.
coronoid depression below, separating the external from the internal surface.-;
upper part is the external bicipital ridge for the insertion of the Pectoralis
major muscle; the lower part is covered by the Brachialis anticus. The external border extends from the posterior part of the great tuberosity to the excondyle, and separate- the external and posterior surfaces; its lower part
it-
the Insertion
3econd canal
it
of the Coraco-brachialis
towardi-
bone (Page
its
19,
Lesson
artery comes
and occasionally
a fourth
mus-
Pronator radii teres. The external surface gives attachment to the Deltoid about two-fifth- or one-half the way down the hone, andbelow this to the
cle.
ANATOMY
IN A NUTSHELL.
The
61
and below
this to the
internal
The
The lower
them.
of the Triceps
part
of the
with the radius and ulna: the part which articulates with the radius is called
is on a higher level than the part which artic-
which
is
by
Above
surface
is
forearm
is
flexed;
The
a
internal condyle
lower level.
It gives
tendon for some of the flexors of the forearm, and the internal lateral ligament.
The external condyle is less prominent than the internal one and gives attachment to the common tendon for the attachment of some of the extensors of the
forearm as well as the Supinator longus and external lateral ligament.
Ossification. The ossification is from seven centers, occasionally eight.
One for the shaft appears about the eighth week of intrauterine life. The one
head the first year, one for the great tuberosity the third year; occasionone for the lesser tuberosity. These three coalesce at the 17th year and join
the shaft about the 20th year.
At the distal extremity there are four centers
for the
al]}'
of ossification;
one for the capitellum appears at the 3rd year; one for the
one for the trochlear at the 10th year; one
in-
for
The nucleus
i
lie
of the internal condyle joins the shaft in the 18th year, while
other three nuclei coalesce and join the shaft the 17th year.
Articulation.
It
given
in
makes
its
the
shoulder-joint,
articulation
with the
and ulna.
Its artic-
description of
which
makes
is
the
elbow-joint.
Elbow-joint. (Plates XXXVIII-XXXIX.)This is a movable joint (diaand belongs to the sub-class ginglymus (hinge-joint.) The part between the trochlear surface of the humerus and ihe greal sigmoid cavity of the
throsis)
ulna is a ginglymus joint, but the part between the capitellum of the humerus
and the head of ihe radius is an arthrodial join! (gliding.)
The pari between
the lesser cavity of the ulna ami the head of ihe radius
is
a trochoides.
The
anterior ligament
is
attached to the humerus above the coronoid and radial fossae and
it
is attached to the anterior surface of
the coronoid process of the ulna and the orbicular ligamenl and the neck of the
above,
in front
radius.
it
is
ANATOMY
62
The
ligaments;
is
it
is
NUTSHELL.
IX A
edge
<>t'
edge of
The Flexor
digitorum
is
sublimits
is
ment, head of the radius and the outer side of the ulna: there are two muscles
attached to this ligament, the Extensor carpi radialis brevior and Supinator
brevis.
brane
capsular ligament.
Synovial
make
mem-
all
pollicis.
and Extensor
indicis.
supply.Musculo-spiral,
Nerve
musculo-cutaneous,
median
and
ulnar
nerve-.
Blood supply.
Anterior
recurrent,
interosseous
radial recurrent.
profunda.
LESSON XIV.
ARTERIES.
Axillary artery.
the
it
firsl
rib,
of
which
it
is
clavicle
and over
leaves the axillary space at the lower border of the tendon of the Teres major,
then
alis
name
take.- the
it
This artery
Brachial artery.
called
below
the
it
is
firsl
behind
it
is
is
above it is
ami the part
XVI.)
This artery has seven branches, (Plate XVII) two from the
Branches.
two from the secami the long thoracic or external mammary, and
three from the third portion, the subscapular, anterior circumflex, and posterfirst
alar thoracic
ior circumflex.
The superior
artery that
it
is
sometimes given
axis.
as a
It
i>
ANATOMY
IN A NUTSHELL.
63
along the upper border of the latter, supplying both these muscles, the Serratus magnus and the chest wall.
It anastomoses with the internal mammary,
intercostal arteries
thoracic.
It
icnlar joint.
arises just
PLATE XX
CORACO-ACROMIAl LIG'T.
0M0-HY0 D AND TRANSVERSE
SUP. ANGLE.
LIGAMENT.(O)
LEVATOR ANGUU
SCAPULAE. (I)
SUPRASPINATUS(O).
NECK
NOTCH
GLENOID FOSSA AND HEAD
CAPSULAR LIGAMENT.
TERES MINOR.(O)
RHOMBOIDEUS
MAJOR.(I).
TERES MAJOR.(O)
lattissimus dorsi.(o)
^^t^j^'
inf.
angle.
It
or descending branch
Deltoid with the cephalic vein, supplying both these muscles; it anastomoses
with the anterior and posterior circumflex arteries.
(2) the acromial branch
which supplies the Deltoid muscle and the acromio-clavicular joint, anastom-
osing with
ANATOMY
1.1
making
IX A
NUTSHELL.
we substitute
ies,
in this
will
PLATE XX]
CONOID
LIG'T.
TRAPEZOID LIGT
RIOCES
SERRATUS
MAGNUS.
Tin
The
I.i
alar thoracic
Si
is
V>
\n
no1
hen
i.\
a
ii
constanl branch;
is
absenl
its
ii
place
filled
by
branch from
on.'
The anterior
to
intercostal, internal
the
mammary, and
mammary
gland.
superior thoracic
ANATOMY
There
arteries.
is
IN A NUTSHELL.
65
mammary
which
is
behind the
main branch.
anterior circumflex arises from the outer side of the axillary artery,
The
passing between the Coraco-brachialis and the short head of the Biceps around
is
The
posterior circumflex
It passes
it.
It
profunda.
or
toid, long
This artery
of the Triceps,
superior profunda,
It
humerus.
The subscapular
muscle with the subscapular nerve to the inferior angle of the scapula, where
it
anastomoses with the posterior scapular and a terminal branch of the transversalis colli; it also anatomoses with the intercostal and long thoracic arteries.
It gives branches to the glands and areolar tissue of the axilla, to the
Teres major, Latissimus dorsi. Subscapular which passes through the triangular space bounded above and internally by the Subscapularis, below by the
Teres major, and externally by the long head of the Triceps.
with the suprascapular and posterior scapular arteries.
It
It
anastomoses
gives branches to
Relations.
In Front.
(1)
(2)
membrane,
(3)
Ex-
ternal anterior thoracic nerve, (4) Acromio-thoracic vein, (5) Cephalic vein.
Outer
Brachial
Side.
First
(4)
intercostal
muscle,
(3)
plexus.
(3)
Inter-
(4)
fascia.
(2)
Pectoralis
major,
(">")
Inner
ANATOMY IN A NUTSHELL
66
Behind.
Subscapular^,
(1)
(2)
Tendon
and
Side. (1)
Outer
Coraco-brachialis,
(2)
Tendon
Circumflex nerve.
Median
nerve.
Musculo-
(3)
cutaneous nerve.
(2)
Axillary veins.
LESSON XV.
Brachial artery.
Plato
XYI-XYII.)
The
the lower border of the Teres major, above which it is called Axillary, to about
one and a half inches below the elbow where it divides into the Radial and
Ulnar.
It
passes along the inner and fore part of the arm. being
is
comparatively superficial.
It
accompanied
tions:
Front.
1\
basilic vein,
(1)
(4)
Biceps.
Behind.
(1)
Triceps,
(2)
Musculo-spiral
nerve.
(3)
Superior profunda
Outer
brachial'^,
Side.
and
(4)
(1)
(3)
Coraco-
Biceps.
(3)
Ulnar
branches are the superior profunda, inferior profunda, nutrient, musanastomotica magna, and occasionally the vasa aberrantia.
The superior profunda, the largest branch, arises from the inner and back
[ts
cular,
pari of the artery opposite the lower border of the Teres major.
It winds backward and outward with the musculo-spiral nerve in the musculo-spiral groove.
It gives off an anterior branch which pierces the external intermuscular septum
to anastomose with the radial recurrent.
It
continues behind the external
intermuscular septum with a branch of the musculo-spiral nerve to the Anconeus, where it anastomoses with the anastomotica magna and interosseous recurrent.
It
supplies the Triceps and Anconeus.
The anterior branch which
it gives off passes to the front of the elbow in the groove between the Supinator
longus ami the Brachialis amicus to the front of the external condyle.
It gives
branches to the Deltoid, Brachialis anticus, and Triceps, and a branch to anastomose with the circumflex artery. The artery continues as the posterior
branch.
The inferior profunda may come from the superior profunda, but generally
comes from the brachial opposite the insertion of the Coraco-brachialis. It
accompanies the ulnar nerve to the back of the internal condyle, having pierced
the internal intermuscular septum from before backward. It anastomoses with
tin- anastomotica magna ami posterior ulnar recurrent.
lt> anterior branch
extends to the front of the internal condyle to anastomose with the anastomotica magna and anterior ulnar recurrent.
PLATE XXII.
CAPSULAR LIGAMENT
INFRASPINATUS
(I).
.HEAO.
TERES MINOR
(I)
(0)
MUSCULO-SPIRAL GROOVE
TRICEPS
(INT. HEAD).(OJ.
CAPSULAR LIGAMENT.
OLECRANON FOSSA.
ANCONEUS
EXTERNAL CONDYLE.
EXT.
INT.
LATERAL LIGAMENT
CONDYLE.
uw
(0)
PLATE
XXIII.
SUPRASPINOUS
HEAD.
SUBSCAPULAR
(I).
GREATER TUBEROSITY.
(I)
CAPSULAR LIGAMENT
LESSER TUBEROSITY.*!.)
LATISSIMUSDORSI
BICIPITAL UI.OOVE.
TERES MAJOR
PECTORALIS MAJOR
(I)
(I).
CORACOBRACHIAL^
IBRACHIALIS ANTICUS
(I)
(I)
NUTRIENT FORAMEN
SUPINATOR LONGUS.
(0).
CONDYLAR RIOGE
EXT.
fSUPRACONDYLOID PROC
(0)
CORONOiD rossA
PRONATOR
TERES
RADII
INT.
(0).
(0)
INT.
(0)
RADIAL DEPRFSSION
(0).
EXTENSOR MINIMI
(0)
(01
SUPINATOR 8REVIS
CONDYLE.
EXTERNAL CONDYLE.
LATERAL LIGAMENT
CAPSULAR LIGAMENT
The
OlGlTI (0).
Left Hi merus
68
Anterior View
(0)
(0).
(U)
ANATOMY
IN A NUTSHELL.
69
The nutrient artery comes from the brachial about the middle of the forearm; it pierces the tendon of the Coraco-brachialis to enter the nutrient canal
which is below the insertion of the Coraco-brachialis; It is directed towards
A branch from the musculo-cutaneous
the elbow (page 19. Lesson 1.)
The artery may be a branch of the
nerve enters the bone with this artery.
superior profunda.
The muscular branches are three or four in number and arise from the outer
and supply the Bicep-. Coraco-brachialis, and Brachialis
amicus. The same muscles are supplied by the musculo-cutaneous nerve.
The anastomotica magna arises two inches above the elbow-joint, passing
>ide of the artery
inward over the Brachialis anticus to pierce the internal intermuscular septum
to pass to the back of the internal and external condyles.
It anastomoses in
front of the internal condyle with a branch from the inferior profunda and anIt anastomoses behind the internal condyle with the
terior ulnar recurrent.
sterior branch of the inferior profunda and the posterior ulnar recurrent.
It anastomoses behind the external condyle with the posterior branch of the
superior profunda and the interosseous recurrent.
or axillary artery with the arteries of the forearm, generally with the radial.
Forearm.
Plate
first
The
first
(Supinator longus,) Extensor carpi radialis longior, and the Extensor carpi
radialis brevior.
The first two are supplied by the musculo-spiral nerve: the
last
spiral
nerve.
Plate
XXXII,)
PLATE XXIV
GROOVES FOR
1ST.-
5TH.-EXTENS0R MINIMI
INDICIS.
DIGITI.
IAL
POSTERIOR
LATERAL LIGAMENT
RADIO-CARPAL LIGAMENT.
SUPINATOR BREVIS
BICEPS
LOWER
TRICEPS
(I).
(I)
CAPSULAR LIGAMENT.
I.i
ii
Radius and
Ulna Posterior
70
(I).
View.
PLATE XXV.
INTER- ARTieULAft-FIBHO-CARTIUCE.
LATERAL LIGAMENT
INT
SUPINATOR LONGUS.lll
PRONATOR QUAORATUS
(I).
RADIUS
PRONAIOR
RADII TERES/1)
FLEXOR SUBLIMISDIGITORUM.
(0
NUTRIENT FORAMEN.
OBLIQUE LINE.
OBLIQUE LIGAMENT
SUPINATOR
TUBERCLE
BICEPS. (I)""
LOWER
(ACCESSORY HEAD).
BRACHIALIS ANTICUS.
NECK OF RADIUS
PRONATOR
RADII
TERESILESSER HEAD)(0)
HEAD OF RADIUS
LATERAL LIGAMENT
CAPSULAR LIGAMENT
UlnaAnterior
71
View.
ANATOMY
72
A NUTSHELL.
IN"
cles
to
it
to these
muscles attached
LESSON XVI.
The Radius (Plates XX IV-XXV)
is theshorterof thetwo bones of the foreextremity is larger than that of the ulna, while its proximal extremity is smaller than that of the ulna. Thesetwo boneslie parallel. The proximal
extremity has a head, neck, and tuberosity; the circumference of the head is
tts inner portion which articulates with the lesser sigmoid cavity of
concave,
arm.
Its distal
the ulna
lar
is
Ligament.
tion of the
of the
head
is
also
age
ament and
distally
it
The
is
distally
process.
border
is
radius;
it
gives
tachmenl
a1
of this
to the third
head
of the
it
and
separates
The inner or interosseous borextends from the posterior pail of the bicipital tuberosity proximally to
the sigmoid cavity of the radius; its distal part divides into an anterior and
the anterior surface from theexternal surface.
der,
extent;
it
separates
border which
is
well
marked
in
membrane attached
to
most
The
of its
posterior
ANATOMY
nal surface
is
IN A NUTSHELL.
73
it
has attached
the Supinator brevis, and about the center the Pronator radii teres, and
distally it is covered by the Extensor carpi radialis longior and Extensor carpi
to
it
radialis brevior
is
quadilateral.
ossis
metacarpi
pollicis
and
and semilunar.
PLATE XXVI
EXTENSOR COMMUNIS DIGITORUM
(I)
(I)
EXTENSOR
INOICIS.
EXTENSOR
MINIMI DIGITI
(I),
EXTENSOR
SECUNDI INTFRNODII
POLLICIS.
il)
EXTENSOR
PRIMI INTERNOOII
POLLICIS.
EXTENSOR
CARPI UL:.ARIS.
(I)
r\
1ST METACARPUS.
EXTENSOR CARPI
RADIALIS LONGIOR
AND BREVIOR.
PISIFROM
Bones of Left
the scaphoid
is
semilunar
is
and articulates with the head of the ulna. The interarticular fibro-cartilage
attached to the border between the sigmoid cavity and the semilunar sur-
is
faces.
The perimeter
is
triangular,
ANATOMY
74
IN A
NUTSHELL.
indicis.
PLATE XXVII
(I)
(I)
FLEXOR
SUBLIMUS DIGITORUM
I 1
'
FLEXOR LONGUS
POLLICIS
(I)
ABDUCTOR AND
FLEXOR BREVIS MINIMI
DIGIT!
(I)
(I)
OPPONENS MINIMI
DIGITI.
OPPONENS POLLICIS
(I)
Ml
HI
EXTENSOR
OSSIS METACARPI POLLICIS
(0)
(0)
OPPONENS POLLICIS
ABDUCTOR POLLICIS.
(I)
(0)
(0)
Bones
Ossification.
oi
From
(0)
ADDUCTOR 0BLIQUUS
POLLICIS.
centers,
one
one
for
the
diaphysis
about
the
year which join- the bone aboul the twentieth year, and one for the proximal
fifth year, which joins the bone about the seventeenth year.
extremity, the
grooves correspond to the second, third, and fourth of the posterior annular ligament
oi tin- wrist-joint
ANATOMY
IN A NUTSHELL.
75
Articulation. It articulates with four bones, the humerus, ulna, scaphoid and semilunar.
Muscles. It has nine muscles attached, the Biceps, third head of the
Flexor sublimis digitorum. Supinator brevis, Flexor longus pollicis, Pronator
quadratus, Pronator radii teres. Supinator longus, Extensor ossis metacarpi
pollicis and Extensor brevis pollicis.
Blood Supply. The nutrient artery is derived from the anterior interosseous trunk: it enters the shaft near the middle of the anterior surface, and
runs towards the proximal end of the bone. The head of the hone is supplied
by the radial recurrent and interosseous recurrent arteries. The lower end is
supplied by the anterior and posterior interosseous arteries and numerous
twigs from carpal arches.
LESSON XVII
The Ulna
(Plates
XXIY-XXY.)
is
proximal extremity islarger than that of the radius, while its distal extremity is smaller than that of the radius. On cross section it is triangular, but its
arm;
its
distal part
physis.
is
in
On
Its
to
the
inner surface
its
is
The internal lateral ligament has an attachThe other surface gives attachment to part of
ment
the Anconeus.
The extremity of
arm is extended.
the process
fits
when
upper surface has a concave impression for the tendon of the Triceps and the anterior margin for the posterior ligament. The
posterior surface is covered by a bursa.
The coronoid (like a crown) makes
the lower part of the greater sigmoid cavity and the upper pari of the bone.
When the
Its upper surface is covered with cartilage in the recent state.
arm is flexed it fits in the coronoid impression of the humerus. <>n its outer
The orbicular
surface is the lesser sigmoid cavity for the head of the radius.
ligament is attached to the margin of the lesser sigmoid cavity.
the
On
it>
ment
inferior surface
Where
anticus.
Its
it
is
On
is
is
lally
from
ment
for the
this
one
for the
Flexor longus
Pronator
radii
teres,
pollicis.
The greater and lesser sigmoid cavities have been described with these two
The diaphysis has three borders and three surfaces. The anterior
processes.
it
is
to the
from of the
It
separates
the anterior and internal surfaces andgives attachment to the Flexor profundus
ANATOMY
76
IN A NUTSHELL.
Pronator quadratus
The
distally.
posterior
back
back part of the styloid process. It is
well marked in the proximal three-fourths and gives attachment to the common
aponeurosis which has three muscles attached to it. viz.. the Extensor carpi
commences
border
at
and continues
of the olecranon
to the
This border
ulnaris, Flexor carpi ulnaris and Flexor profundus digitorum.
The outer or interosseous borseparates the internal and posterior surfaces.
der, is divided above, extending to the anterior and posterior extremities of
the sigmoid cavity; embracing the triangular depression (the bicipital hollow).
In the trout part of this impression lodges the tubercle and tendon of the Biceps, when the arm is pronated, and the back part gives attachment to the
Supinator
distal
face
brevis.
four-fifths
is
grooved
It
is
The
membrane.
in
To
its
its
anterior sur-
extent, which
is
broader
than the distal portion, and gives attachment to the Flexor profundus digiIts distal one-fourth gives attachment to the Pronator quadratus.
torum.
The pronator
is
The
nutrient foramen
on
is
The
is
branch
and
is
proximal one-
The
nutri-
internal surface
is
distally.
The proximal three-fourths gives attachment to the Flexor profunThe posterior
dus digitorum, whereas the distal one-fourth is subcutaneous.
surface
is
between
this line
The
"Uter portion of this surface gives attachment to the Supinator brevis. Ex-
is
'
from the wrist-joint. The margin of the head is received in the sigmoid cavity
and the styloid process is a continuation of the posterior border
projecting from the inner and back part of the bone.
Its apex gives attach-
of the radius
ment
Extensor minimi
ligament;
it>
posterior surface
is
grooved
for the
digiti.
Ossifk ITION.
From three center-, one for the shaft about the eighth
week, one tor the distal extremity about the fourth year which joins the shaft
the eighteenth or twentieth
year,
and one
tor the
proximal extremity
tenth year which join- the shaft the sixteenth or seventeenth year.
Ai:t)<
lation.-
It
humerus and
radius.
the
ANATOMY
Muscles.
It
IN A NUTSHELL.
77
SCAPULAE
ARTERY
GREAT TUBEROSITY
POST.
CIRCUMFLEX ARTERY
CIRCUMFLEX N
MUSCULO-SPIRAL N
THE QUADRILATERAL
SPACE
IS
CIRCUMFLEX
N.
PASSING THROUGH
IT.
THERE
TRIANGLE
THROUGH
IT.
IT
HAS THE
AND
IS
TWO TRIANGUAL
ARE
SAME
BOUNDARIES.
MUSCULO-SPIRAL
BOUNDED ABOVE
N.
BY THE
ONE
PASSING
TERES
THROUGH
IT
The
nutrienl
it
is
from the anterior and posterior ulnar recurrent and from the interosseous recurrent.
The lower end receives twigs from the anterior and posterior interosseous arteries.
ANATOMY
7S
IN A
NUTSHELL.
LESSON XVIII.
The
wrist-joint
is
It
condyloid joint (Plate XL) having all movements exformed by the lower head of the radius and the inter-
is
and
The ulna docs not go
bones distally.
into
and cuneiform
The ligaments
and
The anterior ligament ex-
make
capsular ligament.
tend- from the anterior surface of the lower border of the ulna to the front of
the interarticular fibro-cartilage, also from the anterior surface of the lower
border of the radius and its styloid process, to the palmar surface of the scapand cuneiform bones distally, some fibers continuing to the c*
hoid, semilunar,
magnum and the unciform hones. There are some superficial fibers passing
from the styloid process ^i the ulna to the semilunar and cuneiform. This
The posterior ligament is weaker than the
ligamenl is pierced by small vessels.
anterior one: it extend- from the posterior surface of the lower part of the radius
and the triangular interarticular fibro-cartilage
scaphoid, semilunar and cuneiform
The
bones.
the
tends from the tip of the styloid process of the ulna to the inner surface of the
cuneiform, by one of its divisions, and to the pisiform and annular ligament by
the other.
The
some
fibers
two ligaments:
and outward from
articulation has
first,
the oblique
often absent.
commences beyond
artery passes to
It
affords
vessels pass
ANATOMY
IN A NUTSHELL.
79
back of the forearm between the radius and ulna above this membrane.
inferior radio-ulnar articulation is a trochoides, and is formed by the
head of the ulna and the sigmoid cavity of the raidus and fibro-cartilage. Its
ligaments are the anterior and posterior radio-ulnar which make the capsular
The anterior radio-ulnar ligament passes from the front border of
ligament.
the sigmoid cavity of the radius to the anterior surface of the head of the ulna.
The posterior one is a similar ligament on the posterior surface. The triangular
interartieular fibro-cartilage is at the lower end of the ulna, between the styloid
Its perimeter is attached to the ligaments of the wrist;
process and the radius.
it is attached by its apex to the depression between the head and styloid process of the ulna, by its base to the lower end of the radius.
Sometimes it is
perforated, in such a case the synovial membrane communicates with that of
to the
The
the wrist.
The blood supply is the anterior interosseous and anterior carpal arch.
The nerve supply is the anterior and posterior interosseous. Synovial
membrane, the membrana sacciformis, lines the adjacent surfaces of the ulna
and the interartieular fibro-cartilage. and the ulna and the radius. As stated
before, it sometimes communicates with the wrist-joint.
Brachialis amicus.
Description.
(Plate XVI.)
This is a broad muscle
which covers the elbow-joint and the lower half of the front of the humerus.
It is somewhat compressed from before backward and is broader in the middle
than at either extremity. Its fibers converge to a thick tendon. The outer
border of the muscle is in relation with the musculo-spiral nerve and radial rej
current artery.
Origin.
(1)
Lower
half of outer
of shaft of humerus;
(2) intermuscular septa; (3) commences above at insertion of Deltoid and extends below to within one inch of margin of articular surface.
(Plate XXIII.)
Insertion.
Into a rough depression on the anterior surface of the coron-
Action.
(Plate
Flexor of forearm.
Fifth and sixth cervical
Nerve Supply.
interval between
two
fleshy
XXV.)
through the
musculo-cutaneous
and musculo-spiral.
Blood
Si
pply.-
Brachial artery.
Subanconeus.
Description.- The Subanconeus is a name given to a few
under
from the
surface of the lower pai of the Triceps muscle.
By some
authors it is regarded as the analogue of the Stfbcrureus in the lower limb, but
fibers
it
is
Origin.
Humerus
Insertion.
A< tion.
fossa.
Nerve Supply.
Blood Supply.
Musculo-spiral.
Brachial artery.
teres.
Description.
(Plate
KXIX.) This muscle
beiween which the median nerve enters the forearm.
passes obliquely across the forearm from the inner to the outer side, and ter-
Pronator
arises
It
above olecranon
radii
by two heads,
PLATE XXIX
LEXOR PROFUNDUS
DIGITORUM.
FLEXOR SUBLIMIS
DIGITORUM
LUMBRICALES
ABDUCTOR
INDICIS
DIGITAL ARTERIES^DIGITALtJEKVE
FLEXOR LONG
US POLLICIS
DI&ITI.
ADDUCTOR IRANS
ABDUCTOR
VETSE POLLICIS
FLEXOR BREYIS
POLLICIS
MINIMI DIGIT!.
PALMARIS BREVIS
PISIFORM BONE
ABDUCTOR POLLICIS
OPPONENS
ANT.
POLLICIS
ANNULAR
LIG-'T-
EXTENSOR OSSIS
METACARPI POLLICIS
FLEXOR LONGUS POLLICIS
PALMARIS LONGUS.
SUPINATOR
LONGUS
PRONATOR
RADII TERES.
BRACHIALIS ANTICUS.
TRICEPS.
BICEPS
First
ANATOMY
IN A NUTSHELL.
81
in a flat
One
Origin.
XXV.)
(Plate
radius.
To pronate hand.
Nerve Supply. Median.
Blood Supply. Radial artery.
A' tiin.
Description.
(Plate XXIX.)
This muscle lies
on the inner side of the preceding muscle.
It is slender and
aponeurotic in
Flexor carpi
radialis.
structure at
a
finger.-.
Action.
Flexor of
wrist.
LESSON XIX.
Palmaris
Description.
longus.
and
is
subject to
below: or
or
it
may
may
may
it
Origin.
be muscular
XXIX.) Thi-
it
may
It is
often
be
slender,
is
absent
muscular
and below;
tendon: or
finally,
it
(1)
Insertion.
Palmar fascia
muscles of thumb.
\<
in
intermuscular septa.
(3)
tion.
(Plate
Tenses
Supply.
Blood Supply.
\i:i;\
variation:
consist
fascia:
much
(Plate
i:
(Plate
common
tendon:
(2)
deep
XXIII.)
and occasionally
XXIX
palmar
fascia.
Median.
Radial
of the muscle.
ulnarls.
lies
(Plate-
XXIX-.W
in
the
ANATOMY
82
IN A NUTSHELL.
internal condyle of
the other from inner margin of olecranon, upper two-thirds of posterior border
of ulna by an aponeurosis common to it, the Extensor carpi ulnaris, and Flexor
profundus digitorum, and also from the intermuscular septum. (Plate XXIII.)
Pisiform bone, annular ligament, and base of fifth metaInsertion.
(Plate XXVII.)
carpal and unciform bones.
Ai in
\'u;\
Flexes wrisi
i\.
Si imma
i:
Ulnar.
Blood Supply.
sublimis
Flexor
This
Ulnar artery.
muscle
digitorum
lies just
(perforatus).
preceding and
beneath the
is
the
largest
of
the
The fibers
by three heads.
pass vertically downward, forming a broad and thick muscle which speedily
The superlivides into two planes of muscular fibers, superficial and deep.
ficial plane divides into two parts which end in tendonsfor the middle and ring
fingers; the deep plane also divides into two parts which end in tendons for the
index and little fingers, hut previous to having done so it gives off a muscular
slip which joins that part of the superficial plane which is intended for the ring
finger.
As the four tendons thus formed pass beneath the annular ligament
superficial layer.
muscles of the
It
arises
hand they are arranged in pairs, the superficial pair cormiddle and ring fingers, the deep pair to the index and little
responding
The
tendons
Opposite the bases of
diverge as they pass onward.
fingers.
the first phalanges each tendon divides into two slips to allow the passage of
the corresponding tendon of the Flexor profundus digitorum: the two portions
then unite and form a grooved channel for the reception of the deep flexor
into the
palm
of the
to the
tendon.
Origin.
common
tendon;
(2)
muscular septum.
first
head,
(1)
humerus by
ami (3) inter-
internal condyle of
Third
head, oblique line of radius, from the tubercle to the insertion of the Pronator
radii ten-.
1
XXV-XXIII.)
(Plates
nsertion.
Plate
of
their middle.
Action.
\'u;\
i.
Median.
Supply.
Radial and ulnar arteries.
Flexor profundus digitorum.
Description. (Plate
Hi.<
situated on
the ulnar
side of
the
XXXI.)
This muscle
forearm, immediately
is
The portion
in
distinct
Four Bmall muscles, the Lumbricales, are connected with the tendons of the
Flexor profundus in the palm.
PLATE
XXX
LUMBRICALIS.
INNER
CPPONENS MINIMI
ADDUCTOR MINIMI
tBDUCTOR POLLICIS.
OIGITI
DIGIT!
EXTENSOR
BRE'.IS POLLICIS
FLEXOR V.BLIMlSDIWTORUM.
SUPINATOR BREVIS
RSDIAU
Wi
'
',J.
Vim
I.
u
FLEXOR CARPI RADlAllS
PRONATOR RAlu
BRALhIALIS AMICUS
[bicep: _
Second Layer
83
Anterior
n\\
ANATOMY
Origin.
faces;
Upper three-fourths
(1)
depression ob
(2)
IN A NUTSHELL.
membrane.
terosseous
Insertion.
\.
noN.
(4)
XXV.)
(Plate
Bases of
phalanges.
last
XXVII.)
(Plate
Flexes phalanges.
Supply.
first
and the
Flexor
Longus
pollicis.
Description.
(Plate
preceding
The
pass
fibers
XXXI.)
This
muscle
same plane
lying on the
in a flattened
is
as the
tendon
which passes beneath the annular ligament and is then lodged in the interspace
between the outer head of the Flexor brevis pollicis and the Adductor obliqus
The anterior interosseous vessels and nerve lie between this muscle
pollicis.
and the Flexor profudus digitorum.
Origin.- Front the grooved anterior surface of the shaft of the radius,
from the tuberosity and oblique line to within a short distance of the Pronator
quadratus; also from the adjacent part of the interosseous membrane, and generally by a fleshy slip from the inner border of the coronoid process of ulna, or
from the internal condyle of the humerus.
(Plate XXV.)
Insertion.- Base of last phalanx of thumb.
(Plate XXVII.)
\ tion.
Flexes thumb.
Nerve Supply.- Eighth cervical and first dorsal through the anterior
interosseous branch of the median.
Blood Supply.- Radial artery.
Pronator quadratus.Description.
This is a small,
(Plate XXXI.)
flat, quadrilateral muscle extending transversely across the front of the radius
and ulna, above their carpal extremities.
Origin.
(1) Oblique ridge on lower part of anterior surface of ulna; (2)
l"\\er fourth of anterior surface and anterior border of ulna; and (3) strong
[ON.
Nerve Supply.
branch
interosseous
Eighth
<<\'
Blood Supply.
and
cervical
first
dorsal
through
anterior
median.
Radial
and ulnar
arteries.
LESSON XX.
Supinator longus.
(Brachio-radialis)
forearm;
is
Description.
the mosl
(Plate
superficial
XXXII.)The
muscle on
Supinator longus
the radial
side of
the
is
the elbow,
is
artery,
and
in
in
relation
ANATOMY
IN A NUTSHELL.
85
From the
Origin.
merus and from the external intermuscular septum by a few fibers from the
common tendon of origin of the extensor muscles of the forearm. (Plate XXIII.)
Insertion. Base of metacarpal of index finger, radial side. (Plate XXVI.)
Action. Extends the wrist.
Xerve Supply. Sixth and seventh cervical through the musculo-spiral.
Radial
Blood Supply.
Extensor
This muscle
carpi
artery.
radialis
and
brevior.
Description.
(Plates
XXXII.)
beneath which it is
Its fibers terminate about the middle of the forearm in a flat tenplaced.
don which is closely connected with that of the Longior, and accompanies
it to the wrist, lying in the same groove on the posterior surface of the radius;
it passes beneath the extensor tendons of the thumb, then beneath the annular
shorter
is
preceding,
ligament.
The tendons
partment
of the two preceding muscles pass through the same comannular ligament and are lubricated by a single synovial mem-
of the
brane, but are separated from each other by a small vertical ridge of bone as
they
lie
in the
Origin.
From
common
to it and the three following muscles: from the external lateral ligament of the
elbow-joint, from a strong aponeurosis which covers its surfaces, and from the
(Plate XXIII.)
intermuscular septa.
Insertion.
on
its
(Plate
XXVT.) Base
of metacarpal
bone of middle
finger
radial side.
Action.
It
assists
and may
Nerve Supply.
wrist
Sixth
inter-
osseous.
is
Description.
(Plates
XXXII.)
This
situated at the back part of the forearm and divides just below
the
middle into three fleshy masses, from which tendons proceed; these pass together with the Extensor indicis through a separate compartment of the annular ligament.
two.
PLATE XXXI
FLEXOR PRORINOUS DtGITORUM
FLEXOR SUBLIMIS WGITOHtM
U6A*ENTUm VA6INALE,
FIRST LUMBRICALIS
FIRST DORSAL INTEROSSEOUS
TRANSVERSE
ADDUCTOR POLLICIS.
OBLIQUE
FLEXOR BRE\
IS
DIGJTI
(0)
POLLICIS
(INNER MtADI
(I,.
PALMARIS BREVIS
ABDUCTOR MINIMI
DIGITI
/.BDUCTOR POLUCIS
fl/j,
Mtt'<
\\m :\\
1
.it
(ill :.!'>
V
:
LONGIOR.
J.JPINATOS BREVIS
PALMARIS LONGUS.
'X
m
I
MuscLES OF theJLept
m
m
m
I jfl
F(
BRACHIALIS
Li
v.-
ANTIC!';,
',1
PRONATOR
RADII
TERES
Ml, K
T'4 M
"'
-^TRICEPS
86
ANATOMY
IN A NUTSHELL.
87
Each tendon opposite the metacarpophalangeal articulation becomes narrow and thickened and gives off a thin fasciculus upon each side of the
blends with the lateral ligament and serves as a posterior ligjoint, which
ament; after having passed the joint it spreads out into a broad aponeurosis
which covers the whole of the dorsal surface of the first phalanx, being reinforced in this situation by the tendons of the Interossei and Lnmbricales.
Opposite the
first
(3)
(1)
Into the
common
tendon;
(2)
deep
(Plate XXIII.)
intermuscular septum.
Insertion.
slips,
lateral.
fol-
band and
receives
the middle finger; the third tendon gives off a slip to the second
a very
considerable part
the fourth
of
tendon
slip to join
the
it
goes to
fourth or
innermost
and receives
After the
little finger.
is
di-
in-
serted into the base of the second phalanx, while the two lateral
Action.
To
(Plate
are continued
phalanx and are inserted into the dorsal
XXVI.)
Nerve
Blood Supply.
Posterior interosseous.
minimi
Extensor
digiti.
Description. (Plate
XXXII.) This is a
communis digitorum
with which
it
compartment
is
generally connected.
Its
ductor minimi
a slip
digiti.
Common
septa.
(Plate
External
(Plate
XXXII.)
(Plate XXII.)
condyle of humerus posteriorly.
of posterior surupper
process
of
olecranon
and
fourth
Insertion. Side
Origin.
(Plate
XXIV.)
ANATOMY
8S
Extends forearm.
Seventh and eighth cervical through the musculo-spiral,
Radial and superior profunda.
riON.
A.<
IN A NUTSHELL.
Supply.
Blood Supply.
\i.i,\
i.
LESSON XXI.
Supinator brevis.
cle
It
of
hollow
consists of
Description. (Plate
cylindrical
XXXIII.)
muscular
of
This
the upper
broad mus-
between which
fibers,
arise
is
in
common.
lies
The
the
fibers
form
ulna; (5)
a sling-like fasciculus,
tuberosity.
The
Insertion.
superficial
(Plates
fibers
into
XXIII-XXIV.)
the outer edge of the bicipital
tuberosity and oblique line of the radius; the deeper fibers into the posterior
of the shaft,
midway between
(Plate
is
XXIV.)
Nerve Supply.
Blood Supply
Posterior interosseous.
is
pollicis.
of the
pollicis.
Origin.
From outer part of posterior surface of shaft of ulna below inAnconeus, from the interosseous membrane, and from the middle
sertion of
Insertion.
Bl<
XXIV.)
(Plate XXVII.)
Extends thumb.
Action.
Nerve
(Plate
Si pply.
Si pply.
Extensor brevis
Posterior interosseous.
Posterior interosseous.
pollicis.
Description.
(Plate
XXXIII.)
internodii pollicis,)
The
Exten-
tin
process.
PLATE XXXII
ATTACHMENT
OF
tffc
THIRI
!&)
ATTACH JI
EXTENSOR CO
TO
EXTENSOR
SEC
INCMCIS
EXTENSOR MINIM:
/-
J.
DIGIT!
adductoh
fl
i-ul
EXTENSOR MINIMI
DIGITI
EXTENSOR
COMMUNIS
QiGITORuM.
SUPINATOR LONGUS
BRACHIALIS ANIICUS.
'
it]
Superficial
89
__
biceps.
Layer Posterior
iew
PLATE XXXI 11
-.'!,
DR MINIM
L'iG'T
ABDUCTOR MINIMI
DIGITI
EXTENSOR
IND4CIS.
-SUPINATOR
ONGUS
BRACHIAUS ANTICUS.
Deep
90
Layer
Postesior
View
ANATOMY
Origin.
Posterior surface of
IX A NUTSHELL.
'.'1
longus
Description.
pollicis.
meta-
-(Plate
- membrane.
and from the int<
(Plate
Insertion. Base of first phalanx of thumb.
Ai tion.
Extends the proximal phalanx of thumb.
carpi pollicis
it
XW
1.
posterior inter ss
(Plate
internodii
XXH
The
XXXIII.)
pollicis)
is
much
It
Exlarger
termi-
of the radius.
Origin.
It
Outer part
of
(Plate
XXIV.)
(Plate XX\ I.
Base of last phalanx of thumb.
Insertion.
Action. Extends thumb.
Nerve Supply. Seventh cervical through posterior interosseous.
Blood Supply.
Posterior
interosseous artery.
indicis.
Description.
Plate
of.
common
extensor.
(Plate
XXVI.)
Extends index
Nerve Supply. Seventh cervical through posterior
artery.
Blood Supply. Posterior inter
A' tion.
ring
inter
ss
LESSON XXII.
It-
branches
in
ANATOMY
IX A
NUTSHELL.
The radial recurrent arises from the radial just below the elbow, passes
outward between the Supinator brevis and Supinator longus, also separating
the radial and posterior interosseous uerves; it then runs towards the elbow
between the Supinator longus and the Brachialis anticus to supply these muscles and to anastomose with the anterior terminal branch of the superior profunda.
arm.
^\
anterior carpal of ulnar, thus forming the loop which gives branches to the
wrist-joint.
superficialis volae arises from the artery near the wrist where it is
It passes between the muscles of the ball of
wind around the carpus.
It anastomoses with the ulnar, completing
the thumb, sometime- over them.
The pulse may often be felt in this artery, as
the superficial palmar arch.
The
about
well
to
a.-
the radial,
in
The branches
sal
it
interosseous,
off the
when
anterior
carpal
it
metacarpal or
first
dor-
In this
metarcapal of the thumb, lying upon the scaphoid and trapezium.
situation it is crossed by the three extensors of the thumb, viz., Extensorossis
metacarpi
which
pollicis
is
broad
sal interossei
cles to the
metacarpophalangeal
arch.
It
to join
where
it
supply the contiguous sides of the middle, ring, and little fingers. At their
proximal extremity they receive perforating branches from the deep palmar
At the distal extremity they give perforating branches to the digital
arch.
branches
to join
The metacarpal
carpal, bu1
it
or
first
dorsal interosseous
may
It
extremity it receives perforating branches from the deep palmar arch; at its
distal extremity it gives branches to join the corresponding digital arteries.
The digital arteries end at the firsl interphalangeal joint where they join the
posterior branch of the collateral digital branches.
The dorsales
the base of the
the thumb.
pollicis are
first
ANATOMY
IN A NUTSHELL.
93
The dorsalis indicis arises from the radial just before it passes between the
two heads of the Abductor indicis; it then passes over the dorsum of this muscle, which it supplies, to the radial side of the index finger.
At the first interphalangeal joint it anastomoses with the posterior branch of the radialis indicis.
PLATK XXXIV
lill-fij
SECOND DORSAL
INTEROSSEOUS
FIRST DORSAL
INTEROSSEOUS
Enterossej
The deep palmar arch is formed by the radial, after it pusses between the
two heads of the Abductor indicis, and a terminal branch of the ulnar. This
arch has its convexity distally; it lies upon the bases of the metacarpal bones.
It has five branches, four from the convexity and one from the
concavity.
The princeps polllcis first passes between the Abductor indicis and the
ANATOMY
94
n-
ffh
ti
,,,.,'
/I", palmar
indicis
Abductor
IX A NUTSHELL.
of the
thP distal extremity of the metacarpal
i.
thumb
-I
firsl
it
PLATE XXXV
FIRST
I'ii i:
,,.
,,;:;,',
branches.
They
^tSX^'i
join
,1
ling digital
""""
'
'
They
pass """"""
ANATOMY
IN A NUTSHELL.
95
arteries.
The palmar
recurrent,
Relations of
In
Front.
Longus.
Behind.
teres,
(4)
quadratus,
(1)
Tendon
(5)
Flexor longus
pollicis,
Pronator radii
(6)
Pronator
radius.
Outp:r Side.
(1)
Inner Side.
(1)
LESSON XXIII.
is
branch
It is
.
It
lig-
the two layers of muscles on posterior part of forearm as far as the wrist.
lies
It
It
and ulnar, and anterior interosseous arteries. It gives off the posterior
which passes under the Anconeus to the interval between olecranon and external condyle, where it anastomoses with the superior
profunda, the anastomotica magna and posterior ulnar recurrent.
The muscular branches vary in number and supply the adjacent muscles.
of radial
interosseous recurrent
ANATOMY
96
is
IN A NUTSHELL.
a small
It
passes outward to
anastomose with the anterior carpal of the radial. These two arteries make
It
anastomoses with the anterior interosseous, and
the anterior carpal arch.
It lies beneath the tendons of
recurrent branches from the deep palmar arch.
the
passes beneath the Extensor carpi ulnaris to the hack of the wrist to
It
join the
palmar arch
'The superficial
is
made by
the hand, joining the superficialis volae, or the radialis indicis, or the princeps
Upper half.
Lower half (3)
Front.
dian nerve.
(1)
the Forearm.
in
Superficial
fascia.
(4)
Deep
(2)
Me-
fascia.
Palmar Arch.
digiti,
(3)
net-work of nerves
sit-
BRACHIAL PLEXUS.
LESSON XXIV.
A plexus
uated
in
the
is
net-work.
Its
axilla.
is
It
"brachial" because it supplies the arm or brachium.
anterior primary branches (Principle IV Lesson III) of the
is
is
called
composed
of the
It
fifth, sixth,
seventh,
first
dorsal nerves.
make
the
first
trunk.
cords of the brachial plexus <m account of occupying that relation to the second
part
of the axillary
artery.
(Plates
VI-XVI-XVII.)
PLATE XXXVI
ANATOMY
'.s
The
axillary artery
is
IN A NUTSHELL.
is
called the
first
minor
behind
it
is
'The inner cord gives off the ulnar, internal cutaneous, lesser in-
ous nerves.
The posterior
cutaneous, and the internal anterior thoracic nerves.
cord gives off the three subscapular and divides into the circumflex and musculoternal
spinal nerves.
and posterior
inter-
isseous.
This plexus is situated in the posterior triangle of the neck between the
Scalenus anticus and the Scalenus medius, being covered by the skin. Platysma
myoides, and deep fascia; the posterior belly of the Omo-hyoid and the trans\
clavian artery:
it
it.
It
next
lies
above and
in
to the
and posteriorly
to the
it first
cords
lie
lies to
the
externally.
From
the
The
below
acic,
it.
branches above
it
and branches
posterior thor-
and suprascapular.
fifth
phrenic.
The
from the
and seventh
cervical.
It
is
formed
in
comes
Scalenus medius, then passes behind the brachial plexus and axillary artery to
and
into
branch
to the shoulder-joint,
and one
All
to
the scapula
itself.
The external or
it-
fibers
may
he traced to the
fifth, sixth,
and
ANATOMY
seventh cervical nerves.
the costo-coracoid
It passes
membrane and
IN A NUTSHELL.
99
vessels, pierces
This loop
It
commu-
around the
front and inner side of the axillary artery and branches are often given from it
to
is
The
then pierces the costo-coracoid membrane to supply the Pectoralis minor; after
passing through the substance of this muscle it supplies the Pectoralis major.
The subscapular nerves are three in number, the upper, the middle, and
All are
branch.
It
is
traced to the
common
and seventh
the axillary artery where
fifth,
sixth,
cervical nerves.
It
lies
its
of the
ment over its lower part. The inferior branch supplies the Deltoid and Teres
minor.
The part supplying the Teres minor has a ganglion upon it. It then
pierces the deep fascia to supply the integument on the lower two-thirds of the
of the
branch from the circumflex nerve supplies the long head ol the
Biceps, the head of the humerus and the shoulder joint.
The median nerve is formed by a branch from the outer cord and one from
Triceps.
and
of the Teres
first
Its fillers
may
dorsal nerves.
minor
be traced to the
fifth, sixth,
as a rule, although
it
may
The
branch from the inner cord crosses the third pari of the axillary artery; the
nerve lies then to the outer side of axillary artery, passing to the distal extremity
of the
axilla
arm
it
to pass
lies first
radii teres.
to the
head
the
ol
11
presses
In the
in
the
on this nerve
PLATE
WWII
DEEP
CERVICAL
NODE
AXILLARY NODES
EPICONDYLAR
NODE
OR
GLAND
MEDIAN
CEPHALIC
Superficiai
ANATOMY
arm
it
IN A NUTSHELL.
101
lies to
It lias
no branches
in
it
t<>
the inner
it
After passing between the two heads of the Pronator radii teres it passes
extremity of the forearm where it passes under the anterior annular
to the distal
ligament.
In its course, in the forearm.it first lies between the Flexor sublimis
digitorum ami Flexor profundus digitorum, then between the tendon.- of the
Flexor sublimis digitorum and Flexor longus pollicis.
It supplies all the muscles in
the
first
layer of the forearm except the Flexor carpi ulnaris. which are
the Pronator radii teres. Flexor carpi radialis. and Palmaris longus:
plies the
one muscle
in the
is
it
also sup-
LESSON XXV.
The anterior interosseous nerve is given off just below and is accompanied
by the anterior interosseous artery to the distal extremity of the forearm lying
on the interosseous membrane. The nerve is external to the artery being between the Flexor profundus digitorum and Flexor longus pollicis. This branch
supplies the Flexor longus pollicis, Pronator quadratus, and the outer side of
the Flexor profundus digitorum.
It
and
to the interosseous
membrane,
is
to the
worth
branch from the median.
It
i>
thumb
and
It
fifth digital
finger.
contiguous sides of the index and middle fingers and the middle ami ring
five digital
The
fi]
ANATOMY
L02
IN A NUTSHELL.
The ulnar nerve arises a little below the lower border of the Pectoralis
Its fibers may be traced to
minor, from the inner cord of the brachial plexus.
lies on the inner side of the axillary
It
the eighth cervical and firsl dorsal.
it passes below the insertion of the Coracoforms an acute angle, and, in company with the posterior
branch of the inferior profunda artery, pierces the internal intermuscular septum,
then passing down to the groove between the internal condyle and the ole-
brachialis where
it
cranon process
it
forearm
company with
the pos-
between the Flexor profundus digitorum ami Flexor carpi ulnaris; in the middle third of the forearm
between the same two muscles with the Flexor sublimis digitorum on the other
It is situated on the inner side of the ulnar artery and crosses the anterior
side.
In the forearm it gives off
annular ligament on the radial side of the pisiform.
branches near the elbow-joint which supply the Flexor carpi ulnaris and the
inner part of the Flexor profundus digitorum.
The cutaneous branches arise about the middle of the forearm; there are
two of these branches. The one most superficial pierces the deep fascia near
the wrist to supply the integument and anastomose with the internal cutaneThe other branch, which is the deeper one, is called the palmar cutaneous.
It accompanies the ulnar artery, being upon its anterior surface, to the
ous.
he dorsal cutaneous arises about two or three inches from the wrist;
hand.
terior ulnar recurrent artery.
In the
it
lies
it
passes to the dorsal aspect of the wrist under the Flexor carpi ulnaris, super-
Extensor carpi ulnaris to supply the integument on the ulnar asof the hand and that of the little and half of the ring fingers.
The superficial terminal or palmar branch supplies the Palmaris brevis,
the hypothenar eminence, the inner side of the little finger on its volar aspect,
ficial
to the
pect of the
dorsum
which it supplies.
It
divides in the substance of this
muscle and passes to the outer side of the arm between the Biceps and the
Brachialis amicus, supplying these muscles.
It sends a branch with the nutri-
the Coraco-brachialis
ANATOMY
IN A NUTSHELL.
103
PLAT
i
OBLIQUE. LIGAMENT
POST. LIGAMENT
the median.
It anastomoses
posterior aspect on the radial side of the forearm to the wrist.
musculo-spiral.
of
the
with the radial and the distal external cutaneous
LESSON XXVI.
The musculo-spiral is the largest branch of the brachial plexus. It mid the
supplies musIt
circumflex are the terminal branches of the posterior cord.
Its libers may be traced
cles and integument both above and below the elbow
.
ANATOMY
104
to the fifth, sixth, seventh,
It
commences
IX A NUTSHELL.
and eighth
cervica] nerves
and the
first
dorsal nerve.
behind
Subscapulars. Teres major,
lies on the inner side of the
It first lies
in
the Supinator longus and Extensor carpi radialis longior on the outer side,
and
PLATE XXXIX
8'ceps
,'0BLlQ Ut
T ND0N
0AB/
UGAM Elu r
CUUfi
L 'GAMEH
J"
In
nerve supplies
five
muscles
vi/...
heboid we
cular septum.
will
This
have the
live
it
The musculo-spiral
(just
intermus-
given), an articular
viz.,
posterior interos-
ANATOMY
Its articular
branch
is
IN A NUTSHELL.
105
cutaneous branches supply the integumenl of the arm over the musculoforearm over the radial aspect of the dorsum of the forearm
The
in
the tendon of the Latissimus dorsi, then passes behind the intercosto-humeral
nerve, pierces the dee]) fascia to supply the integument on the middle of the
to the olecranon.
it
Ii
gives off
its
one perforates the outer head of the Triceps, accompanies the cephalic vein to
the elbow and supplies the integument over the lower half of the outer and inner
aspect of the arm.
The lower one is the larger. It arises behind the external
condyle to simply the integument on the lower part of the arm and radial asIt anastomoses with
pect of posterior surface of forearm as far as the wrist.
the musculo-spiral and internal cutaneous.
The radial nerve is the smaller of the two terminal branches of the musculoIt runs towards the wrist under the Supinator
spiral and is purely cutaneous.
longus. It passes in front of the elbow. radial recurrent a., and Supinator bre vis.
In the middle third of the forearm it lies parallel to. and on the outer side of.
The nerve
turns backward beneath the tendon of the Supinator longus and becomes cu-
taneous by piercing the deep fascia of the outer side of the forearm about three
its distal extremity: here it divides into two branches, external
and internal. The externa! one supplies the integument on ball and outer
inches from
pollicis to lie
wrisl in
on the interosseous
company with
membrane on which
it
its
it
branches of distribution
to the wrist-joint
and carpal
joint.-.
muscles
in
all.
Extensor carpi
Extensor longus
It
It
supplies
all
supplies nine
viz.,
ulnaris,
ANATOMY
106
IN A NUTSHELL.
region.
The
its fibers
may
arm
About
half
way along
pierces the deep fascia with the basilic vein, dividing into anterior
arm
and pos-
The
ulnar.
forearm where
passes
in
it
the elbow
dorsum
of the
It
Above
it
its fibers
first
are traced to
In the axilla
it
communicates with the intercosto-humeral forming one or two loops. It is situated on the inner side of the axillary often being separated from the vein by
About the middle of the arm it pierces the dee]> fascia supplythe ulnar nerve.
ing integument over the olecranon.
LESSON XXVII.
The hand. (Plates XXVI-XXVII.)
There
are twenty-seven
bones in
the hand while there are but twenty-six in the foot, there being one more bone
The number of muscles in the
in the carpus (wrist
than in the tarsus (ankle.)
)
hand
is
forearm.
ductor
In
pollicis,
<
in
the foot.
thumb
(thenar
>pponens
pollicis
the
in the
Ab-
pollicis,
two
gel
i.
phalanges,
make
ANATOMY
The scaphoid
ossifies
IN A NUTSHELL.
It
107
viz..
magnum and
semi-
lunar internally.
It
is
pollicis.
The
branch from the anterior interosseous, and small branches from the pos-
terior interosseous.
The semilunar
fourth year.
ossifies the
radius proximally. os
magnum and
It
unciform
distallv.
CAPSULAR LIGAMENT
INT.
LATERAL
\\\ X
LISA! -1ENT
P0
.-X
\]^2i^A *l'^\
1
Tin: Wrist-Joint
on either
side.
It
Posterior
View
i-
the
same
as
the carpus.
The cuneiform
viz.,
ossifies
in
front,
It
articulates with
and unciform
end
of the ulna.
The
cuneiform.
minimi
It
diuiti.
It
to this
three bone-.
distally,
it
and with
from the
distal
bone.
ANATOMY
108
IN A NUTSHELL.
The trapezium ossifies the fifth year, and articulates with four bones, viz.,
scaphoid proximally, trapezoid and second metacarpal internally, and the first
It has three muscles attached, Abductor pollicis, Flexor
metacarpal distally.
brevis pollicis,
metacarpi
ossis
pollicis.
pollicis.
It
attached.
PLATE XLI
CAPSULAR LIGAMENT
Tiii:
Wrist-Joint
Anterior
View
The OS magnum ossifies the first year. It articulates with seven bones,
scaphoid and semilunar proximally, second, third, and fourth metacarpal distally, trapezoid on the radial side, and the unciform on the ulnar side.
It has
one muscle attached, the Adductor obliquus pollicis.
The unciform
ossifies the
second year.
It
ANATOMY
IN A NUTSHELL.
109
Metacarpal bones.
and one
shaft
it
(Plate
VII.)
Each
week
of intrauterine
life,
and that
metacarpi pollicis, Flexor brevis pollicis, and the First dorsal interosseous. The
second metacarpal articulates with five bones, the trapezium, trapezoid, and os
magnum proximally, the third metacarpal internally, and the first phalanx of
the index finger distally.
It
dorsal interossei. Extensor carpi radialis longior on the dorsal aspect of the bone
radialis, First
It
magnum
The
first
phalanx
of the
middle
and Third dorsal interossei, and the Extensor carpi radialis brevior and on
the palmar aspect the Adductor transversus pollicis. Adductor obliquus pollicis,
The fourth metacarpal articulates with five bones.
and Flexor carpi radialis.
os magnum and unciform proximally, os magnum and third metacarpal externally, the fifth metacarpal internally and the first phalanx of the ring finger
It has three muscles attached; on the dorsal aspect the Third and
distally.
Fourth dorsal interossei, and on the palmar aspect the Second palmar interosseous.
The fifth metacarpal articulates with three hones, the unciform proximally, the unciform and fourth metacarpal externally, and the lirst phalanx
of the little finger distally.
It has five muscles attached; the Extensor carpi
ulnaris, Plexor carpi ulnaris, Third palmar Interosseous, Fourth dorsal interosseous, and Plexor ossis metacarpi minimi digiti.
Flood supply of the first metacarpal bone is derived from the princeps
pollicis artery; it enters on the ulnar side, and is directed towards the head
of the
hone.
For
the
second
palmar interosseous.
the proximal end or base
lirsl
of the bone.
For the third metacarpal hone ih< nutrient artery is derived from the
interosseous; il enters as a rule, on the radial side and is directed towards
the base.
ANATOMY
110
IX A NUTSHELL.
second interosseous;
it
is
furnished by the
is
directed towards
fifth
third interosseous;
LESSON XXVIII.
first phalanx of the thumb articulates with two bones, the metacarpal
thumb proximally, and the second phalanx distally. It has five muscles
The
of the
the
Al idiictor
Extensor brevis
flexor longus
pollicis,
pollicis.
pollicis.
phalanx of the index finger articulates with two bones the second
metacarpal proximally. and the second phalanx of the index finger distally.
It
has two muscles attached, the First dorsal interosseous, and the First palmar inThe second phalanx of the index finger articulates with two bones,
terosseous.
the
The
first
first
It
has
three
muscles attached, the Extensor communis digitorum Extensor indicis. and the
The
last
The second phalanx of the ring finger articulates with two bones.
phalanx of the ring finger proximally, and the third phalanx distally.
It
has two muscles attached, the Extensor communis digitorum and Flexor
The third phalanx of the ring finger articulates with one
sublimis digitorum.
hone, the second phalanx proximally. and has two muscles attached, the Exinterosseous.
the
first
tensor
little
finger distally.
dieiti,
fifth
It
Abductor minimi
ANATOMY
IN A
NUTSHELL.
Ill
PLATE XLII
Nerve Supply.
ANATOMY
112
From
Blood Supply.
pollicis. -(
Opponent
XXXI.)
Origin. (Plate
This
(Plate
is
IN A NUTSHELL.
metacarpi
Flexor ossis
Description.
pollieis.)
XXVI.) Palmar
surface
trapezium and
of
annular
ligament.
I
nsertii
Whole length
in.
of
metacarpal of
thumb on
(Plate
radial side.
XXVI.
Flexes metacarpal of thumb.
Action.
Nerve Supply.
Blood Supply.
Flexor brevis
From
pollicis.
radial
and
Description.
(Plate
XXXI.)
This
muscle con-
two portions outer and inner, having separate origins and insertions.
The outer portion is the more superficial and has a sesamoid hone developed in
The inner and deeper portion is very small.
its tendon.
sists of
ament.
Insertion.
Both
metacarpal bone.
first
sides of base of
(Plate
lig-
XXVIII.)
first
XXVII.)
(Plate
through
cervical
(Plate
median;
XXXI.)
This
inner
muscle
by several
and converge to
arises
of the
developed
slips.
in
outward beneath the tendon of the long flexors to join the superficial
portion of the short flexor and the Abductor pollicis.
This muscle was formerly
liquely
(3)
radialis.
anterior carpal
(Plate
(2)
bases
ligaments;
(4)
of
second
XXVII.)
Nerve Supply.
transversus
pollicis.
arches.
Description.
by
its
mon
The
broad base.
libers
it
(Plate
is
XXXI.) This
triangular
in
is
form, arising
is
in
com-
with the inner part of the Flexor brevis pollicis and the Adductor obliquus
pollicis.
From
this
common tendon
a slip
is
prolonged
to the
Extensor longus
pollicis.
Origin.
face.
(Plate
bower tw<
XXVII.)
Insertion.
don.
(Plate
XXVU
firsl
phalanx
of
palmar sur-
thumb by common
ten-
ANATOMY
IN A NUTSHELL.
113
LESSOX XXIX.
Description. (Plate XXXI.) This is a thin, quadmuscle placed beneath the integument on the ulnar side of the hand.
The palmar fascia is in relation with its deep surface and separates it from the
Palmaris brevis.
rilateral
fascia.
tion.
(Plate
finger.
XXXI.)
This
is
a triangular
muscle
Descripimmediately
digiti).
placed
gin.
XXVII.)
Action. Draws fifth metacarpal forward
(Plate
Nerve Supply.
Blood Supply.
Lumbrieales.
Eighth cervical
Ulnar artery.
Description.
so as to
through ulnar.
(Plate
XXXI) The
Lumbricales
are
four
ANATOMY
14
NUTSHELL.
IN A
Origin.
[nsertion.-
hack
each finger.
of
\i
To
ion.
Nerve
flex
firsl
phalanges.
The two
Si pply.
outer
Lumbricales by
the
sixth
cervical
through the third and fourth digital branches of the median; the two inner by
The third lnmthe eighth cervical through deep palmar branch of ulnar.
brical receives the median in almost half the cases.
The Abductor
is
muscles.
by
two heads; (1) Outer head from upper half of ulnar border
of first metacarpal hone. ('_') Inner head from almost the whole length of the
(Plate XXVI.)
radial border of the second metacarpal bone.
side
Into
radial
of
of
first phalanx of index finger.
the
base
Insertion.
Origin.
'The
metacarpal.
Plate
of the
XXVI.
Insertion into the radial side of the first phalanx of middle finger.
The Third dorsal interosseous.
ORIGIN.
By two heads from the adjacent sides of the third and fourth metacarpal bones.
(Plate
XXVI.)
firsl
carpal bones.
phalanx
of
middle
and
finger.
fifth
meta-
XXVI.)
Insertion.
Action.
<
>RIGIN.
(1)
ANATOMY
IN
A NUTSHELL.
115
Insertion. Into the radial side of the first phalanx of ring finger.
Third palmar interosseous.
Origin.
By one head from the radial side of the fifth metacarpal bone.
Into the radial side of the first phalanx of little finger.
Insertion.
Each
finger has
ductor minimi
little
The Ab-
finger.
Nerve Supply.
Blood Supply.
Action. Same
Ulnar.
Deep palmar
arch.
LKSSOX XXX.
Fascia of the arm. Just beneath the skin is the superficial fascia which
has two layers, a superficial one consisting mainly of adipose tissue, and a deep
one which is fibrous in structure and is in contact with the deep fascia. The
back, shoulder above by being attached to the clavicle, the scapula ami the
and to that of the forearm by being attached to the condyles of the humerus and olecranon of the ulna. It is thin over the Biceps, thick over the
Triceps; strengthened on the inner side by fibers from the tendon of the Pectoralis major and Latissimus dorsi, on the outer side by fiber- from the tendon
of the Deltoid; the axillary fascia is also continuous with it.
The external intermuscular septum extending from the insertion of the Deltoid to the External
condyle and attached to the superior condylar ridge joins the inner surface of
spine,
the deep fascia, thus dividing the sleeve or cylinder of fascia into an anterior
and posterior compartment, the anterior one having flexor muscles in it and the
This septum is pierced by the musculothe posterior one extensor muscle.-.
It has five
spiral nerve and superior profunda artery from behind forward.
muscles attached to
it,
viz..
Deltoid,
we
will
In these five
have the
five
muscles
if
we sub-
musculo-spiral nerve.
The
and posterior
division.
Brachialis anticus,
Il
ii.
vi/...
the Triceps,
ANATOMY
lit)
IN A NUTSHELL.
nular ligament which is in reality the aponeurosis which separates the first and
It passes from the pisiform bone
second layers of the muscles of the forearm.
and unciform process to the scaphoid and trapezium; it is a strong fibrous band.
dyle
is
It
in front,
communicating vein
pierced by a
The
receives a
at
is
passes from the outer border of the lower end of the radius across to the inner
side of the pisiform and cuneiform bones, its inner surface being attached to the
ridge on the posterior surface of the radius.
(if
first
It
makes
and Extensor brevis pollicis; the second the Extensor carpi radialis longior
and Extensor carpi radialis brevior; the third the Extensor longus pollicis; the
fourth the Extensor communis digitorum, which is in the superficial layer,
and the Extensor indicis, which is in the deep layer; the fifth, the Extensor
minimi digiti which is in the superficial layer; the sixth, the Extensor carpi
licis
ulnaris which,
is
in
thumb except
those of
it, all
those of the
all
finger except
little
thumb
and two
ulnaris,
Palmaris longus, and Palmaris brevis, making the nine. The tendon of
it
he Flexor carpi radialis pierces the anterior annular ligament and the Palmaris
The median nerve and the
Longus passes over it. but is also attached to it.
tendon- of three muscles pass under it; the muscles are the Flexor sublimis
i
The
hand.
It
Between the
pollicis.
thehand isthinand
is
com-
annular ligament.
fingers
fibers.
it
This fascia
dips
The deep
down
layer
is
is
to
join
the
web which
connects
cesses wh'n h
j<
in
(Plates
XXIX-
XX XI o
Ligamenta vaginalis are fibrous -heaths or theca over the flexor tendons.
are so attached to the phalanges as to form osseo-aponeurotic canals
These -heaths are strong opposite the middle of the first and second phalanges,
They
ANATOMY
but
much
IN A NUTSHELL.
117
Each sheath is lined by a synovial memupon the tendons. The synovial sheaths for the tenthe thumb and little finger are continuous with the two synovial bursa'
thinner opposite the joints.
brane, which
is
reflected
dons of
beneath the anterior annular ligament, but those for the intervening digits
terminate in a sac near the metacarpophalangeal articulation. The outer portion (thenar fascia) covers the ball of the
thumb.
Proximally
it is
attached to
Palmaris brevis and aponeurosis from the tendons of the Extensor ossis metacarpi pollicis.
It continues distally with the ligamenta vaginalia of the Flexor longus pollicis.
The inner
portion or hypothenar fascia, is triangular with the apex proximally and atthe anterior annular ligament, the tendons of
the
tached to the anterior annular ligament and deep fascia of the forearm at the
inner side of the wrist distally it is covered above by the Palmaris brevis.
:
(Plate
XXX.)
LESSON XXXI.
Besides the arterial, venous and capillary circulation there
circulation extending over the
body by beginning
is
lymphatic
in microscopical spaces
and
found on the anterior tibial artery. These nodes manufacture the white blood
There are four other places in the body where they are manucorpuscles.
factured. viz.. spleen, thymus gland, thyroid gland and the red marrow of b
The lymph
of all the
body, except the right side of the head, the right side
cause
it
It is
where it is enlarged (recepand extends through the thorax, through the superior opening
of the thorax, and empties into the left subclavian or innominate vein.
The heart is the main factor in the circulation of the lymph. The other
The lymphatic vessels and nodes, like
factors will be learned in physiology.
After the blood
the veins of the arm, are in two sets, a superficial and deep set.
has passed through the arteries and capillaries, nourishing the various parts, it
comes back by means of the vein.-.
The superficial veins of the distal extremity receive the name radial, anThey lie between the two layers of
terior and posterior ulnar, and median.
It
taculum
chyli)
The
side of the
bend
(Plate
anterior ulnar
of the
hand and
is
wrist.
elbow where
XXXVII.)
formed by
it
It
ANATOMY
lis
The
IN A
NUTSHELL.
from which
median
it
basilic to
form the basilic, which pierces the deep fascia in the inner side and below the
middle of the forearm to ascend with the brachial artery and continues as the
axillary vein.
At times the
common
ulnar
is
The
ii
radial begins
cephalic.
The
cephalic vein passes on the outer side of the Biceps to the groove be-
membrane
it
and
front
to
end
It
in
It
receives radicles
corresponding
to the
the
Subscapularis.
It
It also
ANATOMY
IN A NUTSHELL.
119
The axilla is the anatomical space through which passes the brachial plexus
and the axillary vessels. It is filled with lymphatic vessels and nodes and areolar tissue. It is pyramidal in shape,having four sides, a base. and an apex. The
apex corresponds to
a point
between the
and the
The base
first rib.
is
clavicle, the
is
made by
Plate XVI.
Its boundaries are as follows:
In Front: (1) Pectoraiis major. (2) Pectoraiis minor.
Behind: (1) Subscapulars (above,) (2) Teres major and
(3)
Latissimus
dorsi (below.)
Outer
Side:
(1) Humerus, 2) Biceps, (3) Coraco-brachialis.
Ennek Side: (1) First four ribs and their intercostal spaces. (2) a part of
the Serratus magnus.
The axillary vessels, brachial plexus, branches of the intercostal nerves,
lymphatic nodes, all connected by areolar tissue and fat lie in this space.
In finishing the
hand which
is
arm
as follows:
it is
Plate
XXXVI.
All the integument on the ulnar side of the middle line of the ring finger on
both palmar and dorsal surfaces of the hand is supplied by the ulnar nerve.
This line on the dorsum of the hand may be drawn through the middle
OF THE MIDDLE FINGER INSTEAD OF THE RING FINGER. All (ill the radial side of
this line on palmar surface is supplied by the median, on the dorsal surface by
the radial.
The radial nerve extends to the base of the thumb nail, to the distal
interphalangeal joint of index finger and not quite to the proximal interphalangeal joint of middle finger, and sends a few twigs to the skin of the metaphalangeal articulation of ring finger. The parts of the dorsal of the thumb, index.
middle and ring fingers not supplied by the radial get the median.
The synovial membrane of the wrist (Plate XLII.) This membrane consists of five portions.
First portion is called membrana sacciformis and is
between the interarticular fibro-cartilage and the ulna, also extending between
The second portiox is between the radius and interthe radius and ulna.
articular fibro-cartilage proximally and the scaphoid, semilunar and cuneiform
The third portion is between the trapezium and metacarpal nl the
distally.
thumb. The fourth portion is large and extends between the scaphoid,
semilunar and cuneiform proximally and after sending septa between the bones
of the second row of the wrist ends by separating this second row from the second, third, fourth and fifth metacarpal bones distally.
also sends projecIt
bones
mentioned.
Tim:
just
fifth PORTION is
tions between the metacarpal
between the cuneiform and pisiform bones.
ANATOMY
120
IN A NUTSHELL.
REVIEW QUESTIONS.
1.
2.
:;.
I.
.",.
ft.
7.
8.
!t.
10.
Anatomy.
trim.-
Define each of
its
nine divisions.
What
IS
Aponeurosis.
tendon?
Which way do the nutrient arteries run in the bones of the arm?
Which way do the nutrient arteries run in the bones of the leg?
rive four rules tor
Epiphysis.
11.
1.").
lfi.
7.
18.
19.
l'ii.
21.
22.
23.
1.
25.
is
is
26.
27.
<
28.
'
29.
30.
31.
32.
.",:;.
34.
joint.
uve
all
Same of A.MPHIARTHROSIS.
Same of DIARTHROSIS.
How do ligaments take their names?
What is a muscular nerve?
What is a cutaneous nerve?
What is a musculo-cutaneous nerve?
concerning nerve roots and their branches.
:;.".
Give
36.
Give definition
:;7.
live principles
for
nerve center.
nerve.
38.
.'!'.).
Hi.
II.
12.
Same
Same
Same
Same
Same
of
1st cranial
ANATOMY
50.
Same
Same
Same
Same
Same
Same
What
What
51.
Who
52.
Where
53.
What kind
54.
55.
43.
44.
4o.
46.
47.
48.
49.
56.
57.
58.
121
IN A NUTSHELL.
is
of the blood?
Give rule for arteries and veins above and below the diaphragm.
Name >ome of the veins that do not have valves.
Name
61.
The
62.
The
eight cervical nerves leave the spinal cord above the spinous
The lower
64.
The
The
five sacral
cesses of
66.
Ii7.
68.
what vertebrae?
71.
72.
73.
.Membrane.
74.
75.
70.
77.
78.
7'.i.
80.
The
81.
What
82.
many
many
many
many
many
one-'.'
ANATOMY
22
IN A NUTSHELL.
86.
87.
Wha1 muscles
ss.
\\ lint
83.
84.
85.
<
<
muscl<
Ligament?
Septum?
95.
96.
Ligament ?
Give the three divisions of Axillary Artery.
89.
90.
91.
92.
94.
.i7.
98.
first
99.
<
LOO.
<
rive the
101.
102.
L03.
lo
I.
L06.
107.
ins.
What
What
What
Whai
What
in.").
109.
110.
111.
112.
13.
I.
15.
16.
17.
lis.
1
19.
Desci Lbe
\\
he
lubital fossa?
"hat passes
Name
be bon< sof
be Carpus.
rive articulation of
septum?
septum?
each hone.
0s magnum?
Unciform?
121.
What musclt
What muscles
122.
120.
23.
P_' 1.
125.
hat musclt
How many
bones
in
live
ligamenl
127.
<
rive
Ligaments of scapula.
128.
Give ligaments
'jt\.
to the
the hand?
to the
of clavicle.
of shoulder.
ANATOMY
NUTSHELL.
IN A
123
130.
134.
135.
136.
137.
138.
139.
140.
141.
142.
143.
144.
What
What
What
From
What
What
What
What
What
What
What
kind of joint
is
kind of joint
the elbow?
is
what do cords
(-(inverts
the shoulder?
is
kind of joint
the wrist?
names?
vessels pass
holds the
arm
in position?
150.
How many
How many
151.
Name
152.
149.
membranes
155.
Describe synovial
156.
157.
of wrist.
158.
What muscle
159.
The pulse
160.
161.
162.
What
163.
164.
165.
is
is felt
hand?
1(19.
170.
166.
167.
168.
arch.
How
forearm?
173.
How many
muscles
in
the
hand?
to
ANATOMY
124
What
171.
IN A NUTSHELL.
7").
humerus.
describe the
176.
articulate?
it
PLATE
XLIII.
LUTEUS KESIUS
LATISSIMUS DORS!.
INTERNAL OBLIQUE
CREST OF ILIUM
GLUTEUS MAXIMUS.
TENSOR VAGINAE
FEMORIS
POSTERIOR
SUPERIOR
ILIAC SPINE.
SAflTORIUS
GLUTEUS MINIMUS
POSTERIOR INFERIOR
GREATER SCIATIC
INTERNA,. ILIAC
ILIAC SPINE
(ILIO-SCIATIC)
NOTCH
CAPSULE.
ISCHIUM
NOTCH
SYNOVIAL MEMBRANE
PECTINEAL RIDGE
GEMELLUS SUPERIOR
SPINE OF ISCHIUM
"ECTINEUS
-
RECTI S ABOOMINIS.
PYRAMIOALIS
-fT
ODIir.TnR
-GEMELLUS INFERIOR
OBTURAT
0NK5li'>
V'n
ADOIlCTfUl RRFVIS
OESCFuomr. niMif.
THYROID ^^
T&-
'
'3 ' I {*
-"""^
if
'
OBTURATOR NOTCH
SEMIMEMBRANOSUS
QtlADRATUS FEMORIS
"USES
ADDUCTOR MAGNUS
G8TURAT0R EXTERMUS
177.
17s.
179.
L80.
181.
radius?
ANATOMY
IN A NUTSHELL.
182.
What
183.
Which one
184.
185.
What
What
186.
How many
187.
188.
189.
190.
191.
192.
193.
194.
195.
196.
197.
198.
199.
200.
201.
202.
203.
204.
205.
206.
207.
Why
Why
125
arm?
is
openings
in the
What is lymph?
What else are lymphatics called?
What does the lymphatic system include?
Over how much of the body does it extend?
How many coats have the lymphatics?
The lymphatic glands of the arm are divided into how many
The lymphatic vessels are how divided?
Give blood supply and ossification of clavicle.
The same of Scapula.
The same of Humerus.
The same of Radius.
The same of Ulna.
The same of Carpus.
The same of Metacarpus.
The same of Phalanges.
What
What
is
sets?
Deep branch
of ulna passes
name for
Give another name for
On which side of the
lesser internal
215.
216.
LESSON
Tin: [lium.
XXX II.
(Plates
XLIII-XL1V.)
The ilium which forms less than two-fifths of the acetabulum is the superior
expanded portion of the innominate bone. This portion is limited superiorly
by the arched crest of the ilium, but anteriorly and posteriorly by margins which
diverge at right angles from each other.
The crest is concave inward in front
and is concave outward behind.
is much narrower in its middle than near
It
its
IN A NUTSHELL.
ANATOMY
126
extremities, and there
On
third.
often a
is
is
is
the projection
The
and
the external
lip
the anterior
at
i-
is
extremity.
iliac
To
and internal
is
separated by
the projection
is
at
the
the
lip.
To
the internal
lip
Transversalis abdominalis,
The
[liacus
muscle and
iliac fascia to
(1)
(4)
To the intermediate space i> attached the Internal oblique of the abdomen.
T< nsor vaginae femoris externally.
The anterior superior spine has attached
1
Sartorius
(2)
The
in front. (3)
Qii
straight
spine of the
arises
inferior
m.
ilii,
!iii'
the notch.
is
attach* d
is
bi
hind
th<
middle curved lines and the iliac cresl is occupied by the Gluteus medius. The
Gluteus minimus i< between the middle and inferior curved lines. The reflected head of the Rectus femoris is attached just abov< tin cotyloid cavity to
.mi
oblong mark.
face
I
The
and
iliac fossa
is
ilii
is
muscle exc<
liacus
or venter
concave.
iliac
It
vi
attachment
nter
is
it
,<dv< s
The
is
to the
smooth and
pelvis.
lig-
making
boundary f the groove
the ili<
is
the junction of the pubis ami ilium.
The p< stero-inferior part
again divided,
mi below upward (1) a smooth curved surface in the true pelvis,
giving attachment in part to a portion of the Obturator interims, separated from
the iliac fossa by the iliac portion of the i!io-p< ctineal line: (2) the auricular
surface, for articulation with the sacrum; (3) depr( ssion for the posterior -aeroam<
nt
the inni
-pectineal eminence,
is
<
ANATOMY
ligament;
iliac
127
IN A NUTSHELL.
and Multifidus
(4)
spinae muscles.
ilium receives on
its
On
dorsum
the
arter-
PLATE XLIV.
QUAORATUS LUMBORUM.
TRANSVERSALISAND
s6 'l^^-fr^W^^ltffc^X-?*
THE
ILIAC FASCIA.
ERECTOR SPINAE.L
I,
INTERNAL
ILIAC
MULTIFIDUS SPINAE.
E?W
POST.
INF.
v'
I
;'.'
FOSS/L"^
'>/.4>1 ^\
'(/-.;.
>Jfc
*Tfc
AURICULAR SURFACE;
SPINE OF ILIUM.
ANT
INF
SPINE OF ILIUM.
OBTURATOR INTERNUS.
PSOAS PARVUS
ILIO-PECTINEAL EMINENCE
'
'
,.
<f$r
/j
08TIIRAT0R
/
I
JM
'
U'-B
'
JJk
'
''
"'.
.
S.
'^'^ i^4^WL
'
SYMPHYSIAL SUR C CE
/?$
FORAMEN.
/;"/'.'(
>
;R"
'
'
/H
^
^"LEVATOR ANI
TUBEROSITY OF ISCHIUM.
SUBPUBIC LIGAMENT
TRANSVERSUS PERINEI
JUNCTION OF PUBES AND ISCHIUM
COMPRESSOR URETHRAL
CRUS
PENIS'
flex,
The ischium is supplied by the obturator, internal and ext< rnal circumflex.
The pubis receives twigs from the obturator, internal and external circumdeep epigastric, and pubic branch of the common femoral artery.
These three bones form the is innominatum.
ANATOMY
128
IN A
NUTSHELL
Epiphyses appear
pubis, and one or more for the bottom of the acetabulum.
about the age of puberty and unite with the rest of the bone between the
twentieth and twenty-fifth years.
Articulates with its fellow of the opposite side, the sacrum and femur.
Attachment ok muscles to the ilium, sixteen. To the outer lip of crest,
the (1) Tensor vagina femoris, (2) Obliquus externus abdominis, and (3) Lat1
lumborum, and
lip.
the
(4)
Iliacus, (5)
Transversalis, (6)
Quad-
the
Obliquus internus. To the outer surface of the ilium, the (9) Gluteus maxinii!-. (10) Gluteus medius, (11) Gluteus minimus, reflected tendon of the (12)
Meet ns; to the upper part of the great sacro-sciatic notch, a portion of the (13)
rants
(7)
lips,
(8)
Pyriformis; to the internal surface, the Iliacus, to that portion of the internal
surface below the linea ilio-pectinea, the (14) Obturator internus
and the
(15)
Multifidus spina' to the internal surface of the posterior superior spine; to the
To
the ischium,
Transversalis. (4) Rectus, (5) Pvramidalis, (6) Psoas parvus, (7) Peetincus, (8)
Adductor magnus. (9) Adductor longus, (10) Adductor brevis, (11) Gracilis,
(12) Obturator externus, (13) Obturator internus, (14) Levator ani, (15) Compressor met In a', and occasionally a few filters of the (16) Accelerator urinae.
The
Os Pubis.
of the pelvis,
ANATOMY
IX A NUTSHELL.
129
it.
The
su-
running from the spine of the pubis to the internal aspect of the ilio-pectineal
eminence.
The part between the two rami is the body of the os pubis. Its anterior
is rough and its pelvic surface is smooth.
The Pectineus muscle has its
origin from the ilio-pectineal line and the triangular surface in front of it.
The
obturator crest extends from the pubic spine to the acetabulum below the
The obturator groove is on the inferior surface of the
ilio-pectineal line.
ramus behind the outer part of the crest. It is directed from behind forward
and inward.
The pubic crest gives origin to part of the (1) Conjoined tendon, (2) the
Pyramidalis and (3) Rectus abdominis. To the pubic spine are inserted (1)
Poupart's ligament and the (2) outer pillar of the external abdominal ring.
From the front of the pubis, in the angle between the crest and the symphysis, arises the (1) Adductor longus muscle, and below this the (2) Adductor
Internal to these the (1)
brevis and part of the (3) Adductor magnus.
Gracilis is attached, and external the (2) Obturator externus.
Posteriorly
surface
(1)
this
is
some-
times a flat line passing from the upper margin of the obturator foramen to
the lower end of the symphysis; the (1) Levator ani muscle is attached to it. and
the Obturator and recto-vesical
(2)
fasciae.
The Ischium.
The ischium forms the lower and back part of the innominate bone. It
forms a little more than two-fifths of the cotyloid cavity and bounds the obturator foramen below.
The body has three surand posterior.
The
The
is
showing
its
is
its
upper
limit.
In
Posterior surface
limited behind
is
is
Its
Its
anterior limit
Its
lower limit
attached to
shape
is
posterior limit
is
it
ridge
its
is
the tuberosity.
this surface.
of the bone.
It is limited above by
below
its
it is limited
by the tuberischii. This
surface supports the two Gemelli, the Pyriformis and the Obturator internus.
Below it presents a pari of the groove tor the Obturator externus.
It is
ANATOMY
130
The
internal border
is
IN A NUTSHELL.
synoynmous with
tor foramen.
posterior border has the spine of the ischium a little below its middle.
The
This spine which extends backward and inward marks the lower limit of the
to the Levator ani and (occygeus
It gives attachment
greal sciatic notch.
Between
is
this spine
and postero-inferior.
The external SURFACE of the tuberosity
ternal, internal,
PLATE XLV.
ARTICULAR
PROCESS.
SACRAL
FORAMEN
ERECTOR
SPINA!.
MULTIF1DUS
HIATUS
SPINA!.
SACRALIS,
LEADING INTO
SACRAL CANAL
GLUTEU
MAXI
SACRAL CORNU
GLUTEUS MAXIMUS
COCCYX.
SPHINCTER ANI
Posterior View of Sacrum and Coccyx.
front.
it
ends
in
foramen
The
i'o-i
to its
ANATOMY
IN A NUTSHELL.
131
joins at a little less than half the distance between the body of the os pubis
and the tuberosity of the ischium. The Obturator externus, the Adductor
magnus and the Gracilis are attached to its outer surface. The Crus penis and
it
It
ward and downward. The Ilium forms a little less than two-fifths of the acetabulum. The os pubis forms a little more than one-fifth of the acetabulum.
The Ischium forms a little more than two-fifths of the acetabulum. The rim
of this cavity is prominent, but it is slightly lower in front and behind and has
The depression in the center is
a large notch below called the cotyloid notch.
called the cotyloid fossa, around which is the articular portion of the cotyloid
cavity.
The thyroid
or obturator foramen
sometimes
male
is
brane,
this
foramen
is
called
closed
its
it is
more
triangular.
LESSON XXXIV.
The Pelvis
as a
Whole.
The word pelvis means basin. It is composed of four bones, the sacrum,
coccyx, and the two innominate. If we pass a plane through the sacral promontory, ilio-pectineal line and the upper border of the symphysis, we divide
the pelvis into an upper or false pelvis and a lower or true pelvis. The upper
The sacrum looks downward and forpelvis really belongs to the abdomen.
It is held in
ward. Its anterior surface is broader than its posterior surface.
place by ligaments and the projections into the
iliac articular
surface.
The
plane separating the true and false pelvis marks an angle of 60 degrees with the
horizontal.
The plane
of this outlet
makes an angle
izontal.
The base of the sacrum is about three and one-half inches above the upper
margin of the symphysis. The tip of the coccyx is one-half inch above the apex
of the subpubic arch.
The average
is
sacro-iliac joint of
of
pelvis
the
one side
in
oblique.
antero-posterior.
Inlet
4 1-4 inches
Cavity
4 3-4 inches
Outlet
.3
3-4 inches
5
">
inches
1-4 inches
i;
\\s\ i:nsK.
1-1
inches
:^-4
inches
1-4 inches
the
ANATOMY
132
THE FEMALE
RESPE'
PELVIS DIFFERS
IN A NUTSHELL.
s:
I
|
is
slender. (2)
more
ilia
more
is
shallower,
symphysis is shallower,
i'.ii
tuberosities of ischia are everted. (10) pubic arch is wider and more rounded, ill) margins of ischio-pubic rami are less everted, (12) obturator foramen
is triangular, while in the male it is oval, (13) sacrum is wider and less curved,
true pelvis
also (6)
and
(14)
is
wider,
(7)
inlet is
is
oval, (8)
greater.
The Sacrum.
The sacrum
is
five
upper and back part of the pelvis, being placed between the two innominate
It is a wedge shaped bone with its apex below, and its anterior surface
bones.
wider than
its
posterior surface.
The anterior border of the upper portion or base is called the promontory.
It has four surfaces, a base, an apex, and a central canal.
The anterior surface has four ridges marking the junction of the five segments.
This surface is concave, both vertically and transversely (less so.)
The five segments or vertebras decrease from above downward. At the ends of
the transverse ridges are foramina for the transmission of the sacral nerves.
These
f<
At the
of the vertebrae of
the sacrum.
The
posterior surface
is
median
is
convex.
It
its
line.
Externa] to the articular processes are the foramina for the posterior
processes.
The sacral groove is wide and shallow lodging the Erector spinas. It lies
between the spinous and transverse processes.
The lateral surface is narrow behind but broad above. The upper half of
this surface is called the auricular surface.
It articulates with the ilium and is
covered with fibro-cartilage in the recent state.
Behind this articular surface
are deep impressions for the attachment of the posterior sacro-iliac ligaments.
The lower half of this surface is called the tuberosity, and the borders of this
the
attachment
and part
of
rluteus maxiinus.
The base is the pari which articulates with the last lumbar vertebra. It is
broad and look- upward and forward.
Its anterior part is for the interarticular
fibro-cartilage
and
is
oval.
Its
is
ANATOMY
IN A NUTSHELL.
133
formed by the laminae and spinous process. The superior articular processes are
They are situated on each side of the sacral canal and are
oval and concave.
The intervertebral notches are in front of these
directed backward and inward.
processes.
The al.e are flat triangular areas on each side of the articular processes,
and are continuous with the iliac fossa. The Iliacus muscle has a \'v\v fibers of
origin from the ala.
The apex articulates with the coccyx and is directed downward and forward.
PLATE XLVI.
PROMONTORY.
ARTIC.WITH
LAST LUMBAR.
COCCYGE
LEVATOR ANl
Thirty-five
centers.
and
and
the
and
anatomy
i;^4
in a nutshell.
The Coccyx.
The coccyx is formed by four and sometimes five segments. It has no
SPINAL CANAL, [NTERVERTEBRAL FORAMINA. SPINOUS PROCESSES, LAMIN.E, PEDThe firsl segmenl may be separate bu1 the rest are united and run to a
[CLES.
This bone has an anterior and posterior surface, two borders, a base,
point.
and an apex.
The anterior surface has three transverse grooves marking the union
This surface
ments.
The
posterior surface
terior.
making the
The
fifth
is
is
of the
concave.
convex and has grooves similar to those on the anand articulate with thecornua of the sacrum
are large
transverse processes.
fifth
LESSON XXXV.
(Plate
Description.
Origin:
all
(Plate
the
all
Lumbar
Insertion:
RVE
(1)
vertebrae.
(Plates
XLVIII-XLIX.)
1'lexes thigh
A( pion:
LXXIII.)
-ides of bodies
and
it
Si
I'i'iA
It
is
well
ANATOMY
IN
A NUTSHELL.
135
Origin:
vertebra?
iliac fascia.
Action: Same as Psoas magnus, also makes tense the iliac fascia.
Nerve Supply: Anterior branch of first lumbar.
Blood Supply: Lumbar from abdominal aorta.
Description.
(Plate LXXIII.)
The Iliacus and the Psoas
Iliacus.
magnus are sometimes regarded as one muscle, the Ilio-psoas, since they have
one insertion. The Iliacus which is flat and triangular fills the whole of the
iliac fossa.
(Plates
Origin.
two-thirds of
fossa
iliac
and
inner margin of crest of ilium; (2) in front, anterior superior and inferior spin-
Insertion.
muscle and
Action.
Flexes
in
(Plate
LXIV.)
This
muscle
lies
along the outer side of the thigh and extends from the crest of the ilium to about
one-fourth the distance to the knee.
(Plate
Origin.
Anterior
XLIII.)
and outer surface of anterior superior spinous process between Gluteus medius
and Sartorius muscle, and from fascia covering the Gluteus medius.
Insertion.
(Plate LXIV.)
Between the two layers of the fascia lata.
The fascia is continued downward to external tuberosity of the tibia as a thick-
fifth
lumbar and
first
sacral
through
the
superior gluteal.
gluteal
Description. (Plate
to the tibia,
In the
pa's triangle.
It
is flat,
upper part of
passes
LXXIY.)
This
its
course
it
i<
to
the insertion.
On
ductor longus.
it-
LXIV-LXXIV.)
Is
The femoral
vessels
its
'a
is
femoral
vein, artery,
ANATOMY
136
In the
IN A NUTSHELL.
lies
PLATE XLVII.
A(
u )\.
lie
its
fi-
lower border,
Flexes leu on thigh and continuing to act flexes the thigh on the
i.
Si pply.
Blood Supply.Rectus
lemons.
Branch
of anterior crural.
Femora] artery.
Description. (Plates
LXIV-LXV111-LXXIV.) The
Rectus fenioris together with the Vastus externus, Vastus interims, and the
ANATOMY
Crureus, form one muscle
IN A NUTSHELL.
137
is
This might be called one muscle with four heads and one insertion.
of the leg.
is situated in the middle and anterior part of the group and has two
These heads join at an acute angle. Its superficial fibers are bipenniform. and its deep ones run straight down to the deep aponeurosis. The broad
and thick aponeurosis which occupies the lower two-thirds of the posterior surface of the muscle gradually ends in a flattened tendon.
The Rectus
heads.
LESSON XXXVI.
(Plate
Origin.
XLIII.)
The
from
Insertion.
in
common
and Crureus.
Action.
port
Assists
Anterior crural.
Femoral artery.
Description. (Plates
externus.
Nerve Supply.
Blood Supply.
Vastus
muscle
is
LXIV-LXVIII-LXXIV.)
This
on the under surface at the lower part of this muscle receives the fillers which
form a large fleshy mass. The tendon of this muscle gives an expansion to the
capsule of the knee-joint.
Origin.
and
to ihe
upper
root of the great trochanter, to the outer lip of the gluteal ridge, and to the
upper half of the outer lip of the linea aspera. This aponeurosis covers the
upper three-fourths of the muscle and from its inner surface many fibers take
origin.
A few additional fibers arise from the tendon of the Gluteus maximus,
and from the external intermuscular septum between the Vastus externus and
short head of Biceps.
(Plate LXXIV.)
Insertion.
Action. Extends knee.
Into
patella.
crural.
circumflex.
interims. Description.
LXIV-LXVIII-LXXIV.) If
(Plates
the Rectus is reflected a narrow space is seen between the Vastus interim- and
At this
the Crureus extending upward from the inner border of the patella.
The aponeurospace they can lie separated, bin they arc in reality one muscle.
sis which lies on the deep surface of the muscle receives fibers from the muscle,
Vastus
intermuscular septum.
ANATOMY IN A NUTSHELL.
138
LXXIV.)
Insertion. -(Plate
By
common
Tendon
extensor
into
the
patella, an
A.<
N i;\ e Suppli
Blood Supply.
Crurcus.
Origin.
in
of shaft of
femur
upper two-thirds and from the lower part of the external intermuscular
its
septum.
Its fibers
end
in a superficial
aponeurosis
BLOOD
bundles, but
bu1
may
Plate
I\-i rtion.
This
small muscle.
be attached to
I
artery.
Description.
is
it
Origin.
<
Femoral
Si PPLY.
Subcrureus.
muscle
is
may
most always
distinct
it.
XLIV.)
(Plate
It
LXXIV.)
lig-
ament.
A<
\'i.k\
is
i.
crural.
downward end
condyle of femur
<
to
in a
Insertion.
(Plate LI.)-
Upper
A< tion.
Nerve
Blood
Si pply.
Si pply.
Pectineus.
cle
which
thigh
is
situated
is
flat
Origin.
front of
at
of
the
and quadrilateral.
(Plate
it
Insertion.lines aspera.
scia
XLIII.) (1)
Uio-pectineaJ
line;
(2)
surface of bone in
(Plate XLVIII.)
Rough
line
between
lesser trochanter
and
PLATE
OBTURATOR EXTERNUS
GUITEOUS MEOIUS
(I).
(I).
LIGAMENTUM TERES.
TUBERCLE OF THE
OUADRATUS FEMOfllS
(I)
POST INTERTROCHANTERIC
.VASTUS EXTERNUS
(0)
PSOAS
LIKE.
Jl).
GLUTEAL RIDGE.
GLUTEUS MAXIMUS
(I)
ADDUCTOR MAGNUS
(I)
ADDUCTOR LONGUS
OUTER
BICFJS
(0).
VASTUS EXTERNUS
(0).
CRUREUS
tXT.
(I).
SUPRA CONDYLAR
(0)
LINE.
INT.
SUPRACONDYLAR
LINE.
POPUTEAI SURFACE
ADDUCTOR MAGNUS
II).
ADDUCTOR TUBERCLE.
GASTROCNEMIUS
GASTROCNEMIUS
(0)
(0).
CAPSULl.
LATERAL LIGAMENT.
EXT CONDYLE.
INTERCONDYLAR NOTCH
POST CRUCIAL LIGAMENT
XLVIII.
ANATOMY
140
IN A NUTSHELL.
Adducts thigh.
Action.
Anterior
Nerve Supply.
and occasionally a
arteries.
Adductor Longus
Description. Plates LXIV-LXVIII-LXXI-LXXIV)
This muscle forms the inner boundary of Scarpa's triangle and is the most
It lies on the same plane as the Pectineus.
superficial one of the Adductors.
It
triangular muscle.
a flat,
is
Origin.
(Plate
XL111.)
Front
of OS
symphysis.
Insertion.
r.
near
it-
insertion.
Origin.
(Plate
XLIII.)
Outer
surface of
of os pubis,
same
line,
longus.
Assists in flexing thigh
A( tion.
in
upon
pelvis; also in
walking.
\ki;\
i:
Supply.
Blood Supply.
LESSON XXXVII.
Adductor magnus. Description. (Plates LXIV-LXVIII-LXXI-LXXIV.)
The muscles of the Anterior Femoral Region are separated from the remaining muscles of
ent,
The fourth
one,
when
pres-
line lead-
ing from the greal trochanter to the linea aspera,internal to the Gluteus
max-
Lmus; those from the ramus of the ischium are directed downward and outward
to be inserted by mean- of a broad aponeurosis into the linea aspera and the
ANATOMY
upper part of
its
IN A NUTSHELL.
The
141
mus-
cle, consisting principally of those fibers which arise from the tuberosity of the
ischium, forms a thick, fleshy mass, descends almost vertically and terminates
about the lower third of the thigh in a rounded tendon which is inserted into the
adductor tubercle on the inner condyle of the femur, being connected by a
fibrous expansion to the line leading upward from the tubercle to the linea
aspera.
Adductor
Action.
of thigh.
of profunda.
It is a thick
It
is
to
There is a synovial bursa between this muscle and the great trochanter, one
between its tendon and the Vastus externus, and often one is situated on the
tuberosity of the ischium.
(Plates
Origin.
XLIII-XLV.)
(1)
and
crest of
ilium; (2) posterior surface of lower part of sacrum; (3) side of coccyx; (4)
aponeurosis of Erector spina?; (5) great sacro-sciatic ligament and fascia covering Gluteus medius.
Insertion.
(Plate
XLVIII.)
The
fibers
portion of the muscle, together with the superficial fibers of the lower portion,
terminate in a thick tendinous lamina, which passes across the great trochanter
and
is
inserted into the fascia lata covering the outer side of the thigh the deeper
;
fibers of the lower portion are inserted into the rough line leading from the great
trochanter to the linea aspera between the Vastus externus and Adductor magnus.
sciatic.
this
muscle
lies parallel
The
Gluteus maximus,
its
posterior one-third of
its
is
separated from
by
under the
This is a broad
external surface
bursa
is
trochanter
in
Origin.
front of
(Plates
its
border of
it
lies
synovial
insertion.
XLIII-XLV.)
Outer
and middle curved lines; (2) crest of ilium; (3) fascia covering outer surface.
Insertion.
Oblique line of great trochanter.
(Plate XLIX.)
Action. Adducts the extended thigh, rotates same and supports body
on limb.
Nerve Supply.
Blood Supply.
Superior gluteal.
Superior gluteal.
PLATE XLIX.
GEMELLI
OBTURATOR INTERNUS AND
HI.
GREATER TROCHANTER.
PTRIFORMIS
-'
-
<^''4Mi
ji .",,> ;ft\
,
\* i%<lttJ-'Jk 4
seck.
"*"^^i^i
-
CAPSULE OF
(I).
^g^flM
JjgSft j
'Aj?
to!
1O0UCTOR TUBERCLE.
IOOUCTOR MAGNUS
POPLITEUS
CAPSULAR
INT
LINE.
CONDYLE
PATELLAR FACET
EXT CONOTLE
(0).
ANATOMY
IN A NUTSHELL.
Description. (Plate
143
Insertion.
(Plate
XLVIII.)
Into
great trochanter.
Action.
Adducts
on limb.
Superior gluteal.
Superior gluteal and external circumflex.
Pyriformis. Description. (Plate LXV.) This muscle
Nerve Supply.
Blood Supply.
is
It
its
posterior part
flat
pyra-
and partly
at
with the posterior borderof the Glupasses out of the pelvis through the great sacro-sciatic foramen,
It lies parallel
it
two compartments.
into
the pelvis.
Origin.
and
also
first,
Insertion.
(Plate XLIX.)
Upper border of great trochanter behind,
and partly blended with, the tendon of the Obturator interims and (iemelli
muscles.
Action.
steadying
assists
in
it
Sciatic.
internus. Description. (Plate
Blood Supply.
Obturator
Pyriformis,
joint.
is
LXV.)
This
situated partly within the pelvis and partly at the hack of the hip-
is
grooved
ception of the four or five tendinous bands which are on the deep surface of the
These grooves are covered with cartilage and lined by a synovia] bursa.
These tendinous bands unite into a flattened tendon which passes horizontally
muscle.
outward
one
sac.
It
Origin.
leaves the
(PL-
wall of pelvis.
attached to the
XLIY.)
e
it
'i
is
From
at
theside to the inner surface of the innominate bone below andbehind thepelvic
ANATOMY
144
IN A
NUTSHELL
brim, reaching from the upper part of the great sacro-sciatie foramen above and
It also arises from the inner
behind to the thyroid foramen below and in front.
surface of obturator
membrane except
at its
posterior part,
arch which completes the canal for the passage of the obturator vessels and
nerve, and to a slight extent from the obturator layer of the pelvic fascia which
covers
it.
Insertion.
(Plate
XLIX.)
Into
Bi.<
>(
id
thigh.
and second
first
sacral.
Supply. Sciatic
LESSON XXXVIII.
(Plate LXY.)
This muscle is not
Gemellus superior. Description.
It has a common tendon
It is an aid to the Obturator internus.
always present.
with the Obturator internus. It is smaller than the Gemellus inferior.
Outer surface of spine of ischium and blends
(Plate XLIY.)
Origin.
A.<
tion.
first
(Plate
Origin.
with tendon of
Insertion.
Action.
LXIII.)
Upper part
is
is
larger
of tuberosity of
in-
(Plate
XLIX.)
trochanter.
ischium.
Insertion.
A'
(Plate
XLVIII.)
Quadrate
Nerve Supply.
Las1
Blood
Sciatic
Si pply.
Obturator externus.
The obturator
vessels
lie
line of
PLATE
L.
POPLITEAL NOTCH.
EXTERNAL FIBRO-CARTILAGE.
INT.
FIBRO CARTILAGE?
XAPSUL'E.
SEMIMEMBRANOSUS)
CAPSULE.
STYLOID PROCESS.
POST. TIBIO-FIBULAR
LIGAMENT
SOLEUS
POPLITEUS
(I).
(0)
OBLIQUE LINE.
_SOLEUS
(0).
NUTRIENT FORAMEN.
TIBIALIS POSTICUS
'
(0).
<o).
(0).
NUTRIENT FORAMEN
'ERONEUS BREVIS
(0)..
POST. TIBIO-FIBULAR
i
GROOVE FOR
IGAMENT,
LONGUS DIGITORUM
NT.
LATERAL LIGAMENT.
(MIDDLE FASCICULUsT
ANATOMY
146
IN A NUTSHELL.
This muscle, which covers the outer surface of the anterior wall of the pelvis,
Ls
and triangular.
flat
(Plate XL1II.)
(1) Margin of inner boundary of obturator
foramen: (2) inner two-thirds of outer surface of obturator membrane; (3) tendinous arch of obturator canal.
Origin.
in
place.
\ i.i;\ Supply.
Blood Supply.
i.
Obturator and
Weeps. Description. (Plate
cruris-
femoral.
LXY.)
This
muscle-
Biceps
is
The tendons
flexor
It is
quite
and
large
and
lie
its
of the
(Plate XLIII.)
By two heads; the long head from the lower
and inner impression on the back part of the tuberosity of the ischium, by a
tendon common to it and the Semitendinosus, and from the lower part of the
The femoral, or short head, from the outer lip
greal sacro-sciatic ligament.
Origin.
tending almost as high as the insertion of the Gluteus maximus; also from the
outer prolongation of the linea aspera to within two inches of the outer condyle,
fibers of the
downward and
little
outward, terminates
in
an
aponeurosis which covers the posterior surface of the muscle and receives the
fibers of the short
tendon which
is
head;
this
and by
a small slip
A.CTION.
Nerve Supply.
Blood Supply.
Semitendinosus.
at
the posterior
which
joined.
lies
First,
DESCRIPTION.
(Plate
of the thigh.
LXY.)
It
This
muscle
is
situated
Its
by a bursa.
nous intersection.
joint
Origin.
From
(Plate XLIII.)
common
of the
muscle there
is
generally a tendi-
tent of
[N8ERTION.
their origin.
ft ei-
(Plate LI.)
to
form-
It
;i
little
ANATOMY IN A NUTSHELL.
the inner surface of shaft of that bone.
At
its
147
insertion
it
Action.
rotates
it
inward.
great sciatic.
Semimembranosus. Description. (Plate LXY.) This muscle is membranous above and muscular below. It is situated at the back part and inner
At its origin the aponeurosis covers the upper and anterior
side of the thigh.
part of the muscle, and from this aponeurosis muscular fibers arise and converge to another aponeurosis which covers the lower part of
face
its
posterior sur-
of insertion.
sion on back part of tuberosity of ischium above and to the outer side of the
(Plate
Groove
L.)
Action.
Nerve Supply.
Blood Supply.
LESSON XXXIX.
Femur.
The femur (Plates XLYIII-XLIX) is about one-fourth the length of the
body and is the longest and strongest as well as the largest bone in the body.
When one is standing it inclines inward and a little backward. The main part
Its upper part has a head, neck, a greater trois the shaft or diaphysis.
chanter, and a LESSER TROCHANTER. Its lower part is expanded into TWO
CONDYLES an external one and an internal one. Above each one of these is a
SUPRACONDYLAR LINK.
The neck makes an angle of 12.") degrees with the diaphysis. It i> directed
upward. inward and a little forward, bein^ broad and compressed at the base Inn
isphere.
It
is
an expanded portion of the neck, and forms more than a hemarticulates witli the acetabulum of the innominate bone.
The
The bead
Fossa CAPITIS
is
is
depression
a little
LATE
LI.
SPINE.
INT.
EXTERNAL FIBRO-CARTILAGE.
FIBRO CARTILAGE.
CAPSULE.
OUTER TUBEROSITY.
CORONARY LIGAMENT
ANT. CRUCIAL LIGAMENT
).
TIBIO-FIBULAR LIGAMENT.
KA<
INNER TUBEROSITY.
INT.
LATERAL LIGAMENT
LIGAMENTUM PATELLAE
EXT.
LATERAL LIGAMENT.
(l) ;
(QUADRICEPS EXTENSOR).
GRACILIS
(I)
SARTORIUS
(ij
(0),
SEMI-TENDINOSUS(/
PERONEUS LONGUS
EXT.
SURFACE OF
(0).
TIBIA.
BORDEROR CREST OF
TIBIA
PFRONEAL SURFACF
INT.
(0),
SURFACE OF
flF
FIBULA
TIBIA.
INTEROSSEOUS MEMBRANE
'.
(0;
PERONEUS BREVIS<0).
FIBULA.
PERONEUS TERTIUS
(0).
- SUBCUTANEUS PORTION.
INT.
LATERAL LIGAMENT
EXTERNAL MALLEOUS.
INTERNAL MALLEOLUS.
ANATOMY
IN A NUTSHELL.
149
The
The
the hip-joint.
Gluteus minimus
is
attached to
is
its
anterior surface in a
broad depression.
is
of its
upper border.
On
tubercle
of the
femur.
which marks the JUNCTION of the following muscles: Vastus externus. Gluteus
minimus. Obturator interims, and the two Gemelli. Above and external to
the insertion of the Obturator interims and the Gemelli is the INSERTION of the
tubercle
of the
reus muscles.
The
it is
shaft
arched forward;
is
expanded.
It
lines.
The two Yasti and the Crureus muscles cover
The linea aspera separates the two surfaces posteriorly. This
marked in the middle third of the thigh, bifurcating both above and
is
well
Of
below.
its
chanter making the gluteal ridge for the attachment of the Gluteus maximus.
The
internal division winds around below the lesser trochanter, passing into the
Another line
passes from this line to the lesser trochanter for the attachment
Below the
two
lines
which extend
to
the two
condyles, thus forming the supracondylar lines, which enclose the popliteal sur-
above
this
The Adductor
the Vastus externus.
Between the Adductor magnus ami the
Vastus externus are the Gluteus maximus and the short head of the Biceps.
Between the Adductor magnus and the Vastus internus are the Qiacus, Pecti
At the lower pari of the poplitea
neus, Adductor brevis, and Adductor Longus.
magnus
is
lip
gives attachment
to
ANATOMY IN A NUTSHELL.
150
space above each condyle is the origin of one head of the Gastrocnemius.
The distal extremity has two condyles, which are united anteriorly but
The external condyle
separated posteriorly by the intercondylar notch.
broader and more prominenl anteriorly, while the internal one is more
prominent internally, and it extends to a lower level, when the femur is taken
When the femur articulates with the tibia the two condyles
from the body.
is
(l|1
The
tibial
The
lateral surface of
little
closer
Above the
tuberosity or epicondyle, which gives attachments to ligaments.
The
of
Gastrocnemius.
the
head
outer
for
the
depression
is
a
external condyle
:i
The
The ONE FOE
<
wtkkiok ligament is on the posterior part of the inner surThe one for the posterior ligament is on the
The angle of the
of the inner condyle.
surface
external
of
anterior part
the
neck of femur with the shaft makes no changes after growth is completed.
Blood Supply. The head and neck of the femur receive branches from
The trochanter receives twigs
the sciatic, obturator and circumflex arteries.
tin.
arteries.
it
The nutrient
is
is
derived from
head of the bone. Condyles are nourished by articular branches from the
popliteal and the anastomotic of femoral.
Ossifk \'i ION. - From five centers. The one for the shaft is a primary
center and begins to ossify in the
MONTH and
joins the
bone
in
This
is
the only
Iliacus
below
it.
To the
shaft,
Subcrureus.
To
and Popliteus.
PLATE
THIRD PHALANX
-H
DIGITOfillM
(1)
fl
SECOND PHALANX
FIRST PHALANX
EXTENSOR
BficViS DIGITORUM
(0)
TENDO ACHILLIS.
(1).
LI I.
ANATOMY
152
IN A NUTSHELL.
LESSON XL.
(Plate LXXV.)
Description.
The anterior tibial
anticus.
and nerve run along the outer border of this muscle, which is just beIt is thick and fleshy above, but
neath the fascia on the outer side of the tibia.
tendinous below where it passes through the innermost compartment of the
Tibialis
vessels
tibia;
of
(Plate LI.)
Origin.
of shafl
(">)
Outer tuberosity of
(1)
interosseous
membrane
tibia; (2)
upper two-thirds
of
intermuscular septum.
fascia; (5)
(Plate LIII).
Inner and under surface of internal cuneiform
Insertion.
bone and base of metatarsal of great toe.
Action.
Nerve Supply.
Fourth
and
fifth
lumbar and
first
tibial.
Blood Supply.
Anterior
tibial artery.
This
muscle
(1)
of the joint.
of
6rs1
phalanx.
first
tibial.
Blood Supply.Anterior
tibial.
external
to
this region.
It
LXXV.) This
is
muscle
enlongated and
flat-
and the Peroneus tertius enter the same canal in annular ligament.
It
divides into four slip-, one for each of the four inner toes.
A tendon from
the Extensor brevis digitorum join- the three inner of these tendons on their
tened.
It
Origin. (Plate
LI.)
(1)
Outer tuberosity of
tibia;
(2)
upper three-
membrane;
(4)
ANATOMY
Insertion.
IN A NUTSHELL.
slip
is
153
second phalanx: the two lateral slips, after uniting on the dorsal surface of the
second phalanx, are continued onward and inserted into base of the third.
first
tibial.
Origin.
(Plate
LI.)
(1)
Lower fourth
Insertion.
(Plate
LII.)
Inner
(o)
intermuscular septum.
Action.
foot.
Nerve Supply.
fifth
lumbar and
first
tibial.
Anterior
Description. (Plate
Blood Supply.
Gastrocnemius.
tibial.
leg
and
is
is
LXXVII.)
the larger.
The
Gastrocnemius
An
aponeurosis spreads out from each tendon to cover the posterior part of that
from impression on outer side of external condyle and from posterior surface oi
femur immediately above the condyle. Both heads also arise by a few fibers
from the ridges which are continued upward from the condyle- to the linea a-pera.
(Plate LII.)
Insertion.
Os calcis by tendo Achillis.
Actiox.
Extends foot and flexes leg.
Nerve Supply. First and second sacral through internal popliteal (from
greal
sciatic.)
Soleus.
cnemius
this
i>
broad
flat
muscle.
In
shape
it
the Gastro-
resembles a
sole fish,
this
is
ANATOMY
154
Origin.
(Plato
L.)
IS A NUTSHELL.
Back part
(1)
of
head
of fibula
upper 'hird of
(2)
rior surface of shaft of fibula; (3) oblique line of tibia; (4) middle third of
between the
and
tibial
fibular ori-
beneath which the popliteal vessels and internal popliteal nerve pass.
[nsertion. (Plate LII.) Os calcis by tendo Achillis.
A* HON. Steadies leg on foot prevents body from falling.
N era
i.
The muscular
fascia.
or four inches
may
be
lost in
length.
in
is
finally
about three
It is
Achillis.
It
(Plate
linea aspera
Internal popliteal.
Popliteal.
Nerve Supply.
Blood Supply.
LESSON XLI.
Popliteus. Description.
the popliteal space.
nio-t other
popliteal
muscles
It
in
(Plate
LXXIX.)
This
is
that
its
origin
is
muscle, and
smaller than
is
different
The
its insertion.
from
internal
nerve and the popliteal vessels cross the superficial surface of this
muscle.
Origin.
Action.
Xi:i;\
i;
fourth and
Supply.-
fifth
lumbar and
first
sacral
through internal
popliteal.
Blood Suppli
Popliteal.
on the
occupies most
three grooves
all
lei:
Description.
although
it
(Plate
three different
bono,
one
then
it
Its
tendon
passes through
in
first
to its insertion.
is
PLATE
LIU.
<1).
tf)
(I).
4DQUCT0 HLLUCIS
ELEXOR BREVIS
Ha LLUCISMi
'OUTER PORTION!
(INNER PORTION
LANTAR INTEROSSEOUS
(1).
ABDUCTOR
WIN Ml DIGITI
I
(1)
FLEXOR BREVIS
PERONEUS
LONGUS
H)
NTAR INTEROSSEOUS
TIBIALIS AUTICUS
(0).
(1
DDUCTOR HALLUCIS
(0).
_FLEXOR BREVIS
MINIMI DIGITI
TIBIALIS POSTICUS
(0)
(1)
(0)
(0)
(0)
ABDUCTOR MINIMI
ABDUCTOR HALLUCIS
\0)
DlGlTl
,0|
ANATOMY
156
Origin. (Plate
L.)
IN A NUTSHELL.
Lower two-thirds
(1)
mem-
brane;
Action.
Nerve Supply.
Fifth
lumbar and
and second
first
terior tibial.
Blood Supply.
Posterior
tibial.
small
its
at
occupies nearly
all
Tibialis posticus
internal
(Plate
LXXIX.)
it
this
its
own
Its
muscle
tendon
The tendons
and
This
descends.
common
of the
synovial sheath.
They
are
lie
immediately below
its
tibial
Insertion.
(Plate
LIII.)
Into
toes.
A.CTION.
Flexes
Nerve Supply.
Blood Supply.
toes
posticus.
Tibialis
Fifth lumbar
Posterior
tibial.
Description.
(Plate
the
is
all
all
its
insertion.
It
sends fibers of
in-
the bones of the tarsus except the astragalus, also to second, third,
>rigin.
Plate L.)
tibia,
between commencement of oblique line above and junction of middle and lower
third of shaft below; from upper two-thirds of the internal surface of fibula;
some fibers a bo from deep transverse fascia and intermuscular septa.
I
nsertion.
bono and
Action.
sole inward.
Si pply.
Peroneus longus.-
Posterior tibial.
Description.
first
(Plate
Ion-
ANATOMY
IN A NUTSHELL.
tins is superficial to
The
It is
1 ")7
the fibula and this muscle near the upper part of the bone between the head and
As its tendon passes behind the external malleolus it lies behind the
the shaft.
it is
substance where
it
and
in
these
bone)
is
in its
its direction,
thickened.
(Plate LI.)
Origin.
fibula; (2)
bone.
Action. Extends and everts foot and steadies leg upon foot.
Nerve Supply. Fourth and fifth lumbar and first sacral through musculocutaneous branch of the external popliteal.
Blood Supply. Peroneal.
This muscle is shorter
(Plate LXXIX.)
Peroneus brevis. Description.
and smaller than the Peroneus longus and lies behind it. Its tendon passes
behind the external malleolus in front of that of the Peroneus longus. On the
outer side of the os calcis it is separated from the tendon of the Peroneus longus
on
its
of shaft
of
of little tee
outer side.
Action.
\ki;\ e Supply.
upon
foot.
hist sacral
fifth
through musculo-
Blood Supply.
Peroneal.
LESSON
Xidl.
LXXV.)This is a
Extensor brevis
broad, thin muscle which passes obliquely across the dorsum of the foot and
divides into four tendons.
Beneath this muscle lie the tarsal and metatarsal
arteries
interossei muscles.
(2)
annular ligament.
<
ANATOMY
158
IN A NUTSHELL.
of
first
Action.
first
phalanx
N kve Supply.Anterior
Blood Supply. Dorsalis
tibial.
pedis.
"t'
(Plate
fool
is
on the
LV.)
This
muscle
is
the inner
first
is
It
floor.
(Plate LI 11.)
Origin.-
(1)
Insertion.
Actiox.
(Plate
Nerve Supply.
Blood Supply.
Abductor
LIII.)
Abducts great
toe; flexes
Internal
Internal
minimi
first
phalanx
of greattoe.
proximal phalanx.
plantar.
plantar.
Description.
digiti.
(Plate
LV.)
This
muscle
is
separated from the Flexor brevis digitorum by a vertical septum of fascia, and
has along
first
its
Origin.
(Plate
LIII.)
of os calcic in front of
same
and nerve.
Outer tubercle of os
(1)
both tubercles;
(3)
calcis; (2)
under surface
intermsucular septum.
fascia: (5)
Insertion.
(Plate
LIII.)
Its
metatarsal bone,
fifth
is
inserted, together
first
phalanx
of little toe.
Action.
Abducts
little
toe; flexes
proximal phalanx.
plantar.
External plantar.
Flexor brevis digitorum. (Perforatus.)
Blood Supply.
muscle
called
is
Perforatus because
its
(Perforans.)
Description.
tendons, one for cadi of the four outer toes, these tendons themselves divide
first
phalanges
They divide
This muscle
is
ORIGIN.
of plant a
i-
fascia; (3)
intermuscular septa.
Sides of second phalanges of four lesser toes.
Flexes toes.
Supply.
Internal plantar.
SUPPLY.- Plantar arteries.
Adductor obliquus hallucis.- Description.
\i:i;\
i:
P>!.(oi>
(Plate
LX.)
This
muscle
PLATE LIV
BONE.
THE CENTERS FOR THE BASE OF THE TERMINAL PHALANGES APPEAR AT THE SIXTH YEAR. CONSOLIDATE AT
THE EIGHTEENTH YEAR.
METATARSUS
TWO CENTERS
FOR
EACH
BONE.
CONSOLIDATE AT THE
APPEARS AT THE
THIRD YEAR.
TWENTIETH YEAR.
THE CENTER FOR THE EPIPHYSIS FOR THE CALCANEUM APPEARS AT THE TENTH YEAR. CONSOLIDATES
AT SIXTEENTH YEAR.
ANATOMY
160
IN A
NUTSHELL
occupies the hollow space between the four inner metatarsal bones.
large, thick, fleshy mass passing obliquely across the foot.
Origin.
(Plate
LIII.)
Tarsal
first
phalanx of great
toe,
It is
tendon.
Nerve Supply.
lis.)
Origin.
(Plate
LIII.)
Inferior
outer toes.
Insertion.
(Plate
LIII.)
Outer
side of
first
of the
hallucis.
grouped around the middle line of the middle finger. Each one lias two heads
between which pass the perforating arteries to the dorsum of the foot, except in
the hirst dorsal interosseous between the two heads of which passes the communicating branch
ORIGIN.
Insertion.
common
(Plate LXI.)
(Plate
From adjacent
Bases of
extensor tendon;
LXI.)
first
first
the other three into outer side of second, third, and fourth toes.
Action.Flex
third,
cept the third dorsal interosseous which receives the external only.
Plantar
""i
;ire
three
interossei.
in
DESCRIPTION. (Plate
They
fifth
metatarsal bones.
as the
palmar
LXII.)
The
plantar
interossei of the
inter-
hand and
also
lie
ANATOMY IN A NUTSHELL.
161
External plantar.
Plantar arteries.
PLATE
LV.
EXTERNAL
NERVE
.PLANTAR
LESSON
XLII1.
(Plate LIX.)
The two heads of this
Flexor accessorius.
Description.
muscle are separated from each other by the Long plantar Ligament. The external plantar vessels and nerve lie beneath it when one is standing.
.
ANATOMY
162
(Plate
Origin.
L1II.)
below groove
of os calcis
IN A NUTSHELL.
Inner
for
hallucis.
Nerve Supply.
Bl
Si ppli
External
plantar.
External plantar.
Lumbricales. Description.
(Plate
LIX.)
These
first
i;\
Supply.
i.
Two
Two
outer
Note. The first inner lumbricalis has internal plantar and the three outer
have external plantar in one out of ten cases.
Blood Supply. Plantar arteries.
Description. (Plate LX.) This muscle has one
Flexor brevis hallucis.
origin and two insertions, and is situated along the inner and under surfaces of
The inner tendon joins that of the Abductor
the metatarsal of the great toe.
lialluci-. while the outer one joins the tendons of the Adductor transversus
hallucis and the Adductor obliquus hallucis prior to their common insertion in a
Between these two heads the Flexor longus hallucis lies in a
sesamoid bone.
ive.
Origin.
cuneiform;
(Plate
LIII.)
(1)
(2)
external
first
phalanx
(3)
Insertion.
of greal
(Plate LIII.)
toe.
N i:i;\ Supply.
Blood Supply.
i.
toe.
Internal plantar.
Internal plantar.
Artici LATION.
(1)
One
tibia, (2)
fibula; (3)
os calcis,
and
navicular.
Os
calcis,
supplied by posterior
centers of ossifk
tibial, internal
Two
Artk LATION.
Attachment oi Muscles.
i
Eight: (1)
the tendon
Achillis; (3)
digiti;
(6)
moN.
Plantaris; (4)
part
Abductor
(7)
hallucis; (5)
Abductor minimi
(8) Extensor
brevis digitorum.
Cuboid, supplied by the dorsalis pedis, as are the remaining bones of tarsus.
(
>ssn
[(
vi
[on.
me
center.
ANATOMY
Articulation.
form, and
With
IN A NUTSHELL.
163
four bones; (1) the os calcis; (2) external cunei(4) fifth metatarsal bones; occasionally with the
navicular.
PLATE
LVI.
Ossification.
One center.
Articulation.With four hones:
(
(1)
astragalus
and
Attachment of Muscles.
three
cuneiform;
ANATOMY
164
Ossification.
(3)
One
IN A NUTSHELL.
center.
Peroneus longus.
Middle cuneiform, supplied by dorsalis pedis.
i
>ssification.
One center.
With four bones,
is
navicular, internal
qlation.
Ai;ii<
attached
slip
bone.
to this
Ossification.
One center.
hallucis.
Metatarsus.
Plates LII-LIII.
Blood Supply.
all
Ossification.
tremity, and
first
row
of phalanges.
The number
Attachment of Muscles.
To the
first
first,
of tarsal
fifth.
from the Peroneus longus. To the third, five, the Adductor obliquus hallucis,
Second and Third dorsal and Plrst plantar interosseous, and a slip from the
tendon of the Tibialis posticus. To the fourth, five, the Adductor obliquus
hallucis. Third and fourth dorsal, and Second plantar interosseous, and a slip
from the tendon of the Tibialis posticus. To the fifth, six, the Peroneus brevis
slip
Peroneus
tertius,
digiti,
Adductor transversus
hallucis.
Phalanges.
Blood Supply.
They
Plates
LII-LIII.
loin-
Attachment ok Muscles.- To
165
IN A NUTSHELL.
ANATOMY
Second
toe, three
minimi
digiti.
Abductor minimi
digiti,
PLATE
INTERNAL PLANTAR
EXTERNAL
PLANTAR
LUMBRICALES
COMMUNICATING
TO INTERNAL PLANTAR
NERVE
EXTERNAL PLANTAR
INTERNAL
ARTERY
PLANTAR
ARTERY
NERVE.
ARTERY.
POST. TIBIAL
NERVE
NERVES.
LUMBRICALES, INTERNAL AND EXTERNAL PLANTAH VESSELS AND
Longus hallucis,
Fourth lumbrical. Second phalanges. Great toe; Extensor
one slip ol the
Flexor longus hallucis. Other toes; Flexor brevis digitorum;
phalanges;
common tendon of the Extensor longus and brevis digitorum. Third
brevis
Extensor
and
two slips from the common tendon of the Extensor longus
digitorum, and the Flexor longus digitorum.
ANATOMY
166
IN A NUTSHELL.
LESSON XL1Y.
The
Tibia.
The word tibia means flute. It is also called the shin bone and is situated
It articulates with the
on a plane anterior to and on the inner side of the fibula.
lemur above, tin astragalus below, and the fibula externally. It sustains the
uri'Jn of the entire body above the knee-joint as the fibula does not enter into
1
this articulation.
is called the head, each side of which is a
These tuberosities are continuous in front but are separated behind by the popliteal notch. The upper surface of each tuberosity is concave
tuberosity.
The
surface
internal tuberosity
branosus muscle
The
is
is
is
Longer.
and
its
its
articular
Semimem-
inner border.
band
at the junc-
The anterior
attachment
The
to
the
ligamentum
shaft which
is
tuberosity or tubercle
The lower
is
at the junc-
patellae.
is
It
The anterior border separates the internal and external surfaces and
surfaces.
extends from the anterior tuberosity or tubercle to the front of the inner malThe
leolus.
The lower
The internal border separates the internal
commences above at the back of the inner tuberosity
is
i>
smooth.
ie
of the internal
malleolus.
The
This
external border,
membrane and
It
its
middle portion.
The
internal surface
is
is
convex.
The
insertion
ANATOMY
of the Gracilis
is
NUTSHELL.
IN A
167
Semitendinosus below it. the two being surrounded by the double insertion of
The external surface has on it- upper two-thirds,
the Sartorius. except below.
which is concave, the Tibialis anticus. The lower part of its surface runs for-
ward and
is
PLATE
The
LVIII.
This line
giv<
a1
attached to the triangular area above this line. The middle onethird of the bone is divided into two portion- by a longitudinal ridge, the inner
one of which is for the origin of the Flexor longus digitorum, and the outer one
muscle
is
ANATOMY
168
is
of
IN
A NUTSHELL.
nutrient foramen
is
on
this portion
one
in
for the
than behind.
front
thi> surface
The
is
tibia
It
is
In the middle of
a slight elevation
is
it
head
of the
Ossificatiox.
From
three centers.
hgamentum
patellae.
LESSON XLY.
The Patella.
The sesamoid bone which
extensor muscle
is
is
developed
in
Its
is
pierced
by
vascular foramina.
to
interna] pari
i-
convex.
When
the leg
is
is
in
When it
flexed
also in
this position
The Ugamentum
patellae springs
of
is
in
is
is
in
the patella
is
placed upon a
ANATOMY
plain surface,
its
IN A NUTSHELL.
it
its
169
it
will tip to
belong?.
and the
branch
popliteal.
'ft
|t
'
LUMBRICALIS_
/
|
iff
One
center.
It
is
com-
at
anatomy
170
in a nutshell.
The Fibula.
The word
and
Lies
extends
1
at
its
1-
fibula
means
clasp or pin.
Lower
Its
Level.
tibia.
It
It
is
main purpose
is
is
facet
is
is
is
attached in
extends into the external malleolus which is lower than the internal malleolus.
.Man i- the only animal in which this is true.
It articulates with the astragalus
it-
upper
third.
It
commences
a1
It
the base of the styloid process and ends below in the posterior
below
in
it
and ends
or antero-internal border.
lb
Supply. The fibula receives the nutrient artery of its shaft from
the peroneal branch of the posterior tibial.
The head is nourished by branches
>
from the
inferior external
malleolus
i-
Ossification.
in
the eighth
and the
week
From
three
centers.
of intra-uterine
life.
AXATOMY
appears
year or
in
the fourth or
IN A NUTSHELL.
and
fifth year,
171
The center
later.
and
Articulation-. With two bones: the tibia and the astragalus.
Attachment of Muscles.Nine to the head, the Biceps.
year,
Sol.-us.
and
PLATE LX.
SESAMOID BONE:
&
ec
j fV t? >N
i,
'
The fibula
is
a vestigial
bone
its
in
man and
malleolus.
ANATOMY IN A NUTSHELL.
172
lower epiphysis, through appearing first, unites with the shaft before the upper
In birds, the head of the bone is large, and enters into the formation
epiphysis.
ses
The
end atrophies.
rule
first
is
The
this:
fibula
tion.
LESSOX XLVI.
Arteries
common
lumbar vertebra.
Each
of the ilii.
This division
of these
LXXII-XC)
(Plates
the
on a
is
common
level
iliac arteries
The internal
long and divides
branches:
left
The branches
and an
com-
of these
into an anterior
The
lowing
and
iliac arteries
mon
left side of
(1)
Ilio-hmibar,
lateral
(2)
(3)
gluteal.
The
ilio-
lumbar branch divides into an iliac branch for the Iliacus muscle and the ilium
and a lumbar branch for the Psoas magnus and Quadratus lumborum. The
branch to the Quadratus lumborum semis a spinal branch to the spinal cord
through the last intervertebral foramen. The lateral sacral branch divides
into a superior and inferior division.
The superior one, after anastomosing
with the sacro-media, passes through the first or second anterior sacral foramen
to supply the canal, after which it passes through the corresponding posterior
foramen to the back. The inferior branch, after descending on the sacrum and
coccyx, anastomoses with the sacro-media and has a similar route as the superior
branch.
The gluteal branch passes out of the pelvis through the great sacro-sciatic
foramen, above the Pyriformis muscle. While in the pelvis, it gives branches
and adjacent muscles. Outside of the pelvis it divides into superbranch which passes undes the Gluteus maximus, and deep branch which
to the ilium
ficial
passes between the Gluteus medius and Gluteus minimus, and then divides into
an upper branch which runs along the upper border of the Gluteus minimus,
and a lower branch which runs downward.
Superior vesical,
orrhoidal.
(2)
(Plate-
LXXII-XC)
middle vesical,
(3)
middle hem-
obturator. (Co internal pudic, (7) sciatic; and in the female (8)
uterine, ami (9) vaginal.
The superior vesical branch is that portion of the
fetal
(.">)
is
still
It
the bladder and gives off the artery to the vas deferens, which artery runs with
tin-
spermatic cord.
external
iliac
(umbilical).
artery
is
runs to the bladder and from there along the abominal wall to pass through the
ANATOMY
IN A
NUTSHELL
173
umbilicus to the umbilical cord and the placenta, (Plate IX). The middle
vesical branch passes to the base of the bladder and is generally a branch of the
The inferior vesical branch runs to the base of the bladder,
superior vesical.
prostate gland and seminal vesicales in the male and to the vagina, rectum, and
neck of the bladder in the female. In the female it is called vaginal. The
middle hemorrhoidal branch passes to the rectum and generally arises with the
PLATE
LXI.
lies
it
Interossei.
and
and an ex-
into an internal
muscle and iliac fossa, branches to the bladder, and pubic branches
back of the OS pubis. The internal puttie branch is the -mailer of the
terminal branches of the anterior trunk, and passes ou1 of the pelvis below the
to the Iliacus
to the
ANATOMY
174
IN A NUTSHELL.
After cross-
ing the spine of the ischium, external to the nerve, it passes through the lesser
sacro-sciatic foramen into the pelvis, it now passes through Aleock's canal
about an inch and a half above the tuberosity of the ischium, it now pierces the
triangular ligament where it divides into the dorsal artery of the penis and the
Besides these two terminal branches it has
artery of the corpus cavernosum.
the (1) muscular, (2) inferior hemorrhoidal. (3) superficial perineal, (4) transperineal, (5)
The
sciatic
branch
is
terminal branches of the anterior trunk and passes through the great sacrosciatic foramen below the Pyriformis, then descends between the tuberosity of
the ischium and the trochanter of the femur under the Gluteus maximus, and
then helps to form the crucial anastomosis which is made by four branches, the
first three of which are branches of the profunda artery and the fourth is the
artery gives anastomotic and coccygeal branches, which run through the great
sacro-sciatic ligament to the back of the coccyx, and inferior gluteal branches
(which are three or four) to the Gluteus maximus. and muscular branches to
It sends articular branches to the hip-joint
common
right
In Front.
and
iliac
of the
Common
Iliac Arteries.
LXXII-XCI.)
(Plates
The
(1)
Peritoneum,
Small intestine,
(2)
Sympathetic nerves,
(3)
Ureter.
(4)
Behind. (1) Fourth and fifth lumbar vertebrae, (2) Right common iliac
vein, (3) Lef1 common iliac vein.
Outer Side. (1) Vena cava. (2) Right common iliac vein, (3) Psoas
muscle.
Front.-
(1)
Left
common
Iliac
Peritoneum,
(1)
vein.
(
>i
m.i;
Side.
Fourth and
Psoas
Left
The Relations
of the
In Front.
Behind.
(1)
(1)
(5)
fifth
(3)
Sympathetic nerves,
Ureter.
lumbar
vertebra?,
(2)
Left
iliac
)ii
i;i;
iliac
vein.
Internal Iliac
Peritoneum, and
Interna]
iliac
vein,
(2)
(2)
Ureter.
Lumbo-sacral cord.
muscle.
The Relations
common
magnus muscle.
common
Iwi.i; Side.
Small intestine,
(2)
Behind."
iliac vein.
(Plate XCI.)
(3)
Pyriformis
ANATOMY
In Front.
IN A NUTSHELL.
175
vessels, (5)
ament.
PLATE
Tin.
LXII.
Three Plantah
rossi
i.
LESSON XLVII.
The external
iliac
its
origin,
Poupart's ligamenl
after which
is
branch of
it
is
called
magnus and
this artery
the
which
i-
a1
the lumbo-sacral
magnus muscle
common
i<>
to pass
under
femoral artery.
The deep
11
epi-
Poupart's ligamenl
it
ANATOMY
176
IN A NUTSHELL.
between the peritoneum and the transversalis fascia. After passing under
the vas deferens in the male or the round ligament in the female it curves around
the lower and inner margin of the internal abdominal ring, then ascending it
lies
the longesl
inin
anastomosis
arterial
integument.
iliac
artery
is
also a
iliac
and
The femoral
artery
is
junction of the middle and lower third of the thigh close to the bone,
it is
called
[n Front.(4)
Iliac
(1)
Crural branch
Prolongation of transversalis
Superficial circumflex
fascia, (6)
iliac vein,
(8)
Behind.
(1)
muscle.
(6)
OUTEB
Nerve
to Pectineus, (4)
Capsule of hip-joint.
SlDE.
(1) Anterior crural nerve,
(2)
Psoas muscle,
(5)
(2)
Pubic
Pectineus
PLATE
LXIII.
TWELFTH THORACIC
EXTERNAL CUTANEOUS
FLEXOR
SOLEUS
BREVIS
.HALLUCIS.
ABDUCTOR
TIBIALIS POSTICUS
MINIMI
OIGITI.
MINIMI OIGITI
SEVEN INTEROSSEI.
ACO. TRANS. HALLUCIS.
HALtuClS.
AOD. npi
.
ANATOMY
178
mis nerve,
(6)
IN A NUTSHELL.
(4)
Pectineus muscle,
,::
(5)
Vastus internus,
Inner Side.
The Relations
(1)
(3)
Sartorius.
(Plates LXXII-LXIV.)
Profunda Artery.
Profunda
vein, (3) Superficial femoral
Femoral vein. (2)
of the
Front. (1)
Adductor longus muscle.
I\
arten\
(4)
(4)
Behind.
Qiacus,
(1)
(2)
Pectineus,
Adductor
(3)
brevis,
(4)
Adductor
magnus.
Outer Side.Vastus
1
\\ ER SlDE.-
internus.
Pectineus.
Outer
head,)
(4)
Inner
Side.
Plantaris,
Side.
Gastrocnemius,
(6)
(1) Biceps,
(5)
(1)
Semimembranosus.
(2)
Internal
condyle.
(3)
Gas-
LESSOX XL VI II.
The branches
_'
of the
common
pudic.
The branches
anastomotica magna.
(1)
superficial epigastric,
deep external
muscular branches, (2)
The branches
internal
and
ascends almost to the umbilicus, lying in the superficial fascia on the external
It
anastomoses with branches of the deep epigastric artery.
oblique muscle.
The superficial circumflex iliac artery, after piercing the fascia lata, runs to the
anterior superior spine and crest of the ilium below Poupart's ligament.
It
anastomoses with the deep circumflex iliac and with the gluteal and external
circumflex arteries.
The
in
superior,
the male
and round ligament in the female to the lower part of the abdominal wall, penis,
scrotum in the male, and the labium in the female.
anastomoses with
It
branches of the internal pudic. The deep external pudic artery, also called inPectineus muscle then pierces the fascia lata to pass to the
perineum and scrotum in the male or labium in the female.
It anastomoses with branches of superficial perineal artery. The muscular branches of
ferior, crosses the
slrin of
in
PLATE LXIV
SUPERFICIAL
EPIGASTR
ANT CRUAL
SUPERFICIAL EXTERNAL PUDIC
ARTERr
NERVE
COMMON FEMORAL
FEMORAL VEIN
ADDUCTOR BREVIS
EXTERNAL
CIRCUMFLEX
SCROTUM
JNTERNAL OR LONG
SAPHENOUS
ANASTOMOTICA
ANASTOMOTICA
SUP.
INT.
INF. INT
MAGNA
ILIO-TIBIAL
MAGNA
ANTICULAR
ARTICULAR
A.
INF. EXT.
ARTICULAR
A.
ANATOMY
ISO
end
IN A NUTSHELL.
superficial
with the long saphenous nerve, and adeep branch which runs in front of the
tendon of the Adductor magnus to the inner side of the knee-joint, where it
anastomoses with the anterior tibial recurrent and the superior internal articThe profunda artery itself passes behind the superficial femoral
ular arteries.
vessels od the inner side of the femur and then behind the Adductor longus to
This is sometimes
pierce the Adductor magnus at the lower third of the thigh.
The internal circumflex of the profunda
called the fourth perforating branch.
passes between the Psoas magnus and the Pectineus to the upper border of the
Adductor brevis, at this point it sends one branch inward to the Adductor
muscles and another branch downward under the Adductor brevis. The internal circumflex artery itself now passes between the Quadratus femoris and
the Adductor magnus to join the crucial anastomosis which is formed by the
[NTERNAL CIRCUMFLEX ARTERY, THE EXTERNAL CIRCUMFLEX ARTERY and THE
Si periob perforating all of which are branches of the profunda, and the
is
ward under the Tensor vagina femoris. The descending branches run under
The
the Rectus as far asthe kneeto enter into the circumpatellar anastomosis.
over
pass
outward
the
Crureus
muscle
and
through
the
trans^ erse branches
back
thigh
enter
the
crucial
anastomosis.
of
the
into
to
Vastus externus to the
This external circumflex artery passes between the anterior and posterior divis-
The three perforating branches of the proAdductor magnus to reach the back of the thigh.
The supeRiob ONE passes above the Adductor brevis to join the crucial anastomosis.
The middle one pienes the Adductor brevis. The inferior one
below
the Adductor brevis.
passes
The popliteal artery is a continuation of the femoral and passes through the
popliteal space downward and outward.
At the lower border of the Popliteus
mi scle it gives off the anterior tibial artery and continues as the posterior tibial
ions of the anterior crural nerve.
artery.
The
-pace has
FLOOR,
and
is
It IS
the outer
h<
ad of the Gastrocnemius.
<
found deep
in
An
this space.
The
is
often
all
PLATE LXY
SUPERIOR GLUTEAL
IffJ
^'^4~
INFERI0R
GLorEAL
GEMEUiJS
CRUREUS
SHORT HEAD
OF
BICEPS
PUNTARIS
Of GASTROCNEMIUS
181
ANATOMY
182
NUTSHELL.
IN A
these structures superficially in the median lint', and the external popliteal or
peroneal nerve lies close to the tendon of the Biceps.
of the popliteal artery are, (1)
The branches
in
These branches
rocnemius
the median line and on each side run across the Gast-
may
arise
ductor magnus muscle divides, one of the branches joining the superior external
articular artery and the other branch joining the anastomotic^ magna and the
inferior internal articular artery.
(5)
passes above the outer condyle under the tendon of the Biceps divides into a
dt ep branch which joins the inferior internal articular artery, and anastomotic^
artery and a superficial branch which joins the inferior external articand the descending branch of the external circumflex artery. (6) The
magna
ular
azygos articular
thai
joint.
7)
pierces
ligament of the
the posterior
internal
Inferior
articular
passes
knee-joint to supply
below the inner tuber-
arteries.
(Plates
LXXII-LXXYI)
is
formed by
articular.
branch
(6)
and
anastomotica magna,
(8)
(7)
descending
This
anastomosis has superficial and deep portions. If we substitute in this anastomosis the fourth perforating or terminal branch of the profunda for the posterior tibial recurrent
and azygos
articular,
we
will
to
the knee-joint.
LESSON XLIX.
The
LXXII-LXXVI)
now descends on
membrane and
membrane.
surface of the tibia distally and the anterior ligament of the ankle-joint.
this joint
it
i-
The branches
It
Below
are,
and through the Soleus muscle to the Peroneus longus. (4) Anterior tibial
recurrent which passesupward through the Tibialis anticus to go to the circumpatellar anastomosis. (5) Internal malleolar branch passes under the tendons
PLATE LXVI.
SUPERFICIAL EPIGASTRIC
SUPERF.CIAL
SUPERFICIAL INGUINAL NODES
CIRCUMFLEX
EXTERNAL
ILIAC
FEMORAL
CUTANEOUS VEIN
\\i>
Veins
<>f
Leg
VEIN.
ANATOMY
184
of the
IN A NUTSHELL.
Extensor longus
6) The cMcrnal malleolar passes under the tendons of the
digitorum and Peroneus tertius to the outer malleolus.
The Relations of the Anterior Tibial Artery.
l.\
Front.- -(1) Integument, (2) Superficial and deep fascia, (3) Anterior tibial nerve, (4) Tibialis anticus (overlaps it in the upper part of the leg),
(5)
hallucis (overlaps
BEHIND.
Outeb
1
Side.
it-
The
mvat
(1)
Anterior
tibial
(1)
Tibia,
(2)
Extensor proprius
(3)
ligament
Anterior
It
tibial.
to the first
communicating
artery.
where
LXXII-LXXYI.)
is
the continuation of
passes along the inner side of the foot from the ankle-
The
it
first
it
(6)
slightly,)
it
lower part).
the anterior
joint
(7)
Iwii; Side.
at
it
slightly).
Interosseous membrane,
(1)
of ankle-joint.
(3)
it
it
gives
branch which passes under the Extensor proprius hallucis tendon and runs
along the dorsal aspect of the inner side of the great toe.
The communicating
branch, also called the plantar digital, passes between the two heads of the First
dorsal interosseous muscle to join the external plantar artery, thus
it
now
completing
which runs
branch along the dorsal aspect of the outer side of the little
These three arterieseach receives aposterior perforating branch from the
plantar arch a1 the base of the space, also an anterior perforating branch from
ofthetoes sends
:i
toe.
;it
The Relations
I\ Front.
(1) [ntegument, (2) Fascia, (3) Anterior annular ligament,
Innermost tendon of Extensor brevis digitorum.
Behind.ligament-
to
Outeb
(1)
Astragalus, (2)
Navicular,
(3)
Middle cuneiform,
(4)
The
these bones.
Side.
Iwii; Side.
(2)
Anterior
tibial
nerve.
ANATOMY
IN A NUTSHELL.
LESSON
The
popliteal artery
from here
it
and commences
at the
185
L.
LXIX-LXX)
is a continuatioD of the
lower border of the Popliteus muscle,
passes to the interval between the heel and the internal malleolus
PLATE LXVII.
Jii
it
course
it
lies
ankle-joint.
upon the
Tibialis posticus.
The branches
Vein.
Along
tibia,
its
and
The peroneal
186
ANATOMY
NUTSHELL.
IN A
inner side of the fibula to the lower third of the leg where it divides into an
The peroneal artery itself gives off (a) musanterior and posterior peroneal.
culab branches to the muscles at the hack and outer side of the leg, (b) nutrient to fibula, (c) INTERIOR PERONEAL which runs through the interosseous
membrane and then descends to the outer ankle, (d) Communicating branch
(e) Posruns inward to unite with a similar branch of the posterior tibial,
terior PERONEAL continues with the main artery to the outer side of the os
external calcanean sends several branches to the outer
(f) The
calcis.
(2) Muscular branch* s which pass to the muscles on the back
side of the heel.
of the leg.
branches.
with
Nutrient
(3)
(4)
to
the tibia.
muscular
and unites
Internal calcanean which sends
a similar
(5)
off
tibia
Flu
(Plates
Flexor brevis digitorum and Flexor accessorius to the base of the fifth metaIt now bends inward and arches across the bases of the fourth,
tarsal bone.
ami second metatarsals to the interval between the second and first metawhere it joins the communicating branch of the dorsalis pedis to comThe branches of the external plantar are (1) posterior
plete the plantar arch.
perforating: which are three in number and run between the heads of the three
outer Dorsal mterossei to join the interosseous branches of the metatarsal
third,
tarsal,
arteries. (2)
little toe,
The
first
terosseous spaces to the base of the toes where each one sends an anterior per-
and then
and plantar aspects of the toes.
The internal plantar artery (Plates LV-LVI-LVIII) passes above the Abductor hallucis, then between it and the Flexor brevis digitorum, and from here
along the inner side of the great toe to anastomose with the digital branch from
forating branch
join
to
The Relations
1\
I
(5
Front.
(1)
(3)
Tibia,
Ankle-joint.
Outer
Side.
Inner Side.
Posterior tibial nerve, upper third.
The Relations of the Peroneal Artery. (Plate LXIX.)
In Front,
Behind.
Outer
fit
Side.
Inner Side.
Fibula, (2)
(3)
Veins.
The
external
iliac
vein (Plate
XC)
is
PLATE
EXTERNAL
SPERMATIC
LXVIII.
CUTANEOUS
CORD
ANTERIOR CURAL NERVE
-EMORAL ARTERY
FEMORAL VEIN
PECTINEUS
ADDUCTOR
LONGUS
SCROTUM
OBTURATOR.
ADDUCTOR
MAGNUS
INTERNAL CUTANEOUS
SUB- SARTORIAL
PLEXUS
PATELLAR BRANCH OF
LONG
SAPHENOUS
INTtHNAL CUTANEOUS
SARTORIUS
EXTERNAL POPLITEAL
LONG
OR PERONEAL
MUSCULOCUTANEOUS
SAPHENOUS.
PERONEUS 1LONGUS
AND
NERVE
CUTANEOUS BRANCH OF
MUSCULO -CUTANEOUS
PERONEUS. BREVIS
PERONEUS TERTIUS
ANT.
ANNULAR
LIG.
Limp..
NERVI
ANATOMY
1SS
A NUTSHELL.
IN"
where
it
iliac
make
vein to
the
The external
The
sacro-iliac articulation
side of
to
iliac
iliac
It
iliac
vein at the
first
on the inner
all
all
(1)
the internal
ami
The
membrane and
vesical
and
is
well
lies at
orifice,
it
iliac
The common
(5)
ligament
is
and
it
stance of 4ie uterus and communicates with the ovarian veins before
the internal
and the
mucous
it
joins
vein.
these veins.
The
inferior
the Diaphragm.
It
common
lefi
iliac
in the
fifth
veins
cardium.
The lumbar
veins, (Plate
of the
abdominal
PLATE LXIX.
w///h
si
-,POPL'TEAL
&i
I\
BICEPS
SUPERIOR
EXTERNAL
ARTICULAR
SUPERIOR
ARTERY
ARTICULAR
CUTER HEAD
INTERNAL
ARTERY
GASTROCNEMIUS
INNER HEAD GASTROCNEMIUS
GRACILIS
INFERIOR
ARTICULAR
EXTERNAL
ARTERY
SEMI-TENOINOSUS
SEMIMEMBRANOSUS
INFERIOR
INTERNAL
ARTICULAR
ARTERY
LEXC.1
LOnUS
HALLUCIS
PERONEUS LONGUS
PERONEAL ARTERY
FLXOR
LONGUS
HALLUCIS
PEBCMEOUS LONGUS
PEROHEOUS
BREVIS
INTERNAL
CONTINUATION
ANNULAR LIGAMENT"
OF
TENDO
PERONEAL ARTERY-
ACHILLIS
INTERNAL
CALCANEAL
Leo.
ARTERY
ANATOMY
HJO
and the
walls
transverse processes
of
it
own
connected by longi-
all
in
The
side.
IN A NUTSHELL.
left
to the
azygos vein
The plexus
tube
i>
The
left
renal veins
renal vein.
lie in
front of their
companion
arteries
which
is
an exception
below the Diaphragm. The left vein passes in front of the aorta
empiii s into the inft rior vena cava at a higher level than the right, and
w lute
it
the longer of
ian,
Li
f1
tin-
inferior phrenic,
LESSON
v<
LI.
The hepatic veins begin in the liver in the capillaries of the intralobular
and form three main v< ins which empty into the inferior vena cava as it
in-
lies in
these
v< ins.
hoe
the'
left;
before
it
There
are'
no valves
in
Hepatic artery
Portal vein
1.
2.
Interlobular vein
2.
Interlobular artery
.'!.
3.
Its
4.
Intralobular vein
4.
1.
own
intralobular capillaries
5.
Sublobular vein
5.
Intralobular vein
6.
Hepatic vein
6.
Sublobular vein
7.
Inferior
7.
Hepatic vein
8.
Inferior
It
he
vena cava
will
h pat
ic
vena cava.
be noticed that the blood which passe-s through the Portal vein and
artery has
PLATE LXX
SUPERIOR
EXTERNAL
SUPERIOR
ARTICULAR
INTERNAL
ARTtHT
ARTICULAR
POPITEAL
POPLITEAL
ARTEt.
ARTERY.
NERVE
POSTERIOR LIGAM:
INFERIOR
,'T
OF KNEE
EXTERNAL
ARTICULAR
ARTERY
SEMI-MEMBRANOStl*
INFERIOR
INTERNAL
ARTICULAR
PERONEAL
ARTERY
FLEXOR
LONGUS
DIGITORUn
TIBI4LIS POSTICUS
COMMUNICATING BRANCH
PERONEUS
CONTINUATION
BREVIS
ANNULAR LIGAMENT
INTERNAL
OF
-TEN00
ACHILLIS
PERONEAL ARTERY
INTERNAL
CALCANEAL
AST^RY
ANATOMY
192
The
IN A NUTSHELL.
and deep
set
The
those of the upper extremity, but the valves are more numerous.
superficial veins of the lower extremity lie between the two layers of the superlike
ficial
has
The
fascia.
ii-
veins on the
of the iocs,
and
dorsum
of the foot
form
concavity backward.
ii
in
saphenous.
is
a continuation
of
arch and ascends behind the outer malleolus along the outer border of the
it
median
line of the
posteriorly to perforate the deep fascia in the lower part of the popliteal
space where
it
ends
in the popliteal
its course and it sends a communiend upward and inward to the long saphenous vein.
It
communicates with the dee}) veins below and accompanies the external
This vein has from nine to fourteen valves in it.
saphenous uerve.
The internal or long saphenous vein (Plate LXVI) is a continuation of the
nemius.
It
From
in front of
this point
it
its
From
here
it
through the saphenous opening where it ends in the femoral vein about an inch
and a half below 1'oiipart's ligament. It communicates with the deep veins
It
superficial
The
circumflex
iliac,
its
iliac after
it
outer to
its
inner side.
This vein
It
has four or
ous vein.
Talipes comes from two words, talus which
means
foot.
means
ankle,
may
PLATE
LX.\r.
LUMBAR LIGAMENT
LAST LUMBAR
VERTEBRA,
RECTUS TENDON
GREATER
SACRO- SCIATIC
LIGAMENT
RECTUS TENDON
GLUTEUS MEOIUS
GLUTEUS MINIMUS
VASTUS EXTERNUS
VASTUS INTERNUS
RECTUS FEMORIS
ILIO-TIBIAL
BAND
LIGAMENTUM PATELLAE
Showing Muscles of
I.wki;
ANATOMY
194
We
heel
the foot.
of club-foot:
of the
Talipes calcaneus in
(2)
IN A NUTSHELL.
the foot.
is
Talipes varus in which the footis turned inward the patient walk-
(4)
(5)
Talipes valgus
(flat
is
LXXXIX.)
(Plate
equino-valgus.
(1)
of the principal
made
Syme's amputation
is
and removing the internal malleolus and the external malleolus and
sometimes a slice from the lower part of the tibia. (2) Roux's amputation is
made at the ankle-joint, leaving a large internal flap. (3) Pirogoff's amputation is made by removing all the tarsal bones, except the posterior part of the os
calcis, and a thin slice from the tibia and fibula including the two malleoli. The
small portion of the os calcis which remains is then turned up and united to the
lower surface of the tibia.
(4) Sub-astragaloid amputation is made by removing
heel flap
all
formed.
(5)
Chopart's amputation
all
This operation
made by removing
and astragulas.
removing
is
(6)
all
is
rarely per-
Lisfranc's amputation
made by
is
the metatarsals and phalanges, but not cutting any of the bones.
LESSON
Hip-Joint.
This joint
It
has
is
(Plate
a diarthrodial joint
LXXXII.)
and belongs
five ligaments.
fibrous,
LI I.
Below
loid ligament.
(1)
it
is
intertrochanteric line anteriorly, to the root of the neck of the femur superiorly,
middle of the neck of the femur posteriorly. It has two sets of fiand longitudinal. The circular are best developed at the lower
and posterior part where they form a collar called the zona orbicularis or liga-
and
to the
bers, circular
ment
of Bertin.
time- there
synovial
is
The longitudinal
an opening
membrane
to
femoral or V ligament
and
is
in
fibers
Some-
form
a bursa
it is
(2)
The
ilio-
bifurcated below
PLATE LXXII.
ABDOMINAL AORTA
DEEP EPIGASTRIC
LIO
COMMON
ILIAC
SACRA
LUMBAR
MEDIA
INTERNAL ILIAC
DEEP CIRCUMFLEX
ILIAC A
A.
GLUTEAL
EXTERNAL
A.
A.
A.
ILIAC A.
COMMON FEMORAL
OBTURATOR
SCIATIC
PUDIC
A.
PROFUNDA FEMORAL
A.
EXTERNAL CIRCUMFLEX
ARTERY
CIRCUMFLEX A
INTERNAL
CRUCIAL ANASTOMOSIS
SUPERFICIAL FEMORAL
A.
PERFORATING
ANASTOMOTICA
MAGNA
SUP.
LATERAL
INF. INT.
ANT1CULAR
INT.
INT.
POPLITEAL
EXT.
UG.
INF. EXT.
ARTICULAR
TIBIAL
POST.
TIBIAL
LATERAL
ARTICULAR.
RECURRENT
A.
PERONEAL
INT.
MALLEOLAR
TARSAL
A.
EXT.
MALLEOLI
ANT.
PERONEAL
BRANCH
POST.
DORSALIS
LIG,
PERONEAL
A.
A.
PEDIS
METATARSAL
EXT.
PLANTAR
ANATOMY
196
at the lower
IN A NUTSHELL.
The pubofemoral
(b)
covered by
and
acetabulum
of the
to a depression
membrane and
synovial
a n flection of
vessels.
1
The
thus making
broad
is
at
its
brim
acetabulum, making
of the
and runs
point of attachment
is
under
ligament which
The nutrient
to apoint,
5)
crossi
it
It
vessels
this ligament.
of the hip-joint
is
The
The
longus.
and
muscles
in
tri-
fibers of the
Gluteus niedius
Semimem-
magnus
maximus.
Tin abductors of this joint are the Gluteus medius, and Gluteus minimus.
and the up] r pan f tin Glut< us maximus.
Th< internal rotators an the anterior fibers of the Gluteus medius, Gluteus
'1
Ik
excepl
tin
external rotators
Th(
tin
1<
<
f<
moris.
muscles
lliacus,
to tin
tuberischii.
Bryant's triangle
tin
<
minimus, and
t<
ant*
tor su]
responding
Th(
<
to the
tor
is
a triangle
s]
in<
mad< by N<
f<
and
nn
<
a line
ts a
drawn from
mur continued.
is
and ob
Th<
nerve supply
is
PLATE LXXIII.
ILIO
INGUINAL
EXTERNAL
CUTANEOUS
\m> Parvus.
ANATOMY
198
IN A NUTSHELL.
LESSON
Knee-Joint.
The knee-joint
It is a
is
LI II.
(Plates
a diarthrodial joint
and belongs
This joint
LXXXIII.)
to the subclass ginglymus.
lias flexion,
extension,
and a
slight
Ligainentus muscles are those that cross a joint, they are also called elastic
The ligamentous muscles of the knee-joint are Biceps,
The nerve supply of this joint is the anterior crural, the obturator, the inand external popliteal.
The blood supply of the knee-joint is the anastomotica magna, the five
articular branches of the popliteal, the anterior and posterior tibial recurrent,
and the terminal branches of the profunda.
The flexors of this joint are the Biceps, the Semimembranosus, Semitendinous. Gracilis, Sartorius, and indirectly the Gastrocnemius, Popliteus, and
ternal
Plantaris.
The extensors
by the
Biceps and inner rotation by the Popliteus and Semitendinosus, and to a slight
degree by the Semimembranosus, Sartorius and Gracilis.
The knee-joint
tibia,
found bei w< en the upper pail of the tubercle and the ligament.
The second ligamenl of this set is the posterior ligament, called the ligamentum posticum Winslowii, which is broad and thin and covers the back of
is
(Plate LXXXVI.)
It has a central and two lateral portions,
the lateral portion- are attached above the condyles of the femur superiorly,
the knee-joint.
and
tuberosity of the tibia to the inner side of the upper part of the outer condyle
of the femur.
The
and
flat
and
i-
attached above
is
to the inner
is broad
condyle of the femur and below to
and
to the
PLATK LXXIY.
GLUTEUS
SPERMATIC
MEDIUS
GLUTEUS
CORD
MINIMUS
ADDUCTOR
ILIO-TIBiAL
BANO
OF FASCIA LATA
V'
lIM LIGAMENTUM
PATELLAE
The .Muscles
ix
ANATOMY
200
IN A NUTSHELL.
and one-half
inches.
(Plates
LXXXIII-LXXXVL)
The fourth ligamenl
is
of this set
is
and
is
nowa rounded
cord, being
attached above to the external condyle of the femur and below to the external
It divides the tendon of the Biceps into two
pari of the head of the fibula.
The
LXXXIV-LXXXVI.)
(Plates
portions.
fifth
is
behind and almost parallel with the long external lateral ligament and it
very indistinct, being attached above to the outer condyle of the femur and
lies
is
below
The
left
It
a capsular ligament.
is
is
thin
and
It blends
is
ments.
median
in the
1.
2.
LXXXIII.)
(Plate
(Plate
line.
tibia
LXXXY.)
Transverse ligament.
Anterior extremity of internal semilunar cartilage.
3.
4.
5.
The spine
6.
7.
8.
of tibia.
pint
terior
(Plate
LXXXV.)
The second ligament
attached
and
to a
here
of this set
of the inui
it
is
is
and inward
to
From
condyle, to the fore part of the intercondylar fossa, also to the an-
The semilunar
fibro-cartilages help to
They
portion.
The
lis
anterior extremity
to the tibia
is
its
LXXXV.)
The
anterior extremity
is
is
is
longer antero-pos-
age
is
attached
(Plate
PLATE LXXV
\\
patIllaCj
v,
V!
'
V\
PERONEUS LONGUS
GASTROCNEMIUS
SOLEUS.
PERONEUS TERTIUS
PERONEUS TERTIUS
XTENSOR
DORSAL
INTER02SB.
Muscles
ix
Front
201
oi
Leg.
BREVIS
WGITORUM
ANATOMY
202
IN A NUTSHELL.
head of the
LXXXIV.)
(Plate
tibia.
of the knee-joint
is
It ex-
tends over two inches above the joint under the extensor muscles and it passes
It covers both surfaces of
over the crucial ligaments to the head of the tibia.
the semilunar fibro-cartilages and lines the capsular ligament.
It gives
a cover-
is
a fold of this
membrane.
It
is
triangular in
shape, being attached to the intercondylar notch and extending to the patella.
The ligamenta alalia are two processes of this membrane which are on either
side of the
ligamentum mucosum.
LESSON
LIV.
is
is
of this
tibio-flbular articulation
of the Popliteus
(Plate
The middle
which
Joint.
is
LXXXVI.)
membrane
brane there
is
pass
down from
Above
it
The
fibers
this
mem-
The
is
a syndesmosis joint.
The
inferior
interosseous (igament which passes between the adjacent rough surfaces of the
tibia
and
The
fibula
is
hand
posteriorly.
is
It
triangular in shape.
is
The
posterior ligament
The
is
transverse
PLATE LXXVI.
SUPERIOR INTERNAL
ARTICULAR
ARTERY
INFERIOR
INTERNAL
SUPERIOR EXTERNAL
ARTICULAR APTERY
INFERIOR
EXTERNAL
ARTICULAR ARTERY
ARTERY
ARTICULAR
ANTERIOR
TIBIAL
RECURRENT ARTERY
GASTROCNEMIUS
LONGUS
H
SOLEUS
til
\S
')'i^^
l"-i
BREVIS
TERTIUS
INTERNAL
ARTERY
MALLEOLAR
M
>EDIS
ARTERY-
-AfilMLARi.
[^ Hh'
TENDON
OF
BREVIS
DIGITORUM
EXTENSOR
TARSAL BRANCH
.
METATARSAL 3RANCH
COMMUNICATING BRANCH
DORSALIS
HALLUCIS ARTERY
ANATOMY
21)4
of
two main
parts.
internal malleolus
IN A NUTSHELL.
and by
its
which
is
attached by
its
apex to the
and the
The first is an
external
which
front
of
malleolus and
between
the
the
passes
anterior fasciculus
external lateral ligament consists of three portions.
The
The second
is
calcis.
is
joint.
It
reflected
articulation.
from the
to the
is
is
ous.
LESSOX
Tin. Joints of
the Tarsus.
WIE.XTS
is
l.V.
(Plates
LXXXVII-LXXXVIII.)
an enarthrodia!
BETWEEN THE
and peroneal.
<
>S
joint.
(3)
'
(2)
l.l.X THE ASTRAGALUS AXH THE SCAPHOID THERE IS RUT ONE LIGAMENT.
The superior or dorsal astragalo-scaphoid ligament.
Till. LIGAMENTS BETWEEN THE SCAPHOID, CUBOID, AND THE THREE CUNEIORM are:
Ib.TU
1
(1)
-'
(3)
1
(5)
The plantar ligaments are similarly arranged upon the bottom of the
foot.
PLATE LXXVII.
GASTROCNEMIUS
INNER HEAD
SEMI-MEM3RAN0SUS
POSTERIOR
PERONEJS
TIBIAL NERVE
LONtiUS
Muscles
in
ANATOMY
206
(7)
IN A NUTSHELL.
There are four strong interosseous ligaments passing between the rough
(3)
(4)
There
plantar.
margin
of the peroneal
groove of the
Sonic of the fibers pass over the sheath of the tendon of the Peroneus
cuboid.
longus and are attached to the bases of the second, third, and fourth metacarpal bones.
The
uii
the under surface of the os calcis to the under surface of the cuboid behind
(2)
(3)
tarsal.
(2)
The middle one passes between the external cuneiform and the second
metatarsal.
(3)
third meta-
tarsal.
There auk
(1)
(2)
One
One
six
(4)
One
(
for the
calcaneo-cuboid artciulation.
me
()'))
One
>et
for fourth
in-
terosseous Ligaments!
The
digital
connect- the
firsl
PLATK LXXVUIGLUTEUS
MINIMUS
OBTURATOR
INFERIOR
NERVE
INTERNUS
SMALL
ARTERY
PUDIC
GLUTEAL
PUDIC NERVE.
nglj
SCIATIC
SCIATIC
ARTERY
-- COCCYGEAL BRANCH
TUBERISCHII
GLUTEUS MAXIMUS
INFERIOR PUDENDAL
ADDUCTOR MAGNUS
DESCENDING CUTANEOUS
GRACILIS
EXTERNAL
POPLITEAL
OR
PERONEAL
NTERNAL
POPLITEAL
SOLEUi
POSTERIOR
TIBIAL
NERVE
SOLEUS
PERONEAL ARTERY
INTERNAL CALCANEAN
PLANTAR
Posterior View
207
<k
Entire Leg.
CUTANEOUS
ANATOMY
208
IN A NUTSHELL.
LESSON
Lumbar Plexus.
The lumbar plexus is made of
third,
and
lies in
(Plates
LXIII-LXXIII.)
nerve scuds
LVI.
communicating branch
to the
first
lumbar nerve.
magnus muscle
first,
The twelfth
in front of
second,
dorsal
This plexus
the transverse
lumbar vertebrae.
lumbar nerve divides into two branches, the ilio-hypogastric and
The ilio-hypogastric nerve passes through
(Plate LXX11I.)
the ilio-inguinal.
Psoas
magnus in front of the Quadratus iumborum and
the outer border of the
behind the kidney and the large intestine. It pierces the Transversalis muscle
at the outer border of the Quadratus Iumborum to enter the areolar tissue between the transversalis muscle and the Internal oblique. At this point it freIt divides into a hypogastric
quently joins the last dorsal and inguinal nerve.
branch
hypogastric
passes between the TransThe
branch and an iliac branch.
downward and gives
muscles
forward
and
versalis and the Internal oblique
joins
ilio-inguinal
It
the
nerve and pierces
of
these
muscles.
branches to each
anterior
superior
spine
of the ilium and
near
the
the Internal oblique muscle
of
aponeurosis
the
the median line.
External
oblique
towards
passes beneath the
about
an inch above
of
External
oblique
muscle
aponeurosis
the
It pierces the
to
skin over the
cutaneous
the
abdominal
ring
and
.becomes
supply
the externa]
muscle
pierces
both
Internal
oblique
and the
iliac
branch
the
The
symphysis.
The
point
pierces
the
External
muscle
is
where
it
oblique
Externa] oblique.
front
middle
It
supplies
little
its
portion.
crest
a
in
of
of the ilium
above the
the integument near the Gluteus medius muscle and the Tensor fascia femoris.
The ilio-inguinal nerve passes out of the Psoas magnus muscle a little below
the hypogastric, and thin crosses the Quadratus Iumborum to pass behind the
large intestine, after which it crosses the inner lip of the crest of the ilium posIt now takes a forward course on the upper part of the Iliacus muscle
teriorly.
processes of the
The
first
where
1n'
it
female.
from the
firsl
artery
at
spermatic cord
iliac
Poupart's ligament.
in
artery ami
It
now
it
in
the female.
The Cremas-
PLATE LXXIX.
PtANTARIS
INNER HEAD
BICEPS
OF GASTROCNEMIUS
TENDON OF SEMIMEMBRANOSUS
TIBIALIS
POSTICUS.
PERONEUS
POSTERIOR TIBIAL
NERVE
POSTERIOR TIBIAL
ARTERY
BREVIS
TENOO
ACHILLIS
ANATOMY
210
IN A NUTSHELL.
tciic
muscle
is
the
is
external cutaneous,
which
lumbar nerves.
border of the Psoas magiius muscle it crosses the Iliacus muscle, prior to this
pa>ses behind the caecum on the right side and the iliac colon on the left.
it
of the ilium
it
in
It
now
and a posterior
BRANCH, after passing in the deep fascia for about
becomes cutaneous, and most always divides into an external
it
Tin: anterior
brunch.
four inches,
branch which supplies the skin of the lower half of the outer side of the thigh.
and an internal branch which is distributed to the skin of the outer side of the
The posterior branch supplies the integument of the outer side of the thigh from the greater trochanter to the middle
of the thigh.
The
patellar plexus
internal cutaneous
LESSON
Tlu
largesl
LVII.
n<
It
ond, third, and fourth nerve, and after passing through the outer border of the
Psoas
the Psoas
lit
it
io the
magnus.
of the P>o;i>
twi
which pass<
Hue
it
it
is
separated by part
supply the Pectineus and Sartorius muscle and give off two cutaneous branches,
middle and internal. The deep branches supply the Iliacus. the Rectus
femoris, Vastus interims. Vastus externus, Crueus
is cutaneous.
This anmuscles on the front of the
except
tin Tensor fascia femoris, and in its place it supplies the Iliacus of
abdominal
It
the deep
region.
supplies the Pectineus of the internal femoral
The nerve to the Pectineus passes behind the femoral sheath and in
region.
fiont of the Psoas magnus to end in the anterior surface of the Pectineus.
The
nerve to the Sartorius ends in the upper part of the muscle.
The middle
leg
<
utaneoi
- \i
Sartorius and
u\
it
i;
nt( r into
an
ai
divides into two branches, the outer one of which pierces the
and the two pass down as far as the knee-joint where they
Tin; internal
cutaneous branch
divides into
side of
PLATE LXXX.
THORACIC
MUSCULOCUTANEOUS
SHORT
SAPHENOUS
EXTERNAL
PLANTAR
S IHUSLULUCUIANbOUS
INTERNAL CALCANEAN
ANTERIOR
internal plantar
TIBIAL
ANATOMY
212
IN A NUTSHELL.
canal.
lies
in
LESSON
Sacral Plexus.
The
first,
the
fifth
This plexus
(A)
formed by
is
a part of
and
lumbar nerve.
is
situated
LXIII-LXXIII.)
is
(Plates
sacral plexus
branches of the
LVI1I.
viscera]
fascia
<
branches,
(B)
its
muscular.
branches.
iliac artery.
It
ANATOMY
IN A NUTSHELL.
213
Under (A) visceral branches, we have branches to the pelvic viscera from
Under (B) muscular branches.
third, and fourth sacral nerves.
second,
the
from
first and second sacral nerves.
comes
the
Pyriformis
the
nerve
to
The
(1)
This nerve leaves the pelvis through the great sacro-sciatic foramen, and after
crossing the spine of the ischium enters the Pyriformis muscle on its internal
surface.
PLATE LXXX1.
is
fifth
lumbar and first sacral nerve. It leaves the pelvis above the Pyriformis muscle
and
with the gluteal vessles. It supplies the Gluteus medius, Gluteus minimus
which
are
gray
branches,
Tensor fascia femoris. It also sends sympathetic
nerve.
rami, to the bone, ligament, fascia, and vessels - see sympathetic
ANATOMY
214
IN A NUTSHELL.
(3) The inferior gluteal nerve is derived from the fifth lumbar, first
It leaves the pelvis below the Pyriformis muscle
and second sacral nerves.
It gives muscular branches to
with the sciatic and pudic vessels and nerves.
the
Huteus maximus.
(4)
The nerve
lumbar, and
muscle.
first
to the
sacral
Quadratus femoris
nerves.
It
is
fifth
sends a branch to the Gemellus inferior, and also one to the hip-
It
joint.
The nerve i< the Obturator interims is derived from the fifth lumbar,
and second sacral nerves. It leaves the pelvis below the Pyriformis muscle and re-enters the pelvis through the lesser sacrc -sciatic foramen to be disIt gives a branch to the Gemellus
tributed to the inner surface of this muscle.
i.")i
tirst
superior.
and perineum.
One
the thigh.
Third; Gluteal or ascending cutaneous branches to supply the skin
over the lower and outer part of the Gluteus maximus.
(2)
is
It
It
haves the pelvis below the Pyrifomis muscle. It now crosses the
nerves.
spine of the ischium, being on the inner side of the internal pudic artery, which
it
it
lesser sacro-sciatic
passes through the inner wall of Alcock's canal towards the anus to supply the
ANATOMY
IN A NUTSHELL.
215
passes through the deep perineal space along the inner margin of the ramus of
It now pierces the anterior layer of the triangular ligament,
between the cms penis and the pubic hone, and gives a vaso-motor branch
corpus cavernosum, and passes to the dorsum of the penis to supply the
integument, glans and prepuce in the maleor clitoris in the female.
It is called
the dorsal nerve of the clitoris in the female and is much smaller.
Lying
to the
PLATE LXXXII.
Ligaments of Hip-Joint.
LESSON LIX.
Under (E) great sciatic nerve and its branches we have, (Plate LX Will.)
(1) The great sciatic nerve and its branches which supply both muscles ami
integument below the knee-joint but muscles only above this joint.
plies thirty-seven muscles in all.
It isthe largest nerve in the body and
It
is
sup-
a con-
tinuation of the sacral plexus, except the fourth sacral nerve, since thegreal sciatic
isformed by thelumbo-sacral cord and the anterior branches of the first, second
and third sacral nerves. After passing out of the pelvis below the Pyriformis
muscle
It
may
it
passes between the great trochanter and the tuberosity ^i the ischium.
It generally divides at the lower one-
third of the thigh into an external popliteal or peroneal and an internal popliteal
or popliteal nerve.
leaves the pelvis.
This division
In its course
may
down
LXXVIII)
it
ANATOMY
216
upon the
lies
IX A NUTSHELL.
its
course
it
is
branches
it
divides
it
gives, (a)
its
lower
articular
t<>
ri. ak
(b) MUS<
Before
ami third
LXXVII.)
(Plate
sacral.
This
muscle
arm
on
it
is
in that
its
is
it
It
to the knee-joint
of the Popliteus
lies at first
inner side.
It is like
number:
in
first,
Muscular branches
(2)
and
Soleus.
(3)
joins the
communicans peronei
to
form
the short saphenous nerve, which supplies integument on the posterior part of
the Leg and on the outer side of the foot.
it
(4)
(Plate
just the
LXXVIII.)
lower part of the leg these posterior tibial vessels and the nerve
cular
The
lie
In the
parallel
(1)
with
mus-
to
Internal calcanean (cutaneous) which passes with the inIt supplies the integument and fascia of the heel and
a part of the sole.
(3) Articular branches to the ankle.
(4) Internal
axd external plantar nerves, which are formed by the division of the posdigitorum.
(2)
arteries are just the reverse. the external being Larger than the internal.
It
face of the
and
also supplies
(Plate
fo.t.
Abductor
The
hallucis, (2)
in-
Flexor
LXXXI.)
following fourteen
muscles. (1) Abductor minimi digiti, (2) and (3) the two
outer Lumbricales, (4) Flexor accessorius, (5) Flexor brevis minimi digiti. the
seven [nterossei
1
make
twelve. (13)
the
Adductor transversus
hallucis.
and
ANATOMY IN A NUTSHELL.
217
LESSON LX.
The
external popliteal or peroneal nerve passes along the outer part of the
popliteal space close to the tendon of the Biceps muscle as far as the
fibula.
head of the
(Plate
gives (1)
It
ex-
PLATE LXXXIIL
INTERNAL TUBEROSITY
which begins on the head of the fibula and passes down between the Peronei
muscles and the Extensor brevis digitorum pierces the deep fascia a1 the lower
This nerve supplies the I'erone-third of the leg on its front and outer side.
oneus Longus, Peroneus brevis, and the integumenl mi the dorsum of the foot.
of the nuiselilo-rutaneous nerve passes in
passes to the inner side of the great toe and sends twigs to the integumenl on
to the
ANATOMY
218
IX A
NUTSHELL.
between the second and third toes and divides to supply the adjacent sides of
the cleft.
is
of the toot
and divides
into
two branches.
The
The outer one supplies the integument on the adjacent sides of the fourth
toes.
The outer side of the fifth toe receives the short saphenous
toes.
and
dorsum
fifth
nerve.
The
itorum
to lie
membrane with
where
it
branch.
toes.
It
It
metatarso-
It
The
muscular branches
to Tibialis anticus.
Extensor longus digitorum, Extensor proprius hallucis, Peroneus tertius, Extensor brevis digitorum, and as said before helps to supply two inner Dorsal
interossei.
(2)
Its
LESSOX LXI.
Thk Superficial
the
layers are
die superficial
vessels
and nerves.
of the leg
deep layers.
This fascia
is
beneath
ANATOMY
fascia
IX A
NUTSHELL.
number
<>f
vessels.
219
This fascia
The
is
perforated by the
intimate attachment to the deep fascia below Poupart's Ligament, thus in extravasation of urine,
it
PLATK LXXXIV
TENDON OF ADDUCTOR MAGN05
PLANTARIS
OUTER HEAD OF
GASTROCNEMIUS
NNER HEAD OF GASTROCNEMIUS
TENDON
OF
POPLITEUS v
EXTERNAL LATE"al
'
m\
LIGAMENTS
'
Q *^^^ fl
TENDON OF BICEPS
.;:.*7V-
SLIP
TD
THICKENED
THE
POSTERIOR
LIGAMENT
f4
mi
/HEAD P
'
'
POSTERIOR SUPERIOR
TIBIOFIBULAR
LIGAMENT^
,',|
\\\ }
T B A
'
'
INTEROSSEOUS
MEMBRNE
is
and form-
strong cover-
It is thick in front
beneath the skin and superficial fascia.
and externally, but thin behind and internally. The Gluteus maximus, the
Tensor fascia femoris, the Biceps, the Sartorius, and Quadriceps extensor musThe fascia lata is attached to Poupart's
cles give expansions to the fascia lata.
ligament and the body of the pubic bone anteriorly, to the tuberosity of the
ischium and the rami of the pubes and ischium internally, to the back of the
sacrum and coccyx posteriorly, to the head of the fibula, tuberosities of the
tibia, and condyles of the femur distally.
The external Intermuscular septum
ANATOMY
220
IN A NUTSHELL.
attached to the linea aspera and extends from the insertion of the Gluteus
maximus to the outer condyle of the femur. It separates the Vastus externus
is
from the short head of the Biceps and gives attachment to both of these musThe internal intermuscular septum is attached to the linea aspera and
cles.
extends from the lesser trochanter to the adductor tubercle, thus separating
This intermuscular
the Vastus in tenuis from the Pectineus and Adductors.
is perforated by branches of the profunda artery which pass to the
hamstring muscles and by the superficial femoral artery which passes into the
Smaller septa
popliteal space through an opening in the Adductor magnus.
septum
The
ilio-tibial
medius muscle and divides at the anterior border of the Gluteus maximus to
The iliac portion of the fascia lata is behind the femoral vessels but
enclose it.
This portion is attached to the crest of the ilium
whole length of Poupart's ligament and to the ilio-pectineal line with
Gimbernat's ligament where ^continuous with the iliac fascia. The pubic portion of the fascia is attached above to the ilio-pectineal line.
It passes beneath
the femoral vessels to which it is attached and crosses the Gracilis, Adductor
and
to the
and
It is
half
portion.
LESSON
LXII.
beneath
it
i-
is
AXATOMY
of the fibula.
ankle.
It is
Below
it is
thin where
it
IX A XUTSHELL.
221
Tibialis
PLATE LXXXV.
APERTURE LEADING INTO THE
QUADRICEPS EXTENSOR.
BURSA
BENEATH
THE
ATTACHMENT OF CAPSULAR. OR
'
ANTERIOR
LIGAMENT
TO
FEMUR
POSTERIOR CRUCIAL
LIGAMENT
EXTERNAL LATERAL
LIGAMENT
EXTERNAL
SEMILUNAR
ANTERIOR CRUCIAL-
LIGAMENT
INTERNAL
INTERNAL
SEMILUNAR
LATERAL
LIGAMENT
TRANSVERSE
LIGAMENT
The
LXXV.)
consists of
inferior or
horizontal
two portions,
portion.
The
superior portion passes across the front of the leg between the anterior borders
ANATOMY
222
IN A
XITSHELL.
and the fibula just above the malleoli and binds down the extensor
tendons as they descend on the front of the tibia and fibula. The inferior
portion begins on the outer side of the calcaneum and divides into two layers
of the tibia
the outer border of the Peroneus tertius, one passing in front, the other be-
at
hind ami
at
a canal
which passes upward to be inserted in the front of the internal malleolus and
the other passes across to be inserted on the scaphoid
bon<
fascia.
The tendon
PLATE LXXXYI
EXPANSION FROM QUADRICEPS EXTENSOR TENDON
ANTERIOR CRUCIAL
POSTERIOR
CRUCIAL LIGAMENT
in
is
and
also
one
in
of
lus
in
a single synovial
(Plate
LXIX.)
over which
it
down
membrane.
passes into canals for the passage of the tendons of the flexor
hallucis.
Each
of these canals
ANATOMY
The
and
fascia
on the
the densest of
is
IX A
all
is
223
NUTSHELL.
It
is
tions.
(1)
is
PLATE LXXXVII.
IIBin- FIBULAR
LIGAMENT.
LIGAMENT.
ANT
ANTERIOR
LIGAMENT
OF
INF
ANKLE
DORSAL
DORSAL
FASCICULUS
OF
LIGAMENTS
SCAPHO-CUNEIFORM
INTER CUNEIFORM-LIGAMENTS.
EXT.
* WV
LATERAL LIGAMENT
(POST. FASCICULUS)
TENDO ACHILLIS
DORSAL TARSO- METATARSAL LIGAMENTS
MIDDLE FASCICULUS OF
EXTERNAL LATERAL LIGAMENT
INTERNAL CALCANEOCUBOID LIGAMENT
LIGAMENT
DORSAL CALCANEOCUBOID
INFERIOR
Ligaments of Ankle
tenia] portion
io the
which
is
ductor minimi
digiti.
External
View.
thin in front
and with the central portion of the plantar fascia. (3) The internal lateral
Posteriorly it
portion covers the Abductor hallucis muscle and is quite thin.
is attached to the internal annular ligamenl and continues around the side of the
foot with the dorsal fascia, and e\l< rnally with the middle portion of the plantar
fascia.
ANATOMY
224
IX A NUTSHELL.
REVIEW QUESTIONS.
1.
2.
3.
4.
.">.
(').
How many
How many
Name
muscles
of
in
them
7.
Nerve
8.
9.
10.
11.
12.
13.
to the
it supply?
Nerve to Obturator interims comes from which ones?
What other muscle does it supply?
PLATE LXXXV1II.
DORSAL ASTRAGALO- SCAPHOID LIGAMENT
DORSAL AND
INT.
INT.
LATERAL TARSO-
METATARSAL
DORSAL AND
INT.
LIGAMENT
LATERAL METATARSO-
PHALANGEAL
DORSAL AND
LATERAL
LIGAMENTS
INTERNAL
INTER
PHALANGEAL
OS CALCIS
LIGAMENTS
TIBIO-ASTRAGALOID
INF.CALCANEO-
LIGAMENT
scaphoid ligament
Ligaments of Ankle
1
1.
Wha1
]>:i>ses
Internal View.
15.
What muscle
16.
17.
18.
19.
20.
21.
22.
_':;.
24.
_'.">.
26.
27.
How
How
How
How
the acetabulum?
ANATOMY
28.
29.
30.
IN A NUTSHELL.
225
31.
33.
34.
35.
36.
37.
38.
39.
40.
How
How
How
How
How
What
Name
Name
ankle?
41.
42.
Name
47.
48.
Name
Name
49.
Bound
50.
Who
Scarpa's triangle.
was Scarpa?
Italian Anatomist.
51.
Give the
52.
What
53.
How
1747-1832.
He was
physician to Napoleon.
long
is
the
common
femoral artery?
what branch?
Passes through what canal?
Then through what space?
Then gives off what branches?
Where does this division take place?
58.
what muscle?
60. Anterior tibial continues
61.
(i2.
The
The
it
passes
into
the plantar
64.
(if).
()7.
Name
Leg.
68.
It
divides into
what branches?
PLATE L XX XIX.
TALI
PES""
CAVUS-OR-ARC^U
TAL
P E S
E~QU INO-VALG.U'S*
Forms of
Cub
220
Foot.
TUS
ANATOMY
70.
The external
The anterior
71.
What
69.
IX A NUTSHELL.
what
tibial supplies
227
what branches?
muscle-'.'
75.
76.
From what
77.
How
78.
80.
The
The
The
81.
How many
82.
Xame
Xame
72.
73.
74.
79.
83.
is
plexu.-?
those
it
layers.
85.
What muscle
88.
89.
90.
92.
What
What
93.
94.
95.
91.
96.
97.
98.
The common
The internal
100.
Xame
Xame
101.
The external
102.
What
99.
common
femoral artery.
iliac
iliac
continues as what?
iliac
structures
]>a>-
foramen?
103. What passes through the obturator foramen?
sciatic
104.
What
is
105.
Xame
loti.
What
107.
108.
What
Who
i'.i.
Lived 1661-1709.
was Hunter?
ANATOMY
228
112.
WhyJ
113. Give
114.
115.
116.
called popliteal?
contents.
118.
Why is the
How many
Hi).
117.
IN A NUTSHELL.
Plantaris so called?
bones
in
the foot?
PLATE
XC.
LEFT
PHRENIC
HEPATIC
GASTRIC
ARTERY
-SPLENIC ARTERY
LEFT SUPRARENAL
RENAL ARTERY,
RENAL VEIN
SUPERIOR
MESENTERY,
'
SPERMATIC VEIN
SPERMATIC
ARTERY
EXTERNAL
MESENTERY ARTERY
ILIAC^
'
^INTERNAL
ILIAC
l_'l.
Describe the
122.
J.'!.
ilio-tibia)
leg.
band.
foot?
L24.
125.
Why
120.
called
saphenous?
sole of
the
ANATOMY
127. Describe
IN A NUTSHELL.
229
Poupart's ligament,
PLATE
X(T.
SUPRARENAL CAPSULE
LUMBAR GLANDS
COMMON
ILIAC
ARTERY
SACRAL GLANDS.
t!
EXTERNAL
ILIAC
INTERNAL ILIAC
GLANDS.
GLANDS
V
LYMPHATICS
its
OF
PENIS
Terminal Branches.
What
WAToMY
230
:'.'_'.
IX A
NUTSHELL.
L36.
137.
The length
133.
134.
135.
of the
femur
is
138.
139.
li).
141.
tin
l'_\
What
13.
Why
II.
lo.
Hi.
so called?
The
what nerves?
149.
50.
151.
152.
153.
154.
1.").").
156.
Name
Why
does the
arm admit
of greatf r
157.
158.
159.
Name
160.
What
is
ltd.
attached to each?
Same
io the os
innominatum.
for femur.
171.
Same
Same
Same
Same
Same
Same
Same
172.
165.
166.
167.
L68.
169.
170.
for
fibula.
for tarsus.
for
metatarsus.
for
phalanges.
tor patella.
for
sacrum.
for coccyx.
7:;.
rive
17-1.
176.
and attachment
of
mus-
ANATOMY
231
IN A NUTSHELL.
what branches?
PLATE
XCII.
STERNO-MASTUIU.
INTERCLAVICULAR NOTCH.
COSTAL
APONEUROSES
OF
ABDOMINAL
CARTILAGE
MUSCLES.
181.
Which
Which
is
the larger
is
the larger
ANATOMY
232
IN A NUTSHELL.
186.
LESSON
The Thorax.
LXIII.
(Plate
XC1V.)
The thorax
is
tilages.
is formed by
and the upper margin
The upper border of the manubrium is on a
of the manubrium anteriorly.
In the female the sternum is shorter
level with the second dorsal vertebra.
than in the male, the ribs more movable, and the thorax is smaller. The upper
margin of the manubrium is on a lower level than in the male. There are forty
the
first
of the thorax
is
structures
passing
The
innominate,
internal
(2) left
colli
There are
the thorax.
common
mammary and
(6)
carotid
and
(7)
and
(3) left
(1)
There are
and (2) the two Pneumogastric, (3) and (4) the two phrenic, the six cardiac and the two sympathetic
nerves, the anterior branches of the two first dorsal nerves, and the recurrent
laryngeal nerve of the left side make fifteen.
The veins that pass through this
superior opening are the right and left innominate and the inferior thyroid
veins, making four veins.
There are eight unclassified structures that pass
through this opening in the thorax: Remains of thymus gland, trachea, oesophagus, thoracic duct, apex of each lung, and pleurae.
Then the six muscles,
fifteen nerves that
(1)
fifteen nerves, seven arteries, four veins, and eight unclassified structures make
the forty structures which pass through the superior opening of the thorax.
The Lower opening of the thorax is widest transversely and slopes downward and backward. It is formed by the last dorsal vertebra posteriorly, and
the seventh to the eleventh costal cartilages laterally, and the ensiform cartilage anteriorly.
The Diaphragm separates the thoracic cavity from the
abdominal cavity.
ANATOMY
IN A XUTSHELL.
Diaphragm.
is
(Plate
233
LXXII.)
a partition wall.
It is
musculo-fibrous septum, situated between the upper one-third and the lower
two-thirds of the trunk.
cavity/
It is
It
PLATE
its
general shape
XCTII.
CLAVICULAR NOTCH
STERNO
HYOID,
FIRST
TRIANGULARIS
COSTAL
CARTILAGE
STERNO THYRO
STERNI
ENSIFORM APPENDIX
somewhat
of
it is
like that of
The
Its
circumference
highest part of
all
is
elliptical in
the diaphragm
od the
righl
side
ANATOMY
immediately above the
lowest part of
it
is
1
This
liver.
has
its
is
NUTSHELL.
a litth
the righl
is
IX
p( ritone
origin in
frorrt
um.
from
th<
is
<
left
The
from the under surfaces of the cartilages and bony portion of the six or
sides,
with
The
side.
lumbar vertebra.
last
one
is
the Quadratus
lumborum.
is
Behind
the longer
first
one
is
el
internum.
the covering of
ii
tin
<
mean
diaphragm the
midriff,
The
ANATOMY
phrenic
plexus
NUTSHELL
235
situated near
the diaphragm.
The former behind the
formed by branches from it. These plexus or plexuses
the great sympathetic system, which govt rns tl
ritary actions.
are
IV A
latter
PLATE XClV.
FLOA-
Boxes of
he Thorax.
blow on the head may knock a man senseless bul he Mill lives.
still ad. being governed by the sympathetic system,
but
receive^ a severe blow upon the diaphragm it may
produce instant death.
ere
if
His
if
he
The
ANATOMY
236
IN A NUTSHELL.
killed
and grows from the circumference to the central tendon. All mammals or
Man and horse are examples of land
milk-giving animals have a diaphragm.
animals, the whale and the sea cow are examples of water animals which have
diaphragms. Birds possess a rudimentary form, which is best shown in the
abteryx.
LESSON LXIV.
The muscles which help the Diaphragm in
and (3) The
major
(?)
(4)
Rhomboideus major,
(7)
(2)
(5)
Rhomboideus minor,
(1)
Serratus magnus,
(9)
(6)
Sterno-
lumborum.
is
The sternum (Plates XCTI-XCIII.) is about six inches long and is situated
median line of the thorax in front. It is flat anteriorly and concave posteriorly.
It is broadest above and pointed below, and constricted at the junction of the manubrium with the gladiolus.
The manubrium or first piece of the
sternum is narrow below, but broad above. The anterior surface of the manubrium is concave vertically but convex transversely. The Pectoralis major
in the
second
rib.
the gladiolus.
verse lines, indicating the original divisions of the gladiolus into four portions,
pass from the third, fourth,
lines are not so well
ANATOMY IN A NUTSHELL.
and gives attachment
237
The
lateral border
of the gladiolus articulates with the cartilages of the second, third, fourth, fifth,
sixth,
and seventh
rib;
cartilages articulate
manubrium
The ensiform appendix, cartilaginous hi youth but is partly ossified above
The chondro-xiphoid ligament is attached to its anterior surface,
in the adult.
while the Diaphragm and the Triangularis sterni are attached to its posterior
with the
surface.
of the
below or
bifid
may
it
rib.
Its
apex may be
alba.
Attachment of Muscles:
Pectoralis
major,
Nine
Sterno-cleido-mastoid,
pairs
and one
Sterno-hyoid,
single
muscle.
Sterno-thyroid,
The
Tri-
PLATE XCV.
LATERAL MASS
COSTOTRANSVERSE
FORAMEN
SURFACE
FORAMEN FOR
VERTEBRAL ARTERY
The Atlas
annularis sterni, aponeurosis of the External oblique, Internal oblique, Transversalis,
Ossification:
sixth month.)
From
One
six
centers.
One
for the
manubrium (fifth or
The ones
the gladiolus.
for the
first
two pieces
side.
ANATOMY
238
IN A NUTSHELL.
Blood Supply. Internal mammary arteries through its sternal and perforatum branches, also twigs from the aortic intercostal arteries.
Heart.
The covering
lu ait
it
of the heart
is
It is
from the third to the seventh costal cartilages (inclusive) and between the two
It forms a closed sac. the base of which is attached to the central
pleurae.
ward and surrounds the great vessels for about two inches. Behind the perIn
icardium are (1) the two bronchi. (2) the esophagus, (3) descending aorta.
front are
the margin of the lungs, (2) remains of the thymus gland (above),
On the sides it is covered by the
(3) areolar tissue (below). (4) the sternum.
pleura and the phrenic nerve.
The pericardium is composed of two layers, first a fibrous, second a serous.
It sends prolongations
Tin: fibrous OB external layer is strong and dense.
around the gr< at vessels which join their external coats. It also sends a diverticulum upward on each side of the ascending aorta. The one on the left side of
the ascending aorta passes between the left pulmonary artery and the arch of
The one
the aorta to the ductus arteriosus where it ends in a blind extremity.
on the light side of the ascending aorta passes between this vessel and the superior vena cava, and it also ends in a blind extremity.
This fibrous layer is attached below to the central tendon and muscular substance of the Diaphragm.
Two ligaments, the superior sterno-pericardial and the inferior sterno-pericardial, connect it with the sternum anteriorly.
Tin. serous ok internal layer consists of two portions, first a visceral,
and second a paiital. The visceral layer covers the heart and the great v< ssels
for about an inch and a half and then is reflected upon the inner surface of the
The pulmonary artery and the
fibrous layer forming the parietal portion.
aorta are enclosed in a single tube of pericardium.
Behind this tube there is a
f
passagi
p<
ricardial sinus.
iIk re
.-iin s,
lies
i-
the one
a cul-de-sac.
(.n
between the
left
is
intercostal vein
v< in
of these struc-
known
as the oblique
side
is
The
vena cava
left
partially
si le
lefl
This
left
vein,
superior
may
and downward
to the
of Marshall.
Blood Supply.
The
art<
ri<
to the
mammary
Nerve Supply. Xerxes to the pericardium are from the tenth, phrenic,
and sympath) tic. The' nerve supply to the pericardium, the heart, the pleurae,
and the lungs, is derived from these three sources. As said above' they all go
tei
the
(
|
ricardium.
sympathetic and
ANATOMY
to the heart.
IN A NUTSHELL.
239
LESSON LXV.
The heart (Plate CXXVIII.) is situated in the middle mediastinum between the spinous processes of the fourth dorsal and eighth dorsal vertebra
Its apex is directed downward and forward to the left, and lies
posteriorly.
against the fifth intercostal space three -quarters of an inch to the inn<
sid
of
PLATE XCVI.
ROUGH SURFACE
FOR
CHECK LJGAMEW.
SUP. ARTIC.
ODONTOID
PROC.
ARTIC. GROOVE FOR
TRANSVERSE
LIG.
PROC.
LAMI
SPINOUS PROC
left
The heart
lies
obliquely
behind the lower tw< -thirds of the sternum, extending about three inches to
the left of the median line and one and a half inches to the right.
Its anterior
it
ANATOMY
240
auricle but
its
or atrium which
is
large
and
lies
The
left
IN A NUTSHELL.
It
consists of
vena cava below and has postero-internally to it the left auricle. The
second pari is the auricular appendix, which is small and conical projecting forward and to the left over the root of the aorta. The inner surface of the auricle
inferior
is
smooth except
At
(Plate
pectinati.
this auricular
in
this point
it
CXXIX.)
is
constricted where
5.
in
it
diameter and
rounded by
lies
is
a fibrous ring
ventricle.
membrane and
is
It is sur-
guarded by
The foramina
minima?
is
is
large
and
directs
the blood from the inferior vena cava through the foramen ovale into the
auricle.
It
may
be present or
it
may
left
8. The coronary valve also called Thebesii is a semicircular fold of endocardium which guards the opening of the coronary sinus. This valve may be
double and it prevents regurgitation into it (hiring systole of the auricle.
9. The fossa ovalis is a remains of fetal life.
It is an oval depression lying
on the lower part of the auricular septum marking the position of the foramen
There may be a small foramen in this fossa throughout life.
ovale.
10. The annulus ovalis is a prominent margin of the foramen ovale and is
best marked above and at the sides, while below it is wanting.
11. The musculi pectinati are small muscular folds which are found in the
auricular appendix and the adjacent pari of the sinus venosum.
They end in
1
The
ANATOMY
Its walls are
heart.
IN A NUTSHELL.
241
left
ventricle,
and
it
3.
The chorda?
PLATE XCVII.
A,
U^t?
ARTIC.WVTH
ANT. ARCH 0FA7LA5.
BODY.
gins
t<>
left
7.
ber.
flaps,
one pass
the
left
to the right
The semilunar
Two
valves (Plate
anterior, (a righl
and
of the
XCXXX.)
left),
ANATOMY
242
IN A NUTSHELL.
folds of fibrous
and
free
is
where
it
directed upward.
is
The corpus
Tendinous
valve excepting a
At this point the valve consists of lining
lunula.
membrane
only.
When
the
valve closes the surfaces of the lunula come in contact and the copora arantii
Sinus of valsalva is a pouch behind each valve.
fill the interval at the center.
8.
is
a muscular
beam running
obliquely.
LESSON LXVI
The
left
an auricular appendix.
The atrium
right one.
This auricle
lies
is
two
and
The
is
left
auricular appendix
one,
or only three.
2.
side.
is
It is
The musculi
3.
side
On
4.
there
is
the auricular septum, just above the fossa ovalis of the right auricle,
an impression which is bounded below by a crescentic ridge whose con-
The
left
as thick.
It
is longer than the right and its walls are about three times
forms most of the posterior surface of the heart, all the apex, and
ventricle
left
i>
The
aortic opening
situated
3.
is
The
in
front
and
is
circular
left
and
auricle.
is
is
opening.
ventricular opening similar to the tricuspid valve on the right side of the heart,
luit
is
covered by
to
<
the right
ANATOMY
EN A NUTSHELL.
243
The smaller flap lies to the left and behind. The smaller
flaps are usually found where the two larger flaps meet.
4. The chordae tendinae are thicker, stronger, and less numerous, but have
aortic opening.
posterior,
They
and stronger
PLATE
ANT.
XCVIII.
fORAUEN FOP
VERTEBRAL ARTERY.
TUBERCLE
TRANSVERSE
PEDICLE.
PROC.
SPINOUS
PROC.
7.
in a similar
is
vestibule.
8.
losing
muscular
is
it
by endothelium.
For position of valves of the heart in reference to the chest wall, see Plate
XVII.
The structures of the heart consists of muscular fiber- and fibrous rii gs
The muscular structure called myocardium Ls formed from small striated, and
quadrangular muscular cells which have nude joined end to end to form fibers
and tend to branch, anastomosing with other cells. Some say the heart Is a
voluntary muscle because it has striated fiber-, but l1 is governed by the symi
The
making
it
involuntary
in
left
action.
side than on the right.
Thev
ANATOMY
244
IN A NUTSHELL.
left auricle
in
left
side
and
is
the right,
Blood Supply. The arteries are the right and left coronary. The right
coronary artery arises from the anterior sinus of valsalva and passes forward
between the pulmonary artery and the auricular appendix. From this point it
runs in the right auriculo-ventricular groove to the posterior interventricular
groove, and here
it
comes from
margin
and
right ventricle
It also
The coronary
tricular groove.
may
there
arteries
common
(Plate
trunk and
CXXVII.)
auricle.
righl
The
1.
anterior cardiac vein, also called great cardiac vein, ascends from
the apex of the heart to the base of the ventricle in the anterior interventricular groove.
opens
at
valves,
It
turns to the
left
the back of the heart into the great coronary sinus where
it
it
and
has two
auricle.
2. The middle cardiac vein ends in the great coronary sinus after running
from the apex of the heart to its base in the posterior interventricular groove.
It has one valve at its orifice and it drains the posterior part of both ventri-
cles.
:;.
The
left ventricle is drained by the left or poswhich empty into the great coronary sinus.
or anterior cardiac veins receive the blood from the anterior
The
right
surface of the right ventricle and open separately into the lower part of the
The
righl auricle.
of the heart,
is
largest
5.
The
right or
auricle
and
right
and end(').
in
The
vein which
ventricle
and
it
runs
in
left
is
culo-ventricular groove.
It
receives
the
veins just
mentioned and
also
an
ANATOMY
IX A NUTSHELL.
245
oblique vein from the back of the left auricle which is the remnant of the obliterThis great coronary sinus ends in
ated left vena cava called duct of Cuvier.
the right auricle between the inferior vena cava and the auriculo-ventricular
The opening of this sinus is guarded by a semilunar fold of the lining
opening.
membrane
Venae Thebesii are minute veins which drain the cardiac muscular substance and open directly into the right auricle by the foramina of Thebesii.
7.
LESSON LXVII.
Nerve Supply. The
PLATE XCIX.
UPPER INTERVERTEBRAL NOTCH
SUP.ARTICPROC'S.
TRANSVERSE
PROC'S.
A Dorsal
1.
From nerve
cells
buried
in its
as the intrinsic
ganglia.
2.
3.
From
From
The
intrinsic ganglia
is
and arteries
tor
is called diastole.
and thus carrying on circulation. The expansion
lower in pitch
duration
and
The heart has two sounds. The first is longer in
ventriplace
take
which
during
sounds
than the second. It is made by those
blood
of
rushing
through
cular systole.
(1) Muscular contractions. (2) friction
of the hearl
ANATOMY
24')
the
s<
IN A NUTSHELL.
n.ilunar valves, (3) friction of the heart within the pericardium, (4) fric-
It is
of
norma]
hi art
valves.
The
first
sound
is
ond sound
is
more
easily
median line of the sternum between the fourth costo-sternal articulations. The
sound of this valve is best heard at the base of the ensiform cartilage.
The aortic valve is situated behind the left edge of the sternum on a level with
the lower border of the third rib, and although this valve is on the left side of
the heart we listen to its sounds in the second right or aortic interspace
where they are conveyed. The pulmonary valve is situated behind the junction of the third costal cartilage with the sternum, and although it is situated on
the righl side of the heart its sounds are best heard in the second left or
pulmonary interspace where the sounds are conveyed.
The mitral valve is situated between the left edge of the sternum and the
third and fourth costal cartilages.
We listen at the apex for this sound.
Plate XVII.
They
are the
suprarenal capsules.
less
in
(Plates
CXXI-CXXII-CXXXII.)
spleen,
and the
"lands; the tonsils, the epiphysis, the hypophysis, the coccygeal glands
and carotid glands. A gland is an organ which secrets and pours forth fluid from
one or more ducts, and since these bodies just named have no ducts it would
seem that they could not be called glands, however they have an internal seThe thyroid gland has a duct in the fetus which leads to the base of
cretion.
This gland is very vascular and is situated upon the larynx and
upper part of the trachea. Although closely associated with the trachea, yet
it takes no pari in respiration.
It is the seat of the disease known as bron-
the tongue.
chocele or goiter.
1.
and often
pulsation,
goiter:
is
a great vascularity
pulse.
2.
Fibroid.
3.
Cystic.
Parenchymatous.
Where
This gland consists of two lobes, which are pyriform in shape, and an
The dimensions of the lobes are two inches in length, three-quarters
isthmus.
ANATOMY
of an inch in thickness,
IX A NUTSHELL.
a quarter in breadth.
247
It
extends from
the middle of the thyroid cartilage to the sixth ring of the trachea, and the
isthmus crosses the trachea about the third ring. The isthmus may. in rare
cases, pass behind the trachea in front of the oesophagus. This gland weighs
from one to two ounces. It is larger in the female and is increased in size during menstruation.
Blood Supply.
The
external carotid, supply the apex and inner and fore parts of the lateral lobes.
The
PLATE
axis,
supply the
C.
A Lumbar Vertebra.
outer and posterior portion of the lateral lobes.
on the front
anastomose with the superior and inferior thyand helps to supply the isthmus. The veins arc the superior
thyroid which empties into the internal jugular, and the middle thyroid which
empties into the same, and the inferior thyroid which empties into the innomof the trachea to
roid arteries
Nerve Supply.
From
A
rises
goiter
ami
may
falls
on deglutition.
ANATOMY
248
IN A NUTSHELL.
The Spleen.
The dimensions
aboul five ounces.
(Plate
CXLVI1.)
one by three by
five inches,
and it weighs
and an in-
MaJpighian corpuscles
of various emotions.
The
It
is
situated in the
left
hypochondriac region.
The lymphatics of the spleen are divided into a superficial and a deep
The veins of the spleen form one main vein called the splenic which empties
vessels.
set.
Nerve Supply.
The
splenic plexus
solar plexus
splenic artery.
LESSON LXVIII.
The Thymus Gland.
This gland
It
a fetal
is
is
(Plate
CXXXII.)
situated within the thorax behind the sternum near the neck.
structure and begins to disappear about the second year after birth.
of the sheep is called throat, or neck, sweet bread to distinfrom the pancreas, or stomach sweet breath This gland reaches its
highest development about the second year and its weight it is six drachms.
guish
it
Internal
veins
Blood Supply.
empty into the
mammary,
The
left
Nerve Supply.
Suprarenal Capsules.
(Adrenal Bodies.)
(Plate
CXLVII.)
ANATOMY
IN A NUTSHELL.
249
The lymphatics
of this
ment.
renal plexuses,
phrenic,
will
places.
PLATE
CI.
DORSI-SPINAL VEINS
INTERCOSTAL
INTERCOSTAL
VEI
VENAE
VEIN
BASIS VERTEBRARUM.
ANTERIOR LONGITUDINAL
MENINGO-RACHIDIAN.
Larynx.
The larynx
vocal sound
is
(Plate
It
It
is
opens by the
CXXIL)
is
pharynx and
is
is
con-
ANATOMY
250
IN A NUTSHELL.
structures as one mighl say oedema of the glottis just as he would say mouth to
The anterior part of the glottis is called glottis vocalis and is
include the lips.
hounded by the true vocal cords, while the posterior part is called glottis respiratoria and is hounded by the internal margins of the arytenoid cartilages.
The epiglottis (Plates CXXII-CXXXIV-CXXXV-CXXXVI-CXXXVIL)
i> a valve-like organ which prevents the food from entering into the glottis during
The superior or false vocal cords are two folds of mucous memdeglutition.
Inane which enclose a delicate rounded hand, the superior thyro-arytenoid
ligament. They are called false vocal cords because they are not directly conThe inferior or true vocal cords are two
cerned in the production of the voice.
strong fibrous bands, inferior thyrc-arytenoid ligament, which are covered by
They are called true vocal cords because
a thin layer of mucous membrane.
they are concerned
in
The sinus
false
the arytenoid
(excepting tin
tip)
The
tip of the
another.
The
Thyro-hyoid membrane.
Two
lateral
(Plate
CXXXIV.)
cartil-
The
Crico- thyroid
Two
Two
Two
Two
Two
membrane.
(Plate
CXXXIV.)
crico-arytenoid ligaments.
crico-arytenoid capsular ligaments.
Hyo-epiglottic ligament.
Thyro-epiglottic ligament.
(5)
(8)
posticus.
(3)
Arytenoideus,
Crico-arytenoideus
(6)
(Plate
is
Crico-thyroid,
lateralis,
Thyro-epiglottideus,
Aryteno-epiglottideus
(1)
(7)
(4)
(2)
Crico-
Thyro-aryte-
Aryteno epiglottideus
All
single muscle.
inferior.
CXXXVI.)
ANATOMY
IN A NUTSHELL.
251
LESSON LXIX.
Cricothyroid Muscle.
Origin.
Insertion.
cartilage.
of thyroid
cartil
age.
PLATE
CTI.
ANTERIOR LONGITUDINAL
WENINGO-RACHIDIAN.
POSTERIOR LONGITUDINAL.
YENINCO-RACHIDIAN
VENAE
BASIS VERTEBRARUM
This
is
all
the mus-
the larynx.
Crico-arytenoideus Posticus.
Origin.
From
Insertion.
Into the outer angle of the base of the arytenoid cartilage.
Action. It dilates the glottis bv rotating the arytenoid cartilage outward.
Nerve
Supply'.
Recurrent
Crico-arytenoideus Lateralis.
Origin.
cricoid cartilage.
ANATOMY
252
Insertion.
IN A NUTSHELL.
Action.
T<>
ward.
\i
i;\
Supply.
Recurrent
Thyro -arytenoideus.
Origin.
From the side of the angle of the thyroid cartilage and the crico-
thyroid membrane.
[nsertion.- Into the anterior surface and base of the arytenoid cartilage.
Action. Relaxes the vocal cords by drawing the arytenoid cartilage for-
ward.
Nerve Supply.
Recurrent
Arytenoideus Muscle.
Origin.
This
is
the single muscle of the larynx and comes from the pos-
running
in a transverse direc-
noid cartilages.
Nerve Supply.
Recurrent
superior laryngeal.
Thyro-Epiglottideus.
Origin.
From
arytenoideus.
Insertion.
the aryteno-
epiglottic fold.
Action.
Nerve Supply.
Aryteno-Epiglottideus Superior.
Origin. From
[nsertion.
Into the
glottic
Action.
of the larynx.
Nerve Supply.
Aryteno-Epiglottideus Inferior.
Origin.
From
[nsertion. Into the upper and inner part of the epiglottis. This muscle
separated from the superior muscle by a distinct interval.
It is often called
the Compressor sacculus laryngis of Hilton.
The Triticeo-glottis muscle is a
is
and
is
frequently present.
Its origin
and upward
is
tri-
is
PLATE
m> VC.
;,
4n
tf?
CIII.
ANATOMY
254
IN A NUTSHELL.
of the larynx.
of the
larynx receive the superior laryngeal nerves, all the remaining muscles receive
The Arytenoideus receives both
the inferior <>r recurrent laryngeal nerves.
superior and inferior laryngeal nerves.
1
Supply.
;;.oi in
superior laryngeal artery, join the superior thyroid vein which empties into the
jugular
internal
vein.
inferior
laryngeal
artery join the interior thyroid vein which empties into the innominate vein.
The lymphatics
Trachea.
(Plate
CXX.)
It is also
wind pipe and is the air passage of the body beginning at the larynx
and ending in the bronchial tubes. It is composed of sixteen to twenty cartilages or osseous rings.
The first ring is called the cricoid cartilage, and the
last one is called the pessulus.
This last one is situated at the forking of the
trachea into the right and left bronchial tubes.
The trachea is a musculomembranous tube and it communicates with the mouth and nose through the
larynx, and with the lungs through the bronchial tubes.
All vertebrates, which
breathe air with lungs, have a trachea which is subject to very little variation
in character.
The human trachea is about four and one-half inches long, extending from the sixth cervical vertebra to the fourth dorsal vertebra where it
branches into the two bronchi. The oesophagus is between the trachea and the
spinal column.
The average diameter of the trachea is about four-fifths of an
inch in the cadaver.
The antero-posterior diameter is somewhat less. Durcalled the
ing
arteries.
in
the
Nft
lie
about an inch
and
which
In
is
is
lung.
behind
it
in
its
righl one.
bronchus
right
izontal in
is
is
bronchus.
more horIt is
wider
enters the root of the lung opposite the sixth dorsal vertebra,
It
alioiii
It
and
left
an inch lower than the point whe'e the right bronchus enters
It
has above
it
pulmonary artery
is
a1
first
above, then
in
front of the
left
The
left
bronchus.
LESSON LXX.
Lungs.
Tin
(Plates
CXXI-CXXII-CXXIII.)
word Lung comes from the Latin pulmones, from which comes
pul-
ANATOMY
IX A NUTSHELL.
255
The lungs are two large organs which occupy a great part of the chest
The heart, oesophagus, and the great vessels separate them. They
are the organs of respiration in air breathing vertebrates and communicate
with the pharynx through the trachea. The air cells (alveoli) are from one
The lungs are formed by refiftieth to one-seventieth of an inch in diameter.
monary.
cavity.
The
PLATE
UPPER
_-*->
OR
in
saccular dilata-
CIV.
STELLATE
LIGAMENT
ANTERIOR COSTOVERTEBRAL
FASCICULUS.
ANTERIOR
end
FASCICULUS
MIDDLE FASCICULUS.
.OWER
finally
LIGAMENT
<
capillary
In re
net-work
the blood
is s<
in
which the
from the
parat< d
by the capillary wall and the thin alveolar epithelium of the air cells. The
is comparatively compact, being composed of air breathing tubes bound
tip by connective tissue.
Blood Supply. From the bronchial arteries which vary in number, size.
and origin. The one on the right side may conic from (1) the first aortic inof the
tercostal. (2) by a common trunk with the lefl bronchial from the f
thoracic aorta.
On the left side ther< are generally two which conic from the
air
lung
thoracic aorta.
not return
all
ANATOMY
256
IN A NUTSHELL.
is
is
The lymphatics
numerous.
The base of each lung rests upon the Diaphragm and its apex passes through
Each
the superior opening of the thorax about an inch above the clavicle.
lung is pyramidal in form and the right one is divided into an upper lobe, a
middle lobe, and a lower lobe, while the left lung is divided into an upper lobe
and a lower lobe. The root of each lung is little above the middle at the inner
side and except for this attachment the lung lies free in the pleural cavity which
The lung is elastic and always on a tension. The blood in
it completely fills.
passing through the lungs gives off carbon dioxide to the air in the alveolae and
This process which takes place in the lung is a simple physical
receives oxygen.
change and has nothing to do with any secreting or other activity of the epiiastinum empty into the bronchial veins at the root of the lung.
thelial
cells.
Nerve Supply.
in old age. The specific gravity varies from 345 to 746, water being 1000.
The serous membrane which covers the lung is the pleura (Plates CXXY-CXXVL)
Each pleura is an inclosed sac and they do not touch each other. Each has a
parietal layer called a costal, and a visceral layer called pulmonary.
The
movements of the lungs in the chest are facilitated by serous secretion in the
The parietal pleura has different names for its various portions.
pleura.
1. Tin-: costal pleura is that which lines the ribs, costal cartilages, and
black
intermediate muscles.
2.
3.
structures
4.
the mediastinum.
in
The
<
i;k\
ecal pleura
Blood Supply.
Internal
pericardiac, bronchial.
is
mammary,
dome
of the lung.
to the arteries.
The lymphatics
are numerous.
Nerve Supply.
Sympathetic
of the lung
root
and phrenic.
is
of the lung
comes together
the pleura
directly beneath
it
ANATOMY
IX A NUTSHELL.
257
forming a triangular sheet, passing vertically from the root of the lung to the
Diaphragm, and laterally from the lung to the mediastinal pleura.
The root of the lung is composed of (1) the pulmonary artery, (2) pulmonary
pulmonary plexus,
PLATE
ANTERIOR TUBERCLE
OF ATLAS
TO
CV.
IS
INSERTED
RECTUS CAPITIS
ANTICUS
MINOR
ORIGIN
THE
ORIGIN OF
RECTUS CAPITIS
AND
ANTICUS MAJOR
INSERTION OF INFERIOR
OBLIQUE PORTION
OF LONGUS COLLI
ITS INSERTION IS
posterior
pulmonary plexus,
are the
main structures
down
(7)
tissue.
in
in
in
The
first
(8)
areola!
three of these
each lung:
(Plate
CXXVII.)
In
From above
the righl one
ANATOMY
258
In Front.
IN A NUTSHELL.
(1)
Behind. (1)
vena azygos major.
Above. (1) Vena azygos major.
Below. Broad ligament (ligamentum latum pulmonis.)
Relations of the
Behind. The
In Front.
(1)
left root.
(Plate
CXXVIL)
(2)
pneumogastric nerve,
(3)
posterior
pulmonary plexus.
Above. The arch of the aorta.
Below. The broad ligament (ligamentum latum pulmonis.)
About one hundred cubic inches of air remains in the lungs which cannot
This is called residual air. After an ordinary
(Plate CXXIY.)
be expelled.
expiration one hundred cubic inches of air can be expelled by forced expiration, this is called reserve air.
About twenty or thirty cubic inches of air which
After an
passes in and out during the ordinary breathing is called tidal air.
ordinary inspiration one can inhale one hundred and twenty cubic inches of air,
which is called eomplemental air. After the complemental air has been taken
into the lungs then one may expell all the air, except the residual air, and this
is
LESSON LXXI.
A vertebra (Plate XC1X) consists of a body and an arch, the latter being
formed by two pedicles ami two laminae which support the seven processes.
The body is thick and spongy, convex in front from side to side and concave
vertically on the upper and lower surfaces which are surrounded by bony rims.
Anteriorly are small foramina for nutrient vessels, posteriorly a large foramen
for the exit of the venae basis vertebrarum. The pedicles project backward from
the body, inclining outward; they are noticed above and below, thus forming,
with the adjacent notches, the intervertebral foramina for the entrance of vesThe laminae are two broad plates meeting
sels and the exit of spinal nerves.
in the spinous process belaud and rough on the upper and lower borders for the
attachment of the ligamenta subfiava. The transverse processes, one on each
vide, project outward.
The articular processes, two on each side, superior and
inferior, project from the junction of the lamina? and the pedicles, articulating
above and below with the articular processes of the adjacent vertebrae. Their
upward
outward
the lumbar.
projects
and inward
in
which form
and
the position which they occupy, seven being found in
in
names
number, exclusive
of those
ANATOMY
IN A NUTSHELL.
259
the cervical region, twelve in the dorsal, five in the lumbar, five in the sacral,
(Plate CIII.)
in
PLATE
CVI.
SUPERIOR
OBLIQUE
ORIGIN
SPLENIUS
INFERIOR
OBLIQUE
COLLI
.INSERTION
SCALENUS MEDIUS
.INSERTION
SEMISPINALS COLLI
SCAPULAE
LEVATOR ANGULI
SPlfNIUS COLLI
SCALENUS
CERVICAUS TRANSVERSUS
MEDIUS
COMPLEXUS
LEVATOR ANGULI
SPLENIUS COLLI
SCAPULAE
SEMISPINALS COLLI
CERVICAUS TRANSVERSUS
CERVICAUS ASCENDENS
SOMETIMES
SCALENUS
MEDIUS
COMPLEXUS AND
MULTIFIDUS
SEMISPINALS COLLI
CERVICAUS ASCENDENS
CERVICAUS TRANSVERSUS
SPINAE
SCALENUS MEDIUS
SCALENUS POSTICUS
COMPLEXUS AND TRACHELO
MASTOID. MULTIFIDUS SPINAE
CERVICAUS TRANSVERSUS
CERViCALiS ASCE\0ENS
SCALENUS MEDIUS
SCALENUS POSTICUS
COMPLEXUS AND TRACHELOMASTOID.
- 3
COLLI
MULTIFIDUS SPINAE
SCALENUS MEDIUS
SCALENUS POSTICUS
COMPLEXUS AND TRACHELOMASTOID. MULTIFIDUS SPINAE
j&j*
'
,'
INTERSPINALES
MULTIFIDUS
lAND TO EACH SPINOUS
SPINAE
TRAPEZIUS.
POSTICUS
RHOMBOIDEUS
SUPERIOR.
SPLENIUS.
SERRATUS
COMPLEXUS
MINOR.
The
is
seldom
incr<
ased or diminished.
OND CERVU al
and THE SEVENTH CERVICAL Or VERTEBRA PROMINENS. (Plates XCVXCVI-XCVII.) The great modifications in the form of the atlas and axis arc
d( signed to admit of nodding and rotary movements of the head.
The peculiar vertebra* in the dorsal region are the first, ninth, tenth,
Eleventh, and twelfth. (Plate CVII.) In the lumbar region the fifth is
or AXIS,
ANATOMY
260
IN A NUTSHELL.
The peculiarity of the first dorsal is that it has one facet and a demiThe ninth dorsal has a demi-facet only. The tenth has but one facet
mi its body and one on the transverse process. The eleventh and twelfth have
The
each but one facet on the body, and none on the transverse process.
twelfth resembles a lumbar vertebra in size and shape. The fifth lumbar is much
peculiar.
facet.
deeper
than behind.
in front
Its
spinous process
is
transverse
The
I'm
To
anterior arch.
posterior arch.
To transverse
pro-
cess.
Longus Colli.
Rectus capitis posticus minor.
it.
Inferior oblique.
Superior oblique.
Splenius
colli.
Posterior intertransversalis.
The atlas
fifths of
ment of muscles
is
There
given above.
is
The attach-
the anterior arch for the articulation of the odontoid process of the axis.
process
is
teriorly, being
The
(first
This
it
Where
pos-
the
all
the
is
a diarthrosis
movements of
(Plate XCV.)
the ball-
The nerve supply is the anterior division of the suboccipital (first cervical.)
The ligaments are the anterior occipito-atlantal, posterior occipito-atlantal,
two capsular, two anterior oblique or
The
lateral occipito-atlantal.
is
(Plate CIX.)
margin of the foramen magnum, below to the upper margin of the anterior arch
The central part, which is a continuation of the anterior common
of the atlas.
The
lateral
minores muscles.
is
superficial part of
H( hind
In front of this
is
ANATOMY
IN A NUTSHELL.
261
LESSON LXXII.
The
magnum from
PLATE
is
CVII.
DEMI-FACET
BELOW
DEMI-FACET ABOVE
AN
ENTIRE FACET.
NO FACET ON TRANSVERSE
PROCESS. WHICH
IS
RUDIMENTARY
AN ENTIRE FACE1
NO FACET ON TRANSVERSE PROCESS
INFERIOR
ARTICULA PROCESS
b.
and upper margin of the posterior arch of the atlas. This ligaincomplete on each side for the passage of the vertebra] artery into,
and the suboccipital nerve from, the spinal canal.
In position ii corresponds
terior surface
ment
is
ANATOMY
262
IN A NUTSHELL.
ligamenta subflava which are below the axis but has no elastic tissue in
In front this ligament is attached to the dura mater and behind are the Rectus capitis posticus minor and Superior oblique muscles.
The two capsular ligaments are attached above to the margins of the conto the
its
composition.
dyL
of the occipital
in front of
They
to the jugular process of the occipital bone, and below to the base of the transTheir direction is forward, upward, and inward.
verse process of the atlas.
The
axis
articulation of the lower part of the atlas with the upper part of the
is
between the
artery.
first
The ligaments
are
anterior
atlanto-axial,
posterior
atlanto-axial,
The anterior atlanto-axial ligament is attached above to the anterior surface and lower border of the anterior arch of the atlas, and below to the base
of the odontoid process and the transverse ridge on the front of the body of the
In front in
axis.
It is continuous on each side with the capsular ligaments.
the median line is the anterior common ligament of the vertebral column which
is
mediately
The
in front the
Longus
colli,
It
has im-
In front
nerve.
it
is
is
lique muscle.
ligaments.
and
joint
strengthened
in
front
Each
ligaments.
The transverse ligament is a strong fibrous band passing from the tubercles
on the inner side of the lateral masses of the atlas, holding the odontoid process
in place.
It is thicker in the center and gives fibers which pass above to the
basilar process of the occipital and some passing below to the base of the odontoid process and body of the axis, thus forming a crucial ligament.
This ligament divides the canal of the atlas into two parts, a small anterior one which
is for the odontoid process and a large posterior one for the spinal cord, the spinal
acci ssory nerves, the spinal arteries, vertebral arteries, and the meninges of the
cord.
The
PLATE
CVIII.
TUBERCLE
ARTICULAR PART OF TUBERCLE
SERRATUS
CARTILAGE
Ribs.
MAGNUS
(0)
ANATOMY
264
IN A NUTSHELL.
is
Blood
and ascending pharyngeal arteries. Nerve supply, loop between the first and second cervical nerves. The part between the posterior
surface of the odontoid process and the transverse ligament is a syndesmoodontoid joint. Each of these joints has a synovial membrane. The synovial
membrane of the atlanto-odontoid is surrounded by a capsular ligament of the
same name and is continued with the occipito-atlantal capsular ligament. It
blends with the anterior occipito-atlantal, atlanto-axial, and the central odonThe synovial sac of the syndesmo-odontoid joint is surrounded
toid ligaments.
by a capsule. This sac often communicates with the occipito-atlantal synovial
supply, vertebral
sac.
The ligaments attached to the odontoid process are (1) Occipito-axial ligament (apparatus ligamentosus colli) which is a continuation of the posterior
common Ligament of the vertebral column, some of the fibers continuing to the
anterior margin of the foramen magnum to be continued by the dura mater.
This cuvcrs the odontoid process and its ligaments.
(2) Crucial ligament, the same as the transverse ligament.
(3) Two lateral odontoid or check ligaments passing from the sides of the
apex of the odontoid process to the inner surface of the condyles of the occipital
bone, their direction being outward, upward, and forward.
The
(4)
and
the foramen
magnum
is
above.
to the
It
under surface
is
of the anterior
margin of
lig-
LESSON LXXIII.
The
axis
peculiarity
Its
atlas.
is
the second
is
that
it
spinous process
To body
To spinous
Longus
process
cervical
vertebra.
It
transverse pro-
Spinalis colli
[nterspinales
Multifidus spinae
Supraspinales
Posterior intertransversalis
Transversalis
The seventh
colli
or cervicis
Scalenus medius
vical
XCVI-XCVII.) Its
body of the
in reality the
Inferior oblique
Anterior intertransversalis
cess.
is
colli
Splenitis colli
To
(Plates
cervical
is
is
called vertebra
ANATOMY
IN A NUTSHELL.
265
Its transverse process may, or may not, have the costoThe vertebral artery and vein more often pass in front
of the transverse process than through its foramen: they more often pass
through the left foramen than the right one and the vein more often than the
transverse foramina.
artery.
the
rib,
PLATE
POST. 0CC1PIT0-AXIAL
is
an analogue of
This vertebra
rib.
it.
CIX.
LIG.
VERTICAL
ACCESSORY
ATLANTO- AXIAL
LIG.
LIG.
To bodv
Longus
colli
Trapezius
.'!
capitis
f)
of hack.
Mnltifidus spina'
(i
[nterspinales
S(
mispinalis dorsi
Spinalis
colli
!>
10
Posterior Lntertransversalis
Levatores costarum
12 Thoracic region.
process
Second layer
Rhomboideus minor
To spinous process Splenius
To transverse
Scalenus posticus
13
Scalenus medius
11
ANATOMY
266
To
transverse
process.
To
art icular
process
IN A NUTSHELL.
Musculus accessories
Complexus
Multifidus spina?
Trachelo-mastoid
LESSON LXIV.
The ligaments
1.
of the vertebral
column
(Plate CIV.)
are:
common.
common.
a.
Anterior
1).
Posterior
c.
Intervertebral substance.
el.
2.
3.
4.
Capsular.
a.
5.
a.
Supraspinous.
b.
Interspinous.
The
Intertransverse.
anterior
common
ligament
is
sacro-coccygeal ligament.
dorsal region
It is
and thinnest
its
Its
make
the anterior
in the cervical.
It
is
layer passes from one vertebra to the fourth or fifth above; the second layer
adjacent vertebra?.
The
posterior
common
ligament
is
spinal canal
is
and, like
he anterior one,
ii
is
common
tervertebral substance
it
at
of
common
ligament and
ANATOMY
IN A NUTSHELL.
267
two layers; the superficial extends from one vertebra to the third or
and the deeper connect adjacent vertebrae.
The intervertebral substance or discs forms about one-fourth of the spinal
column. They conform to the shape of the bones adjacent. They are thicker
at the anterior than at the posterior border in the cervical and lumbar regions,
consist of
fourth,
PLATE
CX.
RECTUS
CAPITIS
ANTICUS
_\
MINOR
2ND RIB
SCALENUS ANTICUS
bond
They form
the
main
between the bodies of the vertebra?; they are compressible, elastic, and
In
The
central sub-
The
the adjacent
margins
common
of.
liga-
ANATOMY
268
They
rum.
thicker
in
IN A NUTSHELL.
tached above
to the inner
surface of the lower margin of the lamina of the vertebrae; below to the inner
They
of the lamina.
are continuous with the interspinous ligament at the root of the spinous
the margins of the articular surfaces; the lateral part of the ligamenta subflava
Each
in
joint
is
lined
by a synovial membrane.
These
in
and
the lumbar.
processes, extending
It
is
the sacrum.
The
They
spinales muscles.
the vertebrae; in the cervical region they are often absent, the Intertransversales
LESSON LXXV.
Each rib has the following points: (Plate CVIII.)
Head which is divided by a ridge into two facets, and these
articulate with
the facets on the bodies of the dorsal vertebrae ;the ridge giving attachment to
the interarticular ligament.
ligament;
its
its
anterior surface
Tuberosity,
at
is
its
smooth.
the junction of the neck with the shaft, has a facet for artic-
and
a rough
and nerves.
A.1
its
is
its
its
upper
external extremity
is
Angle, just
in
is
marked by
rough
line, to
which
Bach
Each
rib
is
developed
in
one for the head, one for the shaft, and one for
PLATE
BIVENTER CERVICIS
TRACHELO
SCALENI
MASTOID
VERTEBRAL APONEUROSIS
OBLIQUE
INTERNUS
ORIGIN
OF
ABDOMINIS
ERECTOR SPINAE
CXI.
ANATOMY
270
The
the tuberosity.
last
two
ribs,
IN A NUTSHELL.
by two centers.
The peculiar
and
twelfth.
They
present
respectively
Rib
First
is
one facet.
Muscles of the Back.
back are arranged in five layers. (Plates XVIII-CXI)
Those in the fourth layer get both the internal and external divisions of the
The external divisions supply those
posterior tranches of the spinal nerves.
divisions
The internal
together with the sub-occipital and
in the third layer.
The muscles
of the
(Plates
NERYKS.
First layer.
Trapezius.
2 Latissimus dorsi.
Second
layer.
Page
Page
2 Rhombodideus minor.
Rhomboideus major. Page 55.
Levator angulae scapulae.
XVIII-CXI.)
54.
.1.").
:'>
Third layer.
Serratus posticus superior.
External
3 Splenius capitis.
k spective regions.
Splenius
in their
colli.
Fourth layer.
S \cr.\l
Erector spina'.
DORSAL REGION.
2 Dio-costalis.
Spinalis colli
.'5
5 Spinalis dorsi.
I
i.i;\
[CAL REGION.
6 Cervicalis ascendens.
7 Transversalia
colli.
8 Trachelo-mastoid.
!
Complexus.
They
the
get
the
posterior
internal
branches.
divisions
The
of
Com-
ANATOMY
IX A NUTSHELL.
271
10 Biventer cervicis.
11 .Spinalis
colli.
Fifth layer.
1
Semispinalis dorsi.
2 Semispinalis
are supplied
colli.
of the posterior
4 Rotatores spina?.
5 Supraspinales.
cept
6 Interspinales.
are supplied
3 Multifidus spinae.
Extensor coccygis.
Inferior oblique
8 Intertransversales.
also
occipital nerve.
PLATE CXI
TO
I.
SCALP
CUTANEOUS
OCCIPITALIS
WITH
AURICULAR
Ml
SUPERIOR OBLIQUE
COMPLEXUS
RECTUS CAP.
POSTERIOR
ST.
INF.
DIV
CERVICAL
OBLIQUE
POSTERIOR
-ND.
DIVISION OF
CERVICAL
POSTERIOR
RD
OF
DIVISION
CERVICAL
ssss^-ti
SPLENIUS
COMPLEXUS.
=3^
TRACHELO-MASTdlO
SKIN OVER
TRAPEZIUS
and has
superior. Description.
a serrated outer
(1)
margin.
It
The inner
takes its
Ligamentum
(2)
This
muscle
name from
nuchse,
wi:i;.
its serrated
is
is
quadrilateral
tendinous and
edgeand
its
position.
ANATOMY
272
and
cervical
IN A NUTSHELL.
first,
ligament.
Insertion.
ribs
beyond
their angles.
Action.
To
\i:i;\
Supply.
i:
by raising the
assist in inspiration
serted.
External
ribs into
which
fifth
it is
in-
nerves.
The
Blood Supply.
(2)
muscles
in the
This applies to
ies.
Serratus
from
all
posticus
inferior.
its
Description. This
position.
More than
muscle takes
its
eurosis,
portion
is
arter-
fascia.
name
is
apon-
Its
outer
fleshy.
Origin.
first,
occipital,
its
(1)
lumbar
(1)
twelfth ribs
beyond
Action.
them
their angles.
It assists in
Nerve Supply.
and making
nerves.
the
first
ribs,
of the
back
is
given in
This
muscle has one origin and two insertions and may be called
Lower one-half of the ligamentum nuchas, (2) spinous prothe seventh cervical, and upper six dorsal vertebrae, (3) supraspinous
Origin.
two muscles.
cesses of
(1)
ligament.
Insertion.
(Capitis portion).
(1) mastoid process of temporal bone,
bone beneath the superior curved line. (Colli portion) into the
transverse processes of the first, second, and third cervical vertebra? (posterior
(2) occipital
tubercles.
Action. It
the face to same
flexes the
laterally,
side.
LESSON LXXVI.
Muscles of the Fourth Layer of the Back.
Erector Spinae.
Description.
This
muscle and
muscle
is
covered
it
in
its
continuations
fill
up
the
divides into
its
ANATOMY
IN A NUTSHELL.
fascia,
273
and in the
cervical
region by a
+.
Origin.
(1)
PLATE CXI
1 1.
TWEIPTH NERVE
MAJOR
LONGUS
RECTUS
COLLI
CAPITIS
ANTICUS
MAJOR
GENIO-HYOID
THYRO-HYOID
LONGUS
RECTUS
COLLI
CAPITIS
MAJOR
A'.TlCLiS
DESCENnENS CERVICIS
COMMUNICANS
CERVICIS
OMO-HYOID
LONGUS COLL
RECTUS
CAPITIS
ANTICUS
MAJOR
SCALENUS
ANTICUS
STERNO-HYOID
STERNO
THYROIO
TRAPEZIUS
TRAPEZIUS
SUPRA
clavicular
supra-sternal
SUPRA- ACROMIAL
lie
(.">)
it-
numerous sub-
divisions
Iilo-costalis.
name from
its
Origin.
(Sacro-lumbalis.)
attachments
From
to
Description. This
the ilium and the ril>s.
muscle
take-
its
ANATOMY
274
Into
Insertion.
Lower
IN A NUTSHELL.
It
ribs.
all
the ribs.
separate tendons.
Insertion.
(1) Upper borders of the angles of the six upper ribs,
back of transverse process of the seventh cervical vertebra.
Action. To assist the Erector spina3
Longissimus dorsi. Description. This muscle takes its name from
(2)
its
Origin.
Insertion.
(2)
From
(1)
lumbar
processes of the
(1)
lamina of lumbar
all
fascia.
between the tubercles and angles of the lower ribs (seventh to eleventh.)
Action. To draw down the chest and spine.
Description. This muscle takes its name from its atSpinalis dorsi.
tachment
Origin.
Into
Action.
Cervicalis ascendens.
position
and
Origin.
its
own
its
name from
its
direction.
ribs.
Insertion.
neck
first
vertebra?.
if
if
of fourth,
fifth
If
it
It
pulls the
side.
colli (cervicis.)
Description. This muscle takes its name
attachment
to
the
transverse
from
processes, and its insertion in the neck.
Origin. From upper portion of transverse processes of six upper dorsal
Transversalis
its
vertebrae.
Action.
backward.
If
Trachelo-mastoid.
origin
and
its
Origin.
DESCRIPTION. This
is
muscle takes
its
name from
its
insertion.
(1)
Transverse processes of
first
Insertion.-
ANATOMY
IX A NUTSHELL.
275
Origix.
vertebra?
and
Tips
of transverse processes of
and seventh
cervical vertebra
1
,
from two
upper dorsal
to seven
PLATE CXIV.
PHRENIC NERVE
SUPaAST'PULAR HERVE
PNEUMOGASTRIC
SUBCLAVIAN
ARTERY
INNOMINATE
ARTERY
ARTERY
AXILLARY
MUSCULOCUTANEOUS
MEDIAN
SUBSCAPULAR
ARTERY.
*WSOil 0-SP1RAL N
vpROFimni
ARTERY
Into
of the occipital
bone
ACTION. If both act they draw the head backward, if only one ads it
draws the head to one side, and with the face turned to the opposite side.
Biventer cervicis.
Description. This muscle is one of the so-called
double bellied muscles, and is situated on the Inner side of the Complexus.
Origin. Transverse processes of from two to four upper dorsal vertebrae.
connects
tic
ANATOMY
276
IN A NUTSHELL.
This muscle
is
Origin.
LESSON LXXVII.
Fifth Layer of Muscles of Back.
Description.
Semispinalis dorsi.
and
its
name on account
its
region.
Origin.
fifth, sixth,
Into
first,
To erect the
Action.
Semispinalis
spinal column.
Description. This muscle takes
colli.
its
attachment
Origin. Transverse processes of the upper five or six dorsal vertebra?.
Insertion. Into the spinous processes of the second, third, fourth, and
Action.
To
Description.
Multindus spinas
many
This
muscle takes
name from
its
its
clefts.
Origin.
(1)
Back
of
sacrum
(3)
ilium, (4)
(2)
lumbar ver-
Insertion.
Into
all
the vertebra?
Action.
To
Description.
Rotatores spinae.
This
muscle takes
its
it.
name from
its
There are generally eleven pairs, but they may be found in the
cervical and lumbar regions.
Origin.- Upper and hack parts of the transverse processes in the dorsal
functions.
region
he
inc.
S]
Insertion.-
of the first
oi igin.
Action.
to
Assists the
he opposite
si le.
Suprasplnales. Description.c(
sses in
he cervical
r<
eion.
These
muscles
lie
on
the
spinous
pro-
PLATE CXV.
FRONTAL
ANT,
TEMPORAL
SUPRAORBITAL
COMMUNICATING
WITH OPHTHALMIC
POST. TEMPORAL
ANGULAR
LATERAL
NASAL-
DEEP TEMPORAL
TRANSVERSE FACIAL
INTERNAL MAXILLARY
OCCIPITAL
INFERIOR
u-
TEMPORO- MAXILLARY
CORONARY
JUGULO -CEPHALIC
\\i>
Kace.
ANATOMY
278
IN A NUTSHELL.
Origin.
Insertion.
(first
and third
cervical.)
Action.
Approximate
Intertransversales.
Description.
In
developed, and are in pairs (anterior and posterior) passing between the anterior
in the cer-
vical region.
middle dorsal.
They
one
The other
transverse
pro-
Origin.
Action.
To extend
the coccyx.
it
Description.
ascends.
Spinous process of
Inferior curved of the occipital bone and surface of bone
below.
Action. To rotate the cranium with
around the odontoid process
Origin.
axis.
Insertion.
line
atlas,
of the axis.
Description.
This muscle
is
the smallest
Origin.
atlas.
Insertion.
Description.
inferior
This
curved
muscle
line.
is
narrow below
Origin.
Insertion.
external
to
ACTION.
the Complexus.
To
lines
PLATE CXVI.
PALPEBRASUM
ORBICULARIS
ANGULAR
NASI
LATERALIS
ORBICULARIS
ORIS
.N^-
#Hs
Mmm
Ir^T
ASCENDING
HYPO-GLOSSAL
WWi'M
-'7
i.'-V
PHARYNGEAL
'A
HYPO-
STERNO HYOIDGLOSSAL
CRICOID
THYROID
A.
'
*~
<
Or "l\\\ \C
STERNO THYROID-
N.
AND
CERVICAL
PLEXU!
ANATOMY
280
IX A NUTSHELL.
Description.
This
muscle
is
superior one.
Origin.Apex
Insertion.
A.<
riON.
To
The -kin
The
of axis.
of the
back
is
internal branch of the posterior divisions of the upper six dorsal uerves are
cutaneous, while the external branches of the posterior divisions of the lower
The external divisions of the upper and
six dorsal nerves are cutaneous.
the internal divisions of the lower six have no cutaneous distribution.
The sacro-vertebral articulation is supplied by the fourth and fifth lumbar and
sympathetic nerves.
The
The costotransverse articulations are supThe sacro-iliac articulations are supplied by the posterior divisions of the first and second sacral
The saero-eoccygeal
nerves, the superior gluteal nerve, and sacral plexus.
articulation is supplied by the fourth and fifth sacral and coccygeal nerves.
The ribs and vertebra' an- supplied by the gray rami communicantes.
terior divisions of the spinal nerves.
plied by
LESSON LXXVIII.
Triaxoles of the Neck.
The
side of the
neck
is
in
(Plate XIV.)
lower margin of the jaw-bone and a line continued from the angle of the jaw to
the mastoid process; below, by the clavicle; posteriorly, by the Trapezius; and
anteriorly by the
triangles
The Omo-hyoid
ramifying
in
it-
roof.
By -one these two muscles are called the floor, hut the Longus colli
and Scalenus amicus and pari of the Rectus capitis anticus major form the floor.
This triangle is bounded in fhont by the median line. above by the anterior
thyroid.
PLATE
CXVII.
FRONTAL SINUS
PRINCIPES CERVK.S
A
BRANCH OF OCC.PITAL
ASCENDING PHARYNGEAL
PROFUNDA CERVi:iS
STERNO-MAS'OiD
CRICOID
CARTILAGE
FIRST RIB
TRACHEA
SUP. INTERCOSTAL
1ST
AORTIC
SECOND
Til E
[NTERNAL
'
VROTID A.RTERY.
2.SI
RIB.
INTERCObML
ANATOMY
282
belly nf the
IN A NUTSHELL.
.lust
ed
The second
is bounded
Omo-hyoid; behind by the Sterno-cleido
belly of the
Digastric.
fascia.
Its roof
is
Its floor is
The external
carotid artery has eight branches, five of which are in this triangle, viz., superior
and occipital, with their correswhich empty into the internal jugular, except the occipital
ponding
veins,
all
of
The
below by
is
Sterno-cleido-mastoid
in
this
triangle.
The subclavian or supraclavicular triangle is bounded above by the posterior belly of the )mo-h void. in front by the Sterno-cleido-mastoid, and below
by the clavicle.
Its roof is made by the skin, superficial fascia, Platysma
myoides, and deep fascia and has the suprascapular vessels and nerve lying in
Its floor is made of the digitations of the Serratus magnus, Scalenus posit.
<
ticus.
in
first rib.
It
it.
Tiir.
Suboccipital Triangle.
(Plate CXI.)
PLATE
CXVIII.
POSTERIOR COMMUNICATING
RIGHT POSTERIOR
CEREBRAL
MIDDLE CEREBRAL
LEFT POSTERIOR
CEREBRAL
OPHTHALMIC
OCCIPITAL
ARTERY
ARTERY
PRINCEPS CERVICIS
BRANCH
SUPERFICIAL
OF
PRINCEPS
CERVICIS
ASCENDING CERVICAL
TRANSVERSE CERVICAL
POSTERIOR SCAPULAR
ACROMIAL
BRANCH
BRANCH
SUBSCAPULAR
SUPRASPINOUS
ANTERIOR
BRANCH
CIRCUMFLEX
'"
INFRASPINOUS BRANCH
POSTERIOR CIRCUMFLEX
LONG
THORACIC
SUBSCAPULAR
DORSAL SCAPULAR
INFRA SCAPULAR
BRANCH
SUBSCAPULAR
SECOND
AORTIC
NTERCOSTAL
THIRD
AORTIC
INTERCOSTAL.
Willis.
ANATOMY
284
IN A NUTSHELL.
ligament and the posterior arch of the atlas, and its roof is made by the ComThe vertebral artery lies in a groove on the upper surface of
plexus muscle.
LESSON LXXIX.
Arteries.
The pulmonary
artery (Plate
'XXVIII)
in front of
from the
arises
the aorta.
left
pulmonary
common
artery.
it
left
side of the
passes
It
It is
about two
right pulmonary artery, which is larger and longer than the left, passes
behind the ascending aorta and the superior vena cava where it pierces the
It divides into the branches at the root of the lung, one branch
pericardium.
being for the upper lobe of the light lung and the other for the lower lobe.
The branch which passes to the middle lobe is derived from the upper branch.
The
The
left
left
bronchus
at
it
column
left
e>f
the
'
Ascending,
(2)
It
now
elescends on the
ventricle
to pass
into a right
sions;
left
and backward.
divi-
tion
is
is
and the
pari
to the righl
where
The Relations
I.\
of the
it
ends
is
at the
upper boreler
second
of the
in length.
Pericardium,
It
artery,
(2)
Right
auricular
Remains
of
appendix.
(3)
thymus gland.
auricle.
auricle.
It
arches to the
left
its
e-onvexity
upward
ANATOMY
2v")
IN A NUTSHELL.
and ends
Above.
(1)
PLATE CXIX.
ANTERIOR JUGULAR VEIN
OUTER
INTERNAL
JUGULAR
CERVICAL FASCIA.
VE
VEIN
PNEUMOGASTRIC
NERVE
The Cervical
Below. (1)
arteriosus,
(3)
and
f1
(5)
[n
L<
Eifurcaticn
Superficial
Fascia.
pulircnary
cf
cardiac
plexus,
(4)
artery.
Lef1
(2)
Remains
cf
.hums
bronchus.
Front. (1)
Pleurae
and
lungs, (2)
Remains
of
thymus
gland,
(3)
Left,
ANATOMY
286
pneumogastric nerve,
(4)
IN A NUTSHELL.
nerves
Behind.
Trachea,
(1)
(2)
Deep cardiac
plexus,
Oesophagus,
(3)
(4)
Thoracic duct.
Front.
I\
]
Haphragm.
Behind.
(1)
Root
of left lung,
(2)
CXXVIII.)
Pericardium,
(3)
Oesophagus,
(4)
(1)
veins.
Right Side. (1) Oesophagus (above), (2) Vena azygos major, (3) Thoracdud.
Left Side. (1) Pleura, (2) Left lung, (3) Oesophagus (below.)
The ascending aorta has the right coronary and the left coronary artery
which have been described with the heart. The branches of the arch of the
ic
common
left
(4)
The
(1)
LESSON LXXX.
The innominate artery often
called
brachio-cephalic
of the right
sterno-clavicular articulation
its
beginning
common
carotid.
common
It is
The Relations
it
has
left
Front.
of the
(1)
nerve.
Behind.
Trachea.
Right
Right Side.
(1)
innominate vein,
(2)
Pleura.
Left Side.
Lef1
(1)
Remains
The
rijrht
innominate
at
common
(4)
of
thymus gland.
(2)
CXVI-CXVII)
arises
from the
passes obliquely
(3)
Trachea.
and
It
internal
carotid at the upper border of the thyroid cartilage opposite the fourth cervical
vertebra.
The
left
common
divide into the external carotid and internal carotid at the upper border of the
enclosed
in
common
cervical
vertebra.
ANATOMY
and pneumogastric nerve.
The
IX A NUTSHELL.
287
while the pneumogastric nerve is between the internal jugular vein and common carotid artery but on a plane posterior to them. Occasionally a thyroid
The Relations
this artery.
of the Left
Common
is
as fol-
lows:
Ix Front.
Sternum,
(1)
(2)
Sterno-hyoid and
(3)
Sterno-thyroid muscles.
PLATE CXX.
SUPERIOR CORNU
THYROID
OF
CARTILAGE
CRICOID CARTILAGE
The Trachea.
(4)
of
thymus gland.
Oesophagus,
(1)
Innominate
artery,
lung. (4)
(3)
Thoracic duct.
(2)
Inferior
Left sub-
(4)
artery.
Internally.
(3)
Remains
(2)
nerve,
(2)
thyroid
Left
veins.
pleura,
(.'!)
(3)
Left
ANATOMY
288
NUTSHELL
IN A
LESSON LXXXI
The Relations
arteries
of the
Right
Common
Common
Carotid
the neck).
tin
Anterior jugular
13)
Behind.
(1)
vein.
Longus
colli,
(2)
(.">)
Sym-
(3)
Externally. (1)
Internally.
iii
Internal
jugular vein.
Trachea,
superficial.
The common
mogastric nerve
all lie in
common
sheath.
is
ficial
arteries.
It lies in
gland.
internal
artey
are,
branches;
<
(1)
(4)
superior
occipital
thyroid.
,(5)
(8)
interna]
(2)
(3)
facial,
lingual.
an ascending branch;
is
maxillary, which
are'
(7)
superficial
tem-
terminal branches.
LESSON LXXXI I.
The superior thyroid branch
(Plate
CXVI.)
arises
just
cornu of the hyoid bone, and passes inward and upward across the superior
it
passes
it
to the
PLATE CXXI.
BAND
HTOID
CONNECTING
THYMUS WITH
BONE
ANATOMY
290
IX A NUTSHELL.
larynx
bone.
It
now
PLATE CXXII.
GRFATER CORNU OF HYOID BONELESSER CORNU OF HYOID BONE
MEDIAN
PORTION
OF
THYRO-HYOID
MEMBRANE
K'F> GHIT!-S //
INTERNAL
LARYNGEAL NERVE
POMUN ADAM
THYROID
THYROID
CRICO-THYROID
LEVATOR
ARTERY
GLANDULAE
ARTERY
CARTILAGE
MEMBRANE
THYROIDEA MUSCLE
ARTERY
ANATOMY
IN A NUTSHELL.
291
branch, which runs along the upper border of the hyoid bone, (2) dorsalis
lingile branch, which passes upward under the Hyo-glossus muscle to the
dorsum of the tongue, (3) a sublingual branch, which passes on the Geniohyo-glossus muscle to the sublingual gland, (4) the ranine branch.
much
This
of the artery
is
then passes upward over the lower jaw at the anterior margin
of the Masseter muscle to the angle of the mouth.
This portion of the artery
vical portion.
is
It
It
now
PLATE CXXIII.
fe't^
'
UPPER
'" LOB
Rft&nefl
'
/Vj-OWER LOBEJ, f,
will
Posterior.
inner canthus of the eye.
tion.
The
View of Lungs.
under the
is
called angular
superficial muscles
and has
por-
very
tortuous course.
The branches
[NFERIOR
pharyngeus muscles to the outer side of the pharynx where it divides into two
branches, one of which runs through the Superior constrictor muscle and the
other branch passes over this muscle.
(2) The tonsillar branch which
passes between the Internal pterygoid and Stylo-glossus muscles and after
piercing the Superior constrictor passes to the tonsil.
(3)
The submaxillary
ANATOMY
292
IN A NUTSHELL.
branches, which are three or four in number, pass to the submaxillary gland.
(4) the submental branch, which runs forward on the Mylo-hyoid muscle
and under the Digastric muscle to the symphysis where it divides into a superficial and deep branch which pass over and under the Depressor labii inferioria
muscle to the lip.
(5) Muscular branches which pass to the adjacent muscles.
The branches
of the facial artery given off on the face are, (1) inferior
which runs under the Depressor anguli oris muscle to the lower lip, (2)
[NFERIOR CORONARY which runs in a very tortuous course along the edge of
lab]
\i.
PLATE CXXIV.
COMPLEMENTAl
12
AIR
CUBIC INCHES
TIDAL
T0
20
AIR
30
J0
AIR
Showing
the lower
lip,
(3)
AIR
BREATH
CUBIC INCHES
THAT
IN
AIR
CUBIC INCHES
OUT AT EACH
RESERVE
AIR
A|R
IS
DRIVEN OUT
AIR.
CUBIC INCHES
tin:
is
larger anil
(a) to
tIi*
ANATOMY
IN A NUTSHELL.
293
LESSON LXXXIII.
The
winds around
CXVI)
it.
it
sory nerve and the internal carotid sheath to the space between the mastoid
process of the temporal bone and the transverse process of the atlas.
It now
runs backward in the occipital groove on the mastoid process and pierces the
and passes upward in a tortuous course to the
PLATE CXXV.
PLEURA
while the
course,
to the
men
it
may
the dura
mater.
(3)
ANATOMY
294
muscle
(5)
to
Muscular branches
The
IX A NUTSHELL.
CXVI.)
is
carotid which arises opposite the apex of the styloid process of the temporal
bone and passes between the facial nerve and spinal accessory nerve under the
parotid gland into the groove between the mastoid process of the temporal
In me and the cartilages of the ear where it divides into auricular and mastoid
(parotid), (3)
Its branches are (1) muscular,
branches.
(2) glandular
stylomastoid which passes through the stylo-mastoid foramen to (a) the
tympanum, (b) mastoid cells, (c) semicircular canals, and it anastomoses with
the tympanic branch of the internal maxillary and the petrosal branch of the
middle meningeal, (4) Auricular branch to back of the ear, (5) mastoid to
the scalp above and behind the ear.
The ascending pharyngeal branch (Plate CXVI.) is the smallest and most
deeply seated of the branches of the external carotid and arises from near the
It passes upbeginning of the artery (sometimes from the internal carotid).
PLATE CXXVI.
BRONCHIAL TUBE
of the skull
on the Rectus
capitis anticus
Its
branches are
The
(c)
superficial temporal
upward over
Its
temporal and posterior temporal.
small ones to the parotid gland. (2) articular ones to the
lower jaw, (3) muscular ones to the muscles, (4) anterior temporal which
runs forward to structures on the frontal bone, (5) posterior temporal which
which
it
branches are
(1)
ANATOMY
IN A NUTSHELL.
295
runs upward and backward to structures on the side of the parietal bone, (6)
transverse facial branch which crosses the Masseter muscle and passes be-
tween the zygoma and the duct of the parotid gland (Stenson's) to the side of
the face. (7) middle temporal which passes just below the zygoma through the
temporal fascia to the muscle, and sometimes it sends an orbital branch along
the upper border of the zygoma, (8) an auricular branch which passes to the
external meatus and the front of the ear.
PLATE CXXVII.
S
INTERNAL MAMMARY
TE
= '.-'
VESSELS
INTERNAL MAMMARY
VESSELS
PHRENIC
RIGHT
PARIETAL PLEURA
NERVE
PNEUMOGASTRIC NERVES
VISCERAL PLEURA
OESOPHAGUS
A Transverse
LESSON LXXXIV.
The
CXV1)
artery through the parotid gland to the inner side of the neck of the condyle
of the lower jaw.
It
now
the external pterygoid muscle and crosses the inferior dental nerve and
much
of the artery
is
lateral
is
its
terminal branches.
It
now
passes
now
is
sit-
This
in
portion.
The branches of the maxillary portion are (1) tympanic which passes upward behind the articulation of the lower jaw through the Glasserian fissure
to the ear
drum.
(2)
296
ANATOMY
IN A NUTSHELL.
M,A,X " :u
,
temporal uerve
,
(a) a posterior
(3)
Middlb
of the auriculo*
divides into two branches
PLATE CXXVIII.
WGHT
INFERIOR THYROID
LEFT
RIGHT VERTEBRAL
VEINS
VEIN
COMMON
CAROTID
VEIN
j^EFT
SUBCLAVIAN
VERTEBRAL
VEIN
ARTERY
LEFT SUBCLAVIAN
R'GHT
INTERNAL
MAMMARr"VEIN
LEFT
INTERNAL
MAMMARY
VEIN
LEFT SUPERIOR
INTERCOSTAL VEIN
ARTERIOUS
RIGHT PULMONARY
LEFT PULMONARY
AURICULAR
APPENDIX
AURICULAR APPENDIX
,n "
IarSer
and
00
:"";
ta
ANATOMY
IN A NUTSHELL.
297
branches which pass through the sphenoidal fissure and temporal branches
which pass through foramina in the great wing of the sphenoid to the temporal
fossa.
It
(4) Small meningeal may be a branch of the middle meningeal.
passes through the foramen ovale to the Gasserian ganglion.
(5) Inferior
it
the incisor branch which passes to the incisor teeth and adjacent structures,
and (b) mental branch which runs through the mental foramen
A mylo-hyoid which arises at the inferior dental foramen passes
hyoid groove of the lower jaw to the Mylo-hyoid muscle.
to the chin.
in
the mylo-
PLATE CXXIX.
BETERIC branches which pass through the sigmoid notch to the Masseter musBUCCAL branch which passes between the ramus and the Internal pterygoid muscle to the outer surface of the Buccinator muscle.
The spheno-inaxillary portion gives off (1) alveolar or POSTERIOR dental
cle, (5)
which
arises
in
(2)
[nferior orbital
ANATOMY
298
and
face
it
to the anterior
branches
IN A NUTSHELL.
antrum and
teeth.
(3.)
Descend-
ing palatine which d( Mends in the posterior palatine canal and runs forward
in a groove on the hard palate then up through the foramen of Stenson.
(4)
Vidian branch passes backward through the vidian canal to the pharynx and
(5)
runs through the pterygo-palatine canal to the pharynx and Eustachian tube.
(6)
to the
of the
Dose.
It
walls
nose and the nasi -palatine branch which descends on the septum to the fora-
men
of Stenson.
PLATE CXXX.
DECUSSATING
FIBROUS
TISSUE OF VALVE
CORPUS ARANTII
LESSON LXXXV.
The
The
canal
in
the
This
lateralis,
From
the atlas.
it
the sinus atlantis beneath the vertebral artery, to the inner side of the
Rectus capitis
with
First
anterior branch of the First Spinal nerve (suboccipital) leaves the spinal
and
this point
to the
it
first,
nerve receives
of the
(Plate (XIII).
a filament,
loop join the tenth cranial nerve and the sympathetic, also pass to the Rectus
capitis lateral)-
The
anterior
PLATE CXXXI.
SUBCLAVIAN VEIN
INTERCOSTAL NODES
INTERCOSTAL ARTERY
VEIN AND
NERVE
RECEPJACULUM 'CHYL
mx
mm
flyf
Ijgjn
,
;A
W^
ya|*TH
LUMBAR
Hff
"I
Veins.
ANATOMY
300
IN A
NUTSHELL.
division of the suboccipital nerve sends filaments to the occipito-atlantal articulation and the mastoid cells of the temporal hone.
The posterior branch of the suboccipital nerve is larger than the anterior
branch and does not divide into interna] and external divisions, (Principle II, Page
does the anterior branch, in the sinus atlantis
26). h leaves the spinal canal, as
beneath the vertebral artery, then
it
PLAT!-:
passes
backward
(XXXII.
THYROHYOID MUSCLE
MEMBRANE
THYROHYOID
THYROID CARTILAGE
t
OMO-HTOID
STERNO THYROID
STERNO-MASTCID
CRICOTHYROID MEMBRANE
CRIC0- THYROID
RIGHT
CRICOID
MUSCLE
OESOPHAGUS
CAROTID ARTERY
COMMON
LEFT
FIFTH
INNOMINATE
LEFT
OF CLAVICLE
SECTION OF
RECURRENT NERVE
SUSPENSORY LIGAMENT
LEFT
btCIION
CARTILAGE
VEIN
RIB
LEFT INTERNAL
MAMMARY ARTERY
riangle
Ltis
posticus major.
triangle.
It
join,-
it
oblique, and
It
communicate
sometimes gives
:i
n pass< s either
ANATOMY
IX A NUTSHELL.
301
part of the scalp and the upper part of the neck; this cutaneous branch accompanies the occipital artery and communicates with thegreat occipital and small
(Plate CXII).
occipital nerves.
The superficial origin of the Second Spinal nerve may be as high as a little
above the posterior arch of the atlas or as low as midway between the
posterior arch of the atlas and spine of the axis. The anterior branch
between the posterior arch
behind the vertebral artery and in front
of the axis,
Then
it
It
where
it
cervical to
first
make
the
it
gives off
(1
divides into an
first
loop,
make
and one
the second
which
it
PLATE CXXXIII.
SUPERIOR CORNU
OF
HYOID BONE
MEDIAN
PORTION
OF
CRICO-THYROID MEMBRANE
CRICC- THYROID
MUSCLE
THIRD
RING OF TRACHEA
ANATOMY
302
IN A NUTSHELL.
it
the mandible.
of the helix
and antihelix, (c) the facial branches pass to the superficial lobules
and the integument over and in front of the gland. In the
substance of the gland they unite with the cervico-facial division of the facial
PLATE (XXXIV.
SUPERIOR CORNU
THYROID
MEMBRANE
THYRO-HYG
OF
PORTION
y\
OF
_ MEDIAN
NOTCH OF
CARTILAGE
THYROID
CRICO-THYROID
CARTILAGE
MEMBRANE
INFERIOR CORNU OF
THYROID CARTILAGE.
II
nerve.
com<
great auricular
tld-
or pass
in
front.
One
It
<>n
sends
(4)
of the communicans hypoglossi, and a filament to the SternoCLEIDO-mastoid. This filament communicates with the spinal accessory in
the substance of the muscle.
ANATOMY
IN A NUTSHELL.
303
The posterior branch of the second cervical nerve leaves the spinal (anal
below the Inferior oblique between the posterior arch of the atlas and the
lamina of the axis. This branch is larger than any other posterior branch in
the cervical region and
It
It
PLATE (XXXV.
EPIGLOTTIS
THYROID
ARYTENO-EPIGLOjTTIDEAN
FOLD^t"^
ARYTENOIDEUS
OBLIQUUS
ARYTENOIDEUS
TRANSVERSUS?
^C^-
/~f
(
CARTILAGE
SANTORINI
MUSCULAR PROCESS
OF
ARYTENOID CARTILAGE.
o
'
CRICOID
x
-
&
'
;
-.,
"'
CARTILAGE
==
-'//^
CR1C0- ARYTENOIDEUS
POSTICUS
is
the
the
internal
CCXVI).
The superficial origin of the third cervical nerve may be as high as a little
below THE POSTERIOR ARCH OF THE ATLAS OT as low as THE 3\ NOTION OF THE
upper two-thirds and lower third of spine of \xis. The anterior branch
(Plate
of this nerve
is
It
is
also
ANATOMY
304
IX A
NUTSHELL.
communicans hypoglossi,
branch to
Scalenus medius.
The
come from
all
this nerve.
It
is
and Semispinalis muscles, supplying them, th< n pierces the Trapezius to supply
It communicates with the great occipithe integumenl of the back of tin n< ck.
PLATE CXXXVI.
TRITICEA
CARTILAGO
THYRO-EPIGLOTTlDEAN
LIGAMENT
SUPERIOR
THYROID
CORNU
OF
CARTILAGE
CARTILAGE OF SAN-TOR
SCULAR PROCESS
Nl
OF
CARTILAGE
RYTEN0I0
INFERIOR CORNU OF
THYROID
CARTILAGE
protuberance.
to
The external
in
branch
of the
second
(Plate CXII.)
LESSON LXXXVI.
<i
i,\
[cal Plexus.
(Plate CXIll).
The
Cervical plexus
cervical nerves.
ANATOMY IN A NUTSHELL.
305
the Levator anguli scapulae and the Scalenus medius muscles and under the
Sterno-cleiclo-m ast o id
The branches of
The
superficial
ones divide into ascending and descending, while the deep divide into internal
and external.
are,
is
(1)
sometimes called
of an ascending branch).
These branches
the supraclavicular.
and
(3)
The
supra-acromial.
internal branches are, (1)
cans hypoglossi,
communicating,
(2)
muscular,
(3)
communi-
(4) phrenic.
PLATE CXXXVII.
EPIGLOTTIS
BONE
HYOID
'CUSHION
OF
EPIGLOTTIS
li|j_FALSE VOCAL
THYROID
CARTILAGE
LARYNGEAL
TRUE
CORD
SINUS
VOCAL
CORD
THYRO- ARYTENOID
CRICOID
CARTILAGE
it
varies
in size.
This nerve
is
it
It
perforates the deep fascia and passes into the superficial fascia of the scalp.
the
breaks up into three branches.
(1) An auricular branch which supplies
This nerve
lies
ANATOMY
306
IN A NUTSHELL.
vein.
It
(1)
auricular, which are three or four, anastomose with the auricular branches of
It is distributed to the integument of
the facial and pneumogastric nerves.
(2) A mastoid branch which is
the lobule and the lower part of the concha.
branch crosses the parotid gland and supplies the integument covering the gland.
1:
communicates with the seventh nerve in the gland.
The transverse cervical nerve (superficialis colli) (Plate CCXVI) comes
from the second and third cervical nerves and passes around the posterior border of the Sterno-cleido-mastoid near its middle a little below the great auricular
nerve.
It
now
externa] jugular vein (sometimes over the vein) to spread out into an ascending
and a descending branch. The ascending branch joins the cervical branches
from the facial nerve and supplies integument of the upper part of the neck as
The descending branch supplies the integument of the lower
high as the chin.
half of the neck as far as the sternum.
The communicating branches of the external division of the deep branches
are, (1) a communicating branch from the second cervical nerve to the Sternocleido-mastoid. (2) Those from the third and fourth cervical nerves are distributed to the Trapezius.
cervical nerves
ulae,
It
third, fourth,
branch from the fourth cervical nerve to the fifth cervical nerve.
.Muscular branches pass to the (1) Rectus capitis anticus minor,
capitis anticus major, (3)
(2) Rectus
Longus colli.
formed by branches from the second and third
Rectus capitis
lateralis, (4)
Communicans hypoglossi is
and pass down on the outer
cervical nerves
the middle of the neck where they join the descendens hypoglossi.
This loop
is
off
from
this
ansa
fourth,
and
fifth
cervical nerves,
ANATOMY
IN A NUTSHELL.
It
now
307
tically
downward
mammary
spread out on
its
it
first
part of
artery.
It
now
passes ver-
It perforates the
Diaphragm and
is
under surface.
The right phrenic nerve lies on the outer side of the right innominate vein
and the superior vena cava. It is not as long as the left phrenic nerve and is
more vertical in direction, also seated deeper.
The left phrenic nerve is longer than the right phrenic nerve for two reasons, (1)
it
is
lower on the
left side,
and (2) it goes in a less direct route, because the heart inclines to the left side.
As it enters the thorax it lies behind the left innominate vein and in front of the
pneumogastric nerve, the arch of the aorta, and the root of the lung. The
comes nervi phrenici, which is a branch of the internal mammary artery, passes
to the phrenic nerve.
scendens hypoglossi with the cervical nerves pass to the phrenic nerve.
The right phrenic nerve, after it passes through the Diaphragm, joins a
branch from the solar plexus to form a ganglion, which gives branches to the
hepatic plexus, the suprarenal capsule, and the inferior vena cava.
The
left
it,
LESSON LXXXVII.
The abdominal wall is divided into nine arbitrary areas by four lines; first
circle
around the body connecting the anterior superior spinous processes of
a
the crest of the ilia; a second line drawn around the body connecting the tips
of the ninth or tenth ribs; the other two lines are drawn at right angles to these
from the middle of Poupart's ligament, thus dividing the abdominal wall into
nine areas.
The
Plate
CCXXV.
one above and on the right side is called the right hypochondriac;
the middle one above is the epigastric; the third one the left hypochondriac. The
first one in the middle row on the left side is the left lumbar; the next one is the
umbilical; and the third is the right lumbar.
The one below the right lumbaris
the right iliac or inguinal; the next one in the third row is the hypogastric; and
first
is
the
left iliac
or inguinal.
(iliac)
of the ileum.
PLATE CXXXVIII.
JALL BLADDER
SPLEEN
LIVER
SPLENIC
VEIN
PANCREAS
TRANSVERSE COLON
DESCENDING
ASCENOING
COLON
COLON,
SMALL INTESTINE
ANATOMY
IN A NUTSHELL.
309
Epigastric contains part of the right lobe of the liver, greater part of the
orifices, first
sules.
Umbilical contains the transverse colon, part of the great omentum and
mesentery, transverse portion of the duodenum, and some coils of the jejunum
of
Hypogastric contains
or
when distended
coils of
chyli.
in adults, ureters,
<>t'
pregnancy, often the caecum, appendix vermiformis, sigmoid flexure of the colon,
and the upper part of the rectum.
Left hypochondriac contains the fundus of the stomach, greater part of the
spleen, tail of the pancreas, splenic flexure of the colon,
left
left
Alimentary Canal.
The alimentary canal
mouth to the anus. It is
(Plate
about thirty
is
CXXXVIII).
feet in length,
consists of the following portions: mouth, pharynx, cesophagus. stomach, small intestine which
divisions, (1)
duodenum,
(2)
atic
transverse colon,
splenic
jejunum, and
(3)
and
ileum,
descending
flexure,
colon,
sigmoid
flexure,
The
teeth (Plate
CCXXVI)
A ROOT or
PANG,
The
The
first set are called temone in infancy, the other in childhood and youth.
porary, milk, deciduous teeth and are twenty in number, there being five in
each lateral half jaw, namely two incisors, one canine, and two molars.
In
manent
The bicuspids
of the
per-
half jaw,
two
incisors,
in
each
ANATOMY
310
IN A NUTSHELL.
The arteries to the teeth are derived from the inferior dental and from
the alveolar and infraorbital branches of the internal maxillary.
The nerves are from the inferior dental branch of the inferior maxillary
PLATE CXXXIX.
ORIFICE OF LACHRYMAL CANAL
GROOVE ON
ANTERIOR BORDER OF
SEPTAL CARTILAGE.
LATERAL CARTILAGE
ACCESSORY CARTILAGE.
SEPTAL CARTILAGE
SESAMOID CARTILAGF
ALAR CARTILAGE
fifth,
and
also
Just before the six-year molars are erupted from the gum, forty-eight
teeth in various stages of formation and retrogression can be recognized in the
ANATOMY
twenty
IN A NUTSHELL.
311
two jaws
set.
of the
nerve to these
is
the hypoglossal.
LESSON LXXXVIII.
1. Large circumvallate ("walled around") papillae seven
in number set
an inverted V at the back of the tongue and shaped like truncated cones set
on end in cup-like depressions, whence the name. (Plate CXLIII).
2. Middie-sized fungiform ("mushroom shaped") papillae scattered irregularly over the surface, forming rounded red eminences like mushrooms, whence
their name.
3. Small conical or filiform ("thread-shaped") papillae covering the an-
in
each ending
in a
number
of little processes.
these that are concerned in the whitish coating or furring of the tongue.
It
Be-
composed
closely
They are
two kinds of epithelial cells, gustatory and sustentacular, packed
together.
The microscopic structure of some papillae include certain
the papilla?
is
of
independently of
and are
papilla?,
numerous
four pairs.
especially
in
in
The hypoglossal
is
AXATOMr
312
2.
The
of sensation,
(gustatory,) which
The
is
thirds of the
3.
IX A NUTriHKLL.
it still
retains.
branch of glosso-pharyngeal
lingual
is
PLATE CXL.
FRAENUM LINGUAL
DUCT. OF RiVINUS
ANTERIOR
BELLr
DIGASTRIC
of tongue.
4.
is
The function
still in (p lest
fifth.
and
Some
dorsum and
sides
(Plate CXLIII).
ion.
say
Its
it
it
of the lingual
distribution
is
ANATOMY
IN A NUTSHELL.
is
is
The veins
313
of the tongue
and
facial,
accompany the
arter-
ies.
There are two kinds of glands in the tongue. (Plate CXL). the mucous and
The mucous glands are found all over the surface of the mucous mem-
serous.
The serous
The fraenum
down
binds
is
a fold of the
mucous membrane
mouth which
of the
linguae
restriction or
Fraenum
be tongue-tied.
The dorsum
of the
it
tongue
linguae
is
line
by
about an inch, from the base of the organ, in a depression, the foramen caecum,
The tongue is not the only organ of taste as taste-buds are found on the
back part of the hard palate, on anterior part of the soft palate, and to some
extent in other parts of the pharynx.
The lymphatic
vessels
in
to
sit-
The pharynx (Plate CXLII)is bounded above by(l)the base of the sephnoid
bone and (2) the basilar process of the occipital; behind by (1) the vertebral
column. (2) Longus colli and (3) the Recti capitis antici muscles: it is incomplete in front being bounded by the (1) internal pterygoid plate, (2) pterygothe lower jaw.
maxillary ligament.
(3)
cricoid cartilages.
and
(2)
its
(7)
common
(4)
On
carotid
and
(4)
the internal jugular vein, (6) ninth, (7) tenth, (8) twelfth, and (9) sympathetic nerves and (10) a portion of the Internal pterygoid muscle.
It has
(5)
seven openings, two posterior nares, two Eustachian tubes, the oesophagus, the
is
On
its
posterior wail
ment
Above
to
in
this
is
the tonsils
the bursa
it
has some-
The pharnyx, the throat, technically the joint opening of the gullet and the
is a musculo-membranons pouch situated at the back of the nasal
cavities, mouth and larynx and extending from base of skull to the cricoid cartilage.
It is about five inches long.
It
i- widest (nearly one inch and a half
windpipe,
in the
measurement
four-fifths
its
junction with
the gullet.
its least
Ventro-dorsally
its
ANATOMY
314
IN A NUTSHELL.
vertebrae.
The pharynx also belongs to the respiratory system. The middle
segmenl of the pharynx is common to the alimentary and respiratory systems,
and the tracts followed by the food and air cross obliquely in it. The pharynx
lias three tunics, the mucous, areolar, and muscular.
PLATE
CXI. I.
TENSOR
PALATI.
EUSTACHIAN TUBE
LEVATOR
PALATI
PTERYGOMANDIBULAR LIGAMENT
STYLO-PHARYNGEUS.
9TH NERVE-GLOSS O-PHARYNGEAL
"STYLO-GLOSSUS
STYLOHYOID LIGAMENT
MYLO-HYOID
HYO-GLOSSUS
HYPOGLOSSAL
T
S YL0-HYOID
D
GASTRIC
SUPERIOR
LARYNGEAL
N.
THYROID CARTILAGE
of the
Inferior
Salpingo-pharyngeus.
pharyngeal
plexus.
pharnyx
constrictor,
Plate
CXLI)
Stylo-pharyngeus,
Palato-pharyngeus, and
The Constrictors are supplied by branches from the
The Stylo-pharyngeus by the glosso-pharyngeal nerve
ANATOMY IX A NUTSHELL.
and the
315
geal nerve
gets
its
It
is
supplies
pharynx.
of the
pharynx
is
The
first
of the internal
maxillary.
The
sinus of 3Iorgagni
a space at the
is
of the Superior
constrictor of the pharynx, just under the base of the skull where the muscular
LESSON LXXXIX.
The tonsils (Plate CXXXIX) are two prominent oval bodies situated in thereformed one on each side of the fauces, between the anterior and posThey are composed of lymphoid follicles, surrounded by
terior palatine arches.
They lie near
less dense lymphoid tissue arranged around the walls of crypts.
The blood supply is from the dorsalis lingua? from
the internal carotid artery.
cesses
from
facial
tonsillar
from
facial
(Plate
of the
the
tonsils
tonsil
fifth
form
a plexus
by means
of
which
lies
glosso-pharyngeal nerve.
CXL) is a duct of the parotid gland conveynamed from the Danish anatomist, Nicholas Steno,
mouth;
so
of the tongue.
The ducts
open
The duct
of Bartholin
is
it
or close to
its orifice
into the
mouth.
Thehardpalate(PlateCC.WYIII)
The
soft
by
palate
a movable fold suspended from the posterior bonier of the hard palate, form-
ANATOMY
IX
NUTSHELL
,u
PLATE CX LI
PROBE
THROUGH INFL'NDIBULUM
Hi
VESTIGULE
the Pharynx.
Sagittal Section of the Head and Neck Showing
by
whose
along
pharyngeal plexus.
with certain branches of the pneumogastic through the
anterior pillars of the
The isthmus of the fauces is called the throat. The
the two Palamembrane,
mucous
fan.-.- art in:. Me by two muscles covered with
Palato-pharyngei.
the two
to-glossi, and the posterior pillars are made by
ANATOMY
The next part
IN A NUTSHELL.
is
317
which extends from the spinous process of the sixth cervical vertebra to the
cardiac end of the stomach opposite the spinous process of the ninth dorsal.
It
consists of three coats, an outer or muscular, a middle or areolar, and an internal
All of the alimentary canal above the diaphragm has three coats,
or mucous.
below
it has four coats, these three just mentioned and a serous coat or
and all
peritoneum.
The oesophagus
(Plate
CXLVI)
in the neck,
is
On
boundeb!
in
front
by the
common
part of the lobes of the thyroid gland, and the reBehind by the vertebral column and the Longus colli.
In the thorax it is bounded in front by the trachea, arch of the aorta, left
common carotid artery, left subclavian artery, left bronchus, pericardium, and
Diaphragm. Behind by the vertebral column, Longus colli, vena azygos minor,
right intercostal arteries, thoracic duct, aorta, and the abdominal aorta.
On
the right side by the right lung and pleura, vena azygos major, and the thoracic
duct.
On the left side by the left lung and pleura, and thoracic aorta. The
and right pneumogastric surround the oesophagus, the right
pneumogastric
left
being situated behind it and the left in front, forming the plexus of Gula? in the
muscular coat.
The muscular coat consists at first of three perpendicular bands, the anterior
one being attached to the posterior part of the cricoid cartilage and the lateral
ones being continuous with the Inferior constrictor of the pharynx. These
three bands gradually blend and make a circular muscular band around the
oesophagus.
The next coat is the circular coat which is continuous with the
fibers of the Inferior constrictor and at the upper part of the oesophagus they are
parallel and at the lower part they are parallel, but in the intermediate portion
The upper ones are striped or voluntary muscles, while the
they are oblique.
The glands of the esophagus are compound racelower ones are involuntary.
mose glands which empty by long tubes on the mucous membrane.
The oesophagus (carrying eatables) or gullet is a tube connecting the pharynx
and stomach.
It is about ten inches long.
The blood supply is from the Inferior thyroid which comes from the thyroid axis of the subclavian; branches from
he d( sc< oding thora< ic aorta and from the gast ic branches of the coeliac axis
of abdominal aorta.
The nerve supply is from th< pneumogastric and sympathetic.
They form a plexus in which are groups of ganglion-cells between the
two layers of the muscular coats, and also a second plexus in the submucous
tissue.
ANATOMY
318
IN A NUTSHELL.
LESSON XC.
The stomach
Plate
distensible part of
tion.^, differ
It is
somewhat
like a pear
The fundus
omentum. We
with the large end up and the small end bent side wise to the right.
or splenic end
is
mention that an
with the
liver, spleen,
it
The blood
supply
to
is
from the
coeliac axis.
ANATOMY
IN A NUTSHELL.
319
(1) the gastric artery which runs along the lesser curve from left to right anastomosing with the (2) pyloric branch of the hepatic. Along the greater curve
run the (3) right and (4) left gastro-epiploic arteries, anastomosing at the
middle of the border, the left being a branch of the splenic, the right a branch of
the hepatic through the gastro-duodenalis artery.
The stomach also receives
branches from the splenic (5) vasa brevia at the fundus. The blood of the
stomach is returned into the portal vein; the right gastro-epiploic vein opens
PLATE
the splenic.
CXLIII.
PHARYNX
;
...:-.
\'
:,
<i''i??'i
:^yj
Wm
Hi^t
'St-
the
ANATOMY IN A NUTSHELL.
320
LESSON XCI.
The
meaning
first
of
which
intestine
is
called the
is
is
duodenum; the
literal
duodeno-jejunal flexure.
glands.
duodenal
glands or
the
flexure
The next
called
The
ileum.
first
has glands
It
is
in
called jejunum,
it
called
and the
Brunner's
third part
it
is
below the
duodenum, and the ileum about two-fifths. The glands in the ileum are called
Peyer's pan lies winch are about thirty in number; the intestine is thinner here
The small intestine straightened out would be in the shape
than in other parts.
cone,
with
the base corresponding to the stomach end, and its apex
slender
of a
corresponding to the point where
The
it
caecum.
joins the
be various shapes
and is partly covered with peritoneum; the next part is the ASCENDING COLON
which in 27 per cent of casts is covered with peritoneum; it is about eight and
The next portion is the hepatic flexure which joins
one-half inches long.
This transverse colon is about
the ascending with the transverse colon.
twenty inches long, and is covered with peritoneum. The next part is the
The
splenic flexure which joins the transverse with the descending colon.
descending colon is about nine inch's in length and in 37 per cent of cases is
covered with peritoneum. The next part is called the sigmoid flexure, which
The last part is the rectum (which means
is about fourteen inches in length.
large intestine consists of
straight):
it
not
is
first,
the
rest of
The glands
of the large
intestine are
less
numerous,
itself;
and
lie
along the
The lymphatic
form two
sets, viz.,
those of the
caecum, ascending and transverse colon, which pass through their proper glands
to the
twenty-two
in
length.
fe<
[ts
t.
It
may
be as
many
diameter diminishes
few as eight
from about two inches above to
as thirty-four feet or as
in size
feet
less
inch below.
It
is
to
ANATOMY
the small intestine, which are so
Thev
are
IN A NUTSHELL.
321
membrane and
at the
Brunner,
1653-1727).
sometimes
called
duodenal
glands,
are
small
com-
PLATE CXLIV.
LESSON
The small
XCII.
a branch coming indirectly from the hepatic, the superior pancreaticoduodenalis. The superior mesenteric runs between the layers of the mesentery
and gives off twelve or fifteen branches running downwards and to the left
and
(vasa intestini tenuis,) which break up ami form a series of arches, finally encircling the intestine as small branches.
It
small branch
at
the
ANATOMY
322
IN A NUTSHELL.
beginning, the inferior pancreatico-duodenalis, which, with the superior pancreatico-duodenaJis, forms as arch which lies in the concavity of the duodenum
and which supplies it.
The blood is returned by means of the superior mesenteric vein which,
The lymphatics form a continuous series, which is divided into two sets
The lymphthai of the mucous membrane and that of the muscular coat.
and
end
copious
plexus
in
the
mesenteric
form
a
lacteals.
vessels of both sets
small
intestine
is
means
of
the
superior
supply
the
by
mesenteric
nerve
of
The
The
plexus, which is continuous with the lower part of the solar plexus.
and
finally
form
two
plexuses,
one
blood
vessels,
(Auerfollow
the
branches
bach's) which lies between the muscular coats; and another (Meissner's) in the
submucous coat.
The follicles of Lieberkuhn are found in the large and small intestine.
The large intestine (intestinum crassum) is about a quarter as long as the
It is called large on account of its diameter, being about two
small intestine.
It begins at the right and lower portion
in its broadest part.
inches
half
and a
of the abdomen, passes upward and backward to the under surface of the liver,
thence across the belly to the spleen, from this point downward and forward to
the left and lower part of the abdomen, here it makes a number of curves, and
finally plunges into the pelvis at its back part, and ends close to the perineum,
near the inner opening of the anal colon. Its divisions are the caecum, ascending, transverse, descending colon, sigmoid flexure, and rectum.
The glands
among
between
The
Tho caecum
the right iliac fossa; from this point the ascending colon
Here it forms the hepatic flexure, then passes transversely
across the belly below the stomach, and here the splenic flexure is formed,
then ii passes downward, forming the descending colon.
In the left iliac fossa it
forms the sigmoid flexure, and then passes through the pelvis as the rectum.
The large intestine has four coats with the same arrangement as the stomach
and small intestine: serous, muscular, areolar, mucous.
The large intestine has the crypts of Lieberkuhn and solitary glands. It
has no villi, no valvulse conniventes, no glands of Brunner, no patches of Peyer.
The vermiform appendix is a blind process given off from the caecum, varyin man from three to six inches.
(Plate CLLY.)
lies
in
The opening
nent
lips
latter,
is
of
ANATOMY
matter from
it
other way.
This
The
IN A NUTSHELL.
323
into the small intestine, while they readily allow of a passage the
is
large intestine
is
PLATE CXLV.
LIFT MASTOID PROCESS
GUST'
TWELFTH NERVE.
INT.
LARYNGEAL
N.
HYOIDBONE
iliac at
the rectum.
The
it
also receives a
vessels
form
blood sup-
contiunous series
from the caecum, where the vasa intestini tenuis anastomose with
first branch of the superior mesenteric given to the huge intestine.
The blood supply of the rectum is from the inferior mesenteric by the
Superior hemorrhoidal, from the internal iliac, by the middle hemorrhoidal, and
from the internal pudic by the inferior hemorrhoidal. The vessels at the lower
end of the rectum assume a longitudinal direction, communicating freely at the
anus and less freely above. The blood of the large intestine is turned into the
portal vein by means of the superior mesenteric and inferior mesenteric veins.
At the rectum a communication is se1 up between the systemic and portal system of veins, since some of the Mood of that pari of the intestine is returned into
the internal iliac veins.
In the lower end of the rectum the vein.-, like the arteries, are arranged longitudinally.
This arrangement is called the hemorrhoidal
of arches
plexus.
ANATOMY
324
IN A NUTSHELL.
differ in
intestine.
The rectum (intestinum rectum) extends from the sacro-iliac joint to the
It better deserves the name rectum (straight,) when we say it begins at
amis.
it is
nearer straight.
has the
It
same four coats that the intestine has. Its walls are thicker than those of the
The muscular coat and mucous coat differ from those of the outer porcolon.
The peritoneum of the upper part of the rectum is thrown
tions of the canal.
There are three semilunar transverse
upper part of the rectum on the right side, another about the
middle on the left side, and a third in front, opposite the base of the bladder.
They are called the folds of Houston.
The muscles of the rectum are the Sphincter ani, Internal sphincter, and
Sphincter tertius of Hyrtl. The rectum is supported by proper duplications of
peritoneum, the meso-rectum, and other fasciae.
into folds called appendices epiploic.
one
folds,
in the
Liver.
The Liver
(Plate CLIII)
about one-third of
its
is
and inferior.
and two extremities.
terior,
It
It
it
forms
It
it,
may
viz., anterior,
It is
extend over
pos-
and posterior;
Diaphragm and
anterior
abdominal wall; BELOw,the cardiac end of the stomach, hepatic flexure of colon,
right kidney, and first and second portions of the duodenum; behind, the tenth
and eleventh thoracic vertebra?, crura of Diaphragm,lower end of the oesophagus,
right suprarental capsule, and great vessels.
It has five lobes, (Plate CLXII) five fissures, five vessels, and five ligaments,
Its lobes are the right, left, caudate, quadrate, and Spigelian.
The ligaments
are the coronary, the right and left lateral or triangular, the suspensory, broad
or falciform, and the round ligament.
The round ligament is the remains of
the umbilical vein;
all
sels are the hepatic artery, hepatic veins, the bile ducts,
capillaries like
an artery.
are the transverse, fissure for the gall-bladder, fissure for the inferior
The
made up
The ves-
lymphatic vessels,
Its fissures
vena cava,
fissure.
righl
liver
is
The
of lobules
phrenic.
The
portal veins
may
325
ANATOMY IN A NUTSHELL.
The
PLATE CXLVI.
THYROID CARTILAGE.
CRICOID
FIRST
THORACICT
RIGHT BRONCHUS
LFFT BRONCHUS
CASuiAC END
PYLORIC
END
DUODENUM
1IGHT
COMMON
ILIAC
LEFT
COMMON
ILIAC
ANATOMY
326
go directly into the liver.
IN A NUTSHELL.
The nerves
from the
coeliac
plexus.
The hepatic duct is formed by the right and left bile ducts descending from
The biliary ducts are the cystic ducts which come from the neck of
It joins the hepatic forming the ductus communis cholethe gall-bladder.
dochus. These three are called the biliary ducts. The ductus communis choledochus empties into the descending duodenum about three inches from the
the
liver.
is
known
flesh,
On
as the sweetbread.
it
is
called the
LESSON
The pancreas
receives blood
XCIII.
its
pancreatic
branches, and from the superior mesenteric and hepatic by the inferior and
superior pancreatico-duodenalis arteries, which form a loop running round, below,
and to the right of its head. The blood is returned into the portal vein by
means of the splenic and superior mesenteric veins. The lymphatics terminate
in two glands which lie on the superior mesenteric veins.
The nerve supply of
the pancreas is branches of the solar plexus which accompany the arteries entering the gland.
Sometimes a lobe of the head is detached and has a duct of
its own opening into the duodenum about an inch above the pancreatic duct.
This
In
be
is
The
portal system
(Plate
CXXXVIII)
which
drain the viscera of digestion and unite to form the portal vein; the branches
correspond
to those of
The
inferior mesenteric.
perior mesentkkic, ascends along the right side and in front of the
artery, passes
ANATOMY
IX A NUTSHELL.
327
Splenic, drains the spleen by several branches, which soon unite into one,
this runs
from
left to right,
in a
part of the pancreas and unites with the superior mesenteric at the greater end
of the pancreas forming the portal vein.
and
It receives
PLATE CXLVIT.
mm t
Showing the Viscera Below the Diaphragm.
Ineerior mesenteric, passes upward behind the transverse duodenum
and pancreas to end in the splenic; drains the rectum, sigmoid flexure, and descending colon; and lies to the left of the artery; its hemorrhoidal branches
1
Gastric, two
in
number
as
iliac.
follows:
The
pyloric,
corresponding to the
pyloric branch of the hepatic artery, runs on the lesser curvature towards the
ANATOMY
328
and ends
pylorus,
tric
artery,runs on
IN A NUTSHELL.
The coronary, corresponding to the gastoward the oesophagus, and then curves
in
the lesser
omentum
to
end
the right end of the pancreas by the union of the splenic and superior mesenteric.
11
ascends
in the right
PLATE CXLVIII.
SUPERIOR
PANCREATICO DUODENAUS
INFERIOR
ABDOMINAL AORTA
of the liver,and
right
is
It
The
ANATOMY
IX A NUTSHELL.
329
and then upward in the longitudinal ligament, and, as a single trunk, through
the Diaphragm to the anterior mediastinal glands and thence to the right lymphatic duct: (2) branches which run forward and around the anterior margin to
the under surface, and thence in the longitudinal fissure to glands in the lesser
omentum; (3) branches which pass outward to the right lateral ligament and
thence, coalescing, either through the Diaphragm to the anterior mediastinal
glands, or inward, across the crus. to the thoracic duct: and (4) branches which
PLATE CXLIX
ABOVE
DIAPHRAGM
LESSER OMENTUM
LIVER
M
IN
C^HRAGM
FRONT
LIVER
ABDOMINAL WALL
LEFT
KIDNE1
=>/ CAPSULE
aV-PANCREAS
l.
w c
-
\plEEN
GREAT VESSELS
a/ SOLAR
PLEXUS
t oVTRANSVERSE
CRURA OF
Z
*-
MESO COLON
DIAPHRAGM
BELOW
'eat
omentum
transverse colon
3astr0- splenic
omeutum
Diaphragm
left
lobe to the
left lateral
Those on the under surface form three groups, viz., (1) branches arising
and passing to the lumbar glands; (2) branches
Burroduning the gall-bladder in a plexus and passing, with the hepatic Vessels
to glands in the lesser omentum and (3) branches arising to the left of the gallbladder and passing to the oesophageal glands or glands along the lesser curvato the right of the gall-bladder
The deep
accompany
a1
portal vein
either
enter glands placed along the lesser curvature or the stomach and behind the
pancreas, or join a lacteal before
it
ANATOMY
330
IX A NUTSHELL.
LESSON XCIV.
1V-V-CXCII-CXCIII-CXCIV).
cerebrospinal
or central nervous sysThe
tem, which ('(insists of the brain and spinal cord. The twelve pairs of cranial
nerves, and thirty-one pairs of spinal nerves make the peripheral system.
Besides these two systems there is the sympathetic system which is connected
Spinal Cord.
(Plates
with these two and closely associated with the vessels, viscera, and glands.
The spinal cord extends from the level of the foramen magnum (below the
decussation of the pyramids of the medulla) to the level of the upper border of
Its
the second lumbar vertebra, sometimes only to the first lumbar vertebrae.
length
is
from
one-half ounces.
It
is
somewhat
and
its
It
composed
of white
PLATE
SMALL
CL.
INTESTINE
ASCENDING COLON
Ot'SCENDISG
COLON
AORTA
THEMESSENTERY
Sac.
and forms one of the end stations for the sensory divisions of the
The substantia gelatinosa Rolandi was formerly thought to be
rich in neruoglia tissue, but in fad it is vert poor in this tissue.
The cord
has two enlargements, he i:i;\ ecal ami the lumbar.
The former is between
the third cervical and the second thoracic vertebra, reaching its greatest diameter,
which is transverse, in the sixth cervical, The latter is between the ninth thoracic and 6rs1 lumbar; its greatesl diameter, which is antero-posterior, is opposite
the twelfth thoracic vertebra.
These enlargements occur where the nerves are
given off to supply the extremities.
A- the cord is shorter than the canal, the
lumbar, sacral, and coccygeal nerve roots have a longer course than the nerve
nerve
fifth
cells
nerve.
<
ANATOMY
roots above them.
The
last
331
IN A NUTSHELL.
PLATE
FORAMEN OF WINSLOW
OMENTUM
LESSER
CLI.
SPINAL
PARIETAL PERITONEUM
/ISCERAL
COLUMN
KANCREAS
PERITONEUM
OUOCENUM
TRANSVERSE MESOCOLON
TRANSVERSE COLON
GREAT OMENTUM
THE MESSENTERY
GREAT
CAVITY OF PERITONEUM
POUCH
(I
OF
(i
A S
is
The conus
inedullaris
is
ANATOMY
332
terminates
thread,
in a .slender
IN A NUTSHELL.
is
continuation of the pia mater as far as the base of the coccyx, to the periosteum
It contains very litttle nervous matter, and is distinof which it is attached.
a
guished from the nerves of the cauda equina by its glistening white appearance.
The membranes of the cord are the same as those of the brain, viz., dura
The dura mater of the cord differs from that
mater, arachnoid, and pia mater.
it does not form (1) the internal periosteum, does not
to the walls, does not contain (3) sinuses, and does not send (4)
infoldings into the fissures of the cord. The nerve supply of the dura
mater is from the spinal nerves and filaments from the sympathetic. The dura
mater of both brain and cord send tubular prolongations over the nerves.
adhere
(2)
PLATE
behind
DIAPHRAGM
AND
CLII.
ANTERIOR
WALL OF
ABDOMEN
RIGHT
SUPRARENAL
CAPSULE
GREAT VESSELS
CARDIAC END OF
STOMACH
is
SECOND
COLON
RIP^-
OF
DUODENUM
Liver.
FIRST
It
HEPATIC FLEXURE OF
AND
PORTIONS
KIDNEY
fat, loose
areolar tissue,
and
foramen
magnum, to the axis and the third cervical vertebra, and below to the
posterior surface of BASE of the cocgyx. The subdural space is between the
It is
dura mater and the arachnoid and contains a small quantity of cerebro-spinal
The inner surface of the dura mater is lined with endothelium, and is
fluid.
The arachnoid
sembles
it
in
of the cord
is
more
vessels.
slight
blood supply.
It
It
is
devoid of
pia
ANATOMY
The
pia mater
is
the inner
IN A NUTSHELL.
membrane
of the cord.
333
It is closely
adherent
and sends septa into the anterior and posterior fissures of the cord.
The linea splendens is the thickened line of pia mater along the anterior median
The ligamenta denticulata are fibrous bands which are attached to the
line.
median lateral aspect of the pia mater from the level of the foramen magnum to
The ligaments are midway between the
the level of the first lumbar vertebra.
There are about twenty-one ligaments on
anterior and posterior nerve roots.
each side, extending from the pia mater to the dura mater, carrying the arachnoid along which it, not piercing it. The highest one of the processes is placed
between the hypoglossal nerve and the vertebral artery.
to the cord
PLATE
CLIII.
LEFT
LATERAL
LIGAMENT
LOBE
INFERIOR VENA CAVA
Liver.
reticula
It is situated at
of
medium
confined chiefly to the dorsal region, but also extending a little above and below
LESSON XCV.
The
it.
'
anterior and posterior nerve roots of the spinal cord emerge from the
ANATOMY IN A NUTSHELL.
334
is
portions of
ward
or
it
in
may
varying lengths, or
downward,
in
which
dis-
canal of the embryo, from the walls of which the spinal cord
have
It is
is
is
formed.
The
may
PLATE
CL1V.
RIGHT LOBE'
BILE DUCT
Liver.
A tumor
would be an example of a focal disease, or disease of one of the segments (a portion of the cord with a pair of nerves). Locomotor ataxia is an
example of a systemic disease.
Fractures of the spinal column above the fifth cervical vertebra
above the
origirj of the phrenic nerve, are almost always fatal because of paralysis of the
diaphragm. Fractures of the fifth, sixth, and seventh vertebrae cause paralysis of the intercostal and abdominal
muscles and death usually results.
region the
prognosis
is
not
unfavorable.
Degenerations
in
ANATOMY
IN A NUTSHELL.
335
and fibers which carry impulses for inhibition of reflex action. The vasomotor
and inhibitory fibers pass to the motor cells of the anterior horn. When the
crossed pyramidal tract degenerates these inhibitory and vasomotor fibers are
included, and dilatation of the blood vessels and increased reflexes result.
In spina bifida there is an overbundance of cerebro-spinal fluid with faulty
development of the posterior walls of the lumbar portion of the spinal canal.
In this condition the membranes are pushed through the opening in the spinal
canal by the weight of the cerebro-spinal fluid.
The subarachnoid spaces of the cord and brain are continuous and connected
PLATE
3.
1.
PLEXIUS OF CAPILLARY
INTERLOBULAR VEINS
4.
TWIGS
OF
INTERLOBULAR
V.
VEIN, PASSING
The Vessels of
CLY.
TO
THE
2.
ADJACENT
INTRALOBULAR
VEIN.
LOBULES.
with the fourth ventricle by the foramina of Magendie, Key, and Retzius.
The opening of a spina bifida may drain the cerebro-spinal fluid from the brain
and result in fatal convulsions.
The fissures of the cord are antero-median. postero-median, two anteroThese fissures
lateral, two postero-lateral. and two dorso-intermediate fissures.
divide the cord into eight columns, viz.. ventral, lateral, "Goll, ami Burdack
(posterior.)"
side.
fibers of the
arranged in tracts, but these tract- are not recognizable in the adult cord, but
The
only during development or when affected with disease or degeneration.
facts concerning the tracts have been ascertained by embryologies! and pathological research.
is
somewhat
where the anterior nerve roots leave the cord i> not always called a fissure, and
If we lake this dithe dorso-intermediate one is only in the cervical region.
The
vision there are only eight fissures and eighl columns in the spinal cord.
antero-median fissure extends about one-third the diameter of the cord, toward
ANATOMY
336
It
IN A NUTSHELL.
has
in
it
equal, as in Goll
much
and Burdack.
PLATE
CLVI.
the portion
in
in
matter
(Plate IV).
"H;"
a capital letter
front
it
of the
is
form of
and
the anterior gray commissure, and
is
in the
gray commissure
its
is
membranes
cord
is
in the
The portion
of white
The blood
ANATOMY
337
IN A NUTSHELL.
ies are
to
median
artery.
This artery
PLATE
lies
make one
it
CLVII.
LEFT COMMON
ILIAC VEIN
MIDDLE
branches
and extends the wholelength of the cord. It recieves
oi the spinal cord.
thesubstance
into
branches
sends
lateral spinal arteries, and it
vertebral arteries
The posterior spinals are also two in number; they come from the
from the posterior inferior cerebellar);
a, the side of the medulla (occasionally
supplies,
there is another
the posterior nerve roots (occasionally
cauda equina. Each Begbranch in front of the posterior nerve roots) to the
they pass
down behind
PLATE CLVIH.
NO. 2.
NO. 3.
the Cecum,
Showing the Vermiform Appendix and Four Forms of
338
ANATOMY
nient
IN A NUTSHELL.
339
made by
to the
its
segment above and below. The blood supply of the vertebral column and
ariculation
the vertebral,
is
cervical, intercostal,
nerve supply
is
LESSON XCVI.
Brain.
(Plates
CLXVIII -CLXXXIII.)
There
is
is
called
make
This
last
svsteni
is
called
PLATE CLIX.
ASCENDING
CAECUM.
'
The
the nerve of organic
animal
life.
The
life
^^-=^^5^
4PPFN0IX
Ileo-Ctecal Valve.
is
nervous system
COLON
alkaline,
is
1.
Anterior commissure.
2.
Middle commissure.
3.
Posterior commissure;
4.
Corpus callosum.
5.
Optic commissure.
6.
Pons
Varolii.
is
the brain
Lessened by
white commissures.
L.036,
which
is
more
connected by
ANATOMY
340
7.
Fornix, which
IN A NUTSHELL.
is
The following
1.
Olfactory tracts.
2.
Taenia semicircularis.
3.
Crura cerebri.
4.
Processus-e-cerebello ad testes.
5.
6.
Fornix.
7.
Infundibuluni.
8.
Lamina
0.
Gyrus fornicatus.
10.
Cinerea.
Fasciculus unciformis.
LESSON XCVII.
is
white.
it is
Avhich
is
called cortex,
of the brain
is
PLATE CLX.
MUSCULAR BANDS
TAENIAfc
COLI
CLXV-CLXVI-CLXV1
a
is
).
The substance
thickening of the walls of the tube; the hollow of the tube makes the central
filled
is
There are
dilated as
The rooms, or
ventricles in
it
five ventricles in
front;
the brain.
ANATOMY
IN A
NUTSHELL
341
tricle; as this passage goes forward between the crura cerebri in front, and
the corpora quadrigemina behind, it is contracted and is called the aqueduct of Sylvius (iter e tertio ad quartum ventriculum) from here it passes into
a narrow but high room, called the third ventricle, which is between the optic
;
The brain
mid-brain, and
consists of four
(4)
hind-brain.
in
main parts,
The brain
(1)
is
PLATE CLXI.
CYSTIC
SPLENIC ARTERY
DUCT
SUPRARENAL
CAPSULE
ORIFICE
OF ACCESSORY
PANCREATIC
DUCT.
SUP.
interior
MESENTERIC ARTERY
vena cava.
called the
The
dura mater, arachnoid, and pia mater. The arteries which supply the
dura mater are derived chiefly from the anterior, middle, and posterior menin-
viz.,
geal.
ANATOMY
342
ternal carotid
The
and vertebral
arteries.
A NUTSHELL.
is
fifth, sixth,
the third,
IX
exterior of the
cerebrum
is
uneven, having
hills
and
valleys.
The
hills
The
secondary. The primary are
complete Assure makes an impression in a
are called gyri, or convolutions; the valleys are called sulci, or Assures.
larger fissures are called primary, the others
either
complete
or incomplete.
PLATECLXII.
UUCTUS VENOSUS FISSURE
RIGHT LOBE
LEFT LOBE
UM B,LICAL FISSURE
-GALLBLADDER
F.-SSl).
fissure of Sylvius,
it
it
The
last
two
LESSON XCVIII.
The right and left lobes of the cerebrum are connected by the corpus
CALLOSUM. There are five lobes in each hemisphere of the brain.
The brain is the encephalon; the part of the cerebro-spinal axis which is
contained
the cranium.
cerebellum or
of the
whale
little
five
Its
pounds.
Like the bark (cortex) of a tree the cortical layer of the brain covers the
surfaces of the brain.
It
is composed of cellular nerve-material.
ANATOMY
IN A NUTSHELL.
343
The Assures or sulci of the brain are infoldings of the cortex and the more
numerous and deeper they are, the greater is the amount of the peripheral gray
substance.
is
of the brain
PLATE
CLXIII.
SEROUS COAT
LONGITUDINAL MUSCULAR LAYER
CIRCULAR MUSCULAR
AREOLAR
MUCOUS
LAYER
COAT
COAT
DUODENUM
Orifice.
It
bral artery in
wing
it,
lesser
of sphenoid
isle of Reil.
(c)
sulcus separating
(d)
It
is
The transverse
Calloso -marginal fissure is nearly concentric with the callosal and also
with that of the margin of the hemisphere until a point above the hind end of
(f)
the callosum
ward
to the
is
reached, at which the fissure turns and runs upward and back-
upper border.
ANATOMY
344
IN A NUTSHELL.
(g) Calcarine fissure (from calcar, "a spur"), runs from near the rather
pointed hind end of the hemisphere upward and forward, and just beyond the
middle at the point where it receives the parieto-occipital, binds downward
fissure,
(h)
lateral
of the callosum.
is
below the
fissure of Sylvius
on the
LESSON XCIX
TllK PRINCIPAL LOBES OF
1.
parietal
2.
Frontal lobe
by the
is
fissure of
Parietal lobe
is
(Plates
CLXXV).
Rolando or central
fissure.
PLATE CLXIV
FORE- BRAIN
OPTIC
GERMINAL
NEURAL GROOVE
PRIMITIVE
VESICLE
AREA
SECOND CEREBRAL
STREAK
VESICLE
MESODERM
NEURAL CREST
tin
Occipital lobe
parietal lobe
.">.
fissure, lobule of
island of lb
il
is
is
ANATOMY
IN A NUTSHELL.
345
human brains vary in details of the gyri. and the same brain may
on its opposite sides. The gyri are best marked when one reaches his
highest mental development.
The principal gyri or convolutions are: (Plate CLXXV-CLXXXIIIDifferent
differ
CLXXXIV).
1.
Angular gyrus
is
superior temporal fissure, the hindmost one of the four parietal gyri, separated
by a short
2.
vertical sulcus
Annectent gyrus
is
is
front.
PLATE CLXV.
SURFACE ECTODERM
^^
CREST
TJEURAL
GANGLION
POSTERIOR
SPINAL
NERve
GANGLION
SYMPATHETIC
GANGLION
parietal
Calossal gyrus
is
immedately over the corpus callosum and below the calloso-marginal fissure.
It is continuous behind with the gyrus hippocampi, and ends in the gyrus uncinatus, also called gyrus fornicatus, convolution of the corpus callosum.
The
by
They
are
cerebrum,
and
ANATOMY
346
IN A NUTSHELL.
That part of the first frontal convolution which appears on the median
the hemisphere is the marginal gyrus, or it is that gyrus which arches
10.
side of
The
12.
<>!'
and external.
The
13.
PLATE CLXVI.
OPTIC THALAMUS
EPENCEPHALON
MEDULLA OBLONGATA
TERMINALS
CEREBRAL
&
MID
BRAIN
\ OLFACTORY
DIVERTICULUM
HEMISPHERE
FORAMEN OF MONRO
A Horizontal Section of
a Vertebrate Brain.
and
posterior central
Lateral
Sigmoid gyrus is the somewhat S-shaped fold which curves about the
end of the cruciate fissure and whose surface includes several constant
The temporal
17.
Uncinate gyrus
gyri, a general
is
in
name
the median
L9.
slender
roll of
is
lodged
in
is
the insula.
its
exposed surface.
is
a long
ANATOMY
347
IN A NUTSHELL.
LESSON
C.
Besides the gray matter of the cerebral hemispheres of the cerebellum and
the meddulla oblongata, and the ganglia at the base of the brain are:
(a) Olfactory bulb which is the anterior enlargement of the olfactory-
(b)
Optic thalamus
is
lenticular nucleus
It gives origin to
some
by the
internal cap-
nerve.
PLATE CLXVII.
PINEAL
CORPRA
BODY
fe
%,
QUADRIGEMINA
CEREBELLUM
MEDULLA OBLONGATA
OLFACTORY DIVERTICULUM
THALAMUS
mals below mammals. In man they are marked by a cross-furrow so they are
called corpora quadrigemina, and constitutute what are called the nates or
The optic nerve arises in part from the optic lobes.
testes of the brain.
(e) Tuber annulare is the annular tuber of the brain, the pons Varolii.
The
anterior commissure
is
(Plate
CLXXX).
It
in
viz., in
man
the temporal
It
It
the caudate nucleus and the posterior two-thirds of the lenticular nucleus where
The A.NTERIOB comit is spread out in the substance of the temporal lobe.
missure
is
ANATOMY
348
creases
terior
and
in size
IN A NUTSHELL.
The
man
in
is
in
osmatics
it
is
is
large
The posterior portion of the anterior commissure connects the temlobes and the amygdalae nucleus of opposite sides.
The middle fibers
fishes.
poral
through the olfactory bulb of one side to the temporal lobe of the opposite
Thus we may have a lesion on one temporal lobe producing loss of smell
of the opposite side of the nose called crossed anosmia.
The middle or soft commissure is gray; it is very delicate, though somepas
side.
time-
it
is
double.
It
PLATE CLXVI1I.
EPIPHYSIS
CORPORA QUAORIGEMINA
5TH VENTRICLE
IN
SEPTUM LUCIDUM
FORAMEN
Of
MONRO
HYPOPHYSIS
A
the
month
of intra-uterine life.
It is not really a commissure as no fibers
from one side of the brain to the other.
The posterior commissure is white and is situated behind the upper end of
fifth
pass from
the
it
aquedud of
The
ventricle.
Sylvius.
It
pineal gland
The
fornix
is
composed
of
Longitudinally
arched
bundles of
fibers.
It
ANATOMY
consists of a
IN A NUTSHELL.
pillars
349
pillars
It is sit-
uated just beneath the corpus callosum. its posterior part being attached to the
corpus callosum. The body is triangular with the apex in front and base be-
forms one of the boundaries of the roof of the third ventricle and part
The anterior pillars or columx.e forNICES, descend from the gray matter of the third ventricle behind the anterior
commissure and in front of the foramen of Monro.
As they descend they
spread out. leaving an interval which is occupied by the septum lucidum.
hind.
It
They
receive reinforcements
from the
tsenia semicircularis
PLATE CLXIX.
GREAT
LONGITUDINAL
FISSURE
j&M
OLFACTORY TRACT
of Vizq'd'azyr.
the optic
thalamus called
body of the fornix and between the diverging crura and the splenium of the
corpus callosum is the psalterium or lyra consisting of white matter and having
on its surface some transverse oblique, and longitudinal line-.
From it- fancied
of the
''
semblance
to
is
called a lyra.
Bach
passes around the pulvinar of the optic thalamus and then descends
pillar
in
the
ANATOMY
350
IN A NUTSHELL.
hemisphere of the brain: the commissure magna or trabs cerebri. This strucis peculiar to the mammalia; it is first found in a rudimentary state in the
implacentals, and increases in size and complexity to the highest mammals,
ture
It is also
called callosum.
It
is
and
occipital
It is three
and
one-half inches long on the superior surface and two and one-half inches on the
inferior.
<>f
It
the brain
of the posterior
boundary
of the brain.
It
PLATE CLXX.
BODY Cr LATERAL VENTRICLE.
CHOROID PLEXUS0F CAUDATE NUCLEUS
EXTERNAL CAPSULE
OPTIC TRACT
HlPPOCAMPAL FISSURE
A Coronal
ur.. uri
ALBICANTIA
convex above and concave below, thinner in the center of body than at either
Tin: posteriob end is called the splenium or ped.
The anterior end
which is between the frontal lobes is called the genu or Knee. The rostrum is
is
end.
and
joins the
lamina cinerea.
On
the superior
ANATOMY
ward from the
major are
IN A NUTSHELL.
351
anterior
fibers
occipital lobe.
LESSON
CI.
The septum lucidum forms the inner boundary of the lateral ventricle and
genu and rostrum of the corpus callosum.
Posteriorly
and inferiorly it is united with the fornix and its anterior peduncles. (Plate
CLXXXIV). It consists of two laminae which enclose the fifth ventricle. It is
unites in front with the
PLATE CLXXI.
LATERAL
SINUS
;>
ependyma when
It
is
ANATOMY
352
IN A NUTSHELL.
choroid
plexus
of
the
The
bounary
lateral
tegmentum
of the
The
internal capsule (fibres of the crusta or pes) separate the outer sur-
Each
optic thalamus
(1)
PLATE CLXXI1.
ANTERIOR CORNU
FORAMEN OF MONRO
POSTERIOR CORNU
This surface
depression
is
The
is
Anteriorly
divided by the
is
it
grows
into a
gonum
habenulae.
The
internal
body
is
The
of gray
matter
internal geniculate
situated on the inferior and inner side of the pulvinar, between the
is
It is
353
ANATOMY IN A NUTSHELL.
It is of
mus
The
and
body
PLATE CLXXIII.
ANT COMMUNICATING
The Circle of
developed from the hind*
in
ture,
first
front of
follicles
Willis.
to
Its
(Plate
CL XXX).
ANATOMY
354
NUTSHELL
IN A
Then' arc numerous peduncles of the brain. Those of the cerebellum are
three pairs and are stout bundles of nerve fibres which connect the cerebellum
They
and
are distinguished
The
by
their posi-
superior pair
emerge from the mesial part of the medullary substance of the hemispheres, and
run forward upward to reach the nuclei tegmenti of the opposite sides, after
decussation under the formatio reticularis. Also called (1) crura ad corpora
quadrigemina,
(2) crura
ad cerebrum,
processus-e-cerebello ad testes.
junctoria).
(Plate
(.">)
(3)
(6)
(4)
branchia con-
CLXXXVIII).
PLATE CLXXIV.
The middle
from the
pair
The
fissures of the
The
CI
I.
emerging
(Also called
CLXXXVIII).
(Plate
LESSON
horizontal.
is
in
number
two
vertical
and one
middle
peduncles, and extend- around the outer and posterior border of each hemisphere.
(Plate
CLXXXVIII).
ANATOMY
The vermis
the cerebellum
is
is
IN A NUTSHELL.
255
divided into
is
the pons.
It consists of
semiovale.
is
(a)
mass
open an-
(b)
A somewhat
ciliare.
PLATE CLXXV.
FISSURE OF ROLANDO.
PERFORATING BRANCHES
MIDDLE
CEREBRAL
A.
IN
FISSURE.
OF SYLVIUS.
lies
The lateral tract is continuous with the lateral column of the spinal cord,
behind the olivary body and in front of the restiform.
The restiform body is the inferior peduncle of the cerebellum, by which it
and
It
cere-
of thecord,
The
fillet is
A vesicle is
and cortex
cerebri.
It
is
in a
body.
They
are
I
ANATOMY
356
so transitory,
embryonic and
IN A NUTSHELL.
They
are
^d
braiD
They are
The three commonly form
hind-brain.
five
by the subdivision
of
The
fornix
bundles of
up. as
is
fibres,
Longitudinal
In the human brain it consists of two
an arch.
albicantia pass
corpora
the
from
rise
which
one on each side,
of Monro
pillars of the fornix in front of the foramina
the anteriob
PLATE CLXXVI.
ARR
Section^f Brain).
Showing Blood Supply on Mesial Surface, (Sagittal
somewhat flattened and in apposiand behmd the anterior commissure, these
the corpus callosum and above the
tion to each other, arch backward beneath
fornix and then diverge toward
velum interpositum, forming the body of the
turn down, as the posteriok pillars
the back pari of die corpus callosum, to
cornua of the
fornices), into the floor of the descending
f
lateral ventricles,
The fimbria
concave side
the fornix.
The
is
pillars of
taenia
It
is
and thought
ANATOMY
The cerebellum
is
IX A NUTSHELL.
357
life.
It is
It
is
tricle.
The pons, also called pons Varolii and pons cerebelli, is a great transverse
commissure seen at the base of the brain in front of the medulla. Its fibres
connect the hemispheres of the cerebellum with each other and the medulla.
The medulla oblongata is (a) marrow; (b) the so-called spinal nervous system; the myelon; more fully called medulla spinalis: (c) the hindmost segment
of the brain, continuous with the spinal cord.
PLATE CLXXVII.
stomach)
is
a small cavity.
Those of the
brain are a series of connecting cavities, containing fluids, within the brain,
formed by
a folding
They
ANATOMY
358
The
side,
IN A NUTSHELL.
central fibres of each tract are continued into the optic nerve of the opposite
decussating in the commissure with similar fibres of the opposite tract.
The
ventricles arc
FIFTH
with each other and with the third ventricle through the foramen of Monro.
PLATE CLXXVIII.
NINTH
TENTH
AND ELEVENTH
LIGAMENTMM DENTICULATUM
the aqueduct
of a
It
of Sylvius.
different
layers of the
and
left
ANATOMY
IN A NUTSHELL.
359
LESSON cm.
about one and one-half inches long and threeIt extends
from the foramen magnum inferiorly to the pons superiority. It is the smallest
part of the main divisions of the brain but the largest from a physiological
is
standpoint.
It has five
inhibitory, (3)
main centers
Vasomotor,
in
(4) Diabetic,
it,
and
viz.,
(1)
Respiratory,
(5) Salivary.
(Plate
Cardio-
(2)
CLXXXV1I).
PLATE CLXXIX.
OPHTHALMIC
VEIN-
OLFACTORY BULB
CAVERNOUS SINUS.
OPTIC
OPTIC
|NT.
NERVE
COMMISSURE
CAROTID
ARTERY
OPHTHALMIC DIVISION
OF FIFTH N
THIRD N
FOURTH
BASILAR
SIXTH N
VERTEBRAL
AUDITORY ARTERY,
ANTERIOR
.AUDITORY AND FACIAL
AND
PNEUMOGASTRIC
HYPOGLOSSAL
PETROSAL
STRAIGHT
A.
GLOSSOPHARYNGEAL
SUPERIOR PETROSAL
INFERIOR
A.
SPINAL
SPINAL ACCESSORY
SINUS.
OCCIPITAL SINUS
TORCULAR
HEROPHlLl
RIGHT
LATERAL
SINUS,
SINUS.
>jPERI0R LONGITUDINAL
body
superiority
and the
ANATOMY
360
IN A NUTSHELL.
off,
from
an opening
Next
have part
of the restiform
body.
postero-median
(2)
funiculus
to the olivary
cuneatus,
(3)
the
and
Another name
The
and on each
fissure
side'
of
it
we
posterior surface of
funiculus
is
ped-
is
(1)
Rolando.
(4)
lateral
The
tract.
upper portion of the posterior surface makes the restiform body or the inferior
peduncles of the cerebellum.
PLATE CLXXX.
POST. COMMISSURE.
EPIPHYSIS
OR
PINEAL GLAND.
ANT v COMMISSURE.
U "^FORAMEN
OF MONRO.
OPTIC NERVE.
INFUNDIBULUM.
HYPOPHYSIS
OR
PITUITARY BODY.
The fibres in the cold which travel through the direct cerebellar tract,
which is in the lateral column of the cord, pass up into the medulla into the restiform body, instead of passing straight into the lateral column. The funiculus
Rolando is a continuation of the gray matter from the posterior horn of the
where it is called substantia gelatinosa Rolando, up into the medulla
where it is situated between the funiculus cuneatus and lateral column.
cord,
Cerebellum
about
five
In early child]
situated
in
(little
ounces.
It
1
it
brain)
is
It
weighs
from the
two hemispheres connected
It
consists of
The medulla
is
ANATOMY IN A NUTSHELL.
inferior portion in a groove called the vallecula.
in a
worm between
The
361
falx cerebelli
is
situated
The hemi-
spheres have fissures like the cerebrum but do not have convolutions like the
cerebium but instead have folia. The cerebellum is gray on the outer side and
It
ventricle.
PLATE CLXXXL
CORPORA
QUADRIGEMINA
TRACT
SUPERIOR
CEREBELLAR
PEDUNCLE
FOURTH
VENTRI CLE
^?^^^^ (^^^n;
x
HIDDLE CEREBELLAR
PEDUNCLE
INFERIOR
% ^2f*73
^%l\\ ^
-^>
:
CEREBELLAR
PEDUNCLE
Ml
EIGHTH NERVE
NUCLEUS
Fibers.
(1)
Lingular
Fraenulum
Precentral fissure
(2)
Lobulus centralis
Post-central fissure
Anterior crescentic-lobule
(3)
Oilmen monticuli
Preclival fissure
(4)
Clivus
Post-clival fissure
(5)
Folium cacuminis
Posterior erescentic
lobule.
ANATOMY
3(52
IN A NUTSHELL.
parts:
Flocculus
(2)
Nodule
Uvula
(3)
Pyramid
Biventral
(4)
Tuber valvulae
Post-gracile fissure
Flocculus
(1)
Amygdala
BiventraJ
Amygadala
Slender lobe
Sledner lobe
Post-gracile fissure
(Inferior semilunar)
(Inferior semilunar)
There are four sets of gray nuclei in the white matter of each hemisphere
called (1) Corpus dentatum. (2) Nucleus emboliformis. (3) Nucleus globosis.
(Plate CLNXI).
h Nucleus fastigii.
I
PLATE CLXXXII.
afferent
and efferent
fibres.
The
[NFERIOK ONES connect the cerebrum with the cord and are called the restiform
bodies.
LESSON
The pons
is
CIV.
It is
con-
is
connected
to the
medulla by
fibres
There
It
is
It is
are afferent fibres immediately beneath the superior peduncle in the valve of Vieussens.
of
Its
ANATOMY
IX A NUTSHELL.
363
downward.
is
Its superior
PLATE CLXXXIH.
Anteriorly
(1)
the
fillet.
formatio reticularis,
will
cause paralysis of the opposite side of the face and opposite side of the body
if it is
same
ANATOMY
364
it.
IN A NUTSHELL.
The
posterior portion
is
it.
its
from four main sources (1) from the nucleus gracilis et cuneatus of the
same side. (2) from nucleus gracilis et cuneatus of opposite side, (3) from the
(4) from the
lateral column of the cord through the direct cerebellar tract,
fibres
PLATE CLXXXIV.
The area where the cranial nerves leave the brain substance is called the
The group of cells from which the fibers spring or in which
they end is the deep origin.
(Plate CLXXXVII).
Rule.
The deep origin of all the cranial nerves, except the first and second ;ind a part of the eleventh, is in the floor of the aqueduct of Sylvius or
in the floor of the fourth ventriclk.
The third and fourth have their deep
origin in the aqueduct of Sylvius.
The fifth, sixth, seventh, eighth, ninth,
tenth, pari of the eleveth, and twelfth have their deep origin in the floor of the
Si
perficial ORIGIN.
fourth ventricle.
Definition
for
centre.
(2)
(1)
in
the performance of
some func-
The
and second cranial nerves are processes of the brain and therefore
superficial nor deep origin.
We say there are twelve pairs of
cranial nerves; it would be better to say twelve sets for in the first or olfactory
nerves there are twenty or thirty nerves.
The first nerve is one of special sense,
first
have neither
thai of smell.
for smell
is
in
(Plate
ANATOMY
IN A NUTSHELL.
365
CXCIX) the secondary center in the uncinate gyrus of the temporal lobe
This has been demonstrated
on the mesial surface. (Plate CLXXXII).
by experiments upon animals and by pathological research on the brain of man.
In osmatic animals these lobes (gyrus hypoeampus, uncinate, and hippocampus
major) where the center of smell is located, are well defined. In anosmatic
they aresmall. If the olfactory tract be removed these lobes will atrophy and in
case of lesion in these lobes the loss of smell (anosmia) will follow.
factory tracts, which are white,
lie
The
ol-
from the under surface of the frontal lobe. The bulb is reddish-gray in color
and lies on the cribriform plate of the ethmoid. From the bottom of these bulbs the
olfactory nerves are given off, twenty or thirty in number, to be distributed to
The three roots
the cells of Schultze in the Schneiderian membraxk.
from the tracts are the external, middle, and internal. The external root
PLATE CLXXXV.
white and extends into the anterior end of the hippocampus gyrus of the tem-
The middle one is gray and ends in the trigonum olThe inner one, or mesial hoot, is white and passes backward and
end in the anterior extremity of the gyrus fornicatus. The mesial
poro-sphenoidal lobe.
factorium.
inward
to
root
continuous with one end of the limbic lobe and the external root with
This nerve is made up exclusively of non-medullated fibers.
They
is
the other.
are deficient
a
in
of axis-cylinders with
distant nucleated sheath in which there are, however, fewer nuclei than
ordinary non-medullated
1.
2.
in
the
fibers.
3.
Parosmia
is
4.
Kakosmia
is a
the odor
is
ANATOMY
366
IN A NUTSHELL.
The arachnoid holds the tracts in position in the sulci. The dura mater
covers the nerves and is continuous with the periosteum of the nasal fossa. The
pia
mater
is
PLATE CLXXXYI.
CuHNU OF
LE.-T
LATERAL VENTRICLE
TENIA SEMICIRCULARIS
EXTERNAL CAPSULE
CLAUSTRUM
IN
PIA MATER
HIPPOCAMPAL FISSURE
OF CORPUS CALLOSUM
The second cranial nerve or optic nerve is a process of the brain like the
The center for sigh* bin the cuneate lobule of the occipital lobe. The
optic aerve extend- forward and outward from the optic commissure or chiasma
olfactory.
ter to
of the
is
the cen-
rectangular and
ANATOMY
diaphragma
of the
tuber cinereum.
tracts
sella.
On
Above
either side
is
it
IN A NUTSHELL
is
367
it
is
The
the
optic
extend outward and backward from the chiasma to (1) the external genbody.
(2) The posterior or inferior quadiigeminal body.
(3) The
iculate
PLATE CLXXXVII.
DESCUSSATION OF PYRAMIDS.
mus.
From
(4)
Under part
these four parts the optic radiations extend to the center of sight.
Those
lesion
ANATOMY
368
IN A NUTSHELL.
PLATE CLXXXVIII.
INTERNAL
GCNICULATE
BODY
4TH CRANIAL N
SUPERIOR PEDUNCLE
MEUDLLART VELUM
Tim: Superior
first
The motor
eyeball,
lion
The
frontal,
and the
eyeball
(2)
malar, and
excepting the
oculi, trochlear,
with one of
fifth
iis
is
first.
The
optic nerve
th<
is
roots,
Located
ethmoid,
(3)
in
iris.
sphenoid,
(4)
lachrymal,
(5)
In the
ANATOMY
IN A NUTSHELL.
369
communicates with the cavity of the cranium by (1) the optic foraIt communicates with four fossa?, (1) with
the sphenoidal fissure.
the nasal fossa by the nasal duct. (2) with the temporal fossa, (3) with the
zygomatic fossa. (4) and with the spheno-maxillary fossa. These last three by
The
orbit
men and
(2)
Each
orbit
(1)
supraorbital,
(2)
terior ethmoidal, (4) posterior ethmoidal. (5) optic. (6) sphenoidal fissure, (7)
spheno-maxillary
LESSON
The
floor
maxillary;
is
malar foramina.
CV.
(1)
(2)
(3)
the
PLATE CLXXXIX.
CPTIC TRACT
3RD CRANIAL
-OPTIC TRACT.
N.
-EXTERNAL GENICULATE
MOTOR RCOT OF bTH N.
BODY.
N.
palate.
is
somewhat
fiat
and has
(1)
by
ly;
At
for
the
(2)
its
bones.
two
(1)
the
is
It
the
bom
s,
is
at
(3) the os
The
frontal
root' is formed
bone anterior-
bone;
of
outer angle
by four
suture posteriorly.
orbital plate
(2)
(">)
planum
of the
ethmoid;
(4)
body
maxillary
(2) the
is
formed
lachrymal
of the sphenoid.
mal suture;
(4)
ethmo-sphenoidal foramina.
ANATOMY
370
IN A
NUTSHELL
The outer wall is formed by two bones, the orbital process of the malar and
It presents (1) the opening of the malar
wing of the sphenoid bone.
greater
the
The four boundaries of the orbit make four
canal. (2) spheno-malar suture.
external, superior internal, inferior external,
and inferior internal. The superior external angle has(l) fronto-malar and
angles, viz., the stjperiob
PLATE CXC.
in
the Brain.
fissure
and sixth
PLATE CXCI
ANTERIOR
CONUS
GANGLION ON
POSTERIOR
-THORACIC
MEDULLARS
NERVE
SPINAL ARTERY
XII
ROOT
LUMBAR
COCCYGEAL
FILUM
TERMINALE SURROUNDED
BY
CANDA
\.
EQUINA
ANATOMY
372
The superior
internal
IN A NUTSHELL.
angle has
(1)
and
foramen which transmits the posterior
ethmoidal vessels and sometimes a branch of the nasal nerve. The inferior external angle has the spheno-maxillary fissure which is formed by the greater
wing of thf sphenoid bone externally and the superior maxillary bone and palate
bone internally. This fissure connects the orbit with (1) the temporal fossa,
(2) zygomatic fossa, (3) spheno-maxillary fossa and transmits the infraorbital
artery, superior maxillary nerve and its orbital branches and the ascending
nasal nerve, (2) the posterior ethmoidal
PLATE
CXCII.
DENTICULATUM
LIGAMENTUM
POSTERIOR ROOT
LINEA
SPLENDNS
ANTERIOR
ROOT
The
At
is
ethmo-max-
between the two roots of tin h sser wing of the sphenoid. It transmits
and opthalmic artery, the nerve lying above and inner to the
arten-.
The ligament of Zinn is attached to the circumference of the optic
foramen, deficient at the upper and outer part, and gives a common origin to the
which
is
in
the orbit,
viz..
ANATOMY
373
IX A NUTSHELL.
PLATE
CXCIII.
H
^C\
A.
ATTHELEVEL OF THE6TH
CERVIC/-. NERVfi00rr
ANTERIOR FISSURE
CENTRAL CANAL
POSTERIOR ROOTS
ANTERIOR ROOTS
0.
Transverse Sections
4.
tina
Amblyopia
is
and without an
5.
lesion
Amaurosis
is
<>k
MEDULLARS
E.
ROCTi
Li.\ els.
re-
ANATOMY
374
6.
IN A NUTSHELL.
is
is
7.
Ny<
8.
Hemianopsia
ai.<
is
Myopia
is
PLATE CXCIV.
Hypermetropia
parellel rays
11.
behind the
or
hyperopia
is
far-sightedness,
the
focusing
of
retina.
age dependenl
removed
be
12.
Emmetropia
13.
Astigmatism
is
is
imperfections of
the lens, (2) unequal contraction of the ciliary muscles, (3) retinal imperfections.
PLATE CXCV
PARUTiD
GUND
TEMPORAL
'DISTRIBUTION OF FACIAL NERVE
POSTERIOR AURICULAR
A.
SUBMAXILLARY GLAND
EXTERNAL
$1
*.
'
fig *J*Sfe<i
'
CAROTID
SUBCLAVIAN ARTERY
INNOMINATE
ARTERY
VEIN
INTERCOSTAL ARTERY
NERVE
PARVAGUM OR
PNEUMGGASTRIC
SPLENIC
WITH
COELIAC
Jjx.
"V^).',
RIGHT
V =^S*^SUP
\^^^T
-
VSLiP MESEV
ESENTERIC PLEXUS
SPERMATIC CCRD
ARTERY
SPLENIC
PLEXUS
AXIS
IT?/'
'
'
if-
PUBIS SYMPHYSIS
ANATOMY
370
in
superioris, (2)
IN A NUTSHELL.
(3)
Rectus
Rectus internal,
inferior, (4)
(5)
Rec-
ed to the eye-ball except the Levator palpebrae superioris. The third nerve supseven muscles, ail except the Superior oblique which is sup-
plied
is
(Plate CCVI).
The eye-ball
spheroidal
is
in
forming
its
The
(a)
and being
is
and
retina.
is
mem-
brane, continuous with the cornea in front, the two forming the external coat
of the eye-ball.
The choroid
(b)
is
the coats or tunics of the eye-ball, lining the sclerotic, and lying between
the retina, with
(c)
part of
which
The retina
it is
in
contact by
its
inner surface.
The
is
Plate
the innermost
('(').
(a)
humor.
is
a limpid,
watery
fluid
which
fills
(b)
is
in front of
the vitreous
(c)
is
eye-ball
is
composed
media.
choroid,
of:
(b)
(2)
the
of
'_'.
:;.
\.
CVI.
limitans interna.
5.
6.
7.
layer.
Membrana
Layer of
limitans externa.
roils
(a)
9.
8.
about
Membrana
fills
lens.
(Plate (V,.
1.
of the eye.
iris
substance which
LESSON
The
com-
PLATE CXCVI.
ANTERIOR
VIEW
0^
PONS
VAROLII
Trt.utMINUS NERVE
(DlV'r..)
ttfc
INTERNAL CA"CTIO
"
'.
GLOSSOPHARYNGEAL
VAGUS AND SPINAL ACCESSORi
"
INTERNAL JUGULAR
V|N
OBLONGATA
EDULLA
STERNO-CLEIDO MASTOID
NERVE
HYPOGLOSSAL
14*-
ifel
iUALENUS ANTICUS
PLEXUS
BRACHIAL
SUBCLaKIAN ARTERY
ism
FIRST RIB
INTERCOSTAL
ARTE
VEIN
NERVE
SYMPATHETIC GANGLIA
LIO-HYPOGASTRIC N
OUADRAIUS LUMBORUM
LIO-
Tv)
EXTERNAL
:-mm
SACRAL GANGI
IA
INGUINAL
CUTANEOUS
GENITO
my$r
CRURAL
OR CRURAL NERVE
OBTURATOR N
v r
GRE4T SCIATIC
rnrrv
N.
ANATOMY
378
10.
Pigmentary
IN A NUTSHELL.
Layer.
The refracting media are (1) Aqueous humor, (2) Vitreous humor, and
(3) Crystalline lens.
The capsule of Tenon is a layer of fascia which surrounds the posterior
Where the optic nerve enters it is continuous with
five-sixths of the eve-hall.
Anterior
corneo-sclerotic junction.
it
It is
two Oblique muscles of the eye. Between the anterior and posterior attachments there is a delicate attachment, between the capsule and the eye-ball, of
connective tissue; these constitute extensively lymphatic spaces in which the
eve-ball glidesjthis is a ball-and-socket (enarthrodial) joint. An expansion from
the sheath of the Superior oblique muscle blends with the tendon of the Levator
palpebrse.
An expansion from
is
tarsal plate, therefore these two Recti muscles influence the movements of the
evelids.
The expansion of the sheath of the Internal rectus is attached to the
is
is
very strong,
is
is
point of the anterior curvature of the eye-ball ;the posterior pole is the central
The sagittal axis is a line joining these two
point of the posterior curvature.
The transverse diameter of the eyeball is about one inch, the vertical nine-tenths, and the antero-posterior is intermediate.
The sclerotic coat is fibrous and opaque tunic, occupying the posterior fiveIt is continuous in front with the cornea. The outer
sixths of the eye-ball.
poles.
surface
is
of the choroid by
The
is
is
The sclerotic is
its entrance.
and thinnest about one-fourth an inch from the
cornea.
The canal
of
ii
is
scleroe, is close to
the junction
The structure of the sclerotic is white fibrous tissue intermingled with elastic
tissue and flattened connective tissue corpuscles which are contained in the cell
between the
fibers.
Some
pigmented.
The
It
forms the posterior five-sixths.
a watch crystal fits into the face of
fits
into the
sclerotic
coat
somewhat
like
<
PLATECXCVII.
GANGLION OF
RIBES
CAROTID
70
OF
GANGLION
ROOT
OF
PLEXUS
PNEUMOGASTRIC
TO
TH. NERVE
GLOSSO PHAR
:
VIDIAN
1ST.
CERVICAL
PETROSAL
TO-MECKEL S
GANGLION
NERVE
TO-BRANCHES
<+
*%
CARDIAC
^,
OF
EXTERNAL CAROTID
ARTERY
AND
GANGLION OF
HEPATIC
WRISBERG
PLEXUS
CYSTIC PLEXUS
GASTRO DUODENAL
PYLORIC PLEXUS
GASTRIC V PLEXUS
ST SACRAL
NERVE^T
^PELVIC-
5 TH.
SACRAL
OR
INFERIOR
HYPOGASTRIC PLEXUS
NERVE
GANGLION
OF
IMPAR
CUUCYGEAL NERVE
PLEXUS
ANATOMY
380
IX A
NUTSHELL.
The posterior
is continuous with the sclerotic coat.
concave and projects a little farther backward than the
The posterior surface of the cornea forms the anterior
anterior convex surface.
boundary of the anterior chamber which contains aqueous humor. Its anterior
surface
is
It
is
than
fibers
iris.
formed by
from the stroma of the cornea which pass backward and outward to the
They form an annular meshwork encircling a series of lymphatic spaces
PLATE
CXCVIII.
TO
,-
HIGHER
GANGLION
0.',
SYMPATHETIC TRUNK
DIRECTLY TO VISCERA
SOMATIC VASOMOTOR,
PILOMOTOR,
SECRETORY
RAMI EFFERENTES
SYMPATHETIC TRUNK
vertebrae
ligaments
spinal vessels
and
NTRAL
SPINAL
Dura
NERVE
ROOT
Structure.
The
of epithelial cells
(1)
(a)
Several strata
The external
consists of
cells,
(c)
tough, unyielding, perfectly transparent and continuous with the sclerotic and
consists of aliout sixty flattened lamellae, the fibres passing one lamella to an-
other.
ANATOMY
IN A NUTSHELL.
interstitial
which are
stellate in shape.
(3)
A homogenous
cells, the
elastic
chamber
381
conical corpuscles
lamina.
membrane
(4)
single
of the anterior
of the eye-ball.
Besides these four strata we have the anterior and posterior elastic
lamina. The anterior clastic lamina (n embrane of Bowman) is the uppermost
layer of the corneal
The posterior
terior lining
elastic
membrane
of the cornea.
the ciliary.
Its function
The nerves
are
is
numerous and
It is non-vascular.
LESSON
CVII.
The choroid consists of two layers, an outer and an inner. The inner layer
Ruyschiana is formed by the capillary endings of the vessels of the
They pass forward to within one-eighth of an inch of the cornea
outer coat.
or tunica
PLATE CXIX.
EXTERNAL ROOT FROM TEMPORAL
LOE
feells
of the retina.
optic nerve.
Bhoii
it
is
pierced
by the
of the vessles.
The
ciliary arteries after piercing the sclerotic close to the optic nerve pass
r of the choroid.
The venae vortinumber, are formed by numerous smaller veins
and lie external to the arteri< s. They pierce th< sclerotic midway be1 ween the
cornea and the optic nerve.
The venae vorticosae form the two ophthalmic
veins which join to form the common ophthalmic v< in.
The common ophthalB<
-;r.
to
<
nd
in
five in
mic vein passes from the orbit through the internal inferior angle of the sphen-
ANATOMY
382
IN A NUTSHELL.
noidal fissure (anterior lacerated) into the cavernous sinus which divides into
superior and inferior petrosal sinuses, each of which empties into the lateral
sinus.
vein.
The
and
lateral sinus
This vein receives the subclavian vein thus forming the innominate vein.
The two innominate veins form the superior vena cava which empties into the
righl auricle of the heart. Thus the blood passes from the eye-ball to the heart.
PLATE
CC.
PIGMENTARY LAYER
IAC0BS MEMBRANE
LAYER
OF
p'lO
MEMBRANA
LIMITANS
OUTER NUCLEAR
EXTERNA
VIII
LAYEf
OR GRANULAR LAYER
INNER
OR
NUCLEAR LAYER
GRANULAR LAYER
CONE
GANGLIONIC
LAYER
OF NERVE CELLS
MEMBRANA
L'V.ITANS
INTERNA
common
carotid
it
must
first
it
go through the
Then the
ophthalmic
ANATOMY
IN A
NUTSHELL
383
artery which passes through the optic foramen into the orbit with the optic
However,
nerve.
this artery
In the orbit
it
The branches
Anterior ethmoidal.
7.
Nasal.
of the
2.
Supraorbital.
3.
Posterior ethmoidal.
5.
Internal palpebral.
6.
Frontal
PLATE CCL
foARGJNAL CORNEAL PLEXUS
CIRCULUS
IRIDIS
MAJOR
CONIUNCTIVAL VEIN
ANTERIOR
PROCESSES
VESSELS OF CILIARY
ARTERY
CILIARY
AND CILIARY
IRIS
BODY TO VENA VORTICO'SA
VEIN FROM
EPISCLERAL VEIN
EPISCLERAL ARTERY.
VENA VORTICOSA
BRANCH
FROM
SHORT
POSTERIOR LONG CILIARY AflTERY.
SHORT
POSTERIOR
VESSELS OF PIAL
(Leber).
consists of:
1.
Short ciliary
3.
2.
Long
4.
I.
Muscular.
ciliary
off close to
is
it
Occasionally
may come
it
is
Arteria centralis
retinse.
The lachrymal
comes
Anterior Ciliary.
is
off
derived from
It
one of the
Those to the
lids are
two
in
number,
AXATOMY
IN A NUTSHELL.
bone to anastomose with the deep temporal in the temporal fossa. A branch
from the lachrymal passes through the sphenoidal fissure to the dura mater to
(Plate CCIII).
anastomose with the middle meningeal artery.
The supraorbital artery arises above the optic nerve and passes above the
PLATE
CCII.
CILIARY ARTERY.
ARTERY
COPTIC
N.
V
V
b< neath the root' of the orbil onto the forehead through the supraforamen with the supraorbital nerve.
While in this foramen it gives off
a branch to the diplce.
After leaving the foramen it divides into superficial and
deep branches.
It
supplies muscles, integument and the pericranium on the
h anastomoses with the frontal, anterior temporal, artery of the
forehead,
opposite side, and angular artery.
It supplies the parts at
the inner canthus.
The Superior rectus and Levator palpebral are supplied by it.
orbital
ANATOMY
IX A NUTSHELL.
385
branch to the dura mater and a nasal branch which passes through the cribriform plate of the ethmoid anastomosing with branches of the spheno-palatine.
The anterior ethmoidal accompanies the nasal nerve through the anterior
ethmoidal foramen into the cranium, supplying the anterior ethmoidal cells and
It gives meningeal branches to the dura mater and passes through
frontal sinus.
the nasal slit to be distributed under surface of the nasal bone and the skin of
off a
the nose.
The
two
in
The
is
It
passes
upward
at
the inner angle of the eye anastomosing with the supraorbital and the artery of
the opposite side, to be distributed to the integument, muscles, and pericranium.
is
It gives
It
leaves
sac.
branch anastomoses with the angular and its dorsalis nasi supplies the outer
and anastomoses with the artery of the opposite side and
The
facial.
They
branches.
number.
major which is around the circumference of the iris and the circulus minor
around the papillary margin. The anterior ciliary come from the muscular
branches and pass forward with the tendons of the Recti muscles. They form
a network beneath the conjunctiva and pierce the sclerotic coat a short distance from the cornea to join the circulus major at the iris.
The
ophthalmic.
It
It
to the
and
is
It
In the fetus a branch passes from this artery through Stilling's canal
It lies
LESSON
it
CVIII.
Muscular branches are given off from various branches of the ophthalmic
and are two in number, the superior and inferior. They may come from Uncommon trunk. The superior one supplies the Superior rectus. Levator palThe inferior one supplies the Inferior rectus,
pebrae, and Superior oblique.
This inferior one gives
External rectus. Internal rectus, and Inferior oblique.
off one of the anterior ciliary branches.
Muscular branches are also given off
from the lachrymal, supraorbital, and the ophthalmic itself.
ANATOMY
386
The
The
IN A NUTSHELL.
ciliary
and the
ciliary processes
same structure
ciliary muscle.
They
surrounding the
ciliary processes
iris.
PLATE
CCII I.
NASAL.
SUPRAORBITAL
TEMPORAL
BRANCHES
ETHMOIDAL.
POST.
ETHMOIDAL.
yC^f
^^T^f
LACHRYMAL
ARTERIA
ANT.
CENTRALIS
RETINAE.
OPHTHALMIC.
INTERNAL
CAROTID.
The
iris is
It is
suspended
in
the aqueous
connected to the
ciliary muscle.
The uvea
is
marked
ANATOMY
is
colored and
which
H87
IX A NUTSHELL.
marked by wavy
This surface
is
lines
darkly pigmented.
The
is
membrane
of Descemet.
The frame work
struma which consists of connective tissue containing
blood vessels, nerves, pigment cells, and muscular fibers (involuntary). The
first, sphincter fillers which form a circular narrow band pass to the pupil and
of the
is
iris is
a delicate
This band
about one-thirtieth of an inch in thickwhich are radiating, commence at the outer margin
of the iris, converging towards its center to join the circular one near the pupil.
Some say these are elastic and not muscular. It receives the sympathetic
nerve.
The blood supply is from the Long and anterior ciliary and the vessels
of the ciliary processes.
Nerve supply from the ciliary branches of the lenticular ganglion and long ciliary branches of the nasal nerve which is a branch of the
ophthalmic division of the fifth. The nerves form a plexus around the marin.
The membrana pupillaris is a delicate transparent vascular membrane which
closes the pupil in the fetus.
It disappears about the seventh month.
The retina ends behind the ciliary muscle in an irregular margin, the ora
serrata.
The pars ciliaris (radiating fibers of Muller covered bv pigmented
layers) is a thin membrane passing from the ora serratus to the iris.
The
macula lutea is the most perfect point of vision. It is situated at the center of
receive the third nerve.
ness.
The second,
dilator,
its
poms
is
It
is
The
is
which bind the layers of the retina together. The aqueous humor
and posterior aqueous chambers which are situated between
the posterior surface of the cornea and the anterior surface of the iris and between the posterior surface of the iris and the anterior surface of the crystalline
tissue fibers
fills
lens.
the anterior
It is a slightly
alkaline fluid.
The
lens
is
in contact anteriorly
with the
posteriorly
it
At the pars
ligament of the
the lens.
lens.
It
and one
ciliaris this
in front:
contains elastic
membrane
fibers.
The canal
is
divides sending
the suspensory
of Petit
surrounds
(Plate CC).
It is
situated
ANATOMY
388
IN A NUTSHELL.
the frontal bone resting on the eye-ball and the Superior rectus and External
rectus muscles.
in
ihf center.
It is
The
an almond.
size of
It
is
constricted
on the outer part of the upper lid. The lachrymal canals, two in number, begin
at the puncta lachrymalia in each lid, the superior one passing upward and then
inward to join the inferior one which passes downward and then inward. They
empty
PLATE
CCIV.
MOALJJNE
AXJS
OPTICAL.
FOVEA CENTRALIS
OR CENTRAL PIT
OF THE
MACULA LUTEA.
LESSON CVIX.
The conjunctiva (joined together) which unites the eyelids and the eye-ball
mucous membrane. It lines each eyelid at the base of which it is reflected
mi the eye-ball. The lines of reflection are the fornices. The supeiior one is
the deeper and some of the fibers of the Levator palpebral are inserted into it.
The conjunctiva is loosely attached to the sclerotic cord, but at the outer maris
it
is
The ducts
of the
junctival sac above and the opening of the lachrymal canaliculi at the puncta
lachyrymalia
thick.
below.
conjunctiva
of the
at
membrana
The
It
is
sensitive,
vascular and
thin, transparent
is
plica semilunaris
is
and
is
is
only
a fold of
(Plates
CCV-CCIX).
ANATOMY
The eyebrows
IN A NUTSHELL.
389
two arched eminences over each orbitc,onintegument and muscles and are covered by thick hairs.
connected with the Orbicularis palpebrarum, Corrugator super(supercilia) are
sisting of thickened
Each one
and
cilii,
is
Occipito-frontalis.
is
rudimentary third
The eyelashes
free
eyelid.
(cilia)
margin of each
(5)
Those
lid.
lid.
of the
Each
upper
lid are
(1)
palpebral ligament,
Orbicular muscle,
Meibomian glands,
(6)
(7)
(4)
tarsal
conjunctiva.
The
upper lid has in addition the aponeurosis of the Levator palpebral which is attached to the upper surface of the tarsal plates.
The tarsal plates are in each lid and are formed by lamina of a dense conThe upper one is the larger; it is half oval in shape while the
nective tissue.
lower one is a narrow oblong slit.
The Meibomian glands are lodged in these plates. The palpebral ligaments
are at the outer and inner angle of the eye, forming attachments for the Orbicularis palpebrarum muscle. They form an imperfect diaphragm for the anterior
orifice of
the orbit.
The
third or
motor
median
line
on the
floor of the
and
Its
tegmentum
of the crus.
by the third nerve except the Superior oblique, which receives the fourth nerve and the External rectus, which receives the sixth.
This
nerve also supplies the sphincters of the iris and the ciliary muscle through its
connection with the ciliary ganglion. Remember that the External rectus of
one eye and the Internal rectus of the other eye have their nerve supply from
the same nucleus.
The nucleus of the third nerve receives the fibers from that
of the sixth nerve of the opposite side; this accounts for the fact that one can
move both eyes to the right or left at the same time. From this deep origin
Inferior oblique.
tion
and
It
is
accommoda-
the dura mater anterior and external to the poshaving passed between the superior cerebellar and
the posterior cerebral arteries.
It then passes through the cavernous sinus
It pierces
ANATOMY
390
IN A NUTSHELL.
PLATE
CCV.
DUCTS
OF
LACHRYMAL
GLAND.
LACHRYAMAL SAC
CARUNCLE
NASAL .DUCT
Corrugator
supercilii,
which descend
before
tinned.
it
in
leaves the pons; these fibers supply the three muscles above
muscle or
it
may
may be
When
men-
is
paralyzed the
Prominence of the eye-ball because most of the muscles are relaxed. (2) Extern vl strabismus, the eye-ball being drawn outward
because the External rectus which is supplied by the sixth is not paralyzed.
(3) Ptosis because the Levator palpebrae is paralyzed. (4) Loss of accommodation because the [nternal rectus, the ciliary muscle, and the sphincter pupillse
are paralyzed.
(5) Dilatation of the pupil because the sphincter fibers of
following result
the
iris
(1
are paralyzed.
ANATOMY
IN A NUTSHELL.
LESSON CX.
391
(Plate CCXIII).
PLATE
CCVI.
TARSAL CARTILAGE
it
is
the highest of
all
CCXXIV)
being situated at the upper and inner angle, internal to the frontal nerve.
In
the orbit it passes inward above the origin of the Levator palpebrae to enter the
orbital surface of the Superior oblique.
In the cavernous sinus it communicates with the ophthalmic division of the
fifth,
a recurrent branch backward between the layers of the tentorium as far as the
lateral sinus.
While in the anterior lacerated fissure it may send a branch to
the lachrymal nerve.
If
Superior oblique
wai;i>.
is
lost
the fourth
vision, diplopia.
to
nerve
do so the eye
is
is
now
\\\ \ki>
\\n out-
ANATOMY
392
IN A NUTSHELL.
The
sixth nerve or
close to the
fifth.
median
This origin
teres.
is
and
line
a little lower
This nerve enters the cavernous sinus after the dura mater of the basilar
process of the sphenoid, running through a notch immediately below the pos
From
carotid artery.
this sinus
it
lies
it
on the orbital
surface.
PLATE
CCVII.
RECTUS.
SUP.
INf.
INTERNAL RECTUS.
EXTERNAL RECTUS.
SUP.
RECTUS.
INF.
OBLIQUE.
-OBLIQUE.
'y
Showing the Directions that Muscles of the Eye-Ball Move the Eye.
For
its
For
position
the
of
lie
CCXXXII.)
on
of the External
CCXV).
The
on the Superior oblique, the frontal nerve on the Levator palThe superior division
pebrae, and the lachrymal nerve on the External rectus.
of the third nerve lies along the Superior rectus; the nasal nerve crosses the optic
nerve from without inward: the optic nerve is surrounded anteriorly by the
fourth nerve
lies
ternal rectus.
The
sixth nerve
is
The
in-
nerve
is
some extent
in
its
iris
function.
some
The pupil
of the
is
contracted to
sympathetic
fibers to the
It is
It is
more
compound
like a
spinal
nerve, having
ANATOMY
an anterior or motor, and
393
IN A NUTSHELL.
upon
it.
It is called
origin
by
lis
The deep
is in
Its
sensory portion
is
in a
nucleus
floor
CCXV).
PLATE
CCVTII.
2ND
the
sensory nerve
to the
head and
face,
and
motor NERVE
to the
muscles of mastication.
Its roots pass through an oval opening in the dura mater
The senBory root
near the apex of the petrous portion of the temporal bone.
is from the Gasserian ganglion, which is situated in Meckel's cave.
This cave
is
a depression
temporal bone.
and
it
is
near the apex of the anterior surface of the petrous portion of the
The anterior or motor root passes under the Gasserian ganglion
not joined to
it
fifth
nerve
after
a coin-
pound nerve; in fact it is the only pari of the fifth nerve which is a compound
This ganglion gives off
nerve for the other two divisions are purely sensory.
from its anterior edge three trunks. (1) Ophthalmic, (2) Superior maxillary, and
(3) Inferior
maxillary.
It
ANATOMY IN A NUTSHELL.
394
I.
is
the outer wall of the cavernous sinus below the third and fourth nerves. It
divides into three branches which leave the cranium through the anterior lacer(For relation of these branches see Plate CCXXIV.)
ated or sphenoidal fissure.
The ophthalmic supfrontal,
nasal, and lachrymal.
the
are
branches
These
and skin
of the
membrane
The frontal branch is the largest and is just external to the fourth nerve
and the anterior lacerated or sphenoidal fissure and passes forward on the Levator palpebral dividing into two branches.
PLATE
CCTX.
SUPERIOR FORNIX
UPPER LID
LOWER
LID
INFERIOR FORNIX
LESSON
CXI.
notch.
It gives a
lambdoid suture.
tin'
>ccipito-frontalis to
supply the skin of the lower part of the forehead near the
midline.
The lachrymal
is
ii
It passes to the
under surface of
It passes
ANATOMY
al fissure
395
IN A NUTSHELL.
external and below the frontal nerve and passes along the upper bor-
It
of the eye
and
is
fifth.
In the orbit
it
on
inner side over the optic nerve, below the Superior rectus, then
it
passes between
the Superior oblique and Internal rectus to leave the orbit through the anterior
ethmoidal foramen with the anterior ethmoidal vessels into the cranium.
the cranium
it
In
slit
it
PLATE CCX.
CILIARY PROCESSES.
AND
MUSCLE^
SUSPENSORY
LIGAMENT.
Crystalline Lens.
(a)
(b)
is
and
(c) Anterior
bones and to the mucous membrane of the outer wall of the nose,
branch runs in the groove on the inner surface of the nasal bone. It pierces the
wall of the nose between the nasal bone and the upper lateral cartilage and sup-
integument of the lower part of the dorsum of the nose as far as the tip.
The nasal nerve gives off the following collateral branches:
1. The long root to the ciliary ganglion which runs forward on the outer
of the optic nerve to the upper and back part of the ciliary, lenticular, or
plies the
side
ophthalmic ganglion.
2. Long ciliary branches, two or three
in
side of the optic nerve, join the short ciliary branch from the ganglion, thru
iris,
and the
cornea.
3.
Infratrochlear nerve
is
given
off just
between the Superior oblique and Internal rectus. It communicates with the
Supratrochlear and is distributed to the skin of the eyelid and side of the nose,
conjunctiva, lachrymal sac, and caruncula lachrynialis.
This lenticular, ciliary, or ophthalmic ganglion has three roots.
ANATOMY
396
IX A NUTSHELL.
A MOTOR ROOT from the third nerve, sympathetic root from the cavernous
Its branches are distributed to
plexus, and a sensory root from the nasal.
the iris, ciliary muscle, and cornea.
The superior maxillary division of the fifth is intermediate in size and
11.
It, like the
position between the ophthalmic and inferior maxillary division.
from
part
of the
the
anterior
It
comes
sensory.
purely
ophthalmic branch, is
sinus
in
the
lower
and
cavernous
the
passes
and
through
Gasseriarj ganglion
rotundum,
entering
foramen
the
through
leaves
the
cranium
outer part; it then
PLATE CCXI.
CANAL OF SCHLEMN
POSTERIOR CHAMBER.
CILIARY BODY
CANAL
OF PETIT
CILIARY PROCESSES
EXTERNAL RECTUS
CHOROID COAI
NERVE SHEATH
it
passes forward
it is
it
is
ANATOMY
IX A NUTSHELL.
397
which gives off three branches, (1) palpebral, (2) nasal, and (3) labial.
While in the sphenomaxillary fossa it is in relation with the infraorbital artery
which accompanies it on its course to the face. The branches of distribution are:
(1) those given off in the cranium; (2) those given off in the spheno-maxillarv
fossa; (3) those given off in the infraorbital canal: and (4) those given off on the
face.
Those
in the
PLATE
CCXII.
LEVATOR PALPEBRAE
RECTUS
SUPERIOR;
RECTUS INFERIOR
RECTUS INTERNUS.
INFERIOR OBLIQUE,
The malar branch (subcutaneous mala?) supplies the skin on the prominence of the cluck after passing along the external inferior angle of the orbit
through the foramen
in
it
perforates
the Orbicularis
palpebrarum muscle.
2.
are
two
in
to
the
Bpheno-palatine or Meckel's ganglion but do not end there, for most of the fibers
pass into the palatine nerves.
ANATOMY
398
IN A NUTSHELL.
The third set are (1) the posterior superior dental, usually two in
They pass downward and outward through the ptery go-maxillary
fissure into the zygomatic fossa where they give branches to the mucous membrane of the gums and the posterior part of the mouth. They then enter the
3.
number.
posterior dental canals on the zygomatic surface of the superior maxillary bone
communicate with the middle dental nerve and branches to the lining membrane of the antrum of Highmore (superior maxillary sinus). It also gives off
to
three branches to the molar teeth which enter the foramina at the apices of the
The middle superior dental and the anterior superior dental are
the infraorbital sulcus.
The middle supplies the bicuspid teeth
and the mucous membrane of the antrum and the gums. After leaving the
infraorbital nerve it passes downward and forward in a canal in the superior
(b)
given
off in
maxillary.
ior superior
These branches which supply the teeth anastomose with the anter-
and posterior
is
is
At the junction
of the
RECURRENT TO SYMPATHETIC-
LESSON
(c)
CXII.
is
given
off just
antrum and the nasal branch which enters the nasal fossa through a small
foramen and supplies the mucous membrane of the forepart of the inferior
meatus and its floor. It communicates with the nasal branch from Meckel's
ganglion.
of the orbital.
it
ANATOMY
IN A NUTSHELL.
399
The nasal branch passes inward and upward under cover of the Levator
supply the skin on the posterior part of the lateral aspect of
labii superioris to
the nose.
It joins
mouth and
lid,
also to
labii superioris to
be
mucous membrane
of
to labial glands.
PLATE CCXIV.
TO TENTORIUM CEREBELLI.
--
--
HATES
FROM
...
LESTICULARJiANGLION.
/V^
3RD. NERVE.
,GASSEPIAV JJTRIFAPAL
C.
WITH AURICULOTEMPORAL.
AURICULOTEMPORAL
TOFACIAL
TO TEMPORO-MAXILLARY JOINT.
TO MEATUS-AUDITORIUS.
FACIAL*
C4
X T0
TO
^Vr INFERIOR
TENSOR PALATI
TENSOR TYMPANI.
TO INTERNAL PTERYGOID
is
III. The inferior maxillary division of the fifth, the mandibular branch,
compound nerve after it passes through the foramen ovale. It is the largesl
branch of the
fifth
nerve.
compound
Its
This
ANATOMY
400
ami
chiefly
off a
IN A NUTSHELL.
nilar articulation.
3.
or
three
in
number, which
be-
lies
tween the bone and the upper border of the External pterygoid muscle to
end in the deep surface of the Temporal muscle. The anterior one is from the
The middle one to supply
Buccal to supply the front of the Temporal muscle.
PLATE CCXV.
LEVATOr, PALPEBRAL M.
SUPRATROCHLEAR
SUPERIOR RECTUS
FRONTAL N.
INTERNAL RECTUS M.
N,
OPTIC
SUPRAORBITAL N
N.
EXTERNAL RECTUS
M.
INFERIOR RECTUS M.
TAHSAL CARTILAGE
LACHRYMAL
N.
OF UPPER EYELID
THIRD
LACHYMAL GLAND
N.
FOURTH NERVE.
SIXTH
AND
LACHRYMAL NERVES
NERVE.
OPHTHALMIC
DIV.
OF 5TH N
SUPERIOR MAXILLARY N
INFERIOR OBLIQUE M
GASSERIAN GANGLION.
PALFEBRAL BRANCH
HENO-PALATINEN.
IAN
N.
AURICULOTEMPORAL
NASAL BRANCH
INFERIOR MAXILLARY N
LABIAL BRANCH
SMALL MENINGEAL
MIDDLE MENINGEAL A
ANT.
.SUPERIOR DENTAL
N.
INTERNAL MAXILLARY
A.
AN D A
NFERIOR DENTAL
MIDDLE
SUPERIOR DENTAL A
AND N
NFERIOR DENTAL N
BUCCAL
GINGIVAL
A.
A.
A.
INCISIVE BR._
MYLO-HYOID N
MENTAL
MENTAL
CHORDA-TYMPANI
N.
in
Reference to Other
Structures.
the deep part of the Teiu
goid.
The
>or;il
posterior pari
<<\
the
Temporal muscle.
is
sent to the
PLATE CCXVI.
SUPRATROCHLEAR N
INFRATROCHLEAR
NASAL N
SUPRACLAVICULAR
\\i>
NECK
\i<
k.
ANATOMY
402
4.
The buccal
is
IN A NUTSHELL.
sensory and comes out between the two heads of the Ex-
and
is
5.
mucous membrane
distributed to the
Branch
The
chiefly sensory.
It
is
common trunk
is
larger
and
is
which is purely sensory, but (c) the inferior dental nerve has a few motor fibers
in it which pass to the Mylo-hyoid muscle.
6. The auriculotemporal arises by two heads between which is the middle
It then passes under the External pterygoid muscle, over
memingeal artery.
From here upward
ligament
into the temporo-mandibular joint.
the capsular
parotid
gland
the
temporal
temporal
beneath
the
to
fossa where
artery
with the
and
the
superficial
temporal
cutaneous
posterior
to
artery.
lies
It
it becomes
branch
facial
nerve,
(b)
a
branch
branches:
a
to
the
otic
off
seven
(a)
to
gives
ganglion, (c) two anterior auricular branches distributed to tragus and upper
and outer part of pinna, (d) superior temporal to integument of the greater part
of the temporal region and they anastomose with the seventh, (e) auricular
branch to temporo-maxillarv articulation, (f) branches to external auditory
meatus, which branches are given off in the parotid gland. They pass between
These branches supply the
the cartilage and the bone to enter the meatus.
upper part of the meatus, tympanic membrane, and occasionally the lobule,
(g)
still
it
passes
above the deep part of the submaxillary gland to the sides of the tongue. It
has (a) communicating branches to the anterior dental nerve and submaxillary
ganglion and the twelfth nerve, and (b) branches of distribution to the tongue.
8. TheiNFERiOR dental is the largest branch and passes downward underthe
External pterygoid muscle posterior to the lingual nerve. then to the dental foramen after passing between the ramus and internal lateral ligament. It passes
through the dental canal to emerge at the mental foramen. This nerve has four
main sets of branches, (a) Those to the Mylo-hyoid muscle, (b) branches to the
molar and bicuspid teeth, (c) branches to mucous membrane and canine teeth,
and (d) branches to the integument of chin and lower lip.
The Gasserian ganglion is sometimes called the semilunar ganglion.
It
lies in Meckel's cave near the apex of the petrous portion of the temporal bone.
Beneath this ganglion is the motor root of the fifth nerve and the large superficial petrosal nerve which is a branch of the seventh.
This latter nerve helps
to form the vidian nerve.
Filaments from the cavernous plexus of the sympathetic join this ganglion on its inner side.
Branches pass to the tentorium
ANATOMY
cerebelli
of the
and the
IN A NUTSHELL.
viz.,
from
this ganglion.
The
403
fifth
CCXIV)
is about the
between the optic
nerve and the External rectus muscle. The ophthalmic artery is generally on
This ganglion has three roots, (a) the sensory root which
its inner side.
(1)
size of
is
It is situated
PLATE CCXVII.
SUPERIOR NASAL NERVES
SPHENOPALATINE
MECKEL
NASAL
N.
GANGLION
NERVE
NASAL BONE
OTIC GANGLION
SYMPATHETIC ROOT
AURICULO-TEMPORAL
N.
MIDDLE MENINGEAL
A.
INTERNAL PTERYGOID
TENSOR PALATI
NASO-PALATINE
EXT. PALATINE
NERVE
This
is
of the
mot and
to the
(c)
The
This
is
sw,n-\-
It
from the cavernous plexus of the sympathetic.
This ganglion gives off five or ten short
These
ciliary nerves from the anterior superior and the anterior inferior angles.
nerves pass with the ciliary arteries forward, one set above the optic nerve and
coin* s
ANATOMY
404
the other set below
IN A NUTSHELL.
it.
branch of the fifth, they pierce the back part of the sclerotic coat of the eye and
then pass forward in grooves on the inner surface of the sclerotic coat to supply
(Plate CCII).
the ciliary muscle, iris, and cornea.
LESSON
CXIII.
Most
it.
Its
(b)
ficial
petrosal,
which
is
unite to
(c)
make
The
lion.
of the
fibers of these
the vidian nerve which enters the posterior surface of the gang-
of the
In the middle lacerated foramen it unites with the large deep petrosal which
comes from the carotid plexus and runs through the carotid canal on the outer
It then enters the middle lacerated foramen
side of the internal carotid artery.
superficial petrosal
it
This ganglion
gives off the following branches, (a) ascending which are two or three small
fissure
and supply
riosteum, (b) the anterior palatine, sometimes called large palatine, passes
through the posterior palatine canal and the posterior palatine foramen to the
It
hard palate where it runs forward in a groove nearly to the incisor teeth.
supplies tin- gums, mucous membrane, and glands, and communicates with the
The
naso-palatine nerves.
inferior
nasal branches
anterior
tin- .-oil
palate
when
is
it
and
tonsil,
it
(c)
palatine
is
not
soft
palab
small posterior palatine canal to supply the Levator palati, Azygos uvulae, soft
and uvula. These last two branches with branches from the
This plexus is called
n< rve form a plexus around the tonsil.
circulus tonsillaris,
(e) The superior nasal which arefour or five branches pass
through the sph< no-palatine foramen where they supply the mucous membrane
on tin superior turbinated processes and the middle turbinated boms and also
the mucous membrane of tin posterior ethmoidal cells.
It communicates with
branch
anti
of the anterior
a
which
surface
rior dental by
the
passes to the inner
through
wall of the antrum of Highmor<
forward
naso-palatine
(f) The
passes
palat
tonsil,
glosso-pharyngeaJ
ANATOMY
the spheno-palatine foramen
405
septum.
it
to the anterior
IN A NUTSHELL.
runs
passes through the anterior of the two foramina of Scarpa, while the one on the
membrane behind
(g)
The
pharyngeal branches, called pterygo-palatine, arise from the back of the ganglion and pass with the ptery go-palatine artery through the ptery go-palatine
branches
its
join.
it
the middle
ni<
ningeal artery.
On
"
to sympathetic
fifth, (b)
its
origin as the
Both of these branches are derived prinfrom the interna] pterygoid nerve, (<) Small branches pass to the
chorda tympani and buccal nerves.
passes to the Tensor palati muscle.
cipally
(4)
is
(c) its
sensory root
(a)
motor root
is
five
from the
is
fifth
nerve.
the
ANATOMY
406
mucous membrane
of the
IN A NUTSHELL.
the submaxillary
gland, (b) branches pass from the lingual branch through the submaxillary
ganglion with the chorda tympani to the sublingual gland and tongue.
we
a
Thus
and
sec that each of these four ganglia has three roots, a motor, a sensory
sympathetic.
LESSON CXIV.
(Plate
CCXIX-CCXX.)
sisted of
portio mollis, which is now called the eighth. The pars intermedia arises
from the medulla between the seventh and eighth cranial nerves and is connected
with them at its origin. The seventh nerve or facial nerve is the motor nerve
of the facial muscles of expression, of the muscles of the external ear, Platysma
myoides, Buccinator, posterior belly of the Digastric, Stylo-hyoid, Lingualis,
and Stapedius. This nerve passes with the eighth nerve into the internal audFrom the internal
itory meatus where they are joined by the pars intermedia.
auditory meatus it runs into the aqueductus Fallopii where it has an enlargement upon it called the geniculate ganglion, which is reddish in color. It now
bends backward on the inner wall over the fenestra ovalis and then runs vertically downward behind the tympanum to the stylo-mastoid foramen.
After it
passes out of the stylo-mastoid foramen it runs forward in the parotid gland and
crosses the external carotid artery.
At the ramus of the jaw it divides into the
temporo-facial and cervico-facial branches.
These two branches with their
sub-divisions form the pes anserinus.
The seventh nerve gives off the following branches of communication, (1)
in wditory canal, (a) small branches to the auditory nerve, (2) in aqueduct
of Fallopius, (a) large superficial petrosalfrom thegeniculate ganglion which
with the large deep petrosal forms the vidian nerve. This nerve passes to
Meckel's ganglion,
(b) Small superficial petrosal passes from the geniculate
ganglion to the otic ganglion, (c) external superficial petrosal from the geniculate ganglion to the sympathetic plexus around the middle meningeal artery,
(d) a branch to the auricular branch of the pneumogastric (Arnold's).
(3) At
tin. exit OF the stylo-mastoid foramen (a) a branch to the great auricular
of the cervical plexus, (b) to auriculo-temporal of the fifth, (c) a branch to the
pneumogastric, (d) a branch to the glosso-pharyngeal.
(4) Behind the ear,
a branch of communication
occipital.
the face,
to the small
(5) On
branches to the three divisions of the fifth nerve.
In the neck, branches
(6)
to
arises
to the
ANATOMY
407
IX A NUTSHELL.
Stapedius, (b) chorda tympani arises a quarter of an inch above the stylo-mas-
and passes upward and forward and enters the tympanum through
This opening is between the
its posterior wall.
opening of the mastoid cells and the membrana tympanum. This nerve now
passes between the handle of the malleus and the vertical ramus of the incus to
toid foramen
tympanum where
it
chordae anterius (canal of Huguier) at the inner end of the Glasserian fissure.
PLATE CCXIX.
FROM GLOSSO-PHARYNGEAl
SUPERFICIAL
CERVICAL
now
in
the
tympanum
this
nerve
is
branch of the
fifth
it
to
this
ANATOMY
408
(2)
\i:\i;
IX A
NUTSHELL.
from
the seventh nerve just outside the stylo-mastoid foramen and passes between the
external auditory meatus and the mastoid process where it receives a branch
It communicates with the small occipital
of
the
auricular.
It now divides into an
great
and
branch
mastoid
the
nerve
auricular branch which supplies the Retrahens aurem and an occipital branch
which supplies the Occipitalis muscle, (b) the digastric branch may have its
origin by
common
and
It
glossopharyn-
geal nerve, (c) stylo-hyoid branch enters the Stylo-hyoid muscle near its center
ami communicates with the sympathetic plexus on the external carotid artery.
:;>
On the FACE,(a)it has the temporo-facial branch which passes through
the parotid gland over the external carotid artery and temporo-maxillary vein,
and as it passes over the condyle of the lower jaw it communicates with the
it finally divides into three sets
auriculo-temporal branch of the fifth nerve,
of branches, first, temporal branch which crosses the zygoma of the temporal
bone and supplies the Attrahens aurem and Attolens aurem muscles and joins
with the temporal branch of the temporo-malar of the fifth ami the auriculotemporal also of the fifth.
It supplies the Orbicularis palpebrarum, Corrugator
supercilii, and the Frontalis muscles, and joins the supraorbital and lachrymal
blanches of the ophthalmic division of the fifth; second, the malar branches pass
to the outer portion of the orbit where a few fibers pass to the Orbicularis palpebrarum arid join branches from the lachrymal nerve, and the others supply
the lower eye lid and join the malar branch of the superior maxillary; third, the
infraorbital passes to the parts between the mouth and the orbit and supplies
the superficial facial muscles and the Pyramidalis nasi ami joins with the infratrochlear and nasal branches of the ophthalmic at the inner angle of the orbit.
Other branches pass under the Zygomatici and the Levator labii superioris,
supplying both of these muscles as well as the Levator anguli oris. They form
an infraorbital plexus with the infraorbital branch of the superior maxillary and
buccal branches of the cervical facial nerves.
These branches supply the Levator labii superioris alanine nasi and the muscles of the nose,
(b) The cervical
facial branch passes forward through the parotid gland across the external
carotid artery and receives branches from the great auricular.
It divides opposite the angle of the lower jaw into three sets of branches, first, buccal which
crosses the Masseter muscle to supply the Buccinator and the Orbicularis oris.
These buccal branches join the infraorbital branches of the temporo-facial and
the buccal branches of the inferior maxillary; second, the supramaxillary (mandibular) branches pas> under the Platysma myoides and Depressor anguli oris
to supply the muscle of the chin and lower lip and join the mental branch of the
inferior dental of the fifth: third, the inframaxillary
it.
will
anatomy
of the ear.
vertically
PLATE CCXX.
TERMINATIONS OF
SUPRATROCH LEAR
OF
OF
INFRA TROCHLEAR
INFRA-ORBITAL
\\i
Superfic]
109
\i.
Cki;\ ecal
Plexuj
ANATOMY
410
IN A NUTSHELL.
LESSON CXV.
The ninth cranial nerve called the glosso-pharyngeal passes to the tongue
and the pharynx. It supplies the raucous membrane of the pharynx, tonsil,
and fauces with ordinary sensation, and the tongue it supplies with a nerve of
Its superficial origin is in the
This nerve is a compound nerve.
taste.
(Plate CLXXXVII).
Its
groove between the olivary and restiform bodies.
DEEP ORIGIN is from the lower part of the floor of the fourth ventricle from three
main points. (1) from a nucleus of gray matter beneath the inferior fovea, (2)
from the funiculus solitarius, (3) from the nucleus ambiguus. The nucleus
ambiguus gives motor branches to the glosso-pharyngeal and the tenth nerves
The sensory fibers of the
and to the bulbar part of the spinal accessory nerve.
Van Gehuchten says that
ninth nerve are in the jugular and petrosal ganglia.
the fasciculus solitarius
its
is
The ninth
outward
superficial origin
own
It
and
is
its
sory nerves.
It
descends
in front of
which the nerve is placed while passing through the jugular formen. It is
quite smal] and may be regarded as a segmentation of the lower ganglion.
The
petrous ganglion is the inferior one and is situated in the lower border of the
petrous portion of the temporal bone.
It is much larger than the superior one.
Fibers arise from it to connect this nerve with the tenth and the sympathetic.
It sends two filaments to the pneumogastric, one of which passes to the auricular branch of the pneumogastric, and the other to the ganglion of the root of
in
the tenth.
cervical ganglion,
stylo-mastoid
foramen.
(Plate
CCXXII).
canal
now
is
on
a ridge
passes to the
gives off
(a
between the carotid canal and the jugular fossa. This nerve
tympanum and forms the typmanic plexus. This plexus
tympanic cavity,
(f)
a branch to the
(d)
branches to
estra rotunda.
(2)
number
unite with
to form
ANATOMY
IN A NUTSHELL.
411
of the pharynx.
PLATE CCXXI.
OPTIC NERVE
INFUNDIBULUM
TUBER
CINEREUM
CORPORA VAMMILLARIA
0CUL0-M0T0R
STEP'.
III.'
TROCHLEAR NERVE
LOCUS PERFORATES'
POSTICUS
.
IV.
TRIGEMINAL NERVE V
//
ABDUCENT NERVE
FACIAL NERVE
VI.)
VII.
M'ODLE PEDUNCLE
OP
THE
CEREBELLUM
RESTIFORM
BODY
OLIVARY
BODY
=:, -
ANTERIOR SUPERFICIAL
ARCUATE FIBERS
DECUSSATION OF
SUPERIOR
SEMICIRCULAR
CANAL
EXTERNAL SEMICIRCULAR
CANAL
number, one supplies the circumvallate papillae and mucous membrane of the base of the tongue, and the other sel
supplies the mucous membrane and follicular glands and the posterior one-halt
of the tongue and communicates with the Lingua] nerve.
g
(5)
are
two
in
LESSON CXVI.
The tenth
nerve
the
tro-hepatic.
cranial
nerve,
pneumogastric, or vagus.
Pancoasl
rails
this
the organs of voice and respiration, and motor fiber* to the pharynx, the oesopha-
ANATOMY
412
mis. stomach,
and
ficial origin
is
IN A NUTSHELL.
glosso-pharyngeal.
The
Van Gehuchten
is
in the
says that
The nerve
compartment of the jugular foramen, passing behind the glosso-pharyngeal in the same sheath with the spinal
After leaving the jugular foramen it is connected with the accessory
accessory.
part of the spinal accessory and has an enlargement called the ganglion of the
The accessory part of the spinal accessory nerve sends most of its branches
trunk.
into the pharyngeal and superior laryngeal branches of the tenth, while some of
The tenth nerve now passes down the
its fibers join the ganglion of the trunk.
the only sensory nucleus of the tenth
now
is
neck
in
them but on
common
and the
a plane posterior.
The ganglion
diameter and
is
of the root
is
a small gray
glosso-pharyngeal nerves.
The ganglion
mass about
of the
it is
and the
is
five millimetres in
It also
trunk
and
by which
It
is
is
with the accessory part of the spinal accessory nerve, with the hypoglossal nerve,
ami with the superior cervical ganglion of the sympathetic, and with the loop
between the firsl and second cervical nerves. The branches it gives off are (1)
a pharyngeal, (2) a superior laryngeal, (3) a superior
(
(XX
cardiac
(Plates
CCXXII-
II.
The
downward between
the
first
part of
the subclavian artery and the subclavian vein beside the trachea, behind the
It helps to form
pulmonary plexus. It now passes downward in two cords which
run on the oesophagus and communicate with the pneumogastric nerve of the
opposite side making the oesophageal plexus.
The two divisions of the
pneumogastric nerve mute into one trunk behind the (esophagus and passing
through the oesophageal opening in the Diaphragm, is distributed to the posterior surface ot' the stomach and to the solar plexus and its divisions.
righl
the posterior
PLATE CCXXII.
>
M**^^
ANATOMY
414
IN A NUTSHELL.
The
left
liver.
It occasion-
ally
trunk
lion of thk
to a loop
is
between the
(3) to
the sympathetic.
(2) to
the
The gang-
first
is
membrane
buted
to the
recurrenl
laryngeal,
and
(5)
at
between the
It
common
of the larynx,
subclavian artery.
slightly
mucous membrane
in
and
it
joins a
common
carotid artery.
now runs
It
in a
it
groove
branches
it
PLATE CCXXIII.
SPINAL ACCESSORY
GANGLION
OF
PNEUMOGASTRlC
LINGUAL NERVE
PHARYNGEAL BR
OF PNEUMOGASTRlC
<=HB
MAXILLARY
GANGLION
STEfiNO-MASTOID
NERVE
THIRD
SUPERIOR
LARYNGEAL
CERVICAL NERVE
SPINAL ACCESSORY
BRACHIAL
PLEXUS
INFERIOR
CARDIAC
TRAPEZIUS
PNEUMOGASTRlC
LEFT
COMMON
CAROTID
PHRENIC
PULMONARY PLEXUS
VENAAZYGOS TERTIUS
INTEKCOSTAI
VEI*
ARTERY
IERVE
NA AZYGOS
MINOB
ANATOMY
416
IN A
NUTSHELL.
the intrinsic muscles of the larynx except the Crico-thyroid muscle and
communicates with the superior laryngeal. Near the beginning of this nerve
Between the (esophagus and the trachea
it usually gives off a cardiac branch.
and near its termination it gives some
structures
it
gives branches to these
all
branch)
On
The remainder
trachea.
left
and winds round the arch exand passes up the left side of the
to
the
s in
of its course
is
This
nerve passes through the superior opening of the thorax while the right one does
not.
(6)
pneumogastric
of the
all
left side.
It gives off
three cardiac branches, (a) the superior cervical arises from the pneumogastric
on
of the
war*
and
the
the
1(
side
f1
left
On
the aorta.
between
this arch
behind
it
as
it
is
in
the right side this branch passes in front or beside the innomi-
nate artery on the side of the trachea to join the deep cardiac plexus, (c) Thoracic cardiac branches arise' near the recurrent laryngeal nerve and the one on
the right side' is on a higher level than the one em the left because the recurrent
laryng<
al n<
rve com<
off
to the
em a higher
end
level
on the right
of the trachea to
end
in
side.
arise at the
than
upper ones.
the'
branch*
of the opp<
sit<
1 <
ft
one
is
These
side,
oesophageal
form
the
the'
corresponding
distributed to the
branches, with
accompany
(10)
Diaphragm
Some
of the'
1<
LESSON CXVII.
The eleventh cranial ner\e (Plate CLXXXVII) is called the' spinal acccsIt consists of two main parts. (1) an ACCESSORY or
SOry and is purely motor.
SPINAL PORTION.
THE SUPERFICIAL ORIGIN
MEDULLARY PORTION, and (2)
\
li
ANATOMY
IN A NUTSHELL.
417
is by four or five small filaments from the sides of the medulla just
below the superficial origin of the tenth nerve. Its deep origin is in the floor
of the fourth ventricle in a gray nucleus at the back of the medulla, dorso-
of this nerve
The
spinal portion
vical nerve.
is
from the
The deep
Tin-:
origin of
superficial
the spinal
superfk
upward between
tin
\i.
may
be traced
it
by
to the
roots of the spinal nerves to enter the skull through the foramen
is
just given
origin of the
portion
nerve passes
in a
common
It
While
a fold of arachnoid.
magnum.
it
in
the cranium
it
in-
PLATE CCXXIV.
SUPERIOR DIVISION OF
'W/Ji
NASAL
,RD.
/
'
INFERIOR
DIVISION
OF
RD.
TH.
OPHTHALMIC VEIN
OPTIC
FORAMEN
gnum,
it
passes
downward behind
It
and sonic
of
its
is
connected
fib< rs
become
parated from the spinal portion and pass to the ganglion of the trunk of the
pneumogastric from which they p;>ss to the pharyngeal and superior laryngeal
B<
It
supplies the muscles of the soft palate
branches of the pneumogastric.
through the pharyngeal branch. Some of the branches are continue. below
die ganglioD of the trunk of the pn< umogastric into the recurrent laryng< ;i! ami
cardiac nerves.
This is the nerve that is affect ed in spasmodic torticollis. (Plate
I
CCXXII).
LESSON ('Will.
is exclusively motor and supplies
and the Genio-hyoid muscle and all the ex'I'm
SUPERFICIAL
trinsic muscles of the tongue e\c< pt the PalatO-gloSSUS.
ORIGIN of this nerve arises by tell or fifteen filaments between the pyramidal and
The
ANATOMY
118
IN A NUTSHELL.
CLXXXVII).
(Plate
Its
two bundles through the anterior condyloid foramen after which they unite.
now passes downward hot ween the tenth and eleventh nerves and between the
internal carotid artery and the internal jugular vein to the lower border of the
It
now curves round the occipital artery crossing the exDigastric muscle.
ternal carotid and lingual arteries to pass between the Mylo-hyoid and HyoIt now enters the Genio-hyo-glossus muscle and is continued
glossus muscle.
Its branches of communication are (1) with
forward to the tip of the tongue.
the GANGLION OF the trunk of the pneumogastric, which connection takes
It also communicates with
place close to the exit of the nerve from the skull.
ilu pharyngeal plexus as it winds around the occipital artery.
(2) It communicates with Tin; SUPERIOR CERVICAL GANGLION of the sympathetic which
communication takes place opposite the atlas. (3) It communicates with
TIIK KIKST AND SECOND CERVICAL NERVES.
(4) WlTH THE LINGUAL BRANCH OF
Tin; fifth which communication takes place near the anterior border of the
in
It
Hyo-glossus muscle.
1
1>
CCXXII).
(Plate
off in
(1)
nerves
are'
hpyoglossi
is
muscles.
the
the-
muscle's,
Genio-hyo-glossus,
ferior lingual
(3)
downward
Thyro-hyoid muscle.
following
this ansa
filament from this loop descends into the chest to join the cardiac
From
(a)
(4)
Muscular branches
Stylo-glossus,
(b)
are
Hyo-glossus,
(c)
to
supply
to
the
Genio-hyoid,
(d)
distributed
Sympathetic System.
(XIX.
LESS<
>.\
Plate's
organic
life.
If
differs
the'
it
is
the nerve of
would be
in the
PLATE CCXXV
\i.
Aim:
\-.
ANATOMY
420
IN A NUTSHELL.
communicating artery
and
is
thirty-one of these, one for each spinal nerve, but on account of the coalesecence
of several into one, there are only twenty-three.
There
is
lie
it
(1)
the cen-
consisting of the brain and spinal cord; (2) the twelve cranial nerves
tral
sympathetic system.
is
(3)
the rest
is
and
called
it
<
which supplies th< integumenl supplies the muscle- beneath the integunient and the Lining beneath the muscle, and this nerve- that supplies the lining
nerv<
it
through th< branch's called gray rami.
The sympathetic nerve is
developed from the ganglia upon tin posterior nerve root of the spina! cord.
The
0n< -i of physiologists say ii is d< veloped from the suprarenal capsule-.
does
v< ssels.
sists of
pound.
Tin-
trophic cells
are-
in
the
veite-bral
ganglion of
the-
sympathetic
In tlii> Latt<
place within
the-
case (which
tin
is
sensory
probably
are-
in
the-
true-) reflex
The- super-
ANATOMY
ior cervical ganglion
is
IN A NUTSHELL.
421
situated behind the internal jugular vein and the carotid artery and in front of
the second
sometimes a
little
1.
It is in front of
LESSON CXX.
Four gray rami to the first four spinal nerves.
Branches to the twelfth cranial nerve and branch
PLATE CCXXVI.
BICUSPIDS
MOLARS
and
tenth cranial nerves making the pharyngeal plexus, and other branches to the
superior and external laryngeal nerves.
4.
behind or
in front of
is
in
where it joins the cardiac branches of the tenth and middle cervical cardiac
It
branches of the sympathetic and recurrent and external laryngeal nerves.
descends behind or in front of the right subclavian artery, along the innomi-
The
nate artery to the division of the trachea to enter the deep cardiac plexus.
left one is in front of the left commoD carotid and the arch of the aorta, joining
the superficial cardiac plexus.
5.
subdivisions.
They
to the internal-carotid
and
its
artery.
ANATOMY
422
NUTSHELL.
which comes from
(b)
IN A
the sympathetic around the facial artery, (d) to the geniculate ganglion of the
Sends branches
7.
-i
ts,
side
those on
its
carotid plexus.
pituitary body,
membrane
(l>)
off
(a)
branches to the
(c)
to the
mucous
and the ophthalmic nerve, (e) to the carotid artery, (f) to the ciliary ganglion.
The carotid plexus gives off (a) small deep petrosal to tympanic plexus.
(h) greal deep petrosal to Vidian nerve, (c) to the Gasserian ganglion of the
tilth nerve and (e) to the sixth n#rve.
LESSON CXXI.
The
made by
is
is
it
shape and
two gray rami com-
It is triangular in
often absent.
the coalescence of
sends
(a)
municantes to the fifth and sixth spinal nerves, (b) branches to the thyroid
gland along the inferior thyroid artery, (c) middle cardiac nerve which is behind or in front of the first part of the subclavian artery, joins the upper
cardiac nerve, recurrent laryngeal nerve and ends in the dee}) cardiac plexus.
On the left side this nerve enters the thorax between the left common carotid and the left subclavian artery. It sends an ascending branch to
join the superior cervical ganglion and one inferior to join the inferior cervical
ganglion.
It also
The
behind
i
lorsal.
Its
It is
irregular.
In front
is
first
it
first
sometimes unites.
branches are;
Two
(a)
dorsal to
make
going about
nerves
;)
dorsal;
(b)
in
first
and
the neck.
To
it
it
is
space between the transverse process of the last cervical and the
d<
ep cardiac plexus.
ANATOMY
The
internal branches.
IN A NUTSHELL.
123
of the cord
(2) to the posterior division of the spinal nerves. (3) to the anterior
divisions of the spinal nerves.
These last two pass to the vessels of the skin.
upper
set
is
v<
na cava, the
left
behind
to these ganglia
internal divisions send (1) branches to the aorta. (2) hypogastric plexus
r.
LESSON ('Will.
The
It
branches to anastomose with the branch* s of the opposite side. <:!) branches
on the middle sacral artery, (4) branches to plevic plexuses
branches from impar to tin coccyx and its ligament to the coccygeal gland.
(2)
to plexuses
motor
in this
region"
splanchnics.
the bladder
and
are'
"White' rami of
this region.
c<
fibers
to
ar<
called
muse
rectum ami to the
the longitudinal
and inhibitory
of the
rvical
some
The distribution of
The sympathetic has three
ganglion.
in
sacral
pe Ivic
region.
in
ANATOMY
424
IX A NUTSHELL.
which is situated below and behind the arch of the aorta. For convenience it is
It is formed by all the cardiac
divided into two parts, the superficial and d< ep.
branches and the cardiac branches of the pneumogastric nerve. The three
cardiac branches conic from the three cervical ganglia, the superior from the
superior one. and the middle from the middle one. and the inferior one from the
PLATE CCXXVII.
DENTINF
PULP
CAVITY
mm
X
yr
* J
\ i
off branches to the left coronary plexus and the left auricle.
The
right part gives off branches both to the right and left pulmonary plexuses
and tlir righl auricle.
tion gives
Thus we see that the cardiac plexus is made by sympathetic nerves plus
somatic uerve, and the somatic nerve is the tenth.
LESSON (XXIV.
Tin
><>lar
ABDOMINAL BRAIN.
i<
It
is
ANATOMY
IX A NUTSHELL.
is
made up
of
is
diaphragmaticum.
phragm near
This plexus
is
Its
to (1)
In-
vena cava. (2) supra renal capsule, and (3) hepatic plexus. There is no
ganglion on the left side. It receives branches from the semilunar ganglia and
solar plexus, also from the phrenic nerve.
This plexus gives off branches to the
ferior
renal capsules.
s.
At
size.
its
its
is
receives branches from the solar plexus and semilunar ganglia, also from the
It
This plexus surrounds the renal artery and contains groups of ganglion
Its brandies of distribution enter the hilum of the kidney.
This plexus
aortic plexus
tion to
cava.
Spermatic Plexus.
This plexus accompanies the spermatic vessels to the testes.
aeirtic, anel
pelvic plexus.
It
It elistributes
rec< ives
branches to
In the female this plexus follows the course of the round ligament to the
i>
Cosliac Plexus.
This plexus
coeliac axis.
is
The
right vagus.
stomach.
(2)
accompanies the gastric artery along the lesser curvareceives branches from the coeliac plexus and from the
sends branches of distribution to the stomach and to the
It
plexus.
is
coeliac
distributes
plexus, the
branch
left
It
receives
phrenic
The
gastric plexus,
It
(1)
lesser splanchnic
vagus nerve.
pyloric
gastric plexus
ture of the
left
It
hepatic plexus.
splenic plexus
left
hepal
It
LC
righl
and branches
to the gastro-
plexus.
ANATOMY
421)
from the
It
IN A NUTSHELL.
and
left
left
semilunar ganglion.
n.
and are white and firm. It rec< ives branches from the solar plexus.
and the right vagus nerve. It gives off branches to the
pancreas, all the small intestines, to the ascending and half of the transverse
colon, and to the pancreatico-duodenal plexus.
a large size
PLATE CCXXVIII.
ANTERIOR PALATINE FORAMEN
Tin:
Branches from
plexus form
this
the m<
in
s<
is
It
'Kin-
and
It
Plexus.
and in
between the
ritery.
.a
of 'he artery
\<
This plexus
Hard Palate.
pit
tin-
to
the spermatic
vena cava.
The
inferior
called
the
number
inferior
of
secondary plexuses.
mesenteric ganglion.
Upon
this artery is a
gang-
ANATOMY
427
IN A NUTSHELL.
from the aortic plexus. It distributes branches to half of the transverse colon
and the descending colon, to the sigmoid plexus, to the superior hemorrhoidal
plexus, and to the pelvic plexus.
LESSON CX XV.
This plexus
the
common
Hypogastric Plexus.
situated in front of the promontory
is
iliac arteries.
It
sacrum between
branches from
It bifurcates below into two lateral
This plexus is made up exclusively of
contains no ganglia.
of the
It receives
sympathetic nerves.
Pelvic Plexus.
This
is
the female
iliac
It
in
and vagina.
accompanies
This
lateral continuations of
hypogastric plexus, branches of the sacral part of the gangliated cord, branches
It is distributed to the
plexus.
rectum.
The inferior hsemorrhoidal plexus arises from the back part of the pelvic
plexus and joins with branches from the superior and middle hsemorrhoidal
plexuses.
The
formed
It
is
chiefly
sent off
It
bladder, the vesiculse seminales, the vas deferens, the spermatic plexus.
The
is
prostatic plexus
is
a continuation
downward
Its
and
On
the
size.
sides of the gland are several ganglionic masses from one-fourth to one-half an
inch
in
branches
It distributes
cavernous nerves
It
is
to
The
and
few twigs
mucous membrane
to the clitoris.
uterine plexus arises from the upper pari of the pelvic plexus and ac-
428
ANATOMY
IN A NUTSHELL.
PLATE CCXXIX.
C'JRRUGATOR
SUPERCILII
ORBICULARIS
PALPEBRARUM
TENDO OCULI
LEVATOR
LEVATOR
ALBII
SUPERIORIS
LABII SUPERIORIS
ANTERIOR NASAL
SPINE
OEPRFSSOR
LEVATOR
ALAE NASI
MENTI
GROOVE
DEPRESSOR ANGULI
FOR
FACIAL
ARTERY
ORIS
Tin:
LESSON CX XVI.
The gray rami coimn unit-antes
^d
in,,,,
!
ANATOMY
429
IN A NUTSHELL.
nerves are indigenous in every part of the spinal cord. The branches that pass
from the Anterior Crural and Obturator are gray rami
The superior cervical ganglion gives off four gray rami comgangliated cord.
municantes to the first four cervical nerves. These rami may come from the
sympathetic nerve below the ganglion. The middle cervical ganglion s< ntds two
gray rami to the fifth and sixth cervical nerves. The inferior cervical ganglion
sends two gray rami to the seventh and eighth nerves. The first dorsal ganglion
(stellatum) of the sympathetic or the last cervical sends a gray ramus to the first
One ganglion may send gray rami to two nerves, or two gray
dorsal nerve.
rami to one nerve. In the lumbar and sacral regions the gray rami are long and
pass
magnus muscle.
The white rami communicantes originate in the motor roots of the cranial
and spinal nerves. Some of these white rami pass through the vertebral ganglia
lia.
without interruption, while others arborize with cells in the vertebral gangThe white rami communicantes are indigenous in the thoracic and upper
lumbar regions only, while the gray rami are indigenous in all parts of the cord.
The white rami may be called the visceral divisions of the spinal nerves. Although the white rami are for the most part derived from the ventral or anThe
terior roots, yet some of them come from the dorsal or posterior roots.
white rami from the hist two lumbar, and peihaps also from the third and fourth
lumbar nerves, pass forward by themselves or in company with the gray rami
The fifth lumbar and in si
to join the upper pait of the lumbar gangliated cord.
sacral do not have white rami while the third sacral and possibly tin s cond and
fourth have both white and gray rami.
The fifth sacral and coccygeal nerves
(
no
hav<
white rami.
In Plate
CXCVI1
we
s<
and
D represent
tlu
to the
white or n
sympathetic ganglion of
B has
ganglion below.
segment.
of
its
<
Chas
own segment
a similar origin
a similar origin
'.
nt
i.
its
but ends
in
it
passes to the
the ganglion of
to a prev< rtebral
plexus or directly to
visc< ra.
its
own
ganglion
has
sim-
origin
t<>
iis
destination.
It
passes to
PLATE CCXXX.
CEREBRAL CORTEX
prosencephalon
( [cerebrum)
OPTIC
THALAMUS
mesencephalon
(mid brain)
CORPORA QUADRIOEWINA
CEREBELLAR
CORTEX
NUCLEUS
DENTATUS
METENCEPHALON
NUCLEI
PONTIS
/pONSiCEREBELLUM
ULBAR
NUCLEI
V.
MYELENCEPHALON
( MEQULLA OBLONGATA
SPINAL CORD
ANATOMY
IN A NUTSHELL.
spinal vessels,
431
originates in the
all
sympathetic
in the
ganglion and passes along the gray rami for a short distance then
pass to the vertebra?, intercostal and lumbar vessels.
it
leaves
originates in the
it
to
sym-
LESSON
"The gross anatomy
sympa-
vertebrae, ligaments,
to the
gang-
XXV II.
in the
"
diathesis.
"A
general
nutrition; (b)
it
summary
of the
abdominal brain
i1
is:
that (a)
it
g< n<
an absolute control
its
it
it
pre-
ration; (e)
presides over
(Byron
Rob-
inson).
nvi.ii
Tim Paths.
The cortex
of each
LESSON CXXVIII.
(Pint, s CCX X \-( 'X X X I-( XXXIII).
'(
'(
hemisphere of
tin
brain
These
duction
fibers
maybe divided
into
two
in
according to the
sets,
is
<
dir<
ction of con-
various muscles of the body: and centripetal, or sensory, which convey excita-
PLATE
('(
XXXI.
CEREBRAL CORTEX
prosencephalon
(cerebrum)
mesencephalon
(mid brain)
NUCLEI
PONTIS
MESENCEPHALON
((PONS
CEREBELLUM^
MYELENCEPHALON
MEDULLA OBLONGATA)
NUCLEUS FASCICU
NUCLEUS FASCICU
>
SPINAL
Biiain.
ANATOMY
IN A NUTSHELL.
433
from the skin, mucous membranes, bones, special sense organs, to the
where are produced in an unknown way what we call sensation. Each
half of the body is thus represented in or projected upon the cortex of the opposite
tions
cortex,
name
of
many
are in
maintained.
is
(Plate
CLXXXI). Thev
may speak of
may
Moreover
be, travel.
these groups of fibers often arise from or terminate hi fairly definite areas of the
cortex, which areas are usually called centers.
(Plate CLXXXI 1).
Thus,
that from which springs the fibers that conduct impulses to the muscles which
produce the movements of the hand may be called the motor center of the hand;
1
fibers
along
which visual
impressions travel
is
the
center of sight.
many ways
Of the
which impulses
may
and the
most important that
have been demonstrated. If these impulses travel through the cerebellum we
call the way they pass the indirect route, but if they miss the cerebellum we call
This applies to both motor and sensory
the way they travel the direct route.
in
spinal cord, the following (1), (2), (3), (4), (5), (6), are the
impulses.
Sensory impulses, which are afferent, (centripetal) take the following routes:
(1.)
by means
CCXXX)
By way
of explanation
From
From
mid-brain.
by the way
order
may
Thus we
may
fillet
and gives
and
is
(1))
to the
however some
see
take three.
route
we might say
direct because
it
first order by the way of colgray matter of the anterior horn, the impulses travel through the
AlNTERO-lateral- ground bundle (fasciculi proprii) by neurones oi the second
order to the optic thalamus.
While in the posterior longitudinal bundle (fasciculus longitudinalis medialis) collaterals are given to the bulbar nuclei and
(2.)
laterals to the
mid-brain.
Cortex.
From
This route
direct
first order by the way of colmatter of the cord, they travel by the way of the
tracts of Gower's (antero-lateral ascending) by neurones of the second order
through the dorsal region of the pons and medulla to mid-brain and optic thalamus.
From the optic thalamus neurones of the third order complete the
(3.)
'
ANATOMY
434
This route
is
IN A NUTSHELL.
direct
sensations.
LESSON (XXIX.
(Plate
CCXXX).
i;
second order through the restiform bodies (inferior peduncles of the cerebellum) of the same or opposite side to the vermis, giving off collaterals to the
Impulses now pass from
nuclei in the cerebellum, such as nucleus dentatus.
of the
PLATECCXXX1I.
OPTIC
INTERNAL
\
\
"^^^^^^T^nA
DIAPHRAGMA SELLAE
PITUITARY
."'
'"
7^Ju\
ll^^.X
ADUCENT
CLINOIO PROCESS
rn r
NERVE.
/ TROCHLEAR
^/W'M/^^M^P^
(R^^f^/ ft
:::
/^^^'\ ^-V5^
"
x
-
'
SOP.
INF.
\\^^^
\ \ \ FORAMEN
\ \\
\
/(^ar ^y f'*pT^/^. N
CAVERNOUS SINUS
DIVISION OF
LACHRYMAL BRANCH
TRIGEMINAL
NERVE
/
/
/
/
/
/
SPHENOID
OPHTHALMIC
^T
g^3x//
NERVE^^^^y^ftQ-X^^^^__
B0NEs
^J^^Tp-J^
'
^m^^y^My^m^
SPHENOIDAL SINUS
ARTERY
/ ANTERIOR
^gSS?
-J|f ^FIW
FOSSA.
OPHTHALMIC
NERVE
TROCHLEAR
NERVE
ARTERY
CAROTID
"'
^ ABDUCENT NERVE
MAXILLARY DIVISION OF TRIGEMINAL
NERVE
OVALE
INFERIOR MAXILLARY
DIVISION OF TRIGEMINAL
NERVE
MOTOR RO
'
way
From
he nucleus dentatus impulses pass to the red nucleus of the opposite side through
From
From
This
is
done by means
the red nucleus neurones of the fifth order pass to the optic thalamus.
the optic thalamus neurones of the sixth order pass to the cortex.
!">.!
in
spino-cerebellaris dorso-lateralis)
(fasciculus
cerebellum to the vermis of the same and opposite side by means of neurones of
the
second order.
the vermis neurones of the third order pass to the nucleus dentatus
here by
in
From
From
and from
route
is
hah) inns by
indirect because
n<
urones of the
it
fifth
AX ATOMY
IN A
435
NUTSHELL.
up (Power's tract (fasciculus spinoby neurones of the second older to the mid-brain.
From here they reach the superior worm by the way of the superior peduncles
The remainder of the route is the same as that in route 4
of the cerebellum.
(6.)
cerebellaris ventro-lateralis)
and
The
Neurones of the
5.
indirect route
first
neuroxk SYSTEMS
take six
only three.
may
This route
to
cells of
indirect because
is
complete
it
its
course while
passes through
cerebellum.
LESSON CXXX.
The motor impulses, which
(Plate
CCXXXI).
routes
(1.)
the cerebellum.
Impulses
This route
in this
passing through
direct.
is
and pyramidal
internal capsule,
first
bro-spinalis lateralis) to
end
in the
end
in
From
some
(1>)
same
side to
nd
in the
gray matter
neurone systems
se'e-eind
order to
will carry a
the'
by
(3.)
the'
From
the'
the'
Neurones
now
the'
gray matter
PONTIS, CEREBELLUM, BULThis route passes through the cerebellum therefore it is an inImpulses pass by the neurones of the first order through the
BAR nuclei.
direct
mid-brain.
route.
the'
middle' peduncle's to
to
the'
the pons.
From
the-
here neurones of the third order carry the impulses to the' dentate' nucleus.
Neurones of the fourth order pass from the
Neurones of the fifth order pass from
dentate' nucleus to the bulbar nuclei.
neurones of
the'
From
in
of the
s.
and
rior
PLATECCXWIII.
PROSENCEPHALON
CEREBRAL CORTEV
ERERKUM)
MESENCEPHALON
PONTIS
METENCEPHALON
/PQNS*CEKEBELLUM|
myelencephalon
(medulla oblongata)
SPINAL COHD
436
ANATOMY
flex
IN A NUTSHELL.
437
impulse
reflex
may
pass over
re-
(Plate
pathways.
it
When we
name and
can
hi
it.
boundaries of all the ventricles and describe each structure which helps to
make these boundaries, then we understand something of the brain.
LESSOX CXXXI.
The Transverse Commisures are
1.
2.
Middle commissure.
3.
4.
Optic commissure.
are:
1.
Olfactory tracts.
2.
3.
Crura cerebri.
4.
Processus-e-cerebello-ad-testes.
See
page 354
5.
6.
7.
8.
5.
6.
Fornix.
7.
Gyrus Fornieatus.
8.
Lamina cmerea.
9.
Infundibulum.
(valve of Yieussens.)
9.
Inf.
10.
Fasciculus uniformis.
LESSON CXXXII.
Third Ventricle.
WTKRlnR BORDER.
ROOF.
1.
Corpus callosum.
2.
Fornix.
3.
Velum interpositum
superior).
(Tela choroidea
1.
2.
Anterior
pillars of fornix.
3.
Foramen
of
Monro.
Page 349
Seepage
".11
4.
Epithelium.
1.
Tegmental portion
floor.
P<
of the diverg-
3.
Corpora albican
4.
Tuber cinereum.
5.
Infundibulum.
6.
Lamina cinerea
in.
istkriok BORDER.
1.
Posterior commissure.
2.
Aquedud
Page 348
Page 341
Epithelium from pineal body
3.
to
of
Sylvius.
velum interpositum
(tela choroi-
dea superior).
BIDES.
(anterior wall).
tptic
:,
ANATOMY
>,S
IX A
NUTSHELL.
PLATE CCXXXIV.
BREGMA.
TEMPORAL
RIDGES.
3
CO
NION.
BONE S
l-FRONTAL.
6-MALAR.
2-PARIETAL.
7-LACHRIMAL.
3-0CC1P1TAL.
8-SDR MAXILLARY.
4-TEMPORAL.
9-NASAL.
5-SPHENOID.
KHNF. MAXILLARY.
-SUTURES-
TO LAMBDA
LESSON CX XX III.
L
L.
ROOF
Corpus callosum.
1.
'''" nK
Caudate nucleus.
2.
Taenia semicircularis.
\ti:i; \i.
Ventricle:
OUTER
::
4.
").
6.
1.
Lamina cornea.
Choroid plexus.
optic thalamus.
Fornix.
See
1.
p.-iu<'
2.
3.
18
SIDE.
Septum lucidum.
ANATOMY
439
IX A NUTSHELL.
LESSON CXXX1Y.
Fourth Ventricle.
The
ruof or posterior
boundary
Is
2.
3.
4.
5.
6.
7.
Obex.
8.
Ligulse.
The
floor or anterior
boundary
is
5.
Eminentia teres.
Fovea superior.
Conductor sonorus.
Locus caeruleus.
Fovea inferior.
6.
7.
Trigonum hypoglossi.
Tuberculum acusticum.
1.
2.
3.
4.
8.
LESSON CXXXV.
The
first
cranial nerve
is
called olfactory.
One
The second
cranial nerve
One
optic foramen.
The third
called optic.
is
cranial nerve
is
called
motor
It
is
is
called anosmia.
It
optic neuritis.
oculi.
It
ptosis.
The fourth
cranial nerve
is
cranium through
diplopia.
The
fifth
cranial nerve
is
The ophthalmic
called trifacial.
division Leaves
is
sub-
ject to
convergent
fissure.
squint.
The seventh
cranial nerve
is
called facial.
It
cranium
through the internal auditory meatus and after passing through the aqueduc-
PLATE CCXXXV.
FORAMEN CAECUM
CRISTA GALLI
GROOVE FOR
NASAL NERVE
POSTERIOR
FOR
OLFACTORY NERVES
ETHMOIDAL
FORAMEN
ETHMOIDAL SPINE
OLFACTORY GROOVES
OPTIC FORAMEN
OPTIC GROOVE
OLIVARY PROCESS
ANTERIOR CLINOID
PROCESS
MIDDLE CLINOID PROCESS
_-
GANGLION
MASTOID
FORAMEN
ANATOMY
tus Fallopii
it
NUTSHELL.
IX A
paralyzed after
it
also called
is
it
The eighth
is
its
may
he
passage through
its
origin in the
brain.
in
In
any
the brain
is
bulbar paralysis.
cranial nerve
is
called auditory.
internal auditory
nerve
This nerve
441
It starts to
One
in
disease of this
deafness.
The ninth
cranial nerve
called glosso-pharyngeal.
is
It
Loss of taste
is
ageusia.
The eleventh
cranial nerve
is
The
is
called
hypoglossal.
It
foramen.
It
Paralysis of this
aphasia.
The following
given.
(1)
Valve of Yieussens
is
is
medul-
lary velum.
(2)
is
is
It
The
perforated substance.
(4) Tuber cinereum is a tract of gray matter extending from the optic
commissure to the corpora albicantia. and it is one of the structures in the floor
Lamina cinerea
is
Infundibulum
is
fourth ventricle.
(10)
bands passing
forward from each side of the pineal gland along the edge of the third ventricle
to join the anterior pillars of the fornix.
PLATE CCXXXVI.
ANTERIOR
NERVE
PALATINE VESSEL
PALATI
HAMULAR PROCESS
PROCESS OF PALATE
PTERYGOPALATINE CANAL
BASILAR PROCESS
TENSOR TYMPANI
RECTU!
SPHENOID
PHARYNGEAL SPINE
FOR.
TYMPANI
LEVATOR PALATI
CANAL FOR JACOBSON S NERVE
AQUAEDUCTUS COCHLEAE -
FORAMEN
LACERUM
CANAL FOR
POSTERIUS
ARNOLDS
NERVE
ANTERIOR CONDYLOID
CONDYLOID
LIGAMENTUM
FORAMEN
"
ORAMEN
FORAMEN
NUCHAE
of Base of Skull
442
ANATOMY
(11)
Obex
is a band
The calamus
soriptorius.
ventricle, at the
(12)
end
Ligula
of
nervous matter
of gray
scriptorius
which
is
443
IN A NUTSHELL.
at
is
is
Fovea superior
a depression
is
in
Eminentia teres
is
on each side
It is
(18)
Ala cinerea (trigonum vagi) is a d< pr< ssion below the inferior fovea.
Trigonum hypoglossi is situated on the inner side of the inferior
fovea.
(19)
Tuberculum acusticum
is
fovea.
(20)
lobe,
and
(21)
LESSON CXXXVI.
The relations of the External Carotid Artery.
CXVI-
(Plates
CXVII-CXVIII.
In Front.
(4)
(1)
Anterior border
vein,
(7)
Facial
of
vein,
Sterno-mastoid,
(8)
Digastric
(">)
Hypoglossal
muscle.
(9)
nerve,
Stylo-hyoid
Behind.
pharyngeus,
Superior
(1)
(4)
laryngeal
nerve,
Glosso-pharyngeal nerve,
(5)
(2)
in
fascia.
Lingual
(6)
muscle.
its
Stylo-glossus,
(10)
substance.
(3)
Stylo?
Parotid "land.
Externally.
(1)
nerve,
(4)
(2)
Parotid gland,
(5)
Ramus
(3)
Superior
laryngeal
of jaw.
(1)
The
upper
upward
cervical vertebra? to
in
front of
otid canal
in
cavernous sinus.
This portion
gives off
the
in
of the
ANATOMY
444
IN A NUTSHELL.
upward on
ernous sinus.
off (a)
it
which pass to the pituitary body, Gasserian ganglion, and to the walls of the
cavernous sinus and inferior petrosal sinus, (b) anterior meningeal which
passes over the lesser wing of the sphenoid to the dura mater in the anterior
this artery has been described od page 383, (4) The
fossa, ici ophthalmic
rs
in
(Plate
posterior part.
CLXXIIL)
Tin: anterior
ANTERIOR CERE-
corpus callosum to
its
communicating artert
PLATE CCXXXVIL
ARTIC
PARIETAL
PACCHIONIAN
DEPRESSIONS.
-GROOVES
FOR MEN
1NGEAL
ARTERIES
FORAMEN*
ARTIC. WITH
CAICUM.
GRTR WING
SPHENOID.
3F
ORBITAL PLATE
ARTIC. WITH
ARTIC WITH
MALAR.
ESSER WING.
HRYMAL
FOSSA.
LACHRYMAL.
NASAL
NASAL.
'SPINE
ETHMOIDAL NOTCH
DEPRESSION FOR PULLY OF SUP OBLIQUE
UNDER SURFACE OF NASAL PROC.
its
off
the
<>\'\
to
frontal,
which passes
to the
two
It
also
inferior frontal
fissure of Sylvius
CLXXIII-CLXXV)
its
ANATOMY
445
IN A NUTSHELL.
are anterolateral ganglionic which passes to the corpus striatum, internal capsule and optic thalamus; external and inferior frontal which pass to the third
frontal convolution; ascending frontal which passes to the ascending frontal
convolution; the ascending parietal which passes to the ascending parietal convolution; and parieto-sphenoidal which passes to the angular convolution and
The
at the
in
(Plate
CLXXIII.)
circle of Willis is
base of
the floor of the third ventricle are in the circle of Willis except the tegmental
The
is
in the floor of
arteries that
make
the
this circl e
arc the
it
basilar; the
ganglion of Ribes.
The
the
(a)
wind around
cms cerebri to the under surface of the occipital lobe. Here it sends branches
TO THE UNCINATE LOBE, (b) TO THE CUNEATE LOBE, (c) TO THK TEMPORAL
lobe.
Xear
its
origin
it
receives the
communicating
posterior
artery.
The
LESSON CXXXVII
The Relations of the Entern
kl
Carotid Artery.
(1) Skin, (2) Superficial ami deep fascia, (3) Platysma, (4)
Sterno-mastoid, (5) Occipital artery, (0) Posterior auricular artery. (7) Hypoglossal nerve, (8) Parotid gland, (9) Stylo-glossus, (10) Stylo-pharyngetis.
Ix Front.
(11)
Behind.
ior
laryngeal nerve.
Externally.
Internally.
pharyngeal artery,
(1)
(1)
(4)
Internal
Pharynx,
jugular vein,
(2)
(2)
Pneumogastric nerve.
(3) Ascending
Tonsil.
The Right subclavian artery arises from the innominate opposite the sternoand passes upward and outward to the Scalenus anticus
muscle on the right side. The left Subclavian artery arises from the end of
The artery
the arch of the aorta and ascends to the Scalenus anticus muscle.
clavicular articulation
W ATOMY
440
IX A XI TSHELL.
now runs outward behind the Scalenus anticus muscle then downward under
first rib where it takes the name of axilScalenus anticus muscle divides this artery into three portions.
lary.
The portion
;Ik
<
the
first
xternal to
it is
it
is
Front.
1\
is
(7)
Anterior jugular,
(8)
Internal
jugular,
(9)
Vertebral
veins,
(10)
Pneu-
PLATE CCXXXVIII.
METOPIC
%%
SUTURE.
SUPERCILIARY
Wk'
SUPRAORBITAL
NOTCH OR FORAMEN.
RIDGE.
CORRUGATOR
0BICULAR1S PALPEBRARUM.'
INT.
FRONTAL
EMINENCE
ANGULAR PROC
Extern
\i.
SUPERCILII.
NASAL SPINE.
mogastric nerve, (11) Cardiac nerves, (12) hoop from the sympathetic.
Behind. (1) Recurrent laryngeal nerve, (2) Sympathetic, (3) Pleura
i
Apex
of lung.
Beneath. (1)
In
nerve,
(7i
Pleura,
(2)
Recurrent
laryngeal
nerve.
Tin:
Front.
(4)
Left
Vertebral
(1)
Pneumogastric
carotid artery.
vein,
(8)
(5)
nerve,
(2)
Cardiac
Thoracic duct,
Innominate
vein,
(9)
((i)
nerves,
Left
(3)
Phrenie
internal jugular.
Sterno-thyroid.
(10)
Sterno-
Behind.
(1)
Oesophagus,
(2)
Thoracic duct.
(.'-!)
ANATOMY
Longus
Outer
Inner
Side.
Bide.
Pleura,
(1)
447
colli.
Left lung.
(2)
Trachea.
(1)
IN A NUTSHELL.
(2)
(Esophagus,
Thoracic duct.
(3)
LESSON CXXXVIII.
The Relations of Second Portion of Subclavian Artery are the same
on each
side.
In Front.
vical
'
fascia,
(1)
(4)
Sterno-mastoid,
Phrenic
(5)
nerve,
(6)
Scalenus
auticus.
Subclavian vein.
7)
Behind.
Pleura,
(1)
Scalenus medius.
(2)
(1) Skin, (2) Superficial fascia, (3) Platysma and deep cerDescending branches of cervical plexus, (5) Nerve to subclavius muscle, (6) Subclavius muscle, (7) Suprascapular artery, (8) Supra-
In Front.
scapular vein,
(9)
vein,
vein.
(11) Clavicle.
Scalenus medius,
Brachial plexus,
First
Behind.
Above.
Below.
(1)
(1)
(2)
(2)
plexus.
rib.
LESSON CXXXIX.
The branches of the subclavian artery are (1) vertebral, which arises at
the upper and back part of the artery and passes upward through the foramina
in
magnum
It
11
now
of the occipital
bone
in
it
passes
torn men
After
bone
it
The branches
(A)
to
form
the cer-
vical branches which send muscular branches to the neck, lateral spinal
which pass through the intervertebral foramen and then divides into two
branches one of which runs along the nerve roots to the cord and its coverings,
the other divides into ascending and descending branches which form with
similar branches from
geal
and posterior spina! see page 337. The posbranch of this crania] portion and winds
around the medulla across the restiform body to the under surface of the cereFor description
of anterior spinal
bellum.
is
tin-
last
ANATOMY
lis
IN A
in a
groove
the
posterior cerebral
branch.
The
NUTSHELL
to
its
basilar
(A)
numerous
TRANSVERSE BRANCHES
to
the
polls
>
PLATE CCXXXIX.
ANT. SUP.
ANGLE.
POST.SUF.
ANGLE
ANT.
INF.
ANGLE.
-GROOVES FOR
POST. INF
ODLE MENINGEAL,
ARTERY.
ANCLE.
FOR LATERAL
SINUS.
The
internal
mammary
arises
from the
first
artery opposite the thyroid axis and descends on the posterior surfaces of the
cartilages to the sixth interspace where it divides into the musculo*
phrenic and the superior epigastric branches.
As it passes down it is about a
costal
half an inch
are
(a
iastinum, (c) pericardiac which passes to the anterior surface of the pericardium,
(d)
(e)
terspaces where each branch divides inio two divisions to pass along the mar-
\\
\TOMY IX A NUTSHELL.
449
gland.
Of
its
it
LESSON CXL.
The thyroid
(3)
trans versalis
The
and gives
It crosses
laryngeal nerve.
from the
first
suprascapular, and
arteries.
colli
common
colli
this nerve.
Its
branches are,
tracheal, which pass to the trachea, (b) oesophageal, which pass to the
oesophagus, (c) muscular, which pass to the adjacent muscles, (d) inferior
laryngeal, which passes to the back of the larynx with the recurrent laryngeal nerve, (e) ascending cervical, which passes between the Scalenus anticus muscle and the Rectus capitis anticus major on the anterior tubercles of
(a)
The suprascapular artery crosses the Scalenus anticus muscle behind the
and passes over the transverse ligament of the scapula to the supraspinous and infraspinous fossa?. This artery goes to the clavicle, scapula, and
humerus, as well as to the sterno-clavicular articulation and acromio-clavicular articulation and the shoulder girdle.
The transversalis colli is on a higher level than the suprascapular artery and
crosses the Scaleni muscles and the brachial plexus to the Trapezius muscle.
Here it divides two branches, (a) superficial cervical which ascends under
clavicle
the anterior border of the Trapezius to anastomose with the superficial branch
of the arteria princeps cervicis, (b) tiiio
runs under the Levator anguli scapulae to the superior angle of the scapula and
then descends under the Rhomboidei muscles to the inferior angle of the scapula.
This artery may arise from the third portion of the subclavian.
The superior
(4)
intercostal
first
two
branch which
artery
in
intercostal spaces.
is
distributed
the second
aortic intercostal.
in
In
like
the
first
manner
intercostal space
to
All
it
gives off
The
the posterior
ANATOMY
450
IX A NUTSHELL.
and a small one which passes to the spinal cord and its memThe profundus cervicis most always comes from the superior interIt ascends under
costal, but it may come from the subclavian artery itself.
the Complexus muscle as far the axis to anastomose with the deep branch of the
spinal muscles
brane.
princeps cervicis.
arteria
286. and
its
branches arc (1) pericardiac, which are small arteries and are distributed To
the pericardium. (2) the bronchial arteries are nutrient arteries to the lungs.
may come
right side
(A)
PLATE CCXL.
PARITTAL
FORAMEN.
TEMPORAL
R,DGES
jurtu
:^*~
SQUAMOUS
ART LT'5 Wl
SPHENOID.
PORTION,
TEMPORAL MUSCLE.
^-EMINENCE.
MASTOID
PORTION-
four or five in number,and come from the front of the thoracic aorta and pass ob-
ANATOMY
IN A NUTSHELL.
451
LESSON CXLI.
number. Those of the first and
(5)
second spaces come from the subclavian, and the remaining nine come from the
The last one, which passes along the lower border of the Last
thoracic aorta.
The
rib,
is
The
aorta
is
The lower
dominal wall and into the sheath of the Rectus muscle where they anastomose
with the internal mammary and the deep epigastric artery. The branches of
the intercostal arteries are (a) the posterior or dorsal branch, which passes
backward to the inner side of the anterior costo-transverse ligament where it
is distributed to muscles and integument of the back after dividing into an ex(b) The spinal branch, which passes through
ternal and internal branch,
the intervertebral foramen to be distributed to the spinal cord and its coverings
and the bodies of the vertebrae, (c) The collateral intercostal branch
arises from the intercostal artery close to the angle of the rib and then passes
downward to the upper border of the rib below, along which it passes to anastomose with the anterior intercostals from the internal mammary.
The thoracic aorta commences on a level with the fourth dorsal vertebra
and descends on the left side of the spine to pass through the abdominal opening in the Diaphragm after which it is called abdominal aorta.
The abdominal aorta commences at the aortic opening in the Diaphragm
extends to the front of the body of the fourth lumbar vertebra where it divides
(Plate XCI
into tiih right and lkft common iliac arteries.
|
LESSON CXLI I.
The Relations of the Abdominal Aorta.
In
Front.
cceliac axis,
(4)
(1)
Behind.
Lesser
omentum,
(2)
Stomach.
(1)
duodenum,
lumbar
Left
(9)
((>)
(3)
Branches
Pancreas,
(7)
the
of
Left
renal
veins,
Right Side. (1) Right cms of Diaphragm, (2) Inferior vena cava,
Yena azygos major, (4) Thoracic duct, (5) Right semilunar ganglion.
(3)
ANATOMY
452
IN A NUTSHELL.
this
Left Side. (1) Left lumbar veins. (2) Left semilunar ganglion.
The branches of the abdominal aorta are (1) parietal branches and under
we have (A) phrenic branches which are two in number and as a rule
PLATE CCXLI.
A-0CCIP1T0 FRONTALIS.
B-TRAPEZIUS.
LINEA SUPREMA.
Q-
C-STERNO- MASTOID
INF.
LINE.
R-FOR LIGAMENTUM
D-SPLENIUS
E-COMPLEXU!
NUCHAL.
^%%a
F-0BL'Q5.SUR
G - RECTU S
CAPITUS
POST.
CURVED
INION OR EXT.
OCCIPITAL
PROTUBERANCE.
Ml
T- CREST.
H-NECTUS
CAPIT
&
POST.MIN.
-
U-BASILAR
PROC
RECTU5-
V- PHAR-
CAP.LAT.
YNGEAL
J-FEC-CAB/I
SPINE.
K-RECCftP.AJfT.MJ.
-TUBERCLES
FOR CHECK
L-SURCONSTRICTO
M- POST. CONDYLOID
LIGAMENTS
FORAMEN.
X- JUGULAR PROC.
Y-
muscle behind the inferior vena cava, while the one on the
left side
passes
(B) Ltjmbab
arteries are five pairs and arise from the back of the aorta to pass outward
on the body of the vertebrae beneath the Psoas magnus muscle and the sympathe-
The first two pairs pass under the crura of the Diaphragm and the
one
also
right
passes under the inferior vena cava.
Near the transverse processes of the vertebrae they divide into an abdominal branch, which passes
tic
nerve.
outward beneath the Quadratus lumborum to end between the muscles of the
abdominal wall where they anastomose with the deep epigastric, the internal
mammary, the ilio-lumbar, and the circumflex iliac arteries. It is well to say
ANATOMY
that the
first
IN A NUTSHELL.
lumborum
453
muscle.
is
the dorsal branch which passes with the posterior primary branch of the intercostal nerve and gives off spinal branches which supply the spinal cord and its
coverings.
It
(C)
Sacramedia
is
small branch given off at the bifurcation of the abdominal aorta and passes
over the fifth lumbar vertebra and the sacrum to the coccyx where it anastoa
(Plate XC.)
arteries.
LESSON
CXLIII.
and under these we have (A) coeliac axis, which
is a short trunk about a half of an inch long, arises between the crura of the
Diaphragm just above the Pancreas. It passes horizontally forward and di(2)
The
visceral branches
is
and passes upward to the left side behind the lesser' sac of the
peritoneum to the cardiac end of the stomach. It also uives branches to the
oesophagus, then turns to the right and passes along the lesser curvature of the
stomach sending branches to both sides of the stomach. It anastomoses with
Hepatic artery passes forward and
the pyloric branch of the hepatic artery.
upward between the layers of the lesser omentum to the transverse fissure in
the liver where it divides into right and left hepatic branches to supply the
three branches
it
is
is
is
In
The branches
of the
hepatic artery are Pyloric, which extends along the lesser curvature of the
i.\^stomach passing from right to left to anastomose with the gastric artery.
tro-duodenalis pass behind the first portion of the duodenum and divides
Gastro-epiploiea dextra, which runs along the
into the folio whig branches.
greater curvature of the stomach from right to left to anastomose with the
This artery
gastro-epiploiea sinistra which is a branch of the splenic artery.
Pancreaticogives branches to both the stomach and the great omentum.
duodenalis superior passes between the second part of the duodenum and the
(
pancreas.
it
is
The
is
splenic artery
very tortuous
divides into
pancreatic^
i'\i;\
left
e.
Tin;
in
left
is
its
kidney
to
passes along
It
the spleen.
It
to the right
:i
creas
ANATOMY
454
IN A NUTSHELL.
cceliac axis
duodenum which
of the
portion of the
first
duodenum.
the ascending
PLATE CCXLII.
FOUFALX CEREBRI
TORCULAR
HEROPHILI.
POST CONDYLOID
FORAMEN.
LATERAL SINUS
JUGULAR FOSSA.
GROOVE FOR MEDULLA.
BASILAR PROC.
ANATOMY IN A NUTSHELL.
455
which numerous branches are given off to supply the mesentery and the small
Four or five sets of arches are given off. The ilio-colic artery
intestine.
It passes beis given off from the right side of the superior mesentery artery.
tween the layers of the mesentery to the right iliac fossa where it divides into
two -anehes, ascending and descending. The ascending one passes to the
ascending colon and anastomoses with the colica-dextra. The descending one
passes to the lower part of the ileum, csecum. appendix, and ileo-csecal valve.
The colica-dextra arises from the middle of the superior mesentery artery
and passes behind the peritoneum to the ascending
ion where it gives off an
ascending branch which anastomoses with the colica-media. and a descending
branch which anastomoses with the ileo-colic. Colica-media comes from the
upper part of the concavity of the superior mesenteric artery and passes for-
PLATE CCXLIIL
GRqOVE FOR OLFACTORY
LESSER WING.
REATER WING
TRACT. C
- ANT.CLINOIO
10-
II-
MID. CLINOIO
PROC
-
POSTCLINOID PROC
OLIVARY PROC.
SELLA TURCICA.
12
-SPHENOIDAL
FISSURE.
13-
FORAMEN
VESALII.
H- FORAMEN
CAVERNOUS GROOVE
8-LINGULA
GROOVE FOR
SIXTH WTRVE.
4 -OPTIC GROOVE
5--
FORAMEN
OPTICUM.
PROCESS
15-
\/\ SUPP0RT5
'X-'l
PTERYGOI
-SPINOUS PROC.
1/
16-
OVALE
FORAMEN
SPINOSUM.
FORAMEN ROruNDUM
ward in the transverse meso-colon where it givi s a right branch which anastomoses with the colica-dextra, and a left branch which anastomoses with the
((')
(Plate CLVII.)
The inferior mesentery artery arises from
colica-sinistra.
It
the left side of the aorta aboul an inch and a half above the bifurcation.
supplies the descending colon, sigmoid flexure, and the greater part of the rectum. It lies a1 hist on the left side of the abdominal aorta, then crosses the
Psoas muscle, left common iliac artery, ami un ter, to the back of the rectum.
It gives off the following branches. COLU \->i\i>ti; \. which passes behind the
peritoneum upward in front of the left kidney to th< descending colon where it
divides into an ascending branch, which anastomoses with the colica-media,
and
a descending
ANATOMY
156
IN A NUTSHELL.
is
mesenteric artery and passes behind the rectum to divide into two branches in
One branch passes od cither side to within about six inches
the meso-rectum.
This artery anastothe anus where they subdivide to supply the rectum.
moses with the sigmoid, middle and inferior haemorrhoidal arteries. (D) The
suprarenal, sometimes called middle capsular, are two in number and come
from the abdominal aorta a little below the cceliac axis. They pass obliquely
upward and outward over thecrura of the Diaphragm to the suprarenal body.
They anastomose with the superior capsular of the phrenic and the inferior
(E) The renal arteries are two in number which come
capsular of the renal.
oi
PLATE CCXLIV.
SPHENOIDAL FISSURE, OPTIC FORAMEN
ARTIC.
TEMP'L FOSSA
{ ,\
TEMPORAL.
EXT.
PTERYGOID RIOGE.
PTERYGOID.
FORAMEN ROTUNDUM
'
ZYGOMATIC FOSSA
VIDIAN CANAL.
+ SPHENODAL
'
TURBINAL BONES
VAGlNALPf?0C
SPINOUS PROC.
ROSTRUM.
FORAMEN
y IN"D
HAMULAR PROCESSES
SPJNOSUM.
NOTCH
from
artery,
ing
of
fa1
from the abdominal aorta. They pass downward and outward behind the peritoneum but over the Psoas magnus muscle
arise jusl
and
b<
ur< ter
and external
arteri< s
iliac
canal
t<>
it
sup-
ANATOMY
457
IN A NUTSHELL.
PLATE CCXLV
,'fl\^
PALATI
INTERNAL PTERYGOID
^
TERYG0ID
TENSOR
FOSSA
SUPERIOR CONSTRICTOR
External intercostal*.
side,
LESSOX CXLIV.
Muscles of the Thorax.
Description. Then are
From
fibers of the
b<
m situations
placed
In
b<
inn;
rcostal fascia,
\v<
<
n the
two
surface of tin
which
is
more
set> of muscl<
s.
tw< en the
Indeli-
The
and
tin-
<
commencemi
nt
of the cartilag*
Insertion.
tilages in the
is
The
fib
and
rs,
shown
like tin
Origin.
to the
<
Action.To
s.
r
of the rib
tin
Xki;\ e Supply
Inn rcostal
n< rv< s.
ANATOMY
458
Blood Supply.
Intercostal
IX A NUTSHELL.
arteries.
Their
Description. These are eleven in number.
tillers pass obliquely downward and backward in the opposite direction to those
They extend from the sternum anteriorly to the
of the External intercostals.
Internal intercostal*.
Origin.
From
and the
costal cartilage.
[NSERTION.
PLATE CCXLVI.
MASTOID PORTION
MASSETER.
CLASERIAN FISSURE
CLENOID FOSSA.
^'.W^J^ TRACHELOMAST.
EXT. AUDITORY
MEATUS
STYLOID PROCESS
DIGASTRIC.
STYLO- GLOSSUS
STYLO-HYOID
SPLEVHUS-CAPITIS.
PROCESS.
STYLO- PHARYNGEUS.
STERNOCLEIDOMASTOID-
RETRAHENS AURICULAM
nerves.
arteries.
Origin.
From
Insertion.
Their direction
like thai
of the
>
of the first,
They
Internal intercostals.
are
more often
presenl between the lower ribs than between the upper ribs.
Ai
Depress
[on.
N u;\
i.
Si
I'i'i.i
Blood Supply.
ribs.
Intercostal uerves.
Intercostal arteries.
Triangularis sterni.
is
situated
ANATOMY
IN A NUTSHELL.
459
The attachment
Origin.
of this
From
lower
true ribs,
and
also
the sternum.
Insertion.
Into
and
fifth ribs.
Action.
arteries.
PLATE CCXLVII.
EMINENCE FOR SUP.
SEMI-CIRCULAR CANAL \
SUP. SURF. OF PETROUS
SQUAMOUS
PORTION.
PORTld
DEPRESSION FOR
CASSER1AN GANGLION.
CAROTID CANAL
'
N.
HIATUS FALLOPII
INT AUDITORY MEATUS
AQUEDUCTUS VESTIBULI
Description.
These
the transverse processes of the seventh cervical vertebra and the eleven upper
ANATOMY
460
IN A NUTSHELL.
LESSON CXLV.
The mediastinum
viscera except
the mil
the -pace
sto, I stand.
in
all
the thoracic
the lungs.
ami
Idle,
is
is
posteriorly.
medius,
It
angularis sterni muscle, parts of other muscles, lymphatic nodes, and areolar
tissue.
cavity.
pericardiac
It
is
artery,
pericardium.
It
is
nearly the
same
i.e.,
as the
The
phatic nodes.
posterior
mediastinum
is
and lym-
PLATE CCXLVIII.
EUSTACHIAN TUBE
PROC. COCHLEARIFORMIS.
CAROTID
'
PROMONTORY.
STAPES
^\
CANAL/
AQUEDUCTUS
COCHLEARIFORMIS
l^^EUSTACHIAN TUBE
ROTUNDA
CANAL FOR FENESTRA
-[<- q
PYRAMID.
TYMPANI.
C\\
TYMPANUM.
CAROTID CANAL.
FALLOPII
ANTRUM
%&Y
ANTRUM. \
MARROW
STYL0I0 PROCESS.
AQUEDUCTUS FALLOPII.
CELLS.
It
splanchnic aerves.
Name and
classify these
in
forty structures.
LESSON CXLVI.
Muscles of the Superficial Abdominal Region.
Obliquus externus also called
Descending oblique.
Description.
This
ANATOMY
IN A NUTSHELL.
461
muscle
is
It is situated
region.
domen,
it
connected
It
is
its
attachment
to the lower
extends from
the anterior superior spine of the ilium to the spine of the os pubes ami theiliopectineal line, thus forming Poupart's ligament.
Okigin.
lower
The
From
The attachment
ribs.
of the
of these digitations,
first five
digitations run
which increase
in size
PLATE CCXLIX.
CANAL FOR JACOBSON'S NERVE
AQUAIDUCTUS COCHLEAR
CANAL FOR ARNOLD'S NERVE
JUGULAR FOSSA
VAGINAL PROCESS.
STYLOID PROCESS.
STYLO-MASTOID FOR AM E
JUGULAR SURFACE.
STYLO-PHARYNGEUS
EMINENTIA
OCCIPITAL GROOVE.^
DIGASTRIC
FOSSA.
ARTICULARIS
in size
Insertion. Into the anterior half of th( out< r lip of the cr< si of he
and into the aponeurosis of the muscle extending from the prominence
I
ilium,
of the
ninth costal cartilage to the anterior superior spinous process of the ilium.
Action. To compress the viscera. To flex the thorax on the pelvis or
and parturition.
Nerve Supply. Lower intercostals,
BLOOD SUPPLY. Intercostal and lumbar
assisl
micturition, defecation,
muscle
lies
arteries.
Description. This
Ascending oblique.
bfeneath the External oblique and is smaller and thinner than that
called
muscle.
Origin.-
From
ANATOMY
462
IN A NUTSHELL.
anterior one-third of the middle lip of the crest of the ilium, passes horizontally
and
at
it
Rectus muscle
of its
while the upper three-fourths sends a layer of fascia in front of the Rectus
muscle to be inserted into tbe linea alba and a posterior layer to pass behind
the sheath of the Rectus muscle to be inserted into the linea alba also into the
That part of the muscle which passes obliquely
seventh, eighth. and ninth ribs.
upward
is
inserted in the lower border of the cartilages of the three lower ribs
PLATE
SUP.
CCL.
BORDER
^v
MEDIAN
BORDER.
I'
I'
.'/
SI-,
GROOVE
^'^BfcFOR NASAL NERVE. \*.*$&s^~
./
A?
The Nasal Bone.
where
it
is
is
A.CTION.
Uio-inguinal.
Blood Supply.
Intercostal
ilio-hypogastric,
and lumbar
arteries.
LESSON CXLVIL
Internal oblique takes
Oniiiix.
its
Transversalis.- Description.
of
Diaphragm.
It also
comes
fascia.
ANATOMY
iiig
IX A NUTSHELL.
463
part of the aponeurosis passes horizontally Towards the linea alba, but at
it
Action.
the
ilio-
inguinal.
and lumbar
arteries.
Rectus abdominis. Description. This muscle extends from the symIt is much broader and thinner above than
physis pubes to the sternum.
below and is separated from its fellow by the linea alba. The linea' transversa
There are three such
are tendinous intersections which cross this muscle.
One is situated opposite the umbilicus and one at the extremity of the
lines.
ensiform cartilage, and a third one between these two.
Occasionally one or
two additional lines may be seen. These lines are homologues of ribs. The
sheath of the Rectus muscle contains the Pyramidalis muscle and the superior
epigastric artery, the deep epigastric artery, anel the terminal branches of the
lower intercostal and lumbar arteries anel nerves.
PLATE CCLI.
LACHRYMAL
GROOVE \/wSjk
HAMULUS
By two
Insertion.
Into
is
its
fifth, sixth,
and seventh
ribs,
and
occasionally connected with the costo-ziphoid ligaments and side of the ensi-
form cartilage.
Action. To compress abdominal viscera, and to flex thorax.
Xervk Supply. Lower intercostals.
Blood Supply. Intercostal, lumbar, deep epigastric and superior epigas-
tric
arteries.
Pyramidalis.
Description.
This
muscle
is
situated
in
the
same sheath
with the Rectus abdominis muscle in front of the lower portion of that muscle.
It may be absent on one or both sides, or it may be double on one side.
Origin. From front of pubic bone and anterior pubic Ligament.
Insertion.
Action.
to the umbilicus.
ANATOMY
464
IN A NUTSHELL.
Blood Supply.
in
thin musular
those
of
the
continuous
with
Internal
which
are
oblique
and some
fasciculi
Trans
versalis,
descends
through
of
the
the
external
those
with
abdominal
times
ring from the front of the spermatic cord.
Origin. From the middle of Poupart's ligament.
Insertion. Into the crest of the os pubis and sheath of the Rectus.
Cremaster.
PLATE
CCLII.
NASAL PROC
FQRSUP.TURBINAL.
RIDGE FORMID.TURBINAL.
MIDDLE MEATUS
ANTRUM
RIDGE FOR
NF.TURBINAL.
POST. PALATINE
GROOVE.
INF
ANT. NASAL
SPINE.
MEATUS
-CREST
PALATINE PROC.
ANT PALATINE
GROOVE.
and insertion
origin
this
may
of this
This muscle
muscle.
LESSON CXLVIII.
(1)
(2)
(3)
(4)
sheath formed
l>v
the anterior
of the
is
lumbar
situated in
fascia.
On
the
ANATOMY
IN A NUTSHELL.
465
anterior surface of this muscle beneath this fascia are the last dorsal, ilio-hypogastric,
and
ilio-inguinal nerves.
of the
lumbar
fascia sep-
muscle from the Erector spinae. This muscle as its name implies
broader below than above.
quadrilateral,
is
Origin. From the ilio-lumbar ligament and the crest of the ilium for
about two inches. Occasionally a second portion of this muscle is found situated in front of the muscle, and when so found it has its origin from the upper
arates this
borders of the transverse processes of three or four lower lumbar vertebrae and
is inserted into the lower margin of the last rib.
Insertion.
for
about half
its
length.
Action.
To
last rib
first
LESSON CXLIX
used to name any thin expansion of tissue, and has
Serous membrane, which is the simplest of all
These serous membranes derive their name from the fact that they
forms.
The serous membranes are closed sacs,
are moist with a fluid like blood-serum.
such as the pericardium, pleura, and peritoneum. However, the peritoneum
in the female is an open sac.
(2) Synovial membrane which lines the joints.
This membrane secrets synovia, which resembles the white of egg. Under
synovial membrane we have three classes, (a) articular, which occurs hi joints,
vaginal, which
is
(1)
bursal.
is
synovial bursa
internal peritoneum.
from the body, it would be
or
If it
ANATOMY
466
IN A NUTSHELL.
The peritoneum
(literal
Ln the female
closed sac.
it
is
fold of
peritoneum
going from the lesser curvature of the stomach to the transverse fissure of the
liver
is
omentum and
to the
a fold of
Spleen,
(2)
liver.
(3)
is
omentum.
layers in
fold of
transverse colon
it
called gastro-splenie
is
of
structures
stomach,
are
(4)
entirely
first
covered
portion
with peritoneum:
the
of
duodenum,
small intestine, (6) csecum, (7) transverse colon, (8) sigmoid flexure, (9)
(5)
first
The
creas, (2)
kidney. (3) suprarenal capsule, (4) third portion of the rectum. (5)
and (6) lower portion of the vagina.
it
abdominal wall
it
it
is
reflected
towards the small intestine forming the posterior layer of the mesentery; surrounding the small intestine il passes up to the abdominal wall again, forming
the anterior laverof the mesentery
and thereit
is
from there
ii
forms the fourth and first layers of the greater omentum, passing up to the stomach
ami from there over the anterior border of the stomach and continuing up to
the transverse fissure of the liver forming the anterior layer of the lesser
From
this fissure
ii
omentum.
liver,
forming
the suspensory ligament of the Liver, from there being reflected on the anterior
The
lesser
sac
(Plate
CLI)
is
traced
from
the
posterior
surface
of
the liver, descending and forming the posterior layer of the lesser omentum.
being reflected over the posterior surface of the stomach and from there form-
and third Layersof the greater omentum and from there ascendand forming tli<' anterior laverof the transverse meso-colon up to the pos-
The functions
Lubricates
its
by
a transverse section
(Plate CL.)
of the
adjacent surfaces.
(2)
it
(1)
It
secrets
its
serum which
own
secretion
rOMY IX A XUT>HELL.
may
4 17
be introduce!
is
Ligatory such as
where
which
hind
organs
(5)
to the walls of the abdomen and conducts nutrient nerves and vessels to the
The transverse meso-colon is an example of this. (6) It is omental.
organs.
which means it binds one organ to another. An example the gastro-splenic
the falciform ligament of the liver. (4)
it
makes
a fold
it is
it is
mi
omentum.
toneum
receives
its
The
visceral, peri-
PLATE
CCLIII.
POST.
A-0RB1CULAR1S-
DENTAL CANALS
T- INCISIVE TOSSA.
PALPEBRARUM
P-ARTIC.WITH LACHRYMAL
U-CANINE FOSSA.
B-TENDO-OCULI.
0- INFRAORBITAL GROOVE.
R -MALAR PROC.
V- CANINE FMINENCE.
W-OBRITAL SURFACE.
S -ALVEOLAR PROC.
X- FACIAL SUREACE.
C-LEV.LADU
SUP.
AL/tQUE-NASI. /:/*
Y ZYGOMATIC SURFACE
D-INF.OBUQUE.
^A
E-LEV.LABII-
Z-TUBEROSUY.
SUPERIORIS
F - LEV. ANG.
ORIS.
G- COMPRESSOR
MARIS.
H- DEPRESSOR
ALAl-fJASl.
I
MASSETER.
BUCCIN-
ATOR.
K- NASAL
PROC
L
-NASAL
NOTCH.
M-NASAL
SPINE.
N- NUTRIENT FORAMINA.
External Surface
Blood Supply. The
>f
Superk
Maxill \ky
The
iliac,
its
B< >ne.
arteries.
visceral
splenic,
LESSON
CL.
The kidney (Plate CCLXVI) belongs to the urinary system, which has
but one function, that of elimination, while the alimentary system has two
functions, appropriation
situated between
and elimination.
<<\
The kidney
is
bean-shaped ami
is
ANATOMY IN A NUTSHELL.
468
right kidney is a little lower than the left one on account of the
above the kidney on the right side. The scar, or the point where
the vessels enter and leave the kidney is on the inner border, about its middle.
Its vessels bear this relation to one another, the renal vein, renal artery, and the
The kidney is entirely stripped of peritoneum.
ureter, from before backward.
It has above and in front of it the suprarenal capsule which has something to
do with the pigmentation of the body and is considered by some as belonging
The kidney has the following dimensions,
to the sympathetic nervous system.
four and three-fourths by two and one-half by one and three-fourths inches.
Its nerve supply is from the renal plexus
It weighs from four to six ounces.
which comes from the solar plexus. Its blood supply is the renal, suprarenal,
The right renal vein contains the purest blood in the
spermatic, and Lumbar.
lumbar.
The
liver being
body.
The outer
The kidney
medullary portion.
like a
bunch
of grapes;
it is
is
is
called
in the fetus
made up
of
lobes coalesce entirely disappears in the adult kidney, giving the appearance
one solid body. The physiolological kidney consists of the uriniferous tubules.
These are about one-half million in number and would be fifteen miles in length
This uriniferous tubule consists of (1) a capsule or head,
if placed end to end.
(2) neck, (3) spiral portion, (4) descending portion, (5) loop, (6) ascending
portion, (7) distal spiral portion, (8) convoluted portion, (9) irregular portion,
(Plate CCLXV.)
The
(10) arched portion, and (11) a descending portion.
capsule, or Malpighian body, takes from the blood the water and lesser salts,
The
while the rest of the tube takes the more important salts from the blood.
medullary portion of the kidney consists of Malpighian pyramids, eighteen or
twenty In number, with the apex towards the hilum of the kidney. The apex
consists of infundibula, and the infundibula make the calices, the calices form
of
labi rinth.
cending colon,
Bihim).
(4)
(5)
Jejuno-ileum.
(1)
The
Psoas magnus.
last
rib,
(2)
Diaphragm,
(3)
(3)
Duodenum,
(4)
As-
Quadratus lumborum,
(Plate VIII.)
Suprarenal capsule.
Suprarenal capsule,
In Front.
(1)
(2)
Spleen,
Descending colon,
(7)
(3)
Stomach,
Jejuno-ileum.
(4)
Pan-
'
ANATOMY
Behind.
The
(1)
last
rib,
469
IN A NUTSHELL.
(2)
Diaphragm,
(3)
Quadratus Lumborum,
(Plate VIII.)
Psoas magnus.
The organs of the urinary system are, (1) the two kidneys, which form the
urine from the materials furnished by the blood; (2) the ureters, which con-
(4)
vey the urine away from the kidneys; (3) the bladder in which the urine is
it is discharged, and (4) the urethra, a tube through which the
urine passes from the bladder.
The kidney is a glandular structure whose function is the purification of
It is held in position by its vessels,
the blood by the excretion of the urine.
This fatty tissue forms the
the peritoneum and the abundant fatty tissue.
stored until
" adipose
capsule.
The hilum
'
of the kidney
is
corresponding to the place of the scar on the bean. It is where the ureter goes
out and the vessels and nerves enter. The capsule of the kidney is a smooth
membrane
Floating kidney
is
The
The
of the kidney.
calices of the
is
from
cystitis.
ginnings of the ureter in the pelvis of the kidney surrounding the apices of the
There
which
bula,
in
tubule by the vascular wall and the epithelium of the inner layer of the capsule.
The Malpighian tuft is the glomerulus or vascular network or plexus in a
Malpighian body.
physiologist.
The
kidney
is
ward
of the cortical
AX ATOMY
470
The tubes
make
of Ferrein
IX A NUTSHELL.
They
are in help
to
the cortical substance and are convoluted. The pyramids ofFerrein are formed
by bundles of straight and convoluted renal tubules which constitute the medul-
lary rays, so
They
of Bellini
and Ferrein.
tubes.
The capsule
of Muller
is
invest-
ing the Malpighian tuft probably by two layers, similar to the pleural invest-
ment
the
of
lung's.
PLATE CCLIV.
MASSETER
to the
kidney
is
is
formed
by filaments from the solar plexus and the lesser splanchnic nerve.
The
vascular.
is
(1>)
(a)
Afferent
The kidney
is
very
up between the pyramids of Malbases into cortico-medullary arches which lie be-
pighi to subdivide
their
a1
tween the cortex and medulla, giving off arterioles in both directions, the cortical branches supplying afferent twigs to the glomeruli within the capsules of
Bowman.
The medullary branches running inwards
and looped tubules
straight
of the
The
in
capillary plexus
The
efferent vessels
renal veins.
surface of the kidney receives small arteries which pass through the
to
veins appear
in
the form of
little stellate
and lumbar
vessels
.The super-
ANATOMY
IN A NUTSHELL.
471
communicate with the venous plexus in the adipose capsule and by means of
These vein> are very disthis with the visceral and parietal veins close by.
receptaculum
chyli.
LESSON
The
(Plate VIII.)
ureter
in
is
mammals,
CLI.
urine from
the kid-
The human ureter is a slender tube from fifteen to eighteen inches long running
from the pelvis of the kidney to the base of the bladder, at the posterior angle
It is behind the peritoneum and rests upon the Psoas muscle.
of the trigonum.
Its structure includes (1) a fibrous coat. (2) longitudinal and circular
muscular fibers, and (3) a lining of mucous membrane with vessels and nerves
from various sources. The ureter pierces the wall of the bladder very obliqueIt runs for nearly an inch behind the muscular and mucous coats of the
ly.
bladder.
Blood Supply.
\
(1)
The
(1)
Inferior mesenteric.
renal,
(2)
Spermatic.
(3)
Internal
iliac,
and
Inferior vesical.
Nerve Supply.
Spermatic plexus,
(2)
(3)
Pel-
vic plexus.
The bladder
It
(3)
is
(1)
(-4)
is
The trigonum
the serous.
is
is
at the
is
a triangular
space or
bladder.
When
the bladder
is
collapsed
shows the
its
line
mucous
walls
fall
between them
in
together
in
such
the shape of a
way
with
unequal and widely spread arms, the point of the V indicating the opening of
It> capacity is about
Its dimensions are three by five inches.
the urethra.
a pint.
In the child the bladder is almost an abdominal organ, while in the
adult
it
is
in
the pelvis.
The urachus
the umbilicus.
is
It
a fibrous
represents
l)v
whose
cavities
the navel.
ANATOMY IN
472
NUTSHELL.
A.
The
allantois
is
a fetal
appendage
of
its
urinary passage.
The
umbilical arteries and veins course along the elongated stalk of the
which becomes the umbilical cord, and that part of these allantoic vessels
within the body which does not remain pervious become the urachus and round
sac,
Ligament of the
liver.
as
is
is
cast
off,
the navel.
The uvula
vesica?
is
The
a slight projection of
orifice of
the urethra.
the muscularis.
The bladder is held in place by ligaments which are divided into true and
The true ligaments are five in number; the two anterior, two lateral,
false.
and the urachus (superior). Tin: false ligaments, also five in number, are
formed by folds of the peritoneum. The false are named the two posterior,
two Lateral and superior.
LESSON
The word urethra
which means
(Plates
to urinate.
CLII,
CCLXXII-CCLXXIX)
is
urethrae differ.
It is
a modifica-
ANATOMY
IN A NUTSHELL.
In
man
prostatic,
tions of
is
the urethra extends from the bladder to the end of the penis,
the
473
the membranous,
the spongy
different.
the
three portions
and the
structures
rela-
under surfaces
in contact.
PLATE CCLV.
FRONTAL PROC.
TEMPOROMALAR
CANALS.
7YC0MATIC PROC.
LEVATOR
l.ABU SUP.
ZYG0MAT1CUS
ZYGOMATICS 'M1N-
MAJ.
iosum of the
is
coats,
The bulb
erectile.
penis.
The crista urethra is the crest of the urethra; a longitudinal fold of mucous
membrane and subadjacent tissue on the median line of the floor of the prosabout three-fourths of an inch in length and one-fourth of an
it is greatest.
On the summit open the ejaculatory duct-.
It is also called colliculus seminalis, caput galliaginis, and veruinontanum.
The prostatic sinus is a longitudinal groove in the Hoor of the urethra on
each side of the crest, into which the prostatic ducts open.
tatic urethra,
The
its
pocularis sinus
is
quarter
of the urethra.
It
to hall'
an inch
in
Also called
pair of accessory
the
prostatic or
mucous
secre-
ANATOMY
474
IN A NUTSHELL.
In man they arc small. about the size of a pea, Lying betion into the urethra
neath the membranous portion of the urethra, close behind the bulb and emptyTheir size, shape, and position vary
ing into the bulbous portion of the tract.
in different animals, in some of which they are much more highly developed
than
man.
in
the Largesl
is
of
several orifices of
mucous
follicles,
The glands of Littre are the crypts along the spongy portion of the urethra.
The prostate ("standing in front") is a glandular body situated around the
initial
tion,
and
in
It
develops
at
is
in the
not lose
its
tone.
LESSON
The
meaning
CLIII.
tumor formed by the dispart which has escaped from its natural cavity
branch.
It
It
literal
of hernia
We may
mean hernia
When we
in
some part
of the viscera
tin'
femoral
'4.
Ci;i
through
natural or accidental
2.
unbroken.
ing in
is
of the protrusion of
1.
is
have hernia of the brain and of the coverings of the cord, of the thorax.
or of the abdomen.
aperture
is
of the
a
forms of hernia:
cranial walls.
is
vessels.
Direct inguin
\i.
hernia
is
omentum which
descends through the inguinal canal: but uo1 through the internal abdominal
ring having broken into the canal below this ring in Hesselbach's triangle.
4.
is
is
a hernia
whose course
6.
cavities.
into
ANATOMY
7.
Strangulated hernia
475
IN A NUTSHELL.
compressed
a hernia so tightly
is
some part
in
which
it
Umbilical hernia
is
henna
It is
called
exomphalos.
1.
2.
3.
it
omentum because
it
volume and
increases the
5.
Straining in defecation.
6.
7.
8.
Men have
women have
10.
cor,
I.
11.
12.
long mesentery.
months
in the later
of fetal life
it
a real canal.
is
in
the
Its
male and the round ligament in the female pass through this canal.
direction is downward, forward and inward.
The relations of the inguinal canal.
In Front.
(1) Skin. (2) Superficial fascia. (3) External oblique muscle
for all the way, (4) Internal oblique muscle for the outer third of the canal.
Below.
Behind.
(1)
(2)
Subperitoneal tissue.
Transversalis fascia,
(3)
Triangu-
Peritoneum.
(5)
Peritoneum, which
2.
Extra-peritoneal
3.
4.
5.
Intercolumnar
6.
Two
7.
Skin.
is
fat.
fascia,
This
is
which
inappreciable.
is
ring.
ring.
almost
is
[ngi enal
ANATOMY
476
1.
IN A NUTSHELL.
Peritoneum.
2.
Extra-peritoneal
.'>.
Transversalis fascia.
4.
fat.
the-
indirect hernia.
5.
Intercolumnar
fascia,
of infnndibnliform in the
indirect hernia.
6.
Two
7.
Skin.
PLATE
CCLVI.
CORONOID
PROC.
A-MASSETER.
B-BUCCINATOR.
C-LEVATOR-MENTI.
D-DEPRESSOR-LABU-
INF.
E-DEPRESSOR-ANGULI-ORIS
F-PLATYSMA-MYOIDES.
G-
MENTAL
m/A
MENTAL FORAMEN.
'
PROC.
of the ring.
ANATOMY
The
IN A NUTSHELL.
XV)
477
is
way between
the anterior superior spine of the ilium and the symphysis pubis.
half an inch
is
This
is
much
It Is
about
This
muscle.
The spermatic cord in the male and the round ligament in the female pass
through this opening.
Gimbernat's ligament is about a half an inch in length and larger in the
male than in the female. In the erect posture it is almost horizontal in direction with its base directed outward, it being triangular in form.
It is derived
from the External oblique muscle and is reflected downward and outward from
the spine of the os pubis to be inseretd into the pectineal line.
Its anterior
margin is continuous with Poupart's ligament.
The
it is
abdomen
is
attached by
its
apex to the
From
there
passes inward beneath the spermatic cord behind the inner pillar of the ex-
ternal
where
it
Poupart's ligament
of the
abdomen and
is
crural
formed by the
muscle
This ligament
in front of
lies
is
arch.
LESSON CLIV.
Femoral hernia passes below Poupart's ligament and passes down towards
the saphenous opening in the femoral or crural canal.
opening
it is
called complete,
The coverings of
1.
Peritoneum.
2.
if it
does not
it is
If
it
called incomplete.
outward are:
5.
6.
Superficial fascia.
7.
Skin.
3.
4.
is
is
Transversalis
fascia.
it.
(Plate XVI).
of an inch Long
In Front.
in
ANATOMY
178
Behind.
Kvn
fascia.
Iliac
i;\ \i.ly.
Internally.
IN A NUTSHELL.
septum between
Gimbemat's
it
and the
vein.
fascia
iliac
gastric artery
which
does
it
in
Peritoneum.
2.
3.
Transversalis fascia.
4.
0.
Superficial fascia.
(i.
Skin.
CCLXXXVIII)
occurrence existed
at
birth.
if
life,
is
a hernia
parietal
and
in this
case
when
its
may
there
the intestine does not push forward a sac which comes from the
which
lies
it
a sac formed
in
by the
These
forms of hernia ate called congenital and are always oblique.
The following are the different kinds of congenital hernia:
tunica
1.
vaginalis
Hernia
in
is
still
the tunica
vginalis testis.
is
tis,
this
Hernia
form
in
them
is
tes-
not obliterated.
of congenital
peritoneum which descends with the testicle but is shut off from the tunica
vaginalis testis by a thin septum.
The canal above this septum being still
presenl and communicating with the peritoneal cavity.
Infantile hernia. This form of congenital hernia is rare and is produced by the descent of the hernia through the internal abdominal ring but
'.].
ANATOMY
IN A NUTSHELL.
479
them
tunica vaginalis and the third from the sac around the hernia.
may
In this
form of
ring.
4.
and
is
inal ring as a
PLATE CCLVII.
MUSCLES
PTERYGOID
A-EXT.
GROOVES
LIG'MTS.LTr.
J-MANDIBULAR SPINE.
B-INT. PTERYGOID
K-
C-TEMPORAL.
D-BUCCINATOR
L-SPHENO-MAND'R
MANDIBULAR FORAMEN
LIG'MT.
M-STYLO-MAND'R LIG'WT
F-MYLO-HYOID.
G-GENI0-HYO-GL0SSUS.P-MYLO-HYOID GROOVE
H-GENIO-HYOIDEUS.
3-MYLO-HYOID RIDGE.
R-CAPSULE.
LESSON CLV.
Veins.
is
called a vein.
is
called an artery,
and every
vessel thai
the veins carry impure blood bu1 there are exceptions to each of these cases.
The pulmonary
pure blood.
As
arteries carry
a general
around
it
in
the arteries.
sympathetic
fibers
ANATOMY
480
IN A NUTSHELL.
The veins of the dura mater of the brain are called sinuses, also cavities in
bones arc called sinuses. After the blood has left the heart by way of the
arteries and nourished the entire body, it comes back to the heart by means of
We have a pulmonary venous system and a systemic venous system.
veins.
The
The
down
2.
which
The
Plate
supraorbital vein
it
is
by
joins
with its
branch just before it
It lies parallel
a transverse
At their beginning the frontal veins communiAt the inner angle of the orbit they receive the
it
CXV.
lies
joins to
it is
Its
tonsillar,
(i)
(e)
(c)
dorsal
and
Its radi-
submental,
(j)
(1)
maxillary.
5.
Temporal vein
is
after uniting
(d)
The
transverse facial.
(f)
is
formed by
radicles
which correspond to
the
The temporo-maxillary
maxillary veins
in
vein
is
ANATOMY
IN A NUTSHELL.
4S1
S. The posterior auricular vein conies from a plexus on the side of the head
and hack of ear. It receives the stylo-mastoid vein and branches from the
external ear.
The
It
formed from
occipital vein
of the skull.
It
is
is
a plexus at the
The
CXV.)
(Plate
It is
From
down beneath
exterior part of
Sometimes
in
It
a half
The upper
called a sinus.
is
above the
it
empties
The portion
of
pair of valves
is
lower pair
at its
is
temi-
jugular.
posterior external jugular vein receives the blood from the integu-
occipital
passes
The
it
2.
the sub-
in
this point
in
the tipper and back part of the neck and also from the
It
lies
between the
Splenitis
It
The
joins
its
and integument
of anterior
The
superficial
It
of the face.
lateral sinus.
passes
It
It
fourths of an
d>) lingual,
of neck.
It
down
It
the blood
collects
is
formed by the
in
the
common
For contents of
this
and
carotid sheath
the subclavian vein near the inner margin of the Scalenus ami-
It joins
cus muscle.
formed by
from the
Ii
is
has no valves.
It
is
provided with
inch above
its
a pair of
termination.
geal
of
(f)
occipital,
which
may
be
a radicle
The
vertebral vein
deep muscles
of veins
at
commences
in
the occipital
region
This
is
than one large vein and they run down through the foramina
in
the
ANATOMY
482
IN A
NUTSHELL
When they reach the sixth certransverse processes of the cervical vertebra?.
they form two main trunks, one of which passes through the
vical vertebra
foramen in the transverse process of the sixth cervical vertebra and the other
through thai of the seventh. They now unite into a common trunk which
empties into the back pari of the innominate vein. One pair of valves guard
The radicles of the vertebral vein are (a) muscular, (b) dorsi-spinal,
its mouth.
(c)
(e)
deep cervical,
(f)
first
inter-
costal.
The deep cervical, also called posterior vertebral, lies between the ComIt accompanies the profunda cervicis
plcxus and the Semispinalis muscles.
It empties into the lower end of the vertebral vein.
aitery.
PLATE
CCLVIII.
INFUNDIBULUM
ETHMOIDAL
MIDDLE
uncinate
CANALS
TURBINATED
process
LESSON CLVI.
The
axillary vein
commences
at
At the
Below the
first
rib
it
Lower border of the tendons of the Teres major and Latissimus dorsi it is called
basilic
It has a pair of valves opposite the lower border of the Subscapularis
muscle.
first
is
rib to the
it
cus muscle and the phrenic nerve separate this vein from the subclavian artery.
It has valves about an inch from its termination.
The
right
is
is formed behind
and subclavian veins. It
ANATOMY
passes
first
downward
IN A NUTSHELL.
innominate vein
make
483
at the inferior
border of the
The
internal
common
The
left
the right.
It is
junction of the
first
mediastinal,
half. of the
It is
about three
(c)
It
border
body.
When
the blood is given off from the thoracic aorta into the intercostal
comes back by the intercostal veins, which would have no place to
empty unless there was a special provision made for them. They cannot empty
into the heart, and the inferior vena cava has no length above the Diaphragm,
and the superior vena cava is too high for most of them, so they empty into
veins called azygos veins which connect the superior and inferior vena cava.
The azygos veins have no valves, but their tributaries do have valves. The
arteries,
it
(Plate CXCV).
The vena azygos major, also
mences
at
bar veins,
the
first
(b) or
by
This vein
com-
by
branch from
in
the Dia-
phragm, it passes to the fourth dorsal vertebra along the right side of the vertebral column and ends in the superior ven cava just before it enters the pericardium.
4M
(in
ANATOMY
vena azygos minor from the
NUTSHELL.
IX A
tinal veins, (d) the right bronchial vein, (e) the right superior intercostal vein.
2.
This vein
is
formed by
branch from
renal vein.
along the
left
passes to
the right
behind the
(a)
left
side, (b)
1 1
left
cms
left
column ami
thoracic aorta
of the
at
Diaphragm,
it
passes
to
end
in
>
veins.
upper azygos vein, also called vena azygos tertius. The radicles
of this vein are from the intercostal spaces between the left superior intercostal
These radicles join to
vein and the highest radicle of the vena azygos minor.
The
3.
form
left
main trunk, which empties into the vena azygos major or the vena azygos
Somtimes this vena azygos tertius is wanting, then the left superior
minor.
place.
its
left
empty
right side
side
left
into the
tertius.
LESSON CLVII.
The Portal System of Ykixs.
CXXXVIII.)
(Plates
The
portal system collects the blood from the digestive tract and from the
The veins of this system form the portal vein which enters the liver
and breaks up into branches like an artery into the substance of the liver.
spleen.
The
iliac.
The superior mesenteric vein collects the blood from the small intestine,
the caecum, the ascending colon, and transverse colon.
The radicles of this
2.
vein correspond with the branches of the superior mesenteric artery, just as
the radicles of the inferior mesenteric correspond to the branches of the inferior
the
mesenteric artery.
The
splenic vein
in front of
commences
in front of
the abdominal
The
gastric vein,
is
a large vein
receives radicles
ANATOMY
IX A
NUTSHELL.
485
peritoneum
The
.").
portal vein
is
in
the lesser
omentum
and left branches for the right and left lobes of the
branch to the Spigelian lobe. For the further subdiviliver and also gives
sion of the portal vein see page 190.
The portal vein most always receives the cystic vein, although it may
sometimes end in the right branch of the portal vein.
It
right
;i
PLATE CCLIX.
VERTICAL
PLATE
INFUNDIBULIIM
CRIBRIFORM
PLATE
1.
heart
and passes
From
groove.
commences
at
here
it
passes to the
left
it
2. The posterior cardiac vein (the middle cardiac vein) commence- at the
apex of the heart and passes along the posterior interventricular groove to
1> radicles are. (a) those
empty into the coronary sinus, where it has a valve.
from the posterior surface of the left ventricle, (b) those from the posterior
1
the
The
left
of these.
left
ventricle
and open
ANATOMY
186
anterior cardiac veins collect the blood from the anterior surface of
The
1.
IN A NUTSHELL.
and empty
of
There
are three or four of these veins, and the largest one, which
is
the right
and the
right ventricle.
(h)
Its rad-
of
ventricle.
6. Venae Thesesii, also called venae cordis minimse, open by small orifices
on the inner surface of the right auricle. These orifices are called foramina
Thebesii.
The coronary
7.
hit
sinus
is
a dilatation situated in
auriculo-ventricular groove.
It
receives
all
is
ing.
It
heart,
vein of Marshall.
(Plates CI-CII.)
Dorsi-spinal veins, which collect the blood from the back on either side
veins
in
longitudinal spinal columns, one on each side of the posterior surface of the
veins are situated along the posterior border of the spinal canal.
municate
They com-
freely with the anterior ones, the dorsi-spinal veins, vertebral veins,
intercostal veins,
Venae basis vertebrarum pass from the posterior surface of the vertebrae
found
in
They
collect
The medulli
which forms
spinal veins collect the blood from the substance of the cord
venous plexus around the entire surface of the cord between
ANATOMY
the arachnoid and pia mater.
IN A NUTSHELL.
In the
IS',
None
sinus.
Below
this
have
valves.
LESSON
CLVIII.
Veins of Diplce.
lie between the two plates of the bones of the cranium and can
removing
the outer plate of the skull. They are, (1) the frontal,
be seen by
which empties into the supraorbital vein, (2) the anterior temporal which joins
the deep temporal vein, (3) posterior temporal which joins the lateral sinus,
(4) the occipital which joins the occipital vein or lateral sinus.
Emissary veins are small veins which pass through foramina in the bones of
the cranium to connect the sinuses with the external veins of the head.
The
principal ones are as follows:
(1) One which passes thorugh the parietal for-
These veins
Cerebral Veins.
The
in
and pass forward and inward to the superior Longitudinal sinus, (2) The
median cerebral veins which collect the blood from the convolutions of the
mesial surface of the hemispheres.
These veins empty into the superior veins
face
Inferior
cerebral
veins
collect
the
blood on
the
lower pari of
the great anastomotic vein of the Trolard runs along the horizontal Limb
and
lateral
sinus.
ANATOMY
488
IN A NUTSHELL.
Under the deep set, we have (1.) Venae Galeni, which are two in number.
They pass
Thrv are formed by the vena corporis striata and vena choroidea.
sinus.
These two
enter
the straight
hack and onl of the transverse fissure to
veins generally unite into one vein, just before the entrance into the straight
sinus. (2.) The basilar vein is formed by the junction of the deep Sylvian vein,
the
cms
cerebri to
The
veins.
It
now
passes
backward over
cerebellar veins.
(1)
superior
qnes, which pass forward and inward to end in the straight sinus and the veins
of Galen, but some of them pass outward to the lateral and the superior petrosal
sinus, (2) the inferior cerebellar veins end in the lateral sinus, superior petrosal
and occipital
sinus,
The
sinus.
in
PLATE CCLX.
ARTICULATES WITH ETHMOID.
WITH LACHRYMAL.
WITH LACHRYMAL
MAXILLARY PROC.
WITH
SUP.
MAXILLARY.
POSTERIOR
END.
LESSON CL1X.
The Sinuses of the Dura Mater.
(Plates
CLXXVIII-CLXXIX.)
passes along
ii
at
while the blood from the straight sinus passes into the
ever, this
may
be vice versa.
left lateral
sinus.
How-
At the foramen
section
received
at
righl
it
in
such
a
in
manner
the sinus.
It
receives
veins from the diploe and the dura mater, the superior cerebral veins, and veins
ANATOMY
The torcular Herophili
is
489
IN A NUTSHELL.
The
falx cerebri.
It
section
circular.
is
ends
in
and
also
in size
The
straight sinus
and
cerebelli.
is
The
empty
inferior longitudinal
venae Galeni,
sinus,
into it.
and superior cerebellar veins
4. and 5. The lateral sinuses are two in number and are situated where
The right one, after receiving the blood
the tentorium cerebelli joins the bone.
from the superior longitudinal and occipital sinus, passes to the light as far as
It then passes downward and inthe petrous portion of thetemporal bone.
ward to the jugular foramen, where it receives the inferior petrosal sinus to
make the
jugular vein.
It
The
temporal hone.
left lateral
and
occasionally
occipital sinus,
and then
the right lateral sinus receives the blood from the straight sinus.
6.
and
7.
be double.
It
The
is
occipital sinus
which
is
may
situated where the falx cerebelli joins the hone, ami as said
before,
skull.
8. and 9. The cavernous sinuses pass from the sphenoidal fissure to the
apex of the pelrous portion of the temporal hone. They are formed by the
ophthalmic vein and end by dividing into the superior and inferior petrosal
sinuses.
In
(a)
The
third cranial nerve, (b) the fourth cranial nerve, (c) the ophthalmic division
of the fifth cranial,
(e)
in
(f)
The
of this circle
vein.
hypophysis.
For
CCXXXII.
One
situated along
bone.
it
4'.
ANATOMY
M)
13.
and
14.
The
IN A NUTSHELL.
to the
make
the internal
They
jugular vein.
tion of the
15.
sinuses.
It
Origin.
<
This
(Plate
CCLXXI.)
ori-
is
Insertion.
A.CTION.
To
Nerve Supply
Sympathetic nerve.
Inferior
Blood Supply.
hemorrhoidal.
Description. This muscle surrounds the margin
It is about an
of the anus and is elliptical in shape and thin and flat in form.
inch broad opposite tin anus, and from its anterior to its posterior extremity
is about three inches.
it
It consists of two planes of muscular fibers.
Origin. From the tip of coccyx by a narrow tendon and from super-
ficial fascia
in
front of bone.
Insertion.
Transversus
perinaei,
ani.
and Accelerator
it
urinae.
Nerve Supply.
From
ferior lnemorrhoidal
branch
Blood Supply.
Inferior
in-
Description. This
and
pudic nerve.
It
is
composed
of involuntary
muscu-
fibers.
A'
HON.- -To
lal.
Levator ani.
uated on the side of the pelvis.
cavity.
It
in
is
sit-
the pelvic
From
Origin.
the
of the os
spine of the ischium and from the fascia between these points.
Insertion.
of the coccyx,
The
and those
of these
of
opposite side extending between the coccyx and the margin of the anus.
The middle
fibers,
the
(2)
ANATOMY
The
IN A NUTSHELL.
491
anterior fibers, which are the longest, descend upon the side of the
it
and Transversus
tendon.
Action.
end
It is a
It
of expulsion.
Nerve Supply. Branch from the anterior division of the fourth sacral
and a branch from fhe pudic nerve which sometimes comes from the perineal
or from the inferior hemorrhoidal division.
Blood Supply. Internal pudic.
Coccygeus. Description. This muscle is situated parallel to the Levator
ani but behind it.
Its upper border is separated from the lower border of the
Pyriformis muscle by the internal pudic vessels and nerves.
PLATE CCLXI.
ANTERIOR
ALA.
BORDER.
GROOVE FOR
SEPTAL CARTILAGE
POST. SUP.
P031.
BORDER.
Wk
VIEW.
Ha
GROOVE FOR NASO- PALATINE
NERVE
ALA.
The Vomer.
Origin.
From
the apex of the spine of the ischium and from the lesser
sacro-sciatic ligament.
Insertion.
Into
sacrum.
Action.
Nerve Supply.
Blood Supply.
and
fifth sacral
nerves.
LESSON CLX.
Muscles of the Perineum in the
Transversus perinsei.
Description.
is
This
(Plate
muscle,
narrow muscular
CCLXXI.)
which
of
small tendon.
of
of
passes
across
slip.
Mali:.
of the ischium
by
ANATOMY
492
Accelerator
urinae.
-This muscle
tion.
of the anus.
Bulbo-cavernosus-Ejaculator seminis.)
Descripin the middle line of the perineum just in front
situated
is
in
consists of
It
IN A NUTSHELL.
tendinous raphe.
From
Origin.
raphe
hull)
in
trout.
Erector penis.
part of the
cms
penis and
is
This muscle
the perineum.
Description.
[schio-cavernosus.)
This
muscle covers
broad
in
ities.
Origin.
From
the surface of the cms, and from the adjacent portion of the ramus of the ischium.
Into the sides and into the under surface of the crus penis
[nsertion.
by an aponeurosis.
Action".
By compressing the crus penis, it retards the blood through the
this
manner keeps the organ erect.
veins and in
Nerve Supply. Perineal branch of internal pudic.
Blood Supply.Superficial perineal from internal pudic.
is
to half an inch or
of the os pubis
more.
[nsertion.
Each portion of this muscle divides into two fasciculi which
surround the urethra from the prostate gland behind to the bulbous portion of
They mute at the upper and lower surfaces of this tube
the urethra in front.
with the muscle of the opposite side.
fluids
and
LESSON CLXI.
Mcs< lesofthe Perineum ixthk Female.
Transversus
periiuei.
DESCRIPTION.
This
is
Plate
CCLXXI.)
female which passes across the back part of the perineal space.
Okioiw
From
a small tendon.
the inner
and forepart
ischium by
ANATOMY
IN A NUTSHELL.
41)o
Sphincter
vagina. Description.The
is
mime
part
of
in
the male.
the perineum
aid.
it
and
clitoris,
Action.
a fasciculus
vein.
clitoridis.
Description. This
Origin.
From
is
muscle
is
a smaller muscle.
the eras clitoridis, and also from the surface of the eras and the adjacent portion of the
ramus
Insertion.
of the ischium.
clitoridis.
To
Action.
clitoridis
Nerve Supply.
Blood Supply.
Compressor
Origin.
Insertion.
fibers
its
sub-
while fibers from the posterior portion pass inward to blend with the walls of
the vagina behind the urethra.
Action.
assist in erection.
LESSON CLXII.
The Perineum.
The word Perineum
is
\\>n\
in
(Plate
CCLXIX.)
il
includes the
entire outlet of the pelvis, which extends from the apex of the sub-pubic arch
in
(2)
schii.
is
This
is
in
and
called the true perineum, while the pari behind this line
laterally
(3)
In
is
called
word the term may include in the female all the deeper par between
and the anterior wall of the ledum. Tin- is
ANATOMY
494
The
IN A NUTSHELL.
recutm, having on the outer side of each fossa, the tuberosity of the ischium,
The ischio-rectal fossa is in the form of a pyramid with its apex corresponding
Its base is between
to the junction of the Levator ani and Obturator muscles.
the anus
ani.
maximus and
and
is
filled
THE
1.
FAsei.K OF
The
all
is
which
is
continuous with
This is
PLATECCLXII.
ORBITAL
ORBITAL
PROCESS
SPHENOIDAL
SURFACE
SURFACE
NASAL
POSTERIOR
SPINE
AZYGOS UVULAE
not
thick, but
anteriorly
it
very strong.
It
is
It is
is
pubis ami
ischium.
Some anatomists
It
call
this
fascia
the
anterior
'IH1-;
4.
leaflet of
ANATOMY
IX A XUTSHELL.
495
posteriorly
is
is
called
3.
4.
5.
6.
and nerves.
C'owper's glands.
3.
4.
Pudic veins.
5.
6.
triangular ligament
It is situated on the outer wall of the ischioextending from the lesser sacro-sciatic foramen to the lower border
of the triangular ligament.
The internal pudic vessels and nerve pass through
this canal.
The
into
(1
(Plate
CCLXX.)
\\.
FASCIA, which
is
and
at
it
divides
This layer descends from the white line over the Levator ani muscle, over the
prostate gland. rentum, vesiculae seminales and the bladder.
(2)
The obturator
fascia,
It
which
called
the
anatomy
mm;
in a
nutshell.
cover the Obturator interims muscle, and above Alcock's canal gives
fascia (ischio-rectal) over the lower surface of the Levator ani musanal
the
off
with the corresponding fascia of the opposite side forms the
fascia
This
cle.
pelvis tn
LESSON CLXIII.
(Plates CCLXXXIX-CCXC.)
Lymphatic System.
The lymphatic
which they
from all the body except the right half of the head, the right half of the thorax.
and the upper surface of the liver, and the right arm. The lymph in these
This right lymphastructures just named pass into the right lymphatic duct.
tic
duct
The
lefi
about half an inch long and empties into the tight subclavian vein.
lymphatic or thoracic duct is about eighteen inches long and passes
is
subclavian vein.
may
ii
its
finallyends in the
way
left
or throughits en-
may empty
It has
constricinto the vena azygos major.
and a double valve at its termination.
Every cell in the body is surrounded by lymph and is therefore an aquatic
These cells receive their food from the lymph into which they also
animal.
tions through
throw
their
it
its
entire course
waste
products.
The lymphatic
vessels in the
size
aboui the
si/.e
bronchial
region
to the thoracic
of a small bean.
are
Their color
is
in
the
darker color.
The lymphatics,
vessels
All
in
ANATOMY
IX A NUTSHELL.
497
by
membrane and
their position
is
striction.
The thoracic duct has three coats, (1) an internal or endothelial, (2) a
middle of white connective tissue, (3) an external of areolar tissue. There
are numerous valves in the thoracic duct especially at its upper end, and there
is
a pair at its
seven
The body
(1)
lower thoracic
of the second
vertebra1
(.1)
(3)
lumbar vertebra,
Anterior
common
((>)
(2)
Bodies of the
ligament,
Vena azygos
(4)
Lower
tertius, (7)
(3)
(3)
On Left
Vena azygos
Side.
(1)
Aorta,
(2)
(4)
tertius.
PLATE
ETHMOIDAL
CCLXIII.
PROCESS
ORBITAL
SURFACE
SURFACE
ORBITAL
MAXILLARY
SUPERIOR MEATUS
SURFACE
SPHENO-PALATINE
FORAMEN^
(MC
MEA
-* TUS
< v
;
'fyli
>
/o\V
TURBINATED
INF.
ft,
.'
c,
*|fc-MAXILURY
/^
.x j\\ INFERIOR
MEATUS
ARTICULATES WITH "
/=
PROCESS
_j
ffWm
HORIZONTAL
ARTICULATES
WITH
PLATE
VOMER
AND OPPOSITE
HONE
chyll
is
It
has no valves
in it.
and
its
It
isan irregu-
dimensions are
his
ANATOMY
498
at
IN A NUTSHELL.
central portion.
portion
medulla.
called
is
notch where the arteries enter and the veins and efferent vessels Leave
These nodes make white blood corpuscles.
the node.
There are aboul seven hundred lymphatic nodes in the body andtheyare
hilum
is
situated beneath the deep fascia except the superficial inguinal nodes.
all
LESSON CLXIV.
lymphatic vessels of the upper extremity pass from the tips
Those on the
towards
the shoulder with the superficial veins.
of the fingers
the
elbow
with the
veins
towards
then
the
ulnar
run
with
of
the
arm
side
inner
Those
outer
side of
deep
vessels.
on
the
and
to
the
glands
axillary
basilic vein
The
the
superficial
and
at this point
some
join the
group, while others run with the cephalic vein to the axillary nodes.
few i^ this last set pass between the Deltoid muscle and the Pectoralis major
basilic
to the
subclavian nodes.
The deep lymphatic vessels of the upper extremity pass with the deep blood
They accompany the following arteries in the forearm: (t) radial,
vessels.
They
ULNAK.
(2)
(3) ANTERIOR INTEROSSEOUS, (4) POSTERIOR INTEROSSEOUS.
communicate with the superficial lymphatic vessels at intervals. They accompany the brachial artery from the elbow and pass through the axillary and
subclavian nodes to the thoracic duct on the
left
on the right
lymphatic duct.
The superficial lymphatic nodes of the upper extremity are not numerous.
In the cubital fossa there are two or three and above the internal condyle near
the basilic vein there is one or two.
The deep lymphatic nodes of the upper exremity are found along the radial
side
and ulnar
vessels.
A few
ortwelve around the axillary vessels which drain the front of the chest and the
skin of the back.
The subclavian nodes are two or three which are connected
They lie under the clavicle.
with the axillary nodes and deep cervical nodes.
The
ficial
superficial
fascia.
They
lie
in
the supei-
which follows the internal saphenous vein to the vertical set of the superficial
From these superficial inguinal nodes some efferent vessels
inguinal nodes.
canal by which
it
ANATOMY
other
set
499
IN A NUTSHELL.
passes with the external saphenous vein to join the popliteal nodes.
accompany
the following
(2)
The lymphatic
iliac vessels.
vessels
in
The lymphatic
in
have
a similar course.
The superficial lymphatic nodes of the lower extremity are, (1 eighl or ten
superficial inguinal nodes which lie just under the skin. They consisl of
two sets, (a) the upper oblique along Poupart's ligament, which drains the
scrotum, penis, abdominal wall, perineal and gluteal regions, and urethral
mucous membrane, (b) The vertical set which surrounds the saphenous open)
superficial inguinal
LESSON CLXV.
The
(1)
pass
with the superficial epigastric vessels to the oblique set of the superficial inguinal
nodes.
(2)
A DEEPER SET
superficial iliac blood vessels to the oblique set of the superficial inguinal node-.
them pass with the ilio-lumbar and lumbar blood vessels to the
lumbar nodes. (4) Those of the gluteal region pass around the
lmt most of
lateral
in
nodes.
(7)
in
THOSE
end
in
the superficial
(">)
vessels to
in
in
nodes.
The deep lymphatic vessels of the pelvic and abdominal walls pass with the
biood vessels and are, (1) those which accompany the gluteal vesTHOSE WHICH
BELS, (2) THOSE WHICH ACCOMPANY THE [SCHIATIC VESSELS,
chief
('))
ANATOMY
500
IX A
NUTSHELL
accompany the obturator vessels. All these pass with the internal iliac
(4) Those ok tin: penis pass with the internal
artery to join the Lumbar mules.
pudic vessels to join the internal iliac nodes.
The lymphatic vessels of the bladder pass through
its
join the
The lymphatic
vessels of the
PLATE CCLXIV
SUPERIOR TURBINATED
INFERIOR TURBINATED
The Meatuses.
Tin'
(1)
situated under the peiitoneum and (2) deep ones situated in the substance
of the uterus.
Those from the vagina and from the cervix pass into the sacral
iliac
nodes, while those from the body and fundus pass into
the -broad ligamenl to join those from the ovaries, broad ligaments, and Fallopian tubes to pa-- with the ovarian vessels to the
common
lumbar nodes.
iliac vessels,
They
These lum-
ANATOMY
IN A NUTSHELL.
501
Psoas magnus muscle and help to drain the spinal canal, posterior and lateral
abdominal
walls.
The lymphatic
(2)
lacteals
and
are, (1)
superficial which are placed between the layers of the muscular coat, or
between the nmscnlar and peritoneal coats. They run longitudinally. (2)
Deep which are situated in the submucous tissue and run transversely with
These empty into the thoracic duct.
the mesenteric vessels.
The lymphatic nodes of the small intestine, called mesentery node-, lie
between the layers of the mesentery, and they are about one hundred and
They vary in size from that of a pea to that of a small almond,
fifty in number.
and the largest ones are situated near the duodenum and the ilio-csecal valve.
In these positions they are also more numerous.
The lymphatic
those
of
itself
They
are
-it-
LESSON CLXVI.
The lymphatic
which
liver.
in
two
sets. (1)
lie
in
following groups, (a) those branches which rnn forward ami then
upward
in
the
node-..
of the
ANATOMY
502
IN A NUTSHELL.
pericardium and around the greai vessels at the base of the heart. The vessels
from the liver jus; mentioned which pass through those mediastinal nodes pass
(b) Those vessels winch run around the anterior
into the right lymphatic duct,
to the anterior
to
nude-
in
right lateral
the lesser
omentum.
cms
of
are on the under surface of the liver form the following groups, (a) those branches
arise to the right of the "'all bladder pass to the lumbar nodes, (b) those
branches surrounding the gall bladder pass to the nodes in the lesser omentum,
and (c) those branches arising to the left of the gall bladder pass either to the
oesophageal nodes or to nodes along the lesser curvature of the stomach.
which
the livee
the portal vein, hepatic artery, and hepatic duct into the substance of the liver.
They puss from the liver at the transverse fissure to enter nodes which are
Or
placed along the lesser curvature of the stomach and behind the pancreas.
may
they
The
superficial lymphatic vessels of the thoracic wall pass across the Trape-
and Latissimus dorsi muscle.- behind and the Pectoralis major muscle in
Most of those from the mammary gland
front to end in the axillary nodes.
pass to small nodes which are situated along the lower border of the Pectoralis
major muscle in the axilla, however, a few from the inner side of mammary gland
zius
These
intercostal
join vessels
es-
from
the buck of the thorax and spinal canal which entering the intercostal nodes
descend on the spine to the thoracic duct. The intercostal nodes which are
small, lie on each side of the spine near the costo-vertebral articulation, and
lying between the Intercostal muscles.
(2) The internal
where they
the
umbilicus
which
abdominal
above
mammary
muscles
begin on the
through
upward
Diaphrgam
pass
the
They
communicate with the epigastric.
some
of
those
where they are joined by the intercostal lymphatic vessels to empty into the
right lymphatic duct on the right side, while those on the left side empty into
thoracic duct.
(3)
The
of the
Diaphragm empty
into the
mammary nodes
mammary
lie
at the anterior
vessels.
The posterior mediastinal nodes lie along the aorta and oesophagus, and
communicate with the intercostal nodes, lumbar nodes, and deep cervical
nodes.
The
form
covers the outer surface Of the lung under the pleura, while the deep lymphatic
ANATOMY
503
IX A NUTSHELL.
The lymphatics
of the
Lung empty into the bronchial nodes, which lie around the bifurcation of the
Several efferenl vessels pass from these nodes
trachea and the root of the lung.
to the tracheal nodes and oesophageal nodes at the root of the neck, and those
on the right side empty into the right lymphatic duct, while those on the
side
vessels
lie
left
the subserous or areolar tissue, while the deep cardiac lymphatic vessels
lie
in
in
The thymic vessels pass into the internal jugular veins from the under surthymus gland.
The lymphatics of the oesophagus, after communicating with the posterior
face of the
LESSON CLXVII.
The
(1)
Pos-
PLATE CCLXV.
Tiii';
downward over
Urixiferous Turtles.
just
downward behind
(2)
in
the postero-auricu-
These nodes are situated over the inThe vessels which Leave these
sertion of the Stemo -cleido-mastoid muscle.
(")
Temporal lymphatic vessels,
nodes empty into the superficial cervical.
also called antero-lateral, pass with the superficial temporal veinand end in the
Sterno -mastoid.
gland
ANATOMY
504
and
sonic of
them are
IX A
NUTSHELL.
in
temple,
externa] pails
of the eye
lid.
Their radicles
and
the posterior
The vessels which leave these nodes empty into (a) sub(4) An
maxillary nodes, (b) some of them in the superficial cervical nodes.
anterior or frontal set pass over the frontal hone and empty into the
The buccal Lymphatic nodes are situated
buccal ami submaxillary nodes.
pari of die cheek.
The
end in the submaxillary lymThese nodes are situated beneath the body of the lower jaw in
phatic nodes.
of these nodes.
FROM THE UPPER AND LOWER LIPS \\D SIDE OF NOSE, (2)
FROM THE FLOOR OF THE MOUTH, (3) FROM FRONT PART OF TONGUE, (4) FROM
SUBLINGC \l. Wl> SI BM VXILI.ARY SALIVARY GLANDS, and (")) FROM THE ANTERIOR
PART OF THE CAROTID LYMPHATIC NODES. The vessels that leave these nodes
empty into the deep cervical lymphatic nodes and also into the superficial lymTheir radicles are,
phatic
(1)
nodes.
The suprahyoid lymphatic nodes are two or three in number and are situated in the median line between the anterior bellies of the Digastric muscles.
The superficial lymphatic vessels of the neck join the superfical lymphatic
They empty into
vess< Ls of the seal]) and face and upper part of the thorax.
These nodes are situated between
and the deep fascia along the course of the exSmall lymphatic nodes are found anterior to these between
the hyoid bone and the sternum, also posteriorly over the Trapezius muscle.
The
NODES,
cervical
(2)
lymphatic nodes.
LESSOX CLXVIII.
The deep lymphatic
an- a- follows: (1)
nodes. (2)
vessels of the
They
meningeal i.vMPHATic vessels which pass with the menin-
CEREBRAL
in
foramina
at the
in
dee]) cervical
ANATOMY
IX A NUTSHELL.
505
space by means of the lymph spaces which surround the olfactory nerves.
the
after passing
This
set
of
nodes receives radicles from the (a) inferior of the cranium. (In from the deep
muscle- of the upper part of the neck, (c) from the internal maxillary glands,
from the posterior half of the tongue, (e) from the middle portion of the
(f) the upper part of the larynx, (g) the upper part of the thyroid
Vessels from
gland, (h) and some of the vessels from the submaxillary nodes.
these nodes pass downward to the lower deep cervical nodes.
(2) A lower
the thyroid cartilage to near itset which follows the internal jugular vein fr
termination.
These receive radicles from (a) the lower pari of the neck, (b)
the upper set of lymphatic node-, (c)the Lower part of the larynx, (d) lower
pari of thyroid gland, (e) the upper part of the oesophagus and trachea, (f)
from the superficial cervical nodes. The vessels which leave these node- end
(d)
pharynx,
the jugular lymphatic trunk which mute- with the subclavian lymphatic
trunk to form the right lymphatic trunk on the right side and the thoracic duct
in
on the
left side.
ANATOMY
506
IN A
NUTSHELL
LESSON CLXIX.
Frontal Bone.
The
(Plates
GCXXXVII-CCXXXVIII.)
The
fossae.
external surface of the vertical portion lias the following points for
consideration
1.
of
Tin. metopic
suture
(presenl
in
the young)
(Plate CCXXXVIII.)
The frontal eminence is just below
is
situated
in
the middle
PLATE CCLXVL
RENAL
?-
CAV1TY
J^BERT.INT^J^g
ARTERY
NFUNDIBUIU^
is
below the frontal eminence and
by a groove. This ridge, which is produced by the frontal
sinus, is more disl bid internally.
4. The glabella or nasal eminence is between the superciliary ridges and
continuous with them.
3.
separated from
5.
Tin
si
it
praorbital ^rch
is
The
si
middle thirds
praorbital
<>f
this
mi >t<
arch.
It
ii
or foramen
is
at the
ANATOMY
and
507
7.
and
IN A NUTSHELL.
is
well marked.
8.
It
arch and
marked
not so well
is
is
It
articulates
hone
temporal
ridges run upward and backward from the
The
9.
angular process. The lower ridge gives attachment to the Temporal
with the lachrymal
external
muscle,
consideration
vertical groove which passes along the middle line for the superior
longitudinal sinus, and the edges of this groove give attachment to the falx
1.
cerebri.
2.
is
of this
teriorly.
3.
frontal crest
by
its
is
formed by a notch
a vein
in
pro-
it
The
inferior surface of the horizontal portion has the following point- for
consideration:
1.
of each orbit.
This notch
is
cells
cells.
The lachrymal
fossa, which
is
for the
lachrymal gland,
is
near the
muscle
A depression
is at
"\
ANATOMY
508
A.NTERIOB
4.
NUTSHELL.
IX A
ETHMOIDAL FORAMEN
is
for
and eminences for the frontal convolutions, also grooves for branches of the
anterior and middle meningeal arteries.
This hone has two centers of ossification, one for each half.
Ossification.
It
articulates with the following hones:
Ajrticulation.
(1) the two
parietal, (2) the sphenoid. (3) the ethmoid. (4) two nasal. (5) two superior
maxillary, (6) two Lachrymal, (7) two malar, thus making twelve bones.
Attachment of Muscles. It has three pairs of muscles attached to it.
Corrugator supercilii, (2) Orbicularis palpebrarum, (3) Temporal.
Blood Supply.- The middle and small meningeal arteries on the cerebral
The ethmoidal
surface and the frontal and supraorbital on the outer surface.
arteries and other branches of the ophthalmic artery pass to the horizontal
*
plate
Corrugator supercilii.
Description. This
is
Origin.
the
supraorbital arch.
A.CTION.
Nerve Supply.
third
the forehead.
in
Temporal
Blood Supply.
this
branch of the
Supra-orbital
bone,
(2)
fibers of the
(1)
From
nasal
by
palpebrarum. -Description.
Orbicularis
facial nerve, or
nerve.
(3)
borders and
[NSERTION.
ii-
upper
blending
fibers
and cheek.
cilii.
Origin
Palpebral Portion.
<>v
This portion
INSERTION.
tarsal ligament,
Ai TION.
\u:\
i.
From
is
Into
To
lids,
the external
Supply.
; i
this
Blood Supply.
Temporal branch
of facial
nerve.
Supra-orbital,
frontal
is
a large
ANATOMY
Origin.
of the
(1)
temporal
Insertion.
From temporal
IX A NUTSHELL.
ridge,
(2)
509
temporal
fascia,
(3)
greater part
fossa.
Into
Action.
It
is
PLATE CCLXVII.
W&:
v
xx
Ull
\N
A\V
x)
WJ-): ?''':
11 '
''I
*"/;'/'/'/.,'
'r'i
I,.',:.
''/.////.'/,
J
,.'
l
ir''//'/'
;.,'|M
GLANSCLITORIOIS
FRENULUM
CLITORIDlS
ORIFICIUM
\v
URETHR/e EXTERNUM
MAdU&Xx
LABIUM
,
'.'.'
'
'
LABIUM
POST.
:.\\H...\\-
:"
>''
. > ,_.,..-
'
Nerve Supply.
fifth
COMMISSURE
<
ANUS
'
Av
\V^^
MINUS V_V
x"
Temporal
of Generation.
nerve.
maxillary artery.
LESSON CL XX.
The Parietal Bone.
The
consideration.
two
(Plates
CCXXXIX-CCXL.)
ANATOMY
510
NUTSHELL.
IN A
The external surface of the parietal bone has the following points:
1.
Parietal emineni e near the center of the bone where ossification commences.
TWO
inch apart
Temporal muscle.
4. The parietal foramen
is
The
This foramen
is
is
inconstant.
points:
1.
2.
Furrows
A
3.
There
oi;oo\
which with
i..
its
also
i-
for the
The
suture, which
This border
a synarthrosis joint.
is
is
suture.
Tin-; POSTERIOR BORDER joins the occipital bone and helps to form the
Lambdoid suture.
Tin: [NFERIOR BORDER is divided into the following parts, (a) the anterior.
which is overlaped by the tip of the greater wing of the sphenoid, (b) the middle
part which i> overlaped by the squamous portion of the temporal bone, and
(c) the posterior pari which articulates with the mastoid process of the temporal
bone.
ANGLE
This
is
is
ami the
posterior superior axoi.k is the point where the two parietal bones
hone meet-. This is the location of the posterior fontanelle.
occipital
Tin. posterior [NFERIOR vngle joins the mastoid process of the temporal
hone.
'I'm.
INTERIOR [NFERIOR ANGLE joins the frontal hone and greater wing of
OSSIFICATION.
Artn
occipital bone.
making
This
lation.
(3)
It
bone
ossifies
and
(5)
five bone-.
Attachment of Mi
the Temporal.
s<
les.
Blood Supply.
it,
ANATOMY
IN A NUTSHELL.
511
LESSON CLXXI.
The Occipital Bone.
The
occipital
bone
is
CCXLI-CCXLIL)
(Plates
cranium and
The
is
trapezoidal
external surface
is
ternally.
line
4. The highest curved lixe (linea suprema) is above the superior curved
and gives attachment to epicranial aponeurosis.
5. The inferior curved lixe, which passes outward from the middle of
ment
it.
gives attach-
oblique externally.
7.
Its greatest
tures:
(a)
diameter
is
is
its
a large oval
antero-posteriorly.
membranes,
It
(e)
spinal arteries.
The condyles
8.
foramen magnum.
ward and outward
are convex
and reniform
in
They
shape.
of
the
look back-
The tubercles
9.
They
to
the
12.
A quadrilateral
is
lie
jugular process.
on the externa] surface of the jugular proarticulation with the petrous portion of the temporal bone.
deep <;k<><>\ e is on the upper surface of the jugular process for the
facet
is
lateral sinus.
14.
Ax eminence
(paramastoid
in
animals),
to
the
transverse process of the atlas, gives attachmenl to the Rectus capitis lateralis
is
It
ANATOMY
IN A NTTSHELL.
may
This foramen
double.
lie
Posterior condyloid foramen, which is behind the condyle, transIt is at the bottom of the posterior condyloid
mit.- a vein in the lateral sinus.
is
often
absenl
fossa and
The basilar process of the occipital hone is situated anterior to the foramen
magnum and is quadrilateral in shape. The pharyngeal spine (sagittal ridge)
to the tendinous raphe and the
is on its under surface and uives attachment
There
is
depression
on each side of this spine
muscle.
a
constrictor
Superior
Hi.
PLATE CCLXVIII.
SUB-PUOIC LIGAMENT WITH APERTURE FOR DORSAL VEIN OF THE PENIS
DORSAL NERVE
APERTURES FOR DORSAL ARTERY AND NERVE OF PENIS
ANTERIOR LAYER OF TRIANGULAR
LIGAMENT
SUPERFICIAL
PENIS
'ERY OF
LIGAMENT
CAVERNOSUM
CORPUS
ARTERY TO BULB
BULB
URETHRAL APERTURE
APERTURE FOR COWPER S
DUCT
PUDIC VEINS
DORSAL NERVE.
POSITION OF BULB
POSITION OF
APERTURES
COLLES
FASCIA OF
TURNED
COWPER
GLAND
SUPERFICIAL
FOR
BACKWARDS
POSTERIOR BORDER
OF PERINEAL LEDGE
Colles' Fascia
for the
\.nd
attachmenl of the Rectus capitis anticus major ami Rectus capitis anti-
CUS minor.
The
hone
is
;iic
I'm
for tie'
2.
i;
The
Till.
at
to
l.elli.
4.
sinuses.
(d;<)<)\
ES
ai'c
ANATOMY
IN A NUTSHELL.
513
The internal openings for the anterior condyloid foramina and poscondyloid foramina are seen on each side of the foramen magnum.
The basilar process of the occipital hone on its inner surface has a median
5.
terior
This
is
and on each
groove
petrosal sinus.
where the
occipital
is
poral bone.
The inferior angle (basilar process) joins the body of the sphenoid
The superior border passes from one lateral angle to the superior
hone.
angle
and helps
to
LESSON CLXXII.
are the
Complexus
of the
fourth layer of the back, Splenius capitis of the third layer of the hack, and
fifth
Those attached to the lnferiok curved line and the space retwekn it and the foramen macnum are the Rectus capitis posticus major,
3.
and Rectus capitis posticus minor of the fifth layer of the back.
4. That attached to the transverse process is the Rectus
capitis
major, and Rectus capitis anticus minor of the anterior vertebral region, and
which
is
Origin.
arteries.
The
occipital
the temporal
hone.
The
is
frontal
'cipital
portion
arises
from
the
'yramidalis
of
nasi.
5]
AXATOMY
Corrugator
Ixsi
i;
fibers of this
[ON.
NUTSHELL.
supercilii,
muscle may
IX A
ACTION.The
frontal portion draws the scalp forward and raises the eye
brows and skin over the root of the nose. The occipital portion draws the scalp
backward. The Occipito-frontalis muscle is chiefly a muscle of facial ex-!OH.
i;\
Supply. The
i;
branch
terior auricular
which join
portion
frontal
The
arteries.
branches
of the facial
The
this nerve.
occipitalis minor.
the supraorbital,
receives
portion
occipital
frontal,
arteries.
Trapezius muscle.
For description of
Sterno-cleido-mastoid.
For description of
Superior oblique.
Rectus capitis
vertebral
terior
lateralis.
Description. This
this
region.
Origin. From
Insertion.
this
For description of
For description of
Into
bone.
A<tio\.
\i.i;\
To
Si pply.
laterally.
First cervical
Blood Supply.
DESCRIPTION. This
hind
of
it
is
the
sympal
hei
verges towards
ii>
INSERTION.
ic
it
BeIn front
nerve.
As
vertebrae.
it
passes
upward
it
con-
fellow.
To
ACTION.
tion
It is
it
Origin. From
it
flex and rotate the head, and to restore it to its natural posidrawn backward.
pply.
Firsl cervical and a loop between it and the second cer-
after being
Nerve
Si
vical nerve.
lies
occipito-atlantal articulation.
Its
course
is
obliquely
ANATOMY
IN A NUTSHELL.
.")
1
Origin. From the anterior surface of the lateral mass of the at la-, and
from the root of Its transverse process.
Insertion. Into the basilar process immediately behind the Rectus cap*-
it is
anticus major.
Action.
pharyngeal.
Superior constrictor.
PLATE CCLXIX.
ABDOMINAL MUSCLES
CRANSVERSALIS FASCIA
ILIAC
CREST
ILIAC FASCIA
PERITONEUM
PELVIU
BORDER OF ACETABULUM
RECTOVESICAL FASCIA
~.
&
"
:\A
'J'
HI
SPHINCTERAL
- '.
APEX
'ikr^T>
OF
ISCHIORECTAL FOSSA
m0
hf^
ISCHIORECTAL FASCIA
'I
i,
="",y,
GLUTEUS
OBTURATOR
MAXIMUS
FASCIA
OBTURATOR
INTERN
Its
ami the
Origin.
(1)
From
(4i
This interval
is
is
known
Fossa.
its
hamular
process,
''<>
(6)
i?i a
few
fiber-
ANATOMY
.510
Insertion.
IN A NUTSHELL.
Action.
To
Nerve Supply.
Blood Supply.
the pharynx which
is
its
(1)
blood supply
to
external carotid, and (3) the pterygo-palatine and (4) descending palatine from
LESSON CLXXIII.
Temporal Bone.
(Plates
CCLXVI-CCLXVII-CCLXVIII-CCLXIX.)
The temporal bone lies at the inferior lateral portion of the skull and consquamous, mastoid, and petrous portion. It contains the organs of
sists of a
hearing.
(scale-like)
hone.
The
its
squamous portion
is
short
and broad.
Its
is
It
glenoid process, passes between the auditory process and the mandibular portion of the glenoid fossa.
The
from the upper border of the zygoma and forms part of the temporal ridge (here
called supramastoid crest.)
To THE
and
to
(JPPEB
formed chiefly by the tympanic plate which forms the antero-inferior wall of
the externa] auditory meatus and ends externally in the auditory process.
Tin-:
i-
Glaserian
ANATOMY
IX A NUTSHELL.
squamous portion
of the
oil
is
thin
parietal bone.
is
Sterno-cleido-mastoid.
Retrahens aurem,
(5)
The
digastric fossa
groove, which
Trachelo-mastoid,
(6)
is
The
occipital
for the occipital artery, lies parallel to the digastric fossa in-
is
it.
The mastoid cells are situated in the mastoid
tympanum. They are lined with mucous membrane.
ternally to
into the
(4) Digastric,
Occipito -frontalis.
and open
The upper ones
process
bone between
it-
of the
temporal bone
is
passes forward
and inward.
It
It
and the
of a
is
occipital bone.
i-
This portion of
and
and three
surface.-,
borders.
The base
following points:
This opening
lies
in
it
to the
is
squamous portion
belongs to the petrous portion of the temporal bone and forms the second
point for consideration at the base of the petrous portion, namely, the m diTORY process which is for the attachment of the cartilage of the ear.
The apex, which lies internally at the base of the skull, is received betw<
the greater wing of the sphenoid and the basilar process of the occipital bone.
thus forming the outer boundary of foramen lacerum medium, and contain- the
internal carotid canal.
The
anterior surface of the petrous portion of the temporal bone form- the
of
the skull
and
i>
ANATOMY
.18
IN A NUTSHELL.
CCXLVII.)
Opening of the carotid can
sideration.
1.
It
(Plate
\i.,
i:t
which
is
for tin
ganglion of the
fifth
carotid canal.
o.
i-
Hiatus Fallopi]
Foramen
is
;i
This
PLATE CCLXX.
4
IANGULAR
4.IGAMEN.
PERIGNEAL VESS.
TUBEROSITY OF ISCHIUM
NFERIOR /HEMORRHOIDAL
VESS
Eminence over
is
of this surface.
which
is
This lamina
is
Opening of the
\<>i
is
ANATOMY
auditorius interims.
of the
3.
It
IN A NUTSHELL.
519
process
dura mater.
An angulah
is
vein
the cancellous
to
openings.
LESSON CLXXIV.
The
and from
its
apex to
its
base
it
hone forms
pai
(Plate CCXLIX.)
A rough quadrilateral surface
for consideration:
the cochlea.
4.
Jugular fossa
is a
and with the occipital hone forms the foramen lacerum posterius, which transmits the internal jugular vein and the ninth, tenth, and eleventh cranial nerves.
5. Foramen foe Jacobson's nerve (tympanic branch of the glossopharyngeal) is in the ridge between the jugular fossa and the carotid canal.
6. Foramen for Arnold's nerve (auricular branch of the pneumogastric)
is
in
is
smooth quadrilateral
facet
which articulates
THE AURICULAE
processes,
is
FISSURE, which
is
it.
SUPERIOR BORDER of the pet nuts portion of the temporal hone i> the
It gives attachment
longest and is grooved for the superior longitudinal sinus.
to the tentorium cerebelli and has a notch :it its inner end lor the fifth nerve.
It separates the middle fossa of the base of the skull from the posterior fossa.
The posterior border of the petrous portion of the temporal bone has on
its inner half a groove, which with n similar groove on the occipital bone
Till-:
l<
On
is
;i
notch which
anterior border
bone
is
the
ANATOMY
520
IN A
NUTSHELL
and has an inner portion which articulates with the sphenoid hone, and
shortest
The upper
of
these canals
for the
is
They
Tensor tynipani muscle, and the lower one for the Eustachian tube.
lead into the middle ear.
Ossification. This hone ossifies from ten centers.
ARTICULATION.
tal.
sphenoid.
(3)
Attachment
the
T<>
1.
SQI
It
<>k
(4)
Muscles.It has
VMOUS PORTION
tempero-maxillary region.
To the zygoma, the Masseter muscle of the temporo-maxillary region.
3.
To
mastoid portion,
Tin-:
(a)
(b)
it:
2.
of the
hack.
ie)
region.
(b)
Tothe styloid
4.
>
Supply.
The
(c) Stylo-glosstts of
(c)
It
It
maxillary
Splenius capitis
(f)
.">.
(c)
lar
It
muscles attached to
fifteen
of the
is
internal
basilar,
and
vestibule.
LESSON CLXXV.
Origin and Insertion
<f
2.
connected with
it.
and posteriorly
it
This fascia
i-
deep portion
two portions
it-
is
united
The
Origin.
The
their
;it
it-
zygomatic arch.
These
gland overlaps
insertion.
The parotid
The
The
ANATOMY
IN A NUTSHELL.
521
Insertion.
The insertion
all
is
and
Action.
It
is
a muscle of mastication.
It
raises
lower jaw.
of the
nerve.
facial artery,
PLATECCLXXI.
CAVITY OF
CERVIX WITH
AReOR VITA
EXTERNAL CS
Section.
3.
4.
">13.
Splenitis capitis,
6.
Traehelo-masfoid, which
;i
aponeurosis
hyoid bone.
is
given
off
which
is
This aponeurosis
attached
is
to the
of the
ANATOMY
522
IN A NUTSHELL.
Origin. The origin of the posterior belly is from the digastric groove of
The origin of the anterior holly is
process of the temporal bone.
mastoid
the
from the fossa on the inner surface of the inferior maxillary bone near the
symphysis.
Insertion.-
Into
its
is
to
anterior belly receives the mylo-hyoid branch of the inferior dental nerve.
Blood Supply.
Facial
artery.
8.
Retrahens aurem,
From
Origin.1
nsertk
in.-
of cranial surface.
Action.
Description.
Stylo-pharyngeus.
This
facial
which
muscle,
is
nerve.
extends
from
rounded above and broad and thin below. The stylo-pharyngeus nerve in
lies on die outer side of this muscle.
Origin.- From the inner side and base of styloid process.
Insertion.- Into the Consl ictor muscles, Palato-pharyngeus muscle, and
Action.
Nerve
Si pply.
Blood Supply,
ts
same
as
die pharynx,
which
is
sertion
Description.
Stylo-hyoid.
by the tendon
This
muscle
It
is
is
perforated
near
situated
front of
in
its
its
in-
and
base.
.
body of die hyoid b
Ii
Action.
elevates and retracts the hyoid hone.
Nerve Supply.- facial.
Blood Si pply. Same a- Digastric muscle.
Insertion,
11.
tnto the
Stylo-glossus.
Im
-i
ription.- This
is
the shortesl
and smallest
of the
Styloid muscles.
Origin,
near
its
from
the anterior
Insertion,
of the styloid
a thin
process
aponeurosis.
tongue blends with the Lingualis muscle in front of the Hyo-glossus muscle,
and its oblique portion passes over the Hyo-glossus muscle and decussates with
its
fibers.
ANATOMY
To
Action.
Nerve Supply.
Blood Supply.
12.
NUTSHELL.
IX A
Hypoglossal.
Facial, lingual
523
tongue.
the
This muscle,
which
is
long, thick,
and
[nsertiOn.
Into
ii
blends
pharyngeal
plexus
palate where
sofl
Action.
It
Nerve Supply.
The
spinal
through
accessory
the
possibly from the facial through the petrosal branch of the vidian nerve.
Blood Supply.
Ascending
palatine,
palatine, lingual.
13.
Description.
Tensor tympani.
This
in
muscle
bony
is
situated
above the
is
separated from
under surface
of the petrous
canal.
It
Origin.
From
the canal
it
situated
is
in.
portion of the temporal bone, and the cartilaginous portion of the Eustachian
tube.
Ixskrtion.
Into the handle of the malleus near its root.
Action. To tense the tympanic membrane.
Nerve Supply. From the otic ganglion of the fifth nerve.
Blood Supply. Tympanic branch of ascending pharyngeal.
14. Stapedius.
Description. This is the smallest muscle in the body.
From the sides of the cavity in the tympanum. Its tendon
Origin.
Insertion.
Into the neck of the stapes.
Action. To draw the head of the stapes backward and thus rotating it>
base inward towards the vestibule, and probably compressing the contents of
the vestibule.
Nerve Supply.
Blood Supply.
If).
its
Tympanic
Tympanic
lies at
is
fossa
:it
Insertion.-
palate,
Action.11
tenses
the soft
palate,
deglutition.
Nerve Supply.
Blood Supply.
palatine, lingual.
fifth
nerve.
pharyngeal,
descending
ANATOMY
524
IN A NUTSHELL.
LESSON CLXXVI.
Ethmoid Bone.
The ethmoid bone which
and two
It
is
CCLVIII-CCLIX.
plate
consists of a horizontal plate a perpendicular
lateral
lighl
FOR
POI NTS
(Plates
<
onsideration:
PLATE CCLXXII.
ca T
0Rls
Generation.
A Sagittal Section of the Female Organs of
1.
skull as
it^
is
situated
orbital plates.
in
and between
ANATOMY
2.
Crista galli
It is
teriorly.
is
is
situated
and
thick
IN A NUTSHELL.
in
525
triangular.
of this triangle,
The
which
anterior border
of this triangle,
caecum.
3.
Grooves
are on this plate on each side of the crista galli for the olfactory
bulbs.
4.
Foramina
These foramina are in three rows, (a) an inner row, which leads to the
nasal septum, (b) a middle row which leads to the roof of the nose, and (c) an
outer row which leads to the superior turbinated bone.
5. Nasal slit is on the side of the crista galli anteriorly and is for the
passage of the nasal nerve, which is a branch of the fifth nerve.
6. Triangular notch is at the back of the cribriform plate for the ethmoid
nerves.
The
are grooved
Its sides
tached to
its inferior
border.
consist
of
number of
cellular cavities, and each lateral half presents the following points
for consideration:
1. The ethmoidal cells have thin walls and are situated between two
plates
2.
which form
Os planum
its
sides.
also
process, which
is
is the end
and forms part of the outer wall of the nasal fossa.
4. The superior turbinated process curves downward and outward.
PROCESS passes downward to articulate with the in5. The UNCIFORM
bone
ferior turbinated
and forms part of the inner wall of the antrum of High-
of a thin plate of
plate,
more.
One
Articulation.
It
and frontal of the cranium, and all the bones of the face excepl the two malar
articulates with are: the
and the inferior maxillary. The bones of the face
two
two
palate, two inferior turlachrymal,
two nasal, two superior maxillary,
it
ANATOMY
526
IX A
NUTSHELL.
bu1 as
articulations
\<
hment of Muscles.
There are no
Aaiterior ethmoidal
Blood Supply.
muscles attached
artery,
to this
hone.
LESSON CLXXVII.
Sphenoid Bone.
(Plates
CCXLIII-CCXLIV).
bone forms most of the middle fossa at the base of the skull.
the hones of the cranium, the vomer, two palate and two malar
Occasionally its external pterygoid plate articulates with the
'The sphenoid
It
touches
the
all
face.
It
grooved on each side for the sixth nerve. Thk posterior clinoid processes are a1 each upper angle of the dorsum sella?. Grooves
are situated laterally on the body for the cavernous sinus and the internal
Turcica behind, and
carotid artery.
is
They
of this
groove
posteriori}-.
f.
Thk lingula is a
Thk clivus is a shallow
depression which lodges the pons and slopes backward from the
to be continuous with the basilar groove of the occipital bone.
The
dorsum
This
articulates with
sella'
it
and
This
Sphenoidal
Thk SPHENOIDAL
RBINATED BONE partly closes these cells or sinuses in front and below, but
they communicate with the nose and sometimes with the posterior ethmoidal
cell.-.
This surface articulates with the orbital process of the frontal bone
above, and with the orbital process of the palate bone below, and with the os
plannum of the ethmoid LATERALLY.
The inferior surface has in its mid-line Tin: ROSTRUM, which articulates
Ti
alae of
the vomer.
\TiiMV IN A NUTSHELL.
527
division
(a)
foramen rotundum
foramen ovale
or
(b)
the
inferior
maxillary
division of the fifth nerve, the small petrosal nerve, small meningeal artery,
foramen Vesalii transmits a small vein, tins foramen is often absent, (d)
foramen spinosum transmits the noddle meningeal artery, veins, and sympa(c)
thetic filaments
This foramen
is
often double.
PLATE CCLXXIII.
ANASTOMOSIS OF
UTERINE
AND
OVARIAN ARTERIES.
HELICINE
UTERO-OVARIAN
BRANCHES
LIGAMENT
EXTRFMITY
FIMBRIATED
OF
MBRIA
TUBE
OVARICA
OVARIAN ARTERY.
ILIAC
VAGINAL
INTERNAL
BRANCHES
OS EXTERNUM
of the greater
wing
is
convex and
upper portion
is
The
ment
divided by the
larger
is
lower portion.
to the Tensor palati and internal lateral ligament of the lower jaw.
The
and
is
quadrilateral
in
shape.
The upper
border of this surface articulates with the frontal bone, the outer border with
the malar hone, and the lower border, which is rounded, helps to form the
pterygo-maxillary fissure, while the inner, which is sharp, forms the lower
border of the sphenoidal fissure (anterior lacerated).
notch
ANATOMY
528
IN A NUTSHELL.
upper pari for a branch of the lachrymal artery, and a spine at its center
which gives origin to one head of the External rectus muscle.
'I'lic circumference of the greater wing of the sphenoid articulates with
Tart of its inner portion forms the lower
the temporal and frontal hones.
sphenoidal
fissure and helps to form the foramen lacerum
boundary of the
at its
medium.
3. The lesser wings ni the sphenoid hone (processes of Incrassias) project
outward from the upper and lateral part of the body to end in a sharp point.
Each wing has two roots; the upper is thin and flat, and the lower is thicker and
has near the body a small tubercle to which is attached the ligament of Zinn.
Tin; OPTIC FORAMEN which transmits the optic nerve and the ophthalmic artery
The anterior border of each wing articulates with the
is between these roots.
hone,
the
while
posterior
border lies in the fissure of Sylvius, and ends
frontal
Its upper surface is smooth and
in THE INTERIOR CLINOID process internally.
The lower
flat and is situated in the anterior fossa at the base of the skull.
surface forms the upper border of the sphenoidal fissure and the hack of the
Tin-: sphenoidal fissure (anterior lacerated) is hounded
roof of the orbit.
above by the lesser wing of the sphenoid, internally by the body of the sphenoid, and below by the inner margin of the orbital surface of the greater wing
The following strictures pass through the sphenoidal
of the sphenoid.
fissure:
the third nerve, fourth nerve, three divisions of the ophthalmic division
of the fifth
sympa-
TheTemporal
and the
ANATOMY
IX A NUTSHELL.
529
the pharynx, the Tensor palati of the soft palate the Levator palpebral of the
orbital region, the Superior oblique of the orbital region, the Superior rectus.
Inferior rectus. External rectus,
and
Blood Supply.
vidian,
carotid.
LESSON CLXXVIII.
Temporal muscle which has been described on page 508.
External pterygoid.
Description. This muscle, which passes almost
horizontally between the zygomatic fossa and the condyle of the jaw. is a thick,
1.
2.
Origin.
It arises
the
Supply. External
fifth.
Blood
artery.
Internal pterygoid.
3.
Description.
This
muscle
is
thick
and quad-
rilateral.
Origin.
the tuberosity of the palate bone, and the adjacent pari of the superior maxillary.
Insertion.
Into
Action.To
close the
inward.
Nerve Supply.
Inferior
Blood Supply.
fifth
nerve.
lary artery.
4.
5.
Tensor
6.
Levator
angular
Meshy
in
in
its
palati
pa^
shape and
is
it
>
insertion.
lesser
ANATOMY
530
Into
[nsertion.
lid,
IX A
NUTSHELL
t:\rsal
cartilage, skin of
and conjunctiva.
Action. Lifts the upper lid and antagonizes the Orbicularis palpebrarum.
Nerve Supply. A branch of the third nerve which pierces the su-
Blood
7.
Supply'.
Muscular
-Description.
Superior oblique.
Its tendon
Orsgin. From above the inner margin of optic foramen.
process
bone,
the
internal
angular
the
near
pulley
of
frontal
passes through a
rectus
muscle.
Superior
then beneath the
Into the sclerotic coat between the Superior rectus and ExInsertion.
muscle
at right angles to these muscles.
ternal rectus
PLATE CCLXXIV.
SUPERFICIAL DORSAL VEIN
DEEP DORSAL
DORSAL
VEIN
ARTERY
CORPUS
DARTOS
AREOLAR
TISSUE
CORPUS SPONGIOSIS
A Transverse
Action.
it
its
cornea
8.
Superior rectus.
Description. This
the thinnest
and narrowest
ORIGIN.
From
Insertion.-
Into
corneal junction.
Action.
Nerve Supply.
Blood Si pply.
Third
cranial nerve.
Muscular
U.
Inferior rectus.
Origin.
From
ANATOMY
Insertion.
Into
NUTSHELL.
EN A
531
sclero-
corneal junction.
Recti
muscles.
Origin.
foramen.
optic
Blood Supply.
Muscular branches
All the structures on the floor of the sphenoidal fissure are between the
two heads
11.
of
the
meet
muscles.
Insertion.
It
nerve.
LESSON CLXXIX.
Nasal Bone.
The
its
(Plate CCL).
It
is
is
the face.
The outer
wark.
a
It
vein.
has
surface
many
is
may
This foramen
The inner
convex transversely, but concave from above downits center a foramen for
be double.
The
It
is
surface
is
jus!
superior border articulates with the nasal notch of the frontal bone.
serrated,
thick,
ami narrow.
The
inferior border
The
external
maxillary bone.
border articulate-
with
the
nasal
process of
the superior
ANATOMY
The
IN A NUTSHELL.
its fellow,
the frontal bone above and the perpendicular plate of the ethmoid
Ossification.
of
An
\<
Articulation.
the cranium, and
iiMi.vr
may
cranial region
ossifies
It
of
below.
It
its
fellow
he attached to this
hone
Blood Supply.
Nasal
resembles
behind the lachrymal crest helps to form the inner wall of the
lachrymal crest forms part of the lachrymal
of this surface
groove.
The
its
anterior portion,
while
its
by
posterior portion
its
meatus by
ethmoid bone completes the anterior ethmoidal canals. This surface has a
furrow upon it corresponding to the position of the crest of the external surface.
The anterior border articulates with tin nasal process of the superior
maxillary bone and is the longest.
The posterior border articulates with the os planum of the ethmoid.
The superior border, which is the shortest and thickest, articulates with
1
The inferior border articulates with the lachrymal process of the inferior
turbinated bone, and posteriorly with the orbital plate of the superior maxillary
bone
Ossification.
It
this
ossifies
Articulation.
It
The frontal and ethmoid
articulates with four bones.
and the superior maxillary and inferior turbinated of the face.
Attachment of Muscles. It has one muscle attached to it. namely, the
the palpebral region.
f
Tensor tarsi
Blood Supplj
Inferior orbital, nasal branch of ophthalmic, and anterior
of the cranium,
ethmoii
lal
artei ies.
Tensor
tarsi.
is
Origin.
It
arises
from the
crest of the
Insertion.
ANATOMY
Action.
eye,
and
to
IN A NUTSHELL.
Nerve Supply.
Blood Supply.
PLATE CCLXXV.
ORIFICES OF
URETERS
PLICA URETERICA
TRIGONE
SINUS POCULARIS
COWPEIVS GLAND
MEMBRANOUS URETHRA
CRUS PENIS
ORIFICE OF DUCT OF
COWPER'S GLAND
PECTINIFORM SEPTUM
RPUS SPONGIOSUM
PORA CAVERNOSA
rOSSA NAVICULARS
GCANS
NAL URINAY MLATUS
LESSON CLXXX.
Malab Bone.
The malar bone,
or check bone,
(Plates
is
CCLIV-CCLT
situated
at
It
and
part of
ANATOMY
;,.U
IN A NUTSHELL.
The
to the
The
the oribt.
maxillary hone.
antero-inferior,
labii
articultaes
is
attached to
this border.
The temporal
poral fascia
ridge above
is
The zygomatic
of the
is
is
curved border.
The tem-
border, or postero-inferior,
border of the zygomatic arch and gives origin to the Masseter muscle.
The maxillary process articulates with the superior maxillary bone.
It is
tem-
poral hone.
frontal process articulates with the external angular process of the
The
hone.
frontal
The
also
It
spheno-maxillary fissure
poro-malar canals.
Zygomatic minor
temporo-
Blood Supply.
Levator
labii superioris
Origin.al.-o
From
proprius.
from the lower border of the maxillary process of the malar bone.
Into the facial part of the Orbicularis oris.
Insertion.
\>
[ON.
\'l.l;\
l.
Si PPL1
Blood Supply.
The infraorbital
lip.
facial nerve.
plexus, which
ANATOMY
IN A NUTSHELL.
535
Zygomaticus major.
Origin. From the malar bone on its posterior asped
Into the angle of the mouth.
Insertion.
Action. It raises the lip outward.
of external border.
this muscle.
Origin.
From
malar
of the
bone.
Insertion.
it
labii superioris.
Action.
To
outward.
LESSON CLXXXI.
Superior Maxillary Bone.
The
(Plates CCLII-CCLIII).
in
only one bone of the face larger than the superior maxillary and that
This bone forms parts of the roof of the mouth, of
is the inferior maxillary.
the floor and outer wall of the nose, of the Moor of the orbit; and parts of the
There
is
The external
On
ward.
this surface
muscle.
we have
above the
and outThe
incisor teeth
and gives
External
to this fossa
is
is
at-
Com-
is
nence
is
produced by the canine tooth. The infraorbital foraand nerve, is above the canine fossa.
of the orbit gives attachment to the Levatorlabii superioris propus
vertical ridge
men, which
The margin
is
muscle.
The
matic
Near
posterior, or
fossa.
its
()n
is convex and forms pari of the zygowe have the following points for consideration:
zygomatic surface
this surface
center are the openings of the posterior dental canals for the posterior
The
tuberosity, which
is
at
A groove
the lower
This
pan
of this
tuberosity artic-
just
ANATOMY
536
IX A XUTSHELL.
The superior
its
Its inner border articulates with the orbital process of the palate bone behind,
and with the os planum of the ethmoid in the middle, and with the lachrymal
Its outer border helps in form the spheno-maxillary fissure
bone in front.
and sometimes articulates with the orbital plate of the sphenoid bone. Its
anterior border helps to form the circumference of the orbit and is continuous
PLATE CCLXXVI.
SPERMATIC ARTERY
ARTERY
VAS
OF
DEFERENS.
PAMPINIFORM PLEXUS
HEAD Of
GLOBUS
HYATID
EPIOIDYMUS
MAJOR
MORGAGNI
TAIL OF
EPIDIOYMUS
MINOR
GLOBUS
PORTION
PARIETAL
OF
TUNICA
VAGINALIS.'
Testicle
\\i>
Spermatic Cord.
with the nasal process internally and the malar process externally.
fraorbital groove,
in
which
opens into
in
is
in
The
in-
and foramen.
antrum
for
The
external
to
the
lachrymal groove.
from
depression just
ANATOMY
The
internal surface
is
IX A
NUTSHELL.
537
The
part above the palate process forms part of the outer wall of the nasal fossa
Behind
opening
is
articulates
This surface
groove.
below
is
it
is
anterior to
the lachrymal
is
The
nasal process, which passes upward, inward and backward by the side
of the nose
is
of
this
makes part
surface articulates
with
the
The upper border of the nasal process articulates with the frontal
The anterior border of this process articulates with the nasal bone.
The posterior border of this process has the lachrymal groove for the
bone.
nasal
and the inner margin of this groove articulates ith the lachrymal bone.
while the outer margin of this groove forms pari of the circumference of the
duct,
Orbit.
it
the
lachrymal process of the inferior turbinated bone. This canal which opens
into the inferior meatus, runs downward, outward, and backward.
(Plate
CCLII.)
ANATOMY
538
Areolar process
est
behind and
lias eighl
IN A NUTSHELL.
cavities in
it
This process
is
broad-
is
Its
On
first
lnferior surface
its.
is
It
articulates
with the vomer, the palate, and with its fellow process of the opposite side.
At the point where the two palate processes meet anteriorly is the anteriok
palatine canal or fossa. There are four openings in the bottom of this
the two lateral openings are called foramina of Stenson, and transmit
The anterior and posanterior branches of the descending palatine arteries.
terior foramina are called the foramina of Scarpa, and transmit the naso-palatine nerves.
The left nerve passing through the anterior one and the right
Sometimes a suture passes from this fossa on
nerve through the posterior one.
each side to the interval between the canine and incisor teeth, thus making a
bone called the intermaxillary or incisive hone. See plate CCXXVIII.
The SUPERIOR SURFACE is concave transversely and forms part of the floor of
fossa,
the nose,
Stenson.
of
its
of
is
called
the
SPINE.
OSSIFICATION.
it
the orbital
plate of
the sphenoid.
Attachment of Muscles.
It
it.
The
orbital region, Levator labii superioris aleque nasi of the nasal region,
Levator
Depressor
alse nasi,
maxillary
region,
Internal ptery-
frontal,
Supply.
and
nasal,
Infraorbital,
facial
alveolar,
arteries.
LESSON CLXXXII.
I
(2)
Orbicularis
described
on page 508.
Inferior oblique.
Origin.
It
arises fr
ANATOMY
Insertion.
Into
IN A NUTSHELL.
")o'.l
rectus.
Action.
It
its
upward.
Levator
Origin.
labii
of the
ophthalmic artery.
Insertion.
of
hone.
into the facial
Action.
Elevates
the upper
lip
and
PLATE CCLXXVII.
ATTACHMENT OF TRABECULAE
CONI
&m$l&
rvv^-
VASCULOSI
COLLECTING TUBE
t
jsgp
VAS
DEFERENS
VAS ABERRANS
'MINOR'
RETE TESTIS
IN
MEDIASTINUM
The
(4)
Levator anguli
TESTIS
Testicle.
oris.
bone.
oris.
facial
lift
(5)
Compressor nasi.
Action.
It dilates
(6)
Depressor
incisive fossa.
nasi.
the nostril.
Facial.
Lateralis nasi
Nerve Supply.
Blood Supply.
alse nasi.
Origin.
above the
of the nose.
its
fellow
ANATOMY
540
To contract the
Action.
IN A NUTSHELL.
nostrils.
of the facial.
Origin.It
arises
of the nasal
notch and
sesamoid car-
tilages.
Insertion.
Action.
Facial.
Branches
margin of the
nostril.
\ki;\ e Supply.
Blood Supply.
from the
facial artery.
(8)
(0)
Buccinator.
The upper and lower fibers of the Buccimonth where they decussate to he conthe Orbicularis oris, however, the highest and the
Description.
at
is
Origin.
in
oris
in
del
Xia;\ e
inferior
maxillary
Blood Supply.
Facial
artery.
(10)
(11)
Orbicularis oris.
Description.
The
fibers
of this
rived from the other facial muscles which are inserted into the lips,
The
and
it
has
which belong
to
the
lip itself.
fibers
bone
it
:tnd
has
the
seventh nerve.
inferior coronary,
and
inferior labial.
the origin of the Compressor nasi and Levator anguli oris muscles, and the infraorbital vessels
(
)i;i<;i\.
and nerve
from
as they pass
ANATOMY IN A NUTSHELL.
Insertion.
Action.
Nerve
Blood
lip
541
oris.
lip.
branch of the
facial.
LESSON CLXXXIII.
Inferior Maxillary Honk. (Plates CCLVI-CCLVII).
bone consists of a body shaped something like a
hi nvs shoe with the ends spread, and two vertical rami which meet the body at
The body has the following points for consideration:
nearly a right angle.
The external surface of the body is convex from side to side. bu1 concave
from above downward. The symphysis is a vertical ridge in the middle line
marking the junction of the two lateral portions of the bone. The mental proThe incisive
cess is a prominent triangular eminence which forms the chin.
fossa is situated on each side of the symphysis just below the incisor teeth, ami
The Orbicularis oris has an origin
jives origin to the Levator menti muscle.
The mental foramen is jusl below the interval
just externally from this fossa.
between the bicuspid teeth and is for the passage of the mental vessels and
nerve.
The external oblique line passes outward from the base of the mental
process for a short distance, then passes upward and finally become- continu-
The
inferior maxillary
is
inferior
below
groove near the anterior
The
to side
and convex
It
has the
The genial
in
ment to the Mylo-hyoid muscle. The posterior extremity of this ridge gives
attachment to the Superior constrictor muscle and the pterygo-maxillary ligament.
The submaxillary fossa, which b for the submaxillary gland, is below
the mylo-hyoid ridge.
These oblique line- mi the external surface and the internal surface divide the
body
into an
upper and
lower portion.
i>
thick behind
muscle on
The
teriorly
its
h gives attachment
external surface behind the first molar tooth.
inferior border
which
is
just
is
to the
is
and has
Buccinator
thicker an-
A groove
for the
ANATOMY
542
facial artery
groove
i-
is
od this border
at the
IN A NUTSHELL.
This
The rami of the inferior maxillary bone are the perpendicular portions.
They arc quadrilateral in shape and each one has two surfaces, four borders!
PLATE CCLXXVIII.
GREAT
OMENTUM
ANATOMY
IN A NUTSHELL.
!'
the
jaw.
is
line.
teriorly.
and the condyle of the lower jaw poscrossed by the masseteric vessels and
is
nerve.
is
is
saddled by the
parotid gland.
of the
jaw
is
is
ferior border.
It
The coronoid
its
its first
This canal
anterior one-third.
process, which
of the
ramus,
is
thin. flat,
lower jaw.
Ossification.
This
bone
ossifies
six for
each lateral
half.
Articulation.
It
bone-.
this
Internal
and
pterygoid and
Temporal
of
the
ok
ANATOMY
.",44
IX A
XUTSHELL.
LESSON CLXXXIV.
Masseter muscle which has been described on page o'20.
Internal pterygoid which has been described on page 529.
1.
2.
4.
.").
Origin.
From
sym-
Action.To
retract
Hypoglossal.
Blood Si pply. Lingual.
Genio-hyoideus. Description. This
Xki;\ e Supply.
(>.
it
pa>ses towards
insertion
its
and
lies
muscle increases
It
in
is
breadth as
situated be-
Hypoglossal.
Lingual.
Nerve Supply.
Blood Supply.
Mylo-hyoid.
7.
Origin.
From
Insertion.
running
Into the
body
of the
in
ii"\.
8.
i.
of the fifth.
9.
Origin.
From the external oblique line of the inferior maxillary bone
below and internal to the mental foramen.
Insertion.
Action.
Nerve
Into
the lower
lip
down.
Supramaxillary branch of
facial
nerve.
ANATOMY
Blood Supply.
Branches
IX A NUTSHELL.
from the
545
facial artery.
PLATE CCLXXIX.
AMPULLA OF DUCT
ACINI OF
(HAND
MAMMILLA
ADIPOSE
LOCULUS
AREOLA
GLAND
LOCULUS
The Mammary
12.
Levator
Origin.
From
Insertion.
}land.
Levator menti.
Into
of chin.
Action.-
To
Nerve Supply.
Blood Supply.
13.
Supramaxillarv
Branches
of
the
artery.
ANATOMY
546
major muscles, as
Insertion.
IN A NUTSHELL.
it
foramen.
Helps
A.CTION.
to
LESSON CLXXXV.
[nferioe Turbinated Bone. (Plates CCLX-CCLXIV.)
The inferior turbinated bone, which is situated in the nasal fossa along its
It has two surfaces, two borders, two exouter wall, is curved upon itself.
tremities,
The
to
form the
The
The
The
of
is
meatus.
inferior
bone is convex.
narrow and pointed.
inferior border (free border) passes to within half an inch of the floor
the nose.
superior maxillary bone anteriorly, and with the inferior turbinated crest of
The lachrymal
process
is
It articulates
The maxillary
process,
which
is
but on the external surface of the bone, articulates with the lower edge of the
aperature of the antrum of Eighmore, and also helps to close this opening.
Ossification.-
Articulation.
It
It
ossifies
articulates
with
four
bones.
The ethmoid
>i>
Si pply.
of
the
it.
The
is
thin, while
its
upper portion
vomer
is
is
concave and
divided.
free.
Its
lower portion
ANATOMY
The
IX A NUTSHELL.
547
and the
receives
ethmoid above.
is
by the
ala,
which
fits in
This border
is
bounded on
either
This joint
a schindylesis.
OSSIFICATION.
This bone
from one center.
articulates with bones. The sphenoid and ethmoid
ossifies
Articulation.
of the cranium, the
six
It
of the face.
It
also
LESSON CLXXXVI.
Palate Bone.
The palate bones
(Plates
are
two
CCLXII-CCLXIII-CCXXVIII-CCXXIX).
in number and situated between the superior
maxillary bones and the pterygoid processes of the sphenoid bone at the back
of the nasal fossae.
illary fissure,
spheno-maxillary
form the
to
They
roof, floor,
also help to
matic
fossae.
The inferior surface is also concave and forms the back pail of the hard
and has upon it a transverse ridge for the attachment of the Tensor
tympani aponeurosis. A groove is situated at the outer end of this transverse
palate,
ridge which with the tuberosity of the superior maxillary bone forms the pos
terior palatine canal.
The
anterior border
is
The
internal border
and articulate- with the internal border of itgroove on the upper surface for the reception of the
is
thick
The
The
palate.
is
free
Leal
is
at
righl angle.
to the soft
ANATOMY
548
The
vertical plate
IN A NUTSHELL.
is
is
directed
upward and
slightly
extent.
its
is
The
rough.
back part
orifice of the
antrum
Highmore.
of
The
meatus which
is
below the
PLATE CCLXXX.
meet
ing.
at
MlllC.
The
the
The
The
pterygoid
of this
its
process.
orbital process
is
triangular
in
shape and
is
directed
ANATOMY
IX A NUTSHELL.
549
The articular
the anteriob or maxillary, which articulates with the superior
maxillary bone. internal or ethmoidal surface, which articulates with the
ethmoid hone. and posterior or sphenoidal surface, winch articulate.- with
The free surfaces are the orbital, which
the sphenoidal turbinated bone.
forms part of the Moor of the orbit. ami Tin: external or zygomatic surface,
ward.
It
surface- are
which forms part of the zygomatic fossa. This process has a rounded border
which forms part of the spheno-maxillary fissure.
The sphenoidal process is -mailer than the orbital process and articulates
.superiorly with the body of the sphenoid, and externally with the pterygoid
It has three surfaces and two borders.
Tin: internal
process of the sphenoid.
surface, which is concave, forms part of the outer wall of the nasal
fossathe superior surface, which articulates with sphenoidal turbinated bone,
surface
is
Tin:
help.- to
fossa.
Ossification.
This bone
articulates
It
Attachment of Muscles.
Its
ANTER-
Its
pos-
process.
ossifies
Articulation.
external
process of the
fellow.
This
palatine.
1.
Tensor
2.
palati,
There
Description.
3. Azygos uvulae.
from the name we might think there
of the
median
Origin.
eurosis of
is
is
a pair of these
but one.
There
is
muscles although
one on each side
From
the soft
the nasal spine of the palate bone and the adjacent apopalate.
of spinal accessory,
geal plexus.
Bloob Supply.
4.
Palatine
arteries
LESSON CLXXXVII.
Hyoid Bone. (Plate XIX).
which
is situated a1 the base of the tongue consists
The hyoid bone,
body, two greater cornua, two lesser cornua, making it horse-shoe in shape.
The anterior surface of tin- body is convex and
It is called the lingual bone.
550
AX ATOMY IX A XUTSHELL.
rosis of
Jhondro-glossus.
is
he ankylosed hut
Ossification.
its
lower border.
hotly.
may
its
is
is
attached to
its
apex.
This articulation
generally free.
From
five centers.
artery.
1.
2.
Thyro-hyoid.
Origix.
From
Action.
Into the
Insertion.-
To
of the
hyoid bone.
nerve.
as
''.
59.
4.
5.
6.
7.
8.
o.
Chondro-glossus.-
pari
of
Description.This muscle
Origin.
Insertion.
lesser
Hi.
Supplj
>n Si
sometimes described
glossus
\i.i;\ e
is
Hyo-glossus.
the
ppl"5
.-
Byo-glossus.
-Hypoglossal.
Lingua] artery.
of the tongue.
Hyo-
ANATOMY
Origin.
IN"
A NUTSHELL.
551
Nerve Supply.
Blood Supply.
]
Hypoglossal.
Lingual artery.
Middle constrictor.
Origin.
From
Ik die
ligament.
PLATE CCLXXXI.
DUCTUS ENDOLYMPHATIC!.)";
TYMPANIC CAVITY
SACCULE
MEMRRANA TYMPANI
EXT AUDITORY MEATUS
Blood Supply.
on page 315.
^'2.
tongue
Inferior Ungualis,
in
its
to the
pharynx, which
is
given
This
whole length,
tongue.
LESSON CLXXXVIII.
There auk three Pairs of Meati
The superior meatus, which
is
ses i\
the Nose.
the smallest
of
(Plate
the three,
CCLXIV).
is
situated be-
ANATOMY
552
IN A NUTSHELL.
tweeD the superior turbinated bone and middle turbinated bone at the upper
and back pari of tin- nasal fossa. This meatus occupies the posterior one-third
The spheno-palatine foramen opens into
of the outer wall of the nasal fossa.
it
it
back part of
at the
its
at
cells
The spheno-ethmoidal
open into
recess
is
be-
hind the superior turbinated bone at the superior and posterior part of the
nasal fossa and opens into the sphenoidal sinus.
The middle meatus occupies the posterior two-thirds of the outer wall of
the nasal fossa and
turbinated
inferior
is
bone.
The
inferior meatus,
which
is
the largest of
the meatuses,
is
situated
be-
It will
tween the inferior turbinated bone and the floor of the nasal fossa.
be noticed that the superior meatus occupied the posterior one-third of the
of the
outer wall, while the inferior meatus occupiesthe entire length of the outerwall
of the nasal fossa.
The canal
opens
at the anterior
extremity
of this meatus.
The nasal fossae extend from the base of the cranium to the roof of the
mouth, and are situated on each side of the middle line of the face. They are
two large cavities which are separated from each other by a thin septum. The
anterior nares open on the front of the face from the nasal fossa' while the posterior nares open into the pharynx.
The frontal sinus communicates with
the nasal fossa above, the sphenoidal sinus communicates with the nasal fossa
posteriorly, and the antrum of Highmore and the ethmoidal sinus communiThe orbit is joined to the nasal fossa by the lachrycate with it externally.
The mouth communicates with the nasal fossa by the anterior
The cranium communicates with the nasal fossa by the olfactory foramina, and the spheno-maxillary fossa communicates with the nasal
Sometimes the nasal fossae communifossa by the spheno-palatine foramen.
mal groove.
palatine canal.
They include
all
the septum.
and the inferior maxillary, and in place of these three it has the frontal, ethmoid and sphenoid of the crainum. The ethmoid bone with all its articulation- make the nasal fossa-.
The frontal, ethmoid, and sphenoid are common to the nasal fossa, cranium and the orbits.
There are numerous foramina at the base of the skull extending from the
foramen csecum to the foramen magnum. There are also three large fossae at
the base of the skull, namely, the anterior fossa, middle fossa, ami the posterior
fossa.
(Plate
CCXXXV.)
in
pair-.
ANATOMY
2.
The ethmoidal
fissure
IN A
553
NUTSHELL.
Olfactory foramina for the olfactory nerves and nasal branches of the
ethmoidal
4.
arteries.
nerve.
5.
amen
Thisfor-
LESSON CLXXX1X.
The middle fossa is on a lower level than the interior fossa
HAS THE FOLLOWING FORAMINA ALL OF WHICH ARE IN PAIRS:
1.
and three
wn
and the sixth nerve, also filaments from the cavernous plexus.
ophthalmic vein, recurrent branch from the lachrymal artery, orbital branch
of the middle meningeal artery, and a process of the dura mater.
2. Foramen rotundum through which passes the superior maxillary diviof the fifth nerve,
the
fifth
branch from the ascending pharyngeal artery, carotid artery, and carotid plexus.
7. Hiatus Fallopii through which passes the petrosal branch of the vidian
nerve and the petrosal branch of the middle meningeal artery.
8.
we
in
Thus
the
auditory artery.
2.
The aqueductus
vestibuli
is
pri
ANATOMY
554
IN A NUTSHELL.
sinus,
pneumo-
and spinal accessory nerves, through the posterior one the lateral
and meningeal branches of the occipital, and ascending pharyngeal
arteries.
4.
is
mastoid artery.
.">.
The
is
and
PLATE CCLXXXII.
A\
ma
fa
\\\
ATTOLLENS AURICULAI
HELIX
ANTI-
HELIX
ml
fk
\\
';'//
'
///'
f&
ATTRAHENS AURICULAM
OBLIOUUS AURICULAM
EXTERNAL
AUDITORY
MEATUS
^ARTIUGINEUS
base
pairs.
in
The eleven
the
in
Thus we
and sixteen
make the
in the
middle
-hull.
lesson cxc.
The temporal
fossa (Plate
CCXXXIV)
is
ex-
("_M
It
spheno-malar suture,
(3)
(1)
coronal suture,
(4)
spheno-pari-
ANATOMY
etal suture,
(5)
IN A NUTSHELL.
squamo-parietal suture,
The stephanion
is
(6)
>>>
squamo-sphenoidal suture.
ridge.
The
pterion
is
squamous portion
of
The temporal fossa is deep and concave anteriorly, but convex posteriorly.
marked by grooves which lodge branches of the deep temporal arteries.
The Temporal muscle fills this fossa.
The zygomatic fossa is bounded anteriorlyby the tuberosity of thesuperior
It
is
maxillary bone, posteriorly by the eminentia articularis and the posterior border of the external pterygoid process, superiorly by the pterygoid ridge which
on the outer surface of the greater wing of the sphenoid hone and separates
from the temporal fossa, interiorly by the alveolar border of the superior maxillary bone, externally by the zygomatic arch and the ramus of the lower
is
this fossa
jaw, internally
its
plate.
The
The spheno-maxillary
fissure,
angles internally.
By means
of
this fissure the orbit communicates with the temporal fossa, zygomatic fossa,
and the spheno-maxillary fossa. The superior maxillary nerve and it > orbital
branch, the inferior orbital vessels, and the ascending branches from Meckel's
ganglion (spheno-palatine) are transmitted by this fissure.
The pterygo-maxillary fissure passes at light angles from the inner extremity of the spheno-maxillary fissure and is therefore vertical in direction.
It is formed by the separation of the superior maxillary bone from the
It
pterygoid process of the sphenoid bone and is shaped like the letter \
transmits the branches of the internal maxillary artery and connects the spheno.
The spheno-maxillary
fossa
is
It is bounded
the spheno-maxillary fissure joins the pterygo-maxillary fissure.
by the under surface of the body of the sphenoid bone and orbital process of
the palate bone superiorly, by the superior maxillary bone anteriorly, by the
anterior surface of the base of the pterygoid process and lower part of the anterior surface of the greater
and pterygo-maxillary fissure open into it. The orbital fossa, nasal
fossa, and the zygomatic fossa, and the cavity of the cranium communicate with
this fossa.
The foramen rotundum superiorly, the vidian foramen belo^ and
internal to the foramen rotundum, and the pterygopalatine foramen open on
fissure,
ANATOMY
556
its
IN A NUTSHELL.
posterior wall.
open on
its
inner wall.
of the pos-
maxillary nerve, and the termination of the internal maxillary artery are in
this fossa.
LESSON CXCI.
Female Organs of Generation.
CCLXXI-CCLXXII-CCLXXIII).
(Plates
(1
Fallopian tubes, (4) the ovaries, while the external female organs of
lie
the cervix uteri, the posterior wall reaching the cervix higher up than does the
anterior wall.
the lower half of the anterior wall, while on the posterior wall there are two
ridges
called
rugae pass.
In
dud
Mnllerian
the vagina
is
its
of
is
these ridges
In
left.
The hymen
its
at
-iic.
mammalia
vagina
transverse
a erescentric or circular
is
mucous
name
of vagina.
its entrance.
When the hymen is ruptured warty eminences mark
These are called carunculae myrtiformes. The hymen has the fol-
lowing forms:
Hymen bifenestratus
1.
side by side
2.
pierced by
3.
4.
In
condition
this
period,
Hy.mkn
5.
si
i.
i'ii
i;i.i>
Hymi nsepti
7.
necessary.
is
"i
sis
m EN SUBSEPT1
is
3 is
in
one
The vagina
where
it
is
is
if
tissue.
smallest below
and
largest
where
it
it
surrounds the os
may
uteri,
very dilatable.
it
in
FRONT ok
it
the urethra
AXATOMV
IX A NUTSHELL.
.-).)<
Outer or
The
cle
fibro-elastic.
Middle or muscular.
2.
recto-vesical fascia.
Mucous or
3.
internal.
mus-
The mucous
epithelium,
it
which moisten-
it
is
is
is
follicles,
there-
that of a secretion.
Nerve Supply.
Hypogastric
plexus,
the
pudic
ei ve.
PLATE CCLXXXIII.
TERMINATION OF SEMICIRCULAR
CANALS
APEX OF
MODIOLUS
COCHLEA
WINDING OF
FIRST
COCHLEA
SECOND WINDING OF
HALF
WINDING
COCHLEA
OF
BASE OF COCHLEA
It
iliac
artery, on
either
side.
artery.
Lymphatics
of the vagina
end
in
LESSON CXCII.
The uterus
is
is
is
is
detained
in
ovum
above called the body and a narrow, more cylindrical pari below called the
Within is a cavity which passes out in the Fallopian tube on each
vix.
above ami below opens into the vagina. The cavity narrows as it passes
the cervix
terminate
at
at
into
cer-
side
It
is
it
on
It
consists of
:i
serous or peri-
ANATOMY
IN A NUTSHELL.
ness,
The
ant
is
forms an angle with the vagina close to ninety degrees, and as a rule the
left
superior angle
uterus
is
The body
is
is
flat anteriorly,
the body
covers
The
cervix
is
laterally.
It
posterior surface of
is
its
The
its
is
The
is
This cavity has too lateral cornua above, and a constricted opening (internal
lower angle.
its
The
is
The
external os
is
a transverse orifice at
arbor
It
has an anterior
its
vitse.
IX
is
a posterior lip.
a reflexion of
the peritoneum
to the bladder.
the uterus
and
The two
1.
lateral or
pass From the sides of the uterus to the lateral wall.- of the pelvis,
:i
fibers.
and
6.
ANATOMY
IN A NUTSHELL.
*>">*
then to the
first,
sacrum.
7 and 8. The two round ligaments arc about five inches Long and extend
from the lateral aspect of the fundus of the uterus through the inguinal canals
They are composed of muscular tissue, areolar tissue,
to the labia majora.
and fibrous tissue, as well as vessels and nerves.
The canal of Xuck is a tubule of peritoneum in the young female descending
from the uterus into the inguinal canal. It is usually obliterated in the adult.
Blood Supply. (1) The uterine, which is a branch of the anterior division
of the internal iliac artery. (2) funicular from the superior vesical, (3) the
ovarian from the abdominal aorta.
Nerve Supply. From the inferior hypogastric and ovarian plexus of
the sympathetic, and the third and fourth sacral nerves.
The lymphatics of the cervix end in the pelvic nodes, while those from
the body end in the lumbar node.-.
The coats of the uterus are three, (1) a serous, (2) a muscular, and (3) a
mucous.
The serous coat is the peritoneum which invests the uterus, except at
its
The muscular
coat, which
of the uterus.
composed
of
smooth muscular
fiber inter-
tissue,
to
is
numerous
in
numerous glands upon its surface and is covered with ciliated columnar
The ovula of Naboth are glandules or follicles within the os uteri
and cervical canal which are often distended with mucus, which mucus Naboth
mistook for human ova. hence their name.
A laceration of the cervix in a diathesis or neuropathic constitution
is followed (1) by irritation. (2) indigestion, (3) malnutrition. (4) anemia. (5)
of
epithelium.
neurosis.
LESSON CXCIII.
The Fallopian tubes
Each one
ovum from
the
Fallopian
size
broad
from
ANATOMY
560
1.
IN A NUTSHELL.
The isthmus is the inner constricted third of the tube which is hard,
and nearly horizontal. It is about an inch and a half long and
cylindrical,
one-eighth of an inch
in
diameter.
The
concentric circles.
is
The hydatid
attached to
of
PLATE CCLXXXIV.
CANALb
TERMINATION OF SEMICIRCULAR
^
MODIOLUS
APEX OF
CALA VESTIBULI
c/^^J^S5^---^
WINDING OF
FIRST
SECOND WINDING
OF
COCHLEA
COCHLEA
,B0NY SPIRAL
LAMINA
THIRD
SUP
HALF
WINDING
OF
COCHLEA
"
SCALA TYMPANI
INFERIOR
BASE OF MOOIOLUS
and ovarian
Supply.The nerves
arteries.
Blood Supply.
The
empty
into the
lumbar
lioile-.
The
ovaries,
of generation, are
two
grayish pink bodies situated in the broad ligament behind ami below the Fallo-
The position of the ovary is indicated on the body by the midpian tube.
point of a line drawn from the anterior superior spinous process of the ilium to
symphysis pubis.
The dimensions
third of an inch.
of the
They
a half,
ANATOMY
has
IN A NUTSHELL.
iii
ficial
561
derived from the super-
Ls
would meet
is
vertical
nearlv horizontal.
is
LESSON CXCIV.
The ovary
consists of a vascular
foll-
icles.
The stroma
is
composed
of connective tissue
which has
hi it cells,
white
fibrous tissue, yellow elastic tissue, plain muscular fibers, blood vessels
and
From
nerves.
trabecular to the cortex of the ovary, thus leaving spaces in which are situated
follicle.
This
is
capillar}' plexuses.
is
This
is
Graafian
The
Ovum
is
follicle.
a vascular layer
composed
is
the
cell
follicle.
discus proligenis
is
membrana granulosa
in
which the
imbeded.
The membrana
propria
(vitalline
membrane)
is
The corpus luteum is the yellow spot in the substance of the ovary and is
caused by the rupture of the Graafian follicle, but it disappears when impregnation has not occurred.
When impregnation has occurred it may undergo
remarkable development
The true corpus luteum (corpus luteum of pregnancy)
The
is
usually regarded
false
in
ANATOMY
562
IN A NUTSHELL.
The true corpus luteum continues to grow for two or three months
few weeks.
and may be as large as one-third of the entire ovar}\ It continues till toward
the end of gestation and then shrinks to a small white scar which may not enWhile this is the general rule it
birely disappear until a month after labor.
does not always hold good for bodies which are identical with the true cori'oi;\ i.itka have been found in the virgin ovaries.
The ovary in its descent may pass into the inguinal canal and out the exThis
ternal abdominal ring and become an external organ like the testicle.
is
At the
third
month
the
LESSON CXCV.
The external female organs of generation are known by the term vulva or
pudendum and includes (1) the mons veneris, (2) the labia majora, (3) labia
minora,
Venus)
of
is
pubes
in
is
between the posterior commissure and the hymen. The nerve supply of the
labia majora is the superficial perineal from the pudic and the inferior pudendal
from the small sciatic.
The labia minora (nymphae) are folds of mucous membrane within the labia
They extend from the prepuce of the clitoris to the inner surface
majora.
They
air largesl
and the
The
during pregnancy.
The
vestibule
is
lips
include the
human
species
although it
usually concealed
thra,
and
is
in
in
in
and numerous
that
it
is
as lemurs.
In the
small
It differs
some animals,
is
mammals
human
by a
female
from
ureit is
'
ANATOMY
it is
sists of
it is
distinguish
difficult to
The
563
IN A NUTSHELL.
it
when present
in the female,
remnant
of the pronephros.
clitoridis is a fold,
Ii
is
is
situated in
small peduncu-
homologue
lis
The preputium
It con-
clitoridis.
in
the male
is
CCLXXVI.
clitoris.
The duct
is
tending from the parovarium through the broad ligament to the vagina.
Bulbus vestibuli is a mass of erectile tissue situated on each side of the vestibule beneath the
mucous membrane.
It is
homologous
to the
pus spongiosum in the male, while the pars intermedialis which is a continuation of the bulbus vestibuli anteriorly is homologous to the corpus spongiosum
itself.
PLATE CCLXXXV.
COMMON TERMINATION
POSTERIOR
AUDITORY NERVE
VESTIBULAR
COCHLEAR
OF SUPERIOR
ANO
SEMICIRCULAR CANALS
NERVE
NERVE
EXTERNAL
CUPOLA
SACCULARIS
R10"R
AMPULLA
SEMICIRCULAR CANAL
SUPERIOR
Etosenmuller)
of
Ii
is
is
a
a
relic
in
the
tubular body
It
is present
to the organ ofGiraldes (Paradidymis) in the male.
always
recognized.
cannot
be
and
childhood
only in
The long tube of the parovarium is homologous to the tubeof the epididymis.
homologous
The
in
homologous
to therete testis
and
the male.
Bartholin's glands are the vulvo-vaginal glands which are situated on each
are
named
is
Plate
CCLXXIX).
ANATOMY
564
IN A NUTSHELL.
inguinal.
never dorsal.
Blood Supply.
The
mammary
(long
thoracic),
costal
of the inter-
nerves.
It
and joined at
right angles
by
row of twisting tubes given off from the Malpighian body, and forming a structure resembling a comet.
in
into the
head
of the
the male.
LESSON CXCVI
The Male Organs of Generation. (Plates CCLXXIV-CCLXXV-CCLXXVICCLXXVII-CCLXXVIII).
The
inches
prostate gland
in itsl
to apex.
Its
of this
\i'i.\
shaped
weight
gland
is
is
a1
like a
chestnut and
is
[ts
is
is
base
is
drachms).
The
It
testicle, (six
is
lateral lobes.
is
posterior surface
Its
it
bladder.
-
is
ANATOMY
IN A NUTSHELL.
565
distal
is
of the penis
cle.
The prepuce
is
completely
less
:i
hypospadias there
Is
an opening
In
the female
The dartos is the reddish, cellular, contractile tissue beneath the skin of
The female
the penis and continuous with the dartos tissue of the scrotum.
dartos
is
The dartos
some
fice.
The
nerves,
penis
is
is
areolar tissue of the penis, which contains the superficial vessels and
just beneath the dartos.
tissue.
(Plate
It
is
CCLXXIV).
joined to
The deep
fascia of the
ANATOMY
566
spongiosum.
IN A NUTSHELL.
This fascia and the dartos aided by the Bulbo cavernosi and the
[schio-cavernosi muscles compress the veins of the penis in the action of erection.
giosum,
penis.
(c)
and the dorsal artery. The veins of the penis are in two
veins, which pass between the dartos and fascial sheath
sets,
saphenous
and femoral veins, (b) the deep veins, which drain
in
long
the
end
the corpora cavernosa, corpus spongiosum, end in the deep dorsal vein and in
superficial perineal,
(a)
superficial
Lymphatics of the penis are divided into two sets, (a) superficial ones
which pass to the inguinal nodes, and (b) deep ones which empty into the pelvic
and Lumbar nodes as well as in the inguinal nodes.
Nerve Supply.
ficial
The
perineal branches of the pudic supply the covering of the penis, while the
and
superficial perineal,
PLATE CCLXXXVI.
SEMICIRCULAR CANAL
5CALA TYMPANI
INFERIOR
to
inguinal canal.
It
The vas
from the
testis
deferens, which
to
is
the ejaculatory
of the testicle.
dud.
It
is
recognizable by
its
cord-like
resistance to pressure.
_'.
artery.
The artery
It
arises
from
this artery
which
is
it
divides into an ascending branch
which follows the vas deferens through the inguinal canal, and a descendingbranch which passes n> the dilated poll ion of the vas deferens and the vesicula
seminalis.
:!.
The cremasteric
artery,
which
is
branch of the
ANATOMY
IN A NUTSHELL.
567
through the inguinal canal with the vas deferens andsupplies the Cremasteric
muscle.
4. The spermatic artery, which is a branch of the abdominal aorta, passes
over the Psoas muscle to the internal abdominal ring, then through the inguinal
canal into the scrotum to the testicle.
It
gives off the following branches,
branchesto theureter,
(a) ureteral
muscle,
(c)
epididymal
(b) cremasteric
branches
to the
Cremasteric
bpdy
of the testis.
The spermatic
5.
(i.
7.
deferens.
8.
9.
lar fibers.
The
10.
a relic
is
of the tube
11.
12.
A
A
LESSON CXCVII.
The infundibuliform
cremasteric fascia which
fascia
which
is
is
fascia
from
which
tin
is
all
fascia,
the
and the
outward.
The
the base of the bladder and the rectum, and they serve as reservoirs for the
fluid
which
is
added
to the
They have
semen.
ternal or
The
mucous
ejacnlatory duct
is
verti
montanum
is
diameter
is aboul one-eighth
opens
about one-fill ieth of an inch.
on either side of the opening of the sinus pocularis.
on the
in-
coat.
it
opens
it
Its
is
The testicles are two in number and aresuspended by the spermatic cords.
They weigh less than an ounce and are about an inch and a half long, and inch
and a quarter deep, and about an inch in thickness. They secrete the seminal
fluid.
They have the following coverings from within outward.
portion of
serous covering formed by
1. The tunica vaginalis, which is
;i
;i
the peritoneum which descended with the testicle and afterwards forms
closed
pouch investing it. This tunica consists of two layers, a visceral ami
parietal
strong
layer.
Beneath the tunica vaginalis is the tunica albuginea which i^
fibrous coat (Plate CCLXXVII) and beneath this coat, the tunica vasculosa
(pia mater testis) which is composed chiefly of blood vessels held together by
:i
; i
ANATOMY
568
IX A
NUTSHELL.
This coat lines the tunica albuginea and the various septa
areolar tissue.
2.
and
is
a continuation
:;.
cular fibers (the ('remaster muscle) which are derived from the lower border
of the Internal oblique muscle.
The intercolunmar
4.
which
is
closely adherent
to the dartos.
The scrotum consists of two layers, (a) the integument which is more
and covered in the adult with scattered hair. A raphe is
present in the median line from which pass transverse wrinkles,
(b) The dartos
5.
or less pigmented
which
is
The epididymis (upon the testis) lies at the posterior and superior part
of the testicle and consists of the globus minor which contains the efferent
duct, and the globus major composed of vasa efferentia and coni vasculosa.
If the epididymis were unraveled it would be a tube twenty feet long.
The lobules of the testicle are contained in the spaces formed by the tra1.
epididymis.
body,
is
It
closed tube.
is
Its
life
homologue
a part of
is
The oviduct
is
dud
of
Rathke.
The
which
sessile
persists
of the oviduct
is
the
homologue
of the sessile
hydatid of Morgagni.
LESSON CXCVIII.
The Organs
oi Hearing.
(Plates CCLXXX-CCLXXX VII, inclusive).
These organs consist of three portions.
1.
The external ear, which consists of (a) pinna or auricle which is not of
much importance physiologically, and (b) the meatus auditorius externus,
which is
canal leading inward to the tympanic membrane.
;i
The middle
ANATOMY
IN A NUTSHELL.
569
municates with the naso-pharynx by means of the Eustachian tube, (b) the
mastoid antrum, (c) the mastoid cells,
(b) and (c) are accessory air chambers
tympanum.
The internal ear or labyrinth, contains the membranous labyrinth
which is a cast of the bony structures. The membranous labyrinth contains
the endolymph, and within it are the specialized neuro-epithelial cells and the
terminations of the auditory nerve. The perilymph is on the outside of the
membranous labyrinth.
to
the
3.
is
the projecting part of the ear lying outside of the head, and
is
PLATE CCLXXXVII.
FOR
FOSSA
ARTICULAR SURFACE
INCUS
FOR
LEFT MALLEUS
MALLEUS
HEAD OF MALLtUS
SHORT
SHORT PROCESS
PROCESS
SLENDER PROCESS
HANDLE OR MANUBRIUM
ANTERIOR CRU3
BASE-
POSTERIOR CRUS
BASE
OF
STAPES
The
helix
is
The
lobule
is
in
the lobule.
areolar tissue.
3.
The
is
helix.
The antihelix is a range which begins above the Lobule .-u the antitragus and passing upward bifurcates to enclose a triangular depression called
4.
ANATOMY
570
5.
The concha
IN A NUTSHELL.
is
in
The tragus
is
is
auditory meatus.
It
is
usually covered
inferior border.
The antitragus
is
from which
the extkixsk
Helicis
mencemenl
4.
">.
minor
is
of the helix
Helicis
major
is
when present
is
Transversus aurem
is
Obllquus aurem
is
the seventh
Action
nerve.
of the Intrinsic muscles
is
to retard the
of this canal
is
follicles.
cartilaginous,
osseous.
Tin
LYMPHATICS
meatus end
in the
parotid and
ANATOMY
IN A NUTSHELL.
571
membrane
is
,-'.,
situated obliquely,
so
its
as to form almost
In infancy this
membrane
is
al
>t
2.
membrane.
This
is
its
to
tym-
The
tubercle which
is
is
The
stripe
to the
umbo and
is
formei
Sharpnell's
part of the
brane.
carotid arteries.
Nerve Supply.
The
LESSON CXCIX.
The Middle
The tympanum (drum)
is
Ear.
It
lies
be-
lis antero-posterior
tween the external auditory meatus and the internal ear.
length is about half of an inch, vertically a lil tie more ban half an inch, and its
It consists of two main parts, (a) attic or
width is about one sixth of an inch.
recessus epitympaniticus which is situated in the highesl portion of the tympanic cavity and contains the head of themalleus and the greaterparl of the
do Atrium (tympanic. cavincus.
This attic leads into the mastoid antrum,
ity proper) is situated opposite the tympanic membrane.
The roof of the tympanum is a thin plate of bone (tegmen tympani) which
separates the tympanum from the middle fossa :it the base of the skull.
I
PLATE CCLXXXVII]
ENCYSrtO
HERNIA
INFANTILE
HERNIA.
'NTC
THE
TUNICA
VAGINALIS
HERNIA
HERNIA
INTO
THE
FUNICULAR
PROCESS
ANATOMY
IN A NUTSHELL.
573
tympanum is formed by the thin plate of bone which sepatympanum from the jugular fossa.
The anterior Avail of the tympanum is deficient above where the Eustachian
tube opens into it. This wall separates the tympanum from the carotid canal
The
floor of the
rates the
and has opening of canal for Tensor tympani muscle above, and below the openThese canals are separated from one another by
ing of the Eustachian tube.
the processus cochleariformis.
The
toid cells
tympanum
separates the
tympanum from
large
small openings.
The outer wall of the tympanum is formed by the membrana tympani and
by the squamous portion of the temporal bone above. It has the following
points for consideration:
the
The
tympanum through
this opening.
anterius,
iter chordae
of the
tympanum
is
brane which
2.
is
and
is
closed
by
mem-
is
It is
daria
3.
It is
and
The promontary
is
them.
The pyramid
is
its
summit passes
the tendon of the Stapedius muscle, and a branch of the seventh nerve pierces
the pyramid to supply the Stapedius.
5.
ovalis
branch
of
ascending pharyngeal artery which enters through the Eustachian tube, tymThe veins of the middle ear follow the correspanic branch of vidian artery.
of
ponding arteries and empty into the temporo-maxillary vein, the superior petrosal sinus, the lateral sinus, the internal jugular vein and pharyngeal veins.
The lymphatics of the middle ear end in the posterior auricular and carotid
nodes.
Nerve Supply.
Tympanic
membrane
ANATOMY
.J74
IN A
NUTSHELL
Jacob-son's
(1)
of the tympanum and is formed by the following nerves:
nerve, (2) great superficial petrosal nerve, (3) small superficial petrosal nerve,
small deep petrosal.
I
tympanum
or
:i
'I
The
base
fits
The Ligaments
on the
This
is
a ball-and-socket joint.
membrane
The neck
re-
of the Stapedius.
of the malleus, incus,
fibrous
the head of the malleus to the outer part of the roof of the attic.
_'.
Tin:
wall of the
malleus.
It
Tiii':
:;.
tympanum and
is
is
sometimes described
as the
of
5.
its
apex and
to the
is
incus and to the posterior wall of the attic near the orifice of the mastoid ant urn.
the joints between the malleus and incus, and between the incus and stapes.
cells.
is
lined
into the
PLATE CCLXXXIX.
The Lymph
575
ltic
Max.
ANATOMY
576
IX A
NUTSHELL.
The mastoid cells are no1 present at birth but at the age of puberty there
and they occupy the greater portion of the mastoid process. They
are a few
is
ternal car.
i
tympanum
At the point where the bony portion joins the cartilaginous portion
The opening
tympanum
PLATE CCXC.
Gerrish.)
on the anterior wall, while its pharyngeal opening is on the lateral wall of
This tube is closed except dur
the naso-pharynx behind the posterior nares.
is
ing swallowing,
Levator
palati.
lessox
The Internal
Lai;.
re.
(Labyrinth).
is
the
membranous
labyrinth.
Tin' bony labyrinth is made up of the vestibule, the cochlea, and the
SEMK li;< LAB CAN ^LS.
The membranous labyrinth is smaller than the bony labyrinth of which
i
it
and the space between the two is lined with endothelium which conThe parts which make the membranous labyrinth are, the
tain- parilymph.
rjTRK i.i which is a membranous sac in the vestibule, saccule which is also a
membranous sac in the vestibule, membranous semicirculab canals which
are in 'he osseous canals, and the membranous cochlea which is aspiral tube
is
casl
ANATOMY
IN A NUTSHELL.
is
577
The organ
of Corti
is
in
the
membranous
cochlea.
internal auditory meatus is the opening into the internal oar from the
for the seventh ami eighth nerve and stylo-mastoid artery.
cavity
cranial
is an oval cavity at the entrance to the cochlea within the
vestibule
The
it is about one-fifth of an inch, laterally about onecar.
Vertically
internal
The
tenth of an inch.
It
and membranous
saccule,
tympanum.
It
for consideration:
ligament which
is
from the
3.
is
It
is
vertical crest.
is
a small depression
which
is
In the posterior portion of the vestibule are the five openings of the semicircular canals, while at the anterior portion of the vestibule
is
an opening
The
is
vestibule.
lies in a
and
lies
is
horizontally.
one another and each forms more than a semicircle. The ampulla
is about one-tenth of an inch in diameter.
The cochlea is a bony tube about one and a half inch long situated anteriorly
It resembles a snail shell and coils around a central axis two
to the vestibule.
right angles to
is
is
two-fifths of an inch
in
diameter and
i-
ANATOMY
578
IN A NUTSHELL.
It
is
scala media divides the spiral canal into three parts, the scala tympani
below and the scala vestibuli above, and between these two the scala media.
The scala tympani opens into the tympanum at the fenestra rotunda, however,
The scala vestibuli opens
this opening is closed by the membrana secundaria.
Where these two scalse communicate with each other at
into the vestibule.
The
the
which
ii
The
h
sac.
is
filled
is
a flattened, oblong
branches end
in
is
as the osseous
semicircular canals and are about one-fourth the diameter of the osseous canals.
in
(scala
media)
is
a spiral tube
the spiral canal of the osseous cochlea between the scala vestibuli
and the
scala
ol Cortl
which
tympani.
It is filled with endolymph and contains the organ
is a complex arrangement of modified epithelial cells including
the rods of Corti and the auditory cells.
auditory meati
hearing.
ANATOMY
IN A NUTSHELL.
in the
579
lymphatic vessels.
The
is
origin
in
is
is
on the
outer side of the inferior fovea on the floor of the fourth ventricle
The superficial lateral origin of the auditory nerve is from the auditory
and after winding around the upper end of the restiform body joins the
striae,
mesial root in the groove between the olivary and restiform bodies.
The deep
striae,
last
(3)
lateral origin is
it
nucleus
lies in
(4)
This
roots.
The main trunk of the auditory nerve now passes into the internal auditory
meatus with the facial nerve and the auditory artery. At the bottom of this
meatus it comes to the lamina cribrosa, where it divides into the cochlear branch
and the vestibular branch. (Plate CCXXI).
The cochlear branch sends branches to the saccule, to the ampulla of the
posterior semicircular canal, and to the hair cells of the organ of Corti in the
membranous cochlea.
The vestibular branch has upon it the ganglion of Scarpa,while
auditory meatus
it
in
the internal
The following
off
(1)
the
posterior auricular behind, and the internal maxillary internally, also the trans-
maxillary veins,
(3)
is
common
branch connecting
and
its
this
branches.
(.">)
nerve.
is
of
the gland
is
called socia
parotidis.
This
It
is called
about two and one-half inches long.
After crossing the Masseter muscle and passing
into tin substance of the Buccinator muscle this duct opens upon the inner sur-
The duct
of this gland
is
ANATOMY
580
face of the cheek
This duct
jaw.
IN A NUTSHELL.
is
about the
size of a crow-quill.
It
of the
upper
is
vical
plexus).
is
situated in
the anterior part of the submaxillary triangle of the neck below the mylo-
hyoid ridge of the inferior maxillary bone. The stylo-maxillary ligament separates this gland from the parotid gland, and the Mylo-hyoid muscle separates
it
is
(submaxillary), (3)
is
the frsenum lingua? in a fossa above the mylo-hyoid ridge of the lower jaw close
to the symphysis.
The duct
of this gland
is
This duct opens into the duct of the submaxillary gland near
nation.
Blood Supply.
Nerve Supply.
(2)
submental
fifth
arteries.
(gustatory).
its
termi
ANATOMY
"
IN A NUTSHELL.
ATABLE OF MUSCLES
WITH
Nerve Supply and Page of Description.
Cranial Region.
Occipito-frontalis.
Facial,
or
branches of third
cranial
Attollens aurem.
nerve,
the
Page 513
Auricular Region.
arteries.
Page 522
Palpebral Region.
Orbicularis palpebrarum.
Temporal branch of
Page 508
cranial nerve
Corrugator
supercilii.
Temporal
branch of
facial
or fibers of third
cranial nerve
tarsi.
Tensoi; tymi'wi.
From
Laxator tympani
Ptramidalis
nasi.
Page 508
Page 532
Page
Page
Page
Page
Page
530
Page
">">
529
530
53 1
">:'> 1
Page 538
Page 523
Page 523
Page 531
Nasal
Region.
ANATOMY
Origin.
From
[nsertion.
IN A NUTSHELL.
the Occipito-frontalis.
Into
Com-
nasi.
'i-
Action.
N u;\
i.
Supply.
Facial.
Supply.Facial.
Levator labij buperioris al^bque
><>i>
'.ij
Origin.From
Insertion.
nasi.
Facial
Facial
Page 539
Page 540
Insertion.
Action.
To
Page 539
the nose.
of
Nerve Supply.
Facial.
Facial.
nasi. Facial
Blood Supply.
Depressor al.k
Page 539
Page
Page
Page
Page
534
539
535
535
vim;
LABI)
tNFERiORis.
Facial
Page 545
Page 544
Page 545
Intermaxillary Region.
l'.i
(i
[NATOR.
crania]
fifth
Risorius.
<
>i;h,i \.
Facial
Page 540
From
Into
Action.To draw
i.i;\
i.
Insertion.
aerve
Si pply.
mouth.
mouth backward.
Facial.
through
its
buccal
visions
Temporo-Maxillary Region.
TEMPORAL.Masseter.
Page 508
Page 520
ANATOMY
IN A NUTSHELL.
583
Pterygo-Maxillary Region.
of
the
Inferior
maxillary
of
the
Inferior
maxillary
Page 529
Pterygoideus internus.
Pterygoid
branch
Page 529
Superficial
Platysma myoides.
Cervical
Facial
Spinal
Sterno-cleido-mastoid.
Region.
Page 5
accessory, second
and third
(?)
Page
cal nerves
15
cervil"
Infra-Hyoid Region.
(Depressors of the Os hyoides and the Larynx).
Sterno-hyoid. Branches from the loop of communication between the
Page 40
cervical plexus and twelfth cranial nerve
Sterno-thyroid. Branches from the loop of communication between
Page 41
the cervical plexus and twelfth cranial nerve
Page 550
Thyro-hyoid. Hypoglossal nerve
Page 59
Omo-hyoid. Tenth, twelfth, and cervical plexus
Supra-Hyoid Region.
Digastric.
Posterior
belly
gets
Page 521
Page 522
fifth
nerve Page
Page
Page 5
Genio-hyo-glossus. Hypoglossal nerve
Page 551
Hyo-glossus. Hypoglossal nerve
Page 522
Stylo-GLOSSUS. Hypoglossal nerve
Page 550
Chondro-glossus. Hypoglossal nerve
Page 551
Inferior lingualis. Hypoglossal nerve
Superior lingualis lies near the upper surface of the tongue passing
from base to apex. Its action is to shorten the tongue and make ii concave
longitudinally.
Nerve Supply.
Hypoglossal.
broad.
anatomy
584
Palatoglossus.
Origin.
From
in a nutshell.
its
fellow of
Insertion.
Action.
It
also pulls
down
the velum.
Nerve Supply.
geal plexus.
Action.
It
lifts it
is
line.
cartilage.
It
Action.
joins
Constricts
Nerve
Internal
Supply.-
plexus.
geal
Blood Supply.
facial
otic
of the
tongue
of the
pharynx.
Muscles of the Anterior Vertebral Region.
First
cervical
ANATOMY
(a)
IX A NUTSHELL.
585
portion.
is from the bodies of the first, second,
and seventh cervical vertebra?.
portion into the body of the second, third, and fourth
and third
dorsal,
and
of the sixth
Insertion of this
cervical vertebra?.
of the trans-
Action.
is
first,
second, and
vertebra?.
To
flex
is
and sixth
cervical vertebra?.
it.
the}'
fifth,
first
rib
It flexes
first rib.
fifth,
Is
its
substance
is
nerve.
of
first rib
for
It flexes
first
rib.
Tlii<
Origin.
From
is
Insertion.
Into
Action.
It flexes
rib.
ANATOMY
586
Nerve Supply.
Blood Supply.
From
IN A NUTSHELL.
Crico-thyroid.
Externa]
Crico-arytenoideus lateralis.
Recurrent
Page 251
and
Page 252
mogastric uerve
Arytenoideus.-Recurrent
laryngeal
Thyro-artenoideus.
Recurrent
laryngeal
nerve
Thyro-epiglottideus.
Recurrent
Page 252
nerve
Aryteno-epiglottideus superior.
ArytEno-epiglottideus inferior.
Trapezius.Spinal
LATISSIMUS DORSI.
Second
Page
45
52
layer.
Levatob ANGULI suapul.e. Third and fourth, sometimes the fifth Page r>o
Page 55
Rhomboideus .major. Fifth cervical nerve
Page 55
Rhomboideus minor. Fifth cervical nerve
Third layer.
Splenius capitis.
Splenius colli.
in
Page 272
.Page 272
Fourth layer.
\l.
\M> LUMBAR REGIONS.
SACB
Exectok
I
SPiNiE.-
tarsal region.
Ilio-Costalis.
Page 273
Musci
i.i
\<
Page 274
Longissimus dorsi. -External division of posterior branches of spinal
nerves
Page 274
branches of spinal nerves
Spinalis dorsi.
[nternal
Page 274
<
tervical region.
Cervn ojs
nerve-
\><
endens.
Page 274
'
ANATOMY
Transveksalis colli.
IN A NUTSHELL.
External division
587
nerves
Pag
Trachelo-mastoid. Internal divisions of posterior branches, also suboccipital and great oeeipitial nerves
Pag 27
Complexus. Internal divisions of posterior branches, also suboccipital
and great occipital nerves
271
g<
;
BrvENTEK
cervicis.
External
division of
nerves
Spinalis colli.
Internal
27f
Page 275
Fifth layer.
Semispinalis dorsi.
Internal
divisions
of
the
posterior
branches
spinal nerves
Pagi
Semispinalis colli.
nerves
Page
Multifidtjs spin.e.
Internal
divisions
of
posterior
J7
<
branches of spinal
Page 276
nerves
Rotatores
of
276
-pix.e.
Internal
Page 276
nerves
Supraspinales. Internal
Page 276
Interspinales. Internal
Page 278
Extensor coccyges.
Internal
Page 278
nerves
Intertransversales.
branches of spinal
Page 278
Page -7 s
nerves
capitis
Suboccipital
inferior.
and
greal
Page -7 s
Page -7 s
occipital
nerves
Page 280
'
Thoracic Region.
fntercostal
Intercostales interni. Entercostal
Infra* ostales. Intercostal nerves
Inter* ostales externi.
Intercostal
Intercostal
nerves
Page
nerves
Page 158
l>,
Page 458
l> s
nerves
Page
nerves
Page 159
Diaphragmatic Region.
plexus, intercostal, and phrenic nerves .. Page 233
Diaphragm.Phrenic
Superficial
Obliquus externus.
Obliquus internus.
iUo-inguinal nerve
Lower
Lower
Abdominal Region.
intercostal
Page 160
nerves
intercostals,
ilio-hypogastric,
etiraes
''''-'
"''
ANATOMY
588
Lower
IN A NUTSHELL.
Transversalis.
intercostuls,
ilio-hypogastric,
inguinal nerve
In
the male.
491
492
492
492
In the female.
492
493
493
493
Pectoralis
major.
Pectoralis minor.
Subclavitjs.
External
Internal
and
internal
anterior
thoracic
nerves
Page
Page
Page
41
50
42
Serratus MAGNUS.
Posterior
thoracic
from the
fifth
Acromial Region.
Deltoid.
Circumflex nerve
Page
43
Page
56
Subscapulars.
Supraspinatus.
Infraspinatus.
Teres minor.-
56
55
Page
56
Fifth
Fifth cervical
through circumflex
ANATOMY
Teres major.
Fifth
IN A
and sixth
NUTSHELL.
589
Page
56
Page
Page
58
.Page
79
I'air<-
50
Page
79
Posterior
Triceps.
58
Humeral Region.
musculo-spiral.
Subaxcoxeus.
Page
Page
Palmaris loxgus. Median-nerve
Page
Flexor carpi ulnaris. Ulnar nerve
Page
Flexor sublimis digitorum. Median nerve
Page
Flexor profundus digitorum. Ulnar and anterior interosseous. Page
Flexor loxgus pollicis. Anterior interosseous
Page
Proxator quadratus. Anterior interosseous
Page
79
81
81
81
82
82
84
84
Radial Region.
Supinator loxgus.
Musculo-spiral nerve
Musculo-spiral nerve
Posterior interosseous.
Page
Page
84
.Page
s ">
85
(2)
of the
posterior surface of the ulna, (3) from the posterior border of the ulna with the
fifth
metacarpal hone.
s7
Page
Anconeus. Musculo-spiral nerve
Supixator brevis. Posterior interosseous nerve
Pag<
Extensor ossis metacarpi pollicis. Posterior interosseous nerve P
ss
ss
ss
91
91
Page
Page
Page
Page
12
12
L2
ANATOMY
590
Adductor transversus
IN A NUTSHELL.
Ulnar nerve
Ulnar Region.
Palmaris brevis. Ulnar nerve
Abductor minimi digiti. Ulnar nerve
Flexor brevis minimi digiti. Ulnar nerve
Flexor ossis metacarpi minimi digiti. Ulnar nerve
Palmer Region.
Lumbricales.
Two
pollicis.
Page 112
Page
Page
Page
Page
median;
two inner
ulnar nerve
Iliac
113
113
get the
Region.
Iliacus.
113
Page 113
Page 114
Page 114
113
Page 134
branches of second, and third lumbar through the
first
Anterior
Page 135
Anterior Femoral Region.
Fourth and
fifth
lumbar and
first
sacral through
Page 135
Anterior crural
Page 135
Rectus. Anterior crural
Page 136
Vastus externus. Anterior crural
Page 137
Vastus internus. Anterior crural
Page 137
Crureus. Anterior crural
Page 138
Subcrureus. Anterior crural
Page 138
Internal Femoral Region.
rRACiLis. Third and fourth lumbar through the obturator nerve. Page 138
PectinetjS. Anterior
obturator accessory and occasionally branch
Sartorius.
crural,
Page
Page
Page
Page
Obturator nerve
sciatic nerves
138
140
140
140
Gluteal Region.
sciatic nerve.
.Page 141
Page
Page
Page
nerves Page
141
143
ANATOMY
IN A NUTSHELL.
591
Great
nerve
Anterior Tibio-Fibular Region.
Tibialis anticus. Anterior
nerve
Extensor longus digitorum. Anterior
nerve
Extensor propius halluces. Anterior
nerve
Peroneus tertius. Anterior
nerve
Semimembranosus.
sciatic
Page 147
tibial
Page 152
Pago 152
tibial
tibial
Pane 152
Page loo
tibial
Gastrocnemius. Internal
Plantaris.
popliteal
from great
sciatic nerve.
sciatic
nerve
Page 153
Page 154
Page 53
Page 154
Peroneus
nerves
Peroneus
Fibular Region.
longus. Alusculo-cutaneous, a
brevis. Alusculo-cutaneous, a
narves
Page 157
Dorsal Region of the Foot.
Anterior
tibial
nerve
Page 157
The
Page 158
Page 158
Page 158
Page
161
tarsal.
Action.
To
flex
the
little
toe.
(pedis).
External
plantar
nerve
Page
lnterossei.
enterossei.
firsl
mo
and
nerve
Page 160
Page L60
The
tibial
INDEX.
593
INDEX
Ankle
joint blood
ligaments of
Annec'ent gyrus, 345
joint
Abdoinen,
307
contents of, 307-309
regions of, 307
superficial muscles of, 460
deep muscles of 464
veins of, 186
lymphatics of, 499
Abdominal ring
brain function
of.
431
''
aorta. 4.51-172
circumflex artery, 65
el
mediastinum 460
nerve roots. 333
Spinal arteries. 337
tibial nerve. 218
tibial vein
192
tibial artery, 1N4-1S0
Acromio-clavicular articulation, 38
clavicular articulation ligaments, 38
clai icular articulation blood and nerve supply, 38
Adductor transversus hallucis muscle, 160
obliquus hallucis muscle, 158
magnus muscle, 140
brevis muscle, 140
longus muscle. 140
transversa pollicis muscle, 112
Adductor obliquus pollicis muscle, 112
ulna
Antrum
recurrent
of
182
of,
artery, 95
569
ihelix of ear,
126
Aponeurosis description
17
of,
of,
26
definition of, 17
\nii- tendinous,
17
leu.
178
es of,
19
117
questions on,
lymphatics
muscles
of,
120
198
gyrus, 345
artery, 292
of,
195
Anconeus muscle, 87
Angular vein, 180
Angle of jaw. 543
Angular processes, 507
Angiology definition
Ankle joint. 21)1-202
182
Highmore, 537
Amaurosis, 373
Amblyopia, 373
Amphiarthrosis, divisions
magna
arterj
branches
thoracic artery. 64
tibial artery
172
divisions of,
tibial recurrent
Ant
17
Adult circulation, 39
Ala cinerea of brain, 443
Alar thoracic artery, 64
Alcock's canal, 495-214
Alimentary canal, 309
Anatomy
148
jugular vein, IM
Antero-lateral ground bundle tract, 433
Allantois,
385
muscle, 111
minimi digiti muscle, 113
Accelerator urinse muscle, 492
of,
hmoidal arterj
intercostal arteries,
pollicifi
Adenology definition
114
external, 476
17
cent ralis
princeps
receptaculi
ret ina
cen
ici
artery,
ill
INDEX.
594
Arteries,
acromial thoracic, 63
alar thoracic,
li
gastro-duodenalis, 453
gluteal, 172
gastric,
453-327
carpal, 92-96
hand
cerebral, 444
hepatic, 453
communicating, 444
ethmoidal, 385
hyoid, 288
hypogastric, 33
interosseous, 95
ileo-colic,
448
meningeal, 444
ilio-lumbar, 172
spinal, 337
mesentery, 455
thyroid, 449
laryngeal, 449
vesical, 172
dental, 297
labial, 292
innominate, 286
intercostal,
182-180
tibial,
recurrent, 95
aorta, 284
articular of knee, 182
448
bladder
of,
lingual,
445
lumbar, 452
lateral
interosseous, 95
media, 455
sinistra, 455
coronary, 244-292
cremasteric, 560-176
crico-thyroid, 290
cutaneous of leg, 182
cystic, 453
deep palmar arch, 93
ulnar, 90
iliac,
metacarpal, 92
middle cerebral, 444
meningeal, 296
hemorrhoidal, 172
vesical, 173
musculo-phrenic, 449
nasal, 385
lingua', 291
external carotid,
iliac,
malleolar, 18
186
1st
291
170
occipital,
of,
19
172
293
oesophageal, 450-
palmar recurrent, 95
interossei, 94
pancreatica? parvse and magna, 453
pericardiac, 450-448
93
IM
hallucis, IM
pedis,
mammary,
obturator,
ophthalmic, 383-444-308
ovarian, 457
186
dorsalis pollicis, 92
femoral,
metatarsal, 184
nutrient rule
176-178
epigastric, 175-178
descending palatine, 298
circumflex
facial,
meningeal, 293
mesenteric, 326
455
colica dextra,
sacral, 172
mediastinal, 448
453
coeliac axis,
tarsal,
290
long thoracic, 64
385
30
plantar,
182
184
lachrymal, 383
of,
Artery external
maxillary, 295
pudic, 173
circle of Willis.
indicia,
172
iliac,
tarsal.
286
cerebellar, 448
digital,
carotid, 443
palpebral, 385
carotids.
common
mammary, 448
brachial, 66
ciliary,
66
450
intercostal,
malleolar,
472
bronchial, 450
calcanean. 186
coats
455
inferior profunda,
thoracic, 64
ulna;
106
of,
i:i-288
175
peroneal,
186
phrenic, 44N-452
plantar digital, 184
pterygoid, 297
posterior carpal, 92-96
cerebral, 445
circumflex, 65
communicating, 445
INDEX.
384
Artery, ethmoidal,
595
Artery, ulnar, 95
umbilical. 472
interosseous, 95
mediastinal, 450
uterine. 174
perforating, 186
vasa aberrantia. 69
brevia. 453
scapular, 449
spinal.
tibial.
337
180-185
vas deferens
182
ulnar recurrent, 95
popliteal. 176
princeps pollicis. 93
tibial recurrent.
profunda, 176
pterygo-palatine, 298
176
pudic.
566
of,
vertebral. 447
wrist of, 92
articular of knee. 182
Articular process of vertebra
Articulation, acromio-clavicular. 38
pulmonary. 284
femur. 150
pyloric. 4.53
frontal
radial. 91
submaxillary. 291
subscapular, 65
submental. 292
194
humerus; of, 61
ilium of. 128
inferior radioulnar, 79
maxillary bone of, 543
turbinated bone of, 546
knee, 198
lachrymal bone of. 532
metatarsal bone of, 164
metatarsophalangeal. 164
metacarpophalangeal. 110
middle radioulnar, 78
nasal bone of. 532
occipital bone of, 513
palate bone of, 549
parietal bone of. 510
pudic bones of, 128
sacrum. 133
sacro-vertebral
92
radial recurrent
radialis indicia,
94
ranine. 291
renal.
456
rule of, 32
sciatic.
174
sigmoid, 455
spheno-rnaxillary. 297
palatine. 298
splenic. 453-327
spermatic. 456-567
sternal,
448
subclavian, 445
sublingual, 291
suprascapular. 449
suprarenal. 456
iliac,
of,
508
circumflex
iliac.
178
epigastric. 178
176
palmar arch, 96
superficialis volas, 92
288
superior intercostal. 449
epigastric, 449
mesentery. 454
hemorrhoidal. 456
superfieial descending.
280
133
coccygeal.
supraorbital, 384
femoral,
bone
hip-joint.
134
vesical,
fibular.
172
182
profunda. 66
perforating.
94
thoracic. 62
laryngeal. 288
thyroid, 288
sural. 182
temporal, 294
thoracic- aorta, 451
291
449
tympanic, 295
tracheal.
Auriculotemporal
nerve,
102
INDEX.
596
boundaries
\
of,
long,
19
malar, 333
malleus, 574
19
manubrium, 236
metacarpal, 106
metatarsus, 164
middle cuneiform, 164
middle cuneiform, 164
118-482
vein,
\\i- bone, 26
nasal,
531
navicular. 163
occipital,
511
368
162
palate, 547
parietal, 509
orbit of,
Hack -km
280
o/,
muscles
'270
of,
Basilar artery,
vein,
os calcis,
18
488
process,
pelvis,
prominences
duct, 315
471
urachus
arteries of, 472
ligaments of, 472
lymphatics, 500
Blood penis vessels of, 566
of,
Bone
28
cavities of, 22
35
Lcle,
I".
cranium
525-20
268
sacrum, 132
scapuhe, 45
sesamoid, 20-168
short, 20
sphenoid, 526
stapes, 574
sternum, 236
rib,
69
vomer, 546
Wormian,
definition of, 23
Brain,
of, 574
eminences of, _'_'
Bones, externa] cuneiform, 164
ethmoid,
eai
">-'
339
cortex
20
femur,
flat,
Bbula.
forearm
127
128
radius, 69
pubic.
vertebra, 258
cuboid, 162
tare.
19
pubis,
ulna,
of,
of,
22
temporal, 516
tibia. 166
turbinated, 528
260
axis, 264
atlas,
:cj \.
of,
162
as1 ragalus,
els
131
phalanges, 164
processes definition
."Hi"
17
I7(i
69
506
gladiolus, 236
of,
frontal,
i:>7
eminentia
In oid,
342-343
348-437
fourth ventricle, 439
fovea superior, 443
inferior. 443
ganglia of. 343
gyri of, 345
inferior medullary velum, 441
infundibulum, 441
ilium.
incus,
fissures of.
25
">7
fornix.
internal eimifonn
163
inferior maxillary.
.">
turbinated,
546
innominate, 128
irregular,
443
5 19
I
teres,
2(1
ischium, 127-129
INDEX.
Brain lateral ventricle, 438
lamina cinerea, 441
ligula. 443
lobes of. 344-342
longitudinal commissures. 340-437
locus cseruleus. 443
middle commissure. 348-437
obex, 443
Brain, olfactory tract. 365-437
optic commissure. 437-366
peduncles of. 354
pineal gland 441
pons varolii, 362-437
posterior commissure. 437-348
perforated space. 441
ta?nia semicircularii, 356-437
tela choroidia inferior. 441
third ventricle. 437
transverse commissures. 339-437
trigonum hypoglossi. 443
tuber cinereum. 441
tuberculum acusticum. 443
ventricles. 340-358
valve of Yieussens 441
Brachial plexus. 96
communicating branches, 98
artery. 66
relations of, 66
Brachialis amicus muscle. 79
Bronchus, 254
Bronchial veins. 4^4
arteries. 450
Brunner's glands, 321
Bryant's triangle. 196
Buccal nerve. 40_>
Buccinator muscle. 540
Buck's fascia. 495
Bulbus vestibuli. 563
Cseeum. 320
Calcarine fissure. 344
597
Cavernou- sinus
189
-.
plexu-. 422
Cell-
of Sehultz
Cerebellum fi tires
Cerebrum lobeexterior
354
of.
344
342
of.
of.
Cerebellar vein-.
Cerebral veil
hernia. 474
Cervix, laceration
431
of.
Chiasma, 366-357
Chondro-glossus muscle, 550
Chopart's amputation, 194
Choroid plexuses of brain, 441
Choroid coat of eye, 381-376
Chord* tendinea 241-243
Ciliary ganglion. 395-403
Ciliary body, 386
1
arteries.
Circle of Willis.
44.'.
Circular sinus
443
internal,
triangle, superior,
inferior.
280
134
282
muscles attached,
_-.-u- muscle,
191
30
Capsular ligament. 48
I"
Cliton-
of knee.
muscles attached,
*>
1]
INDEX.
598
Cceliac axis,
plexus,
153
l-'">
494
Colles's fascia,
320
descending, 320
Colon, transverse, 320
Columns of Bertin, 468
Of Clarke, 333
lolon ascending,
Columns
Common
carneae, 24 1-2 13
intero
Commissures
of brain,
339
nerve, 306
Compressor urethra' muscle, 492-493
Communicans hypoglossi
nasi muscle, 539
Conus
arteriosus, 241
medullaris,
Crystalline
humor
of eye,
Cutaneous
vein,
485
246
goitre,
331
fascia of
arm, 115
ulnar artery branch, 96
palmar arch, 93
Deltoid muscle. 43
Cranial ner\
nen
es
376
lonarium, 353
muscle, 251
thyroid artery, 290
thyroid muscle, 251
Crista galli, 525
218
fascia,
139
second, 366
nerves description
e
of, 364-27
nerve- rule of origin, 364
nerves table of, 27
Cremastei muscle
Hit
of,
26
[NDEX.
Digastric muscle, 521
triangle, 282
cribriform plate
475
coverings of
Dorsi-spinal veins, 486
Discus proligerus of ovum, 561
Diseases of spinal cord, 334
Dorsalis linguae artery. 291
Dorsal interossei muscle, 160-114
Dorsalis pedis artery, 184
hallucis artery. 184
Dorsales indicis artery, 93
pollicis artery, 92
Duct of Gartner, 563
Ductus arteriosus, the 33
Duodenum, 320
Dura Mater of cord, 332
blood supply, 341
nerve supply, 341
sinuses of, 488
of,
Ethmoidal
Ethmoid notch, ">o7
Eustachian tube, .".7 <
>
veins
">-''
525
of,
valve.
1(1
Exophthalmic goitre, 16
Extensor carpi-radialis longior muscle 35
-'
muscle, 91
longus pollicis muscle, 91
digitorium muscle, L52
indicis
muscle, 87
metacarpi pollicis muscle, y ^
proprius hallucis muscle, 152
Externa] abdominal ring, 476
annular ligament. 222
auditory canal, 570
blood supply of, 570
nerve supply of, .">7<t
iiiiiiimi digil
<i~-i~
480
carotid artery,
13
til
cuneiform bone,
muscles attached. 104
cutaneous nen e, 210
ear, 568-569
blood and nerve supply
genitals, female, 562
I
Ear,
568
bones
574
576
intrinsic muscles
nerve of, 577
pinna, 569
of,
internal,
tympanum
of,
of,
570
186
intermuscular septum
mammary
Esophagus,
pterygoid muscle,
31
Eye-ball, 3<;s
coal
of,
376
Eye
I
ye
\.
389
389
muscles of,
lashes,
lid-.
525
525
525
nsorj
">-'''
ligament
nasal
slit,
processes
of,
of,
525
190
,184
thoracic nerve, us
Extrinsic ligaments "t larynx, 250
tarsal arterj
of,
foramina
">-'!
317
Ethmoid bone, 524
coats
artery, 64
of teeth, 311
Encephalon, 341
Encysted hernia, 479
Endocardium, 244
Ensiform appendix, 237
Epigastric region, 309
Epiblast, 331
Epididymis, 568
Epiphysis, 353
Epeneephalon, 341
Epiglottis, 250
til'
61
Enamel
219
of,
(leg>,
arm), 115
571
joint, 61
ligaments
570
iliac vein,
vestibule, 5777
Ejaculatory duct, 567
Elbow
artery.
iliac
of,
17">
Face
1\
nerves
ol
.-:
INDEX.
600
Foramen
of Winslow. 465
Win-low relations of. 465
Fire-arm description of, 69
of
origin,
106
radial region, 69
480
vein,
bones of, 69
Formatio reticularis, 363
Fornix, 348-437
description of, 356
pillars of, 349
Fossa of helix, 569
ampulla, 560
560
isthmus, 560
fimbria.
133
proprli,
u]j
navicularis of urethra. 17
ovalis,
Buck's, 195
cribriform, 218
thigh deep
of,
description
band
219
Fovea
of pelvic,
Frsenum
s
1
477
sheath,
177
of,
507
345
nerve, 394
178
360
Rolando, 360
Fungiform papilla?, 311
176
gracilis,
anal. 477
hernia,
313
bone sinuses
.">ti2
gyri,
132
uretbra, 474
pelvic,
relations of
lingua?,
4-t3
auces, 316
iinale organs of generation external.
brancbe-
358
cochlearis, 577
hemispherica, 577
and superior of brain.
Fractures of spinal column, 334
195
superficial of thigh, 2
439
inferior
495
recto-vesical,
of,
391
ventricle,
17
of,
116
lata. 219-220
of leg, 220
obturator, 495
plantar. 223
perineum, V.t.~>
>f
of,
240
178
ring,
minimi
digiti muscle, 1 13
bre\i> pollicis muscle, 11-
196
longus digitorum muscle,
longus hallucis muscle, 15
,
15*6
l
Foramen
tecum, ~<r,j
caecum of tongue, :i
lacerum medium, 553
magnum, 511-332
Monro, .:)!
ovale, 527
<
rotundum,
r,J7
Bpinosum, 553-527
Vesalii, 527 553
82
[NDEX.
Gluteal aponeurosis, 220
Gluteus maximus muscle, 141
medius muscle, 141
601
tunica vaginalis
17s
testis,
Goitre. 246
Hemianopsia, 374
Hemorrhage
Graafian
561
follicles,
363
of pons,
Hilton'- law, 25
128-421
plexus,
omentum, 318
veins, 190
215
sciatic nerve,
veins division
404
capsular ligament, 19
crucial anastomosis, 174
extensors,
Gyrus fornicatus
of brain, 4.37
description
of,
106
Humerus, description
1
systole of. 2 15
sounds
2 45
of.
246
of,
causes
crural.
47
(7
of.
condyles
and
description
of.
of.
til
surfaces
of.
til
'
arteries,
plexus,
1
127
179
82
lie!
KM
loll.
relations of,
126
fossa,
126
veins, 188
Uiacua muscles,
II
!l
4li'
.11
tel J
35
I'.'i
limn.
funicular, 478
femoral,
artioulati
477
notch,
474
lesser, tin
till
nutrient of, 69
lumbar, 474
phrenic, 474
encysted,
border-
Iliac ai terj
direct inguinal, 17
km;
60
of.
of greater
tleo-cecal valve,
474
indirect,
uberositj
175
of,
cerebral.
of.
121)
l'.n;
H
Hand
190
of,
346
operti,
12.".
f.
of.
-'7
25
\\S
lis
INDEX.
602
cavernous portion
petrous portion
band, 220
Impar ganglion,
of,
443
123
of,
443
445
capsule, 352
bone, 574
Inguinal hernia indirect, 174
Incus
of,
475
ear,
muscle, 557
longitudinal sinus, 489
lingualis
Internal
rami
of,
542
dental canal
543
of,
570
mammary
artery, 448
lymphatics
radio-ulnar articulation, 79
of, 501
ligament, 268
Interspinales muscles, 278
Intertrans\ ersales muscle, 278
Interspinous
Iris,
rectal fossa,
172
muscle. 55
vessical artery,
Infraspinatus
Infracostal
muscle,
rectal region
of brain, 441-437
Infundibuliform fascia, 568-567
Infundibulum of heart, 241
Inguinal canal. 17."i
of.
490
175
of,
Innominate articulations.
Innominate artery. 286
2S
bone. 128
vein-. 482-483
Intermuscular septum of
leg,
annular ligament
auditory artery,
494
muscles
Ischium, 127
158
Infundibulum
canal relation
386
222
148
218
25
elbuw, 61
ligaments, description
shoulder, 48
knee. 179
wrist, 78
of,
24
INDEX.
Kakosmia, 365
Ki<lney. blood supply
columns
of, 4i i8-
'
of Bertin. 4(is
description
of,
dimensions
of,
469
4ti7
468
function of, 469
hiluni of, 469
lymphatics of, 501
medullary portion, 468
Malpighian pyramids of, 469
nerve supply of, 4tjs-47i>
pyramids of Ferrin. 468
pelvis of, 469
relations of its vessel-. 4ds
relation of, 468
<car of. 468
tubes Bellini, 470
tubes Ferrein. 470
tube- Henle. 470
uriniferous tubules of. 46S
Knee-joint, description of, 19s
peritoneum.
Leva
mi muscles, 459
Levator anguli scapohe must
anguli ori- mus
ani muscle. 49(1
labii mferioris
muscle, 545
palpebral mu-cl.
palati muscle,
labii superioris ala?que na-i
muse
llti
triangular. 477
flexors. 198
extensors. 198
Pourpart'-. 477
Winslowii, 198
ligaments of 198
of Zinn. 322
astragali and scaphoid, 2n4
of ankle-joint. 203
anterior annular.
Gimbernat'-.
116-221
477
acromio-claviculai
broad vein
capsular.
194
coraco-humeral, 4s
Lachrymal
190
of.
of bladder. 472
383
artery.
of clavicle. 38
bone. 532
-clavicular.
38
26
external lateral. 62
gland
glenoid.
description
f(
nerve.
87
394
194
206
interosseous,
Lacuna magna
Lamina cinerea
cribrosa,
48
of hip-joint
Lacteals, 501
of.
47:-!
ischio-capsular,
of brain, 345-437-441
378
spiralis of ear.
194
194
internal lateral. 62
of liver. 324
577
of vertebra-. 258
odontoid, 264
4(14
intestine-. 32(1-322
occipito-atlantal, 260-261
Larynx. 249
calcis
"- calcis
358
ventricle boundary
ilio-femoral,
posterior annular.
16
posterioi
of radio-ulnar articulation,
ventricle.
of
of,
43s
79
scapulav,
is
of wri-t-ji'
I.igula of brai
1
.
'
-'07
540-534
INDEX.
604
nerve. 402-411
Lisfranc's amputation, 194
of spleen. 501
319
Little four,
of pharynx, 505
rectum, 500
renal, 471
of scalp, 503
Lymphatics
stomach. 501
supra-hyoid, 504
of
of testicle, 501
thoracic wall.
502
313
500
vessels of body, 496
of
of tongue.
of
328
190
Lobes of cerebellum, 344-361
f liver. 324
Lobule of ear, 569
superficial vessels
uterus,
superficial
gels of,
Locus coeruleus
of brain,
443
thoracic artery, 6
subscapular nerve, 99
Longitudinal commissures of brain, 340-437
Longissmus dorsi muscle. _'7
extremity veins. 192
Lumbar
152
arteries,
hernia. 474
nodes, 500
plexus, 208
plexus, blood supply of, 212
region right and left. 307
Lymph,
description
LymphaticOf
117
abdomen, 499
of
arm.
of,
of bladder. 500
of
face.
of,
.",ii
of head.
.",11
196
Of heart. 503
of intestines,
Of kidney.
of leg,
501-320-322
.",111
199
of liver,
199
of lung,
502
of mouth. 505
of neck. 504
PI7
superficial
oesophagus
..rbit.
",ii I
pan
pelvis,
199
578
gland. 564
blood supply, 564
nerve supply. 567
Manubrium. 23G
Malar bone. ."33
bone zygomatic process of, 534
bone muscles attached, 534
Male organs of generation. 564
Malpighian tuft, 469
pyramids, 469
of kidney, 468
Malleus bone, 574
Marginal gyrus, 346
Masseter muscle. 52m
Mastoid foramen. 554
antrum, 574
cells.
57t',
process, 517
'
>i
in se,
Meckel's ganglion.
551
4(14
Mediastinum description
of,
460
of,
360
501
of lower extremities,
tunic.
utricularis,
Mammary
198
description
duct. 196
M
Macula acustica
INDEX.
Membrana
571
tensa,
Membrane,
405
465
cutaneous description
of,
defiinition of,
mucous description
no;,
pollicis,
465
ransA
ei
465
465
Meningo-rachidian veins, 486
Meningeal artery. 293
transversus pollicis,
anconeus, 87
:int itragicus, 570
aryetnoideus, -'.'._'
Mesoblast, 331
Mesentery, The 466
Mesenteric artery, 321
superior and inferior, 326
arj teno-epiglottideus,
of at hi-. 260
of.
synovial description
of,
plexus, 426
Metacarpal bones, 109
Mitral
artery,
bicep-. 5s-
brachialis anticus, 79
buccinator, 540
cervicalis ascendens,
-'7
chondro-glossus, 550
of coccyx, 134
coccygeus, 491
coniplexu-. 274
ipressor
nasi,
urethras,
539
192
urethra. 403
coraco-brachudi-. 58
corrugator cut i- ani, 190
supercilii,
cremastei
46
crico-arytenoideus, 251
thyroid, 251
crureus, 138
deltoid,
13
242
valve.
dorsal
ear,
oculi
nerve,
:;s9-368
315
lymphatics of. 505
Middle constrictor muscle, 551
Muscular accessorius, 274
Musculo cutaneous muscles supplied by, 102
spiral muscles supplied by, 103
Multifidus spinse muscle, 276
Musculi pectinati, 2 10
Muscles of abdomen, 160
abductor hallucis, 58
1
digiti,
158
digiti,
accelerator urine,
brevis,
longus.
maerous,
140
140
160-1 14
570
192
spinse,
of
272
esophagus,
:;i
of. 526
extensor brevis digitorum, 157
of.
minimi
minimi
interossei,
ethmoid hone
439
paralyses of, 390
oculi
521
digastric,
addud or
Hi
biventer cervicis, 27
173
234
Mouth, ducts
24
of
vesical
J~>-
of hack. 27(1
attachments
of axis, Jo
112
192
hi
pollicis,
communis
digitoi
um
'.'l
longus digitorum,
longus pollicis, 91
minimi
digiti
pollicis,
52
s7
longus hallucis,
h">i
profundus digitorum
sublimis din
forced inspiratioi
expiral ion
frontal
85
278
coccygis,
iadicis,
85
ioi
bone
iifin in
ol
-
B5
INDEX.
606
.544
genio-hyoideus,
byo-glossus, S
medius,
parietal
gluteus maximus,
palmar
helicis
of
273
158
female.
192
153
tertius.
of
pharynx, 314
154
plantari.-.
543
plantar
inten
160
i.-ci.
oblique. 538
popliteus, 154
principles of, 24
530
rectus,
minor, 50
perineum, male, 491
135
Lnfracostals,
13
pectoralis major. 41
band, L06
major. 570
minor. 570
of hyoid hone. 550
hyo-glossus, 550
,,f
ilio-costalis,
14
longus, 81
pectineus. 13s
143
gracili
iliacus,
51(1
palmaris brevis,
niininms,
bone
interossei,
infraspinatus, 55
internal cremasteric, 567
intertransversales, 278
pyriformis.
intercostal-.
158
pterygoid, 529
531
rectus,
278
inter spinales,
lumhorum.
minor, 514
latissimus dorsi, 52
ani.
54
545
inferioris,
proprius, 540-534
523
palate,
palpebra 529
longissimus dorsi, 27
lumbricales band,
foot.
135
of scapulae, 50
551
multifidus spina-. 27(i
i
Dumber
oid, 5
semimembranosus,
semitendinosus,
hone,
of.
semispinalis
.",:',_'
externus,
160
internus,
hil
s|
276
dorsi,
colli.
493
i74
stapedius, 523
51
''
digiti,
12
orbicularis oris,
ihincter vagina,
spinalis
..
omo-hyoid, 59
opponens minimi
1
hi
occipito-frontalis,
pollicis,
dorsi,
17
colli,
14(>
276
stylo-pharyngeus, 522
of -oft palate, 316
soleus, 153
_':;
internus,
271
superior,
sartorius,
of nasal
539
162
minor, 278
514
abdominus, 463
femoris, 136
of rectum, 324
ret rahens aurem, 522
rhomboideus minor, 55
rot at ores spinas, 276
of sacrum. 133
serratus magnus, 54
lateralis,
anptili scapulas,
lahii
4f>4
of larynx, 250
levator
143
region, 490
ischio-rectal
sterno-cleido-ma&toid, 4
hyoid. 40
1
13
thyroid, 41
stylo-glossus,
540
hyoid,
522
522
272
INDIA.
NasaJ arterj
bone, 531
muscles attached
supinator brevis, 88
longus, 84
56
subscapularis,
cresl
-pin-. 5:;s-:,ii7
ner\
530
notch.
supraspinales, 276
supraspin&tus, 55
of temporal bone. 520
temporal. 520-508
tensor vaginae femoris, 135
teres major. 56
attachment
Neck. Lymphatics
lymph node-
minor, 56
tympani, 523
Nerve abducent
523
of thorax, 457
thyro-arytenoideus, 252
5111
of,
505
210
KM
interosseus,
218
tibial,
550
264
auditory. 579
axis
152
156
of,
of tongue. 311
auriculo-temporal, 402
buccal. 402
trachelo-mastoid. 274
570
50
tragicu.-.
centers definition
triceps.
cervical,
transversalis
colli,
transversalis,
462
45
vastus externus. 137
137
dental, 398
roots
pollicis,
88
external cutaneous, 21
boracic, 98
plantar. 216
531
sphincter ani, 490
to lac-
pterygoid, 529
facial. 4(17
of eye. 529
398
genii o-crural,
carpi radialis,
-'1
161
it
215
to hip-joinl
13
mi
212
ilio-hypogastric
nallucis, 162
ilio-ihguinal,
278
inferior dental.
12
longus digitorum,
Mucous membrane,
in
superficial petrosal
(ligitorum. 158
auricular
sciatic,
.Si
81
pollicis,
glosso-pharyngeal,
accessorius,
ulnaris,
27
ol
dorsal, 35
rectus,
flexor
304
aurem. 570
l".i
27
circumflex, 99
trapezius.
of fern ui-.
ot.
3'
plexus,
-74
internus,
163
392
anterior crural,
epiglottideus, 252
tibialis anticus.
of muscles,
of,
palati.
thyro-hyoid,
507
52.-,
-lit.
posticus,
552
fossae,
oblique, 530
rectus.
60*
156
133
1
maxillai
399
internal cutaneous, K 6
19
description
Myelon, 341
Mylo-hj oid muscle, 544
Myology, definition of. 17
Myopia. 374
102
gluteal, 21
of.
165
tioracic,
plantai
to
kidney,
'.
216
I7n
labial
of Lancisi
\0
608
INDEX.
Nerve,
lesser internal
cutaneous, 106
scapular. 99
Neuroretinitis, 373
Neurology, definition
Neuron system, 433
L'08
Nodes
lingual, 402-411
Song
sii'
lumbar
plexus, 208
definition of, 27
oculi,
389-368
103
musculo-spinal,
nasal, 390
obturator.
L'12
Obex
of brain, 443
Obliquus aurem muscle, 570
plexus, 315
artery,
phrenic, 306
105
thoracic, 98
tibial,
216
180
principles of, 26
pudendal, 214
pudic, 214
pneumogastric,
muscle
1
105
recurrent laryngeal, 414
sinus,
plexus, 212
vein,
214
subscapular, 99
suboccipital. 298-300
"IN
sympathetic, 418
temporal deep, 400
tongue of, 31
tonsillar. Ill
cen
ical,
-*
; <
* v
:'.!_'
tubular prolongations
twelfth cranial. 117
mpanic,
HO
to ureter.
471
489
282
of,
487-481
r:in-\ erse
332
nerve, 394
Optic commissure. 357-366-437
foramen 368-553-52S
nerve, 366-439
lesions of, 367
radiations, 367
thalamus, 347
thalami, 352
,
Wrisberg, km;
Nrr\ on- system, 3
Neuroglia, 331
Neuron, 341
\0
513
splanchnics, 423
of,
triangle,
suprascapular.
513
Sacro-iliac articulation,
sciatic,
of,
ossification
radial,
sacral
172
post-auricular, 408
posterior interosseous,
popliteal,
mammary, 562
motor
motor
17
lymphatic,
99-101
nie.lian,
internal
of,
213
[NDEX.
Optic
tracts,
367
coverings
346
gyri.
of,
Opponens minimi
368
lobe.
muscle, 113
digiti
:;
bone muscle
muscle. 112
Orbicularis oris muscle. 540
palpebrarum muscle, 508
Orbit, description of, 368
angles of, 370
pollicis
ossification,
to-occipital
Pectineus muscle,
:^
Peduncles of cerebellum, 362
I
brain.
.;:.
258
Pelvis.
131
dimensions
of.
i:;i
supply, 566
dartos
565
a, 565
corpus spongiosum, 565
Penis nerve supplj 566
.
Perineum
central tendon of, 195
fascia of,
19
muscles of female,
of male.
met ure-
-i
4<I2
l!l|
195
iii.
triangular ligament
Paricardium,
of.
510
fissun
Paroophoroi
Parosmia, 365
veins. 190
description
Mo
of,
Ovum,
609
561
Pericardiac arterj
Peroneal
of,
495
238
18-450
artery,
186
Peroneus ten
Peritoneum
Palmar
muscles,
arteries,
Palpebral
398
nerve,
Pampiniform plexus,
Pancreas 326
95
190
porl ion
laj ei
tempi
'
165
ered bj
ol
165
no
n al
bone, 517
nut rient
153
arterj
164
Pharynx, 313
boundari
373
Paradidymis, 568
Papillitis.
246
description
isceral
ei
<-<>\
artery, 453
goitre,
net urea
Papillae of tongue, 31
Parenchymatous
166
166
parietal laj
-t
of, 4i>7
81
Palmar recurrent
magna
....
14
supply
interossci arteries, HI
bl
of, olid
f,
313
openings in
'hi ynx, blood supply,
in
e supp
i
-,
lymphat
ii
muscles
of. 31
.'(15
of
muaclaa
164
INDEX.
610
Pharyngeal nerve, 410
nerve of vagus,
plexus,
';!
II
tonsil, 313
Phrenic artery of aorta, 452
Pharygneal
artery,
L8
mediastinum, 460
174
hernia,
306
nerve,
125
plexus,
vein-. 190
l'ia
mater
of brain, 34
333
380
Pineal gland, 353
Pinna "f ear, 569
Pirogoff's amputation, 194
of cord,
Pillar- of
iri-.
Placenta, 3
spinal arteries.
tibial artery,
relation of,
l'lai
vein.
154
Pouch
ysma mj
Poupart
Plexus
cei
oides muscle, 5 15
bi achial, 3
\
coccygeal, 35
definition of,
'!
-anal. 35
Pleura. 256
nerve supply
blood supply
256
256
of,
of,
Pneumogastric accessorj
connect tons
part.
412
111
of,
Ill
nerve. 111-41
cardiac branches,
16
pulmonary branches,
right,
L6
412
Pocularis sinus,
17:'.
Pons, 362
construction
of, 363
363
nei \ e- of, 363
varolii, 357-362-437
of,
180
L92-180
Portal system, 326- is
vein, 324 is:, mo
Po tei
annulai Ligament
nerves,
'i
cai pal
nei
16
408
e,
artery,
ein,
l*>
communicat ing
Pyramids
circumflex arterj
65
arterj
commissure, 348
ci
indj
I'
id
153
glands, 318
is.'i
cerebral artery,
commissure
2 16
Pyloric, 318
181
110
Pulsating goitre.
Pulvinar, 352
art<
cardiac
fissure,
vein,
vein,
563
Presbyopia, 375
Prevertebral plexus of symphatic, 123
Princeps pollicis artery, 93
Processus-e-cerebello-ad-te-te-. 354-437
cochleariformis, 520
Profunda artery, 176-180
femora] artery branches of. 178
artery perforating branches of. 180
Pronator quadratus muscle. 84
radii teres muscle, 79
Prosencephalon, 341
Prostate gland. 5IJ4-474
Prostat ie sinus, 473
Pseudocele, 358
Psoas magnus muscle, 134
parvus muscle. 134
Pterygoid artery, 297
processes, 528
bone. 128-127
am iculai
477
clitoridis,
i'
558
ligament
space,
's
Pterygo-maxillary
cru;- cerebri,
branches
of Douglas,
Preputium
35
Leal,
MIL'
161
muscle,
Plantaris
186
thoracic nerve, 98
tibial nerve, 216
Plate,
Y-'<7
180-185
of brain, -;is
foramen, 55
137
of
errein, 468
Pyramidalis muscle, 463
Pyramidal tracts. 334
Idier- of, 435
Pyriformis muscle,
13
I
555
INDEX,
duel
Rhinencephaion, 34J
Rhomboideus minor mulungs, 257
res spins
Roux's amputation, 194
Ruga of stomach
Rule oi
164
Quadrilateral space, 77
Question review. 120
Radial nerve,
611
10.5
artery relations
of, 95
branches of, 92
muscular branches of, 92-95
Saccule if
Sacral groove, 132
sympathetii
recurrent artery, 92
region forearm. <>9
plexus, 213
Radius description
of,
72
Sacro-vertebral articulation,
.Sacrum. 132
of, 72
muscles attached. 75
perimeter of, 73
Radio-ulnar articulation. 79
blood supply of, 79
nerve supply of, 79
Ramus of ischium. 130
Ranine artery, 291
Receptaculum chyli, 497
Recto-vesical fascia, 495
borders
base
133
ate,
muscle.
132
of,
articulation. 133
lateralis
,~>su
580
Saphenous opening, 220
sublingual,
veins. 192
Sartorius muscles,
135
Scapula description
514
articulation
of.
Is
ligament- o
muscles of, 50
Scalp lympha
Scarpa'- foramina, 538
Scarpa'- triangle, 176
Rectum, 320
of, 324
muscles of, 324
lymphatic- of, 500
Recurrent laryngeal nerve. 414
Keflex impulses. 437
Refracting media of eye, 378
Renal arteries, 456
lymphatic-. 17!
plexus, 425
description
membrane
Schneiderian
Sciatic
artery,
Sclerotic coat
17
of
Scrotum. 568
Second ner\
Segment- of cord
258
258
Restiform body, 360
liber- of, 364
Respiratory center, 359
Semicircular canal of
Semi-pinali-
air,
Semilunar
e air,
layers
endinosis muscle,
Sen- iry,
378
colli
Septum lucidun
-.
Review
iiuesiionb, lowei
muscll
muscle, 276
council
impulses, routi
"i
extremity, 22
p..-l
icu- SU|
i.s
muscle* af
Se\ enl
200
241
Semimembranosus muscle,
dor-i
of,
fibro-cartilages,
valves,
Retina, 376
description
376
description of
veins, 190
Residua]
15
Is
of.
16
17
INDEX.
612
membrane, 571
Sharpnell's
column fractures
veins of, 486
18
Shoulder join!
ligaments
1)1
supply of, 18
net \ e supply nf, 48
Small meningeal arterj 297
occipital nerve, 301-305
.
nen
sciatic
21
e,
36
of,
circular,
489
inferior longitudinal,
petrosal 490
189
!.
489
occipital,
rhomboidalis, 33
-upei
ii
petrosal,
Spleen, 248
udinal, 4SX
189
490
valsalva of, 242
Sigmoid artery, 455
gyrus, 346
flexure, 320
Sixth nerve, 392
Skej '- amputation, 19
Skin of back, 280
Skull, base foramina of, 552
Sofl palate, 315
transverse,
plexus, 125
Splenic vein, 484
muscles
Solar plexus,
function
3] 6
of,
I-
123
lesser,
lmiirit
ii
489
straight,
of.
334
Smell, center
of,
131
clavicular articulation, 38
Sounds
cleido-mastoid muscle, 40
hyoid muscle. 4
246
matic artery. 576-456
cord, 566
of hear;.
plexus,
thyroid muscie,
sternal
125
Stomach, 318
blood supply of, 318
nerve supply of, 318
muscles of, 318
relations of, 319
glands of, 318
lymphatics of, 501
Stroma of ovary, 561
Straight
<
pterygoid processes
tin lunate,
nei ve,
sinus,
189
528
bom
of,
11
448
Sternum, 236
veins, 576-190
Spheno-maxillary artery, 297
fossa, 555
B
lire
555
Spheno palat tne artery, 298
branches of, 297
Sphenoidal fissure, 553 528
Sphenoid bone, 526
nutrient ai terj of, 529
if, 527
foi amina
ii s of, 528
lessei wings of, 528
muscles ai tached, 528
orbital surface of, 527
t i
arteries,
193
H 6-441
muscle, 522
pharyngeus muscle, 522
Styloid process, 519
Subanconeus muscle, 79
Subarachnoid spaces, 335
Subastragaloid amputation, 194
hyoid
[NDEX.
Subscapular nerve-. 99
Subclavian artery, 4-1.5
relations of 44t>vein,
613
mesentery artery, 454
nteric
484
vein,
plexus
oblique muscle.
17
482
282
Subcrureus muscle, 138
Subdural space. 332
Subflava ligament, 266
Submaxillary ganglion, 405
Submaxillary triangle, 282
Submental artery. 292
Suboccipital nerve, 300-298
triangle. 282
Subclaviu> muscle, 12
Subscapular^ muscle, 56
Subscapular artery. 65
Subsartorial plexus, 212
Substantia gelatinosa rolandi, 330
Sulci. 342-343
Suprahyoid lymphatics. 504
Suprarenal artery. 456
capsules. 248
blood supply of, 248
nerve supply of. 249
vein. 190
Suspensory ligament of ovary, 561
Superficiali< volae artery. 92
Suprascapular artery, 449
nerve, 98
Supraorbital artery, 384
nerve. 394
notch. 372-506
vein, 487-480
Suprarenal plexus.
Supratrochlear nerve 394
perforating arte
triangle,
petrosal
sinus,
189
profunda artery, 66
radio ulnar articulation, 7^
rectus
in
thoracic artery, 62
vena
artery
vesica]
Supinator brevis
17_'
sv
muscle,
Supraspinatus muscle, 55
Supraspinales muscle, Sura'
182
arteries,
Suspensory Ligament
Sylvian fis-ure. 343
Syme
amputate
378
'94
".
neM
-'ympathetic
e\e
ol
ll
cervical
dorsal, 420
lumbar, 420
120
sacral,
development
gross
of,
anatomy
12
431
of,
lumbar, 423
lumbar, 423
sacral, 423
motor
178
143
libers to eye.
thoracic ganglia,
Synarthrosis divisions
Syndesmology
!-'_'
25
of,
definition of, 17
membrane
Synovia]
description
of,
405
of,
421
182
artery,
pr<
of
lachrymal
-'
arcuatus. 194
valgus, I'M
varus, 194
equinus, 194
310
488
nerves
antrum
areolar
l!
sinus,
of.
194
plantus, 194
Tarsal plate- of li
longitudinal
Bemicircularis, 356-352
Talepes description
calcaueous,
branches
Tegmenl um
Highmore, 537
groove,
537
of,
:>b>
of
pon
najor muscli
Tela choroide
inferior of brain,
ro-maxillarj vein,
sphenoidal
lobe, 344
fissure,
s"
INDEX.
614
auditory meatus
surface,
inferior
517
of,
519
Tongue nerves
of,
511
Temporal
554
muscle, 520-508
nerves ileep, 400
ridges, 507
veins. 4S7-4S0
Tendino-trochanteric band,
Tendon, definition of. 17
196
532
of,
lymph
567
311
of.
of.
papilla?,
311
311
blood supply
of,
Tonsils description
artery,
nerve,
Tenth nerve. 41
Tentorium cerebelli, 360
Tensor palati muscle, 523
tarsi muscle,
Tongue, 311
muscles
Tonsillar
gyri,
fossa,
567
covering;
Tibialis
bone, 51b
of,
313
315
291
411
INDEX.
Tympanic
lil/i
nerve, 410
walls
of,
573
interim-
muscle,
137
Velum interpositum,
Vena azygos ma joi 183
:;.">l
u
Ulnar artery, 95
branches of, 95
relations of, 96
nerve muscles supplied by, 102
Ulna, description of, 75
anterior posterior borders of, 76
muscles of, 77
nutrient artery of, 77
olecranon process of, 75
female, 474
minor,
1M
tertius,
184
i^
Galeni,
Thebesii, 245 l6
Ventricle of brain, 3 10
descripti
f,
357
358
Ventricularis terminales
Vermiform appendix, ;'._'_'
Vermis of cerebellum, 355
number
of,
Vertebra?, description
cervical,
258
coccygeal, 258
dorsal, 258
lumbar, 258
sacral, 258
vein. 481
Vesiculse seminales
Vestibule
Vessels
if
of
567
190
liver,
577
ear,
238
181
192
tibial,
118-482
axillary.
188
basilar,
of
broad Ligament
bronchial.
Is
cardiac, 2
190
488
cerebellar,
187
cerebral,
Vagina, 556
blood supply of 557
Vaginal coats of, 557
Vagus nerve, 411
Vallecula, 361
Valvular conniventes, 321
Valves of heart, 241
location, 246
of Vieussens of brain, 441
Vasa aberrant ia, 69
l.n\ ia, 453
efferentia, 568
intestini tenuis, 454
motor center, 359
fibers to head, 431
Vas aberrans, 567
deferans, 566
Vastus extemus muscle, 137
of,
_'.">s
cystic,
Veins deep.
IIS
cervical,
description
182
of,
30
diploe,
of
dorsi
186
spinal,
external
iliac,
.
facial,
Is
160
femoral,
frontal
187
180
186
INDEX.
616
Veins, gastric, 484
great cardiac,
485
Thebesii, 486
of heart, 485
vertebral, 481
hepatic, 190
iliac,
188
inferior
Villi,
mesenteric.
In
innominate, 482-483
internal jugular, 481
iliac, 188
mn.Tri1lB.ry, 480
left cardiac, 485
lower extremity, 192
lumbar, 188
of medulla, 488
medulli spinal, 486
meningo rachidian,
occipital,
320
cerebral, 487
lsc>
487-481
ovarian, 190
phrenic, 190
488
180-192
portal, 324-190-485
of pun.-,
popliteal,
Worm
cardiac, 485
92
ligaments of, 78
nerve supply of, 78
synovial membrane of, 119
arteries of,
192
external jugular, 481
pulmonary, 30
renal, 190
right coronary, 486
saphenous, 192
subclavian, 482
spermatic, 190-567
tibial,
of spinal
of cerebellum, 361
Wrist-joint, 78
joint
cord, 486
column, 486
484
-picnic,
Y-ligament, 194
Yellow
(macula lutea),
Yellow spot of ovary, 561
temporo-maxillary, 480
temporal, 480-487
umbilical, 472-34
Veins, valves of, 32
(corpus luteum),
inferior, 34
corporis
choroidea, 488
250
suprarenal, 190
systemic, 30
vena cava
cartilage,
supraorbital, 487-480
striati.
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